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01.
medRxiv (Medicine) 2026-06-11

Vascular Phenotyping in Parkinson's Disease: Diabetes Mellitus Operationalizes a Microvascular Metabolic Syndrome Cluster Across PPMI Diagnostic Cohorts

Background: Diabetes mellitus elevates Parkinson's disease (PD) risk, via hypothesized cerebrovascular mediation. Whether the diabetes/prediabetes vascular-risk phenotype concentrates in cardiometabolic risk or macrovascular events across prodromal and clinically diagnosed PD remains unresolved. Objectives: To quantify the vascular-risk burden associated with diabetes/prediabetes across the PPMI diagnostic cohorts to test whether this association differs by cohort. Methods: Cross-sectional analysis of 413 PPMI participants (76 healthy controls, 145 prodromal PD, 192 clinically diagnosed PD) examined diabetes/prediabetes (n = 73) and seven vascular risk factors. The Vascular Burden Score (0 to 7) was a priori partitioned into microvascular and macrovascular sub-scores. Modified Poisson regression estimated adjusted prevalence ratios (aPR), adjusted for age, sex, and body mass index. A cohort-by-diabetes interaction tested cross-cohort consistency. Sensitivity analyses incorporated nigral diffusion tensor imaging (PD-risk biomarker) and FreeSurfer white matter hypointensity volume (cerebrovascular marker). Results: Diabetes/prediabetes elevated Vascular Burden Score ({beta} = 0.53, 95% CI 0.29 to 0.77, p < 0.001) versus non-diabetic participants, with a non-significant cohort-by-diabetes interaction (F = 0.29, p = 0.747). Three microvascular factors survived false discovery rate correction: obesity (aPR 2.28), hypertension (aPR 1.60), and hyperlipidemia (aPR 1.45). Macrovascular events showed no diabetic amplification ({beta} = -0.06, p = 0.25). In the imaging-phenotyped subset, Vascular Burden Score components contributed classifier variance distinct from nigral microstructure. Conclusions: Diabetes/prediabetes operationalize a microvascular cluster stable across prodromal and idiopathic PD. Cardiometabolic phenotyping may complement established PD-risk biomarkers (dopamine transporter SPECT, nigral diffusion), pending longitudinal validation linking vascular phenotype to dopaminergic markers.

02.
arXiv (CS.CV) 2026-06-16

Self-Supervised Learning as Discrete Communication

Most self-supervised learning (SSL) methods learn continuous visual representations by aligning different views of the same input, offering limited control over how information is structured across representation dimensions. In this work, we frame visual self-supervised learning as a discrete communication process between a teacher and a student network, where semantic information is transmitted through a fixed-capacity binary channel. Rather than aligning continuous features, the student predicts multi-label binary messages produced by the teacher. Discrete agreement is enforced through an element-wise binary cross-entropy objective, while a coding-rate regularization term encourages effective utilization of the constrained channel, promoting structured representations. We further show that periodically reinitializing the projection head strengthens this effect by encouraging embeddings that remain predictive across multiple discrete encodings. Extensive experiments demonstrate consistent improvements over continuous agreement baselines on image classification, retrieval, and dense visual prediction tasks, as well as under domain shift through self-supervised adaptation. Beyond backbone representations, we analyze the learned binary codes and show that they form a compact and informative discrete language, capturing semantic factors reusable across classes.

03.
arXiv (CS.CV) 2026-06-17

MaineCoon: Pursuing A Real-Time Audio-Visual Social World Model

As an increasing majority of global video content is consumed on social platforms for interactive social purposes, video generation models built for social worlds are important but largely overlooked by previous studies. In this work, we define the position of social world models and build a prototype model as the first step towards this goal. While previous world models successfully simulate physical environments or gaming world exploration, they remain fundamentally detached from human-centric social dynamics. To bridge this gap as the first step to social world models, we present MaineCoon, the first real-time audio-visual autoregressive model that has 22B parameters and is capable of real-time streaming generation and sub-second interaction, with a record-breaking frame rate of up to 47.5 FPS, on a single GPU. To the best of our knowledge, MaineCoon is also the first real-time audio-visual generation model specifically optimized for social-interactive applications. To enable efficient and stable training, we introduce several novel techniques into MaineCoon, including self-resampling, cross-modal representation alignment, domain-aware preference optimization, and reinforced online-policy distillation (ROPD). We also design the first agentic streaming inference framework that supports thousand-second-scale or even longer generation while mitigating drift with agentic cache management and prompt planing. These innovations significantly accelerate training while optimizing real-time inference performance. We believe this work not only sets a new state-of-the-art (SOTA) performance benchmark for high-quality, low-latency, and long-horizon audio-visual autoregressive models, but also points out the paradigm shift desired for next-generation AI-native social platforms.

04.
arXiv (CS.LG) 2026-06-15

Machine-learned particle flow as a foundation model for collider physics

arXiv:2606.14373v1 Announce Type: cross Abstract: The workflow from particle collision to physics analysis passes through a series of reconstruction steps that are traditionally modular and disconnected, with no shared representation linking low-level detector data to high-level analysis tasks. We show that casting event reconstruction as a machine learning problem naturally produces such a shared representation. We repurpose a machine learning model trained for particle-flow reconstruction (MLPF) to perform three distinct analysis tasks: jet flavor identification, jet energy regression, and missing momentum regression. By appending the per-particle latent representations learned during reconstruction as additional input features, we substantially improve over baselines that use kinematic features alone. We further demonstrate that a single linear layer trained using only the latent representations achieves competitive performance against state-of-the-art baseline architectures, and outperforms the baseline for missing momentum regression with approximately 35 times fewer parameters. These results demonstrate that the latent representations learned during reconstruction encode essential physics information needed for downstream analysis, establishing MLPF as a foundation model and offering a concrete step toward an end-to-end pipeline from detector data to physics analysis.

05.
PLOS Medicine 2026-06-01

The NIH 2025 Public Access Policy: Immediate access, unequal costs

by Caitlin R. Ryus, Caroline Raymond King, Edward R. Melnick The NIH 2025 Public Access Policy eliminates embargo periods for federally funded research, expanding who can read science. Yet without addressing article processing charges and market concentration, the policy risks creating new barriers to who can afford to perform and publish their science. In this Perspective, Caitlin Ryus and colleagues discuss the NIH 2025 Public Access Policy, highlighting that while expanding who can read science, the policy risks creating new barriers to who can afford to perform and publish their science.

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

Navigating the Safety-Fidelity Trade-off: Massive-Variate Time Series Forecasting for Power Systems via Probabilistic Scenarios

arXiv:2606.13338v1 Announce Type: new Abstract: Probabilistic forecasting models are increasingly deployed on multivariate systems with distinct channel physics and operational constraints, but existing benchmarks evaluate neither property at scale. Public canonical multivariate benchmarks cap out at 2,000 channels, while power-system benchmarks either lack temporal structure or probabilistic evaluation. We introduce PowerPhase, a probabilistic forecasting benchmark built on six transmission grids ranging from 2,000 to 36,964 jointly forecasted channels, more than an order of magnitude beyond popular canonical multivariate benchmarks. Each target trajectory is the output of an AC power-flow solve, and PowerPhase ships with constraint-aware metrics, including Safety_mBrier, NECV, and CVaR-alpha, that complement CRPS and Distortion. Across eight baselines and three seeds, distributional accuracy and constraint satisfaction rank models differently, a trade-off we term safety-fidelity. We further propose PowerForge, a scenario-based quantile forecaster with type-specific decoding heads and a causal bridge between variable groups, which achieves the best average rank on every grid.

07.
arXiv (CS.CL) 2026-06-19

How LLMs Fail and Generalize in RTL Coding for Hardware Design?

Translating sequential programming priors into the parallel temporal logic of hardware design remains a crucial bottleneck for large language models(LLM). To investigate this, we introduce a new error taxonomy grounded in problem solvability, inspired by cognitive theory. Our taxonomy categorizes failures into syntactic, semantic, solvable functional, and unsolvable functional types. Evaluations reveal a strict empirical ceiling on the VerilogEval benchmark, as frontier models plateau at a 90.8% initial pass rate. These plateaus are defined by unsolvable functional errors, exposing persistent knowledge gaps immune to test time compute scaling. Furthermore, we expose a striking surface convergence gap: optimization readily eliminates syntax errors but concurrently exacerbates deeper functional failures. Our findings demonstrate that alignment techniques merely teach models to compile. While repeated sampling strategies can patch solvable errors, register-transfer level(RTL) coding capacity remains strictly bounded by pretraining knowledge. Addressing challenges in the current LLM based hardware generation pipeline requires more studies in model reasoning rather than alignment interventions.

08.
arXiv (CS.AI) 2026-06-19

ScholarQuest: A Taxonomy-Guided Benchmark for Agentic Academic Paper Search in Open Literature Environments

arXiv:2606.20235v1 Announce Type: cross Abstract: Academic paper search is a core step in scientific research, and LLM-based search agents are emerging as a promising paradigm for iterative, intent-driven literature exploration. However, existing benchmarks are insufficient for systematically evaluating agentic academic search under realistic open literature environments. We propose ScholarQuest, a large-scale, taxonomy-guided benchmark for agentic academic paper search. ScholarQuest is constructed from over 1,000 computer science topics and four representative research intents, including method-oriented, setting-anchored, comparison-based, and scope-controlled queries. It further provides scalable answer construction and a shared retrieval backend ScholarBase for reproducible evaluation. Benchmarking results show that agentic methods outperform single-shot retrieval baselines, yet the best-performing agent only achieves 0.314 Recall@100 and 0.355 Recall@All, indicating substantial room for improvement. In addition, analyses of search efficiency, intent-level robustness, and failure cases further highlight the benchmark's ability to provide multi-dimensional evaluation signals for academic paper search agents.

09.
arXiv (math.PR) 2026-06-18

Multi-Dimensional Cohomological Phenomena in the Lower Multiparametric Model

作者:

arXiv:2402.02573v4 Announce Type: replace-cross Abstract: In the past two decades, extensive research has been conducted on the (co)homology of various models of random simplicial complexes. So far, it has always been examined merely as a list of groups. This paper expands upon this by describing both the ring structure and the Steenrod-algebra structure of the cohomology of the lower multiparametric model. We prove that the ring structure is always a.a.s trivial, while, for certain parameters, the Steenrod-algebra a.a.s acts non-trivially. This reveals that complex multi-dimensional topological structures appear as subcomplexes of this model.

10.
arXiv (quant-ph) 2026-06-19

The use of Peres lattices in periodically driven systems

arXiv:2606.20009v1 Announce Type: new Abstract: We demonstrate the strength of the method of Peres lattices in periodically driven quantum systems. The method, which has previously been used mostly in stationary systems, enables us to efficiently detect resonances in the driven system, to monitor the onset of chaos, and to recognize critical properties of the Floquet modes. It also allows quick comparisons of the spectra of Floquet modes for various driving Hamiltonians and transparent tests of the iterative approximation techniques based on effective stationary Hamiltonians.

11.
arXiv (CS.LG) 2026-06-18

MetaboNet-Bench: A Multi-modal Benchmark for Glucose Forecasting in Type 1 Diabetes

arXiv:2606.18640v1 Announce Type: new Abstract: Glucose forecasting algorithms are an important aspect of glycemic control management in type 1 diabetes. So far, the research community has developed numerous algorithms and models for forecasting. However, it is well-recognized that the lack of standardized model performance evaluation benchmarks makes fair comparison difficult and hinders further innovation, and thus benchmark standardization is in urgent need. Furthermore, many published glucose forecasting algorithms are limited to CGM data alone, ignoring other multimodal signals such as insulin dosing and carbohydrate intake. Here, we introduce MetaboNet-Bench, a benchmark for multimodal glucose forecasting for patients with type 1 diabetes that provides an extensible open-source evaluation framework for comparison of glucose forecasting algorithms that leverage glucose, insulin, and carbohydrate data. We then demonstrate its utility by benchmarking several recently published glucose forecasting models and a custom multimodal time-series model, representing different model architectures. The results show that the benefit of adding data modalities is conditioned on the complexity of the model and that incorporating more clinical metrics helps identify meaningful gaps to fill for future research.

12.
arXiv (CS.LG) 2026-06-16

Tangram: Unlocking Non-Uniform KV Cache Compression for Efficient Multi-turn LLM Serving

arXiv:2606.06302v2 Announce Type: replace Abstract: Multi-turn LLM serving accumulates dialogue history whose Key-Value (KV) cache grows with every turn and every user, quickly exceeding the model weights themselves and making memory – not compute – the binding constraint on throughput. Non-uniform KV compression, which allocates heterogeneous budgets across attention heads, preserves accuracy far better than uniform schemes, yet remains impractical: modern serving stacks assume identical KV lengths across heads, so heterogeneity traps freed memory as page fragmentation, spends up to 25% of prefill time reclaiming scattered pages, and skews GPU workloads that inflate decode latency by up to $1.7\times$ or burn 15–20% of each decode step on re-planning. We observe that this heterogeneity need not be discovered at runtime: head-wise retention follows a two-level structural regularity – an input-invariant head ranking with narrowly bounded per-head ratios – that can be calibrated offline from as few as 50 samples. Building on this insight, we present Tangram, a serving framework that statically resolves what prior systems handle dynamically: Budget Reservation fixes each head's post-compression footprint at scheduling time, eliminating page reclamation; Ragged Paging clusters similar-budget heads into independent page tables, turning fragmentation into reclaimable memory; and Ahead-of-Time Load Balancing precomputes balanced GPU partitions with zero runtime planning. Implemented on vLLM, Tangram serves as a drop-in substrate for existing non-uniform compression methods, matching their accuracy while improving end-to-end throughput by up to $2.6\times$ over the full-KV baseline. Our implementation is publicly available at https://github.com/aiha-lab/TANGRAM.

13.
medRxiv (Medicine) 2026-06-22

ECG-Guided Pre-Screening of Family Members for Hypertrophic Cardiomyopathy

Background: Current clinical guidelines recommend serial ECG and echocardiographic surveillance for first-degree relatives of probands with Hypertrophic Cardiomyopathy (HCM). Objectives: To evaluate the accuracy and validity of ECG alone as a pre-screening tool for the diagnosis of HCM and to develop a random forest (RF) model for HCM phenotype prediction. Method: Pediatric relatives of primary HCM probands attending the cardiomyopathy screening program at The Hospital for Sick Children were included from 1993 to 2025. Subjects were followed until the last follow-up, censored at phenotype conversion. ECGs were classified as normal or abnormal based on predefined parameters. Associations between binary ECG variables and HCM phenotype were assessed using Phi ({varphi}) coefficient. A Random Forest classifier was developed using significant ECG variables (70:30 training: test split) and evaluated using precision, recall, specificity, negative predictive value, F1 score and AUROC. Feature importance was assessed using SHAP analysis. Variables with an impact of >5% were included in a simplified model, which was evaluated by repeating performance metrics and externally validated in a healthy cohort. Results: 350 screened relatives (44% female, mean follow-up 6.8 +- 4.8 years) were included. At baseline, 13% (46350) were phenotype-positive for HCM. 9 subjects converted during the surveillance. Thirteen ECG variables were significantly associated with phenotype-positive HCM and were included in the full random forest model. Four variables had >5% impact (Left ventricular hypertrophy, right ventricular hypertrophy, T-wave inversion and ST-segment depression) and were included in a simplified model, which maintained high specificity (93% vs 97%), negative predictive value (97% vs 93%) and AUROC (90% vs 96%). The simplified model classified 83% subjects as phenotype-negative, with eight being false-negative, all of whom developed an abnormal ECG in a mean of 1 year, and none had an interim adverse cardiac event. The simplified model was evaluated in an independent healthy cohort of 153 school-age subjects and correctly identified 98% as phenotype-negative with 100% NPV. Conclusion: ECG abnormalities were strongly associated with phenotype-positive status. A simplified ECG-based random forest model using four ECG variables demonstrated high specificity and negative predictive value for identifying phenotype-negative subjects. If prospectively validated, this could reduce the need for concurrent echocardiographic screening by up to 83% per encounter, lowering screening burden and cost.

14.
arXiv (quant-ph) 2026-06-12

To Cool, or Not to Cool? Displacement Sensing with Hot Quantum States

arXiv:2606.13650v1 Announce Type: new Abstract: Quantum-enhanced displacement sensing with bosonic systems is typically formulated assuming that the oscillator is cooled close to its ground state before nonclassical probe preparation. We investigate whether such near-ground-state initialization is necessary, or whether sensitive probes can instead be generated directly from thermal states. We analyze hot quantum probes produced by squeezing, number-raising, and Schrödinger-cat-state generation applied to thermal inputs. We identify two distinct mechanisms by which thermal mixedness can remain compatible with enhanced displacement sensitivity. First, projecting a mixed probe onto a definite parity sector removes the usual thermal suppression of the displacement quantum Fisher information, which can then increase with initial thermal occupation. Second, coherent superpositions of opposite displacements can retain sensitivity through coherence between their displaced components, even when the underlying state is mixed. We use these two mechanisms to classify hot-state protocols according to whether their sensitivity comes from parity selection, coherence between displaced components, or both. Finally, we formulate an experimentally relevant optimization problem comparing initial cooling with direct hot-state preparation under realistic decoherence and show that complete cooling is not universally optimal. Our results establish hot-state engineering as a route to quantum-enhanced bosonic displacement sensing without mandatory ground-state initialization.

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

Repurposing a Speech Classifier for Guided Diffusion-Based Speech Generation

arXiv:2606.20457v1 Announce Type: cross Abstract: Classifier guidance is a way to control diffusion generation by using a noise-conditioned classifier to steer the sampling process toward a target class. One drawback of classifier guidance is that it requires two separately trained models: a classifier and a diffusion model. We therefore study a more compact alternative in which a conventionally trained speech classifier is repurposed as the backbone for diffusion generation. Starting from a frozen noise-conditioned classifier in log-Mel space, we attach a lightweight subnetwork that reuses intermediate classifier representations and train only this subnetwork under a Denoising Score Matching objective. Our work shows that a pretrained classifier can be repurposed for conditional generation, providing an appealing bridge between discriminative modeling and conditional speech synthesis resulting in high speech quality within a single-backbone model, with reduced memory footprint and computational cost.

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

Dynamic Link Prediction with Temporally Enhanced Signed Graph Neural Networks

arXiv:2605.26290v2 Announce Type: replace Abstract: Temporal signed networks (TSNs) model the time evolution of cooperative and adversarial relationships that arise in applications such as social media analysis, trust and reputation systems, and financial transaction networks. While graph neural networks (GNNs) perform well for static or unsigned link prediction, effective learning in temporal signed graphs remains challenging due to the interaction of signed relations, evolving structure, and balance-theoretic constraints. To address this gap, we propose a modular temporal enhancement framework for signed GNNs that integrates historical context into otherwise static architectures. The framework introduces a Historical Context Integration Module (HCIM) that combines learnable recency-aware temporal weighting, LSTM-based embedding trajectory modeling, and multi-head temporal attention to capture both short- and long-term signed interaction dynamics. Historical information is fused with current node representations using either global or node-adaptive weighting, allowing the architecture-agnostic framework to accommodate heterogeneous temporal behaviors. We instantiate the approach on the Self-Explainable Signed Graph Transformer (SE-SGformer), preserving interpretability while extending it with temporal awareness. Experiments on real-world and synthetic TSNs, including Bitcoin OTC, Bitcoin Alpha, Reddit, and small-world network models, demonstrate consistent and statistically significant improvements over the static baseline.

17.
arXiv (CS.CV) 2026-06-15

MirrorCheck: Efficient Adversarial Defense for Vision-Language Models

Vision-Language Models (VLMs) are increasingly susceptible to sophisticated adversarial attacks, including adaptive strategies specifically designed to bypass existing defenses. To address this vulnerability, we propose MirrorCheck, a robust and model-agnostic detection framework that operates effectively in both unimodal and multimodal settings. MirrorCheck leverages Text-to-Image (T2I) models to regenerate visual content from captions produced by the target model and assesses semantic consistency by comparing feature-space embeddings between the original and synthesized images. To enhance robustness against adaptive attacks, MirrorCheck introduces a stochastic defense strategy that randomly selects T2I generators and image encoders from a diverse model zoo. Additionally, we incorporate a novel One-Time-Use (OTU) perturbation applied to the selected encoder embeddings, regulated by a scaling factor, which decreases the effectiveness of adaptive attacks. Extensive experiments across multiple threat scenarios demonstrate that MirrorCheck consistently outperforms baseline methods, and maintains its utility even under strong adaptive adversarial conditions.

18.
medRxiv (Medicine) 2026-06-10

Epidemiology of Cervical Precancerous Lesions: Prevalence and Predictors from Pap Smear Screening in Hawassa City Hospitals, Sidama Region, Ethiopia. Institutional-Based Cross-sectional Study

Background: Cervical cancer is the fourth most common cancer in women worldwide and remains a major public health challenge. In Ethiopia, it is the second leading cause of cancer deaths, with around 8,000 new cases and 6,000 deaths each year. Region?specific data on the prevalence and predictors of precancerous lesions remain scarce, yet such information is vital for guiding targeted reproductive health strategies. This study therefore examined the prevalence and predictors of cervical precancerous lesions among women aged 21-60 years undergoing Pap smear screening in public hospitals in Hawassa City, Sidama Region. Methods: An institution-based cross-sectional study was conducted among 241 women attending Pap smear screening at public hospitals in Hawassa City from March to August 2025. Sociodemographic and clinical data were collected via interviews and medical records. Lesions were classified based on the standardized international framework for reporting cervical cytology results from Pap smears per the Bethesda system. Multivariable logistic regression identified predictors p

19.
arXiv (math.PR) 2026-06-11

Percolation phase transition on planar spin systems

arXiv:2105.13314v2 Announce Type: replace Abstract: In this article we study the continuity and sharpness of the phase transition for percolation models defined on top of planar spin systems. The two examples that we treat in detail concern the Glauber dynamics for the Ising model and a Dynamic Bootstrap process. For both of these models we prove that their phase transition is continuous and sharp, providing also quantitative estimates on the two point connectivity. The techniques that we develop in this work can be applied to a variety of different percolation models based on spin-flip dynamics. We also discuss some of the problems that can be tackled in a similar fashion.

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

Something from Nothing: Data Augmentation for Robust Severity Level Estimation of Dysarthric Speech

arXiv:2603.15988v3 Announce Type: replace-cross Abstract: Dysarthric speech quality assessment (DSQA) is critical for clinical diagnostics and inclusive speech technologies. However, subjective evaluation is costly and difficult to scale, and the scarcity of labeled data limits robust objective modeling. To address this, we propose a three-stage framework that leverages unlabeled dysarthric speech and large-scale typical speech datasets to scale training. A teacher model first generates pseudo-labels for unlabeled samples, followed by weakly supervised pretraining using a label-aware contrastive learning strategy that exposes the model to diverse speakers and acoustic conditions. The pretrained model is then fine-tuned for the downstream DSQA task. Experiments on five unseen datasets spanning multiple etiologies and languages demonstrate the robustness of our approach. Our Whisper-based baseline significantly outperforms SOTA DSQA predictors such as SpICE, and the full framework achieves an average SRCC of 0.761 across unseen test datasets.

22.
medRxiv (Medicine) 2026-06-12

The Clinical Characteristics and mortality outcomes of Atrial fibrillation complicating Heart failure with reduced ejection fraction: A prospective study from South Africa

Background: A growing burden of cardiovascular risk factors has raised cardiovascular disease-related mortality in Sub-Saharan Africa (SSA), driving higher prevalence of heart failure with reduced ejection fraction (HFrEF) and its complication with atrial fibrillation (AF). No prospective study has examined AF's clinical impact on HFrEF in SSA. Aim: To determine AF prevalence in HFrEF, describe HFrEF-AF clinical characteristics, and determine AF's impact on mortality. Methods: In this prospective observational study at a tertiary hospital in Johannesburg, 136 HFrEF patients were enrolled and categorised as HFrEF- SR (sinus rhythm) or HFrEF-AF. Baseline clinical characteristics and biochemistry were recorded. Comprehensive echocardiography including left atrial strain by 2D speckle-tracking was performed. Median follow-up was 30.6 months. Results: AF was present in 28 patients (21%). The mean age was 58.7 {+/-} 14.9 years (52.9% male) and differed between groups (p < 0.001). Hypertensive heart disease was the leading cause of HFrEF (36%). Compared with SR, HFrEF-AF patients had poorer health status (KCCQ 27 [16-43] vs 45 [32-60], p < 0.001) and lower left atrial strain (26.2 {+/-} 11.3%, p < 0.001). Guideline-directed medical therapy was suboptimal in the AF group: anticoagulation use was higher than SR (60% vs 9.5%, p < 0.001) but overall inadequate; HFrEF-AF patients received lower median doses of carvedilol (15.6 mg vs 25 mg, p = 0.002) and enalapril (10 mg vs 20 mg, p = 0.004), and fewer received spironolactone (50% vs 75.3%, p = 0.013). Survival was significantly lower in HFrEF-AF (0.41 [0.22-0.61]) versus SR (0.73 [0.61-0.82], p < 0.001). Independent predictors of mortality included prior stroke, lower TAPSE and KCCQ, and higher E/e' and heart rate. Conclusion: AF is common among HFrEF patients in this SSA cohort (though lower than in high-income countries) and associates with worse clinical status, suboptimal therapy, and higher mortality.

23.
arXiv (CS.CL) 2026-06-12

NaturalFlow: Reducing Disruptive Pauses for Natural Speech Flow in Simultaneous Speech-to-Speech Translation

Simultaneous speech-to-speech translation aims to enable near-real-time communication by minimizing latency, offering a compelling, real-time alternative to the high latency of consecutive translation. However, the excessive pursuit of low latency often results in fragmented chunk-wise speech. Consequently, listeners are subjected to an unnatural acoustic flow punctuated by frequent pauses, which could increase their cognitive load. To bridge this gap, we introduce a fluency-aware optimization framework designed to discover the sweet spot between the low-latency benefits of simultaneous translation and the natural flow of consecutive translation. Our framework minimizes inter-chunk silences by leveraging model-internal signals, including linguistic diversity and induced temporal variability in speech durations. Experiments on short- and long-form benchmarks show that our framework produces natural speech flow while maintaining competitive latency and translation quality.

24.
arXiv (CS.CV) 2026-06-17

Evaluating Synthetic Data Generation for Domain Generalization in Fetal Brain MRI Segmentation

Fetal brain tissue segmentation from magnetic resonance imaging (MRI) is crucial for studying neurodevelopment, but remains challenging due to data heterogeneity and limited annotations. Domain randomization (DR) has recently emerged as a promising strategy for single-source domain generalization by synthesizing training images with randomized artifacts, contrast, and resolution. In this work, we investigate how to maximize the out-of-domain (OOD) generalization of DR-based methods. We evaluate several synthetic data generation strategies for DR, with a particular focus on our recently proposed framework, FetalSynthSeg. We show that simple Gaussian mixture-based intensity modeling outperforms more complex physics-based simulations, and that intensity clustering (subdividing tissue classes based on intensity) improves OOD robustness. Evaluated on 348 fetal subjects from four sites spanning 0.55-3T and both T1w and T2w contrasts, FetalSynthSeg reaches state-of-the-art performance on several FeTA 2024 testing datasets (80-85 Dice score) and, for the first time, offers robust segmentation on modalities other than T2w for fetal brain segmentation (80 Dice on dHCP-T1w dataset). Compared with state-of-the-art methods such as BOUNTI, nnU-Net ensemble, and the FeTA 2024 winner, FetalSynthSeg delivers comparable or superior accuracy while maintaining strong robustness across domain shifts. Our code, model weights, and Docker image ready for easy inference are available at https://hub.docker.com/r/vzalevskyi/fetalsynthseg.

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

Bridging Modal Isolation in Interleaved Thinking: Supervising Modality Transitions via Stepwise Reinforcement

Interleaved thinking, where a unified multimodal model alternates between textual reasoning and visual generation, has shown promise on spatial and physical tasks. However, in complex long-chain scenarios, we identify a fundamental failure mode: generated images diverge from the textual context while subsequent text ignores the visual evidence, causing the two modalities to alternate without genuinely informing each other. We term this Modal Isolation and attribute it to compounding information loss at modality boundaries. We decompose each reasoning cycle into atomic operations and define modality transition loss, quantifying cross-modal hallucination (text-to-image) and visual utilization deficit (image-to-text) at each boundary. We propose MoTiF (Modality Tiransition Fidelity), a two-stage training framework that directly optimizes these transitions: Reflective SFT trains the model to detect and recover from erroneous visual outputs; Flow-GRPO improves image generation fidelity via reinforcement learning. All training signals in MoTiF derive from transition-level fidelity rather than end-task accuracy. Across four visual puzzle benchmarks, this transition-level supervision substantially improves both cross-modal coherence and final task accuracy. The results demonstrate that effective interleaved reasoning requires explicit structural supervision at modality boundaries, not merely scaling or end-task optimization.