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01.
arXiv (quant-ph) 2026-06-17

Microwave-free vector magnetometry and crystal orientation determination with Nitrogen-Vacancy centers using Bayesian inference

arXiv:2512.13835v2 Announce Type: replace Abstract: Nitrogen-vacancy (NV) centers in diamond provide a solid-state platform for quantum sensing. While optically detected magnetic resonance techniques offer high sensitivity, their reliance on microwaves introduces heating and stray electromagnetic fields that can perturb nearby samples. Optical approaches based on cross-relaxation between differently oriented NV centers remove this constraint but have so far required stringent alignment of the external field with crystallographic axes, restricting their practicality. Here we introduce a general framework for microwave-free vector magnetometry at near-zero field that leverages Bayesian inference to extract both the magnetic field vector and the NV orientation directly from photoluminescence maps. An analytical model of cross-relaxation resonances enables efficient inference under arbitrary field and orientation configurations, while naturally incorporating the discrete degeneracies of the NV symmetry. We experimentally demonstrate robust orientation determination and vector-field reconstruction, establishing a general route toward compact and alignment-free NV magnetometers for practical sensing applications.

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

Pulling The REINS: Training-Free Safety Alignment of Video Diffusion Models via Representation Steering

Open-weight video diffusion models can generate photorealistic unsafe content, from violence to misinformation, yet existing defenses either require expensive safety fine-tuning that degrades general capability, or apply external filters that are trivially bypassed by adversarial prompts. We present REINS (REpresentation-space INference-time Safety steering), a training-free method that aligns video diffusion models at inference time by steering their internal representations toward safe generation. Our key finding is that safety-relevant structure is linearly encoded in the hidden-state activations of video diffusion transformers, and a single direction, discovered via Supervised PCA on binary safety labels, suffices to separate safe from unsafe generation trajectories. At inference, adding this direction to hidden states at an intermediate transformer layer redirects generation from harmful content to semantically related safe alternatives, with no weight updates, no concept enumeration, and negligible computational overhead. Through mechanistic analysis, we reveal that while safety information accumulates monotonically with transformer depth, steering effectiveness peaks at intermediate layers (~50% depth), exposing a fundamental tradeoff between information availability and downstream propagation capacity. We evaluate REINS across 9 video diffusion models, multiple parameter scales (1.3B-5B), and both text-to-video and image-to-video generation, to our knowledge, the broadest safety evaluation suite in the video generation literature.

03.
arXiv (CS.LG) 2026-06-18

The Road to Artificial SuperIntelligence: A Comprehensive Survey of Superalignment

arXiv:2412.16468v4 Announce Type: replace Abstract: The emergence of large language models (LLMs) has sparked discussion on Artificial Superintelligence (ASI), a hypothetical AI system that surpasses human intelligence. Although ASI remains hypothetical and far beyond current AI capabilities, discussing its potential and exploring its feasibility and potential risks is critical for the development of future AI systems. The idea of superalignment originates from scalable oversight, which studies how to supervise increasingly capable AI systems when direct human supervision becomes insufficient. In this paper, we focus on the superalignment problem: "The process of supervising, controlling, and governing artificial superintelligence." We first review scalable oversight paradigms-Sandwiching, Self-Enhancement, and Weak-to-Strong Generalization – then analyze the limitations of current paradigms through the lens of possibility and impossibility, discuss key challenges, and propose pathways for the safe and continual improvement of future AI systems.

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

SalArt-VQA: Diagnosing Whether VLMs Understand Salient Artifacts in Generated Images

Vision-language models (VLMs) are increasingly used to detect whether AI-generated images contain visible artifacts, yet their ability to analyze such artifacts remains poorly understood. A correct image-level decision can still hide important failures: a model may correctly flag an artifact while relying on the wrong visual cue, selecting the wrong region, or describing a defect that the image does not support. To evaluate these behaviors directly, we introduce SalArt-VQA, a diagnostic benchmark for fine-grained SALient ARTifact understanding in AI-generated images. SalArt-VQA contains 950 images and 3,681 human-authored multiple-choice questions spanning artifact images, matched real reference images, and paired generated reference images. Four aligned question types evaluate presence detection, semantic localization, spatial grounding, and evidence-grounded defect identification, while the reference splits test calibration and abstention when the annotated defect is absent. Across 20 VLMs, SalArt-VQA reveals failures that image-level detection accuracy hides: the strongest model reaches 99.37% detection recall on artifact images but answers all four artifact-side questions correctly on only 53.26% of images. Comparing artifact images with artifact-free references reveals a sensitivity-calibration tradeoff: sensitive models often make unsupported artifact claims, while conservative models avoid false alarms largely by missing real artifacts. These results show that high artifact detection accuracy alone does not imply grounded artifact understanding. SalArt-VQA exposes these hidden failure modes and provides a fine-grained evaluation of whether VLM artifact claims are supported by local visual evidence.

05.
medRxiv (Medicine) 2026-06-18

Development and Initial Validation of the Quality of life Evaluation in NF2-related Schwannomatosis Trials (QUEST) Assessment

Individuals with NF2-related schwannomatosis (NF2-SWN) experience a complex constellation of physical, emotional, and social symptoms that substantially impact quality of life (QoL). Although disease-specific patient-reported outcome measures are increasingly important for evaluating treatment benefit in clinical trials, existing NF2-SWN QoL measures have limitations in content coverage and sensitivity to change. This study describes the development and initial validation a new disease-specific QoL assessment – the Quality of Life Evaluation in NF2-related Schwannomatosis Trials (QUEST). Using a three-phase, mixed-methods approach, items were generated through concept elicitation interviews with individuals with NF2-SWN and clinicians, prioritized via patient survey data, and refined through iterative cognitive debriefing procedures. The resulting 21-item QUEST assesses the extent to which NF2-SWN has negatively impacted a persons daily life over the past seven days. Initial psychometric evaluation was conducted in an international sample of 174 individuals with NF2-SWN aged 15 years and older (117 women (67%), 158 White individuals (89%)). Exploratory factor analysis supported a four-factor structure, and the total score demonstrated excellent internal consistency and strong test-retest reliability. Evidence of construct validity was demonstrated through hypothesized associations with disease-specific, generic, and domain-specific QoL measures, as well as known-groups validity based on self-reported disease severity and number of prior surgeries. Incremental validity analyses indicated that QUEST explained unique variance beyond existing measures. Together, findings support the QUEST as a reliable and valid disease-specific QoL measure with strong content validity and feasibility for use as a clinical trial endpoint in NF2-SWN.

06.
arXiv (quant-ph) 2026-06-24

The $\omega$-Effect from a Multimode Squeezed Graviton State

arXiv:2606.24613v1 Announce Type: cross Abstract: The $\omega$-effect in entangled neutral-meson systems provides a sensitive probe of CPT violation induced by quantum-gravitational environments. In open quantum systems, interactions with inaccessible gravitational degrees of freedom can render the reduced meson dynamics non-unitary, causing the CPT operator to become ill-defined, even when the underlying microscopic Hamiltonian is CPT invariant. We present a microscopic derivation of the $\omega$-effect arising from a multimode squeezed gravitational environment generated by an axion cloud around a Kerr black hole. Using the Takagi decomposition of the associated complex symmetric squeezing kernel, the graviton field is expressed in terms of independent squeezed supermodes possessing anomalous correlators. These correlators provide a microscopic quantum counterpart of the stochastic fluctuations that appear in earlier D-particle foam descriptions of the $\omega$-effect, replacing phenomenological variances of flavour-changing D-particle recoil by calculable graviton correlation functions. After tracing over the graviton bath, the anomalous correlators and the weak-interactions-induced mixing combine to generate transitions between the antisymmetric and symmetric two-meson sectors. This results in a small exchange-symmetric admixture, parametrised by $\omega$, in the otherwise antisymmetric EPR state. We obtain an explicit expression for $\omega$ in terms of a sum over Takagi supermodes weighted by their squeezing amplitudes and phases together with the weak-interaction flavour-mixing matrix element. The resulting framework suggests that the $\omega$-effect may be a generic signature of non-classical states of gravitational environments, extending beyond the specific axion-cloud scenario considered here. The observability of the $\omega$-effect from other astrophysical and microscopic black-hole sources is discussed.

07.
arXiv (CS.CV) 2026-06-17

Edit3DGS: Unified Framework for Dynamic Head Editing via 2D Instruction-Guided Diffusion and 3D Gaussian Splatting

We present Edit3DGS, a unified framework for dynamic 3D head editing that integrates 2D instruction-guided diffusion with 3D Gaussian splatting. Unlike prior approaches that separately address frame-based edits or static 3D reconstruction, our method couples semantic controllability in the image domain with photorealistic, temporally consistent 3D representations. Given an input video, editable facial regions are masked and modified using a text-conditioned diffusion model to support fine-grained operations such as expression transformation, attribute modification, and appearance refinement. The edited frames are then aggregated through 3D Gaussian splatting to produce a coherent, high-fidelity avatar that preserves both identity and motion dynamics. To enforce consistency, Edit3DGS incorporates multi-view batch editing and lightweight inpainting strategies that recover lost expressions across timesteps. Experimental results demonstrate that our framework enables controllable, artifact-free head editing with smooth temporal transitions, offering practical applications in virtual avatars, immersive communication, film production, and interactive media.

08.
arXiv (CS.CV) 2026-06-16

The Vision Encoder as a Privacy Boundary: Visual-Token Side Channels in Encoder-Free Vision-Language Models

A vision encoder compresses image pixels into semantic embeddings, implicitly acting as a privacy boundary by preserving semantic content while attenuating pixel-local detail required for exact text recovery. Encoder-free vision-language models (VLMs) remove this boundary by routing image patches directly into the language-model token stream, thereby exposing an architectural privacy attack surface: intermediate visual tokens become a pre-output side channel. Under a token-access adversary, decoders invert visual-token streams from two encoder-free VLMs, Gemma4 and Fuyu, recovering recognizable image structure and readable held-out access codes, whereas matched encoder-based controls localize target regions but recover no exact strings. Within-model ablations show that the operative factor is spatial sampling fidelity of the visual-token grid, especially character-direction sampling density, rather than token or value count. The leakage is not limited to exported tokens: Gemma4 layer-0 key-value cache tensors are directly invertible, placing the side channel within KV caches commonly persisted by production serving stacks for decoding efficiency. The attack survives clutter, realistic document degradation, and zero-shot transfer to public document images, and it resists value-level defenses such as additive noise and quantization. Effective mitigation must therefore reduce spatial sampling, making removal of the vision encoder a first-class privacy decision in VLM deployment.

09.
arXiv (CS.CV) 2026-06-11

What Semantics Survive the Connector? Diagnosing VLM-to-DiT Alignment in Video Editing

Flow matching based video generative models have been increasingly relying on prepended Vision-Language Models (VLMs) to handle complex, instruction-based video editing. The prevailing assumption underlying this paradigm is that a connector module can seamlessly align the VLM's rich multi-modal reasoning with the original text embedding space of DiTs. However, we hypothesize that this alignment acts as a severe semantic bottleneck, degrading fine-grained structural variables. Verifying this is challenging, as end-to-end evaluations conflate alignment failures with generation errors, and natural datasets lack disentangled annotations. To rigorously investigate this, we propose a controlled data processing pipeline based on video composition that results in TRACE-Edit, a diagnostic dataset focusing on relation-based editing. Leveraging this dataset, we propose a comprehensive diagnostic protocol to analyze two important designs of meta-query and connector in the existing video editing models. Systematic evaluation of four representative model cases reveals that fine-grained structural semantics can be severely degraded during alignment. Our findings overturn the assumption of lossless semantic transfer, identifying the VLM-to-DiT alignment as a major bottleneck and providing a new diagnostic foundation for future multi-modal alignment architectures.

10.
arXiv (CS.CL) 2026-06-15

Efficiency-Performance Trade-offs in Neural Speaker Diarization via Structured Pruning and Low-Bit Quantization

Streaming speaker diarization is crucial for time-critical medical dispatch, but deploying it on resource-constrained hardware requires smaller, faster models. Using SIMSAMU, a dataset of simulated medical-dispatch conversations, we evaluate streaming behavior before compressing the segmentation model with pruning and low-bit quantization. We characterize performance across a range of streaming latency budgets and find that additional buffering is not consistently beneficial, while very low-latency operating points can substantially degrade performance. Our study shows that model compression trades performance for memory footprint, and we highlight an operating point where FP16 reduces model size by half with essentially unchanged real-time factor, at a cost of a 40\% relative DER increase against the baseline. This work characterizes the trade-offs for real-time deployment and contributes to speech technology that can enable reliable human communication in time-critical contexts.

11.
arXiv (CS.AI) 2026-06-16

Agentic Framework for Deep Learning workload migration via In-Context Learning

arXiv:2606.15994v1 Announce Type: new Abstract: Translating deep learning models from PyTorch's flexible, object-oriented design to JAX's functional, stateless setup is usually a manual and error-prone task. Automated migration is challenging because Large Language Models (LLMs) struggle with strict and dynamic API alignment and are prone to mistakes for exacting operations. We propose a fully autonomous system that combines In-Context Learning (ICL) with oracle-driven self-debugging. First, we curated an ICL context that serves as a strict reference for idiomatic JAX styling and test case generation. Second, instead of depending on the LLM to deduce mathematical outputs, we run the source PyTorch modules to get their actual dynamic tensor states. This creates an unchangeable execution oracle. We then use an autonomous agentic loop to synthesize tests based on the oracle data. The test cases are executed repeatedly, and the traceback is sent back to the LLM for self-correction. Ablations show that combining ICL references with oracle grounding and self-debugging greatly outperforms pure instructional and basic agentic baselines. This improvement does not add an excessive computational overhead. Our lightweight pipeline achieves 91% numerical equivalence (compared to baseline: 9%, instruction + self-debugging: 27%) on neural modules, providing a highly reliable, scalable blueprint for cross-framework migration. This has been validated across several state-of-the-art models including SAM (segment anything), T5, Code Whisper amongst others showing high numerical equivalency. Code: https://github.com/AI-Hypercomputer/accelerator-agents/tree/main/MaxCode

12.
arXiv (quant-ph) 2026-06-19

Exact Markovian Dissipation Requires Singular Energy Resources

arXiv:2606.19510v1 Announce Type: new Abstract: The Gorini–Kossakowski–Lindblad–Sudarshan (GKLS) equation describes irreversible quantum dynamical semigroups. We show that this description cannot be exact under physically regular energy conditions. We prove that the open-system survival probability under physically regular energy conditions has sublinear decay, whereas any dissipative GKLS semigroup has a linear short-time decay. Hence exact Markovian dissipation requires singular energy resources: an unbounded-below total Hamiltonian or infinite initial energy, and a divergent interaction-energy moment. Therefore, a dissipative time-independent GKLS equation should be regarded as an effective description rather than the exact reduced dynamics of a Hamiltonian dilation satisfying physically regular energy conditions.

13.
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.

14.
arXiv (quant-ph) 2026-06-16

Interaction-enabled topological pumping of Rydberg electrons

arXiv:2606.15126v1 Announce Type: cross Abstract: Topological pumping is a paradigmatic realization of quantized transport in band systems, yet its fate in strongly correlated regimes, especially with long-range interactions, remains largely unexplored. Here we report the experimental observation of interaction-enabled topological pumping of correlated Rydberg electrons in a synthetic lattice. We show that dipolar exchange interactions induce a controllable shift of the underlying topological singularity in parameter space, such that a fixed pumping trajectory can be driven through successive topological transitions by tuning the interaction strength alone. This leads to the emergence and breakdown of quantized transport. The observations are consistent with an effective Rice-Mele description with interaction-renormalized onsite potentials and are supported by characterizing the adiabaticity and robustness to control trajectory imperfections. Our results establish a platform for exploring interaction-controlled topological transport beyond perturbative regimes and open a route toward engineering correlated topological matter in synthetic quantum systems.

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

DeXposure-Claw: An Agentic System for DeFi Risk Supervision

Decentralized finance exposes supervisors to fast-moving, networked credit risks. General-purpose LLM agents fit this setting poorly: they over-read weak evidence and recommend high-stakes interventions, while existing evaluations offer no regulator-aligned way to measure the resulting false alarms. We introduce DeXposure-Claw, a forecast-grounded agentic supervision system that routes LLM decisions through structured evidence: (1) DeXposure-FM, a graph time-series foundation model, forecasts future exposure networks; (2) deterministic monitors and stress scenarios then turn those forecasts into typed alerts, attribution signals, and scenario evidence; and (3) data-health and confidence gates constrain escalation before DeXposure-Claw emits auditable supervisory tickets with rationales. We further develop DeXposure-Bench, a six-axis evaluation harness, whose decision axis scores tickets against a regulator-aligned absolute-loss ground truth and an explicit false-intervention rate. Experiments on five years of weekly real data fully support our system. Code is at https://github.com/EVIEHub/DeXposure-Claw.

16.
medRxiv (Medicine) 2026-06-18

Automated Airways Characterization and Assessment of Cystic Fibrosis from CT Imaging

Background Advancements in medical imaging have enabled non-invasive diagnosis and staging of cystic fibrosis (CF) using CT scans, revealing dilated airways, an increased number of visible airways, and airway generation splits in these patients. However, manual characterization of airways remains time-consuming and challenging due to the numerous structural changes, thereby limiting clinical feasibility. This study aims to develop an automated algorithm to characterize airways from segmented lung CT scans and apply this to a retrospective population. This approach reduces the time required to analyze images and obtain disease-staging results. Methods This framework consists of two stages. The first stage extracts and skeletonizes the airway tree from lung CTs, while the second stage measures lung features, including airway volumes, branch counts, generation splits, diameters, and cross-sectional areas. This permits comprehensive characterization for use in clinical assessment. Results The airways analysis was performed on 169 CT volumes ranging in age from 6 to 18 years of age, revealing substantial differences in detected airway branches, generation splits, and normalized airway volume between the control and CF groups. The framework also measures airway diameters and cross-sectional areas, revealing an increase in the number of small airways in cystic fibrosis patients, due to early bronchiectasis. These findings align with previous research and demonstrate the framework's ability to accurately quantify airway changes in patients with CF. Discussion The framework extracts entire airway trees, facilitating measurements of volume, branch count, diameters, and cross-sectional areas, which change with CF severity and/or treatment. However, partial lung atelectasis can limit the accuracy of airway detection in moderate-to-severe cases. Funding NIA U54 AG054345 and NIA R21 AG07857501

17.
medRxiv (Medicine) 2026-06-10

General-purpose large language models can achieve physician-level accuracy in complex medical data extraction

Background: Unstructured data represent about 80% of total electronic health records (EHR) data. Structuring this free text is essential for advancing clinical research, including cohort selection for trials, retrospective studies, and the development of disease registries. While manual chart review (MCR) remains the gold standard for extracting this clinical data, the process is inherently slow, resource-intensive, and susceptible to errors from human fatigue. We evaluated the extraction accuracy, safety, and efficiency of the HeLIX (Hepatology Logic-Integrated Extraction) framework, a Large Language Model (LLM) protocol using Google Gemini 3 Pro, compared to a gold-standard Manual Chart Review (MCR). Methods: A prospective validation study was conducted using 50 high-complexity, simulated hepatology discharge summaries designed to replicate the real-world heterogeneity of EHRs. The HeLIX framework employed a Zero-Shot, Structured Chain-of-Thought (CoT) prompting strategy enforced by a three-layer architecture: Clinical Reasoning Trace, Schema Enforcement, and Evidence Verification. The model extracted 45 distinct clinical variables. Performance was benchmarked against a consensus MCR. Results: Across 2,250 evaluated data points, the model achieved an overall Extraction Accuracy of 99.24% (95% CI: 98.8%-99.5%), with perfect concordance in 35/45 (77.8%) variables. For binary diagnostic variables, the model demonstrated an overall F1-score of 0.98, Recall of 0.99 and substantial inter-rater reliability (Cohens {kappa} = 0.97). Hallucinations were exceptionally rare (2/2250; 0.08%). Critical errors affecting clinical management occurred in only 2 instances (

18.
arXiv (CS.AI) 2026-06-15

Thinking Outside the [Chat]Box: Bridging Computer Science and Industrial Design for Cognitive-Inclusive Generative AI

arXiv:2606.14306v1 Announce Type: cross Abstract: Current Generative AI (GenAI) interfaces remain largely constrained to chatbox interaction, which can impose high cognitive demands on users and create substantial barriers for people with intellectual disabilities (ID), including prompt formulation difficulties, response overload, and limited mechanisms to assess information reliability. To explore alternative interaction models for cognitive accessibility, we conducted a cross-disciplinary co-design challenge in which two student cohorts (Computer Science and Industrial Design) developed interface concepts from the same set of functional requirements (e.g., prompt scaffolding, structured output, GUI-based refinement, transparency, and personalization). Comparing the resulting proposals reveals both convergence on foundational requirements (notably initial calibration, proactive prompting, and direct manipulation of response fragments) and complementary contributions that outline a multi-layered support system. Computer Science teams primarily produced structural scaffolding, emphasizing predictability, navigability, and trust through mechanisms such as reliability indicators, explicit sources, and context management for long conversations. Industrial Design teams emphasized experiential scaffolding, focusing on pacing, attention guidance, multimodality, and proactive agency, including step-by-step response flows, focus modes, and assistant-like integrations. We synthesize these findings into a dual-layer scaffolding framework that expands the design space for cognitively accessible GenAI interaction beyond chat-centric models and motivates future work on expert refinement, technical feasibility, and empirical validation with users with ID.

19.
arXiv (CS.CV) 2026-06-18

How far have we gone in Generative Image Restoration? A study on its capability, limitations and evaluation practices

Generative Image Restoration (GIR) has achieved impressive perceptual realism, but how far have its practical capabilities truly advanced compared with previous methods? To answer this, we present a large-scale study grounded in a new multi-dimensional evaluation pipeline that assesses models on detail, sharpness, semantic correctness, and overall quality. Our analysis covers diverse architectures, including diffusion-based, GAN-based, PSNR-oriented, and general-purpose generation models, revealing critical performance disparities. Furthermore, our analysis uncovers a key evolution in failure modes that signifies a paradigm shift for the perception-oriented low-level vision field. The central challenge is evolving from the previous problem of detail scarcity (under-generation) to the new frontier of detail quality and semantic control (preventing over-generation). We also leverage our benchmark to train a new IQA model that better aligns with human perceptual judgments. Ultimately, this work provides a systematic study of modern generative image restoration models, offering crucial insights that redefine our understanding of their true state and chart a course for future development.

20.
arXiv (CS.AI) 2026-06-16

Driving, Fast or Slow? Neuro-Symbolic Guidance for Motion Prediction in Multi-Modal Ground Mobility

arXiv:2606.15251v1 Announce Type: cross Abstract: Accurate and interpretable motion prediction for heterogeneous traffic spaces, including pedestrians, bicycles, cars, and trucks, is essential for safe autonomous navigation. Nevertheless, state-of-the-art approaches remain predominantly black-box, lacking explicit encoding of the regulatory and behavioral constraints of real-world mobility. We propose Trajectory Compliance-Shaping (TraCS), a neuro-symbolic framework that augments existing black-box motion prediction backbones with interpretable and probabilistic first-order logic. To do so, TraCS employs an agentic code-generation pipeline to bridge the gap between natural-language descriptions of traffic regulations and probabilistic motion prediction. Furthermore, TraCS employs a reactive data-streaming inference engine that maintains and efficiently updates compliance landscapes as scenes evolve. To prevent TraCS from overconfidently steering the backbone's predictions in the wrong direction, we propose a neural confidence rating learned as a context-aware attenuation of the compliance signal. We demonstrate on the Argoverse 2 benchmark how TraCS consistently improves state-of-the-art prediction backbones, showing that probabilistic and symbolic compliance reasoning is a broadly applicable and computationally efficient complement to purely neural motion predictors.

21.
medRxiv (Medicine) 2026-06-22

Generative Artificial Intelligence in Psychotherapy Practice: A Global Online Survey of Mental Health Professionals' Adoption

Background: Generative artificial intelligence (GenAI) tools, including large language model (LLM)-based platforms such as ChatGPT, Google Gemini, and Microsoft Copilot, are being adopted across healthcare settings with increasing speed. Despite the increasing popularity of GenAI, empirical data on the extent and nature of adoption by mental health clinicians in routine psychotherapy practice globally remain scarce. Objective: This study aimed to characterize current use patterns of GenAI tools among a global sample of practicing mental health professionals, including prevalence of use, specific tools employed, clinical and administrative purposes served, perceived effect on workload, and the institutional context shaping adoption (e.g., encouragement, prohibition, and training). Methods: We administered a cross-sectional online survey to a global convenience sample of licensed mental health professionals who provide psychotherapy as part of the scope of their practice (i.e., psychotherapists, psychologists, counsellors, nurses, and psychiatrists). Participants were recruited via professional networks, purposely avoiding the use of social media platforms. Within the survey, we captured GenAI use behaviors in psychotherapy contexts, and demographic and professional background data. Descriptive statistics were analyzed for all variables. Multivariate logistic regression was used to examine demographic and professional predictors of GenAI use. Results: A total of 766 mental health professionals who provide psychotherapy from 30 countries completed the survey. Of these, 54.6% (n=418) reported having purposely used at least one GenAI tool in psychotherapy clinical practice. ChatGPT was the most frequently used tool (354/418, 84.7%). The most commonly reported clinical purpose was assisting with treatment planning (175/418, 41.9%), followed by managing administrative tasks (173/418, 41.4%) and generating psychoeducational materials for clients (166/418, 39.7%). 82.8% of AI users reported that these tools reduced their overall work burden. Only 18.1% (139/766) of respondents reported institutional encouragement to use AI tools, while 81.1% (621/766) reported not having received any professional training on AI use. Predictors of AI adoption included younger age and rural practice setting. Conclusions: In this global convenience sample survey, GenAI use among mental health professionals in psychotherapy settings is widespread, concentrated in a wide variety of clinical and administrative tasks. Formal training and institutional guidance substantially lag behind current adoption patterns. These findings highlight an urgent need for evidence-based competency frameworks, regulatory clarity, and professional education to support safe and ethically informed integration of AI into clinical mental health practice.

22.
PLOS Medicine 2026-06-23

Comparisons of core component delivery in cardiac rehabilitation programs by country income classification and decade based on the 2025 Global Audit Update: A survey study

by Gabriela Lima de Melo Ghisi, Rachael P. Carson, Karam Turk Adawi, Rongjing Ding, Warner M. Mampuya, Mariya P. Jiandani, Jimena Martinez, Monserrat Cruz Rivero, Claudia V. Anchique, Dinah L. van Schalkwijk, Jonathan Gallagher, Buket Akinci, Dion Candelaria, Jirapa Champaiboon, Daniel F. Quesada-Chaves, Tone M. Norekvål, Iwona Szadkowska, Borut Jug, Evangelia Kouidi, Marta Supervia, Won-Seok Kim, Chamila Mettananda, Lilian Mbau, Gulsim T. Aimakova, Sherry L. Grace, on behalf of the ICCPR Global Cardiac Rehabilitation Audit Update Investigators Background Cardiovascular disease (CVD) remains a leading global health burden. Cardiac rehabilitation (CR) is essential to reducing morbidity and improving patient outcomes. Since the COVID-19 pandemic, CR delivery worldwide has evolved, yet these changes have not been systematically charactemkjrized. The objective of this study was to characterize globally: (1) the delivery of core CR components, including risk factors assessed, patient education practices, and program resources; (2) differences in these elements by country income classification and relative to the initial 2016 Global CR Audit. Methods and findings A cross-sectional Audit update was conducted. Program-level data were collected from May 1st to September 1st 2025 using a REDCap survey adapted from previous Audits. Eligible respondents were leads of phase II/post-discharge CR programs providing at least an initial assessment, structured aerobic exercise, and ≥1 additional core component. ICCPR associations and local leaders supported program identification. Main outcomes were core components delivered (10 assessed), risk factors assessed (14 assessed), patient education dose (hours/patient/program), and program resources (17 assessed). Generalized linear mixed models (GLMM) tested differences by income classification and (when applicable) changes since 2016. Of 7,025 programs identified globally, 1,505 (62% median country response rate) initiated a survey from 90/113 (80%) countries with CR. The median number of core components offered was 8/program (p25, p75 = 6, 10), with upper-middle income countries offering significantly more components overall (median = 9), and also high-income countries offering more than low-income countries (8 versus 6, p 

23.
arXiv (CS.CL) 2026-06-11

Self-Attention as Transport: Limits of Symmetric Spectral Diagnostics

When a language model processes a hallucinated response, its attention routing tends to fail in one of two shapes: over-concentrating on a narrow set of positions, or spreading so diffusely that relevance is diluted, and the shape of the failure carries diagnostic signal. We study these shapes as a diagnostic characterization, computed from attention matrices under forced scoring of benchmark-labeled responses rather than during live generation. A widely used family of spectral methods analyzes the symmetric component of the degree-normalized attention operator, which governs transport capacity; we prove that every transpose-invariant spectral diagnostic of this operator is structurally orientation-blind (it cannot distinguish an operator from its transpose, and therefore cannot detect information-flow direction), with a converse to the blindness theorem bounding any Lipschitz diagnostic's transpose sensitivity by the asymmetry coefficient $G$. Pairing this with a closed-form bipartite-Cheeger landscape for canonical causal architectures, we show that uniform causal attention satisfies an $n$-independent floor $\phi \ge 1/5$, while window attention pierces the floor as $O(w/n)$; failure modes are shape-different, not just value-different. This floor is an idealized-architecture benchmark, not an empirical attractor: the fraction of real attention heads that pierce it is itself an architectural signature. The resulting two-axis diagnostic ($\phi$ for capacity, $G$ for direction) yields a falsifiable polarity prediction: bottleneck- and diffuse-dominated benchmarks should exhibit opposite polarity. Under length-controlled evaluation, transport features retain interpretable signal (0.62-0.84 LC-AUROC) across the tested decoder-only, encoder-only, and encoder-decoder models, with polarity reversing as predicted between HaluEval and MedHallu.

24.
PLOS Medicine 2026-06-09

Prediction of hospitalisation in young children with pneumonia in Malawi: A machine learning-based approach

by Patrick Staunton, Mohammad Adib Makrooni, Master Chisale, Billy Nyambolo, Joseph Wu, Damien McCarthy, Mark Ledwidge, Yasir Bin Nisar, Chris Watson, Balwani Mbakaya, Cathal Seoighe, Joe Gallagher Background Globally, pneumonia remains the single biggest cause of mortality in children under 5 years of age. This study sought to train and test a prediction model for hospitalisation within 7 days after initial presentation in 2- to 59-month-old Malawian children with WHO-defined pneumonia in primary care and compare its performance to existing risk prediction models. Methods and findings BIOTOPE is a cohort study of children with pneumonia in a primary healthcare setting in Malawi. The training cohort involved nine primary care centres and the testing cohort involved two primary care centres in Northern Malawi. The training cohort was recruited between December 2022 and April 2023 while the testing cohort was recruited in 2016. Participants were consecutive children aged 2–59 months presenting with cough and/or difficulty breathing and who were diagnosed as WHO-defined pneumonia in primary care of any severity. The training cohort was used to train and validate a machine learning model with a prespecified primary outcome defined as hospitalisation and/or death within 7 days as the outcome. This model was then further evaluated in the testing cohort.Median age was 15 months (interquartile range 8−27) in the training and 17 months (interquartile range 9−29) in the external testing cohort (52.1% and 54.4% male, respectively). Hospitalisation occurred in 14.3% (294) of the training cohort and 12.1% (55) of the testing cohort. There was one death in the training cohort only. WHO danger signs were present in 17.6% (360) and 15.9% (70) of children in the training and testing cohorts, respectively. The optimal machine learning model achieved an area under the receiver operating characteristic and precision recall curves of 0.87 and 0.57, respectively, in the testing cohort outperforming existing risk prediction models; furthermore, this model produced an expected calibration error of 0.16 (a logistic regression model using severity status as the response variable and the log odds of the machine learning model’s calibrated probabilities produced an intercept estimate of −0.32 and a slope estimate of 1.13). Key limitations include the use of hospitalisation and/or death as a severity outcome, which may reflect health system factors rather than true disease severity, that mortality-based comparisons were not possible due to low mortality in these primary care cohorts, and that comparator tools were developed for hospital populations rather than primary care populations. Conclusion This machine learning score outperformed traditional pneumonia risk scores in predicting hospitalisation within 7 days in Malawian children presenting to primary care. Traditional pneumonia risk scores diminish in performance when externally applied to new datasets suggesting they may not generalise well beyond their original derivation settings. Mortality-related findings are not applicable as there was only one death in this cohort. Overall these findings support the potential of machine learning to meaningfully improve early identification of children at risk of severe pneumonia in low-resource primary care settings. Further external validation and clinical impact studies are needed to confirm these results.

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arXiv (CS.CL) 2026-06-11

Judging Against the Reference: Uncovering Knowledge-Driven Failures in LLM-Judges on QA Evaluation

While large language models (LLMs) are increasingly used as automatic judges for question answering (QA) and other reference-conditioned evaluation tasks, little is known about their ability to adhere to a provided reference. We identify a critical failure mode of such reference-based LLM QA evaluation: when the provided reference conflicts with the judge model's parametric knowledge, the resulting scores become unreliable, substantially degrading evaluation fidelity. To study this phenomenon systematically, we introduce a controlled swapped-reference QA framework that induces reference-belief conflicts. Specifically, we replace the reference answer with an incorrect entity and construct diverse pairings of original and swapped references with correspondingly aligned candidate answers. Surprisingly, grading reliability drops sharply under swapped references across a broad set of judge models. We empirically show that this vulnerability is driven by judges' over-reliance on parametric knowledge, leading judges to disregard the given reference under conflict. Finally, we find that this failure persists under common prompt-based mitigation strategies, highlighting a fundamental limitation of LLM-as-a-judge evaluation and motivating reference-based protocols that enforce stronger adherence to the provided reference.