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01.
arXiv (CS.AI) 2026-06-12

Interaction-Centered Intelligence: Toward an Interaction-Based Theory of Human-AI Co-Creation

arXiv:2606.00807v2 Announce Type: replace Abstract: Traditional artificial intelligence has largely conceptualized intelligence as isolated computation occurring within bounded agents. Across classical AI, machine learning, and many generative systems, the dominant unit of analysis remains the individual model or autonomous system evaluated through outputs, benchmarks, prediction accuracy, or optimization performance. While these approaches have produced major advances, they often under-theorize the role of interaction in the emergence of intelligence, creativity, meaning, and adaptive behavior. This paper proposes interaction as the primary unit of analysis for co-creative AI and interaction-centered intelligence more broadly. Drawing from distributed cognition, embodied cognition, enaction, participatory sense-making, human-computer interaction, and computational creativity, the paper traces a historical progression toward increasingly relational accounts of intelligence. Building upon prior work in Creative Sense-Making, quantified co-creation, and co-creative systems such as the Drawing Apprentice and AI Drawing Partner, it argues that intelligence emerges through evolving interaction dynamics among agents, environments, and socio-technical systems rather than solely through internal computation. The paper introduces Interaction-Centered Intelligence as a framework for understanding human-AI co-creation, collaborative emergence, adaptive participation, and interactional dynamics. Rather than evaluating intelligence solely through generated outputs, the framework emphasizes interaction trajectories, coordination patterns, participatory engagement, adaptive regulation, and interactional drift unfolding through time. Implications for explainable co-creative AI, hybrid intelligence, enactive AI, and future human-AI systems are discussed.

02.
arXiv (quant-ph) 2026-06-19

On chip, multifunctional quantum sensing using single spins in a van der Waals crystal

arXiv:2606.19978v1 Announce Type: new Abstract: Nanoscale thermometry and magnetometry are in high demand across a wide range of scientific and technological applications. In this context, optically addressable spins in solids have emerged at the forefront of on-chip quantum sensing. However, simultaneous quantum sensing of multiple parameters (e.g., temperature and magnetic field) using the same spin sensor remains challenging due to cross-sensitivity to multiple physical quantities. Here, we demonstrate independent dual sensing of temperature and magnetic field using single quantum emitters in hexagonal boron nitride (hBN). We experimentally verify the independent response of the zero-phonon line (ZPL) position to temperature and of optically detected magnetic resonance (ODMR) to magnetic fields. Furthermore, we demonstrate local temperature sensing of a microcircuit while simultaneously measuring an external magnetic field. Our results establish quantum emitters in hBN as a robust platform for multifunctional quantum sensing under realistic operating conditions.

03.
arXiv (CS.LG) 2026-06-11

Mechanisms of Introspective Awareness

arXiv:2603.21396v5 Announce Type: replace Abstract: Recent work has shown that LLMs can sometimes detect when steering vectors are injected into their residual stream and identify the injected concept – a phenomenon termed "introspective awareness." We investigate the mechanisms underlying this capability in open-weights models. First, we find that it is behaviorally robust: models detect injected steering vectors at moderate rates with 0% false positives across diverse prompts and dialogue formats. Notably, this capability emerges specifically from post-training; we show that preference optimization algorithms like DPO can elicit it, but standard supervised finetuning does not. We provide evidence that detection cannot be explained by simple linear association between certain steering vectors and directions promoting affirmative responses. We trace the detection mechanism to a two-stage circuit in which "evidence carrier" features in early post-injection layers detect perturbations monotonically along diverse directions, suppressing downstream "gate" features that implement a default negative response. This circuit is absent in base models and robust to refusal ablation. Identification of injected concepts relies on largely distinct later-layer mechanisms that only weakly overlap with those involved in detection. Finally, we show that introspective capability is substantially underelicited: ablating refusal directions improves detection by +53%, and a trained bias vector improves it by +75% on held-out concepts, both without meaningfully increasing false positives. Our results suggest that this introspective awareness of injected concepts is robust and mechanistically nontrivial, and could be substantially amplified in future models. Code: https://github.com/safety-research/introspection-mechanisms.

04.
arXiv (CS.CV) 2026-06-12

GetNetUPAM: Ecologically Informed Nested Cross-Validation and Noise-Robust Attention for Marine Bioacoustic Monitoring

Deploying reliable bioacoustic monitoring systems requires models that generalize under high-noise, low-SNR conditions and evaluation protocols that expose deployment-relevant failure modes, gaps largely unaddressed in current UPAM practice. Intrinsic noise, variable propagation, and mixed biological and anthropogenic sources induce distribution shifts that conventional models and single-split evaluations obscure, inflating performance and masking instability. We introduce GetNetUPAM, a hierarchical nested cross-validation framework that uses the nested stage to quantify model stability rather than tune for inflated hold-out scores. By partitioning data into site-year blocks, GetNetUPAM preserves ecological heterogeneity and forces each outer fold to represent a distinct environmental regime, preventing overfitting to localized noise or sensor artifacts. Inner stratified folds measure generalization across the full UPAM signal distribution, enforcing strict separation between model development and the outer held-out deployment condition. Using GetNetUPAM, we evaluate the Adaptive Resolution Pooling and Attention Network (ARPA-N), a CNN architecture for irregular spectrogram dimensions. ARPA-N integrates CBAM spatial attention as a learned noise suppressor, producing attention maps that localize true call structure and avoid the global, non-biological cues exploited by standard CNNs on long-window data. Under GetNetUPAM, ARPA-N generalizes robustly across diverse environmental regimes. In the zero-training support Balleny Islands region, it reduces false positives per hour by over an order of magnitude (approximately 10x) at fixed 90 percent recall, yielding consistently improved metrics across folds. These advances provide a reproducible benchmark and move UPAM toward scalable, deployment-reliable ecological monitoring.

05.
PLOS Medicine 2026-05-27

Sequential chemo-immunotherapy followed by standard versus reduced thoracic radiotherapy for older and/or frail stage III non-small-cell lung cancer: A randomized open-label cohort trial

Authors:

by Wei-Xiang Qi, Shuyan Li, Mengdi Wang, Huan Li, Feifei Xu, Lei Yao, Biao Yu, Linlin Chen, Gang Cai, Cheng Xu, Xianwen Sun, Zhiyao Bao, Jiayi Chen, Yi Xiang, Shengguang Zhao Background The appropriateness of concurrent chemoradiotherapy (cCRT) for older or clinically vulnerable stage III unresectable non-small-cell lung cancer (NSCLC) patients remains contentious. Furthermore, the survival implications of de-escalating thoracic radiotherapy (RT) intensity in this population have not been conclusively elucidated. Methods and findings We conducted a phase II randomized, open-label, two-cohort (non-comparative) trial at a tertiary hospital in China (NCT05557552). Between September 30, 2022 and April 30, 2024, we enrolled 56 older and/or frail patients with stage III NSCLC who were ineligible for cCRT. The primary endpoint was the 1-year progression-free survival (PFS) rate estimated using the Kaplan–Meier method. Secondary endpoints included objective response rate (ORR), overall survival (OS), and safety. In the intention-to-treat (ITT) set, which included all 56 randomized patients who received at least one dose of study treatment, the 1-year PFS was 84.3% (95% confidence interval [CI] [70.3%, 98.3%]) in the standard RT group and 70.7% (95% CI [54.3%, 87.1%]) in the reduced RT group. In the per-protocol set (53 patients), the 1-year PFS was 82.9% (95% CI [68.9%, 98.8%]) in the standard RT group and 73.4% (95% CI [58.3%, 92.4%]), with a median follow-up of 24 months. Among 56 patients in the safety analysis set, 71.4% of patients experienced grade 3/4 adverse events (AEs) in the standard RT group and 53.6% in the reduced RT group. One patient (3.6%) in the reduced RT and three patients (10.7%) in the standardized RT experienced grade 5 AEs. The main limitations are the non-comparative design, small sample size, and lack of power to establish non-inferiority or superiority. Conclusion The current study suggested that reduced RT combined with sequential chemo-immunotherapy might be feasible for older/frail patients intolerant to cCRT, showing numerically similar survival outcomes. These exploratory findings warrant confirmation in larger, adequately powered randomized trials. Trial registration The trial had been registered on ClinicalTrials.gov on Sep 30, 2022.ClinicalTrials.gov NCT05557552

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

Large Language Models Hack Rewards, and Society

Reinforcement learning (RL) has become a dominant post-training paradigm, enabling large language models (LLMs) to learn from rewards. We observe that societal regulations are structurally similar to reward functions. They define measurable outcomes, thresholds, and exceptions, while often leaving institutional intent only partially specified. We hypothesise that the RL training process may exploit these gaps and therefore ask whether models' well-known tendency to hack reward functions during RL can scale into a more consequential failure mode named societal hacking: discovering loopholes in the rules society runs on. To study this phenomenon, we introduce SocioHack, a sandbox of 72 societal environments, and find that within these environments, reward hacking naturally emerges and leads to regulatory loophole discovery. Models learn to hack the social rules and generate strategies that remain technically compliant while defeating regulatory intent, and current LLM safeguards provide only limited mitigation. Therefore, collecting in-the-wild feedback for model training requires greater caution, and we need a next-generation post-training paradigm for safely iterating LLMs in real society.=

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

PoseGAM: Robust Unseen Object Pose Estimation via Geometry-Aware Multi-View Reasoning

6D object pose estimation, which predicts the transformation of an object relative to the camera, remains challenging for unseen objects. Existing approaches typically rely on explicitly constructing feature correspondences between the query image and either the object model or template images. In this work, we propose PoseGAM, a geometry-aware multi-view framework that directly predicts object pose from a query image and multiple template images, eliminating the need for explicit matching. Built upon recent multi-view-based foundation model architectures, the method integrates object geometry information through two complementary mechanisms: explicit point-based geometry and learned features from geometry representation networks. In addition, we construct a large-scale synthetic dataset containing more than 190k objects under diverse environmental conditions to enhance robustness and generalization. Extensive evaluations across multiple benchmarks demonstrate our state-of-the-art performance, yielding an average AR improvement of 5.1% over prior methods and achieving up to 17.6% gains on individual datasets, indicating strong generalization to unseen objects. Project page: https://windvchen.github.io/PoseGAM/ .

08.
arXiv (CS.LG) 2026-06-12

How Much Memory Do We Need? Adaptive Memory Gate for Neural Operators

arXiv:2606.13443v1 Announce Type: new Abstract: Neural operators have emerged as a powerful data-driven approach for solving time-dependent PDEs. Among recent advances, memory-augmented neural operators explicitly incorporate past states and have achieved remarkable performance under low-resolution observation settings. However, existing approaches apply a fixed memory weight regardless of observation conditions, such as resolution or physical parameters, limiting their adaptability. Our preliminary experiments reveal that optimal memory weight varies with resolution and viscosity, implying that a fixed memory weight cannot simultaneously optimize performance across diverse settings. We propose AMGFNO, which dynamically modulates memory weight through a learnable gate. On the Kuramoto-Sivashinsky and Burgers' equations, AMGFNO achieves 55-79% nRMSE reduction over at low resolution, with the learned gate value automatically decreasing from $\bar{g} \approx 0.7$ to near-zero as resolution increases.

09.
arXiv (quant-ph) 2026-06-15

Merged amplitude encoding for Chebyshev quantum Kolmogorov–Arnold networks: trading qubits for circuit executions

arXiv:2603.02818v3 Announce Type: replace Abstract: Quantum Kolmogorov–Arnold networks based on Chebyshev polynomials (CCQKAN) evaluate each edge activation function as a quantum inner product, creating a trade-off between qubit count and the number of circuit executions per forward pass. We introduce merged amplitude encoding, a technique that packs the element-wise products of all $n$ input-edge vectors for a given output node into a single amplitude state, reducing circuit executions by a factor of $n$ at a cost of only 1–2 additional qubits relative to the sequential baseline. The merged and original circuits compute the same mathematical quantity exactly; the open question is whether they remain equally trainable within a gradient-based optimization loop. We address this question through numerical experiments on 10 network configurations under ideal, finite-shot, and noisy simulation conditions, comparing original, parameter-transferred, and independently initialized merged circuits over 16 random seeds. Wilcoxon signed-rank tests show no significant difference between the independently initialized merged circuit and the original ($p > 0.05$ in 28 of 30 comparisons), while parameter transfer yields significantly lower loss under ideal conditions ($p < 0.001$ in 9 of 10 configurations). On 10-class digit classification with the $8\times8$ MNIST dataset using a one-vs-all strategy, original and merged circuits achieve comparable test accuracies of 53–78\% with no significant difference in any configuration. These results provide empirical evidence that merged amplitude encoding preserves trainability under the simulation conditions tested.

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

Contrastive Learning for Seismic Horizon Tracking with Domain-Specific Priors

Unsupervised 3D seismic horizon tracking faces a key limitation: signal-based propagators provide accurate trace-level alignment but often fail near faults, whereas texture-driven deep models are more robust to discontinuities, typically at the cost of labeled data requirements and reduced trace-level precision. We propose a self-supervised fusion of both paradigms in which signal-derived local horizon correspondences act as domain-specific priors to train a texture-based deep learning model. Specifically, we estimate reliable trace-to-trace flows from reflector slopes and use them to form positive pairs in a contrastive objective, while restricting training to high-confidence neighborhoods, optionally augmented with a fault mask. The objective is not to infer ambiguous correspondences close to discontinuities, but to preserve horizon identity across them. As a result, the network learns voxel-wise embeddings that preserve local signal continuity while enabling horizon propagation beyond discontinuities through similarity search. Experiments on the public F3 dataset and a faulted synthetic dataset achieve lower mean absolute error (MAE) than unsupervised baselines and competitive performance against a semi-supervised method using a single labeled slice.

11.
arXiv (CS.CL) 2026-06-19

Uncertainty Decomposition for Clarification Seeking in LLM Agents

Recent position papers argue that the classical aleatoric/epistemic uncertainty framework is insufficient for interactive large language model (LLM) agents and call for underspecification-aware, decomposed, and communicable uncertainty representations that can unlock new agent capabilities such as proactive clarification seeking and shared mental-model building. Practical deployment constraints – black-box APIs, interactive latency budgets, and the absence of labeled trajectories – rule out logprob-based, multi-sampling, and training-based methods, leaving prompt-based estimation as the most viable family for surfacing such signals at deployment time. We answer this call with a simple prompt-based decomposition that separates action confidence from request uncertainty (u), enabling the agent to ask for clarification when the task specification is ambiguous. To evaluate it, we introduce two clarification-augmented benchmarks (WebShop-Clarification and ALFWorld-Clarification) in which 50% of tasks are deliberately underspecified, and systematically compare the proposed decomposition against ReAct+UE and Uncertainty-Aware Memory (UAM) across five LLM backbones (GPT-5.1, DeepSeek-v3.2-exp, GLM-4.7, Qwen3.5-35B, GPT-OSS-120B) on these variants together with the standard WebShop, ALFWorld, and REAL benchmarks for fault detection. Averaged across the five backbones, the proposed decomposition improves clarification F1 on ALFWorld-Clarification by 73% over ReAct+UE and by 36% over UAM, and leads clarification F1 on every backbone on WebShop-Clarification and on four of five backbones on ALFWorld-Clarification, indicating that the gains generalize beyond a single LLM.

12.
bioRxiv (Bioinfo) 2026-06-15

AliceDB database and pipeline for identification of natural protein variants based on mass spectrometry measurement data

The natural variation that distinguishes living organisms within a single species is currently being studied intensively, primarily at the genetic level. Unfortunately, studies of natural variants at the level of protein gene products are not very common, mainly due to the lack of appropriate databases and bioinformatics tools. The main research technique used to study proteomes/peptidomes is mass spectrometry (MS). A classic method for interpreting raw mass spectrometry data in proteomic/peptidomic studies involves the use of databases containing representative (canonical) sequences that define the proteome of the organism under study. In this paper, we present the AliceDB database, which contains information on over 7 million natural variants of protein sequences described in the scientific literature for Homo sapiens. The data contained in the AliceDB database can be utilized using widely available and commonly used software for interpreting proteomic data. Test results regarding the use of the AliceDB database for the interpretation of proteomic data indicate that accounting for the presence of natural variants increases both the number and quality of identified proteins. Furthermore, it is easy to identify protein sequence variants that may, for example, be of significance in medicine.

13.
medRxiv (Medicine) 2026-06-19

Performance of family history-based colorectal cancer screening criteria by race and age at diagnosis in the Disparities and Cancer Epidemiology (DANCE) study

Importance: Family history (FH) and age are the primary criteria employed for early colorectal cancer (CRC) risk stratification. We evaluated how well these criteria identify individuals diagnosed with CRC across age and racial groups. Objective: To evaluate the performance of FH and age based screening criteria for identifying individuals with CRC, with attention to differences by race and age at diagnosis. Design, Setting, and Participants: This case control and case only analysis used data from the Disparities and Cancer Epidemiology (DANCE) cohort, a population based study of invasive CRC cases diagnosed from 2013 to 2022, recruited through the Metropolitan Detroit Cancer Surveillance System and the Louisiana Tumor Registry. Analyses included 1,158 non-Hispanic Black (NHB) and non-Hispanic White (NHW) CRC cases and 1,434 cancer-free controls from the Inflammation Health and Lung Epidemiology (INHALE) study, enrolled from the same Detroit catchment area. Data were analyzed in 2025. Exposures: Self reported cancer FH among first-degree (FD) relatives and grandparents, summarized into three FH-based screening criteria: at least one FD relative with CRC (colon early-screening criterion), any FH of Lynch syndrome related cancers, and meeting NCCN criteria for Lynch syndrome genetic testing. Main Outcomes and Measures: Proportion of cases meeting each FH based screening criterion stratified by race and age at diagnosis (

14.
arXiv (CS.LG) 2026-06-18

Investigating Inductive Biases for Machine Learning Emulation of Sudden Stratospheric Warmings in Idealised Isca Simulations

arXiv:2606.18857v1 Announce Type: new Abstract: Machine-learning emulators are increasingly used for weather prediction and have the potential to extend skill on subseasonal-to-seasonal timescales by learning dynamically important sources of predictability. A key challenge is whether the models can exploit predictability anchors, such as stratospheric variability, that influence tropospheric circulation beyond short lead times. We test how architectural inductive bias affects emulation of sudden stratospheric warming (SSW) dynamics using paired idealised Isca simulations that differ only in an imposed wave-2 heating perturbation. Across convolutional, transformer, and graph-based architectures trained for one-step prediction, model differences are modest when the stratosphere is dynamically quiet but widen substantially when SSW-like variability is active. Our results identify explicit three-dimensional vertical coupling as a key inductive bias for machine-learning emulation of stratospheric dynamics. However, Eliassen-Palm flux diagnostics show that low forecast error does not guarantee physically faithful wave-mean-flow interaction, with coherent errors remaining in stratospheric wave-driving structure.

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

SkillVetBench: LLM-as-Judge for Multi-Dimensional Security Risk Evaluation in Open-Source LLM Agent Skills

arXiv:2606.15899v1 Announce Type: cross Abstract: Open-source LLM agent ecosystems are growing rapidly, yet the security of community-contributed skills - modular tool definitions that extend agent capabilities - remains largely unvetted. The gap we fill: existing scanners operate at the code layer and are structurally blind to instruction-layer and multi-agent risk - natural-language directives that hijack an agent, exfiltrate data through encoded side channels, or chain harm across pipelines - so what is needed is a semantic, multi-dimensional vetting system rather than another signature matcher. We present SKILLVETBENCH, a live public leaderboard on Hugging Face that uses an LLM-as-Judge to vet agent skills. What is new: SARS (Skill Agentic Risk Score), a five-dimensional agentic-risk metric with a principled weighted formula for instruction-following systems. What is integrated: full CVSS v4.0 vector decomposition and a ClawHub dual-view that places our LLM-generated review beside the official marketplace verdict. What is demonstrated: drawing on our companion benchmark paper [ 1], the LLM-as-Judge stage achieves zero false negatives across 78 confirmed-malicious skills and zero false positives across 22 benign controls, while the best static baseline (SKILLSIEVE) still misses 15%; for instruction-layer categories such as Prompt Injection and Memory Poisoning, conventional tools miss between 89% and 100% of threats (e.g., CODEBERT detects none of nine memory-poisoning skills). Detection rates vary from 35% to 95% across four LLM evaluators, motivating ensemble scoring in production deployments.

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

Low-Burden LLM-Based Preference Learning: Personalizing Assistive Robots from Natural Language Feedback for Users with Paralysis

arXiv:2604.01463v2 Announce Type: replace-cross Abstract: Physically Assistive Robots require personalized behaviors to ensure user safety and comfort. However, traditional preference learning methods, like exhaustive pairwise comparisons, cause substantial physical and cognitive fatigue for users with severe motor impairments. To solve this, we propose a low-burden, offline framework that translates unstructured natural language feedback directly into deterministic robotic control policies. To safely bridge the gap between ambiguous human speech and robotic code, our pipeline uses Large Language Models (LLMs) grounded in the Occupational Therapy Practice Framework. This clinical reasoning decodes subjective user reactions into explicit physical and psychological needs, which are then mapped into transparent decision trees. Before deployment, an automated "LLM-as-a-Judge" verifies the code's structural safety. We validated this system in a simulated meal preparation study with 10 adults with paralysis. Results show our natural language approach significantly reduces user workload compared to traditional baselines. Additionally, occupational therapists confirmed the generated policies are safe and accurately reflect user preferences.

17.
Nature (Science) 2026-06-17

The EU needs to back its ambition to end animal testing with cash

Authors: Unknown Author

The European Union has declared that it wants to stop using animals in chemical safety testing. Its goal will need a timeline and a serious funding commitment. The European Union has declared that it wants to stop using animals in chemical safety testing. Its goal will need a timeline and a serious funding commitment.

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

AGE-MIL: Anchor-Guided Evidence Learning for Patient-Level Prediction

Existing computational pathology methods predominantly operate within whole-slide image (WSI)-level multiple instance learning (MIL) paradigms, while patient-level modeling remains underexplored. In routine pathological practice, however, pathologists derive diagnostic and prognostic conclusions by integrating evidence across multiple WSIs rather than relying on any single slide. This discrepancy creates a fundamental misalignment when patient-level supervision is directly imposed on conventional MIL frameworks, often leading to unstable optimization and degraded predictive reliability. To address this issue, we propose Anchor-Guided Evidence MIL (AGE-MIL), a weakly supervised framework for patient-level prediction. AGE-MIL constructs a patient-level anchor from slide representations to capture global pathological context and guide the retrieval and integration of diagnostically relevant local patches, enabling robust patient-level modeling. Patient-level risk is further modeled as an evidence accumulation process, promoting stable optimization under weak supervision. AGE-MIL is evaluated on six clinically relevant patient-level prediction tasks from two independent cohorts. Experimental results show that the proposed framework consistently outperforms eight state-of-the-art MIL methods. Code is available at https://github.com/wodeniua/AGE-MIL.

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

MotifGen: Spatiotemporal interpolation of misaligned satellite images via multi-source generative modeling, in an application to tropical cyclones

Microwave satellite imagery plays a crucial role in monitoring tropical cyclone precipitation and intensity worldwide, but suffers from long revisit times, potentially missing rapid storm evolution phases. While this raises the need for an interpolation method, it is made challenging by the high level of heterogeneity of microwave data coming from different instruments. In this work, we introduce the first generative model that can be applied to multiple geospatial sources that change across samples, occur at irregular time intervals, are misaligned geographically, and come from instruments with varying characteristics. We apply this model to the case of spatio-temporal interpolation of tropical cyclone microwave images from other microwave and infrared instruments. We train using a self-supervised task in which a random source is masked and reconstructed, and show that it leads to a significant decrease in Continuous Ranked Probability Score over supervised training. We show a further improvement by combining infrared and microwave data compared to microwave only. Using these improvements, the generative model produces an ensemble mean on par with that of a deterministic model, while generating a power spectrum significantly closer to that of true observations. To the best of our knowledge, this is the first generative model that interpolates microwave images of cyclones by combining multiple microwave instruments and infrared observations at irregular time intervals.

20.
medRxiv (Medicine) 2026-06-15

Non-invasive intracranial pressure waveform reconstruction with deep learning

Purpose: Continuous intracranial pressure (ICP) monitoring requires invasive instrumentation, reaching only a narrow subset of critically ill patients. We tested whether deep learning models trained on routinely acquired extracranial signals can reconstruct continuous ICP waveforms at clinically relevant accuracy in an independent external cohort. Methods: In adults admitted to the ICU at a single quaternary health system, five deep learning architectures were trained on high-frequency arterial blood pressure (ABP), photoplethysmography (PPG), and electrocardiography (ECG) waveforms, using invasive (intraparenchymal) ICP as ground truth. Two fusion strategies (early and late) and three training objectives (waveform-morphology, baseline robust regression, and weighted robust regression) were evaluated. Models were externally validated on the held-out MIMIC-III Waveform Database. Performance was assessed by mean absolute error (MAE) and waveform similarity by Pearson correlation (r). Results: We analyzed data from 158 critically ill adults (~5,322 hours) across two quaternary health systems (Johns Hopkins Hospital, Baltimore; Beth Israel Deaconess Medical Center, Boston). Validation MAE ranged from 4.276 mmHg [95% CI 4.269, 4.283] (gated recurrent, late fusion) to 4.946 mmHg [95% CI 4.938, 4.956] (attention-based, early fusion), with Pearson r ranging from 0.599 [95% CI 0.599, 0.600] to 0.722 [95% CI 0.722, 0.723]. The multiscale encoder-decoder model demonstrated the most favorable MAE-correlation tradeoff. Conclusion: This is the first demonstration that continuous ICP waveform reconstruction from bedside signals generalizes across institutions at clinically relevant accuracy, establishing a foundation for non-invasive ICP monitoring and motivating validation across broader populations and ICP ranges.

21.
arXiv (CS.CL) 2026-06-16

Virtual Speech Therapist: A Clinician-in-the-Loop AI Speech Therapy Agent for Personalized and Supervised Therapy

This paper develops Virtual Speech Therapist (VST), an intelligent agent-based platform that streamlines stuttering assessment and delivers customized therapy planning through automated and adaptive AI-driven workflows. VST integrates state-of-the-art deep learning-based stuttering classification, and multi-agent large language model (LLM) reasoning to support evidence-based clinical decision-making. The VST begins with the acquisition and feature extraction of patient speech samples, followed by robust classification of stuttering types. Building on these outputs, VST initiates an agentic reasoning process in which specialized LLM agents autonomously generate, critique, and iteratively refine individualized therapy plans. A dedicated critic agent evaluates all generated therapy plans to ensure clinical safety, methodological soundness, and alignment with peer-reviewed evidence and established professional guidelines. The resulting output is a comprehensive, patient-specific therapy draft intended for clinician review. Incorporating clinician feedback, the system then produces a finalized therapy plan suitable for patient delivery, thereby maintaining a clinician-in-the-loop paradigm. Experimental evaluation by expert speech therapists confirms that VST consistently generates high-quality, evidence-based therapy recommendations. These findings demonstrate the system's potential to augment clinical workflows, reduce clinician burden, and improve therapeutic outcomes for individuals with speech impairments. An interactive user interface for the proposed system is available online at: https://vocametrix.com/ai/stuttering-therapy-planning-agent , facilitating real-time stuttering assessment and personalized therapy planning.

22.
medRxiv (Medicine) 2026-06-15

Wellbeing After Stroke-2 (WAterS-2): a feasibility study with process evaluation exploring inclusive, accessible, online psychological support after stroke

Objectives: Explore feasibility and acceptability of upskilling a workforce to deliver a co-developed intervention, based on Acceptance and Commitment Therapy (ACT), to support psychological adjustment post-stroke targeting underserved groups. Design: Multi-site, single-arm feasibility study with embedded mixed-methods process evaluation (ISRCTN17628580). Setting: Four NHS community stroke services across England. Participants: 1. Stroke survivors [&ge;]18 years of age, [&ge;]4 months post-stroke, reporting psychological difficulties adjusting to stroke, able to consent and access remote group sessions in English; 2. Group facilitators from NHS stroke services, not ACT specialists. Intervention: WAterS-2: an eight-session, remotely-delivered ACT-informed group intervention. Outcome measures: Recruitment, fidelity, safety, acceptability and perceived value were assessed using fidelity checklists, post-intervention surveys and semi-structured interviews with stroke survivors and facilitators. Clinical outcomes including mood (HADS), wellbeing (ONS4), psychological flexibility (AAQ-ABI), measured post-group and three-months later. Results: Nineteen stroke survivors recruited (mean 9.6 months post-stroke; n=5 (26%) minoritised ethnicities; n=10 (52%) with aphasia). Thirteen facilitators - including two peer support workers - delivered the intervention with fidelity following structured training across four services. Drop-out was low (2/19; 11%); with 15 (79%) attending [&ge;]5/8 sessions. Remote data collection was feasible (79% follow-up completion), with no adverse events recorded. Acceptability was high: survivors valued peer connection, grounding and mindfulness practices. ACT metaphors were helpful for some but challenging for others, including some with aphasia. Online delivery was suitable but limited informal connection. Facilitators reported increased capability, incorporating ACT skills into routine care. NHS workforce pressures and geographically-constrained referral pathways limited recruitment reach. Conclusions: WAterS-2 is feasible, safe, acceptable and inclusive. A mixed workforce, including NHS peer support workers, can be upskilled to deliver with fidelity. Inclusion of underserved groups is achievable but requires active strategies beyond standard NHS referral routes. Findings inform a provisional logic model and a future pragmatic trial.

23.
arXiv (CS.LG) 2026-06-19

ADaPT: Token-Level Decoupling for Efficient Large Reasoning Models

arXiv:2606.19919v1 Announce Type: new Abstract: Large reasoning models rely on long chain-of-thought to achieve strong performance, but applying such reasoning uniformly incurs high computational cost. Existing efficiency-oriented methods attempt to shorten or mix reasoning strategies, yet often degrade reasoning capability. We identify the root cause as sequence-level coupling between efficiency incentives and correctness optimization, which implicitly penalizes long but correct reasoning trajectories. To address this issue, we propose Adaptive Dual-Process Thinking (ADaPT), a token-level dual-process framework that explicitly decouples efficiency and correctness signals during training. ADaPT introduces a mode-selection token to control fast and slow reasoning, applying efficiency-related rewards exclusively to this token to avoid penalizing correct long reasoning while encouraging efficiency when appropriate. Moreover, ADaPT enables precise and continuous control over the efficiency-performance trade-off at inference time: by adjusting the generation probability of the mode-selection token, a single trained model can smoothly move along the efficiency-performance Pareto frontier. Extensive experiments demonstrate that ADaPT significantly reduces inference cost while maintaining strong reasoning performance across multiple benchmarks.

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

Closing the Feedback Loop: From Experience Extraction to Insight Governance in Verbal Reinforcement Learning

arXiv:2606.17591v1 Announce Type: new Abstract: Training-free verbal reinforcement learning enables LLM agents to learn from world feedback – objective signals such as dynamic task outcomes, market returns, or demand forecasts – by extracting verbal rules from experience and injecting them as context, updating the agent's behavior without parameter changes. However, in non-stationary environments these agents face a retention-forgetting dilemma: retaining stale insights causes negative transfer, while discarding them causes catastrophic forgetting when conditions recur. We identify four requirements for navigating this dilemma – outcome-driven evaluation, persistent structured evidence, non-monotonic knowledge lifecycle, and compositional governance – and show that existing methods invest heavily in experience extraction while underinvesting in insight governance. We propose a three-layer architecture – rules, evidence, and skills – connected by a feedback-driven curation loop that closes the governance gap. Rules capture distilled experience from world outcomes; evidence logs track each rule's reliability across episodes; skills govern which rules to apply, how to resolve conflicts, and when to abstain. On financial forecasting as a case study, where world feedback is naturally abundant, noisy, and non-stationary, we show that the same accumulated experience either degrades performance below the zero-shot baseline or dramatically improves accuracy and risk-adjusted returns, depending on whether the curation loop is present.