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01.
arXiv (CS.CL) 2026-06-15

Persuasion Index: A Theory-Guided Framework for Persuasion Analysis

Identifying persuasive rhetorical cues is critical across domains, from detecting information manipulation and improving AI safety to advancing public health communication. We propose Persuasion Index (PI), a taxonomy of 15 dimensions grounded in persuasion theories from psychology and communication, and one transparent implementation using 55 sub-features built from lexicons and rule-based detectors. The taxonomy is modular: individual detectors can be replaced while preserving the theoretical structure. By evaluating PI on four public datasets varying in domain, style, and outcome measures, we show that PI provides a shared feature space for interpreting rhetorical patterns associated with persuasion-related outcomes. Linear models show that PI features carry meaningful predictive signal while remaining computationally lightweight. Dimension-level analyses reveal recurring associations between PI dimensions and persuasion outcomes across datasets, while also highlighting topic- and stance-specific variation. We release PI as an open-source package and web interface for principled and auditable analysis of human and AI-mediated communication.

02.
arXiv (CS.LG) 2026-06-16

Diffusion Offline Reinforcement Learning for Fair and Energy-Efficient UAV-Assisted Wireless Networks

arXiv:2606.16331v1 Announce Type: new Abstract: The integration of generative artificial intelligence with wireless communication and signal processing systems has opened new avenues for intelligent, data-driven decision-making in future 6G networks. This work proposes a diffusion soft actor-critic (Diffusion-SAC) approach that leverages offline reinforcement learning (RL) enhanced by denoising diffusion probabilistic models (DDPMs) to optimize trajectory and scheduling control in unmanned aerial vehicle (UAV) networks. While offline RL methods, such as conservative Q-learning (CQL), can learn from static datasets, they often struggle to generalize in low-data or dynamic conditions. To address this, we combine the robustness of CQL with the generative power of diffusion models, enabling expressive and signal-aware policy learning that generalizes beyond behavior policies. Applied to a UAV-assisted wireless network, the proposed framework minimizes transmission energy and improves fairness among devices. Simulations show that Diffusion-SAC outperforms standard offline RL baselines, achieving more stable convergence and higher rewards even with limited datasets. The method enhances data efficiency, reduces energy consumption, and increases throughput by more than 35 % compared to existing algorithms, demonstrating its potential for robust policy learning in next-generation wireless control systems.

03.
arXiv (CS.CL) 2026-06-16

CoRA: Confidence-Rationale Alignment for Reliable Chain-of-Thought Reasoning

Chain-of-thought (CoT) reasoning can improve LLM performance, but high answer confidence may be misleading when the accompanying CoT rationale is plausible yet incomplete or poorly supported. We study confidence–rationale alignment: whether a model's confidence in its committed answer is justified by its generated rationale. We introduce a GRPO-based reinforcement learning framework that jointly rewards answer correctness, committed-answer probability, and rubric-based rationale support, where the rubric assesses grounding, coherence, task match, and connection to the selected answer without revealing the gold answer to the judge. Across MedQA, MathQA, and OpenBookQA using three open-weight LLMs, our method reduces the confidence–rationale alignment error by up to 26.51% compared with untuned checkpoints, SFT, and correctness-only GRPO, while maintaining competitive accuracy and often improving calibration. These results show that reliable CoT reasoning requires not only confident answers, but rationales that substantively support them.

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

LAUKIN: A Multi-jurisdictional Common Law Contract Dataset

Multinational companies increasingly require cross-jurisdictional contract review, yet existing legal NLP datasets are largely restricted to a single jurisdiction. We introduce LAUKIN (Legal equivalence dataset of Australia, UK, and INdia), a dataset of clause pairs (AU-UK, UK-IN, IN-AU) labelled for boolean legal equivalence. We develop a novel multi-stage retrieval and reranking pipeline to construct the initial clause pair mapping, with a subset of clause pairs subsequently annotated by legal experts as Equivalent or Not Equivalent. The dataset comprises 14,727 clause pairs from 204 contracts across 8 agreement types, of which 3,000 are manually labelled: 900 train, 600 dev, and 1,500 test. We evaluate 12 models across 4 techniques, achieving a best macro-F1 of 65.11%, establishing LAUKIN as a challenging benchmark. Results reveal that, despite shared legal heritage, drafting conventions diverge significantly across jurisdictions, making cross-jurisdictional equivalence classification non-trivial. LAUKIN also includes 11,727 unlabelled training pairs to support future semi-supervised learning research in legal NLP.

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

The use of Peres lattices in periodically driven systems

arXiv:2606.20009v1 Announce Type: new Abstract: We demonstrate the strength of the method of Peres lattices in periodically driven quantum systems. The method, which has previously been used mostly in stationary systems, enables us to efficiently detect resonances in the driven system, to monitor the onset of chaos, and to recognize critical properties of the Floquet modes. It also allows quick comparisons of the spectra of Floquet modes for various driving Hamiltonians and transparent tests of the iterative approximation techniques based on effective stationary Hamiltonians.

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

Beyond Similarity: Temporal Operator Attention for Time Series Analysis

arXiv:2605.11287v2 Announce Type: replace-cross Abstract: A persistent paradox in time-series forecasting is that structurally simple MLP and linear models often outperform high-capacity Transformers. We argue that this gap arises from a mismatch in the sequence-modeling primitive: while many time-series dynamics are governed by global temporal operators (e.g., filtering and harmonic structure), standard attention forms each output as a convex combination of inputs. This restricts its ability to represent signed and oscillatory transformations that are fundamental to temporal signal processing. We formalize this limitation as a simplex-constrained mixing bottleneck in softmax attention, which becomes especially restrictive for operator-driven time-series tasks. To address this, we propose $Temporal Operator Attention (TOA)$, a framework that augments attention with explicit, learnable sequence-space operators, enabling direct signed mixing across time while preserving input-dependent adaptivity. To make dense $N \times N$ operators practical, we introduce Stochastic Operator Regularization, a high-variance dropout mechanism that stabilizes training and prevents trivial memorization. Across forecasting, anomaly detection, and classification benchmarks, TOA consistently improves performance when integrated into standard backbones such as PatchTST and iTransformer, with particularly strong gains in reconstruction-heavy tasks. These results suggest that explicit operator learning is a key ingredient for effective time-series modeling.

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

What Does the Weight Norm Control in Grokking? Logit-Scale Mediation under Cross-Entropy

arXiv:2606.18465v1 Announce Type: cross Abstract: Grokking, the delayed jump from memorization to generalization, is usually tied to the weight norm: a smaller norm generalizes sooner. We ask what the norm actually controls. Holding the weight norm fixed by clamping and varying only an output temperature, we slide the grokking delay across its entire norm-induced range under cross-entropy; matching the effective logit scale back to baseline recovers about 85% of the delay at two moduli. Across a grid of norms and temperatures the delay collapses onto the logit scale alone (R2 = 0.97), with the norm adding 1-2% beyond it. The effect is loss-dependent: under mean-squared error the logit scale is pinned and the norm acts through a different route. A memorization control, a float64 softmax-collapse audit, and a no-LayerNorm transformer point to the same channel. Forking arms from one identical state, the delay follows the held norm value and not the clamp operation, which closes a rescaling-artifact concern. The proximal variable is the logit scale and the softmax saturation it drives; the weight norm is only an upstream handle. All numbers, tables, and figures reproduce from released code and data.

09.
arXiv (CS.CL) 2026-06-18

ForecastBench-Sim: A Simulated-World Forecasting Benchmark

Forecasting benchmarks for general-purpose AI systems usually inherit the constraints of the real world: outcomes resolve slowly, tail events are rare, and counterfactual questions are difficult to score. We introduce ForecastBench-Sim, a simulated-world forecasting benchmark built on game rollouts from Freeciv, a turn-based strategy game modelled on the Civilization series. Forecasters receive a fixed world report (a structured snapshot of the current game state) and answer questions about hidden future states; the benchmark then continues the simulation and scores forecasts. Because the world is simulated, the same setup can generate continuous or binary forecasting questions at arbitrary time horizons, paired intervention worlds for conditional or causal questions, and resolved examples of rare or disruptive outcomes. We describe the benchmark pipeline, question families, scoring protocol, and release artifacts, and report validation slices from model evaluations and an anonymized human pilot. ForecastBench-Sim is intended to complement real-world forecasting benchmarks by providing controlled, immediately resolvable tasks for studying probabilistic reasoning under dynamic world states.

10.
arXiv (CS.AI) 2026-06-18

LLM-Evolved Domain-Independent Heuristics for Symbolic AI Planning

arXiv:2605.29649v2 Announce Type: replace Abstract: Heuristic search is the dominant paradigm in symbolic AI planning, and the strongest heuristics are the result of decades of work by planning researchers. Recent work has shown that large language models (LLMs) can design heuristics for individual planning domains, but no LLM-generated heuristic has so far worked on arbitrary planning tasks. In this paper, we use evolutionary search to produce the first LLM-generated domain-independent heuristics that exceed the hand-engineered state of the art. We let an LLM mutate parent heuristics written in C++, store candidates in a MAP-Elites archive keyed on informedness and speed and calculate fitness scores by blending coverage with solving time. To place the evolved programs in context, we additionally benchmark a broad set of hand-engineered heuristics on their informedness-speed tradeoff, which to our knowledge has not been done before. On unseen testing domains, our best evolved heuristic solves more tasks than even the strongest baseline, with our full heuristic suite spanning the Pareto frontier of said tradeoff. We also find that seeding evolution from the trivial blind heuristic outperforms seeding from the strong FF heuristic, even when the resulting program is itself an FF variant, and that LLM reasoning effort affects how often candidates compile much more than the quality of those that do. Because the evolved programs are plain C++, they slot into existing planners as drop-in replacements and inherit the soundness and completeness guarantees of the underlying search.

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

Toten: Knowledge-Based Ontological Tokenization Of Physical Quantities And Technical Notation In Brazilian Portuguese

Byte-Pair Encoding tokenization is statistically efficient for vocabulary compression, but semantically blind to structured technical entities, fragmenting physical quantities, numbers, units, and symbolic expressions into lexically arbitrary subwords. We present TOTEN, a knowledge-based ontological tokenization framework that replaces statistical derivation with declarative classification grounded in a formal ontology of engineering entities (OEE). We formalize TOTEN as the triple : the ontology gathers types, structural principles, composition relations, and preservable invariants; the classification function maps raw text into typed regions; and the instantiator family yields a self-descriptive structured representation. Robustness derives from deterministic coupling with three external oracles: Pint (dimensional), Unicode Character Database (typographic), and RSLP (Portuguese morphology). Intrinsic evaluation covers four properties verifiable by construction – ontological atomicity, dimensional equivalence, typographic robustness, and numerical reconstruction – over an internal, physically validated benchmark (EngQuant, N=800) and four Brazilian Portuguese external corpora (N=1771 eligible cases). We also report detection recall, distinguishing coverage from conditional atomicity. Against eight state-of-the-art baselines, TOTEN achieves unit ontological atomicity in all contrasts and numerical reconstruction of 0.775-0.904 on external corpora, vs. 0.627-0.703 for the best baseline (Quantulum3); on EngQuant, 0.780 vs. 0.340. Differences are statistically significant (McNemar with Holm correction). Spearman correlation between internal and external rankings confirms concurrent validity of the control benchmark. Dimensional equivalence shows statistical parity with Pint, the oracle from which the system inherits dimensional authority.

12.
Nature (Science) 2026-06-09

People are turning to AI chatbots to plug gaps in health information

A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies. A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies.

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

Context-Aware RL for Agentic and Multimodal LLMs

Large language models (LLMs) often fail when answering requires identifying a small but decisive piece of evidence within a long or complex context, such as a single line in a tool trace or a subtle detail in an image. We propose ContextRL, a context-aware reinforcement learning (RL) method that improves long-horizon reasoning and multimodal performance through an indirect auxiliary objective. Instead of supervising only the final answer, ContextRL presents the model with a query, an answer, and two highly similar contexts, and rewards it for selecting the context that supports the query–answer pair, thereby encouraging fine-grained grounding. We construct contrastive context data in two domains: for coding agents, trajectories serve as contexts, yielding 1k pairs built via condition filtering; for multimodal reasoning, images serve as contexts, yielding 7K pairs built via generative editing and similarity search. ContextRL achieves average gains of +2.2% over standard GRPO on 5 long-horizon benchmarks, and +1.8% across 12 diverse visual question answering benchmarks. To disentangle the effect of the proposed objective from that of additional data, we compare against data-augmentation baselines that repurpose the same contrastive contexts as standard query–context–answer examples. These baselines provide little to no improvement, showing that the gains arise from the proposed context-selection objective rather than from the contrastive data alone.

15.
arXiv (CS.LG) 2026-06-19

QMaxCal: Path-Space Regularization for Open Quantum Control via Girsanov's Theorem

arXiv:2606.19947v1 Announce Type: cross Abstract: Reliable quantum control in the presence of decoherence requires policies that combat the effect of environmental noise on the controlled dynamics. Open quantum systems under continuous monitoring generate classical measurement records whose drift depends on the noise experienced by the system; the records of two evolutions sharing the same decoherence channels differ only in this drift, so Girsanov's theorem yields a closed-form, differentiable estimator of the KL divergence between their trajectory distributions. We instantiate this estimator with two physically motivated reference measures, yielding two regularizers that both drive the system toward states where the effects of decoherence are minimal: the Wiener KL (KL_W), which is empirically more effective under certain conditions on the noise model, and the drift-variance regularizer (R_DV), which works for all noise models. Both are qualitatively distinct from existing penalties on control fluence or smoothness: they penalize the observable consequences of control on the decoherence channels rather than the control amplitude itself. The regularizers outperform unregularized gradient-based and reinforcement-learning baselines across a range of open quantum systems – including single- and multi-qubit benchmarks and a multi-qubit chain calibrated to a published snapshot of the IBM Kingston processor – along several axes of evaluation: final-state fidelity, robustness to mismatch in the assumed noise model (gains grow from +17 pp at training noise to +27 pp under 2.5x noise mismatch), and occupation of forbidden states. The regularizers reduce infidelity by up to 50%, with ~16% gains on the calibrated IBM Kingston chain.

16.
medRxiv (Medicine) 2026-06-16

Infections and suicide and self-harm: a population-based matched cohort study

Background Infections have been associated with adverse mental health outcomes, including suicide, but evidence beyond severe or central nervous system infections is limited. We investigated associations between a range of acute infections and subsequent suicide/self-harm outcomes. Methods We conducted six infection-specific matched cohort studies using English primary care records from the Clinical Practice Research Datalink Aurum (2007-2024), linked to hospital admissions and mortality data. Adults ([≥]18 years) with a primary care record of infection (gastroenteritis, lower respiratory tract [LRTI], skin/soft-tissue [SSTI], urinary tract [UTI], sepsis, meningitis/encephalitis [positive control]) were matched (age, sex, practice, calendar period) to up to five comparators without infection. We estimated hazard ratios (HRs) for suicide/self-harm outcomes using Cox regression, stratified by matched set and implicitly adjusting for matching factors, with additional adjustment for deprivation, lifestyle factors, and comorbidities. We examined whether associations varied over time, by infection severity, antimicrobial treatment, sex, and prior mental health conditions. Findings Cohorts ranged from 18,192 individuals with meningitis/encephalitis (matched to 90,915 without) to 398,099 with SSTI (matched to 1,743,747). After adjustment, individuals with infection had a higher hazard of suicide/self-harm outcomes than comparators across all cohorts: sepsis (HR 1.79, 95% CI 1.65-1.93), gastroenteritis (1.62, 1.55-1.70), meningitis/encephalitis (1.56, 1.32-1.84), UTI (1.41, 1.33-1.50), SSTI (1.37, 1.31-1.43), and LRTI (1.37, 1.31-1.44). Risk was highest in the year post-infection, attenuating over time, and was higher among severe infections and those without prior mental health conditions. Interpretation Common acute infections recorded in primary care are associated with increased risk of suicide and self-harm, particularly following severe infections and in the year post-infection. Findings support suicide risk monitoring following acute infection, particularly among individuals without prior mental health conditions, and highlight infection prevention as a potentially modifiable strategy in vulnerable populations. Funding Wellcome and La Caixa. Copyright This work is licensed under a Creative Commons Attribution (CC BY) licence.

17.
arXiv (quant-ph) 2026-06-12

Exotic critical states as fractional Fermi seas in the one-dimensional Bose gas

arXiv:2602.17656v2 Announce Type: replace-cross Abstract: Critical quantum field theories occupy a central position in modern theoretical physics for their inherent universality stemming from long-range correlations. As an example, the Tomonaga-Luttinger liquid (TLL) describes a wealth of one-dimensional quantum systems at low temperatures. Its behavior is deeply rooted in the emergence of an effective Fermi sea, leading to power-law correlations and Friedel oscillations. A promising direction to realize systems exhibiting novel universal behavior beyond TLL is through the generalization of the underlying Fermi sea. In this Letter, we show that fractional Fermi seas with reduced occupancy arise in an integrable Bose gas driven out of equilibrium by cyclic changes in interactions from repulsive to attractive. The correlation functions feature signatures of criticality incompatible with a conventional TLL, suggesting a novel critical phase. Our predictions, based on Generalized Hydrodynamics, are directly relevant to cold atoms.

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

STAR-NT: Spatiotemporal Acceleration of Real-Time Neural Transparency Rendering

arXiv:2606.16747v1 Announce Type: cross Abstract: Neural order-independent transparency delivers high-quality rendering of overlapping transparent surfaces, but its geometry passes and network input generation remain costly, particularly on mobile and legacy hardware. We present a spatiotemporal acceleration framework that exploits spatial and temporal coherence to reduce this overhead while preserving visual quality. Spatially, we use adaptive quadtree-based screen-space subdivision to scale geometry pass resolution according to local color variance. Temporally, selected frames reuse the previous transparency result through depth-based reprojection instead of full rendering. Together, these optimizations reduce rendering cost and integrate efficiently into existing real-time rendering pipelines.

19.
arXiv (CS.AI) 2026-06-15

TwinBI: An Agentic Digital Twin for Efficient Augmented Interactions with Business Intelligence Dashboards

arXiv:2606.13731v1 Announce Type: new Abstract: Business intelligence (BI) increasingly combines dashboard interaction with LLM-based assistance, but these two modes often fall out of sync during multi-step analysis. As users switch between direct dashboard manipulation and natural-language queries, it becomes difficult to preserve a consistent analytical state across filters, hierarchies, metrics, and chart context. We present TwinBI, an agentic digital-twin framework that couples an LLM-based agent system with an executable BI dashboard state. TwinBI unifies conversational interaction, dashboard manipulation, semantic grounding, and provenance tracking through a shared analytical state reconstructed from a unified interaction log. It also exposes artifacts such as schema views, SQL, logs, and an /insights command for state-grounded analytical summaries. We evaluate TwinBI in two complementary ways. In a controlled A/B benchmark with the same backbone agent, TwinBI improves exact-match accuracy from 43.3% to 63.3%, partial-credit accuracy from 48.3% to 70.8%, and substantially reduces timeout rate from 40.0% to 10.0% relative to Dashboard alone. In a usability study, participants benefited from the integrated dashboard-and-chat workflow, with high task accuracy, moderate workload, and favorable ratings for state-aware interaction mechanisms. These results suggest that TwinBI improves both agent-level analytical reliability and user-facing analytical support by turning visible dashboard state into richer actionable context. Our dataset and source code are available at: https://github.com/simonjisu/TwinBI

20.
arXiv (CS.CL) 2026-06-19

PsyScore: A Psychometrically-Aware Framework for Trait-Adaptive Essay Scoring and ZPD-Scaffolded Feedback

Effective Automated Essay Scoring (AES) are expected to support both reliable assessment and actionable instructional feedback. However, existing approaches often treat scoring and feedback as separate components: neural scoring models provide limited interpretability, while Large Language Model (LLM)-based feedback is typically insensitive to learners proficiency levels. To address this fragmentation, this work proposes PsyScore, a psychometrically-aware framework that integrates diagnostic assessment with instructional scaffolding through a shared latent ability representation. PsyScore comprises three key modules: a Trait-Adaptive Neural IRT Scorer that incorporates the Graded Partial Credit Model (GPCM) into a neural architecture, enabling the precise estimation of student ability while maintaining psychometric interpretability, a ZPD-Scaffolded Feedback Generator, which conditions multi-agent feedback strategies on the diagnosed ability parameter to adapt instructional focus across different proficiency levels, and a Multi-Perspective Feedback Evaluation Strategy that assesses feedback quality via pairwise preference judgements and student revision simulations. Experiments on the ASAP++ dataset demonstrate that PsyScore achieves competitive scoring performance while providing more pedagogically aligned feedback.

21.
arXiv (quant-ph) 2026-06-11

Probing Quantum States over Spacetime Through Interferometry

arXiv:2507.19258v3 Announce Type: replace Abstract: Establishing a notion of the quantum state that applies consistently across space and time could be a crucial step toward formulating a relativistic quantum theory. We give an operational meaning to multipartite quantum states over arbitrary regions in spacetime through a causally agnostic measurement, a measurement scheme that can be consistently implemented independently of the causal relation between the regions. We prove that such measurements can always be implemented with interferometry, also known as the scattering circuit technique, wherein the conventional density operator, the recently developed quantum state over time (QSOT), and the process matrix formalisms smoothly merge. This framework allows for a systematic study of mixed states in the temporal setting, which turn out to be crucial for modeling quantum non-Markovianity. Based on this, we demonstrate that two different ensembles of quantum dynamics can be represented by the same QSOT, indicating that they cannot be distinguished through interferometry. Moreover, our formalism reveals a new type of spatiotemporal correlation between two quantum dynamics that originates from synchronized propagation in time under time-reversal symmetry. We show that quantum systems with such correlation can be utilized as a reference frame to distinguish certain dynamics indistinguishable under time-reversal symmetry.

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

HSQ-VLM: A Novel Spatially-Constrained Quadrant Segmentation VLM Model for Explainability in Diabetic Retinopathy

Diabetic Retinopathy (DR) is an aggressive retinal disease and a leading cause of global blindness, yet its clinical management is currently hindered by the black-box nature of diagnostic AI. While deep learning models achieve high classification accuracy, there is a critical lack of explainability methods capable of detailing the exact anatomical landmarks and lesion distributions that lead to a clinical decision for DR. Therefore, we propose HSQ-VLM, a novel quadrant segmentation pipeline on fundus images that utilizes a Landmark-Anchored Cartesian Cross-Attention mechanism to unify visual feature extraction with structured clinical reasoning. Unlike traditional methods that rely on arbitrary image partitioning, our pipeline implements 4-quadrant Topological Latent Partitioning (TLP) to dynamically align retinal features with a fovea-centered coordinate system. This allows the Vision-Language Model to generate natural language reports that quantify pathology with anatomical precision. On a dataset of 3,500 high-resolution fundus images, this innovative methodology achieved a lesion detection sensitivity of 99.6% for hemorrhages and 96.4% for microaneurysms, while demonstrating a significant reduction in boundary-ambiguity errors compared to standard segmentation baselines.

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

A Judge-Aware Ranking Framework for Evaluating Large Language Models without Ground Truth

arXiv:2601.21817v3 Announce Type: replace-cross Abstract: Evaluating large language models (LLMs) on open-ended tasks without ground-truth labels is increasingly done via the LLM-as-a-judge paradigm. A critical but under-modeled issue is that judge LLMs differ substantially in reliability; treating all judges equally can yield biased leaderboards and misleading uncertainty estimates. More data can make evaluation more confidently wrong under misspecified aggregation. We propose a judge-aware ranking framework that extends the Bradley-Terry-Luce model by introducing judge-specific discrimination parameters, jointly estimating latent model quality and judge reliability from pairwise comparisons without reference labels. We establish identifiability up to natural normalizations and prove consistency and asymptotic normality of the maximum likelihood estimator, enabling confidence intervals for score differences and rank comparisons. Across multiple public benchmarks and a newly collected dataset, our method improves agreement with human preferences, achieves higher data efficiency than unweighted baselines, and produces calibrated uncertainty quantification for LLM rankings.

25.
medRxiv (Medicine) 2026-06-12

A Machine Learning Pipeline for Scalable Annotation of Patient-Ventilator Dyssynchrony from Bedside Ventilator Data

Objective: Patient-ventilator dyssynchrony (PVD) is a common and clinically consequential problem in critically ill patients receiving invasive mechanical ventilation. Yet automated identification of PVD subtypes at scale remains an unmet clinical need, owing to the lack of large annotated bedside waveform datasets. Methods: We developed and validated a semi-supervised algorithm for automated annotation of PVD. In two medical ICUs at a tertiary academic center, bedside devices continuously collected airway flow and pressure waveforms from the ventilators. We developed a software interface with an information retrieval system that grouped similar breaths for expert human review, yielding 1,542,296 labeled breaths across eight categories: 2 labels for breath delivery mode, 5 labels for PVD subtypes, and 1 label denoting a normal breath. Two pulmonary physicians with expertise in ventilator training and education provided the expert reference labels. We trained an initial classification model on a model-derivation set of 771,148 breaths (divided into training and validation) and evaluated it on a hold-out test set of 771,149 breaths A semi-supervised approach was utilized to extend labeling to an additional 12,965,000 unlabeled breaths. Results: The supervised model performed well across all labels, with Macro-F1 scores between 0.96 and 1.00. Semi-supervised learning across 12 rounds expanded the training set from 771,148 to 8,563,995 breaths without significant performance degradation. Conclusion: We developed a practical and scalable system for automated PVD annotation that performed well across all subtypes. This work provides a reproducible foundation for automated PVD labeling to support the development of machine-learning-based clinical decision support systems for identifying patient-level asynchrony.