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

Schattor: Schatten-family methods for deep learning optimization

arXiv:2606.15702v1 Announce Type: cross Abstract: Modern deep learning optimization features heterogeneous parameter structures, noisy gradients, and highly nonconvex landscapes, posing significant challenges for both algorithm design and theoretical analysis. Motivated by the limitations of SGD and the success of adaptive optimizers, we propose {\it Schattor}, a family of adaptive first-order methods based on Schatten norms. Schattor unifies SGD and the recently proposed matrix-variate adaptive optimizer Muon within a single Schatten-norm-based framework. We establish dimension-free stationarity guarantees for methods in the Schattor family for stochastic matrix optimization problems via a novel matrix martingale moment bound. We also develop multi-block extensions that adaptively balance block-wise optimization progress and prove dimension-free stationarity guarantees in this more general setting.

02.
arXiv (CS.CL) 2026-06-11

Pre-AF 13: An Interpretable Atrial Fibrillation Risk Score Mined from Discharge Reports

Background. Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a major determinant of prognosis. Established AF risk scores rely on factors (older age, hypertension) nearly ubiquitous among patients with cardiovascular disease (CVD), offering limited stratification in this high-risk group. Most target long-term (5-10 year) rather than medium-term prediction. We developed interpretable ML models predicting AF risk over a 24-month and entire follow-up horizon in CVD patients using routinely collected hospital data. Methods. Single-center retrospective study of electronic health records from the National Research Cardiology Center (Russia) for patients aged >=18 with CVD but without pre-existing AF, hospitalized more than once between January 2012 and May 2019. A custom NLP pipeline transformed unstructured discharge reports into 73 structured features, combining a rule-based parser with transformer-based NER. Using LightAutoML we built a full model (73 features), a simple model (reduced subset), and a linear model for a bedside risk score. Performance was assessed by ROC AUC, compared with CHARGE-AF, C2HEST, MHS, and HAVOC, and interpreted via SHAP. Results. Of 80,576 records from 45,000 patients, 17,562 met inclusion criteria; 1,438 (8.19%) developed AF. The full model reached ROC AUC 0.735 (24-month) and 0.696 (entire follow-up); the simple model was nearly identical (0.725, 0.696). All non-linear models outperformed the four clinical risk scores (ROC AUC 0.53-0.64). The simple model uses 13 features and is named Pre-AF 13. SHAP identified age and left atrial volume as dominant predictors. A linear risk score (Pre-AF 9) stratified observed 24-month AF incidence from ~7% to 36%. Conclusion. Interpretable ML models built from routinely collected EHR data identify high-AF-risk CVD patients, outperforming established clinical risk scores.

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

Orchestrated Reality: From Role-Play to Living, Playable Game Worlds – LLM-Driven World Simulation as a Parameterized-Action POMDP

arXiv:2606.16014v1 Announce Type: cross Abstract: Many games rely on storytelling combined with systems that track levelling, NPC behaviour, and consequence simulation; bridging tightly-authored narrative with deeply-simulated worlds – most acute in sandbox and open-world settings – has been prohibitively expensive. LLM-driven worlds open a new path: a single harness can coordinate numerical state, narrative voice, storytelling pacing, and rule logic together. Realising this requires the LLM system to sustain a persistent world (who is where, what has just happened, what is currently true), which today's deployed systems do not: the narrative voice asserts state in free prose without any validated representation, so a fully autonomous game engine remains infeasible. We treat this as an architectural choice, not a limitation of language models, and report work in progress on a framework – orchestrated reality – that makes the world a canonical object owned by a singleton orchestration agent analogous to the tabletop-RPG Game Master (GM). We formalise an LLM-driven game world for a human player as a Parameterized-Action POMDP: state is a tree of canonical JSON entities, actions decompose as $a=(k, x_k)$ (a discrete intent kind plus structured JSON parameters), the agent observes only a narrative projection $o=O(s)$ of state, and the transition kernel $F$ is an LLM-driven Plan-Diff-Validate-Apply (PDVA) pipeline that commits schema-validated, content-hashed JSON deltas. We give the formal model, a JSON-state example, a worked single-turn example, and a catalogue of 15 illustrative incidents drawn from a real deployment showing the framework in action. Empirical validation through a planned human player study – together with multi-NPC concurrent agency and deployment as an RL environment – is situated as future work.

04.
arXiv (CS.CL) 2026-06-18

ToolGrad: Efficient Tool-use Dataset Generation with Textual "Gradients"

Prior work synthesizes tool-use LLM datasets by first generating a user query, followed by complex tool-use annotations like depth-first search (DFS). This leads to inevitable annotation failures and low efficiency in data generation. We introduce ToolGrad, an agentic framework that inverts this paradigm. ToolGrad first constructs valid tool-use chains through an iterative process guided by textual "gradients", and then synthesizes corresponding user queries. This "answer-first" approach led to ToolGrad-500, a dataset generated with more complex tool use, lower cost, and almost 100% pass rate. Experiments show that ToolGrad models outperform those trained on expensive baseline datasets and proprietary LLMs. The ToolGrad source code, dataset, and models are available at https://github.com/zhongyi-zhou/toolgrad.

05.
arXiv (CS.CV) 2026-06-12

Skeleton Sparsification and Densification Scale-Spaces

The Hamilton-Jacobi skeleton, also known as the medial axis, is a powerful shape descriptor that represents binary objects in terms of the centres of maximal inscribed discs. Despite its broad applicability, the medial axis suffers from sensitivity to noise: Minor boundary variations can lead to disproportionately large and undesirable expansions of the skeleton. Classical pruning methods mitigate this shortcoming by systematically removing extraneous skeletal branches. This sequential simplification of skeletons resembles the principle of sparsification scale-spaces that embed images into a family of reconstructions from increasingly sparse pixel representations. We combine both worlds by introducing skeletonisation scale-spaces: They leverage sparsification of the medial axis to achieve hierarchical simplification of shapes. Unlike conventional pruning, our framework inherently satisfies key scale-space properties such as hierarchical architecture, controllable simplification, and equivariance to geometric transformations. We provide a rigorous theoretical foundation in both continuous and discrete formulations and extend the concept further with densification. By growing the skeleton successively instead of shrinking it, we allow inverse progression from coarse to fine scales. Densification scale-spaces can even reach beyond the original skeleton to produce overcomplete shape representations with relevancy for practical applications. Through proof-of-concept experiments, we demonstrate the effectiveness of our framework for practical tasks including robust skeletonisation, shape compression, and stiffness enhancement for additive manufacturing.

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

Interpolation between Convolution and Attention via K-Nearest Neighbors

作者:

The shift from Convolutional Neural Networks to Transformers has reshaped computer vision, yet these two architectural families are typically viewed as fundamentally distinct. Convolutional Neural Networks are defined by spatially local convolution operations, while Transformers rely on global self-attention. We argue that convolution and self-attention, despite their apparent differences, can be unified within a single k-nearest neighbor aggregation framework. The critical insight is that both operations are special cases of neighbor selection and weighted aggregation. Convolution selects neighbors by spatial proximity while self-attention selects by feature similarity, revealing that they lie on a continuous spectrum rather than representing categorically different computations. We introduce Convolutional Nearest Neighbors (ConvNN), a unified framework that formalizes this connection. ConvNN exactly recovers standard and depthwise convolution by restricting neighbor selection to normalized spatial coordinates, and exactly recovers self-attention and its sparse variants, including KVT-attention, by replacing spatial proximity with scaled dot-product similarity. Beyond these special cases, ConvNN serves as a drop-in replacement for both convolution and attention layers, enabling systematic exploration of the intermediate spectrum between local and global aggregation through configurable similarity functions, neighbor selection strategies, positional encodings, and aggregation kernels.

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

Reinforcement Learning-Guided Retrieval with Soft Fusion for Robust Multimodal Imitation Learning under Missing Modalities

arXiv:2606.15514v1 Announce Type: cross Abstract: Robotic systems perceive the world through multiple input modalities – including visual camera streams and natural language instructions – and must select appropriate actions based on these signals. However, assuming the permanent availability of all input devices is unrealistic, as sensors may fail, become occluded, or drop out entirely during deployment. Robust handling of such missing-modality scenarios is therefore essential for real-world robot operation. This paper introduces RL4IL, a reinforcement learning guided method for imitation learning that selects the most suitable action for a given observation by identifying the most relevant expert demonstrations from a training library. A reinforcement learning policy, trained via Proximal Policy Optimisation over Breadth-First Search candidate sets, ranks candidate demonstrations and a soft cross-attention fusion head aggregates their action signals to produce the final prediction. When a modality is missing at inference time, a dedicated per-modality RL retrieval policy identifies donor demonstrations from the training library, and a soft imputation head reconstructs the missing embedding via cross-attention over the top-ranked donors – without requiring any retraining of the system. Experiments on three LIBERO benchmark suites demonstrate that RL4IL substantially outperforms state-of-the-art imitation learning methods under sensor dropout conditions, while requiring no policy network training. The code can be found at https://github.com/h-ismkhan/Reinforcement-Learning-via-kNN-for-Robotic-Learning-with-Missing-Camera

08.
Nature (Science) 2026-06-24

Global high-resolution mapping of seagrass to support conservation

Seagrass ecosystems underpin coastal biodiversity1 and provide vital ecosystem services, including shoreline protection2, food security3 and climate mitigation4. Despite growing recognition as a nature-based climate solution, seagrasses are among the least mapped and most poorly understood vegetated coastal ecosystems5. Here we present, to our knowledge, the first global 10-m spatial resolution maps and change analysis of seagrass extent in clear, shallow coastal waters, derived from 4.75 million Sentinel-2 MSI satellite images for two periods (2019–2020 and 2023–2024). Using a deep-learning classifier trained on curated reference data, we identified 148,506 km2 of seagrass globally, including 5,961 km2 of intertidal and 142,545 km2 of subtidal areas. Sixty-nine per cent of global seagrass extent is concentrated in The Bahamas, Cuba, the USA, Australia and Indonesia, yet only 21% of seagrass areas are located within marine-protected areas. Over the 4 years of the study, 5,969 km2 (4%) of seagrass was lost, and an additional 6,221 km2 (4.2%) was degraded from dense to sparse cover in tropical regions. Our findings identify seagrass meadow hotspots and vulnerable regions to inform conservation and climate policy. Global high-resolution mapping shows widespread seagrass loss and degradation since 2019, with most meadows outside protected areas, highlighting urgent conservation and climate-policy needs.

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

NTIRE 2024 Challenge on Image Super-Resolution (x4): Methods and Results

This paper reviews the NTIRE 2024 challenge on image super-resolution ($\times$4), highlighting the solutions proposed and the outcomes obtained. The challenge involves generating corresponding high-resolution (HR) images, magnified by a factor of four, from low-resolution (LR) inputs using prior information. The LR images originate from bicubic downsampling degradation. The aim of the challenge is to obtain designs/solutions with the most advanced SR performance, with no constraints on computational resources (e.g., model size and FLOPs) or training data. The track of this challenge assesses performance with the PSNR metric on the DIV2K testing dataset. The competition attracted 199 registrants, with 20 teams submitting valid entries. This collective endeavour not only pushes the boundaries of performance in single-image SR but also offers a comprehensive overview of current trends in this field.

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

Bilevel Data Curation for LLM Fine-tuning: Offline Selection and Online Self-Refining Generation

Supervised fine-tuning (SFT) datasets are critical to the downstream performance of large language models, yet they often contain low-quality or harmful question-response pairs. To improve SFT data quality, we develop a unified bilevel framework that combines offline data selection with the online self-refining generation. In the offline setting, bilevel data selection (BDS) selects question-response pairs from the offline SFT dataset to maximize the validation performance. We theoretically show that the optimal model given by BDS outperforms direct data mixing approach in useful data coverage. Moreover, we provide a global convergence analysis for gradient-based BDS approach for one-layer Transformer, showing that the epsilon-global optimum of offline BDS is achievable in finite time. Although efficient, offline BDS discards potentially harmful questions together with responses, thereby reducing question diversity. We address this limitation by refining the responses to selected questions using online self-refining generation framework. However, BDS is inefficient to update the response weights when responses are regenerated online. To address this issue, we introduce bilevel multi-objective optimization (BMO) for response-level weighting. We show that BMO recovers the same validation-aligned solution as BDS, but admits a closed-form importance-ratio weight that adapts to regenerated responses. Experiments on LLM quality enhancement and safety-aware fine-tuning demonstrate that the proposed framework consistently improves both data quality and downstream fine-tuning performance.

11.
arXiv (quant-ph) 2026-06-24

Fractional squeezing: spectra and dynamics from generalized squeezing Hamiltonian with fractional orders

作者:

arXiv:2601.15693v2 Announce Type: replace Abstract: We generalize the generalized-squeezing problem to include fractional values of the squeezing order $n$. This approach allows us to determine the locations of critical points at which qualitative changes in behaviour occur and accurately predict the behaviour at these critical points, which are challenging for conventional computational methods. Based on our numerical calculations, we identify with a high degree of confidence the point at which the spectrum turns from continuous to discrete and the point at which oscillations turn from having asymptotically infinite amplitudes to having finite amplitudes. Furthermore, we numerically investigate the behaviour in the large $n$ regime and provide an intuitive explanation for the numerical results.

12.
arXiv (CS.AI) 2026-06-24

When Language Overwrites Vision: Over-Alignment and Geometric Debiasing in Vision-Language Models

arXiv:2605.08245v4 Announce Type: replace-cross Abstract: Vision-Language Models (VLMs) increasingly power high-stakes applications, from medical imaging to autonomous systems, yet they routinely hallucinate, confidently describing content not present in the input. We investigate the root causes of these failure modes with a mechanistic analysis focusing on the decoder-based VLMs. We trace these failure modes to a geometric over-alignment: to bridge the modality gap required by attention mechanisms, decoder-based VLMs over-align visual embeddings with the text manifold, injecting a statistical linguistic bias that systematically overshadows fine-grained visual evidence. While prior work either aggressively closes this gap or suppresses hallucinations through expensive black-box decoding strategies, none addresses the underlying geometric cause. We provide the first quantitative characterization of this over-alignment, demonstrating that linguistic bias concentrates in the top principal components of a universal, dataset-agnostic text subspace. Building on this insight, we propose two complementary remedies: a training-free inference strategy and a bias-aware fine-tuning paradigm, both of which explicitly project out this subspace from visual representations. Our methods significantly reduce hallucinations across POPE, CHAIR, and AMBER benchmarks, and improve CLAIR scores on long-form captioning tasks, with the training-free variant adding no computational overhead over the base model.

13.
arXiv (CS.AI) 2026-06-25

Communicability-Inspired Positional Encoding (CIPE)

arXiv:2606.25293v1 Announce Type: cross Abstract: Positional encodings (PEs) are essential for Transformers. Yet designing effective PEs for non-Euclidean graphs remains challenging. Such encodings should ideally induce an Attention-Compatible Geometry for self-attention: not merely describing graph structure, but defining a geometry whose inner products reflect meaningful structural relatedness. To realize this geometry, we propose Communicability-Inspired Positional Encoding (CIPE), built from communicability, a measure between pairs of nodes that aggregates contributions from paths of all lengths. By construction, CIPE inner products recover communicability, converting global multi-path connectivity into an attention-ready similarity geometry. For practical Transformer training, we introduce dimensionality alignment, mapping graph-size-dependent CIPE representations to prescribed dimensions while faithfully preserving the induced geometry. Empirically, CIPE improves structure-agnostic Transformers by 35.5% on average across seven benchmarks, outperforming representative PEs; it also consistently improves structure-biased graph Transformers, where competing PEs often yield only marginal benefits. These results position CIPE as a principled framework for attention-compatible graph positional encodings.

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

Group-Sparse Matrix Factorization for Transfer Learning of Word Embeddings

Unstructured text provides decision-makers with a rich data source in many domains, ranging from product reviews in retail to nursing notes in healthcare. To leverage this information, words are typically translated into word embeddings – vectors that encode the semantic relationships between words – through unsupervised learning algorithms such as matrix factorization. However, learning word embeddings from new domains with limited training data can be challenging, because the meaning/usage may be different in the new domain, e.g., the word ``positive'' typically has positive sentiment, but often has negative sentiment in medical notes since it may imply that a patient tested positive for a disease. In practice, we expect that only a small number of domain-specific words may have new meanings. We propose an intuitive two-stage estimator that exploits this structure via a group-sparse penalty to efficiently transfer learn domain-specific word embeddings by combining large-scale text corpora (such as Wikipedia) with limited domain-specific text data. We bound the generalization error of our transfer learning estimator, proving that it can achieve high accuracy with substantially less domain-specific data when only a small number of embeddings are altered between domains. Furthermore, we prove that all local minima identified by our nonconvex objective function are statistically indistinguishable from the global minimum under standard regularization conditions, implying that our estimator can be computed efficiently. Our results provide the first bounds on group-sparse matrix factorization, which may be of independent interest. We empirically evaluate our approach compared to state-of-the-art fine-tuning heuristics from natural language processing.

15.
arXiv (CS.CV) 2026-06-24

CrossFusion: A Multi-Scale Cross-Attention Convolutional Fusion Model for Cancer Survival Prediction

Cancer survival prediction from whole slide images (WSIs) is a challenging task in computational pathology due to the large size, irregular shape, and high granularity of the WSIs. These characteristics make it difficult to capture the full spectrum of patterns, from subtle cellular abnormalities to complex tissue interactions, which are crucial for accurate prognosis. To address this, we propose CrossFusion, a novel multi-scale feature integration framework that extracts and fuses information from patches across different magnification levels. By effectively modeling both scale-specific patterns and their interactions, CrossFusion generates a rich feature set that enhances survival prediction accuracy. We validate our approach across six cancer types from public datasets, demonstrating significant improvements over existing state-of-the-art methods. Moreover, when coupled with domain-specific feature extraction backbones, our method shows further gains in prognostic performance compared to general-purpose backbones. The source code is available at: https://github.com/RustinS/CrossFusion

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

Federated Learning for Feature Generalization with Convex Constraints

arXiv:2606.14416v1 Announce Type: new Abstract: Federated learning (FL) often struggles with generalization due to heterogeneous client data. Local models are prone to overfitting their local data distributions, and even transferable features can be distorted during aggregation. To address these challenges, we propose FedCONST, an approach that adaptively modulates update magnitudes based on the parameter strength of the global model. This prevents over-emphasizing well-learned parameters while reinforcing underdeveloped ones. Specifically, FedCONST employs linear convex constraints to ensure training stability and preserve locally learned generalization capabilities during aggregation. A Gradient Signal to Noise Ratio (GSNR) analysis further validates the effectiveness of FedCONST in enhancing feature transferability and robustness. As a result, FedCONST effectively aligns local and global objectives, mitigating overfitting and promoting stronger generalization across diverse FL environments, achieving state-of-the-art performance.

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

SAAS: Self-Aware Reinforcement Learning for Over-Search Mitigation in Agentic Search

Agentic search enables LLMs to solve complex multi-hop questions through iterative reasoning and external search. Despite the effectiveness, these systems often suffer from a critical limitation in practice: agents fail to recognize their own knowledge boundaries, blindly triggering searches when internal knowledge suffices and failing to terminate search even when adequate evidence has been collected. The lack of self-awareness leads to severe over-search, incurring substantial inference latency and prohibitive computational cost. To this end, we propose SAAS, a novel RL framework designed to cultivate dynamic self-awareness that precisely regulates search behavior without compromising accuracy. SAAS introduces three key components: (i) a search boundary modeling mechanism, which identifies the search boundary under the evolving policy by contrasting search-disabled and search-enabled rollouts; (ii) a boundary-aware reward module, which translates this boundary awareness into trajectory-level penalties, suppressing unnecessary and redundant searches; and (iii) a stage-wise optimization strategy, which leverages a sequential curriculum to prioritize reasoning over search regularization, thereby avoiding reward hacking. Extensive experiments demonstrate that SAAS substantially reduces over-search, while maintaining accuracy. Our code and implementation details are released at https://github.com/XMUDeepLIT/SAAS.

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

Dense Coordinate-List Fine-Tuning Induces a Controllable Interference Surface in Vision-Language Models

arXiv:2606.14507v1 Announce Type: new Abstract: Fine-tuning vision-language models to emit dense coordinate lists improves visual grounding but also changes how models serialize, repeat, and terminate structured outputs. We study this behavior as a generation and control surface. In Gemma 4 12B, high-capacity q/k/v/o LoRA raises class-aware F1@0.3 from 0.007 to 0.448 while inducing repeated-tail pressure (duplicate rate 0.080, max repeat 23). A q/v rank sweep keeps max repeat at 21-22 across ranks 4-64, showing capacity persistence. The target signal is separable: object-level repeat-stop removes exact repeated records (duplicate rate 0.000, max repeat 1) while preserving F1 (0.494 to 0.490) and stricter F1@0.5 (0.381 to 0.385). Structure-axis probes localize the effect to bbox-coordinate object lists; dense non-bbox and spatial/count JSON remain repeat-clean, including under high-capacity adapters. Qwen3-VL-8B reproduces a clean controlled endpoint (F1@0.3 0.318, duplicate rate 0.000), and COCO 2017 reproduces acquisition plus duplicate pressure. Dense coordinate-list adaptation therefore creates a structure-bound, cross-family interference surface that can be measured and controlled.

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

Trimodal Glioma Representation Alignment via Volumetric Contrastive Learning

Glioma grading and survival prediction require the integration of heterogeneous information collected at different spatial and biological scales. Histopathology describes tissue morphology, mRNA expression captures molecular activity, and magnetic resonance imaging provides a non-invasive view of tumor extent and radiological heterogeneity. Existing glioma prognosis models often combine only two of these sources, while their alignment objectives remain mostly pairwise. This paper introduces GLORIA, a novel trimodal framework for GLioma Omics - Radiology - hIstopathology Alignment. GLORIA processes whole-slide image regions, gene-expression profiles, and 3D MRI volumes through modality-specific encoders, projects them into a shared latent space, and aligns them with a Gramian contrastive loss that measures the volume spanned by the three modality embeddings. The aligned representations are fused through a cross-modal gating module and optimized jointly for three-class glioma grading and overall survival prediction. We evaluate GLORIA on a matched TCGA-GBM/LGG and BraTS21 cohort, comprising 132 patients with all three modalities. On the shared trimodal test set, GLORIA improves over the bimodal WSI-mRNA baseline in all the metrics considered.

21.
arXiv (CS.LG) 2026-06-24

KLip-PPO: A per-sample KL perspective on PPO-Clip

arXiv:2606.23932v1 Announce Type: new Abstract: Proximal Policy Optimization (PPO) is the standard policy-gradient algorithm for on-policy reinforcement learning. The literature presents it in two forms, a clipped surrogate that bounds the importance ratio between successive policies and a Kullback-Leibler penalty between them. These forms are treated as separate algorithms with their own gradients, their own hyperparameters, and their own reference implementations, and a sizeable body of empirical work compares them. We show that the gradient of the clipped surrogate is reproduced exactly by a Kullback-Leibler surrogate whose coefficient varies per sample, with closed-form dependence on the importance ratio and the advantage. The identity holds at every minibatch step and across the entire inner loop, and on five MuJoCo continuous-control benchmarks the two losses produce indistinguishable training curves. The reformulation exposes a structural feature of the clipped surrogate that the min notation hides. PPO-Clip's implicit per-sample penalty is a step function at the boundary of the trust region, and the shape of this coefficient is the natural design axis for generalising the algorithm. We sketch the resulting follow-up directions in the discussion.

22.
arXiv (CS.CV) 2026-06-12

Allure of Craquelure: A Variational-Generative Approach to Crack Detection in Paintings

Recent advances in imaging technologies, deep learning and numerical performance have enabled non-invasive detailed analysis of artworks, supporting their documentation and conservation. In particular, automated detection of craquelure in digitized paintings is crucial for assessing degradation and guiding restoration, yet remains challenging due to the possibly complex scenery and the visual similarity between cracks and crack-like artistic features such as brush strokes or hair. We propose a hybrid approach that models crack detection as an inverse problem, decomposing an observed image into a crack-free painting and a crack component. A deep generative model is employed as powerful prior for the underlying artwork, while crack structures are captured using a Mumford–Shah-type variational functional together with a crack prior. Joint optimization yields a pixel-level map of crack localizations in the painting.

23.
medRxiv (Medicine) 2026-06-22

Virtual Responsive Neurostimulation Implantation: From Intracranial Connectivity to Optimized Lead Placement

Responsive neurostimulation (RNS) is an implanted device that delivers direct brain stimulation for drug-resistant focal epilepsy. Individual responses are highly variable, and no validated framework exists to predict outcome or guide lead placement before implantation. We hypothesized that this variability is partly explained by lead placement in relation to patterns of functional connectivity in brain networks. Fourty-nine patients with drug-resistant focal epilepsy who underwent pre-implantation intracranial EEG (iEEG) and RNS implantation across three independent epilepsy centers were retrospectively studied. We developed a composite functional connectivity score, based on simple Spearman correlation, combining the standard deviation and kurtosis of interictal iEEG connectivity distributions to predict the response outcome in a training cohort (HUP, n=18) and validated in two independent cohorts (NYU, n=17; UCSF, n=14). We accounted for a spatial mismatch between iEEG and RNS electrodes with a distance-based correction. The score was extended to generate patient-specific 3D maps of predicted RNS efficacy across 200 simulated, or virtual RNS, lead configurations. Accuracy of the score in predicting clinical outcome was 72% at the group level, 61% at the individual patient level, and, after distance-based optimization, 100% in patients with RNS electrodes placed close to location of iEEG electrodes. Applied to the validation cohort, the same score reached 68% accuracy (71% balanced accuracy, 55% sensitivity, 88% specificity). The spatial combination of the scores at different SEEG contacts localization gives a spatial score for each patient. Responders showed significantly higher spatial scores than non-responders, supporting that actual RNS lead placement in responders was located in map-identified favorable regions. Interictal iEEG functional connectivity predicts individual RNS response across independent epilepsy centers, and patient-specific 3D maps derived from this biomarker could prospectively guide lead implantation toward favorable network regions, opening a promising avenue toward network-informed RNS surgical planning.

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

Representing Piecewise-Linear Functions by Functions with Minimal Arity

arXiv:2406.02421v2 Announce Type: replace-cross Abstract: Any continuous piecewise-linear function $F\colon \mathbb{R}^{n}\to \mathbb{R}$ can be represented as a linear combination of $\max$ functions of at most $n+1$ affine-linear functions. In our previous paper [``Representing piecewise linear functions by functions with small arity'', AAECC, 2023], we showed that this upper bound of $n+1$ arguments is tight. In the present paper, we extend this result by establishing a correspondence between the function $F$ and the minimal number of arguments that are needed in any such decomposition. We show that the tessellation of the input space $\mathbb{R}^{n}$ induced by the function $F$ has a direct connection to the number of arguments in the $\max$ functions.

25.
medRxiv (Medicine) 2026-06-22

A blinded, counterbalanced rater design for evaluating AI-assisted summarisation of tertiary clinical genomics reports: methodology of the QNOMX-VHIR-CPSP-001 Phase 1 study

Background. Tertiary clinical genomics reports condense layered molecular findings into documents that treating oncologists must read, translate, and act upon; manual summarisation of these reports is time-consuming and variable. Tools that assist summarisation and translation into local languages are emerging, yet the field lacks an agreed methodology for evaluating such tools before any downstream clinical use. The appropriate first endpoint is fidelity of the generated summary to its source report, assessed by qualified human raters under blinded scoring, not downstream variant classification. Methods. QNOMX-VHIR-CPSP-001 Phase 1 is a single-site, non-interventional clinical performance study conducted at Vall d'Hebron Institut de Recerca (VHIR) under ISO 20916:2019 as a Clinical Performance Study Protocol. De-identified tertiary cancer genomics reports from pediatric oncology cases are summarised by the AI-assisted summarisation system under evaluation and, in parallel, by the standard manual workflow. Qualified raters score both summary types against the source genomics report using the Quality Summary Index (QSI), a six-dimension, five-point rubric adapted from the Provider Documentation Summarization Quality Instrument, under a blinded, counterbalanced, two-period crossover with a minimum fourteen-day washout. Two co-primary composite endpoints, content and presentation, are analysed for non-inferiority under a Bayesian hierarchical model, with a frequentist linear mixed model as the convergence check. Inter-rater reliability is reported as Krippendorff's ; a Monte-Carlo power analysis of the fixed clustered design is pre-specified. Discussion. The design isolates summarisation quality from clinical decision-making by scoring both summary types against the same source report under blinding, counterbalancing, and a fourteen-day washout. Conclusion. The QSI rubric, the counterbalanced crossover, and the pre-specified Bayesian primary with frequentist convergence check define a replicable protocol for early-stage evaluation of AI-assisted summarisation in tertiary genomics reporting; observed variance components will inform sample-size determination for Phase 2.