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01.
arXiv (CS.CV) 2026-06-16

Tool-IQA: Augmenting Image Quality Assessment with Simple Tools

Vision-Language Models (VLMs) have been increasingly adopted for Image Quality Assessment (IQA). However, current methods typically employ a static one-shot scoring paradigm, despite the fact that humans assess image quality through dynamic visual inspection, e.g., selectively adjusting views to verify details and subtle artifacts. Specifically, relying solely on a single-pass observation introduces two primary limitations: first, perceiving the image only at a global scale restricts the assessment of finer local details; second, the original intensity distribution of the image may overwhelm the visibility, leading to insufficient inspection of image quality. To address these issues, we propose Tool-IQA, shifting the assessment mechanism from passive scoring to a tool-augmented workflow. In particular, we equip VLMs with simple yet effective view tools: a Magnifier to inspect local details, and a Gamma Corrector to uncover visibility and hidden artifacts. The assessment follows a structured pipeline that consists of an initial observation with rubric notes, a tool-augmented in-depth inspection, and a final quantification for calibrated quality score. Furthermore, to ensure efficient and purposeful tool callings, we introduce a batch-aware training strategy to reward tool interactions that can yield positive contributions rather than simply encouraging usage. Experiments on a variety of IQA benchmarks demonstrate that, with effective tool calling and calibrated assessment, our proposed Tool-IQA significantly outperforms existing state-of-the-art models, e.g., it achieves a PLCC of 0.854 on the challenging CLIVE dataset.

02.
arXiv (CS.CL) 2026-06-15

A Computational Audit of Demographic Association Encoding in ClinicalBERT Language Predictions

Transformer-based clinical language models are increasingly integrated into high-stakes clinical decision support pipelines, yet the computational mechanisms through which demographic associations encoded in medical documentation propagate into model probability distributions remain empirically underspecified. We present a systematic computational audit of representational bias in ClinicalBERT (Alsentzer et al., 2019), a BERT-based model pretrained on MIMIC-III discharge summaries, employing two complementary probing methodologies: Log Probability Bias Analysis (LPBA), which quantifies demographic descriptor-induced shifts in masked token probability distributions across behavioral and evaluative semantic categories, and Masked Language Model-based analysis (MLM), which probes internal representational structure for demographic agency attribution encoding across 98 real clinical sentence templates and eight intersectional race-gender combinations. Corpus frequency analysis operationalizes the distinction between statistical disparity and bias amplification by benchmarking model outputs against empirical term frequencies in the MIMIC-III training corpus. Of 32 statistically significant findings, 65.6% contradict observed corpus distributions, rising to 80% for Black patients and 87.5% for agency attribution under MLM probing, providing direct empirical evidence that representational bias in ClinicalBERT operates predominantly through model-internal amplification rather than training data inheritance. Keywords: natural language processing, clinical documentation, algorithmic auditing, representational bias, health equity 1

03.
arXiv (CS.AI) 2026-06-19

ZeSTA: Zero-Shot TTS Augmentation with Domain-Conditioned Training for Data-Efficient Personalized Speech Synthesis

arXiv:2603.04219v2 Announce Type: replace-cross Abstract: We investigate the use of zero-shot text-to-speech (ZS-TTS) as a data augmentation source for low-resource personalized speech synthesis. While synthetic augmentation can provide linguistically rich and phonetically diverse speech, naively mixing large amounts of synthetic speech with limited real recordings often leads to speaker similarity degradation during fine-tuning. To address this issue, we propose ZeSTA, a simple domain-conditioned training framework that distinguishes real and synthetic speech via a lightweight domain embedding, combined with real-data oversampling to stabilize adaptation under extremely limited target data, without modifying the base architecture. Experiments on LibriTTS and an in-house dataset with two ZS-TTS sources demonstrate that our approach improves speaker similarity over naive synthetic augmentation while preserving intelligibility and perceptual quality. Audio samples are available on our web page.

04.
arXiv (quant-ph) 2026-06-11

Nonlocal continuous-variable gates by amplified optical connections

arXiv:2603.12866v2 Announce Type: replace Abstract: Nonlocal quantum gates, coupling quantum systems located at a distance, are crucial for distributed quantum computing. To this aim, high-capacity optical noiseless connections between different processing units are essential for transmitting large amounts of information per mode. Simultaneously, optical quantum computing offers future high-speed multimode quantum processors. We propose a library of feasible protocols to implement a necessary nonlocal continuous-variable (CV) quantum nondemolition (QND) gate between two distant users sharing a quantum channel and exploiting classical communication. The users are endowed with a newly achieved high-fidelity and large-bandwith element - single-pass phase-sensitive optical parametric amplifier (OPA), that allows for both online squeezing and channel-loss compensation. The use of OPAs enhances quality of the resulting gate in terms of both excess noise and entangling capability. The proposed schemes are also applicable to CV cluster state fusion, providing a first step towards development of distributed CV measurement-based quantum computation.

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

Multi-Class Brain Tumor Classification Using Advanced Deep Learning Models: A Comparative Study

Despite recent advancements in deep learning, accurately classifying brain tumors from MRI images continues to pose challenges. In this research, we present a comprehensive evaluation of five different convolutional neural networks (CNN) architectures, including a customized baseline model and four pre-trained models - for use in classifying multi-class brain tumors using a clinically-sourced dataset of approximately 10,000 MRI images. We have utilized five different architectures; VGG16, VGG19, DenseNet121, and EfficientNetB0, which were all tested and trained within an identical experimental framework. Performance was measured by both overall accuracy and tumor-wise recall as a means to measure the clinically-relevant performance of each architecture. We found that EfficientNetB0 had the best overall classification accuracy at 95%, when compared to the other architectures tested; specifically VGG16 (94.37%), VGG19 (92.29%), DenseNet121 (90.91%) and the customized CNN (78.00%). An especially important finding of our research was the considerable improvement in detecting meningiomas; specifically, while simple CNNs could detect meningiomas with a recall rate of approximately 20%, EfficientNetB0 was able to detect meningiomas with a recall rate of 89%. Meningiomas are often difficult to detect because they can appear very subtly on MRI images. Additionally, an interesting finding was that the deeper VGG19 performed worse than the shallower VGG16. This indicates that in many cases the architectural efficiency of a CNN model may be more important than its depth when working with medical images. Overall, EfficientNetB0 appears to provide the optimal trade-off between classification accuracy, number of parameters used in the model and clinically meaningful performance.

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

Indefinite Quantum Causality

arXiv:2606.19438v1 Announce Type: new Abstract: In recent years, operational approaches to quantum foundations have been developed as a means of understanding the core principles and distinctive features of quantum theory. Such approaches typically view physical processes as sequences of operations, with earlier operations serving as causes of later effects. However, a growing literature is emerging on the possibility of relaxing this assumption and allowing for quantum indefiniteness in the causal order. This development stems from a variety of motivations, both fundamental and applied, including exploring the role of causality in quantum theory, the interplay between quantum theory and general relativity, and higher-order quantum computing. A prominent offshoot of this development is the emergence of indefinite causal order as a feasible resource for quantum information processing. This review provides an overview of the current state of the art in the field, covering the methodology underlying indefinite quantum causality within the so-called "process matrix formalism", outlining key results and experimental implementations, and discussing recent advances.

07.
arXiv (CS.AI) 2026-06-17

Fixed-Point Reasoners: Stable and Adaptive Deep Looped Transformers

arXiv:2606.18206v1 Announce Type: new Abstract: Looped architectures provide an inductive bias toward learning step-by-step procedures for tasks that require compositional reasoning. The number of effective layers reached by looping determines the quality of the solution these models find. Like deep architectures, looped architectures are prone to a signal propagation problem induced by depth as the halting decision is postponed. In this paper, we address this signal propagation issue using pre-norm layers and residual scaling. Building on these architectural modifications, we propose FPRM, a Transformer-based Fixed-Point Reasoning Model that uses fixed-point convergence as an end-to-end halting mechanism in a looped architecture. We show that fixed-point halting allows FPRM to adapt its compute to task difficulty. FPRM is effective on common reasoning benchmarks, namely Sudoku, Maze, state-tracking, and ARC-AGI.

08.
arXiv (CS.AI) 2026-06-17

KANLib – An Modular, Extensible and Fast Kolmogorov-Arnold Network Implementation

arXiv:2606.17927v1 Announce Type: cross Abstract: Kolmogorov-Arnold Networks (KANs) have recently emerged as a promising alternative to traditional multilayer perceptrons by replacing linear weights with learnable univariate functions. Despite their theoretical advantages in interpretability and expressiveness, practical research of KANs remains difficult due to high computational costs and inconsistent feature support across existing frameworks. This paper introduces KANLib, a modular, extensible, and computationally efficient framework for developing and evaluating KAN architectures. KANLib unifies core concepts from existing implementations, including PyKAN, EfficientKAN, and FastKAN, within a consistent software architecture that emphasizes flexibility, feature parity, and high performance. The framework supports two basis function types, adaptive grid rescaling, grid extension, and fine-grained architectural customization while maintaining compatibility with standard PyTorch workflows. Experimental evaluation on the California Housing benchmark demonstrates that KANLib reproduces the predictive behavior of established reference KAN implementations while achieving competitive computational efficiency. Furthermore, the framework enables the exploration of architectural variations beyond standard KAN formulations with only minor impacts on predictive performance. Overall, KANLib provides a robust foundation for future research on scalable and extensible KAN architectures.

09.
medRxiv (Medicine) 2026-06-22

Leishmaniasis on YouTube: a critical appraisal of the quality, reliability, and transparency of educational content

Background: Leishmaniasis is a neglected tropical disease of significant global public health importance, for which accurate information is essential to support prevention and early care-seeking, particularly in endemic, resource-limited settings. YouTube is a widely used source of health information, but the quality and reliability of leishmaniasis-related content have not been evaluated. We aimed to assess the quality, reliability, and transparency of English-language YouTube videos on leishmaniasis. Methods: We conducted a cross-sectional analysis of YouTube videos retrieved via the YouTube Data API on 15 June 2026 using the terms "leishmaniasis," "cutaneous leishmaniasis," and "visceral leishmaniasis." After applying eligibility criteria and screening the 150 most-viewed eligible videos, 48 videos were included. Two reviewers independently assessed each video using the modified DISCERN (mDISCERN) tool, the Global Quality Score (GQS), and the JAMA benchmark criteria, with disagreements resolved by consensus. Inter-rater agreement was assessed using the intraclass correlation coefficient (ICC), and associations were examined using Spearman's rank correlation. Results: Of 402 videos retrieved, 48 met the inclusion criteria. The median GQS was 3.00 (IQR 2.00-4.00) and median mDISCERN was 3.00 (IQR 2.38-4.50), indicating moderate quality and reliability, while the median JAMA score was 2.00 (IQR 1.00-2.00), reflecting limited transparency; no video met all four JAMA criteria. The overwhelming majority of videos (47/48, 97.9%) were of professional or institutional origin. Inter-rater agreement was good to excellent (ICC 0.883 for GQS, 0.896 for mDISCERN, 1.000 for JAMA). The instruments were strongly inter-correlated (mDISCERN-GQS rho = 0.841, p < 0.001). Quality scores did not correlate positively with views, likes, or video duration; comments correlated weakly and negatively with mDISCERN (rho = -0.337, p = 0.031) and JAMA (rho = -0.381, p = 0.014). Conclusions: YouTube videos on leishmaniasis are of moderate quality and reliability but limited transparency, and are produced almost exclusively by professional sources. Video popularity, length, and age were not indicators of quality. There is a need for experts and institutions to produce clearly authored, well-sourced, and transparent educational content on this neglected tropical disease.

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

Flux-Guard: Facial Identity Protection using diffusion models

The widespread deployment of face recognition (FR) systems exposes personal images shared on social media and public platforms to identity linkage and privacy risks. Existing adversarial privacy protection methods can degrade unauthorized FR performance but are not compatible with generative face editing. Artificial intelligence-driven face editing tools are gaining popularity, which has significantly increased user demand for personalized portrait generation and social sharing. However, current editing methods often preserve identity features, making the edited images still susceptible to tracking by malicious FR systems. Thus, this paper proposes Flux-Guard, a privacy-preserving face editing framework based on adversarial attacks, which integrates face editing and privacy protection within a unified generative process. Specifically, we design a flow trajectory control method to align semantic manipulations with the generative process and introduce latent-space adversarial optimization with an adaptive perceptual-loss-driven weighting strategy, dynamically adjusting adversarial strength to maximize attack effectiveness while preserving visual quality. Extensive experiments demonstrate that Flux-Guard supports face editing while significantly improving attack success rates against cross-domain face recognition models on the CelebA-HQ and LADN datasets. Furthermore, evaluation results for commercial APIs have confirmed its effectiveness in real-world applications. The code is released at https://github.com/JLMWang/Flux-Guard.

11.
arXiv (quant-ph) 2026-06-16

Systematic Construction of Time-Dependent Hamiltonians for Microwave-Driven Josephson Circuits

arXiv:2512.20743v4 Announce Type: replace Abstract: Time-dependent electromagnetic drives are fundamental for controlling complex quantum systems, including superconducting Josephson circuits. In these devices, accurate time-dependent Hamiltonian models are imperative for predicting their dynamics and designing high-fidelity quantum operations. Existing numerical methods, such as black-box quantization (BBQ) and energy-participation ratio (EPR), excel at modeling the static Hamiltonians of Josephson circuits. However, these techniques do not fully capture the behavior of driven circuits stimulated by external microwave drives, nor do they include a generalized approach to account for the inevitable noise and dissipation that enter through microwave ports. Here, we introduce numerical techniques that leverage classical microwave simulations, efficiently executable in finite-element solvers, to obtain the time-dependent Hamiltonian of microwave-driven superconducting circuits with arbitrary geometries under charge, flux, or mixed electromagnetic modulation. Importantly, our techniques do not rely on a lumped-element description of the superconducting circuit, in contrast to previous approaches to tackling this problem. We demonstrate the versatility of our approach by characterizing the driven properties of realistic circuit devices in complex electromagnetic environments, including coherent dynamics due to charge and flux modulation, as well as drive-induced relaxation and dephasing. Our techniques offer a powerful toolbox for optimizing circuit designs and advancing practical applications in superconducting quantum computing.

12.
arXiv (CS.AI) 2026-06-17

TRACE: Learning to Compute on Circuit Graphs

arXiv:2509.21886v3 Announce Type: replace Abstract: Learning to compute, the ability to model the functional behavior of a circuit graph, is a fundamental challenge for graph representation learning. Yet, the dominant paradigm is architecturally mismatched for this task. This flawed assumption, central to mainstream message passing neural networks (MPNNs) and their conventional Transformer-based counterparts, prevents models from capturing the position-aware, hierarchical nature of computation. To resolve this, we introduce TRACE, a new paradigm built on an architecturally sound backbone and a principled learning objective. First, TRACE employs a Hierarchical Transformer that mirrors the step-by-step flow of computation, providing a faithful architectural backbone that replaces the flawed permutation-invariant aggregation. Second, we introduce function shift learning, a novel objective that decouples the learning problem. Instead of predicting the complex global function directly, our model is trained to predict only the function shift, the discrepancy between the true global function and a simple local approximation that assumes input independence. We validate this paradigm on various circuits modalities, including Register Transfer Level graphs, And-Inverter Graphs and post-mapping netlists. Across a comprehensive suite of benchmarks, TRACE substantially outperforms all prior architectures. These results demonstrate that our architecturally-aligned backbone and decoupled learning objective form a more robust paradigm for the fundamental challenge of learning the functional behavior of a circuit graph.

13.
arXiv (CS.AI) 2026-06-18

ProfiLLM: Utility-Aligned Agentic User Profiling for Industrial Ride-Hailing Dispatch

arXiv:2606.18803v1 Announce Type: new Abstract: Bringing Large Language Models (LLMs) into industrial ride-hailing dispatch as semantic feature extractors over platform-scale behavioral logs is a compelling but under-explored data systems problem. Production matching pipelines remain dominated by structured numerical features, yet decisive behavioral signals (e.g., a driver's habitual aversion to certain regions) are inherently contextual and naturally expressible as LLM-generated user profiles. However, scaling such profiling to a live, millisecond-latency dispatcher faces three intertwined constraints rarely addressed together: on a platform with millions of daily orders, logs exceed any LLM's context window by orders of magnitude; most users are long-tail, with too few interactions for per-user profiling; and surface-fluent profiles do not necessarily improve downstream prediction utility. We present ProfiLLM, an agentic LLM data pipeline that operationalizes utility-aligned user profiling for production matching systems through two modules. (1) Tool-Augmented Global Knowledge Mining equips an LLM agent with 27 analytical tools to mine platform-scale data, producing reusable global knowledge, adaptive user clustering rules, and region-level supply-demand priors. (2) Utility-Aligned Profile Exploration generates multiple candidate profiles per cluster, evaluates them via a lightweight downstream utility proxy, iteratively refines the best candidates and constructs preference pairs for DPO fine-tuning. Deployed on DiDi's production dispatcher, ProfiLLM achieves up to +6.14% relative AUC improvement in outcome prediction, up to +4.35% GMV gain in dispatching simulation, and consistent improvements in a 14-day online A/B test including +0.47% GMV, +0.33% Completion Rate, and -0.82% Cancel-Before-Accept rate.

14.
arXiv (CS.AI) 2026-06-11

KAN-MLP-Mixer: A comprehensive investigation of the usage of Kolmogorov-Arnold Networks (KANs) for improving IMU-based Human Activity Recognition

arXiv:2605.19031v2 Announce Type: replace Abstract: Kolmogorov-Arnold Networks (KANs) have demonstrated an exceptional ability to learn complex functions on clean, low-dimensional data but struggle to maintain performance on noisy and imperfect real-world datasets. In contrast, conventional multi-layer perceptrons (MLPs) are far more tolerant to noise and computationally efficient. Replacing all MLP components with KANs in HAR models often degrades accuracy and computation efficiency, highlighting an open challenge: how to combine KANs' precision with MLPs' noise robustness and efficiency. To address this, we systematically explore various placements of KAN modules within deep HAR networks and propose a hybrid architecture that strategically synergizes the strengths of both paradigms, which uses a KAN-based input embedding layer, retains MLP layers for intermediate feature mixing, and introduces a specialized LarctanKAN module for final activity classification. Across eight public HAR datasets, the hybrid KAN-MLP model achieves an average macro F1 score relative improvement of 5.33\% compared pure-MLP model, significantly outperforming standalone KAN and MLP baselines. Furthermore, integrating this hybrid strategy into other state-of-the-art HAR architectures consistently boosts their performance. Our findings demonstrate that a carefully orchestrated combination of KAN, MLP, or other conventional neural components yields more robust and accurate HAR models for real-world wearable sensing environments.

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

Interpretable Sperm Morphology Classification via Attention-Guided Deep Learning

arXiv:2606.20438v1 Announce Type: new Abstract: Male infertility is a major cause of couple infertility, often linked to abnormal sperm morphology. While deep learning models offer automated analysis, most lack interpretability, limiting their clinical adoption. This study proposes an attention-guided deep learning framework for sperm morphology classification. We combine a pretrained EfficientNet-B0 with a Convolutional Block Attention Module (CBAM) to focus on key areas of the sperm head, improving both accuracy and interpretability. Evaluated on the SMIDS and HuSHem public datasets, our model achieves accuracies of 90.2% and 93.9% (macro F1 scores of 0.913 and 0.948), outperforming SimpleCNN and standard EfficientNet-B0. Furthermore, we use Grad-CAM++ visualizations to highlight features influencing the model's decisions. The results demonstrate that this accurate and transparent framework is a practical tool for automated sperm analysis in fertility clinics.

16.
Nature (Science) 2026-06-12

‘Student Geng’ ignites research-integrity scandal in China after calling out senior academics<b> </b>

作者:

Video blogger’s viral accusations of data manipulation in Nature journals have sparked intense debate and speedy institutional investigations. Video blogger’s viral accusations of data manipulation in Nature journals have sparked intense debate and speedy institutional investigations.

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

Non-Hermitian skin effect induced by spatial noncommutativity

arXiv:2606.12961v1 Announce Type: new Abstract: In all known schemes for the non-Hermitian skin effect, the non-Hermitian ingredient that drives the skin localization, whether asymmetric hopping or gain and loss, is invariably introduced by hand as an independent model parameter along the skin direction. Here we show that when two spatial coordinates do not commute, the skin effect can break free of this paradigm: a gain-loss potential applied along one coordinate automatically generates non-reciprocity along the other through the coordinate noncommutativity, driving all eigenstates to pile up exponentially at a boundary. We term this phenomenon the noncommutative skin effect. The inverse skin length is proportional to the noncommutativity parameter and is given by an analytic formula, exact in the thermodynamic limit and verified by exact diagonalization of lattice models; the reflection symmetry of the imaginary potential furnishes an exact criterion for the presence or absence of the effect, valid rigorously for finite-size systems. For a sinusoidal imaginary potential, the skin direction of all eigenstates flips collectively at parameter points fixed purely by geometry. Because the flip point is independent of the potential strength, the reversal constitutes a zero-crossing measurement scheme intrinsically robust against systematic errors, from which the noncommutativity parameter can be extracted directly. The qualitative transition of the eigenstates from uniform to exponentially localized renders the effect a nonperturbative probe of spatial noncommutativity, and the Peierls-phase structure of its lattice model is in principle accessible to cold-atom synthetic dimensions, photonic resonators, and topolectrical circuits.

18.
arXiv (CS.CL) 2026-06-19

EndoCoT: Scaling Endogenous Chain-of-Thought Reasoning in Diffusion Models

Recently, Multimodal Large Language Models (MLLMs) have been widely integrated into diffusion frameworks primarily as text encoders to tackle complex tasks such as spatial reasoning. However, this paradigm suffers from two critical limitations: (i) MLLMs text encoder exhibits insufficient reasoning depth. Single-step encoding fails to activate the Chain-of-Thought process, which is essential for MLLMs to provide accurate guidance for complex tasks. (ii) The guidance remains invariant during the decoding process. Invariant guidance during decoding prevents DiT from progressively decomposing complex instructions into actionable denoising steps, even with correct MLLM encodings. To this end, we propose Endogenous Chain-of-Thought (EndoCoT), a novel framework that first activates MLLMs' reasoning potential by iteratively refining latent thought states through an iterative thought guidance module, and then bridges these states to the DiT's denoising process. Second, a terminal thought grounding module is applied to ensure the reasoning trajectory remains grounded in textual supervision by aligning the final state with ground-truth answers. With these two components, the MLLM text encoder delivers meticulously reasoned guidance, enabling the DiT to execute it progressively and ultimately solve complex tasks in a step-by-step manner. Extensive evaluations across diverse benchmarks (e.g., Maze, TSP, VSP, and Sudoku) achieve an average accuracy of 92.1%, outperforming the strongest baseline by 8.3 percentage points. The code and dataset are publicly available at https://internlm.github.io/EndoCoT/.

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

SACE: Concept Erasure at the Semantic Singularity in Visual Autoregressive Models

The rapid progress of visual autoregressive (VAR) models has unlocked a transformative frontier for high-fidelity text-to-image synthesis, while heightening concerns over the safety alignment of generated content. Naive application of existing erasure techniques to VAR models causes catastrophic semantic collapse and visual artifacts, since they are predominantly designed for the homogeneous denoising steps of diffusion models. To address this foundational challenge, we first propose the Semantic Singularity Axiom, which posits that any target semantic concept embedded within a prompt is definitively locked at Scale-0. Then rigorously validate this axiom through our proposed Incremental Semantic Saliency Analysis (ISSA),which also enable the community to transparently inspect the coarse-to-fine semantic injection process. Guided by this insight, we introduce the first scale-aware concept erasure framework (SACE) for VAR models. By strictly confining interventions to the first scale, our approach couples an Entropy-Regularized Erasure Objective to prevent high-entropy sampling degeneration, alongside a restorative preservation loss to safely anchor the integrity of entangled benign priors. Extensive experiments demonstrate that our method achieves surgical concept erasure performance across various domains with minimal training overhead, timely and elegently resolute the critical safety vulnerabilities inherent in emerging VAR architectures. Code is available at: https://github.com/limerenceysy/SACE}{https://github.com/limerenceysy/SACE.

20.
medRxiv (Medicine) 2026-06-11

Corticospinal tract risk modifies motor recovery after minimally invasive surgery for intracerebral hemorrhage: a secondary analysis of MISTIE-III

Objective: Outcome after surgical hematoma evacuation for intracerebral hemorrhage (ICH) depends on hematoma location. As corticospinal tract (CST) integrity affects motor recovery after stroke, we hypothesized that CST integrity drives heterogeneity in surgical outcomes and investigated this in a secondary analysis of MISTIE-III participants. Methods: Risk of CST injury was categorized into four levels, based on the interaction between the CST, the hematoma, and perihematomal edema (PHE) on automatically segmented stability CT: no risk, PHE infiltration, hematoma infiltration, and complete interruption of the CST. Associations with outcome were tested using multivariable linear regression for motor National Institutes of Health Stroke Scale (NIHSS) at day 180 and ordinal regression for modified Rankin Scale (mRS) at day 365, introducing an interaction term between CST risk and treatment group. Results: Day 180 motor NIHSS was significantly lower for 'no risk' ({beta}:-3.77, [95% confidence interval [CI]: -5.8 to -1.70], p=0.0003) and 'PHE infiltration' ({beta}:-2.3, [95%CI: -3.5 to -1.1]; p=0.0002) vs. 'complete interruption'. Surgery was associated with lower Day 180 motor NIHSS in participants with hematoma infiltration ({beta}:-2.07, [95%CI: -3.8 to -0.4], p=0.016). Compared to complete interruption, 'no risk' (adjusted odds ratio [aOR]:0.27, [95%CI: 0.10 to 0.74], p=0.01) and 'PHE infiltration' (aOR:0.41, [95%CI: 0.23 to 0.74]; p=0.003) were associated with lower odds of unfavorable day 365 mRS. Surgery was associated with lower mRS in participants with no risk (aOR:0.23, [95%CI: 0.05 to 0.97, p=0.045). Interpretation: Increasing CST risk is associated with worse motor recovery (day 180) and disability (day 365). CST risk modifies the effect of the MISTIE-III procedure on motor recovery and disability.

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

Rubric-Guided Self-Distillation: Post-Training Without Rubric Verifiers

arXiv:2606.12507v1 Announce Type: new Abstract: Rubrics have emerged as an alternative to RLVR in open-ended domains where a single ground-truth final answer is not available. Existing rubric-based training methods rely on an LLM verifier that scores each rollout against rubrics. This introduces substantial training-time overhead, exposes optimization to verifier-specific biases, and reduces rubric feedback to a sparse end-of-trajectory signal. We propose Rubric-Guided Self-Distillation (RGSD), a verifier-free training method in which the base policy, conditioned on the rubric, serves as the teacher for the unconditioned student. RGSD distills the rubric-conditioned teacher distribution into the student token-by-token, replacing sparse trajectory-level rewards with dense per-token learning signals and removing the LLM judge from the training loop entirely. Across Qwen-2.5 (3B, 7B) and Qwen3-Thinking (4B, 8B) models on medical and science domains, RGSD achieves rubric satisfaction comparable to judge-based GRPO while using one on-policy rollout per prompt and no training-time verifier calls. Ablations show that raw rubrics provide a stronger teacher enrichment signal than self-generated reference responses, while a stronger GRPO judge can outperform RGSD in some settings, positioning RGSD as a complementary verifier-free alternative when verifier cost or reliability is the bottleneck.

22.
medRxiv (Medicine) 2026-06-15

Iron deficiency testing among people with incident heart failure in primary care

Background: Given around 50% of people with heart failure have a degree of iron deficiency, guidelines recommend screening. It is uncertain to what extent this is done in primary care and whether testing is equitable. Aim: To report the proportion of people with incident heart failure who undergo a ferritin test within 12 months. Design and setting: Retrospective primary care cohort study using Clinical Practice Research Datalink Aurum data, between 2016 and 2021. Methods: We report the proportion of adults with an incident diagnosis of heart failure who received a ferritin test within 12 months. Multivariable logistic regression was used to examine the odds of testing based on key demographic covariates and co-morbidities. Results: Among 105,749 individuals with an incident diagnosis of heart failure (mean age 71.6 years, SD 14.3), only 35,688 (33.7%) received a ferritin test within the subsequent year. Increasing age (odds ratio 1.25 per 10-year increase, 95% CI: 1.24-1.27), female sex (male sex OR 0.86, 0.84-0.89) and Asian ethnicity (OR 1.70, 1.59-1.80) were all associated with increased odds of testing as were diagnoses of coeliac disease (OR 1.86, 1.58-2.21), type 1 diabetes (OR 1.82, 1.51-2.19) and cirrhosis (OR 1.64, 1.43-1.87). There was geographic variation in testing, even in adjusted analyses. Conclusion: In a large primary care dataset, two thirds of people with incident heart failure did not receive a ferritin test for iron deficiency within a year of diagnosis demonstrating a gap in current practice and an opportunity for improvements in service delivery.

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

Pathway-Structured Privileged Distillation for Deployable Computational Pathology

Integrating transcriptomics and histopathology can improve cancer risk modelling, yet practical use is constrained by the limited availability of RNA profiling in routine settings. Here we introduce Mixture of Pathway Experts (MoPE), a knowledge-distillation framework that reframes multimodal learning as privileged distillation for histology-only inference. MoPE is motivated by the partial observability between RNA profiles and whole-slide images: histology can capture morphology-linked consequences of certain molecular programmes, but cannot be expected to reconstruct the full transcriptomic state. MoPE encodes RNA-derived pathways and transfers the molecular supervision to pathway-indexed pathology experts through memory-usage alignment. Across diverse public benchmarks and two independent breast cancer cohorts, MoPE consistently improved WSI-only inference performance relative to baseline methods. Pathway-usage analyses and human-audited visual inspection provide bounded inspection of model behaviour and candidate morphology-linked readouts. These results support pathway-structured privileged distillation as a promising route to using molecular information during training while preserving RNA-free inference.

24.
medRxiv (Medicine) 2026-06-22

Multisite Real-World Validation of an Electronic Health Record-Integrated Generative Artificial Intelligence Tool for Venous Thromboembolism Risk Stratification

Background: Guiding risk-appropriate inpatient thromboprophylaxis requires venous thromboembolism (VTE) risk stratification; however, reliable risk determination remains inconsistent in routine care. Health systems increasingly pilot artificial intelligence (AI) tools, yet few studies demonstrate rigorous evaluation in the context of a learning health system (LHS). We evaluated the performance of a pilot electronic health record (EHR)-integrated generative AI (GenAI) system, inHealth General Reasoner (iHGR), for VTE risk stratification versus clinician order set classifications and physician-adjudicated chart review. Methods: This multisite retrospective validation study included adult inpatient admissions at Johns Hopkins Medicine between June 21, 2025, and Dec 18, 2025 (checklist-based order set from June 21, 2025 - November 19, 2025, and clinician judgement-based order set from November 29 - December 18, 2025). From 758 eligible admissions, we randomly sampled 500 balanced by site and order set periods. iHGR and clinician-selected order set classifications were compared with the reference standard (RS). Primary outcomes were iHGR sensitivity and specificity. Secondary analyses compared the order sets with the same RS to evaluate workflow comparators and error patterns. Results: iHGR achieved 81.8% sensitivity (95% CI 77.3-85.6) and 70.9% specificity (63.6-77.3). The checklist-based order set had 61.3% sensitivity (53.7-68.5) and 86.2% specificity (77.4-91.9). The clinician judgement-based order set had 78.1% sensitivity (71.3-83.7) and 65.4% specificity (54.3-75.0). False-negative iHGR classifications were associated with missed narrative risk factors. Conclusion: iHGR showed higher sensitivity for VTE risk than checklist-based order sets and clinician judgement without introducing systematic bias. In silico evaluation of pilot AI systems within LHSs can identify clinically important performance trade-offs and implementation targets before operational scale-up. Narrative clinical data abstraction remained a key limitation, supporting the use of GenAI to support rather than supplant clinician judgement.

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arXiv (CS.AI) 2026-06-17

C2FL: Clustered Continual Federated Learning under Spatial and Temporal Drift

arXiv:2606.18003v1 Announce Type: cross Abstract: Collective Adaptive Systems (CAS) increasingly rely on machine learning to let each node learn from locally sensed data, aligning its behavior with the surrounding environment. Scaling this intelligence, however, raises fundamental challenges: sensed data is often privacy-sensitive, preventing centralized collection; nodes are mobile, traversing regions where nearby nodes perceive similar phenomena while distant ones observe radically different conditions, creating natural spatial clusters; and these distributions evolve over time due to mobility, introducing temporal drift that makes local models progressively stale. These dynamics arise across domains - vehicular sensing, drone-based monitoring, smartphone crowdsensing - yet the interplay of privacy, spatial heterogeneity, and temporal drift severely undermines conventional learning strategies. Therefore, we propose C2FL, a fully distributed Federated Learning (FL) approach where nodes self-organize into learning groups through spatial clustering, reflecting the geographic structure of the environment. To counteract temporal drift, each node combines experience replay with a dwell-time-aware adaptive averaging step, progressively incorporating the regional consensus as it remains longer within the same area, while preserving previously acquired knowledge under evolving distributions. We evaluate our approach on synthetic experiments that systematically reproduce spatial and temporal shifts, showing that standard federated strategies degrade significantly under these conditions and that our method restores robust collective adaptation.