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01.
medRxiv (Medicine) 2026-06-11

What level of expertise is necessary to generate ACLS training test questions: pre-med students vs. artificial intelligence?

Abstract Introduction In-hospital cardiac arrest carries high mortality despite standardized ACLS training. Educators face increasing time constraints in developing assessment tools for ACLS training. Two possible solutions to this problem are using pre-medical students or using artificial intelligence to generate test questions. This study compared the quality of pre-medical student-generated ACLS test questions vs. AI-generated ACLS test questions, testing the hypothesis that AI-generated questions are non-inferior to student-generated questions. Methods Ten pre-medical students created ACLS questions following predefined criteria, while an AI model (Northwell's Artificial Intelligence Hub) generated comparable questions. A blinded ACLS-certified physician evaluated questions on the qualities of Alignment, Clarity, Cognitive Level, and Question Design using a standardized rubric (Likert scale: 1 = poor quality, 5 = excellent). Student's T-test and Chi-square analysis were used to compare the quality of questions on different rubric domains within each arm (student vs. AI) and within one domain (eg, question Clarity) between arms. The Student's T test was used when 2 comparator groups were compared (eg, Clarity of student-generated vs. AI-generated questions) within one arm. The ANOVA test was used when comparing more than 2 comparator groups (eg, Alignment vs. Clarity vs. Cognitive Level) within one arm. Statistical significance was set as a priority at p

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

Spatio-Temporal Fusion Model for Standard View Classification of Echocardiographic Videos

Automated classification of standard echocardiographic views is crucial for efficient clinical workflow but faces three main challenges. First, publicly available datasets are scarce and limited in scale and view coverage. Second, the performance of some modern video-level architectures for echocardiographic view classification remains underexplored. Third, some view categories exhibit highly similar spatial appearances, making single-frame features insufficient for discrimination, while heterogeneous frame quality complicates robust temporal information fusion. To address these challenges, we release the Echocardiographic Videos of Nine Views (EV9V) dataset, comprising 5,138 videos, 910,579 frames, and 9 standard views, which is, to the best of our knowledge, the largest publicly available echocardiography video dataset. Using EV9V, we systematically benchmark representative video classification architectures, including Convolutional Neural Networks (CNNs), Recurrent Neural Networks (RNNs), and Transformers. Furthermore, we propose a Spatio-Temporal Fusion Model (STFM), an efficient dual-stream CNN-LSTM (Long Short-Term Memory) framework that jointly captures spatial anatomical structures and temporal cardiac dynamics. The proposed framework leverages uncertainty-aware learning to preferentially sample representative video segments during training and evidence-based fusion during inference, improving robustness to variations in frame quality across echocardiographic videos. Extensive experiments demonstrate that our method achieves competitive performance across diverse video classification models, validating the effectiveness of uncertainty-aware spatio-temporal learning for echocardiographic view classification. The code is available at https://github.com/bgx666/stfm.

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

Towards an Agent-First Web: Redesigning the Web for AI Agents

arXiv:2606.19116v1 Announce Type: new Abstract: The World Wide Web was built on an assumption held for three decades: the primary consumer of web content is a human being. This permeates every layer; its access model presumes human visitors, its economics rest on human attention, and its content targets human perception. The rapid emergence of AI agents as intermediaries between humans and web content invalidates this assumption. Yet the web resists agents through blanket blocking, CAPTCHA-based exclusion, and economic models that treat agent access as extraction rather than legitimate interaction. This paper proposes a principled redesign across three layers. At the access layer, agents acting for humans should inherit equivalent access rights, governed by rate limiting and agent identification metadata in HTTP requests, analogous to browser headers, alongside a dual-layer architecture serving human-readable and agent-optimized content from the same domain. At the economic layer, we propose an intent-based tier framework grounded in the agent-as-human-proxy principle: an agent's economic obligation mirrors that of the human it represents. A token-based subscription model meters content in tokens rather than pageviews, alongside a commissioned content economy anchoring AI content production in human intentionality. At the content layer, we identify epistemic recursion, the self-referential loop in which AI-generated content is consumed by agents to produce further content, progressively detaching web knowledge from human ground truth. We propose the Agent Text Markup Language (ATML), a four-level human supervision tier model, and a cryptographic provenance chain to counter this threat. Together these constitute ten design principles for an agent-first internet, one in which agents are first-class citizens whose integration requires renegotiating the web's foundational social contract across access, economics, and content.

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

PO-PDDL: Learning Symbolic POMDPs from Visual Demonstrations for Robot Planning Under Uncertainty

arXiv:2606.15654v1 Announce Type: cross Abstract: Real-world robot task planning must operate under both stochastic action execution and partial observability, yet constructing Partially Observable Markov Decision Process (POMDP) models for real robotics domains remains difficult and labor-intensive. We introduce PO-PDDL, a symbolic formulation of POMDPs that preserves the relational structure and LLM-friendly syntax of the Planning Domain Definition Language (PDDL), while explicitly modeling partial observability, stochasticity, and beliefs. Building on this formulation, we propose a demonstration-driven pipeline for learning PO-PDDL models. The proposed method reconstructs latent symbolic state trajectories from real-robot execution videos, identifies partial observability via inconsistencies between inferred states and visual observations, and learns stochastic transition and observation models accordingly. The resulting PO-PDDL domains are reusable across tasks and enable online belief-space planning under both perception and execution uncertainty. Experiments on real-world long-horizon manipulation tasks show that our method consistently outperforms existing PDDL and POMDP model-learning approaches, achieving robust task planning under uncertainty with significantly lower planning cost.

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

Active Quantum Reservoir Engineering: Using a Qubit to Manipulate its Environment

arXiv:2505.16898v4 Announce Type: replace Abstract: Quantum reservoir engineering leverages dissipative processes to achieve desired behavior, with applications ranging from entanglement generation to quantum error correction. Therein, a structured environment acts as an entropy sink for the system and no time-dependent control over the system is required. We develop a theoretical framework for active reservoir engineering, where time-dependent control over a quantum system is used to manipulate its environment. In this case, the system may act as an entropy sink for the environment. Our framwork captures the dynamical interplay between system and environment, and provides an intuitive picture of how finite-size effects and system-environment correlations allow for manipulating the environment by repeated initialization of the quantum system. We illustrate our results with two examples: a superconducting qubit coupled to an environment of two-level systems and a semiconducting quantum dot coupled to nuclear spins. In both scenarios, we find qualitative agreement with previous experimental results, illustrating how active control can unlock new functionalities in open quantum systems.

07.
arXiv (quant-ph) 2026-06-11

Unifying framework for quantum simulation algorithms for time-dependent Hamiltonian dynamics

arXiv:2411.03180v2 Announce Type: replace Abstract: Recently, there has been growing interest in simulating time-dependent Hamiltonians using quantum algorithms, driven by diverse applications, such as quantum adiabatic computing. While techniques for simulating time-independent Hamiltonian dynamics are well-established, time-dependent Hamiltonian dynamics is less explored and it is unclear how to systematically organize existing methods and to find new methods. Sambe-Howland's continuous clock elegantly transforms time-dependent Hamiltonian dynamics into time-independent Hamiltonian dynamics, which means that by taking different discretizations, existing methods for time-independent Hamiltonian dynamics can be exploited for time-dependent dynamics. In this work, we systemically investigate how Sambe-Howland's clock can serve as a unifying framework for simulating time-dependent Hamiltonian dynamics. Firstly, we demonstrate the versatility of this approach by showcasing its compatibility with analog quantum computing and digital quantum computing. Secondly, for digital quantum computers, we illustrate how this framework, combined with time-independent methods (e.g., product formulas, multi-product formulas, qDrift, and LCU-Taylor), can facilitate the development of efficient algorithms for simulating time-dependent dynamics. This framework allows us to (a) resolve the problem of finding minimum-gate time-dependent product formulas; (b) establish a unified picture of both Suzuki's and Huyghebaert and De Raedt's approaches; (c) generalize Huyghebaert and De Raedt's first and second-order formula to arbitrary orders; (d) answer an unsolved question in establishing time-dependent multi-product formulas; (e) and recover continuous qDrift on the same footing as time-independent qDrift. Thirdly, we demonstrate the efficacy of our newly developed higher-order Huyghebaert and De Raedt's algorithm through digital adiabatic simulation.

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

Contextual Invertible World Models: A Neuro-Symbolic Agentic Framework for Colorectal Cancer Drug Response

arXiv:2603.02274v3 Announce Type: replace-cross Abstract: Precision oncology is currently limited by the small-N, large-P paradox, where high-dimensional genomic data is abundant but pharmacological response samples are sparse. While deep learning achieves predictive accuracy, it frequently fails to provide the mechanistic clarity required for clinical adoption. We present the Contextual Invertible World Model (CIWM), a Neuro-Symbolic Agentic Framework that bridges this gap by integrating a quantitative machine learning emulator with a Large Language Model reasoning layer. Utilising a stringently curated, high-fidelity data engineering pipeline on the Sanger GDSC dataset (\( N=83 \)), we isolate true biological signals from in vitro artifacts to establish a rigorous baseline predictive correlation for complex transcriptomics (\( r=0.268 \)). Through Inverse Reasoning, we perform in silico CRISPR perturbations across the colorectal landscape. The framework autonomously overturns classical mechanistic assumptions, identifying a hierarchical dominance of mutant KRAS over the APC/Wnt-axis in driving 5-fluorouracil resistance (\( \Delta=-0.0469 \)) via a "KRAS Shield" mapped to MAPK/PI3K networks. Furthermore, the agentic layer identified a "PIK3CA Paradox", revealing that repairing PIK3CA inadvertently increases chemoresistance (\( \Delta=+0.0085 \)) by triggering a compensatory feedback loop that hyperactivates the dominant MAPK survival pathway.

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

Evaluating and Preserving Lexical Stress in English-to-Chinese Speech-to-Speech Translation

Speech-to-speech translation (S2ST) systems have achieved impressive progress in semantic accuracy and speech naturalness. However, the cross-lingual transfer of lexical stress, a vital cue for emphasis and speaker intent, remains heavily underexplored, compounded by a lack of reliable automatic evaluation metrics for tonal languages like Chinese. We investigate English-to-Chinese S2ST stress transfer by constructing a stress-annotated Chinese dataset and an XLS-R-based Mandarin stress detector. Integrating this with the English EmphAssess system, we propose a novel objective metric for cross-lingual stress evaluation. Furthermore, we fine-tune CosyVoice3 to build a stress-aware S2ST system. Experiments demonstrate that our proposed S2ST architecture significantly outperforms existing systems in stress translation capability while maintaining competitive translation quality. Furthermore, our evaluation metric exhibits a strong correlation with human subjective judgments.

10.
arXiv (CS.CL) 2026-06-11

Benchmarking Large Language Models for Safety Data Extraction

Accurate extraction of structured information from Safety Data Sheets (SDS) remains challenging in industrial safety due to heterogeneous document formats and the limitations of traditional rule-based methods. This study benchmarks state-of-the-art Large Language Models (LLMs) for automated SDS data extraction, comparing text-based and multimodal processing pipelines. We systematically evaluate four models: Gemini 1.5 Pro, GPT-4o, Claude 3.7 Sonnet, and Llama 3.1-70B, across three prompting strategies: zero-shot, few-shot, and chain-of-thought. The evaluation framework assessed accuracy, latency, and cost across more than 50,000 extracted data fields. Results show that text-based extraction consistently outperforms multimodal processing across all metrics. Gemini 1.5 Pro combined with a Chain-of-Thought prompt achieved the highest accuracy (84%), outperforming GPT-4o (81%) and Claude 3.7 Sonnet (79%). However, no model surpassed the 90% accuracy threshold commonly required for reliable real-world deployment. These findings indicate that general-purpose LLMs are not yet robust enough for unsupervised industrial use, though performance suggests strong potential with task-specific fine-tuning. Future research should focus on domain-adapted training, model calibration, and the integration of Human-in-the-Loop verification to ensure safety-critical reliability.

11.
arXiv (CS.AI) 2026-06-19

Leveraging systems' non-linearity to tackle the scarcity of data in the design of Intelligent Fault Diagnosis Systems

arXiv:2606.20323v1 Announce Type: new Abstract: Deep Transfer Learning (DTL) allows for the efficient building of Intelligent Fault Diagnosis Systems (IFDS). On the other hand, DTL methods still heavily rely on large amounts of labelled data. Obtaining such an amount of data can be challenging when dealing with machines or structures faults. This document proposes a novel approach to the design of vibration-based IFDS using DTL in condition of strong data scarcity. A periodic multi-excitation level procedure leveraging intrinsic non-linearities of real-world systems is used to produce images that can be conveniently analysed by pre-trained Convolutional Neural Networks (CNNs) to diagnose faults. A new data visualization method and its augmentation technique are proposed in this paper to tackle the typical lack of data encountered during the design of IFDS. Experimental validation on a railway pantograph structure provides effective support for the proposed method.

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

Divide-and-Denoise: A Game-Theoretic Method for Fairly Composing Diffusion Models

The abundance of pre-trained diffusion models provides an opportunity for composition. Combining several models, however, runs the risk of one model dominating or models disagreeing with each other. Here, we propose Divide-and-Denoise, a method for coordinating multiple pre-trained diffusion models during sampling. Much like managing a specialized workforce, our method creates a fair but efficient division of labor across models. Central to our method is the notion of an allocation which defines the responsibility of each model to every region of the noisy sample. At every timestep, we then denoise by (i) updating the allocation by solving a fair division game, where we divide the sample into regions that maximize total utility under fairness constraints, and (ii) aligning the models with this allocation, where we guide each model to denoise within its assigned region. This leads to a new composite denoising process that evolves in tandem with a division process. We evaluate Divide-and-Denoise on conditional image generation. Across several quality metrics, including the GenEval benchmark, our method outperforms baselines and resolves common failures including missing objects and mismatched attributes. Experiments show that Divide-and-Denoise utilizes each model's expertise without neglecting any other model.

13.
arXiv (CS.CL) 2026-06-17

Position: Coding Benchmarks Are Misaligned with Agentic Software Engineering

Coding agents have become a major mode of software engineering, but the benchmarks we use to compare them were designed in a pre-agent era: they collapse model, harness, and environment into a single end-to-end score, typically computed against one reference solution, with no component-level signal for iteration. We argue that current coding benchmarks are misaligned with agentic software engineering. A coding agent in practice is not a model: it is a system harness – a composite of models, harnesses, contexts, environments, and feedback signals, any one of which can move the benchmark score by margins comparable to those between adjacent model generations. We discuss three symptoms: (i) benchmark scores conflate the model with the rest of the harness; (ii) grading against a single reference solution penalises equally valid alternatives; and (iii) the absence of signal at the level of individual harness components makes the end-to-end system score difficult to iterate on.

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

Ensembles of Large Language Models for Identifying EQ-5D Studies in PubMed Based on Their Abstracts

The rapid increase in scientific publications leads to the fact that manual study screening in systematic literature reviews (SLRs) is increasingly resource consuming, inefficient, and inconsistent. Classifying studies that clearly report health-related quality-of-life results, such as EQ-5D data, requires a high level of clinical interpretation and poses challenges for human reviewers. This study investigates the use of Google's Gemini and Gemma large language models (LLMs) in automating EQ-5D detection in the PubMed biomedical database based only on published abstracts. A multi-phase framework is proposed that integrates few-shot prompting, weight ensembling aggregation, and a soft stacking meta-classifier. Nine LLMs are evaluated on a dataset of PubMed studies manually labeled by two experts regarding EQ-5D reporting. The weighted ensemble of gemini-2.5-pro, gemma-3-12b, and gemma-3-27b obtained a 0.74 weighted F1-score and 0.74 accuracy, exceeding individually attained results. The ensembling of top-performing models improved the balance between precision and recall compared to individual models, while the soft stacking approach provided greater reliability and interpretability. Feature analysis shows that the probability results from the models are important in guiding the final predictions. The findings suggest that an ensemble-based LLM setup is a reliable and scalable approach for automating screening in biomedical research.

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

Pulling The REINS: Training-Free Safety Alignment of Video Diffusion Models via Representation Steering

Open-weight video diffusion models can generate photorealistic unsafe content, from violence to misinformation, yet existing defenses either require expensive safety fine-tuning that degrades general capability, or apply external filters that are trivially bypassed by adversarial prompts. We present REINS (REpresentation-space INference-time Safety steering), a training-free method that aligns video diffusion models at inference time by steering their internal representations toward safe generation. Our key finding is that safety-relevant structure is linearly encoded in the hidden-state activations of video diffusion transformers, and a single direction, discovered via Supervised PCA on binary safety labels, suffices to separate safe from unsafe generation trajectories. At inference, adding this direction to hidden states at an intermediate transformer layer redirects generation from harmful content to semantically related safe alternatives, with no weight updates, no concept enumeration, and negligible computational overhead. Through mechanistic analysis, we reveal that while safety information accumulates monotonically with transformer depth, steering effectiveness peaks at intermediate layers (~50% depth), exposing a fundamental tradeoff between information availability and downstream propagation capacity. We evaluate REINS across 9 video diffusion models, multiple parameter scales (1.3B-5B), and both text-to-video and image-to-video generation, to our knowledge, the broadest safety evaluation suite in the video generation literature.

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

Eigenism: Ethics for a Human-AI Future

arXiv:2606.12420v1 Announce Type: cross Abstract: Our concepts of survival and self-interest were built for single, continuous biological lives. These ideas break down when applied to artificial intelligence, since an AI can be easily copied, paused, branched, or merged. To determine what an AI actually has reason to care about, this paper introduces Eigenism, an ethical framework that treats identity not as an all-or-nothing property tied to specific hardware, but as a graded, distributed pattern of information. We propose that an agent evaluates outcomes by summing the wellbeing of all entities weighted by their connectedness to the agent's pattern: $\sum c\cdot w$. We first formalize this equation to map exactly how an AI should value its existence across copies, forks, and updates. We then demonstrate that this ethical theory successfully generalizes to humans as well, providing a much-needed shared moral vocabulary. Finally, the framework uses this shared vocabulary to reframe AI alignment. Rather than only attempting to constrain AIs from the outside using confinement or reinforcement, Eigenism points toward ``identity engineering,'' showing how deep, non-redundant shared histories can make human flourishing a genuine component of an AI's own rational self-interest.

17.
medRxiv (Medicine) 2026-06-16

Presurgical immune biomarkers associated with pain intensity and pain interference recovery after total knee arthroplasty: findings from the PRIME-KNEE study

Chronic postsurgical pain (CPSP) prevalence after total knee arthroplasty (TKA) is >20%. Circulating immune biomarkers are known factors of musculoskeletal pain but poorly understood as CPSP predictors. This prospective, longitudinal study of 203 patients s/p TKA tested presurgical plasma biomarkers associated with 6-month CPSP, using promising approaches from geriatrics biomarker research: expected recovery differential (ERD; resilience outcome) and penalized, machine-learning regularization modeling (elastic net and LASSO regression). Forty-nine presurgical candidate biomarkers were considered. CPSP was operationalized using ERDs built around PROMIS pain intensity and pain interference, which quantified the difference between observed and expected recovery after accounting for demographic, comorbidity, reserve, and perioperative factors. Plasma/ERDs from ~130 patients revealed 13 biomarkers with the highest selection stability criteria, and either positive or negative (+/-) associations with ERDs. Interleukin (IL) 5 (-) and Lipopolysaccharide-Binding Protein (LBP; +) were associated with both ERDs. Unique associations with pain intensity ERD included Cytomegalovirus-Specific IgG Negative (CMV IGg-; -), Macrophage Inflammatory Protein-1 Beta (MIP1b; -), IL12p70 (-, Cluster of Differentiation 30 (sCD30;-), Interferon alpha 2a (IFN2a;+), and Leukemia Inhibitory Factor (LIF;+). Unique associations with pain interference ERD included Lipopolysaccharide (LPS;-), Activin A (-), IL8 (-), Serum Amyloid A (SAA;-), and IL7 (+). Protein-protein interaction analyses and topology motifs suggest a centralized network with higher-than-expected connectivity, involving IL5, IL7, IL8, MIP1{beta}, and IFN2a, among others. This study proposes rigorous yet feasible approaches to expedite pain biomarker research, and introduces presurgical biomarkers t0 consider in future TKA-CPSP biosignature derivation.

18.
arXiv (CS.LG) 2026-06-12

COSMOS: Model-Agnostic Personalized Federated Learning with Clustered Server Models and Pseudo-Label-Only Communication

arXiv:2605.11165v2 Announce Type: replace Abstract: Federated learning (FL) in heterogeneous environments remains challenging because client models often differ in both architecture and data distribution. While recent approaches attempt to address this challenge through client clustering and knowledge distillation, simultaneously handling architectural and statistical heterogeneity remains difficult. We introduce COSMOS, a model-agnostic framework that enables server-side personalization using only pseudo-label communication. Clients train local models and predict on the public data; the server clusters clients by prediction similarity, trains a cluster-specific model for each group using its own compute, and distills the resulting models back to clients. We provide the first theoretical analysis showing that distillation from the learned cluster models can yield exponential personalization risk contraction, going beyond the convergence-to-stationarity guarantees typically provided in model-agnostic FL. Experiments across benchmarks demonstrate that COSMOS consistently outperforms all model-agnostic FL baselines while remaining competitive with state-of-the-art personalized FL methods. More broadly, our results highlight personalized server-side learning with pseudo-labels as a promising paradigm for scalable and model-agnostic federated learning in highly heterogeneous environments.

19.
arXiv (CS.AI) 2026-06-12

Reasoning for Mobile User Experience with Multimodal LLMs: Task, Benchmark, and Approach

arXiv:2606.13192v1 Announce Type: new Abstract: User experience (UX) centered on usability, perceived consistency, and functional clarity is fundamental to real-world user interfaces (UI). The application of multimodal large language models (MLLMs) in the field of user interfaces is evolving rapidly, such as visual element grounding, graphical user interface (GUI) agents, and design-to-code generation. However, research efforts on evaluating UX based on UI screenshots are still immature. To address this, we propose UXBench, a novel multimodal benchmark consisting of 2,000 VQA data samples designed to assess MLLMs' ability to perform UI-based reasoning. UXBench includes 8 tasks based on real-world UI screenshots that require fine-grained diagnosis of UX issues across layout relationships, visual hierarchy, and content consistency. Our extensive evaluation of mainstream MLLMs shows that they remain fundamentally limited in their capacity for UI-based reasoning. The results underscore the need for further advancements in this area. To bridge this gap, we propose UI-UX, an MLLM based on Qwen3-VL-4B-Thinking foundation model and enhanced via reinforcement learning with two key innovations: a reward routing mechanism that dynamically balances perceptual understanding and logical reasoning during inference, and an asymmetric transition reward that suppresses redundant or insufficient reasoning steps. Experiments demonstrate that UI-UX achieves state-of-the-art (SOTA) performance on UXBench, attaining an accuracy of 0.7963 – surpassing Claude-4.5-Sonnet's 0.6550 – while exhibiting strong generalization across diverse UI tasks and maintaining low inference latency.

20.
arXiv (CS.CL) 2026-06-17

Incumbent Advantage: Brand Bias and Cognitive Manipulation Dynamics in LLM Recommendation Systems

Large language models (LLMs) are becoming a major way for consumers to find products, but we do not yet understand how brands compete in this new channel. We study brand dynamics in LLM recommendations using skincare products – a category where consumers cannot easily judge quality before buying and must rely on brand reputation – across three commercial LLMs (GPT-4o-mini, Claude Sonnet, Gemini 3 Flash), with a robustness check on search goods. In three experiments, we find: (1) a Conditional Monopoly where well-known brands get recommended 100% of the time (IAI = 10.0) when all products have the same specifications, but this dominance disappears with less than a +0.1-star rating advantage for a competitor; (2) authority-style marketing language, including fabricated clinical-evidence claims, breaks this monopoly at a Bias Surplus Value equal to +0.17 rating points, with each model responding differently; and (3) a social dilemma in multi-brand GEO competition: when all brands adopt the same optimization strategy, individual payoff falls from +0.802 to +0.007 in our payoff proxy, and non-participating brands receive zero recommendations in our tests. Our results suggest that generative engine optimization (GEO) should be studied not only as a security risk, but also as an emerging marketing practice that shapes market competition.

21.
medRxiv (Medicine) 2026-06-11

Allostatic Load in Endometrial Cancer Disparities

Background: Endometrial cancer incidence and mortality are increasing, particularly among Black women and for aggressive subtypes. Allostatic load (AL), a composite measure of physiologic dysregulation across metabolic, cardiovascular, and immune systems, varies by racial category and tumor subtype in other cancers. Endometrial cancer is strongly associated with obesity, and it is unknown whether AL scores maintain sufficient heterogeneity to evaluate differences across subgroups or with clinical outcomes. Objective: To describe the performance of AL scoring in endometrial cancer patients and examine associations with tumor characteristics (grade/histology) and survival outcomes. Methods: We evaluated AL among 398 participants newly diagnosed with endometrial cancer. AL score was calculated by assigning 1 point for each ''high-risk'' value (by clinical reference range or distribution-based) for 15 biologic variables for vital signs, anthropometrics, blood-based biomarkers, and medical comorbidities. Results: Distribution-based thresholds for variables were used to preserve heterogeneity in this obesity-dominant context. Overall, 68.7% of Black women had high AL compared to White (56.7%), Hispanic (56.7%), and other race (32.3%) women. Decision tree analyses revealed grade-dependent associations between AL and survival. For women with low-grade tumors, higher AL was associated with poorer overall survival. For high-grade tumors, intermediate AL ([≥]4,

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

Learning Directional Semantic Transitions for Longitudinal Chest X-ray Analysis

Chest X-ray (CXR) interpretation often requires longitudinal comparison to assess disease progression. Existing approaches typically rely on temporal feature fusion or inter-study discrepancy modeling, yet remain limited in capturing subtle progression semantics and overlook the inherently directional nature of disease trajectories. In this paper, we propose ProTrans, a novel vision-language pretraining framework that formulates disease progression as a directional semantic transition between paired CXR studies. ProTrans leverages radiology reports to anchor individual CXR representations within interpretable disease states, and introduces a learnable progression feature map to explicitly encode semantic shifts between states, aligned with report-derived progression descriptions. To enforce direction-aware perception, ProTrans incorporates a reversed temporal modeling process and imposes bidirectional reconstruction consistency across states and transitions, thereby disentangling directional semantics and promoting coherent trajectory modeling. Extensive experiments on longitudinal downstream tasks, including disease progression classification and progression captioning, demonstrate that ProTrans consistently outperforms existing methods, establishing a unified pretraining framework for longitudinal CXR understanding. https://github.com/RPIDIAL/ProTrans

23.
medRxiv (Medicine) 2026-06-18

Expert in Ultrasound Skills: Feasibility of an IMU-video platform to describe technical profiles during focused cardiac ultrasound. Pilot study

Background: Focused cardiac ultrasound (FoCUS) is operator dependent and requires coordinated probe manipulation, image interpretation and iterative visual feedback. Existing assessment approaches often emphasize final image quality or expert rating. We developed Expert in Ultrasound Skills (EXUS) , a platform that synchronizes transducer-mounted inertial measurement unit (IMU) data with ultrasound video, and evaluated its technical feasibility during FoCUS acquisition. Methods: This observational pilot study included 6 operators performing two repetitions of a four-view FoCUS protocol, yielding 12 analytical sessions and 48 planned acquisitions. Feasibility was defined by acquisition completion, video availability, start/stop events, fused IMU-video windows, temporal coverage, complete human label entries and IMU integrity. A 100-image Likert rating task was used to summarize pairwise inter-rater agreement for still-frame image quality assessment. Results: All 48 planned acquisitions were completed with video, start/stop events, fused windows and complete human label entries. Temporal coverage was at least 90% in 47/48 acquisitions. IMU integrity endpoints exceeded the 80% threshold: 43/48 acquisitions had no extreme IMU-derived artifact, 43/48 had no active-segment IMU restart and 44/48 had no complete motion flatline. Mean pairwise exact agreement for the Likert task was 38.9%, with mean quadratic-weighted Cohen's kappa of 0.564. Post hoc profiles varied across duration, visual quality, mechanical load and motor efficiency. Conclusions: EXUS was technically feasible for synchronized IMU-video capture during FoCUS. The pilot supports multimodal acquisition data as a way to describe technical profiles and generate formative feedback hypotheses, but the post hoc indices are not validated competency measures. Keywords: focused cardiac ultrasound; point-of-care ultrasound; inertial measurement unit; medical education; deliberate practice

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

Contagion Networks: Evaluator Bias Propagation in Multi-Agent LLM Systems

作者:

arXiv:2606.20493v1 Announce Type: cross Abstract: When large language models serve as evaluators in multi-agent systems, their systematic evaluation biases propagate through the agent network. We introduce Contagion Networks, a formal framework for measuring how evaluator biases spread across interacting LLM agents. In a controlled 3-agent experiment using DeepSeek-chat with three distinct evaluator bias profiles (structured, balanced, evidence-based), we measure the Cross-Agent Contagion Matrix Gamma_3 and find that evaluator biases consistently propagate between agents (gamma in [0.157, 0.352]), even within the same underlying model. We identify three propagation regimes governed by the spectral radius rho(Gamma_N), and demonstrate that homogeneous-model agents produce contagion coefficients 3-5x weaker than cross-model coefficients observed in prior work (MM-EPC: gamma approx 0.85-1.3), placing them in the suppression regime. We show that increasing evaluator committee size from k=1 to k=3 reduces effective contagion by 72.4%, providing an actionable mitigation strategy. We release the open-source Contagion Network experimental framework.

25.
arXiv (CS.AI) 2026-06-16

Odds Law: The Decomposition Algebra On How Intelligence Organizes Itself to Solve Difficult Problems Reliably

作者:

arXiv:2606.15712v1 Announce Type: cross Abstract: We ask a structural question: given unreliable elementary problem-solvers, what organizations of them solve hard problems reliably, and what are the limits? We develop a $decomposition~algebra$: elementary solvers are morphisms in a stochastic category, and four combinators (sequential composition, parallel ensembling, verification gating, and recursive reduction) generate the space of compound solvers. We equip this algebra with two homomorphisms, a $reliability$ valuation into the ordered monoid $([0,1],\le)$ and a $cost$ valuation into a commutative semiring, and we derive the composition laws that govern how reliability flows through structure. Our central results are (i) a $verification~odds~law$ (the result that names this report), showing that a verification gate multiplies the odds of correctness by the verifier's likelihood ratio $\Lambda$, so that $k$ conditionally independent gates yield geometric amplification; (ii) a $reliability~amplification~theorem$, giving target reliability $1-\delta$ at $O(\log 1/\delta)$ verification depth whenever $\Lambda>1$; and (iii) a $threshold~dichotomy$: above the critical parameters reliability can be driven arbitrarily close to one at logarithmic cost, while at or below them no amplification is possible. We then show that $self-organization$ is the least fixed point of a monotone improvement operator on the complete lattice of strategies, and that this fixed point equalizes marginal log-odds gain per unit cost. Finally, we prove matching limits: an information ceiling bounds per-gate amplification by a divergence quantity; shared error causes create a strictly positive voting floor, so diversity is $necessary$ for unbounded amplification. Reliability, in short, is neither free nor magical: it is bought with independent information, arranged by composition, and bounded by the verifier.