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01.
arXiv (CS.CL) 2026-06-11

ProHiFlo: Hierarchical Flow Matching with Functional Guidance for De Novo Protein Generation

De novo protein generation has transformative potential in therapeutic design, enzyme engineering, and synthetic biology. While diffusion-based and flow matching approaches have achieved progress, they typically operate at single resolution and lack mechanisms for incorporating functional constraints. We introduce ProHiFlo, a hierarchical flow matching framework with three innovations: (1) coarse-to-fine generation that models backbone geometry before refining to all-atom coordinates, reducing computational cost while maintaining accuracy; (2) functional guidance leveraging pretrained predictors to steer generation toward desired properties without retraining; (3) adaptive SE(3)-equivariant architecture for efficient multi-scale processing. Experiments on unconditional generation, motif scaffolding, and functional design demonstrate state-ofthe-art performance while requiring 4 fewer sampling steps. On enzyme active site scaffolding, ProHiFlo achieves 58.9% success rate compared to 41.2% for RFDiffusion.

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

A Controlled Benchmark of Quantum-Latent GAN Augmentation for Brain MRI

Medical image classification is often constrained by limited labeled data, motivating generative augmentation; recently, quantum generative models have been proposed for this purpose, frequently reporting accuracy gains. However, such claims are typically based on single training runs, do not match the parameter budgets of the quantum and classical generators, and do not characterize the data regime in which any benefit appears. We present a controlled benchmark that isolates the contribution of a quantum generator to brain-MRI augmentation. Images are encoded into a KL-regularized latent space in which a conditional Wasserstein GAN with gradient penalty is trained using either a variational quantum generator or a classical generator of near-identical parameter count (1648 vs. 1632). Synthetic samples are decoded and used to augment a pretrained classifier across labeled data fractions from 5% to 100%, evaluated over eight random seeds with paired significance testing (with multiple-comparison correction) and with intraset diversity and latent-distribution analyses. Across all fractions, no augmentation variant significantly outperforms real-data-only training, and the quantum and classical generators are statistically indistinguishable. Any low-data benefit behaves as regularization rather than faithful data expansion:synthetic samples are off distribution and severely mode collapsed precisely where data is scarce, and the quantum generator is no more diverse thanits classical counterpart. We release the protocol as a testbed for rigorous evaluation of quantum generative augmentation in medical imaging.

03.
arXiv (CS.CL) 2026-06-11

Language Shapes Mental Health Evaluations in Large Language Models

Multilingual large language models (LLMs) are increasingly used in socially sensitive mental health contexts, including support chatbots, screening, and content moderation. This raises a reliability question: do semantically equivalent mental health inputs elicit comparable evaluations across languages, or systematic shifts consistent with language-associated social and cultural contexts? We examine this question in an English-Chinese setting with GPT-4o and Qwen3-32B using a two-level framework: construct-level evaluative orientation, measured by psychometric stigma instruments, and decision-level behavior, measured by binary stigma detection and four-class depression severity classification. Across instruments and models, Chinese prompts elicit higher stigma-related scores than English prompts. At the decision level, Chinese prompts reduce sensitivity to stigmatizing content and produce more conservative depression severity judgments, leading to more under-estimation errors. These findings show that prompt language can shift both evaluative orientation and downstream behavior in LLM-based mental health evaluation. They highlight the need to evaluate multilingual LLMs not only for aggregate performance, but also for whether they apply comparable evaluative standards across languages in socially sensitive domains.

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

Proact-VL: A Proactive VideoLLM for Real-Time AI Companions

Proactive and real-time interactive experiences are essential for human-like AI companions, yet face three key challenges: (1) achieving low-latency inference under continuous streaming inputs, (2) autonomously deciding when to respond, and (3) controlling both quality and quantity of generated content to meet real-time constraints. In this work, we instantiate AI companions through two gaming scenarios, commentator and guide, selected for their suitability for automatic evaluation. We introduce the Live Gaming Benchmark, a large-scale dataset with three representative scenarios: solo commentary, co-commentary, and user guidance, and present Proact-VL, a general framework that shapes multimodal language models into proactive, real-time interactive agents capable of human-like environment perception and interaction. Extensive experiments show Proact-VL achieves superior response latency and quality while maintaining strong video understanding capabilities, demonstrating its practicality for real-time interactive applications.

05.
arXiv (CS.AI) 2026-06-18

HAARES Half-Split Residual Basis Routing for Deep Transformers

Authors:

arXiv:2606.06564v2 Announce Type: replace-cross Abstract: Block-level residual routing makes learned residual aggregation practical by routing over block summaries, but each summary compresses an ordered sequence of attention and MLP updates into one cumulative vector. We propose \method{}, a lightweight residual basis router that keeps the cumulative block source and adds one half-split detail basis, computed as the difference between first-half and second-half residual updates. The detail basis is RMS-matched and updated online, exposing coarse intra-block trajectory information without dense sublayer-level routing. Across OpenWebText, cross-domain character-level benchmarks, and BPE-tokenized OpenWebText, the empirical pattern is depth-dependent: gains are small or mixed at shallow depth and most reliable in 48-layer models. In the 201M 48-layer setting, \method{} improves over Block AttnRes across all three seeds, while a 453M two-seed probe shows the same direction. Ablations rule out source duplication, random signed details, fixed detail-source biases, or block-count changes alone. Cost analysis shows that the method is FLOP-light but not wall-clock-free: it adds memory and routing overhead, yet its relative arithmetic cost is amortized as width grows and earlier convergence can reduce time-to-target.

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

INDEQS: Informed Neural controlled Differential EQuationS

arXiv:2606.19138v1 Announce Type: new Abstract: Neural Controlled Differential Equations (NCDE) provide a powerful continuous-time framework for forecasting time series, but standard graph-based extensions typically learn spatial structure purely from data, even in settings where a directed graph structure is known a priori. We introduce Informed Neural controlled Differential EQuationS (INDEQS), a graph-based NCDE forecasting method that incorporates prior knowledge of a directed graph at distinct architectural positions. INDEQS separates inner mixing of hidden states across graph nodes from outer mixing between vector field and control, and offers both a lightweight graph-constrained variant and a more expressive variant, learning additional graph connections from data via adaptive graph convolutions. To systematically study when graph informedness is beneficial in forecasting, we devise a continuous advection simulation on directed graphs, yielding synthetic spatio-temporal datasets with known ground-truth flow structure. We then evaluate INDEQS on two real-world tasks: river discharge forecasting on a hydrological network and traffic flow prediction on PeMS08. Across these synthetic and real-world benchmarks, outer informedness consistently improves mean absolute error over an uninformed NCDE with comparable parameter count, particularly on larger graphs, while inner informedness offers a more parameter-efficient alternative when strict adherence to a known adjacency is desired. A comparison of discrete convolutional and continuous-time decoders further shows that continuous decoders yield better accuracy and greater temporal flexibility on real-world tasks. An implementation of INDEQS and the advection simulation is available at https://github.com/Mitchi1/indeqs.

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

Deployment-Centered Evaluation: Predicting Query-Level Rejection Risk in a Clinical LLM System

arXiv:2606.12702v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly integrated into clinical systems, making it essential to evaluate the real-world utility of these systems. However, static benchmarks tend to measure correctness rather than user acceptance, aggregate performance across queries, and require densely annotated datasets – leading to major blind spots for evaluating clinical systems. In this work, we perform a deployment-centered evaluation of an LLM system embedded within electronic health records at an academic medical center, where user feedback is sparse but closely reflects the deployment conditions. Specifically, we train a pre-response classifier that estimates the risk that a future interaction will result in the user rejecting the LLM response, based on query content and deployment-specific context available before generation. We conduct a prospective analysis of our model over 4.5 months of user feedback, finding that our prediction model achieves an AUROC of 0.719. Further, we estimate the benefit of such predictions in two downstream use cases (guardrail triggering and abstention). Our key conceptual insight is that making use of deployment-specific context (i.e., the provider type, department name, language model used for response), as opposed to only query content, improves the ability to predict whether the user will reject the system output. Altogether, our empirical case study demonstrates the feasibility of predicting user rejection using deployment-specific context, opening the door to targeted guardrails.

08.
arXiv (quant-ph) 2026-06-19

Hybrid VQE-CVQE algorithm using diabatic state preparation

arXiv:2512.04801v2 Announce Type: replace Abstract: We propose a hybrid variational quantum algorithm that has variational parameters used by both the quantum circuit and the subsequent classical optimization. Similar to the Variational Quantum Eigensolver (VQE), this algorithm applies a parameterized unitary operator to the qubit register. We generate this operator using diabatic state preparation. The quantum measurement results then inform the classical optimization procedure used by the Cascaded Variational Quantum Eigensolver (CVQE). We demonstrate the algorithm on a system of interacting electrons and show how it can be used on long-term error-corrected as well as short-term intermediate-scale quantum computers. Our simulations performed on IBM Brisbane produced energies well within chemical accuracy.

09.
medRxiv (Medicine) 2026-06-16

Upper airway disease in primary ciliary dyskinesia: Clinical management and factors influencing decision-making, a multicentre analysis

Background Upper airway disease is common in primary ciliary dyskinesia (PCD), but management evidence is limited. We aimed to describe management practices and identify factors influencing management decisions. Methods Using data from the Ear-Nose-Throat (ENT) Prospective International Cohort of patients with PCD (EPIC-PCD) and an ENT-specialist survey across participating centres, we described management practices recorded at routine follow-up. We assessed clinical factors associated with practices via mixed-effects logistic regression models. In a subgroup of patients, we assessed factors associated with initiation or discontinuation of practices. Results We included 579 patients: median age 15 years, 46% female. Nasal rinsing (54%) and nasal corticosteroids (22%) were most frequently prescribed. Among 466 patients with available data, 47 had grommets (10%) and 42 hearing aids (9%). Nasal corticosteroids and rinsing were more frequently prescribed in patients with polyps (odds ratio [OR] 3.74, 95% confidence interval [CI] 1.80-7.76; OR 3.39, 95% CI 1.37-8.37) or turbinate hypertrophy (OR 1.89, 95% CI 1.03-3.47; OR 2.89, 95% CI 1.55-5.38), and upper airway nebulisation in patients with frequent nasal symptoms (OR 2.86, 95% CI 1.11-7.39). Management practices differed between centres, as seen also by the specialists survey responses. In 177 patients with multiple visits, initiation of nasal rinsing was associated with frequent nasal symptoms (OR 3.18, 95% CI 1.24-8.18) and turbinate hypertrophy (OR 3.21, 95% CI 1.20-8.59). Conclusion Upper airway disease management in PCD varies and is partly guided by symptom burden and clinical findings. This variation across centres highlights the need for care standardisation and PCD-specific management guidelines.

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

Trade-offs in Medical LLM Adaptation: An Empirical Study in French QA

The development of large language models (LLMs) has led to an increased focus on their adaptation to specialized domains and languages, yet the effectiveness of domain adaptation strategies remains unclear. We present a study of medical domain adaptation using French medical question-answering (QA) as a case study. We compare continual pretraining (CPT), supervised fine-tuning (SFT), and their combination across three model families, multiple sizes, and three initialization types, explicitly disentangling adaptation effects from base model choice. We evaluate both multiple-choice (MCQA) and open-ended QA (OEQA) under greedy and constrained decoding using automatic metrics and LLM-as-a-Judge evaluation. For MCQA, CPT+SFT most often achieves the best scores, but gains over SFT are small and frequently not statistically significant, making SFT a strong and cost-effective default. For OEQA, CPT consistently improves overlap-based metrics, while SFT often degrades generation quality; instruction tuning and CPT+SFT are preferred by LLM-based evaluation. Cross-lingual experiments further show effective transfer from French adaptation to English benchmarks. Overall, we provide practical guidelines for selecting adaptation strategies under computational constraints.

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

Conflict-Aware Federated Fine-Tuning of Large Language Models with Mixture-of-Experts

arXiv:2606.15625v1 Announce Type: new Abstract: The continuous scaling of large language models (LLMs) incurs prohibitive computational costs, making Mixture-of-Experts (MoE) a scalable alternative for efficient fine-tuning via sparse activation. While federated learning (FL) emerges as the paradigm for privacy-preserving collaborative optimization, integrating MoE into FL under data heterogeneity may trigger conflicting expert optimizations. Client-specific data distributions force same-indexed experts to optimize under inconsistent or even conflicting feature-label correlations. This mismatch induces destructive interference during aggregation, thus destabilizing the optimization trajectory and degrading model performance. To address this issue, we propose FC-MoE, a federated conflict-aware framework for MoE fine-tuning. It employs an importance aware weighting scheme to prioritize reliable local updates and utilizes gradient consensus projection to suppress conflicting updates, ensuring a stable global optimization path. Moreover, a local knowledge retention mechanism further preserves specialized client expertise by re-anchoring domain-specific residuals. Extensive experiments demonstrate that FC-MoE accelerates convergence and enhances both global and local model performance in non-IID federated environments.

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

From Benchmarks to Skills: Low-Rank Factors for LLM Evaluation

Current evaluations of large language models (LLMs) rely heavily on a growing collection of benchmarks and on aggregate benchmark scores, yet it remains unclear what this comparison actually captures, and what these scores reveal about models' underlying capabilities. Here, we propose a new paradigm for LLM evaluation, by asking whether benchmark performance reflects many independent abilities, or rather relies on a small number of shared dimensions. To answer this, we apply Factor Analysis (FA) to a massive performance matrix of LLMs versus benchmarks \((60\times44)\) revealing an intrinsically low-rank structure of that matrix. That is, a small number of latent factors captures most of the structure in the full task space. This low-rank geometry reveals substantial redundancy across existing tasks and explains why many benchmarks appear to be measuring overlapping abilities. We further show that these latent factors correspond to coherent, skill-like, dimensions of LLM behavior. Leveraging this latent skill-space, we deliver three practical tools for LLM evaluation and downstream users: (i)~identifying redundant tasks, (ii)~profiling new models using a small subset of tasks, and (iii)~selecting models aligned with desired skill profiles. Our method provides a solid alternative to the de-facto standard of a single aggregate score, and establishes an interpretable and practical framework for understanding and benchmarking LLM core capabilities.

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

A prior-free blind detection of information leakage from model predictions

arXiv:2606.11267v1 Announce Type: new Abstract: Data leakage – contamination of a model with information unavailable at baseline – is the dominant reproducibility failure in machine-learning-based science, yet detection tools require training code, external data, or domain expertise. None operates on the artifact an auditor most often holds: the model's output. We ask what can be decided about leakage from predictions and outcomes alone. We give a decision-theoretic framework in which leakage diagnostics are functionals of the predicted-risk/outcome law, parameterized by a threshold-weighting linked to proper scoring rules and decision-curve analysis. We prove a sharp impossibility: a recalibrated leak matching an honest model's calibration and discrimination is indistinguishable from honest performance by any function of the predictions, so the broad class is detectable only against an externally supplied ceiling on achievable discrimination. We then prove what leakage cannot hide: a near-deterministic subgroup – the signature of a near-label leak – produces a sustained unit-purity head that no legitimate predictor of a non-deterministic outcome can manufacture, yielding a prior-free test. These results organize leakage into a trichotomy – miscalibrated, broad-calibrated, and deterministic – each with a matched detector and failure mode. We validate on UK Biobank using time-windowed comorbidity leakage with known, graded severity, measuring a detection floor of $\Delta\cstar \approx 0.007$ on this endpoint, below which residual leakage is undetectable from output and too small to alter conclusions. The numerical floor is cohort- and endpoint-specific; the structural lesson is general: output-only detection fails where residual leakage is indistinguishable from an honestly stronger predictor. The test returns a verdict on a prediction vector in under a second on commodity hardware.

14.
arXiv (CS.CV) 2026-06-19

Current World Models Lack a Persistent State Core

World models are increasingly regarded as a decisive step toward artificial general intelligence, yet modeling the physical world demands more than rendering convincing frames on demand: it requires an internal world state that keeps evolving over time, decoupled from observation, so that objects endure and events run to their conclusions whether or not a camera is watching, much as the moon holds to its orbit when no one is looking. This requirement is a blind spot of existing benchmarks, which reward surface properties such as fidelity, motion, and camera controllability while never asking whether a generated world keeps evolving once it is unobserved. We introduce WRBench, the first systematic diagnostic benchmark that treats camera motion as an intervention on observability and resolves evaluation into a human-calibrated chain that asks whether the camera executes the requested interaction, whether the scene stays continuous and identifiable while in view, and whether a returning target remains consistent with the event that was set in motion. Across 9{,}600 videos from 23 models spanning four control paradigms, one finding proves stubborn: current systems maintain the observed world as a tracking shot, resuming a returning target in the state at which it was abandoned rather than advancing the event while it went unseen. Because this failure recurs across control paradigms, model families, and increments of scale, robust world-state evolution does not follow from cleaner imagery, tighter control, richer geometric priors, or sheer parameter count We therefore argue that the stability of the physical state kernel and the consistency of worldlines under viewpoint intervention should become first-class objectives of world-model design, so that a world model captures how the world will unfold rather than how the next frame appears.

15.
arXiv (CS.CV) 2026-06-15

CineOrchestra: Unified Entity-Centric Conditioning for Cinematic Video Generation

Cinematic video depicts multiple subjects acting or interacting at specific moments, captured with deliberate camera movement, and stitched together by shot transitions. Together, these elements demand a level of fine-grained control beyond current text-to-video models. Existing work addresses each axis in isolation: multi-subject personalization, temporal control, multi-shot synthesis, or camera control; no prior framework jointly integrates all four. We present CineOrchestra, a unified video diffusion model that controls subjects, events, cameras, and shot transitions simultaneously. Our key insight is that these heterogeneous cinematic elements share a fundamental structure: each is an entity acting over a specific temporal interval, which can therefore all be expressed through one shared structure of entity-centric conditioning primitives, augmented with reference images for visual entities. This formulation reduces the architectural challenge to a single positional encoding problem, which we solve with two parameter-free coordinated rotary embeddings: (a) an interval-sampled temporal RoPE that yields consistent attention behavior across events of dramatically varying duration, and (b) a 2D entity-temporal cross-attention RoPE that disambiguates per-entity conditions and routes each to its corresponding spatiotemporal region. On two new benchmarks, CineOrchestra outperforms six per-axis specialists on dense caption following and shot-transition timing, with consistent gains in a pairwise user study and component ablations.

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

Your Mouse and Eyes Secretly Leak Your Preference: LLM Alignment using Implicit Feedback from Users

To align a Large Language Model (LLM), most existing methods collect explicit human feedback and train a reward model to predict the human preference based on the response text. These existing methods have two key limitations. First, the users rarely provide explicit feedback for LLM responses, which makes the high-quality preference annotation expensive to collect. Second, the methods do not leverage implicit human feedback, which has proven vital to the economic moats of Internet giants. To quantify the value of implicit feedback, we build a new dataset called IFLLM, which collects 1336 multi-turn questions from the 59 Mechanical Turk workers, their mouse trajectories, and eye gazing points to the LLMs' responses from their webcams. IFLLM shows that the users have very diverse types of gazing behavior and mouse trajectories. Our reward model based on the implicit user feedback boosts the accuracy of the text-based reward model from 55% to 64% and nearly triples the relative response quality improvements after applying the DPO to eight LLMs, demonstrating the value of implicit feedback in the wild. Our data collection website, dataset, and codes can be found at https://github.com/themehulpatwari/llm-implicit-feedback/.

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

Spectrally Regularized Latent Flow Matching for Turbulence Generation

arXiv:2606.11691v1 Announce Type: new Abstract: Latent diffusion and flow matching have emerged as leading approaches for synthetic turbulence generation, yet they systematically under-represent dissipation-range amplitudes. We introduce a latent flow matching framework with a spectrally regularized compression stage that directly targets this failure mode. On a 256^2 DNS dataset at Re_f \approx 2250, replacing an MSE-trained VAE with a zone-weighted log-spectral objective raises deep-dissipation retained spectral power from 25% to 94% in reconstruction and from 20% to 79% in unconditional generation. The improved latent representation also yields a substantially better sampling cost-fidelity tradeoff: the MSE-trained latent space imposes a fundamental quality ceiling near DD bias -0.70 that no integrator or step-count can overcome, while the spectrally regularized latent space reaches DD bias -0.117 at just 20 function evaluations. Mechanistically, encoder-decoder swap experiments show that the improvement is driven primarily by encoder-induced latent reorganization rather than decoder capacity, while a support-amplitude decomposition reveals that MSE-trained models behave as conservative suppression models, minimizing pointwise error by attenuating intermittent high-wavenumber structure. Both pipelines recover the second-order structure function and the correct sign of S_3, indicating the correct cascade direction without explicit supervision. A small residual gap in the magnitude of S_3 suggests that phase-coherent triadic organization remains a complementary axis to amplitude fidelity for future generative turbulence models.

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

On the Benefits of Weight Normalization for Overparameterized Matrix Sensing

arXiv:2510.01175v2 Announce Type: replace Abstract: While normalization techniques are widely used in deep learning, their theoretical understanding remains relatively limited. In this work, we establish the benefits of (generalized) weight normalization (WN) applied to the overparameterized matrix sensing problem. We prove that WN with Riemannian optimization achieves linear convergence, yielding an exponential speedup over standard methods that do not use WN. Our analysis further demonstrates that both iteration and sample complexity improve polynomially as the level of overparameterization increases. To the best of our knowledge, this work provides the first characterization of how WN leverages overparameterization for faster convergence in matrix sensing.

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

QueryGaussian: Scalable and Training-Free Open-Vocabulary 3D Instance Retrieval

arXiv:2606.19733v1 Announce Type: cross Abstract: Efficiently retrieving specific 3D instances from large-scale scenes via natural language prompts remains a formidable challenge in multimedia analysis. Existing approaches predominantly follow a "scene-level embedding" paradigm, which requires distilling high-dimensional semantic features into every 3D primitive. This strategy suffers from a fundamental architectural bottleneck: memory and computational costs scale linearly with scene complexity, inevitably triggering out-of-memory (OOM) failures in city-scale environments. To address this barrier, we propose QueryGaussian, a training-free framework for expeditious and scalable open-vocabulary 3D instance retrieval. Unlike holistic semantic distillation, QueryGaussian employs an instance-level query mechanism that decouples semantic understanding from geometric representation. Specifically, we leverage pre-trained 2D vision models to interpret user prompts and lift segmentation masks into 3D via a concurrent maximum-weight association strategy, ensuring semantic-visual consistency. To mitigate projection ambiguity, we introduce a temporal fusion module with multi-stage adaptive density clustering. Experimental results demonstrate that QueryGaussian not only matches the accuracy of state-of-the-art methods but also delivers a decisive efficiency leap, reducing GPU memory usage by over 70% and accelerating inference by 180x. Crucially, QueryGaussian enables expeditious instance retrieval on city-scale scenes containing tens of millions of Gaussians using consumer-grade hardware.

21.
arXiv (quant-ph) 2026-06-12

Matrix phase-space representations for gaussian boson sampling

arXiv:2503.12749v2 Announce Type: replace Abstract: We introduce coherent matrix phase-space distributions. These use conservation laws and symmetries to improve the accuracy and speed of quantum phase-space representations. As an example, this is applied to validation of low-loss Gaussian boson sampling (GBS) quantum computational advantage experiments, where classical generation of the random photon-number counts is exponentially hard. Large improvements in sampling errors are demonstrated compared to previous methods. Matrix phase-space representations also provide a large numerical speed-up, due to their (at worst) quadratic scaling, compared to other methods for validating total count probabilities of large-scale, low-loss GBS networks.

22.
medRxiv (Medicine) 2026-06-18

Expert in Ultrasound Skills: Feasibility of an IMU-video platform to describe technical profiles during focused cardiac ultrasound. Pilot study

Background: Focused cardiac ultrasound (FoCUS) is operator dependent and requires coordinated probe manipulation, image interpretation and iterative visual feedback. Existing assessment approaches often emphasize final image quality or expert rating. We developed Expert in Ultrasound Skills (EXUS) , a platform that synchronizes transducer-mounted inertial measurement unit (IMU) data with ultrasound video, and evaluated its technical feasibility during FoCUS acquisition. Methods: This observational pilot study included 6 operators performing two repetitions of a four-view FoCUS protocol, yielding 12 analytical sessions and 48 planned acquisitions. Feasibility was defined by acquisition completion, video availability, start/stop events, fused IMU-video windows, temporal coverage, complete human label entries and IMU integrity. A 100-image Likert rating task was used to summarize pairwise inter-rater agreement for still-frame image quality assessment. Results: All 48 planned acquisitions were completed with video, start/stop events, fused windows and complete human label entries. Temporal coverage was at least 90% in 47/48 acquisitions. IMU integrity endpoints exceeded the 80% threshold: 43/48 acquisitions had no extreme IMU-derived artifact, 43/48 had no active-segment IMU restart and 44/48 had no complete motion flatline. Mean pairwise exact agreement for the Likert task was 38.9%, with mean quadratic-weighted Cohen's kappa of 0.564. Post hoc profiles varied across duration, visual quality, mechanical load and motor efficiency. Conclusions: EXUS was technically feasible for synchronized IMU-video capture during FoCUS. The pilot supports multimodal acquisition data as a way to describe technical profiles and generate formative feedback hypotheses, but the post hoc indices are not validated competency measures. Keywords: focused cardiac ultrasound; point-of-care ultrasound; inertial measurement unit; medical education; deliberate practice

23.
medRxiv (Medicine) 2026-06-18

Intra-arterial recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) thrombolysis for acute medium vessel occlusion (MeVO-TNK): Study rationale and design

Background The optimal management of acute ischemic stroke caused by medium vessel occlusion (MeVO) remains uncertain. Recent randomized trials have failed to demonstrate a clear benefit of endovascular therapy in this population, whereas intra-arterial thrombolysis (IAT) has emerged as a biologically plausible alternative. However, prospective evidence supporting IAT in MeVO is lacking, and the optimal dosing strategy for stand-alone IAT remains undefined. Aim To preliminarily evaluate the efficacy and safety of intra-arterial tenecteplase (IA-TNK) plus standard medical therapy (SMT) compared with SMT alone in patients with acute MeVO stroke, and to explore a stepwise IA-TNK dosing strategy. Design The MeVO-TNK trial is a multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE), exploratory phase II study. A total of 60 participants with imaging-confirmed MeVO will be randomized 1:1 to receive either IA-TNK plus SMT or SMT alone. Participants presenting beyond 6 hours from symptom onset must demonstrate salvageable penumbral tissue on advanced imaging. Those assigned to the intervention group will receive up to two intra-arterial boluses of tenecteplase (0.0625 mg/kg per bolus), with the second bolus administered based on angiographic assessment of reperfusion and safety. Outcomes The primary efficacy outcome is final infarct volume measured at 72{+/-}24 hours after randomization. Secondary efficacy outcomes include the proportions of patients achieving modified Rankin Scale (mRS) scores of 0-1, 0-2 and 0-3 at 90 days, a shift analysis of the mRS distribution at 90 days, early neurological deterioration, and National Institutes of Health Stroke Scale score at 7 days or discharge. The primary safety outcome is symptomatic intracranial hemorrhage within 24 hours. Conclusions This trial will provide preliminary evidence on the biological efficacy, reperfusion potential and safety of stand-alone IA-TNK for acute MeVO stroke, helping to address an important evidence gap and inform the design of future confirmatory studies.

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

Grammar of the Wave: Towards Explainable Multivariate Time Series Event Detection via Neuro-Symbolic VLM Agents

arXiv:2603.11479v3 Announce Type: replace-cross Abstract: Time Series Event Detection (TSED) aims to localize semantically meaningful events in time series data, with critical applications in high-stakes domains. Unlike statistical anomalies, events are often defined by natural-language descriptions with internal temporal-logic structures across multiple physical channels. However, in real-world settings, dense event annotations are expensive to obtain, making purely supervised learning difficult. We introduce Language-guided TSED, a setting where a model is given textual event descriptions and must ground them to intervals in multivariate signals with little or no labeled data. To address this problem, we propose Event Logic Tree (ELT), a knowledge representation framework that converts linguistic descriptions into structured temporal logic over signal primitives. Building on ELT, we present SELA, a neuro-symbolic VLM agent framework that iteratively grounds primitives from signal visualizations and composes them under ELT constraints, producing both event intervals and faithful tree-structured explanations. We further release a real-world benchmark across energy and climate domains with expert knowledge and annotations. Experiments show that SELA improves over supervised fine-tuning and existing zero/few-shot time series reasoning baselines.

25.
arXiv (CS.LG) 2026-06-12

Optical Implementation of Equilibrium Propagation Using Spatial Photonic Ising Machines

arXiv:2606.13454v1 Announce Type: cross Abstract: Equilibrium Propagation offers a compelling alternative to traditional machine learning for training energy-based networks. Here we demonstrate a hybrid optical-digital implementation of EP using a Spatial Photonic Ising Machine (SPIM). The SPIM exploits the gauge transformation method to optically encode both continuous neuron states and rank-1 binary trainable patterns as phase modulations via a spatial light modulator, with inference realized using a finite difference scheme. The experimental system is evaluated on the Wine classification dataset. The potential of this approach, including the use of continuous couplings and structured coupling matrices, is evaluated numerically on the more complex MNIST dataset. Our work provides a concrete pathway toward energy-efficient physical implementations of Equilibrium Propagation.