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01.
medRxiv (Medicine) 2026-06-22

Impact of Antidiabetic Medications on IgG and Plasma Protein N-Glycosylation in Type 2 Diabetes Patients

Introduction. Diabetes is a growing global health challenge, necessitating effective management strategies. Glycosylation, a highly regulated post-translational protein modification, has emerged as a pivotal factor in diabetes pathophysiology. However, the modulation of protein glycosylation by antidiabetic treatment is still largely unknown. This study explored the longitudinal effects of four distinct antidiabetic therapies - metformin, insulin, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and glucagon-like peptide-1 receptor agonists (GLP-1RA) - on plasma protein and immunoglobulin G (IgG) glycosylation in patients with type 2 diabetes (T2D). Research Design and Methods. Plasma protein and IgG N-glycans were enzymatically released, purified and chromatographically profiled in a cohort of 124 patients, examined at four time points, to assess therapy-induced glycan alterations. Linear mixed models adjusting for covariates and multiple testing (FDR

02.
arXiv (CS.AI) 2026-06-17

Agentic AI-based Framework for Mitigating Premature Diagnostic Handoff and Silent Hallucination in Healthcare Applications

arXiv:2606.18068v1 Announce Type: new Abstract: Recent advances in Large Language Models (LLMs) and multi-agent systems have driven the rise of Agentic AI, showing promise for medical reasoning. However, open-ended conversational agents remain prone to two critical failure modes: premature diagnostic handoff and silent clinical hallucinations that may go undetected before reaching the patient. In this work, we propose a multi-agent framework that addresses both issues by replacing ``LLM-as-a-judge'' routing with deterministic orchestration constraints. The framework incorporates two safety mechanisms. First, a neuro-symbolic state-tracking gate enforces completeness of the OLDCARTS clinical protocol (Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, and Severity) by blocking diagnostic transitions until all required dimensions are collected. Second, an epistemic uncertainty quantification (UQ) gate computes semantic entropy (H) across K=5 independent diagnostic samples to identify and intercept divergent outputs before delivery. We evaluate the system using simulated patient agents powered by the llama-3.1-70b-instruct model on 150 test cases. The full architecture achieves 49.3% diagnostic precision, representing an absolute improvement of 11.3 percentage points over an unconstrained baseline. Additionally, we observe a statistically significant negative correlation (r = -0.181, p < 0.05) between OLDCARTS completeness (\sigma) and semantic entropy (H), suggesting that structured information gathering is associated with reduced diagnostic uncertainty.

03.
arXiv (quant-ph) 2026-06-12

Vacuum photon emission and mean electromagnetic field in pair-creating external backgrounds

arXiv:2606.12547v1 Announce Type: cross Abstract: We develop a perturbative description of vacuum radiative processes in quantum electrodynamics with a prescribed external electromagnetic background capable of producing electron-positron pairs. Since the initial vacuum is then unstable and the in- and out-vacua are inequivalent, radiative observables require a real-time formulation beyond the ordinary in-out approach of vacuum-stable QED. Using the Keldysh-Schwinger-Fradkin nonequilibrium technique, we derive the mean number density of emitted photons through the second nonvanishing order in the fine-structure constant. The leading term, of order $\alpha$, reproduces the known vertex and tadpole mechanisms, while the complete order-$\alpha^2$ correction contains interference, loop, and induced-current contributions. We also give an independent derivation based on the spectral decomposition of the identity operator in the in-Fock space, where the photon number density is represented as a sum of squared transition amplitudes and vacuum-disconnected terms are canceled by the optical theorem generalized to an unstable vacuum. In addition, we compute the mean electromagnetic field through order $e^3$, including the electromagnetic dressing of the induced vacuum current, and verify it using the corresponding Schwinger-Dyson equations. The final formulas are expressed in terms of exact solutions and propagators of the Dirac equation in the external background and apply to general spacetime-dependent field configurations.

04.
medRxiv (Medicine) 2026-06-16

The Target48 Neurodegeneration Panel: A Novel Tool for Profiling Protein Signatures in Neurodegenerative Disorders

Introduction: Novel tools for absolute quantification of established and emerging fluid neuro-biomarkers are required to advance diagnostic studies and improve biological insights. Methods: We conducted an extensive analytical and clinical validation of the Olink Target 48 Neurodegeneration panel (T48 Neuropanel) in 352 paired CSF and plasma samples from cognitively unimpaired controls (CU), Alzheimer dementia (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB), n=44 per group. Comparisons with benchmark assays were performed. Results: Good detectability (CSF: 31 out of 42 assays; plasma: 38 out of 42 assays) and technical performance was observed. Benchmark assays showed good correlations, supporting method transformation formulas. Next to emerging biomarkers (MMP10, ITGB2), discriminative performance was excellent in AD: CSF pTau217: AUC=1; FTD: plasma NfL: AUC=0.952; and DLB: CSF DDC: AUC=0.901. Discussion: This analytical and clinical validation of the T48 Neuropanel highlights initial cut-offs and emerging biomarkers to aid clinical studies for the diagnosis, prognosis, and monitoring of neurodegenerative diseases. Highlights: The T48 Neuropanel shows robust analytical performance, with high detectability across both plasma and CSF matrices. The T48 Neuropanel validates established (i.e., pTau217, Abeta42, NfL, and GFAP) and emerging biomarkers (i.e., DDC, MMP10, ITGB2, ITGAM, NPTX2, NPTXR, SMOC1, sTREM1, and sTREM2) in CSF and plasma. CSF NfL, GFAP, ITGB2, and ITGAM and plasma GFAP were dysregulated across AD, FTD, and DLB dementias. -The multiplex design of the T48 Neuropanel enables rich biological interpretation by simultaneously quantifying established and emerging neurodegeneration biomarkers. Importantly, the inclusion of absolute quantification facilitates the establishment of cut-offs, supporting its potential for clinical translation.

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

Quantum optical photoelectron interferometry

arXiv:2606.13447v1 Announce Type: new Abstract: We present a general theoretical framework for multiphoton processes driven by quantum light fields, establishing a direct link between photon statistics and photoelectron observables. Our results show that the autocorrelation and cross-correlation functions, which quantify the underlying photon statistics, are directly mapped onto the resulting photoelectron spectra. Although our framework is broadly applicable, we demonstrate specifically in the example of reconstruction of attosecond beating by interference of two-photon transitions (RABBIT) the influence of the light statistical properties. In this approach, the amplitude, contrast and phase of the oscillations of the sideband signal as a function of pump-probe delay reveal the quantum nature of light. We analyze these observables across several quantum configurations, including correlated infrared and harmonic modes, as well as the uncorrelated case with non-classical harmonic statistics, thereby establishing a general framework for quantum-light RABBIT spectroscopy. We compare the analytical theory with numerical simulations for the case of classical harmonics and an infrared field in a squeezed coherent state, obtaining excellent agreement. Our results reveal how the interplay between classical and quantum correlations dictates the coherence of the photoemission process, providing a new window into the quantum-optical foundations of attosecond science.

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

Experimental Characterization and Modeling of Measurement-Induced State-Transitions in a Fluxonium Superconducting Qubit

arXiv:2606.17866v1 Announce Type: new Abstract: Superconducting qubits are most often measured using dispersive readout, which, ideally, implements a projective quantum non-demolition (QND) measurement. While a larger readout drive can increase the signal and, thus, reduce discrimination errors in the readout, strong microwave drives may also cause non-QND errors by driving the qubit to a state outside the computational subspace. In this work, we experimentally characterize measurement-induced state transitions (MIST) in a fluxonium qubit over its full external flux range. We further numerically calculate the MIST errors, and find that the theory accurately predicts eleven experimentally identified regions with increased MIST. In addition to transitions to higher fluxonium levels, we also find that, at certain flux points, MIST errors are dominated by transitions that include the transmission-line-like array modes of the fluxonium's superinductor. The excellent match between theory and experiment validates that the models accurately predict the occurrence of MIST in these systems, and further highlights the influence of array modes in fluxonium readout.

07.
arXiv (quant-ph) 2026-06-25

Modelling the Impact of Device Imperfections on Electron Shuttling in SiMOS devices

arXiv:2512.03853v3 Announce Type: replace Abstract: Extensive theoretical and experimental work has established high-fidelity electron shuttling in Si/SiGe systems, whereas demonstrations in Si/SiO2 (SiMOS) remain at an early stage. To help address this, we perform full 3D simulations of conveyor-belt charge shuttling in a realistic SiMOS device, building on earlier 2D modelling. We solve the Poisson and time-dependent Schrodinger equations for varying shuttling speeds and gate voltages, focusing on potential pitfalls of typical SiMOS devices such as oxide-interface roughness, gate fabrication imperfections, and charge defects along the transport path. The simulations reveal that for low clavier-gate voltages, the additional oxide screening in multi-layer gate architectures causes conveyor-belt shuttling to collapse to the bucket-brigade mode, inducing considerable orbital excitation in the process. Increasing the confinement restores conveyor-belt operation, which we find to be robust against interface roughness, gate misalignment, and charge defects buried in the oxide. However, our results indicate that defects located at the Si/SiO2-interface can induce considerable orbital excitation. For lower conveyor gate biases, positive defects in the transport channel can even capture passing electrons. Hence we identify key challenges and find operating regimes for reliable charge transport in SiMOS architectures.

08.
arXiv (quant-ph) 2026-06-12

QuBE/Qubex: an integrated hardware-software system for superconducting qubit experiments with broadband control

arXiv:2606.13010v1 Announce Type: new Abstract: Achieving high-fidelity operation in large-scale superconducting qubit systems requires not only control hardware with broad frequency coverage, low crosstalk, and tight synchronization but also software that coordinates system configuration, experiment execution, and data analysis. Here we present an integrated qubit-control system that combines broadband microwave hardware with a pulse-level software stack for scalable superconducting qubit experiments. The hardware provides broadband microwave coverage, including an instantaneous span of up to 1.6 GHz from a control output, while the software reduces setup and calibration overhead through automated configuration and built-in experiment workflows. We validate the system on a 64-qubit fixed-frequency transmon chip through full-chip frequency identification and representative demonstrations, including multi-unit far-detuned cross-resonance calibration and benchmarking that yields a measured two-qubit gate fidelity of 98.34%, and multilevel readout beyond the computational subspace. By disclosing the hardware architecture and releasing the software stack as open source, this work provides an inspectable hardware-software foundation for scalable superconducting qubit control experiments.

09.
medRxiv (Medicine) 2026-06-17

Targeted Proteomic Profiling of Nasal Fluid from the Brain-Nose Interface

The brain-nose interface is an anatomical junction where olfactory neurons from the olfactory bulb traverse the cribriform plate into the nasal mucosa, providing minimally invasive access to the central nervous system (CNS). We hypothesized that nasal fluid from this region could enable detection of neurology-relevant proteins using targeted multiplex assays. Using nosecollect, a targeted nasal sampling device, nasal fluid proximal to brain-nose interface was collected from cognitively impaired patients, alongside matched cerebrospinal fluid (CSF) and plasma. After nasal sample-specific dilution optimization and intra-assay precision evaluation, all matrices were profiled with the Olink Target 96 Neurology and NUcleic acid Linked Immuno-Sandwich Assay CNS disease 120 (NULISAseq CNS Disease 120) panels. Nasal fluid showed technically repeatable detection (intra-assay coefficient of variation

10.
medRxiv (Medicine) 2026-06-16

Validation of a Smartphone-Image-Based Computer-Vision Model for Lean Mass and Body Fat Estimation Against Dual-Energy X-ray Absorptiometry

Introduction Body composition, rather than body weight alone, is an increasingly important health metric, and preservation of lean mass has become a central concern in obesity treatment, aging, and chronic disease management. Dual-energy X-ray absorptiometry (DXA) provides accurate assessment of fat and lean tissue, but its cost and logistical requirements limit repeated measurement. Computer-vision approaches show promise for estimating adiposity from smartphone images, but lean-mass estimation remains less established. Methods We evaluated a computer-vision body composition model, applied to consumer-grade smartphone photographs, against DXA in a held-out validation sample of 195 adults from an ongoing cross-sectional study. Body fat percentage and total lean mass percentage were co-primary outcomes; for total lean mass percentage, an image-only configuration (no added covariates) was pre-specified as primary. Agreement was quantified using Lin's concordance correlation coefficient (CCC) as the lead statistic, with Pearson correlation, mean absolute error, root mean square error, mean bias, and Bland-Altman limits of agreement. In secondary analyses, appendicular lean mass and total lean mass percentage were each estimated with and without routine anthropometric and demographic inputs (body weight, height, age, and sex). Results Total lean mass percentage agreed with DXA from image features alone (CCC 0.916). Body fat percentage, estimated with routine inputs added, agreed at least as closely (CCC 0.930). Adding routine inputs barely changed agreement for total lean mass percentage but markedly improved it for appendicular lean mass, an absolute quantity that scales with body size. Conclusions A smartphone-image-based model estimated both body fat and lean mass with strong agreement to DXA, with lean mass percentage from image features alone. The approach needs no fixed equipment or ionizing radiation. Whether it can track change over time, including in incretin-based weight loss where lean mass preservation is a concern, was not assessed in this cross-sectional study.

11.
medRxiv (Medicine) 2026-06-15

Two Blood-based Endotypes Reveal Divergent Clinical Outcomes of Fibrotic Hypersensitivity Pneumonitis

Rationale: Fibrotic hypersensitivity pneumonitis (fHP) is an antigen-driven, life-threatening interstitial lung disease characterized by heterogeneous radiologic features, clinical outcomes, and treatment responses. Objectives: To identify blood-based fHP endotypes that inform mechanism, prognosis and therapeutic response. Methods: We performed integrative analyses of multi-compartment transcriptomic data derived from whole blood, peripheral blood mononuclear cells, bronchoalveolar lavage, and surgical lung biopsies, alongside circulating plasma proteomics. Multiple clustering algorithms were cross-compared to ensure robustness and reproducibility of endotypes identification. Immune cell composition was inferred using bulk RNA-seq deconvolution and annotated with BAL single-cell RNA-seq. Pathway activities were characterized using Gene Set Enrichment Analysis. Transplant-free survival (TFS) was evaluated for endotype and corticosteroid exposure by Kaplan-Meier methods, with hazard ratios analyzed using multivariable Cox proportional hazards models. Results: Two molecular endotypes, lymphocytic-associated (L-fHP) and non-lymphocytic-associated (N-fHP), were identified and validated. L-fHP showed enrichment of adaptive immune signaling and lymphocyte predominance, whereas N-fHP demonstrated myeloid-cell activation with neutrophil and macrophage predominance. Corticosteroid exposure was associated with worse TFS in L-fHP but not in N-fHP after adjusting for age, sex, and baseline pulmonary function. Compared to L-fHP, N-fHP had poorer baseline pulmonary function, faster 12-month FVC decline, and shorter TFS. N-fHP also exhibited elevated neutrophil-associated markers, including matrix metalloproteinase-9, across paired transcriptomic and proteomic datasets, supporting a neutrophil-driven, cross-compartment disease process. Conclusion: Multi-omic, multi-compartment analysis identifies two reproducible fHP endotypes with distinct clinical outcomes and corticosteroid responses, supporting a precision medicine approach beyond current clinical and radiologic classification.

12.
arXiv (quant-ph) 2026-06-16

The Inverse Born Rule Equivalence. On the Informational Limits of Real-Valued Amplitude Encodings and the Measurement of Quantum Advantage in Data Embeddings

arXiv:2602.21350v2 Announce Type: replace Abstract: When does quantum data encoding provide genuine quantum advantage, and when does it merely rephrase a classically solvable problem? We prove an Equivalence Theorem demonstrating that any encoding mapping classical data to real-valued amplitudes, $\vert\psi_c\rangle = \sum_i c_i \vert i\rangle$ with $c_i \in \mathbb{R}$ and $\sum_i c_i^2 = 1$, composed with a data-independent parameterised unitary and computational-basis measurement, yields exactly the class of classical quadratic forms. We identify the geometric mechanism driving this collapse: the restriction to $\mathbb{R}$ forces a vanishing Berry connection, removing the complex phases required for data-dependent quantum interference. To operationalize this boundary, we introduce encoding diagnostics – phase complexity $C[\Phi]$ and mode-wise von Neumann mutual information $I[\Phi]$ – and link them to the information-geometric excess $\Delta g$. We show that for all real-valued encodings, $\Delta g = 0$ identically. We term the misidentification of such models as evidence of quantum computational power the Inverse Born Rule Fallacy. Supported by numerical experiments, our results establish that complex-phase structure is a strictly necessary condition for data-driven (Type~B) quantum advantage.

13.
arXiv (CS.AI) 2026-06-18

Learning-Based Decision Making for Combustion Phasing Control in Multi-Fuel CI Engines with Latent Fuel Reactivity Estimation

arXiv:2606.18393v1 Announce Type: cross Abstract: Multi-fuel compression-ignition engines offer fuel flexibility but introduce uncertain, time-varying fuel reactivity, represented by cetane number (CN), which complicates cycle-to-cycle combustion-phasing control. This work formulates CA50 regulation under latent CN variation as a partially observable sequential decision problem and systematically evaluates controllers with increasing temporal and representational capacity, including LinUCB, history-augmented contextual bandits, observation-only DDPG, recurrent DDPG, and a proposed GRU-guided RL framework. A Gaussian-process surrogate trained on experimental multi-fuel engine data provides a controlled and reproducible evaluation environment. Results show that myopic and fixed-history bandit methods degrade under CN variation, observation-only RL suffers from latent-state aliasing, and generic recurrence is insufficient when CN evolves rapidly. The proposed framework learns a compact GRU-based representation of fuel reactivity from combustion history and conditions both actor and critic on this estimated signal rather than oracle CN. By training the policy on the same imperfect fuel-reactivity information available at deployment, the controller avoids train-deploy inconsistency in conventional online estimate-then-control pipelines. Across unseen CN trajectories, the policy achieves stable CA50 regulation with mean absolute tracking error below 0.25{\deg} CA at the training setpoint, while producing smooth, physically consistent SOI and glow-plug-power actuation. These results show that combustion control under latent, continuously evolving fuel dynamics requires more than standalone estimation or generic recurrence. By aligning fuel-reactivity inference with control policy learning, the proposed framework enables reactivity-aware decision-making using the same estimated state available during deployment.

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

PiDA: Phonetically-Informed Data Augmentation for Robust Vietnamese Speech Translation

Cascaded speech translation (ST) systems suffer from error propagation when Automatic Speech Recognition (ASR) outputs incorrect transcripts. We present the first systematic categorization of ASR errors for Vietnamese ST, classifying substitution errors by phonetic cause and quantifying their impact on downstream Neural Machine Translation (NMT) performance using Linear Mixed-Effects Modelling. We confirm that most ASR substitution errors arise from phonetic confusions rather than random noise, and that these phonetic errors significantly degrade ST quality. Motivated by this finding, we propose Phonetically-Informed Data Augmentation (PiDA), which generates ASR-like corruptions by substituting words with phonetically similar alternatives using phonetic word embeddings. Fine-tuning on a PiDA-augmented version of FLEURS Vietnamese-English improves translation of erroneous ASR outputs (up to +2.04 BLEU over standard fine-tuning) while also slightly improving clean-text performance.

15.
medRxiv (Medicine) 2026-06-12

Crimean-Congo haemorrhagic fever virus transmission: exploring perceptions of human-animal-tick interactions across six districts in Uganda

Crimean-Congo haemorrhagic fever virus (CCHFV) causes a viral zoonotic disease transmitted through tick bites and direct contact with infected blood or tissue of infected animals. Socio-ecological and behavioural risk factors for CCHFV exposure in Uganda remain poorly understood, which can lead to the omission of key risk factors in quantitative survey design and limit our wider understanding. In this study, we explored human-animal-tick interaction transmission risks in Uganda. We conducted 24 focus group discussions (FGDs) and 31 key-informant interviews (KIIs) across six environmentally and socio-ecologically diverse districts, between October 2023 and March 2024. Study sites were selected using K-prototype analysis, which combined environmental and socio-ecological variables to identify distinct clusters within Uganda. FGDs were conducted separately with groups of community leaders, men, women and teenagers with stratified purposive sampling. Medical doctors, veterinarians, traditional healers, district surveillance officers, and herdsmen were individually interviewed as key informants and purposively sampled. Data were transcribed and translated into English, and analysed thematically using iterative categorisation in NVivo 14. Most participants reported tick bites, some as frequently as every day. Close contact with animals was common, including sleeping next to them in the same building, largely due to concerns about animal theft. Less frequent but notable practices included slaughtering animals for consumption or sacrifice and interactions with wild animals during hunting. Slaughtering and butchering an animal which was sick or had died was reportedly performed by participants in most districts. Plucking and roasting engorged ticks was a practice described in the Kaabong and Arua districts of Northern Uganda. These practices and behaviours highlight potential key risks of CCHFV transmission and underscore the need for future studies to address specific behaviours, to quantify if, and to what extent, they present an exposure risk. Further work should include underlying reasons for the behaviours, which would help ensure that culturally appropriate interventions are targeted.

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

Uncertainty Is Not a Safety Net for Clinical VQA, but Can It Anticipate Model Failure?

Safe deployment of clinical vision-language models (VLMs) requires reliable uncertainty estimation (UE): a signal indicating when predictions should be trusted or escalated to a clinician. We test whether current UE methods actually deliver this signal. Benchmarking 8 methods across 12 VLMs on clinical visual question-answering (VQA), we find that UE quality is not an intrinsic property of the UE method: it tracks model accuracy, degrading precisely where the model performance is weakest, and therefore where reliability is most needed. When we stress-test models by hiding the correct option among the multiple-choice answers (NOTA perturbations), accuracy collapses while uncertainty barely changes, leaving models systematically miscalibrated. Yet, we find that uncertainty on the unperturbed input reliably anticipates which predictions will collapse under NOTA, indicating that UE in current VLMs carries diagnostic information about model fragility. Our results position UE as a diagnostic tool for identifying fragile predictions and motivate perturbation-based evaluation as a path toward safe clinical deployment.

17.
medRxiv (Medicine) 2026-06-24

Pembrolizumab, Temozolomide and HSPPC-96 Vaccine in Newly Diagnosed Glioblastoma Post-Chemoradiation: Results from a Multi-institutional, Phase 2, Randomized, Placebo-Controlled Trial

Background: GBM is one of the most common and most aggressive brain tumors in adults, and upfront standard of care treatment has limited efficacy. Immune checkpoint inhibitor strategies have significantly improved outcomes in various solid tumors but have not proven effective in GBM, suggesting other strategies may be needed to realize their full potential. Methods: GBM patients were treated with upfront standard of care chemoradiation with temozolomide and pembrolizumab, followed by adjuvant temozolomide and pembrolizumab for six nine-week cycles. Depending on production of sufficient vaccine, patients were randomized into HSPPC-96 vaccine or placebo group (q4 weeks) while those with failed vaccine production continued on study unblinded as an ancillary group. The primary objective was overall survival at one year, and secondary endpoints were progression-free survival at six months, overall and progression-free survival, radiographic response, and tolerability by patient-reported outcomes and adverse event documentation. Results: 90 patients were screened, 32 were treated (8 vaccine, 9 placebo, 15 ancillary), and 26 were evaluable for radiographic responses prior to accrual termination. The study did not meet its primary endpoint of overall survival at one year (65.5% in vaccine group, 75% in placebo). Progression-free endpoints were mildly improved in the vaccine group but were not significant, and response rates were not significantly different. The regimen was well-tolerated and safe. Conclusions: Though limited by early discontinuation, these findings do not support the combination of pembrolizumab and HSPPC-96 vaccine with standard of care therapy. Trials Registration: ClinicalTrials.gov identifier: NCT03018288

18.
arXiv (math.PR) 2026-06-24

Queues with Correlated Service Times – the $M/M_D/c$ Model

arXiv:2606.24881v1 Announce Type: new Abstract: This paper studies multi-server queueing systems with correlated service times, modeled as the $M/M_D/c$ queue, which is a natural extension of the recent work by Thapa and Zhao [Thapa-Zhao:2026]. In this model, arrivals follow a Poisson process, while service times across servers exhibit dependence captured by the Marshall–Olkin multivariate exponential distribution (MO-MVED). We first develop a rigorous sample-path construction of the system and establish that the resulting queueing process is a continuous-time Markov chain. We then analyze the stationary behavior of the $M/M_D/c$ model. In the homogeneous case, we derive a complete solution via geometric tail structure and explicit boundary equations, recovering a tractable one-dimensional representation. In the heterogeneous case, we establish a general framework combining a geometric tail with a finite boundary system, and prove existence, uniqueness, and nonnegativity of the stationary distribution. The above results provide a unified analytic framework extending classical $M/M/c$ theory to correlated-service settings, and reveal how dependence among service times fundamentally affects system performance and structure. Beyond the $M/M_D/c$ model, We next study the interplay between Marshall–Olkin service dependence and queue-state Markovianity. On the one hand, Marshall–Olkin dependent service completions are shown to preserve Markovianity for a broad class of queueing systems. On the other hand, if a queueing process admits a Markovian state description without tracking service ages, residual service times, or service phases, then its service mechanism must satisfy a weak multivariate lack-of-memory property and consequently belongs to the Marshall–Olkin family. These results provide a probabilistic foundation for the use of Marshall–Olkin multivariate exponential service times in Markovian queueing models.

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

Self-Prompting Small Language Models for Privacy-Sensitive Clinical Information Extraction

Clinical named entity recognition from dental progress notes is challenging because documentation is highly unstructured, domain-specific, and often privacy-sensitive. We developed a locally deployable framework that enables small language models to self-generate, verify, refine, and evaluate entity-specific prompts for extracting multiple clinical entities from dental notes. Using 1,200 annotated notes, we evaluated candidate open-weight models with multi-prompt ensemble inference and further adapted selected models using QLoRA-based supervised fine-tuning and direct preference optimization. Model performance varied substantially, highlighting the need for task-specific evaluation rather than reliance on generic benchmarks. Qwen2.5-14B-Instruct achieved the strongest baseline performance. After DPO, Qwen2.5-14B-Instruct and Llama-3.1-8B-Instruct achieved micro/macro F1 scores of 0.864/0.837 and 0.806/0.797, respectively. These findings suggest that automated prompt optimization combined with lightweight preference-based post-training can support scalable clinical information extraction using locally deployed small language models.

20.
arXiv (quant-ph) 2026-06-24

Offline Channel-Independent QAOA Angles for RIS Power Aggregation: Unit-Circle Phase Dictionaries and Infinite-Size Spin-Glass Limits

arXiv:2606.24540v1 Announce Type: new Abstract: Reconfigurable intelligent surfaces (RIS) maximize received power by setting per-element phases. Discrete-phase optimization is NP-hard in the worst case, while the quantum approximate optimization algorithm (QAOA) applied to RIS faces limited phase alphabets, either per-problem angle optimization or uncharacterized training cost exposed to barren plateaus, and no scalable performance benchmark. We introduce a $2^{M}$-phase $\theta$ dictionary for optimizing power $\|\mathbf{A} \, e^{j\theta}\|^{2}$ having $K \times N$ channel matrix $\mathbf{A}$ and QAOA angle offline optimization with instance and size-independent infinite-size limit of the mixed-$q$ Gaussian ensemble of Basso et al. Our design bounds the spin-Hamiltonian interaction order to at most quartic for any $M$, and the deployed order-2 reduction lies below the even-$q\!\ge\!4$ regime in which constant-level QAOA limitations are proved. We perform analytical, state-vector, matrix-product-state and Pauli-path-simulation numerical studies for $N=K \leq 100$ and QAOA depth $p=9$, verifying offline angle transfer to Rayleigh, Rician/line-of-sight, cascaded double-fading and spatially-correlated RIS channels at $N\!\in\!\{5,12\}$. We observe performance reaching a near-optimal multi-start single-flip local-search reference for $N\!\le\!16$ under order-2 modeling with $2^{5}{=}32$-phase dictionary while the order-4 model shows a performance ceiling below the classical reference. The approach suggests a route to near-optimal large-$N$ performance on future fault-tolerant (FTQ) quantum computers, which enable the higher-depth QAOA circuits.

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

Plan, Don't Pose: Long Composite Motion Generation with Text-Aligned BFM

arXiv:2605.29906v2 Announce Type: replace Abstract: Text-to-motion (T2M) generation has broad applications in character animation, virtual avatars, and human-robot interaction. Existing methods typically generate pose trajectories or motion tokens directly from language, forcing a single model to handle semantic interpretation, long-horizon structure, and low-level physical realization. This coupling makes them costly and often unreliable for long, compositional, or semantically dense prompts. We propose Text2BFM, the first framework that aligns natural language with pretrained Behavioral Foundation Models (BFMs) for T2M generation without relying on heavy end-to-end motion generators. Text2BFM operates in the latent policy space of a frozen BFM, using it as an executable motion prior. A text-aligned variational behavioral bottleneck compresses BFM policy-latent sequences into compact motion representations that are compatible with language and preserve long-horizon behavioral structure. Generation is performed in this compact behavioral manifold with a lightweight conditional generator, and the resulting latent encoded behaviors are decoded into policy latents that drive the pretrained frozen BFM. By decoupling semantic planning from motion execution, Text2BFM achieves efficient, robust T2M generation and strong performance on long, compositional textual descriptions.

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

Are LLM Evaluators Really Narcissists? Sanity Checking Self-Preference Evaluations

Recent research has shown that large language models (LLMs) favor their own outputs when acting as judges, undermining the integrity of automated post-training and evaluation workflows. However, it is difficult to disentangle which behaviors are explained by narcissism versus experimental confounds. Specifically, LLM evaluators may deliver self-preferring verdicts when comparing responses to questions they fail on; these verdicts may not depend on the identity of the author, but on evaluator quality. We correct this by directly comparing the judge's voting distribution in cases where it evaluates itself versus another model. This evaluator quality baseline reveals that only 51% of examples in previous findings retain statistical significance against this null hypothesis, covering 89.6% of total self-preference probability mass. Finally, we compare the entropy of voting distributions, suggesting uncertainty-driven overlap, and show that our procedure enables more careful documentation against the backdrop of judge-bias research.

23.
arXiv (CS.CV) 2026-06-11

How Seemingly Inconsequential Design Choices Dictate Performance of LLMs in Pathology

General-purpose large language models (LLMs) are routinely used as baselines when evaluating specialized pathology models on whole-slide images (WSIs). Because WSIs exceed contemporary model context limits, LLM baselines routinely use small, high-magnification patches processed independently via majority voting, without systematic evaluation of seemingly inconsequential design choices such as patch size, patch count, and magnification. Generalist LLMs have consistently underperformed specialized systems, reinforcing the perception that domain-specific training or architectural adaptation is necessary for pathology tasks involving WSIs. Here, we conduct a systematic factorial analysis of four input design factors: inference mode, patch size, magnification, and patch count. We demonstrate that prior studies have overstated the gap between specialized models and general-purpose LLMs by choosing non-optimized input configurations. On the MultiPathQA benchmark, switching to a single balanced configuration (large patches at lower magnification, processed jointly) raises GPT-5 from 15.1% to 39.5% on cancer-type classification (TCGA) and from 38.1% to 62.9% on organ classification (GTEx). Per-task optimization yields further gains up to 43.9% (TCGA) and 71.6% (GTEx). The same configuration generalizes to two other models and to a fully held-out CPTAC cohort, where it improves Gemini 3 Flash by 23.4 percentage points without any task-specific tuning.

24.
arXiv (CS.AI) 2026-06-11

Generalizing Beyond Suboptimality: Offline Reinforcement Learning Learns Effective Scheduling through Random Solutions

arXiv:2509.10303v2 Announce Type: replace-cross Abstract: Online reinforcement learning (RL) approaches have demonstrated strong performance on Job Shop Scheduling (JSP) and Flexible JSP (FJSP) problems by learning scheduling policies through direct interaction with simulated environments. However, these methods often require extensive training interactions, limiting their sample efficiency and practical applicability. Motivated by this challenge, we introduce Conservative Discrete Quantile Actor-Critic (CDQAC), an offline RL algorithm that learns effective scheduling policies directly from static, suboptimal datasets. CDQAC couples a quantile-based critic with delayed policy updates to estimate the return distribution of machine-operation pairs. Extensive experiments on JSP and FJSP benchmarks demonstrate that CDQAC consistently outperforms the data-generating heuristics, surpasses state-of-the-art offline and online RL baselines, and is highly sample efficient, requiring only 1 to 5% of the original dataset to learn high-quality policies. Our analysis suggests that, in scheduling, offline RL performance is governed mainly by state-action coverage rather than the quality of individual trajectories. Scheduling couples a dense reward aligned with the makespan objective with equal-length trajectories across heuristics, enabling effective learning from a broad range of behaviors. Consistent with this observation, datasets generated by a simple random heuristic with broader coverage let it outperform policies trained on datasets produced by stronger heuristics such as Genetic Algorithms.

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arXiv (CS.AI) 2026-06-16

GIST-CMTF: Goal-State Inference for Causal Minimal Tool Filtering in LLM Agents

arXiv:2606.16813v1 Announce Type: new Abstract: Tool-augmented LLM agents rely on runtime filtering to decide which tools should be visible at each step. Causal Minimal Tool Filtering (CMTF) reduces tool-choice confusion by exposing only the next causally necessary tool frontier, but it assumes that the user request has already been mapped to a symbolic goal state. In practice, requests such as "handle my appointment" or "take care of this email" may correspond to multiple possible goals. This creates wrong-goal execution, where an agent follows a valid causal tool path for an unintended objective. We introduce GIST-CMTF, a goal-state inference layer that predicts candidate symbolic goals over the same state-transition vocabulary used by CMTF, estimates ambiguity, and either applies CMTF or exposes clarification as a causal action that produces missing goal or state variables. We evaluate GIST-CMTF across seven model backends, six filtering methods, and 120 controlled tool-use tasks. GIST-CMTF achieves 97.0% task success, compared with 80.1% for top-goal CMTF and 82.9% for semantic-goal CMTF. It reduces wrong-goal execution from 19.4% under top-goal CMTF to 2.5%, while preserving the one-tool exposure of causal filtering and using substantially fewer tokens than all-tools exposure. These results suggest that reliable tool-augmented agents should validate goal state, not only tool relevance, before exposing external actions.