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01.
medRxiv (Medicine) 2026-06-16

Efficacy of Ergothioneine Supplementation on Postpartum Fatigue, Sleep Quality, and Quality of Life: A Randomized, Double-Blind, Placebo-Controlled Trial

Background: Postpartum asthenia, characterized by severe fatigue, sleep disturbances, and physiological stress, lacks effective targeted interventions. Ergothioneine (EGT) is a unique, naturally occurring antioxidant that actively accumulates in mitochondria, offering a compelling therapeutic rationale for systemic recovery. This study aimed to evaluate the efficacy of EGT in accelerating postpartum functional restoration and alleviating fatigue. Methods: This single-center, randomized, double-blind, placebo-controlled trial enrolled 40 postpartum women (SF-36 total score [≤] 70) who had ceased breastfeeding. Participants were randomized (1:1) to receive either 120 mg/day of EGT or a matched placebo for 30 days. Efficacy was assessed using the SF-36, Pittsburgh Sleep Quality Index (PSQI), Fatigue Scale-14 (FS-14), and Traditional Chinese Medicine (TCM) asthenia scale. To rigorously evaluate the treatment effects, advanced statistical modeling, including Linear Mixed-Effects Models (LMM) and Analysis of Covariance (ANCOVA) adjusted for baseline covariates, was employed. Results: All 40 participants completed the trial. The EGT group demonstrated robust and accelerated functional recovery. Notably, significant improvements in sleep quality (p = 0.0361) and systemic fatigue (p = 0.0059) were observed as early as Day 15. Importantly, EGT yielded a statistically significant between-group superiority in alleviating mental fatigue compared to placebo at Day 15 (p = 0.0313). By Day 30, the EGT cohort exhibited substantial within-group improvements across all primary metrics, including SF-36 (+35.94%, p = 0.0006) and FS-14 (-27.78%, p = 0.0011). Furthermore, as an additional physiological benefit, EGT induced a selective and significant reduction in hepatic transaminases (ALT: -30.42%; AST: -17.44%) within normal limits, a trend not observed in the placebo group. EGT was exceptionally well-tolerated with no treatment-related adverse events. Conclusions: EGT supplementation (120 mg/day) safely accelerates postpartum functional recovery, offering rapid relief from mental fatigue and sleep disturbances within 15 days, while concurrently optimizing hepatic physiological status. These preliminary clinical signals warrant confirmation in larger, adequately powered cohorts. Trial Registration: ChiCTR2500114171; Prospectively registered on 2025-12-08.

02.
arXiv (CS.CV) 2026-06-12

Person Identification from Contextual Motion

We consider the problem of identifying people based on their motion styles. We present a generative model describing the action instance creation process and derive a probabilistic identity inference scheme for two common person identification scenarios motivated by the surveillance and authentication applications. We introduce a novel, interactive, scenario for person identification from motion patterns. To this end, we formalize the identification process in the context of a sequential message exchange session between the subject and the system. The subject's behavior is modeled using a probabilistic generative model inspired by the Human Information Processing (HIP) paradigm. At each stage, the system presents a visual stimulus (a cue) to the subject and records their motion response. The cue is selected so as to maximize the mutual information of the expected response and the subject's identity. Once recorded, the response is used to update the a posteriori probability over possible subjects' identities. The process terminates once a sufficient classification confidence level is reached. To the best of our knowledge, this is the first time person identification is addressed in such interactive setting. We report high recognition rates on five publicly available datasets and our own novel dataset consisting of 4,476 recordings of 22 test subjects responding to 15 cues.

03.
arXiv (CS.CL) 2026-06-17

PACE-RAG: Patient-Aware Contextual and Evidence-Constrained RAG for Clinical Drug Recommendation

Drug recommendation requires a deep understanding of individual patient context, especially for complex conditions like Parkinson's disease. While LLMs possess broad medical knowledge, they fail to capture the subtle nuances of actual prescribing patterns. Existing RAG methods also struggle with these complexities because guideline-based retrieval remains too generic and similar-patient retrieval often replicates majority patterns without accounting for the unique clinical nuances of individual patients. To bridge this gap, we propose PACE-RAG (Patient-Aware Contextual and Evidence-Constrained RAG). Rather than directly copying frequent medications from retrieved patients, PACE-RAG personalizes recommendations by first extracting patient-specific clinical features, retrieving cases around these features, and then refining the final prescription using the patient's current symptoms, active medication history, and focus-specific prescribing tendencies. By analyzing treatment patterns tailored to specific clinical features, PACE-RAG generates patient-specific medication recommendations along with an explainable clinical summary. Evaluated on a Parkinson's cohort and the MIMIC-IV benchmark using Llama-3.1-8B and Qwen3-8B, PACE-RAG achieved state-of-the-art performance, reaching F1 scores of 80.84% and 47.22%, respectively. These results suggest that PACE-RAG is a robust and clinically grounded framework for personalized decision support. Our code is available at: https://github.com/ChaeYoungHuh/PACE-RAG.

04.
arXiv (CS.CV) 2026-06-16

DeepMine-Mamba: Mitigating Information Dilution in Mamba-Based State Space Models for Document Image Binarization

Document image binarization aims to separate foreground text from degraded backgrounds while preserving thin, broken, and low-contrast strokes. Although deep learning methods have improved binarization performance, most existing approaches rely on convolutional, transformer-based, or generative architectures, while Mamba-based state space models remain largely unexplored for this task. In this work, we investigate Mamba-based feature propagation and observe that direct state-space propagation may dilute weak foreground cues during long-range modeling, especially faint ink traces, fragmented characters, and boundary-sensitive stroke details. To address this problem, we propose DeepMine-Mamba, a Mamba-based binarization framework equipped with a novel Anti-Dilution Gate that estimates propagation-induced feature changes and selectively restores stroke-sensitive local responses while suppressing unnecessary background enhancement. Experiments on DIBCO/H-DIBCO benchmarks under a strict leave-one-year-out protocol show that DeepMine-Mamba achieves competitive overall performance, with strong average FM and Fps across benchmark years. Ablation results further show that the Anti-Dilution Gate is the key component for mitigating propagation-induced foreground dilution and improving stroke preservation.

05.
arXiv (CS.CV) 2026-06-11

Semantic Segmentation of Node and Edge Diagrams for Assistive Technology

In this paper, we present a novel set of related models for semantic segmentation of node-link diagrams. These diagrams are frequently used to represent mathematical graphs, relationships between concepts, and flowcharts. Such diagrams are difficult to access non-visually; while some assistive interfaces have been designed for node-link diagrams, they rely upon a machine-readable representation of the diagram, whereas such diagrams will generally be made available as bitmap images. Our compact deep learning models show excellent quantitative and qualitative performance on a large synthetic dataset of node-link diagrams, reaching per-pixel accuracy over 93\%.

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

Mitigating scalability challenges in LUT-based neural networks via pruning optimisations

arXiv:2407.02362v3 Announce Type: replace-cross Abstract: Modern deep neural networks heavily rely on a large number of multiply-accumulate operations, which constitute the predominant computational cost. To address this, Look-Up Table (LUT)-based matrix multiplications have emerged as a promising alternative for reducing the computational cost and time of the multiply-accumulate operations in a neural network. However, the LUT-based neural network still faces the scalability challenge due to the inherent limitations of LUT-based matrix multiplication. To mitigate these scalability limitations, this paper proposes a scalable and energy-efficient LUT-based approximate matrix multiplication unit (LUT-MU) constituting the basic component of the neural networks by integrating a pruning strategy on the MADDNESS algorithm, a LUT-based matrix multiplication methodology. With increasing problem size and precision demands in matrix multiplication, our proposed LUT-MU architecture effectively constrains resource expansion. The case study shows that deploying our LUT-MU in neural network architectures, including fully connected layers (MNIST) and ResNets (CIFAR-10, ImageNet)-on XCZU7EV and XCZU19EG FPGAs, produces up to $1.6 \times$ throughput improvement and $4.2 \times$ energy efficiency gains over mainstream CUDA-based network implementations, and $1.8\times$ energy efficiency compared to leading quantised neural network implementations, with moderate impact on accuracy. Compared to original MADDNESS-based neural networks, our LUT-MU shows $1.3$ to $2.6\times$ resource savings based on various resolution configuration settings of MADDNESS.

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

Effects of sparsity and superposition on loss in simple autoencoders

arXiv:2606.18538v1 Announce Type: new Abstract: One of the major difficulties in the mechanistic interpretability of neural networks is the occurrence of polysemanticity, which suggests that each neuron is typically responsible for multiple different tasks, impeding a clean interpretation of their function. The seminal paper of Elhage et al. (2022) argues that this occurs due to superposition, a phenomenon where the neural network represents distinct features as non-orthogonal directions in a lower-dimensional space, a strategy that allows much greater compression of the data without sacrificing fidelity due to the feature sparsity of input vectors. Elhage et al. (2022) empirically validates these hypotheses in a rather natural and simple autoencoder with sparse inputs. The contribution of the present work is to analyze the mathematical basis for the occurrence and optimality of superposition, while rigorously corroborating some of their findings. In particular, we provide upper and lower bounds for the L2 reconstruction loss, tight in the very sparse regime, for power activation functions. A short list of interesting open problems are also included at the end.

08.
arXiv (CS.CV) 2026-06-19

Vision-Reasoning-Guided Occlusion Removal from Light Fields

Occlusion-robust scene recovery remains a major challenge in computational imaging, particularly in natural environments where dense foreground vegetation severely limits visibility. We propose a vision-reasoning-guided light field occlusion removal framework that combines the visibility recovery capability of light field integration (LFI) with the semantic reasoning capacity of vision-language models (VLMs). Multi-view observations are first integrated via LFI to suppress foreground occlusions and produce an initial visibility-enhanced representation. A VLM is then incorporated as a conditional semantic prior to restore degraded structures and recover fine details, guided by the observed measurements. To improve recovery consistency and reduce hallucination artifacts, we introduce a multi-sample fusion strategy that aggregates multiple generated hypotheses into a unified estimate. Experimental results on synthetic and real-world datasets demonstrate state-of-the-art performance, achieving the highest average SSIM across four synthetic light field benchmark scenes (4-Syn) and strong generalization across structured and unstructured acquisition settings. These results highlight the effectiveness of combining physical imaging constraints with vision-language reasoning for robust perception under severe occlusion, with applicability to search-and-rescue and exploratory robotic navigation.

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

Can Vision Foundation Models Navigate? Zero-Shot Real-World Evaluation and Lessons Learned

arXiv:2603.25937v2 Announce Type: replace-cross Abstract: Visual Navigation Models (VNMs) promise generalizable, robot navigation by learning from large-scale visual demonstrations. Despite growing real-world deployment, existing evaluations rely almost exclusively on success rate, whether the robot reaches its goal, which conceals trajectory quality, collision behavior, and robustness to environmental change. We present a real-world evaluation of five state-of-the-art VNMs (GNM, ViNT, NoMaD, NaviBridger, and CrossFormer) across two robot platforms and five environments spanning indoor and outdoor settings. Beyond success rate, we combine path-based metrics with vision-based goal-recognition scores and assess robustness through controlled image perturbations (motion blur, sunflare). Our analysis uncovers three systematic limitations: (a) even architecturally sophisticated diffusion and transformer-based models exhibit frequent collisions, indicating limited geometric understanding; (b) models fail to discriminate between different locations that are perceptually similar, however some semantics differences are present, causing goal prediction errors in repetitive environments; and (c) performance degrades under distribution shift. We will publicly release our evaluation codebase and dataset to facilitate reproducible benchmarking of VNMs.

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

Improved Stochastic Optimization of LogSumExp

arXiv:2509.24894v4 Announce Type: replace-cross Abstract: The LogSumExp function, dual to the Kullback-Leibler (KL) divergence, plays a central role in many important optimization problems, including entropy-regularized optimal transport (OT) and distributionally robust optimization (DRO). In practice, when the number of exponential terms inside the logarithm is large or infinite, optimization becomes challenging since computing the gradient requires differentiating every term. We propose a novel convexity- and smoothness-preserving approximation to LogSumExp that can be efficiently optimized using stochastic gradient methods. This approximation is rooted in a sound modification of the KL divergence in the dual, resulting in a new $f$-divergence called the Safe KL divergence. Our experiments and theoretical analysis of the LogSumExp-based stochastic optimization, arising in DRO and continuous OT, demonstrate the advantages of our approach over existing baselines.

11.
arXiv (math.PR) 2026-06-19

Asymptotic properties for fully coupled delayed forward-backward stochastic differential equations

arXiv:2606.19925v1 Announce Type: new Abstract: We investigate the asymptotic behavior of solutions to a class of fully coupled forward-backward stochastic differential equations with time-delayed generators. Such systems arise naturally in stochastic models with memory effects and constitute a significant extension of the classical fully coupled FBSDE framework. The presence of delay introduces additional analytical difficulties due to the dependence of the coefficients on the past trajectories of the solution processes and the resulting non-Markovian structure. Under suitable assumptions on the coefficients, we study the asymptotic properties of a perturbed delayed FBSDE driven by a small noise parameter. We first establish the convergence in distribution of the associated solution processes as the perturbation parameter tends to zero. We then prove almost sure convergence towards the solution of the corresponding deterministic limiting system. As a consequence of these asymptotic results, we derive a large deviation principle for the solution processes. Our results extend the asymptotic analysis of Cruzeiro, Gomes and Zhang (2014) from the classical fully coupled FBSDE setting to the delayed framework, and complement existing works on weakly coupled delayed forward-backward systems. They provide, to the best of our knowledge, the first large deviation principle for fully coupled forward-backward stochastic differential equations with delayed generators.

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

Multi-Agent Reinforcement Learning from Delayed Marketplace Feedback for Objective-Weight Adaptation in Three-Sided Dispatch

arXiv:2606.13604v1 Announce Type: new Abstract: Dispatch in three-sided marketplaces provides a natural setting for reinforcement learning from world feedback: decisions are evaluated by delayed operational outcomes such as delivery speed, courier utilization, and merchant congestion. We present a deployed reinforcement learning system at DoorDash that adapts dispatch objective weights in a large-scale food-delivery marketplace using delayed signals. Rather than replacing the combinatorial assignment optimizer, a store-level policy learned from logged marketplace data selects a discrete multiplier that shifts the dispatch optimizer's tradeoff between delivery quality and batching efficiency. This interface enables offline policy learning under noisy, delayed, and coupled feedback while preserving production feasibility constraints and operational safeguards. We train a shared value function using centralized offline data and decentralized store-level execution, with Double Q-learning targets and a conservative regularizer to reduce out-of-distribution value overestimation. In a production switchback experiment, the offline-trained policy increases batching and reduces courier-side time costs without degrading customer-facing delivery quality. Results illustrate how world feedback from a live economic and logistics system can be used to safely adapt decision policies online.

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

Detect Before You Leap: Mirage Detection in Vision-Language Models

Vision-language models (VLMs) can produce confident visual answers even when the required visual evidence is missing, blank, or unrelated to the question. This failure mode, recently described as mirage (mirage2026), is especially concerning in medical and document VQA, where a plausible but visually ungrounded answer may be mistaken for image-based evidence. We study the complementary problem of pre-release mirage detection: given an image-question pair, determine whether the VLM should answer or abstain before generation. To that end, we propose a novel model-agnostic Text-Conditioned Layer-wise Internal Alignment (TC-LIA) method that probes patch-token representations across the layers of a CLIP ViT-H/14 vision encoder. The key idea is to project layer-wise image patch tokens into the final CLIP embedding space and measure their similarity with the question embedding, thereby tracking whether question-relevant visual evidence emerges across vision layers. TC-LIA summarizes this alignment trajectory using final image-text cosine similarity, late-layer top-k patch-text alignment, early-to-late gain, and layer-wise slope. These features are combined with pixel-statistic based blank/noise detection, zero-shot domain routing, and structured VLM self-assessment in an ensemble. Across five VQA domains with related, unrelated-real, and blank/noise inputs, and across twelve VLM backbones, Qwen2.5-VL-32B achieves the highest three-class detection accuracy of 94.7% with a 3.0% mirage rate, while Qwen2.5-VL-72B achieves 94.6% accuracy with a lower 2.8% mirage rate. Baseline mirage rates span 21.7-66.6%.

14.
medRxiv (Medicine) 2026-06-11

Incremental costs of transitioning from four to eight WHO-recommended antenatal care visits in Uganda: A costing analysis from a societal perspective

Background In 2016, the World Health Organization revised its antenatal care (ANC) recommendation from four to eight visits. For low- and middle-income countries like Uganda, where achieving even four visits remains a challenge, this transition has significant cost implications for both the health system and households. This study estimated the incremental costs of adopting the eight-visit model from a societal perspective. Methods The study was conducted in six government health facilities in southwestern Uganda. A micro-costing approach estimated health facility costs (personnel, equipment, consumables, and overhead). Costs incurred at patients end (transport, ultrasound, medical expenses, and time) were collected from 785 women using a questionnaire, with all costs in 2025 USD. Results For an average of 4.3 visits, total cost per woman was $100.1: facility costs $43.7 (43.7%), and patient costs $56.4 (56.3%). Transitioning to eight visits would increase total cost by $57.8 (57.8%), of which $36.4 (63.0%) would fall on households, equivalent to 68.8% of average monthly household income. Total costs would rise by 55.4% ($115.5 to $179.5) at Health Center IVs and 64.3% ($102.3 to $168.1) at Health Center IIIs, with facility costs up 43.4% and 62.9% and patient costs up 61.2% and 65.7%, respectively. Conclusion Transitioning to eight ANC visits would impose a large financial burden on households, with the incremental patient cost equivalent to more than two-thirds of average monthly household income. Equitable implementation requires improving availability of medicines and diagnostics, subsidizing transport, exploring telemedicine or community-based models, and improving efficiency at lower-tier health centers.

15.
arXiv (CS.LG) 2026-06-16

Hierarchical Advantage Weighting for Online RL Fine-Tuning of VLAs from Sparse Episode Outcomes

arXiv:2606.17043v1 Announce Type: cross Abstract: When pretrained VLA policies are fine-tuned through online RL, each rollout episode produces only a single binary outcome (success or failure), yet the actor update requires per-transition supervision. Existing approaches commonly reduce this sparse outcome to a single scalar reward or advantage signal, which conflates distinct forms of transition-level feedback and provides limited guidance once basic task success becomes achievable. First, a single scalar signal conflates the two objectives of viability and efficiency; once basic success is achieved, the binary label provides no gradient to distinguish efficient completions from slow ones. Second, real-world rollouts mix autonomous and intervention segments; naively assigning episode outcomes across these boundaries introduces incorrect credit assignment. To address these issues, we propose Hierarchical Advantage-Weighted Behavior Cloning (HABC), which trains separate critic heads for these two objectives on different data subsets and combines their outputs with a state-adaptive balance. A state-adaptive gate $g_t$ merges their one-step advantages, prioritizing viability when success is uncertain and shifting to efficiency only when viability is high, and converts the result into per-transition weights on the actor loss. Intervention-aware credit assignment further restricts outcome labels to segments executed by the current policy, preventing supervision from leaking across intervention boundaries. In real-robot experiments on three contact-rich bimanual tasks, HABC raises success from supervised fine-tuning (SFT) baselines of 36%, 44%, and 12% to 92%, 88%, and 38%.

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

Formalizing and Mitigating Structural Distortion in LLM Attention for Zero-Shot Graph Reasoning

arXiv:2606.15633v1 Announce Type: new Abstract: Large Language Models (LLMs) have shown promise for reasoning over Text-Attributed Graphs (TAGs). However, applying LLMs to graphs requires linearizing their structure into sequences, introducing distortion rooted in the graph bandwidth problem. While this distortion has been shown to degrade performance, it is often attributed to prompt design or model scale, leaving the underlying mechanism unclear. In this work, we show how rotary positional embeddings turn graph linearization into bandwidth-dependent attention decay, suppressing attention between graph-adjacent nodes that are forced far apart in the serialized sequence. This shifts the focus of LLM-based graph reasoning from prompt engineering and scaling toward correcting attention misalignment. Motivated by this analysis, we propose Graph-aligned Language Attention (GaLA), a lightweight, inference-time modification for LLMs. GaLA biases attention toward graph-adjacent nodes while preserving the LLM's sequential inductive biases. Across TAG benchmarks, GaLA improves performance with negligible overhead, demonstrating that distortion is a correctable bottleneck in LLM-based graph reasoning.

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

Agreement in Representation Space for Open-Ended Self-Consistency

Self-consistency improves LLM reasoning by sampling multiple outputs and selecting the most consistent answer, but existing formulations largely rely on exact matching and therefore remain limited to tasks with categorical outputs. In this work, we study self-consistency in open-ended generation tasks such as code synthesis and text summarization. We hypothesize that consistency can be understood as a geometric property of the generation space, where semantically compatible generations concentrate in similar regions of representation space. To study this hypothesis, we introduce Embedding-Based Agreement (EBA), a simple training-free operationalization that estimates agreement by clustering sampled generations in embedding space. Through experiments on mathematical reasoning, code generation, and summarization, we show that agreement in representation space provides a robust and scalable signal of self-consistency for open-ended tasks. In particular, EBA consistently outperforms random selection and exhibits more stable scaling behavior than recent selection approaches based on LLM evaluation or uncertainty estimation. We further show that these agreement signals remain stable across model families and embedding spaces, even with native hidden representations. Finally, our analysis shows that the geometric location occupied by sampled generations is strongly correlated with generation quality: generations concentrated near central regions of representation space tend to correspond to more reliable outputs, whereas peripheral generations are substantially less accurate. Overall, our findings support viewing self-consistency as a property of the geometric organization of sampled generations rather than exact symbolic overlap.

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

Characterizing Admissible Objective Functions for Hierarchical Clustering

arXiv:2604.23628v2 Announce Type: replace-cross Abstract: Hierarchical clustering is a fundamental task in data analysis, but classical methods have long lacked a principled objective function. Dasgupta [STOC~2016] took an important step toward addressing this gap by proposing a well-motivated objective function for cluster trees. Cohen-Addad et al. [J. ACM 2019] subsequently introduced the notion of admissibility: an objective function is admissible if, whenever the input similarity matrix admits generating trees, its minimizers are precisely those generating trees.They also gave a necessary and sufficient condition for admissibility within a family of objective functions based on aggregate intercluster similarity. We refer to this family as sum-type objective functions. However, apart from Dasgupta's original objective function, no explicit admissible objective functions in this family were provided. In this paper, we study admissible objective functions for hierarchical clustering in two directions. For sum-type objective functions, we give a complete characterization when the scaling function is a symmetric polynomial of degree at most two, and we derive sufficient conditions for degree-three polynomials. We also show that the recursive sparsest cut algorithm achieves an O$(\phi)$-approximation ratio for the admissible objective functions covered by our characterization, where $\phi$ is the approximation factor of the sparsest cut subroutine. We then introduce max-type objective functions, where cluster interaction is measured by maximum, rather than aggregate, intercluster similarity. For this class, we characterize which objective functions are admissible for arbitrary symmetric scaling functions and give a complete characterization when the scaling function is a symmetric polynomial of degree at most two.

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

DCP-Prune: Ultra-Low Token Pruning with Distribution Consistency Preservation

Recent vision token pruning methods effectively preserve model performance under moderate token budgets but become unstable under ultra-low token budget. Our analysis shows that as the pruning budget decreases, accuracy degradation is often accompanied by larger feature distribution shifts. Critically, the degree of this distribution shift strongly correlates with performance degradation. To better characterize this phenomenon, we introduce a lightweight distribution consistency metric to estimate the distribution shift between retained and full tokens. Motivated by these observations, we propose a two-stage pruning framework consisting of Anchor-Context Graph Recovery (ACGR) and Text-Aware Token Cluster Selection (TATCS). Specifically, ACGR transfers contextual information before token removal, while TATCS dynamically re-selects representative tokens when severe distribution shift is detected. Extensive experiments demonstrate that our method achieves superior and more stable performance under ultra-low token budget. Notably, it retains 92.1% of the upper-bound average performance on LLaVA-1.5-7B with only 16 visual tokens.

20.
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.

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

Entropy-Gradient Inversion: Moving Toward Internal Mechanism of Large Reasoning Models

The advancement of Large Reasoning Models (LRMs) has catalyzed a paradigm shift from reactive ``fast thinking'' text generation to systematic, step-by-step ``slow thinking'' reasoning, unlocking state-of-the-art performance in complex mathematical and logical tasks. However, the field faces the fundamental gap between token-level behavioral analysis and internal reasoning mechanisms, and the instability of reinforcement learning (RL) for reasoning optimization relying on costly external verifiers. We identify and formally define Entropy-Gradient Inversion, a robust negative correlation between token entropy and logit gradients that acts as a definitive geometric fingerprint for LRM reasoning capability. Building on this, we propose Correlation-Regularized Group Policy Optimization (CorR-PO), which embeds this inversion signature into RL reward regularization. Extensive experiments on various reasoning benchmarks across multiple model scales show CorR-PO consistently outperforms state-of-the-art baselines, confirming that stronger inversion directly correlates with superior reasoning performance.

22.
medRxiv (Medicine) 2026-06-11

Conversational Speech for Respiratory Triage in Primary Care: A Pilot Study

作者:

Background. Respiratory complaints account for a substantial share of adult ambulatory care visits, and triaging them accurately has direct consequences for antibiotic stewardship and pathogen-specific therapy. Prior work has investigated voice as a triage signal, but that literature is dominated by single-condition detection from scripted speech in crowdsourced or controlled clinical settings and has not been evaluated at primary care scale on conversational ambient audio. Methods. A dataset of 514,377 ambient-recorded primary care visits from 379,225 adult patients at a US clinic network was used, with per-visit clinically assigned ICD-10 diagnosis codes and de-identified demographic and geographic metadata. Patient audio was extracted from each doctor-patient conversation, and spectral, voice quality, and prosodic features were computed. Eleven binary classification tasks were defined, aligned with a respiratory triage cascade (e.g., acute respiratory versus acute non-respiratory illness, and lower versus upper respiratory tract infection). An acoustic model (feed-forward network) was trained independently for each task using patient-stratified five-fold cross-validation and evaluated on a held-out test set. Each task's model was also compared against six non-acoustic baselines using a single demographic, geographic, or temporal variable. The 11 trained classifiers were composed into a hierarchical cascade and illustrated as case studies on selected patients. Results. Test-set AUC across the 11 tasks ranged from 0.602 (95% CI: 0.588-0.614) to 0.745 (95% CI: 0.742-0.748), with a mean expected calibration error of 0.018. Six of eleven binaries outperformed all confounder baselines. Four binaries showed median within-stratum AUC of 0.62-0.70 when the confounder was held fixed, indicating acoustic discrimination beyond what the confounder alone explains. The exception was the pneumonia versus non-pneumonia lower respiratory tract infection binary, which failed against the patient-city confounder baseline, plausibly reflecting a clinic-level difference in ICD-10 coding. Conclusion. Conversational primary care audio carries acoustic signal that discriminates clinically meaningful respiratory contrasts. Absolute performance is moderate, but the conditions are stricter than prior work: conversational speech and differential-diagnosis contrasts among sick patients. This pilot study is a baseline for voice-based clinical AI moving beyond sick-versus-healthy detection toward differential-diagnosis panels and a proof-of-concept for hierarchical reasoning.

23.
medRxiv (Medicine) 2026-06-22

Repeat expansions in Parkinson's disease and parkinsonism across ancestries: insights from a global genetic cohort

Expanded short tandem repeats contribute to a broad spectrum of neurodegenerative diseases, yet their roles in Parkinson's disease (PD) and parkinsonism remain incompletely characterized, especially across diverse ancestries. We analyzed short-read whole-genome (WGS) and clinical exome sequencing (CES) data from 38,365 individuals (28,861 WGS; 9,504 CES), encompassing 23,242 patients with PD, 4,729 patients with atypical parkinsonism and 10,394 healthy controls from 11 genetic ancestries. To determine carrier frequencies and characterize repeat structures across diverse ancestries, we genotyped 12 established pathogenic loci where normal, intermediate, and pathogenic alleles can be reliably differentiated using short-read sequencing data. Additionally, we conducted threshold-based associations to determine the minimum threshold associated with increased PD risk in 15,995 individuals (8,591 PD, 7,404 controls) of European ancestry. Pathogenic repeat expansions were detected in 62 patients (56 PD and 6 atypical parkinsonism) and 5 controls across seven loci (AR, ATXN1, ATXN2, ATXN3, CACNA1A, HTT and THAP11), spanning seven ancestries. Among these, ATXN2 expansions were the most frequently observed in PD and were present in African, East Asian, European and Middle Eastern ancestries. Additionally, intermediate ATXN2 repeat expansions exhibited a strong, length-dependent association with PD risk in the European population, with individuals with [≥]32 repeats having a more than four-fold increased risk (odds ratio 4.25, 95% confidence interval 1.80-12.05). Overall, >92% of expanded alleles harbor CAA interruptions within the CAG tract. Pathogenic expansions at other loci, such as ATXN3 and THAP11, showed more ancestry-specific distributions. Clinically, individuals with pathogenic ATXN2 and ATXN3 expansions most often presented with typical PD features but frequently showed earlier disease onset and a strong family history of PD. This large-scale, multi-ancestry study comprehensively maps the genetic landscape of pathogenic and intermediate repeat expansions in PD. Our findings confirm a length- and structure-dependent risk association for ATXN2 with PD in the European population, and highlight the pleiotropic effects of repeat expansions across the parkinsonian spectrum.

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

RoVE: Rotary Value Embeddings Attention for Relative Position-dependent Value Pathways

arXiv:2606.11275v1 Announce Type: cross Abstract: Rotary Position Embeddings (RoPE) make attention scores position-relative but leave the value pathway position-blind: the message sent by a value token is the same regardless of its distance from the query. We propose RoVE, a parameter-free modification that makes values position-sensitive by rotating them simultaneously with keys, and show that it turns RoPE attention into attentive convolution. This new perspective unifies several independent formulations of the same operation across computer vision, robotics, and modern LLM architectures. Trained 124M and 354M GPT-2 models show consistent empirical gains over RoPE on few-shot in-context learning, out-of-distribution perplexity, and long-context retrieval, with the clearest improvements on tasks that require long-range aggregation.

25.
arXiv (CS.CL) 2026-06-19

Investigating Human-Model Discrepancies in Speech Quality Assessment via Acoustic and Prosodic Perturbations

Mean opinion score (MOS) prediction models are widely used as proxy metrics in text-to-speech (TTS) research, yet their ability to capture quality differences beyond acoustic fidelity remains unclear. We investigate this via controlled perturbations on speech: acoustic degradation, prosodic errors, and manipulation of speaker-specific characteristics such as pitch and speaking rate. We obtained MOS predictions for these speech samples from both human listeners and the model, and analyzed the differences in their perceptual characteristics. Results show that most models track acoustic degradation well, while all are insensitive to prosodic errors despite large subjective score drops. For speaker characteristics, models exhibit a double dissociation: strong mean fundamental frequency (F0) biases absent in human ratings, yet insensitivity to speaking rate and F0 variability that humans notice. These findings highlight limitations of scalar MOS prediction beyond acoustic fidelity.