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01.
arXiv (CS.LG) 2026-06-17

Another Look at Log-PCA for Probability Measures: A Dynamical Formulation and Statistical Convergence

arXiv:2606.17196v1 Announce Type: cross Abstract: This paper is concerned with learning principal variations of random probability measures on $\mathbb{R}^m$ under the Wasserstein geometry. We introduce a new dynamical formulation to interpret the log-PCA, a linearized principal geodesic analysis, as a variational approach. Our differentiable version, termed as the Wasserstein Tangential PCA (WT-PCA), captures the local principal modes of geodesic variations of a (weighted) probability measure on the Wasserstein space via its covariance operator at barycenter. Based on the dynamical perspective and leveraging parallel transport structure of the optimal transport problems, we derive a general statistical convergence rate of the empirical WT-PCA when estimated from data in terms of the 2-Wasserstein distance between the population and empirical barycenter reference measures.

02.
medRxiv (Medicine) 2026-06-11

Malaria Risk among Internally Mobile Individuals and Heterogeneous Mobility Patterns in Two Hypoendemic Communities: Implications for Malaria Elimination in the Peruvian Amazon.

Background: Human mobility is increasingly recognized as a key factor influencing malaria transmission dynamics, particularly in low-transmission settings approaching elimination. This study aimed to assess mobility patterns and their association with malaria risk in two hypoendemic communities in the Peruvian Amazon. Method: A longitudinal study was conducted in the communities of Libertad and Urcomirano (Mazan River basin). Monthly population screenings were combined with weekly active and passive case detection. A total of 678 individuals were enrolled. Mobility patterns were assessed through structured questionnaires, and social network analysis was used to characterize travel connections. Log-binomial regression analysis was applied to identify risk factors associated with malaria infection. Result: Internally, mobile individuals in Libertad showed a higher malaria incidence (>32.47 cases per 1,000 person-months) than those in Urcomirano (

03.
arXiv (CS.AI) 2026-06-25

RARM: Confidence-Gated Progress Reward Modeling for RL in Manipulation

arXiv:2606.22027v2 Announce Type: replace-cross Abstract: Reinforcement learning for robot manipulation is often bottlenecked by reward design, especially in long-horizon tasks: sparse success rewards provide weak supervision, while hand-crafted dense rewards are tedious to design and generalize poorly across tasks. Progress-based reward models offer a promising alternative by estimating how far an observation has advanced toward task completion, but existing approaches often require task-specific demonstrations or progress labels, and can assign high rewards to visually plausible but physically incorrect states. We introduce the Reference-Anchored Reward Model (RARM), a lightweight visual comparator that converts a single successful demonstration into a dense, progress-aware reward. RARM is trained once on general-purpose videos with a contrastive temporal objective, requiring no robot-specific data, task-specific reward labels, or per-task reward engineering. At deployment, RARM matches rollout clips to reference clips and rewards only confident forward progress, suppressing uncertain matches that may otherwise produce false-positive rewards. Across 9 simulated manipulation tasks from LIBERO and MetaWorld and 4 real-world tasks, RARM achieves the best overall success rates in subsequent RL training, with particularly large gains on long-horizon tasks such as cloth folding, where unreliable progress estimates are especially harmful.

04.
arXiv (CS.LG) 2026-06-16

Neuromorphic Wireless Split Computing with Resonate-and-Fire Neurons

arXiv:2506.20015v2 Announce Type: replace Abstract: Neuromorphic computing offers an energy-efficient alternative to conventional deep learning accelerators, particularly for real-time processing of time-series data. However, many edge applications, such as wireless sensing and audio recognition, generate streaming signals with rich spectral features that are not effectively captured by conventional leaky integrate-and-fire (LIF) spiking neurons. This paper investigates a wireless split computing architecture that employs resonate-and-fire (RF) neurons with oscillatory dynamics to process time-domain signals directly, eliminating the need for costly spectral pre-processing. By resonating at tunable frequencies, RF neurons extract time-localized spectral features while maintaining low spiking activity. This temporal sparsity translates into significant savings in both computation and transmission energy. Assuming an OFDM-based analog wireless interface for spike transmission, we present a complete system design and evaluate its performance on audio classification and modulation classification tasks. Experimental results show that the proposed RF-SNN architecture achieves comparable accuracy to conventional LIF-SNNs and ANNs, while substantially reducing spike rates and total energy consumption during inference and communication.

05.
arXiv (CS.CL) 2026-06-17

MLLP-VRAIN UPV system for the IWSLT 2026 Simultaneous Speech Translation task

This work describes the participation of the MLLP-VRAIN research group in the shared task of the IWSLT 2026 Simultaneous Speech Translation track. Our submission utilizes the recently released Parakeet and Qwen 3.5 models to create a robust, cascaded solution for long-form SimulST through the use of adaptive "black-box" policies. We explore relaxations of these policies to achieve better quality-latency trade-offs. Compared to last year, we participate on all language directions. In addition to this, for the En$\rightarrow${De, It, Zh} directions we also participate in this year's new context track employing a combination of ASR word-boosting and a RAG mechanism of offline pre-translated exemplars to guide generation and enrich our system with domain-specific context. Finally, we provide a detailed latency analysis of our system. Compared to last year, results on the MCIF En$\rightarrow$De test set shows a substantial quality improvement of +5.82 XCOMET-XL. Our context track processing further improves performance by +1.03.

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

RollArt: Disaggregated Multi-Task Agentic RL Training at Scale

arXiv:2512.22560v2 Announce Type: replace-cross Abstract: Agentic Reinforcement Learning (RL) trains LLMs through multi-turn interactions with environments, producing workloads that mix compute-bound prefill, bandwidth-bound decoding, CPU-heavy environment execution, and bursty reward evaluation. Existing systems either colocate all stages on a single GPU cluster or decouple them only at a coarse granularity, overlooking hardware heterogeneity and incurring substantial synchronization overhead across stages. We present ROLLART, a system for multi-task agentic RL on disaggregated infrastructure. ROLLART maps each pipeline stage to best-fit hardware, routing prefill-heavy tasks to compute-optimized GPUs, decode-heavy tasks to bandwidth-optimized GPUs, and environments to CPU clusters. It decouples rollout at the trajectory level, allowing generation, environment interaction, and reward scoring to proceed independently, so that slow or failed environments never block the others. ROLLART offloads stateless reward computation to serverless infrastructure and overlaps rollout with training via staleness-bounded asynchronous weight synchronization. Our results demonstrate that ROLLART effectively improves training throughput and achieves 1.31–2.05 \(\times\) training time reduction compared to various RL systems. We also evaluated ROLLART by training a hundreds-of-billions-parameter MoE model for Qoder product on an Alibaba cluster with above 3,000 GPUs, demonstrating its stability and scalability.

07.
arXiv (CS.AI) 2026-06-12

Neuro-Symbolic Agents for Regulated Process Automation: Challenges and Research Agenda

arXiv:2606.13405v1 Announce Type: new Abstract: LLM-based agents are entering regulated industries where they automate judgment intensive quality management processes. We argue that symbolic structures already embedded in these domains, including regulations, typed process models, and compliance constraints, should be treated not merely as external monitoring mechanisms but as core architectural components that shape the agent's decision-making and behavior. We propose compliance-by-construction as a complementary paradigm to guardrail-based monitoring: a structural foundation that prevents control-flow violations, while guardrails remain essential for catching semantic errors. We identify a structured set of neuro-symbolic research challenges on foundational and capability level and show that addressing them jointly enables compliance-by-construction. We call on the neuro-symbolic community to engage with regulated process automation as a high impact research domain.

08.
arXiv (CS.CV) 2026-06-15

MUSE: Agentic 3D Scene Authoring via Memory-Grounded Incremental Requirement Satisfaction

Text-driven 3D scene generation is a promising technique for digital content creation, embodied AI simulation, and interactive design, yet practical workflows often require refining, extending, or correcting existing scenes while preserving non-target content. Existing methods can produce realistic and structurally plausible scenes, but they generally lack editability with requirement-level state tracking, so part-level failures often lead to full-scene regeneration or manual intervention. To tackle this challenge, we formulate controllable 3D scene authoring as incremental requirement satisfaction, unifying construction and editing. In this paper, we present MUSE, a memory-grounded multi-agent framework in which an Architect compiles instructions into structured requirements, a Sculptor executes local scene operations, and an Inspector verifies each step while updating Working, Scene, and Skill Memory. To evaluate requirement-level controllability and preservation-aware editing, we introduce AuthorBench, offering 145 constrained construction cases and a 1,584-case preservation-aware editing pool paired with external structured checks. On full construction cases, MUSE improves All-Goal success from 37.9 to 80.7 and surface-constraint fulfillment from 35.0 to 92.6 over the strongest baseline. On a stratified 240-case editing test split, MUSE achieves 49.6 All-Goal success, 99.9 preservation rate, and only 0.6 unintended change rate. Beyond automated metrics, human evaluations on compared local-editing baselines support stronger alignment with user intent, and downstream navigation-proxy tests indicate stronger spatial stability. Combined with ablations validating our memory designs, these results establish MUSE as an effective framework for controllable 3D scene authoring.

09.
arXiv (CS.CL) 2026-06-24

The African Language Tax: Quantifying the Cost, Latency, and Context Penalty of Tokenizing African Languages in Frontier LLMs

Commercial large language models bill, scale latency, and budget context per token. Yet tokenizers assign more subword tokens to the same meaning in some languages than in others, so speakers of languages with high token-fertility pay a structural penalty before a model is ever invoked. This penalty is documented for multilingual settings in general, but it has not been measured systematically for African languages at the level of enterprise deployment economics and cognitive context capacity. We measure it across 20 African languages spanning five language families and three scripts (Latin, Ge'ez/Ethiopic, N'Ko; 19 appear in the primary FLORES-200+ corpus, with Nigerian Pidgin measured via MAFAND-MT only), using parallel corpora so that the language effect is isolated from content. Across 11 frontier and open tokenizers on FLORES-200+, every African language carries a tokenization premium above English (median 1.88x on GPT-5 / o200k_base, up to 8.92x for N'Ko); the penalty is largest for Ethiopic and N'Ko scripts (reaching 7-9x) and is near-invariant across corpora (FLORES vs SIB-200 Pearson r = 0.9998). Translated into deployment terms, this results in up to 8.9x inference cost and an equivalent generation-latency multiplier (N'Ko vs English on GPT-5; 7.4x for Amharic), and as little as 11% of English's effective context window. The best currently available tokenizer for African languages, Gemma 4, reduces the mean premium from 3.31x (cl100k_base) to 2.38x, but no tokenizer eliminates the penalty. We release an open measurement tool (afri-fertility), a public leaderboard, a results dataset, and mitigation guidance for African builders. The penalty falls hardest on the languages whose speakers can least afford it, a digital divide encoded directly into the subword vocabulary.

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

Strain- and Electric-Field-Tunable Valley Polarization in Mo0.75V0.25Te2(Mo3VTe8) for Valleytronic Application

arXiv:2606.19954v1 Announce Type: cross Abstract: Valley polarization in 2D TMDs is promising for low-power valleytronic and spin-valley information processing, but time-reversal symmetry in pristine nonmagnetic TMDs keeps the K+ and K- valleys degenerate, limiting device applications. In this work, we investigated the structural stability, electronic properties, and tunable valley polarization of V-alloyed MoTe2 monolayer, Mo0.75V0.25Te2, using first-principles density functional theory (DFT) calculations. Substitutional alloying of MoTe2 with V introduced magnetic exchange interaction, which, together with spin-orbit coupling (SOC), lifted the valley degeneracy at the unequal valleys. The alloyed structure was found to be energetically and dynamically stable due to the absence of imaginary phonon modes. In pristine MoTe2, SOC produced spin splittings of 34.0 meV and 218.9 meV in the conduction bands and valence bands, respectively, but no valley polarization was observed. In contrast, Mo0.75V0.25Te2 exhibited spontaneous valley polarization of 37.3 meV in the conduction band and 78.2 meV in the valence band. The valley polarization was further enhanced by external electric fields and biaxial strain. A transverse electric field along the crystal c axis produced the maximum valley splitting of 132.8 meV in the valence band, whereas biaxial tensile strain increased the valence band valley splitting up to 160.8 meV. The maximum conduction band valley splitting reached 54.4 meV under 2% biaxial compressive strain. These results demonstrated that V alloying, combined with electric-field and strain engineering, provides an effective strategy for achieving large and tunable valley polarization in MoTe2. Thus, Mo0.75V0.25Te2 can be considered a promising 2D platform for tunable valleytronic device applications, such as transistors and sensors.

11.
arXiv (quant-ph) 2026-06-16

A Gauge-Covariant Geometric Framework for Non-Hermitian Quantum Systems

arXiv:2606.15922v1 Announce Type: new Abstract: We develop a comprehensive, gauge-covariant geometric framework for non-Hermitian quantum systems in the quasi-Hermitian regime, that is, the region of parameter space where the non-Hermitian Hamiltonian admits a real spectrum and a positive-definite metric operator. We build this framework by elevating the Dyson map to a central geometric object. This map is the transformation that converts a non-Hermitian Hamiltonian into an equivalent Hermitian one. From it we construct the Dyson connection and decompose it into Hermitian and anti-Hermitian parts, identified respectively as {\it stretching } and {\it rotation } components. This decomposition cleanly separates the genuine physical metric deformations from the unitary gauge redundancies. Working with manifestly gauge-covariant states, we then derive the complex non-Hermitian Berry phase and the quantum geometric tensor (QGT), and show that the non-Hermitian geometric curvature originates from the non-commutativity of the stretching components at the operator level. We further analyse the geometric singularities near an exceptional point (EP) and uncover a distinct hierarchy of divergences. For a general two-level non-Hermitian model, the quantum metric tensor (QMT) exhibits a leading-order divergence $\sim |\epsilon_\mu|^{-2}$, while the Berry curvature shows a weaker, subleading divergence $\sim |\epsilon_\mu|^{-3/2}$, with $\epsilon_\mu$ denoting the parameter displacement from the EP along an individual parameter axis $\mu$. Finally, we examine physical realizations of this model, including the non-Hermitian Su–Schrieffer–Heeger (SSH) and Hatano–Nelson (HN) models, where exact analytical results confirm the predicted critical scaling laws and illustrate the metric-deformation-driven non-Hermitian geometries.

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

SAG: SQL-Retrieval Augmented Generation with Query-Time Dynamic Hyperedges

Retrieval-Augmented Generation (RAG) offers an effective approach for large language models to access external knowledge. However, existing methods rely on dense similarity retrieval and face inherent limitations in handling structured constraints and multi-hop reasoning. Incorporating knowledge graphs partially alleviates these issues, but at the cost of semantic fragmentation, high maintenance overhead, and difficult incremental updates. This paper introduces SAG (SQLRetrieval Augmented Generation), a structured architecture for retrieval and agent systems. Instead of pre-building a global static graph, SAG converts each chunk into one semantically complete event and a set of indexing entities, then uses SQL join queries to dynamically link events that share entities into local hyperedges,constructing, at query time, a dynamically instantiated local index structure. This design avoids the need for global graph rebuilding and ongoing maintenance; the system naturally supports incremental writes, concurrent processing, and continuous scaling through its reliance on standard database infrastructure. Across HotpotQA, 2WikiMultiHop, and MuSiQue, three standard multi-hop benchmarks,SAG achieves the best results on 8 out of 9 Recall@K metrics, reaching 80.0% Recall@5 on MuSiQue, the benchmark with the highest multi-hop reasoning demands.SAG has also been deployed at a production scale of hundreds of millions of data items, with online retrieval latency kept within seconds. Project site and code are available at https://github.com/Zleap-AI/SAG-Benchmark.

13.
arXiv (CS.AI) 2026-06-16

Orcheo: A Modular Full-Stack Platform for Conversational Search

arXiv:2602.14710v2 Announce Type: replace-cross Abstract: Conversational search (CS) requires a complex software engineering pipeline that integrates query reformulation, ranking, and response generation. CS researchers currently face two barriers: the lack of a unified framework for efficiently sharing contributions with the community, and the difficulty of deploying end-to-end prototypes needed for user evaluation. We introduce Orcheo, an open-source platform designed to bridge this gap. Orcheo offers three key advantages: (i) A modular architecture promotes component reuse through single-file node modules, facilitating sharing and reproducibility in CS research; (ii) Production-ready infrastructure bridges the prototype-to-system gap via dual execution modes, secure credential management, and execution telemetry, with built-in AI coding support that lowers the learning curve; (iii) Starter-kit assets include 45+ off-the-shelf components for query understanding, ranking, and response generation, enabling the rapid bootstrapping of complete CS pipelines. We describe the framework architecture and validate Orcheo's utility through case studies that highlight modularity and ease of use. Orcheo is released as open source under the MIT License at https://github.com/AI-Colleagues/orcheo.

14.
arXiv (math.PR) 2026-06-25

Exponential Rank Bounds for Random Matrices

arXiv:2606.25204v1 Announce Type: new Abstract: Fix $b\in(0,1)$, let $1\leq k\leq n$, and let $A=(A_{ij})$ be an $n\times n$ random matrix with independent real entries satisfying $$ \sup_{x\in\mathbb{R}}\mathbb{P}\{A_{ij}=x\}\leq b0$ such that $$ \mathbb{P}\{\operatorname{rank} A\leq n-k\}\leq \exp(-cnk), \qquad 1\leq k\leq n. $$

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

Symmetric Linear Dynamical Systems are Learnable from Few Observations

arXiv:2512.05337v2 Announce Type: replace-cross Abstract: We consider the problem of learning the parameters of a $N$-dimensional stochastic linear dynamics under both full and partial observations from a single trajectory of time $T$. We introduce and analyze a new estimator that achieves a small maximum element-wise error on the recovery of symmetric dynamic matrices using only $T=\mathcal{O}(\log N)$ observations, irrespective of whether the matrix is sparse or dense. This estimator is based on the method of moments and does not rely on problem-specific regularization. This is especially important for applications such as structure discovery.

16.
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

17.
arXiv (quant-ph) 2026-06-11

Emergent mirror symmetry in the optimization of the central-spin quantum battery

arXiv:2606.11557v1 Announce Type: new Abstract: Quantum batteries provide a useful setting for exploring nonequilibrium many-body effects in energy storage. Here we investigate the optimization of a quantum battery based on the central-spin model. We identify two complementary structural indicators associated with the effective charging dynamics: one yields an upper bound on the average charging power, while the other characterizes the buildup of stored energy. We show that these two indicators are jointly optimized at a distinguished initial charger excitation number, which selects a particular Dicke sector of the model. At this common optimal point, the effective charging Hamiltonian becomes exactly mirror symmetric, suggesting mirror symmetry as a useful structural indicator for optimizing quantum batteries. We further show that the corresponding optimal dynamics can be closely approximated by product initial states, in particular by spin coherent states whose excitation-number distribution is centered at the symmetry-selected point. Our results establish a direct connection between charging performance, optimal-state structure, and emergent symmetry in the central-spin quantum battery, and suggest symmetry as a useful organizing principle for efficient charging in interacting many-body quantum systems.

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

Towards Physically Realizable Adversarial Attenuation Patch against SAR Object Detection

Deep neural networks have demonstrated excellent performance in SAR target detection tasks but remain susceptible to adversarial attacks. Existing SAR-specific attack methods can effectively deceive detectors; however, they often introduce noticeable perturbations and are largely confined to digital domain, neglecting physical implementation constrains for attacking SAR systems. In this paper, a novel Adversarial Attenuation Patch (AAP) method is proposed that employs energy-constrained optimization strategy coupled with an attenuation-based deployment framework to achieve a seamless balance between attack effectiveness and stealthiness. More importantly, AAP exhibits strong potential for physical realization by aligning with signal-level electronic jamming mechanisms. Experimental results show that AAP effectively degrades detection performance while preserving high imperceptibility, and shows favorable transferability across different models. This study provides a physical grounded perspective for adversarial attacks on SAR target detection systems and facilitates the design of more covert and practically deployable attack strategies. The source code is made available at https://github.com/boremycin/SAAP.

20.
medRxiv (Medicine) 2026-06-23

Linking mpox wastewater surveillance with reported clinical cases in three countries in Sub-Saharan Africa

The emergence of the novel monkeypox virus (MPXV) clade Ib in the Democratic Republic of the Congo (DRC) and neighboring countries in late 2023 highlighted the need for rapid, scalable surveillance approaches to support outbreak detection and response. As part of the ODIN-Mpox project, wastewater surveillance (WWS) systems were established as an emergency public health measure in three Sub-Saharan African countries (DRC, Tanzania, and Burkina Faso) to evaluate the feasibility of wastewater-based monitoring for mpox and strengthen local surveillance capacity. Between January 2025 and April 2026, 117 wastewater samples were collected from selected sites and analyzed for MPXV DNA using targeted qPCR assays. Clinical mpox data were obtained from national surveillance systems and WHO reports to assess epidemiological linkages between wastewater detections and reported infections. Six wastewater samples tested positive for MPXV DNA. During the study period, DRC experienced the highest disease burden, with weekly reported cases peaking at about 3,000 in January 2025, while Tanzania reported a peak of 20 weekly cases in March 2025. No confirmed clinical cases were reported in Burkina Faso. No clear relationship was observed between reported case numbers and qPCR Ct values in positive wastewater samples. Despite the low detection frequency, the project demonstrated the operational feasibility of implementing MPXV wastewater surveillance in resource-limited settings and established laboratory capacity for environmental monitoring of emerging infectious diseases. Given the early stage of WWS implementation in the region, the study identified opportunities for further system strengthening, including optimization of sample processing and reporting workflows, improved access to laboratory supplies, and enhanced integration of environmental and clinical surveillance data streams. These findings highlight the value of WWS as a complementary component of integrated public health surveillance systems and emphasize the need for continued investment in laboratory capacity, harmonized methodologies, governance frameworks, and knowledge exchange to enhance outbreak preparedness and response in low-resource settings.

21.
arXiv (quant-ph) 2026-06-25

Experimental probe of quantum coherence in top-quark pair production

arXiv:2602.21069v2 Announce Type: replace-cross Abstract: We investigate quantum coherence in top–antitop spin states produced at the LHC using the $l_1$-norm of coherence applied to the reconstructed spin density matrix. Combining Standard Model predictions with recent CMS measurements of spin-correlation coefficients, we study the dependence of coherence on the invariant mass $M_{t\bar t}$ and the scattering angle. We find that coherence is large both near the production threshold and in boosted central events, whereas an intermediate-mass region exhibits reduced interference strength and enhanced sensitivity to radiative effects. This non-monotonic kinematic behavior originates from the helicity-interference structure of the underlying QCD production amplitudes. Recasting the CMS measurements in terms of quantum coherence yields values that are broadly consistent with Standard Model expectations. Our results establish quantum coherence as an experimentally accessible probe of spin dynamics in top-quark pair production and demonstrate its potential as a precision observable for studies of the top-quark spin-density matrix at hadron colliders.

22.
arXiv (CS.AI) 2026-06-16

A Security Analysis of Long-Horizon Agentic AI Systems: Threats, Evaluation, and Framework Development

arXiv:2606.14816v1 Announce Type: cross Abstract: This paper presents a structured analysis of security challenges in long-horizon agentic AI systems. The study reviews existing threats, evaluation approaches, attack propagation mechanisms, and security frameworks. A taxonomy of security threats and a framework for analyzing attack propagation are proposed to support future research in agentic AI security

23.
medRxiv (Medicine) 2026-06-24

Predicting Chemotherapy Response from Staging Laparoscopy Images

Background: For patients with metastatic gastrointestinal cancers, chemotherapy resistance is a common phenomenon that, if known in advance, would allow for individualized treatment decisions. This study aimed to test the feasibility of developing a deep learning computer vision system that uses laparoscopy images depicting peritoneal surface metastases (i.e., capturing the in-vivo optical appearance of metastases as a summary of their molecular makeup) to predict whether a patient is resistant to standard chemotherapy. Methods: The retrospective observational feasibility study included 35 adult patients who underwent staging laparoscopy for non-colon gastrointestinal adenocarcinoma with biopsy-confirmed peritoneal surface metastases and who underwent chemotherapy as their only treatment modality. Chemotherapy resistance was determined based on each patient's observed cancer-specific survival after controlling for confounders. Results: Of 35 patients, 17 were assigned to the chemotherapy sensitive group and 18 to the chemotherapy resistant group. The study cohort provided 1010 laparoscopy image patches of 101 biopsy-confirmed metastases. A densely connected convolutional neural network with cross-validation provided the best results for correctly predicting chemotherapy resistance at the patient level (accuracy 0.80 (95%CI 0.63-0.92), sensitivity 0.72, specificity 0.88, AUC-ROC 0.78). Saliency maps demonstrated the system's trustworthiness. Conclusion: In this study, a prototype surgical computer vision system designed to determine chemotherapy resistance from operative images of peritoneal surface metastases demonstrated its technical feasibility. Further development and validation in a multi-institutional clinical study are pending.

25.
medRxiv (Medicine) 2026-06-18

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

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