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01.
medRxiv (Medicine) 2026-06-22

Regional Service-System Conditions Associated with Facility-Linked Home-Based Specialist Care in Japan: A Claims-Based Ecological Study of Home Dialysis

作者:
Suzuki↗K. T↗

Background Complex chronic care is increasingly delivered in patients' homes while remaining linked to specialist facilities for training, monitoring, and backup care. Home dialysis provides a useful case because peritoneal dialysis (PD) and home hemodialysis (HHD) share a home-facility delivery structure but differ in technical and operational requirements. This study examined regional service-system conditions associated with the presence and scale of PD and HHD in Japan. Methods This ecological study used publicly available claims, administrative, census, and geospatial data harmonized to 334 Secondary Medical Areas. Regional indicators were organized into four domains: dialysis service delivery, implementation support for home-based care, hospital backup capacity, and living and sociodemographic context. Diffusion was examined using claims-based indicators of regional presence and post-presence scale, analyzed separately for PD and HHD with Firth penalized logistic regression and zero-truncated negative binomial regression, respectively. Results PD was observed in 271 regions and HHD in 109. Patterns of associated regional conditions differed by modality and stage. PD was associated mainly with existing dialysis-service organization, whereas HHD was associated with broader regional supports, including home-care delivery, living infrastructure, transition support, and hospital-system indicators. Conditions associated with presence differed from those associated with scale. Cross-modality associations suggested that shared regional factors may shape the distribution of both modalities. Conclusions Regional conditions for home dialysis diffusion in Japan differed by modality and stage. PD was linked mainly to existing dialysis-service organization, whereas HHD was linked to multi-domain regional support for technically demanding home treatment. Under standardized reimbursement, local service-system capacity may remain important for modality- and stage-specific diffusion of home dialysis.

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02.
arXiv (quant-ph) 2026-06-16

Scalable Graph State Generation with O(1) Local Feedforward in Quantum Networks

作者:
Xiaoyi Zheng↗Chan-Tong Lam↗Lin Chen↗Zheng Xing↗

arXiv:2606.16375v1 Announce Type: new Abstract: The development of quantum networks faces a key challenge: the contradiction between probabilistic long-range entanglement generation and finite coherence time. Existing routing protocols typically focus on global state computation or path optimization. As the network scales up, classical delays accumulate and exacerbate decoherence, leading to a decrease in entanglement fidelity. To reduce routing decision delays to levels far below the coherence time of qubits, we propose a protocol based on local measurement and classical feedforward. This protocol reduces the local decision complexity to amortized O(1) level, ensuring that the decision delay is always much smaller than the coherence time of qubits. We map this protocol onto a dual-species trapped-ion platform and perform hybrid simulations. The results show that the proposed protocol performs well in terms of both resource efficiency and time feasibility. Noise analysis indicates that readout fidelity is the main bottleneck of this protocol, but noise suppression can be achieved by employing an erasure transformation in the dual-species architecture, combined with spatial multiplexing and branch independence, thereby ensuring the generation of high-fidelity star subgraphs. This protocol provides a clear path to achieving high-fidelity star subgraphs. These subgraphs can serve as general modules, merging to construct arbitrary subgraphs, providing a feasible solution for future fault-tolerant distributed quantum computing.

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03.
Nature (Science) 2026-06-11

‘Footballers are not superheroes’: we must tackle the mental and physical pressures of elite sport

作者:
David Adam↗

As the men’s football World Cup gets under way, how the game weighs on the health of athletes still isn’t talked about enough, says player-turned-medic Vincent Gouttebarge. As the men’s football World Cup gets under way, how the game weighs on the health of athletes still isn’t talked about enough, says player-turned-medic Vincent Gouttebarge.

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04.
arXiv (CS.CV) 2026-06-16

R2RDreamer: 3D-aware Data Augmentation for Spatially-generalized 2D Manipulation Policies

作者:
Xiuwei Xu↗Haowen Sun↗Angyuan Ma↗Yiwei Zhang↗Zhenyu Wu↗Xiaofeng Wang↗Bingyao Yu↗Zheng Zhu↗Jie Zhou↗Jiwen Lu↗

Spatial generalization is critical for imitation-learned manipulation policies, but achieving it typically requires scaling demonstrations across diverse object poses, robot configurations, and camera viewpoints. Data augmentation from a few source demonstrations offers a practical alternative to costly real-world collection. Simulation-based augmentation can create controllable variation, but requires complex environment and object setup and may introduce a sim-to-real gap. Recent real-to-real methods avoid these issues by jointly editing 3D observations and action trajectories from real demonstrations, yet they still rely on strong 3D scene parsing and geometry completion, and often produce observations tailored to 3D pointcloud policies rather than RGB-based 2D policies. We propose R2RDreamer, a real-to-real demonstration augmentation framework that preserves the geometric consistency of 3D action-observation editing while moving visual completion to 2D video space. Specifically, R2RDreamer first performs lightweight 3D augmentation by editing incomplete object pointclouds and end-effector trajectories in a shared 3D frame; it then projects the edited scene into masked image-space control videos with occlusion-aware reasoning and uses a dense-control image-to-video model to complete temporally coherent RGB observations. Experiments on spatially shifted manipulation tasks with both 2D diffusion-style policies and vision-language-action policies show that R2RDreamer improves spatial generalization from limited source demonstrations, with analyses validating the contributions of 3D editing, occlusion-aware projection, and video completion.

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

Descriptive versus Regulatory Uncertainty in Bounded Predictive Systems

作者:
Ahmed Gamal Eldin↗

arXiv:2605.18909v2 Announce Type: replace Abstract: Any system that models the world under finite representational capacity must compress; any compression entails a prior; and the prior is the system's bias. What has not been established is whether uncertainty participates in the dynamics governing future behavior, or merely describes the output distribution without consequence. We introduce a structural distinction between descriptive uncertainty, which does not recursively modulate the system's policy, and regulatory uncertainty, which directly enters the optimization landscape and drives persistent adaptive restructuring. We prove formally that current transformer architectures are confined to descriptive uncertainty at inference. We ground this in thermodynamics via Landauer's principle: for uncertainty to be regulatory, epistemic error must cost real energy; in a decoupled system, hallucinations and correct derivations dissipate identical energy. We test this empirically across three locally-deployed language models (3B, 8B, 70B parameters). Token-level Shannon entropy is statistically invariant across tasks spanning pattern retrieval, causal operator application, and out-of-distribution causal generalization in all three models (all pairwise p >= 0.568; within-model ranges 0.011-0.028 nats), while task accuracy varies substantially across the same conditions (0%-100%). Entropy and accuracy are orthogonal. The decoupling is scale-invariant: larger models achieve higher accuracy but identical entropy flatness. This structural incapacity is not resolvable by additional parameters or training data. Genuine epistemic grounding requires physical coupling between thermodynamic substrate state and information processing cost.

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

Where's the Plan? Locating Latent Planning in Language Models with Lightweight Mechanistic Interventions

作者:
Nicole Ma↗Nick Rui↗

arXiv:2605.07984v2 Announce Type: replace-cross Abstract: We study planning site formation in language models – where internal representations of structurally-constrained future tokens form during the forward pass, and whether they causally drive generation. Using rhyming-couplet completion as a clean test of forward-looking constraint, we apply two lightweight methods (linear probing and activation patching) across Qwen3, Gemma-3, and Llama-3 at more than ten scales. Probing shows that future-rhyme information is linearly decodable at the line boundary, with signal that strengthens with scale in all three families. Activation patching reveals that only Gemma-3-27B causally relies on this encoding, exhibiting a handoff in which the causal driver migrates from the rhyme word to the line boundary around layer 30. Every other model we test conditions on the rhyme word throughout generation, with near-zero causal effect at the line boundary despite strong probe signal. We localize the Gemma-3-27B handoff to five attention heads through two-stage path patching that recover ~90% of the rhyme-routing capacity at the newline.

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

Toward Vibe Medicine: A Self-Evolving Multi-Agent Framework for Clinical Decision Support

作者:
Qianxue Zhang↗Yiming Ren↗Shihuan Qin↗Xiao Zhang↗Liao Zhang↗Jinyang Huang↗Zhengliang Liu↗Chenbin Liu↗Hongying Feng↗Jingyuan Chen↗Yuzhen Ding↗Weihang You↗…

arXiv:2606.15504v1 Announce Type: new Abstract: In recent years, the advances of large language models and autonomous agents have revolutionized the healthcare field, facilitating diagnosis and improving treatment results. However, most existing AI systems rely on pre-trained knowledge and predefined pipelines, which struggle to learn dynamically from the interactive chat session history that contains patient outcomes and past failures. To address this limitation, we propose VIBEMed, a multi-agent framework with a built-in self-evolution mechanism and architecture-level safety sandbox for robust clinical decision support. The system integrates three specialized agents, including a Clinical Diagnostic Agent (CDA) for hypothesis generation, a Therapeutic Execution Agent (TEA) for treatment planning, and a Clinical Evolution Manager Agent (CEMA) that distills longitudinal clinical feedback into reusable knowledge, transforming multimodal patient information into personalized medical decisions. Through self-evolution mechanism, the framework enables iterative updates across memory, model behavior, and decision strategies, allowing the system to improve over time. Experimental results show that VIBEMed demonstrates superior performance through its evolving mechanism in complex clinical cases, particularly in tasks that require integrated decision-making and longitudinal planning. The framework also supports reliable end-to-end decisions in challenging scenarios such as oncology treatment planning, highlighting its feasibility in real-world clinical contexts. Overall, VIBEMed provides a practical path beyond static AI systems toward adaptive, experience-driven clinical decision support, demonstrating the value of combining multi-agent collaboration with continuous evolution for advancing precision medicine.

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08.
arXiv (CS.CL) 2026-06-15

WorkBench Revisited: Workplace Agents Two Years On

作者:
Olly Styles↗

The best agent on WorkBench in March 2024, GPT-4, completed 43% of tasks and took an unintended harmful action, such as emailing the wrong person, on 26% of them. We re-visit the benchmark in June 2026 and find that the best agent to date, Claude Opus 4.8, completes 89% and takes an unintended harmful action on 2.5%. Aside from this considerable progress in frontier agent performance, three things stand out. First, capability and safety go together on WorkBench rather than trade off, so the models that finish the most tasks also do the least unintended damage. Second, while several classes of error have been totally eliminated, frontier models still make some basic mistakes that occasionally result in irreversible harm, such as sending an email to the wrong person. Third, the rise of open-weight models has drastically lowered costs for a performance level that was previously only accessible to proprietary models, while frontier costs have stayed relatively stable. We release an updated version of the benchmark with data and code quality improvements, new model scores, and analysis of agent progress on WorkBench since 2024.

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09.
arXiv (CS.CL) 2026-06-17

Environment-Grounded Automated Prompt Optimization for LLM Game Agents

作者:
Rean Clive Fernandes↗Lukas Fehring↗Theresa Eimer↗Marius Lindauer↗Matthias Feurer↗

LLM agents in interactive environments are highly sensitive to their prompts, yet prompt engineering remains a manual, task-specific process. We introduce an automated prompt optimization framework for LLM agents that decomposes the observation-to-action pipeline into a goal-conditioned descriptor agent and an action selection agent, and iteratively refines each module's prompt through an LLM-driven evolutionary loop guided by environment returns. We propose a behavior analyzer to attribute episode outcomes to specific prompt components, and a mutator to propose targeted revisions to the prompt, before validating them through environment rollouts. We evaluate on all five BabyAI tasks in the BALROG benchmark, comparing our pipeline against BALROG's RobustCoTAgent under both plain and guided prompt initializations. Optimization improves performance consistently across tasks and conditions, without requiring updates to the model weights. On PutNext, a multi-step coordination task where the RobustCoTAgent achieves 0% success, our framework reaches up to 72.5% success rate using the same underlying LLM with optimized prompts. These results suggest that a multi-agent framework, combined with automatic prompt optimization, enhances LLMs without the need for fine-tuning or extensive human supervision.

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10.
medRxiv (Medicine) 2026-06-15

Active commuting, anxiety symptoms and mental wellbeing: a dose-response study

作者:
Joensuu↗Jussila↗J. J↗Lanki↗Tiittanen↗Pasanen↗T. P↗Ekelund↗Halonen↗J. I↗

Climate change draws attention to the planetary health perspective in sport and exercise sciences, that is, to physical activity that supports both human wellbeing and environmental sustainability. Active commuting is a sustainable form of physical activity with well-established somatic health benefits. However, more knowledge is needed on its relationship with mental health. We examined dose-response associations between active commuting, anxiety symptoms, and mental wellbeing among Finnish adults, and whether green commuting environment moderates these relationships. We used data from the cross-sectional Environment and Health Survey collected in June-September 2023 in the ten largest cities in Finland. Employed participants with data on anxiety symptoms (Generalized Anxiety Disorder-7, GAD-7), mental wellbeing (World Health Organization-Five Well-Being Index, WHO-5), commuting profile over a year (mode, frequency, distance, and perceived greenness along the commute route), and sociodemographic and lifestyle factors were included (n=1,672; mean age 45.3 years; 53.8% women). Active commuting was defined as travelling the entire commute by walking or cycling (including e-biking) that was converted into approximated annual km/week and MET-h/week. We used linear and logistic regression with restricted cubic splines to evaluate dose-response associations, adjusted for key covariates. The role of perceived greenness was tested using an active commuting x commute greenness interaction term. We found no dose-response relationships between active commuting and anxiety symptoms or mental wellbeing in any of the models. No effect modification by commute greenness was observed. More research on how active commuting may support planetary health from a mental health perspective is needed.

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11.
arXiv (CS.LG) 2026-06-15

Recovery thresholds for hidden weighted sparse graphs

作者:
Zhe Hou↗Jingcheng Liu↗

arXiv:2606.14335v1 Announce Type: cross Abstract: Recovering structural information from noisy high-dimensional data is a fundamental task in statistical inference. We investigate the recovery thresholds for a graph hidden in a randomly weighted complete graph. Specifically, an unknown graph $H^* \in H_n$ is chosen uniformly at random, and hidden in a complete graph of $n$ vertices as follows: the weight of an edge $e \in H$ is distributed independently according to $P_n$; otherwise the weight is distributed independently according to $Q_n$. The goal is to recover almost all of $H$ from these edge weights. Assuming a local Lipschitzness of the Rényi divergence between distributions $P_n$ and $Q_n$, and a mild density condition for the graphs $H_n$, we give a unified characterization of the information-theoretic limit for recovering almost all of $H$ (also known as almost exact recovery). Our characterization connects the KL divergence between $P_n$ and $Q_n$ to the logarithm of the first moment threshold of $H$ in the Erdős-Rényi random graph model $G(n,p)$. Our lower bound also extends to the task of partial recovery, in which only a constant $\lambda$-fraction of $H$ needs to be recovered. Last but not least, for certain Bernoulli and Exponential regimes, and for Gaussian distributions, we are able to show an All-or-Nothing (AoN) threshold phenomenon at the exponential scale.

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12.
arXiv (CS.AI) 2026-06-11

Reinforcement Learning Disrupts Gradient-Based Adversarial Optimization

作者:
Xinhai Zou↗Chang Zhao↗Alireza Aghabagherloo↗Dave Singel\'ee↗Robin Degraeve↗Bart Preneel↗

arXiv:2606.12251v1 Announce Type: cross Abstract: Gradient-based adversarial attacks remain a dominant threat to deep neural networks (DNNs), as they exploit gradient information to efficiently optimize adversarial perturbations. To address this, we investigate whether reinforcement learning (RL) training can disrupt the gradient structure used by attackers by training image classifiers with policy-gradient objectives and epsilon-greedy exploration. Through systematic experiments across CIFAR-10, CIFAR-100, and ImageNet-100 with multiple architectures, we find that RL-trained classifiers significantly disrupt gradient-based adversarial optimization. To explain this, we conduct a comprehensive mechanism analysis using loss landscape visualization, static and dynamic gradient indicators, and predictive entropy. Our analysis reveals that RL acts as an implicit regularizer, producing models with highly unstable gradient directions and smaller gradient magnitudes. This combination makes each PGD step both unreliable in direction and limited in magnitude, causing gradient-based attacks to fail within practical iteration budgets. We further show that combining RL with adversarial training (RL-adv) provides a dual-layer defense operating at two complementary levels: RL degrades gradient information available to attackers (gradient-level defense), while adversarial training strengthens decision boundaries (boundary-level defense). RL-adv achieves the highest robustness across all major attack types evaluated, including gradient-based (PGD, AutoAttack), transfer-based, and query-based attacks, outperforming SL-adv by a significant margin. These findings identify RL-induced gradient disruption as a complementary robustness mechanism and motivate future research on hybrid SL-RL training schedules that combine SL's efficiency with RL's gradient-regularization properties.

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13.
arXiv (CS.AI) 2026-06-19

A Deep Generative Model for Resting-State EEG Synthesis and Transferable Representation Learning

作者:
Yeganeh Farahzadi↗Morteza Ansarinia↗Zoltan Kekecs↗

arXiv:2503.02636v5 Announce Type: replace-cross Abstract: Resting-state EEG provides a non-invasive view of spontaneous brain activity, but extracting meaningful patterns is often limited by scarce high-quality data and reliance on manually engineered features. Generative adversarial networks (GANs) can synthesize neural signals and learn transferable representations directly from raw data, a dual capability that remains underexplored in EEG research. Here, we introduce REST-GAN, a GAN-based framework for resting-state EEG that combines adversarial training with an auxiliary self-supervised reconstruction objective to support signal synthesis and unsupervised feature extraction. Although trained only on raw time-domain signals, without explicit frequency-domain or sensor-topographic supervision, the generated time series reproduced key temporal, spectral, and connectivity properties of real EEG. In band-power feature space, generated samples showed high precision and recall across eyes-open and eyes-closed conditions (EO: 0.91/0.67; EC: 0.87/0.65), while group-average spectral coherence matrices showed low mean absolute differences from real data across frequency bands (~0.01-0.03). The representations learned by the model's critic transferred to independent resting-state demographic classification tasks, outperforming models trained directly on raw EEG and showing competitive performance relative to a recent EEG foundation model, while requiring substantially less training data and computational resources. These findings highlight a computationally efficient, architecture-driven strategy in which generative models serve not only as EEG signal generators, but also as unsupervised feature extractors. This approach may support more data-efficient EEG analysis while reducing reliance on manual feature engineering. The implementation code for REST-GAN is available at: https://github.com/Yeganehfrh/REST-GAN.

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14.
arXiv (CS.CV) 2026-06-19

Vision-Reasoning-Guided Occlusion Removal from Light Fields

作者:
Mohamed Youssef↗Oliver Bimber↗

Occlusion-robust scene recovery remains a major challenge in computational imaging, particularly in natural environments where dense foreground vegetation severely limits visibility. We propose a vision-reasoning-guided light field occlusion removal framework that combines the visibility recovery capability of light field integration (LFI) with the semantic reasoning capacity of vision-language models (VLMs). Multi-view observations are first integrated via LFI to suppress foreground occlusions and produce an initial visibility-enhanced representation. A VLM is then incorporated as a conditional semantic prior to restore degraded structures and recover fine details, guided by the observed measurements. To improve recovery consistency and reduce hallucination artifacts, we introduce a multi-sample fusion strategy that aggregates multiple generated hypotheses into a unified estimate. Experimental results on synthetic and real-world datasets demonstrate state-of-the-art performance, achieving the highest average SSIM across four synthetic light field benchmark scenes (4-Syn) and strong generalization across structured and unstructured acquisition settings. These results highlight the effectiveness of combining physical imaging constraints with vision-language reasoning for robust perception under severe occlusion, with applicability to search-and-rescue and exploratory robotic navigation.

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

Universal Manipulation Exoskeleton: Learning Compliant Whole-body Policies with Real-time Torque Feedback

作者:
Litian Liang↗Jingxi Xu↗Xinda Qi↗Yujun Cai↗Houzhu Ding↗Luqi Wang↗Zhixin Sun↗Jyh-Herng Chow↗Ming Yang↗Mark Cutkosky↗

arXiv:2606.14218v1 Announce Type: cross Abstract: For robots to work safely in household environments, they need to be compliant and react to torque and force feedback during contact. However, the majority of existing data collection pipelines still lack the ability to capture force and torque data for learning active compliant policies. In this paper, we present Universal Manipulation Exoskeleton (UME), an upper-limb exoskeleton that provides real-time haptic torque feedback while recording whole-arm configurations and joint torque signals for teleoperation. With transparent torque feedback, human operators can even unsheathe kinematically constrained objects while blindfolded. UME is low-cost, lightweight, and portable. Equipped with an embedded IMU, it enables teleoperation for mobile manipulation. With our proposed universal retargeting algorithm, UME can teleoperate a range of robots, including the 7DoF OpenArm, 7DoF Franka, and 6DoF X-ARM. We demonstrate that this combination of capabilities enables learning bimanual, whole-body, and active compliant policies that operate effectively in highly constrained spaces. The learned robust autonomous policies achieve high success rates across a variety of tasks, including long-horizon mobile manipulation, force-mediated box flipping, visually occluded box pushing, and space-constrained tabletop manipulation. Videos, code, and additional information can be found at https://ume-exo.github.io.

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16.
arXiv (CS.AI) 2026-06-17

Treatment Response Optimized Clinical Decision Support AI System via Digital Twin Simulation

作者:
Xinyu Qin↗Anil K. Sood↗Ruiheng Yu↗Sara Corvigno↗Elaine Stur↗Lu Wang↗

arXiv:2606.17405v1 Announce Type: new Abstract: Clinical decision support AI systems (CDSASs) must adapt to evolving patient conditions in real-time while adhering to strict safety constraints. We present an online adaptive framework that integrates Treatment Effect (TE) estimation to quantify clinical benefits, a patient Digital Twin (DT) to simulate treatment trajectories, and Reinforcement Learning (RL) for sequential decision-making. The AI system is initially trained on historical medical records and operates in a continuous learning loop. To ensure safety, a rule-based module monitors vital signs and blocks contraindicated treatments. Cases with strong internal model disagreement are flagged for clinician review, simulated in our experiments via a pre-trained outcome model. We validate our framework using both a synthetic clinical simulator and a real-world ovarian cancer dataset from The Cancer Genome Atlas (TCGA). In both simulated and clinical settings, our method demonstrated superior effectiveness and stability in recommending treatments compared to standard computational baselines. Furthermore, the AI system maintains low latency and requires expert consultation for only a minority of cases in our experimental validation, demonstrating its potential as a safe, clinician-supervised tool for personalized medicine that continuously improves through practical use.

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

Non-negative Matrix Factorisation with Topological Regularisation

作者:
Matias de Jong van Lier↗Shizuo Kaji↗Keunsu Kim↗

arXiv:2606.17531v1 Announce Type: new Abstract: We investigate the learning of interpretable bases in non-negative matrix factorisation (NMF) by regularising the topology of the learned basis functions. Our approach is motivated by the observation that many data modalities can be viewed as non-negative functions on a structured domain, where the quality of a basis is intrinsically linked to its topology. However, naive methods for incorporating the topology of the support are often hindered by discreteness and threshold dependence, rendering them unsuitable for continuous optimisation. We address these challenges by employing persistent homology as a stable, threshold-free topological quantifier and by designing topological scores that integrate into the NMF objective as regularisers. The resulting framework encompasses spatially coherent image components, periodic time-series structures, and clique-like graph signals within a unified modelling language.

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

Where, What, Why, and Importance: Structured Defect Grounding for Text-to-Image Feedback

作者:
Huaisong Zhang↗Hao Yu↗Yuxuan Zhang↗Jiahe Wang↗Xinrui Chen↗Haoxiang Cao↗Feng Lu↗Wendong Zhang↗Changqian Yu↗Chun Yuan↗

Despite generating increasingly photorealistic images, text-to-image (T2I) models still exhibit localized, subtle, and structurally complex failures. Diagnosing these failures requires instance-level feedback that answers where a defect occurs, what type it is, why it is defective, and its importance to overall image quality. While recent dense-feedback methods move beyond scalar supervision, their heatmap-centric representations still formulate diagnosis as pixel-field regression, making it difficult to localize variable-cardinality defects and bind semantic reasons to individual failures. To address this representation bottleneck, we propose Structured Defect Grounding (SDG), which casts T2I diagnosis as structured set prediction by modeling each defect as a (location, type, reason, importance) tuple. To make this formulation trainable and measurable, we introduce SDG-30K, a 30K-image dataset with box-grounded annotations across four modern T2I generators, together with a dedicated evaluation protocol, SDG-Eval. Building on this structured representation, we further present a diagnosis-to-alignment framework in which a Vision-Language Model (VLM) serves as the SDG detector, and BoxFlow-GRPO converts predicted defect sets into box-derived, importance-weighted spatial rewards for diffusion model alignment. Extensive experiments show that our SDG detector outperforms leading proprietary VLMs on structured defect grounding, while SDG-guided rewards consistently improve T2I alignment and support localized image refinement. These results establish SDG as a unified, instance-level interface for diagnosing, evaluating, and enhancing modern generative models.

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19.
medRxiv (Medicine) 2026-06-17

Clinician knowledge and self-efficacy in snakebite management: A cross-sectional assessment in Northern Uganda

作者:
Kamugisha↗MUSOKE↗Ssewante↗Bongomin↗

Background: Snakebite envenomation (SBE) is a major public health crisis in rural Uganda, yet it remains a neglected tropical disease. Effective management is often compromised by systemic barriers and a lack of clinician training. This study assessed clinician self-efficacy and objective knowledge regarding SBE management in Northern Uganda. Methods: A descriptive, cross-sectional study was conducted between February and July 2025 among 379 healthcare workers in Gulu, Omoro, and Pader districts. A validated questionnaire was used to collect data on socio-demographics, self-reported efficacy (scale 1-10), and objective knowledge. Knowledge scores [&ge;]70% were categorized as adequate. Multivariable logistic regression identified independent predictors of adequate knowledge, and Spearmans correlation ({rho}) assessed the relationship between knowledge and self-efficacy. Results: The participants had a mean age of 35.6 years (SD {+/-}7.3), were predominantly female (56.5%, 214/379), and most (83.6%, 317/379) practiced at Health Centre III level facilities. While 53.8% (204/379) reported prior training, 48.3% (183/379) of these had not received an update in over 10 years. Adequate knowledge was demonstrated by 51.5% (195/379) of participants. In the multivariable analysis, practicing in Omoro (adjusted odds ratio [aOR]: 0.3, 95% CI: 0.1-0.6, p < 0.001) or Pader (aOR: 0.2, 95% CI: 0.1-0.4, p < 0.001) was associated with lower odds of adequate knowledge compared to Gulu district. Prior training significantly increased the odds of adequate knowledge (aOR: 2.3, 95% CI: 1.3-4.2, p = 0.006). A moderate positive correlation was observed between self-efficacy and objective knowledge (Spearmans {rho} = 0.33, p < 0.0001). Conclusion: Approximately half of the frontline healthcare workers in Northern Uganda lack adequate knowledge on SBE management, with significant geographic differences and outdated training. The gap between clinician self-efficacy and objective knowledge poses a risk to patient safety. Regular, mandatory refresher training and targeted educational outreach to remote districts are required to reduce SBE-related morbidity and mortality.

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20.
arXiv (CS.AI) 2026-06-19

AI4SE and SE4AI Exploration: A Decade Looking Back and Forward

作者:
H. Sinan Bank↗Daniel R. Herber↗Thomas Bradley↗

arXiv:2606.19630v1 Announce Type: new Abstract: The March 2020 INCOSE INSIGHT special issue on AI and Systems Engineering (SE) became the most downloaded issue in the publication's history and launched a research community that now draws over 250 registrants to its annual workshop. In this article, we trace the progress in AI and SE across three phases (labeled here foundational, applied, and LLM inflection) based on the authors' reading of the field's core papers, and describe our opinions of where the community has converged and where critical gaps remain. Separately, a human-AI agreement literature review leveraging both human expertise and six AI models was performed to assess the relevance of 1,712 INCOSE INSIGHT articles and 889 SERC publications. The results identify five critical research gaps and offer guidance for practitioners navigating AI adoption, assurance, and workforce transformation in SE. We share the agreement data and the AI4SE/SE4AI Explorer web application so readers can compare their own relevance judgments with the human and AI raters.

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21.
arXiv (CS.CV) 2026-06-18

Bridging Single Distortion Artifacts and Mmultifactorial Clinical Quality: Few-shot Biparametric MRI Quality Assessment via Distortion-trained Prototypical Networks

作者:
Yuheng Tang↗Alexander Ng↗Wen Yan↗Natasha Thorley↗Pawel Rajwa↗Yipei Wang↗Aqua Asif↗Clare Allen↗Louise Dickinson↗Francesco Giganti↗Shonit Punwani↗Daniel Alexander↗…

Clinical prostate multi-parametric MRI relies heavily on high-quality diffusion-weighted imaging (DWI), yet reading DWI is frequently compromised by geometric distortion, often caused by rectal air. Assessing quality via the PI-QUAL scoring system is an emerging clinical standard, but it is subjective, time-consuming and suffers from a class imbalance where low-quality cases are diverse and relatively scarce. Using the PRIME clinical trial as an example, there are $6\%$ images with PI-QUAL scores lower than 4, $87\%$ of DWI issues are due to distortion. Many of the other clinical quality issues are under-represented. To address this common dual-scarcity of annotated clinical data, we propose a few-shot biparametric prototypical network for automated image quality assessment (IQA). Our framework utilizes a dual-branch 3D ResNet to fuse T2-weighted and DWI features, providing anatomical context to distinguish true morphology from distortion. To handle real-world heterogeneity, we introduce feature-wise linear modulation (FiLM) and a gradient reversal layer (GRL) to align feature distributions conditioned on varying b-values while suppressing acquisition-related biases. We demonstrate that a model meta-trained solely on comparatively objective, readily obtainable distortion labels can effectively adapt to predicting complex, multi-factorial clinical quality scores such as PI-QUAL using only five representative samples. Experimental results on two datasets show that our method significantly outperforms few-shot learning baselines for this challenging IQA task, offering a practically feasible and data-efficient solution for standardizing prostate MRI quality control in clinical workflows.

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22.
medRxiv (Medicine) 2026-06-22

Development and validation of a risk prediction algorithm to estimate all-cause mortality among community-dwelling Canadians: the Mortality Population Risk Tool (MPoRT)

作者:
Manuel↗Bader Eddeen↗Fines↗Bennett↗Fisher↗Jessri↗Perez↗Tuna↗Sanmartin↗Sequeira↗Li↗Rosella↗…

BACKGROUND: The risk of all-cause mortality can inform decision-making for chronic disease prevention. We developed a predictive algorithm to estimate the 5-year risk of death among community-dwelling adults. METHODS: We derived and validated the Mortality Population Risk Tool (MPoRT) using data from population health surveys in Canada (the Canadian Community Health Survey) and the United States (the National Health Interview Survey), survey years 2001 to 2011, linked to vital statistics. The outcome was death within five years of the survey response. The algorithm was developed using data from Ontario respondents using a Cox proportional hazards model, then modified and re-estimated to allow cross-national assessment in Canada and the United States. Twenty-three prespecified predictors were assessed: seven sociodemographic, six behavioural, and ten general health and chronic disease. RESULTS: 527,369 respondents aged 20 to 105 years were included in the Canadian and United States development and validation cohorts, with 43,758 deaths during 3.68 million person-years follow-up. The final sex-specific MPoRT algorithms each contained 21 variables, showing strong discrimination (C-statistic: females 0.874 [0.871–0.877]; males 0.867 [0.865–0.871]) and good calibration overall and in 246 of 247 subgroups. Discrimination was modestly attenuated (0.01 decrease in C-statistic) in cross-national validation between Canada and the United States, with good calibration across all 71 subgroups. INTERPRETATION: MPoRT accurately discriminated all-cause mortality using only self-reported data, enabling broad application without clinical measures. While validation outside North America is needed to confirm broader applicability, MPoRT is designed for straightforward recalibration using routinely available national mortality data. This supports targeted chronic disease prevention strategies at both the population and individual levels, though the limitations inherent to self-reported predictors should be considered when interpreting predictions.

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

Comparing Linear Probes with Mahalanobis Cosine Similarity

作者:
Zhuofan Josh Ying↗Peter Hase↗Nikolaus Kriegeskorte↗

arXiv:2606.19603v1 Announce Type: new Abstract: Linear probes are widely used in interpretability research and often compared by cosine similarity. The Mahalanobis cosine similarity (MCS) between two directions, which reweights the inner product by test data covariance, is a natural task-aware refinement. Ying et al. (2026) report that a probe's MCS to a reference probe trained on the out-of-distribution (OOD) data near-perfectly linearly predicts the probe's OOD AUROC (R^2 = 0.98). Here, we extend this empirical finding across models, layers, and concept domains, and prove this general phenomenon in closed form: For balanced classes whose projections are Gaussian, OOD AUROC and MCS to the reference probe are linear because both are sigmoid-shaped functions of the probe's signal-to-noise ratio (SNR) on the test data. The theory also predicts when this linearity fails, which we verify empirically. MCS offers a theoretically grounded and empirically effective alternative to Euclidean cosine similarity for comparing linear probes.

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

Sobolev Approximation by Fixed-Size Neural Networks with Arbitrary Accuracy

作者:
Baicheng Li↗Haizhao Yang↗Shijun Zhang↗

arXiv:2606.16975v1 Announce Type: cross Abstract: In this work, we investigate new activation functions for achieving arbitrary-accuracy Sobolev approximation by fixed-size neural networks. We first show that any function in $W^{2,\infty}((a,b)^d)$ can be approximated with arbitrary accuracy, measured in the $W^{1,\infty}$-norm, by a fixed-size neural network using the Elementary Universal Activation Function ($\mathrm{EUAF}$). To extend this result to $W^{s,\infty}((a,b)^d)$ for $s\in\mathbb{N}$, we introduce a smooth activation $\mathrm{DUAF}_{\infty}$ from the family of Differentiable Universal Activation Functions ($\mathrm{DUAF}_n$). We prove that any function in $W^{s,\infty}((a,b)^d)$ can be approximated with arbitrary accuracy in the $W^{s-1,\infty}$-norm by a fixed-size $\mathrm{DUAF}_{\infty}$-activated network. We further construct sigmoidal variants $\widetilde{\mathrm{DUAF}}_n$ and show that, for every $1\leq s\leq n$, fixed-size $\widetilde{\mathrm{DUAF}}_n$-activated networks still approximate any $f\in W^{s,\infty}((a,b)^d)$ with arbitrary accuracy in the $W^{s-1,\infty}$-norm. In all these results, the width and depth bounds are computed explicitly, and the proposed activations are elementary.

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25.
arXiv (CS.AI) 2026-06-15

DIFF-ERO: A Conformance-Aware Loss for Deep Learning in Process Mining

作者:
Johannes De Smedt↗Jari Peeperkorn↗Artem Polyvyanyy↗Jochen De Weerdt↗

arXiv:2606.14283v1 Announce Type: cross Abstract: Deep learning has driven many recent advances in process analytics, especially for predictive and prescriptive monitoring. However, standard objectives such as cross-entropy optimize local next-step likelihoods and only implicitly capture control-flow structure. As a result, models can achieve high token-level accuracy while permitting imprecise global behaviour. We introduce DIFF-ERO, a conformance-aware loss function for deep learning models on process data. DIFF-ERO is a differentiable formulation of entropy-based stochastic conformance that incorporates control-flow information during training. Our approach constructs batch-level stochastic transition matrices with soft edge memberships, allowing structural precision and recall signals to directly inform backpropagation. The loss is model-agnostic and can be applied whenever the final representation parametrizes stochastic transitions. We instantiate DIFF-ERO in transformer encoder-decoder pipelines for next-activity prediction and use it jointly with cross-entropy to analyse its theoretical components with respect to convergence. Across benchmarks comparing other loss functions and targets, DIFF-ERO shows improved predictive performance where structure matters most while maintaining parity elsewhere. At the same time, the learned stochastic automaton converges towards the structural ground truth, indicating that the network internalizes process model structure.

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