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01.
arXiv (CS.LG) 2026-06-18

Provable quantum speedups for computing persistence in topological data analysis

arXiv:2410.21258v2 Announce Type: replace-cross Abstract: Topological data analysis (TDA) aims to extract noise-robust features from a data set by examining the number and persistence of holes in its topology. We provide an efficient quantum algorithm for a computational problem closely related to a core task in TDA – determining whether a given hole persists across different length scales. Further, we prove the problem itself is $\mathsf{BQP}_1$-hard, implying that a classical solution is extremely unlikely; this stands in contrast to all previous quantum approaches to TDA, where the problems were also intractable for quantum computers, or where a rigorous proof of classical hardness still remains open. This result implies an {exponential} quantum speedup for this problem under standard complexity-theoretic assumptions. Our approach relies on encoding the persistence of a hole in a variant of the guided sparse Hamiltonian problem, where the guiding state is constructed from a harmonic representative of the hole.

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

Robust Local Polynomial Regression with Similarity Kernels

arXiv:2501.10729v3 Announce Type: replace-cross Abstract: Local Polynomial Regression (LPR) is a widely used nonparametric method for modeling complex relationships due to its flexibility and simplicity. It estimates a regression function by fitting low-degree polynomials to localized subsets of the data, weighted by proximity. However, traditional LPR is sensitive to outliers and high-leverage points, which can significantly affect estimation accuracy. This paper revisits the kernel function used to compute regression weights and proposes a novel framework that incorporates both predictor and response variables in the weighting mechanism. The focus of this work is a conditional density kernel that robustly estimates weights by mitigating the influence of outliers through localized density estimation. The proposed method is implemented in Python and is publicly available at https://github.com/yaniv-shulman/rsklpr. The population analysis quantifies the bias induced by density-based robust weighting, and the reported experiments show lower empirical bias than iterative robust LOWESS while remaining competitive with standard LOWESS. This advancement provides a promising extension to traditional LPR, opening new possibilities for robust regression applications.

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

Fair Online Resource Allocation

arXiv:2606.18679v1 Announce Type: cross Abstract: We study the problem of fair online resource allocation, motivated by applications such as refugee resettlement and airline scheduling, where agents arrive sequentially and must be assigned to facilities with limited capacities. We introduce a model that maximizes the overall welfare subject to resource constraints and a Lipschitz fairness requirement, which ensures that similar agents arriving in the same batch receive similar expected outcomes. We first analyze the offline problem, proving that the value of the optimal fair allocation is at least an $\Omega(1/\gamma)$ fraction of the optimal unfair allocation, where $\gamma$ is the fairness coefficient, thereby bounding the price of fairness. For the online setting, we propose an algorithm based on dual mirror descent that enforces fairness constraints within batches while estimating optimal dual variables. We prove that this algorithm achieves sublinear regret relative to the optimal offline fluid benchmark. Finally, we validate our theoretical results using real-world data from the Refugee Economies Programme, demonstrating the algorithm's performance and examining the trade-offs between welfare maximization and fairness enforcement.

04.
arXiv (CS.AI) 2026-06-18

Explaining Attention with Program Synthesis

arXiv:2606.19317v1 Announce Type: cross Abstract: A longstanding goal of research on interpretable deep learning is to replace opaque neural computations with human-meaningful symbolic descriptions. In this paper, we propose an approach for approximating the behavior of components of deep networks with executable programs. We focus on attention heads in transformer language models. For a given head, we first compute its associated attention matrices on a collection of randomly selected training examples. Next, we prompt a pre-trained language model with a summary of these matrices, and instruct it to generate a set of Python programs that can reproduce the associated attention patterns given only text from the input sentence. Finally, we re-rank programs according to how well our final set of programs predict behavior on held-out inputs. We demonstrate that a set of fewer than 1,000 such generated programs can reproduce the attention patterns of heads in GPT-2, TinyLlama-1.1B, and Llama-3B, achieving an average Intersection-over-Union similarity above 75% on TinyStories. Moreover, the best-fit programs can replace neural attention heads without substantially affecting model behavior: replacing 25% of attention heads with programmatic surrogates across the three models incurs only a 16% average perplexity increase, while maintaining performance on a variety of downstream question answering benchmarks. This work contributes a scalable pipeline for reverse-engineering attention heads in transformer models using human-readable, executable code, advancing a path toward symbolic transparency in neural models.

05.
arXiv (quant-ph) 2026-06-15

Who can compete with quantum computers? Lecture notes on quantum inspired tensor networks computational techniques

arXiv:2601.03035v2 Announce Type: replace Abstract: This is a set of lectures on tensor networks with a strong emphasis on the core algorithms involving Matrix Product States (MPS) and Matrix Product Operators (MPO). Compared to other presentations, particular care has been given to disentangle aspects of tensor networks from the quantum many-body problem: MPO/MPS algorithms are presented as a way to deal with linear algebra on extremely (exponentially) large matrices and vectors, regardless of any particular application. The lectures include well-known algorithms to find eigenvectors of MPOs (the celebrated DMRG), solve linear problems, and recent learning algorithms that allow one to map a known function into an MPS (the Tensor Cross Interpolation, or TCI, algorithm). The lectures end with a discussion of how to represent functions and perform calculus with tensor networks using the "quantics" representation. They include the detailed analytical construction of important MPOs such as those for differentiation, indefinite integration, convolution, and the quantum Fourier transform. Three concrete applications are discussed in detail: the simulation of a quantum computer (either exactly or with compression), the simulation of a quantum annealer, and techniques to solve partial differential equations (e.g. Poisson, diffusion, or Gross-Pitaevskii) within the "quantics" representation. The lectures have been designed to be accessible to a first-year PhD student and include detailed proofs of all statements.

06.
bioRxiv (Bioinfo) 2026-06-17

DNA-binding specificity recognition from predicted homologous protein-DNA structures

Predicting protein DNA-binding specificity is essential for understanding gene regulation and disease mechanisms. Existing deep learning methods typically infer specificity from a single protein-DNA complex structure, which limits their ability to capture the diverse geometric patterns underlying protein-DNA recognition. Homologous protein-DNA interfaces provide complementary structural evidence and richer geometric features related to interatomic interactions. To address the limited diversity and coverage of experimentally determined complexes, we constructed a large-scale library of predicted homologous protein-DNA complex structures. Building on this resource, we propose HomoDSP, a template-retrieval-based framework for accurate DNA-binding specificity prediction. Benchmark evaluations and validation on newly released JASPAR 2026 samples indicate that HomoDSP outperforms existing methods in both accuracy and generalization, with particularly substantial gains on high-error samples. Moreover, this performance is largely retained when AlphaFold3-predicted complex structures are used as input. Template- and residue-level interpretability analyses suggest that HomoDSP improves prediction by focusing on DNA-affinity residues across multiple homologous templates. Finally, universal Protein Binding Microarrays evaluations on AI-designed DNA-binding proteins show that HomoDSP rescues a baseline failure mode in which the baseline method produces incorrect predictions because of training-set bias. Together, these results support the use of homologous template interfaces as informative structural priors for decoding protein DNA-binding specificity.

07.
arXiv (CS.LG) 2026-06-17

Noise-Driven Exploration and Transient Freezing Select Flat Minima in Stochastic Gradient Descent

arXiv:2601.10962v2 Announce Type: replace Abstract: Stochastic gradient descent (SGD) is central to deep learning, yet the dynamical origin of its preference for flatter, more generalizable solutions remains unclear. Here, by analyzing SGD learning dynamics, we identify a nonequilibrium mechanism that governs solution selection during training. Numerical experiments reveal a transient exploratory phase in which SGD trajectories repeatedly escape sharp valleys and migrate toward flatter regions of the loss landscape before becoming confined to a final basin. Using a tractable physical model, we show that SGD noise reshapes the loss landscape into an effective potential that preferentially stabilizes flat solutions. We further uncover a transient freezing mechanism: as training progresses, the flattening landscape suppresses transitions between competing valleys. Stronger SGD noise delays this freezing transition, prolonging the exploratory phase and thereby increasing the probability of convergence to flatter minima. Together, these results provide a unified physical framework connecting learning dynamics, loss-landscape geometry, and generalization, and suggest guiding principles for the design of more effective optimization algorithms.

08.
arXiv (CS.CV) 2026-06-18

ProductConsistency: Improving Product Identity Preservation in Instruction-Based Image Editing via SFT and RL

Recent advances in instruction-based image editing have enabled models to perform complex visual edits from natural language instructions. However, in product-centric scenarios where preserving product features, branding, and textual elements are critical, current open and closed source models often struggle to maintain this fine-grained object identity. This issue is further compounded by the lack of datasets for instruction-based product image editing with text fidelity constraints, leaving it largely treated as an implicit capability of instruction-based image editing models. In this work, we introduce the ProductConsistency dataset which is designed to improve product-centric image editing. Our approach includes a supervised fine-tuning (SFT) dataset of 87k samples for product editing, a reinforcement learning (RL) dataset with 869 unique product images, and a new benchmark dataset, the ProductConsistency Benchmark, to allow rigorous and standardized evaluation of editing models. To guide RL training, we propose a Cyclic Consistency reward that enforces semantic preservation of product identity by using caption similarity between the original product description and captions generated from the edited image. We fine-tune both Qwen-Image-Edit-2511 and Flux.1-Kontext-dev using our dataset and demonstrate consistent improvements over baseline models in OCR and Perceptual metrics, and MLLM-based evaluations as well, indicating stronger product consistency, text rendering, and overall visual quality; with the Qwen-Image-Edit-2511 model achieving a 5x reduction in the character error rate. The code and pipeline is available at https://anonymous.4open.science/r/ProductConsistency-6FCC/README.md

09.
arXiv (math.PR) 2026-06-17

Limit theorems for descents and inversions of shelf-shuffles

arXiv:2510.00343v2 Announce Type: replace Abstract: We prove central limit theorems for the number of descents and inversions of permutations produced by shelf-shuffles. These are a model for casino card shuffling machines. We show the asymptotic normality of the number of descents in two limiting regimes depending on the ratio of cards to shelves. On the other hand, we study the inversions by employing a modification of the techniques from Islak's analysis of the statistics of riffle shuffles. In particular, we obtain a bound for the rate of convergence for inversions that is independent of the number of shelves.

10.
arXiv (CS.CV) 2026-06-19

GEN-Guard: Correcting Generalization Failures for Deployable Federated Surgical AI

Federated Learning (FL) in surgical video AI enables collaborative model training without sharing sensitive data. However, standard evaluation practices - selecting the "best" global model based only on validation data from participating hospitals - can lead to suboptimal deployment choices. We identify this critical failure mode as performance leakage, where the selected model overfits internal federation data and fails to generalize to unseen institutions. We propose GEN-Guard, a practical post-hoc framework to detect and correct generalization failures in federated surgical AI. It integrates Generalization Detection via Client-Blocked Evaluation (CBE), which validates performance on isolated client distributions to prevent performance leakage, and Generalization Correction through Disagreement-Aware Distillation (DAD), which learns adaptive feature-level corrections for cross-institutional robustness. Both components operate after standard FL convergence while providing robust support for zero-shot adaptation to unseen environments. We first quantify the severity of performance leakage, observing Model Selection Failures (MSFs) exceeding 80% under standard evaluation. GEN-Guard is evaluated on two multi-center clinical challenges: surgical phase recognition in laparoscopic cholecystectomy and polyp segmentation in colonoscopy. Across both datasets, GEN-Guard consistently corrects these failures, improving in-federation F1 scores by up to 2 points, unseen-institution performance by up to 3 points, and worst-case institutional performance by 3-9 points. Performance leakage represents a systematic and previously under-recognized risk in federated surgical AI. GEN-Guard provides a practical solution for detecting and correcting such failures. By improving cross-institutional robustness and zero-shot generalization, it strengthens the reliability of FL for real-world surgical deployment.

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

MyPCBench: A Benchmark for Personally Intelligent Computer-Use Agents

Current benchmarks for computer-use agents evaluate models in impersonal environments. This leaves a gap between evaluation and deployment where personal assistants are expected to work across a user's whole digital life, including their context, historical data, and logged-in accounts. This gap is widest on web tasks, where live web evaluations cannot exercise sites that require logging in or personal information, the kind of site a real personal assistant has to drive. We introduce MyPCBench, which tests computer-use agents as personal assistants on a Linux desktop populated with 17 simulated real-world web applications and a full desktop stack, all seeded for one canonical persona, Michael Scott from The Office. We define 184 tasks in this environment, each inspired by a real request drawn from the OpenClaw community, and benchmark six closed and open-weight models with a uniform computer+bash tool surface. We find that the best model, Claude Opus 4.6, fully solves 55.4\% of the tasks, the only model above 50\%. Model failures cluster on tasks that span many applications and on long trajectories, where personalization stresses an assistant the most. We release the environment, task set, and agent harness at https://mypcbench.com.

12.
arXiv (quant-ph) 2026-06-11

Dark state spectroscopy in nonlinear waveguide quantum electrodynamics

arXiv:2606.11997v1 Announce Type: new Abstract: Quantum systems face a fundamental trade-off: they must remain decoupled from the environment to maintain long coherence times, yet they require interactions with the environment to be accessible for measurement. As a prime example, emitter arrays coupled to waveguides facilitate collective modes that, owing to interference, can suppress radiation into the waveguide. While complete destructive interference creates perfectly dark states with infinite lifetimes, their inherent decoupling makes them unmeasurable in standard waveguide quantum electrodynamics. Consequently, current approaches must rely on system non-idealities that permit measurement but limit the coherence times. In this work, we lift this limitation by proposing the use of weakly squeezed light generated in \{chi}(2) nonlinear waveguides for the spectroscopy of completely dark states. We show that the fluorescence spectrum probes transitions between the dressed dark states of the emitter array. This work paves the way towards the measurement and control of dark states, with applications for robust quantum memories, computation, and communication.

13.
arXiv (CS.LG) 2026-06-17

Adaptable Method for Crystal Design across Diverse Constraints and Objectives with Pretrained Property Predictors

arXiv:2410.08562v5 Announce Type: replace-cross Abstract: Advanced crystal design can accelerate materials discovery across applications from photovoltaics to spintronics. Practical design must satisfy multiple properties and physical constraints, yet existing machine-learning-based approaches to such design often depend on large datasets, retraining, or task-specific generators. Here, we show that direct predictor-guided gradient optimization enables data-efficient, constraint-rich crystal design by combining off-the-shelf predictors with site-wise element masks, template initialization, and task-specific losses. In perovskites, it outperformed generative and Bayesian baselines under three targets – band gap, formation energy, and tolerance factor – and two hard constraints. DFT assessment further showed band-gap targeting competitive with a leading generative model despite using predictors trained on roughly one-tenth of the data. By flexibly combining pretrained predictors with application-oriented masks and custom losses, the same framework supported half-metal design. Such modularity could help researchers and engineers translate diverse application requirements directly into optimized candidate crystals with minimal computational cost.

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

Efficient Reinforcement for Visual-Textual Thinking with Discrete Diffusion Model

RL-based post-training has been widely adopted to enable interleaved visual and textual reasoning in unified multimodal models capable of both text and image generation. However, most existing approaches are built upon autoregressive (AR) unified models, which require full image regeneration during visual reasoning. In this work, we demonstrate that multimodal discrete diffusion models are effective alternatives to AR models for reinforcement learning in interleaved reasoning, owing to their ability to perform efficient visual rollouts via localized visual editing rather than full image-token regeneration. This reduces rollout computation during GRPO by 26.9\% compared to AR baselines, with minimal performance drop. Despite the improved efficiency, we find that joint reward assignment, which employs a shared reward signal across modalities, introduces cross-modal interference between unrelated image and text token sequences during RL updates. To address this issue, we propose factorized reward assignment, a strategy that assigns rewards independently to text and vision segments. With factorized reward assignment, our RL approach achieves an 11.2% improvement over joint reward assignment and a 38.04% improvement over the base model.

15.
medRxiv (Medicine) 2026-06-15

Quantitative insights into the role of phages and plasmids in the persistence of nontuberculous mycobacteria in chloraminated drinking water

Nontuberculous mycobacteria (NTM) are opportunistic pathogens that persist in chloraminated drinking water systems, yet the roles of phages and plasmids in their persistence remain largely unexplored. Using genome-resolved and quantitative metagenomics, we characterized NTM, phages, prophages, and plasmids in a chloraminated building plumbing system. Bacterial metagenome-assembled genomes (MAGs) and viral operational taxonomic units (vOTUs) were quantified at mean concentrations of 8.41 * 10^7 and 8.00 * 10^8 copies/L, respectively, including seven NTM MAGs at a mean total concentration of 4.01 * 10^5 copies/L. NTM concentrations were highest at the site with the lowest bacterial and viral diversity. Predicted NTM-infecting virus concentrations were inversely related to NTM concentrations across sites, suggesting complex phage-host dynamics that warrant direct experimental investigation. NTM, putative phages, prophages, and plasmids encoded functions related to disinfectant tolerance, stress response, metal resistance, and secretion. These findings identify phage interactions, prophages, and plasmids as overlooked genomic and ecological dimensions of NTM persistence in engineered water systems.

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

Using Explainability as a Training-Time Reliability Signal for Efficient ECG Classification

arXiv:2606.12252v1 Announce Type: cross Abstract: Training deep neural networks for clinical time-series analysis is computationally demanding, yet many healthcare settings lack the resources required for repeated model development and deployment. This challenge is particularly evident in electrocardiogram classification, where large datasets and long training schedules make efficiency practically important. Progressive Data Dropout reduces training cost by excluding samples from gradient updates once they are learned, but it relies on model confidence and may retain samples that are difficult due to noise or ambiguity rather than useful signal. In this work, we introduce ERTS, an explainability-based reliability training signal for efficient ECG classification. ERTS uses explanation quality during training to distinguish between informative and unreliable uncertainty. Building on progressive data selection, we compute Grad-CAM attention maps for candidate samples and derive a focus score that measures whether model predictions are supported by coherent and localised patterns. Samples with low focus are filtered out, while those with meaningful attention are prioritised for gradient updates. We evaluate ERTS across three ECG datasets and multiple backbone architectures, showing consistent improvements in macro-F1 alongside reduced effective training cost. These results suggest that explanation quality can serve as a practical signal for improving both efficiency and reliability in clinical time-series learning. Code will be released.

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

Designing AI-Supported Focus Groups: A Role x Modality Playbook

arXiv:2606.11835v1 Announce Type: cross Abstract: Collecting participants' lived experiences is central to design research. Focus groups are uniquely valuable because participants not only share individual accounts but also respond to one another, surfacing comparison, disagreement, and collective sensemaking. However, focus groups are resource-intensive and highly sensitive to facilitation: moderators must probe for specificity, balance participation, manage topic flow, and sustain psychological safety, and subtle facilitation choices can shape what becomes salient. Recent HCI work and commercial meeting tools show that generative AI can scaffold live conversation through prompting, turn regulation, thematic mapping, and real-time summarization. Yet UXR teams lack a clear map of what these capabilities mean in focus groups and what methodological risks they introduce. We synthesize AI supports for live conversation and translate them into a focus-group-specific playbook organized by AI role (tool, co-host, host) and modality (text, voice, embodied).We synthesize prior work on AI-supported live conversation and propose a focus-group-specific playbook of AI supports organized by role (tool, co-host, host) and modality (text, voice, embodied). We characterize interactional trade-offs and identify open questions for evaluating AI-supported focus groups as methodological configurations.

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

CoBit: Language Modeling with Bitstream Diffusion

Diffusion language models (DLMs) promise parallel, order-agnostic generation, but on standard benchmarks they have historically lagged behind autoregressive models in sample quality and diversity. Recent continuous flow and diffusion approaches have narrowed this gap. In this work, we further close the autoregressive gap by modeling text as a continuous diffusion process over fixed-width binary bitstreams. We refer to the resulting model as CoBit (Continuous Bitstream Diffusion). Our approach represents semantic tokens as analog bit sequences and uses a matched-filter residual parameterization to isolate contextual learning from analytic independent-bit posteriors. Crucially, we adopt a stochastic sampler that applies Langevin-type corrections gated by the entropy-rate profile, concentrating stochasticity in high-information regions while remaining nearly deterministic elsewhere. On LM1B, our 130M-parameter model reaches a generative perplexity (GenPPL) of 59.76 at matched real-data entropy (4.31) using 256 neural function evaluations (NFEs), outperforming prior DLM baselines and reaching the autoregressive reference. On OpenWebText (OWT), our sampler establishes a new continuous-DLM Pareto frontier, achieving GenPPL 27.06 at entropy 5.26 using 4x fewer steps than previous 1024-NFE baselines. Scaling the same recipe to a 462M-parameter model (CoBit-M) further improves the OWT GenPPL-entropy frontier over the 130M model (CoBit-S) and over medium-scale continuous and discrete DLM baselines, reaching GenPPL 19.5 at entropy 5.40, near real-data entropy (5.44), and approaching pretrained GPT-2 Medium over the high-quality region. As an additional benefit, bitstream diffusion removes the O(V) vocabulary scaling bottleneck of standard DLMs: by predicting O(log V) bitwise logits via semantic bit-patching, it lowers memory and raises throughput, a scalable paradigm as vocabulary sizes grow.

19.
arXiv (CS.LG) 2026-06-16

GradPower: Powering Gradients for Faster Language Model Pre-Training

arXiv:2505.24275v4 Announce Type: replace Abstract: We propose GradPower, a lightweight gradient-transformation technique for accelerating language model pre-training. Given a gradient vector $g=(g_i)_i$, GradPower first applies the elementwise sign-power transformation: $\varphi_p(g)=(sign(g_i)|g_i|^p)_{i}$ for a fixed $p>0$, and then feeds the transformed gradient into a base optimizer. Notably, GradPower requires only a single-line code change and no modifications to the base optimizer's internal logic, including the hyperparameters. When applied to Adam (termed AdamPower), GradPower consistently achieves lower terminal loss across diverse architectures (LLaMA, Qwen2MoE), parameter scales (66M to 2B), datasets (C4, OpenWebText), and learning-rate schedules (cosine, warmup-stable-decay). The most pronounced gains are observed when training modern mixture-of-experts models with warmup-stable-decay schedules. GradPower also integrates seamlessly with other state-of-the-art optimizers, such as Muon, yielding further improvements. Finally, we provide theoretical analyses that reveal the underlying mechanism of GradPower and highlight the influence of gradient noise.

20.
medRxiv (Medicine) 2026-06-15

Poly-Social Risk for Hypertension Among Black and Latina Women

Background: Hypertension is a leading modifiable cardiovascular risk factor prominently influenced by health-related social needs (HRSN). Whether detailed information on HRSN can improve identification of hypertension among minoritized women is unknown. Methods: Black and Latina women aged 18-65 years completed the Centers for Medicare and Medicaid Services Accountable Health Communities Screening Tool, assessing 13 HRSN domains. Hypertension was ascertained by a validated EHR-based algorithm or self-report of hypertension. Logistic regression tested associations of HRSN with hypertension. LASSO regression with 10-fold cross-validation was used to derive a poly-social risk score in the training set (random 70%) and tested in the validation set (30%) against a sociodemographic model (age, race, income, education). Results: Among 1302 participants (mean [SD] age 40.1 [11.3] years, 70.4% Black, 44.3% Latina), higher cumulative burden of HRSN was associated with increased odds of hypertension (adjusted odds ratio [aOR] for each additional domain of HRSN: 1.07 [95% CI 1.01-1.14], P=0.02). Food insecurity (aOR 2.30 [1.37-3.87], P= 0.002), lapse in utilities (aOR 1.44 [1.04-1.96], P=0.02), poor concentration (aOR 1.57 [1.13-2.17], P=0.007), and social isolation (aOR 1.77 [1.14-2.73], P=0.01) were associated with hypertension. In the validation set, the poly-social risk score did not improve discrimination for hypertension vs. the sociodemographic model (AUC 0.76 [95% CI 0.71-0.81] vs. AUC 0.80 [0.75-0.85]). Conclusion: In this cross-sectional analysis of Black and Latina women, greater cumulative social disadvantage was associated with hypertension. While inclusion of HRSN did not improve hypertension prediction beyond conventional sociodemographic indices, findings may inform targeted interventions among minorities at cardiometabolic risk.

22.
medRxiv (Medicine) 2026-06-22

The Unsteady Return of Command-Following: Recovery and Instability of Bedside Motor Command-Following After Acute Brain Injury

Background/Objective: Following a verbal command marks the bedside transition from unresponsiveness to overt recovery of consciousness after acute brain injury. Its timing across phenotypes, stability once present, and dependence on sedation are uncharacterized at scale. Methods: Retrospective cohort of adults with acute brain injury, first intensive care unit stay, MIMIC-IV. Command-following was the Glasgow Coma Scale motor response "Obeys Commands." Among patients not following commands at admission, cumulative incidence was estimated with death or hospice and discharge without recovery as competing events. Instability was quantified as transient first recovery and threshold crossings; examinations were tagged for concurrent sedation. Principal findings were externally validated in the multicenter eICU Collaborative Research Database. Results: Of 13,900 brain-injured patients with three or more motor examinations, 5,498 (39.6%) were not following commands at admission. The cumulative incidence of first command-following was 43.5% by 24 hours and 65.0% by 14 days, ranging at 14 days from 36.9% in anoxic injury to 77.2% in ischemic stroke (anoxic versus ischemic stroke at 72 hours, difference 0.41; adjusted P = .002). Among 3,573 patients who recovered, the first recovery was transient in 22.2%, and 62.4% crossed the threshold repeatedly. Non-following was strongly associated with sedation, consistent with an arousal-dependent examination. In eICU, the 14-day incidence was 64.8%, and transient first recovery was 22.7%, closely matching the primary cohort. Conclusions: After acute brain injury, overt bedside command-following returns early but unsteadily, with phenotype-dependent timing, threshold fluctuation, and strong dependence on sedation. A single charted observation is an unreliable index of the underlying state.

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

A Comprehensive Survey of Medical Image Segmentation: Challenges, Benchmarks, and Beyond

Medical image segmentation plays a critical role in clinical diagnostics, treatment planning, disease monitoring, and neurological disorder identification. This article presents a comprehensive review of its systematic development, covering widely used public datasets, representative methods built on the U-Net, Transformer, and SAM architectures, and key evaluation metrics with their differences, followed by an analysis of major challenges from multiple perspectives. Unlike surveys that focus on a single model family or a specific clinical application, this review organizes U-Net-, Transformer-, and SAM-based methods within a unified analytical framework, with a particular focus on their effectiveness in improving segmentation accuracy and efficiency. This work aims to guide future research and support clinical translation of medical image segmentation, with all related resources publicly available in our GitHub repository: https://github.com/andrew-pengyu/Awsome_MedSeg/tree/main.

24.
arXiv (CS.AI) 2026-06-12

Echo2ECG: Enhancing ECG Representations with Cardiac Morphology from Multi-View Echos

arXiv:2603.08505v2 Announce Type: replace-cross Abstract: Electrocardiography (ECG) is a low-cost, widely used modality for diagnosing electrical abnormalities like atrial fibrillation by capturing the heart's electrical activity. However, it cannot directly measure cardiac morphological phenotypes, such as left ventricular ejection fraction (LVEF), which typically require echocardiography (Echo). Predicting these phenotypes from ECG would enable early, accessible health screening. Existing self-supervised methods suffer from a representational mismatch by aligning ECGs to single-view Echos, which only capture local, spatially restricted anatomical snapshots. To address this, we propose Echo2ECG, a multimodal self-supervised learning framework that enriches ECG representations with the heart's morphological structure captured in multi-view Echos. We evaluate Echo2ECG as an ECG feature extractor on two clinically relevant tasks that fundamentally require morphological information: (1) classification of structural cardiac phenotypes across three datasets, and (2) retrieval of Echo studies with similar morphological characteristics using ECG queries. Our extracted ECG representations consistently outperform those of state-of-the-art unimodal and multimodal baselines across both tasks, despite being 18x smaller than the largest baseline. These results demonstrate that Echo2ECG is a robust, powerful ECG feature extractor. Our code is accessible at https://github.com/michelleespranita/Echo2ECG.

25.
arXiv (CS.AI) 2026-06-11

MetaPlate: Counterfactual-Guided RAG-LLM Tool for Personalized Food Recommendation and Hyperglycemia Prevention

arXiv:2606.10120v2 Announce Type: replace-cross Abstract: Postprandial hyperglycemia is a key risk factor for metabolic disorders; however, existing dietary guidance is often static, impractical, and insufficiently personalized, providing recommendations that are difficult to follow or not impactful. While recent advances leverage continuous glucose monitoring (CGM) and machine learning to predict glycemic responses, these approaches are largely predictive and lack actionable guidance. Moreover, recommendation systems are often misaligned with user goals and require extensive input. We present MetaPlate, a counterfactual explanation (CF) guided, context-aware decision-support framework that generates personalized meal recommendations to mitigate postprandial glucose excursions in healthy adults. MetaPlate integrates multimodal data, including CGM readings, wearable-derived physiological signals, and user-provided meal inputs from $25$ individuals to model pre-meal context. A machine learning model predicts glucose response, while a CF optimization module adjusts meal composition modifying macronutrient amounts to maintain glucose levels within a target range ($\leq 140$ mg/dL). An LLM-based retrieval-augmented generation (RAG) layer enhances interpretability by producing human-readable recommendations using constrained search of the USDA food database. We evaluate MetaPlate via a structured expert-in-the-loop assessment with registered dietitians (RDs), comparing performance before and after prompt refinement. Results show improvements in meal realism, portion suitability, and recommendation likelihood, with expert feedback indicating a shift from clinically implausible outputs to actionable, contextually appropriate recommendations. Our findings emphasize the importance of domain knowledge and structured constraints in LLM-driven systems and highlight the potential of MetaPlate as a real-time personalized dietary decision-support tool.