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01.
medRxiv (Medicine) 2026-06-15

Primary care practitioners preconception health literacy and information-seeking: A cross-sectional survey.

Background Parental health before pregnancy influences maternal and child outcomes. Primary care professionals, including general practitioners [GPs], midwives, and naturopaths, can provide preconception care, yet many report limited knowledge and difficulty accessing relevant information. This study described Australian GPs, midwives, and naturopaths preconception health literacy, including knowledge and ability to access information. Methods Between July and September 2022, Australian GPs, midwives, and naturopaths completed a 32-item online cross-sectional survey. Participants were recruited through professional associations, and data were analysed using descriptive and inferential statistics Results Participants (N=373) included naturopaths (40.7%), GPs (32.4%), and midwives (26.8%). Reported barriers to clinician health literacy including lack of preconception care resources (25.5%), and limited clinician knowledge (23.6%). The proportion identifying limited clinician knowledge differed significantly between professions (GP: 31.4%; midwives: 23.0%; naturopaths: 17.8%; p=0.030). The highest level of accurate knowledge regarding preconception exposures was for pre-pregnancy obesity (82.7%), while low birth weight was the most accurately identified preconception outcomes (83.7%). Incorrect responses were most common for maternal multivitamin use as an exposure (28.3%) and childhood leukaemia as an outcome (26.3%). Differences between professions were strongest for infant outcomes, with moderate associations observed for shoulder dystocia (V=.2355), precipitous labour (V=.2173), macrosomia (V=.2060), labour dystocia (V=.2018) and cryptorchidism (V=.2018). Discussion Preconception health literacy varies across primary care professions. Clinicians require greater access to targeted resources and education tailored to their differing scopes of practice and experience. Improving clinician preconception health literacy may strengthen consistent evidence-based care and support better maternal, child, and long-term family health outcomes.

02.
arXiv (quant-ph) 2026-06-11

Random Grover Search

arXiv:2606.11759v1 Announce Type: new Abstract: Grover's algorithm achieves a quadratic speedup for unstructured search given a global oracle for the target set. In many applications, however, the target set is specified as the intersection of multiple constraint sets. Constructing a global oracle for the intersection can be costly, whereas the individual constraint oracles are often much simpler to implement. We study a randomized Grover search algorithm that directly uses these constraint oracles. At each iteration, one of the corresponding Grover operators is selected at random. For the two-operator case with uniform sampling, we prove that the success probability approaches one after \[ \Theta \left(\frac\pi4\sqrt{\frac{N}{r}}\right) \] iterations, where $r$ is the size of the intersection. Thus, the algorithm achieves the same asymptotic query complexity as standard Grover search but without requiring a global oracle. We then generalize the analysis to arbitrary sampling distributions and an arbitrary number of Grover operators through an auxiliary operator that approximates the expected Grover evolution, while retaining the same asymptotic complexity. We further show that highly biased sampling distributions can still achieve near-unit success probability, enabling cheaper Grover operators to be used more frequently. Finally, we prove asymptotic optimality and support the theoretical results with numerical simulations.

03.
arXiv (quant-ph) 2026-06-17

Quantum-HPC Software Stacks and the openQSE Reference Architecture: A Survey

arXiv:2604.20912v2 Announce Type: replace Abstract: Quantum resources are increasingly integrated into high-performance computing (HPC) and cloud environments, but quantum high-performance computing (QHPC) software stacks remain isolated, often proprietary, full-stack solutions lacking common interfaces across runtime, resource management, orchestration, and execution layers. This paper analyzes nine production QHPC stacks and identifies common design patterns and emerging requirements, covering deployment models, application interaction patterns, SDK support, and readiness for fault-tolerant operation. The survey exposes consistent needs in runtime abstraction, resource management, interconnect semantics, and observability. Based on these findings, we propose the open quantum-HPC software ecosystem ( openQSE) reference architecture as a first step toward unifying the state-of-the-practice. openQSE defines a set of layer boundaries that allow different implementations to interoperate while preserving deployment flexibility, and is structured to support both current noisy intermediate-scale quantum (NISQ) workloads and future fault-tolerant quantum computing (FTQC) systems without changes to upper-layer application interfaces.

04.
arXiv (CS.AI) 2026-06-12

Mapping AI Programs in the U.S: A Status Report from Early 2026 and an Analysis of AI Majors and Minors

arXiv:2606.12428v1 Announce Type: cross Abstract: We present a report on the status of undergraduate Artificial Intelligence (AI) programs in the United States in Spring 2026. In so doing, we 1) describe our scraping and mapping tools, which dynamically update to track the state of AI education in the U.S., and 2) create a historic record at a time of great upheaval. The tool we developed, available at https://cicmap.ai, detects, scrapes, and displays data from more than 350 undergraduate AI programs–majors, minors, concentrations, and certificates–at 4-year universities. Our tool searched over 560 institutions to locate these programs, a sample that represents 86\% of all undergraduate Computer Science (CS) graduates in the U.S. This tool allows prospective students, guidance counselors, administrators, and faculty to easily access AI program requirements and is designed to continually update as new programs emerge. To the best of our knowledge, this survey represents the most comprehensive snapshot of the state of AI programs in the U.S. to date. With this work we offer three important contributions: 1) a record of AI programs in the U.S. at a time of great upheaval; 2) a tool to explore AI programs and their requirements; and 3) an analysis of the courses required for 66 AI majors and 87 AI minors. Our analysis of majors and minors shows great variability in the size and the requirements of these degrees, but we note two takeaways. First, not all majors require a general AI course, but if they don't, they do require a Machine Learning (ML) course. Second, while more than a third of majors require an Ethics in AI course, just under a quarter of AI minors do.

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

PIGEON: VLM-Driven Object Navigation via Points of Interest Selection

Object navigation in unseen indoor environments requires agents to perform semantic search under partial observability. Vision-language models (VLMs) provide strong semantic-spatial priors for this task, but how to interface them with robot navigation remains challenging: dense VLM inference is expensive, while abstracting environments into symbolic memories often separates high-level reasoning from the raw visual evidence that supports it. We propose we propose PIGEON (Point of Interest Guided Exploration for Object Navigation), a VLM-driven framework that formulates object navigation as raw-observation-grounded sparse decision problem. PIGEON introduces Points of Interest (PoIs) as sparse visual decision units that couple geometrically executable waypoints with raw egocentric observations. Rather than using VLMs as dense controllers or restricting them to frontier ranking, PIGEON enables VLMs to select among task-critical PoIs, including exploration frontiers, suspected target objects, traversable stairs, and floor-level summaries, while low-level planners execute continuous motion between them. This PoI interface further makes high-level navigation decisions verifiable, allowing us to develop an RLVR pipeline that improves local VLMs without manual Chain-of-Thought annotations. Extensive experiments on Habitat ObjectNav benchmarks show that PIGEON achieves state-of-the-art zero-shot performance, scales consistently with foundation model capacity, and transfers to Active Embodied Question Answering with only prompt modifications. Real-world deployments on physical robots further demonstrate its robustness and efficiency.

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

Hardware- and Vision-in-the-Loop Validation of Deep Monocular Pose Estimation for Autonomous Maritime UAV Flight

arXiv:2606.19176v1 Announce Type: cross Abstract: Autonomous UAV operations on ships require reliable vision-based relative pose estimation, yet at-sea validation is costly, weather-dependent, and risky. This paper presents a hardware-validated vision-in-the-loop framework that enables fully autonomous indoor flight while emulating photorealistic maritime environments. Rendered maritime views are processed onboard by a deep transformer-based monocular pose estimator. Delayed vision measurements are fused with high-rate IMU data using a delayed Kalman filter to provide consistent state estimates for geometric control. The system captures critical embedded effects, including perception latency, asynchronous updates, and computational constraints, that are absent in pure simulation. Autonomous takeoff, trajectory tracking, and landing experiments demonstrate stable closed-loop flight. The results establish a safe and hardware-realistic intermediate stage for developing maritime UAV autonomy prior to shipboard deployment.

07.
arXiv (CS.CL) 2026-06-12

Beyond the Commitment Boundary: Probing Epiphenomenal Chain-of-Thought in Large Reasoning Models

Chain-of-thought (CoT) reasoning is the dominant paradigm for inference-time scaling in language models, yet the causal influence of individual steps on the final answer poorly understood. We estimate each step's causal importance via early exit and use this measure to study how answers form across the reasoning traces of several model families. Across diverse tasks, we find that reasoning typically crosses a commitment boundary – a sharp transition from transient intermediate guesses to a stable, high-confidence answer. This transition often happens in a single step, well before the model's reasoning block ends, and is followed by epiphenomenal CoT steps that leave the final answer probability unaltered. Using attention probes, we show that answer-formation stages can be linearly decoded from intermediate reasoning steps with high accuracy and generalize robustly to unseen reasoning tasks. We exploit this signal to early-exit reasoning blocks at the commitment boundary, reducing the length of CoTs up to 55\% on average with negligible impact on model performance.

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

Agentic Framework for Deep Learning workload migration via In-Context Learning

arXiv:2606.15994v1 Announce Type: new Abstract: Translating deep learning models from PyTorch's flexible, object-oriented design to JAX's functional, stateless setup is usually a manual and error-prone task. Automated migration is challenging because Large Language Models (LLMs) struggle with strict and dynamic API alignment and are prone to mistakes for exacting operations. We propose a fully autonomous system that combines In-Context Learning (ICL) with oracle-driven self-debugging. First, we curated an ICL context that serves as a strict reference for idiomatic JAX styling and test case generation. Second, instead of depending on the LLM to deduce mathematical outputs, we run the source PyTorch modules to get their actual dynamic tensor states. This creates an unchangeable execution oracle. We then use an autonomous agentic loop to synthesize tests based on the oracle data. The test cases are executed repeatedly, and the traceback is sent back to the LLM for self-correction. Ablations show that combining ICL references with oracle grounding and self-debugging greatly outperforms pure instructional and basic agentic baselines. This improvement does not add an excessive computational overhead. Our lightweight pipeline achieves 91% numerical equivalence (compared to baseline: 9%, instruction + self-debugging: 27%) on neural modules, providing a highly reliable, scalable blueprint for cross-framework migration. This has been validated across several state-of-the-art models including SAM (segment anything), T5, Code Whisper amongst others showing high numerical equivalency. Code: https://github.com/AI-Hypercomputer/accelerator-agents/tree/main/MaxCode

09.
arXiv (CS.CL) 2026-06-12

MARD: Mirror-Augmented Reasoning Distillation for Mechanism-Level Drug-Drug Interaction Prediction

Mechanism-level drug-drug interaction (DDI) prediction requires identifying which enzyme or pharmacodynamic axis is implicated, in which direction, and with which evidence – not merely whether two drugs interact. We introduce a reproducible mechanism-level DDI labelling and evaluation protocol with a structured 7-family/147-subtype taxonomy, leakage-safe cold-split protocols, and auditable reasoning metrics for evaluating pharmacological prediction beyond flat interaction classification. We propose a pipeline that produces a 7B reasoning MARD (Mirror-Augmented Reasoning Distillation), combining three training innovations: a single-token KL divergence on direction tag that ties the model's prediction, per-loss PRM-weighted DPO with programmatic hard negatives, and a leakage-safe mechanism-aware retrieval channel. Process-reward step labels are automatically verifiable against DrugBank-structured fields, requiring no human or LLM judges. On the April-2026 DrugBank release, our MARD-7B is the only system in a 32-system comparison whose accuracy survives drug-pair novelty, beating the best baseline by +13.9 pp and GPT-4o by +6.7 pp at ~1% of frontier API cost. Further analysis reveals an anti-memorisation signature where accuracy improves on rarely seen drugs, suggesting that gain comes from structured pharmacological reasoning rather than drug-frequency memorisation. We release corpus, DDI-PRM, retrieval index, and training code.

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

Recursive Scaling in Masked Diffusion Models

arXiv:2606.18022v1 Announce Type: new Abstract: Masked diffusion models (MDMs) have recently emerged as a promising paradigm for sequence generation. Scaling MDMs is conventionally achieved by increasing the parameter count or the number of denoising steps. We introduce Recursive Masked Diffusion Models (R-MDMs), which add recursive depth as a third scaling axis by repeatedly applying the same denoising transformer within each diffusion step. Recursion enables iterative refinement of the output through parameter reuse, increasing effective model depth without increasing parameter count. Across structured generation tasks, including Sudoku and Countdown, we show that R-MDMs achieve substantially improved parameter efficiency: a model with $L$ recursive iterations often matches the performance of non-recursive baselines with roughly $L\times$ more parameters. Moreover, recursive refinement can partially substitute for additional denoising steps, allowing recursive models to reach the same generation quality with fewer forward passes at inference time. These results suggest that recursive depth is a practically useful scaling mechanism for MDMs, improving both parameter efficiency and the allocation of test-time compute.

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

A Decision-Theoretic View of Test-Time Training: When, How Far, and Which Directions to Adapt

arXiv:2606.15569v1 Announce Type: new Abstract: Test-time training (TTT) adapts a pretrained model to each prompt via parameter updates, improving accuracy under pretraining-to-test distribution shifts. Yet, its performance often suffers from instability and sensitivity to hyperparameters such as update steps and subspace. We explain this behavior through a decision-theoretic lens, treating TTT as implicit Bayesian inference in the kernel regime. Under a Gaussian process benchmark, we show that TTT reduces prediction error when updates are spectrally matched to the prompt's signal-to-noise ratio and aligned with query-relevant eigen-directions. This perspective underpins the following results: (1) we show when fixed update steps and subspaces fail under distribution shifts, motivating adaptive strategies; (2) we prove that selecting update steps via prompt evidence admits a PAC-Bayes guarantee against overfitting; and (3) we characterize the Bayes-optimal update subspace under a linear-Gaussian correction model, yielding a scoring rule for selecting Transformer blocks and heads. Our theory helps explain the empirical instability of TTT, taking a step toward principled guidance for when, how far, and which directions to adapt.

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

GRASP: Gradient-Aligned Sequential Parameter Transfer for Memory-Efficient Multi-Source Learning

arXiv:2606.14900v1 Announce Type: new Abstract: Multi-source transfer learning faces a fundamental scalability bottleneck: existing approaches require either loading all K source models into memory simultaneously during parameter fusion, requiring O(K) memory, or deploying all models at inference time, making production deployment infeasible. We propose GRASP (Gradient-Aligned Sequential Parameter Transfer), which achieves superior knowledge integration while maintaining O(1) memory consumption through three key innovations: (1) sequential processing that merges one source at a time into an evolving target model, (2) parameter-wise gradient alignment that selectively transfers only parameters whose optimization directions align with the target domain, avoiding negative transfer, and (3) iterative fine-tuning that adapts transferred knowledge before integrating the next source. Extensive experiments across three continual learning benchmarks (Yearbook, CLEAR-10, CLEAR-100) spanning 10 to 108-year temporal distribution shifts and four architectures (1.3M to 25.6M parameters) demonstrate that GRASP achieves 93.5% mean accuracy over all datasets and architectures compared to ensemble method's 71.7% accuracy while requiring only constant memory versus K models for standard multi-source fusion. Critically, GRASP's sequential previously merged models and scales to arbitrarily many sources without memory growth, making it uniquely suitable for resource-constrained deployment and continually evolving source domains.

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

AnalogFed: Privacy-Preserving Discovery of Analog Circuits at Scale with Federated Generative AI

arXiv:2507.15104v2 Announce Type: replace-cross Abstract: Recent advances in generative AI (GenAI) have shown transformative potential for modern hardware design. However, existing GenAI-driven approaches fall short of enabling large-scale electronic design automation (EDA) due to the proprietary and siloed nature of hardware datasets, which cannot be centralized for model training. Achieving at-scale GenAI-driven EDA, therefore, requires a novel privacy-preserving framework that can leverage distributed data without compromising confidentiality. This work introduces AnalogFed, the first privacy-preserving framework for large-scale analog circuit topology discovery using federated learning (FedL) and GenAI. AnalogFed establishes the feasibility of collaborative analog topology design while addressing key security challenges: it mitigates membership inference attacks (MIAs) through a novel input perturbation strategy based on dummy token injection, and defends against model inversion attacks with customized, efficient homomorphic encryption. Extensive experiments demonstrate AnalogFed's effectiveness and efficiency, achieving strong privacy protection without degrading model utility. This framework lays the foundation for scalable, multi-party collaboration in next-generation hardware design automation with GenAI.

14.
Nature Medicine 2026-06-10

Brain Health for Economic Resilience: a data-driven framework for the brain-positive economic transition

Announced in this Comment and in collaboration with Nature Medicine is the convening of the Brain Health for Economic Resilience Commission, a global, transdisciplinary effort to define, measure and operationalize brain health and cognitive capacity as foundational drivers of economic resilience.

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

Deep Temporal Modeling and Ensemble Fusion for Multimodal Emotion Recognition from Physiological Signals

Physiological stress and emotion recognition are important for health monitoring and affective computing. In this work, we present a comprehensive evaluation of deep learning models such as Long Short-Term Memory (LSTM), Temporal Convolutional Networks (TCN), and Transformer on the WESAD dataset for multimodal affect recognition using wrist and chest sensor signals. We perform ablation studies to assess the individual contributions of each modality by training models on wrist-only and chest-only inputs. In addition, we implement a late-fusion ensemble strategy that combines predictions from all three architectures trained on multimodal input. We also employ early fusion at the sensor level by concatenating wrist and chest signals before feeding them into each model. Our results show that Transformer models consistently achieve the highest accuracy in multimodal settings, while TCN models perform best in the wrist-only configuration. The ensemble method yields the highest overall accuracy (98.91 +/- 0.13%) and macro-F1 score (98.56 +/- 0.17%). These findings demonstrate the effectiveness of sensor fusion and ensemble-based fusion in developing robust systems for physiological emotion recognition.

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

A Text Recognition Dataset from Sahidic Coptic Ancient Manuscripts

In this work, we target Handwritten Text Recognition (HTR) in low-resource scenarios, which arise from underrepresented languages, rare scripts, and degraded visual conditions typical of historical documents. We introduce SCAM (Sahidic Coptic Ancient Manuscripts), a new line-level dataset built from digitized ancient manuscripts written in the extinct Sahidic Coptic dialect. The dataset reflects a realistic and challenging setting, as it combines heterogeneous acquisition conditions across libraries with typical manuscript degradations such as ink fading, bleed-through, and material deterioration. In addition to visual complexity, SCAM poses significant linguistic challenges due to the scarcity of resources for Sahidic Coptic, its uncommon alphabet, and dialect-specific diacritics. To support research in low-resource HTR, we benchmark several state-of-the-art approaches based on different paradigms, highlighting their limitations and strengths in this setting. Our results underline the gap between current HTR performance on well-resourced modern scripts and historically grounded, low-resource scenarios, thus providing a reference point for future developments.

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

HorusEye: Language as Dynamic Attention for Emergency Visual Analysis

作者:

We introduce HorusEye, Language as Dynamic Attention for Emergency Visual Analysis. Our investigation followed five stages. The first one is benchmarking RefCOCO-Degraded, a dataset of 15,244 images (3,811 base images x 4 conditions: Clean, Fog, Smoke and Thermal) with systematic visual degradation. Through four research questions, we evaluate multiple VLMs (Gemini, Qwen2-VL, BLIP-2, LLaVA, Kosmos-2) across visual grounding the second stage, language feedback recovery the third one, health VQA tasks the fourth, and hallucination analysis the final stage. Our key finding is that language feedback effectiveness is model-dependent: Gemini achieves +47.3% improvement in thermal conditions through iterative language feedback, while Qwen2-VL shows -5.1% degradation under the same protocol. We also identify the 'Thermal Paradox' where cropping strategies that improve RGB performance catastrophically fail in thermal imagery. Furthermore, BLIP-2 uniquely hallucinates more under degradation, making it unsuitable for emergency deployment

18.
arXiv (quant-ph) 2026-06-19

Subsystem Quantum Error Correction for Noisy Quantum Metrology

arXiv:2606.19628v1 Announce Type: new Abstract: Quantum error correction has been successfully applied to enhance the precision of parameter estimation in the presence of noise. Nonetheless, existing methods require a number of noiseless, controllable ancillae and lack efficient encoding and decoding procedures. In this Letter, we demonstrate that subsystem error correction provides a new direction that can substantially simplify the metrological protocol. We derive general conditions under which subsystem stabilizer codes achieve the Heisenberg limit and show that, for broad classes of noise, this can be realized by syndrome-free protocols using at most a single ancilla qubit. Furthermore, we extend this framework to dynamical error correction and show that Floquet codes can protect time-dependent metrological signals in reaching the Heisenberg limit.

19.
PLOS Medicine 2026-05-12

Social contact patterns in the United Kingdom following the COVID-19 pandemic: The Reconnect cross-sectional survey

by Lucy Goodfellow, Billy J. Quilty, Kevin van Zandvoort, W. John Edmunds Background Close-contact and respiratory infectious diseases are spread through social interactions. Measuring these interactions has transformed our ability to understand transmission and control these infections. Social contact patterns were disrupted during the COVID-19 pandemic and have been affected by wider demographic, cultural, and workplace changes since then. Methods and findings To estimate post-pandemic social contact patterns in the United Kingdom, we conducted a cross-sectional social contact survey from November 2024 to March 2025 on a nationally representative sample of participants. Interactions were captured by age, gender, and across socioeconomic status (SES) and ethnic groups. We calculated the mean number of daily contacts and contact matrices, stratified by variables of interest, using a negative binomial regression model weighted by age, gender, ethnic group, and weekday/weekend. 13,238 participants were recruited, 3,019 of whom were aged under 18 years old; survey response rates were 36% and 27% for adults and children, respectively. The mean number of daily contacts was 9.1 (95% confidence interval (CI): 8.7, 9.5); this figure was 13.8 (95% CI: 12.8, 14.9) for children, and 7.8 (95% CI: 7.4, 8.2) for adults. Higher numbers of contacts were positively associated with employment, household income, and educational qualifications held. Contact matrices showed high levels of age-assortativity, as well as inter-generational contacts in the home. Contacts were assortative between ethnic groups and SES in all settings; this effect was strongest between ethnic groups in the home, and between SES in the workplace. We constructed socially-stratified next-generation matrices for a novel respiratory pathogen, projecting that the majority White ethnic group would account for the largest share of new infections (76.7% (95% CI: 75.5, 77.9) of cases), but that per-capita infection risk would disproportionately affect minority ethnic groups, with the risk for the Black population being 2.27 (95% CI: 2.06, 2.51) times that of the White population. This study may be limited by the inherent recall biases and reporting fatigue involved with self-reporting contacts. Conclusions This study provides crucial data to inform post-pandemic mathematical models of infectious disease transmission, and allows ethnicity and SES to be incorporated in such models.

20.
arXiv (CS.AI) 2026-06-15

RAMAC: Multimodal Risk-Aware Offline Reinforcement Learning and the Role of Behavior Regularization

arXiv:2510.02695v3 Announce Type: replace-cross Abstract: In safety-critical domains where online data collection is infeasible, offline reinforcement learning (RL) is attractive only if policies achieve high returns without catastrophic lower-tail risk. Prior work on risk-averse offline RL achieves safety at the cost of either (i) value/model-based pessimism or (ii) restricted policy classes that limit expressiveness, whereas diffusion/flow-based expressive generative policies have largely been used in risk-neutral settings. We introduce Risk-Aware Multimodal Actor-Critic (RAMAC), a simple, modular, model-free framework that couples an expressive generative actor (e.g., diffusion/flow) with a distributional critic and optimizes a composite objective that combines Conditional Value-at-Risk (CVaR) with behavioral cloning (BC), enabling risk-sensitive learning in complex multimodal scenarios. Since out-of-distribution (OOD) actions are a major driver of catastrophic failures in offline RL, we further provide an objective-level analysis showing that controlling behavior divergence via BC suppresses OOD actions and stabilizes CVaR. Instantiating RAMAC with a diffusion actor, we illustrate these insights on a 2-D risky bandit and evaluate on Stochastic-D4RL, observing consistent gains in $\mathrm{CVaR}_{0.1}$ while maintaining strong returns. The code and experimental results are available on the \href{https://kaifukazawa.github.io/ramac-project/} {project website}

21.
medRxiv (Medicine) 2026-06-16

Using visual biofeedback to reduce step length error at fast walking speeds is feasible after stroke

Background and Purpose: Walking after stroke is often characterized by persistent biomechanical impairments and reduced walking capacity. While visual biofeedback can improve gait mechanics and fast walking can enhance capacity, it is unclear whether individuals post-stroke can effectively use biofeedback at higher walking speeds to address both deficits simultaneously. This study examined the effects of walking speed on the ability of participants with chronic stroke to reduce step length (SL) errors using visual biofeedback. Methods: Sixteen individuals with chronic stroke walked on a treadmill at slow, self-selected, and fast speeds with and without visual SL biofeedback. Absolute SL error relative to individualized targets was calculated for paretic and non-paretic limbs. Linear mixed-effects models with piecewise linear splines assessed the effects of speed, limb, and feedback condition. Post hoc comparisons were performed for significant interactions. Results: At lower speeds, increasing speed reduced SL error in both limbs (p < 0.001). At higher speeds, the effects of speed were dependent on limb and condition (p < 0.001). Paretic SL error increased with speed without feedback but remained stable with feedback (p < 0.001). Non-paretic SL error decreased with speed regardless of condition. SL error was greater in the paretic limb overall (p < 0.001). Discussion and Conclusions: Fast walking alone did not reduce paretic SL errors. Participants with chronic stroke can effectively use visual biofeedback to reduce paretic SL errors at higher speeds, supporting its integration into high-intensity gait training to simultaneously treat biomechanical impairments and walking capacity deficits after stroke.

22.
arXiv (CS.CV) 2026-06-18

SMART: A Flexible, Interpretable, and Scalable Spatio-temporal Brain Atlas from High-Resolution Imaging Data

We introduce SMART, a framework for learning a flexible, interpretable, and scalable spatio-temporal brain atlas from longitudinal high-resolution 3D medical images. Existing approaches to spatio-temporal atlas construction rely on black-box generative models that lack flexibility, limit interpretability, and struggle to scale to high-dimensional data. SMART addresses these challenges by learning a continuous disease-time atlas that decouples global group-wise disease dynamics from their patient-specific anatomical manifestation. Guided by anatomically inspired priors, SMART models interpretable global trajectories of regional progression along a shared disease timeline through region-specific differential equations. Global trajectories are further personalized to individual anatomies via dense diffeomorphic displacements parameterized by a flexible and scalable multi-scale Neural Cellular Automata. Evaluated on five longitudinal MRI datasets in Alzheimer's disease (ADNI-1/GO/2, OASIS-3, AIBL; > 1,300 subjects), SMART produces anatomically meaningful predictions of disease progression and achieves state-of-the-art forecasting accuracy and improved temporal consistency over adversarial and diffusion baselines. Our approach establishes a new paradigm for flexible, interpretable, and scalable modeling of spatio-temporal change in high-dimensional medical image time-series.

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

Virtual Speech Therapist: A Clinician-in-the-Loop AI Speech Therapy Agent for Personalized and Supervised Therapy

This paper develops Virtual Speech Therapist (VST), an intelligent agent-based platform that streamlines stuttering assessment and delivers customized therapy planning through automated and adaptive AI-driven workflows. VST integrates state-of-the-art deep learning-based stuttering classification, and multi-agent large language model (LLM) reasoning to support evidence-based clinical decision-making. The VST begins with the acquisition and feature extraction of patient speech samples, followed by robust classification of stuttering types. Building on these outputs, VST initiates an agentic reasoning process in which specialized LLM agents autonomously generate, critique, and iteratively refine individualized therapy plans. A dedicated critic agent evaluates all generated therapy plans to ensure clinical safety, methodological soundness, and alignment with peer-reviewed evidence and established professional guidelines. The resulting output is a comprehensive, patient-specific therapy draft intended for clinician review. Incorporating clinician feedback, the system then produces a finalized therapy plan suitable for patient delivery, thereby maintaining a clinician-in-the-loop paradigm. Experimental evaluation by expert speech therapists confirms that VST consistently generates high-quality, evidence-based therapy recommendations. These findings demonstrate the system's potential to augment clinical workflows, reduce clinician burden, and improve therapeutic outcomes for individuals with speech impairments. An interactive user interface for the proposed system is available online at: https://vocametrix.com/ai/stuttering-therapy-planning-agent , facilitating real-time stuttering assessment and personalized therapy planning.

24.
medRxiv (Medicine) 2026-06-17

Treatment of Multi-Drug-Resistant Tuberculosis with Second-Line All-Oral Drugs in Ghana: Incidence of Adverse Events.

Introduction: The treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging due to the toxicity of second-line medications and suboptimal treatment outcomes. This study aimed to determine the incidence of adverse events and identify factors associated with these events in patients undergoing treatment for MDR-TB with second-line all-oral drugs in Ghana. Methods: This retrospective cohort study reviewed the medical records of 384 MDR-TB patients treated with second-line all-oral drugs at selected health facilities in Ghana, including the Greater Accra Regional Hospital, Eastern Regional Hospital, and Kumasi South Hospital. Data were extracted using the Kobo Collect tool, capturing patient demographics, baseline clinical and laboratory characteristics, treatment regimens, and adverse events. The study period spanned from 2020 to August 2024. Results: The study included a total of 384 MDR-TB patients, with a mean age of 45 years (SD = 15). The majority of patients were male (65.78%), and most were within the 45-64 years age group (33.85%), followed by those aged 25-44 years (31.25%). Regionally, the highest number of cases were reported from the Greater Accra Region (39.06%), followed by the Eastern Region (31.25%) and Kumasi South Hospital (29.69%). Approximately one in four patients (25%) presented with comorbidities, with HIV being the most common (19.5%). The most frequently reported adverse events were diarrhea (14%), dizziness (13.7%), and vomiting (12.3%). Most of these were mild to moderate in severity and tended to decrease as treatment progressed. Severe adverse events, such as leukopenia and acute kidney injury, were rare, occurring in less than 5% of patients. Over the course of treatment, gastrointestinal adverse events such as vomiting and nausea showed a significant decline, indicating possible patient adaptation or improved clinical management. Results from the multivariate Poisson regression analysis revealed that age and comorbidities were significant predictors of adverse events. Patients aged 65 years and above had a 56% lower risk of developing adverse events compared to younger patients (Adjusted Risk Ratio [aRR] = 0.44, 95% CI: 0.25-0.79, p = 0.005). Conversely, patients with comorbid conditions such as diabetes or hypertension were approximately 2.6 times more likely to experience adverse events compared to those without comorbidities (aRR = 2.65, 95% CI: 1.58-4.43, p < 0.001). The effect of sex was not statistically significant after adjustment (aRR = 1.03, 95% CI: 0.70-1.50, p = 0.86). At the end of the treatment period, 74.9% of patients achieved successful outcomes, including both those who were cured and those who completed treatment without being classified as cured. However, 25.1% had unsuccessful outcomes, which included treatment failure, relapse, or death. Conclusion: In conclusion, adverse events are common in the treatment of MDR-TB with second-line All-Oral drugs, with gastrointestinal adverse events being the most prevalent. These findings highlight the importance of monitoring and managing adverse events to optimize treatment outcomes for MDR-TB patients in Ghana.

25.
arXiv (CS.LG) 2026-06-17

CoCoEmo: Composable and Controllable Human-Like Emotional TTS via Activation Steering

arXiv:2602.03420v2 Announce Type: replace-cross Abstract: Emotional expression in human speech is nuanced and compositional, often involving multiple, sometimes conflicting, affective cues that may diverge from linguistic content. In contrast, most expressive text-to-speech systems enforce a single utterance-level emotion, collapsing affective diversity and suppressing mixed or text-emotion-misaligned expression. While activation steering via latent direction vectors offers a promising solution, it remains unclear whether emotion representations are linearly steerable in TTS, where steering should be applied within hybrid TTS architectures, and how such complex emotion behaviors should be evaluated. This paper presents the first systematic analysis of activation steering for emotional control in hybrid TTS models, introducing a quantitative, controllable steering framework, and multi-rater evaluation protocols that enable composable mixed-emotion synthesis and reliable text-emotion mismatch synthesis. Our results demonstrate, for the first time, that emotional prosody and expressive variability are primarily synthesized by the TTS language module instead of the flow-matching module, and also provide a lightweight steering approach for generating natural, human-like emotional speech.