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01.
medRxiv (Medicine) 2026-06-10

Development of a Novel Blood-Based Assay for Brain-Derived Tau and Its Validation in Traumatic Brain Injury

Brain-derived tau (BD-tau) is an emerging blood-based biomarker for neurodegeneration, yet there are currently limited well validated BD-tau assays available for research and clinical use. To enhance access to this vital biomarker for neurological disorders including traumatic brain injury (TBI), we developed a novel blood-based immunoassay for BD-tau on the ultra-sensitive Quanterix HD-X platform using Single Molecule Array technology. Analytical validation assessed dilution linearity, specificity, precision, detection limits, and spike recovery, each recording robust metrics in agreement with international expert recommendations. The assay demonstrated robust validation metrics, achieving between-run stability of 95% when analyzing aliquots from six independent plasma and serum samples across five analytical runs. It also showed strong dilution linearity when diluted four-fold and achieved over 90% recovery when spiked with cerebrospinal fluid. Next, we evaluated the clinical utility of the assay in cohorts of individuals with traumatic brain injury (TBI), where strong performances were recorded whether using the 2-step or 3-step assay formats ({rho}= 0.94; p < 0.0001). Furthermore, plasma BD-tau distinguished samples from TBI patients based on time from injury and severity (AUC=0.93). Plasma BD-tau differentiated between favorable and unfavorable functional outcomes in the acute-severe group. Our findings underscore the significant potential of the BD-tau assay as a biomarker for TBI in the severe phase.

02.
arXiv (CS.AI) 2026-06-16

TNODEV: Toolbox for Neural ODE Verification

arXiv:2606.16567v1 Announce Type: new Abstract: Neural ordinary differential equations (neural ODE) have started to appear in safety critical settings such as continuous-time controllers for cyber-physical systems and classifiers integrated into automated decision pipelines, raising the question of whether their behavior can be formally verified. Existing tools dedicated to neural ODE provide only a single reachability call without iterative input set refinement, limiting the precision of their verdicts to whatever one reachability call can deliver. We present TNODEV, the first sound formal verifier for neural ODE that integrates a falsification checker, a fast interval-based reachability backend based on continuous-time mixed monotonicity, a verification and refinement loop with three input-set splitting heuristics, and a parallel scheduler in a single end-to-end pipeline. TNODEV supports safe-set inclusion verification on pure neural ODE, neural ODE in closed loop with a neural network controller and general neural ODE (GNODE), with the safe set specified either as an interval or as the half-space intersection induced by a target classification label. We evaluate TNODEV on a range of benchmarks across safe-set inclusion and classification-robustness properties, including a direct reachability comparison against NNV~2.0 and CORA and a verification comparison against NNV2.0 on MNIST general neural ODE classifiers.

03.
arXiv (CS.CV) 2026-06-11

Cross-Domain Multi-Person Human Activity Recognition via Near-Field Wi-Fi Sensing

Wi-Fi-based human activity recognition (HAR) provides substantial convenience and has emerged as a thriving research field, yet the coarse spatial resolution inherent to Wi-Fi significantly hinders its ability to distinguish multiple subjects. By exploiting the near-field domination effect, establishing a dedicated sensing link for each subject through their personal Wi-Fi device offers a promising solution for multi-person HAR under native traffic. However, due to the subject-specific characteristics and irregular patterns of near-field signals, HAR neural network models require fine-tuning (FT) for cross-domain adaptation, which becomes particularly challenging with certain categories unavailable. In this paper, we propose WiAnchor, a novel training framework for efficient cross-domain adaptation in the presence of incomplete activity categories. This framework processes Wi-Fi signals embedded with irregular time information in three steps: during pre-training, we enlarge inter-class feature margins to enhance the separability of activities; in the FT stage, we innovate an anchor matching mechanism for cross-domain adaptation, filtering subject-specific interference informed by incomplete activity categories, rather than attempting to extract complete features from them; finally, the recognition of input samples is further improved based on their feature-level similarity with anchors. We construct a comprehensive dataset to thoroughly evaluate WiAnchor, achieving over 90% cross-domain accuracy with absent activity categories.

04.
arXiv (CS.CL) 2026-06-11

T2MM: An LLM Supported Architecture For Inquiry-Based Modeling

Model Construction is a foundational practice in science learning that relies on visualization and interactivity. Large Language Models, increasingly augmented with multimodal capabilities, have been integrated in education contexts to support learning. However, these tools lack visual interactivity that is required by some learning contexts. We introduce Text to Multimodal Model (T2MM), a robust, dynamic LLM supported architecture that assists in model construction within the open inquiry ecology-based modeling software Virtual Experimental Research Assistant (VERA). T2MM accounts for the current context of the learner's model and creates interactive models, rather than static images, enabling the model to remain responsive to manual adjustment. To measure technical feasibility, we evaluate T2MM through a custom procedurally generated dataset of natural language learner modeling requests and target models within the VERA system. T2MM outperforms a baseline model generation architecture implemented through LLM-supported full code generation, common in the literature, across all measured success metrics. Our contribution not only outlines LLM integration into a inquiry-based learning modeling tool, but also describes a possible architecture through which more interactive multimodal LLM tools can be created.

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

EEG-FM-Bench: A Comprehensive Benchmark for the Systematic Evaluation and Diagnostic Analyses of EEG Foundation Models

arXiv:2508.17742v3 Announce Type: replace-cross Abstract: Electroencephalography foundation models (EEG-FMs) have advanced brain signal analysis, but the lack of standardized evaluation benchmarks impedes model comparison and scientific progress. Current evaluations rely on inconsistent protocols that render cross-model comparisons unreliable, while a lack of diagnostic analyses obscures the internal mechanisms driving transfer efficiency and scaling behaviors. To address this, we introduce EEG-FM-Bench, a unified system for the standardized evaluation of EEG-FMs. The benchmark integrates 14 datasets across 10 paradigms and incorporates diverse experimental settings, including multiple fine-tuning strategies, task organizations, and classifier configurations, supported by tools for gradient and representation analysis. Our experiments and analysis reveal several critical insights: (1) multi-task learning often acts as a useful regularizer that mitigates overfitting in data-scarce EEG contexts, although negative transfer can arise under specific task paradigms; (2) pre-training efficiency is currently limited by gradient conflicts between reconstruction objectives and downstream tasks; (3) under released checkpoints and a matched downstream protocol, model or data scale alone does not fully explain transfer performance, while objective alignment, adaptation compatibility, and EEG-specific design appear to be important factors. This benchmark enables fair comparison and reproducible analysis, providing a step toward fairer comparison and more interpretable analysis of EEG-FMs. Code is available at https://github.com/xw1216/EEG-FM-Bench.

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

FlowBank: Query-Adaptive Agentic Workflows Optimization through Precompute-and-Reuse

Large Language Model (LLM)-based multi-agent systems are increasingly powerful, but current agentic workflow optimization paradigms make an unsatisfying trade-off. Task-level methods spend substantial offline compute yet deploy only a single workflow, leaving complementary candidates unused, while query-level methods synthesize a new workflow per query at substantial inference cost. Our motivating analysis shows these paradigms are more complementary than competing: workflows discovered during offline search often solve different subsets of queries, and many queries handled by expensive query-level generation can already be solved by cheaper precomputed workflows. This suggests a different objective: rather than searching for one universally best workflow or regenerating one per instance, we should build a compact bank of reusable, complementary workflows and select among them adaptively at inference time. Doing so requires solving three coupled problems: generating complementary rather than redundant candidates, compressing them into a small deployable portfolio, and assigning each query to the right workflow under a performance-cost trade-off. To this end, we present FlowBank, a three-stage framework for portfolio-based agentic workflow optimization. Diversifying proposes DiverseFlow to steer search toward under-covered queries and produce a high-coverage candidate pool. Curating proposes CuraFlow to compress this pool into a compact portfolio with minimal redundancy. Matching casts deployment as edge-value prediction on a query-workflow bipartite graph and routes each incoming query to the portfolio member with the best predicted utility. Across five benchmarks, FlowBank achieves the highest average score among the evaluated methods while remaining cost-competitive, improving over the strongest automated and handcrafted baselines by 4.26% and 14.92% relative, respectively.

07.
arXiv (CS.AI) 2026-06-15

Moonlight in Latent Space: Chirality and Structural Correspondence Between Beethoven's Op. 27 No. 2 and Machine Learning Mechanisms

arXiv:2606.14612v1 Announce Type: cross Abstract: We show that the three movements of Beethoven's "Moonlight Sonata" (Op. 27 No. 2) instantiate three distinct machine learning architectures – not by analogy, but by structural correspondence. Through computational analysis of the score (entropy, Jensen-Shannon divergence, dissonance, hand distributional overlap, self-similarity matrices, temporal memory decay, and contextual pitch embeddings), we establish four counterintuitive findings: (1) perceived musical "temperature" is governed by throughput, not distributional width; (2) the lightest movement carries the highest dissonance; (3) the movements implement streaming, recurrent, and periodic positional encoding memory architectures; and (4) the same pitch class acquires different contextual identities across movements, analogous to contextual vs.static embeddings in NLP – and unsupervised clustering recovers the tonal structure without music-theoretic input. We construct a reverse sonification (decoding analytical features back into MIDI) and quantify the chirality of the encode-decode cycle: what distributions preserve and sequential ordering destroys. Prompted by a listener's observation that the decoded piece sounds like "mirror isomers that can't be superimposed," the chirality measurement reveals reconstruction loss increasing monotonically with n-gram order. Bootstrap baselines and subsample checks confirm all movements carry sequential information above noise, though raw values are confounded by sample size. Cross-domain comparison shows natural language has higher chirality than music, reflecting stronger sequential constraints.

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

QuantKAN: A Unified Quantization Framework for Kolmogorov Arnold Networks

arXiv:2511.18689v3 Announce Type: replace Abstract: Kolmogorov–Arnold Networks (KANs) replace linear weights with spline-based functions, offering strong expressivity but posing challenges for low-precision deployment due to heterogeneous parameter distributions. We introduce QuantKAN, the first unified framework for quantization-aware training (QAT) and post-training quantization (PTQ) of KANs. The framework employs branch-aware quantizers for base and spline parameters and extends modern QAT and PTQ methods to spline-based layers across EfficientKAN, FastKAN, PyKAN, and KAGN. Experiments on MNIST, CIFAR-10/100, TinyImageNet, and ImageNet provide the first unified QAT/PTQ KAN benchmarks and show that DSQ is the most robust QAT method at aggressive low-bit settings, while GPTQ is the strongest PTQ method at moderate precision. Sensitivity analyses reveal architecture-specific failure modes: spline/basis parameters dominate in FastKAN, while base or scaling parameters dominate in EfficientKAN, GRAM, and PyKAN. Vivado HLS estimates on a Xilinx UltraScale+ device further suggest up to 3.32$\times$ throughput and 7.7$\times$ lower estimated dynamic energy per inference under W4A4, exposing a residual basis-evaluation tax that motivates basis-aware microarchitecture. QuantKAN is available at https://github.com/OSU-STARLAB/QuantKAN/.

09.
arXiv (CS.CV) 2026-06-17

Theoretical Grounding of Out-Of-Distribution Detection With Reinforcement Learning Optimizer

Out-of-distribution (OOD) detection in dynamic open-world environments requires a model to continually adapt to evolving data distributions while generalizing to covariate-shifted inputs and rejecting semantic-shifted OOD examples. Most existing OOD detection methods optimize only the current-step objective and do not explicitly account for how post-deployment environment changes affect future OOD behavior. In this paper, we establish a theoretical grounding for dynamic OOD detection using a reinforcement learning (RL)-guided optimizer that explicitly favors updates that reduce the semantic OOD false positive rate over time. We develop a novel augmented optimizer that uses an RL-guided correction term on top of standard gradient descent (GD) and show its improvement over both future-domain generalization and semantic-OOD rejection. We analyze temporal error decomposition in terms of model-change and environment-change generalization errors and develop a new theoretical framework for comparing the generalization errors under both GD and RL-guided optimizers.

10.
arXiv (CS.CV) 2026-06-24

Heterogeneous Knowledge Distillation via Geometry Decoupling and Momentum-Aware Gradient Regulation

Heterogeneous Knowledge Distillation (HKD) aims to transfer knowledge across varying architectures (e.g., from Transformer to CNN) but inherently suffers from severe training instability. We reveal that this instability stems from two highly coupled challenges: massive feature norm discrepancies that cause optimization drag, and severe gradient conflicts between the primary and distillation objectives arising from distinct inductive biases. To achieve stable distillation, we propose SPOFA, a framework built upon a novel Feature and Gradient Dual Stabilization mechanism. Specifically, at the feature level, we introduce a LayerNorm-based decoupling projector that explicitly decouples feature magnitude from direction, creating a bounded and stable space for semantic alignment. At the gradient level, we propose a momentum-driven Exponential Moving Average (MEMA) dynamic scaler. By establishing a robust historical baseline of the optimization trajectory, MEMA actively evaluates instantaneous gradient conflicts and adaptively penalizes harmful distillation signals, guaranteeing stable convergence. Importantly, SPOFA achieves this dual stabilization with an extremely lightweight parameter footprint. Extensive experiments on two mainstream benchmarks demonstrate that SPOFA achieves state-of-the-art accuracy, significantly outperforming computationally expensive methods while introducing only minimal computational overhead compared to standard baselines.

11.
arXiv (CS.AI) 2026-06-24

Can Aggregate Invariants Accelerate Continuous Subgraph Matching? Limits, Laws, and a Dynamic Spectral Index

arXiv:2606.24421v1 Announce Type: new Abstract: Spectral filtering recently delivered substantial pruning for static subgraph matching: Laplacian interlacing rejects candidates whose neighborhoods cannot host the query. We study whether such aggregate structural tests can accelerate continuous subgraph matching (CSM) over dynamic graphs, and answer in three parts. First, lazily maintained spectral bounds are infeasible exactly where spectral pruning has value: we characterize the tightest safe rule over a formalized perturbation relaxation and show that even it loses essentially all pruning power within four touching updates. Second, exact maintenance is affordable when selective: pruning utility and recomputation cost are anti-correlated across vertices – hubs provably never prune – so recomputing small-neighborhood spectra on touch sustains exact local spectra at microseconds per update, complete by construction. Third, integrated into a decoupled CSM benchmark against an identical-minus-spectra control, the tests remove up to $51\%$ of candidates or safely skip up to $47\%$ of update enumerations, yet enumeration intermediates remain unchanged – beyond the gates' skipped first-level bindings, typically zero – across two engines, four real graphs, two stream types, and $77$ solved queries; a constructed radius-stratified workload confirms the instrument detects the exception when one exists ($-99.9\%$ intermediates, $748\times$ faster). Aggregate tests accelerate what scales with candidate sets – construction, list scans – never adjacency-guided exploration. We distill an intermediate-invariance methodology for evaluating CSM filters and release a reusable dynamic local-spectra index.

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

Data-driven sparse identification of governing PDEs via knockoff filters and multi-criteria trade-offs

arXiv:2605.26631v2 Announce Type: replace-cross Abstract: We propose KO-PDE-IDENT, a data-driven framework for identifying parsimonious partial differential equations (PDEs) with false discovery rate (FDR) control. PDE discovery from noisy observations is often hindered by extreme multicollinearity among candidate terms, which causes typical sparse-regression methods to select spurious terms. To address this problem, KO-PDE-IDENT initially mines a support set of potential candidate terms via model-X knockoff filters with finite-sample FDR control, then refines and ranks the surviving PDE alternatives. The framework integrates three components. First, knockoff feature statistics are constructed by coupling $\ell_{0}$-constrained adaptive best-subset selection with SHapley Additive exPlanations (SHAP), yielding an effective and computationally efficient difference statistic. Second, a recursive feature elimination (RFE) procedure removes terms whose marginal contributions are dispensable and assesses statistical necessity through knockoff-perturbed hypothesis testing. Third, the final model selection is formulated as a multi-criteria decision-making (MCDM) problem, where the optimal governing equation is the alternative that best balances a wide range of criteria such as predictive accuracy, model complexity and coefficient uncertainty. We evaluate KO-PDE-IDENT on five canonical PDEs under severe noise corruption. Empirical results show that our framework can exactly recover the true PDE structure, eliminating false discoveries while retaining all true underlying terms, with low coefficient estimation error.

13.
arXiv (CS.LG) 2026-06-18

Does VLA Even Know the Basics? Measuring Commonsense and World Knowledge Retention in Vision-Language-Action Models

arXiv:2606.19297v1 Announce Type: new Abstract: Embodied Vision-Language-Action (VLA) models are typically obtained by fine-tuning powerful pretrained VLMs on robotics data, yet it is unclear how much commonsense and factual knowledge they retain after adaptation. Failures on knowledge-sensitive tasks are ambiguous, conflating missing knowledge with poor generalization of low-level control. We introduce Act2Answer, a lightweight protocol that adapts VLM knowledge benchmarks to VLA evaluation by requiring agents to answer through action. Each question becomes a short tabletop episode where the agent performs a single object-placement action to select among candidate answers, yielding an action-grounded success rate with reduced control confounds. We curate a test suite of such environments across diverse commonsense and world-knowledge categories and introduce layerwise intent probing to localize answer-relevant information across the VLM backbone and action head. In a large-scale study of 7 VLA models and 9 VLM baselines, we systematically rank models across categories, finding that VLAs show solid performance on simple concepts while exhibiting larger gaps on richer semantic categories relative to their source VLMs, that VQA co-training is associated with better knowledge retention, and that answer-relevant signals peak in middle VLA layers but attenuate in upper layers. Act2Answer is available at https://tttonyalpha.github.io/act2answer/.

14.
arXiv (CS.AI) 2026-06-16

AIChilles: Automatically Uncovering Hidden Weaknesses in AI-Evolved Systems

arXiv:2606.15834v1 Announce Type: new Abstract: The computer systems community has recently seen growing interest in AI-driven system evolution, where AI agents iteratively rewrite systems. Frameworks such as AdaEvolve and Engram report 12-60% score improvements over human-designed algorithms. While these results are promising, there are practical concerns if these AI-evolved programs can perform worse on unseen workloads and exhibit scalability regressions. Given the speed and scale of AI-generated code, we need automated mechanisms to uncover such identify hidden weaknesses in AI-evolved systems programs. To this end, we develop AIChilles that takes as input a baseline program $P$ and an AI-evolved program $P'$, AIChilles searches for valid workloads where $P'$ regresses relative to $P$ in correctness, runtime, memory usage, or output quality. To tackle the diversity in system applications, weakness types and potential bugs, AIChilles combines deterministic workload-parameter extraction, agent-based constraint inference, differential oracles, and code-frequency coverage to discover diverse failures. Across five system applications and 30 AI-evolved programs, AIChilles finds 49 distinct hidden weaknesses. We also show that explicitly including AIChilles in the AI-driven development lifecycle can mitigate several of these weaknesses.

15.
arXiv (CS.CV) 2026-06-24

Does it matter which Gaussians you pick in 4D Gaussian streaming?

Anchor-driven 4D Gaussian streaming methods such as Instant Gaussian Stream (IGS) update a dynamic scene each frame from a compact set of Gaussian anchors, chosen by default with Farthest Point Sampling (FPS) at a fixed budget of $8{,}192$. Because these anchors act as control points that drive the whole scene through linear blend skinning, the rule used to choose them ought to affect reconstruction quality. We test this by holding the IGS pipeline fixed and changing only the sampler, comparing FPS, random, uniform, an opacity-scale heuristic, and a learned policy across budgets and refinement settings on N3DV and MeetingRoom. At deployment budgets the sampler has no measurable effect: a cheap random or uniform sampler at $4{,}096$ anchors matches FPS@8192 within measurement error, the default budget is over-provisioned, and the result holds on a second backbone (3DGStream). The learned policy is mixed rather than consistently better: it can improve the N3DV validation set at tight budgets, but does not give a stable cross-dataset rule, and selection is never the bottleneck because refinement dominates runtime. We will release our full sweep and evaluation protocol as a sampler benchmark.

16.
arXiv (CS.CV) 2026-06-18

Clinically Aligned Geometry Constraints for Robust IVUS Vessel Boundary Segmentation

Intravascular ultrasound (IVUS) lumen and external elastic membrane (EEM) segmentation is important for quantitative coronary plaque burden assessment. Errors in lumen or EEM delineation directly propagate to plaque area, plaque burden and geometric measurements. However, standard methods prioritising overlap scores often suffer from boundary drift and topology errors, leading to inaccurate clinical measurements. We present GeoCat, a geometry-consistent network that processes 5-frame IVUS clips using dual Cartesian-polar encoders with cross-domain attention and temporal fusion. A differentiable geometry consistency loss directly supervises clinically relevant descriptors including diameters, orientations, and cross-sectional areas. The model is trained on 12,242 annotated frames from 146 patients acquired with two commercial IVUS systems. We evaluate performance using both segmentation accuracy and plaque-relevant clinical metrics, including Dice/IoU, boundary measures(95HD (mm), ASSD), topology violation rate, and clinical geometry errors (dmax/dmin, angles, and areas). On our dataset, GeoCat achieves a Dice of 0.93, reduces 95HD to 0.14 mm, and lowers topology violations to 1.0%. Importantly, it significantly improves geometric fidelity, yielding diameter errors of 0.13-0.16 mm and angular errors of ~8 degrees, supporting reliable plaque burden quantification.

17.
PLOS Computational Biology 2026-06-12

Ten simple rules for executing an inherited research plan in computational biology

by Sahar Javaheri Tehrani, Toni Ingolf Gossmann Trainees in computational biology frequently inherit research plans whose aims, datasets, analytical strategies, and technical constraints were defined before their arrival. These plans often emerge from grants, collaborations, legacy codebases, shared high-performance computing environments, or partially completed analyses. While such plans provide a useful scaffold, they rarely specify all implementation details, prior assumptions, evaluation criteria, or dependencies needed for reliable execution. The transition from inheriting a partially articulated plan to producing reproducible results therefore creates an execution gap: a phase in which trainees must reconstruct what the project is, which elements are fixed, which remain negotiable, and which technical or organizational assumptions need to be tested before full-scale analysis begins. In this Ten Simple Rules article, we provide a practice-oriented framework for stabilizing inherited computational biology projects before workflows, benchmarks, and decision paths become entrenched. We do not claim that the individual practices described here are novel in isolation. Rather, our contribution is to organize familiar practices into a sequenced framework for a recurrent but under-articulated phase of computational research: inherited-plan execution. Computational biology makes this phase especially important because projects often combine heterogeneous datasets, fragile software environments, undocumented preprocessing choices, benchmarking assumptions, distributed collaborators, and asymmetrical access to contextual knowledge. By making this transition visible and operational, the rules aim to help trainees, supervisors, and collaborators reduce ambiguity, test feasibility, document decisions, and support reproducible and equitable project execution under real-world constraints.

18.
arXiv (CS.AI) 2026-06-19

Cost-Optimal LLM Routing with Limited User Feedback under User Satisfaction Guarantees

arXiv:2606.19376v1 Announce Type: cross Abstract: Inference costs for large language model (LLM) applications are rapidly growing, driven by surging demand and rising infrastructure cost. Users expect high-quality responses, and in commercial settings this is formally codified in Service Level Agreements (SLAs), creating a fundamental tension between cost and quality. Recent progress on cost-aware LLM request routing has shown potential to resolve this tension, but existing approaches rely on complete feedback signals, offline training, extensive per-workload tuning, and most lack SLA guarantees or inference-time adaptivity. We introduce SLARouter, an online routing algorithm that learns a cost-optimal policy from the sparse, one-sided user feedback available in production systems. SLARouter provides theoretical guarantees for both cost optimality and strict SLA compliance. Experiments across a wide range of LLM benchmarks show that SLARouter satisfies SLA constraints without the need for per-benchmark tuning, reducing operating cost by up to 2.2x over existing baselines.

19.
medRxiv (Medicine) 2026-06-15

Prevalence and Clinical Impact of Pathogenic Variants in Cardiomyopathy Genes Among Individuals with Cardiac Conduction Disorders

Importance: Cardiac conduction disorders have traditionally been regarded as a secondary manifestation of underlying structural heart diseases. However, isolated conduction disorders may precede the onset of heart failure (HF) suggesting shared mechanisms. Objective: To evaluate the prevalence and clinical significance of pathogenic/likely pathogenic (P/LP) rare variants in cardiomyopathy genes among individuals with conduction disorders. Design, Setting, and Participants: Biobank analysis of 192,834 participants with whole genome sequence data from Vanderbilt's BioVU and 353,092 participants from the All of Us Research Program (AoU). Participants with primary conduction disorder (left bundle branch block [LBBB], right bundle branch block [RBBB], high-grade atrioventricular block [AVB]) were identified after excluding secondary causes. Exposures: P/LP variants in cardiomyopathy genes. Main Outcomes and Measures: Primary outcome was P/LP carrier status by age and HF status. Secondary outcomes included incident HF and composite ventricular arrhythmias/sudden cardiac death/mortality (VA/SCD/mortality). Results: Among 16,959 participants with conduction disorders in BioVU and 13,442 in AoU, 432 (2.6%) and 206 (1.5%) were P/LP carriers, respectively. Conduction disorder was independently associated with carrier status (BioVU p

20.
medRxiv (Medicine) 2026-06-15

ICD-10 Code Ambiguity Obscures Treatment-Eligible Adults with Spinal Muscular Atrophy: A Single-Center Chart Review and Patient Outreach Study

Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.

21.
arXiv (quant-ph) 2026-06-16

Benchmarking Quantum Extreme Learning based on Gaussian Boson Sampling

arXiv:2606.15230v1 Announce Type: new Abstract: Reservoir models offer a hardware-efficient learning paradigm for noisy intermediate-scale quantum devices by exploiting untrained quantum dynamics as a fixed feature map and restricting optimization to a simple classical readout layer. We propose a quantum extreme learning machine implemented using gaussian boson sampling and an encoding strategy that achieves high classification accuracy while reducing optical resource requirements. Classical inputs are jointly encoded in the squeezing parameters and in the interferometer unitary, enabling sampling-based, highly nonlinear feature maps while leveraging large-scale GBS output statistics, which are conjectured to be classically intractable. We systematically compare multiple families of quantum features accessible in the same setup and find that photon-number sampling probabilities provide the best performance, consistent with their higher effective feature dimensionality. Finally, we benchmark against classical nonlinear baselines and analyse robustness under noisy scenarios, showing competitive performance with fewer trainable parameters and indicating practical promise for near-term photonic implementations.

22.
arXiv (CS.AI) 2026-06-19

PSCT-Net: Geometry-Aware Pediatric Skull CT Reconstruction via Differentiable Back-Projection and Attention-Guided Refinement

arXiv:2606.19867v1 Announce Type: cross Abstract: Computed Tomography (CT) is essential for diagnosing pediatric craniofacial abnormalities, yet poses radiation risks to developing anatomies. Reconstructing 3D CT from sparse bi-planar X-rays offers a low-dose alternative but is severely ill-posed. Existing methods employ geometry-agnostic feature lifting, naively projecting 2D features into 3D without explicit spatial modeling, causing depth ambiguity and degraded osseous boundaries. We present PSCT-Net, a geometry-aware framework with differentiable back-projection. Differentiable back-projection establishes a spatially faithful volumetric prior, alleviating depth ambiguity. An Attention-Guided Projection (AGP-3D) module then learns non-linear voxel-wise correspondences between 2D regions and 3D locations. A Bidirectional Mamba (BiM-3D) module captures long-range volumetric dependencies with linear complexity. We further curate a private institutional pediatric skull CT cohort, PedSkull-CT, comprising normal and pathological cases for internal evaluation, addressing the gap in adult-centric, trunk-focused datasets.

23.
arXiv (CS.LG) 2026-06-15

Direct Fisher Score Estimation for Likelihood Maximization

arXiv:2506.06542v2 Announce Type: replace-cross Abstract: We study the problem of likelihood maximization when the likelihood function is intractable but model simulations are readily available. We propose a sequential, gradient-based optimization method that directly models the Fisher score based on a local score matching technique which uses simulations from a localized region around each parameter iterate. By employing a linear parameterization to the surrogate score model, our technique admits a closed-form, least-squares solution. This approach yields a fast, flexible, and efficient approximation to the Fisher score, effectively smoothing the likelihood objective and mitigating the challenges posed by complex likelihood landscapes. We provide theoretical guarantees for our score estimator, including bounds on the bias introduced by the smoothing. Empirical results on a range of synthetic and real-world problems demonstrate the superior performance of our method compared to existing benchmarks.

24.
medRxiv (Medicine) 2026-06-23

Agentic Autodiscovery of Diastolic Dysfunction Phenotypes from Surface Electrocardiogram

Background: Left ventricular diastolic dysfunction (LVDD) is a major determinant of heart failure (HF), yet its assessment relies on multiparametric echocardiography, limiting scalability. We previously demonstrated that generative artificial intelligence (AI) can synthesize tissue Doppler imaging (TDI) waveforms from the 12-lead ECG. The growing complexity of candidate architecture creates a need for automated model-discovery frameworks. Objectives: To evaluate agentic AI-based auto-discovery for ECG-based LVDD assessment using either raw ECG or synthetic TDI waveforms. Methods: Two attention-based agentic AI architectures were developed using an automated large language model-driven refinement framework that optimized transfer-learning and multimodal architectures through autonomous proposal, validation, and selection of candidate model configurations. Development was performed in 1,011 paired ECG-echocardiography studies and externally validated in 983 patients using two reference frameworks: (i) data-driven phenogroups and (ii) the 2025 ASE Diastolic Function Guidelines. External validation was performed in CODE-15% (n=219,567) for HF-related mortality and EchoNext (n=35,718) for structural heart disease associations. Results: Despite the modest cohort size, the ECG-based agentic search achieved area under the receiver operating characteristic curve (AUCs) of 0.87 (95% CI: 0.85-0.89) and 0.83 (95% CI: 0.80-0.86) for phenogroup and guideline-based LVDD severity classification. Corresponding AUCs for the synthetic TDI-based model were 0.82 (95% CI: 0.80-0.85) and 0.80 (95% CI: 0.77-0.84), respectively. In large-scale external validation, both models stratified incident HF mortality with subdistribution hazard ratios ranging 5.5 to 9.5 (Gray's p

25.
arXiv (CS.LG) 2026-06-18

Strategic Feature Selection

arXiv:2606.18867v1 Announce Type: new Abstract: When algorithmic predictors inform resource allocation in high-stakes domains such as healthcare, these predictors must account for strategic manipulation of input features. The typical solution is to redesign the predictor itself to explicitly account for strategic interactions. In practice, however, decision makers are often constrained to adjusting coarser levers within existing prediction pipelines. For example, healthcare organizations often select which features to exclude based on perceived manipulability, while using standard regularization procedures to shrink the coefficients of retained features. In this work, we initiate a formal study of strategic classification through feature selection and its interaction with ridge regularization. Our main finding is that excluding individual features based on their manipulability alone is generally suboptimal. We provide a fine-grained characterization of the performance of a feature subset under optimal regularization, yielding new insights for policy design. Motivated by this characterization, we develop a practical algorithm for jointly choosing the feature set and the level of ridge regularization. Through a real-world case study on a healthcare payments benchmark, we illustrate how our algorithm can guide the design of coarse policy levers in practice. Our results provide a principled, practical framework for mitigating the effects of strategic behavior in algorithmic decision-making systems.