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01.
arXiv (math.PR) 2026-06-15

Laws of Large Numbers for Non-Independent Random Variables on Hyperspaces with respect to the Hausdorff Metric

arXiv:2011.07199v5 Announce Type: replace Abstract: This paper investigates the limit behavior of the Minkowski sums for sequences of set-valued random variables. When the underlying space is finite dimensional, by using the support function, we establish the weak and strong laws of large numbers for non-independent random variables in the hyperspace with respect to the Hausdorff metric $d_H$.

02.
arXiv (CS.CL) 2026-06-12

Trait, Not State: The Durability of Reading Identity in Social Highlighting

Prior work on a social web highlighter located individuality in selection – which documents a person chooses to highlight – but measured it cross-sectionally. We ask the temporal question: is a reader's selection signature a trait or a state? We freeze each reader's first six months of highlighting as a profile and track its own-vs-other advantage on their later selections at growing gaps (to 24+ months), with negatives drawn from the same calendar era – so supply drift cannot masquerade as personal drift – at a coarse global level and at a fine level whose negatives and controls come from the reader's own interest neighborhood; the anchor cell reproduces the prior cross-sectional level (+0.188 vs +0.169), validating the harness. Four results. Within the same users, the fine-layer advantage shows no statistically detectable paired decline at any horizon (6-12 month retention R = 1.00 [0.85, 1.18], n = 212; the farthest bin is compatible with a modest decline; the only contrast whose interval excludes zero is the coarse layer at 12-24 months, about 13%). The signal is not reducible to repeated domains (~90% survives excluding all profile sources). Within-person drift is slow (a recent-half profile beats the old half by +0.042). Prospectively, personal profiles – even one built from a reader's earliest documents, median 20 months before evaluation – rank their next reads at roughly 3x the AP of every simple non-personal prior tested. We use "trait" operationally (a stable signature under continued engagement); the scope is heavy, long-tenured readers of one platform, and exposure is not separable from choice.

04.
arXiv (CS.CL) 2026-06-12

Beyond Uniform Tokens: Adaptive Compression for Time Series Language Models

Large language models (LLMs) have enabled time series (TS) analysis by jointly modeling numerical observations and textual context through a shared token interface. However, TS tokens and prompt tokens exhibit fundamentally different information structures, making uniform token processing inefficient. In this paper, we study token efficiency in TS language modeling from an asymmetric-token perspective. We show that TS tokens have highly uneven spectral contributions, where many tokens share redundant frequency patterns while a small subset preserves critical temporal evidence. We also observe that prompt-token influence attenuates with model depth, suggesting that full prompt retention across all layers is unnecessary. Based on these findings, we develop an adaptive token budgeting framework that compresses TS tokens via frequency-domain structure and progressively reduces prompt tokens across layers. Experiments across forecasting, classification, imputation, and anomaly detection demonstrate up to 7.68$\times$ inference acceleration and performance gains in 78\% of evaluated settings, showing the effectiveness of asymmetric token compression for scalable TS foundation models.

05.
arXiv (quant-ph) 2026-06-16

Improved Cryogenic Photodiode Optical Biasing for Low-Noise and Low-Jitter Superconducting Nanowire Single-Photon Detectors

arXiv:2606.07140v2 Announce Type: replace Abstract: We experimentally demonstrate an improved optical biasing scheme for superconducting nanowire single-photon detectors (SNSPDs), which employs a cryogenic InGaAs-InP photodiode (PD) as a local bias source. It is found that, under illumination from a stable external light source, this PD generates a stable photocurrent in a cryogenic environment (~2.3 K), with fluctuations in the photocurrent primarily attributed to fluctuations in the incident optical power. Furthermore, by screening and effectively blocking stray photons leaking from the PD, which give rise to background dark counts, we have achieved an SNSPD exhibiting an ultra-low intrinsic dark count rate of 1e-4 cps. Utilizing this improved optical biasing technique, our SNSPD achieved performance comparable to that obtained under conventional electrical biasing: a system detection efficiency of 80.7%, a background dark count rate of 32.6 cps, and a minimum timing jitter of 57.5 ps. These results indicate that cryogenic-PD-based optical biasing serves as a viable, low-noise, and low-jitter alternative to traditional electrical biasing. Moreover, this work offers useful design guidance for the future development of PD-based low-noise bias sources and for the construction of all-photonic SNSPD systems tailored for high-precision quantum photonics applications.

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

Pruning via Causal Attribution Preserves Reasoning Performance in Large Language Models

Large language models (LLMs) excel at multi-step reasoning but incur substantial inference cost. We introduce Causal Attribution Pruning (CAP), a training-free method that identifies critical attention heads by measuring their causal impact on reasoning tasks and uses these head-level scores to guide fine-grained weight pruning. For each attention head, CAP estimates the expected performance degradation when the head is masked during forward passes on a small calibration set of reasoning problems. These causal scores are then converted into weight-level importance values for the corresponding projection matrices. Unlike magnitude-only or activation-based criteria, CAP's interventional measurement directly captures each head's functional contribution, yielding relative accuracy gains of up to 61% over Wanda on ARC-Challenge at 20% sparsity. We evaluate CAP on GSM8K, StrategyQA, and ARC-Challenge using Llama-3-8B-Instruct and Mistral-7B-Instruct at 10%, 20%, and 50% sparsity. At moderate sparsity (10-20%), CAP improves over Wanda in most model-benchmark configurations. with especially large gains on ARC-Challenge for Llama-3. Our results suggest that attention-head-level causal attribution can better preserve reasoning performance on downstream benchmarks than correlational pruning criteria at equivalent sparsity, while remaining limited by coarse MLP attribution at 50% sparsity.

07.
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.

08.
arXiv (CS.AI) 2026-06-24

Random Rule Forest (RRF): Interpretable and Manageable Ensembles of LLM-Generated Questions for Predicting Success from Unstructured Data

arXiv:2505.24622v3 Announce Type: replace Abstract: Many high-stakes screening tasks require predicting rare outcomes from unstructured text, where errors are costly and decisions must be auditable. We introduce Random Rule Forest (RRF), an interpretable ensemble that uses a large language model (LLM) not as an end-to-end predictor but as a generator of simple YES/NO questions. Each question acts as a weak learner, and their responses are combined by a plain unit-weight vote into an auditable ``green-flags'' scorecard: enough independent positive signals indicate a higher chance of success. We argue this deliberate simplicity is a robust default when positives are scarce and learned weights are hard to estimate. We evaluate RRF in two low-base-rate domains. On early-stage startup screening from founder profiles, RRF produces a transparent scorecard whose precision is several times the base rate (with light expert input raising it further) and, unlike direct prompting, its operating point can be controlled directly. On an established Phase~I clinical-trial benchmark, RRF outperforms published baselines on the threshold-independent metrics PR-AUC and ROC-AUC. Together these show that LLMs can serve as auditable feature generators for high-stakes text-based decisions, combining transparency with competitive predictive performance.

09.
arXiv (CS.LG) 2026-06-12

Deep Sleep Classification via EEG Signal Criticality: A Passive BCI Approach for Sleep-Improvement Neurofeedback

arXiv:2606.13017v1 Announce Type: cross Abstract: Automated sleep staging is a fundamental application of passive Brain-Computer Interfaces (pBCI), decoding spontaneous neural states to enable closed-loop interventions independent of user intent. This study evaluates criticality features derived from Detrended Fluctuation Analysis (DFA) for the specific identification of deep sleep (N3). We analyzed $347,232$ EEG epochs from $290$ older women using UMAP manifold learning to visualize state transitions. Subsequently, six classifiers were benchmarked via 10-fold cross-validation, using balanced accuracy to determine the optimal "state-sensing" engine for neurofeedback.Naive Bayes achieved the highest mean balanced accuracy ($87.17\% \pm 0.24\%$), significantly outperforming a fully connected deep neural network (FNN: $81.58\%$) and Random Forest ($80.97\%$). Linear models (LDA: $57.21\%$; SVM: $51.01\%$) performed poorly, indicating that DFA-derived criticality features reside on a distinct, non-linear manifold. Probabilistic decoding of EEG criticality provides a high-accuracy sensing mechanism for pBCIs. This robust classification pipeline supports the development of state-dependent neurofeedback, such as targeted auditory stimulation, to enhance cognitive recovery.

10.
arXiv (quant-ph) 2026-06-16

Symmetry Breaking through Superselection by Boundary Conditions

arXiv:2606.15272v1 Announce Type: cross Abstract: Spontaneous symmetry breaking (SSB) is central to modern physics but is conventionally defined only for infinite systems, raising challenges for its interpretation in finite, real-world setups. This paper argues that the key to resolving this issue lies in the underappreciated role of boundary conditions in quantum systems. Inspired by both the relational approach to symmetries and the physical mechanism behind symmetry breaking, we formulate a relational interpretation of SSB: a finite system exhibits SSB relative to a reference environment which can induce perturbations across the boundary. This eliminates the need for the thermodynamic limit, offering a more physical picture of SSB that emphasizes the observable consequences of the interactions that real-life systems inevitably have with their environment. We show how, in this relational interpretation, SSB for both lattice systems and (gauge) field theories should be understood as subtle, rather than spontaneous, symmetry breaking, still in contrast to explicit symmetry breaking. We also explain how algebraic definitions of SSB for infinite systems relate to the intuitive picture of SSB in finite systems and illustrate how asymptotic boundary conditions push the environment "to infinity". In this way, our relational interpretation of SSB provides a unified conceptual framework applicable to symmetry-breaking in systems of any size.

11.
PLOS Medicine 2026-05-29

Characterization of the VHH-Fc construct rimteravimab in healthy adults and patients hospitalized for mild-to-moderate COVID-19: Two Phase 1 randomized clinical trials

Authors:

by Ellen Jansen, Viki Bockstal, Florence Herschke, Per Olsson Gisleskog, Manuela Rinaldi, Angélique Boerboom, Salah Hadi, Natalia Gaibu, Michel Moutschen, Dominique Tersago Background Variable Heavy domain of Heavy chains (VHH) are innovative tools to target unique epitopes, yet few have been developed as heavy chain-only antibodies for clinical use. Rimteravimab (referred to here as XVR011) is a humanized antibody developed for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19), consisting of two identical VHHs targeting the receptor binding domain (RBD) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike, with a human immunoglobulin (Ig) G1 fragment constant of antibody (Fc), silenced for Fc effector functions. We conducted two Phase 1 studies in healthy volunteers or hospitalized COVID-19 patients to evaluate its safety, tolerability, pharmacokinetics and immunogenicity. Methods and findings A randomized, double-blinded, single-center, placebo-controlled, single ascending dose study was performed in healthy volunteers (Phase 1a, EXEVIR0102, EudraCT 2021-003707-17), in parallel to an open-label, multi-center, single ascending dose study in patients hospitalized for mild to moderate COVID-19 (Phase 1b, EXEVIR0101, EudraCT 2020-005299-36, NCT04884295). Participants received a single intravenous infusion of 250, 500 or 1,000 mg of XVR011. The primary objective for both trials was the safety and tolerability of XVR011. Pharmacokinetics were evaluated as a secondary objective in Phase 1a and as an exploratory objective in Phase 1b. Efficacy (evaluated as respiratory parameters and COVID-19 clinical status) and antiviral activity in patients were evaluated as a secondary objective in Phase 1b. Immunogenicity was evaluated as an exploratory objective. Part 2 of the EXEVIR0101 study (initially a phase 1b/2 study) was not conducted due to the loss of XVR011 potency against SARS-CoV-2 Omicron BA.2. Demographics, safety, efficacy, and immunogenicity were analyzed using descriptive statistics, while pharmacokinetics were analyzed with noncompartmental pharmacokinetics (PK) modeling.In the Phase 1a study, there were no infusion-related reactions, serious treatment-emergent adverse events (TEAEs) or TEAEs grade ≥3. 22/30 volunteers (73.3%) reported 53 TEAEs (49 Grade 1, 4 Grade 2) with none being related to XVR011. The most common TEAE was headache (n = 8, 26.7%) in various treatment groups. In the Phase 1b study, 27 hospitalized patients were enrolled, and followed up to 30 days. Seven patients (25.9%) reported a total of 15 TEAEs, the majority (80%) being mild to moderate (Grade 1–2). There were no treatment-related serious TEAEs. All TEAEs resolved by the end of the study. Peak exposure (maximal concentration, Cmax) and systemic exposure (area under the curve, AUC0-t, and AUC0-inf) for XVR011 increased dose-proportionally. Geomean half-life ranged from 15.4 to 17.0 days in Phase 1a, while individual half-life ranged from 11.4 to 15.6 days in Phase 1b. SARS-CoV-2 viral load, as detected in nasopharyngeal samples by reverse transcription and quantitative polymerase chain reaction (RT-qPCR), decreased similarly in all cohorts compared to baseline. No treatment-induced anti-drug antibodies (ADA) were detected in Phase 1a. In Phase 1b, higher XVR011 concentrations increased the likelihood of ADA formation, without impacting pharmacokinetics and pharmacodynamics. No obvious dose-response in COVID-19 clinical status or respiratory parameters was observed.Technological limitations included study size, absence of placebo for the Phase 1b, absence of repeated dosing, evolving SARS-CoV-2 variants and standard-of-care. Conclusions XVR011 displayed a favourable safety, tolerability, pharmacokinetics, and immunogenicity profile, both in healthy volunteers and in patients hospitalized for mild to moderate COVID-19. These data pave the way for the design and clinical development of VHH-Fc constructs.

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

BluTrain: A C++/CUDA Framework for AI Systems

arXiv:2606.24780v1 Announce Type: new Abstract: Progress in deep learning is, at scale, more a matter of systems engineering than of modelling: the behaviour of a model in training (its throughput, its memory footprint, and the numerical fidelity of the result) is determined less by the architecture itself than by how that architecture is expressed on the hardware. To achieve absolute control over this hardware expression while abstracting away systems complexity to make modelling seamless and eliminating the need for repetitive orchestration logic, BluTrain was architected from first principles as a robust, lightweight, and architecture-general training framework in standard C++ and the core CUDA programming model. Every layer is implemented natively: a typed tensor module with reverse-mode autograd, a linear-algebra library, a caching allocator, a multi-mode distributed-execution module, and an MLIR-based deep-learning compiler. In formal evaluations training a 124M-parameter GPT-2 baseline in FP32 on an 8-GPU 6000 Ada system, BluTrain outperforms industry-standard baselines in both throughput (sustaining an average of 407K tokens/s versus PyTorch's 395K tokens/s) and memory efficiency (achieving up to a 22% footprint reduction), while strictly preserving numerical fidelity and converging to a marginally lower final validation loss. With every layer explicitly open to native tuning, the performance ceiling is the framework's own to raise.

13.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

14.
arXiv (CS.AI) 2026-06-18

Why SWAVE May Not Be All You Need:A Concept-Evolution Retrospective on Complex-Valued Recurrent Language Models

arXiv:2606.18324v1 Announce Type: cross Abstract: SWave is a complex-valued recurrent language model (169.26M parameters, D=384, L=16, T=2048) trained on FineWeb-Edu using 2xH100 NVL. It was designed around three founding premises: that representing language as complex waves rather than real-valued numbers enables richer information encoding; that a Cayley-parameterised unitary transition provides a mathematical guarantee against state decay or explosion; and that a hidden state which rotates rather than shrinks preserves signal integrity over arbitrarily long contexts. The core of SWave evolved substantially across three development phases. The Resonance Head was found to structurally admit imaginary-channel collapse as a global loss minimum (a failure mode we term cos-domination collapse) and was superseded by an untied head with independent real and imaginary embedding tables from the Phase-Associative Memory (PAM) architecture. This resolved the degenerate minimum and enabled stable 200,000-step training (best-step PPL 22.0 at step 89,861). ComplexNorm and the Wave Propagation Scan proved load-bearing throughout all three phases and were retained to the final architecture. ProtectGatedScan was reframed as a structural prior rather than a learned behaviour. The four multi-scale retention concepts showed no measurable improvement under controlled evaluation and were found non-load-bearing. The ComplexGatedUnit was superseded by a real-valued squared-ReLU channel mixer with fewer parameters. The auxiliary training objectives showed no benefit once structural constraints were resolved. The investigation yields a formal characterisation of cos-domination collapse, a parallel scan with a log-space backward pass for numerical stability, six transferable engineering principles for complex-valued recurrent training, and a plan-to-code traceability methodology for catching structural divergences that conventional test suites miss.

15.
arXiv (CS.AI) 2026-06-11

A New Perspective on Precision and Recall for Generative Models

arXiv:2511.02414v3 Announce Type: replace Abstract: With the recent success of generative models in image and text, the question of their evaluation has recently gained a lot of attention. While most methods from the state of the art rely on scalar metrics, the introduction of Precision and Recall (PR) for generative model has opened up a new avenue of research. The associated PR curve allows for a richer analysis, but their estimation poses several challenges. In this paper, we present a new framework for estimating entire PR curves based on a binary classification standpoint. We conduct a thorough statistical analysis of the proposed estimates. As a byproduct, we obtain a minimax upper bound on the PR estimation risk. We also show that our framework extends several landmark PR metrics of the literature which by design are restrained to the extreme values of the curve. Finally, we study the different behaviors of the curves obtained experimentally in various settings.

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

Simulation-Augmented Multi-Step Split Conformal Prediction for Aggregated Forecasts

arXiv:2606.16356v1 Announce Type: new Abstract: We study uncertainty quantification for aggregated forecasting tasks such as annual totals and year-over-year growth rates. We propose SA-MSCP, a simulation-augmented multi-step split conformal method that generates future paths from cross-validated residuals using a block bootstrap and constructs prediction intervals from empirical quantiles. Experiments show that SA-MSCP improves empirical coverage over a simulated-path baseline for aggregated and growth-rate targets. Our results demonstrate that simulation-enhanced conformal calibration is an effective and general framework for uncertainty quantification in aggregated time-series forecasting.

17.
medRxiv (Medicine) 2026-06-19

Cardiometabolic multimorbidity and care experiences in primary healthcare among Brazilian adults aged 50 and over (ELSI-Brazil)

Background: Population aging and the rising burden of non-communicable diseases have increased the prevalence of cardiometabolic multimorbidity (CM-MM) among older adults. Patient-reported experience measures (PREMs) are recognized as essential components of healthcare quality assessment, yet evidence on primary care experiences among individuals with CM-MM remains scarce. Objective: To analyze primary care experiences according to the presence of cardiometabolic multimorbidity among Brazilians aged 50 years and older. Methods: Cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021; n = 9,949). CM-MM was defined as the self-reported coexistence of two or more of the following conditions: hypertension, diabetes mellitus, dyslipidemia, acute myocardial infarction, and stroke. Primary care experiences were assessed using a validated 12-item instrument organized into four domains: first-contact access, longitudinality, communication, and care coordination. Associations were estimated using Poisson regression adjusted for sociodemographic, health conditions, and healthcare utilization variables, with stratified analysis by Family Health Strategy (FHS) coverage. Results: CM-MM prevalence was 25.5%, with a progressive increase by age and an inverse gradient by education. Individuals with CM-MM reported significantly more positive experiences in longitudinality (mean index 2.53 vs. 2.34; adjusted PR = 1.22; 95%CI 1.12-1.33; p < 0.001) and, to a lesser extent, in communication (mean index 2.68 vs. 2.58; adjusted PR = 1.10; 95%CI 1.00-1.20; p = 0.041). No statistically significant differences were found in first-contact access or care coordination. After stratified by FHS coverage, the observed differences in longitudinality and communication were no longer statistically significant. Conclusions: CM-MM was associated with more positive primary care experiences in longitudinality and communication. The absence of differentiated experiences in first-contact access and coordination highlights structural gaps in primary care responsiveness to individuals with greater clinical complexity. Keywords: Multimorbidity; Cardiometabolic diseases; Primary Care; Patient-reported experience measures; Older adults; ELSI-Brazil.

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

VistaRef: Boosting Visual Spatial Orientation Awareness for Pointing-to-Object Detection

Grounding deictic gestures in natural images is fundamental to AR and human-robot collaboration, providing a basis for seamless spatial interaction. While Transformer-based visual models have achieved significant progress in general object detection, their global attention mechanisms often neglect micro-geometric relationships, degrading orientation accuracy. In pointing tasks, this deficiency manifests as an inability to accurately capture the pointing ray implied by finger poses, which results in pointing drift and localization ambiguity when dealing with distant or densely packed objects. To address this, we propose VistaRef, a framework designed to explicitly enhance spatial orientation awareness. First, we develop the Local Hand Entity Modeling (LHEM) module, which incorporates hand-pose embeddings to strengthen the model's capability to capture subtle finger deviations. Second, drawing inspiration from multi-view geometry, we construct the Geometric Ray Modeling (GRM) module to transform implicit orientation information into explicit spatial geometric features, guiding feature aggregation and deep fusion via attention mechanisms. Furthermore, we introduce a novel Orientation-Consistent Alignment Loss (OCAL) to synergistically supervise hand presence and pointing consistency, ensuring that all architectural improvements collectively serve the core objective of spatial localization. Experimental results demonstrate that VistaRef significantly outperforms the baseline, achieving a 14-point absolute gain in grounding accuracy. Qualitative analysis further confirms that VistaRef effectively models the geometric correlation from hand to target, bridging the spatial perception gap inherent in traditional Transformers for complex scenarios. Code: https://github.com/lingli1724/VistaRef.

19.
medRxiv (Medicine) 2026-06-23

Changes in hierarchical brain dynamics of rumination following mindfulness-based cognitive therapy for depression

Major depressive disorder (MDD) is a leading cause of disability worldwide with risk of onset and recurrence linked to depressive ruminative thought patterns. Mindfulness-based cognitive therapy (MBCT) is an evidence-based treatment for depression that targets the ability to recognise, decenter, and disengage from ruminative thought patterns. Elucidating how MBCT impacts hierarchical brain organisation may be key to understanding the processes by which MBCT can modulate ruminative tendencies. In a randomised controlled functional magnetic resonance imaging (fMRI) trial on individuals with MDD (N=80) before and after MBCT in addition to treatment as usual (TAU), we investigated changes in hierarchical brain organisation during resting-state and rumination. We built whole-brain models to obtain generative connectivity (GEC) matrices per patient and quantified brain hierarchy by measuring the global directedness and regional trophic levels in each GEC, in which greater directedness reflects more directional information flow and less recurrence. Global directedness in MBCT+TAU compared to TAU increased during rumination, with no changes during resting-state. Furthermore, increased regional breadth of hierarchy during rumination was related to improvements in clinical and behavioural outcomes following MBCT+TAU. Increased brain hierarchy during rumination following mindfulness training may be consistent with a shift away from self-reinforcing negative mental loops towards more differentiated and less coupled cognitive and bodily cycles, supporting MBCT's ability to interrupt ruminative processes. Hierarchical brain dynamics may hold promise as a treatment-sensitive marker and a potential mechanism of therapeutic change in MBCT for depression.

20.
arXiv (CS.LG) 2026-06-16

Decoupling Inference from State Updates in Low-Latency Feature Engines via Probabilistic Thinning

arXiv:2606.16981v1 Announce Type: cross Abstract: Streaming data systems increasingly underpin Machine Learning workflows that maintain large numbers of continuously updated aggregations. In production settings, each incoming event typically triggers read-modify-write operations to persistent storage, making high-frequency state updates a dominant source of latency, contention, and operational cost. In this work, we decouple inference from state persistence in streaming Machine Learning pipelines via probabilistic thinning: every event is scored, but durable state updates are selectively triggered by informative events. Unlike approaches that shed input or state, we show that persistence-path control is achievable without a high-frequency in-memory control plane or cross-worker coordination, relying exclusively on approximate statistics retrieved from disk-backed key-value stores. We model the resulting stochastic processes, derive bounds on filtering rates, and prove that common time-based aggregations remain unbiased under variance-aware formulations, preventing systemic error accumulation. We evaluate the approach in a controlled setting that isolates per-event costs, demonstrating substantial reductions in storage Input/Output and serialization overhead. Across experiments, up to 90% of events are excluded from the persistence path while preserving and in some cases improving downstream utility.

21.
arXiv (CS.CL) 2026-06-15

Deja Vu at Scale: Paraphrase-Robust Detection of Duplicate Gherkin Steps in Behaviour-Driven Software Testing with Sentence-Transformer Embeddings and a 1.1M-Step Open Benchmark

Context. Behaviour-Driven Development (BDD) suites in Gherkin accumulate step-text duplication with documented maintenance cost. Prior detectors either require runnable tests or are single-organisation, leaving a gap: a static, paraphrase-robust, step-level detector and a public benchmark to calibrate it. Objective. We release (i) the largest cross-organisational BDD step corpus to date, (ii) a labelled pair-level calibration benchmark, and (iii) a four-strategy detector with a consolidation-savings model linking clusters to ISO/IEC 25010 maintainability sub-characteristics. Method. The corpus contains 347 public GitHub repositories, 23,667 .feature files, and 1,113,616 Gherkin steps, SPDX-tagged. The detector layers exact hashing, normalised Levenshtein, sentence-transformer cosine, and a Levenshtein-banded hybrid. Calibration uses 1,020 manually labelled step pairs under a released rubric (60-pair overlap, Fleiss kappa = 0.84). We report precision, recall, and F1 with bootstrap 95% CIs under the primary rubric and a score-free relabelling, and benchmark against SourcererCC-style and NiCad-style lexical baselines. Results. Step-weighted exact-duplicate rate is 80.2%; median-repository rate is 58.6% (Spearman rho = 0.51). The top hybrid cluster has 20,737 occurrences across 2,245 files. Near-exact reaches F1 = 0.822 on score-free labels; semantic F1 = 0.906 under the primary rubric reflects a disclosed stratification artefact. Lexical baselines reach F1 = 0.761 and 0.799. The savings model estimates 893,357 corpus-wide eliminable step occurrences; on the median repository 62.5% of step lines are eliminable.

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

ScaleToT: Generalizing Structured LLM Reasoning for Billion-Scale Low-Activity User Modeling

arXiv:2606.24605v1 Announce Type: new Abstract: Accurate user modeling often depends on rich interaction histories, which are unavailable for billions of low-activity users. Large Language Models (LLMs) can infer latent user states from static profiles, but this reasoning becomes unreliable when profiles are sparse, and applying an LLM to billions of users is prohibitively expensive. We present ScaleToT, which learns structured reasoning from a small LLM-processed subset and extends it to the broader low-activity user population. To improve reasoning reliability, ScaleToT constructs typed user-state chains with a bounded entropy-guided Tree-of-Thought (ToT) refinement procedure. To make this structured reasoning usable from sparse profiles, the teacher-curated chains are used to train a student model on static profiles through supervised fine-tuning (SFT) and Outcome-Driven Segment-Aware Implicit Reward Policy Optimization (OSIPO). ScaleToT then transfers the student's reasoning representations to a lightweight profile encoder, providing shared reasoning signals for the remaining users without LLM inference. We evaluate ScaleToT on lifetime value (LTV) prediction in a billion-scale advertising deployment. A randomized online A/B test increased LT30 by 6.738\%, while offline reasoning covered only 7.32\% of the potential population, greatly reducing compute cost compared with full-population reasoning.

23.
arXiv (CS.AI) 2026-06-12

Deterministic Integrity Gates for LLM-Assisted Clinical Manuscript Preparation: An Auditable Biomedical Informatics Architecture

arXiv:2606.09500v3 Announce Type: replace Abstract: As autonomous research agents and AI co-scientist systems push large language models (LLMs) from drafting toward end-to-end manuscript production, the bottleneck shifts from generation to verification. Fluent LLM output can hide fabricated citations, numbers that drift from source tables, and unmet reporting-guideline items; existing tools generate without verifying, and self-critique inherits the blind spots that produce confident fabrication. We describe an architecture pairing generation with verification, resting on three principles: decompose the workflow into self-contained skills, gate every stage transition with halt-on-failure, and resolve each integrity question with the cheapest sufficient mechanism, a deterministic, re-executable check where one suffices and a prose-level probe only where interpretation is unavoidable. This determinism-where-possible split, organized as an integrity-gate taxonomy, is the core contribution. It is realized as MedSci Skills, an open-source toolkit of 43 skills with a 21-detector deterministic tier, evaluated on three public-dataset pipelines (STARD, PRISMA, STROBE) and a seeded-defect ablation. Across the three pipelines every content-hash manifest verified clean and the gates surfaced real defects; on 27 identical injected defects the deterministic gates detected all 27 with no false positives on the matched clean fixtures, whereas a single-prompt LLM reviewer detected 11, its misses in code, bibliography, and style defects the prose hides. Determinism-where-possible verification yields an auditable, re-executable trail that exposes the evidence a human needs to check an LLM-assisted manuscript: feasibility and reproducibility evidence, not a claim of human-competitive quality, which a separate blinded study addresses. MedSci Skills is MIT-licensed and archived (v3.8.0).

24.
medRxiv (Medicine) 2026-06-23

Differential Recovery Trajectories of Emergency Otolaryngologic Conditions across the COVID-19 Pandemic: A Six-year Longitudinal Study from an Urban Emergency Center

Authors:

Objective: The COVID-19 pandemic markedly altered social activity patterns, healthcare utilization, and the epidemiology of infectious diseases. However, its long-term impact on emergency otolaryngologic conditions remains incompletely understood. This study investigated long-term trends in emergency otolaryngologic conditions before, during, and after the COVID-19 pandemic using comprehensive data from a large urban emergency clinic in Osaka, Japan. Methods: All new otolaryngologic outpatients who visited the Chuo Emergency Medical Clinic (CEMC) in Osaka City between 2019 and 2024were retrospectively analyzed. Annual trends in absolute numbers and relative proportions of emergency otolaryngologic conditions were examined by anatomical region and disease category, using 2019 as the pre-pandemic baseline. Results: A total of 99,324 new otolaryngologic outpatients were analyzed. Overall emergency visits declined sharply to approximately half of baseline in 2020, followed by a gradual but incomplete recovery toward pre-pandemic levels by 2024. Most anatomical categories declined to 45-61% of baseline in 2020 and exhibited gradual yet incomplete recovery through 2023; in stark contrast, laryngeal conditions diverged sharply, surging beyond pre-pandemic levels after 2022. Acute infectious otorhinolaryngologic diseases fell to 23-50% of baseline in 2020 and showed variable recovery (69-103%) by 2024. Notably, laryngitis exceeded the baseline, reaching 132% in 2023, whereas epiglottic edema exhibited only a transient increase approaching the baseline in 2021. Non-infectious emergency conditions generally showed only a marginal decrease in 2020 and remained relatively stable throughout the study period, except for sudden sensorineural hearing loss (SSNHL), which dropped sharply to 39% of the baseline in 2020 and remained persistently reduced through 2024. Traumatic emergencies declined variably to 53-81% of the baseline in 2020, followed by an incomplete recovery, reaching only 55-69% by 2024. Conclusion: Emergency otolaryngologic conditions demonstrated heterogeneous recovery trajectories following the COVID-19 pandemic. While most infectious and traumatic conditions gradually but incompletely normalized, laryngeal conditions showed a distinct post-pandemic surge, and SSNHL remained persistently suppressed. These findings reveal heterogeneous, condition-specific recovery trajectories that reflect both genuine shifts in community pathogen burden, true traumatic incidence, and persistent alterations in healthcare-seeking behaviors, insights essential for resource allocation during future public health emergencies.

25.
arXiv (CS.CV) 2026-06-16

SLU-2K: A Question-Based Benchmark for Semantic Evaluation of Sign Language Translation

Sign Language Translation (SLT) is typically evaluated with surface-form metrics such as BLEU and ROUGE, which reward lexical overlap but do not directly measure whether a translation preserves the meaning of the source sign sequence. This is in contrast with the final objective of integrating SLT in assistive technology. In this work, we shift the focus from Sign Language Translation (SLT) to Sign Language Understanding (SLU), with particular emphasis on semantic understanding. Specifically, we evaluate systems based on their ability to correctly recover, from the input video, key semantic aspects of the original sentence, such as actions taking place and facts about people and objects. To enable this evaluation systematically, we propose SLU-2K, a dataset of 2,350 closed-ended video question-answer pairs based on the popular PHOENIX-2014T and CSL-Daily datasets. To obtain SLU-2K, we propose and extensively evaluate an automated data generation pipeline which produces questions across 7 categories, namely actions, locations, numbers, objects, people, time, and weather conditions. We show the potential of SLU-2K by evaluating popular Multimodal Large Language Models (MLLMs) and two representative state-of-the-art systems, MMSTL and SpaMo. Our results show that MLLMs reach near-random performance, highlighting the need for a more systematic integration of SLU in current AI systems. Furthermore, state-of-the-art translation systems carefully fine-tuned on in-domain data still exhibit a substantial semantic gap, with results ranging from 56.7% to 75.2%. These findings suggest that current SLT evaluation protocols overestimate true understanding and that future progress should be measured not only by fluency and n-gram overlap, but also by semantic correctness. Code, prompts, and benchmark files are available at https://github.com/ZenoTsT/SLU-2K