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

Public transit gains and spatially uneven travel demand changes after NYC congestion pricing

arXiv:2606.17530v1 Announce Type: cross Abstract: New York City implemented the nation's first cordon-based congestion pricing program in January 2025, providing an opportunity to evaluate how system-wide urban mobility responds to large-scale pricing interventions. Because such policies generate spillovers across modes and locations, credible control groups are difficult to construct. We address this challenge using time series foundation models to generate probabilistic counterfactual demand forecasts with calibrated uncertainty. Applying this framework to bus, subway, and aggregate trip volume data, we find that post-policy bus and subway ridership increased significantly relative to expected no-policy demand, while overall travel demand decreased modestly. The effects are spatially heterogeneous: while reductions in overall travel demand are concentrated within the Congestion Relief Zone, transit gains extend beyond Manhattan's core. Socio-demographic analyses further reveal uneven adaptation across neighborhoods, highlighting spatial equity implications. Our framework provides a scalable approach for the uncertainty-aware evaluation of system-wide urban interventions when clean control groups are unavailable.

02.
PLOS Medicine 2026-06-02

Proteomic signatures of early retinal neurodegeneration in type 2 diabetes mellitus

Authors:

by Huangdong Li, Ziyu Zhu, Shaopeng Yang, Weijing Cheng, Shaoying Tan, Zhuoyao Xin, Lei Zhang, Zhuoting Zhu, Shida Chen, Wenyong Huang, Wei Wang Background Retinal neurodegeneration is an early and independent feature of diabetic retinal disease and has been proposed as a window into the systemic neural consequences of diabetes, yet accessible molecular biomarkers and individualized prediction tools remain scarce. We aimed to identify circulating plasma protein signatures of diabetic retinal neurodegeneration (DRN) and to translate them into a clinically usable risk prediction system. Methods and findings In this multi-cohort prospective observational study, we integrated high-throughput plasma proteomics with longitudinal optical coherence tomography (OCT) in two independent populations. The discovery cohort comprised 1,492 participants had baseline plasma proteomics and OCT, and 1,218 were followed with repeated OCT over 6 years in Guangzhou Diabetic Eye Study (GDES). DRN was quantified by the annualized OCT-derived retinal nerve fiber layer thinning rate. In multivariable analyses adjusted for age, sex, smoking, systolic blood pressure, HbA1c, and diabetes duration, we identified 71 plasma proteins associated with development and progression of DRN. These proteins mapped onto pathways governing inflammatory immune recruitment, extracellular matrix remodeling, and microvascular homeostasis, providing a plausible biological basis for DRN. We developed a proteomics-based DRN model (Pro-DRN) using eight machine learning (ML) algorithms, including XGBoost and LightGBM. In the independent test set, Pro-DRN achieved a C-index of 0.860, rising to 0.908 when integrated with clinical variables. Compared with six conventional models, Pro-DRN improved discrimination (ΔC-index 0.137 to 0.159; all P 

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

Lect\=uraAgents: A Multi-Agent Framework for Adaptive Personalized AI-Assisted Learning and Embodied Teaching

Effective personalized AI-assisted learning demands systems that can not only generate accurate learner-specific educational materials, but also dynamically adapt their instruction to diverse learners. However, existing educational agents have primarily focused on lecture content automation and simulations, which often fall short of modelling multimodal and embodied instructional methods tailored for the individual learner. To this end, we propose Lect\=uraAgents - a multi-agent framework that enables personalized learning through end-to-end adaptive embodied teaching. At its core, Lect\=uraAgents mirrors a professor-student relationship, in which a ProfessorAgent leads a collaborative team of specialized subordinate agents through research, planning, review, and embodied delivery of lecture contents that adapt to a learner's needs. The framework offers three main contributions: (1) a hierarchical multi-agent architecture for end-to-end personalized learning; (2) an adaptive embodied teaching mechanism, wherein the ProfessorAgent executes visible and pedagogically motivated teaching actions (e.g., handwrite, highlight, underline, etc.) over contents in a teaching environment; and (3) a Teaching Action-Speech Alignment (TASA) algorithm that employs salience-based heuristics and temporal semantic segmentation to generate coherent teaching action sequences aligned with learner profiles. We evaluate Lect\=uraAgents on diverse courses at high school, undergraduate, and graduate levels using sample-specific rubric-based analysis; with generated lecture materials and teaching actions assessed and validated by expert educators. Experimental results show consistent gains in lecture content quality, embodied teaching quality, assessment, and personalization over existing approaches, positioning Lect\=uraAgents as a pedagogically well-grounded framework for personalized learning at scale.

04.
arXiv (CS.AI) 2026-06-19

Analyzing Defensive Misdirection Against Model-Guided Automated Attacks on Agentic AI Systems

arXiv:2606.20470v1 Announce Type: cross Abstract: Agentic AI systems increasingly rely on language-model components to interpret instructions, process external data, invoke tools, and coordinate with other agents. These capabilities make prompt-injection and jailbreak attacks more consequential, especially as attackers adopt model-guided automation to scale probing, prompt refinement, and response evaluation. This work analyzes the resulting attack-defense setting through a probabilistic model of a target system, its defense mechanism, and the attacker's automated judge. Our analysis shows that conventional detect-and-block defenses can allow attacker success rate (ASR) to approach one as the query budget grows, since predictable refusals provide useful feedback to automated search. We then examine detect-and-misdirect, where detected malicious interactions receive controlled, non-operational responses designed to induce false-positive errors in the attacker's judge. This strategy reduces the positive predictive value of attacker-selected candidates and yields a bounded asymptotic ASR. We evaluate a proof-of-concept realization of this strategy through Contextual Misdirection via Progressive Engagement (CMPE), a lightweight conversational misdirection method designed to replace predictable refusal text with safe but strategically misleading responses in automated jailbreak settings. On jailbreak benchmarks, CMPE reduces estimated ASR upper bounds by up to two orders of magnitude and nearly eliminates verified attack success in end-to-end PAIR and GPTFuzz attack runs.

05.
arXiv (quant-ph) 2026-06-12

Invariant Measures and Weak-Magic-Injection Asymptotics in Random Monitored Quantum Circuits

arXiv:2606.13470v1 Announce Type: new Abstract: Monitored quantum circuits provide a natural setting in which scrambling, measurements, and measurement-conditioned updates compete within a stochastic many-body dynamics. From the viewpoint of nonstabilizer resource theory, this competition is especially relevant because Clifford-compatible operations preserve the stabilizer structure, while weak non-Clifford perturbations inject magic resource. Most of the existing understanding of monitored quantum circuits has been shaped by numerical simulations and phenomenological descriptions, while a rigorous dynamics theory remains less developed. In this paper, we address this gap by developing an analytical framework which lays a rigorous mathematical foundation for the study of random monitored quantum dynamics. Specifically, we study a class of monitored quantum circuits driven by random Clifford. We prove the existence and uniqueness of the stationary law, which gives an ergodic description of the long-time dynamics. We then resolve the leading asymptotics of steady magic in the weak-magic-injection limit. This tangent description makes the contrast between resource measures transparent: in odd-prime local dimension, the steady Gross–Wigner mana has a linear leading asymptotic, whereas in qubit systems the steady 2-stabilizer Rényi entropy has a quadratic leading asymptotic. These different powers reflect the distinct local geometries of the two resource measures near the stabilizer layer. In this way, this work develops an analytical framework that first establishes the stationary ergodic dynamics of random monitored quantum circuits.

06.
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.

07.
arXiv (CS.CV) 2026-06-11

Diffusion-based Cumulative Adversarial Purification for Vision Language Models

Vision Language Models (VLMs) have shown remarkable capabilities in multimodal understanding, yet their susceptibility to adversarial perturbations poses a significant threat to their reliability in real-world applications. Despite often being imperceptible to humans, these perturbations can drastically alter model outputs, leading to erroneous interpretations and decisions. This paper introduces DiffCAP, a novel diffusion-based purification strategy that can effectively neutralize adversarial corruptions in VLMs. We theoretically establish a provable recovery region in the forward diffusion process and meanwhile quantify the convergence rate of semantic variation with respect to VLMs. These findings manifest that adversarial effects monotonically fade as diffusion unfolds. Guided by this principle, DiffCAP leverages noise injection with a similarity threshold of VLM embeddings as an adaptive criterion, before reverse diffusion restores a clean and reliable representation for VLM inference. Through extensive experiments across six datasets with three VLMs under varying attack strengths in three task scenarios, we show that DiffCAP outperforms existing defense techniques by a substantial margin. Notably, DiffCAP significantly reduces both hyperparameter tuning complexity and the required diffusion time, thereby accelerating the denoising process. Equipped with theorems and empirical support, DiffCAP provides a robust and practical solution for securely deploying VLMs in adversarial environments. The source code is available at https://github.com/JasonFu1998/DiffCAP.

08.
arXiv (quant-ph) 2026-06-15

Sensitivity of polaron-molecule observables to MDR/GUP-like ultraviolet deformations at low energies via quantum computing

arXiv:2606.14479v1 Announce Type: new Abstract: We show that impurity many-body observables can display enhanced sensitivity to ultraviolet deformations of generalized-uncertainty-principle and modified-dispersion-relation type at accessible energy scales. Using a deformed polaron-molecule Hamiltonian constructed to preserve the infrared sector, we quantify the impact of such deformations on spectral and Ramsey observables and implement the corresponding dynamics in a controlled quantum computing setting. We identify regimes near the polaron-molecule crossover where small ultraviolet deformations are strongly amplified, leading to experimentally resolvable changes in quasiparticle properties and spectral response. Our results establish a concrete sensitivity-based route to low-energy quantum-gravity phenomenology in a well-defined many-body platform and delimit the validity of the effective description. Furthermore, we report experimental validation on the QRed superconducting quantum processor (BSC-CNS).

09.
arXiv (CS.AI) 2026-06-17

First, do NOHARM: towards clinically safe large language models

arXiv:2512.01241v3 Announce Type: replace-cross Abstract: Large language models (LLMs) are routinely used by physicians and patients for medical advice, yet their clinical safety profiles remain poorly characterized. We present NOHARM (Numerous Options Harm Assessment for Risk in Medicine), a 1,100-task benchmark of primary care-to-specialist consultation cases to measure the frequency and severity of harm from LLM-generated medical recommendations. NOHARM covers 10 specialties, with 12,747 expert annotations for 4,249 clinical management options. Across 28 LLMs, recommendations carried the potential for severe harm in up to 22.6% of cases, with errors of omission accounting for more than 80% of severe errors. In a randomized trial of 101 generalist physicians, human benchmark performance significantly improved with AI assistance, yet physicians remained far from realizing the potential of AI tools, frequently ignoring essential advice surfaced by AI. Safety performance tracked general-intelligence and medical-knowledge benchmarks across the full range of models but decoupled at the frontier. Despite strong performance on existing evaluations, widely used AI models can produce medical advice with the potential for severe harm at non-trivial rates, highlighting the importance of explicit measurement of clinical safety.

10.
arXiv (CS.LG) 2026-06-16

ML Inference Scheduling with Predictable Latency

arXiv:2512.18725v3 Announce Type: replace Abstract: Machine learning (ML) inference serving systems can schedule requests to improve GPU utilization and to meet service level objectives (SLOs) or deadlines. However, improving GPU utilization may compromise latency-sensitive scheduling, as concurrent tasks contend for GPU resources and thereby introduce interference. Given that interference effects introduce unpredictability in scheduling, neglecting them may compromise SLO or deadline satisfaction. Nevertheless, existing interference prediction approaches remain limited in several respects, which may restrict their usefulness for scheduling. First, they are often coarse-grained, which ignores runtime co-location dynamics and thus restricts their accuracy in interference prediction. Second, they tend to use a static prediction model, which may not effectively cope with different workload characteristics. In this paper, we evaluate the potential limitations of existing interference prediction approaches, finding that coarse-grained methods can lead to noticeable deviations in prediction accuracy and that static models degrade considerably under changing workloads.

12.
arXiv (CS.LG) 2026-06-19

On the QUEST for Uncertainty Quantification via Highest Density Regions

arXiv:2606.19569v1 Announce Type: new Abstract: Uncertainty quantification (UQ) is essential for reliable decision-making in safety-critical applications in probabilistic machine learning. For regression problems, dominant scalar UQ approaches - notably, those based on proper scoring rules - measure uncertainty via pointwise predictive risk. This can lead to counterintuitive results when the target statistic is not the conditional expectation. We propose an alternative framework, in which uncertainty is characterised by the volume of the most probable subset of a distribution's support. QUEST (Quantifying Uncertainty via highest dEnSiTy regions) is a novel approach to UQ based on the concentration of Lebesgue measure at a distribution's peak(s), evaluated at one or more values of a robustness parameter $\alpha$. We establish connections between our measures and classical statistics from information theory and economics. We show that, unlike popular alternatives based on proper scoring rules, QUEST measures of epistemic and aleatoric uncertainty satisfy a set of axioms adapted from the UQ literature, including monotonicity under distributional spread and invariance to location shifts. Selective prediction benchmarks confirm that QUEST performs favourably against standard measures such as variance and differential entropy.

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

Fix Initial Programs and Iteratively Refine Repair Instructions Toward Non-Elimination Multi-Turn Program Correction

arXiv:2604.23989v2 Announce Type: replace-cross Abstract: Recent work on large language models (LLMs) has emphasized the importance of scaling inference compute. From this perspective, the state-of-the-art method Scattered Forest Search (SFS) has been proposed, employing Monte Carlo Tree Search with carefully crafted initial seeds and textual optimization for multi-turn program correction. However, its complexity makes it unclear what factors contribute to improvements in inference performance. To address this problem, we analyze SFS and propose a simpler method, \textsc{Iterative Refinement of Repair Instructions} (IRRI), which fixes initial programs and iteratively refines repair instructions. Because of the simplicity of IRRI, we theoretically establish the non-elimination of IRRI using Oracle-Guided Inductive Synthesis (OGIS). Experiments on several program generation benchmarks suggest that IRRI achieves inference performance comparable to state-of-the-art methods. These results indicate that, even without complex search structures, refining initial programs with high-quality repair instructions alone can effectively improve inference performance.

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

Disentangling Linguistic Relatedness from Task Alignment in Cross-Lingual Transfer

We study cross-lingual transfer by fine-tuning seven large language models (4B–671B parameters) on Arabic and evaluating zero-shot reading comprehension on Semitic languages and non-Semitic controls. Across dense and Mixture-of-Experts architectures, we find no evidence of Semitic-specific transfer: models with weak baselines improve dramatically across all languages, while strong-baseline models show only marginal gains regardless of language family. A chain-of-thought ablation reinforces this finding – the same models that benefit most from fine-tuning benefit equally from inference-time reasoning, suggesting both mechanisms address task-format alignment rather than cross-lingual knowledge transfer.

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

Efficient On-Device Diffusion LLM Inference with Mobile NPU

arXiv:2606.13740v1 Announce Type: new Abstract: Diffusion large language models (dLLMs) accelerate generation by denoising multiple tokens in parallel, making them attractive for latency-sensitive mobile inference. However, repeated denoising introduces substantial computation on smartphones. Mobile neural processing units (NPUs) offer high-throughput dense matrix computation, but efficiently exploiting them remains challenging: token commitment shrinks per-block effective workloads, token revision complicates KV cache reuse, and limited NPU-visible address space incurs costly remapping and data transfer overheads. In this paper, we propose llada.cpp, the first NPU-aware inference framework for accelerating dLLMs on smartphones. llada.cpp aligns block-wise dLLM inference with the execution characteristics of mobile NPUs through three techniques. (1) Multi-Block Speculative Decoding fills the shrinking workload in late-stage current-block decoding with speculative future-block tokens. (2) Dual-Path Progressive Revision keeps committed tokens revisable until stable and refreshes unstable tokens through a CPU-side path without stalling dense NPU execution. (3) Swap-Optimized Memory Runtime compacts NPU-visible address layouts and overlaps data staging with NPU computation to reduce remapping and transfer overheads. We implement llada.cpp as an end-to-end framework and evaluate it across diverse hardware platforms and dLLM workloads. llada.cpp reduces LLaDA-8B generation latency by 17x-42x over the CPU baseline with prefix KV cache reuse, while preserving generation quality.

16.
arXiv (CS.LG) 2026-06-18

ActiTect: A Generalizable Machine Learning Pipeline for REM Sleep Behavior Disorder Screening through Standardized Actigraphy

arXiv:2511.05221v3 Announce Type: replace Abstract: Isolated rapid eye movement sleep behavior disorder (iRBD) is a major prodromal marker of $\alpha$-synucleinopathies, often preceding the clinical onset of Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy. While wrist-worn actimeters hold significant potential for detecting RBD in large-scale screening efforts by capturing abnormal nocturnal movements, they become inoperable without a reliable and efficient analysis pipeline. This study presents ActiTect, a fully automated, open-source machine learning tool to identify RBD from actigraphy recordings. To ensure generalizability across heterogeneous acquisition settings, our pipeline includes robust preprocessing and automated sleep-wake detection to harmonize multi-device data and extract physiologically interpretable motion features characterizing activity patterns. Model development was conducted on a cohort of 78 individuals, yielding strong discrimination under nested cross-validation (AUROC = 0.95). Generalization was confirmed on a blinded local test set (n = 31, AUROC = 0.86) and on two independent external cohorts (n = 113, AUROC = 0.84; n = 57, AUROC = 0.94). To assess real-world robustness, leave-one-dataset-out cross-validation across the internal and external cohorts demonstrated consistent performance (AUROC range = 0.84-0.89). A complementary stability analysis showed that key predictive features remained reproducible across datasets, supporting the final pooled multi-center model as a robust pre-trained resource for broader deployment. By being open-source and easy to use, our tool promotes widespread adoption and facilitates independent validation and collaborative improvements, thereby advancing the field toward a unified and generalizable RBD detection model using wearable devices.

17.
arXiv (CS.CL) 2026-06-19

Characterizing Narrative Content in Web-scale LLM Pretraining Data

The narrative composition of web-scale LLM pretraining corpora remains largely unexplored even though narrative is a fundamental mode of human communication. We present the first fine-grained study of narrative features in Dolma, a 3-trillion-token open pretraining corpus. Drawing on narrative theory, we design a framework spanning three core narrative elements (agency, setting, and events) operationalized as 11 interpretable dimensions. After sampling and annotating a diverse set of 400 passages, we finetune and validate NarraBERT, a RoBERTa-based model for fine-grained narrative prediction. We apply NarraBERT to 3M passages, resulting in a new dataset, NarraDolma. We find (i) narrative structure is measurable at scale across extremely heterogeneous data, (ii) we uncover a continuous, multidimensional narrative structure underlying web text, and (iii) narrative qualities are unequally distributed across pretraining sources and topics in ways that current curation practices neither measure nor account for. Our framework, dataset, and analyses provide a foundation for understanding how narrative qualities are distributed in LLM pretraining data and for studying how data composition affects narrative reasoning tasks. We publicly release NarraDolma and NarraBERT.

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

On the Stability of Nonlinear Dynamics in GD and SGD: Beyond Quadratic Potentials

arXiv:2602.14789v2 Announce Type: replace Abstract: The dynamical stability of the iterates during training plays a key role in determining the minima obtained by optimization algorithms. For example, stable solutions of gradient descent (GD) correspond to flat minima, which have been associated with favorable features. While prior work often relies on linearization to determine stability, it remains unclear whether linearized dynamics faithfully capture the full nonlinear behavior. Recent work has shown that GD may stably oscillate near a linearly unstable minimum and still converge once the step size decays, indicating that linear analysis can be misleading. In this work, we explicitly study the effect of nonlinear terms. Specifically, we derive an exact criterion for stable oscillations of GD near minima in the multivariate setting. Our condition depends on high-order derivatives, generalizing existing results. Extending the analysis to stochastic gradient descent (SGD), we show that nonlinear dynamics can diverge in expectation even if a single batch is unstable. This implies that stability can be dictated by a single batch that oscillates unstably, rather than an average effect, as linear analysis suggests. Finally, we prove that if all batches are linearly stable, the nonlinear dynamics of SGD are stable in expectation.

19.
arXiv (CS.CV) 2026-06-17

MLLMs Get It Right, Then Get It Wrong: Tracing and Correcting Late-Layer Textual Bias

When vision contradicts text, multimodal large language models (MLLMs) consistently favor text, even when images provide clear evidence otherwise. This bias poses risks for applications requiring visual grounding, yet its cause remains unclear. In this paper, we uncover a surprising finding: models often get it right initially, forming correct vision-based predictions in their intermediate layers, before changing their minds and favoring text in the final output. We call this "late-layer textual override". The visual information is encoded, it simply does not survive to the output. More intriguingly, we find that how predictions change reveals whether they're correct: 85% of failures shift toward text, while 89% of successes shift toward vision. This directional signature enables a simple but powerful intervention: when we detect a confident visual prediction being suppressed, we restore it. We propose CALRD (Conflict-Aware Layer Reference Decoding), a training-free method that recovers overridden predictions at inference time. Experiments across five MLLMs of varying architectures demonstrate up to 9.4% absolute improvements on conflict benchmarks while largely preserving standard performance, without training or external knowledge. It recovers what the model already knew but failed to preserve.

20.
arXiv (math.PR) 2026-06-16

Plateau Gaps of Poisson Correctors Encode Metastable Reaction Rates

arXiv:2606.14789v1 Announce Type: cross Abstract: Metastable reaction rates are commonly inferred from transition-state fluxes, mean first-passage times, or fitted kinetic models. We show that they are directly encoded in the plateau gap of an occupation-time Poisson corrector. For a centered basin-occupation observable, the Poisson corrector develops metastable plateaus in the reactant and product basins, and their separation determines the forward and backward transition rates. This construction requires only the generator, stationary measure, and metastable partition, and therefore does not rely on a predefined transition-state surface. In overdamped and underdamped double-well dynamics, the plateau-gap rate recovers the Kramers, Grote-Hynes, and Pollak-Grabert-Hänggi hierarchy. The same corrector-martingale decomposition yields a reactive-noise density, revealing where stochastic forcing contributes to transitions in configuration or phase space. Thus, reaction rates and their fluctuation sources emerge from a single corrector field.

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

GENEB: Why Genomic Models Are Hard to Compare

Progress in genomic foundation models is difficult to assess due to fragmented benchmarks, incompatible evaluation protocols, and task-specific reporting. As a result, claims of superiority or generality across models are often not directly comparable. We introduce GENEB, a large-scale diagnostic benchmark that evaluates frozen representations from 40 genomic foundation models across 100 tasks spanning 13 functional categories under a unified probing-based protocol, including few-shot regimes. GENEB enables controlled comparison across model scale, architecture, tokenization, and pretraining data while explicitly exposing task-level trade-offs. Our analysis shows that aggregate leaderboards are unstable: model rankings vary sharply across task categories, scale provides only modest and inconsistent gains, and architectural and pretraining alignment frequently outweigh parameter count. These results highlight limitations of current evaluation practices and position GENEB as a reference framework for principled comparison and category-aware model selection in genomic machine learning.

22.
arXiv (CS.AI) 2026-06-24

It's Complicated: On the Design and Evaluation of AI-Powered AAC Interfaces

arXiv:2606.24854v1 Announce Type: cross Abstract: Artificial intelligence (AI) can enhance what people who use augmentative and alternative communication (AAC) are able to do with their systems. However, evaluating AI-powered AAC interfaces can be difficult. People are intersectional beings and current evaluation metrics can struggle to capture the multifaceted and nuanced desires people may have for their AAC. We explore the complicated nature of six AAC problem spaces, explore how AI might be used in these spaces, and suggest more robust methods of evaluation that take the intersectional nuances of people into account. We also discuss broader issues that arise across these problem spaces and how they could be addressed using our proposed evaluation methods.

23.
arXiv (CS.CV) 2026-06-17

Do We Really Need Diffusion? A Fast U-Net for Paired Medical Image Translation

Magnetic resonance imaging-signal fat fraction (MRI-SFF) quantifies tissue fat and serves as an established biomarker for metabolic and musculoskeletal disorders. The acquisition requires, however, specialized MRI sequences, which are not available routinely. We investigate whether SFF can be estimated from widely available T2-weighted (T2w) MRI via image-to-image translation (I2I). We further compare a lightweight 4-level U-Net to a state-of-the-art Denoising Diffusion Probabilistic Model (DDPM) using a dataset of 230 048 paired 2D images (183 517 train, 23 621 val, 22 910 test) from the German National Cohort (NAKO). Both models clearly outperform the identity baseline (Pearson correlation r = 0.769, mean absolute error MAE = 0.070 +/- 0.054), which confirms that the models learn a non-trivial cross-modal mapping. Interestingly, the lightweight U-Net outperforms the DDPM in both correlation (r = 0.975 vs. 0.962) and error (MAE = 0.014 +/- 0.015 vs. 0.019 +/- 0.019), while reducing inference time by a factor of 208 (25.2 ms vs. 5 227.2 ms per image using 50 Denoising Diffusion Implicit Model (DDIM) steps). The strong clinical performance at substantially reduced computational cost enables real-time clinical use.

24.
medRxiv (Medicine) 2026-06-10

Impact of Early Treatment on Symptom Improvement and Procedural Events among Men with BPH and Bothersome Lower Urinary Tract Symptoms: A Contemporary Analysis of the American Urological Association Quality (AQUA) Registry

PURPOSE: As the armamentarium of BPH therapies continues to expand, it remains imperative to maximize patient satisfaction and minimize decisional regret. We sought to determine the impact of time from BPH diagnosis to index treatment on symptom improvement and subsequent procedural events. MATERIALS AND METHODS: We queried the American Urological Association Quality Registry for men [&ge;] 40 years old with BPH, available IPSS data, and no receipt of prior BPH treatment. Index treatment included medication, surgery, or minimally invasive surgical therapy (MIST). Outcomes included IPSS over 3 years of follow-up, change in percentage of mild lower urinary tract symptoms (LUTS) by 3 months, and time to procedural event. Patients were stratified by time from index diagnosis to treatment by 3 years. Outcomes were compared across time-to-treatment cohorts with appropriate statistical tests with p < 0.05 as significant. RESULTS: 43,919 patients met criteria with 19,642 pursuing treatments. Patients pursued treatment at comparably lower baseline IPSS compared to prior prospective series. Patients undergoing surgery and MIST had significantly higher baseline IPSS, while medical comorbidities were significantly more common among men initiating pharmacotherapy. Early surgery and MIST were associated with significant improvement in IPSS within 6-12 months and an increase in mild LUTS by 3 months. All forms of early treatment were associated with delayed time to procedural events, including catheterization and fulguration. CONCLUSIONS: Early procedural intervention for BPH is associated with early symptom improvement and delayed time to procedural events among real-world, contemporary practice.

25.
arXiv (CS.CV) 2026-06-17

Visuals Lie, Consistency Speaks: Disentangling Spatial Attention from Reliability in Vision-Language Models

Multimodal Foundation Models are increasingly used as reasoning agents, making reliability, knowing when a model may hallucinate, critical. A common intuition, which we call the Attention-Confidence Assumption, holds that reliability follows from "structural" visual perception: tight attention on relevant regions should signal a trustworthy answer, while scattered attention signals confusion. We challenge this through the VLM Reliability Probe (VRP), a systematic cross-family study of reliability signals in contemporary Vision-Language Models (VLMs). We introduce structural-attention metrics, cluster counts (C_k) and spatial entropy (H_s), to quantify the visual encoder's gaze, and track its evolution (Delta H_s) across layers. This reveals a "Symbolic Detachment": models often "Early Lock" visual features only to diffuse attention later, severing early perception from final generation. Contrary to the grounding hypothesis, we find a "Cluster Failure": spatial attention has near-zero correlation (R approx 0.001) with accuracy. Instead, reliability is a phenomenon of generation dynamics and internal-state distributions. Self-Consistency, the agreement rate across sampled reasoning paths, is the dominant predictor of truth (R = 0.429). Scaling causal interventions exposes a sharp architectural divergence: LLaVA locks its prediction in a fragile late-stage bottleneck, whereas PaliGemma and Qwen2-VL distribute reliability globally, staying resilient even when ~50% or more of their most predictive layer is destroyed. For current VLMs, reliability signals are detached from visual grounding maps and are best inferred from generation-time dynamics and hidden-state probes.