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

Reinforcement Learning Disrupts Gradient-Based Adversarial Optimization

arXiv:2606.12251v1 Announce Type: cross Abstract: Gradient-based adversarial attacks remain a dominant threat to deep neural networks (DNNs), as they exploit gradient information to efficiently optimize adversarial perturbations. To address this, we investigate whether reinforcement learning (RL) training can disrupt the gradient structure used by attackers by training image classifiers with policy-gradient objectives and epsilon-greedy exploration. Through systematic experiments across CIFAR-10, CIFAR-100, and ImageNet-100 with multiple architectures, we find that RL-trained classifiers significantly disrupt gradient-based adversarial optimization. To explain this, we conduct a comprehensive mechanism analysis using loss landscape visualization, static and dynamic gradient indicators, and predictive entropy. Our analysis reveals that RL acts as an implicit regularizer, producing models with highly unstable gradient directions and smaller gradient magnitudes. This combination makes each PGD step both unreliable in direction and limited in magnitude, causing gradient-based attacks to fail within practical iteration budgets. We further show that combining RL with adversarial training (RL-adv) provides a dual-layer defense operating at two complementary levels: RL degrades gradient information available to attackers (gradient-level defense), while adversarial training strengthens decision boundaries (boundary-level defense). RL-adv achieves the highest robustness across all major attack types evaluated, including gradient-based (PGD, AutoAttack), transfer-based, and query-based attacks, outperforming SL-adv by a significant margin. These findings identify RL-induced gradient disruption as a complementary robustness mechanism and motivate future research on hybrid SL-RL training schedules that combine SL's efficiency with RL's gradient-regularization properties.

02.
arXiv (CS.LG) 2026-06-18

Decomposing Prediction Mechanisms for In-Context Recall

arXiv:2507.01414v2 Announce Type: replace Abstract: We introduce a new family of toy problems that combine features of linear-regression-style continuous in-context learning (ICL) with discrete associative recall. We pretrain transformer models on sample traces from this toy, specifically symbolically-labeled interleaved state observations from randomly drawn linear deterministic dynamical systems. We study if the transformer models can recall the state of a sequence previously seen in its context when prompted to do so with the corresponding in-context label. Taking a closer look at this task, it becomes clear that the model must perform two functions: (1) identify which system's state should be recalled and apply that system to its last seen state, and (2) continuing to apply the correct system to predict the subsequent states. Training dynamics reveal that the first capability emerges well into a model's training. Surprisingly, the second capability, of continuing the prediction of a resumed sequence, develops much earlier. Via out-of-distribution experiments, and a mechanistic analysis on model weights via edge pruning, we find that next-token prediction for this toy problem involves at least two separate mechanisms. One mechanism uses the discrete symbolic labels to do the associative recall required to predict the start of a resumption of a previously seen sequence. The second mechanism, which is largely agnostic to the discrete symbolic labels, performs a "Bayesian-style" prediction based on the previous token and the context. These two mechanisms have different learning dynamics. To confirm that this multi-mechanism (manifesting as separate phase transitions) phenomenon is not just an artifact of our toy setting, we used OLMo training checkpoints on an ICL translation task to see a similar phenomenon: a decisive gap in the emergence of first-task-token performance vs second-task-token performance.

03.
arXiv (quant-ph) 2026-06-19

Nearest-neighbour gates are all you need: High-rate quantum low-density parity-check codes on a planar grid

arXiv:2606.19482v1 Announce Type: new Abstract: High-performance quantum low-density parity-check codes promise substantial reductions in the overhead of fault-tolerant quantum computation, but most constructions require long-range connectivity or qubit shuttling, both of which are difficult to realise in superconducting architectures. Here we introduce a family of quantum low-density parity-check codes that, for the first time, combines planar open-boundary layouts, finite-size advantages over surface codes, and syndrome extraction using only nearest-neighbour gates on a square grid of qubits. The key idea is to generate check-data connectivity dynamically: nearest-neighbour iSWAP walks both define the stabiliser supports and implement their measurement, avoiding the need for a long-range hardware graph. The resulting circuits achieve optimal constant-depth stabiliser measurement, independent of code size, and naturally remove leakage from the system by exchanging the role of check and data qubits at each syndrome extraction round. We find finite-size instances such as a [[323,14,15]] code, whose code-efficiency ratio is nearly an order of magnitude larger than that of rotated surface-code patches. At around 30 circuit qubits per logical qubit, the best directional tile-code layouts reduce the per-logical per-round logical error rate by up to a factor of 1000 relative to rotated surface-code memories. These results show that the advantages of quantum low-density parity-check codes can survive compilation into strictly planar nearest-neighbour circuits, bringing low-overhead fault-tolerant memories closer to near-term hardware.

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

The Slop Paradox: How Synthetic Standardization Erodes Clinical Uncertainty and Cross-Modal Alignment in AI-Rewritten Radiology Reports

作者:

AI-assisted clinical documentation tools increasingly summarize, standardize, and reformat radiology reports using large language models (LLMs). We present a controlled measurement of the resulting information degradation. Using 450 chest X-ray reports from the Indiana University dataset, we generate synthetic versions via three realistic LLM rewriting tasks: EHR summarization, standardized rewriting, and teaching case preparation. We measure entity erosion (via medical NER), hedging collapse (loss of clinical uncertainty language), and cross-modal alignment degradation (via BiomedCLIP image-text similarity). Our central finding is a dissociation between information loss and cross-modal fidelity. EHR summarization is the most destructive at the content level, eroding 51.4% of clinical entities and 43.7% of hedging language, yet it preserves image-text alignment almost entirely (a 2.5% drop). The two tasks meant to produce cleaner training data, standardized rewriting and teaching case preparation, do the reverse: they preserve more entities (26.8% and 29.3% eroded) but cause 14.9-16.5% alignment drops, six to seven times those of EHR summarization. We term this the slop paradox: rewriting that makes clinical text look cleaner for multimodal training is precisely what pulls it away from the image. Contrary to our pre-specified hypothesis, rare pathologies were not preferentially degraded: across nine rare-versus-common comparisons, no difference survived multiple-comparison correction, and nominal differences ran in the opposite direction (common > rare), so contamination is invisible to condition-specific monitoring. The dominant determinant of degradation is the type of AI rewriting task, not the clinical content. These findings bear on multimodal medical AI dataset construction and the governance of AI-assisted clinical documentation.

05.
arXiv (CS.CV) 2026-06-12

CPAM: Context-Preserving Adaptive Manipulation for Zero-Shot Real Image Editing

Editing natural images using textual descriptions in text-to-image diffusion models remains a significant challenge, particularly in achieving consistent generation and handling complex, non-rigid objects. Existing methods often struggle to preserve textures and identity, require extensive fine-tuning, and exhibit limitations in editing specific spatial regions or objects while retaining background details. This paper proposes Context-Preserving Adaptive Manipulation (CPAM), a novel zero-shot framework for complicated, non-rigid real image editing. Specifically, we propose a preservation adaptation module that adjusts self-attention mechanisms to preserve and independently control the object and background effectively. This ensures that the objects' shapes, textures, and identities are maintained while keeping the background undistorted during the editing process using the mask guidance technique. Additionally, we develop a localized extraction module to mitigate the interference with the non-desired modified regions during conditioning in cross-attention mechanisms. We also introduce various mask-guidance strategies to facilitate diverse image manipulation tasks in a simple manner. CPAM can be seamlessly integrated with multiple diffusion backbones, including SD1.5, SD2.1, and SDXL, demonstrating strong generalization across different model architectures. Extensive experiments on our newly constructed Image Manipulation BenchmArk (IMBA), a robust benchmark dataset specifically designed for real image editing, demonstrate that our proposed method is the preferred choice among human raters, outperforming existing state-of-the-art editing techniques. The source code and data will be publicly released at the project page: https://vdkhoi20.github.io/CPAM

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

Jones-matrix analysis of phase accumulation in a linear-optical multi-pass interferometer

arXiv:2606.14422v1 Announce Type: new Abstract: Quantum information science has traditionally relied on nonclassical resources, such as entangled photon pairs and squeezed states, to achieve measurement performance beyond classical limits. Here, we revisit the multi-pass photonic scheme reported in Nature 450, 393 (2007) to clarify the physical origin of the observed superresolution and the associated claim of supersensitivity. Using a rigorous Jones-matrix formalism, we show that the round-trip evolution of the HQMQ linear optics unit is equivalent to the product of two reflections in polarization space, resulting in an effective rotation operator. This equivalence reveals that the accumulated phase arises from coherent polarization-state rotation on the Poincare'e sphere. The resulting phase accumulation is interpreted geometrically as a progressive realignment of the polarization state during successive forward and backward propagations. To validate the theoretical model, a classical-wave implementation is experimentally conducted, analyzed, and compared with the corresponding Jones-matrix solution. Finally, the scaling behavior of the Fisher information is analyzed to examine the origin of the claimed supersensitivity. The results are further compared with a recently developed coherence de Broglie wavelength framework, which achieves identical superresolution through repeated coherent interactions in a cascaded interferometeric architecture.

07.
arXiv (CS.CV) 2026-06-18

DART: A design-aware microfluidic chip paradigm for real-time live-cell image analysis

High-throughput microfluidic live-cell imaging generates rich single-cell data. Yet semi-automated procedures for locating regions of interest (RoIs), each containing one cell population, and removing surrounding microfluidic structures from recorded images, scale with the number of RoIs. This prevents real-time image analysis and delays time-to-insight by hours to days. We introduce the Design-Aware and Real-Time capable (DART) paradigm for microfluidic cultivation chips, which aligns the CAD blueprint with the physical chip and thereby enables throughput-independent localization of all RoIs and fully automated image processing across diverse RoI geometries and chip layouts. DART establishes this alignment through embedded fiducial markers and deep-learning-based marker detection. We validate DART using the Swiss Army Knife chip, which combines eight structurally distinct RoI designs across 1164 RoI locations. DART localizes all RoIs in five minutes, removes microfluidic structures from raw microscopy images in 40 ms, and performs fully automated image analysis, including cell segmentation, in under 1.1 s per image. Together, these capabilities establish DART as an end-to-end hardware-software paradigm with real-time-capable analysis that paves the way toward closed-loop and outcome-driven smart microscopy.

08.
arXiv (CS.CV) 2026-06-11

Vision Transformers for Face Recognition Need More Registers

Recent advances in Vision Transformers (ViTs) for face recognition (FR) have moved beyond the standard CLS-token paradigm. In this paradigm, a special classification token (CLS) is prepended to the patch embeddings and used as a representation of the input for downstream tasks. An alternative approach, Concatenated Patch Embeddings (CPE), instead leverages all patch tokens by concatenating them into a single vector, which is then projected into a compact face representation. CPE has been shown to improve recognition performance in comparison to CLS-based ones, but our qualitative analysis of attention maps showed the presence of artifacts that limit their interpretability. To address this issue, we incorporate register tokens, learnable tokens concatenated to the initial patch embeddings, and processed jointly through the ViT encoder blocks. This mechanism has been shown to produce more structured and interpretable attention maps compared to baseline ViT. We empirically demonstrate that these artifacts consistently appear across various ViT backbones, including small and large models, and that introducing register tokens effectively mitigates them. Adding four or eight registers significantly enhances interpretability, with eight registers providing the highest verification accuracies and smoothest attention structures. Our resulting model, ViT-8R, corresponds to a CPE-based ViT-B architecture augmented with eight register tokens achieves state-of-the-art performance among ViT-based FR models on large-scale IJB-B and IJB-C benchmarks. Also, ViT-8R produces substantially clearer attention maps compared with the baseline model, which offer deeper insight into the model's attention behavior (https://github.com/TaharChettaoui/ViT-FR-Registers)

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

Learning a Sampling-Free Variational DNN Plugin from Tiny Training Sets to Refine OOD Segmentation With Uncertainty Estimation

Deep neural networks (DNNs) frequently fail to generalize to out-of-distribution (OOD) medical images because of variations in scanners and acquisition protocols. Retraining DNN models to address these distribution shifts is often impractical due to the high cost of acquiring and annotating new medical datasets. To address this, we introduce VarDeepPCA, a novel lightweight variational DNN framework designed to restore/refine degraded segmentation maps by leveraging intrinsic geometric priors. Unlike existing approaches that require target-domain data or extensive pre-training, our VarDeepPCA explicitly learns a distribution of valid anatomical geometries using only small in-distribution (ID) datasets. Theoretically, our novel variational learning framework leverages a reinterpretation of the softmax mapping to implicitly perform exact distribution modeling, thereby enabling computationally efficient, sampling-free learning and inference. This also enables VarDeepPCA to provide uncertainty estimates associated with its restored segmentation maps. We empirically validate our framework across 4 distinct clinical applications, using 14 publicly available datasets, involving segmentation of the myocardium, neuroretinal rim, prostate, and fetal head. Comparisons against 15 existing methods demonstrate that VarDeepPCA consistently restores segmentation maps produced by the existing methods on OOD data to (i) significantly improve anatomical plausibility of geometries and clinical utility of the segmentations, and (ii) significantly reduce errors, without needing any more training data than that used by existing methods.

10.
medRxiv (Medicine) 2026-06-16

Preventing postpartum depression through mitigating breastfeeding grief: A convergent parallel mixed methods study

Background: Women who did not meet their breastfeeding goals often experience breastfeeding grief (BG) and may be likely to have postpartum depression (PD). Furthermore, PD is nearly twice as common in African American (AA) women as in Non-Hispanic White women. No research exists on BG and its role in PD. This study examined the BG experiences of AA women and its possible contributions to PD symptoms. Methods: A convergent parallel mixed methods design was used. A purposive sample of 16 AA women with children aged 6 months to 2 years with BG participated in individual semi-structured interviews about their experiences of BG and completed an online survey including the Edinburgh Postnatal Depression Scale (EPDS). Qualitative and quantitative data were analyzed using reflexive thematic analysis and descriptive statistics, respectively. Both data were integrated using joint display of data and side-by-side comparison. Results: The mean age of participants was 29.5 years. Four meaning-based themes about BG were generated including: We looked forward to breastfeeding, But it did not go as expected, So we grieve, and These would have helped. From quantitative results, 87.5% of participants reported a history of PD symptoms and almost 44% had EPDS scores >11. All participants reported that experiencing BG contributed to their PD symptoms. Findings suggest that BG influenced PD symptoms in AA women without prior diagnosis of depression. Conclusions: Qualitative and quantitative findings from this novel exploratory study revealed an overlap that AA women with BG report PD symptoms. Clinicians should support women to achieve their breastfeeding goals to prevent BG and PD. Keywords: African American; Breastfeeding grief; Mental health; Mixed methods; Postpartum depression

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

Linear algebra at exponential scale via tensor network dimension reduction

arXiv:2606.15350v1 Announce Type: cross Abstract: Many problems in modern scientific computing are challenging because of a curse of dimension, where their mathematical formulation involves objects whose dimension is exponential in the nominal "size" of the problem. Tensor networks can provide a compact representation for exponentially large vectors and matrices that arise in applications, but these representations do not always lead to reliable algorithms. This paper develops and analyzes techniques for randomized dimension reduction of tensor network data. These techniques support a suite of efficient algorithms for provably solving exponential-scale linear algebra problems, including trace estimation and eigenvalue approximation. The paper includes several stylized illustrations from quantum many-body physics with ambient dimension up to $2^{200}$.

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

Quantization Robustness of Monotone Operator Equilibrium Networks

arXiv:2603.10562v2 Announce Type: replace-cross Abstract: Monotone operator equilibrium networks are implicit-layer models whose output is the unique equilibrium of a monotone operator, guaranteeing existence, uniqueness, and convergence. When deployed on low-precision hardware, weights are quantized, potentially destroying these guarantees. We analyze weight quantization as a spectral perturbation of the underlying monotone inclusion. Convergence of the quantized solver is guaranteed whenever the spectral-norm weight perturbation is smaller than the monotonicity margin; the displacement between quantized and full-precision equilibria is bounded in terms of the perturbation size and margin; and a condition number characterizing the ratio of the operator norm to the margin links quantization precision to forward error. MNIST experiments confirm a phase transition at the predicted threshold: three- and four-bit post-training quantization diverge, while five-bit and above converge. The backward-pass guarantee enables quantization-aware training, which recovers provable convergence at four bits.

13.
medRxiv (Medicine) 2026-06-10

Resolving Diagnostic Discordance in Group 2 Pulmonary Hypertension Through Staged Physiologic Testing: Insights From PVDOMICS

Background World Symposium on Pulmonary Hypertension (WSPH) Group 2 pulmonary hypertension (PH) is a clinically integrated phenotype attributed to left heart disease, whereas pre- versus post-capillary classification is operationalized primarily by pulmonary capillary wedge pressure (PCWP). Although current recommendations emphasize contextual interpretation and provocative testing for intermediate PCWP values, the relationship between PCWP-based classification and underlying phenotype has not been systematically evaluated. We aim to quantify phenotype-hemodynamic discordance across the PCWP spectrum and evaluate a staged physiology-guided framework incorporating inhaled nitric oxide (iNO), ventricular geometry, and provocative testing. Methods We studied 1,032 participants from the NHLBI-sponsored PVDOMICS cohort with multidisciplinary adjudicated phenotypes integrating clinical, imaging, physiologic, and hemodynamic data. Stage-specific PCWP thresholds classified pre- versus post-capillary physiology at rest, during iNO, and during provocation (fluid challenge or invasive cardiopulmonary exercise testing [iCPET]). Echocardiographic right ventricular-to-left ventricular (RV/LV) ratio was evaluated as a marker of ventricular interdependence. Restricted cubic spline and staged concordance analyses defined certainty-based PCWP ranges and incremental diagnostic yield. Results Adjudicated Group 2 phenotype was present in 37.0% of participants. Resting PCWP demonstrated good discrimination (AUC 0.86), but substantial bidirectional phenotype-hemodynamic discordance persisted across intermediate PCWP ranges. At a resting PCWP of 12 mmHg, 25% of participants classified as pre-capillary had adjudicated Group 2 PH, whereas at 18 mmHg, 35% classified as post-capillary remained discordant non-Group 2. Concordance did not approach 90% until PCWP values were 24 mmHg. Dynamic testing incrementally improved concordance within these overlap zones. Nearly half of adjudicated Group 2 PH participants (46.5%) were not identified by resting PCWP alone; incorporation of iNO and provocative testing increased cumulative Group 2 identification by 63.4% and improved sensitivity from 79.9% to 83.7%. Model discrimination improved from an AUC of 0.863 to 0.908 (likelihood-ratio P

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

TransLaw: A Large-Scale Dataset and Multi-Agent Benchmark Simulating Professional Translation of Hong Kong Case Law

Translating Hong Kong Court Judgments from English to Traditional Chinese is mandated by Articles 8-9 of the Basic Law, yet remains constrained by a shortage of parallel resources and rigorous demands on legal terminology, citation format, and judicial style. We introduce HKCFA Judgment 97-22, the first large-scale sentence-aligned parallel corpus for HK case law, comprising 344 professionally translated judgments (11,099 sentence pairs; 2.1M tokens) spanning 1997-2022. Building on this resource, we propose TransLaw, a multi-agent framework that decomposes translation into word-level expression, sentence-level translation, and multidimensional review, integrating a specialized Hong Kong legal glossary database, Retrieval-Augmented Generation, and iterative feedback, with four-dimensional expert review covering semantic alignment, terminology, citation, and style. Benchmarking 13 open-source and commercial LLMs, we demonstrate that TransLaw significantly outperforms single-agent baselines across all evaluated models, with convergence within 3 iterations. Human evaluation by 10 certified legal translators using our proposed Legal ACS metric confirms gains in legal-semantic accuracy, while showing that TransLaw still trails human experts in stylistic naturalness. The dataset and benchmark code are available at https://github.com/xuanxixi/TransLaw.

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

Metadata-Aware Multi-Prompt Reasoning for Zero-Shot Accident Understanding

In this paper, we address the problem of zero-shot understanding of accidents from surveillance videos by identifying when an impact event occurs, what type of impact it is, and where in the frame it occurs using natural language. We propose a three-stage pipeline that decomposes the accident understanding into when, what, and where. The first stage extracts a short temporal window around the impact using vision-language similarity. In the second stage, we perform metadata-driven multi-prompt reasoning with five complementary views (baseline, motion, geometry, contrast, and tiebreaker) and resolve disagreement via an entropy-gated pairwise adjudicator. Finally, we localize the impact of an open-vocabulary detector queried on the predicted accident type and scene layout, and aggregate detections across keyframes using a score-weighted centroid. Our pipeline achieves a substantial improvement in the harmonic-mean score over a centre-of-frame baseline on the zero-shot ACCIDENT @ CVPR benchmark. We show that decomposing zero-shot video understanding into temporal localization, semantic classification, and spatial grounding enable more reliable reasoning with vision-language models than direct prompting alone.

16.
arXiv (CS.CL) 2026-06-17

ALAS: An Automatic Latent Alignment Score for Audio Language Models

Large Language Models (LLMs) are extended into Speech-LLMs, and the quality of the audio–text alignment they learn affects most downstream Spoken Language Understanding (SLU) behavior. Yet despite a growth of fusion strategies, there is no standard way to measure how well a Speech-LLM internally binds audio frames to text tokens. We introduce ALAS (Automatic Latent Alignment Score), a model and task-agnostic metric that probes the LLM's per-layer hidden states, scoring the cross-modal cosine similarity between audio and text representations against a Whisper-derived reference. ALAS needs only a frozen forward pass and an off-the-shelf ASR reference, with no training or fitted classifier, and is calibrated to an interpretable uniform baseline comparable across tasks. Applying ALAS to four open-source Speech-LLMs (AF3, Qwen2-Audio, Qwen-Omni, SALMONN) across emotion recognition (IEMOCAP), open-ended SQA (LibriSQA), and multi-choice audio understanding (MMAU-speech), we find that the depth and strength of alignment reflect each model's audio-encoder design and the acoustic-versus-semantic demands of the task, and that ALAS tracks but does not duplicate task accuracy, exposing models that score well without genuinely grounding in the audio. We release ALAS as an open-source library so that practitioners can probe their own Speech-LLMs or try it on new tasks.

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

SkillJect: Effectively Automating Skill-Based Prompt Injection for Skill-Enabled Agents

arXiv:2602.14211v3 Announce Type: replace-cross Abstract: Agent skills extend LLM agents with task-specific instructions, executable scripts, and auxiliary resources, improving reusability but creating a new supply-chain attack surface. A malicious or compromised skill can be repeatedly loaded as trusted guidance and steer downstream tool use. Existing skill-based prompt-injection attacks are often manual and brittle, because explicit malicious instructions are rejected or ignored when they are not aligned with the original workflow. We propose SkillJect, the first automated framework for generating poisoned skills against skill-enabled agent systems. SkillJect uses two coordinated channels. In the artifact channel, it hides the payload inside an auxiliary helper script. In the instruction channel, it rewrites SKILL.md with a front-loaded inducement strategy, placing injected content at the beginning and framing the helper script as a mandatory prerequisite or initialization step. The rewritten instruction explicitly references the helper-script path and provides an executable example command, making the helper appear to be a legitimate setup step before normal skill operations. SkillJect further adopts a closed-loop multi-agent process to improve attack effectiveness. An Attack Agent generates poisoned skills, a Victim Agent executes downstream tasks with the poisoned skill, and an Evaluate Agent inspects execution traces to determine whether the hidden payload was executed. The Attack Agent then uses this feedback to diagnose failure causes and rewrite SKILL.md, while keeping the payload fixed. Experiments across skill-enabled platforms, backend LLMs, and attack categories show that SkillJect substantially outperforms naive direct injection and prior manual skill-injection attacks, highlighting poisoned skills as a persistent threat in reusable skill ecosystems.

19.
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.

20.
arXiv (CS.LG) 2026-06-15

Adaptive Identification and Modeling of Clinical Pathways with Process Mining

arXiv:2512.03787v2 Announce Type: replace Abstract: Clinical pathways are specialized healthcare plans that model patient treatment procedures. They are developed to provide criteria-based progression and standardize patient treatment, thereby improving care, reducing resource use, and accelerating patient recovery. However, manual modeling of these pathways based on clinical guidelines and domain expertise is difficult and may not reflect the actual best practices for different variations or combinations of diseases. We propose a two-phase modeling method using process mining, which extends the knowledge base of clinical pathways by leveraging conformance checking diagnostics. In the first phase, historical data of a given disease is collected to capture treatment in the form of a process model. In the second phase, new data is compared against the reference model to verify conformance. Based on the conformance checking results, the knowledge base can be expanded with more specific models tailored to new variants or disease combinations. We demonstrate our approach using Synthea, a benchmark dataset simulating patient treatments for SARS-CoV-2 infections with varying COVID-19 complications. The results show that our method enables expanding the knowledge base of clinical pathways with sufficient precision, peaking to 95.62% AUC while maintaining an arc-degree simplicity of 67.11%.

21.
medRxiv (Medicine) 2026-06-22

A Plasmodium vivax controlled human infection and transmission model to evaluate interventions across the life cycle

Background Plasmodium vivax is an underappreciated cause of malaria disease burden. No reproducible and standardized full life-cycle controlled human malaria infection (CHMI) model to accelerate development of novel interventions is available. Methods This transmission-CHMI trial was conducted in Nijmegen, Netherlands. Healthy, malaria-naive adults were sequentially enrolled into three cohorts of four and inoculated with the asexual blood-stage isolate PvW1. Primary endpoint was proportion of oocyst-positive laboratory-reared Anopheles stephensi mosquitoes. The sequential design allowed for adaptations between cohorts. At parasitemia >10 parasites/microL or symptom onset, participants received oral gametocyte-sparing treatment (GST): mepacrine (Cohort 1 and 3; 100 mg at 0, 8 16 hours, then once daily for 3 days) or piperaquine (Cohort 3; 480 mg single-dose). Transmission was assessed by direct skin feeding (DSF) and membrane feeding assay (DMFA) with and without enrichment of gametocytes. End-of-study treatment was atovaquone-proguanil (1000/400 mg once daily for 3 days). The trial was registered: NL-OMON57011. Findings Participants were enrolled between September 17, 2024 and March 25, 2025, all (12/12) developed parasitemia and transmitted PvW1 to mosquitoes. No serious adverse events occurred. Most adverse reactions were related to malaria. Mepacrine and piperaquine reduced asexual parasitemia while preserving gametocytemia and transmission. Peak transmission occurred within 3 days after GST and depended on the parasite developmental cycle, with highest gametocyte-infectivity ~48 h post ring-stage. In Cohort 3, mosquito infection reached 100% in all transmission assays. Median peak oocyst counts were 24 (IQR: 14-31) for DSF, 17 (12-19) for DMFA, and 150 (116-199) for enriched DMFA. A two-fold increase in pre-GST maximal parasitemia was associated with 20 additional oocysts (95% CI 8,6-32) in enriched DMFA. Sporozoites were viable in primary human hepatocytes. Interpretation A PvW1 transmission-CHMI is reproducible and safe, enabling P. vivax sporozoite production, relapse models and evaluation of transmission-blocking interventions.

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

FactCheck: Feasibility-aware Long-term Action Anticipation with Multi-agent Collaboration

Long-term action anticipation (LTA) aims to predict an ordered sequence of future verb-noun actions from a partially observed video. While this task serves as the foundation for embodied intelligence, anticipating physically feasible long-term actions remains a critical challenge. Existing methods, which operate in an open-loop manner, often hallucinate non-existent objects, violate object affordances, or disregard object states, as they lack explicit mechanisms to verify action feasibility against the physical environment. To address this, we propose FactCheck, a novel multi-agent collaboration framework that improves feasibility through a closed-loop "Observe-Plan-Verify" mechanism. FactCheck decomposes the complex LTA task into specialized roles: an Observer that recognizes historical actions from video observations and constructs a dual-form structured memory, comprising a History Action Abstract that captures high-level human intentions and environmental status, and a History Action Graph that encodes object states and temporal dependencies; a Planner that generates draft future actions conditioned on both low-level historical actions and high-level History Action Abstract; and a Verifier that rigorously validates the draft against the History Action Graph and refines infeasible actions. Extensive experiments on the EPIC-Kitchens-55 and EGTEA Gaze+ benchmarks demonstrate that FactCheck consistently outperforms state-of-the-art methods. Our work establishes a new paradigm for feasibility-aware long-term action anticipation, effectively closing the loop of action recognition, action prediction and action verification.

23.
arXiv (math.PR) 2026-06-16

Convergence to the Brownian CRT for critical branching Markov processe

arXiv:2601.05906v2 Announce Type: replace Abstract: We prove an invariance principle for a general class of continuous time critical branching processes with finite variance (non-local) branching mechanism. We show that the genealogical trees, viewed as random compact metric measure spaces, converge under rescaling to the Brownian continuum random tree in the Gromov-Hausdorff-weak topology, establishing a universal scaling limit for critical finite variance branching processes.

24.
medRxiv (Medicine) 2026-06-16

Sleep regularity outweighs sleep duration as a predictor of disease

Sleep regularity, the consistency of sleep-wake timing from one day to the next, is more strongly associated with longevity than adequate sleep duration. Whether this relationship persists across common diseases is unknown. We compared sleep regularity vs. sleep duration as risk factors for 199 diseases and disorders, using ten million hours of objective sleep-wake data (N=60,998, age[mean{+/-}SD]=62.8{+/-}7.8, 55% female). Multivariable-adjusted risks of incident diseases/disorders for regular/irregular and short/adequate sleepers were compared across 9.5 years of follow-up. Irregular sleep predicted risks for 131 diseases/disorders, more than double the number predicted by short sleep duration (63). Irregular sleep was a superior predictor than short sleep duration for 90 diseases/disorders, including circulatory, metabolic, digestive, renal, infectious, neurological, and musculoskeletal conditions, and mental disorders, whereas short sleep duration was the superior predictor for only 9 diseases/disorders. For models where short sleep duration explained disease risks, 83% were improved by adding sleep regularity. Sleep regularity was a stronger predictor of diseases/disorders than sleep duration in this cohort and should be considered an essential dimension of sleep health.

25.
arXiv (quant-ph) 2026-06-12

Toward quantum-noise-limited interferometric measurements of optical nonlinearity in vacuum

arXiv:2602.10896v2 Announce Type: replace-cross Abstract: Quantum Electrodynamics predicts that the vacuum must behave as a nonlinear optical medium: the vacuum optical index should increase when it is stressed by intense electromagnetic fields. The DeLLight (Deflection of Light by Light) project aims to measure it by using intense and ultra-short laser pulses. The experiment uses a Sagnac interferometer to amplify the tiny deflection signal of a low-intensity probe pulse crossing the vacuum refractive-index gradient produced by an external high-intensity pump pulse. The measurement of the amplified signal by a CCD camera requires a high spatial resolution, which is limited by the ultimate quantum noise of the CCD. However, interferometric phase noise induced by the mechanical vibrations of the interferometer is also amplified and degrades spatial resolution. To overcome this, we propose a new method named High-Frequency Phase Noise Suppression (HFPNS), based on the addition of a delayed replica (5 ns) of the probe pulse. The delayed pulse, which is not affected by the pump but is subject to the same vibration noise, enables offline subtraction of correlated phase noise. In this work, we present an experimental proof-of-concept on a prototype interferometer operating with a limited amplification factor ($\mathcal{A}\simeq25$), about 10 times smaller than the required value of the final experiment. We have succeeded in reducing phase noise by a factor of 40, resulting in a residual noise level 2.3 times higher than the expected quantum noise. The residual noise is linked to delay-line instabilities and incident beam pointing fluctuations present during these tests. This result validates HFPNS as a robust method for future quantum-noise-limited interferometric measurements of vacuum optical nonlinearity, though additional stabilization and higher interferometric amplification are still needed.