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01.
medRxiv (Medicine) 2026-06-16

Investigating naming error patterns after non-invasive brain stimulation and language treatment in persons with aphasia

Authors:
Sydnor↗M. J↗Johnson↗M. A↗Lammers↗Murter↗J. L↗Lindquist↗Sebastian↗

Abstract Background: Transcranial direct current stimulation (tDCS) paired with behavioral language therapy can improve naming in persons with aphasia (PWA), yet naming errors persist. Little is known about how naming error patterns change after non-invasive brain stimulation is combined with language treatment. Aims: To examine whether right cerebellar tDCS plus computerized aphasia therapy changes the types of naming errors in people with chronic aphasia across timepoints, and to determine whether effects differ by cerebellar tDCS polarity (anode vs. cathode). Methods and Procedures: In a randomized, double-blind, sham-controlled, within-subject crossover study, we retrospectively analyzed behavioral data from 24 individuals with post-stroke aphasia. Each participant completed two 15-session intervention periods (3-5 sessions/week) with active cerebellar tDCS + computerized aphasia therapy and sham + computerized aphasia therapy, separated by a two-month washout. General linear models (GLMs) assessed longitudinal changes in six error types (semantic, phonological real word, phonological nonword, no response, mixed, unrelated) on an untrained picture naming task (Philadelphia Naming Test; PNT) and a trained task (Naming 80; N80). Additional GLMs evaluated polarity effects with 2 (Group: anode vs. cathode) x 2 (Treatment) interactions, and treatment-order effects with 2 (Group: tDCS-first vs. sham-first) x 2 (Treatment) interactions. Outcomes and Results: Active cerebellar tDCS did not significantly change error types for trained items (N80). For untrained items (PNT), active tDCS reduced several error types relative to sham, with the clearest and most durable reduction in phonological nonword errors; more moderate reductions occurred for phonological real word and unrelated errors. Mixed errors showed a marginally opposite pattern, tending to increase after tDCS and decrease after sham. Polarity analyses indicated broadly similar effects across anodal and cathodal stimulation overall, but only the anode group showed a reliable treatment effect for phonological nonword errors on the PNT. Treatment-order analyses revealed no significant order effects. Conclusions: Our results indicate a shift in naming error types, particularly after tDCS treatment for the untrained naming task (PNT). These findings may help guide the course of treatment approaches of those with aphasia and what error naming pattern types may show changes post stroke when combining non-invasive brain stimulation and computerized aphasia therapy. Clinical Trial Registration: Cerebellar Transcranial Direct Current Stimulation and Aphasia Treatment [NCT02901574] Keywords: aphasia, naming errors, non-invasive brain stimulation, cerebellar tDCS, computerized aphasia treatment

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02.
arXiv (CS.LG) 2026-06-18

Trainable Photonic Measurement for Physics-Informed PDE Learning

Authors:
Jiale Linghu↗Hao Dong↗Yangshuai Wang↗

arXiv:2606.18713v1 Announce Type: new Abstract: Photonic quantum machine learning offers a route to trainable physical representations built from phase, interference and measurement. However, its role in scientific machine learning remains largely unexplored. Physics-informed neural fields provide a natural setting, because differential equations require trial spaces that preserve phase, frequency and derivative structure. Here we introduce a photonic quantum neural field in which coordinates become trainable optical phases, are mixed by multi-photon Fock-space interference and are decoded from photon-number measurements. The photonic circuit is optimized as the neural-field representation itself, not as a fixed feature map or hardware accelerator. Photonic measurement is therefore a trainable representation on which the physics-informed residual is minimized. Across seven elliptic, wave, nonlinear dispersive and inverse PDE benchmarks, we observe a phase-complexity transition: classical coordinate and Fourier-feature networks suffice in smooth regimes, whereas the photonic field is most accurate when residual derivatives amplify phase mismatch. In the hardest regimes it gives the lowest errors, with margins reaching an order of magnitude and about one quarter of the trainable parameters of classical baselines. Frozen and shuffled controls, together with noise stress tests, attribute this gain to learned interference and stable Fock-probability readout under compound perturbations. These results identify photonic quantum measurement as a representation-learning principle for scientific machine learning.

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03.
arXiv (math.PR) 2026-06-15

Stationary measures for higher spin vertex models on a strip

Authors:
Zongrui Yang↗

arXiv:2309.04897v2 Announce Type: replace-cross Abstract: We introduce a higher spin vertex model on a strip with fused vertex weights. This model can be regarded as a generalization of both the unfused six-vertex model on a strip arXiv:2212.09111 and an 'integrable two-step Floquet dynamics' model introduced in arXiv:1711.08884. We solve for the stationary measure using a fused version of the matrix product ansatz and then characterize it in terms of the Askey-Wilson process. Using this characterization, we obtain the limits of the mean density along an arbitrary down-right path. It turns out that all these models share a common phase diagram, which, after an appropriate mapping, matches the phase diagram of open ASEP. This provides evidence for the universality of this phase diagram.

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04.
arXiv (CS.AI) 2026-06-19

How Do Instructions Shape Speech? Cross-Attention Attribution for Style-Captioned Text-to-Speech

Authors:
Nityanand Mathur↗Hamees Sayed↗Wasim Madha↗Apoorv Singh↗Sameer Khurana↗Akshat Mandloi↗Sudarshan Kamath↗

arXiv:2606.20532v1 Announce Type: new Abstract: Style-captioned text-to-speech systems use natural language to control voice characteristics, but how individual words influence acoustic output remains unclear. Understanding this is critical for diagnosing failure modes and improving controllability in expressive TTS. We propose cross-attention attribution for speech diffusion models, adapting the DAAM framework to the speech domain for the first time, and apply it to CapSpeech-TTS. Our method extracts per-token heatmaps across 25 layers and 24 ODE steps. We analyze 3,600 (style caption, text transcript) combinations comprising 120 style captions conditioning the generation of 30 text transcripts each, revealing how caption tokens shape waveforms. Results show: (1) style tokens have lower temporal variance than content/function tokens, confirming global conditioning; (2) style attention correlates with F0 and energy; (3) style conditioning peaks in early steps and deep layers; (4) attention entropy reaches its minimum at layer 17, co-occurring with the style importance peak, indicating maximal network selectivity at the most style-critical stage. This is the first study of how natural language influences cross-attention in speech diffusion models

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05.
arXiv (CS.LG) 2026-06-19

Full-Self Diagnostics (FSD): Physics-Grounded Visual Biomarker Inference from Smartphone Video via Inverse Problems and Operator Learning

Authors:
Jonathan Thomas↗Harsh Thaker↗

arXiv:2606.19372v1 Announce Type: cross Abstract: We present Full-Self Diagnostics (FSD), a unified mathematical framework for recovering latent physiological states from unconstrained 9-second facial videos captured by consumer smartphones. The approach integrates five mutually reinforcing components: (1) a physics-based forward model derived from the radiative transfer equation and chromophore absorption that maps camera observables to biomarker concentrations; (2) an information-theoretic observability theory proving that multi-channel visual signals (spectral, pulse, respiratory, micro-expression, and oculomotor) contain strictly increasing mutual information with physiological state; (3) a stable, Tikhonov-regularized inverse problem with domain-uniform identifiability guarantees; (4) an operator-learning formulation that enables generalization across devices, resolutions, and populations; and (5) a supervised learning procedure, interpretable as stochastic variational inference, that continuously refines the model from paired biosensor ground truth with performance improving proportionally to one over the square root of the number of paired observations. Empirical validation on 38812 real-world paired scans across 59 subjects demonstrates practical performance. Self-collected data from the lead author (glucose range 35-550 mg/dL) yields MARD of 29.86 percent with 97.57 percent of predictions in Clarke Error Grid Zones A+B and only 0.27 percent in the dangerous Zone E. A well-managed diabetic participant achieves MARD of 17 percent in the narrower 70-180 mg/dL band. These results confirm that consumer-grade facial video encodes sufficient structured information for clinically relevant, non-invasive biomarker inference under fully unconstrained conditions, with performance scaling predictably as more paired data becomes available.

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

The Safety-Aware Denoiser for Text Diffusion Models

Authors:
Amman Yusuf↗Zhejun Jiang↗Mijung Park↗

arXiv:2605.08116v2 Announce Type: replace-cross Abstract: Recent work on text diffusion models offers a promising alternative to autoregressive generation, but controlling their safety remains underexplored. Existing safety approaches are geared toward autoregressive models and typically rely on post-hoc filtering or inference-time interventions. These are inadequate for effectively addressing safety risks in text diffusion models. We propose the Safety-Aware Denoiser (SAD), a safety-guidance framework in text diffusion models. The SAD modifies the iterative denoising process such that the text sample at the final denoising step is steered toward provably safe regions of the text space. This inference-time method can integrate safety constraints into the denoiser, avoiding computationally expensive retraining of the underlying diffusion model and enabling flexible, lightweight safety guidance. We evaluate the safety of the generated text using the SAD, with respect to hazard taxonomy, memorization, and jailbreak. Experimental results show that SAD substantially reduces unsafe generations while preserving generation quality, diversity, and fluency, outperforming existing methods. These results demonstrate that our safety guidance during denoising provides an effective and scalable mechanism for enforcing safety in text diffusion models.

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

InfoNCE Induces Gaussian Distribution

Authors:
Roy Betser↗Eyal Gofer↗Meir Yossef Levi↗Guy Gilboa↗

arXiv:2602.24012v2 Announce Type: replace Abstract: Contrastive learning has become a cornerstone of modern representation learning, allowing training with massive unlabeled data for both task-specific and general (foundation) models. A prototypical loss in contrastive training is InfoNCE and its variants. In this work, we show that the InfoNCE objective induces Gaussian structure in representations that emerge from contrastive training. We establish this result in two complementary regimes. First, we show that under certain alignment and concentration assumptions, projections of the high-dimensional representation asymptotically approach a multivariate Gaussian distribution. Next, under less strict assumptions, we show that adding a small asymptotically vanishing regularization term that promotes low feature norm and high feature entropy leads to similar asymptotic results. We support our analysis with experiments on synthetic and CIFAR-10 datasets across multiple encoder architectures and sizes, demonstrating consistent Gaussian behavior. This perspective provides a principled explanation for commonly observed Gaussianity in contrastive representations. The resulting Gaussian model enables principled analytical treatment of learned representations and is expected to support a wide range of applications in contrastive learning.

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08.
arXiv (CS.AI) 2026-06-12

Cluster Aggregated GAN (CAG): A Cluster-Based Hybrid Model for Appliance Pattern Generation

Authors:
Zikun Guo↗Adeyinka. P. Adedigba↗Rammohan Mallipeddi↗

arXiv:2512.22287v3 Announce Type: replace-cross Abstract: Synthetic appliance data are essential for developing non-intrusive load monitoring algorithms and enabling privacy preserving energy research, yet the scarcity of labeled datasets remains a significant barrier. Recent GAN-based methods have demonstrated the feasibility of synthesizing load patterns, but most existing approaches treat all devices uniformly within a single model, neglecting the behavioral differences between intermittent and continuous appliances and resulting in unstable training and limited output fidelity. To address these limitations, we propose the Cluster Aggregated GAN framework, a hybrid generative approach that routes each appliance to a specialized branch based on its behavioral characteristics. For intermittent appliances, a clustering module groups similar activation patterns and allocates dedicated generators for each cluster, ensuring that both common and rare operational modes receive adequate modeling capacity. Continuous appliances follow a separate branch that employs an LSTM-based generator to capture gradual temporal evolution while maintaining training stability through sequence compression. Extensive experiments on the UVIC smart plug dataset demonstrate that the proposed framework consistently outperforms baseline methods across metrics measuring realism, diversity, and training stability, and that integrating clustering as an active generative component substantially improves both interpretability and scalability. These findings establish the proposed framework as an effective approach for synthetic load generation in non-intrusive load monitoring research.

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09.
bioRxiv (Bioinfo) 2026-06-23

Systematic benchmarking of zero-shot utility and robustness in single-cell transcriptomic foundation models

Authors:
Liu↗Feng↗Pan↗Chen↗Ren↗Ye↗Sakurai↗Lin↗Zhang↗

Single-cell foundation models (scFMs) have been proposed as reusable representations for transcriptomic analysis, yet their practical utility and robustness when applied without task-specific fine-tuning remain incompletely characterized. Here, we systematically evaluated single-cell transcriptomic representations in zero-shot settings across 20 methods, 6 downstream tasks and 1,607 datasets comprising nearly 21.8 million cells. We characterized model behavior along three complementary dimensions: baseline utility, structural robustness, and dataset-level drivers of performance variability. Our large-scale analysis reveals a decoupling between utility and robustness: methods ranking highly on standard benchmarks often show marked instability under shifts in dataset structure. Furthermore, no single model performs uniformly well across tasks. In several tasks, classical statistical representations based on highly variable genes remain competitive under zero-shot conditions. Together, these results define the practical boundaries of zero-shot use in scFMs and provide a large-scale benchmark and decision framework for representation selection in single-cell genomics.

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10.
medRxiv (Medicine) 2026-06-22

Knowledge, Attitudes, and Practices Regarding Maternal Nutrition Counselling Among Frontline Health Workers in Udupi, Karnataka, India: A Sequential Explanatory Mixed-Methods Study

Authors:
Amrutha↗M. S↗Rao↗C. R↗Hebbar↗Vennila↗Maiya↗G. A↗Bhat↗Kotebagilu↗N. P↗Bhagavath↗…

Background Indias maternal nutrition profile is undergoing a dual-direction shift, with persistent undernutrition coexisting alongside rising overweight and micronutrient deficiencies. Despite national efforts through Integrated Child Development Services (ICDS) and the National Health Mission (NHM), maternal dietary diversity remains suboptimal in India. Frontline health workers (FLWs) play a central role in delivering nutrition counselling; however, gaps remain between knowledge and its translation into practice, highlighting the need to strengthen training, applied competencies, and health system support within primary care settings. Objective To assess knowledge, attitudes, and practices (KAP) regarding maternal nutrition counselling among FLWs and to explore contextual factors influencing counselling delivery. Methods A sequential explanatory mixed-methods study was conducted in Udupi, Karnataka, India. In phase one, 46 FLWs- Accredited Social Health Activists (ASHA), Community Health Officers (CHO), and Primary Health Care Officers (PHCO) completed a validated Knowledge, Attitudes, and Practices (KAP) questionnaire. Data were analysed using descriptive statistics, Kruskal-Wallis test, Spearman correlation, and exploratory multiple linear regression. In phase two, one focus group discussion with 21 participants was conducted and analysed using reflexive thematic analysis. Results FLWs demonstrated moderate KAP scores (37.50 {+/-} 5.09), with lower scores observed in dietary diversity knowledge and counselling practices. CHOs and PHCOs had significantly higher knowledge (p < 0.001) and practice scores (p = 0.002) compared to ASHAs, while attitudes were similar across cadres. Knowledge was positively associated with practice ({rho} = 0.389, p = 0.008). Exploratory regression indicated that cadre and knowledge were associated with practice, while attitude was not statistically significant. Qualitative findings suggested that counselling was largely protocol-based and constrained by workload, limited counselling tools, economic barriers, and cultural food practices. Conclusion Despite positive attitudes towards maternal nutrition counselling, frontline health workers demonstrated gaps in knowledge and counselling practices. Mixed-methods findings suggest that counselling delivery is shaped by both provider competencies and health-system constraints, highlighting the need for implementation-focused strategies to strengthen maternal nutrition counselling in routine antenatal care.

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11.
arXiv (CS.AI) 2026-06-19

The Autonomy Tax: Defense Training Breaks LLM Agents

Authors:
Shawn Li↗Yue Zhao↗

arXiv:2603.19423v2 Announce Type: replace-cross Abstract: Large language model (LLM) agents increasingly rely on external tools (file operations, API calls, database transactions) to autonomously complete complex multi-step tasks. Practitioners deploy defense-trained models to protect against prompt injection attacks that manipulate agent behavior through malicious observations or retrieved content. We reveal a fundamental capability-alignment paradox: defense training designed to improve safety systematically destroys agent competence while failing to prevent sophisticated attacks. Evaluating defended models against undefended baselines across 97 agent tasks and 1,000 adversarial prompts, we uncover three systematic biases unique to multi-step agents. Agent incompetence bias manifests as immediate tool execution breakdown, with models refusing or generating invalid actions on benign tasks before observing any external content. Cascade amplification bias causes early failures to propagate through retry loops, pushing defended models to timeout on 99\% of tasks compared to 13\% for baselines. Trigger bias leads to paradoxical security degradation where defended models perform worse than undefended baselines while straightforward attacks bypass defenses at high rates. Root cause analysis reveals these biases stem from shortcut learning: models overfit to surface attack patterns rather than semantic threat understanding, evidenced by extreme variance in defense effectiveness across attack categories. Our findings demonstrate that current defense paradigms optimize for single-turn refusal benchmarks while rendering multi-step agents fundamentally unreliable, necessitating new approaches that preserve tool execution competence under adversarial conditions.

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12.
arXiv (CS.AI) 2026-06-19

Repurposing a Speech Classifier for Guided Diffusion-Based Speech Generation

Authors:
Rostislav Makarov↗Timo Gerkmann↗

arXiv:2606.20457v1 Announce Type: cross Abstract: Classifier guidance is a way to control diffusion generation by using a noise-conditioned classifier to steer the sampling process toward a target class. One drawback of classifier guidance is that it requires two separately trained models: a classifier and a diffusion model. We therefore study a more compact alternative in which a conventionally trained speech classifier is repurposed as the backbone for diffusion generation. Starting from a frozen noise-conditioned classifier in log-Mel space, we attach a lightweight subnetwork that reuses intermediate classifier representations and train only this subnetwork under a Denoising Score Matching objective. Our work shows that a pretrained classifier can be repurposed for conditional generation, providing an appealing bridge between discriminative modeling and conditional speech synthesis resulting in high speech quality within a single-backbone model, with reduced memory footprint and computational cost.

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

SirenFNO: Efficient and Full Frequency Learning of Fourier Neural Operators

Authors:
Pengqing Shi↗Jie Yin↗Stephen Tierney↗Junbin Gao↗

arXiv:2606.11518v1 Announce Type: cross Abstract: Fourier neural operators (FNOs) are effective and efficient surrogates for approximating solutions of PDEs and generalize across discretizations. However, owing to the reliance on frequency truncation to maintain learning efficiency of FNOs, empirical studies suggest that FNOs exhibit spectral bias toward low-frequency information, which may hinder the learning capability especially for certain PDEs with strong high-frequency oscillations. To address this limitation, we propose SirenFNO, a novel framework that leverages sinusoidal representation networks (SIRENs) to learn implicit neural representations and performs mode-wise kernel parameterization. Our SIREN parameterization learns a full-grid spectrum with a constant and discretization-independent parameter count, thereby eliminating the need for frequency truncation. We further extend SirenFNO with functional tensor decompositions to enhance parameter and learning efficiency. Empirical results show that our SirenFNO consistently outperforms FNO with approximately $4$ to $15$ times parameter reductions with preserved discretization invariance, and our functional decomposition variants obtain performance improvements with a maximum of $73$ times fewer parameters across multiple PDE benchmarks.

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

Cross-modal Identity Mapping: Minimizing Information Loss in Modality Conversion via Reinforcement Learning

Authors:
Haonan Jia↗Shichao Dong↗Xin Dong↗Zenghui Sun↗Jin Wang↗Jinsong Lan↗Xiaoyong Zhu↗Bo Zheng↗Kaifu Zhang↗

Large Vision-Language Models (LVLMs) often omit or misrepresent critical visual content in generated image captions. Minimizing such information loss will force LVLMs to focus on image details to generate precise descriptions. However, measuring information loss during modality conversion is inherently challenging due to the modal gap between visual content and text output. In this paper, we argue that the quality of an image caption is positively correlated with the similarity between images retrieved via text search using that caption. Based on this insight, we further propose Cross-modal Identity Mapping (CIM), a reinforcement learning framework that enhances image captioning without requiring additional annotations. Specifically, the method quantitatively evaluates the information loss from two perspectives: Gallery Representation Consistency and Query-gallery Image Relevance. Supervised under these metrics, LVLM minimizes information loss and aims to achieve identity mapping from images to captions. The experimental results demonstrate the superior performance of our method in image captioning, even when compared with Supervised Fine-Tuning. Particularly, on the COCO-LN500 benchmark, CIM achieves a 20% improvement in relation reasoning on Qwen2.5-VL-7B.

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15.
arXiv (CS.AI) 2026-06-11

HERO: Hindsight-Enhanced Reflection from Environment Observations for Agentic Self-Distillation

Authors:
Haoran Liu↗Yuwei Zhang↗Xiyao Li↗Bohan Lyu↗Jingbo Shang↗

arXiv:2606.11559v1 Announce Type: new Abstract: Reinforcement learning typically improves multi-turn agent capabilities through the terminal outcome of the trajectories, which makes it difficult to determine credit assignments for each intermediate turns. Recent on-policy self-distillation methods offer a promising alternative by converting privileged feedback into dense token-level supervision through a self-teacher. Our study is motivated by the unexpected performance degradation observed when naively extending this paradigm to multi-turn settings, which we attribute to a lack of alignment between privileged feedback, such as successful trajectories or terminal outcomes, and the student's current decision context. We introduce HERO, a hindsight-enhanced self-distillation framework that uses next environment observations as locally aligned feedback. After each rollout, HERO reflects on the completed interaction to convert each observation into a compact turn-level diagnosis, that captures actionable feedback about the original action such as its necessity, validity or failure cause. On TauBench and WebShop, HERO improves task success and reduces unnecessary turns over environment-feedback-only self-distillation and GRPO. It is especially effective under limited training turn budgets, where successful rollouts are rare and GRPO provides weak reward-contrast signals.

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

A Practical Evaluation Method for Long-Form Simultaneous Speech-to-Speech Translation

Authors:
Yulin Xue↗Siqi Ouyang↗Lei Li↗

Simultaneous speech-to-speech translation (SimulS2ST) enables real-time cross-lingual communication, but existing evaluation has focused largely on short or pre-segmented speech rather than long-form, continuous input. Prior approaches are difficult to reproduce and make assumptions that do not hold for end-to-end systems. We present a practical evaluation method for long-form SimulS2ST. Given source speech, pre-segmented source transcripts, and reference translations, we run automatic speech recognition (ASR) and forced alignment on the generated target speech to recover token-level timestamps, then apply a sentence-embedding-based aligner to match the target text to its corresponding source sentences. This enables sentence-level computation of latency and quality metrics, including YAAL and xCOMET, which are then aggregated into final system-level scores. Experiments on representative SimulS2ST systems show that the method is effective in practice and reveal that current systems suffer from substantial latency accumulation on long speech.

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17.
arXiv (quant-ph) 2026-06-16

Bright Emission from Dark Sources in Hyperbolic Media

Authors:
Evgenii E. Narimanov↗

arXiv:2606.16071v1 Announce Type: cross Abstract: Hyperbolic media enable ultra-strong light-matter interactions through their extreme field localization and small mode volumes, but low-loss realizations are fundamentally limited to the mid-infrared, owing to the long lifetimes of optical phonons in high-quality crystals. Here we show that bright emitters operating at visible or near-infrared frequencies can be used to generate radiation in this regime by inducing mid-infrared population dynamics, thereby creating a source in the hyperbolic frequency band without a corresponding dipole transition. We demonstrate that even a source with vanishing dipole and higher multipole moments - strictly non-radiating in any isotropic medium - becomes radiatively active in a hyperbolic environment. This enables visible and near-infrared control of light-matter interactions in polaritonic hyperbolic materials, establishing a new low-loss solid-state quantum optics platform.

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18.
arXiv (CS.CV) 2026-06-11

Tac-DINO: Learning Vision-Tactile Features with Patch Alignment

Authors:
Hong Li↗Yankang Dong↗Yue Xu↗Yihan Tang↗Mingzhu Li↗Jiamin Qiu↗Qihang Yao↗Xing Zhu↗Yujun Shen↗Nan Xue↗Yong-Lu Li↗

Touch is the primary medium through which humans interact with the environment. Currently, tactile learning mainly focuses on image-level pretraining or alignment. However, tactile signals correspond to local object contact, while research into scale alignment and holographic matching remains limited and proper datasets and benchmarks also lack. To bridge this gap, we first construct a data collection system to acquire a large-scale tactile dataset, with over 20 K tactile contacts from 505 real-world objects. Building on this dataset, we design a Vis-Tac Holographic Matching Benchmark to evaluate vision-tactile local-to-global alignment ability. Then we propose Vision-Tactile Patch Alignment (VTPA) methods for vision-tactile representation learning. Experiments demonstrate that these exceed the performance of methods without alignment and align with whole-object images.

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19.
medRxiv (Medicine) 2026-06-15

Validating Field-Feasible Measures of Recent Khat Use: A Diagnostic Accuracy Study Comparing Amphetamine Immunoassay and Assisted Self-Report Against HPLC in an Ethiopian Male Cohort

Authors:
Atkinson↗H. F↗Mekonnen↗Suleman↗Oetzel↗Soboka↗Widmann↗Toennes↗S. W↗Tesfaye↗Stewart↗S. A↗…

Background: Khat (Catha edulis) is a widely consumed natural amphetamine-analog used across East Africa and the Arabian Peninsula. Accurate field-feasible measurement of recent khat use is a prerequisite for large-scale epidemiological research; yet no validated alternatives to laboratory reference methods have been identified in the scientific literature. This nested validation study evaluated the diagnostic accuracy of two point-of-care measures, a commercial amphetamine immunoassay and a Timeline Followback (TLFB) Assisted Self-Report (ASR), against high-performance liquid chromatography (HPLC) quantification of urinary norephedrine (NE), while additionally assessing agreement between the two field measures. Methods: A prospective, random sub-sample of 119 male participants aged 18-40 years from the Gilgel Gibe Field Research Center (GGFRC) longitudinal cohort, Ethiopia (validation timepoint T2, 2015), was used. Three index-reference comparisons were conducted: (1) amphetamine immunoassay (nal von minden, Drug-Screen AMP test, 300 ng/mL cutoff) vs. HPLC; (2) binary ASR (past-week use) vs. HPLC; and (3) binary ASR vs. immunoassay. Sensitivity (positive percent agreement, PPA), specificity (negative percent agreement, NPA), positive predictive value (PPV), negative predictive value (NPV), overall accuracy (overall percent agreement, OPA), and Cohen's kappa were calculated with 95% confidence intervals. Pre-specified secondary analyses applied three pharmacokinetically-informed recall windows (0-2, 3-5, and 6-7 days prior to interview) to ASR. Results: Against HPLC (77 positive, 42 negative), the immunoassay showed perfect specificity (1.0 [0.916-1.0]) and PPV (1.0 [0.91-1.0]) but low sensitivity (0.52 [0.40-0.64]), NPV (0.53 [0.42-0.65]), overall accuracy (0.69 [0.60-0.77]), and weak kappa (0.43 [0.34-0.52]). Binary ASR showed high sensitivity (0.96 [0.89-0.99]), specificity of 0.60 [0.433-0.74], PPV (0.81 [0.72-0.89]), NPV (0.89 [0.72-0.98]), with overall accuracy 0.83 [0.75-0.89] and moderate kappa (0.60 [0.51,0.69]). Restricting ASR to use within 0-2 days improved specificity to 0.69 [0.52-0.84], PPV to 0.86 [0.77-0.93], overall accuracy to 0.87 [0.79-0.93], and kappa to 0.69 [0.61-0.78] (moderate), while sensitivity (0.96 [0.89-0.99]) and NPV (0.89 [0.72-0.98]) remained stable. Against the immunoassay, ASR achieved high PPA of (1.0 [0.91-1.0]), NPA of 0.35 [0.25-0.47], OPA of 0.57 [0.48-0.66], and minimal kappa (0.27 [0.19-0.35]). Conclusions: Time-stratified ASR (0-2 days) is a valid, scalable alternative to biological testing for recent khat use in resource-limited settings. The immunoassay's 300 ng/mL cutoff functions as a marker of heavy or recent high-dose khat use rather than any-use detection. Its perfect specificity and PPV make it valuable as a confirmatory test for substantial exposure, while its lower sensitivity reflects calibration to amphetamine rather than to khat-derived cathinone metabolite. Keywords: khat; Catha edulis; diagnostic accuracy; STARD; self-report; immunoassay; HPLC; Ethiopia; substance use measurement

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20.
medRxiv (Medicine) 2026-06-15

Artificial Intelligence-Based Detection of Airway Mucus Plugs on CT and Associations With Clinical Outcomes in COPDGene

Authors:
Oyer↗Namvar↗Hoff↗B. A↗Bosma↗Labaki↗W. L↗Kazerooni↗E. A↗Martinez↗F. J↗Hatt↗…

RATIONALE: Airway mucus plugging is a clinically relevant manifestation of airway pathology in chronic obstructive pulmonary disease (COPD) and is associated with increased mortality even in early disease; however, visual computed tomography (CT) assessment is subjective and labor intensive. OBJECTIVES: To develop an AI-based quantitative CT method for automated detection of airway mucus plugging and evaluate associations with physiologic impairment and clinical outcomes. METHODS: Inspiratory CT scans from 8,971 COPDGene Phase 1 (GOLD 0-4 and PRISm) participants were analyzed. An AI-based framework combining 3D airway segmentation discontinuities and convolutional neural network classification identified mucus plug obstructions, yielding mucus plug burden (total plug count). Associations with outcomes were evaluated using covariate-adjusted models. MEASUREMENTS AND MAIN RESULTS : Higher mucus plug burden was associated with lower post-bronchodilator FEV % predicted ({rho} = -0.41; P < 0.001), greater air trapping (LAA < -856 HU; {rho} = 0.33; P < 0.001), worse health status (SGRQ; {rho} = 0.31; P < 0.001), and shorter 6-minute walk distance ({rho} = -0.26; P < 0.001). Among GOLD 1-4 participants, mucus plug presence was independently associated with increased all-cause mortality (adjusted hazard ratio, 1.28; P < 0.005) and exacerbation frequency (adjusted incidence rate ratio, 1.32; P < 0.005). Plug presence was also associated with increased respiratory mortality across GOLD categories and cardiovascular mortality in GOLD 1-2. CONCLUSIONS: AI-based quantitative CT assessment of airway mucus plugging provides a scalable, reproducible measure associated with physiologic impairment and adverse outcomes in COPD, supporting its role in risk stratification and future therapeutic studies.

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21.
arXiv (CS.LG) 2026-06-16

Early Anomaly-Onset Detection based on Wigner–Ville Distribution Slice Spectra: A Transmission-Grid Test Case

Authors:
Eduardo Jr Piedad↗Eduardo Prieto-Araujo↗Oriol Gomis-Bellmunt↗

arXiv:2606.15856v1 Announce Type: cross Abstract: Operational disturbance monitoring in power networks requires decisions to be made from waveform windows as they arrive, rather than from completed records after the event. This study evaluates full-vector Wigner–Ville Distribution Slice (WVDS) spectra for sequential anomaly-onset detection in high-voltage grid-voltage waveforms. The approach keeps the bilinear midpoint interaction structure of the Wigner–Ville distribution and represents each 128-sample voltage window by a 128-dimensional slice spectrum, avoiding manually selected fault-frequency markers. WVDS is used with a baseline-normalized deviation (BND) score and is compared against the BND of Fast Fourier Transform (FFT-BND), raw-window autoencoders, FFT autoencoders, and WVDS autoencoders under the same thresholding and three-window persistence rule. A synthetic autoencoder–clustering teacher is used to select RTE fault records that start from an initially normal region and then transition to anomalous behavior. On the filtered test set, FFT-BND achieves the highest sensitivity, whereas WVDS-BND provides the lowest false-alarm operating point, reducing record-level pre-onset false alarms to 0.69%. The autoencoder comparison follows the same selectivity pattern: WVDS reconstruction decreases false alarms relative to FFT reconstruction but misses more examples. The results indicate that preserved WVD cross-term information can form a selective representation for online grid-waveform anomaly monitoring when false alarms are costly.

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22.
medRxiv (Medicine) 2026-06-15

HPV Self-Sampling in Cervical Screening: A Rapid Review

Authors:
Tesha↗N. A↗Nevill↗Taylor-Rowan↗Mulholland↗Quinn↗Noel-Storr↗Sutton↗A. J↗Wu↗

Introduction Cervical cancer is the fourth largest cause of cancer deaths in women. HPV self-sampling could increase uptake of cervical screening. This rapid review aimed to determine the accuracy, concordance, uptake and acceptability of self-sampling over clinician-collected samples in high income countries. Method We followed Cochrane Rapid Reviews Methods. Top-up of 4 systematic reviews and meta-analyses was performed. Narrative data synthesis was conducted and meta-analysis where applicable. Databases searched were MEDLINE, EMBASE, CENTRAL and clinical trial registries. Risk of bias was assessed using AMSTAR 2, QUADAS, the Cochrane Risk of Bias (RoB), or the Nudelman and Otto, 2020 tool, depending on the study type. Findings The review included 39 studies for accuracy, 38 studies for concordance, 37 uptake and 48 studies for acceptability. Self-sampling has similar accuracy as clinician-collected samples when PCR-based assays are used. The overall agreement of self-sampling and clinician-collected samples was 87.1%(95%CI;85.6-88.6) with a kappa value of 0.70(95%CI;0.67-0.73). Mail-to-all strategies had higher uptake with participation differences of 11.3%(95%CI:8.4-14.2) in the intention-to-treat analysis and 7.7%(95%CI:4.7-10.8) in the per protocol analysis. Self-sampling is acceptable to non-attendees (91%(95%CI;85.3-94.6). Conclusion and Recommendation Self-sampling shows good performance on the four clinical effectiveness indicators of accuracy, concordance, uptake and acceptability.

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23.
arXiv (CS.CV) 2026-06-18

SegmentAnyTreeV2: Scaling Transformer-Based Tree Instance Segmentation Across Sensors, Platforms, and Forests

Authors:
Maciej Wielgosz↗Stefano Puliti↗Rasmus Astrup↗

We present SegmentAnyTreeV2, a sensor- and platform-agnostic framework for semantic and instance segmentation of forest point clouds. The model combines a serialization-based Point Transformer v3 backbone with a lightweight semantic head and a tree-focused cross-attention mask decoder. Semantic predictions restrict instance decoding to tree-class voxels, while instance-aware query initialization, one-to-many seed supervision, and asymmetric mask scoring improve separation in dense and structurally complex stands. We further introduce FOR-instance v3, an expanded benchmark comprising 427 scenes and 26,496 annotated trees across diverse biomes, forest structures, and LiDAR platforms. On the FOR-instanceV2 test split, SegmentAnyTreeV2 achieves 90.5% precision, 80.2% recall, 85.0% F1, 90.7% coverage, and 87.6% semantic mIoU, outperforming previous learning-based methods in both instance detection and mask completeness. Zero-shot evaluation on independent sites further demonstrates strong cross-domain generalization.

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24.
medRxiv (Medicine) 2026-06-15

Automated AI-Based Ventricular Subcompartment Segmentation and Volumetry in Idiopathic Normal Pressure Hydrocephalus

Authors:
Mutke↗M. A↗Griot↗S. A↗Wasserthal↗Indrakanti↗A. K↗Vishwanathan↗Mahmutoglu↗D'Antonoli↗T. A↗Bach↗…

Purpose In idiopathic normal pressure hydrocephalus (iNPH), longitudinal monitoring of ventricular size is important for diagnosis and treatment follow-up. This study aimed to validate a fully automated AI model for CT ventricular volumetry with subcompartments and to compare AI-derived volume changes with routine radiology assessments. Methods This retrospective, single-center study included 88 patients with iNPH and 456 non-contrast-enhanced head CT examinations. The model was trained on 38 manually labeled CT scans with 12 ventricular subcompartments. Outcomes included segmentation accuracy, correspondence between AI-derived longitudinal ventricular volume changes and radiology report categories (decreased, unchanged, increased), radiologist detection thresholds for ventricular change, and paired pre- and postoperative volume changes in 22 patients with ventriculoperitoneal shunt. Results Mean segmentation accuracy was high (Dice, 0.83). 91% of 100 segmentations were rated as excellent by an expert neuroradiologist. AI-derived ventricular volume changes corresponded well to radiology report categories (median total ventricular volume changes of -17% in cases reported as decreased, 0% in unchanged cases, and +22% in increased cases; all p < 0.001). Radiologists reported ventricular volume change in 50% of cases at an AI-measured relative volume change of +/-6%, and in 90% of cases at +21% for enlargement and -18% for decrease. After shunt placement, ventricular volume decreased by -8% (median), with the largest relative reductions observed in the right temporal and occipital horns. Conclusions Automated AI-based ventricular segmentation on CT enables accurate and reproducible assessment of ventricular volume changes in iNPH and complements routine radiological evaluation for longitudinal and postoperative monitoring.

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

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

Authors:
Nikita Kachaev↗Andrey Moskalenko↗Matvey Skripkin↗Nikita Kurlaev↗Daria Pugacheva↗Albina Burlova↗Mikhail Kolosov↗Denis Shepelev↗Andrey Kuznetsov↗Elena Tutubalina↗Aleksandr I. Panov↗Alexey K. Kovalev↗…

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

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