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01.
arXiv (CS.LG) 2026-06-12

Bulk-Calibrated Credal Ambiguity Sets: Fast, Tractable Decision Making under Out-of-Sample Contamination

arXiv:2601.21324v2 Announce Type: replace-cross Abstract: Distributionally robust optimisation (DRO) minimises the worst-case expected loss over an ambiguity set that can capture distributional shifts in out-of-sample environments. While Huber (linear-vacuous) contamination is a classical minimal-assumption model for an $\varepsilon$-fraction of arbitrary perturbations, including it in an ambiguity set can make the worst-case risk infinite and the DRO objective vacuous unless one imposes strong boundedness or support assumptions. We address these challenges by introducing bulk-calibrated credal ambiguity sets: we learn a high-mass bulk set from data while considering contamination inside the bulk and bounding the remaining tail contribution separately. This leads to a closed-form, finite $\mathrm{mean}+\sup$ robust objective and tractable linear or second-order cone programs for common losses and bulk geometries. Through this framework, we highlight and exploit the equivalence between the imprecise probability (IP) notion of upper expectation and the worst-case risk, demonstrating how IP credal sets translate into DRO objectives with interpretable tolerance levels. Experiments on heavy-tailed inventory control, geographically shifted house-price regression, and demographically shifted text classification show competitive robustness-accuracy trade-offs and efficient optimisation times, using Bayesian, frequentist, or empirical reference distributions.

02.
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.

03.
arXiv (CS.CV) 2026-06-18

Data-Forcing Distillation: Restoring Diversity and Fidelity in Few-Step Video Generation

Recent progress has shown promise in distilling multi-step video diffusion models into efficient few-step students. Among them, Distribution Matching Distillation (DMD) and its successor DMD2 achieved strong generation quality and fast convergence. However, due to the nature of the reverse Kullback–Leibler (KL) objective, these methods exhibit two persistent failure modes: a substantial drop in sample diversity, and visibly over-saturated outputs that deviate from real-video appearance. In this work, we propose Data-Forcing Distillation (DFD), a simple post-training framework that restores diversity and fidelity in DMD with only a single-line of code change. At its core is the teacher score discrepancy to guide the student toward the real-data distribution, pulling it to missing modes (mitigating mode collapse) and away from problematic modes absent in real data (avoiding over-saturation). We provide an in-depth theoretical analysis of our framework and validate our approach on text-to-video, image-to-video, and autoregressive video generation. With only 100–300 steps of finetuning, DFD effectively restores diversity and fidelity on both Wan2.1-1.3B and Cosmos-Predict2.5-2B model, resolving the over-saturation artifacts with significantly better video dynamics and appearance, and even outperforms the teacher model.

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

MagPlus: Bridging Micro-to-Regular Facial Expressions through Learnable Magnification

Facial micro-expressions are subtle and short-lived facial movements that provide important cues about genuine human emotions. However, modeling and generating them remains difficult because annotated micro-expression data is limited and the underlying facial motions are extremely weak. Existing micro-expression generation methods therefore often suffer from limited quality, weak robustness, and poor generalization. We propose MagPlus, a transferable micro-expression processing pipeline that connects micro-expression analysis with standard facial animation models. Instead of training a dedicated generator from scratch, MagPlus learns to magnify subtle facial motions into the range of regular facial expressions, transforming micro-expressions into signals that are compatible with existing facial expression processing models. The magnified sequence is then used by a standard facial expression model for tasks such as transfer and synthesis. A complementary DeMagPlus module then restores the generated motion back to realistic micro-expression intensity levels while preserving the synthesized dynamics. We evaluate the framework using four facial animation models: FOMM, FSRT, MetaPortrait, and EmoPortraits. None of these models are trained on micro-expression data. Experiments show that MagPlus-DeMagPlus enables pretrained macro-expression models to generate more realistic micro-expression motion without retraining the backbones.

05.
arXiv (CS.AI) 2026-06-19

Creativity Reconsidered: Generative AI and the Problem of Intentional Agency

arXiv:2601.15797v2 Announce Type: replace Abstract: Many theorists maintain that conscious intentional agency is a necessary condition of creativity. We argue that this requirement, which we call the Intentional Agency Condition (IAC), should be abandoned. We motivate this by highlighting the problems this criterion encounters in the face of recent advances in generative AI, which is ostensibly creative despite being incapable of intentional agency. We present two corpus analyses to illustrate the rapidly increasing tendency of people to predicate creativity to generative AI. In response to this predicament, theorists of creativity have proposed a range of conflicting solutions, which we critically evaluate. We find that none of these satisfyingly resolves the initial predicament, and we therefore propose a novel approach. Our claim is that ascriptions of creativity are dependent on what we call creative ability. This solution explains why intentional agency is important for judgements of creativity, without being a necessary condition. Our approach thereby accommodates AI creativity without dismissing the intuition that perceived intentions are of key importance for ascriptions of creativity.

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

Quantized Stochastic Primal-Dual Methods for Distributed Optimization under Relaxed Global Geometry

arXiv:2606.11339v1 Announce Type: cross Abstract: We study distributed optimization with stochastic gradients and finite-bit communication modeled by random (unbiased) quantization. We propose q-PDGD, a quantized stochastic primal-dual method, and analyze it under relaxed global geometry. Under restricted secant inequality (RSI), a constant step-size yields linear contraction to an explicit neighborhood determined by gradient noise, quantization distortion, and network connectivity, while a diminishing step-size achieves O(1/k) convergence without shared-minimizer assumptions. Under Polyak-Lojasiewicz (PL) inequality, we obtain linear-to-neighborhood convergence in the same stochastic quantized setting. Our results match the best-known centralized stochastic rates in oracle complexity, and are supported by experiments demonstrating the predicted tradeoffs between quantization level, step-size choice, and graph structure.

07.
arXiv (quant-ph) 2026-06-15

Extensible Fluxonium Architecture Using Tunable Couplers with Low Shunt Capacitance

arXiv:2606.01647v2 Announce Type: replace Abstract: Fluxonium qubits have demonstrated high-fidelity operations and long coherence times in small-scale systems, highlighting their promise for quantum computing. However, large-scale integration into a high-performance two-dimensional (2D) qubit array remains the central challenge for practical applications. In this work, we introduce an extensible architecture for scaling up fluxonium qubits in 2D grids. To address the key challenges, namely achieving controllable strong interaction and high connectivity for qubits featuring small shunting capacitors (footprints), we propose using low-shunt-capacitance couplers to enable tunable interactions between fluxonium qubits. When embedded into 2D square lattices, large couplings can be achieved even with relatively small coupling capacitances, thus enabling multiple connections with sufficient capacitance budget. We further propose coupler realizations based on generalized flux qubit circuits, specifically the quarton and the fluxonium, and demonstrate that both enable fast, high-fidelity gates with low spectator errors, while supporting multiple connections on 2D grids.

08.
arXiv (CS.CL) 2026-06-16

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

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

09.
arXiv (CS.LG) 2026-06-18

On the Stability of the Jacobian Matrix in Deep Neural Networks

arXiv:2506.08764v3 Announce Type: replace Abstract: Deep neural networks are known to suffer from exploding or vanishing gradients as depth increases, a phenomenon closely tied to the spectral behavior of the input-output Jacobian. Prior work has identified critical initialization schemes that ensure Jacobian stability, but these analyses are typically restricted to fully connected networks with i.i.d. weights. In this work, we go significantly beyond these limitations: we establish a general stability theorem for deep neural networks that accommodates sparsity (such as that introduced by pruning) and non-i.i.d., weakly correlated weights (e.g. induced by training). Our results rely on recent advances in random matrix theory, and provide rigorous guarantees for spectral stability in a much broader class of network models. This extends the theoretical foundation for initialization schemes in modern neural networks with structured and dependent randomness.

10.
arXiv (CS.CV) 2026-06-12

Comparing Commercial Depth Sensor Accuracy for Medical Applications

Depth estimation has numerous medical and surgical applications. We benchmark four depth sensors on a porcine bone specimen, a porcine belly specimen, and a silicone kidney phantom using stylus-sampled references. These objects contain several real-world challenges, including homogeneous surfaces, specular surfaces, and subsurface scattering. The comparison includes stereo, structured-light, and time-of-flight sensors at a distance of approximately 50 cm. Specifically, the Intel RealSense D405 (Intel RealSense, United States), PMD Flexx2 (pmdtechnologies, Germany), Stereolabs ZED 2i (Stereolabs, France), and Zivid 2M+ 60 (Zivid, Norway) are compared. The Zivid 2M+ 60 performed best across all objects and metrics considered in this work. The ZED ranked second for real tissue, but last on the phantom.

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

OpenVTON-Bench: A Large-Scale High-Resolution Benchmark for Controllable Virtual Try-On Evaluation

Recent advances in diffusion models have significantly elevated the visual fidelity of Virtual Try-On (VTON) systems, yet reliable evaluation remains a persistent bottleneck. Traditional metrics struggle to quantify fine-grained texture details and semantic consistency, while existing datasets fail to meet commercial standards in scale and diversity. We present OpenVTON-Bench, a large-scale benchmark comprising approximately 100K high-resolution image pairs (up to $1536 \times 1536$). The dataset is constructed using DINOv3-based hierarchical clustering for semantically balanced sampling and Gemini-powered dense captioning, ensuring a uniform distribution across 20 fine-grained garment categories. To support reliable evaluation, we propose a multi-modal protocol that measures VTON quality along five interpretable dimensions: background consistency, identity fidelity, texture fidelity, shape plausibility, and overall realism. The protocol integrates VLM-based semantic reasoning with a novel Multi-Scale Representation Metric based on SAM3 segmentation and morphological erosion, enabling the separation of boundary alignment errors from internal texture artifacts. Experimental results show strong agreement with human judgments (Kendall's $\tau$ of 0.833 vs. 0.611 for SSIM), establishing a robust benchmark for VTON evaluation.

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

Towards Personalized Federated Learning for Dysarthric Speech Recognition

arXiv:2606.13253v1 Announce Type: cross Abstract: Speech recognition is challenging for dysarthric speakers. While federated learning (FL)-based ASR can be an effective tool for protecting privacy, it suffers from heterogeneity issues caused by speaker variability. Forcing all speakers to share the same model components can be suboptimal under such heterogeneity, making personalization a promising direction; however, related research on dysarthric speech remains limited. To this end, this paper explores two aggregation strategies to achieve personalization, including the parameter-based averaging strategy and the embedding-based averaging strategy. Experiments on UASpeech and TORGO show that the proposed methods outperform the baseline regularized FedAvg by statistically significant WER reductions of up to 0.99% absolute (3.15% relative) on UASpeech and 0.56% absolute (4.73% relative) on TORGO, respectively.

13.
arXiv (CS.AI) 2026-06-19

VCG: A Multimodal Retrieval Framework for E-Commerce Video Feeds under Extreme Cold-Start Conditions

arXiv:2606.19627v1 Announce Type: cross Abstract: The digital commerce landscape is shifting from static, search-driven catalogs to dynamic, immersive video feeds. This transition introduces an ``extreme cold-start'' problem: unlike traditional items, new short-form videos lack the dense interaction history required for collaborative filtering. Furthermore, immersive feeds introduce strong position and duration biases that distort standard engagement signals. In this paper, we demonstrate the Video Candidate Generation (VCG) system, a scalable multimodal retrieval engine designed to solve these challenges in a large-scale e-commerce environment. By leveraging a domain-adapted vision-language model (based on CLIP), we map users and videos into a shared semantic space, enabling zero-shot retrieval based on visual content rather than behavioral history. We detail the system's architecture and present a rigorous evaluation comparing generative (LLM) vs. discriminative (CLIP) embeddings. Our results show that while generative models excel at attribute prediction, they suffer from embedding space collapse in retrieval tasks. Online A/B testing demonstrates that VCG effectively mitigates engagement biases, yielding a 50\% uplift in deep video completion. To showcase the system's capabilities, we present an interactive demonstration featuring three bi-directional retrieval scenarios: Product-to-Video, Video-to-Product, and Zero-Shot Semantic Search.

14.
arXiv (CS.AI) 2026-06-15

Mask, Sample, Revise: A Revisable CTMC Inference Stack for Guided Discrete Flow Matching Text-to-Speech

arXiv:2606.13989v1 Announce Type: cross Abstract: Recent alignment-free non-autoregressive (NAR) text-to-speech (TTS) models formulate synthesis as a conditional infilling task, bypassing explicit duration predictors and external aligners. When speech is represented with neural codec tokens, the infilling problem becomes discrete, making Discrete Flow Matching (DFM), a Continuous-Time Markov Chain (CTMC) framework for discrete generation, a natural fit. However, inference-time control for stable low-step conditional infilling remains underexplored. We propose Mask, Sample, Revise, an inference-time CTMC stack for alignment-free DFM-TTS. The stack combines predictor-free guidance to strengthen text conditioning, prompt-matched conditional coupling to align the probability path with the acoustic prompt, and SC-ReMask, a schedule-constrained remasking mechanism that introduces token-to-mask transitions so early de-masking decisions can be revised. These components require no post-hoc fine-tuning and operate in a single tau-leaping sampler. Controlled ablations show that this stack improves intelligibility and robustness in the low-NFE prompted setting, outperforming unguided and guidance-only samplers with substantially more steps.

15.
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,

16.
arXiv (math.PR) 2026-06-19

Extremal representations of functions of matrices and applications to multivariate prediction

arXiv:2606.19359v1 Announce Type: cross Abstract: Motivated by two seminal results of multivariate prediction theory by Helson and Lowdenslager and by Wiener and Masani we prove extremal representations of functions of matrices and derive their prediction-theoretic consequences. We also sketch a way to obtain matricial inequalities from our results. The main goal of the paper is the computation of the infimum of a set of values of the form $tr(A \Delta A^*)$, where $\Delta$ is a given non-negative Hermitian $n \times n$ matrix and the choices for $A$ exhauste a certain set of $n \times n$ matrices. In particular, we focus on norm-bounded unit spheres with certain types of properties of unitary invariance, what allows an application of the theory of majorization.

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

Symplectic Transversality and Endpoint Green Estimates for Finite-Horizon Pontryagin Systems

arXiv:2606.17762v1 Announce Type: cross Abstract: We study horizon-uniform local branches of finite-horizon discrete-time Pontryagin boundary value systems after smooth control elimination. The central input is a two-point endpoint inverse for the linearization. We verify this inverse from scaled stable–unstable boundary transversality, prove the associated endpoint-corrected Green estimate, and combine it with weighted contractions to obtain existence, uniqueness, Lipschitz dependence, and first-order expansions with constants independent of the horizon. The framework covers smooth nonlinear endpoint maps, including the original Pontryagin rows that fix the initial state and couple the terminal costate to the terminal state. Symplectic and Riccati criteria verify the inverse hypothesis at the level of the matrix data; in particular, every stabilizable linear-quadratic system with invertible dynamics and definite weights is covered, including noncommuting coupled data. A numerical section illustrates the certificates and the horizon-uniform first-order expansion.

18.
arXiv (math.PR) 2026-06-11

Asymptotic analysis of the finite predictor for fractional Gaussian noise

arXiv:2504.01562v2 Announce Type: replace-cross Abstract: This paper proposes a new approach to the asymptotic analysis of the finite predictor for stationary sequences. Our method yields the exact asymptotics of both the relative prediction error and the partial correlation coefficients. The underlying assumptions are analytic in nature, making the approach applicable to processes with long-range dependence. The ARMA-type process driven by fractional Gaussian noise (fGn), which had previously remained elusive, is used as a case study.

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

Thermodynamic Value of XOR-Game-Induced Side Information in a Szilard Engine

arXiv:2605.12044v3 Announce Type: replace Abstract: We introduce a Szilard-type thermodynamic valuation of side-information channels induced by Bell-type correlations. In each round, a two-level working system is thermalized with a degenerate Hamiltonian, so that its physical microstate is a uniform classical bit. A trusted referee embeds this bit into a finite two-player XOR game, and a correlation resource produces a compressed controller bit. The controller uses only this compressed bit as side information for feedback. The construction is formulated first for arbitrary finite XOR games. The referee encoding makes the game-winning event equivalent to correct prediction of the physical microstate. Consequently, the induced side-information channel is binary symmetric, with success probability equal to the XOR-game winning probability of the supplied behaviour. The reversible Szilard feedback value is therefore fixed by the mutual information between the microstate and the controller record. Optimizing over local, quantum, and nonsignalling behaviour sets turns the corresponding game values into local, quantum, and nonsignalling thermodynamic ceilings. The construction is an effective-channel valuation, not a claim that Bell nonlocality is thermodynamic fuel. The controller receives only the compressed prediction bit, not the auxiliary variables that define the game. The thermodynamic costs of the referee, the correlation resource, and the preprocessing are not included. When controller-memory reset is included in a full cycle, the net work is non-positive, consistently with the second law.

20.
arXiv (math.PR) 2026-06-17

Limit theorems for random Dirichlet series with summation over primes, with an application to Rademacher random multiplicative functions

arXiv:2508.15032v2 Announce Type: replace Abstract: It is shown that two conjectures put forward in the recent article Iksanov and Kostohryz (2025) are true. Namely, we prove a functional central limit theorem (FCLT) and a law of the iterated logarithm (LIL) for a random Dirichlet series $\sum_p \frac{\eta_p}{p^{1/2+s}}$ as $s\to 0+$, where $\eta_1$, $\eta_2,\ldots$ are independent identically distributed random variables with zero mean and finite variance, and $\sum_p$ denotes the summation over the prime numbers. As a consequence, an FCLT and an LIL are obtained for $\log \sum_{n\geq 1} \frac{f(n)}{n^{1/2+s}}$ as $s\to 0+$, where $f$ is a Rademacher random multiplicative function.

21.
medRxiv (Medicine) 2026-06-16

Infections and suicide and self-harm: a population-based matched cohort study

Background Infections have been associated with adverse mental health outcomes, including suicide, but evidence beyond severe or central nervous system infections is limited. We investigated associations between a range of acute infections and subsequent suicide/self-harm outcomes. Methods We conducted six infection-specific matched cohort studies using English primary care records from the Clinical Practice Research Datalink Aurum (2007-2024), linked to hospital admissions and mortality data. Adults ([≥]18 years) with a primary care record of infection (gastroenteritis, lower respiratory tract [LRTI], skin/soft-tissue [SSTI], urinary tract [UTI], sepsis, meningitis/encephalitis [positive control]) were matched (age, sex, practice, calendar period) to up to five comparators without infection. We estimated hazard ratios (HRs) for suicide/self-harm outcomes using Cox regression, stratified by matched set and implicitly adjusting for matching factors, with additional adjustment for deprivation, lifestyle factors, and comorbidities. We examined whether associations varied over time, by infection severity, antimicrobial treatment, sex, and prior mental health conditions. Findings Cohorts ranged from 18,192 individuals with meningitis/encephalitis (matched to 90,915 without) to 398,099 with SSTI (matched to 1,743,747). After adjustment, individuals with infection had a higher hazard of suicide/self-harm outcomes than comparators across all cohorts: sepsis (HR 1.79, 95% CI 1.65-1.93), gastroenteritis (1.62, 1.55-1.70), meningitis/encephalitis (1.56, 1.32-1.84), UTI (1.41, 1.33-1.50), SSTI (1.37, 1.31-1.43), and LRTI (1.37, 1.31-1.44). Risk was highest in the year post-infection, attenuating over time, and was higher among severe infections and those without prior mental health conditions. Interpretation Common acute infections recorded in primary care are associated with increased risk of suicide and self-harm, particularly following severe infections and in the year post-infection. Findings support suicide risk monitoring following acute infection, particularly among individuals without prior mental health conditions, and highlight infection prevention as a potentially modifiable strategy in vulnerable populations. Funding Wellcome and La Caixa. Copyright This work is licensed under a Creative Commons Attribution (CC BY) licence.

22.
bioRxiv (Bioinfo) 2026-06-11

A multi-agent system for spine MRI report generation from multi-sequence imaging

Spinal pathology is a leading cause of pain and disability worldwide. Spine magnetic resonance imaging (MRI) is central to clinical evaluation, yet its interpretation remains complex and time-consuming, requiring integration of information across multiple imaging sequences and anatomical regions. Despite recent advances in automated MRI analysis, effectively combining multi-sequence data while preserving sequence-specific diagnostic information remains an open challenge. Here we present SpineAgent, a multi-agent framework for spine MRI report generation built upon a multi-sequence foundation model trained on routine clinical data from 32,047 patients and 453,683 MRI series, comprising a total of 13,441,191 MRI slices. To accommodate diverse modalities of sequences, we first pre-train two DINOv3-based encoders separately on T1- and T2-weighted sequences. We then introduce a continual training strategy that learns a synthesizer to embed images of other sequences using the T1 and T2 encoders, producing patient-level embedding that integrates various signals across MRI sequences. Using these embeddings, SpineAgent achieves state-of-the-art performance, with mean 10.8% AUROC improvement across 17 spinal condition-prediction tasks compared to the best competing method, and demonstrates strong generalizability under cross-manufacturer and cross-cohort evaluation. Beyond classification, SpineAgent enables pathology localization by identifying findings-relevant slices and segmenting pathological regions. It also supports multimodal image-report retrieval, providing a solid foundation for scalable and explainable MRI report generation. We further integrate these validated capabilities of SpineAgent into 37 specialized agents for condition diagnosis, pathological-region localization, and clinically-similar-cases retrieval. Finally, we incorporate their outputs as structured tokens within a Medical Report Agent trained end-to-end for report generation. Through both automated metrics and expert evaluation by five radiologists, SpineAgent achieves leading performance in spine MRI report generation. Together, SpineAgent introduces a continual training approach for multi-sequence spine MRI understanding. By decomposing report generation into clinically grounded subtasks addressed by specialized agents, the SpineAgent framework enables accurate, interpretable and generalizable spine MRI reporting across diverse imaging sequences and anatomical regions.

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

Spectral Adaptive Conformal Prediction for Structured Non-Exchangeable Data

arXiv:2606.15950v1 Announce Type: cross Abstract: Conformal prediction gives prediction intervals with finite-sample coverage when the data are exchangeable. Many time-indexed datasets are not exchangeable. They have seasons, recurring regimes, changing frequencies, or other forms of structured dependence. This paper studies a simple way to use that structure. We propose spectral adaptive conformal prediction, a method that forms weighted conformal quantiles using local spectral similarity and then updates the target miscoverage level online. The spectral weights choose calibration residuals that look relevant to the current test point. The adaptive update corrects the long-run miss rate when uncertainty changes over time. We give an approximate coverage result for the fixed spectral weighted quantile and a deterministic long-run calibration result for the adaptive update. Simulations with recurring regimes and slowly changing frequencies, together with three U.S. real-data examples, show that the hybrid method can improve on fixed spectral weighting, while also showing that spectral weighting must be monitored through effective sample size diagnostics.

24.
medRxiv (Medicine) 2026-06-10

Exploratory Assessment of Pulsed-Wave Doppler Representations of Lung Sounds Using Deep Learning: An In-Vitro Phantom Study

The increasing availability of portable ultrasound systems motivates exploration of novel approaches to respiratory signal assessment. In this in-vitro study, we investigate whether pulsed-wave (PW) Doppler ultrasound can capture structured spectral patterns from replayed lung sound recordings. Digitized respiratory sounds were replayed through a tissue-mimicking ultrasound phantom, generating 1,478 PW Doppler spectral images from recordings associated with healthy subjects and several externally labeled disease categories. Exploratory classification experiments using a ResNet-18 architecture demonstrated that these Doppler representations contain learnable differences under controlled conditions. These findings motivate further investigation into PW Doppler as a potential representation of respiratory acoustics.

25.
medRxiv (Medicine) 2026-06-12

High coverage, persistent gaps: quality of Antenatal Care and its determinants in Zambia based on the 2024 Demographic and Health Survey.

Abstract Background Evaluating antenatal care (ANC) quality is critical to reducing maternal and neonatal mortality. In Zambia, despite high basic ANC attendance, comprehensive national evidence on the clinical content and quality of services remains limited. This study assessed the coverage of WHO-recommended ANC interventions and identified factors associated with care quality using the latest national data. Methods A cross-sectional analysis was conducted using data from the 2024 Zambia Demographic and Health Survey. The final analytic sample comprised 4,829 women aged 15-49 with a live birth in the preceding 5 years. A composite index of 15 selected, equally weighted WHO-recommended components evaluated clinical assessment, counseling/screening, preventive interventions, and utilization. Survey-weighted Poisson regression estimated adjusted incidence rate ratios (aIRRs) for the count of ANC components received. Results The mean ANC quality score was 12.5 out of 15 (95% CI: 12.4-12.6), and 78.5% (95% CI: 77.0-80.0) of women achieved adequate ANC ([≥] 12/15 components). While individual clinical and counseling coverage generally exceeded 90%, only 47.2% (95% CI: 45.3-49.0) of women initiated care during the first trimester, and just 4.8% (95% CI: 4.1-5.6) achieved [≥] 8 ANC contacts. Maternal education was the strongest and most stable predictor of quality across all models. Compared to no education, higher education was associated with an 8.0% higher expected quality score (aIRR = 1.080, 95% CI: 1.051-1.110). Lower ANC quality was significantly associated with unwanted pregnancies (aIRR = 0.970, 95% CI: 0.956-0.993) and with residence in Western (aIRR = 0.923, 95% CI: 0.897-0.951) and North Western (aIRR = 0.966, 95% CI: 0.937-0.996) provinces. Absence of distance barriers and residence in Eastern, Luapula, and Copperbelt provinces were associated with higher quality scores. Conclusion While average ANC component coverage in Zambia is high, critical gaps persist in early initiation and total contact frequency. Care adequacy is strongly influenced by maternal education, relationship status, pregnancy intention, and regional inequities. These findings underscore the need for interventions targeted at uneducated women, preventing unintended pregnancies, and underserved regions such as Western and North Western Provinces. Keywords: Antenatal care quality, ANC content, Zambia, maternal education.