Medical
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Evidential Reasoning Advances Interpretable Real-World Disease Screening
2026-05-14 17:56:07Chenyu Lian, Hong-Yu Zhou, Jing QinAbstract
Disease screening is critical for early detection and timely intervention in clinical practice. However, most current screening models for medical images suffer from limited interpretability and suboptimal performance. They often lack effective mechanisms to reference historical cases or provide transparent reasoning pathways. To address these challenges, we introduce EviScreen, an evidential reasoning framework for disease screening that leverages region-level evidence from historical cases. The proposed EviScreen offers retrospection interpretability through regional evidence retrieved from dual knowledge banks. Using this evidential mechanism, the subsequent evidence-aware reasoning module makes predictions using both the current case and evidence from historical cases, thereby enhancing disease screening performance. Furthermore, rather than relying on post-hoc saliency maps, EviScreen enhances localization interpretability by leveraging abnormality maps derived from contrastive retrieval. Our method achieves superior performance on our carefully established benchmarks for real-world disease screening, yielding notably higher specificity at clinical-level recall. Code is publicly available at this https URL.
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https://arxiv.org/abs/2605.15171
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TFGN: Task-Free, Replay-Free Continual Pre-Training Without Catastrophic Forgetting at LLM Scale
2026-05-14 16:46:26Anurup GanguliAbstract
Continually pre-training a large language model on heterogeneous text domains, without replay or task labels, has remained an unsolved architectural problem at LLM scale. Existing methods rely on replay buffers, task identifiers, regularization penalties that scale poorly, or sentence-classification-scale evaluation. We introduce TFGN, an architectural overlay for transformer language models that produces input-conditioned, parameter-efficient updates while leaving the rest of the transformer unchanged. On six heterogeneous text domains (Prose, Python, Math, Biomedical, Chinese, JavaScript) at 1B tokens per phase across three model scales (~398M, ~739M, ~9B) and two regimes (From-Scratch and Retrofit), TFGN achieves backward transfer of -0.007 at LLaMA 3.1 8B Retrofit, HellaSwag retention 0.506/0.504/0.510, and >=99.59% L2-orthogonal gradient separation between domain pairs - with no replay, no task IDs, no Fisher penalty. The same matrices show positive cross-domain forward transfer: held-out JavaScript PPL drops 26.8% at LLaMA-8B Retrofit and 62.0% at GPT-2 Medium From-Scratch purely from Python training. Two extensions on the same substrate close further open problems. A closed-loop meta-control layer (Extension A) reduces forgetting by an additional 81% at ~398M, mapping onto the System A and System M roles of Dupoux et al. (arXiv:2603.15381). An operator-level plan vector (Extension B) reshapes forward-pass behavior at 99.96% cosine fidelity over 30 source->target pairs. The architectural insight is a Read/Write decomposition: the forward pass is fully dense, while cross-domain parameter updates are structured so prior-domain subspaces are not written to. To our knowledge, TFGN is the first architecture that simultaneously closes catastrophic forgetting at LLM scale, realizes a closed-loop autonomous-learning meta-controller, and carries an operator-level latent planner.
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https://arxiv.org/abs/2605.15053
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COTCAgent: Preventive Consultation via Probabilistic Chain-of-Thought Completion
2026-05-14 16:17:35Zihan Deng, Xiaozhen Zhong, Chuanzhi XuAbstract
As large language models empower healthcare, intelligent clinical decision support has developed rapidly. Longitudinal electronic health records (EHR) provide essential temporal evidence for accurate clinical diagnosis and analysis. However, current large language models have critical flaws in longitudinal EHR reasoning. First, lacking fine-grained statistical reasoning, they often hallucinate clinical trends and metrics when quantitative evidence is textually implied, biasing diagnostic inference. Second, non-uniform time series and scarce labels in longitudinal EHR hinder models from capturing long-range temporal dependencies, limiting reliable clinical reasoning. To address the above limitations, this work presents the Probabilistic Chain-of-Thought Completion Agent (COTCAgent), a hierarchical reasoning framework for longitudinal electronic health records. It consists of three core modules. The Temporal-Statistics Adapter (TSA) converts analytical plans into executable code for standardized trend output. The Chain-of-Thought Completion (COTC) layer leverages a symptom-trend-disease knowledge base with weighted scoring to evaluate disease risk, while the bounded completion module acquires structured evidence through standardized inquiries and iterative scoring constraints to ensure rigorous reasoning. By decoupling statistical computation, feature matching, and language generation, the framework eliminates reliance on complex multi-modal inputs and enables efficient longitudinal record analysis with lower computational overhead. Experimental results show that COTCAgent powered by Baichuan-M2 achieves 90.47% Top-1 accuracy on the self-built dataset and 70.41% on HealthBench, outperforming existing medical agents and mainstream large language models. The code is available at this https URL.
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https://arxiv.org/abs/2605.15016
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Quantifying and Mitigating Premature Closure in Frontier LLMs
2026-05-14 16:02:28Rebecca Handler, Suhana Bedi, Nigam ShahAbstract
Premature closure, or committing to a conclusion before sufficient information is available, is a recognized contributor to diagnostic error but remains underexamined in large language models (LLMs). We define LLM premature closure as inappropriate commitment under uncertainty: providing an answer, recommendation, or clinical guidance when the safer response would be clarification, abstention, escalation, or refusal. We evaluated five frontier LLMs across structured and open-ended medical tasks. In MedQA (n = 500) and AfriMed-QA (n = 490) questions where the correct choice had been removed, models still selected an answer at high rates, with baseline false-action rates of 55-81% and 53-82%, respectively. In open-ended evaluation, models gave inappropriate answers on an average of 30% of 861 HealthBench questions and 78% of 191 physician-authored adversarial queries. Safety-oriented prompting reduced premature closure across models, but residual failure persisted, highlighting the need to evaluate whether medical LLMs know when not to answer.
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https://arxiv.org/abs/2605.15000
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MicroscopyMatching: Towards a Ready-to-use Framework for Microscopy Image Analysis in Diverse Conditions
2026-05-14 15:44:26Xiaofei Hui, Haoxuan Qu, Hossein Rahmani, Shuohong Wang, Jeff W. Lichtman, Jun LiuAbstract
Analyzing microscopy images to extract biological object properties (e.g., their morphological organization, temporal dynamics, and population density) is fundamental to various biomedical research. Yet conducting this manually is costly and time-consuming. Though deep learning-based approaches have been explored to automate this process, the substantial diversity of microscopy analysis settings in practice (including variations of biological object types, sample processing protocols, imaging equipment, and analysis tasks, etc.) often renders them ineffective. As a result, these approaches typically require extensive adaptation for different settings, which, however, can impose burdens that are often practically unsustainable for laboratories, forcing biomedical researchers to still commonly rely on manual analysis, thereby severely bottlenecking the pace of biomedical research progress. This situation has created a pressing and long-standing need for a reliable and broadly applicable microscopy image analysis tool, yet such a tool is still missing. To address this gap, we present the first ready-to-use microscopy image analysis framework, MicroscopyMatching, that can reliably perform key analysis tasks (including segmentation, tracking, and counting) across diverse microscopy analysis settings. From a fundamentally different perspective, MicroscopyMatching reformulates diverse microscopy image analysis tasks as a unified matching problem, effectively handling this problem by exploiting the robust matching capability from pre-trained latent diffusion models.
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https://arxiv.org/abs/2605.14980
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BiFedKD: Bidirectional Federated Knowledge Distillation Framework for Non-IID and Long-Tailed ECG Monitoring
2026-05-14 14:31:02Zixuan Shu, Tiancheng Cao, Hen-Wei HuangAbstract
Electrocardiogram (ECG) monitoring in Internet of Medical Things (IoMT) networks is constrained by strict data-sharing regulations and privacy concerns. Federated learning (FL) enables collaborative learning by keeping raw ECG data on devices, but frequent transmissions of high-dimensional model updates incur heavy per-round traffic over bandwidth-limited links. To alleviate this bottleneck, federated distillation (FD) replaces parameter exchange with logit-based knowledge transfer. However, the performance of FD often degrades under the non-independent and identically distributed (non-IID) and long-tailed label distributions in ECG deployments. To address these challenges, we propose a bidirectional federated knowledge distillation (BiFedKD) framework that employs an aggregation-by-distillation pipeline with temperature scaling to produce a stable global distillation signal for cross-client alignment. Experiments on the MIT-BIH Arrhythmia dataset show that BiFedKD improves accuracy and Macro-F1 over the baseline by $3.52\%$ and $9.93\%$, respectively. Moreover, to reach the same Macro-F1, BiFedKD reduces communication overhead by $40\%$ and computation cost by $71.7\%$ compared with the baseline.
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https://arxiv.org/abs/2605.14886
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Can Visual Mamba Improve AI-Generated Image Detection? An In-Depth Investigation
2026-05-14 13:09:16Mamadou Keita, Wassim Hamidouche, Hessen Bougueffa Eutamene, Abdelmalik Taleb-Ahmed, Xianxun Zhu, Abdenour HadidAbstract
In recent years, computer vision has witnessed remarkable progress, fueled by the development of innovative architectures such as Convolutional Neural Networks (CNNs), Generative Adversarial Networks (GANs), diffusion-based architectures, Vision Transformers (ViTs), and, more recently, Vision-Language Models (VLMs). This progress has undeniably contributed to creating increasingly realistic and diverse visual content. However, such advancements in image generation also raise concerns about potential misuse in areas such as misinformation, identity theft, and threats to privacy and security. In parallel, Mamba-based architectures have emerged as versatile tools for a range of image analysis tasks, including classification, segmentation, medical imaging, object detection, and image restoration, in this rapidly evolving field. However, their potential for identifying AI-generated images remains relatively unexplored compared to established techniques. This study provides a systematic evaluation and comparative analysis of Vision Mamba models for AI-generated image detection. We benchmark multiple Vision Mamba variants against representative CNNs, ViTs, and VLM-based detectors across diverse datasets and synthetic image sources, focusing on key metrics such as accuracy, efficiency, and generalizability across diverse image types and generative models. Through this comprehensive analysis, we aim to elucidate Vision Mamba's strengths and limitations relative to established methodologies in terms of applicability, accuracy, and efficiency in detecting AI-generated images. Overall, our findings highlight both the promise and current limitations of Vision Mamba as a component in systems designed to distinguish authentic from AI-generated visual content. This research is crucial for enhancing detection in an age where distinguishing between real and AI-generated content is a major challenge.
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URL
https://arxiv.org/abs/2605.14799
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Vision-Core Guided Contrastive Learning for Balanced Multi-modal Prognosis Prediction of Stroke
2026-05-14 11:28:57Liren Chen, Lidong Sun, Mingyan Huang, Junzhe Tang, Yinghui Zhu, Guanjie Wang, Yiqing Xia, Ting XiaoAbstract
Deep learning and multi-modal fusion have demonstrated transformative potential in medical diagnosis by integrating diverse data sources. However, accurate prognosis for ischemic stroke remains challenging due to limitations in existing multi-modal approaches. First, current methods are predominantly confined to dual-modal fusion, lacking a framework that effectively integrates the trifecta of medical images, structured clinical data, and unstructured text. Second, they often fail to establish deep bidirectional interactions between modalities; To address these critical gaps, this paper proposes a novel tri-modal fusion model for ischemic stroke prognosis. Our approach first enriches the data representation by employing a Large Language Model (LLM) to automatically generate semi-structured diagnostic text from brain MRIs. This process not only addresses the scarcity of expert annotations but also serves as a regularized semantic enhancement, improving multimodal fusion robustness. Furthermore, we design a core component termed the Vision-Conditioned Dual Alignment Fusion Module (VDAFM), which strategically uses visual features as a conditional prior to guide fine-grained interaction with the generated text. This module achieves a dynamic and profound fusion through a dual semantic alignment loss, effectively mitigating modal heterogeneity. Extensive experiments on a real-world clinical dataset demonstrate that our model achieves state-of-the-art performance.
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https://arxiv.org/abs/2605.14710
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Beyond Instance-Level Self-Supervision in 3D Multi-Modal Medical Imaging
2026-05-14 10:10:34Tan Pan, Shuhao Mei, Yixuan Sun, Kaiyu Guo, Chen Jiang, Zhaorui Tan, Mengzhu Li, Limei Han, Xiang Zou, Yuan Cheng, Mahsa BaktashmotlaghAbstract
Self-supervised pre-training methods in medical imaging typically treat each individual as an isolated instance, learning representations through augmentation-based objectives or masked reconstruction. They often do not adequately capitalize on a key characteristic of physiological features: anatomical structures maintain consistent spatial relationships across individuals (instances), such as the thalamus being medial to the basal ganglia, regardless of variations in brain size, shape, or pathology. We propose leveraging this cross-instance topological consistency as a supervisory signal. The challenge arises from the inherent variability in medical imaging, which can differ significantly across instances and modalities. To tackle this, we focus on two alignment regimes. (i) Intra-instance: with pixel-level correspondences available, a cross-modal triplet objective explicitly preserves local neighborhood topology. (ii) Inter-instance: without such supervision, we derive pseudo-correspondences to control partial neighborhood alignment and prevent topology collapse across modalities. We validate our approach across 7 downstream multi-modal tasks, achieving average improvements of 1.1% and 5.94% in segmentation and classification tasks, respectively, and demonstrating significantly better robustness when modalities are missing at test time.
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https://arxiv.org/abs/2605.14654
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Med-DisSeg: Dispersion-Driven Representation Learning for Fine-Grained Medical Image Segmentation
2026-05-14 08:49:36Zhiquan Chen, Haitao Wang, Guowei Zou, Hejun WuAbstract
Accurate medical image segmentation is fundamental to precision medicine, yet robust delineation remains challenging under heterogeneous appearances, ambiguous boundaries, and large anatomical variability. Similar intensity and texture patterns between targets and surrounding tissues often lead to blurred activations and unreliable separation. We attribute these failures to representation collapse during encoding and insufficient fine grained multi scale decoding. To address these issues, we propose Med DisSeg, a dispersion driven medical image segmentation framework that jointly improves representation learning and anatomical delineation. Med DisSeg combines a lightweight Dispersive Loss with adaptive attention for fine grained structure segmentation. The Dispersive Loss enlarges inter sample margins by treating in batch hidden representations as negative pairs, producing well dispersed and boundary aware embeddings with negligible overhead. Based on these enhanced representations, the encoder strengthens structure sensitive responses, while the decoder performs adaptive multi scale calibration to preserve complementary local texture and global shape information. Extensive experiments on five datasets spanning three imaging modalities demonstrate consistent state of the art performance. Moreover, Med DisSeg achieves competitive results on multi organ CT segmentation, supporting its robustness and cross task applicability.
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https://arxiv.org/abs/2605.14579
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SpectraFlow: Unifying Structural Pretraining and Frequency Adaptation for Medical Image Segmentation
2026-05-14 08:37:10Zhiquan Chen, Haitao Wang, Guowei Zou, Hejun WuAbstract
Medical image segmentation remains challenging in low-data regimes, where scarce annotations often yield poor generalization and ambiguous boundaries with missing fine structures. Recent self-supervised pretraining has improved transferability, but it often exhibits a texture bias. In contrast, accurate segmentation is inherently geometry-aware and depends on both topological consistency and precise boundary preservation. To address this problem, we propose a two-stage framework that couples structure-aware encoder pretraining with boundary-oriented decoding. In Stage-1, we aim to learn structure-aware representations for downstream segmentation in low-data regimes. To this end, we propose Mixed-Domain MeanFlow Pretraining, which aligns images and binary masks in a shared latent space through latent transport regression, where masks act as conditional structural guidance rather than prediction targets, making the pretraining task-agnostic. To further improve training stability under scarce supervision, we incorporate a lightweight Dispersive Loss to prevent representation collapse. In Stage-2, we fine-tune the pretrained encoder with a lightweight decoder that combines Direct Attentional Fusion for adaptive cross-scale gating and Frequency-Directional Dynamic Convolution for high-frequency boundary refinement under appearance variation. Experiments on ISIC-2016, Kvasir-SEG, and GlaS demonstrate consistent gains over state-of-the-art methods, with improved robustness in low-data settings and sharper boundary delineation.
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URL
https://arxiv.org/abs/2605.14566
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DermAgent: A Self-Reflective Agentic System for Dermatological Image Analysis with Multi-Tool Reasoning and Traceable Decision-Making
2026-05-14 05:41:11Yize Liu, Siyuan Yan, Ming Hu, Lie Ju, Xieji Li, Feilong Tang, Wei Feng, Zongyuan GeAbstract
Dermatological diagnosis requires integrating fine-grained visual perception with expert clinical knowledge. Although Multimodal Large Language Models (MLLMs) facilitate interactive medical image analysis, their application in dermatology is hindered by insufficient domain-specific grounding and hallucinations. To address these issues, we propose DermAgent, a collaborative multi-tool agent that orchestrates seven specialized vision and language modules within a Plan-Execute-Reflect framework. DermAgent delivers stepwise, traceable diagnostic reasoning through three core components. First, it employs complementary visual perception tools for comprehensive morphological description, dermoscopic concept annotation, and disease diagnosis. Second, to overcome the lack of domain prior, a dual-modality retrieval module anchors every prediction in external evidence by cross-referencing 413,210 diagnosed image cases and 3,199 clinical guideline chunks. To further mitigate hallucinations, a deterministic critic module conducts strict post-hoc auditing via confidence, coverage, and conflict gates, automatically detecting inter-source disagreements to trigger targeted self-correction. Extensive experiments on five dermatology benchmarks demonstrate that DermAgent consistently outperforms state-of-the-art MLLMs and medical agent baselines across zero-shot fine-grained disease diagnosis, concept annotation, and clinical captioning tasks, exceeding GPT-4o by 17.6% in skin disease diagnostic accuracy and 3.15% in captioning ROUGE-L. Our code is available at this https URL.
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https://arxiv.org/abs/2605.14403
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Deciphering Neural Reparameterized Full-Waveform Inversion with Neural Sensitivity Kernel and Wave Tangent Kernel
2026-05-14 04:49:23Ruihua Chen, Yisi Luo, Bangyu Wu, Xile Zhao, Deyu MengAbstract
Full-waveform inversion (FWI) estimates unknown parameters in the wave equation from limited boundary measurements. Recent advances in neural reparameterized FWI (NeurFWI) demonstrate that representing the parameters using a neural network can reduce the reliance on the high-quality initial model and wavefield data, at the cost of slow high-resolution convergence. However, its underlying theoretical mechanism remains unclear. In this study, we establish the neural sensitivity kernel (NSK) and the wave tangent kernel (WTK) to analyze their convergence behavior from both model and data domains. These theoretical frameworks show that the neural tangent kernel (NTK) induced by neural representation adaptively modulates the original sensitivity and wave tangent kernels. This modulation leads to several key outcomes, i.e., the spectral filtering effect, the gradient wavenumber modulation, and the wave frequency bias, connecting the convergence behavior of NeurFWI with the eigen-structures of NSK and WTK. Building on these insights, we propose several enhanced NeurFWI methods with tailored eigen-structures in NSK and WTK to improve inversion performances and efficiency. We numerically validate these theoretical claims and the proposed methods in seismic exploration, and firstly extend their application to medical imaging.
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https://arxiv.org/abs/2605.14370
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Fusion-fission forecasts when AI will shift to undesirable behavior
2026-05-14 00:26:32Neil F. Johnson, Frank Yingjie HuoAbstract
The key problem facing ChatGPT-like AI's use across society is that its behavior can shift, unnoticed, from desirable to undesirable -- encouraging self-harm, extremist acts, financial losses, or costly medical and military mistakes -- and no one can yet predict when. Shifts persist in even the newest AI models despite remarkable progress in AI modeling, post-training alignment and safeguards. Here we show that a vector generalization of fusion-fission group dynamics observed in living and active-matter systems drives -- and can forecast -- future shifts in the AI's behavior. The shift condition, which is also derivable mathematically, results from group-level competition between the conversation-so-far (C) and the desirable (B) and undesirable (D) basin dynamics which can be estimated in advance for a given application. It is neither model-specific nor driven by stochastic sampling. We validate it across six independent tests, including: 90 percent correct across seven AI models spanning two orders of magnitude in parameter count (124M-12B); production-scale persistence across ten frontier chatbots; and a priori time-stamped prediction eleven months before the Stanford 'Delusional Spirals' corpus appeared, and independently confirmed by that corpus of 207,443 human-AI exchanges. Because it sits architecturally below the current safety stack, the same formula provides a real-time warning signal that current alignment does not supply, portable across current and future ChatGPT-like AI architectures and instantiable in application domains where competing response classes can be defined.
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https://arxiv.org/abs/2605.14218
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Towards Fine-Grained and Verifiable Concept Bottleneck Models
2026-05-14 00:08:09Yingying Fang, Haijie Xu, Shuang Wu, Mariathasan Anish, Guang YangAbstract
Concept Bottleneck Models (CBMs) offer interpretable alternatives to black-box predictors by introducing human-relatable concepts before the final output. However, existing CBMs struggle to verify whether predicted concepts correspond to the correct visual evidence, limiting their reliability. We propose a fine-grained CBM framework that grounds each concept in localized visual evidence, enabling direct inspection of where and how concepts are encoded. This design allows users to interpret predictions and verify that the model learns intended concepts rather than spurious correlations. Experiments on medical imaging benchmarks show that our learned concept space is information-complete and achieves predictive performance comparable to standard CBMs, while substantially improving transparency. Unlike post-hoc attribution methods, our framework validates both the presence and correctness of concept representations, bridging interpretability with verifiability. Our approach enhances the trustworthiness of CBMs and establishes a principled mechanism for human-model interaction at the concept level, paving the way toward more reliable and clinically actionable concept-based learning systems.
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https://arxiv.org/abs/2605.14210
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Keyed Nonlinear Transform: Lightweight Privacy-Enhancing Feature Sharing for Medical Image Analysis
2026-05-13 21:17:41Haebom Lee, Gyeongjung KimAbstract
Feature sharing via split inference offers a lightweight alternative to federated learning for resource-constrained hospitals, but transmitted features still leak patient identity information and lack practical mechanisms for controlled feature sharing. We propose Keyed Nonlinear Transform (KNT), a drop-in feature transformation that applies key-conditioned obfuscation to intermediate representations. KNT reduces re-identification AUC from 0.635 to 0.586, corresponding to a 36% reduction in above-chance identity signal, while introducing only 0.15 ms CPU overhead, without backbone retraining, and preserving classification performance within 1.0 pp. Our analysis shows that KNT's nonlinear transform prevents closed-form inversion and shifts recovery to iterative gradient-based optimization under full key compromise, substantially increasing inversion difficulty. The same transform generalizes to dense prediction tasks, incurring only a 4.4 pp Dice reduction on skin-lesion segmentation without retraining. These results position KNT as a practical and efficient privacy layer for split inference deployments.
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URL
https://arxiv.org/abs/2605.14123
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When Evidence Conflicts: Uncertainty and Order Effects in Retrieval-Augmented Biomedical Question Answering
2026-05-13 21:02:24Yikun Han, Mengfei Lan, Halil KilicogluAbstract
Biomedical retrieval-augmented large language models (LLMs) often face evidence that is incomplete, misleading, or internally contradictory, yet evaluation usually emphasizes answer accuracy under helpful context rather than reliability under conflict. Using HealthContradict, we evaluate six open-weight LLMs under five controlled evidence conditions: no retrieved context, correct-only context, incorrect-only context, and two mixed conditions containing both correct and contradictory documents in opposite orders. In this conflicting-evidence order contrast, where the same two documents are both present and only their order is reversed, accuracy drops for every model and 11.4%--25.2% of predictions flip. To support abstention in these difficult cases, we also evaluate a conflict-aware abstention score that combines model confidence with a detector of evidence conflict. In the two hardest conditions, this score improves selective accuracy over confidence-only, with mean gains of 7.2--33.4 points in incorrect-only (`IC') and 3.6--14.4 points in incorrect-first conflicting (`ICC') conditions across 75%, 50%, and 25% coverage. These results show that conflicting biomedical evidence is both an uncertainty and robustness problem and motivate evaluation and abstention methods that explicitly account for evidence disagreement.
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URL
https://arxiv.org/abs/2605.14115
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ProtoMedAgent: Multimodal Clinical Interpretability via Privacy-Aware Agentic Workflows
2026-05-13 20:57:37Alvaro Lopez Pellicer, Plamen Angelov, Marwan Bukhari, Yi Li, Eduardo Soares, Jemma KernsAbstract
While interpretable prototype networks offer compelling case-based reasoning for clinical diagnostics, their raw continuous outputs lack the semantic structure required for medical documentation. Bridging this gap via standard Retrieval-Augmented Generation (RAG) routinely triggers ``retrieval sycophancy,'' where Large Language Models (LLMs) hallucinate post-hoc rationalizations to align with visual predictions. We introduce ProtoMedAgent, a framework that formalizes multimodal clinical reporting as an iterative, zero-gradient test-time optimization problem over a strict neuro-symbolic bottleneck. Operating on a frozen prototype backbone, we distill latent visual and tabular features into a discrete semantic memory. Online generation is strictly constrained by exact set-theoretic differentials and a reflective Scribe-Critic loop, mathematically precluding unsupported narrative claims. To safely bound data disclosure, we introduce a semantic privacy gate governed by $k$-anonymity and $\ell$-diversity. Evaluated on a 4,160-patient clinical cohort, ProtoMedAgent achieves 91.2\% Comparison Set Faithfulness where it fundamentally outperforms standard RAG (46.2\%). ProtoMedAgent additionally leverages a binding $\ell$-diversity phase transition to systematically reduce artifact-level membership inference risks by an absolute 9.8\%.
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https://arxiv.org/abs/2605.14113
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Neurosymbolic Auditing of Natural-Language Software Requirements
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Natural-language software requirements are often ambiguous, inconsistent, and underspecified; in safety-critical domains, these defects propagate into formal models that verify the wrong specification and into implementations that ship unsafe behavior. We show that large language models, equipped with an SMT solver, can audit such requirements: translating them into formal logic, detecting ambiguity through stochastic variation in the generated formalization, and exposing inconsistency, vacuousness, and safety violations through solver queries on the resulting specification. We present VERIMED, a neurosymbolic pipeline that operationalizes this idea for medical-device software requirements, and report two findings. First, stochastic variation across independent formalizations is a signal of ambiguity: requirements that admit multiple plausible interpretations produce SMT-inequivalent formalizations, and bidirectional SMT equivalence checking turns this disagreement into a solver-checkable test. Second, the usefulness of symbolic feedback depends on its granularity: in counterexample-guided repair on a hemodialysis question-answering benchmark, concrete SMT counterexamples raise verified accuracy from 55.4% to 98.5%. Over an extensive experimental evaluation on open-source hemodialysis safety requirements, we show that the LLM-based approach in VERIMED successfully reduces ambiguity-sensitive requirements and enables rigorous auditing of software requirements through SMT-based queries.
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URL
https://arxiv.org/abs/2605.13817
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VoxCor: Training-Free Volumetric Features for Multimodal Voxel Correspondence
2026-05-13 17:20:26Guney Tombak, Ertunc Erdil, Ender KonukogluAbstract
Cross-modal 3D medical image analysis requires voxelwise representations that remain anatomically consistent across imaging contrasts, scanners, and acquisition protocols. Recent work has shown that frozen 2D Vision Transformer (ViT) foundation models can support such representations, but typical pipelines extract features along a single anatomical axis and adapt those features inside a registration solver for one image pair at a time, leaving complementary viewing directions unused and producing representations that do not transfer to new volumes. We introduce VoxCor, a training-free fit--transform method for reusable volumetric feature representations from frozen 2D ViT foundation models. During an offline fitting phase, VoxCor combines triplanar ViT inference with a compact closed-form weighted partial least squares (WPLS) projection that uses fitting-time voxel correspondences to select modality-stable anatomical directions in the triplanar feature space. At transform time, new volumes are mapped by triplanar ViT inference and linear projection alone, without fine-tuning or registration. Voxel correspondences can then be queried directly by nearest-neighbor search. We evaluate VoxCor on intra-subject Abdomen MR--CT and inter-subject HCP T2w--T1w tasks using deformable registration, voxelwise k-nearest-neighbor segmentation, and segmentation-center landmark localization. VoxCor improves the hardest cross-subject, cross-modality transfer settings, reduces encoder sensitivity for dense correspondence transfer, and yields registration performance competitive with handcrafted descriptors and learned 3D features. This positions VoxCor as a reusable feature layer for downstream multimodal analysis beyond pairwise registration. Code, configuration files, and implementation details are publicly available on GitHub at \href{this https URL}{guneytombak/VoxCor}.
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URL
https://arxiv.org/abs/2605.13798
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