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01.
arXiv (CS.AI) 2026-06-16

Graphical-Probabilistic Modeling of Generative Flows in LLM-Native Software Systems

arXiv:2606.15943v1 Announce Type: cross Abstract: Engineering LLM-native software remains a challenging and immature field. Current practice is largely exploratory, relying on experimentation and heuristic techniques such as prompting and context engineering. These, however, are low-level and lack the principled structure needed to support design-level reasoning or analysis. In contrast, traditional software engineering leverages modularity and abstraction to communicate and analyze system behavior. To bring similar rigor to LLM-native development, we propose methods for documenting generative flows and for stating properties of LLM-based software designs. Such methods must account for the stochastic, prompt-dependent behavior of large language models while remaining expressive enough to capture emergent phenomena. Our initial approach is based on graphical probabilistic models, tailored to capture phenomena characteristic of LLM-native systems. This framework – what we term Generation Networks – aims to provide a foundation for principled reasoning about generative interactions and system-level properties in LLM-centric software architectures.

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

WEQA: Wearable hEalth Question Answering with Query-Adaptive Agentic Reasoning

arXiv:2606.18147v1 Announce Type: new Abstract: Language models are remarkably capable at medical question answering, in some cases surpassing the accuracy of general physicians. However, answering questions about wearable health data remains challenging and understudied, as these ubiquitous sensors produce continuous, high-dimensional, and longitudinal data, which is non-trivial to align with text-centric distributions in LLM pretraining. The diversity of sensor modalities and user intents cannot be effectively handled by a fixed reasoning workflow or a single pretrained foundation model. To address these challenges, we propose WEQA, a query-adaptive agent framework that unifies LLM reasoning with specialized wearable analytical and modeling tools. An LLM controller is employed to synthesize execution plans and dynamically route each query to the appropriate combination of sensor analysis and pretrained models, and perform grounded response auditing with external knowledge. We also curate a benchmark spanning four open wearable datasets comprising analytic and predictive tasks in three different health domains. Experiments show that our framework is 24% more accurate than LLM and agentic baselines, and a blinded study with 12 medical experts and 8 users shows substantial gains in usefulness and clinical soundness.

03.
arXiv (CS.AI) 2026-06-16

Autonomous End-to-End SOH Prediction Services for Battery Systems via Temporal-Contrastive Representation Learning

arXiv:2606.16434v1 Announce Type: cross Abstract: Accurate state of health (SOH) estimation is a critical diagnostic service for lithium-ion battery management. However, reliance on labor-intensive manual feature engineering and opaque black-box models hinders scalable industrial deployment. To address this, we introduce TC-SOH: a modular, plug-and-play service architecture for autonomous, end-to-end SOH prediction. TC-SOH employs a temporal-contrastive mechanism and a cross-window prediction pretext task to extract degradation-relevant representations directly from raw operational data. To improve transparency, we connect model efficacy with representation diagnostics: visualization, sensitivity analysis, redundancy analysis, bidirectional probing, future-SOH probing, and temporal shuffling show that learned features overlap with selected expert descriptors while retaining additional SOH-relevant variation, and that ordered temporal context improves subsequent-SOH prediction. Across four public datasets, TC-SOH outperforms the considered physics-informed and data-driven baselines, reducing MAPE by 1.91 times and RMSE by 2.13 times.

04.
arXiv (CS.CL) 2026-06-11

Cross-modal Consistency Guidance for Robust Emotion Control in Auto-Regressive TTS Models

While Text-to-Speech (TTS) systems enable emotional control via natural-language instructions, expressiveness, naturalness, and speech quality degrade when the target emotion conflicts with the textual semantics. We propose a Cross-modal Consistency Guided Classifier-Free Guidance (CCG-CFG) method with dynamic scales based on the degree of inconsistency between the text emotion and the explicit speech emotion, replacing the dropout condition with the text emotion. We also distill the CCG-CFG guidance signal using a hard-sample mining strategy, improving the TTS model's emotional alignment capability. Evaluations on five emotional corpora and two TTS benchmarks show that our approaches applied to CosyVoice2 achieve up to a 12% absolute improvement in emotion-recognition accuracy and a 10% relative improvement in subjective scores, outperforming baselines including HierSpeech++, Qwen3-TTS, and original CosyVoice2, while preserving intelligibility, naturalness, and high speech quality.

05.
arXiv (CS.LG) 2026-06-25

Randomized Kriging Believer for Parallel Bayesian Optimization with Regret Bounds

arXiv:2603.01470v3 Announce Type: replace Abstract: We consider the optimization problem of an expensive-to-evaluate black-box function, in which we can obtain noisy function values in parallel. For this problem, parallel Bayesian optimization (PBO) is a promising approach, which aims to optimize with fewer function evaluations by selecting a diverse input set for parallel evaluation. However, existing PBO methods suffer from poor practical performance or lack theoretical guarantees. In this study, we propose a PBO method, called randomized kriging believer (KB), based on a well-known KB heuristic and inheriting the advantages of the original KB: low computational complexity, a simple implementation, versatility across various BO methods, and applicability to asynchronous parallelization. Furthermore, we show that our randomized KB achieves Bayesian expected regret guarantees. We demonstrate the effectiveness of the proposed method through experiments, including those on real-data emulators.

06.
arXiv (CS.CV) 2026-06-25

ScaleHP: Estimating Hand Pose in Metric Space

Accurate metric-space hand pose estimation (HPE) is essential for immersive human-computer interaction and robotics. However, most existing methods predict poses in a root-relative coordinate system and cannot estimate the hand in absolute metric scale. In this work, we observe that the intrinsic proportional relationships among human hand bones encode stable anthropometric priors that implicitly correlate with the overall metric size of the hand. Leveraging this insight, we present ScaleHP, an end-to-end one-stage hand pose estimation framework that bypasses fragile extrinsic depth modules to recover the hand in metric space. ScaleHP employs a transformer-based decoder with a novel scale token to fuse multi-scale morphological and appearance features. By solving for metric coordinates through a perspective-constrained least-squares approach, we achieve high-precision pose estimation in the camera coordinate system. ScaleHP delivers state-of-the-art performance, including 35.8 CS-MPJPE on FreiHand and 4.6/5.9 PA-MPJPE on DexYCB and HO3Dv3. These results demonstrate that internal biological constraints significantly reduce relative geometry and absolute metric errors, offering a robust solution for generalized, real-world hand tracking.

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

Artemis: Anatomy-Resolved inTervention for Eliminating Multimodal NeuroImage confounderS

arXiv:2606.18287v1 Announce Type: new Abstract: Multimodal neuroimaging, integrating functional connectivity from fMRI and structural connectivity from DTI, enables non-invasive analysis of brain networks using graph neural networks. However, demographic factors such as age and sex systematically confound the relationship between brain connectivity and clinical outcomes, causing GNNs to exploit spurious shortcuts rather than learning causally invariant representations. While recent causal GNN methods introduce causality at the graph-modeling level, their causal mechanisms remain domain-agnostic without accounting for the real-world confounders inherent in clinical neuroimaging data. Moreover, brain networks are constructed from atlas-based parcellations where each region exhibits distinct sensitivity to demographic factors, necessitating region-aware adjustment. We propose Artemis, a region-level causal framework that bridges this gap with causal intervention at each brain region independently by learning region-specific confounder representations with lightweight parameters. Our adjustment comprehensively utilized the multimodal functional and structural features for graph reasoning as a plug-in module compatible with arbitrary GNN backbones. Experiments on three benchmarks, ADNI for disease diagnosis, OASIS for dementia staging, and HCP for sex classification, demonstrate consistent improvements over representative GNN-based baselines. Multiple supporting experiments further demonstrate statistical significance and neuroscientific interpretability.

08.
arXiv (CS.AI) 2026-06-17

Model Validation of Agentic AI Systems: A POMDP-Based Framework for Belief-State, Forecast, and Policy Validation

arXiv:2606.17383v1 Announce Type: cross Abstract: Agentic artificial intelligence systems introduce a new class of model risk. Unlike traditional predictive models, autonomous agents continuously acquire information, form beliefs regarding latent states of the environment, generate forecasts, select actions, and adapt their behavior over time. Existing validation methodologies focus primarily on predictive accuracy and therefore provide limited insight into the quality of the underlying decision process. This paper proposes a model validation framework for agentic AI based on Partially Observable Markov Decision Processes (POMDPs). The framework decomposes autonomous decision making into information, beliefs, forecasts, actions, and utility, allowing each component to be validated independently. Large language models (LLMs) are formalized as approximate Bayesian filtering operators, and a model-risk taxonomy is developed encompassing state-space, filtering, forecast, policy, utility-specification, and parameter risks. The model risk validation methodology is demonstrated through a portfolio-management case study in which an agent infers latent market regimes from market and macroeconomic information, generates belief-conditioned forecasts, and constructs portfolios using a Black–Litterman framework. Empirical validation combines performance analysis, belief calibration diagnostics, coverage tests, ablation studies, and parameter-sensitivity analysis. The results indicate that latent-state inference contributes independently to decision quality and that the principal conclusions remain robust across a broad range of parameter values. The principal contribution of the paper is a practical framework for extending established model risk management concepts to autonomous AI systems and providing a rigorous foundation for their validation, governance, and monitoring.

09.
bioRxiv (Bioinfo) 2026-06-12

Computational Design of Optimal Sequences for Targeted Hypermutagenesis Using Recombination-Coupled Diversity-Generating Retroelements

Diversity-generating retroelements (DGRs) are natural systems that accelerate evolution via targeted hypermutation at adenines. We previously developed DGRec, a system combining DGRs and recombineering for programmable mutagenesis in Escherichia coli. We here address two important issues with DGRec: the dependence of mutagenesis efficiency on the dgrRNA secondary structure and the variability of the reverse-transcription biases with sequence context and position. First, we introduce and validate a method to recode non-functional templates, i.e. with low mutagenesis efficiency, into highly functional ones through synonymous mutations. Second, we develop a Long Short-Term Memory (LSTM) model to predict DGRec mutational profiles for any given template sequence. By integrating this LSTM model with our recoding method, we establish a comprehensive workflow for customized directed evolution, enabling researchers to precisely fine-tune DGRec in vivo mutagenesis to their engineering needs.

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

Visualizing Uncertainty: Spatial Maps of Missing and Conflicting Evidence in Deep Learning

arXiv:2606.15767v1 Announce Type: cross Abstract: Understanding when and why deep neural networks are uncertain is crucial for deploying reliable machine learning systems in safety-critical domains. While existing uncertainty quantification methods provide scalar measures of model confidence, they offer limited insight into which spatial regions of an input contribute to different types of uncertainty. We propose a novel visualization framework, Uncertainty Activation Map (UAM), that combines Evidential Deep Learning (EDL) with Full-Gradient Class Activation Mapping (FullGrad) to generate interpretable spatial uncertainty activation maps. Our approach distinguishes between two fundamental types of uncertainty: vacuity, representing lack of evidence, and dissonance, capturing conflicting evidence between competing hypotheses. By leveraging the complete gradient decomposition property of FullGrad and the principled uncertainty quantification of Subjective Logic, our method produces theoretically grounded visualizations that highlight specific image regions responsible for model uncertainty. With this framework, vacuity and dissonance activation maps are generated by computing belief-weighted attributions, enabling identification of where models lack knowledge versus where they encounter ambiguous evidence. Extensive evaluations across multiple benchmark datasets demonstrate that the proposed framework effectively addresses the critical gap between uncertainty quantification and explainability, providing intuitive visual feedback to assess model reliability in complex visual recognition tasks.

11.
arXiv (quant-ph) 2026-06-17

Hybrid Acousto-Optical Double Dressing of a Two-Level System

arXiv:2509.25847v2 Announce Type: replace Abstract: We experimentally investigate resonance fluorescence from a two-level system in a novel configuration where a strong laser drives an optical Rabi oscillation while an acoustic field parametrically modulates the frequency of the two-level system. We observe emission spectra that deviate markedly from the standard Mollow triplet, including dynamical cancellation of the central peak. A doubly dressed state model incorporating hybridization among the emitter, optical field, and acoustic field captures these features. Guided by this model, we experimentally validate the condition for optimal cooling of acoustic phonons in an emitter-optomechanical system. These results reveal new regimes of strongly driven quantum nonlinear interactions.

12.
arXiv (CS.CV) 2026-06-18

Conditional Latent Diffusion Model with Fourier-based Motion Modelling for Virtual Population Synthesis

In-silico trials of medical devices require the generation of virtual populations of anatomies. In cardiovascular applications, virtual anatomy is typically represented as a 3D+t mesh sampled from a generative model. However, most existing mesh generators focus on static anatomy, while sequence models often lack explicit periodicity. To this end, we propose 4D F-MeshLDM, a conditional generative framework comprising a convolutional mesh VAE to encode meshes, a structural latent space that parameterises motion using a truncated Fourier series, and a diffusion prior that learns the latent distribution over Fourier coefficient tokens. By conditioning the diffusion process on clinical covariates via affine modulation, we enable controllable synthesis. Sampling tokens and performing inverse Fourier synthesis yield cycle-consistent latent trajectories, which can be decoded into 3D+t cardiac mesh sequences. Experiments on 5,000 UK Biobank subjects demonstrate that 4D F-MeshLDM outperforms state-of-the-art baselines in anatomical fidelity and achieves near-zero cycle closure error. Furthermore, the generated cohorts accurately preserve clinical functional indices, highlighting the potential of our framework for reliable in-silico cardiac trials.

13.
arXiv (CS.CV) 2026-06-24

High-Fidelity Synthetic Transmission Electron Microscopy Image Generation Using Diffusion Probabilistic Models for Data-Limited Semiconductor Metrology

Advanced semiconductor nodes drastically increased demand for Transmission Electron Microscopy (TEM), yet destructive sample preparation, slow imaging and high costs severely limit the availability of diverse datasets needed for downstream machine learning (ML). Synthetic data generation is becoming essential, but current generative models often miss TEM-specific noise, structural detail, and stochastic variability crucial for evaluation. We present a Denoising Diffusion Probabilistic Model (DDPM) framework for synthetic TEM image generation under extreme data scarcity. A progressive patch-based training strategy scales from low-resolution patches to full images, enabling from-scratch training with only 15 samples. We integrate a custom TrivialAugment adaptation, cross-process domain transfer, classifier guidance, and RePaint-style inpainting, culminating in full-image generation that preserves global structural and spatial relationships in compliance with FAB metrology requirements. Beyond synthesis, we repurpose DDPM feature representations for segmentation, partitioning encoder feature maps to obtain coherent region masks. Our synthetic images achieve up to MS-SSIM > 0.98 and qualitative expert assessment consistent with structural similarity results, facilitating downstream ML training for defect detection, segmentation, and metrology while preserving statistical and physical realism.

14.
arXiv (CS.AI) 2026-06-17

Adaptive Domain Models: Bayesian Evolution, Warm Rotation, and Principled Training for Geometric and Neuromorphic AI

arXiv:2603.18104v5 Announce Type: replace Abstract: Prevailing AI training assumes reverse-mode automatic differentiation over IEEE-754 arithmetic. The memory overhead of training relative to inference, optimizer complexity, and structural degradation of geometric properties through training are consequences of this arithmetic substrate. This paper develops an alternative training architecture grounded in three prior results: the Dimensional Type System and Deterministic Memory Management framework (Haynes 2026), which establishes stack-eligible gradient allocation and exact quire accumulation as design-time verifiable properties; the Program Hypergraph (Haynes 2026), which establishes grade preservation through geometric algebra computations as a type-level invariant; and the b-posit bounded-regime design (Jonnalagadda et al. 2025), which makes posit arithmetic tractable across hardware targets conventionally considered inference-only. Their composition enables depth-independent training memory bounded to approximately twice the inference footprint, grade-preserving weight updates, and exact gradient accumulation, applicable uniformly to loss-function-optimized and spike-timing-dependent neuromorphic models. We introduce *Bayesian distillation*, a mechanism by which the latent prior structure of a general-purpose model is extracted through the ADM training regime, resolving the data-scarcity bootstrapping problem for domain-specific training. For deployment, we introduce *warm rotation*, an operational pattern in which an updated model transitions into an active inference pathway without service interruption, with correctness formalized through PHG certificates and signed version records. The result is a class of domain-specific AI systems that are smaller and more precise than general-purpose models, continuously adaptive, verifiably correct with respect to the physical structure of their domains, and initializable from existing models.

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

CADO: From Imitation to Cost Minimization for Heatmap-based Solvers in Combinatorial Optimization

arXiv:2602.08210v2 Announce Type: replace Abstract: Heatmap-based solvers have emerged as a promising paradigm for Combinatorial Optimization (CO). However, we argue that the dominant Supervised Learning (SL) training paradigm suffers from a fundamental objective mismatch: minimizing imitation loss (e.g., cross-entropy) does not guarantee solution cost minimization. We dissect this mismatch into two deficiencies: Decoder-Blindness (being oblivious to the non-differentiable decoding process) and Cost-Blindness (prioritizing structural imitation over solution quality). We empirically demonstrate that these intrinsic flaws impose a hard performance ceiling. To overcome this limitation, we propose CADO (Cost-Aware Diffusion models for Optimization), a streamlined Reinforcement Learning fine-tuning framework that formulates the diffusion denoising process as an MDP to directly optimize the post-decoded solution cost. We introduce Label-Centered Reward, which repurposes ground-truth labels as unbiased baselines rather than imitation targets, and Hybrid Fine-Tuning for parameter-efficient adaptation. CADO achieves state-of-the-art performance across diverse benchmarks, validating that objective alignment is essential for unlocking the full potential of heatmap-based solvers.

16.
arXiv (quant-ph) 2026-06-25

Self-testing Quantum Supermaps

arXiv:2606.25124v1 Announce Type: new Abstract: By certifying quantum operations from measurement statistics directly, without any assumption on the internal workings of the devices involved, self-testing enables a uniquely reliable identification of quantum objects. While such device-independent characterization has been shown to be possible for states, measurements and channels, it has so far not been extended to quantum supermaps – operations that act on quantum channels themselves and can combine them in either a well-defined causal order or also, remarkably, in an indefinite causal order. Here we show that quantum supermaps can be identified device-independently. Specifically, we obtain two levels of certification, depending on the network structure of the experiment: when each slot of the supermap accepts a single uncharacterized black box, identification up to local embedding combs is obtained; when several black boxes are inserted within each slot, identification up to local extracting and injecting maps is achieved. We illustrate our approach on four examples – the identity comb, a bit-flip error-correcting comb, the comb describing Grover's algorithm, and the quantum switch – providing in particular the first self-test of both a quantum algorithmic comb and a causally indefinite quantum process. Notably, in the latter case, this provides a new way to certify causal indefiniteness in a device-independent manner.

17.
arXiv (CS.CV) 2026-06-11

SceneMiner: Identity-Preserving Multi-Task Fine-Tuning for Unified BEV Scene Mining

Mining hard, safety-critical scenes from driving logs is bottlenecked by the absence of difficulty labels, and no single proxy, collision risk, trajectory ambiguity, or semantic rarity suffices to find such scenes on its own. We present SceneMiner, a unified, camera-only bird's-eye-view pipeline that emits complementary mining signals from a frozen vision-language backbone in a single forward pass, with no LiDAR or radar: a retrieval embedding for text-prompted scenario search, a multi-label scene-tag distribution, and a continuous physics-based risk score (a motion forecast is a byproduct, not a contribution). Building such a multi-head model exposes our central finding, a failure mode we term cross-task interference: adding or upgrading one head shifts a shared activation stream and degrades weight-frozen sibling heads, so freezing parameters alone is insufficient. Our contribution, identity-preserving multi-task fine-tuning, removes this interference by zero-initializing every new sub-module and freezing every parameter that feeds the shared stream. The mining heads are thereby preserved bit-identically while training only ~102k parameters. The tagging head reaches mAP 0.4614 (micro-F1 0.5557) on 20 scene tags by pooling each scene into 32 visual tokens, and the embedding head supports text-prompted retrieval, validated qualitatively. Code is available at: https://anonymous.4open.science/r/sceneminer_anonymous-64E5

18.
arXiv (math.PR) 2026-06-12

Data-driven subsampling rates for diffusion parameter estimation of SDEs

arXiv:2606.13615v1 Announce Type: new Abstract: We study the problem of diffusion parameter estimation for stochastic differential equation (SDE) models in scenarios where data and model are compatible only on specific scales that have yet to be determined. We introduce a simple and efficient method for selecting suitable rates at which given time series data should be subsampled in order to ensure that the statistical structure of the subsampled data is consistent with the behavior of the SDE model on an infinitesimal scale. Our approach is based on analyzing the statistics of the lengths of monotonically increasing or decreasing segments in the subsampled data sequence, which we refer to as monotone runs. As an analytical foundation, we prove for a large class of SDEs with additive noise that the lengths of monotone runs at an infinitesimal scale are approximately geometrically distributed with success probability $1/2$. This universal characterization is employed to derive an automated method for selecting appropriate subsampling rates for given time series data that is directly applicable in real-world scenarios and does not rely on an asymptotic framework of multiscale diffusions. The approach is demonstrated using an application from industrial mathematics concerning surrogate models for fiber lay-down curves in production processes of nonwoven textiles.

19.
arXiv (quant-ph) 2026-06-17

Impulse Decoding of Quantum LDPC Codes: Equivalence of Degeneracy and Code-Shortening

arXiv:2606.18240v1 Announce Type: new Abstract: Quantum error correction is essential for building scalable quantum computers. Within the stabilizer formalism, the Calderbank-Shor-Steane framework constructs quantum codes from pairs of classical linear codes. A distinctive feature in this setting is degeneracy, where multiple equivalent error estimates exist-a phenomenon that has no classical counterpart, and the lack of a meaningful classical coding-theoretic interpretation of which has remained a gap in the literature. In this paper, we demonstrate that degeneracy is closely related to the classical operation of shortening of a linear block code. Interestingly, the shortening here takes place at the decoder rather than at the encoder. Leveraging this insight, we present a parallel decoding scheme for quantum low-density parity-check codes, which we term impulse decoding, that significantly outperforms belief propagation with ordered statistics decoding, as well as several other existing techniques, under both code-capacity and circuit-level noise, with significantly lesser complexity. We then present another algorithm based on decoding of residual errors, which when combined with impulse decoding achieves further performance improvement under circuit-level noise.

20.
arXiv (CS.AI) 2026-06-25

CausalRAG2: Hierarchical Causal Knowledge Graph Design for RAG

arXiv:2602.05143v2 Announce Type: replace Abstract: Retrieval augmented generation (RAG) has enhanced large language models by enabling access to external knowledge, with graph-based RAG emerging as a powerful paradigm for structured retrieval and reasoning. However, existing graph-based methods often over-rely on entity-centric node matching and lack explicit causal modeling, leading to unfaithful or spurious answers. Prior attempts to incorporate causality are typically limited to local or single-document contexts and also suffer from information isolation that arises from modular graph structures, which hinders scalability and cross-module causal reasoning. To address these challenges, we propose CausalRAG2, a framework that rethinks knowledge organization for graph-based RAG through causal gating across hierarchical modules. CausalRAG2 explicitly models causal relationships to suppress spurious correlations while enabling scalable reasoning over large-scale knowledge graphs. We also introduce HolisQA, a benchmark for holistic comprehension beyond entity-centric matching. Extensive experiments demonstrate that CausalRAG2 consistently outperforms competitive graph-based RAG baselines across multiple datasets and evaluation metrics. Our work establishes a principled foundation for structured, scalable, and causally grounded RAG systems. Our code and HolisQA benchmark are available at https://github.com/Pwnb/CausalRAG2.

21.
medRxiv (Medicine) 2026-06-22

Agentic Artificial Intelligence for Hospital Readmission Review: A Single-Center Blinded Evaluation and Exploratory Qualitative Analysis

Background: Manual review of 30-day hospital readmissions can identify actionable quality and safety problems, but it is labor-intensive. We developed and evaluated an agentic AI workflow for evidence-grounded readmission review. Materials and methods: We studied adult patients with unplanned 30-day readmission after discharge from a medicine hospitalist service at a single academic health system. An AI agent using a large language model queried a database containing notes, encounters, procedures, laboratory results, and other clinical data, and completed the same structured readmission-review rubric used by physicians. In the primary comparative evaluation, 20 randomly selected readmissions from 2025 were each reviewed by two physicians and the AI system. Blinded physician evaluators rated review quality. After rubric refinement, the AI workflow was applied to 100 recent readmissions in an exploratory expanded-cohort analysis of recurring improvement opportunities. Results: In the primary comparative evaluation, the AI classified 9/20 readmissions (45%) as preventable, compared with 19/40 physician reviews (47.5%). Blinded overall quality ratings were similar for AI and physician reviews (4.35 vs. 4.20 on a 1-5 scale; mean difference 0.15, 95% CI -0.20 to 0.48; p=0.49), as were factuality/support and usefulness/actionability ratings. No AI hallucinations were identified during factuality review. Agreement on preventability and primary readmission category was low for both AI-human and human-human comparisons. The AI system cost $0.23 per chart; physician reviewers took a median of 15 minutes, corresponding to an estimated $42.43 per chart. In the exploratory expanded-cohort analysis, AI-assisted review identified recurring vulnerabilities in post-discharge follow-up plans, incomplete inpatient workups, medication-safety transitions, and indwelling-device transitions. Conclusions: Agentic AI produced readmission reviews with similar blinded quality ratings to physician reviews in this small single-center primary comparative evaluation and supported identification of recurring quality-improvement themes in the exploratory expanded-cohort analysis. Preventability judgments remained variable among both AI and physicians, underscoring the need for human oversight and prospective evaluation before operational use.

22.
medRxiv (Medicine) 2026-06-24

Repetitive Transcranial Magnetic Stimulation over Primary Somatosensory Cortex for Upper Limb Function in Stroke: An Exploratory Randomized Controlled Trial

Background: Stroke often causes Upper Limb (UL) functional impairments. The Primary Somatosensory Cortex (S1) plays an important role in motor learning. Repetitive Transcranial Magnetic Stimulation (rTMS) over S1 could enhance UL recovery. We aimed to explore its preliminary effects on UL motor activity and function post-stroke. Methods: An exploratory parallel-group randomized controlled trial in people with chronic stroke (>3 months) and moderate hemiparesis was conducted. Participants received 20 sessions of active or sham 5Hz rTMS over affected S1, with Robot-Assisted Therapy and Task-Oriented Training, 5 days/week for 4 weeks. The primary endpoint was UL motor activity (Action Research Arm Test, ARAT). Secondary measures were the UL Fugl-Meyer Assessment (UL-FMA) and sensory outcomes. Results: The baseline-adjusted mean difference (MD) in ARAT was 4.05 points [0.78, 7.33], favoring active stimulation. Secondary measures did not favor active stimulation (UL-FMA: MD = 2.62 [-1.51, 6.76]; sensory outcomes showed no between-group differences). Conclusion: High-frequency rTMS over S1 may enhance UL motor activity (ARAT), but no evidence for motor impairment (UL-FMA) or sensory domains was found. Compensation rather than restoration may underlie this improvement. Stimulation targets should match the intended recovery domain, although larger trials are needed to confirm these preliminary findings.

23.
medRxiv (Medicine) 2026-06-12

Mathematical analysis of the overall survival after chemoradiotherapy of limited-stage small cell lung cancer and the effect of dose/fractionation

The purpose of this work is to analyze the 2-year overall survival (OS2y) of limited-stage small cell lung cancer (LS-SCLC) treated with chemoradiotherapy (CRT), aiming at characterizing the response of LS-SCLC, and in particular the /{beta} value and proliferation parameters. Through a systematic analysis of the literature, we collated a dataset containing 57 entries (3363 patients) of response of LS-SCLC treated with CRT. Radiotherapy schedules ranged from hyper- to hypofractionation. Four radiobiological models to describe the OS2y were investigated, with progressive levels of complexity including the effect of radiotherapy, chemotherapy, treatment year and toxicity. The Akaike Information Criterion (AIC) was used to compare models, and the profile likelihood methodology to compute confidence intervals. Model 4, which includes the effect of radiotherapy, chemotherapy, treatment year and dose-dependent toxicity, provided the best fits of the experimental data (lowest AIC value). While being the best model, model 4 still fails to provide a good prediction of the OS2y, in particular failing to predict the survival of the schedules achieving the lower/higher survivals. The radiobiological analysis of the dose-response of LS-SCLC to CRT does not allow to narrowly constrain the value of response parameters. We attribute this limitation to the large heterogeneity of this disease. Nonetheless, our analysis shows a large /{beta} value (>9 Gy, 95% CI), which implies a low fractionation effect in the radiotherapy of LS-SCLC. and an accelerated proliferation of tumor cells, {lambda}' > 1.6 Gy/day (95% CI), after a kick-off time of ~4-5 weeks, which supports the use of accelerated protocols to avoid the effect of tumor proliferation on the clinical outcome.

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

FlowR2A: Learning Reward-to-Action Distribution for Multimodal Driving Planning

arXiv:2606.24231v1 Announce Type: new Abstract: Multimodal driving planning faces a long-standing tension between two paradigms: scoring-based methods benefit from dense reward supervision but are confined to a fixed action vocabulary, while anchor-based methods generate proposals dynamically yet suffer from sparse supervision constrained to a single ground-truth trajectory. In this work, we propose FlowR2A, which resolves this tension by reframing simulation-based rewards from discriminative targets into generative conditions. By learning the reward-conditioned action distribution from dense trajectory-reward pairs with a flow-matching decoder, FlowR2A unifies the dense supervision of scoring-based methods with the proposal generation of anchor-based methods in a single generative model, forcing the model to internalize the correlation between an action and its outcomes in safety, progress, comfort, and rule compliance. To balance hard safety constraints against soft progress objectives, we introduce fine-grained per-timestep reward conditioning and reward noise augmentation. The generative formulation naturally supports controllable test-time sampling via reward guidance and anchored sampling, producing high-quality proposals. FlowR2A achieves state-of-the-art results on the NAVSIM v1 and v2 benchmarks, with multimodal proposals of substantially higher quality than prior methods.

25.
arXiv (CS.AI) 2026-06-19

Interpretable Sperm Morphology Classification via Attention-Guided Deep Learning

arXiv:2606.20438v1 Announce Type: new Abstract: Male infertility is a major cause of couple infertility, often linked to abnormal sperm morphology. While deep learning models offer automated analysis, most lack interpretability, limiting their clinical adoption. This study proposes an attention-guided deep learning framework for sperm morphology classification. We combine a pretrained EfficientNet-B0 with a Convolutional Block Attention Module (CBAM) to focus on key areas of the sperm head, improving both accuracy and interpretability. Evaluated on the SMIDS and HuSHem public datasets, our model achieves accuracies of 90.2% and 93.9% (macro F1 scores of 0.913 and 0.948), outperforming SimpleCNN and standard EfficientNet-B0. Furthermore, we use Grad-CAM++ visualizations to highlight features influencing the model's decisions. The results demonstrate that this accurate and transparent framework is a practical tool for automated sperm analysis in fertility clinics.