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01.
arXiv (CS.AI) 2026-06-18

A Link between Shock-wave Theory and Symmetry-reduced Stochastic Gradient Descent for Artificial Neural Networks

arXiv:2606.18303v1 Announce Type: cross Abstract: We develop a mathematically explicit link between shock-wave theory and the symmetry-quotiented learning dynamics of stochastic gradient descent, drawing on differential geometry, Lie group theory, and fluid mechanics. Specifically, after quotienting parameter symmetries and applying local-entropy coarse-graining, the effective dynamics satisfy a viscous Hamilton–Jacobi equation on the quotient manifold. Moreover, under the assumption that the raw parameter dynamics can be summarized by a gradient field on the quotiented space, the gradient of the coarse-grained loss function obeys a Burgers-type equation, and shock formation can be established rigorously. We apply our theory to multilayer perceptrons, convolutional neural networks, Transformers, and mean-field networks, and show that they obey the Hamilton–Jacobi or Burgers-type equations. We conjecture that this framework also yields practical diagnostics for deep learning. In architectures such as Transformers, raw parameter norms are often distorted by symmetry redundancy and may therefore be misleading, whereas symmetry-corrected quotient observables provide a principled basis for monitoring, forecasting, and controlling training-phase transitions.

02.
arXiv (CS.CV) 2026-06-18

Quantification of Uncertainty with Adversarial Models in Medical Image Segmentation

Reliable pixel-level uncertainty quantification holds the potential to transform clinical workflows by enabling high-fidelity longitudinal monitoring and distinguishing true pathological changes from artifacts. Ideally, these models provide the stability required for critical treatment planning and surgical intervention. However, standard deep learning models often suffer from miscalibration, yielding overconfident predictions that mask underlying vulnerabilities at subtle pathological boundaries. To address this, we propose QUAM-SM, a post-hoc framework using targeted adversarial search to identify "adversarially fragile" pixels. By actively seeking perturbations that expose predictive instability, our method highlights regions where decisions are most vulnerable to being flipped. Importantly, the framework disentangles epistemic uncertainty from aleatoric uncertainty. Experiments on two public datasets with multiple expert annotations demonstrate that QUAM-SM outperforms both standard and recent uncertainty estimation approaches in terms of reliability and boundary sensitivity. Code is available at https://github.com/HanaJebril/quam_sm

03.
Nature (Science) 2026-06-24

An ECG biomarker for sudden cardiac death discovered with deep learning

Sudden cardiac death is, in theory, preventable with defibrillators. But every year, many patients die without defibrillators because doctors fail to predict their risk1. The only predictive biomarker in wide use, cardiac left ventricular ejection fraction (LVEF), misses most sudden cardiac deaths2, and flags many low-risk patients for futile defibrillators that never fire3,4. Here we apply deep learning to a dataset linking all electrocardiograms (ECGs) in a Swedish region to death certificates. The resulting model isolates a high-risk group (2.2% of the sample) with a 7.0% annual rate of sudden cardiac death, higher than those with reduced LVEF (1.9% of the sample; 4.6% annual rate). Notably, 86.1% of the model’s high-risk patients were not flagged by LVEF. High-risk ECG patients with defibrillators implanted were 54.4% less likely to die than expected, suggesting a mortality benefit. We externally validate the model in a US health system, in which it predicts ventricular arrhythmias that cause sudden death; and a Taiwanese hospital registry, in which it specifically predicts future arrhythmic cardiac arrests. To visualize the waveform morphology ‘discovered’ by the predictive model, we pair it with a generative model of the ECG waveform. Together, they reveal a biomarker that is easily visible and robustly predicts sudden cardiac death, but has not to our knowledge been previously described. Tying the biomarker’s shape to electrophysiological first principles, we form and preliminarily test a new hypothesis on the mechanism of sudden cardiac death. A deep-learning model trained on electrocardiogram (ECG) waveforms identifies an easily visible biomarker that predicts sudden cardiac death more accurately than the current clinical state of the art.

04.
arXiv (math.PR) 2026-06-16

Stein's method for the matrix normal distribution

arXiv:2601.11422v2 Announce Type: replace-cross Abstract: This work presents the first systematic development of Stein's method for matrix distributions. We establish the basic essential ingredients of Stein's method for matrix normal approximation: we derive an extended-generator-based Stein identity from a matrix Ornstein-Uhlenbeck diffusion with two-sided scales, provide an explicit semigroup representation for the solution of the Stein equation, and obtain regularity estimates for the solution. The new methodology is demonstrated in three examples: (i) smooth Wasserstein distance bounds to quantify the matrix central limit theorem (a didactic example), (ii) a Wasserstein distance bound for the matrix normal approximation of the centered matrix $T$ distribution, and (iii) a Stein's method-of-moments approach to estimating the row and column covariance factors of the matrix normal, yielding a flexible class of weighted flip-flop Stein estimators that generalize Dutilleul's classical flip-flop algorithm and naturally accommodate row/column importance weights, systematic missingness, and projection onto structured covariance families. The latter two examples are intrinsically matrix-valued and cannot be treated using naive vectorization.

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

HRIR-Former: Grid-Free Time-Domain Reconstruction of Head-Related Impulse Responses with a Spatially Encoded Transformer

arXiv:2603.27998v2 Announce Type: replace-cross Abstract: Individualized head-related impulse responses (HRIRs) enable binaural rendering, but dense per-listener measurements are costly. We address HRIR spatial up-sampling from sparse per-listener measurements: given a few measured HRIRs for a listener, predict HRIRs at unmeasured target directions. Prior learning methods often work in the frequency domain, rely on minimum-phase assumptions or separate timing models, and use a fixed direction grid, which can degrade temporal fidelity and spatial continuity. We propose HRIR-Former, a time-domain, grid-free binaural Transformer for reconstructing HRIRs at arbitrary directions from sparse inputs. It uses sinusoidal spatial features, a Conv1D refinement module, and auxiliary interaural time difference (ITD) and interaural level difference (ILD) heads. On SONICOM, it improves normalized mean squared error (NMSE), cosine distance, and ITD/ILD errors over prior methods; ablations validate modules and show minimum-phase preprocessing is unnecessary.

06.
Nature (Science) 2026-06-24

Genetic diversity of late Neanderthals in northwestern Europe

Archaeological, osteological and genetic evidence suggests that Neanderthals lived in small groups1,2; however, less is known about whether these groups were part of isolated communities or belonged to larger, well-connected populations3. The dense concentration of broadly contemporaneous Neanderthal sites in the Meuse Basin, Belgium4, provides a rare opportunity to study regional populations at high resolution. Here we generated genetic data from 27 Neanderthals who lived less than approximately 52,500 years ago from ten archaeological sites in Belgium and France, including a high-coverage genome from a 45,000-year-old individual from Goyet, Belgium. We show that most of these individuals are more closely related to one another than to other contemporaneous late Neanderthals in Europe. Further, some of these individuals carry DNA from a Neanderthal lineage predating the split of late Neanderthals. Although these Neanderthals overlapped temporally with early modern humans in northwestern Europe from around 47,000 years ago, we find no evidence of recent gene flow from modern humans. They also do not show the genetic signatures of mating among close relatives found in Altai Neanderthals, suggesting that they lived in larger or better-connected groups. Moreover, genetic load did not accumulate over time, arguing against progressive genetic deterioration as a driver of Neanderthal extinction. Genetic sequencing of multiple late Neanderthals living less than 52,500 years ago provides an overview of genetic diversity and demonstrates that even low-coverage nuclear genome data can increase resolution of within-Neanderthal diversity.

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

When Does Trajectory-Level Supervision Permit Efficient Offline Reinforcement Learning?

arXiv:2606.18531v1 Announce Type: cross Abstract: Offline reinforcement learning is typically analyzed under process-level reward supervision, yet many sequential decision datasets record only trajectory-level outcomes. We develop a statistical theory for offline policy optimization from such outcome-level supervision. We first study the canonical setting where the target remains the expected cumulative reward, but each offline trajectory provides only a scalar label whose conditional mean is the cumulative return. We propose OPAC, a pessimistic actor-critic algorithm that learns a latent reward model and optimizes a policy from trajectory-level labels. We prove a high-probability guarantee of order $\widetilde O(H^2\sqrt{C_{sa}(\pi^\star)/n})$ and a matching lower bound, characterizing the sharp statistical cost of replacing process-level rewards with one trajectory-level label. We then extend the principle to preference-based feedback, preserving the leading horizon and concentrability dependence up to preference-model constants. Finally, we study generalized outcome-based offline RL, where both the supervision and the objective are trajectory-level quantities induced by a nonlinear aggregation of latent per-step rewards. This problem is not learnable in general: for all-success objectives, any offline learner may require $\Omega(2^H)$ trajectories even with deterministic transitions and constant concentrability. We then identify a tractable regime through two structural coefficients, $\kappa_\mu(\sigma)$ and $\chi_\mu(\sigma)$, capturing information loss in outcome aggregation and generalized Bellman updates, under which generalized OPAC achieves polynomial sample complexity. Together, our results delineate when outcome-level supervision enables sample-efficient offline control and when missing process-level rewards create fundamental statistical barriers.

08.
arXiv (CS.LG) 2026-06-24

Layer-wise Geometric Approximation Rates for Deep Networks

arXiv:2604.20219v2 Announce Type: replace Abstract: Depth is widely viewed as a central contributor to the success of deep neural networks, whereas standard neural network approximation theory typically provides guarantees only for the final output and leaves the role of intermediate layers largely unclear. We address this gap by developing a quantitative framework in which depth admits a precise scale-dependent interpretation. Specifically, we design a single shared mixed-activation architecture of fixed width $2dN+d+2$ and any prescribed finite depth such that each intermediate readout $\Phi_\ell$ is itself an approximant to the target function $f$. For $f\in L^p([0,1]^d)$ with $p\in [1,\infty)$, the approximation error of $\Phi_\ell$ is controlled by $(2d+1)$ times the $L^p$ modulus of continuity at the geometric scale $N^{-\ell}$ for all $\ell$. The estimate reduces to the geometric rate $(2d+1)N^{-\ell}$ if $f$ is $1$-Lipschitz. Our network design is inspired by multigrade deep learning, where depth serves as a progressive refinement mechanism. For every prescribed terminal depth, the construction yields a finite nested family of prefix readouts whose earlier correction terms remain embedded in later readouts. Thus the approximation may be truncated within the prescribed depth range once the desired certified accuracy is reached.

09.
arXiv (CS.LG) 2026-06-15

A Unified Framework for Structured Flow Modeling: From Representation to Verification and Model Discovery

arXiv:2605.18250v3 Announce Type: replace-cross Abstract: Many dynamical systems can be described in terms of structured flows combining source/sink behavior, cyclic dynamics, and topology-constrained transport. These features arise across a wide range of physical, engineered, and data-driven systems. The objective of this work is to establish a unified perspective on such systems, to identify modeling approaches that balance expressivity, interpretability, computational complexity, and data requirements, and to investigate how highly expressive models can be used to uncover the dominant mechanisms underlying observed dynamics. Starting from the Helmholtz-Hodge decomposition of continuous vector fields, we review the recently proposed Graph Vector Field (GVF) framework and its discrete representation on simplicial complexes. We then introduce a hierarchy of alternative approaches, including parametric conditional models, linear graph dynamical systems, and reduced Hodge representations. Finally, we propose a verification and validation methodology based on benchmark datasets from well-understood physical systems and on systematic model-reduction and ablation studies. The resulting family of structured-flow models within a common framework, ranging from low-dimensional parametric representations to full GVF formulations, supports a diagnostic methodology in which gradient, curl, harmonic, and topological contributions are systematically assessed through ablation studies. This process enables the identification of dominant mechanisms underlying the observed dynamics and guides the construction of simplified models tailored to the available data and operational constraints. By separating structural verification, behavioral verification, and domain-specific validation, the proposed approach provides a foundation for scalable and interpretable analysis of complex dynamical systems across multiple application domains.

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

DivRL: Disentangled Self-Similarity Rewards for Diverse Subject-Driven Generation

Subject-driven image generation faces an "Identity-Diversity Paradox", where strong identity preservation often leads to rigid and low-diversity outputs. We propose a post-training framework called DivRL that jointly optimizes identity consistency and structural diversity simultaneously by leveraging disentangled visual features from a robust similarity model. Specifically, we introduce a Negative Self-Similarity Measure (nSSM) to quantify structural diversity, and Visual Semantic Matching (VSM) to evaluate identity consistency. We propose an "Explore-and-Suppress" strategy that treats VSM as a gated constraint: the model freely explores structurally diverse configurations, and only samples that violate the identity threshold are penalized via a quadratic hinge loss. This converts identity preservation from a competing objective into a feasibility constraint, allowing nSSM and VSM to improve jointly. Experiments demonstrate that our method effectively pushes the model to generate both consistent and diverse images and improves structural diversity while maintaining comparable identity consistency through a gated optimization formulation.

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

Synthetic Counteradaptation: A Principle of Human-AI Co-evolution

arXiv:2606.15503v1 Announce Type: new Abstract: In this paper, we introduce the concept of synthetic counteradaptation, a process where human and AI systems co-evolve by adapting to each other's strategies and behaviors. Synthetic counteradaptation occurs when AI systems develop novel strategies or social protocols, prompting humans to extract insights and adapt their own behaviors in response, leading to the emergence of new agent interaction dynamics. To illustrate these dynamics, we analyze examples from various contexts, including the game of Go, mixed-motive social interactions, and geopolitical simulations. By exploring these cases, we demonstrate how synthetic counteradaptation provides a framework for understanding the recursive and co-evolutionary nature of human-AI interactions in multi-agent environments.

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

Self-Prompting Small Language Models for Privacy-Sensitive Clinical Information Extraction

Clinical named entity recognition from dental progress notes is challenging because documentation is highly unstructured, domain-specific, and often privacy-sensitive. We developed a locally deployable framework that enables small language models to self-generate, verify, refine, and evaluate entity-specific prompts for extracting multiple clinical entities from dental notes. Using 1,200 annotated notes, we evaluated candidate open-weight models with multi-prompt ensemble inference and further adapted selected models using QLoRA-based supervised fine-tuning and direct preference optimization. Model performance varied substantially, highlighting the need for task-specific evaluation rather than reliance on generic benchmarks. Qwen2.5-14B-Instruct achieved the strongest baseline performance. After DPO, Qwen2.5-14B-Instruct and Llama-3.1-8B-Instruct achieved micro/macro F1 scores of 0.864/0.837 and 0.806/0.797, respectively. These findings suggest that automated prompt optimization combined with lightweight preference-based post-training can support scalable clinical information extraction using locally deployed small language models.

13.
arXiv (quant-ph) 2026-06-24

A Universal All-Fiber Quantum Buffer for the Telecom Band

arXiv:2606.24681v1 Announce Type: new Abstract: The realization of a scalable quantum internet relies on the ability to temporally align asynchronous photonic signals through on-demand buffering. While matter-based quantum memories achieve long storage times, their extremely narrow bandwidths and cryogenic requirements pose significant barriers to integration with existing telecommunications infrastructure. Conversely, current all-optical memories operate at room temperature but are hampered by high input/output losses and a lack of universality across different photonic degrees of freedom. Here, we demonstrate a universal, fully fiber-integrated quantum buffer operating over the full telecom C-band that overcomes these fundamental trade-offs. By implementing an actively switched dual-Sagnac cavity driven by cross-phase modulation, we achieve an ultra-low input/output loss of 0.46 dB and a storage time exceeding 18 $\mu$s. The device exhibits an operational bandwidth exceeding 12.5 THz ($\sim$100 nm), covering the full telecom C-band. We show the simultaneous buffering of over 200 temporal modes with the ability to address them either collectively or one by one. We demonstrate high-fidelity storage for all three degrees of freedom compatible with optical fiber propagation, namely time-bin, frequency-bin, and polarization qubits, along with faithful preservation of entanglement, confirming the platform's true universality. These results provide a robust, room-temperature solution for the high-rate synchronization of multidimensional quantum states, clearing a major hurdle for the deployment of global photonic quantum networks.

14.
arXiv (CS.AI) 2026-06-24

OmniPath: A Multi-Modal Agentic Framework for Auditing Wheelchair Accessibility

arXiv:2606.24129v1 Announce Type: new Abstract: For a wheelchair user, a standard blue line on a map is often a broken promise. While platforms like OpenStreetMap (OSM) successfully capture where a path is, they frequently fail to convey how it physically feels to travel on it. This information barrier is problematic for wheelchair users. To solve this issue, we present OmniPath, a system that moves from passive mapping to proactive environmental auditing. Our framework fuses the network topology of OSM with the submeter precision of high-density aerial LiDAR (USGS 3DEP) to create a high-fidelity 3D model of the pedestrian environment. Rather than simply routing a user, our agent virtually traverses the network, analyzing the surface in 0.5 meter increments. It rigorously quantifies physical friction points specifically running slope, cross slope, and vertical discontinuities against ADA compliance standards, calculating a weighted severity score to categorize hazards from ``Mild'' to ``Critical.'' To ensure real world reliability, we validated the system against 200 physical ground truth field surveys across the National Mall using stratified random sampling. The framework demonstrated strong diagnostic reliability for high-severity hazards, achieving F1-scores of 0.60 for Severe and 0.58 for critical categories. By automating this micro-scale inspection, OmniPath identifies the ``invisible'' barriers that standard maps miss, effectively transforming a static dataset into accessibility data source that anticipates accessibility challenges before the user ever leaves home.

15.
arXiv (CS.CL) 2026-06-12

SICI: A Semantic-Pragmatic Complexity Index Reveals Regime Shifts in LLM Stance Detection

Prompt-based LLMs are increasingly used for stance detection, but harder examples are not always repaired by clearer instructions, reasoning prompts, retrieval, or debate. We introduce SICI (Stance Inference Complexity Index), a seven-dimensional diagnostic measure of the semantic-pragmatic burden imposed by a target–text pair. Across SemEval-2016 and VAST, SICI predicts LLM accuracy better than surface proxies and shows substantial cross-scorer reliability ($\alpha=0.771$). More importantly, LLM errors change regime as SICI increases: low-complexity examples invite over-attribution, especially Against predictions; intermediate examples form an unstable boundary; and high-complexity examples rapidly concentrate on None. This phase-transition-like structure persists across GPT-3.5, GPT-4o-mini, DeepSeek-V3, and GPT-4o, although stronger models move the boundaries. A 15-method intervention study further shows that prompting, retrieval, and debate often shift models along the attribution–abstention axis rather than removing the high-complexity bottleneck.

16.
bioRxiv (Bioinfo) 2026-06-22

Few-Shot Classification of C. elegans Developmental Stages via Explainable Hierarchical Hyperbolic Graph Embeddings

Automated, accurate, and fast developmental-stage classification of C. elegans from microscopy-based morphological images is essential for aging research, drug screening, and disease modeling. However, it remains challenging due to morphological similarities between stages and the limited annotated data. In this work, we propose HyperDev, a hyperbolic few-shot learning framework that addresses these limitations by directly encoding developmental hierarchies in the embedding space, unlike conventional Euclidean approaches that treat stages as independent classes. HyperDev uses Poincare ball geometry, combined with a biologically informed developmental prior, to naturally represent stage relationships. We introduce our selfcurated C. elegans dataset spanning seven developmental stages (Egg, L1-L4, Adult, Dauer) with extreme class imbalance (6-8 samples per minority class). HyperDev achieves competitive classification accuracy (76.9-88.3%) while providing intrinsic explainability across nine 7-way few-shot evaluation settings. The learned embeddings exhibited strong biological alignment (Pearson r = 0.669, p < 0.001), while significantly outperforming ProtoNet (r = 0.187), MatchingNet (r = 0.235), and RelationNet (r = 0.464). These results establish hyperbolic geometry as a principled approach to explainable few-shot learning in biological imaging, where understanding learned representations is as critical as predictive performance. Clinical Relevance–By enabling explainable, data-efficient developmental staging from scarce samples, HyperDev supports improved phenotype quantification for aging research, disease modeling, and drug screening. Index Terms–Hyperbolic learning, few-shot classification, developmental staging, Caenorhabditis elegans, interpretability, explainability.

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

Ensemble RL through Classifier Models: Enhancing Risk-Return Trade-offs in Trading Strategies

作者:

arXiv:2502.17518v3 Announce Type: replace-cross Abstract: This paper presents a comprehensive study on the use of ensemble Reinforcement Learning (RL) models in financial trading strategies, leveraging classifier models to enhance performance. By combining RL algorithms such as A2C, PPO, and SAC with traditional classifiers like Support Vector Machines (SVM), Decision Trees, and Logistic Regression, we investigate how different classifier groups can be integrated to improve risk-return trade-offs. The study evaluates the effectiveness of various ensemble methods, comparing them with individual RL models across key financial metrics, including Cumulative Returns, Sharpe Ratios (SR), Calmar Ratios, and Maximum Drawdown (MDD). Our original experimental results demonstrate that ensemble methods often outperform base models in terms of risk-adjusted returns, providing better management of drawdowns and overall stability. However, both the original analysis and the additional reproduction reported in this version show that ensemble performance is sensitive to the choice of variance threshold \(\tau\), classifier group, RL-agent pair, and market universe. The reproduction evidence strengthens the conclusion that classifier-assisted ensemble selection can improve robustness, while also clarifying that the advantage is conditional rather than automatic across all datasets. This study emphasizes the value of combining RL with classifiers for adaptive decision-making, with implications for financial trading, robotics, and other dynamic environments.

18.
arXiv (CS.CV) 2026-06-16

Polyp-D2ATL: Deep Domain-Adaptive Transfer Learning for Colorectal Polyp Classification under Label Distribution Shift

Early and highly accurate prediction of colorectal polyps, as an important sign of one of the most dangerous types of cancer, will result in saving more lives. Despite the advancements in colorectal polyp classification, many challenges remain in obtaining an automated polyp prediction system that is able to diagnose the difficult-to-predict polyps accompanied by different features in real scenarios, where the model can handle imbalanced data, label distribution shift, and cross-modality generalization successfully. In this study, we propose Polyp-D2ATL, a novel framework accompanied by a specific training strategy, which mitigates these limitations and effectively predicts the different classes of polyps belonging to the NICE classification. Our extensive experiments on the PICCOLO validation and test sets demonstrate that the proposed Polyp-D2ATL significantly outperforms existing state-of-the-art models across various reliable metrics, achieving an accuracy of 82.38%, a Macro-F1 of 77.49%, and a specificity of 87.47% on the validation set, alongside consistent improvements on the held-out test set which demonstrates the generalization capacity and clinical applicability of the proposed approach.

19.
bioRxiv (Bioinfo) 2026-06-11

VFUSE: Virulent Feature Understanding with Sparse autoEncoders

Generative models have shown remarkable progress in a variety of domains such as protein design, but such power enables the opaque generation of hazardous proteins. In this work, we introduce VFUSE (Virulent Feature Understanding with Sparse autoEncoders), a mechanistic interpretability approach that trains SAEs on diffusion-transformer activations to audit protein models for hazard-aware features. We apply VFUSE to RoseTTAFold3 and RFDiffusion3, popular open-weight models for protein folding and synthesis. We find that for certain blocks, linear probes detect hazardous designs significantly better when fit in the SAE latent space over the original model's representations: improving interpretability without sacrificing model performance. Furthermore, we identify monosemantic features from the SAE that fire only on hazardous designs at up to AUROC 0.84 (q < 10-13).

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

Enhancing Brain MRI Anomaly Detection and Reasoning with ROI Rethink and Synthetic Data

Medical vision-language models typically generate diagnoses through single-pass inference without indicating which image regions support their conclusions. This lack of spatial grounding limits clinical utility: outputs cannot be audited, and models may hallucinate findings on normal scans. We present BrReMark (Brain Rethink via ROI Marking), a framework that introduces explicit region marking into brain MRI diagnosis. The model first generates hypotheses about potential abnormalities and grounds them through explicit bounding box marking, then verifies conclusions by re-examining the marked evidence. Training combines supervised fine-tuning on structured reasoning trajectories with reinforcement learning using a composite reward over localization accuracy and diagnostic reasoning. Furthermore, we integrate a domain randomization-based pathology synthesis augmentation strategy to improve the model's generalizability to out-of-distribution (OOD) data. On internal benchmark, BrReMark improves mAP50 from 0.74% to 37.54% compared to the base model, while achieving 21.57% Clinical F1 and 45.26% diagnostic accuracy. On NOVA OOD benchmark, it also achieves competitive overall performance with a 45.7% reduction in false positives compared to the state-of-the-art, indicating reduced hallucination on rare pathologies. These findings suggest that explicit hypothesis-verification grounding is a practical path toward trustworthy open-ended brain MRI diagnosis across both in-distribution and OOD settings.

21.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

22.
medRxiv (Medicine) 2026-06-12

High coverage, persistent gaps: quality of Antenatal Care and its determinants in Zambia based on the 2024 Demographic and Health Survey.

Abstract Background Evaluating antenatal care (ANC) quality is critical to reducing maternal and neonatal mortality. In Zambia, despite high basic ANC attendance, comprehensive national evidence on the clinical content and quality of services remains limited. This study assessed the coverage of WHO-recommended ANC interventions and identified factors associated with care quality using the latest national data. Methods A cross-sectional analysis was conducted using data from the 2024 Zambia Demographic and Health Survey. The final analytic sample comprised 4,829 women aged 15-49 with a live birth in the preceding 5 years. A composite index of 15 selected, equally weighted WHO-recommended components evaluated clinical assessment, counseling/screening, preventive interventions, and utilization. Survey-weighted Poisson regression estimated adjusted incidence rate ratios (aIRRs) for the count of ANC components received. Results The mean ANC quality score was 12.5 out of 15 (95% CI: 12.4-12.6), and 78.5% (95% CI: 77.0-80.0) of women achieved adequate ANC ([&ge;] 12/15 components). While individual clinical and counseling coverage generally exceeded 90%, only 47.2% (95% CI: 45.3-49.0) of women initiated care during the first trimester, and just 4.8% (95% CI: 4.1-5.6) achieved [&ge;] 8 ANC contacts. Maternal education was the strongest and most stable predictor of quality across all models. Compared to no education, higher education was associated with an 8.0% higher expected quality score (aIRR = 1.080, 95% CI: 1.051-1.110). Lower ANC quality was significantly associated with unwanted pregnancies (aIRR = 0.970, 95% CI: 0.956-0.993) and with residence in Western (aIRR = 0.923, 95% CI: 0.897-0.951) and North Western (aIRR = 0.966, 95% CI: 0.937-0.996) provinces. Absence of distance barriers and residence in Eastern, Luapula, and Copperbelt provinces were associated with higher quality scores. Conclusion While average ANC component coverage in Zambia is high, critical gaps persist in early initiation and total contact frequency. Care adequacy is strongly influenced by maternal education, relationship status, pregnancy intention, and regional inequities. These findings underscore the need for interventions targeted at uneducated women, preventing unintended pregnancies, and underserved regions such as Western and North Western Provinces. Keywords: Antenatal care quality, ANC content, Zambia, maternal education.

23.
medRxiv (Medicine) 2026-06-22

Symptom-based phenotype discovery in motor neuron disease using natural language processing of electronic health records

Background: Motor neuron disease (MND) is a fatal neurodegenerative condition with significant clinical heterogeneity that is incompletely captured by existing phenotype classifications based on onset site. Electronic health records (EHRs) contain detailed symptom documentation in clinical narratives that may enable data-driven discovery of clinically meaningful patient subgroups. Methods: We developed a natural language processing (NLP) pipeline using MedCAT to extract symptoms from clinical notes of 2,361 people with a confirmed diagnosis of MND at a tertiary neurology center. MND cohort confirmation used three complementary methods: clinic attendance records, text-based diagnosis detection, and NLP extraction with negation detection. Extracted symptoms were filtered to Unified Medical Language System semantic type T184 (Sign or Symptom) with removal of negated concepts. Patients were clustered using latent class analysis on binary symptom profiles. Survival differences were assessed using Kaplan-Meier analysis, log-rank tests, and Cox proportional hazards regression. Results: From the first clinical notes, we identified four clusters of symptoms among 872 patients and 76 symptoms: Motor-Bulbar (n=373), Motor-Tremor (n=154), Sensory-Pain (n=222), and Motor-Respiratory (n=123). When extended to all clinical notes (n=2,065; 184 symptoms), these reorganized into three clusters: Autonomic-Respiratory (n=472), Nocturnal-Respiratory (n=338), and Classic Motor (n=1,255). Survival differences were significant across all clusters in both the first notes and all notes analyses (log-rank p < 0.001). Conclusions: NLP-based symptom extraction from EHRs identifies clinically meaningful MND subgroups that extend beyond traditional onset-site classifications. Autonomic-respiratory symptom burden is associated with poorer survival while a newly identified Sensory-Pain subtype with a better prognosis. These data-driven phenotypes may improve prognostication and inform targeted supportive care.

24.
arXiv (CS.AI) 2026-06-11

MODF-SIR: A Multi-agent Omni-modal Distilled Framework for Social Intelligence Reasoning

arXiv:2606.12018v1 Announce Type: new Abstract: We propose a multi-agent collaborative framework built upon a lightweight Multimodal Large Language Model (MLLM), specifically designed for social intelligence reasoning. A key feature of our approach is that both the training and inference phases are augmented via knowledge distillation. Within this architecture, multi-modal data pertinent to social intelligence is precisely localized. Furthermore, relevant long-tail events are identified, extracted, and rendered as formatted, explicit text. This formatting strategy prevents critical long-tail information from being overshadowed by head events and environmental noise during the tokenization process. Specifically, we integrate Test-Time Adaptation (TTA) across the entire reasoning pipeline, encompassing the extraction and representation of long-tail events, Chain-of-Thought (CoT) prompting, and self-reflection. This TTA mechanism is also distillation-enhanced, utilizing Low-Rank Adaptation (LoRA) to fine-tune the foundation model exclusively for instance-level reasoning. Extensive evaluations against various open-source and proprietary AI models across multiple benchmarks demonstrate the effectiveness of the proposed framework. With around 30% of training data from IntentTrain, we achieve state-of-the-art results. Codes are available at https://github.com/eeee-sys/MODF-SIR, demo is available at https://huggingface.co/spaces/Harry-1234/MODF-SIR, LoRA is available at https://huggingface.co/Harry-1234/MODF-SIR and the dataset for training router is available at https://huggingface.co/datasets/Harry-1234/IntentRouterTrain.

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

FineDialFact: A benchmark for Fine-grained Dialogue Fact Verification

Large language models are known to produce hallucinations - factually incorrect or fabricated information - which poses significant challenges for many natural language processing applications, such as dialogue systems. As a result, detecting hallucinations has become a critical area of research. Current approaches to hallucination detection in dialogue systems primarily focus on verifying the factual consistency of generated responses. However, these responses often contain a mix of accurate, inaccurate or non-verifiable facts, making the use of a single factual label overly simplistic and coarse-grained. In this paper, we introduce a benchmark, FineDialFact, for fine-grained dialogue fact verification, which involves verifying atomic facts extracted from dialogue responses. To support this, we construct a dataset based on publicly available dialogue datasets and evaluate it using various baseline methods. Experimental results demonstrate that methods incorporating Chain-of-Thought reasoning can enhance performance in dialogue fact verification. Despite this, the best F1-score achieved on the HybriDialogue, an open-domain dialogue dataset, is only 0.74, indicating that the benchmark remains a challenging task for future research. We release our dataset and code at https://github.com/XiangyanChen/FineDialFact.