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01.
arXiv (CS.CV) 2026-06-17

Disentangling Perception and Reasoning in Multimodal LLMs via Reward Design

Reinforcement learning with verifiable rewards has driven major gains in LLM reasoning, and it is intuitive to assume this recipe will transfer well to multimodal models. However, multimodal models do two things: first, perceive what is in an image, then reason about what it implies. Because these stages are graded jointly, it is hard to tell how much room reasoning alone has to grow. We study this on algorithmic visual puzzles, where both components are necessary and show that perception, not reasoning, is the binding constraint. Replacing images with simple textual descriptions raises performance by over 20 points on average for Claude models. We then evaluate six reward designs aimed at inducing visual grounding during reasoning without chain-of-thought supervision. Training Qwen-2.5-VL-7B with GRPO, reward design induces long, structured reasoning with self-reflection and visual references, yielding a 5.56-point gain over the base model. These gains are, however, uneven; no single reward improves all categories, and rewards with verifiable accuracy signals trade out-of-domain transfer for in-domain accuracy. These results point to perception-aware reward design as a path forward, so that signals correct perception at its source rather than the reasoning that inherits its errors.

02.
arXiv (CS.CV) 2026-06-17

Contactless Respiratory Monitoring on Heterogeneous Mobile Robots: A Multimodal Edge-Computing Framework

Respiratory-rate (RR) monitoring is a critical component of remote triage and victim assessment in emergency response, disaster recovery, and infectious-disease scenarios, where minimizing physical contact can reduce responder risk and improve operational safety. However, field deployment of contactless RR monitoring remains challenging due to variable illumination, posture changes, platform heterogeneity, and the impracticality of wearable sensors in hazardous environments. In this paper, we present a modality-adaptive contactless RR monitoring framework for heterogeneous mobile robots with onboard edge computing. The proposed system combines brightness-adaptive sensor selection across RGB, thermal, near-infrared (NIR), and low-light cameras, keypoint-guided chest ROI extraction for posture-robust monitoring, and a signal-quality-index (SQI)-based filtering mechanism for reliable respiratory estimation. We implement and evaluate the framework on three robotic platforms spanning quadruped and wheeled locomotion and multiple edge-computing architectures. Experiments conducted across diverse lighting conditions, subject poses, and robot-to-subject distances demonstrate that the framework generalizes across platforms without per-platform algorithmic retuning, while revealing modality-specific operational boundaries. RGB provides the broadest coverage up to 8m, NIR remains effective up to 6m, thermal is reliable only at short range, and low-light sensing supports monitoring in complete darkness up to 8m. Overall, the results demonstrate the feasibility of multimodal contactless RR monitoring on mobile robots and support its use as a foundation for autonomous triage and victim assessment in hazardous search-and-rescue settings.

03.
medRxiv (Medicine) 2026-06-22

Symptom-based phenotype discovery in motor neuron disease using natural language processing of electronic health records

Background: Motor neuron disease (MND) is a fatal neurodegenerative condition with significant clinical heterogeneity that is incompletely captured by existing phenotype classifications based on onset site. Electronic health records (EHRs) contain detailed symptom documentation in clinical narratives that may enable data-driven discovery of clinically meaningful patient subgroups. Methods: We developed a natural language processing (NLP) pipeline using MedCAT to extract symptoms from clinical notes of 2,361 people with a confirmed diagnosis of MND at a tertiary neurology center. MND cohort confirmation used three complementary methods: clinic attendance records, text-based diagnosis detection, and NLP extraction with negation detection. Extracted symptoms were filtered to Unified Medical Language System semantic type T184 (Sign or Symptom) with removal of negated concepts. Patients were clustered using latent class analysis on binary symptom profiles. Survival differences were assessed using Kaplan-Meier analysis, log-rank tests, and Cox proportional hazards regression. Results: From the first clinical notes, we identified four clusters of symptoms among 872 patients and 76 symptoms: Motor-Bulbar (n=373), Motor-Tremor (n=154), Sensory-Pain (n=222), and Motor-Respiratory (n=123). When extended to all clinical notes (n=2,065; 184 symptoms), these reorganized into three clusters: Autonomic-Respiratory (n=472), Nocturnal-Respiratory (n=338), and Classic Motor (n=1,255). Survival differences were significant across all clusters in both the first notes and all notes analyses (log-rank p < 0.001). Conclusions: NLP-based symptom extraction from EHRs identifies clinically meaningful MND subgroups that extend beyond traditional onset-site classifications. Autonomic-respiratory symptom burden is associated with poorer survival while a newly identified Sensory-Pain subtype with a better prognosis. These data-driven phenotypes may improve prognostication and inform targeted supportive care.

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

CASR: A Robust Cyclic Framework for Arbitrary Large-Scale Super-Resolution with Distribution Alignment and Self-Similarity Awareness

Arbitrary-Scale SR (ASISR) remains fundamentally limited by cross-scale distribution shift: once the inference scale leaves the training range, noise, blur, and artifacts accumulate sharply. We revisit this challenge from a cross-scale distribution transition perspective and propose CASR, a simple yet highly efficient cyclic SR framework that reformulates ultra-magnification as a sequence of in-distribution scale transitions. This design ensures stable inference at arbitrary scales while requiring only a single model. CASR tackles two major bottlenecks: distribution drift across iterations and patch-wise diffusion inconsistencies. The proposed SSAM module aligns structural distributions via superpixel aggregation, preventing error accumulation, while SARM module restores high-frequency textures by enforcing correlation-guided consistency and preserving self-similarity structure through correlation alignment. Despite using only a single model, our approach significantly reduces distribution drift, preserves long-range texture consistency, and achieves superior generalization even at extreme magnification.

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

RGFVR: Reference-Guided Face Video Restoration with Flow Matching

Face video restoration from degraded observations is challenging, as it requires simultaneously recovering visual fidelity, temporal consistency, and subject identity. Existing approaches are often either reference-free, which can lead to identity loss when person-specific facial details are lost, or subject-specific, which limits generalization to unseen identities. We propose a subject-agnostic, reference-guided framework for identity-preserving face video restoration. Our method introduces bimodal perceptual-descriptive identity conditioning into a pretrained flow-based text-to-video generator and employs a two-stage training strategy to strengthen identity guidance during restoration. Experiments show that our approach improves restoration fidelity, temporal consistency, and identity preservation, achieving superior performance under challenging video degradations, including downsampling, blur, noise, and compression artifacts. The code is available under: https://github.com/batuhanntosun/RG-FVR.

06.
medRxiv (Medicine) 2026-06-12

Microbial etiology, antibiotic susceptibility profiles, and multidrug resistance of urinary tract infections at a secondary healthcare facility in Ghana

Background: Rising antibiotic resistance challenges empirical therapies for urinary tract infections (UTIs). This study evaluated the microbial etiology, susceptibility profiles, and multidrug resistance (MDR) patterns of uropathogens among outpatients at the Berekum Holy Family Hospital, Ghana. Methods: This cross-sectional study (February to August 2021) screened 263 symptomatic outpatients. Mid-stream urine samples underwent quantitative culture, biochemical identification, and antimicrobial susceptibility testing via the Kirby-Bauer disc diffusion method following the 2021 CLSI guidelines. Results: Significant bacteriuria prevalence was 22.8% (60/263). UTIs predominated in females (78.3%, 47/60; p = 0.1501) and individuals [&ge;]45 years (33.3%, 20/60). Gram-negative rods accounted for 90.0% of isolates, primarily Escherichia coli (26.7%), Citrobacter spp. (25.0%), and Enterobacter spp. (21.7%); Staphylococcus aureus (10.0%) was the only Gram-positive pathogen. Extreme phenotypic resistance was observed against piperacillin/tazobactam (98.3%), cefotaxime (93.3%), tetracycline (88.3%), and cefoperazone (85.0%). Conversely, highest therapeutic susceptibilities were retained by amikacin (78.3%), levofloxacin (61.7%), and gentamicin (58.3%). Conclusion: The high prevalence of MDR uropathogens against advanced beta-lactamase inhibitor combinations and cephalosporins necessitates an immediate re-evaluation of regional empirical protocols. Amikacin, levofloxacin, and gentamicin remain viable options prior to culture confirmation. These findings establish a crucial phenotypic baseline to guide localized prescribing policies and regional antimicrobial resistance tracking strategies.

07.
arXiv (CS.AI) 2026-06-19

Zero-Inflated Gaussian Distributions Enable Parameter-Space Sparsity in Estimation-of-Distribution Algorithms

arXiv:2606.19369v1 Announce Type: cross Abstract: Estimation-of-distribution algorithms (EDAs) are a powerful class of evolutionary methods for black-box optimization, especially when little is known about the structure of the objective. Whereas classical evolutionary algorithms rely on hand-designed mutation and crossover operators, hard to devise for unknown problem structures, and a source of bias, EDAs sidestep operator design entirely: they fit a probability distribution to the best individuals and sample the next generation from it. EDAs are well established on continuous parameter spaces, but they have not previously been generalized to sparse ones, in which most coefficients of a good solution are exactly zero. Existing sparse black-box optimizers therefore reintroduce exactly what EDAs were designed to avoid: hand-crafted sparsity operators, bi-level schemes alternating between support set and active values, zeroing thresholds, and other baked-in assumptions. We close this gap by proposing multivariate zero-inflated Gaussian (ZIG) distributions as EDA sampling laws. A latent Gaussian model with separate indicator and value dimensions represents sparsity patterns, correlations among active parameters, and the interactions between the two, so sparsity patterns and active values are optimized jointly, hierarchy-free. We show that the latent parameters of this model are identifiable from observed samples, unlike in the missing-data settings where related constructions originate, and introduce practical amortized inversion-based estimators for them. The estimators accurately recover latent correlation structures, and on the Lunar Lander benchmark the resulting ZIG-EDA converges faster and reaches higher final returns than a dense Gaussian EDA, a hand-crafted sparse evolutionary algorithm, and an ad-hoc sparse EDA, while finding controllers with only a small fraction of parameters active.

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

Privacy from Symmetry: Orthogonally Equivariant Transformers for LLM Inference

arXiv:2606.16461v1 Announce Type: new Abstract: Running large language models locally is often impractical, pushing inference on sensitive text to third-party providers. Split inference partially mitigates this by keeping tokens on the client and sending only hidden representations, but these representations can still be recovered via nearest-neighbor search against the public embedding table. We propose an orthogonal obfuscation procedure in which the client multiplies embeddings by a secret orthogonal matrix before transmission. To enable correct inference under arbitrary rotations, we introduce ConjFormer, a transformer variant that is exactly $\mathrm{O}(d)$-equivariant via a lightweight normalization change (scalar RMSNorm) together with blockwise orthogonal conjugation of all linear weights. As a result, the server performs the full forward pass entirely in the rotated basis and never observes unrotated hidden states. Experiments on GPT-2 and Llama 3.2 1B models fine-tuned on PubMed show that orthogonal obfuscation eliminates direct cosine nearest-neighbor inversion and reduces token recovery from over 35% top-10 to at most 1.3%, while increasing perplexity by only 0.4% after fine-tuning. These results indicate that enforcing symmetry at the architectural level can provide a practical defense for privacy-preserving LLM inference without noise injection or heavy cryptographic machinery.

09.
medRxiv (Medicine) 2026-06-22

Pump-Free Patient-Derived Human Proximal Tubule Microphysiological System for Modeling Flow-Dependent Epithelial Maturation and Cisplatin Injury

Recent initiatives by the U.S. Food and Drug Administration and the National Institutes of Health to reduce animal testing in drug development have highlighted the need for in vitro platforms that better recapitulate human biology for preclinical safety assessment. Drug-induced nephrotoxicity remains a major cause of drug attrition, underscoring the need for human-relevant kidney models. To address this, a pump-free human patient-derived proximal tubule microphysiological system was developed by integrating human renal proximal tubular epithelial cells (hRPTECs), isolated from non-tumorous nephrectomy cortex, with a porous membrane-based microfluidic device. Expanded hRPTECs were cultured for 10 days under static conditions or rocker-driven shear stress approximating physiological proximal tubular flow. Shear stress increased epithelial density, enhanced proximal tubule marker expression (Na+/K+-ATPase and aquaporin-1), and improved Zonula occludens-1 and occludin localization. Bulk RNA sequencing demonstrated transcriptomic changes associated with enhanced apical maturation and epithelial signature. In cisplatin-induced injury assays, shear-conditioned epithelia exhibited reduced cell density and increased {gamma}H2AX staining, indicating greater sensitivity to nephrotoxicity. These findings demonstrate that rocker-driven shear stress promotes epithelial maturation in patient-derived hRPTECs. The pump-free human patient-derived proximal tubule microphysiological system offers a practical, scalable, and physiologically relevant platform for modeling flow-dependent proximal tubule biology and assessing human-relevant nephrotoxicity.

10.
arXiv (CS.AI) 2026-06-17

KFTD: Koopman-Fourier Time-Differentiable Network for Continuous Ocean Spatiotemporal Forecasting

arXiv:2606.17070v1 Announce Type: cross Abstract: Accurate oceanic forecasting is critical for climate monitoring and disaster early warning. However, ocean spatiotemporal forecasting encounters the double challenges of modeling complex dynamical systems and ensuring computational efficiency. We present Koopman Fourier Time-Differentiable (KFTD) Network, a time continuous twostage paradigm that decouples interpolation from prediction to achieve efficient and scalable spatiotemporal modeling. We map complex nonlinear dynamics into the Koopman linear space and exploit Fourier analysis to enable continuous time interpolation at arbitrary sub-steps. A lightweight residual network consumes the high fidelity intermediate states to yield the final forecast. Unlike diffusion models, KFTD eliminates multi step noise sampling and directly evolves the system in continuous time, yielding a 4 computational speedup. We further introduce a DPP Loss that supports arbitrary PDE constraints in an endtoend manner, breaking the physical consistency bottleneck of pure data-driven approaches. Empirical results on four ocean datasets confirm that our continuous time framework reduces MSE by an average of 5.6% (up to 12.7% for SST) and improves efficiency over MCVD by 76.25%.

11.
medRxiv (Medicine) 2026-06-19

Validation of an Artificial Intelligence-Assisted Mobile Application for Dietary Oxalate Assessment in Kidney Stone Prevention

Background: Calcium oxalate nephrolithiasis is the most common type of kidney stone disease. Dietary oxalate intake is an important modifiable factor. Assessing dietary oxalate exposure in clinical practice poses challenges due to limitations of traditional dietary recall tools and variability in food composition data. Artificial intelligence (AI) applications in mobile health may offer scalable solutions for better dietary monitoring and kidney stone prevention. We examined the ability of StoneFree AI to estimate dietary oxalate from verbal and image-based food inputs. Objective: To evaluate the accuracy and limitations of StoneFree AI, for estimating dietary oxalate intake from verbal food descriptions and meal images, and to evaluate errors from entries that may inform future clinical use in kidney stone prevention. Methods: StoneFree AI is a cross-platform mobile application that uses a multimodal large language model (Google Gemini) to interpret verbal food descriptions and visual food images. The identified foods were mapped to oxalate values using the Harvard Oxalate Database. System performance was evaluated using 804 verbal food entries and 276 portion-size food images obtained from the ASA24 dietary assessment database. Verbal inputs were compared with reference oxalate values using absolute error and predefined agreement thresholds ({+/-}1, {+/-}5, {+/-}10 mg). Image-based inputs were evaluated against mutually exclusive primary error categories, including food identification, portion estimation, ingredient recognition, oxalate reference selection, and non-analyzable cases. Results: For verbal food entries, the AI system showed strong agreement with reference oxalate values. Overall, 82.1% of estimates were within {+/-}1 mg, 91.5% within {+/-}5 mg, and 94.5% within {+/-}10 mg of reference values. The mean absolute error was 3.32 mg, the median absolute error was 0.10 mg, and the concordance correlation coefficient (CCC) was 0.860. Image-based inputs showed a higher overall error rate of 63.0%, primarily due to food identification errors (33.0%), inaccurate portion estimation (11.0%), and ingredient recognition errors (9.8%). Most errors occurred with visually complex meals, such as mixed dishes and grain-based foods. Conclusions: AI-assisted estimation of dietary oxalate intake demonstrated high accuracy when structured verbal inputs were used but was less reliable for image-based meal analysis. These findings suggest AI-enabled mobile tools may support dietary monitoring for kidney stone prevention, particularly when user input is structured. Further refinement of computer vision models and prospective clinical validation are required before widespread clinical implementation.

12.
arXiv (CS.LG) 2026-06-17

ConTex: Reformulating Counterfactual Generation For Time Series Forecasting

arXiv:2606.18049v1 Announce Type: new Abstract: Decision-making with deep learning-based time series forecasting requires not only accurate predictions but also actionable insights. However, current architectures do not inherently provide such information. Specifically, guidance is needed on how current conditions must be modified to shift from a predicted outcome to a desired future scenario. Counterfactual explanations provide a natural framework for this task, as they represent minimal input changes that alter the model's prediction, indicating when and how intervention is required. Existing approaches rely on instance-wise optimization, leading to inconsistency across instances, high computational costs, and limited applicability in real-time settings. To address these limitations, we reformulate counterfactual generation for time series forecasting as the problem of learning a globally consistent intervention strategy, allowing counterfactuals to be generated through a single shared function. We propose Counterfactual Time Series Explanations (ConTex), a model-agnostic, decomposed architecture comprising a temporal context encoder and a conditional encoder, followed by two heads that capture interventions in terms of temporal relevance and modification strength. This structure overcomes the instability and inconsistency of instance-based approaches by producing targeted, interpretable interventions across time and feature dimensions in a single forward pass, making it suitable for real-time applications. Across multiple forecasting architectures and benchmark datasets, ConTex achieves state-of-the-art validity while generating sparse counterfactuals that minimize the number of necessary interventions. Additionally, our approach reduces computational cost by at least 12-36x compared to instance-wise generation and supports real-time inference at approximately 0.007 seconds.

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

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

作者:

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

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

A Temporal Planning Framework for Disruption Aware Dynamic Route Optimization in Heterogeneous Railway Systems

arXiv:2606.14582v1 Announce Type: new Abstract: Efficient route optimization play a vital role in ensuring both safety and punctuality in railway operations. It is very crucial particularly in heterogeneous multi-gauge railway networks with varying train speed, stopping pattern, infrastructure compatibility constraints increase coordination complexity. In single-track systems these challenges are further intensify due to all trains to share the same track and requires frequent track switching.Stochastic disruptions events including blocked tracks, blocked trains, engine failure and speed slowdowns introduces additional unpredictability in operations and deviate the timetable. However, existing studies predominantly focuses on high-level timetabling, omitting operational details such as track switching coordination. As a result leaving decision to human operators, increasing safety risks into railway operations. This study proposes a framework based on temporal planning for dynamic route optimization and disruption management in heterogeneous railway systems. The framework formulates railway operations as a temporal planning problem using PDDL 2.1 with explicitly modeling gauge compatibility constraints and diverse disruption scenarios. It generates conflict-free timestamped operational plans specifying both optimized schedules and executable action sequences. To evaluate the proposed framework, we developed a benchmark problem set with 200 instances using up to 1,000 track points and 120 trains. Two state-of-the-art temporal planners and a plan validator were employed to assessed the framework. The experimental results demonstrate that the framework effectively generates temporal operational plans for heterogeneous railway systems and handles multi-gauge constraints, disruptions, and reduces dependence on manual decision making.

15.
medRxiv (Medicine) 2026-06-15

Cost-Performance Evaluation of Large Language Models for Aspect-Based Sentiment Analysis of HCAHPS Patient Comments: A Validation Study

Background: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) free-text comments contain actionable feedback, but timely, scalable, and affordable sentiment analysis remains challenging for health systems that rely on third-party vendors. Objectives: To evaluate cost-performance tradeoffs between a cost-optimized and a flagship large language model (LLM) for aspect-based sentiment analysis of HCAHPS comments, using human inter-rater agreement as a reproducibility benchmark. Methods: We analyzed 512 free-text HCAHPS comments collected from two community hospitals in calendar year 2023. Six trained reviewers (medical students, recent medical graduates, and practicing internists) independently assigned positive, negative, or neutral labels to each comment-aspect pair; the majority label among three reviewers formed the consensus reference standard. Two OpenAI models - GPT-5-nano (cost-optimized) and GPT-5 (flagship) - were prompted in a zero-shot setting via the OpenAI API. We calculated pairwise Cohen's {kappa} to establish a human inter-rater baseline, then compared each model's labels to the consensus using Cohen's {kappa}, accuracy, weighted F1, and per-call cost and latency. Results: Mean human inter-rater agreement was {kappa} = 0.79 (substantial). Both LLMs exceeded this baseline (cost-optimized {kappa} = 0.85; flagship {kappa} = 0.85) with nearly identical accuracy (0.92) and weighted F1 (0.93 vs. 0.93). Performance was strong on positive (F1 ~ 0.97) and negative (F1 ~ 0.90) classes but poor on the underrepresented neutral class (F1

16.
arXiv (math.PR) 2026-06-11

Patterned matrices with random walk entries

arXiv:2512.04612v3 Announce Type: replace Abstract: It is well known that the weak limit of a suitably scaled continuous-time random walk (CTRW) is the Brownian motion. We investigate the convergence of certain patterned random matrices whose entries are independent CTRWs and their time-changed versions, in a non-commutative probability framework. For the Wigner link function, the limits are free Brownian motion and its time-changed version driven by an inverse stable subordinator. For the symmetric circulant and the circulant with CTRW entries, we use their explicit eigenvalue expressions to define some empirical processes that converge weakly to a Brownian motion and a complex Brownian motion, respectively. For matrices with iid entries, and for elliptic matrices, the algebraic limits are equal in $*$-distribution to processes whose marginals are circular and elliptic variables, respectively. A random time-changed variant of these results is also established.

17.
arXiv (CS.CV) 2026-06-11

MedCTA: A Benchmark for Clinical Tool Agents

To make clinically grounded decisions, medical AI agents are expected to go beyond simple recognition and be capable of tool retrieval, evidence acquisition, and integration. Existing benchmarks largely evaluate isolated perception or single-turn question answering, and therefore provide limited visibility into failures of planning, tool recruitment, and rollout reliability. We introduce MedCTA, a benchmark for evaluating medical tool agents on clinician-validated, step-implicit tasks grounded in realistic multimodal clinical inputs, including radiology images, pathology slides, and reports. MedCTA comprises 107 real-world clinical tasks with clinician-verified executable trajectories over 5 deployed tools, and supports process-aware evaluation of tool selection, argument validity, execution stability, trajectory fidelity, and outcome quality. We benchmark 18 open- and closed-source multimodal models and find that even frontier systems remain brittle in multi-step clinical tool use: autonomous rollouts are dominated by protocol failures, premature stopping, and incorrect tool recruitment, while gold-standard tool routing yields large but still incomplete gains. These results show that strong backbone perception does not translate into reliable agentic behavior in clinical settings. MedCTA provides a rigorous testbed for auditing, diagnosing, and advancing trustworthy medical AI agents. The dataset and evaluation suite are available at https://ivul-kaust.github.io/MedCTA/

18.
medRxiv (Medicine) 2026-06-19

Specific epigenetic age acceleration measures are associated with oral health outcomes in U.S. adults

Objectives: Oral health conditions impact a significant proportion of the global population. Chronological age is a known risk factor; however, characterization of epigenetic age remains limited and is expected to provide additional insight into biological mechanisms. Materials and Methods: The National Health and Nutrition Examination Survey (NHANES) was used to analyze the effect of epigenetic age measures of DunedinPoAm, and epigenetic age acceleration (EAA) of Horvath, Hannum, Weidner, Lin, VidalBralo, PhenoAge, GrimAge, and GrimAge2, on various oral health outcomes from survey and examination results. Univariable and multivariable logistic regression were performed, adjusting for sex, race-ethnicity, education, poverty income ratio categories, and dental insurance coverage status. Results: DunedinPoAm was associated with the last dental appointment being for an existing issue (p=0.0093), poor general oral condition (p=0.0226), limiting food due to teeth problems (p=0.0031), and recommendation to see a dentist within the next two weeks (p=0.0171). EAAs for PhenoAge, GrimAge, and GrimAge2, were associated with a smaller number of oral health outcomes, whereas EAAs for Horvath, Hannum, Weidner, Lin, and Vidal-Bralo showed no associations. Conclusions: In a representative U.S. population, DunedinPoAm was most consistently positively associated with different adverse oral health outcomes compared with other epigenetic aging measures. Tracking specific epigenetic ages such as DunedinPoAm, EAA GrimAge, EAA GrimAge2, and PhenoAge, may aid in additional monitoring of oral health outcomes. Understanding specific aging-related CpGs associated with oral health may aid in elucidating underlying molecular mechanisms.

19.
arXiv (CS.CV) 2026-06-17

TextMesh4D: Zero-shot Text-to-4D Mesh Generation

Large-scale, high-quality dynamic 3D (4D) assets are essential for learning physically grounded representations, but remain costly to capture and annotate at scale. This limits the viability of supervised 4D learning and motivates zero-shot text-to-4D generation leveraging pretrained diffusion priors. To model complex dynamics, prior methods typically adopt implicit 3D representations (e.g., NeRFs or 3DGS) for their deformation capacity. However, their implicit nature provides limited control over surface topology, which hinders high-fidelity geometry and makes temporally coherent surface reconstruction challenging. To address these limitations, we explore zero-shot text-to-4D mesh generation. However, a structural mismatch arises when combining diffusion-based guidance with topology-constrained meshes: the guidance is noisy and spatially inconsistent, while meshes impose severe topological constraints, making direct vertex-level deformation unstable. In this paper, we introduce TextMesh4D, the first zero-shot framework for text-to-4D that directly generates dynamic meshes by addressing the above challenge at two complementary levels. Geometrically, we shift deformation modeling from vertices to faces via a Jacobian Deformation Field (JDF), enabling topology-aware surface reconstruction through an integrability-enforcing integration formulation. Semantically, we propose a Local-Global Semantic Regularizer (LGSR) that preserves identity over time by jointly constraining local deformation plausibility and global shape consistency. Extensive experiments demonstrate state-of-the-art temporal consistency, structural fidelity, and visual quality, while remaining efficient on a single 24GB GPU.

20.
arXiv (CS.CL) 2026-06-11

Pretrained self-supervised speech models can recognize unseen consonants

Modern pretrained self-supervised automatic speech recognition models are trained on large-scale audio data to encode speech into contextualized representations. However, their training data are heavily skewed toward high-resource languages with little data from low-resource languages, raising concerns about the potential underrepresentation of typologically uncommon speech sounds such as click consonants primarily found in Khoisan languages. This leads to our central research question: Can these models recognize click consonants as accurately as other speech sounds? To address this question, we fine-tune and compare pretrained self-supervised speech models (Wav2Vec2 and HuBERT) on data from two click-rich Khoisan languages (G|ui and West !Xoon). Our results reveal that the fine-tuned models consistently recognize clicks more accurately than non-clicks, suggesting that self-supervision enables generalization across human speech sounds including rare phonemes.

21.
arXiv (CS.CL) 2026-06-12

The Pragmatic Persona: Discovering LLM Persona through Bridging Inference

Large Language Models (LLMs) reveal inherent and distinctive personas through dialogue. However, most existing persona discovery approaches rely on surface-level lexical or stylistic cues, treating dialogue as a flat sequence of tokens and failing to capture the deeper discourse-level structures that sustain persona consistency. To address this limitation, we propose a novel analytical framework that interprets LLM dialogue through bridging inference – implicit conceptual relations that connect utterances via shared world knowledge and discourse coherence. By modeling these relations as structured knowledge graphs, our approach captures latent semantic links that govern how LLMs organize meaning across turns, enabling persona discovery at the level of discourse coherence rather than surface realizations. Experimental results across multiple reasoning backbones and target LLMs, ranging from small-scale models to 80B-parameter systems, demonstrate that bridging-inference graphs yield significantly stronger semantic coherence and more stable persona identification than frequency or style-based baselines. These results show that persona traits are consistently encoded in the structural organization of discourse rather than isolated lexical patterns. This work presents a systematic framework for probing, extracting, and visualizing latent LLM personas through the lens of Cognitive Discourse Theory, bridging computational linguistics, cognitive semantics, and persona reasoning in large language models. Codes are available at https://github.com/JiSoo-Yang/Persona_Bridging.git

22.
medRxiv (Medicine) 2026-06-16

Deployment-readiness audit of calibration, clinical utility, and fairness in perioperative infection prediction

Objective: Clinical risk scores intended to guide patient-level decisions can show strong average performance. However, predicted probabilities can be systematically too high or too low in specific subgroups even when overall performance is strong. We audited deployment readiness of a strong end-of-surgery postoperative infection model across clinically relevant subgroups and tested mitigation strategies in miscalibrated subgroups. Materials and Methods: We analyzed out-of-fold predictions for 10,719 surgical procedures at a Swiss tertiary hospital, with 504 postoperative bacterial infection events. Prespecified axes were recorded sex, age stratum, and an EHR-derived physiological-reserve proxy. Within subgroups and pairwise intersections, we evaluated discrimination, calibration, threshold-specific errors, and decision-curve net benefit at the prespecified operating threshold. We compared group-specific isotonic recalibration with Wasserstein-barycenter postprocessing and demonstrated portability in SUPPORT2. Results: Overall AUROC was 0.876. While sex-marginal discrimination was similar in women and men (0.878 vs 0.875), age and reserve stratification revealed deployment-readiness failures. Calibration-in-the-large ranged from -0.86 in frail patients to -2.47 in non-frail patients. At the 0.10 operating threshold, decision-curve net benefit was positive in frail patients but negative in pre-frail and non-frail patients. Isotonic recalibration corrected average physiological-reserve-stratified calibration without worsening Brier scores, whereas Wasserstein postprocessing worsened calibration in most procedure clusters. Discussion: Discrimination-only or sex-marginal evaluation would have missed subgroup failures with clinical-utility implications. Conclusion: Subgroup fairness audits for clinical deployment should jointly evaluate discrimination, calibration, and utility. We implemented the audit as the open-source isitfair framework for identifying deployment-relevant subgroup failures, comparing mitigation strategies, and generating structured reports.

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

Discriminative Span as a Predictor of Synthetic Data Utility via Classifier Reconstruction

In many real-world computer vision applications, including medical imaging and industrial inspection, binary classification tasks are characterized by a severe scarcity of positive samples. A widely adopted solution is to generate synthetic positive data using image-to-image transformations applied to negative samples. However, a fundamental challenge remains: how can we reliably assess whether such synthetic data will improve downstream model performance? In this work, we propose a geometry-driven metric that predicts the utility of synthetic data without requiring model training. Our approach operates in the embedding space of a pre-trained foundation model and represents the dataset through difference vectors between samples. We evaluate whether the weight vector of a linear classifier can be expressed within the subspace spanned by these variations by measuring the relative projection error. Intuitively, if the variations induced by synthetic data capture task-relevant directions, their span can approximate the classifier, resulting in low projection error. Conversely, poor synthetic data fails to span these directions, leading to higher error. Across multiple datasets and architectures, we show that this metric exhibits strong correlation with downstream classification performance of CNNs trained on mixtures of real negative and synthetic positive data. These findings suggest that the proposed metric serves as a practical and informative tool for evaluating synthetic data quality in data-scarce settings.

24.
arXiv (math.PR) 2026-06-18

Geometric obstructions to Lipschitz transport between weighted Hessian $\mathrm{CD}(\kappa,\infty)$ manifolds

arXiv:2606.11085v2 Announce Type: replace Abstract: We construct a weighted Riemannian manifold $(\mathbb R^2,g,\mu)$ satisfying $\mathrm{CD}(1/2,\infty)$, the curvature-dimension condition, with the following property: if $\gamma$ denotes a centered Gaussian measure on $\mathbb R^2$, then there is no Lipschitz map $T:(\mathbb R^2,\|\cdot\|) \to (\mathbb R^2,g)$ satisfying $T_\#\gamma=\mu$. Building on this, we prove a Weyl-type asymptotic law for the eigenvalues of the weighted Laplacian $-\Delta_{g,\mu}$ and show that they are asymptotically negligible when compared to the eigenvalues of $-\Delta_{\gamma}$. These results give strong counterexamples to two questions of E. Milman and complement the recent counterexample of Aryan.

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

SkillWiki: A Living Knowledge Infrastructure for Agent Skills

While knowledge is managed through Wikipedia and software through GitHub, agent skills still lack an infrastructure for large-scale production, governance, and evolution. SkillWiki is a living knowledge infrastructure that supports the organization, grounding, and continuous evolution of agent skills by transforming heterogeneous knowledge into reusable skill assets linked to their originating evidence. Our demonstration presents the complete skill lifecycle, from knowledge ingestion and skill production to provenance-aware exploration, governance, and execution-driven evolution. SkillWiki highlights a future in which knowledge, skills, and execution experience co-evolve within a shared infrastructure. The live demonstration and source code are publicly available at https://github.com/Huangdingcheng/SkillWiki.