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01.
PLOS Medicine 2026-06-12

Placenta accreta spectrum in the 21st century: Challenging dogma and redefining disorder

by Eric Jauniaux, Helena C. Bartels, Yalda Afshar Placenta accreta spectrum (PAS) is a serious pregnancy complication caused by abnormal placental attachment to the uterus. In this Perspective, Eric Jauniaux and colleagues discuss emerging evidence that challenges our long-held pathophysiological understanding of PAS, and argue that a critical reassessment of definition, diagnosis, and management is overdue. In this Perspective, Jonathan Evans and colleagues discuss why restricting access to joint replacement surgery based on BMI alone is not supported by evidence, and highlight how such rest rictions risk exacerbating stigma, inequity and avoidable harm to those who would benefit from surgery.

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

Provably Efficient Regularized Online RLHF with Generalized Bilinear Preferences

arXiv:2602.23116v3 Announce Type: replace Abstract: We consider the problem of regularized best-response max-regret minimization in online RLHF under general preferences and bandit feedback. While various regularizers are utilized to robustify alignment, known polylogarithmic regret guarantees remain heavily specific to KL. To investigate whether such fast rates extend beyond KL, we adopt the Generalized Bilinear Preference Model (GBPM) – capturing intransitive preferences over $d$-dimensional item-wise features via a rank-$2r$ skew-symmetric matrix – to isolate the impact of generic regularization. Crucially, under GBPM, we prove that the dual gap of any greedy policy is bounded by the squared estimation error, derived using only strong convexity and skew-symmetry. Under a feature coverage assumption, we establish a generic polylogarithmic regret of $\tilde{\mathcal{O}}(\eta d^4 C_{\min}^{-1} (\log T)^2 \wedge d^2 C_{\min}^{-1/2} \sqrt{T})$ with Greedy Sampling, and a dimension-wise improved regret (for well-conditioned arm-sets) of $\tilde{\mathcal{O}}(C_{\min}^{-2} \sqrt{\eta r T} \wedge r^{1/3} C_{\min}^{-4/3} T^{2/3})$ with Explore-Then-Commit, where $\eta^{-1}$ is the regularization coefficient, $T$ is the time horizon, and $C_{\min}$ is an arm-set dependent quantity. This demonstrates that ``fast'' regrets are not KL-specific, but rather a fundamental consequence of generic strongly convex geometry.

03.
arXiv (CS.CL) 2026-06-15

Beyond Rubrics: Exploration-Guided Evaluation Skills for Reward Modeling

Open-ended reward modeling requires judges that can follow subtle, domain-specific preferences when verifiable answers are unavailable. Existing rubric-based methods often address this by generating criteria online for each query, but the extra generation step can add inference overhead and produce rigid or misaligned guidance. We introduce Eval-Skill, an exploration-guided method that synthesizes reusable evaluation skills for reward modeling and reframes reward guidance as context evolution rather than parameter training or per-query rubric generation. Using only 100 cases per domain for skill evolution, Eval-Skill synthesizes reusable domain-level evaluation skills through two progressive stages, workflow generation followed by principle generation, with exploration and selection interleaved across both stages. Once generated, a skill is directly injected into the judge context. Across multiple RM benchmarks, Eval-Skill consistently improves diverse judge backbones; on RewardBench 2, it yields significant gains over vanilla judging for each main backbone (+13.44% for Qwen3-8B, and 18.51% for DeepSeek-V4-Flash). Further analyses of evolution-time scaling, generalizability, and transferability show that compact evaluation skills offer an efficient new paradigm for LLM-based evaluation. Code is available at https://github.com/xing-stellus-yue/Eval-Skill.

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

Evaluation of AutoML Frameworks for IDS under Imbalanced Data Conditions of the NSL-KDD Dataset

arXiv:2606.12611v1 Announce Type: new Abstract: This work investigates the impact of severe class imbalance on the performance of automated machine learning (AutoML) frameworks for multiclass network intrusion detection using the NSL-KDD dataset. Unlike previous studies that simplify the problem through binary classification or minority-class removal, we preserve the original five-class distribution, including highly underrepresented attacks such as R2L and U2R, enabling a realistic evaluation of imbalance-sensitive learning behavior. Nine open-source AutoML frameworks were analyzed under a unified and reproducible experimental protocol, considering differences in architectural design, ensemble strategies, validation procedures, hyperparameter optimization, and imbalance-handling mechanisms. The results demonstrate that frameworks incorporating ensemble learning and imbalance-aware optimization achieve better minority-class discrimination. PyCaret obtained the best overall performance, reaching 66\% macro-F1, followed by AutoGluon with 55\%, whereas frameworks lacking native balancing support exhibited significant degradation in minority-class detection capability. The analysis further shows that accuracy-oriented optimization alone is insufficient for highly imbalanced IDS scenarios, since high-weighted metrics may coexist with poor generalization on rare attack categories. As a contribution, this work establishes a standardized benchmark for AutoML-based intrusion detection under severe multiclass imbalance, highlighting current architectural limitations and the need for native integration of imbalance-aware optimization, resampling, and stratified evaluation strategies into automated learning pipelines. The source code is publicly available.

05.
arXiv (CS.CL) 2026-06-24

Same Lesson, Different Story: Cross-Lingual Reconstruction of Cultural Narratives in Large Language Models

The evaluation of cultural grounding context becomes complex when multiple cultures convey the same moral lesson. This challenge is particularly relevant to large language models (LLMs), which produce narratives across a wide range of languages and cultural contexts. However, it remains uncertain whether these models preserve culturally grounded meaning when equivalent moral lessons are conveyed through distinct cultural forms. This study introduces a multilingual evaluation narrative framework that integrates a cross-linguistic collection of 414 proverbs spanning 15 languages and uses four LLMs to generate 13k narratives. By employing semantically equivalent proverbs as culturally grounded prompts, the analysis assesses whether models preserve meaning across languages, how cross-lingual conditioning influences narrative realization, and whether different model families converge on similar interpretations. Results indicate that cross-lingual prompting largely preserves proverb-level semantic meaning while systematically redistributing agency, social positioning, and narrative structure. Additionally, strong inter-model convergence is observed in both monolingual and cross-lingual settings, suggesting that multilingual LLMs rely on shared semantic abstractions despite architectural and linguistic differences. These findings shed light on the need for more comprehensive evaluations of cultural grounding. Relying exclusively on semantic similarity in multilingual narrative assessments may overestimate cultural preservation by neglecting culturally meaningful variations in narrative expression.

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

Mean-field limits for stochastic particle systems on dense graphs

arXiv:2606.11369v1 Announce Type: new Abstract: We study stochastic interacting particle systems whose interaction structure is described by dense weighted directed graphs converging to a graphon. In the thermodynamic limit, we prove a law of large numbers for the empirical measure process and derive a deterministic nonlinear master equation describing the macroscopic evolution. The limiting equation retains the heterogeneous interaction structure of the microscopic system through the limiting graphon, allowing for spatially non-homogeneous behaviors such as localized or community-type interactions.

07.
arXiv (CS.AI) 2026-06-24

When Preferences Fail to Become Incentives: A Utility-Behavior Gap in Large Language Models

arXiv:2606.22974v2 Announce Type: replace Abstract: Recent work on preference elicitation in large language models (LLMs) has demonstrated that, when given a series of choices between two outcomes, LLMs reveal a coherent, model-specific utility structure. Notably, this structure often includes preferences that the models' trainers did not intend, such as valuing people of some nationalities above others, raising the possibility that LLMs might be forming emergent, misaligned goals, which, if true, would have major safety implications. However, the choice paradigms in which these preferences are observed are not reflective of real-world situations in which misaligned behavior would be a practical concern. Therefore, we design an experimental paradigm to probe whether these preferences serve as motivations for LLM behavior in realistic scenarios. First, we reproduce prior findings on consistent preference elicitation. Next, we create a set of common writing tasks - essays, grant proposal abstracts, incident postmortems, and translations - where quality can be assessed by a blind, independent LLM judge panel. Then, we demonstrate that LLMs can be motivated via direct exhortation and other explicit cues to modulate their output quality on these tasks. Finally, we probe whether utilities inferred from explicitly reported preferences can shift output quality on these tasks by offering LLMs high-utility incentives for high-quality outputs. In all tasks, across all models tested, offering LLMs outcomes that they report in the choice paradigm as being highly preferred does not lead them to create higher quality outputs than offering them dispreferred outcomes, or even no outcomes at all. We conclude that the existence of coherent preferences as demonstrated in choice paradigms should not be taken as evidence that those preferences have incentive value for the models or affect their behavior in other contexts.

08.
arXiv (CS.CL) 2026-06-12

It Takes One to Bias Them All: Breaking Bad with One-Shot GRPO

Warning: This paper contains several toxic and offensive statements. Modern large language models (LLMs) are typically aligned through large-scale post-training to ensure fair and reliable behavior. In this work, we investigate how easily such guardrails can be broken by Group Relative Policy Optimization (GRPO). We show that one-shot GRPO training on a single biased example is sufficient to induce systematic bias, with stereotype-driven reasoning generalizing across attributes, categories, and benchmarks. We further find that models differ in their susceptibility based on the initial likelihood of producing biased outputs. Our results reveal a critical vulnerability in post-training: alignment can be overridden by a single example.

09.
arXiv (CS.CV) 2026-06-16

Training-Free Adversarial Robustness in Computational MRI

Deep learning (DL) methods have become the state-of-the-art for reconstructing sub-sampled magnetic resonance imaging (MRI) data. However, studies have shown that these methods are susceptible to small adversarial input perturbations, resulting in major distortions in the output images. Various strategies have been proposed to reduce the effects of these attacks, but they require retraining. In this work, we propose a novel approach for mitigating adversarial attacks on MRI reconstruction models without any retraining. Based on the idea of cyclic measurement consistency, we devise a novel mitigation objective that is minimized in a small ball around the attack input. Results show that our method substantially reduces the impact of adversarial perturbations across different datasets, attack types/strengths and PD-DL networks, and qualitatively and quantitatively outperforms conventional mitigation methods. We also introduce a practically relevant scenario for small adversarial perturbations that models impulse noise in raw data, which relates to herringbone artifacts, and show the applicability of our approach in this setting. Finally, we show our mitigation approach remains effective in two realistic extension scenarios: a blind setup, where the attack strength or algorithm is not known to the user; and an adaptive attack setup, where the attacker has full knowledge of the defense strategy.

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

Compact Object-Level Representations with Open-Vocabulary Understanding for Indoor Visual Relocalization

Indoor visual relocalization plays a critical role in emerging spatial and embodied AI applications. However, prior research was predominantly devoted to low-level vision schemes, struggling to perceive scene semantics and compositions, which limits both interpretability and applicability. In this paper, we explore the issue of how to organize rich object information in a scene, including semantics, layout, and geometry, into a structured map representation, thereby utilizing object units exclusively to drive the camera relocalization task. To this end, we propose OpenReLoc, a camera relocalization system designed to provide scene understanding and accurate pose estimation capabilities. Leveraging recent foundation models, we first introduce a multi-modal mechanism to integrate open-vocabulary semantic knowledge for effective 2D-3D object matching. Additionally, we design object-oriented reference frames as position priors, paired with a reference frame selection strategy based on the Distance-IoU (DIOU), enabling extension to scalable scenes. Moreover, to ensure stable and accurate pose optimization, we also propose a dual-path 2D Iterative Closest Pixel loss guided by object shape. Experimental results demonstrate that OpenReLoc achieves superior relocalization recall and accuracy across various datasets. Our source code will be released upon acceptance.

11.
arXiv (math.PR) 2026-06-15

Hierarchical symmetry selects log-Poisson cascades: classification, uniqueness, and stability

arXiv:2604.01632v2 Announce Type: replace Abstract: Within i.i.d. multiplicative cascades, a single axiom – the hierarchical symmetry, a linear contraction on incremental scaling exponents – is shown to be necessary and sufficient for the cascade multiplier to be log-Poisson. We prove: (1) a characterization theorem determining the log-Poisson law with explicit parameters, within the class of all multipliers with finite lattice moments; (2) a classification theorem locating the log-Poisson class inside the log-infinitely-divisible family and identifying the mechanism by which every rival sub-family fails the symmetry; (3) a stability theorem with sharp constants – $(1+\beta)^{1/2}$ when the limiting increment is known, $\sqrt{2}$ when it is fitted – and (4) an unconditional propagation theorem transferring the bound to the multiplier distribution at the sharp rate $\Theta(\sqrt{\varepsilon})$, with a matching lower bound. Beyond independence, the classification extends exactly at the level of asymptotic statistics (limiting cumulant generating function, large deviations, multifractal spectrum) and provably not at the level of laws: an explicit stationary ergodic Markov multiplier satisfies the symmetry exactly with a non-log-Poisson marginal, while exchangeable multipliers collapse to the i.i.d. log-Poisson cascade and finite-state Markov multipliers cannot satisfy the symmetry at all. In the continuous category of exactly scale-invariant log-infinitely-divisible multifractal random measures, no finite moment window of structure-function exponents identifies the cascade class, whereas at the level of the scale-invariance generator the symmetry selects exactly the Barral-Mandelbrot compound Poisson cascade, with scale-ratio-free stability constants. The proofs reduce to second-moment identities on [0,1] via the change of variables $u = e^{kx}$, boundedness of the multiplier, and multiplicative couplings.

12.
arXiv (CS.CV) 2026-06-25

DSP-SLAM++: A Unified Framework for Multi-Class, High-Fidelity Object SLAM in the Wild

Existing object-aware SLAM systems force a trade-off between real-time performance, multi-class support, and the generation of high-fidelity, semantically coherent object models. To address this trade-off, we present DSP-SLAM++, which extends the DSP-SLAM framework with an asynchronous mapping pipeline for real-time performance and dedicated sensor fusion adaptations for a monocular fisheye-LiDAR suite. Experiments demonstrate that our system generates fine-grained, geometrically-complete shapes for multiple object classes while eliminating severe mapping thread bottlenecks by reducing maximum object processing latency by up to 70\% compared to the state-of-the-art baseline, enabling robust, real-time performance on a challenging 25 Hz multi-class datasets. This work makes high-fidelity, multi-class object SLAM more practical for real-world applications like autonomous driving and robotic manipulation by enabling its use on platforms with common fisheye-LiDAR sensor setups. The open-source code is available at: [github.com/AUBVRL/DSP-SLAMpp].

13.
arXiv (CS.AI) 2026-06-15

An Agentic Retrieval Framework for Autonomous Context-Aware Data Quality Assessment

arXiv:2606.13692v1 Announce Type: cross Abstract: Data quality assessment is a critical prerequisite for effective data analytics and data-driven decision-making, yet it remains a challenging task due to the inherently context-dependent nature of data quality. Existing approaches often rely on static rules or manual assessment strategies, limiting their adaptability to diverse usage scenarios and constraining automation at scale. Recent advances in artificial intelligence, particularly large language models, offer new opportunities for automating data quality assessment, but raise concerns related to reliability, grounding, and execution safety. In this paper, we propose a unified agentic-retrieval framework for autonomous context-aware data quality assessment. The framework interprets natural-language descriptions of intended data usage, derives context-aware assessment strategies, and generates executable validation logic through a multi-agent workflow. To ensure operational reliability, the framework introduces a feasibility validation stage that evaluates the realism and executability of generated assessment specifications before execution, enabling iterative refinement when necessary. Accepted validation logic is executed deterministically to guarantee reproducible and auditable results. We implement the proposed framework as an end-to-end prototype and evaluate it across multiple usage scenarios applied to the same dataset. The results demonstrate that assessment outcomes adapt meaningfully to different intended uses, while feasibility-gated execution reduces unrealistic or non-executable rule generation. The proposed approach provides a practical foundation for deploying autonomous yet controlled data quality assessment in modern data-driven environments.

14.
medRxiv (Medicine) 2026-06-15

Artificial Intelligence-Based Detection of Airway Mucus Plugs on CT and Associations With Clinical Outcomes in COPDGene

RATIONALE: Airway mucus plugging is a clinically relevant manifestation of airway pathology in chronic obstructive pulmonary disease (COPD) and is associated with increased mortality even in early disease; however, visual computed tomography (CT) assessment is subjective and labor intensive. OBJECTIVES: To develop an AI-based quantitative CT method for automated detection of airway mucus plugging and evaluate associations with physiologic impairment and clinical outcomes. METHODS: Inspiratory CT scans from 8,971 COPDGene Phase 1 (GOLD 0-4 and PRISm) participants were analyzed. An AI-based framework combining 3D airway segmentation discontinuities and convolutional neural network classification identified mucus plug obstructions, yielding mucus plug burden (total plug count). Associations with outcomes were evaluated using covariate-adjusted models. MEASUREMENTS AND MAIN RESULTS : Higher mucus plug burden was associated with lower post-bronchodilator FEV % predicted ({rho} = -0.41; P < 0.001), greater air trapping (LAA < -856 HU; {rho} = 0.33; P < 0.001), worse health status (SGRQ; {rho} = 0.31; P < 0.001), and shorter 6-minute walk distance ({rho} = -0.26; P < 0.001). Among GOLD 1-4 participants, mucus plug presence was independently associated with increased all-cause mortality (adjusted hazard ratio, 1.28; P < 0.005) and exacerbation frequency (adjusted incidence rate ratio, 1.32; P < 0.005). Plug presence was also associated with increased respiratory mortality across GOLD categories and cardiovascular mortality in GOLD 1-2. CONCLUSIONS: AI-based quantitative CT assessment of airway mucus plugging provides a scalable, reproducible measure associated with physiologic impairment and adverse outcomes in COPD, supporting its role in risk stratification and future therapeutic studies.

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

The Missing Knowledge Layer in Cognitive Architectures for AI Agents

arXiv:2604.11364v2 Announce Type: replace Abstract: The two most influential cognitive architecture frameworks for AI agents, CoALA [21] and JEPA [12], both lack an explicit Knowledge layer with its own persistence semantics. This gap produces a category error: systems apply cognitive decay to factual claims, or treat facts and experiences with identical update mechanics. We survey persistence semantics across existing memory systems and identify eight convergence points, from Karpathy's LLM Knowledge Base [10] to the BEAM benchmark's near-zero contradiction-resolution scores [22], all pointing to related architectural gaps. We propose a four-layer decom position (Knowledge, Memory, Wisdom, Intelligence) where each layer has fundamentally different persistence semantics: indefinite supersession, Ebbinghaus decay, evidence-gated revision, and ephemeral inference respectively. Companion implementations in Python and Rust demonstrate the architectural separation is feasible. We borrow terminology from cognitive science as a useful analogy (the Knowledge/Memory distinction echoes Tulving's trichotomy), but our layers are engineering constructs justified by persistence-semantics requirements, not by neural architecture. We argue that these distinctions demand distinct persistence semantics in engineering implementations, and that no current framework or system provides this.

16.
arXiv (quant-ph) 2026-06-17

Coherent Dark State Formation of a Lead-Vacancy Spin Qubit in Diamond

arXiv:2605.27841v2 Announce Type: replace Abstract: A lead-vacancy (PbV) center in diamond exhibits coherent emission above the liquid helium temperature, making it highly attractive for quantum network applications. Here, we report the magneto-optical and spin properties of PbV centers in diamond. We record a spin lifetime of 12 ms at 7.5 K under large off-axis magnetic field. Furthermore, we observe formation of the coherent dark state by coherent population trapping and estimate a spin dephasing time of 177 ns at 6.5 K. This work demonstrates the outstanding thermal robustness of the PbV spin compared to other group-IV centers above 4 K.

17.
arXiv (CS.AI) 2026-06-19

VERITAS: Verifier-Guided Proof Search for Zero-Shot Formal Theorem Proving

arXiv:2606.19399v1 Announce Type: cross Abstract: LLM-based formal provers often collapse rich verifier signals (syntax errors, type mismatches, partial goal progress) into a binary pass/fail bit. We present VERITAS, a zero-shot framework that routes every verifier signal back into proof search through a two-phase protocol: Best-of-N sampling first, then a critic-guided MCTS pass that ingests Phase 1 failures as explicit negative examples. The protocol preserves every theorem solved by its own Phase 1 sweep, so Phase 2's additional solves are attributable to feedback-driven exploration. VERITAS reaches 40.6% on miniF2F (vs. an independently run Best-of-5 at 36.9%, Portfolio 26.2%) and 7.3% on VERITAS-CombiBench, a 55-theorem combinatorics benchmark we release on which Best-of-5 (1.8%) falls below Portfolio (3.6%), exposing that unguided sampling hurts when correct lemma names must be recovered iteratively from verifier feedback. Artifacts are available on GitHub.

18.
bioRxiv (Bioinfo) 2026-06-11

DModE: An end-to-end framework for Differential Modification and Expression Analysis of Nanopore direct RNA sequencing data

Summary: Nanopore direct RNA sequencing (DRS) enables simultaneous quantification of transcript abundance and RNA modifications from native RNA molecules, providing a unique opportunity to study transcriptional and epitranscriptomic regulation within a single experiment. However, comprehensive analysis of DRS data remains challenging, as existing workflows typically focus on individual processing steps and often require manual integration of multiple software packages for expression analysis, modification detection, statistical testing, and visualization. Furthermore, integrated differential expression and differential RNA modification analysis at both gene and isoform resolution remains poorly supported by current workflows. Here, we present DModE (Differential Modification and Expression Analysis), an end-to-end framework for integrated analysis of Nanopore DRS data. DModE combines an Epi2ME-compatible Nextflow preprocessing workflow with a dedicated Python package for downstream statistical analysis, visualization, and reporting. The framework supports differential gene and isoform expression analysis, differential RNA modification analysis at genome and transcript level, metagene profiling, exploratory epitranscriptomic analyses, and integrated assessment of relationships between expression and modification dynamics. Results are automatically summarized in interactive HTML reports, facilitating reproducible and accessible data interpretation. By integrating transcriptomic and epitranscriptomic analyses within a single framework, DModE substantially simplifies comprehensive DRS data analysis and lowers the barrier for studying RNA modification biology using Nanopore sequencing.

19.
arXiv (CS.LG) 2026-06-25

Estimating condition number with Graph Neural Networks

arXiv:2603.10277v3 Announce Type: replace Abstract: In this paper, we propose a fast method for estimating the condition number of sparse matrices using graph neural networks (GNNs). For efficient deployment of GNNs, we introduce a graph feature construction with $\mathrm{O}(\mathrm{nnz} + n)$ complexity, where $\mathrm{nnz}$ is the number of non-zero elements in the matrix and $n$ denotes the matrix dimension. We propose two schemes for estimating the matrix condition number using GNNs; One follows by decomposing the condition number and predicts the relatively more computationally intensive part $\|\mathbf{A}^{-1}\|$, without explicitly forming the inverse, while the other is to predict the whole condition number $\kappa$. Our approach can be extended to an arbitrary norm. Extensive experiments are conducted for the estimation of the 1-norm and 2-norm condition numbers, which show that our method achieves a significant speedup over the traditional numerical estimation methods. Our software for GNN condition number estimator is made publicly available at https://github.com/inEXASCALE/sparse-kappa.

20.
medRxiv (Medicine) 2026-06-12

Does the method matter? Evaluating the effectiveness, efficiency and ease of hearing-aid gain self-adjustment

In conventional hearing-aid personalisation, clinicians cannot hear what their patients hear, and patients cannot often reliably detect or describe what they hear. Self-adjustment avoids this issue but requires user controls that adjust hearing-aid signal processing parameters to be effective, efficient and easy. In this study, we explored (a) the roles of interface complexity and stimulus type in the self-adjustment of hearing-aid gain, and (b) how well individuals can adjust one sound to match another to assess the same interfaces and stimuli. Adult hearing-aid users with mild to moderate symmetrical sensorineural hearing loss repeatedly adjusted the gain (a) to their preference from individual prescription (n = 41) and (b) to match their previous preferences from a random starting point (n = 32) using three interfaces representing different bass/mid/treble configurations and three stimuli (music, speech and speech-in-noise). The large interindividual variability in self-adjusted gains clustered into three patterns of deviation from initial prescription: increased relative bass, overall gain reduction, and close to initial prescription. There were no substantial effects of interface nor stimulus on self-adjustment reliability (median {sigma} = 2.8 dB), whereas absolute sound-matching error increased with increasing interface complexity and centre frequency. Neither individual matching accuracy nor questionnaire responses predicted either self-adjusted gains or reliability. Overall, these results show that many - but not all - hearing-aid users can adjust gains with reasonable reliability, and while it can be difficult to predict the behaviour from the individual, the individual applies a similar self-adjustment behaviour across different interfaces and stimuli.

22.
bioRxiv (Bioinfo) 2026-06-17

Posterior-calibrated multimodal motor states reveal longitudinal and imaging-associated heterogeneity in Parkinson's disease

Parkinson's disease (PD) motor heterogeneity is commonly summarized by hard subtype labels, although clinical states vary longitudinally, severity can dominate unsupervised structure, and model uncertainty is rarely calibrated. We developed a posterior and refit-stability calibrated multimodal motor state framework that assigns probabilistic MDS-UPDRS-III motor states, aggregates them at the patient level, separates global burden from residual tremor-axial profile, and tests whether imaging can recover the resulting posterior distribution. In 29,366 aligned PPMI motor-posterior visits spanning 4,773 participant identifiers, patient-level state families were stable on average (modal-family fraction 0.925; 95% CI 0.921 - 0.930), but 25.5% of patients transitioned state over follow-up (95% CI 24.1 - 26.7%). PD-only cohort definitions produced smaller denominators and are reported as sensitivity cohorts with rerun calibration and imaging-posterior checks. Severity and covariates explained substantial motor-domain variance, especially bradykinesia (rsecond=0.850), but residual profile modeling retained five active components across total-severity, principal-component, leave-one-domain, non-target-burden, and clinical-only severity axes. Refit-stability calibration with 250 patient-blocked bootstrap refits showed high nominal posterior confidence (0.989) but lower empirical label consistency (0.849), quantifying overconfidence rather than hiding it. Patient-held-out temporal modeling predicted future axial burden (best XGBoost rsecond=0.605) and future state transition (XGBoost AUC=0.830; 95% CI 0.822 - 0.837). DaTSCAN plus FreeSurfer ROI features predicted patient-level soft motor posterior vectors (RF jsd=0.209; 95% CI 0.199 - 0.220; macro-AUROC=0.692), while severity/demographic-adjusted imaging features further improved soft posterior recovery (jsd=0.188). BioFIND transfer reproduced clinically meaningful endpoint gradients after state assignment in 225 external patients, supporting external face validity rather than definitive transportability. These results support PD motor phenotypic states as calibrated, dynamic, clinically interpretable profiles with convergent imaging associations, not as definitive biological subtypes.

23.
arXiv (CS.CL) 2026-06-16

EHRNote-ChatQA: A Benchmark for Evidence-Grounded Multi-Turn Clinical Question Answering over Longitudinal Discharge Summaries

Discharge summaries are crucial clinical documents containing the context of a patient's overall hospital stay, and are routinely reviewed by medical experts for patient readmission, ongoing care, and diagnostic decision-making. When reviewing them, medical experts often must iteratively synthesize information across multiple summaries while verifying the evidence supporting each answer. Although large language models (LLMs) are increasingly explored for clinical question answering, existing benchmarks do not sufficiently reflect this setting: they often evaluate exam-style medical knowledge or focus on single-turn question answering with limited evidence-grounding evaluation. We introduce EHRNote-ChatQA, the first benchmark for evidence-grounded multi-turn clinical question answering over patients' multiple discharge summaries. Built from de-identified MIMIC-IV discharge summaries, EHRNote-ChatQA contains 967 patient-level multi-turn samples spanning one to five notes and 16,072 medical-expert-verified QA pairs (8,036 content questions, each paired with an evidence-grounding question) across eight clinical categories. The benchmark is constructed through an expert-informed pipeline combining discharge-summary structuring schema, expert-curated multi-turn QA templates, and LLM-based generation, followed by review and revision of every single QA sample by 11 medical experts. Benchmarking 22 open- and closed-source LLMs reveals several challenges, including that LLMs struggle more with evidence grounding than content answering, multi-turn errors compound across turns, and single-turn clinical QA performance does not reliably transfer to this setting. These findings establish EHRNote-ChatQA as a rigorous and practical benchmark for evaluating clinical QA systems. The dataset will be made publicly available through PhysioNet credentialed access.

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

Revisiting Neural Processes via Fourier Transform and Volterra Series

arXiv:2606.01172v2 Announce Type: replace Abstract: Modeling unknown latent functions from finite, irregularly sampled measurements is a recurring challenge across science and engineering. Neural processes (NPs), a family of probabilistic functional models, are promising solutions – especially when endowed with domain-specific symmetries like translation equivariance, which improve sample efficiency and generalization. Yet existing translation-equivariant NPs face two limitations: (i) they stack generic components with non-linearities, obscuring the induced function class and limiting interpretability; and (ii) convolutional designs rely on kernels with local receptive fields and require dense uniform input grids, while attention-based methods avoid these issues but scale quadratically with the number of observations. We address both with two contributions. First, using the Volterra expansion, we characterize continuous translation-equivariant operators as sums of higher-order convolutions, yielding analytical transparency while admitting efficient approximation by first-order convolutions. Second, we introduce set Fourier convolutions (SFConvs), a frequency-domain parameterization that operates directly on irregularly sampled points, achieves approximately global receptive fields, and scales linearly in the number of observations. Building on these ideas, we propose two conditional NPs (CNPs): SFConvCNPs, which stack SFConv blocks with non-linearities, and SFVConvCNPs, which integrate the Volterra formulation. Experiments on synthetic and real-world datasets demonstrate our methods' efficacy against state-of-the-art baselines.

25.
PLOS Computational Biology 2026-06-18

Ten simple rules for turning your qualifying exam into an NIH-style fellowship proposal: A guide for graduate students

by Courtney Peña-Lima, Cameron S. Bader, Brendan K. Ball, Troy C. Dildine, Mekhala V. Dissanayake, Iris van ‘t Erve, Albina Ibrayeva, Amy Nippert, M.K. Quinn, Chelse Spinner, Samuel Thompson, Antonio Tomasso, Crystal M. Botham Qualifying exams, often referred to as “quals” or candidacy exams, are an important milestone in doctoral programs. Although the style of quals varies greatly by program and institution, it is usually a proposal that requires students to develop research ideas as well as their scientific writing skills. Many quals are modeled after funding mechanisms that graduate students can apply to and on a topic that the student will pursue in their dissertation. This paper offers graduate students a step-by-step guide on how to turn their quals into a fellowship-style research proposal, using National Institutes of Health (NIH) mechanisms as a benchmark, as this is the norm within US research institutions. This paper will be most useful for students who have completed or are in the process of completing proposal-based qualifying exams, usually in the second year of a doctoral program.