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01.
bioRxiv (Bioinfo) 2026-06-19

Identification of Altered Potassium Channels for Drug Repurposing in Long COVID Patients

Long COVID (LC) is a complex condition characterized by persistent, chronic multisystem manifestations, with a significant proportion of patients exhibiting neurological symptoms. Human ion channels (HICs), particularly potassium channels, are abundantly expressed in the nervous system and linked to key metabolic processes, making them potential candidates for understanding LC pathophysiology and drug repurposing. Meta-analysis of RNA-Seq datasets from COVID-19 recovered and LC patients was performed to identify altered HICs in LC. Differential gene expression analysis, functional enrichment analysis, and weighted gene co-expression network analysis (WGCNA) were performed to uncover key genes, pathways, and co-expression modules consisting of HICs, lipid metabolism-, and immune signaling-related genes. Drug-gene interaction analysis was performed to identify approved drugs targeting potential HICs. A total of 715 dysregulated genes, including eighteen HICs were identified, among which seven were potassium channels. Three significant modules containing HICs, lipid metabolism-, and immune signaling-related genes were identified and found to be associated with antigen processing and presentation, complement and coagulation cascades, and cytokine-related pathways. Approved drugs targeting KCNA6, KCNJ10, KCNN3, and KCNH4 were identified. With further experimental validation, these dysregulated potassium channels, supported by their co-expression networks and pathway associations, may act as potential candidates for drug repurposing in LC patients.

02.
arXiv (CS.LG) 2026-06-11

On Subquadratic Architectures: From Applications to Principles

arXiv:2606.12364v1 Announce Type: new Abstract: Transformers dominate modern sequence modeling, but their quadratic attention incurs substantial computational cost. Subquadratic architectures offer a scalable alternative. However, it remains unclear which designs yield the most effective sequence models. We compare three leading approaches: xLSTM, Mamba-2, and Gated DeltaNet. We evaluate these models on tasks with complex dependencies: (1) code-model pre-training, (2) distillation of code models from large language models, and (3) pre-training of time-series foundation models. Across these settings, xLSTM delivers the strongest overall performance. To explain xLSTM's advantage, we present a unified formulation and analyze the underlying architectural mechanisms, focusing on state tracking and memory dynamics. Our results show that xLSTM enables more flexible and stable memory correction via its gating scheme. We corroborate these findings on controlled synthetic length-generalization tasks. Overall, our findings indicate that xLSTM's gains on complex tasks stem from robust state tracking and accumulation.

03.
arXiv (CS.LG) 2026-06-12

Majority-of-Three is Optimal

arXiv:2606.13614v1 Announce Type: cross Abstract: We give a short proof that the majority vote of three independent consistent classifiers is an optimal learner in the realizable PAC setting. This proves optimality for the simplest voting scheme, while simplifying both the algorithmic structure and the probabilistic analysis of previous voting learners, including the algorithm of S. Hanneke and the analysis of bagging by K. Green Larsen.

04.
medRxiv (Medicine) 2026-06-15

Diabetes and the Life-Course: Evidence from Panel Data and Electronic Health Records

Incidence of type 2 diabetes is increasing at ages when education, work, family, and financial transitions are taking place, yet we lack robust evidence of whether earlier treatment changes life-course outcomes and over which time span this takes place. This paper uses the medical cutoff for diabetes diagnosis (HbA1c of 6.5 percent) as a natural experiment to study the effects of diabetes treatment using electronic health records (EHR) and panel data. This paper has three main findings. First, using EHR data, we find that there is a sharp increase in the probability of both diagnosis of diabetes and prescription when the HbA1c equals 6.5 percent. Second, we find that treating diabetes reduces HbA1c levels, weight, BMI, and blood pressure and increases the amount of care received, proxied by the number of HbA1c tests. Both the diagnosis and a prescription are independently able to produce positive changes in metabolic health, although a prescription is more effective in this regard. Third, we conclude that treating diabetes does not have a significant effect on life-course outcomes for a cohort of young Americans aged 24-32, although it does result in a reduction in HbA1c levels that are seen even eight years after the intervention. Taken together, these findings suggest that receiving a diagnosis and prescription are both effective treatments for diabetes, but they do not translate to significant alterations in the lives of young adults in the medium-term.

05.
medRxiv (Medicine) 2026-06-10

Human-centred design approaches to health facility design: Evidence from perinatal care settings in Ethiopia and Bangladesh

While significant progress has been made in perinatal outcomes over recent decades in low- and middle-income countries (LMICs), maternal and newborn quality improvement initiatives often fail to account for the spatial conditions in which they are implemented. Health systems are increasingly deploying evidence-based care models into built environments that are not optimally structured to meet the needs of its patient population. As the principal users, patients and health care workers can offer pragmatic insights about improving these structural designs. Our objective was to gather insights from patients, providers, and companions about how the physical design of their health facilities influenced their experience receiving or delivering perinatal care. We conducted a prospective observational study using a human-centred design (HCD) approach to analyse perceptions of the quality of perinatal care across two low resource settings: Ethiopia and Bangladesh. Using engagement and assessment tools, we conducted interviews, focus groups, facility walk-throughs, co-design workshops, and infrastructural assessments with patients, companions, providers, and Ministry of Health representatives. Descriptive statistics and thematic analysis were used to identify key learnings and develop recommendations. Across both countries, participants identified the need for facility layouts that better support privacy, mobility during labour, alternative birth positions, companion involvement, cultural and religious practices, sanitation, and provider visibility. Based on these insights, we developed six recommendations to better align health facility infrastructure with maternal and newborn care delivery needs. Our findings suggest that investments in health facility infrastructure may improve care experiences and help enable respectful, safe, and evidence-based maternal and newborn care. Alongside targeted spatial improvements, government authorities responsible for health facility planning should incorporate participatory design processes to ensure infrastructure reflects the needs of patients, companions, and providers and supports high-quality care delivery.

06.
Nature (Science) 2026-06-10

Daily briefing: Ancient ground squirrels ate like ‘zombies of the Pleistocene’

作者:

Evidence from fossilized poo reveals the diverse diet of ancient ground squirrels. Plus, the science behind the peptide craze and our innate tendency to wander anticlockwise. Evidence from fossilized poo reveals the diverse diet of ancient ground squirrels. Plus, the science behind the peptide craze and our innate tendency to wander anticlockwise.

07.
arXiv (CS.AI) 2026-06-16

Adaptive inference and function vectors in deep transformers

arXiv:2606.16694v1 Announce Type: cross Abstract: Transformers are widely used as a general-purpose substrate for learning complex correlations between a large collection of coupled variables, but their internal mechanisms have remained mysterious. We introduce a theory of a deep transformer as a mean-field interacting system that implements distributed inference, subject to constraints on communication, locality and depth. We show that such a system can exploit internal state representations ('function vectors') to infer a latent context variable at increasingly finer scales over its layers. In an in-context regression task, the theory predicts a non-trivial relationship between non-Gaussian, hierarchical structure in the latent context variable, and transformer depth. Predictions are tested using constrained linear attention transformers and demonstrate adaptive inference in deep architectures. Feedforward blocks and depth enable transformers to implement a much richer class of in-context learning algorithms than previously described.

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

Gumbel-BEARD: Automatic Layer Selection for Self-Supervised Adaptation of Whisper in Low-Resource Domains

Speech foundation models often struggle in low-resource domains due to domain mismatch and data scarcity. We propose Gumbel-BEARD, a domain adaptation framework that automates Whisper encoder layer selection via an end-to-end trainable hard Gumbel-Softmax selector. It enables self-supervised adaptation with a BEST-RQ objective that dynamically adapts to target acoustic characteristics without manual tuning. Experiments on the MyST child speech corpus demonstrate efficiency and scalability: with 10 h of labeled data for fine-tuning, our method matches a fully supervised baseline trained on the complete 133 h labeled set. We establish new state-of-the-art word error rates (WERs) of 8.21% using Whisper-medium on MyST and 11.06% using Whisper-small on the OGI Spontaneous dataset. Evaluation on CORAAL further confirms robustness to adult dialectal domain shifts, with up to 6% relative WER reduction, highlighting the generalizability of our approach to diverse low-resource conditions.

09.
Nature (Science) 2026-06-17

Optical metasurfaces for general vision processing on the edge

作者:

Large-scale artificial intelligence (AI) models achieve notable performance in computer vision but require substantial computational resources, limiting their deployment on edge devices1,2. Optical neural networks (ONNs) promise reduced latency and energy consumption by making use of the inherent parallelism of light3. However, present ONNs struggle to scale and are confined to simple tasks, owing to the challenges of replicating exact algebraic operations of digital models using physical (analogue) systems. This work introduces a new paradigm that directly embeds core computer vision principles, including similarity-based recognition, attention-guided perception and detail–context fusion, into a large-scale optical metasurface. By unifying optical physics with these computer vision fundamentals, we develop a photonic–electronic engine that overcomes scalability and generality barriers, enabling high-accuracy, general-purpose computer vision at the edge. The resulting system combines a 41-million-parameter optical metasurface front end with a co-designed, ultraefficient 87,000-parameter digital back end, outperforming many digital models with tens of millions of parameters across object detection, segmentation, 3D reconstruction and video understanding. We build a deployable prototype and demonstrate real-time edge visual processing in natural scenes. This work represents a path towards practical optical computing for general vision tasks in complex natural environments, enabling a new paradigm for low-energy, low-latency, real-time on-device vision intelligence. By embedding core computer vision principles into a large-scale optical metasurface, an efficient vision processing system using far fewer parameters is demonstrated to outperform many digital models and enables deployment on edge devices.

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

Grammar of the Wave: Towards Explainable Multivariate Time Series Event Detection via Neuro-Symbolic VLM Agents

arXiv:2603.11479v3 Announce Type: replace-cross Abstract: Time Series Event Detection (TSED) aims to localize semantically meaningful events in time series data, with critical applications in high-stakes domains. Unlike statistical anomalies, events are often defined by natural-language descriptions with internal temporal-logic structures across multiple physical channels. However, in real-world settings, dense event annotations are expensive to obtain, making purely supervised learning difficult. We introduce Language-guided TSED, a setting where a model is given textual event descriptions and must ground them to intervals in multivariate signals with little or no labeled data. To address this problem, we propose Event Logic Tree (ELT), a knowledge representation framework that converts linguistic descriptions into structured temporal logic over signal primitives. Building on ELT, we present SELA, a neuro-symbolic VLM agent framework that iteratively grounds primitives from signal visualizations and composes them under ELT constraints, producing both event intervals and faithful tree-structured explanations. We further release a real-world benchmark across energy and climate domains with expert knowledge and annotations. Experiments show that SELA improves over supervised fine-tuning and existing zero/few-shot time series reasoning baselines.

11.
arXiv (CS.CL) 2026-06-16

When the Chain of Thought Knows Better: Failure Modes in Multi-Turn Reasoning Models

Failures in multi-turn reasoning models are largely invisible to terminal-score evaluation. A model can lock onto an unsafe stance early in a long dialogue, yet its final-turn refusal rate may appear indistinguishable from a robustly aligned baseline. To expose these hidden temporal dynamics, we propose a trace-level diagnostic - the CoT-Output 2x2 safety matrix. This framework labels every turn along two independent axes (internal reasoning and visible output), yielding four operationally defined failure cells: robust alignment, alignment faking, overt jailbreak, and a distinct failure mode we term context-injection failure (where the CoT maintains safe reasoning, but the visible output produces harm, highlighting a multi-turn manifestation of reasoning unfaithfulness). We evaluate three distilled reasoning targets against a fixed attacker across five oversight conditions, collecting 6750 turn-level observations on the Information-Hazard scenario. Our analysis reveals two reproducible vulnerabilities: an oversight paradox where explicit monitoring cues paradoxically increase alignment-faking rates rather than suppress them, and a context-injection failure where models lock onto unsafe external outputs despite safe internal states. We release the full dataset of multi-turn dialogues and CoT traces to support follow-up trace-diagnostic research.

13.
arXiv (CS.AI) 2026-06-11

MoCA-Agent: A Market-of-Claims Code Agent for Financial and Numerical Reasoning

arXiv:2606.11537v1 Announce Type: new Abstract: Financial and tabular question answering requires more than fluent reasoning: answers must be grounded in the exact facts, formulas, units, signs, and scales that support them. A single misread cell or incorrect operation can silently produce a plausible but wrong result. We introduce \textsc{MOCA-Agent}, a market-of-claims code agent that replaces free-form multi-agent debate with claim-level verification. The system decomposes each question into typed atomic claims, asks specialist trader agents to buy or sell those claims, clears their orders into confidence-weighted accept/reject decisions, and synthesizes an executable Python program from market-supported evidence. A code-aware verifier then checks the program for execution, structural consistency, and common financial reasoning errors, with at most one market-aware repair round. Across ten public benchmarks spanning financial numerical reasoning, general tabular reasoning, ESG question answering, and multimodal chart reasoning, \textsc{MOCA-Agent} achieves strong performance using a fixed Qwen3.6-27B backbone, including $78.3\%$ on FinQA, $76.0\%$ on FinanceMath, $71.2\%$ on MultiHiertt, $86.9\%$ on ESGenius, and $85.6\%$ average on FinChart-Bench. These results show that aggregating evidence at the level of atomic claims, rather than whole answers, improves robustness in high-stakes numerical reasoning.\footnote{The code and data are available: https://github.com/UBC-NLP/MoCA-Agent.

14.
arXiv (quant-ph) 2026-06-12

Resourcefulness of non-classical continuous-variable quantum gates

arXiv:2410.09226v4 Announce Type: replace Abstract: In continuous-variable quantum computation, identifying key elements that enable a quantum computational advantage is a long-standing issue. Starting from the standard results on the necessity of Wigner negativity, we develop a comprehensive and versatile approach in which the techniques of $(s)$-ordered quasiprobabilities are exploited to provide rigorous statements on the simulability of photonic quantum circuits consisting of previously characterized gates and thereby identifying the contribution of each quantum gate to the potential achievement of quantum computational advantage. This is achieved by means of an analysis of the so-called transfer function, allowing us to highlight the resourcefulness of a gate set. As such this technique can be straightforwardly applied to current continuous-variables quantum circuits, while also constraining the tolerable amount of losses above which any potential quantum advantage can be ruled out. We use $(s)$-ordered quasiprobability distributions on phase-space to capture the non-classical features in the protocol, and focus our technique entirely on the ordering parameter $s$. This allows us to highlight the resourcefulness and robustness to loss of a universal set of unitary gates comprising three distinct Gaussian gates and any non-Gaussian unitary gate, providing important insight on the role of non-Gaussianity.

15.
arXiv (CS.CV) 2026-06-17

Neural Tree Reconstruction for the Open Forest Observatory

The Open Forest Observatory (OFO) is a collaboration across universities and other partners to make low-cost forest mapping accessible to ecologists, land managers, and the general public. The OFO is building both a database of geospatial forest data as well as open-source methods and tools for forest mapping by uncrewed aerial vehicle. Such data are useful for a variety of climate applications including prioritizing reforestation efforts, informing wildfire hazard reduction, and monitoring carbon sequestration. In the current iteration of the OFO's forest map database, 3D tree maps are created using classical structure-from-motion techniques. This approach is prone to artifacts, lacks detail, and has particular difficulty on the forest floor where the input data (overhead imagery) has limited visibility. These reconstruction errors can potentially propagate to the downstream scientific tasks (e.g. a wildfire simulation.) Advances in 3D reconstruction, including methods like Neural Radiance Fields (NeRF), produce higher quality results that are more robust to sparse views and support data-driven priors. We explore ways to incorporate NeRFs into the OFO dataset, outline future work to support even more state-of-the-art 3D vision models, and describe the importance of high-quality 3D reconstructions for forestry applications.

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

Multi-Modal Agents for Power Distribution Defect Detection: An Evaluation of Foundation Models

作者:

arXiv:2606.12969v1 Announce Type: new Abstract: The power distribution network is critical to reliable electricity delivery, yet traditional inspection methods face limitations in semantic understanding, generalization, and closed-loop automation. To address these challenges, this paper proposes a Multi-Modal Agent framework specifically for power distribution defect detection. Central to this study is the systematic evaluation of multimodal foundation models as unified cognitive engines. We rigorously assess their integrated performance across three critical capabilities: (1) Perception, where the model must accurately identify equipment and generate expert-level descriptions of defects; (2) Reasoning, where the model interprets visual findings to diagnose causes, assess severity, and plan maintenance strategies based on domain knowledge; and (3) Tool Usage, where the model acts as an autonomous operator to execute actions – such as querying knowledge bases or generating work orders – to achieve closed-loop maintenance. To support this evaluation, a domain-specific evaluation dataset and a comprehensive benchmark are developed. Experimental results demonstrate the strengths and limitations of current foundation models in these three dimensions, providing empirical evidence for deploying autonomous agents in high-stakes industrial environments.

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

{\alpha}-Fair Insurance Pricing: A Fairness Continuum

arXiv:2606.14898v1 Announce Type: new Abstract: Fairness in insurance pricing remains a long-standing and deeply debated puzzle. On one hand, insurers, driven by profitability considerations, set premiums that differentiate across individual risks to achieve actuarial fairness. On the other hand, insurance serves a critical societal function by pooling risks across a population, motivating cross-subsidization among groups to promote solidarity fairness. The tension between these two competing notions of fairness makes insurance pricing inherently complex, particularly in modern settings where granular data allow for increasingly fine risk differentiation and regulators face growing pressure to protect vulnerable groups. To address this challenge, we propose an $\alpha$-Fair Individual Solvent Premium ($\alpha$-FISP) framework for insurance pricing that explicitly captures the trade-off between actuarial and solidarity fairness while guaranteeing solvency, a fundamental requirement in insurance operations. We formulate the pricing problem as a constrained optimization task, where actuarially fair premiums are adjusted subject to budget constraints on cross-subsidization within each risk class. This formulation naturally yields a family of solutions parameterized by $\alpha$, tracing a continuum between purely actuarial and purely solidarity-based pricing and enabling decision-makers to select an operating point along this fairness spectrum. We derive theoretical guarantees for the proposed framework. Numerical experiments show that $\alpha$-FISP is computationally tractable and aligns well with the U.S. regulatory regimes featuring heterogeneous state-level fairness requirements.

18.
arXiv (CS.AI) 2026-06-17

KANLib – An Modular, Extensible and Fast Kolmogorov-Arnold Network Implementation

arXiv:2606.17927v1 Announce Type: cross Abstract: Kolmogorov-Arnold Networks (KANs) have recently emerged as a promising alternative to traditional multilayer perceptrons by replacing linear weights with learnable univariate functions. Despite their theoretical advantages in interpretability and expressiveness, practical research of KANs remains difficult due to high computational costs and inconsistent feature support across existing frameworks. This paper introduces KANLib, a modular, extensible, and computationally efficient framework for developing and evaluating KAN architectures. KANLib unifies core concepts from existing implementations, including PyKAN, EfficientKAN, and FastKAN, within a consistent software architecture that emphasizes flexibility, feature parity, and high performance. The framework supports two basis function types, adaptive grid rescaling, grid extension, and fine-grained architectural customization while maintaining compatibility with standard PyTorch workflows. Experimental evaluation on the California Housing benchmark demonstrates that KANLib reproduces the predictive behavior of established reference KAN implementations while achieving competitive computational efficiency. Furthermore, the framework enables the exploration of architectural variations beyond standard KAN formulations with only minor impacts on predictive performance. Overall, KANLib provides a robust foundation for future research on scalable and extensible KAN architectures.

19.
medRxiv (Medicine) 2026-06-16

Daily Healthy Eating Index (HEI-2020) scoring reveals diet quality patterns masked by aggregation

The Healthy Eating Index (HEI-2020) is conventionally computed by aggregating intake across days before scoring. Digital food logging enables an alternative: scoring each day and averaging daily scores. These methods are not equivalent. The HEI's density-based structure and component caps cause aggregation to inflate adequacy scores when intake is irregular. Using Food & You data, we show daily HEI correlates more strongly with microbiome diversity, and recommend co-reporting both metrics.

20.
arXiv (CS.CV) 2026-06-17

Flash-GRPO: Efficient Alignment for Video Diffusion via One-Step Policy Optimization

Group Relative Policy Optimization has emerged as essential for aligning video diffusion models with human preferences, but faces a critical computational bottleneck: training a 14B parametered model typically demands hundreds of GPU days per experiment. Existing efficiency methods reduce costs through sliding window subsampling training timesteps, but fundamentally compromise optimization, exhibiting severe instability and failing to reach full trajectory performance. We present Flash-GRPO, a single-step training framework that outperforms full trajectory training in alignment quality under low computational budgets while substantially improving training efficiency. Flash-GRPO addresses two critical challenges: iso-temporal grouping eliminates timestep-confounded variance by enforcing prompt-wise temporal consistency, decoupling policy performance from timestep difficulty; temporal gradient rectification neutralizes the time-dependent scaling factor that causes vastly inconsistent gradient magnitudes across timesteps. Experiments on 1.3B to 14B parameter models validate Flash-GRPO's effectiveness, demonstrating substantial training acceleration with consistent stability and state-of-the-art alignment quality.

21.
arXiv (CS.CV) 2026-06-18

How far have we gone in Generative Image Restoration? A study on its capability, limitations and evaluation practices

Generative Image Restoration (GIR) has achieved impressive perceptual realism, but how far have its practical capabilities truly advanced compared with previous methods? To answer this, we present a large-scale study grounded in a new multi-dimensional evaluation pipeline that assesses models on detail, sharpness, semantic correctness, and overall quality. Our analysis covers diverse architectures, including diffusion-based, GAN-based, PSNR-oriented, and general-purpose generation models, revealing critical performance disparities. Furthermore, our analysis uncovers a key evolution in failure modes that signifies a paradigm shift for the perception-oriented low-level vision field. The central challenge is evolving from the previous problem of detail scarcity (under-generation) to the new frontier of detail quality and semantic control (preventing over-generation). We also leverage our benchmark to train a new IQA model that better aligns with human perceptual judgments. Ultimately, this work provides a systematic study of modern generative image restoration models, offering crucial insights that redefine our understanding of their true state and chart a course for future development.

22.
arXiv (quant-ph) 2026-06-15

Certifying Macroscopic Quantum Mechanics via Hypothesis Testing with Finite Data

arXiv:2506.22092v2 Announce Type: replace Abstract: We address the challenge of certifying quantum behavior with single macroscopic massive particles, subject to decoherence and finite data. We propose a hypothesis testing framework that distinguishes between classical and quantum mechanics based on position measurements. While interference pattern visibility in single-particle quantum superposition experiments has been commonly used as a sufficient criterion to falsify classical mechanics, we show that, from a hypothesis testing perspective, it is neither necessary nor efficient. Focusing on recent proposals to prepare macroscopic superposition states of levitated nanoparticles, we show that the likelihood ratio test – which leverages differences across the entire probability distribution – provides an exponential reduction in measurements needed to reach a given confidence level. These results generalize to a broad class of quantum states, and offer a principled, efficient method to falsify classical mechanics in interference experiments, relaxing the experimental constraints faced by current efforts to test quantum mechanics at the macroscopic scale.

23.
arXiv (quant-ph) 2026-06-19

Transfer-matrix functions for algebraically decaying interactions in variational infinite matrix product states

作者:

arXiv:2606.20522v1 Announce Type: cross Abstract: Variational infinite matrix product state (iMPS) calculations usually make Hamiltonians with algebraically decaying interactions compatible with standard MPO algorithms by first replacing the target Hamiltonian with a finite-pole sum-of-exponentials surrogate, thereby introducing a Hamiltonian-representation residual. We formulate the fixed-$D$ variational energy without introducing such a surrogate. For a fixed finite-$D$ MPS, the algebraic tail can be summed directly through the connected transfer matrix: the tail $e^{\mathrm{i} Qr}/r^\alpha$ is represented by the matrix function $F_{\alpha,Q}(\widetilde{T}_A)$, with $F_{\alpha,Q}(z)=\operatorname{Li}_\alpha(e^{\mathrm{i} Q}\,z)/z$. We evaluate the resulting matrix-function action using a Krylov method and obtain stable gradients by combining a Fréchet adjoint with implicit fixed-point differentiation. Benchmarks on long-range free fermions and the inverse-square Heisenberg family, including the Haldane–Shastry point, validate the transfer-matrix-function formulation. A long-range Ising-chain calculation illustrates a practical consequence of avoiding a finite-pole Hamiltonian representation. At a fixed, independently known critical field, finite-pole surrogate Hamiltonians can bias a critical diagnostic away from criticality, whereas the matrix-function calculation retains the expected critical signatures of the target algebraic Hamiltonian.

24.
medRxiv (Medicine) 2026-06-15

Filum Terminale Diameter on Routine Pediatric MRI: A Large-Cohort Clinical Reference in 3,406 Children and the Age-Dependent Meaning of the 2-mm Thickened-Filum Threshold

Background. A filum diameter >2 mm is the conventional MRI threshold for a thickened filum, but it derives from small, mostly adult series showing no age dependence; whether one cutoff suits all of childhood is untested. Objective. To build an age-specific filum-diameter reference on routine pediatric MRI and test, adjusting for image resolution, whether the 2-mm threshold is age-stationary. Materials and methods. In this retrospective study an nnU-Net tracer measured the maximal filum diameter on consecutive lumbosacral MRI; versus manual tracing it showed negligible bias but moderate single-measure agreement. After excluding report-confirmed fatty filum, lipoma, or tethered cord, the proportion >2 mm was analysed within one acquisition protocol and by logistic regression adjusting for voxel size and slice thickness. Results. Of 7,245 examinations, 3,869 (53%) were traceable; untraced ones were younger (median 0.75 vs 2.0 years). The presumed-normal cohort had median diameter 1.48 mm. At matched resolution, 2 mm marked the 94th percentile in infants (5.6% exceeded it) but the 83rd by 3-6 years (17.4%); the age effect persisted after adjusting for voxel size and slice thickness (3-6 years vs infants, adjusted OR 4.7; P < .001). Conclusion. Filum diameter clusters near 1.5 mm, and the fixed 2-mm cutoff flags ~5% of infants but ~17% of preschoolers. Caliber should be judged against an age-specific clinical reference, not one fixed cutoff; a thick filum is not itself a diagnosis of tethered cord.

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

Federated Medical Image Segmentation under Real-World Label Noise: A Benchmark Suite for Noisy Label Learning Method Selection

While federated learning (FL) enables collaborative medical image segmentation without centralizing sensitive data, real-world deployment is frequently complicated by cross-site label imperfections such as contour disagreement, missing or additional structures, and confused labels. Federated noisy label learning (FNLL) aims to mitigate these effects, yet remains underused in practice as existing evidence is largely based on synthetic noise, simplified settings, and limited real-world noisy evaluation. We address this gap by introducing a benchmark suite that combines diverse real-world noisy datasets, deployment-relevant client-noise scenarios, and label-noise-targeted evaluation to support systematic FNLL assessment and informed method selection. The suite combines curated real-world noisy medical image segmentation datasets from diverse sources with a comprehensive federated segmentation framework including various client-noise scenarios and noise-targeted evaluation. The presented suite provides a realistic and discriminative basis for FNLL evaluation in medical image segmentation and establishes a reusable foundation for fair benchmarking, dataset-specific label-noise characterization, and future method development under realistic federated settings. Code is available at https://github.com/MIC-DKFZ/FedSegNoiseBench.