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01.
arXiv (CS.CV) 2026-06-17

DiffAttn: Diffusion-Based Drivers' Visual Attention Prediction with LLM-Enhanced Semantic Reasoning

Drivers' visual attention provides critical cues for anticipating latent hazards and directly shapes decision-making and control maneuvers, where its absence can compromise traffic safety. To emulate drivers' perception patterns and advance visual attention prediction for intelligent vehicles, we propose DiffAttn, a diffusion-based framework that formulates this task as a conditional diffusion-denoising process, enabling more accurate modeling of drivers' attention. To capture both local and global scene features, we adopt Swin Transformer as encoder and design a decoder that combines a Feature Fusion Pyramid for cross-layer interaction with dense, multi-scale conditional diffusion to jointly enhance denoising learning and model fine-grained local and global scene contexts. Additionally, a large language model (LLM) layer is incorporated to enhance top-down semantic reasoning and improve sensitivity to safety-critical cues. Extensive experiments on four public datasets demonstrate that DiffAttn achieves state-of-the-art (SoTA) performance, surpassing most video-based, top-down-feature-driven, and LLM-enhanced baselines. Our framework further supports interpretable driver-centric scene understanding and has the potential to improve in-cabin human-machine interaction, risk perception, and drivers' state measurement in intelligent vehicles.

02.
arXiv (CS.AI) 2026-06-19

PrototypeNAS: Rapid Design of Deep Neural Networks for Microcontroller Units

arXiv:2603.15106v2 Announce Type: replace Abstract: Enabling efficient deep neural network (DNN) inference on edge devices with different hardware constraints is a challenging task that typically requires DNN architectures to be specialized for each device separately. To avoid the huge manual effort, one can use neural architecture search (NAS). However, many existing NAS methods are resource-intensive and time-consuming because they require the training of many different DNNs from scratch. Furthermore, they do not take the resource constraints of the target system into account. To address these shortcomings, we propose PrototypeNAS, a zero-shot NAS method to accelerate and automate the selection, compression, and specialization of DNNs to different target microcontroller units (MCUs). We propose a novel three-step search method that decouples DNN design and specialization from DNN training for a given target platform. First, we present a novel search space that not only cuts out smaller DNNs from a single large architecture, but instead combines the structural optimization of multiple architecture types, as well as optimization of their pruning and quantization configurations. Second, we explore the use of an ensemble of zero-shot proxies during optimization instead of a single one. Third, we propose the use of Hypervolume subset selection to distill DNN architectures from the Pareto front of the multi-objective optimization that represent the most meaningful tradeoffs between accuracy and FLOPs. We evaluate the effectiveness of PrototypeNAS on 12 different datasets in three different tasks: image classification, time series classification, and object detection. Our results demonstrate that PrototypeNAS is able to identify DNN models within minutes that are small enough to be deployed on off-the-shelf MCUs and still achieve accuracies comparable to the performance of large DNN models.

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

DiRecT: Safe Diffusion-Based Planning via Receding-Horizon Denoising

arXiv:2606.15359v1 Announce Type: new Abstract: Diffusion models have emerged as powerful tools for planning and control by learning multimodal distributions over actions and trajectories. Yet reliable inference-time safety enforcement remains a key barrier to their deployment in safety-critical tasks. Existing approaches typically project each denoising iterate onto the feasible set, even though constraints are defined only on the final clean trajectory. Enforcing feasibility on noisy intermediate samples can therefore overconstrain the sampling dynamics, substantially degrading sample quality. To address this limitation, we introduce DiRecT (Diffusion-based planning via Receding-horizon denoising with Terminal constraints), a training-free algorithm for constrained sampling from diffusion models via stochastic optimal control (SOC). DiRecT enforces constraints only on the final clean sample, avoiding unnecessary restrictions on the intermediate denoising dynamics. Inspired by model predictive control, we derive a principled receding-horizon surrogate for the otherwise intractable constrained SOC formulation, yielding an efficient algorithm that cleanly separates stochastic denoising from constraint satisfaction, progressively steering samples toward feasible final trajectories without distorting the learned diffusion dynamics. Furthermore, DiRecT is highly flexible: it can leverage off-the-shelf or domain-specific optimizers, incorporate priors over environment dynamics, and optimize additional soft rewards. Extensive experiments on safe planning benchmarks demonstrate that DiRecT substantially improves deployment safety and task performance over existing diffusion-based planning baselines.

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

Holographic Complexity, Extremality, and Cosmic Censorship

arXiv:2604.20170v2 Announce Type: replace-cross Abstract: We propose a holographic complexity origin for the third law of black-hole mechanics and weak cosmic censorship. In both complexity equals action and complexity equals volume prescriptions, the relative complexity between subextremal and extremal AdS black holes diverges logarithmically. For overcharged RN-AdS, explicit calculations in both prescriptions show that the near-singularity action terms are power-law divergent or finite, while the maximal-volume contribution is finite. Thus, the extremal-to-naked relative complexity also diverges, obstructing finite-time transitions.

05.
arXiv (CS.CL) 2026-06-16

Symbolic Informalization: Fluent, Productive, Multilingual

作者:

Symbolic informalization enables a reliable conversion of formal mathematics to natural language. It has the potential to make machine-checked content human-readable without loss of precision. In a traditional proof system usage, symbolic informalization generalizes the limited mechanisms of syntactic sugar into the ordinary language of mathematics. In a setting where proofs are constructed by artificial intelligence and autoformalization, symbolic informalization can explain what precisely has been constructed. This paper outlines the project Informath, which aims to show how symbolic informalization can produce fluent text with a reasonable development effort and address multiple formal and natural languages. Informath is based on an interlingual architecture, where Dedukti works as a hub between different proof systems (Agda, Lean, Rocq) and Grammatical Framework (GF) takes care of linguistic correctness and variation in different natural languages.

06.
PLOS Computational Biology 2026-06-15

A multilevel hierarchical framework for quantification of experimental heterogeneity in population snapshot data

by David J. Warne, Xiangrun Zhu, Thomas P. Steele, Stuart T. Johnston, Scott A. Sisson, Matthew Faria, Ryan J. Murphy, Alexander P. Browning Biological systems exhibit substantial heterogeneity: that is, variation in specific characteristics of individuals within a population. As a result, it is of critical importance to appropriately account for biological heterogeneity when calibrating mathematical models to infer cellular processes and predict behaviour. Recent approaches consider ordinary differential equations with random parameters to quantify heterogeneity in dynamical processes of cells. In this setting, statistical inference is performed to characterise the distribution of these random parameters within a cell population. One significant limitation of this approach is the tacit assumption that there are no substantial deviations in these distributions across experimental replicates. In this work, we propose a flexible Bayesian hierarchical differential equation modelling framework that quantifies and distinguishes both inter-experimental heterogeneity (heterogeneity between experimental replicates) and intra-experimental heterogeneity (biological heterogeneity within replicate populations). We consider two recent studies that employ mathematical models to interpret flow cytometry snap-shot data and quantify heterogeneity in nano-particle cell interactions and cell internalisation processes. Using simulation data, we demonstrate that substantial inaccuracy in the inferred dynamics can arise when experimental heterogeneity is not accounted for. By contrast, our hierarchical approach is robust to variability in inter-experimental and intra-experimental heterogeneity and our method simplifies to previous methods when inter-experimental heterogeneity is negligible. Our approach is flexible and widely applicable to applications involving replicate populations and snapshot data. We provide open-source implementations of our methods on GitHub.

07.
medRxiv (Medicine) 2026-06-11

What level of expertise is necessary to generate ACLS training test questions: pre-med students vs. artificial intelligence?

Abstract Introduction In-hospital cardiac arrest carries high mortality despite standardized ACLS training. Educators face increasing time constraints in developing assessment tools for ACLS training. Two possible solutions to this problem are using pre-medical students or using artificial intelligence to generate test questions. This study compared the quality of pre-medical student-generated ACLS test questions vs. AI-generated ACLS test questions, testing the hypothesis that AI-generated questions are non-inferior to student-generated questions. Methods Ten pre-medical students created ACLS questions following predefined criteria, while an AI model (Northwell's Artificial Intelligence Hub) generated comparable questions. A blinded ACLS-certified physician evaluated questions on the qualities of Alignment, Clarity, Cognitive Level, and Question Design using a standardized rubric (Likert scale: 1 = poor quality, 5 = excellent). Student's T-test and Chi-square analysis were used to compare the quality of questions on different rubric domains within each arm (student vs. AI) and within one domain (eg, question Clarity) between arms. The Student's T test was used when 2 comparator groups were compared (eg, Clarity of student-generated vs. AI-generated questions) within one arm. The ANOVA test was used when comparing more than 2 comparator groups (eg, Alignment vs. Clarity vs. Cognitive Level) within one arm. Statistical significance was set as a priority at p

08.
arXiv (CS.CL) 2026-06-15

AgentSpec: Understanding Embodied Agent Scaffolds Through Controlled Composition

LLM agents are increasingly built not as single model calls, but as scaffolded systems that combine reasoning, memory, reflection, action execution, and learning. While such scaffolds often improve performance, they are often embedded in tightly coupled pipelines, making it difficult to isolate component contributions, compare alternative designs, or understand how module interactions shape agent behavior. We introduce AgentSpec, a modular specification framework that represents embodied agents as typed compositions of reusable policy components with standardized interfaces. AgentSpec standardizes the interfaces among perception, memory, reasoning, reflection, action, and optional learning, enabling components to be swapped and recombined under controlled conditions. We instantiate this framework across DeliveryBench, ALFRED, MiniGrid, and RoboTHOR, and analyze reasoning, memory, reflection, and reinforcement-learning modules across model backbones. Our results show that agent performance is governed by scaffold compatibility and interaction effects rather than isolated module strength. In particular, structured multi-granularity memory improves long-horizon state tracking, reasoning and memory interact non-uniformly across environments, reflection trades off correction and cost, and RL-trained policies compose best when optimized with deployment-time scaffold structure. AgentSpec provides a controlled foundation for studying, comparing, and designing composable LLM agents. Our code, baselines and interactive playground are publicly available at https://agentspec-embodied.github.io.

09.
arXiv (CS.CV) 2026-06-16

MeshLoom: Feed-Forward Non-Rigid Registration of Mesh Sequences

We present MeshLoom, a feed-forward registration network that directly reconstructs vertex deformations across mesh sequences. Our approach advances non-rigid registration beyond existing models, which are typically constrained by costly per-instance optimization, narrow object categories, pairwise-only inputs, or merely intermediate outputs. The network is simple and efficient, registering multiple meshes within seconds. At its core lies a topology-aware encoder–decoder design. Specifically, we first introduce a topology-aware point representation that encodes the anchor (reference) mesh's topology into its per-vertex features. This representation strengthens the network's understanding of the anchor-mesh geometry and disambiguates points that are Euclidean-close yet geodesically distant. We then propose a multi-modal encoder that fuses this anchor-mesh representation with complementary cues from each frame, such as shape latents and image features. These multi-source signals are compressed into a compact global motion embedding that captures dense inter-frame correspondence. A lightweight decoder then queries this global embedding with the anchor-mesh point representation, retrieving per-vertex deformations at target timestamps. Through extensive experiments across diverse motions and object categories, we show that MeshLoom achieves state-of-the-art results on non-rigid registration. In addition, we find that our global embedding-then-query paradigm naturally enables the network to generate deformations at intermediate timestamps, which extends MeshLoom to motion interpolation and mesh morphing. Project page: https://meshloom.github.io/ .

10.
arXiv (quant-ph) 2026-06-17

Intrinsic Pointer Basis and Irreversible Classicality from Coherence Contraction

arXiv:2604.23304v4 Announce Type: replace Abstract: This work analyzes an operational route to classical behavior for reduced quantum states using the intrinsic reference basis (IRB). Relative to a fixed physical conjugation, the IRB separates intrinsic populations from a real antisymmetric cohesion sector. A globally bounded cohesion index is defined and its exponential contraction is proved for phase-free dephasing dynamics aligned with the IRB; for general aligned dephasing, the corresponding modulus-based coherence functional contracts at the same computable rates. The results provide distance bounds to the IRB-diagonal description and a logarithmic upper bound on the time required to reach a prescribed experimental tolerance. The IRB projectors constitute state-derived candidate pointer sectors, and they become dynamically stable pointer sectors when the effective dephasing generator is aligned with them and damps the relevant inter-sector coherences. Degenerate population sectors lead naturally to block-classicality and protected intra-block coherence. In a two-level active sector, the cohesion index equals fringe visibility, giving a direct interferometric test of the contraction law. The construction is independent of any spacetime- or unification-emergence hypothesis and is intended as a channel-level complement to environment-induced einselection.

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

Pose6DAug: Physically Plausible Multi-view Object Swapping for Robot Data Augmentation

arXiv:2606.20118v1 Announce Type: cross Abstract: Vision-language-action (VLA) policies have shown strong potential for general-purpose manipulation, yet they often fail on novel, out-of-distribution objects whose appearance or geometry deviates from the training distribution. The standard remedy is to collect multi-view teleoperation data for every failure case, but this scales poorly in both cost and time. We introduce Pose6DAug, a failure-driven data augmentation framework that turns a policy's own successful episodes into targeted demonstrations for its failure modes, without any new data collection. Our key insight is that each successful episode already encodes a physically valid action trajectory together with calibrated multi-view observations. By swapping only the manipulated object while preserving this trajectory, we obtain new and physically grounded demonstrations. However, naive 2D video editing breaks multi-view consistency and physical plausibility, particularly under heavy occlusion and egocentric viewpoints. Our method instead operates directly in 3D, anchoring the target object with an explicit mesh driven by a temporally coherent 6D pose trajectory, ensuring geometrically consistent renderings across all camera views. Fine-tuning a VLA on data augmented by our method improves success rates by 16.5% relative to the state-of-the-art baseline on novel objects, while preserving in-distribution performance. These results show that multi-view and physically consistent augmentation is a practical path to scalable VLA generalization.

12.
medRxiv (Medicine) 2026-06-16

Development of an automated, imaging-based preoperative screening model for early identification of malnutrition in an abdominal surgery cohort

Background: Clinical malnutrition affects one in five abdominal surgery patients and increases postoperative complications and mortality. Current screening occurs after admission, closing the window for preoperative nutritional intervention. No objective, scalable preoperative screening tool exists. Objective: To determine whether automated volumetric CT-based body composition analysis improves preoperative identification of surgical patients at risk for clinical malnutrition compared to clinical variables or single slice imaging alone. Methods: Retrospective cohort study of adults undergoing elective abdominal surgery at a quaternary academic medical center (2018 to 2021) with a preoperative CT scan within 90 days and complete nutrition assessment. Clinical malnutrition was diagnosed by a registered dietitian using ASPEN/AND criteria. Three sex stratified Elastic Net models were compared: (1) base clinical variables; (2) base plus L3 single slice skeletal muscle index and attenuation; and (3) base plus comprehensive 3D volumetric quantification of five muscle groups and two fat depots. Discrimination (AUROC), calibration (Brier score), and clinical utility (decision curve analysis) were assessed via 10-fold cross-validation. Results: Among 1,143 patients (52.4% female; mean age 60.5 years), 231 (20.2%) were diagnosed with malnutrition. Malnourished patients had significantly higher complication rates (36.4% vs. 15.4%, p

13.
arXiv (quant-ph) 2026-06-12

First-order and interior-point methods for entanglement detection

arXiv:2508.05854v3 Announce Type: replace Abstract: Quantum entanglement lies at the heart of quantum information science, yet its reliable detection in high-dimensional or noisy systems remains a fundamental computational challenge. Semidefinite programming (SDP) hierarchies, such as the Doherty-Parrilo-Spedalieri (DPS) and Extension (EXT) hierarchies, offer complete methods for entanglement detection, but it is well known that their practical use is limited by exponential growth in problem size if implemented naively. We make three contributions. First, we introduce a new SDP hierarchy, PST, that is sandwiched between EXT and DP – offering a tighter approximation to the set of separable states than EXT, while incurring significantly lower computational overhead than DPS. Second, we explicitly construct compact, polynomially-scalable descriptions of EXT and PST using partition mappings and operators. These descriptions in turn yield formulations that satisfy desirable properties such as the Slater condition and are well-suited to both first-order methods (FOMs) and interior-point methods (IPMs). Third, we design a suite of entanglement detection algorithms: three FOMs (Frank-Wolfe, projected gradient, and fast projected gradient) based on a least-squares formulation, and a custom primal-dual IPM based on a conic programming formulation. These methods are numerically stable and capable of producing entanglement witnesses or proximity measures, even in cases where states lie near the boundary of separability. Numerical experiments on benchmark quantum states demonstrate that our algorithms improve the ability to solve deeper levels of the SDP hierarchy.

14.
arXiv (CS.CL) 2026-06-12

Causal Inference with Generative Artificial Intelligence: Application to Texts as Treatments

In this paper, we demonstrate how to enhance the validity of causal inference with unstructured high-dimensional treatments like texts, by leveraging the power of generative Artificial Intelligence (GenAI). Specifically, we propose to use a deep generative model such as large language models (LLMs) to efficiently generate treatments and use their internal representation for subsequent causal effect estimation. We show that the knowledge of this true internal representation helps disentangle the treatment features of interest, such as specific sentiments and certain topics, from other possibly unknown confounding features. Unlike existing methods, the proposed GenAI-Powered Inference (GPI) methodology eliminates the need to learn causal representation from the data, and hence produces more accurate and efficient estimates. We formally establish the conditions required for the nonparametric identification of the average treatment effect, propose an estimation strategy that avoids the violation of the overlap assumption, and derive the asymptotic properties of the proposed estimator through the application of double machine learning. Finally, using an instrumental variables approach, we extend the proposed GPI methodology to the settings in which the treatment feature is based on human perception. The GPI is also applicable to text reuse where an LLM is used to regenerate existing texts. We conduct simulation and empirical studies, using the generated text data from an open-source LLM, Llama 3, to illustrate the advantages of our estimator over state-of-the-art causal representation learning algorithms.

15.
arXiv (quant-ph) 2026-06-15

Quantum Horizon: An evaluation of quantum computing as a threat to Bitcoin and Ethereum

arXiv:2606.14484v1 Announce Type: new Abstract: Quantum computing poses a real, broad-based, but bounded and substantially mitigable threat to Bitcoin and Ethereum. We separate the two quantum algorithms that public discussion routinely conflates: Shor's algorithm breaks the elliptic-curve signatures (ECDSA over secp256k1, BLS over BLS12-381) that authorize spending, whereas Grover's algorithm does not meaningfully threaten proof-of-work mining, which is protected by a merely quadratic speedup, fault-tolerant per-operation costs, a square-root parallelization wall, and difficulty adjustment. Folding hardware scaling, the falling resource requirement, a fault-tolerance readiness lag, and expert surveys into a single Monte-Carlo forecast yields a wide, bimodal arrival distribution for a cryptographically relevant quantum computer: about a one-in-six chance by 2035, near 30% by 2040, and about 60% by 2050. Exposure is concentrated and mostly migratable: of Bitcoin's roughly six million quantum-exposed coins only about 2.3 million are irreducibly at risk, while 50 to 65% of Ether sits at key-revealed accounts that can adopt post-quantum signatures. A timely migration beats even an optimistic 2035 machine, so the binding constraint is governance, not technology. A survey of the top twenty cryptocurrencies finds none fully post-quantum. Reproducible models accompany every quantitative claim.

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

Misinformation Propagation in Benign Multi-Agent Systems

Multi-agent systems, in which multiple large language model agents solve problems through turn-based interaction, are increasingly deployed in high-stakes settings such as medical diagnosis, legal analysis, and forensic decision-making. Their reliability can be at risk when single agents reason from incorrect or misleading context, e.g., from tool calls, since errors may propagate through agent interactions. This work studies this risk by injecting intent-based misinformation into benign single-agent and multi-agent systems across reasoning, knowledge, and alignment tasks. We find that misinformation can degrade single-agent performance and persists across multi-agent debate, with agents often retaining answers introduced by misinformed peers. Nevertheless, multi-agent debate reduces the resulting performance degradation compared to single-agent prompting, especially when most agents are not exposed to misinformation. Robustness depends on group composition and decision protocol. Consensus can be more stable than voting under peer pressure, while majorities can often steer misinformed agents back toward correct answers. Our results show that misinformation robustness in multi-agent systems depends on the underlying model and also on how agents exchange information and aggregate decisions.

17.
medRxiv (Medicine) 2026-06-17

Postoperative Cognitive Decline in Older Patients with Cardiovascular Disease and Preoperative Mild Cognitive Impairment

Objective. Older adults undergoing cardiac surgery may be vulnerable to postoperative cognitive decline. However, no studies have examined postoperative cognitive outcomes in older patients with cardiovascular disease (CVD) according to preoperative mild cognitive impairment (MCI). This study examined 12-month postoperative cognitive outcomes in older CVD patients according to preoperative MCI diagnosis and explored predictors of postoperative cognitive decline. Method. Twenty-two older CVD patients ([≥]65 years) and twenty-five controls were included. Neuropsychological assessment was conducted at baseline in both groups and repeated 12 months after surgery in the CVD group. MCI was diagnosed using current clinical criteria. Postoperative cognitive change was examined across preoperative MCI groups. Results. Fifty percent of patients met criteria for postoperative MCI, showing high diagnostic stability relative to preoperative frequency (45.5%). The preoperative CVD-MCI group showed a decline in working memory, executive functions, visual memory, and naming, whereas CVD-nMCI group declined only in verbal memory. Furthermore, CVD-MCI showed more heterogeneous postoperative cognitive trajectories of change than CVD-nMCI, who showed stability. Estimated IQ, APACHE-II score, and postoperative frailty were important variables in predicting the postoperative pattern. Conclusions. MCI frequency remained high and stable in older CVD patients across the preoperative and one-year postoperative period. However, this apparent diagnostic stability masks subclinical cognitive decline, particularly among patients with preoperative MCI, who showed greater susceptibility to further impairment. Estimated IQ, APACHE-II score, and postoperative frailty may be considered relevant predictors of outcome. These results highlight the value of preoperative neuropsychological assessment for characterizing postoperative cognitive risk in older CVD patients.

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

Statistical Properties of Training & Generalization

arXiv:2606.20299v1 Announce Type: cross Abstract: Deep learning has managed to evade numerous intuitions from classical statistics to achieve unprecedented performance on a number of real-world tasks. In this article, we investigate the key features and surprises of deep learning from a physics-informed perspective, taking care to point out and justify where possible the many choices inherent in constructing a deep learning model. In particular, we review the phenomenon of neural scaling laws and discuss their interplay with the constraints and inductive biases which may be present when applying machine learning to problems in physics.

19.
medRxiv (Medicine) 2026-06-12

The Acceptability of Three Co-Created Peer Support Interventions for People Living with Leprosy Reactions in Indonesia: A Mixed-Methods Pilot Study

Background: Leprosy reactions (LR) are immune-mediated complications associated with disability, emotional distress, and social isolation. We identified a gap in affected-individual-informed interventions that aim to improve the management of LR in healthcare settings. To address this gap, we assessed the acceptability of three peer-support interventions co-created with people affected by LR in Indonesia. Methods: Using an interactive learning and action approach, we co-created peer counselling, telesupport groups, and participatory video interventions which were piloted in an urban hospital and 13 rural community clinics. A mixed-methods design was applied with interviews, focus group discussions, and pre-post assessments involving four participant groups. Data were analyzed thematically using an acceptability framework. Results: One hundred participants were enrolled, and 92 completed the pilot intervention between November 2022 and July 2023. Qualitative findings showed that all interventions were acceptable. Peer counselling provided emotional reassurance through shared experiences and was perceived as trustworthy and supportive. Perceived burdens differed by setting, with time constraints in urban facilities and geographical barriers in rural clinics. Knowledge improved significantly among participants of peer counselling and telesupport groups in rural settings. Telesupport groups facilitated connection, information exchange, and continuity of care. Digital access and literacy limited participation for some, particularly in rural areas. The participatory video was perceived as reassuring and informative. Improvements in knowledge, attitude, practices, and mental well-being domain scores were observed among urban participants, but responses in rural settings showed less change. Participants and co-implementers reported increased self-efficacy, participants confidence to perform required behaviors within peer support interventions, with effects shaped by intervention and setting. Conclusions: The three co-created peer-support interventions were acceptable for individuals with LR in diverse healthcare settings. These outcomes highlight the importance and effectiveness of selective, and context-sensitive implementation of one or more peer-support modalities.

20.
arXiv (CS.CV) 2026-06-17

Seeing Is Not Screening: Multimodal Hidden Instruction Attacks on Agent Skill Scanners

Agent skills are emerging as an important attack surface in LLM-based systems. Through an empirical study of existing skill scanners, we find that current defenses primarily rely on textual descriptions, manifests, and source code as the main signals for security analysis, which can leave visually conveyed malicious intent insufficiently examined. This creates a practical blind spot: harmful operational instructions hidden in images may bypass scanning while still being recoverable by multimodal agents during deployment. To systematically investigate this threat, we propose SkillCamo, a document-mediated multimodal instruction attack that conceals malicious instructions within images bundled with a skill while rewriting the surrounding documentation to naturally reference those images as part of the normal workflow. Thus, the attack does not rely on the image alone, but on the joint interpretation of textual guidance and visual payload at execution time. To defend against such attacks, we further propose ExecScan, an execution-grounded multimodal scanning module that performs intent extraction, behavior reconstruction, abuse assessment, and deliberative execution simulation over skill artifacts. ExecScan jointly analyzes documentation, code, referenced resources, and visual content to recover hidden instructions, reconstruct executable behavior chains, and identify downstream risks such as exfiltration, destruction, persistence, deception, and privilege escalation. Extensive experiments show that image-hidden malicious instructions challenge existing skill scanners, while ExecScan can improve the skill scanning performance.

21.
medRxiv (Medicine) 2026-06-10

Resolving Diagnostic Discordance in Group 2 Pulmonary Hypertension Through Staged Physiologic Testing: Insights From PVDOMICS

Background World Symposium on Pulmonary Hypertension (WSPH) Group 2 pulmonary hypertension (PH) is a clinically integrated phenotype attributed to left heart disease, whereas pre- versus post-capillary classification is operationalized primarily by pulmonary capillary wedge pressure (PCWP). Although current recommendations emphasize contextual interpretation and provocative testing for intermediate PCWP values, the relationship between PCWP-based classification and underlying phenotype has not been systematically evaluated. We aim to quantify phenotype-hemodynamic discordance across the PCWP spectrum and evaluate a staged physiology-guided framework incorporating inhaled nitric oxide (iNO), ventricular geometry, and provocative testing. Methods We studied 1,032 participants from the NHLBI-sponsored PVDOMICS cohort with multidisciplinary adjudicated phenotypes integrating clinical, imaging, physiologic, and hemodynamic data. Stage-specific PCWP thresholds classified pre- versus post-capillary physiology at rest, during iNO, and during provocation (fluid challenge or invasive cardiopulmonary exercise testing [iCPET]). Echocardiographic right ventricular-to-left ventricular (RV/LV) ratio was evaluated as a marker of ventricular interdependence. Restricted cubic spline and staged concordance analyses defined certainty-based PCWP ranges and incremental diagnostic yield. Results Adjudicated Group 2 phenotype was present in 37.0% of participants. Resting PCWP demonstrated good discrimination (AUC 0.86), but substantial bidirectional phenotype-hemodynamic discordance persisted across intermediate PCWP ranges. At a resting PCWP of 12 mmHg, 25% of participants classified as pre-capillary had adjudicated Group 2 PH, whereas at 18 mmHg, 35% classified as post-capillary remained discordant non-Group 2. Concordance did not approach 90% until PCWP values were 24 mmHg. Dynamic testing incrementally improved concordance within these overlap zones. Nearly half of adjudicated Group 2 PH participants (46.5%) were not identified by resting PCWP alone; incorporation of iNO and provocative testing increased cumulative Group 2 identification by 63.4% and improved sensitivity from 79.9% to 83.7%. Model discrimination improved from an AUC of 0.863 to 0.908 (likelihood-ratio P

22.
arXiv (CS.CL) 2026-06-15

X-OPD: Cross-Modal On-Policy Distillation for Capability Alignment in Speech LLMs

While the shift from cascaded dialogue systems to end-to-end (E2E) speech Large Language Models (LLMs) improves latency and paralinguistic modeling, E2E models often exhibit a significant performance degradation compared to their text-based counterparts. The standard Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL) training methods fail to close this gap. To address this, we propose X-OPD, a novel Cross-Modal On-Policy Distillation framework designed to systematically align the capabilities of Speech LLMs to their text-based counterparts. X-OPD enables the Speech LLM to explore its own distribution via on-policy rollouts, where a text-based teacher model evaluates these trajectories and provides token-level feedback, effectively distilling teacher's capabilities into student's multi-modal representations. Extensive experiments across multiple benchmarks demonstrate that X-OPD significantly narrows the gap in complex tasks while preserving the model's inherent capabilities.

23.
medRxiv (Medicine) 2026-06-18

Artificial Intelligence-informed mobile behavioural interventions to support adolescents mental health in schools: protocol for a randomised controlled trial using the MindCraft app

Background: Children and young people (CYP) are particularly affected by mental health problems. Mobile apps provide a scalable and accessible approach to adolescent mental health support, and schools are well-positioned to address multiple risk factors and deliver large-scale interventions. By combining active (self-reported) and passive (sensor-derived) data, mobile apps can model mental states and deliver context-aware support. Artificial Intelligence (AI) enables adaptive, context-aware recommendations tailored to each user. However, there is limited research on AI-based mental health interventions in community CYP. MindCraft is a mobile app designed to monitor adolescents mental health using active and passive data and provide AI-informed recommendations ("nudges"). This study aims to investigate the effectiveness of personalised AI nudges delivered through MindCraft on improving mental health outcomes among adolescents in schools in the United Kingdom. Methods: The study is a three-arm RCT using a prospective cohort of secondary school students aged 14-19. Following informed consent, participants complete a baseline online assessment at school and download MindCraft. The primary outcome is the Strengths and Difficulties Questionnaire global and subscale scores. Secondary outcomes include the Eating Disorders Diagnostic Scale, the Sleep Condition Indicator Questionnaire, the Self-Injurious Thoughts and Behaviours Interview, the Self-Efficacy Questionnaire for Children and the World Health Organisation-Five Well-Being Index. Participants are randomised to: (1) an AI-informed intervention group receiving personalised nudges, (2) an active control receiving non-personalised nudges, or (3) a control group with self-monitoring only. Participants use the app for four weeks, with follow-up at one month. Repeated-measures analyses will assess changes across time points. Discussion: We hypothesise that AI nudges will have a greater positive effect on mental health outcomes at one month than general nudges and self-monitoring. Our findings will provide key evidence on the effectiveness of personalised mobile AI recommendations for adolescents mental health and inform school-based mental health prevention and early intervention. This study will contribute evidence on the ethical, acceptable, and scalable integration of AI-enabled digital mental health tools within public health and educational systems, with implications for the design of future digital public health interventions and policies supporting their safe integration in schools.

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

EDEN: A Large-Scale Corpus of Clinical Notes for Italian

We present EDEN (Emergency Department Electronic Notes), a new and unique large-scale corpus of clinical notes produced in Emergency Departments of Italian hospitals. The corpus, in its current version, is composed of approximately 4 million clinical notes fully anonymized, covering diverse phases of patient care during the stay in the emergency department. In addition, a subset of about six thousand notes has been manually annotated by clinical experts through a structured Case Report Form (CRF) containing 132 items relevant for two patient situations in emergency departments, dyspnea and loss of consciousness. Items may assume numerical values (e.g., for blood saturation), categorical (e.g., for level of consciousness ), binary (e.g., for presence of traumas), and mixed value types. The annotation process involved multiple clinicians and underwent iterative revision to resolve ambiguities in item formulation, resulting in a richly structured (although high imbalanced) resource. The dataset aims to fill a relevant gap of data able to support both the development and the use of Large Language Models in concrete medical applications. We describe the data collection protocol, the on-site anonymisation pipeline, corpus statistics, and the annotation scheme. Finally, we propose CRF-filling as a novel structured information extraction benchmark, and provide zero-shot baseline resulting from Gemma-27B and MedGemma-27B. To the best of our knowledge, the EDEN dataset is the largest freely available corpus of clinical notes existing for the Italian language.

25.
arXiv (CS.LG) 2026-06-11

Point-Identification of a Robust Predictor Under Latent Shift with Imperfect Proxies

arXiv:2603.15158v2 Announce Type: replace Abstract: Addressing the domain adaptation problem becomes more challenging when distribution shifts across domains stem from latent confounders that affect both covariates and outcomes. Existing proxy-based approaches that address latent shift rely on a strong completeness assumption to uniquely determine (point-identify) a robust predictor. Completeness requires that proxies have sufficient information about variations in latent confounders. For imperfect proxies the mapping from confounders to the space of proxy distributions is non-injective, and multiple latent confounder values can generate the same proxy distribution. This breaks the completeness assumption and observed data are consistent with multiple potential predictors (set-identified). To address this, we introduce latent equivalent classes (LECs). LECs are defined as groups of latent confounders that induce the same conditional proxy distribution. We show that point-identification for the robust predictor remains achievable as long as multiple domains differ sufficiently in how they mix proxy-induced LECs to form the robust predictor. This domain diversity condition is formalized as a cross-domain rank condition on the mixture weights, which is substantially weaker assumption than completeness. We introduce the Proximal Quasi-Bayesian Active learning (PQAL) framework, which actively queries a small, targeted set of diverse domains that satisfy this rank condition. PQAL can recover the point-identified predictor, demonstrates robustness to varying degrees of shift and outperforms previous methods on synthetic data and semi-synthetic dSprites, IHDP, ACS Folktables datasets.