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01.
arXiv (quant-ph) 2026-06-17

DRAG-Compatible Leakage Suppression in Landau–Zener Control via Isoprobability Twins

arXiv:2506.19572v4 Announce Type: replace Abstract: Analytically solvable models – particularly the Landau-Majorana-Stückelberg-Zener (LMSZ) and Allen-Eberly-Hioe (AEH) models – underpin many quantum-gate implementations and population-transfer protocols. However, their canonical pulse shapes are incompatible with modern leakage-suppression techniques and some systems. Most notably, the constant Rabi envelope of the LMSZ pulse prevents many leakage-suppression approaches, which require smoothness. We address both limitations by developing the concept of isoprobability twin models: distinct pairs of Rabi frequency $\Omega(t)$ and detuning $\Delta(t)$ that yield identical post-pulse transition probabilities based on the Delos-Thorson transformation. In this work, we formalise the method by experimentally demonstrating the equivalence of multiple LMSZ and AEH twin models on IBM's ibm_kyiv processor. Finally, we show a staggering leakage reduction by more than 3 orders of magnitude using a custom DRAG implementation of a cosine LMSZ isoprobability model.

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

Intrinsic Gradient Suppression for Label-Noise Prompt Tuning in Vision-Language Models

Contrastive vision-language models like CLIP exhibit remarkable zero-shot generalization. However, prompt tuning remains highly sensitive to label noise, as mislabeled samples generate disproportionately large gradients that can overwhelm pre-trained priors. We argue that because CLIP already provides a near-optimal initialization, adaptation should be inherently conservative, particularly against the extreme gradient updates common in noisy settings. To this end, we propose Double-Softmax Prompt Tuning (DSPT), a hyperparameter-free method for intrinsic gradient suppression. By applying a sequential probabilistic normalization, DSPT induces a self-adaptive saturation zone that suppresses gradients from high-error noisy samples while maintaining informative updates. We also provide both theoretical analysis and empirical evidence about how this mechanism achieves adaptive suppression. This design transforms ``gradient vanishing'', traditionally a training bottleneck, into a principled noise-filtering shield for label-noise prompt tuning. Extensive experiments confirm that this simple, drop-in design achieves state-of-the-art robustness across various noisy benchmarks, outperforming methods with complex architectures and handcrafted hyperparameters.

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

FlowBank: Query-Adaptive Agentic Workflows Optimization through Precompute-and-Reuse

Large Language Model (LLM)-based multi-agent systems are increasingly powerful, but current agentic workflow optimization paradigms make an unsatisfying trade-off. Task-level methods spend substantial offline compute yet deploy only a single workflow, leaving complementary candidates unused, while query-level methods synthesize a new workflow per query at substantial inference cost. Our motivating analysis shows these paradigms are more complementary than competing: workflows discovered during offline search often solve different subsets of queries, and many queries handled by expensive query-level generation can already be solved by cheaper precomputed workflows. This suggests a different objective: rather than searching for one universally best workflow or regenerating one per instance, we should build a compact bank of reusable, complementary workflows and select among them adaptively at inference time. Doing so requires solving three coupled problems: generating complementary rather than redundant candidates, compressing them into a small deployable portfolio, and assigning each query to the right workflow under a performance-cost trade-off. To this end, we present FlowBank, a three-stage framework for portfolio-based agentic workflow optimization. Diversifying proposes DiverseFlow to steer search toward under-covered queries and produce a high-coverage candidate pool. Curating proposes CuraFlow to compress this pool into a compact portfolio with minimal redundancy. Matching casts deployment as edge-value prediction on a query-workflow bipartite graph and routes each incoming query to the portfolio member with the best predicted utility. Across five benchmarks, FlowBank achieves the highest average score among the evaluated methods while remaining cost-competitive, improving over the strongest automated and handcrafted baselines by 4.26% and 14.92% relative, respectively.

05.
medRxiv (Medicine) 2026-06-11

Parent and physiotherapist perceptions about movement skills of young children with juvenile idiopathic arthritis

Objective: The onset of juvenile idiopathic arthritis (JIA) in the early years ([≤]5 years) may negatively impact movement skill (encompassing related concepts of gross motor skills, fundamental movement skills, and functional ability) development. Few studies have explored the perceptions and needs of parents and physiotherapists towards children's difficulty with these movement skills, essential to identify potential areas for added support. The objective of this study is to understand the perceptions of physiotherapists and parents towards movement skills of children with JIA. Methods: Seventeen parents and 24 physiotherapists completed an online questionnaire consisting of multiple choice and open-ended questions about the movement skills of young children with JIA. Demographic and multiple choice questions were quantitively analysed using descriptive statistics. Open-ended responses were analyzed using qualitative conventional content analysis. Results: About half (47%) of parents perceived their children to have movement difficulties, and 75% of physiotherapists described the movement skills of children with JIA as worse than other children of the same age. Our qualitative analysis revealed three general themes including: functional task difficulties; clinical variability in movement skills; and psychosocial components of movement skill difficulties. Conclusion: This study provides an analysis of perceptions of physiotherapists and parents towards the movement skills of young children with JIA. A significant proportion of parents and physiotherapists identify movement difficulties among children with JIA that impact daily life. Future interventions co-designed with both parents and care providers targeting movement skills are needed.

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

Hybrid Acousto-Optical Double Dressing of a Two-Level System

arXiv:2509.25847v2 Announce Type: replace Abstract: We experimentally investigate resonance fluorescence from a two-level system in a novel configuration where a strong laser drives an optical Rabi oscillation while an acoustic field parametrically modulates the frequency of the two-level system. We observe emission spectra that deviate markedly from the standard Mollow triplet, including dynamical cancellation of the central peak. A doubly dressed state model incorporating hybridization among the emitter, optical field, and acoustic field captures these features. Guided by this model, we experimentally validate the condition for optimal cooling of acoustic phonons in an emitter-optomechanical system. These results reveal new regimes of strongly driven quantum nonlinear interactions.

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

Neuromorphic Wireless Split Computing with Resonate-and-Fire Neurons

arXiv:2506.20015v2 Announce Type: replace Abstract: Neuromorphic computing offers an energy-efficient alternative to conventional deep learning accelerators, particularly for real-time processing of time-series data. However, many edge applications, such as wireless sensing and audio recognition, generate streaming signals with rich spectral features that are not effectively captured by conventional leaky integrate-and-fire (LIF) spiking neurons. This paper investigates a wireless split computing architecture that employs resonate-and-fire (RF) neurons with oscillatory dynamics to process time-domain signals directly, eliminating the need for costly spectral pre-processing. By resonating at tunable frequencies, RF neurons extract time-localized spectral features while maintaining low spiking activity. This temporal sparsity translates into significant savings in both computation and transmission energy. Assuming an OFDM-based analog wireless interface for spike transmission, we present a complete system design and evaluate its performance on audio classification and modulation classification tasks. Experimental results show that the proposed RF-SNN architecture achieves comparable accuracy to conventional LIF-SNNs and ANNs, while substantially reducing spike rates and total energy consumption during inference and communication.

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

From Seeing to Experiencing: Scaling Navigation Foundation Models with Reinforcement Learning

Navigation foundation models trained on massive web-scale data enable agents to generalize across diverse environments and embodiments. However, these models, which are trained solely on offline data, often lack the capacity to reason about the consequences of their actions or adapt through counterfactual understanding. They thus face significant limitations in real-world urban navigation, where interactive and safe behaviors, such as avoiding obstacles and moving pedestrians, are critical. To tackle these challenges, we introduce the Seeing-to-Experiencing (S2E) learning framework to scale the capability of navigation foundation models with reinforcement learning. S2E combines the strengths of pretraining on offline videos and post-training through reinforcement learning. It maintains the model's generalizability acquired from large-scale real-world videos while enhancing its interactivity through reinforcement learning in simulation environments. Specifically, we introduce two innovations: (1) an Anchor-Guided Distribution Matching strategy for offline pretraining, which stabilizes learning and models diverse motion patterns through anchor-based supervision; and (2) a Residual-Attention Module for reinforcement learning, which obtains reactive behaviors from simulation environments without erasing the model's pretrained knowledge. Moreover, we establish a comprehensive end-to-end evaluation benchmark, NavBench-GS, built on photorealistic 3D Gaussian Splatting reconstructions of real-world scenes that incorporate physical interactions. It can systematically assess the generalizability and safety of navigation foundation models.

09.
arXiv (CS.CV) 2026-06-15

Diffusion-Refined Segmentation and Vision-Language Interpretation for Pediatric Brain Tumor MRI

Accurate pediatric brain tumor segmentation remains challenging due to limited annotated data, heterogeneous imaging phenotypes, diffuse tumor boundaries, and class imbalance across tumor subregions. Here, we present a two-stage deep learning framework for improving multi-modal pediatric brain MRI segmentation and clinical interpretation. First, we evaluate 3D Res U-Net and Swin-UNETR baselines on BraTS-PEDs MRI scans, using four co-registered modalities to predict tumor core, whole tumor, and enhancing tumor regions. Second, we introduce diffusion-based refinement models conditioned on coarse Swin-UNETR predictions, including a 3D DDPM refiner and MedSegDiff. Conditioning substantially improves diffusion stability and performance, particularly for enhancing tumor boundary segmentation. Conditioned MedSegDiff achieves the strongest boundary agreement with the lowest HD95. Finally, predicted tumor volumes and representative segmentation overlays are integrated with a multimodal language model to generate structured radiology-style reports. Together, our results suggest that coarse-to-refined diffusion segmentation can improve pediatric tumor boundary delineation and support end-to-end interpretable AI-assisted neuro-oncology workflows.

10.
arXiv (CS.CV) 2026-06-19

VisDom: Sparse Novel View Synthesis with Visible Domain Constraint

Sparse novel view synthesis (NVS) remains challenging due to the ambiguity of recovering 3D geometry from few input views. While NeRF- and Gaussian Splatting (GS)-based methods perform well with dense supervision, they often overfit in sparse settings, producing floating artifacts and inconsistent geometry. Silhouette consistency is commonly used as a regularizer, but it remains insufficient, as silhouette-consistent regions can extend beyond the true object geometry. We introduce VisDom, a learning-free geometric constraint that augments classical carving-based visual hull reconstruction by enforcing a minimum multi-view visibility requirement. Specifically, we define a visible domain as the subset of 3D space observed by at least $K$ views and use it as an additional filtering criterion on top of standard silhouette-based reconstruction. This provides a stronger spatial prior in sparse-view settings. We integrate VisDom into both implicit (NeRF) and explicit (GS) pipelines by restricting volumetric sampling and guiding Gaussian placement during optimization. Experiments on three challenging datasets show consistent improvements in sparse-view NVS, enabling high-quality object-centric reconstruction from as few as four input images. Our method is domain-agnostic, requires only silhouettes, and introduces no learned parameters, making it a simple complement to existing approaches. Applying VisDom on top of GaussianObject further improves performance on Omni3D and MipNeRF360, while matching or surpassing it at 22 $\times$ lower training cost.

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

Can Agents Distinguish Visually Hard-to-Separate Diseases in a Zero-Shot Setting? A Pilot Study

The rapid progress of multimodal large language models (MLLMs) has led to increasing interest in agent-based systems. While most prior work in medical imaging concentrates on automating routine clinical workflows, we study an underexplored yet clinically significant setting: distinguishing visually hard-to-separate diseases in a zero-shot setting. We benchmark representative agents on two imaging-only proxy diagnostic tasks, (1) melanoma vs. atypical nevus and (2) pulmonary edema vs. pneumonia, where visual features are highly confounded despite substantial differences in clinical management. We introduce a multi-agent framework based on contrastive adjudication. Experimental results show improved diagnostic performance (an 11-percentage-point gain in accuracy on dermoscopy data) and reduced unsupported claims on qualitative samples, although overall performance remains insufficient for clinical deployment. We acknowledge the inherent uncertainty in human annotations and the absence of clinical context, which further limit the translation to real-world settings. Within this controlled setting, this pilot study provides preliminary insights into zero-shot agent performance in visually confounded scenarios.

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

Amortized Probabilistic Retrieval of Atmospheric CO2 from OCO-2 Spectra Using Deep Learning with Laplace Approximations and Normalizing Flows

arXiv:2606.17413v1 Announce Type: new Abstract: Space-based monitoring of atmospheric carbon dioxide (CO2) is essential for constraining the global carbon budget. NASA's Orbiting Carbon Observatory-2 (OCO-2) estimates column-averaged dry-air mole fractions of CO2 (XCO2) using high-resolution spectra. However, current operational retrieval algorithms are computationally expensive and do not properly quantify uncertainties. We present a novel deep learning framework that addresses these challenges. Due to the difficulties of ground-truth data for real satellite observations, we develop and validate our approach using a high-fidelity simulation dataset. This dataset, created to support OCO-2 uncertainty quantification (UQ), incorporates realistic forward model errors. Our architecture encodes spectral bands using a multi-branch neural network and estimates posteriors of the full CO2 column or desired summaries thereof using two scalable UQ methods: Laplace approximations and normalizing flows. Our approach has five key advantages relative to operational "full-physics" solvers: (1) Amortization: Inference is orders of magnitude faster, enabling real-time processing of massive data streams; (2) Model error robustness: By training on simulations that explicitly include model discrepancies, our method accounts for systematic errors often neglected by standard inversions; (3) Point estimate accuracy: We achieve superior predictive accuracy compared to baseline methods; (4) Improved UQ: The probabilistic outputs yield better-calibrated uncertainty estimates; and (5) Non-Gaussian posteriors: When utilizing normalizing flows, our framework successfully models complex, asymmetric posterior distributions, overcoming the limitations of the Gaussian assumption. These results suggest that simulation-based deep learning is a viable path toward next-generation operational processing systems.

13.
arXiv (quant-ph) 2026-06-17

Cumulant expansion approach to the decay dynamics of interacting Mössbauer nuclei after strong impulsive excitation

arXiv:2510.00970v2 Announce Type: replace Abstract: Recent progress in accelerator-based x-ray sources brings higher excitation of ensembles of Mössbauer nuclei closer to experimental feasibility. Yet, a theoretical modeling of the decay dynamics of the interacting nuclear ensemble after the impulsive excitation is still an open challenge. Here, we derive a set of nonlinear equations which is capable of efficiently modeling large nuclear ensembles for arbitrary degrees of excitation. As key signature for higher excitation, we identify a non-linear time-evolution of the nuclear dipole phase, which can be tuned via the scattering geometry, and interferometrically be measured. Furthermore, we identify interesting finite-size effects in the nuclear dynamics of small ensembles. Our results provide important guidance for future experiments aiming at the non-linear excitation of nuclei. We further envision the exploration of finite size-effects in Mössbauer spectroscopy with highest spatial resolution, i.e., small sample volumes.

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

Spectral Analysis of Molecular Features: When Richer Features Do Not Guarantee Better Generalization

arXiv:2510.14217v2 Announce Type: replace Abstract: The spectral properties of feature embeddings offer critical insights into model generalization and representation quality. While deep learning models are widely used for molecular property prediction, kernel methods remain competitive in low-data regimes, yet their spectral behavior is largely unexplored. We present the first comprehensive spectral analysis of kernel ridge regression across diverse representations-including molecular fingerprints (ECFP), pretrained transformers, graph neural networks, and 3D descriptors-evaluated on QM9 and 3 MoleculeNet benchmarks. Surprisingly, richer spectral features do not consistently yield better generalization performance, contradicting common representation heuristics used in self-supervised learning (SSL). Across 4 spectral metrics, only ECFP-based kernels show a strictly positive correlation with performance. Transformer and global 3D representations exhibit mixed behavior, whereas local 3D representations show consistently negative correlations. Truncation analysis further emphasizes this disparity: for local 3D representations on thermodynamic targets, fewer than 2\% of eigenvalues (and occasionally as few as 0.02\%) are needed to recover 95\% of performance, whereas ECFP and transformer kernels require significantly more. By demonstrating a strong dependence on both task and representation, our results challenge the heuristic that richer spectra inherently improve generalization, providing new guidance for evaluating representations in SSL and in label-limited scientific tasks.

15.
arXiv (CS.CV) 2026-06-12

Dual-Constrained Diffusion Image Compression for Operational Rate-Distortion-Perception Optimization

The rate-distortion-perception (RDP) trade-off extends classical rate–distortion theory by imposing a distributional constraint on reconstructions, providing a unified framework for neural image compression that jointly governs fidelity and perceptual realism. While prior work achieves near-optimal rate–perception trade-offs, practical frameworks explicitly realizing the full RDP surface remain scarce, primarily due to the difficulty of introducing common randomness at the decoder. We propose DCIC (Dual-Constrained Diffusion Image Compression), which integrates a learned codec with a diffusion-based decoder governed by joint distortion and idempotence constraints. The distortion constraint bounds reconstruction fidelity relative to the base codec output; the idempotence constraint – requiring that re-encoding the restored image recovers the base codec reconstruction – serves as a tractable surrogate for the distributional perception requirement. Together, they steer the reverse denoising process via iterative optimization with consistent noise injection, realizing common randomness without additional rate overhead. At fixed rate, dual attenuation factors $(K_D, K_P)$ jointly navigate the Pareto frontier of the distortion-perception plane, enabling continuously adjustable fidelity-realism trade-offs from a single bitstream. DCIC$_{RD}$ ($K_P{=}0$) and DCIC$_{RP}$ ($K_D{=}0$) arise as boundary curves, with DCIC$_{RDP}$ ($K_D = K_P=1$) realizing the optimal interior operating point. Experiments on CelebA-HQ, CLIC2020, and ImageNet-1K across CNN, Transformer, and hybrid architectures confirm that DCIC$_{RDP}$ achieves superior BD-PSNR over all perceptual codecs, while DCIC$_{RP}$ matches dedicated perception-oriented methods in BD-FID, validating the practical value of full RDP surface navigation.

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

Recover Semantics First, Generate Better: Improved Latent Modeling for 3D MRI Reconstruction and Cross-Contrast Synthesis

Multi-contrast magnetic resonance imaging (MRI) provides complementary information for clinical diagnosis. However, acquiring all MRI sequences is often time-consuming and costly. Recent generative models perform cross-contrast synthesis to address this issue by inferring absent contrasts from the available ones. Nevertheless, synthesizing 3D MRI presents significant challenges. Due to the massive volume sizes, operating directly in the pixel space is computationally prohibitive; therefore, a common approach is to first compress the 3D volumes into a latent space and subsequently train generative models in that space. We observe that existing compression architectures face several critical issues: they under-preserve long-range anatomical coherence, discard clinically meaningful semantics, and rely on optimization objectives that lead to over-smoothed reconstructions. Ultimately, these shortcomings compromise the performance of subsequent generative models. In this work, we propose a semantics-first latent modeling framework for 3D MRI reconstruction and cross-contrast synthesis. Specifically, we introduce a Latent Harmonization Encoder (LHE) to capture global anatomical dependencies, ensuring coherent volumetric representations. To mitigate semantic degradation during latent compression, we further design a Semantic Recovery Block (SRB) that injects high-level priors from a self-supervised semantic teacher, enhancing contrast-aware separability in the latent space. Additionally, we propose an Anatomy-aware Frequency Loss (AFL) to adaptively preserve diagnostically relevant high-frequency structures. Extensive experiments on two public multi-contrast MRI datasets demonstrate consistent improvements in reconstruction fidelity and cross-contrast synthesis quality. Our code is available at https://github.com/script-Yang/RSF.

17.
arXiv (CS.AI) 2026-06-18

Spotlight: Synergizing Seed Exploration and Spot GPUs for DiT RL Post-Training

arXiv:2606.19004v1 Announce Type: cross Abstract: Reinforcement learning (RL) post-training of Diffusion Transformers (DiTs) is prohibitively expensive, requiring thousands of high-end GPUs. Existing works explore two directions to reduce cost: seed exploration improves training convergence by selecting high-contrast samples, yet adds compute to the critical path; spot GPUs offer 69–77\% lower cost, yet sit idle during training because DiT rollouts finish nearly simultaneously, which prevents LLM-style pipelining of rollout with training. Spot preemptions further break Sequence Parallelism (SP) groups, fragmenting GPU topology. We present Spotlight, the first system that harvests spot GPUs for DiT RL post-training. Spotlight rests on two key insights we devise: (1)~we show that exploration can tolerate stale model weights because exploration that uses the model weights from the previous iteration preserves the relative ranking of random seeds, allowing exploration to run on idle spot GPUs during training. (2)~SP reconfiguration can reuse on-node state, reducing group recovery from minutes to sub-second launches. Built on these insights, Spotlight introduces three techniques: a bandit-based exploration planner that maximizes reward variance within the training time budget, elastic sequence parallelism that reconfigures SP groups on the fly via persistent schedulers and intra-node weight copying, and a preemption-aware pull-based request scheduler that balances load and commits in-flight state upon preemption. We implement Spotlight on the open-source RL platform ROLL and evaluate it on Qwen-Image post-training. Spotlight reaches the same target validation score $4\times$ faster than baselines, reducing total cost by $1.4$-$6.4\times$ while achieving superior image quality on DeepSeek-OCR and Geneval datasets with resolution $512\times512$ and $1280\times1280$.

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

Benchmarking Local LLMs for Natural-Language-to-SQL Querying in Biopharmaceutical Manufacturing: An Empirical Benchmark on Consumer-Grade Hardware

Biopharmaceutical manufacturing organizations operate under regulatory frameworks such as FDA guidance, EU Good Manufacturing Practice (GMP), and the EU AI Act, which can restrict the use of cloud-based artificial intelligence systems. Locally deployed large language models (LLMs) offer a privacy-preserving alternative, but their suitability for pharmaceutical manufacturing tasks remains underexplored. This study evaluates four open-source LLMs (Qwen 2.5 Coder 7B, Llama 3.1 8B, Mistral 7B, and Meditron 7B) deployed locally via Ollama for natural-language-to-SQL generation over a pharmaceutical manufacturing database. A FastAPI-based evaluation platform, PharmaBatchDB AI, was developed using a synthetic Microsoft SQL Server database containing approximately 63,000 records across Batch, Manufacturing Execution System (MES), and Clean-In-Place (CIP) modules. Models were benchmarked on 60 domain-specific natural-language questions using metrics including SQL extraction rate, SQL compliance, factual consistency, ROUGE-L, hallucination rate, throughput, and latency. Qwen 2.5 Coder 7B, Llama 3.1 8B, and Mistral 7B generated SQL for all evaluation tasks, while Meditron 7B failed on nearly all tasks due to context-window limitations and poor SQL generation capability. Llama 3.1 8B achieved the highest SQL compliance, whereas Qwen 2.5 Coder 7B achieved the strongest overall text similarity and factual consistency. Performance differences between the two leading models were not statistically significant. The results show that code-tuned general-purpose LLMs outperform a domain-specific biomedical model on structured query generation for pharmaceutical manufacturing data. Although fully local, GxP-aligned NLQ systems are feasible on consumer hardware, current performance levels still require human oversight and downstream validation for regulated use.

19.
medRxiv (Medicine) 2026-06-16

High-Risk Anti-Seizure Medication Use in Childbearing-Age People with Epilepsy in a Taenia solium Endemic Region

Background: People of childbearing potential with epilepsy in regions endemic for Taenia solium, where neurocysticercosis (NCC) is highly prevalent, represent a vulnerable population due to the elevated burden of epilepsy and resource limitations. Clinical practice in these settings remains poorly characterized. This study characterized anti-seizure medication (ASM) prescribing patterns by medication risk profiles among people of childbearing potential with epilepsy in Northern Peru, a region highly endemic for T. solium. Methods: Participants were drawn from a prospective, population-based epilepsy cohort in Tumbes, Peru (2006 to 2020). The analytic population included females with epilepsy aged 15 to 49 years. The primary outcome was pregnancy-associated ASM risk of congenital malformations and adverse neurodevelopmental outcomes. ASMs were classified as ''Established Low Risk'' (lamotrigine, levetiracetam), ''Possible Risk/Inadequate Data'' (carbamazepine, phenobarbital, phenytoin), and ''Established High Risk'' (valproic acid). Prescription patterns were examined in relation to demographic and clinical characteristics. Results: Among 1,975 individuals with epilepsy, 685 were people of childbearing potential. Approximately 34.9% met criteria for probable or definite NCC. Most ASM prescriptions were in the ''Possible Risk/Inadequate Data'' category (87.0%), and 12.8% received ''Established High Risk'' medications. In multivariable analysis, high-risk prescribing was associated with prior ASM use and polytherapy. Discussion: People of childbearing potential with epilepsy were predominantly treated with carbamazepine, phenytoin, phenobarbital, and valproate, reflecting local ASM availability. Despite evidence supporting lamotrigine and levetiracetam in pregnancy, prescribing patterns reflect local formulary constraints. These findings highlight a gap between guideline recommendations and real-world prescribing in resource-limited settings, underscoring the need for context-specific treatment strategies.

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

Hierarchical mutual distillation for multi-view fusion: Learning from all possible view combinations

Multi-view learning often struggles to effectively leverage images captured from diverse angles and locations. Learning methods for unstructured multi-view images remain largely underexplored. We propose a novel Hierarchical Mutual Distillation for Multi-View Fusion (HMDMV) method, which can handle both structured and unstructured multi-view scenarios. It makes predictions utilizing all possible view combinations: single view, partial multi-view, and full multi-view. The method generates predictions for each view combination and then applies hierarchical mutual distillation to enhance inter-view consistency. An uncertainty-based weighting mechanism further refines the fusion process by adjusting the influence of each view combination according to its prediction confidence, reducing the impact of low-confidence views. Extensive experiments on large-scale structured and unstructured datasets demonstrate that HMDMV consistently achieves state-of-the-art classification accuracy. Another unique advantage of HMDMV is that it provides improved flexibility in inference, allowing for more or fewer view counts in inference than those used in training without additional processing. We also provide a light version with reduced training cost by designing an efficient strategy that randomly samples subsets of view combinations during each training iteration. These results highlight HMDMV's robustness in real-world settings where view availability is variable or incomplete. The code is available at https://github.com/labhai/HMDMV.

21.
arXiv (CS.AI) 2026-06-17

Agentic AI-based Framework for Mitigating Premature Diagnostic Handoff and Silent Hallucination in Healthcare Applications

arXiv:2606.18068v1 Announce Type: new Abstract: Recent advances in Large Language Models (LLMs) and multi-agent systems have driven the rise of Agentic AI, showing promise for medical reasoning. However, open-ended conversational agents remain prone to two critical failure modes: premature diagnostic handoff and silent clinical hallucinations that may go undetected before reaching the patient. In this work, we propose a multi-agent framework that addresses both issues by replacing ``LLM-as-a-judge'' routing with deterministic orchestration constraints. The framework incorporates two safety mechanisms. First, a neuro-symbolic state-tracking gate enforces completeness of the OLDCARTS clinical protocol (Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, and Severity) by blocking diagnostic transitions until all required dimensions are collected. Second, an epistemic uncertainty quantification (UQ) gate computes semantic entropy (H) across K=5 independent diagnostic samples to identify and intercept divergent outputs before delivery. We evaluate the system using simulated patient agents powered by the llama-3.1-70b-instruct model on 150 test cases. The full architecture achieves 49.3% diagnostic precision, representing an absolute improvement of 11.3 percentage points over an unconstrained baseline. Additionally, we observe a statistically significant negative correlation (r = -0.181, p < 0.05) between OLDCARTS completeness (\sigma) and semantic entropy (H), suggesting that structured information gathering is associated with reduced diagnostic uncertainty.

22.
medRxiv (Medicine) 2026-06-15

Investigation of Intra-Fraction Stability and Inter-Fraction Reproducibility of Deep Inspiration Breath-Hold Across Two Hypofractionated Radiotherapy Regimens in the HYPORT Adjuvant Study.

Background: Deep Inspiration Breath Hold (DIBH) is a widely used respiratory motion management technique for minimizing cardiac dose in left-sided breast radiotherapy. In the Breast HYPORT Adjuvant study, DIBH was employed for cardiac sparing in patients without nodal irradiation using a standardized institutional protocol with the Varian Real-time Position Management (RPM) system. Both moderate-hypofractionation (control arm - 40Gy in 15 fractions) and one-week hypofractionation (experimental arm - 26 Gy in 5 fractions) regimens were delivered using this protocol. This study aimed to evaluate the robustness of DIBH by analyzing intra-fraction stability and inter-fraction reproducibility of breath-hold amplitude across the two treatment regimens. Methods: Respiratory waveforms acquired during each treatment session were analyzed to determine the median breath-hold amplitude and its standard deviation during beam delivery. Intra-fraction stability was assessed from vari- ations within individual treatment sessions, while inter-fraction reproducibility was evaluated relative to the simula- tion waveform amplitude across all treatment sessions. These parameters were compared between the two HYPORT regimens to examine breath-hold consistency during treatment delivery. Moreover, an additional comparison was made between the one-week hypofractionation regimen and the first five fractions of the moderate-hypofractionation regimen to evaluate the effect of treatment duration . Lung volumes from free-breathing and DIBH CT scans were analyzed to assess the effectiveness of patient breath-hold training. Results: Both arms demonstrated an average 1.7-fold increase of air volume in lung during the breath-hold position, confirming the effective implementation of DIBH during treatment planning and delivery. Structured training resulted in increased breath-hold amplitudes, with gains of 22.87% and 24.16% with respect to the first trial session in the experimental and control arms, respectively. Both regimens receive equivalent doses for approximately the same air volume in lung . Despite the different prescription doses in the two arms (26 Gy vs. 40 Gy), the experimental arm achieved an equivalent mean heart dose of 2.91% (75.6 cGy) compared with 2.95% (118.51 cGy) in the control arm, suggesting a similar cardiac preservation protocol adopted during treatment planning. Intra-fraction stability was similar between the control arm and the experimental arm, with median amplitude variations of 1.006 mm (95% CI: [0.998-1.015]) and 1.079 mm (95% CI: [1.067-1.097]), respectively. In contrast, inter-fraction reproducibility improved in the experimental arm, with lower deviation from simulation amplitude (0.44 {+/-} 0.24 mm vs. 0.66 {+/-} 0.25 mm) for the entire treatment schedule. The stability and reproducibility of experimental arm were further compared with the first five fractions of the control arm. The results were similar to those of the experimental arm. Conclusion: In this study, we compared two treatment regimens in terms of intra-fraction stability and inter-fraction reproducibility during DIBH radiotherapy. Both regimens demonstrated comparable intra-fraction stability, indicating effective motion management irrespective of treatment duration. However, the experimental arm showed better inter- fraction reproducibility, suggesting more consistent breath-hold performance throughout the treatment course. Based on stability and reproducibility, a reasonable narrowing of the DIBH gating window may be implemented with minor changes to the institutional protocol. The observed trend highlights the potential for improved consistency with the experimental approach and supports further investigation to better understand the underlying factors and strengthen these findings in future studies.

23.
medRxiv (Medicine) 2026-06-11

Development of iADJUST: a theory-informed, patient co-designed digital psychological intervention for adjustment in chronic kidney disease

Background: Psychological distress is common in chronic kidney disease (CKD) and is associated with reduced quality of life, treatment non-adherence, and worse clinical outcomes. Distress in CKD is also linked to difficulties adjusting to the demands of illness management. Despite this, psychological support remains inconsistently integrated within kidney care pathways, and existing interventions often lack clear theoretical specification and explicit targeting of mechanisms underpinning adjustment to CKD. Objectives: To describe the systematic development of iADJUST, a theory-informed patient co-designed digital psychological intervention targeting key cognitive and behavioural mechanisms involved in adjustment to CKD. Methods: Intervention development was guided by the Medical Research Council framework for complex interventions. A structured, iterative process integrated empirical evidence, psychological theory, and patient and public involvement and engagement. The Common-Sense Model of Self-Regulation and cognitive behavioural theories informed the identification of modifiable maintaining mechanisms associated with adjustment to CKD. Intervention components were mapped onto these mechanisms and refined through co-design with people living with CKD. Results: iADJUST is a six-session self-guided digital psychological intervention delivered over 12 weeks and supplemented by therapist contact. The intervention targets illness-related uncertainty, fatigue-related activity dysregulation, catastrophic what-if thinking, self-critical evaluation, and behavioural withdrawal. It integrates psychoeducation, cognitive and behavioural strategies, maintenance planning, and elements from acceptance and commitment therapy and compassion-focused approaches. Content is delivered through video, audio, and guided tasks and activities. Conclusion: iADJUST provides a theory-informed, evidence-based psychological intervention for CKD explicitly mapping intervention components to maintaining cognitive and behavioural mechanisms implicated in adjustment. Feasibility evaluation is underway.

24.
arXiv (CS.AI) 2026-06-19

Policy-aware Vector Search: A Vision for Fine Grained Access Control in Vector Databases

arXiv:2606.19803v1 Announce Type: cross Abstract: Vector databases are increasingly used in security sensitive contexts with Retrieval Augmented Generation and organizational AI pipelines; however, their security capabilities remain limited. Specifically, Fine-grained Access Control (FGAC) which is required to ensure that data access adheres to user-specific policies is not fully supported in modern vector databases. Unlike relational databases, vector databases combine structured and unstructured attributes to provide semantic, approximate query results, which complicates FGAC implementation. This creates an inherent tension between enforcing FGAC policies correctly, achieving high ANN search recall and maintaining low query latency. In this paper, we present a vision for Policy-aware Vector Search by formalizing the FGAC policy model in vector databases as well as the enforcement problem. We compare various enforcement strategies, present preliminary findings, and identify key open challenges for future research in policy-aware vector search.

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arXiv (CS.AI) 2026-06-19

Enhancing Generative Auto-bidding with Offline Reward Evaluation and Policy Search

arXiv:2509.15927v5 Announce Type: replace-cross Abstract: Auto-bidding is a critical tool for advertisers to improve advertising performance. Recent progress has demonstrated that AI-Generated Bidding (AIGB), which learns a conditional generative planner from offline data, achieves superior performance compared to typical offline reinforcement learning (RL)-based auto-bidding methods. However, existing AIGB methods still face a performance bottleneck due to their inherent inability to explore beyond the static dataset with feedback. To address this, we propose AIGB-Pearl (Planning with \textbf{EvaluAtor via RL}), a novel method that integrates generative planning and policy optimization. The core of AIGB-Pearl lies in constructing a trajectory evaluator to assess the quality of generated scores and designing a provably sound KL-Lipschitz-constrained score-maximization scheme to ensure safe and efficient exploration beyond the offline dataset. A practical algorithm that incorporates the synchronous coupling technique is further developed to ensure the model regularity required by the proposed scheme. Extensive experiments on both simulated and real-world advertising systems demonstrate the state-of-the-art performance of our approach.