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01.
medRxiv (Medicine) 2026-06-11

Wealth-Related Inequalities in Cesarean Section Utilization Among Facility-Based Births in Bangladesh: Evidence from Public and Private Healthcare Facilities

Authors:
Mahmud↗

Background Bangladesh has experienced a rapid increase in cesarean section (CS) utilization over the past two decades. While previous studies have documented socioeconomic disparities in CS use, evidence on how wealth-related inequalities differ between public and private healthcare facilities remains limited. This study assessed the magnitude and drivers of socioeconomic inequality in CS utilization among facility-based births in Bangladesh. Methods We analyzed data from 3,008 facility-based births reported in the 2022 Bangladesh Demographic and Health Survey (BDHS). Survey-weighted multivariable logistic regression was used to identify factors associated with CS utilization. Wealth-related inequality was assessed using concentration curves and the Erreygers-corrected concentration index (ECCI). Regression-based decomposition of the standard concentration index was performed to quantify the contribution of socioeconomic, demographic, and healthcare-related factors to observed inequalities overall and separately for public and private facilities. Results Overall, 71.2% of facility-based births were delivered by CS, with substantially higher prevalence in private facilities (84.2%) than in public facilities (35.9%). Women delivering in private facilities had markedly higher odds of CS than those delivering in public facilities (adjusted odds ratio [AOR]: 9.07; 95% confidence interval [CI]: 7.17-11.47). Significant pro-rich inequality was observed overall (ECCI: 0.154; 95% CI: 0.117-0.191), with inequality substantially greater in public facilities (ECCI: 0.189; 95% CI: 0.114-0.264) than in private facilities (ECCI: 0.049; 95% CI: 0.014-0.084). Decomposition analysis showed that household wealth was the dominant contributor to inequality, particularly the richest wealth quintile, accounting for 81.5% of overall inequality, 63.8% in public facilities, and 109.7% in private facilities. Conclusions Wealth-related inequalities in CS utilization remain substantial in Bangladesh despite widespread use of the procedure. Although pro-rich inequality exists across both sectors, inequality is considerably greater in public facilities and is driven by different mechanisms across facility types. Policies should simultaneously improve equitable access to medically necessary CS and reduce unnecessary procedures, particularly within the private sector.

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

Radar-Guided Polynomial Fitting for Metric Depth Estimation

Authors:
Patrick Rim↗Hyoungseob Park↗Vadim Ezhov↗Jeffrey Moon↗Alex Wong↗

We propose POLAR, a novel radar-guided depth estimation method that introduces polynomial fitting to efficiently transform scaleless depth predictions from pretrained monocular depth estimation (MDE) models into metric depth maps. Unlike existing approaches that rely on complex architectures or expensive sensors, our method is grounded in a fundamental insight: although MDE models often infer reasonable local depth structure within each object or local region, they may misalign these regions relative to one another, making a linear scale and shift (affine) transformation insufficient given three or more of these regions. To address this limitation, we use polynomial coefficients predicted from cheap, ubiquitous radar data to adaptively adjust predictions non-uniformly across depth ranges. In this way, POLAR generalizes beyond affine transformations and is able to correct such misalignments by introducing inflection points. Importantly, our polynomial fitting framework preserves structural consistency through a novel training objective that enforces local monotonicity via first-derivative regularization. POLAR achieves state-of-the-art performance across three datasets, outperforming existing methods by an average of 24.9% in MAE and 33.2% in RMSE, while also achieving state-of-the-art efficiency in terms of latency and computational cost.

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

Human Cognition in Machines: A Unified Perspective of World Models

Authors:
Timothy Rupprecht↗Pu Zhao↗Amir Taherin↗Arash Akbari↗Arman Akbari↗Yumei He↗Tooba Imtiaz↗Sean Duffy↗Juyi Lin↗Yixiao Chen↗Rahul Chowdhury↗Enfu Nan↗…

This report of world models distinguishes prior works by the cognitive functions they innovate. Many works claim an almost human-like cognitive capability in their world models. To evaluate these claims requires a proper grounding in first principles from human and machine cognition theory. In moving towards human-like world models we present a conceptual unified framework for world models that fully incorporates all the cognitive functions (i.e., memory, perception, language, reasoning, imagining, motivation, and metacognition) and identify gaps in existing research as a guide for future states of the art. In particular, we find that motivation (especially intrinsic motivation) and metacognition remain drastically under-researched, and we propose concrete directions to address these gaps informed by active inference and global workspace theory. We also introduce epistemic world models, a new category encompassing agent frameworks for scientific discovery that operate over structured knowledge. Our taxonomy, applied to video, embodied, and epistemic world models, suggests research directions where prior taxonomies have not.

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04.
arXiv (CS.CL) 2026-06-16

LLM-based Visual Code Completion for Aerospace Geometric Design

Authors:
Hau Kit Yong↗Robert Marsh↗Edmar A. Silva↗Andr\'as S\'obester↗Stuart E. Middleton↗

Recent advances in both Large Language Models (LLMs) and Vision Language Models (VLMs) have seen a step change in their ability to perform visual code completion, but the aerospace industry, which prioritizes safety and explainabilty over rapid LLM adoption, currently has no publicly announced LLM-based geometric design copilot systems in commercial use by aerospace Original Equipment Manufacturers (OEMs). This paper presents a LLM-based visual programming copilot application for aerospace engineering design tasks, using a visual programming variant of the ReAct methodology and GPT 5.4. In addition to the copilot, we describe Wingbuilder, a new Grasshopper plugin library with custom components for aerospace-specific geometry abstraction, and an associated Aerospace Visual Programming Dataset (AVPD) with 18 aerospace expert designed tasks at different levels of difficulty alongside ground truth solutions. We evaluate our copilot application with a user trial involving two experienced aerospace engineers from a large aircraft manufacturing company. We find our copilot visual programming ReAct methodology was successful in generating suggestions that participants found helpful, but slow ReAct inference times limit its usefulness to more complex time-consuming tasks where waiting for good copilot solution suggestion was worthwhile. Participants reported they liked the tool and would be willing to use it in the future.

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

The table maker's quantum search

Authors:
Benjamin C. A. Morrison↗Stefanos Kourtis↗

arXiv:2601.13306v2 Announce Type: replace Abstract: We show that quantum search can be used to compute the hardness to round an elementary function, that is, to determine the minimum working precision required to compute the values of an elementary function correctly rounded to a target precision of $n$ digits for all possible precision-$n$ floating-point inputs in a given interval. For elementary functions $f$ related to the exponential function, quantum search takes time $\tilde O(2^{n/2} \log (1/\delta))$ to return, with probability $1-\delta$, the hardness to round $f$ over all $n$-bit floating-point inputs in a given binade. For periodic elementary functions in large binades, standalone quantum search yields an asymptotic speedup over the best known classical algorithms and heuristics. We then estimate the resources required for a fault-tolerant implementation of the proposed algorithm for the $\sin$ and $\cos$ functions in double precision. We find that, although the algorithm can in principle compete with the fastest known practical method for computing the hardness to round over all binades in the format, it requires qubit coherence times that are unrealistically long for present technology.

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

Equivariant Flow Matching for Symmetry-Breaking Bifurcation Problems

Authors:
Fleur Hendriks↗Ond\v{r}ej Roko\v{s}↗Martin Do\v{s}k\'a\v{r}↗Marc G. D. Geers↗Vlado Menkovski↗

arXiv:2509.03340v4 Announce Type: replace-cross Abstract: Bifurcation phenomena in nonlinear dynamical systems often lead to multiple coexisting stable solutions, particularly in the presence of symmetry breaking. Deterministic machine learning models are unable to capture this multiplicity, averaging over solutions and failing to represent lower-symmetry outcomes. In this work, we formalize the use of generative AI, specifically flow matching, as a principled way to model the full probability distribution over bifurcation outcomes. Our approach builds on existing techniques by combining flow matching with equivariant architectures and an optimal-transport-based coupling mechanism. We generalize equivariant flow matching to a symmetric coupling strategy that aligns predicted and target outputs under group actions, allowing accurate learning in equivariant settings. We validate our approach on a range of systems, from simple conceptual systems to physical problems such as buckling beams and the Allen–Cahn equation. The results demonstrate that the approach accurately captures multimodal distributions and symmetry-breaking bifurcations. Moreover, our results demonstrate that flow matching significantly outperforms non-probabilistic and variational methods. This offers a principled and scalable solution for modeling multistability in high-dimensional systems.

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07.
arXiv (CS.CV) 2026-06-19

SSD: Spatially Speculative Decoding Accelerates Autoregressive Image Generation

Authors:
Shilong Xiang↗Zirui Zhang↗Lijun Yu↗Chengzhi Mao↗

Autoregressive models excel in visual generation by treating images as 1D sequences of discrete tokens, mirroring language modeling. However, this flattening discards the intrinsic 2D spatial locality of visual signals, creating severe computational bottlenecks during inference. We introduce Spatially Speculative Decoding (SSD), a framework that aligns the predictive objective with the natural geometry of images. Rather than predicting only the immediate next token in a 1D sequence, our model simultaneously predicts the adjacent horizontal token and the token directly below it. By capitalizing on this 2D spatial correlation, spatially speculative decoding overcomes the memory wall in visual inference. Our approach accelerates autoregressive image generation by up to 13.3x while maintaining high fidelity on DPG-Bench and GenEval. Our results suggest that respecting the underlying geometry of vision unlocks massive computational efficiencies, paving the way for real-time, high-resolution autoregressive generative models.

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08.
arXiv (quant-ph) 2026-06-17

Approximately Decoding the Colour Code

Authors:
Mark Walters↗

arXiv:2606.18035v1 Announce Type: new Abstract: Recently we showed that minimum weight decoding in the (6.6.6 planar) colour code is NP-hard. However, it remained an open question as to whether it was possible to approximate the minimum weight decoding arbitrarily closely in polynomial time. In this paper we prove that it is possible: for any $\varepsilon>0$ there is an polynomial time algorithm that, given a syndrome, can find an error-set generating that syndrome whose weight is at most $1+\varepsilon$ times the weight of the minimum weight decoding. As a consequence we see that, for any $\varepsilon>0$, there is a polynomial time algorithm that can correct all errors of weight up to $(1-\varepsilon)d/2$ in the distance $d$ colour code (so almost up to the theoretical $d/2$ limit). The polynomial we give is impractically large, but it does open the door for sensible polynomial time algorithms that approximate minimum weight decoding and, in particular, shows that approximate decoding is not NP-hard.

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09.
arXiv (CS.LG) 2026-06-16

Stochastic Schrödinger Diffusion Models for Pure-State Ensemble Generation

Authors:
Jian Xu↗Wei Chen↗Shigui Li↗Chao Li↗Jingyuan Zheng↗Delu Zeng↗John Paisley↗Qibin Zhao↗

arXiv:2605.03573v3 Announce Type: replace-cross Abstract: Quantum machine learning increasingly relies on pure-state representations, motivating generative models that sample directly in quantum representation space rather than perturbing classical inputs and re-encoding. We introduce Stochastic Schrödinger Diffusion Models (SSDMs), a score-based generative framework that defines diffusion, scores, and reverse-time sampling intrinsically on the complex projective manifold $\mathbb{CP}^{d-1}$ under the Fubini–Study metric. SSDMs combine a Riemannian Ornstein–Uhlenbeck forward diffusion with a stochastic Schrödinger realization, and learn reverse-time dynamics driven by the Riemannian score. Our central technical contribution is a local-time learning objective that exploits the local Euclidean OU limit of intrinsic manifold diffusions in Fubini-Study normal coordinates to obtain an analytic teacher score, bypassing the intractable transition densities that limit existing Riemannian score-based models. Across synthetic, physics-inspired (TFIM, XXZ), and quantum feature-state benchmarks up to $14$ qubits, SSDMs match target pure-state ensembles by orders of magnitude on MMD and observable statistics over both ambient Euclidean and matched Riemannian score-based baselines, and improve representation-level diagnostics for downstream quantum kernel methods.

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10.
arXiv (CS.AI) 2026-06-15

When Sample Selection Bias Precipitates Model Collapse

Authors:
Xinbao Qiao↗Xianglong Du↗Wei Liu↗Jingqi Zhang↗Peihua Mai↗Meng Zhang↗Yan Pang↗

arXiv:2606.13732v1 Announce Type: new Abstract: The proliferation of recursive training on synthetic data can alleviate data scarcity but risks model collapse, where repeated training erodes distributional tails and homogenizes outputs. Data selection is widely viewed as a remedy, yet its reliability depends critically on the reference distribution used by the verifier. We show that in low-resource verification regimes, where each verifier observes only a small, fragmented, and biased slice of the target manifold, selection itself becomes biased. This situation naturally arises in low-resource data silos such as healthcare consortia or proprietary financial institutions, where raw data cannot be pooled and local references are inherently incomplete. As a result, selection preferentially retains samples aligned with the local manifold while pruning globally relevant tail modes, turning from a safeguard against collapse into a mechanism that precipitates it. We theoretically prove that such siloed selection accelerates collapse and induces power-law diversity decay. As an initial mitigation, we construct Wasserstein proxy references from multiple silos without sharing raw data. Empirical results confirm that local-reference selection fails on skewed distributions, whereas collaborative proxy references mitigate diversity degradation, suggesting that recursive synthetic-data pipelines require particular caution when real-data coverage is fragmented or scarce.

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

Certifiable Safe RLHF: Semantic Grounding and Fixed Penalty Constraint Optimization for Safer LLM Alignment

Authors:
Kartik Pandit↗Sourav Ganguly↗Arnesh Banerjee↗Shaahin Angizi↗Arnob Ghosh↗

arXiv:2510.03520v2 Announce Type: replace-cross Abstract: Ensuring safety is a foundational requirement for large language models (LLMs). Achieving an appropriate balance between enhancing the utility of model outputs and mitigating their potential for harm is a complex and persistent challenge. Contemporary approaches frequently formalize this problem within the framework of Constrained Markov Decision Processes (CMDPs) and employ established CMDP optimization techniques. However, these methods exhibit two notable limitations. First, their reliance on reward and cost functions renders performance highly sensitive to the underlying scoring mechanism, which must capture semantic meaning rather than being triggered by superficial keywords. Second, CMDP-based training entails tuning dual-variable, a process that is both computationally expensive and does not provide any provable safety guarantee for a fixed dual variable that can be exploitable through adversarial jailbreaks. To overcome these limitations, we introduce Certifiable Safe-RLHF (CS-RLHF) that introduces a cost model trained on a large-scale corpus to assign semantically grounded safety scores. In contrast to the lagrangian-based approach, CS-RLHF adopts a rectified penalty-based formulation. This design draws on the theory of exact penalty functions in constrained optimization, wherein constraint satisfaction is enforced directly through a suitably chosen penalty term. With an appropriately scaled penalty, feasibility of the safety constraints can be guaranteed at the optimizer, eliminating the need for dual-variable updates. Empirical evaluation demonstrates that CS-RLHF outperforms state-of-the-art LLM model responses rendering at-least 5 times efficient against nominal and jail-breaking prompts

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

Group-Sparse Matrix Factorization for Transfer Learning of Word Embeddings

Authors:
Kan Xu↗Xuanyi Zhao↗Hamsa Bastani↗Osbert Bastani↗

Unstructured text provides decision-makers with a rich data source in many domains, ranging from product reviews in retail to nursing notes in healthcare. To leverage this information, words are typically translated into word embeddings – vectors that encode the semantic relationships between words – through unsupervised learning algorithms such as matrix factorization. However, learning word embeddings from new domains with limited training data can be challenging, because the meaning/usage may be different in the new domain, e.g., the word ``positive'' typically has positive sentiment, but often has negative sentiment in medical notes since it may imply that a patient tested positive for a disease. In practice, we expect that only a small number of domain-specific words may have new meanings. We propose an intuitive two-stage estimator that exploits this structure via a group-sparse penalty to efficiently transfer learn domain-specific word embeddings by combining large-scale text corpora (such as Wikipedia) with limited domain-specific text data. We bound the generalization error of our transfer learning estimator, proving that it can achieve high accuracy with substantially less domain-specific data when only a small number of embeddings are altered between domains. Furthermore, we prove that all local minima identified by our nonconvex objective function are statistically indistinguishable from the global minimum under standard regularization conditions, implying that our estimator can be computed efficiently. Our results provide the first bounds on group-sparse matrix factorization, which may be of independent interest. We empirically evaluate our approach compared to state-of-the-art fine-tuning heuristics from natural language processing.

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13.
arXiv (CS.CL) 2026-06-11

Beyond Third-Person Audits: Situated Interaction Auditing for User-Centered LLM Bias Research

Authors:
Andr\'es Abeliuk↗Cinthia Sanchez Macias↗Valentina Alarc\'on↗\'Alvaro Madariaga↗Claudia Lopez↗

Research on bias in large language models (LLMs) has predominantly focused on third-person audits, which study how models represent or evaluate demographic groups as external subjects. However, this paradigm overlooks a structural blind spot because the user is absent from the audit. In practice, LLMs are used in open-ended, personal interactions, during which the model implicitly represents the user and adjusts its responses accordingly. When identical requests yield different responses depending on who is asking, bias manifests not in how the model describes others but in how it treats its interlocutor. We propose Situated Interaction Auditing (SIA), a user-centered framework for studying how user profile signals – implicit sociodemographic markers, writing style, and stated identity – systematically shape LLM response quality, content, and tone. We demonstrate the framework through a case study that intersects gender and socioeconomic status signals across multiple task domains and outline a research agenda for SIA as a new mission for natural language processing.

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14.
arXiv (CS.LG) 2026-06-17

Price of metric universality in vector quantization is at most 0.11 bit

Authors:
Alina Harbuzova↗Or Ordentlich↗Yury Polyanskiy↗

arXiv:2602.05790v2 Announce Type: replace-cross Abstract: Fast computation of a matrix product $W^\top X$ is a workhorse of modern LLMs. To make their deployment more efficient, a popular approach is that of using a low-precision approximation $\widehat W$ in place of true $W$ (``weight-only quantization''). Information theory demonstrates that an optimal algorithm for reducing precision of $W$ depends on the (second order) statistics of $X$ and requires a careful alignment of vector quantization codebook with PCA directions of $X$ (a process known as ``waterfilling allocation''). Dependence of the codebook on statistics of $X$, however, is highly impractical. This paper proves that there exist a universal codebook that is simultaneously near-optimal for all possible statistics of $X$, in the sense of being at least as good as an $X$-adapted waterfilling codebook with rate reduced by 0.11 bit per dimension in the case when $W$ is Gaussian. Such universal codebook would be an ideal candidate for the low-precision storage format, a topic of active modern research, but alas the existence proof is non-constructive. Equivalently, our result shows existence of a net in $\mathbb{R}^n$ that is a nearly-optimal covering of a sphere simultaneously with respect to all Hilbert norms.

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

Fibonacci Steady-States and Persistent Oscillations in an Ordered Multimode Dicke Model

Authors:
Miriam J. Leonhardt↗Kai M\"uller↗Oliver Lunt↗Andrew J. Daley↗

arXiv:2606.13072v1 Announce Type: new Abstract: Ultracold atoms in multimode optical cavities provide a rich testbed for many-body phenomena enabled by light-mediated interactions. Recent experiments include realizations of spin glasses and associative memories, as described by multimode Dicke models with disordered couplings. However, the properties of multimode Dicke models with ordered coupling geometries remain largely unexplored. In this work, we investigate the stable steady-states of the multimode Dicke model with an ordered nearest-neighbor coupling geometry, where $n_c$ atomic clusters are coupled via $n_c-1$ cavity modes. We show that the number of mean-field stable steady-states in the superradiant phase exhibits Fibonacci scaling with the number of atomic clusters, and that a subset of these steady-states exhibit persistent oscillations. Using both the truncated Wigner approximation and the numerically-exact hierarchy of pure states, we further demonstrate that these features of the stable steady-state solutions persist for finite cluster sizes. Ordered multimode Dicke models, such as the nearest-neighbor coupling geometry considered here, are accessible with current experimental technologies and point toward a broader class of strongly interacting dissipative systems with similarly rich behavior.

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16.
bioRxiv (Bioinfo) 2026-06-16

RetroMol: Parsing a shared encoding from natural products and their biosynthetic gene clusters

Authors:
Meijer↗Williams↗S. E↗Terlouw↗Charusanti↗Kok↗Skinnider↗M. A↗Weber↗van der Hooft↗J. J. J↗Healy↗…

Natural products such as polyketides and nonribosomal peptides (NRPs) are important sources of bioactive compounds, including many antibiotics. Many of them are assembled by modular enzyme complexes and further modified and diversified by tailoring reactions encoded by biosynthetic gene clusters (BGCs). Although natural products and their coding BGCs describe different data modalities of the same biochemical process, a unified language to jointly describe their biochemistry is lacking. Here we introduce a sequence-based representation of the core biosynthesis of modular natural products, which we call primary sequences, that bridges chemical structures and BGCs. We also present RetroMol, an algorithm that parses either natural product structures or their encoding BGCs into their primary sequences of natural product building blocks. RetroMol allows for similarity scoring between natural products and BGCs, enabling the retrieval of compounds, BGCs, and a combination of the two, based on their biosynthetic similarity. This can, for instance, be used to retrieve biosynthetically similar but structurally dissimilar compounds, or link natural products to candidate coding BGCs in large experimental datasets. We demonstrate the latter by rediscovering the nocardichelin B BGC as a proof of principle. We also exemplify the utility of biosynthetic similarity by showing various pairs of biosynthetically similar compounds with low structural similarity. Together, these results establish primary sequences as a shared biosynthetic encoding for natural product comparison and BGC prioritization.

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17.
medRxiv (Medicine) 2026-06-16

Exercise Training Improves Skeletal Muscle Insulin Sensitivity and Reprograms the Adipose Transcriptome in Heavier Monozygotic Twins

Authors:
Hentila↗Ullrich↗Ojala↗Lietzen↗M. S↗Heiskanen↗M. A↗Van der Stede↗Honkala↗Helmio↗Rajander↗Eskola↗…

Exercise training improves skeletal muscle insulin sensitivity, yet its effects on white adipose tissue remain incompletely understood. We investigated how adiposity and exercise training influence insulin-stimulated glucose uptake in skeletal muscle and abdominal subcutaneous adipose tissue (ASAT), alongside adaptations in gene expression and DNA-methylation. Ten monozygotic twin pairs discordant for BMI underwent [18F]FDG-PET/CT imaging of skeletal muscle (vastus lateralis, VL) and ASAT during a euglycemic-hyperinsulinaemic clamp before and after six months of exercise training. VL and ASAT biopsies were analyzed using mRNA-sequencing and reduced representation bisulfite sequencing. Exercise training improved whole-body and VL insulin sensitivity in leaner and heavier co-twins (p

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18.
arXiv (quant-ph) 2026-06-16

Intrinsic preservation of plasticity in continual quantum learning

Authors:
Yu-Qin Chen↗Shi-Xin Zhang↗

arXiv:2511.17228v2 Announce Type: replace Abstract: Artificial intelligence in dynamic, real-world environments requires the capacity for continual learning. However, standard deep learning suffers from a fundamental issue: loss of plasticity, in which networks gradually lose their ability to learn from new data. Here we show that quantum learning models naturally overcome this limitation, preserving plasticity over long timescales. We demonstrate this advantage systematically across a broad spectrum of tasks from multiple learning paradigms, including supervised learning and reinforcement learning, and diverse data modalities, from classical high-dimensional images to quantum-native datasets. Although classical models exhibit performance degradation correlated with unbounded weight and gradient growth, quantum neural networks maintain consistent learning capabilities regardless of the data or task. We identify the origin of the advantage as the intrinsic physical constraints of quantum models. Unlike classical networks where unbounded weight growth leads to landscape ruggedness or saturation, the unitary constraints confine the optimization to a compact manifold. Our results suggest that the utility of quantum computing in machine learning extends beyond potential speedups, offering a robust pathway for building adaptive artificial intelligence and lifelong learners.

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

S2D2: Fast Decoding for Diffusion LLMs via Training-Free Self-Speculation

Authors:
Ligong Han↗Hao Wang↗Han Gao↗Kai Xu↗Akash Srivastava↗

Block-diffusion language models offer a promising path toward faster-than-autoregressive generation by combining block-wise autoregressive decoding with within-block parallel denoising. However, in the few-step regime needed for practical acceleration, standard confidence-thresholded decoding is often brittle: aggressive thresholds hurt quality, while conservative thresholds require unnecessary denoising steps. Existing approaches that address this issue either require additional training or incur extra test-time compute. We present S2D2, a training-free self-speculative decoding framework for block-diffusion language models. Our key observation is that a block-diffusion model becomes autoregressive when the block size is reduced to one, allowing the same pretrained model to act as both drafter and verifier. S2D2 inserts a speculative verification step into standard block-diffusion decoding and uses lightweight routing policies to decide when verification is worth its cost. This yields a hybrid decoding trajectory in which diffusion proposes tokens in parallel, while the autoregressive mode acts as a local sequence-level critic. Across three mainstream block-diffusion families, S2D2 consistently improves the accuracy-speed tradeoff over strong confidence-thresholding baselines. On SDAR, we observe up to $4.7\times$ speedup over autoregressive decoding, and up to $1.57\times$ over a tuned dynamic decoding baseline while improving accuracy by up to $4.5$ points. On LLaDA2.1-Mini, S2D2 remains complementary to built-in self-correction, including a conservative setting where it is $4.4\times$ faster than the static baseline with slightly higher accuracy.

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20.
medRxiv (Medicine) 2026-06-18

Human Intuition vs. Computational Precision: Neurologists, Feature-based Models, and Deep Learning for Stroke Prognosis

Authors:
Herzog↗Blindenbacher↗Globas↗Haeberlin↗M. I↗Baumgartner↗Capecchi↗Inauen↗Sick↗Majoie↗C. B↗van Zwam↗…

Background: Prognostication in large vessel occlusion (LVO) stroke remains challenging. Although several prognostic models exist, their comparison to clinician performance, human-model interaction, and specific sources of human bias remain poorly understood. Methods: Using pre-treatment clinical and CT data from the MR CLEAN trial (n=500), six neurologists predicted three-month modified Rankin Scale (mRS) scores for 40 patients, both unaided and assisted by a validated feature-based model (MR PREDICTS). Human performance was benchmarked against MR PREDICTS and a multimodal, interpretable deep learning (DL) approach using raw imaging data. We explicitly assessed neurologists? ability to estimate model-required imaging features and identified systematic human biases. Models were additionally validated in a larger MR CLEAN trial cohort (n=404). Results: For predicting the full mRS distribution, standalone models achieved good ordinal agreement (MR PREDICTS quadratic weighted kappa (QWK) 0.51 [0.24 to 0.70]; DL model 0.49 [0.25 to 0.67]), significantly outperforming unaided neurologists (QWK 0.27 [0.10, 0.42]). Neurologists showed systematic overoptimism, predicting lower mRS scores than observed. Furthermore, there was poor accuracy in extracting imaging features. Raters? ASPECTS predictions deviated by 3.4 points from the confirmed scores, and collateral score accuracy was 44.6%. However, for predicting binary mRS (0-2 vs. 3-6), accuracy was comparable between unaided neurologists (64.17% [55.42% to 72.92%]) and models (MR PREDICTS 67.50% [52.50% to 82.50%]; DL model 63.16% [47.37% to 78.95%]). Model-assistance modestly improved and harmonized neurologists? predictions (QWK 0.41 [0.22 to 0.55]; binary accuracy 68.75% [58.33% to 78.34%]. Model performance remained robust in the larger cohort. Conclusions: Multimodal prognostic models outperform clinicians in predicting the full range of mRS outcomes, while human error in imaging assessment and systematic optimism bias are primary drivers of prognostic inaccuracy. End-to-end DL models eliminate human-input variability and hold strong potential as an automated second opinion to support prognostication and decision-making in acute LVO stroke.

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21.
arXiv (CS.CV) 2026-06-16

CASHEW: Stabilizing Multimodal Reasoning via Iterative Trajectory Aggregation

Authors:
Chaoyu Li↗Deeparghya Dutta Barua↗Fei Tao↗Pooyan Fazli↗

Vision-language models achieve strong performance across a wide range of multimodal understanding and reasoning tasks, yet their multi-step reasoning remains unstable. Repeated sampling over the same input often produces divergent reasoning trajectories and inconsistent final predictions. To address this, we introduce two complementary approaches inspired by test-time scaling: (1) CASHEW, an inference-time framework that stabilizes reasoning by iteratively aggregating multiple candidate trajectories into higher-quality reasoning traces, with explicit visual verification filtering hallucinated steps and grounding reasoning in visual evidence, and (2) CASHEW-RL, a learned variant that internalizes this aggregation behavior within a single model. CASHEW-RL is trained using Group Sequence Policy Optimization (GSPO) with a composite reward that encourages correct answers grounded in minimal yet sufficient visual evidence, while adaptively allocating reasoning effort based on task difficulty. This training objective enables robust self-aggregation at inference. Extensive experiments on 13 image understanding, video understanding, and video reasoning benchmarks show significant performance improvements, including gains of up to +26.2 percentage points on ScienceQA and +9.1 percentage points on EgoSchema.

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22.
arXiv (quant-ph) 2026-06-19

QMCtwin: Master-Equation Simulation of Syndrome Statistics Beyond Pauli Noise

Authors:
Tong Shen↗Huo Chen↗Benchen Huang↗Tyler Takeshita↗Arian Vezvaee↗Izhar Medalsy↗Daniel A. Lidar↗

arXiv:2606.19848v1 Announce Type: new Abstract: As quantum error correction moves toward large-scale experimental implementations, decoder performance increasingly depends on how faithfully hardware noise is translated into syndrome statistics. Standard stabilizer workflows achieve scalability by replacing device dynamics with stochastic Pauli or detector-error models, but this compression can discard coherent phase information, nonunital drift, continuous-time effects of always-on couplings, and correlations generated by simultaneous Hamiltonian and dissipative evolution. Here we present QMCtwin, a sign-problem-suppressed quantum Monte Carlo framework for master-equation simulation of QEC circuits, and apply it to a full syndrome-extraction round of a distance-$7$ rotated surface code with $97$ physical qubits. The open-system model includes realistic superconducting-device noise mechanisms such as relaxation, pure dephasing, coherent gate miscalibration, residual $ZZ$ crosstalk, and drive-qubit detuning. By directly estimating syndrome observables from the QMC-generated stochastic density matrix estimator, we compare the master-equation dynamics with their Pauli-twirled Clifford simulation counterparts. QMCtwin predicts syndrome-extraction biases and correlations between syndromes and proxies of logical-string-parity that are absent or strongly suppressed in the stochastic Pauli description. We introduce information-theoretic diagnostics that further quantify how information concerning syndromes versus string-parity proxies differs between the realistic master-equation simulation and the corresponding Pauli-twirled model. These results show that QMC-based master-equation digital twins can expose noise features hidden by conventional Pauli/Clifford noise models and provide a practical path toward more accurate decoder-facing syndrome models.

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23.
medRxiv (Medicine) 2026-06-15

Routine use of oral iron for people with heart failure and iron deficiency in primary care; retrospective cohort study

Authors:
Maharajan↗Jones↗Bankhead↗Erone↗Haynes↗Katumba↗Li↗Maynard↗Roy↗Shah↗Stanworth↗Smith↗…

Aims: Iron deficiency is common among people with heart failure and associated with morbidity and mortality. While intravenous iron improves clinical outcomes, oral iron continues to be prescribed in routine practice despite limited evidence of benefit. Methods: We completed a retrospective primary care cohort study (2016 to 2021) to investigate the proportion of people with an incident diagnosis of heart failure who had iron deficiency identified (defined as ferritin

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

Improving Medical Communication using Rubric-Guided Counterfactual Recommendations

Authors:
Adrian Cosma↗Nicoleta-Nina Basoc↗Andrei Niculae↗Cosmin Dumitrache↗Emilian Radoi↗

Text-based telemedicine increasingly relies on lightweight patient feedback, however, such feedback primarily reflects perceived communication quality rather than medical accuracy. We introduce an LM-guided counterfactual recommendation pipeline that discovers and refines interpretable communication features such as tone, personalization, actionability and completeness in addressing patient concerns, without interfering with the medical content. These features are used together with patient-doctor interaction metadata to estimate positive feedback. At inference time, the system searches over low-cost ordinal feature changes and recommends minimal communication changes predicted to increase the probability of positive feedback, while independent auditor models test whether these gains generalize beyond the selection model. Across interactions, recommendations yield a mean +6.41% gain in predicted positive feedback probability under independent auditors, and are non-negative for 93.31% of recommendations. These results suggest that small, interpretable communication changes can capture most predicted gains while preserving the doctor's control over medical reasoning and final wording.

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25.
bioRxiv (Bioinfo) 2026-06-11

SPARK: A Systems-level Computational Framework for Reconstructing Transcriptomic State Organisation in Lung Adenocarcinoma

Authors:
Kulkarni↗Sengupta↗Kumar↗

Lung adenocarcinoma (LUAD) exhibits substantial molecular heterogeneity, which complicates tumour stratification and limits the ability of mutation-centric models to capture tumour behaviour and predict patient outcomes. This study investigates whether coordinated transcriptomic programs can provide a systems-level representation of tumour states. Bulk RNA-sequencing data from the TCGA-LUAD cohort were analysed to reconstruct pathway-level transcriptomic organisation using a stability-optimised network framework (SPARK). This analysis identified eight transcriptomic modules representing coordinated biological processes active across tumours. Module activity scores were subsequently used to derive a composite Transcriptomic Risk Score through elastic-net Cox proportional hazards modelling. The resulting risk score showed a significant association with overall survival in the discovery cohort and improved prognostic discrimination beyond clinical variables. An independent evaluation in the CPTAC-LUAD cohort confirmed the prognostic signal and preserved risk stratification across patient groups. Unsupervised clustering of module activity further revealed three transcriptomic patient groups characterised by distinct biological programs, genomic alteration patterns, and survival outcomes. Single-cell analysis also demonstrated that the identified transcriptomic modules reflect coordinated organisation of the tumour-immune-stromal ecosystem across cellular compartments. Together, these findings suggest that LUAD heterogeneity can be organised into coordinated transcriptomic programs with measurable clinical relevance, providing a systems-level framework for representing tumour molecular states.

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