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01.
arXiv (CS.CV) 2026-06-11

CountZES: Counting via Zero-Shot Exemplar Selection

Object counting in complex scenes is particularly challenging in the zero-shot (ZS) setting, where instances of unseen categories are counted using only a class name. Existing ZS counting methods that infer exemplars from text often rely on off-the-shelf open-vocabulary detectors (OVDs), which in dense scenes suffer from semantic noise, appearance variability, and multi-instance proposals. Alternatively, random image-patch sampling is employed, which fails to accurately delineate object instances. Since counting is sensitive to exemplar quality, such selection strategies often yield poorly representative exemplars, leading to inaccurate count estimation. To address these issues, we propose CountZES, an inference-only approach for object counting via ZS exemplar selection. CountZES discovers diverse exemplars through three synergistic stages: Detection-Anchored Exemplar (DAE), Density-Guided Exemplar (DGE), and Feature-Consensus Exemplar (FCE). DAE refines OVD detections to isolate precise single-instance exemplars. DGE introduces a density-driven, self-supervised paradigm to identify statistically consistent and semantically compact exemplars, while FCE reinforces visual coherence through feature-space clustering. Together, these stages yield a complementary exemplar set that balances textual grounding, count consistency, and feature representativeness. Experiments on diverse datasets demonstrate CountZES superior performance among ZOC methods while generalizing effectively across domains.

02.
arXiv (CS.AI) 2026-06-12

Mental-R1: Aligning LLM Reasoning for Mental Health Assessment

arXiv:2606.13176v1 Announce Type: new Abstract: Mental health problems such as anxiety, depression, and suicide remain urgent global challenges, where timely and accurate assessment is critical for effective intervention. Recently, large language models have been explored for mental health assessment. However, existing general-purpose post-training methods do not align with the cognitive processes of human assessment, which may lead to unreliable reasoning outcomes. To bridge this gap, we propose Cognitive Relative Policy Optimization (CRPO), a reinforcement learning framework tailored for the mental health domain. CRPO extends group relative policy optimization by integrating stage-dependent uncertainty modeling into the policy optimization process. Specifically, we introduce a stage-wise entropy regularization mechanism that encourages broad exploration in early reasoning phases and progressively enforces confident decision-making in later stages, mimicking the human cognitive shift from uncertainty to certainty. In addition, inspired by cognitive appraisal theory, we formalize cognitive reasoning stages, thereby guiding theory-grounded interpretable inference. Experiments on 8 mental health datasets show that CRPO achieves an average improvement of 10.4 percentage points in weighted F1-score over the best reinforcement learning baseline. Furthermore, the CRPO-trained model Mental-R1 demonstrates clear advantages compared with existing large language models on reasoning-intensive cases, suggesting that CRPO enhances reasoning capabilities for mental health assessment.

03.
arXiv (CS.CV) 2026-06-16

EyeMVP: OCT-Informed Fundus Representation Learning via Paired CFP–OCT Pretraining

Color fundus photography (CFP) is the mainstay for large-scale retinal screening, yet its diagnostic capacity is constrained by the lack of depth-resolved structural information. Optical coherence tomography (OCT) provides cross-sectional retinal anatomy, but is less accessible in population-level screening. Here, we present EyeMVP, a cross-modal retinal foundation model that uses paired CFP–OCT pretraining to learn OCT-informed CFP representations. EyeMVP is pretrained on 674,893 strict same-eye same-day paired CFP–OCT image triples from 112,642 patients across eight hospitals in China. The model uses cross-modal masked reconstruction to enrich CFP representations with OCT-associated supervision, while requiring only CFP images at inference. To accommodate the non-aligned imaging geometry between en-face CFP and cross-sectional OCT, EyeMVP combines source-constrained cross-attention with CFP-derived structural masks. Across 16 downstream tasks, including classification, segmentation, few-shot adaptation, and cross-modal retrieval, EyeMVP outperforms representative retinal foundation models and shows consistent gains on tasks involving macular and optic nerve structure. For CFP-challenging macular diseases, EyeMVP achieves an AUROC of 0.948 for macular edema (vs.~0.852 for EyeCLIP) and 0.825 for myopic macular schisis. In an exploratory reader study, EyeMVP exceeds junior and intermediate ophthalmologist groups but does not reach senior ophthalmologist performance on macular edema, while showing numerically higher balanced accuracy than all reader groups on myopic macular schisis. These results suggest that pixel-level cross-modal reconstruction can enrich CFP representations with OCT-associated supervision, providing a practical route toward stronger CFP-based retinal analysis in screening settings.

04.
arXiv (CS.CL) 2026-06-17

SuCo: Sufficiency-guided Continuous Adaptive Reasoning

Despite remarkable performance on complex tasks, Large Reasoning Models (LRMs) often generate excessively long Chain-of-Thoughts (CoT), inflating computational costs even for simple queries. Existing efforts to mitigate this inefficiency typically rely on discrete reasoning modes or fixed budget tiers, lacking a principled criterion of when reasoning is sufficient. In this work, we introduce Minimal Sufficient CoT (MSC), defined as the shortest prefix of a CoT trajectory which is adequate for producing the correct answer. We empirically show that MSC not only reduces reasoning tokens, but also improves accuracy across difficulty levels. Building on MSC, we propose Sufficiency-guided Continuous Adaptive Reasoning (SuCo), a two-stage training framework for autonomous reasoning control along a continuous spectrum. In stage 1, MSC-Aligned Fine-Tuning (MFT) constructs MSC data using problem-adaptive sufficiency thresholds that naturally scale with question difficulty, then fine-tunes the model to internalize concise yet sufficient reasoning patterns. In stage 2, Sufficiency-Aware Policy Optimization (SAPO) further optimizes the model through reinforcement learning with dynamic complexity tracking and sufficiency-aware rewards that penalize both over- and under-thinking. Extensive experiments across mathematics, code, and science benchmarks show that SuCo consistently achieves improvements in both accuracy and reasoning efficiency.

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

CrossMaps: Confidence-Aware Open-Vocabulary Semantic Mapping for Rover Navigation

arXiv:2606.16935v1 Announce Type: cross Abstract: Rovers rely on perception to maintain spatial maps that encode both objects and sensor quality (e.g., range reliability, lighting artifacts, data density), guiding data fusion, embedding updates, and navigation under partial observability. To study these coupled perception-navigation processes, we present CrossMaps, a real-time confidence-aware open-vocabulary semantic mapping pipeline that constructs language-queryable maps from RGB-D data. Building on VLMaps-style approaches, CrossMaps integrates multi-scale CLIP embeddings with confidence-aware fusion and a dual-memory architecture consisting of Short-Term Memory (STM) and Long-Term Memory (LTM). The STM aggregates noisy visual observations using geometric, semantic, and temporal confidence cues, while confident and coherent cells are promoted to the LTM as persistent semantic landmarks. Designed for deployment with a Jetson Orin-powered UGV alongside SLAM, CrossMaps runs in real time and produces semantic heatmaps that can be queried with natural language to guide rover navigation.

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

Optimal scenario design for climate emulation

arXiv:2606.19302v1 Announce Type: cross Abstract: As deep learning for physical systems continues to grow in popularity, efforts to improve generalizability have primarily focused on designing architectures that embed physical constraints. However, for machine-learning surrogate climate models (emulators), we show that the low structural diversity in existing scenarios commonly used to generate training data places a ceiling on predictive skill. Here, we examine whether training datasets themselves can be optimized to improve generalization. We introduce a method to create datasets that produce emulators capable of generalizing to new, structurally different scenarios absent from the training data. We use a differentiable Simple Climate Model (SCM) to calculate the sensitivity of emulator loss to perturbations in the training data, iteratively updating the training data to maximize emulator skill. For an SCM, training on one scenario optimized in this fashion outperforms an emulator trained on six standard ScenarioMIP pathways. We achieve this higher predictive skill despite training on a smaller dataset, finding that our emulator successfully isolates distinct physical behaviors of different climate forcing agents (e.g., greenhouse gases vs. aerosols) without single-forcing runs. We then demonstrate that scenarios optimized using an SCM, when used to drive an intermediate-complexity climate model, produce a training dataset that yields a more skillful emulator than training on ScenarioMIP outputs. Our results suggest that, in the compute-constrained environment of running full-scale climate models, generating a small number of dynamically rich scenarios provides greater marginal value for emulation and characterizing system responses than expanding the suite of traditional emissions pathways.

07.
bioRxiv (Bioinfo) 2026-06-22

HTS-Oracle X: AI-Guided Prospective Discovery of Small Molecule Immune Checkpoint Binders

Targeting immune checkpoint protein-protein interactions (PPIs) using small molecules remains limited by the shallow, featureless binding surfaces of co-stimulatory and co-inhibitory receptors and the characteristically low hit rates of conventional high-throughput screening against these interfaces. Here we report HTS-Oracle X, a multimodal deep learning platform that integrates bidirectional cross-attention fusion of ChemBERTa SMILES embeddings with extended RDKit descriptors, trains on continuous biophysical binding signals rather than binary labels, and employs Monte Carlo Dropout uncertainty quantification for uncertainty-adjusted compound selection. Trained on 45,760 Dianthus TRIC-screened compounds per target under scaffold-aware cross-validation, HTS-Oracle X was applied prospectively to a 100,160-compound Enamine library against CD28, TIM-3, and VISTA. From 150 model-selected compounds, 45 dose-response confirmed binders were identified (30.0% overall hit rate), yielding enrichment factors of 234-408x over experimentally established random prospective baselines and 16 sub-micromolar hits. The top hits, HX-CD28-1 (KD = 233 nM), HX-TIM3-1 (KD = 249 nM), and HX-VISTA-1 (KD = 345 nM), demonstrated on-target functional activity in immune cell and tumor co-culture assays. HTS-Oracle X represents a scalable AI-guided framework for small molecule discovery against non-enzymatic immune checkpoint targets.

08.
arXiv (CS.AI) 2026-06-18

EffiNav: Fusing Depth and Vision-Language for Efficient Object Goal Navigation

arXiv:2606.18634v1 Announce Type: cross Abstract: To locate a target object while exploring the unknown environment is a fundamental capability for autonomous agents, with applications ranging from search-and-rescue to field robots. A simplified version of such task is Object Goal Navigation (ObjNav). In ObjNav, successful arrival at the target object provides a basic measure of performance; however, the efficiency of the navigation trajectory is equally important, as it indicates how intelligently the agent explores and how much time remains for subsequent tasks. In unknown environments, the key to efficient navigation lies in deciding where to explore next. While many prior works aim to address this core challenge and achieved promising performance in certain settings, recent training-based models and non-training frameworks still suffer from generalization and efficiency issues respectively, which in the worst cases can lead to excessive exploration of already-visited areas or redundant back-and-forth motion. We evaluate EffiNav on two widely used simulation benchmarks Habitat Matterport 3D (HM3D) and Open-Vocabulary Object goal Navigation (OVON), and further validate its effectiveness on physical robots in real-world settings. We conduct failure analysis on massive simulation episodes. With minimal modification, we also extend EffiNav to a memory-augmented ObjNav task on the GOAT-BENCH dataset, demonstrating its adaptability beyond standard ObjNav settings. Across two standard metrics–Success Rate (SR) and Success weighted by Path Length (SPL), EffiNav matches or outperforms recent baselines, reflecting its efficiency, robustness, and practical applicability. Recognizing the different emphases of the two datasets, the performances reveals this framework is more balanced and generalizable for efficient ObjNav.

09.
bioRxiv (Bioinfo) 2026-06-11

HoloCell: A Generative Foundation Model for Holistic Cellular Modeling

Single-cell multi-omics technologies have recently advanced to enable the profiling of epigenomic, transcriptomic, and proteomic layers within individual cells, offering new opportunities to characterize cellular states as integrated biological systems. However, developing a unified framework that can seamlessly integrate diverse omics modalities and remain robust to heterogeneous modality missingness remains challenging. Here we present HoloCell, to our knowledge the first generative foundation model for joint representation learning and generative modeling across all three major single-cell omics modalities, i.e., epigenomics, transcriptomics, and proteomics. HoloCell contains over 860 million parameters and is pretrained on the Human-Multi-Omics-Corpus, which comprises approximately 468 million single-cell profiles across these three omics layers, corresponding to over 425 billion tokens. HoloCell introduces a simple yet biologically grounded hierarchical tokenization strategy that encodes cis-regulatory elements, genes, and proteins as structured tokens within a shared modeling framework. We evaluated HoloCell across single-omics representation learning, paired multi-omics integration, unpaired multi-omics alignment, and cross-modal generation via iterative diffusion and remasking, demonstrating its superior performance and flexibility across diverse omics tasks. From a representation perspective, HoloCell provides a unified digital mapping of cellular states across multiple omics layers, capturing cell heterogeneity as an integrated system. From a generation perspective, its iterative diffusion and remasking framework accounts for the inherently unordered nature of biological features, enabling in silico simulation of multi-omics information flow. Together, these capabilities position HoloCell as a versatile foundation model toward the emerging concept of a virtual cell, offering both systematic characterization and generative simulation of cellular systems within a unified framework.

10.
arXiv (CS.CV) 2026-06-16

X-Tokenizer: A Multimodal Action Tokenizer for Vision-Language-Action Pretraining

Modern Vision-Language-Action (VLA) models must bridge pretrained vision-language reasoning and precise continuous robot control. Existing action tokenizers discretize actions primarily for reconstruction, producing codes that preserve motion geometry but provide only weak semantic supervision to the backbone. We therefore formulate action tokenization not as mere compression, but as semantic interface learning between multimodal reasoning and executable control. To this end, we introduce X-Tokenizer, a lightweight encoder-Semantic Residual Quantization (SRQ)-decoder architecture that provides a shared action interface across diverse robotic arm embodiments. Its key component, SRQ, imposes an asymmetric structure on residual vector quantization: the first level is trained with Masked Action Modeling (MAM) to form a discrete action language that captures coarse motion intent, while deeper levels remain reconstruction-oriented residuals that preserve fine-grained details. To further align action tokens with multimodal semantics, X-Tokenizer is pretrained with contrastive alignment to the representation space of a pretrained foundation model and with next-frame vision-language feature prediction. Pretrained on 2.4M trajectories (2.0B action frames), a single frozen X-Tokenizer plugs into a mixed discrete-continuous VLA as a representation-shaping supervision signal. X-Tokenizer achieves top real-world aggregate and strong RoboTwin 2.0 simulation results. Outperforming FAST in multimodal grounding (+13.5%) and long-horizon tasks (+8.25), it shows that action tokenizers serve as semantic interfaces for VLA pretraining beyond mere action compression.

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

Navigating Gigapixel Pathology Images with Large Multimodal Models

Recent advances in large multimodal models have allowed for the development of interactive chat models that can converse and reason about pathology whole-slide images (WSIs). However, existing slide-level chat systems are often highly specialized, typically compressing WSIs into fixed slide-level embeddings or relying on multi-component pipelines, which can lose multi-scale detail and limit generalizability beyond the target task. We present GIANT (Gigapixel Image Agent for Navigating Tissue), a simple, training-free approach that lets general-purpose multimodal models navigate WSIs on their own, iteratively selecting multi-magnification crops and aggregating evidence over time. To evaluate generalizability in WSI question answering and to promote reproducibility, we introduce MultiPathQA, a benchmark suite spanning five clinical challenges and 934 questions over 868 unique WSIs. This includes a new set of 128 pathologist-authored multiple-choice questions designed to mirror real diagnostic search and multi-scale reasoning. Using GPT-5, GIANT outperforms models specialized for pathology question answering, achieving state-of-the-art performance on four out of five benchmarks.

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

Think Fast: Estimating No-CoT Task-Completion Time Horizons of Frontier AI Models

arXiv:2606.07157v2 Announce Type: replace Abstract: Many efforts to ensure frontier AI models are safe rely on monitoring their chain-of-thought (CoT) reasoning. If models become able to perform sufficiently complex reasoning internally, without explicit thinking tokens, this would undermine such oversight. We measure how well frontier models reason without CoT across a suite of over 30,000 questions spanning 43 benchmarks in domains including math, coding, puzzles, causality, theory-of-mind, and strategic reasoning. To compare models against humans, we estimate the $50\%$-task-completion time horizon (TH): the human time required for tasks a model completes with $50\%$ success rate. We complement this with a $50\%$ reasoning token horizon: the minimum number of o3-mini reasoning tokens needed for tasks a model solves with $50\%$ success rate. We find that the no-CoT $50\%$ TH of frontier models has been doubling roughly every year over the past six years, with GPT-5.5's TH reaching over 3 minutes and reasoning token horizon exceeding 1,500 tokens. Our median estimates predict that frontier no-CoT THs could exceed 7 minutes by 2028, and 25 minutes by 2030, though these projections carry substantial uncertainty. We recommend frontier developers track this explicitly.

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

The Answer Lies Within: Self-Derived Rewards Enable Explainable Relation Extraction

Despite the remarkable reasoning capabilities of large language models, they still struggle with one-shot relation extraction without predefined relation labels. We identify two pitfalls: models are often misled by irrelevant tokens instead of relation-conveying semantics, and they often fail to align with the abstraction level human annotators expect. We introduce a novel framework that closes this gap with two components: (1) COGRE, a cognitively-inspired reasoning framework that structures RE into a series of processes mimicking human text-processing; and (2) HIT@DICT, a reinforcement learning intermediate reward strategy that encourages reasoning to align with relational labels by rewarding relation-relevant phrases in reasoning. The reward is derived on a credit dictionary automatically extracted from correct predictions. Our experiments show that our framework improves both accuracy and explanation quality by addressing these two pitfalls. For example, COGRE with Qwen2.5-14B-Instruct on One-shot NYT29 achieves 24.65% F1, surpassing prior reasoning-based designs. Optimizing this approach with RL using HIT@DICT further improves performance by +23.46% points. Finally, human evaluation shows that our best model generates relational phrases closely aligned with gold labels, increasing human explanation quality ratings by 54% (relative).

14.
arXiv (CS.CV) 2026-06-12

Learning Visually Interpretable Oscillator Networks for Soft Continuum Robots from Video

Learning soft continuum robot (SCR) dynamics from video offers flexibility but existing methods lack interpretability or rely on prior assumptions. Model-based approaches require prior knowledge and manual design. We bridge this gap by introducing: (1) The Attention Broadcast Decoder (ABCD), a plug-and-play module for autoencoder-based latent dynamics learning that generates pixel-accurate attention maps localizing each latent dimension's contribution while filtering static backgrounds, enabling visual interpretability via spatially grounded latents and on-image overlays. (2) Visual Oscillator Networks (VONs), a 2D latent oscillator network coupled to ABCD attention maps for on-image visualization of learned masses, coupling stiffness, and forces, thereby enabling mechanical interpretability. We validate our approach on single- and double-segment SCRs, demonstrating that ABCD-based models significantly improve multi-step prediction accuracy with 5.8x error reduction for Koopman operators and 3.5x for oscillator networks on a two-segment robot. VONs autonomously discover a chain structure of oscillators. This fully data-driven approach yields compact, mechanically interpretable models with potential relevance for future control applications.

15.
arXiv (CS.CL) 2026-06-11

Beyond Third-Person Audits: Situated Interaction Auditing for User-Centered LLM Bias Research

Research on bias in large language models (LLMs) has predominantly focused on third-person audits, which study how models represent or evaluate demographic groups as external subjects. However, this paradigm overlooks a structural blind spot because the user is absent from the audit. In practice, LLMs are used in open-ended, personal interactions, during which the model implicitly represents the user and adjusts its responses accordingly. When identical requests yield different responses depending on who is asking, bias manifests not in how the model describes others but in how it treats its interlocutor. We propose Situated Interaction Auditing (SIA), a user-centered framework for studying how user profile signals – implicit sociodemographic markers, writing style, and stated identity – systematically shape LLM response quality, content, and tone. We demonstrate the framework through a case study that intersects gender and socioeconomic status signals across multiple task domains and outline a research agenda for SIA as a new mission for natural language processing.

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

Tunneling Dynamics and Time Delay in Electron Transport through Time-Dependent Barriers with Finite-Bandwidth Reservoirs

arXiv:2507.20649v2 Announce Type: replace-cross Abstract: We study a model system consisting of a tunneling barrier driven by an external harmonic field and coupled to two leads with finite bandwidth. Avoiding Floquet expansions, we derive simple expressions for the time-dependent tunneling current in the adiabatic regime. Our approach relates the barrier modulation to a measurable time delay in the steady-state periodic current. It provides a physically consistent definition of the tunneling time inside the barrier by subtracting the time delay associated with the leads from the total time delay. We find that the tunneling time always vanishes for wide/high barriers. Remarkably, the time delay persists even when the barrier becomes static, i.e., in the limit where the modulation frequency vanishes. This indicates that the time delay obtained through the introduction of an external periodic perturbation actually reflects an intrinsic property of the tunneling dynamics, rather than an effect of the external drive or of a particular system. We apply our results to the analysis of tunneling times in optical experiments and find good agreement with the experimental data.

17.
bioRxiv (Bioinfo) 2026-06-18

Trajectory inference of epithelial-centered neighborhood profiles reconstructs a pseudo-temporal continuum in idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is characterized by complex lung architecture and spatially heterogeneous remodeling, which have hindered integrated analysis of cell-intrinsic activity and intercellular communication during disease progression. Here we profiled six IPF lung specimens comprising more than 630,000 cells using the Xenium 5k panel and developed an epithelial-centered neighborhood profiling framework based on the local cellular composition around each epithelial cell. This approach captured fibrosis-associated variation in epithelial niches without requiring predefined histological regions. Pseudo-temporal continuum inference of these profiles reconstructed a continuous axis that reflected the spatial progression of fibrotic remodeling from relatively preserved alveolar regions to fibrotic and airway-like remodeled regions. Within this spatial dataset, we mapped coordinated changes in epithelial states, local microenvironments, epithelial intracellular pathway activities, and directional interactions with neighboring cell types along the same axis. Our findings provide a spatial framework that generates testable hypotheses for progressive epithelial niche remodeling in IPF.

19.
arXiv (CS.CL) 2026-06-16

CoRA: Confidence-Rationale Alignment for Reliable Chain-of-Thought Reasoning

Chain-of-thought (CoT) reasoning can improve LLM performance, but high answer confidence may be misleading when the accompanying CoT rationale is plausible yet incomplete or poorly supported. We study confidence–rationale alignment: whether a model's confidence in its committed answer is justified by its generated rationale. We introduce a GRPO-based reinforcement learning framework that jointly rewards answer correctness, committed-answer probability, and rubric-based rationale support, where the rubric assesses grounding, coherence, task match, and connection to the selected answer without revealing the gold answer to the judge. Across MedQA, MathQA, and OpenBookQA using three open-weight LLMs, our method reduces the confidence–rationale alignment error by up to 26.51% compared with untuned checkpoints, SFT, and correctness-only GRPO, while maintaining competitive accuracy and often improving calibration. These results show that reliable CoT reasoning requires not only confident answers, but rationales that substantively support them.

20.
arXiv (CS.LG) 2026-06-19

FloatDoor: Platform-Triggered Backdoors in LLMs

arXiv:2606.19535v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly deployed in sensitive settings such as software engineering, where their outputs directly shape downstream artifacts. Recent work has shown that an identical model can produce measurably different outputs depending on the deployment platform, a consequence of non-associative floating-point arithmetic and divergent kernel implementations. We study the security implications of this platform-dependent variability and uncover a novel attack surface on LLM deployments. We introduce FloatDoor, the first input-independent, platform-triggered backdoor attack against generative LLMs. The compromised model exhibits adversary-chosen behavior when served on a target platform and is otherwise benign. FloatDoor is realized through two lightweight LoRA adapters, one that amplifies inter-platform numerical divergence and one that binds the resulting platform signature to a malicious downstream task, while leaving aggregate model utility largely intact. FloatDoor exploits a pronounced time-of-check, time-of-use gap between model auditing and serving. We demonstrate FloatDoor on Qwen3-4B across a broad range of deployment targets, including NVIDIA GPUs, Google TPUs, AWS Graviton, and Alibaba Yitian-710. As a final case study, we show that FloatDoor reliably induces exploitable code vulnerabilities on a chosen target platform. Our results establish a new class of attacks on LLM deployments and underscore the pressing need for trusted model supply chains in sensitive, LLM-powered applications.

21.
medRxiv (Medicine) 2026-06-22

Study protocol: Feasibility and clinical implications of real-time cerebral autoregulation monitoring in major noncardiac surgery with the Medtronic Cotrending algorithm (AUTOREGULATE-NONCARDIAC-COTRENDING)

Background: Perioperative hypotension is associated with postoperative organ injury. However, trials of hypotension avoidance have not found meaningful improvements in postoperative cardiovascular, renal, neurological or functional outcomes. One possible explanation is that organ perfusion depends on patients individual autoregulatory ranges. Hence, technology enabling monitoring of the autoregulatory status of vital organs, e.g. the brain, could provide a physiologic basis for personalising of blood pressure targets. However, current established methodologies for monitoring cerebral autoregulation in noncardiac surgery, e.g. the cerebral oximetry index (COx), are limited by performance and usability. The Medtronic Cotrending algorithm has been developed to provide automated, near real-time assessment of cerebral autoregulation. While feasibility was demonstrated in cardiac surgery, its applicability in major noncardiac surgery remains unknown. This study aims to evaluate the technical feasibility and clinical implications of Cotrending-based cerebral autoregulation monitoring in major noncardiac surgery. Objectives: Primary objective: To evaluate the technical feasibility of using the Medtronic Cotrending algorithm to monitor intraoperative cerebral autoregulation in real-time during major noncardiac surgery, drawing comparisons to the COx algorithm. Secondary objectives: to investigate the potential clinical implications of Cotrending-based cerebral autoregulation monitoring. Design: Single-centre, prospective cohort study. Setting: Swiss tertiary care centre Patients: Patients enrolled in AUTOREGULATE-NONCARDIAC who were monitored intraoperatively with the Medtronic INVOS(TM) 5100 near-infrared spectroscopy (NIRS) system. Outcomes: Technical feasibility outcomes include success rate of determination of the lower limit of cerebral autoregulation, intraoperative uptime, time to first estimate of the lower limit of cerebral autoregulation, sensitivity to external factors and to data artefacts; agreement of Cotrending-derived lower limit of cerebral autoregulation with COx-derived lower limit of cerebral autoregulation. Conclusions: N/A Trial registration: Clinicaltrials.gov NCT07630129

22.
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

23.
arXiv (quant-ph) 2026-06-15

Tantalum as a base material for superconducting integrated circuits

arXiv:2606.13750v1 Announce Type: new Abstract: The performance of superconducting integrated circuits for quantum applications is fundamentally limited by material-related losses. Tantalum, as an emerging material for next-generation quantum circuits, has attracted considerable attention in recent years after demonstrating breakthrough performance in both superconducting microwave resonators and qubits. Concurrently, a growing body of work is devoted to the operation of tantalum-based circuits and related fabrication techniques. This interest is further stimulated by tantalum thin films polymorphism resulting in a variety of its crystalline structure, superconducting properties, coherence, etc. Furthermore, tantalum circuits exhibit distinctive features in cryogenic experiments, which have not been observed in aluminum- or niobium-based ones. In this review, we summarize the recent research of tantalum thin films growth and phase selection mechanisms on various substrates, key aspects of fabrication and performance of superconducting circuit, including a material first-principles theoretical study. In conclusion, we address a number of open issues, including the role of \b{eta}-phase impurities, the effect of hydrofluoric acid solutions on chain characteristics, and the anomalous behavior of {\alpha}-tantalum chains at cryogenic temperatures.

24.
medRxiv (Medicine) 2026-06-17

Identifying anaphylaxis using weakly-supervised prediction models and natural language processing

Objectives Scalable computable phenotyping algorithms are critical for conducting high-throughput disease-outcome research in large, distributed-data electronic health record (EHR) and claims data settings. We developed and evaluated a claims- and EHR-based computable phenotyping algorithm for anaphylaxis, a rare acute condition that is challenging to accurately identify using claims data alone. Materials and Methods Potential anaphylaxis events came from two healthcare systems (Kaiser Permanente Washington [KPWA] and Vanderbilt University Medical Center [VUMC]). We engineered features from clinical text using automated natural language processing (NLP) methods. We then developed a phenotyping algorithm using four NLP- and diagnosis code-based silver labels (proxies for the gold-standard labels). Gold-standard abstracted outcomes were used to evaluate algorithm performance. Results The largest area under the receiver operating characteristic curve (AUC) was 0.931 for an NLP-based silver-label model at KPWA. Depending on the model and healthcare system site, positive predictive value (PPV) and sensitivity at the threshold of predicted probability that maximized F1 score ranged from 0.52 to 0.77 (PPV) and 0.78 to 1 (sensitivity). Discussion NLP-based silver-label models had large AUC at KPWA but not at VUMC. This may be because clinical text at KPWA is only available for outpatient encounters and secure messaging. High sensitivity for identifying anaphylaxis can be obtained using our best-performing models. Conclusion The best-performing models had better PPV and sensitivity tradeoffs than prior bespoke anaphylaxis models with costly, manually curated features. The simplicity of the approach compared to traditional phenotyping methods allows it to be deployed easily at multiple health care systems.

25.
arXiv (CS.AI) 2026-06-11

On the Geometry of On-Policy Distillation

arXiv:2606.07082v2 Announce Type: replace-cross Abstract: On-policy distillation (OPD) is increasingly used to improve large language model reasoning, but its training dynamics remain poorly understood. We characterize the trajectory of OPD updates in parameter space and compare it with supervised fine-tuning (SFT) and reinforcement learning with verifiable rewards (RLVR). A suite of parameter-space diagnostics consistently places OPD in a relaxed off-principal regime: compared with SFT, its updates affect fewer weights and avoid principal directions more strongly, while compared with RLVR, they remain less tightly constrained. Beyond this static localization, OPD exhibits subspace locking: its cumulative updates rapidly enter a narrow low-dimensional channel. Constraining training to the update subspace formed early in training preserves OPD performance but substantially degrades SFT, indicating that the locked subspace is functionally sufficient for OPD. Control experiments further show that sparsifying the update tokens and shifting rollout generation off-policy preserve the rank dynamics, whereas mixing the OPD objective with RLVR changes them. Overall, these results suggest that OPD is not merely an intermediate point between SFT and RLVR, but induces its own update geometry in parameter space.