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01.
Nature Medicine 2026-06-17

General-purpose chatbots outperform clinical AI tools on physicians’ real-world questions

Authors: Unknown Author

Specialized clinical AI tools are entering medical practice with little independent testing. In a head-to-head evaluation across two public benchmarks and real questions from physicians, three general-purpose frontier large language models outperformed two leading clinical AI tools, which performed no better than Google search AI overview.

02.
medRxiv (Medicine) 2026-06-15

Non-Parametric Ancestry Adjustment for Polygenic Scores

Modern polygenic risk scores (PRS) exhibit shifts correlated with ancestry, leading to erroneous predictions for non-European individuals when models are trained on predominantly European cohorts. Such shifts arise from, among other factors, (1) algorithmic limitations in the ability of PRS model training to detect causal variants, rather than nearby variants with ancestry-dependent correlations to the causal one, (2) under-representation of alleles with higher prevalence in non-European populations in the association study training, and (3) gene-by-environment interactions where the environment is correlated with genetic ancestry. Current ancestry-adjustment methodologies often discretize individuals into population categories and apply a simple affine mapping to reduce these genetic ancestry biases. However, such approaches provide suboptimal adjustments, particularly for admixed individuals. In this work, we introduce a detailed theoretical characterization of ancestry-dependent biases and propose novel methods based on non-parametric neighborhood techniques that provide more accurate empirical results and admit statistical consistency guarantees. Extensive experiments using the UK Biobank demonstrate the effectiveness of the proposed methods.

03.
medRxiv (Medicine) 2026-06-18

Device assessed 24-hour movement behaviour and cardiovascular disease mortality amongst cancer survivors.

Background: Cancer survivors face elevated risks of mortality from cardiovascular disease (CVD). The potential importance of physical activity (PA) and other behaviours across the 24-hour day (e.g. sedentary behaviour (SB) and sleep) for CVD-mortality risk is not well understood in this at-risk population. Objectives: To assess the importance of 24-hour movement behaviour, using a compositional approach, for mitigating CVD-mortality amongst cancer survivors. Methods: Participants with a prior cancer diagnosis were drawn from the UK Biobank accelerometry sub-study (n=6,158). Accelerometer-derived movement (moderate-to-vigorous PA (MVPA), vigorous PA (VPA), moderate PA (MPA), light PA (LPA), SB, sleep) was examined in relation to CVD-mortality, identified from health record linkage data (using Fine-Gray Cox proportional-hazards models adjusted for demographic, health, lifestyle covariates). Results: Median follow-up was 8.0 years (Q1-Q3: 7.4-8.5), with n=500 (8.2%) deaths (CVD-deaths: n=118). Greater MVPA, in place of any other behaviour, was inversely associated with CVD-mortality with e.g. 10% lower hazard if MVPA theoretically replaced 7 minutes (mins)/day SB (Hazard ratio (HR): 0.91, (95% Confidence Interval: 0.86-0.95)), 9 mins/day LPA (HR: 0.90, 0.83-0.97), or 11 mins/day sleep (HR: 0.90, 0.83-0.97). The VPA component of MVPA proved critical, requiring only ~1-2 additional mins/day for equivalent hazard reduction. Sleep duration, was also inversely associated with CVD-mortality. A 10% lower hazard required replacing 29 mins/day of SB with sleep (HR: 0.90, 0.84-0.96); no other behavioural replacement amongst SB, sleep or LPA could provide an equivalent risk reduction. Conclusions: Among cancer survivors, the most potent reduction in CVD-mortality followed theoretically reallocating time to higher intensity movement.

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

Toward Entanglement Bootstrap for Conformal Field Theory in Any Dimension

arXiv:2606.12540v1 Announce Type: cross Abstract: Given a quantum critical wavefunction in any dimension, we propose a reconstructed Hamiltonian, analogous to the ones previously found for 1+1d CFT and for 2+1d bosonic liquid topologically-ordered states. We test numerically that, for known regularized approximate CFT groundstates (on the icosahedron and the fuzzy sphere), (1) they are close to the groundstate of their reconstructed Hamiltonian, and (2) the spectrum of their reconstructed Hamiltonian on the unit sphere has CFT properties (integer spacing of descendants) and matches known low-lying energies. We show that this provides an automated method to improve the finite-size effects in a fixed Hilbert space.

05.
arXiv (CS.LG) 2026-06-19

Adversarial Bandit Optimization with Globally Bounded Perturbations to Convex Losses

arXiv:2606.19891v1 Announce Type: new Abstract: We study adversarial bandit optimization in which the loss functions may be non-convex and non-smooth. In each round, the learner selects an action and observes only the loss incurred at that action. The loss consists of an underlying convex and $\beta$-smooth component and an adversarial perturbation that may be chosen after observing the learner's action. The perturbations are subject to a global budget controlling their cumulative magnitude over time. This framework extends the globally budgeted, post-action perturbation model from underlying linear losses to general convex and $\beta$-smooth losses. For this broader class, we establish expected regret guarantees that explicitly characterize the effect of the perturbation budget. To establish these guarantees, we modify a standard bandit optimization algorithm and develop an analysis that controls the additional regret caused by the perturbations. In the absence of perturbations, our results reduce to regret guarantees for the standard bandit convex optimization setting with $\beta$-smooth losses.

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

LatentLens: Revealing Highly Interpretable Visual Tokens in LLMs

Transforming a large language model (LLM) into a vision-language model (VLM) can be achieved by mapping the visual tokens from a vision encoder into the embedding space of an LLM. Intriguingly, this mapping can be as simple as a shallow MLP transformation. To understand why LLMs can so readily process visual tokens, we need interpretability methods that reveal what is encoded in the visual token representations at every layer of LLM processing. In this work, we introduce LatentLens, a novel approach for mapping latent representations to descriptions in natural language. LatentLens encodes a large text corpus and stores contextualized token representations for each token in that corpus. Visual token representations are then compared to these contextualized representations and the top-nearest neighbor representations serve as descriptions of the visual token. We evaluate this method on 15 different VLMs, showing that commonly used methods, such as LogitLens, substantially underestimate the interpretability of visual tokens. With LatentLens instead, the majority of visual tokens are interpretable across all studied models and all layers. Qualitatively, we show that the descriptions produced by LatentLens are semantically meaningful and provide more fine-grained interpretations for humans compared to individual tokens. More broadly, our findings contribute new evidence on the alignment between vision and language representations and open up new directions for analyzing the latent representations of LLMs.

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

Towards a Bridge Layer Between Bibliographic and Formalized Mathematical Knowledge

Authors:

arXiv:2606.11430v1 Announce Type: cross Abstract: Mathematical knowledge is split between bibliographic databases (e.g., MathSciNet, zbMATH Open) and formal proof libraries (e.g., Lean mathlib), preventing unified access between published results and their formalizations. We propose a relational bridge-database that aligns publication metadata with formal artifacts, providing an interoperability layer between mathematical literature and machine-verifiable proofs. We introduce a paper-level formalization score that measures how much of a publication is covered in formal systems. As a feasibility study, we show how such scores can be estimated via cross-document alignment between informal texts and Lean formalizations, enabling large-scale analysis of formalization coverage. This framework is a first step toward integrating bibliographic and formal mathematical ecosystems into scalable, machine-actionable knowledge graphs linking publications to formal proof objects.

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

SPARK: Security Knowledge Priming and Representation-Guided Knowledge Activation for LLM-based Secure Code Generation

arXiv:2606.16244v1 Announce Type: cross Abstract: Large language models routinely generate code with exploitable security flaws. Prior literature attributes this limitation to a lack of security expertise, steering current defense mechanisms toward heavy fine-tuning or external knowledge retrieval, which introduces significant computational overhead and data bias through redundant code examples. Contrary to this view, we argue that pretraining corpora are already rich in security material. The bottleneck is activation: without an explicit and brief cue, statistical pressure toward common training-distribution patterns suppresses the model's safety-relevant representations. We present SPARK, an inference-time security harness that activates this latent knowledge without any retraining. The harness has two parts. Component~I retrieves a few of the relevant Common Weakness Enumeration (CWE) entries for each coding task and appends a short structured cue to the prompt; this alone is enough to surface the model's existing security representations. Component~II adds a precomputed token bias to the logits at every decoding step. We obtain the bias by projecting a safe-direction vector, the unit difference between the mean safe and mean unsafe last-layer hidden states, through the language model head. The bias is computed once offline; applying it costs a single vector addition per generated token. We evaluate SPARK on 9 open-source models across C++, Java, and Python, and compare with 7 baselines spanning fine-tuning and retrieval-augmented methods. SPARK matches or improves on the best baseline in every setting while preserving HumanEval utility. We further test Component~I in a black-box setting on 7 of today's strongest models, including Claude, DeepSeek, and GPT, demonstrating the bottleneck of insecure code generation and the improvements enabled by our method.

09.
Nature (Science) 2026-06-10

Whole-genome duplication shaped cell-type evolution in the vertebrate brain

Authors:

The complex brains of vertebrates have more cell types than those of their closest relatives. Whole-genome duplications (WGDs) occurred during early vertebrate evolution1, but it is unclear whether the duplicated genes (ohnologues) facilitated cell-type evolution. Here using brain single-cell transcriptomes from five chordates—human2, mouse3, lizard4, lamprey5 and amphioxus—we report that many cell-type families with conserved core transcription factors in vertebrates do not show one-to-one homology with amphioxus. Moreover, ohnologues, particularly those from the first WGD, were more important than small-scale duplication paralogues for vertebrate cell-type evolution. To explore whether ohnologues are mechanistically important for this process, we predicted ancestral cell-type states and compared them to amphioxus and experimentally investigated macroglia. The findings indicate that ohnologues had a role in early vertebrate cell-type diversification. Moreover, by examining paralogue expression across cell types and species, we show that expression changes were mainly driven by dosage selection and subfunctionalization. We also link ohnologues to cellular diversity at different anatomical and cell-type scales. Our findings demonstrate the importance of WGDs for the evolution of early vertebrate brain complexity and highlight that the resultant ohnologues continued to capacitate cell-type evolution long after they were formed. Analyses of brain single-cell transcriptomes from human, mouse, lizard, lamprey and amphioxus reveal that duplicated genes (ohnologues) played a pivotal part in early vertebrate cell-type diversification.

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

NoiseTilt: Noise-Tilted Reverse Kernels for Diffusion Reward Alignment

arXiv:2606.18066v1 Announce Type: new Abstract: We introduce the Noise-Tilted Reverse Kernel (NTRK), a reward-guided diffusion sampler that injects reward gradients through the noise term, leaving the pretrained reverse kernel unchanged and requiring only a single sample per step. Reward-guided sampling at inference time has greatly expanded the versatility of pretrained diffusion models. Yet existing methods face a trade-off. Gradient-based guidance shifts the reverse mean, steering generation but pushing intermediate states outside the region that the model was trained on and degrading quality. Search-based methods preserve quality but gain no gradient signal. No prior method achieves both. NTRK resolves this by keeping the reverse mean fixed and biasing the noise term toward high reward. We introduce a whitening operator, the central mechanism behind NTRK, that makes the reward gradient safe to inject as noise without losing its guiding signal. Across various reward alignment tasks, NTRK outperforms recent state-of-the-art baselines without losing sample quality. Remarkably, on aesthetic generation, NTRK surpasses the reward of the best baseline at 500 NFEs using only 25 NFEs, a 20$\times$ reduction in compute.

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

Towards UAV Image Dehazing: A UAV Atmospheric Scattering Model, Benchmark, and Geometry-Aware Deep Unfolding Network

In UAV applications, haze significantly obscures distant details and weaken structural information, hindering the recovery of details. Current UAV scenarios still face two key challenges: (i) paired hazy/clean images from the real world are unobtainable, while the classical atmospheric scattering model is inadequate for modeling the spatially non-uniform haze in UAV imagery; (ii) existing dehazing methods struggle to remove the heavy haze accumulated in the upper regions of UAV images. To address these issues, we first propose a UAV Atmospheric Scattering Model (UASM), which explicitly incorporates flight altitude, viewing pitch, and extinction to characterize the non-uniform haze distribution in UAV imaging. Based on UASM, we develop a physics-driven dehazing framework, termed Geometry-aware Proximal Deep Unfolding Network (GP-DUN). Specifically, GP-DUN consists of three key modules: a Latent Geometry Estimator (LGE) that infers transmittance consistent with UAV imaging geometry, a Geometry-aware Gradient Descent Module (GeoGDM) that embeds UASM into the data-fidelity term and performs physics-consistent closed-form updates, and an Pooling-Expert Proximal Mapping Module (PE-PMM) that learns an implicit prior to restore textures and structures beyond the capability of explicit physical modeling. In addition, we further construct UASM-HazeSet, which provides controllable paired synthetic data together with 2,285 real UAV haze images for testing. Extensive experiments show that GP-DUN consistently outperforms existing methods on both UASM-HazeSet and real UAV haze benchmarks.

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

Federated Learning for Feature Generalization with Convex Constraints

arXiv:2606.14416v1 Announce Type: new Abstract: Federated learning (FL) often struggles with generalization due to heterogeneous client data. Local models are prone to overfitting their local data distributions, and even transferable features can be distorted during aggregation. To address these challenges, we propose FedCONST, an approach that adaptively modulates update magnitudes based on the parameter strength of the global model. This prevents over-emphasizing well-learned parameters while reinforcing underdeveloped ones. Specifically, FedCONST employs linear convex constraints to ensure training stability and preserve locally learned generalization capabilities during aggregation. A Gradient Signal to Noise Ratio (GSNR) analysis further validates the effectiveness of FedCONST in enhancing feature transferability and robustness. As a result, FedCONST effectively aligns local and global objectives, mitigating overfitting and promoting stronger generalization across diverse FL environments, achieving state-of-the-art performance.

13.
medRxiv (Medicine) 2026-06-15

Quantitative Gait Categorization in Parkinson's Disease with and without Freezing of Gait

Background: Freezing of gait (FOG) is a disabling and often underrecognized feature of Parkinsons disease (PD). Objective gait analysis may improve characterization of this motor symptom. Objective: To compare quantitative 3D gait parameters in PD with FOG (PDF) and PD without FOG (PDNF) in a routine clinical cohort. Methods: We retrospectively analyzed a sequential sample of 180 patients with PD referred for motion analysis between 2020 and 2024. All patients underwent 3D motion capture in the off-medication state. Eighteen gait outcomes spanning pace, rhythm, postural control, variability, and asymmetry domains were derived from steady-state walking tasks. FOG status was determined using physician documentation and Movement Disorder Society Unified Parkinsons Disease Rating Scale (MDS-UPDRS) items. Group differences between PDF (n=99) and PDNF (n=81) were evaluated using independent samples t-tests, with outcomes adjusted for disease duration and corrected for multiple comparisons. A secondary analysis among PDF compared those in Hoehn and Yahr (H&Y) stage [≥]III to those in H&Y [≤]II. Results: PDF had longer disease duration, higher OFF MDS-UPDRS III scores, and higher Hoehn and Yahr stage than PDNF but were similar in age and sex. After adjusting for disease duration and multiplicity, PDF demonstrated reduced step length, stride length, and forward velocity, and greater cadence variability, while most postural control, and asymmetry measures were comparable between groups. Among PDF, advanced H&Y stage was associated with impaired pace and rhythm, similar to previous reports among PD in general. Conclusion: In this large, sequential, clinically referred cohort, FOG was associated with more advanced PD and specific impairments in pace and gait variability. These findings support comprehensive 3D gait analysis as an objective tool to better delineate FOG-related gait abnormalities and identify features that may predict FOG, informing targeted interventions.

14.
arXiv (quant-ph) 2026-06-15

Extensible Fluxonium Architecture Using Tunable Couplers with Low Shunt Capacitance

arXiv:2606.01647v2 Announce Type: replace Abstract: Fluxonium qubits have demonstrated high-fidelity operations and long coherence times in small-scale systems, highlighting their promise for quantum computing. However, large-scale integration into a high-performance two-dimensional (2D) qubit array remains the central challenge for practical applications. In this work, we introduce an extensible architecture for scaling up fluxonium qubits in 2D grids. To address the key challenges, namely achieving controllable strong interaction and high connectivity for qubits featuring small shunting capacitors (footprints), we propose using low-shunt-capacitance couplers to enable tunable interactions between fluxonium qubits. When embedded into 2D square lattices, large couplings can be achieved even with relatively small coupling capacitances, thus enabling multiple connections with sufficient capacitance budget. We further propose coupler realizations based on generalized flux qubit circuits, specifically the quarton and the fluxonium, and demonstrate that both enable fast, high-fidelity gates with low spectator errors, while supporting multiple connections on 2D grids.

15.
arXiv (quant-ph) 2026-06-12

Reservoir-controlled electromagnetically induced gratings in a weakly driven two-level medium

arXiv:2606.13085v1 Announce Type: cross Abstract: We theoretically investigate the transmission and diffraction of a weak probe field from an electromagnetically induced grating formed in a weakly driven two-level medium coupled to engineered quantum reservoirs. Using a perturbative solution of the optical Bloch equations in the weak-driving regime, we analyze how normal-vacuum, thermal, and broadband squeezed-vacuum environments modify the probe susceptibility and consequently reshape both the spatial transmission function and the far-field diffraction patterns. We show that reservoir statistics have a pronounced impact on the diffraction response by altering the amplitude and phase of the induced grating. Thermal reservoirs enhance the transmission modulation and increase the intensity of the dominant diffraction orders, whereas squeezed-vacuum reservoirs generate strongly phase-sensitive modifications that selectively redistribute optical power among diffraction channels. We further demonstrate that the detuning between the squeezed reservoir and the driving field provides an efficient mechanism for controlling diffraction directionality, leading to substantial amplification of selected angular orders. In two-dimensional geometries, squeezed-vacuum correlations produce highly structured phase landscapes and strongly anisotropic diffraction patterns, enabling directional enhancement of specific diffraction channels while suppressing others. These results establish reservoir engineering as a versatile approach for controlling transmission, diffraction efficiency, and angular selectivity in minimal two-level systems, with potential applications in programmable photonic devices, beam steering, and quantum optical platforms.

16.
arXiv (CS.CV) 2026-06-15

Encoder Winners Do Not Reliably Transfer Across VLA Backbone Scale: A Frozen-Backbone Grafting Diagnostic

Vision-language-action (VLA) policies typically inherit their vision encoder from upstream VLM releases, but it is unclear whether an encoder choice validated on a small VLA transfers to a larger backbone. We introduce a frozen-backbone grafting diagnostic: the vision tower of a released VLA is replaced by a candidate encoder under a fixed protocol (adaptive average pooling, LayerNorm, and a single trainable linear projector), with the language model and action expert frozen. Across four encoders, two LIBERO suites, two backbones (SmolVLA-450M and $\pi_{0.5}$-3.3B), and two-to-three seeds per cell (40 main grafting runs plus native, LoRA, pooling, and zero-/shuffled-image controls, all scored by offline action MSE), the small-backbone winner does not reliably select the large-backbone top tier: SigLIP is best on SmolVLA across both suites, while on $\pi_{0.5}$ DINOv2-small leads the spatial suite and the object suite is a seed-sensitive near-tie band; three of the four backbone-suite comparisons (and 11 of 12 seed-level cells) support backbone-dependent rankings. The grafting wrapper is itself non-neutral with opposite sign across backbones (+45-56% MSE on the SmolVLA native tower, -50-52% on $\pi_{0.5}$), so all conclusions are conditional on the fixed grafting protocol. We position frozen grafting as a cheap target-backbone diagnostic to run before committing to an encoder at scale, not as a closed-loop deployment claim.

17.
bioRxiv (Bioinfo) 2026-06-11

A Deep Hypergraph Learning Model for Predicting Antimicrobial Combination Effects Across Bacterial Targets

Antimicrobial resistance (AMR) creates an urgent need for efficient strategies to identify effective antibacterial combinations. Combination therapy, including antimicrobial peptides (AMPs) paired with conventional antibiotics, is a promising approach, but exhaustive experimental screening across drug pairs and bacterial targets is impractical. This study introduces a hybrid GCN-based hypergraph neural network (HGNN) for predicting antimicrobial-agent combination outcomes against bacterial targets. Each antimicrobial-agent-antimicrobial-agent-bacterium triplet is represented as a ternary hyperedge, enabling the model to learn context-dependent interaction patterns. The framework integrates SMILES-derived molecular graph embeddings for antimicrobial agents, including conventional antibiotics and AMPs, with taxonomy-derived bacterial representations. The prediction task was formulated as a three-class classification problem: synergy, antagonism, and non-interaction. The non-interaction class included experimentally verified indifferent records and synthetic presumed non-interaction triplets generated by negative sampling. Model development used drug-pair-grouped splitting, five-fold grouped cross-validation within the training/validation partition, and final evaluation on a held-out test set. On the held-out three-class test set, the selected GCN-based HGNN achieved an accuracy of 0.83, weighted F1-score of 0.84, macro F1-score of 0.80, and ROC-AUC of 0.95. Per-class evaluation showed accuracies of 0.80 for synergy, 0.92 for antagonism, and 0.85 for non-interaction. Pair-type analysis showed strong performance across AMP-AMP, AMP-conventional antibiotic, and conventional antibiotic-conventional antibiotic combinations. These findings suggest that hypergraph-based representation learning can support computational prioritization of antimicrobial combinations for experimental follow-up. Further studies will be needed to improve model interpretability and to perform prospective validation of predicted synergistic combinations.

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

A Conservation Law for Equilibrium Propagation and Coupled Learning

arXiv:2606.15444v1 Announce Type: cross Abstract: In this paper we show that the physical learning methods known as coupled learning (CL) and equilibrium propagation (EP) conserve a mass-like quantity in the trainable parameters in the continuous-time, small-nudging limit. We prove that this conservation holds in a broad range of physically relevant settings. We then show that the conservation law constrains the training dynamics in a way that makes convergence reliable in important settings for linear circuits. We conclude by discussing some practical implications of this conservation law.

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

RGFVR: Reference-Guided Face Video Restoration with Flow Matching

Face video restoration from degraded observations is challenging, as it requires simultaneously recovering visual fidelity, temporal consistency, and subject identity. Existing approaches are often either reference-free, which can lead to identity loss when person-specific facial details are lost, or subject-specific, which limits generalization to unseen identities. We propose a subject-agnostic, reference-guided framework for identity-preserving face video restoration. Our method introduces bimodal perceptual-descriptive identity conditioning into a pretrained flow-based text-to-video generator and employs a two-stage training strategy to strengthen identity guidance during restoration. Experiments show that our approach improves restoration fidelity, temporal consistency, and identity preservation, achieving superior performance under challenging video degradations, including downsampling, blur, noise, and compression artifacts. The code is available under: https://github.com/batuhanntosun/RG-FVR.

20.
arXiv (CS.CV) 2026-06-11

Frozen Multimodal Embeddings for Personality and Cognitive Ability Assessment in Asynchronous Video Interviews

Predicting psychological traits from asynchronous video interviews (AVIs) is a challenging multimodal learning problem because labeled datasets are limited while each response contains high-dimensional visual, acoustic, and verbal signals. This paper presents our solution for the ACM Multimedia AVI Challenge 2026, which evaluates two tasks: Track~1 predicts self-reported HEXACO personality traits from personality-related interview responses, and Track~2 classifies cognitive ability levels from structured AVI responses. We treat the problem as a small-sample representation learning task. Instead of fine-tuning large pretrained models, we use frozen multimodal encoders, including CLIP for visual features, Whisper for acoustic features and transcripts, and RoBERTa, E5, and DeBERTaV3 for textual representations, followed by low-capacity downstream models. For Track~1, our trait-specific regression and late-fusion system achieves an average validation MSE of 0.2696, improving over the official baseline of 0.3334. Ablation results show a three-step improvement from a global model (0.3189), to per-trait modeling (0.2871), to per-trait late fusion (0.2696), corresponding to a 19.1\% relative MSE reduction over the official baseline. For Track~2, a compact subject-attribute baseline reaches 0.5781 accuracy, while our multimodal ensemble reaches 0.5313, both above the official baseline of 0.4062. We interpret this result as evidence of possible subject-attribute shortcuts in the validation split rather than robust cognitive inference from AVI content. Overall, our findings suggest that AVI-based psychological assessment benefits from trait-specific multimodal modeling, but cognitive ability prediction requires careful control of dataset shortcuts.

21.
arXiv (CS.LG) 2026-06-19

EFIQA: Explainable Fundus Image Quality Assessment via Anatomical Priors

arXiv:2606.20108v1 Announce Type: cross Abstract: Image quality control is vital for a wide range of downstream applications. Deep learning-based image quality assessment methods typically train classifiers on dataset-specific quality labels, inheriting two limitations: (1) generalization is tied to the labeling criteria of the training set and (2) these methods cannot provide spatial feedback on where the quality is degraded, lacking explainability. In this work, we propose EFIQA, a framework that requires no quality-related supervision and produces spatial quality maps by design. Rather than learning ``what is degradation" from human-annotated labels, EFIQA learns ``what should be there" by leveraging anatomical priors. For fundus photography, we instantiate this as a two-stage approach, by first training an unsupervised anomaly detector via masked anatomical inpainting to identify regions of missing vasculature, and then distilling this prior knowledge into a shallow adapter mapping features of a frozen foundation model to precise quality maps. External-dataset evaluation demonstrates that this label-free approach with minimal adaptation achieves better performance and explainability compared with supervised methods across benchmarks with different quality criteria, highlighting its potential for real-world applications.

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

The Silent Cost of Artificial Intelligence Assistance: A Theory of Autonomy Surrender, the Recovery Mechanism, and the Restoration of Human Agency

arXiv:2606.13962v1 Announce Type: cross Abstract: The integration of artificial intelligence into human decision-making environments has introduced a previously undertheorized cost: the gradual surrender of human autonomy in exchange for access to information and computational assistance. Building on the Human Identity and Autonomy Gap (HIAG) framework, this paper advances a theoretical model of autonomy surrender as a measurable, cumulative process driven by cognitive bandwidth depletion. The model proposes three interacting mechanisms: the silent cost of AI assistance, in which autonomy is transferred incrementally and without awareness; the surrender threshold, beyond which reclaiming autonomous function becomes cognitively and psychologically difficult; and the recovery mechanism, which establishes the design obligation and the ethical responsibility accompanying deliberate human re-assumption of control. The paper argues that human re-entry into the decision loop is not a passive option but an active cognitive event requiring intentional bandwidth restoration. The design of AI systems must incorporate structured re-entry pathways, here termed recovery mechanisms, that preserve human agency while appropriately distributing responsibility. The model further predicts a terminal state, here termed preference inversion, in which functional dependence on AI assistance is experienced not as a deficit but as a preference, transforming the restoration of autonomy from a design problem into a cultural and political one. Implications are drawn for AI system design, governance frameworks, and human factors research.

23.
medRxiv (Medicine) 2026-06-22

ECG-Guided Pre-Screening of Family Members for Hypertrophic Cardiomyopathy

Background: Current clinical guidelines recommend serial ECG and echocardiographic surveillance for first-degree relatives of probands with Hypertrophic Cardiomyopathy (HCM). Objectives: To evaluate the accuracy and validity of ECG alone as a pre-screening tool for the diagnosis of HCM and to develop a random forest (RF) model for HCM phenotype prediction. Method: Pediatric relatives of primary HCM probands attending the cardiomyopathy screening program at The Hospital for Sick Children were included from 1993 to 2025. Subjects were followed until the last follow-up, censored at phenotype conversion. ECGs were classified as normal or abnormal based on predefined parameters. Associations between binary ECG variables and HCM phenotype were assessed using Phi ({varphi}) coefficient. A Random Forest classifier was developed using significant ECG variables (70:30 training: test split) and evaluated using precision, recall, specificity, negative predictive value, F1 score and AUROC. Feature importance was assessed using SHAP analysis. Variables with an impact of >5% were included in a simplified model, which was evaluated by repeating performance metrics and externally validated in a healthy cohort. Results: 350 screened relatives (44% female, mean follow-up 6.8 +- 4.8 years) were included. At baseline, 13% (46350) were phenotype-positive for HCM. 9 subjects converted during the surveillance. Thirteen ECG variables were significantly associated with phenotype-positive HCM and were included in the full random forest model. Four variables had >5% impact (Left ventricular hypertrophy, right ventricular hypertrophy, T-wave inversion and ST-segment depression) and were included in a simplified model, which maintained high specificity (93% vs 97%), negative predictive value (97% vs 93%) and AUROC (90% vs 96%). The simplified model classified 83% subjects as phenotype-negative, with eight being false-negative, all of whom developed an abnormal ECG in a mean of 1 year, and none had an interim adverse cardiac event. The simplified model was evaluated in an independent healthy cohort of 153 school-age subjects and correctly identified 98% as phenotype-negative with 100% NPV. Conclusion: ECG abnormalities were strongly associated with phenotype-positive status. A simplified ECG-based random forest model using four ECG variables demonstrated high specificity and negative predictive value for identifying phenotype-negative subjects. If prospectively validated, this could reduce the need for concurrent echocardiographic screening by up to 83% per encounter, lowering screening burden and cost.

24.
arXiv (CS.CL) 2026-06-18

Trade-offs in Medical LLM Adaptation: An Empirical Study in French QA

The development of large language models (LLMs) has led to an increased focus on their adaptation to specialized domains and languages, yet the effectiveness of domain adaptation strategies remains unclear. We present a study of medical domain adaptation using French medical question-answering (QA) as a case study. We compare continual pretraining (CPT), supervised fine-tuning (SFT), and their combination across three model families, multiple sizes, and three initialization types, explicitly disentangling adaptation effects from base model choice. We evaluate both multiple-choice (MCQA) and open-ended QA (OEQA) under greedy and constrained decoding using automatic metrics and LLM-as-a-Judge evaluation. For MCQA, CPT+SFT most often achieves the best scores, but gains over SFT are small and frequently not statistically significant, making SFT a strong and cost-effective default. For OEQA, CPT consistently improves overlap-based metrics, while SFT often degrades generation quality; instruction tuning and CPT+SFT are preferred by LLM-based evaluation. Cross-lingual experiments further show effective transfer from French adaptation to English benchmarks. Overall, we provide practical guidelines for selecting adaptation strategies under computational constraints.

25.
arXiv (CS.CV) 2026-06-12

ECA: Efficient Continual Alignment for Open-Ended Image-to-Text Generation

Incremental Learning (IL) for Open-ended Image-to-Text Generation (OpenITG) enables models to continuously generate accurate, contextually relevant text for new images while preserving previously acquired knowledge. Unlike prior studies, this paper addresses a more practical scenario in which the predominant category of visual data shifts over time as environments evolve. In this context, we introduce a new notion of continual alignment, which incrementally adapts the alignment module within pre-trained VLMs to preserve high-quality cross-modal representations. Based on this idea, we propose Efficient Continual Alignment (ECA), a novel exemplar-free IL approach for OpenITG. The key challenge is enabling the model to acquire new, task-specific features while minimizing interference with the established alignment without accessing raw data from previous tasks. To address this, ECA employs three core mechanisms: a Mixture of Query (MoQ) module that adapts task-specific query tokens, a Fisher Dynamic Expansion (FeDEx) that dynamically expands model structure based on a Fisher Information Matrix (FIM)-based metric, and an embedding dictionary with Dictionary Replay (DR) to retain past knowledge. To evaluate ECA's performance, we construct four new IL OpenITG benchmarks that better reflect real-world scenarios. Experimental results demonstrate that ECA significantly mitigates catastrophic forgetting and improves IL performance compared to baseline methods. Code and benchmarks are available at https://github.com/Snowball0823/ECA.