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01.
arXiv (CS.CL) 2026-06-11

PoQ-Judge: A Multi-Architecture Evaluation Framework for Cost-Aware Proof-of-Quality in Decentralized LLM Inference

Decentralized LLM inference networks need lightweight, reference-free quality evaluation for Proof of Quality (PoQ). We present PoQ-Judge, a framework that trains dedicated judge models to score query-output pairs without ground-truth references. We study three architectures across the quality-cost tradeoff: a TextCNN judge, a MiniLM cross-encoder, and a DeBERTa judge. Using two-stage training on UltraFeedback plus GPT-labeled in-domain data, the best model reaches 0.747 Pearson correlation with the ground-truth proxy on a held-out test set, outperforming reference-based evaluators from prior work. As a reference-free component in composite scoring, it achieves 0.645 Pearson correlation, matching the best single reference-based evaluator while removing the need for reference answers. We also show that online calibration identifies semantic quality as the dominant dimension and that cascade evaluation reduces cost by 72.7 percent with only modest quality loss. Results are much stronger on QA than summarization, pointing to proxy quality as the main remaining limitation.

02.
arXiv (quant-ph) 2026-06-17

Efficient time-series prediction on NISQ devices via time-delayed quantum extreme learning machine

arXiv:2602.21544v2 Announce Type: replace Abstract: We proposed a time-delayed quantum extreme learning machine (TD-QELM) for efficient time-series prediction on noisy intermediate-scale quantum (NISQ) devices. By encoding multiple past inputs simultaneously, TD-QELM achieves shallow circuit depth independent of sequence length, thereby, mitigating noise accumulation and reducing computational complexity. Experiments using the NARMA benchmark on both noiseless simulations and IBM's 127-qubit processor demonstrate that TD-QELM consistently outperforms conventional quantum reservoir computing in prediction accuracy and noise robustness. These results highlight TD-QELM as a practical and scalable framework for time-series learning on current NISQ hardware.

03.
arXiv (quant-ph) 2026-06-19

Emergency hub placement with a neutral-atom quantum computer

arXiv:2606.19589v1 Announce Type: new Abstract: We study the problem of emergency operation center placement in disaster response, where a minimal number of hubs must be selected to ensure timely coverage of all affected locations. This task can be formulated as a minimum dominating set problem on a graph encoding reachability within a target response time. We propose a hybrid quantum-classical approximation framework that leverages neutral-atom quantum computers as independent set samplers. Candidate dominating sets are constructed from both small maximal independent sets and complements of large independent sets, and are subsequently refined via a lightweight classical procedure. We benchmark the approach on synthetic instances and realistic case studies, and implement it on the Fresnel quantum processor by Pasqal, solving instances of up to 100 nodes. Our results show that quantum-generated samples, despite hardware noise, enable near-optimal solutions of the placement problem. Overall, our results demonstrate that neutral-atom devices operating in analog mode can already be used to tackle graph optimization problems for real-world applications.

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

DRIVESPATIAL: A Benchmark for Spatiotemporal Intelligence in VLMs for Autonomous Driving

Spatiotemporal intelligence in autonomous driving (AD) requires an agent to integrate multi-view observations into a coherent scene representation, maintain object continuity across viewpoints and time, and reason about spatial relations, interactions, and future dynamics. However, existing AD vision-language benchmarks largely focus on single-view, static, ego-centric, or single-source question answering, leaving it unclear whether current Vision-Language Models (VLMs) can truly construct and reason over dynamic driving scenes. We introduce DriveSpatial, a benchmark of 15.6K human-verified QA pairs across 20 tasks from five large-scale AD datasets. DriveSpatial evaluates four abilities: Cognitive Scene Construction, Multi-view Relational Understanding, Temporal Reasoning, and Generalization. Unlike prior benchmarks, DriveSpatial is generated from a dynamic multi-relational scene graph that encodes object states, spatial relations, interactions, camera visibility, and temporal correspondences, enabling QA pairs that enforce genuine cross-view and spatiotemporal reasoning. Evaluating 15 representative VLMs reveals a substantial human-model gap: the strongest model trails humans by 28.4 points, with Cognitive Scene Construction emerging as the key bottleneck. Further diagnostics show that language-only prompting is insufficient, while explicit BEV grounding consistently improves performance. These results suggest that current VLMs lack the scene-construction ability needed for reliable spatiotemporal driving intelligence. DriveSpatial and its construction pipeline will be released to support future research.

05.
arXiv (math.PR) 2026-06-16

High-Order Talagrand and Eldan–Gross Inequalities via Besov-Type Variance Functionals

arXiv:2606.14876v1 Announce Type: new Abstract: By introducing high-order Besov-type variance functionals that generalize the canonical variance, we develop a unified framework for proving high-order Talagrand-type inequalities that relate high-order energies to Fourier weights. Applying this machinery, we establish high-order Poincaré-type, $L^p$–$L^q$, isoperimetric-type, Falik–Samorodnitsky and Eldan–Gross inequalities, all with explicit constants, in both the Boolean and Gaussian settings. Fundamentally, our semigroup-based framework relies primarily on hypercontractivity and high-order Bismut-type derivative estimates, and is broadly applicable.

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

Shape of Thought: Progressive Object Assembly via Visual Chain-of-Thought

Multimodal models for text-to-image generation have achieved strong visual fidelity, yet they remain brittle under compositional structural constraints, notably generative numeracy, attribute binding, and part-level relations. To address these challenges, we propose Shape-of-Thought (SoT), a visual CoT framework for process-supervised progressive shape assembly in the rendered 2D domain, without external engines at inference time. SoT trains a unified multimodal autoregressive model to generate interleaved textual plans and rendered intermediate states, helping the model capture shape-assembly logic without producing explicit geometric representations. Unlike text-only CoT, each decision is grounded in a rendered state, making counts, attachments, topology, and intermediate part-addition errors inspectable across the trajectory. To support this paradigm, we introduce SoT-26K, a large-scale dataset of grounded assembly traces derived from part-based CAD hierarchies, and T2S-CompBench, a benchmark for evaluating structural integrity and trace faithfulness. Fine-tuning on SoT-26K achieves 88.4% on component numeracy and 84.8% on structural topology, outperforming direct generation by +24.2 points on component numeracy and +19.3 points on structural topology. SoT establishes a transparent testbed for rendered-domain structure-aware generation. The code is available at https://github.com/yuhuo03/Shape-of-Thought.

07.
arXiv (CS.CV) 2026-06-12

Bounding Boxes as Goals: Language-Conditioned Grasping via Neuro-Symbolic Planning

For robotics to be effectively integrated into household or industrial environments, machines must adapt to natural-language prompts in real time. Although Vision-Language Models (VLMs) have enabled zero-shot generalization in robot task and motion planning (TAMP), current state-of-the-art approaches often remain computationally "heavyweight" or require extensive training on thousands of demonstrations. We present GRASP (Grounded Reasoning and Symbolic Planning), a framework designed as a step toward open-vocabulary tabletop manipulation. Our approach leverages a pretrained VLM to translate natural-language queries into neuro-symbolic goal states, grounded in the physical world via a bounding-box detection pipeline. Unlike methods that rely on fixed color lists or hard-coded coordinates, GRASP enables robots to interpret abstract spatial concepts such as "top shelf" and execute tasks without additional fine-tuning. We achieve 73.3% overall success across 90 real-robot trials at three difficulty levels, requiring no task-specific training.

08.
medRxiv (Medicine) 2026-06-22

Burden of Cardiovascular Disease in Brazil, 1996-2023: A Retrospective Descriptive Study of the Epidemiology and Impact on Public Healthcare with Emphasis on Acute Myocardial Infarction

Background Cardiovascular diseases (CVD) are the leading cause of death worldwide, and their epidemiology is correlated with genetic predisposition, exposure to risk factors, sex, age, access to medical care, and other sociodemographic characteristics. Brazil is a developing country with a vast territory, which leads to structural inequalities. Estimates of CVD in Brazil, in its regions, and in its population are poorly evaluated and analysed. Methods We obtained CVD-related data from the Brazilian Unified Health System (SUS) and analysed mortality and morbidity from 1996 to 2023 by sex, race/ethnicity, age, and region. We calculated the risk of death from the most prevalent diseases, the average length of hospital stay, and the costs associated with heart transplantation. Findings In Brazil, acute myocardial infarction was the pathology that led to the highest number of deaths across all variables analysed during the evaluated period. Other CVD were also related to causes of death and morbidity, such as hypertensive diseases and heart failure. Interpretation Brazil presents a serious challenge to the public health system due to the high number of deaths and the progressive mortality rate. This study represents a fundamental contribution to the basis for formulating public health policies aimed at reducing the growing impact associated with these diseases. Funding CNPq, CAPES, FAPEMIG, INCT

09.
arXiv (CS.CV) 2026-06-12

V-JEPA 2.1: Unlocking Dense Features in Video Self-Supervised Learning

We present V-JEPA 2.1, a family of self-supervised models that learn dense, high-quality visual representations for both images and videos while retaining strong global scene understanding. The approach combines four key components. First, a dense predictive loss uses a masking-based objective in which both visible and masked tokens contribute to the training signal, encouraging explicit spatial and temporal grounding. Second, deep self-supervision applies the self-supervised objective hierarchically across multiple intermediate encoder layers to improve representation quality. Third, multi-modal tokenizers enable unified training across images and videos. Finally, the model benefits from effective scaling in both model capacity and training data. Together, these design choices produce representations that are spatially structured, semantically coherent, and temporally consistent. Empirically, V-JEPA 2.1 achieves state-of-the-art performance on several challenging benchmarks, including 7.71 mAP on Ego4D for short-term object-interaction anticipation and 40.8 Recall@5 on EPIC-KITCHENS for high-level action anticipation, as well as a 20-point improvement in real-robot grasping success rate over V-JEPA-2 AC. The model also demonstrates strong performance in robotic navigation (5.687 ATE on TartanDrive), depth estimation (0.307 RMSE on NYUv2 with a linear probe), and global recognition (77.7 on Something-Something-V2). These results show that V-JEPA 2.1 significantly advances the state of the art in dense visual understanding and world modeling.

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

Does My Embedding Reflect That $A = B$? Evaluating Mathematical Equivalence in Embedding Models

Because mathematics is highly abstract, a single statement can take very different forms depending on what subfield it is framed in. There are many examples where breakthroughs occurred after researchers discovered that a question had already been answered in a different field. At the same time, the growth of new resources related to formalization has increased the need for tools that enable efficient and reliable navigation between mathematical 'languages' (e.g., from Lean to natural language). In this paper, we investigate whether current embedding models capture mathematical equivalence. To do this, we introduce the Mathematically Equivalent but Lexically Different Pairs (MELD) Dataset, a collection of mathematically equivalent statements that are expressed in very different language. We show that current state-of-the-art embedding models tend to group statements by the terminology used to make them instead of the underlying math. Motivated by this, we propose a contrastive approach to learning embeddings of mathematical text that focuses on aligning informal statements with different formalizations. Our experiments demonstrate that this leads to improvements not only on informal-formal retrieval tasks but also on MELD, which only contains natural language statements.

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

Transformer-Based Warm-Starting for Feasible and Optimal Terminal Approach to Tumbling Objects with Space Manipulators

arXiv:2606.17317v1 Announce Type: cross Abstract: Real-time trajectory generation for on-orbit robotic servicing is challenging due to the nonlinear coupling between spacecraft bus motion, manipulator dynamics, visibility cone, and trajectory-level safety constraints. This paper studies learning-based warm-starting for sequential convex programming (SCP) in the terminal approach of a space manipulator toward a tumbling target. The proposed framework decomposes the problem into a system center-of-mass translational planning stage and a coupled attitude–manipulator torque-allocation stage, and applies a causal transformer warm-start to the latter, which constitutes the dominant computational bottleneck. Linear and flow matching action decoders are compared under different action-chunking and training dataset sizes, and the resulting warm-starts are evaluated under both cost-optimal and feasibility projection using SCP. Across 300 held-out scenarios, the learned warm-start reduces the second-stage SCP iteration count by up to 28% and the runtime by 23% while preserving the final control-cost distribution. When the learned warm-starts are used for nonconvex feasibility projection, they nearly halve the runtime relative to cost-optimal SCP, while avoiding the catastrophic high-cost tail behavior observed when initialized heuristically. These results indicate that sequence-model warm-starts can improve both the computational efficiency and trajectory robustness of optimization-based terminal guidance for space manipulation.

12.
medRxiv (Medicine) 2026-06-17

Nickel and Dimed: How a Common Earth Element is Short-Changing Our Health

Nickel has been studied for a long time as an environmental contaminant but less so in its connection to population health. It does not announce itself as loudly as its transition metal brethren like mercury and cadmium, but its chemical properties permit it to be deleterious as a low-dose, chronic exposure, particularly among those with immune systems sensitized to it. There is a growing evidence base and vocabulary to discuss nickel's affect on health. However, in the U.S., there are not recent, reliable estimates of the share of the population with a nickel allergy, let alone how much nickel Americans are exposed to through their diet. This paper seeks to close this evidence gap by creating a new dataset of dietary nickel and other heavy metal exposure and assessing how high levels of dietary nickel exposure shape local demand for health care services. We use soil data from the U.S. Geological Survey and data on agricultural product transport from FoodFlows.org to create a county-level dietary nickel exposure index. We then use a large electronic health record database and double machine learning to estimate how demand for primary care services varies across levels of dietary nickel exposure. We find that counties with high nickel exposure experience an increase in the share of primary care office visits for symptoms highly suggestive of nickel poisoning. This result survives multiple hypothesis test corrections and placebo tests. Our research suggests that nickel has harmful effects on individual health whose exposure can be measured at a population level, and is shaping primary care across the U.S.

13.
bioRxiv (Bioinfo) 2026-06-16

Integrative Transfer Network: Deep Transfer Learning Across Populations and Prediction Targets

作者:

Large-scale clinical and biomedical datasets increasingly contain both diverse subgroup attributes (e.g., demographic or clinical subgroups) and multiple prediction targets. Although various machine learning approaches can address subgroup differences or multi-target prediction, they often consider these aspects independently rather than jointly. To more effectively capture the shared and subgroup-specific information in such complex datasets, we propose the Integrative Transfer Network (ITN), a deep neural network designed to leverage data across subgroups and multiple related outcomes simultaneously. In extensive experiments, including time-to-event and classification tasks where demographic subgroups and multiple disease endpoints are prevalent, ITN demonstrates consistent improvements in subgroup-specific prediction by borrowing strength from other subgroups and outcomes. We envision ITN as a unified framework for learning from heterogeneous datasets where subgroup-specific insights are critical.

14.
arXiv (math.PR) 2026-06-11

Persistent Homology of the Planar Wiener Sausage: Brownian Scaling and a Logarithmic Expectation Law

arXiv:2606.11248v1 Announce Type: new Abstract: We study degree-one persistent homology of the planar Wiener-sausage filtration generated by standard Brownian motion without drift. In the drifted case, regeneration along the drift direction leads to linear-in-time laws for persistent-homological observables. In the recurrent zero-drift case, this renewal structure disappears. The organizing mechanism is instead Brownian self-similarity: the persistence diagram at time $T$ is equal in law to the image of the unit-time diagram under spatial dilation by $\sqrt T$. Consequently, large-time questions on fixed radius windows are transformed into small-radius questions for the unit-time Brownian trace. Let $B$ be standard planar Brownian motion, let $K_T=B\left(\left[0,T\right]\right)$, and let $K_T^{\left(r\right)}$ be the radius-$r$ Wiener sausage. Since $K_T^{\left(r\right)}$ is connected, its first Betti number $\beta_1^T\left(r\right)$ is the number of bounded complementary components of $K_T^{\left(r\right)}$. For a bounded nonnegative Borel function $\psi$ supported in a compact interval $\left[a,b\right]\subset\left(0,\infty\right)$, we consider the smoothed Betti-curve observable $\left[r_0,r_1\right] \mathrm{\Phi}_\psi \left(T\right) = \int_{r_0}^{r_1} \beta_1^T \left( r \right) \psi \left( r \right) dr$. We prove that there exist absolute constants 0

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

BRDFusion: Physics Meets Generation for Urban Scene Inverse Rendering

Inverse rendering of urban scenes from captured videos enables numerous applications, including content creation and autonomous driving simulation. Physically-based rendering methods follow and control lighting physics, but suffer from reconstruction and rendering artifacts. While generative models produce realistic videos, they offer limited consistency and controllability. We present BRDFusion, a unified framework that combines two complementary models for inverse and forward rendering. Specifically, BRDFusion recovers explicit, consistent scene properties with physical modeling and alleviates optimization ambiguity with generative priors. During forward rendering, the physical model provides controllable rendering from the scene configuration, and the generative model denoises and fixes artifacts. Therefore, our method produces high-quality videos while allowing precise control, outperforming baselines in real and synthetic scenes. Moreover, BRDFusion supports novel-view relighting, night simulation, and dynamic object insertion/editing. Project page: https://shigon255.github.io/brdfusion-page/

16.
medRxiv (Medicine) 2026-06-17

Wearable-Grade Lead Reduction Disproportionately Degrades ECG AI Performance in Elderly Patients: Evidence from PTB-XL and MIT-BIH

Consumer wearable devices increasingly use single-lead electrocardiograms (ECGs) for cardiac monitoring, but these signals contain substantially less spatial information than the clinical 12-lead standard. Whether this reduction dispro- portionately affects older adults, who often present with more complex cardiac conditions, remains poorly understood. In this study, we evaluated the impact of lead reduction on AI-ECG diagnostic performance across age groups. A 1D resid- ual neural network was trained on 21,091 PTB-XL ECG recordings spanning five diagnostic superclasses and assessed using 12-, 6-, 2-, and 1-lead configurations. Under the full 12-lead setting, model accuracy declined from 84.5% in patients younger than 40 years to 66.2% in patients aged 75 years or older. Progressive lead reduction further widened this gap. Under the 1-lead configuration, accuracy decreased by 14.1 percentage points in the 75+ group but by only 0.4 percent- age points in the

17.
arXiv (CS.AI) 2026-06-18

Dual-Channel Grounded World Modeling (DCGWM): Structural Prevention of Objective Interference Collapse via Heterogeneous External Grounding with Inward-Only Gradient Flow

arXiv:2606.18688v1 Announce Type: cross Abstract: Joint Embedding Predictive Architectures (JEPAs) are a leading approach to world model representation learning. We identify a failure mode in JEPA-based world models grounded against two qualitatively distinct external signals: physical dynamics (sparse, high-magnitude, constraint-satisfying gradient corrections) and social-behavioral dynamics (diffuse, distribution-matching corrections). We term this Objective Interference Collapse (OIC): we argue that joint learning in a shared latent space causes the dominant channel to systematically collapse the subordinate channel's representational subspace, in a manner not resolvable by loss weighting alone. We propose Dual-Channel Grounded World Modeling (DCGWM), designed to structurally prevent OIC through a partitioned latent space (physical subspace Z_p, behavioral subspace Z_b) with inward-only gradient flow. A Physical Grounding Channel updates only Z_p via VICReg-style alignment to physical measurements; a Social-Behavioral Grounding Channel updates only Z_b via alignment to trajectories from an emergent multi-agent simulation. An Inter-Channel Interface Module couples the subspaces at the task level without cross-subspace gradients. An Asymmetric Grounding Adherence Loss penalizes rollout drift with a hard hinge for physical violations and a soft KL for behavioral divergence. A Generative Rendering Layer is architecturally isolated from the latent world model. We present three theoretical results: the partition removes the gradient-interference pathway implicated in OIC; each grounded subspace inherits anti-collapse guarantees from its alignment objective; and generative isolation is necessary under a stated assumption on the generative objective's geometry. This manuscript establishes the problem formulation and architecture; experimental validation is ongoing and will be reported in a future revision.

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

Applicability Condition Extraction for Therapeutic Drug-Disease Relations

arXiv:2606.14031v1 Announce Type: new Abstract: Identifying conditions that a certain drug takes therapeutic effect on a target disease is crucial for clinical decision-making support. However, most existing biomedical information extraction methods have focused on identifying only relations between drugs and diseases, while largely overlooking the context-specific conditions where such relations can apply. To address this problem, we introduce the task of applicability condition extraction for therapeutic drug–disease relations from biomedical research literature. We create the first dataset that has manually annotated triples of drugs, diseases, and applicability conditions on biomedical paper abstracts with 1,119 drug-disease pairs. Using this dataset, we systematically evaluate the performance of a range of existing methods. In addition, we propose a new method that enhances LoRA to consider relations between drugs and diseases. Our method consistently outperforms strong baselines across different evaluation settings. The source code and dataset of this paper can be obtained from: https://github.com/guantingluo98/Drug-ACE

20.
arXiv (CS.CV) 2026-06-15

Efficient Online 3D Multi-Camera Multi-Object Tracking and Pose Estimation

This paper proposes a fast and online method for jointly performing 3D multi-object tracking and pose estimation using multiple monocular cameras. Our algorithm requires only 2D bounding box and pose detections, eliminating the need for costly 3D training data or computationally expensive deep learning models. Our solution is an efficient implementation of a Bayes-optimal multi-object tracking filter, enhancing computational efficiency while maintaining accuracy. We demonstrate that our algorithm is significantly faster than state-of-the-art methods without compromising accuracy, using only publicly available pre-trained 2D detection models. We also illustrate the robust performance of our algorithm in scenarios where multiple cameras are intermittently disconnected or reconnected during operation.

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

Graph neural networks at war: integrating cybersecurity and drone intelligence in the Israeli-Iranian conflict

arXiv:2606.17119v1 Announce Type: cross Abstract: Physical cyber systems have brought about new threats and challenges in detection and immediate response. This study examines how Graph Neural Networks (GNNs) can be used to aid cybersecurity and drone management in a physical cyber system comprising of cyber intrusions and unmanned aerial vehicles (UAVs). By providing a bridge between structural understanding of graphical neural networks, this work has provided an integrated procedure that allows intrusion detection systems to educate on underlying network structures, identify malicious activity, and facilitates drone response measures. Based on an emulation-based case study, cyberattacks models were created to provoke the responses of the drones, which proved that graph-based learning can assist with the situational awareness, swarm coordination, and adaptive maneuver. According to the performance valuation, this method has a detection rate of 94.2, average area under the receiver operating characteristic (ROC) of 0.955 and an average response time of 1.4 seconds. Comparative experiments reveal that proposed GraphSAGE network is more effective than the Graphical Convolutional Networks (GCNs) and Graphical Attention Networks (GATs) in the identical situation. Such findings prove that graphical neural networks can be used to avert intrusion and response of dynamic cyber-physical systems.

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

VoidPadding: Let [VOID] Handle Padding in Masked Diffusion Language Models so that [EOS] Can Focus on Semantic Termination

MDLMs generate text by denoising a preallocated masked response canvas, making response-length modeling central to instruction tuning. Existing MDLMs often inherit the autoregressive convention of using repeated \texttt{[EOS]} tokens for padding during instruction tuning, giving \texttt{[EOS]} a dual role as both a semantic terminator and a padding token. We show that this dual role is a root cause of \texttt{[EOS]} overflow under large-block decoding. To decouple these roles, we propose VoidPadding, which introduces \texttt{[VOID]} for padding and reserves \texttt{[EOS]} for termination. During inference, the learned \texttt{[EOS]} signal enables early stopping, while the learned \texttt{[VOID]} signal guides adaptive response canvas expansion. On Dream-7B-Instruct, VoidPadding improves the block-size-averaged four-task mean across mathematical reasoning and code generation benchmarks by \(+17.84\) points over the original model and \(+6.95\) points over RainbowPadding, while reducing decoding NFE by 55.7\% on average. Code is available at https://github.com/Haru-LCY/VoidPadding.

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

FlowBender: Feedback-Aware Training for Self-Correcting Conditional Flows

Conditional diffusion and flow models routinely fail to satisfy the very constraints that define their task. For instance, a depth-conditioned model often produces images whose re-extracted depth disagrees with the input, even though the forward operator–the depth predictor defining the constraint–is available during both training and inference. Existing approaches generally fall into two categories: supervised models that treat the conditioning signal as a static cue and ignore alignment information at inference, and guidance-based methods that consult it through hand-tuned linear updates, typically trading fidelity to the condition against the plausibility of the generated sample. We argue that the fundamental gap in both paradigms is that the model is never trained to utilize its own alignment error. We introduce FlowBender, a closed-loop framework that treats this error as a first-class input, training the network to learn a correction policy conditioned on inference-time feedback. At each step, an unguided look-ahead pass estimates the clean signal, a task-specific deviation is computed via the forward operator, and a refinement pass consumes this signal to produce a corrected velocity. We propose several variants of FlowBender, including a gradient-based formulation for differentiable operators and a zero-order variant for non-differentiable settings such as JPEG compression. For efficient sampling, we introduce a prior-step shortcut that enables closed-loop correction at a minimal additional computational cost. Across image-to-image translation, restoration, and 3D mesh texturing, FlowBender consistently outperforms standard supervised baselines, alignment-loss-augmented training, and state-of-the-art inference-time guidance, improving fidelity and plausibility simultaneously rather than trading them against each other. Project page: https://flow-bender.github.io/

25.
medRxiv (Medicine) 2026-06-15

Investigation of Intra-Fraction Stability and Inter-Fraction Reproducibility of Deep Inspiration Breath-Hold Across Two Hypofractionated Radiotherapy Regimens in the HYPORT Adjuvant Study.

Background: Deep Inspiration Breath Hold (DIBH) is a widely used respiratory motion management technique for minimizing cardiac dose in left-sided breast radiotherapy. In the Breast HYPORT Adjuvant study, DIBH was employed for cardiac sparing in patients without nodal irradiation using a standardized institutional protocol with the Varian Real-time Position Management (RPM) system. Both moderate-hypofractionation (control arm - 40Gy in 15 fractions) and one-week hypofractionation (experimental arm - 26 Gy in 5 fractions) regimens were delivered using this protocol. This study aimed to evaluate the robustness of DIBH by analyzing intra-fraction stability and inter-fraction reproducibility of breath-hold amplitude across the two treatment regimens. Methods: Respiratory waveforms acquired during each treatment session were analyzed to determine the median breath-hold amplitude and its standard deviation during beam delivery. Intra-fraction stability was assessed from vari- ations within individual treatment sessions, while inter-fraction reproducibility was evaluated relative to the simula- tion waveform amplitude across all treatment sessions. These parameters were compared between the two HYPORT regimens to examine breath-hold consistency during treatment delivery. Moreover, an additional comparison was made between the one-week hypofractionation regimen and the first five fractions of the moderate-hypofractionation regimen to evaluate the effect of treatment duration . Lung volumes from free-breathing and DIBH CT scans were analyzed to assess the effectiveness of patient breath-hold training. Results: Both arms demonstrated an average 1.7-fold increase of air volume in lung during the breath-hold position, confirming the effective implementation of DIBH during treatment planning and delivery. Structured training resulted in increased breath-hold amplitudes, with gains of 22.87% and 24.16% with respect to the first trial session in the experimental and control arms, respectively. Both regimens receive equivalent doses for approximately the same air volume in lung . Despite the different prescription doses in the two arms (26 Gy vs. 40 Gy), the experimental arm achieved an equivalent mean heart dose of 2.91% (75.6 cGy) compared with 2.95% (118.51 cGy) in the control arm, suggesting a similar cardiac preservation protocol adopted during treatment planning. Intra-fraction stability was similar between the control arm and the experimental arm, with median amplitude variations of 1.006 mm (95% CI: [0.998-1.015]) and 1.079 mm (95% CI: [1.067-1.097]), respectively. In contrast, inter-fraction reproducibility improved in the experimental arm, with lower deviation from simulation amplitude (0.44 {+/-} 0.24 mm vs. 0.66 {+/-} 0.25 mm) for the entire treatment schedule. The stability and reproducibility of experimental arm were further compared with the first five fractions of the control arm. The results were similar to those of the experimental arm. Conclusion: In this study, we compared two treatment regimens in terms of intra-fraction stability and inter-fraction reproducibility during DIBH radiotherapy. Both regimens demonstrated comparable intra-fraction stability, indicating effective motion management irrespective of treatment duration. However, the experimental arm showed better inter- fraction reproducibility, suggesting more consistent breath-hold performance throughout the treatment course. Based on stability and reproducibility, a reasonable narrowing of the DIBH gating window may be implemented with minor changes to the institutional protocol. The observed trend highlights the potential for improved consistency with the experimental approach and supports further investigation to better understand the underlying factors and strengthen these findings in future studies.