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

From Static Inference to Dynamic Interaction: A Survey of Streaming Large Language Models

Standard Large Language Models (LLMs) are predominantly designed for static inference with pre-defined inputs, which limits their applicability in dynamic, real-time scenarios. To address this gap, the streaming LLM paradigm has emerged. However, existing definitions of streaming LLMs remain fragmented, conflating streaming generation, streaming inputs, and interactive streaming architectures, while a systematic taxonomy is still lacking. This paper provides a comprehensive overview and analysis of streaming LLMs. First, we establish a unified definition of streaming LLMs based on data flow and dynamic interaction to clarify existing ambiguities. Building on this definition, we propose a systematic taxonomy of current streaming LLMs and conduct an in-depth discussion on their underlying methodologies. Furthermore, we explore the applications of streaming LLMs in real-world scenarios and outline promising research directions to support ongoing advances in streaming intelligence. We maintain a continuously updated repository of relevant papers at https://github.com/EIT-NLP/Awesome-Streaming-LLMs.

02.
PLOS Computational Biology 2026-06-09

Multi-stable oscillations in cortical networks with two classes of inhibition

by Arnab Dey Sarkar, Bard Ermentrout In the classical view of cortical rhythms, interactions between excitatory pyramidal neurons (E) and inhibitory parvalbumin-expressing interneurons (I) are sufficient to generate gamma- and beta-band oscillations. However, it is now well established that multiple inhibitory interneuron subtypes exist and that they play important roles in the generation and modulation of these rhythms. In this paper, we develop a spiking network model consisting of populations of E, I, and an additional interneuron type, somatostatin-expressing neurons (S), which receive excitation from the E cells and inhibit both the E and I populations. The S cells are further modulated by a third inhibitory subtype, vasoactive intestinal peptide (VIP) neurons, which receive inputs from other cortical areas. We reduce the spiking network to a system of nine differential equations that describe the mean membrane potential, firing rate, and synaptic conductance for each population. Using this reduced model, we identify a wide range of parameters that exhibit multiple coexisting rhythms. Employing tools from nonlinear dynamics, we then explore the roles of the two classes of inhibition, as well as VIP modulation, in shaping the properties of these rhythms.

03.
medRxiv (Medicine) 2026-06-15

Reaching out-of-school girls with HPV vaccination: A qualitative evaluation in six low- and middle-income countries using the RE-AIM framework

Background Infection with human papillomavirus (HPV), the primary cause of cervical cancer, disproportionately affects women in low- and middle-income countries (LMICs). While school-based vaccination of adolescent girls against HPV is highly effective, this strategy systematically excludes out-of-school (OOS) girls. Using the RE-AIM framework, we explored strategies to reach OOS girls with HPV vaccination across six African and Asian LMICs. Methods We conducted semi-structured key informant interviews with 32 vaccination program stakeholders from Cambodia, Cameroon, Kenya, Malawi, Mozambique, and Uganda between May and September 2024. Interviews explored countries implementation successes, challenges, and strategies to reach OOS girls with HPV vaccination and sustainability considerations. Data were analyzed using a hybrid team-based thematic analysis approach guided by the RE-AIM framework. Results Community outreach-based strategies, typically integrated into routine immunization outreach, were identified as the most effective approach to reach OOS girls with HPV vaccination. Targeted strategies, such as locating outreach clinics in community venues frequented by OOS girls (e.g., churches, markets) enhanced implementation. Perceived effectiveness of these strategies varied across participants, and formal assessment of effectiveness was constrained by the absence of disaggregated vaccination coverage data by school enrollment status. Some subpopulations of OOS girls (i.e., girls in nomadic or migrant communities, urban OOS girls) were not readily reached through standard outreach approaches, prompting implementation of adapted and tailored strategies for these subpopulations. Costs associated with conducting outreach in harder-to-reach areas were major barriers to reaching OOS girls, presenting challenges to the sustainability and cost-effectiveness of these approaches. Conclusions Routine community outreach platforms were widely perceived as most effective for reaching OOS girls. Strengthening disaggregated monitoring systems, adapting outreach for harder-to-reach subpopulations of OOS girls, and financing delivery models for tailored outreach strategies will be critical to improving equitable HPV vaccine coverage among OOS girls.

04.
arXiv (quant-ph) 2026-06-12

Optimal classical shadow estimation of unitary channels at Heisenberg limit

arXiv:2606.13638v1 Announce Type: new Abstract: Full tomography of an unknown quantum evolution is resource-intensive and often unnecessary when the goal is only to predict selected properties. This motivates the study of classical shadow estimation of unitary channels (CSEU), a task in which one queries an unknown $d$-dimensional unitary $U$ and stores classical data that can later be used to predict expectation values $\mathrm{tr}[O \cdot U\rho U^\dagger]$ up to additive error $\varepsilon$ for arbitrary input states $\rho$ and observables $O$. We propose a parallel, non-adaptive CSEU protocol using $\mathcal{O}(d\varepsilon^{-1})$ queries when the input states or observables have constant rank. This achieves Heisenberg scaling with respect to $\varepsilon$ and is query-optimal, as we prove a matching $\Omega(d\varepsilon^{-1})$ lower bound that remains valid even with stronger access to the unknown unitary. Our query-optimal CSEU protocol provides a versatile and powerful tool for quantum learning theory, pushing the performance limits of several fundamental learning tasks, including unitary channel tomography, Hamiltonian learning, boundary-regime quantum channel tomography, Pauli transfer matrix learning, inverse-free amplitude estimation, pure-state property estimation, and shallow-circuit learning. Remarkably, we show that optimal unitary channel tomography can be achieved using only parallel queries, closing the gap between the best achievable efficiency of parallel and sequential tomography protocols. Together, these applications establish our framework as a fundamental tool for learning properties of quantum processes, particularly for certain key tasks that require high precision.

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

IAPO: Input Attribution-Aware Policy Optimization for Tool Use in Small Multimodal Agents

arXiv:2606.11652v1 Announce Type: new Abstract: This paper investigates reinforcement learning (RL) methods for improving tool-calling capabilities in multimodal small language model (SLM) agents. While existing works have explored various reward designs to improve agentic tool-calling ability, these approaches face inherent limitations for SLM training, especially under multimodal scenarios. First, many existing methods evaluate tool use correctness through exact matching against certain ground-truth or predefined formats. However, this assumption is often unsuitable for multimodal tasks, where multiple tool use paths may be valid and annotated tool trajectories are typically unavailable. Second, such sparse and brittle binary rewards provide little guidance on how to improve the underlying decision process, making them particularly difficult for multimodal SLM to learn from. To address these issues, we propose Input Attribution-Aware Policy Optimization (IAPO), an RL algorithm for improving tool use in multimodal SLM by aligning the model's attribution across input components with that of a stronger teacher. Experiments on Qwen2.5-VL-3B show that the proposed method improves visual question answering accuracy by an average of 3% across six test sets compared with existing visual tool use work, by helping the model attend to the most relevant input evidence.

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

Semantic Robustness Certification for Vision-Language Models

Vision-language models (VLMs) are now widely used in downstream tasks. However, real-world applications often expose VLMs to distribution shifts induced by semantic variation (e.g., shape, size, and style). Robustness certification determines if a model's prediction changes when transformations are applied to its input. While most certification frameworks study geometric or pixel-level transformations over inputs, this work proposes a novel framework that enables certifying VLM robustness under semantic-level transformations. Leveraging the open-vocabulary capability of VLMs, we use text prompts as semantic proxies to construct transformations parameterized by an extent that controls the degree of semantic variation. By characterizing the VLM decision boundary in closed form, our framework quantitatively certifies extent intervals for which the predicted class remains unchanged under the semantic transformation. Our framework is the first to certify VLM robustness under semantic-level variations without requiring additional data for each variation, making it practical to apply. Experiments on both synthetic and real-world data show that our framework enables certifying robustness under diverse semantic variations across scenarios.

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

KVEraser: Learning to Steer KV Cache for Efficient Localized Context Erasing

Post-hoc context erasing over the KV cache is challenging because a local edit has a global consequence: once a span has been processed, its influence propagates into the cached states of all subsequent tokens. This issue arises naturally in long-context LLM applications, where stale retrieved facts, incorrect tool observations, retracted user preferences, or harmful prompt injections may be identified only after prefill. Exact erasing must then recompute all tokens after the deleted span, making its computational cost depend on suffix length rather than erased-span length. We introduce KVEraser, a learned KV-cache editing method for efficient localized context erasing. Given a processed context and a span to remove, KVEraser replaces only the KV states of the erased interval with learned steering states while reusing the remaining cache unchanged. To learn a transferable erasing mechanism, we build a two-stage training pipeline: generic span-neighbor pre-training teaches the eraser to suppress the influence of the erased span, while task-specific fine-tuning adapts this capability to downstream scenarios. Experiments show that KVEraser nearly matches full recomputation in post-erasure performance on in-domain tasks across 1K–32K context lengths, while its latency increases by only 24% compared with a 17.6x increase for full recomputation. KVEraser also generalizes to unseen long-document QA tasks with harmful factual distractors, achieving the best performance among approximate baselines with a 3–4x speedup over full recomputation.

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

Do LLMs Reliably Identify Correct Information Units in Aphasic Discourse?

Correct Information Units (CIUs) are central to discourse assessment in aphasia because they quantify communicative informativeness rather than linguistic form alone. However, CIU scoring is time intensive and requires trained raters. This study examined whether instruction-tuned large language models (LLMs) can reliably perform token-level CIU classification from aphasic discourse transcripts. Sixteen picture-description transcripts elicited with the Cat Rescue stimulus were annotated for CIU status according to Nicholas and Brookshire (1993). The sample spanned four severity strata: control, mild, moderate, and severe aphasia. Four publicly available instruction-tuned LLMs were benchmarked under zero-shot and two few-shot prompting conditions across five stratified random seeds. Performance was evaluated against consensus human labels using accuracy, precision, recall, F1, and Cohen's kappa. Zero-shot prompting was insufficient across models. In contrast, few-shot prompting yielded substantial gains and produced competitive performance for three viable models. Mean few-shot F1 scores ranged from 0.776 to 0.817 across Llama-3.1-8B, Qwen2.5-7B, and Mistral-7B, with no significant differences between fixed global and per-chunk local example selection. Phi-3-mini was unstable and did not yield reliable performance. Viable models showed high recall but lower precision, suggesting systematic over-classification of tokens as CIUs. Performance also varied by discourse severity, with the weakest results in more severe aphasia. Few-shot LLM prompting can support automated CIU identification without gradient-based task training, but agreement with human annotation remains insufficient for fully autonomous use. These findings support LLM-based CIU scoring as a promising human-in-the-loop component of discourse assessment systems.

09.
arXiv (CS.AI) 2026-06-19

Automating SKILL.md Generation for Computer-Using Agents via Interaction Trajectory Mining

arXiv:2606.20363v1 Announce Type: new Abstract: Explicit skill libraries make computer-using agents easier to inspect, but it remains unclear whether such libraries can be mined from interaction data in a way that improves downstream policies. We study this question through a three-stage pipeline that segments GUI trajectories, clusters segments into candidate skills, and trains a skill-aware policy from the resulting annotations. The mined clusters are readable on the source benchmark: five of eight clusters have at least 0.95 purity against InteraSkill Workflows labels. However, readability does not imply transfer. GRPO improves IW skill-step accuracy only from 18.5\% to 20.5\%, leaves BrowseComp+ essentially unchanged, and underperforms trivial frequency priors on key source-domain metrics. We therefore present the method as a diagnostic study: trajectory mining can expose inspectable skill structure, but the current boundary detector, orderless segment representation, and offline reward model are insufficient for reliable cross-domain policy improvement.

10.
arXiv (CS.CL) 2026-06-24

Escaping the Self-Confirmation Trap: An Execute-Distill-Verify Paradigm for Agentic Experience Learning

Experience-driven self-evolution is critical for large language model (LLM) agents to improve through open-world interaction. However, existing experience learning methods mostly rely on single-agent loops, where the same agent executes tasks, summarizes outcomes, and determines memory content. This setup makes agents vulnerable to the Self-Confirmation Trap: wrong-but-self-consistent trajectories are misidentified as successful experience, leading to cumulative errors during retrieval and reuse. To address this issue, we propose EDV, an Execute-Distill-Verify framework for reliable experience learning. In the Execute stage, multiple heterogeneous agents explore the same task space in parallel to generate diverse candidate trajectories. In the Distill stage, a dedicated third-party agent comparatively analyzes these trajectories to produce candidate experiences, reducing executor-centric summarization bias. In the Verify stage, the execution group validates candidates via a consensus mechanism, and only approved experiences are written into shared or private memory. By decoupling the three stages, EDV transforms experience learning from isolated self-reflection into collaborative construction, filtering erroneous and noisy content before memory insertion. We evaluate EDV on three challenging long-horizon benchmarks: tau2-bench, Mind2Web and MMTB. Results show EDV consistently outperforms strong baselines, validating that reliable experience construction is essential for robust agent self-evolution. Our code is available at https://github.com/shidingz/EDV.

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

PoseGAM: Robust Unseen Object Pose Estimation via Geometry-Aware Multi-View Reasoning

6D object pose estimation, which predicts the transformation of an object relative to the camera, remains challenging for unseen objects. Existing approaches typically rely on explicitly constructing feature correspondences between the query image and either the object model or template images. In this work, we propose PoseGAM, a geometry-aware multi-view framework that directly predicts object pose from a query image and multiple template images, eliminating the need for explicit matching. Built upon recent multi-view-based foundation model architectures, the method integrates object geometry information through two complementary mechanisms: explicit point-based geometry and learned features from geometry representation networks. In addition, we construct a large-scale synthetic dataset containing more than 190k objects under diverse environmental conditions to enhance robustness and generalization. Extensive evaluations across multiple benchmarks demonstrate our state-of-the-art performance, yielding an average AR improvement of 5.1% over prior methods and achieving up to 17.6% gains on individual datasets, indicating strong generalization to unseen objects. Project page: https://windvchen.github.io/PoseGAM/ .

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

Utility-Constrained Policy Optimization

arXiv:2606.14029v1 Announce Type: new Abstract: Constrained MDPs (CMDPs) are a widely adopted framework for incorporating safety into RL agents; however, the framework does not support risk-sensitive constraints. This can be problematic: For example, CMDPs allow for optimal solutions that, in order to satisfy the risk-neutral constraints, mix infrequent catastrophic behaviors and frequent, overly conservative ones. Moreover, prior empirical results suggest that enforcing stricter, risk-sensitive constraints can improve performance even under risk-neutral evaluation. The natural framework to incorporate risk-sensitive constraints is utility-constrained MDPs (UCMDPs), but no practical solutions for this problem existed. In this work, we introduce a simple yet powerful methodology for UCMDPs and constrained RL. Besides allowing for risk-sensitive constraints, our framework does not require us to fix constraint limits in advance of training the agent, provided that a sensible range is known. This increases policy flexibility and, in practice, allows for adjustments to these limits at no extra training cost. Besides benefiting from the generality of the framework, our agent shows strong performance in practice, consistently matching or outperforming existing baselines in several Safety Gymnasium benchmark tasks.

13.
arXiv (CS.AI) 2026-06-24

An Introduction to Causal Reinforcement Learning

arXiv:2606.24160v1 Announce Type: new Abstract: Causal inference provides a set of principles and tools that allow one to combine data and knowledge about an environment to reason with questions of counterfactual nature, i.e., what would have happened had reality been different, even when no data of this unrealized reality is currently available. Reinforcement learning provides methods to learn a policy that optimizes a specific measure (e.g., reward, regret) when the agent is deployed in an environment and pursues an exploratory, trial-and-error approach. These two disciplines have evolved independently and with virtually no interaction between them. We note that they operate over different aspects of the same building block, counterfactual relations, which makes them umbilically connected. Based on these observations, novel learning opportunities arise when this connection is explicitly acknowledged and mathematized. To realize this potential, we note that any environment where the RL agent is deployed can be decomposed as a collection of autonomous mechanisms with different causal invariances, parsimoniously modeled as a structural causal model; any standard RL setting implicitly encodes such a model. This formalization allows us to put under a unifying treatment different modes of learning, including online, off-policy, and causal calculus learning, which appear unrelated in the literature. However, these modalities are not exhaustive: we introduce several natural and pervasive classes of learning settings that entail novel dimensions of analysis. Specifically, we introduce and discuss through causal lenses generalized policy learning, where to intervene, imitation learning, and counterfactual learning. These tasks lead to a broader view of counterfactual learning and suggest great potential for studying causal inference and reinforcement learning side by side, which we call causal reinforcement learning (CRL).

14.
medRxiv (Medicine) 2026-06-15

Artificial Intelligence-Based Detection of Airway Mucus Plugs on CT and Associations With Clinical Outcomes in COPDGene

RATIONALE: Airway mucus plugging is a clinically relevant manifestation of airway pathology in chronic obstructive pulmonary disease (COPD) and is associated with increased mortality even in early disease; however, visual computed tomography (CT) assessment is subjective and labor intensive. OBJECTIVES: To develop an AI-based quantitative CT method for automated detection of airway mucus plugging and evaluate associations with physiologic impairment and clinical outcomes. METHODS: Inspiratory CT scans from 8,971 COPDGene Phase 1 (GOLD 0-4 and PRISm) participants were analyzed. An AI-based framework combining 3D airway segmentation discontinuities and convolutional neural network classification identified mucus plug obstructions, yielding mucus plug burden (total plug count). Associations with outcomes were evaluated using covariate-adjusted models. MEASUREMENTS AND MAIN RESULTS : Higher mucus plug burden was associated with lower post-bronchodilator FEV % predicted ({rho} = -0.41; P < 0.001), greater air trapping (LAA < -856 HU; {rho} = 0.33; P < 0.001), worse health status (SGRQ; {rho} = 0.31; P < 0.001), and shorter 6-minute walk distance ({rho} = -0.26; P < 0.001). Among GOLD 1-4 participants, mucus plug presence was independently associated with increased all-cause mortality (adjusted hazard ratio, 1.28; P < 0.005) and exacerbation frequency (adjusted incidence rate ratio, 1.32; P < 0.005). Plug presence was also associated with increased respiratory mortality across GOLD categories and cardiovascular mortality in GOLD 1-2. CONCLUSIONS: AI-based quantitative CT assessment of airway mucus plugging provides a scalable, reproducible measure associated with physiologic impairment and adverse outcomes in COPD, supporting its role in risk stratification and future therapeutic studies.

15.
arXiv (CS.AI) 2026-06-24

ATHENA: Agentic Team for Hierarchical Evolutionary Numerical Algorithms

arXiv:2512.03476v3 Announce Type: replace-cross Abstract: Progress in computational science depends on complex numerical workflows that must faithfully encode physical laws, yet translating conceptual insight into reliable code remains a major bottleneck. Although large language models can generate isolated code fragments, they lack the structured reasoning required to design, verify, and iteratively refine complete scientific pipelines. Here we introduce ATHENA, an agentic framework explicitly designed to emulate scientific research modeled as a knowledge-driven contextual bandit process. Its core loop separates conceptual policy from numerical realization through expert-derived conceptual scaffolding, enabling principled diagnosis, reformulation, and repair of computational strategies. Across scientific computing and scientific machine learning tasks, ATHENA autonomously derives and correctly applies exact analytical solutions, constructs stable numerical solvers, diagnoses ill-posed formulations, and orchestrates hybrid symbolic-numeric workflows. Quantitatively, ATHENA matches and frequently surpasses the accuracy of expert-authored reference solutions reported in the literature on canonical benchmarks. By reframing computation as an object of agentic reasoning, our framework enables autonomous orchestration of heterogeneous algorithms across scientific domains.

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

Computational Safety for Generative AI: A Hypothesis Testing Perspective

作者:

arXiv:2502.12445v2 Announce Type: replace Abstract: AI safety is a rapidly growing area of research that seeks to prevent the harm and misuse of frontier AI technology, particularly with respect to generative AI (GenAI) tools that are capable of creating realistic and high-quality content through text prompts. Examples of such tools include large language models (LLMs) and text-to-image (T2I) diffusion models. As the performance of various leading GenAI models approaches saturation due to similar training data sources and neural network architecture designs, the development of reliable safety guardrails has become a key differentiator for responsibility and sustainability. This paper presents a formalization of the concept of computational safety, which is a mathematical framework that enables the quantitative assessment, formulation, and study of safety challenges in GenAI through the lens of signal processing theory and methods. In particular, we explore two exemplary categories of computational safety challenges in GenAI that can be formulated as hypothesis testing problems. For the safety of model input, we show how sensitivity analysis and loss landscape analysis can be used to detect malicious prompts with jailbreak attempts. For the safety of model output, we elucidate how statistical signal processing can be used to detect AI-generated content. Finally, we discuss key open research challenges, opportunities, and the essential role of signal processing in computational AI safety.

17.
arXiv (CS.LG) 2026-06-15

On the Geometry and Optimization of Polynomial Convolutional Networks

arXiv:2410.00722v3 Announce Type: replace Abstract: We study convolutional neural networks with monomial activation functions. Specifically, we prove that their parameterization map is regular and is an isomorphism almost everywhere, up to rescaling the filters. By leveraging on tools from algebraic geometry, we explore the geometric properties of the image in function space of this map - typically referred to as neuromanifold. In particular, we compute the dimension and the degree of the neuromanifold, which measure the expressivity of the model, and describe its singularities. Moreover, for a generic large dataset, we derive an explicit formula that quantifies the number of critical points arising in the optimization of a regression loss.

18.
PLOS Medicine 2026-05-26

Requiring code sharing to strengthen transparency and trust in research

by Helen Lumbard, Lauren Cadwallader, Devin Soper, on behalf of the PLOS Medicine Staff Editors PLOS Medicine has always championed open science and data transparency. Now, recognizing that code is as essential a research artifact as the data it analyzes, we are strengthening our code sharing policy to further ensure reproducibility and trust in the scientific record. Recognizing that code is as essential a research artifact as the data it analyzes, this Editorial outlines how PLOS Medicine is strengthening its code sharing policy to further ensure reproducibility and trust in the scientific record.

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

FlowR2A: Learning Reward-to-Action Distribution for Multimodal Driving Planning

arXiv:2606.24231v1 Announce Type: new Abstract: Multimodal driving planning faces a long-standing tension between two paradigms: scoring-based methods benefit from dense reward supervision but are confined to a fixed action vocabulary, while anchor-based methods generate proposals dynamically yet suffer from sparse supervision constrained to a single ground-truth trajectory. In this work, we propose FlowR2A, which resolves this tension by reframing simulation-based rewards from discriminative targets into generative conditions. By learning the reward-conditioned action distribution from dense trajectory-reward pairs with a flow-matching decoder, FlowR2A unifies the dense supervision of scoring-based methods with the proposal generation of anchor-based methods in a single generative model, forcing the model to internalize the correlation between an action and its outcomes in safety, progress, comfort, and rule compliance. To balance hard safety constraints against soft progress objectives, we introduce fine-grained per-timestep reward conditioning and reward noise augmentation. The generative formulation naturally supports controllable test-time sampling via reward guidance and anchored sampling, producing high-quality proposals. FlowR2A achieves state-of-the-art results on the NAVSIM v1 and v2 benchmarks, with multimodal proposals of substantially higher quality than prior methods.

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

What Drives Test-Time Adaptation for CLIP? A Controlled Empirical Study from an Update Perspective

Vision-Language Models (VLMs) such as CLIP have become a standard backbone for open-vocabulary recognition, yet their zero-shot predictions remain vulnerable to distribution shifts encountered at deployment. Test-Time Adaptation (TTA) has recently been extended to CLIP as a lightweight solution, leading to a rapidly growing body of TTA4CLIP methods. However, empirical progress in this area has largely outpaced our understanding of what truly drives adaptation, where their gains originate, and under which shifts they remain reliable. In this paper, we take a step back from the pursuit of state-of-the-art accuracy and conduct a systematic controlled study of TTA4CLIP. We first organize existing methods into three unified paradigms according to what is updated at test time. We then introduce TTABC, an open-source TTA Benchmark for CLIP, which standardizes evaluation protocols and integrates more than 20 representative methods. Our controlled empirical analysis focuses on three key areas. First, we determine the driving factors in parameter-based methods, revealing that adaptation gains are primarily driven by test-time evidence and reliable proxies rather than heavy optimization. Second, we explore evidence utilization beyond heavy parameter tuning, showing that competitive and efficient performance can be achieved through cross- or current-sample evidence and lightweight prototype updates. Finally, we demonstrate that there is no silver bullet for TTA: no single adaptation paradigm is universally optimal, and the preferred paradigm depends on the nature of shift. We hope our benchmark and study provide a clearer understanding of the current TTA4CLIP landscape and establish a foundation for further research.

21.
medRxiv (Medicine) 2026-06-17

Diagnostic Concordance of Immediate Versus 1-Hour Technetium-99m Hydroxydiphosphonate Scintigraphy in Suspected Transthyretin Amyloid Cardiomyopathy

Background Bone-avid tracer myocardial scintigraphy for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) has traditionally employed imaging at one or 3-hour intervals. Technetium-99m hydroxydiphosphonate (99mTc-HDP) has unique characteristics that may enable earlier imaging. We investigated the diagnostic concordance of immediate versus 1-hour acquisitions. Methods Consecutive patients with suspected ATTR-CM underwent planar imaging and SPECT/CT immediately and at 1-hour following the administration of 99mTc-HDP. Perugini grades and heart to contralateral lung (H/CL) ratios were assessed. Target-to-background ratios (TBRs) were calculated on the SPECT/CT acquisitions using the left ventricular (LV) septum and three background regions: aorta, LV blood-pool, and vertebrae. We assessed diagnostic concordance using Cohen's Kappa ({kappa}), temporal stability using paired t-tests, and correlation between timepoints using Pearson's coefficient (r). The 1-hour SPECT/CT interpretation served as the protocol reference standard. Results Forty-eight patients (83% male; median age, 80 [73-85] years) were evaluated. One-hour SPECT/CT identified 19 positive and 29 negative cases. Immediate SPECT/CT demonstrated 100% diagnostic concordance with the 1-hour reference standard ({kappa} = 1.000; 95% CI: 1.00 to 1.00; p < 0.001). The LV septum/LV Blood-Pool TBR showed the highest correlation (r = 0.956; 95% CI: 0.922 to 0.975; p < 0.001). The LV Septum/Aorta TBR demonstrated high correlation (r = 0.918; 95% CI: 0.857 to 0.953; p < 0.001) and remained stable in the ATTR-negative cohort (-0.02; 95% CI: -0.08 to 0.04; p = 0.54). Significant decrease in the LV Septum/Vertebrae TBR in the ATTR-negative (-0.55; 95% CI: -0.64 to -0.47; p < 0.001) and ATTR-positive cohorts (-1.14; 95% CI: -1.39 to -0.89; p < 0.001) was observed. Conclusions Immediate 99mTc-HDP SPECT/CT is diagnostically concordant with standard 1-hour protocols. By leveraging SPECT/CT and the favorable kinetics of 99mTc-HDP, immediate-phase imaging can accurately reproduce 1-hour acquisitions in cases of suspected ATTR-CM. This expedited approach may improve nuclear laboratory throughput and patient satisfaction.

23.
arXiv (CS.AI) 2026-06-18

Veriphi: Attack-Guided Neural Network Verification with Dataset-Dependent Training Methods

arXiv:2606.18454v1 Announce Type: cross Abstract: We present Veriphi, a GPU-accelerated neural network verification system that combines fast adversarial attacks with formal bound certification using alpha,beta-CROWN methods. Through systematic experiments on MNIST and CIFAR-10 using three training methodologies (standard, adversarial, certified), we demonstrate that training method effectiveness is fundamentally dataset-dependent. Interval Bound Propagation (IBP) achieves 78% certified accuracy on simple MNIST (784 dimensions) but provides negligible certification performance on the more complex CIFAR-10 dataset, where PGD adversarial training dominates with 94% certification at small perturbations. We achieve 5x verification speedup through attack-guided falsification and scale our approach to production-size models (105.8M parameters) for real-world aerospace logistics optimization. Our results challenge the assumption that certified training universally outperforms adversarial training, showing context matters critically for verification strategy selection.

24.
medRxiv (Medicine) 2026-06-18

MOSAIC: Methylation-Oriented Site Analysis and Information Classifier for Robust Epigenomic Classification of Acute Leukemia in Clinical Cohorts with Variable Tumor Purity

DNA methylation-based classification offers a rapid diagnostic complement to conventional molecular workflows in acute leukemia. Existing classifiers are trained on array-derived reference cohorts whose construction favors specimens with adequate tumor content, leaving clinically relevant low-purity specimens underrepresented and classifier robustness in this regime uncharacterized. On held-out low-purity specimens, existing classifiers were concordant with expert pathology in only 7 of 10 (MARLIN) and 5 of 10 (ALMA) cases, motivating a classifier built to maintain accuracy at low tumor purity. We developed MOSAIC (Methylation-Oriented Site Analysis and Information Classifier), a neural network classifier built to maintain accuracy across the full range of tumor purities encountered in clinical practice. MOSAIC is a neural network trained on publicly available array-based methylation data augmented with native methylation calls from Oxford Nanopore sequencing. MOSAIC was evaluated on low-purity specimens held out entirely from training. On these held-out low-blast leukemia specimens, all below 25% blasts and including a case at 1.4%, MOSAIC was concordant with expert pathology in every case, recovering the correct subtype where diluted disease signal would otherwise be mistaken for normal or unrelated tissue. Gradient-based saliency analysis showed that the network relies on a partially distinct set of discriminative CpG probes when classifying low-blast specimens. MOSAIC demonstrates that augmenting training with clinically representative clinical specimens yields methylation-based leukemia classification that maintains effectiveness under the variable tumor purity of real clinical cohorts.

25.
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