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01.
arXiv (quant-ph) 2026-06-11

Super-Heisenberg Non-Equilibrium Quantum Sensing with Waveguide-Coupled Emitters

arXiv:2606.11975v1 Announce Type: new Abstract: We explore an array of quantum emitters as non-equilibrium probes, coupled to a one-dimensional photonic waveguide, aiming to estimate its properties such as wave number which encodes the waveguide frequency and dispersive characteristics. By considering transient dynamics following initial excitation, we show that the quantum Fisher information (QFI) can be significantly enhanced through careful emitter positioning. For two-emitter probes, optimal spacing stabilizes populations and coherences in the single-excitation subspace, suppressing super radiant decay and extending both the magnitude and longevity of QFI. Randomized emitter configurations also reveal that vanishing waveguide-mediated cross decay maximizes both achievable sensitivity and the temporal duration over which information about the parameter remains accessible. Extending to multipartite probes, we demonstrate that the maximum QFI and its temporal integral scale with system size, exceeding the Heisenberg limit for all positioning strategies. Our results highlight the potential of waveguide-coupled emitter arrays as versatile quantum sensors, where collective radiative dynamics can be harnessed to achieve tunable, long-lived, and enhanced precision.

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

ReFree: Towards Realistic Co-Speech Video Generation via Reward-Free RL and Multilevel Speech Guidance

Speech-driven talking character animation seeks to generate life-like portrait videos that convey natural conversation behavior, aligning facial motion with spoken audio. Although recent advances in video generation have substantially improved realism in video-based animation, achieving both accurate lip articulation and expressive behavior remains challenging. Existing approaches typically trade off precise phoneme-to-lip synchronization against dynamic facial expressions and head motion, yielding animations that are either accurate yet rigid, or expressive but poorly synchronized. We address this challenge by proposing ReFree-S2V, a flow-matching speech-to-portrait animation framework that builds upon a pretrained video generation model to achieve fine-grained speech articulation and high-level expressive cues in speech-driven portrait animation. This model introduces a multi-level speech representation capturing phonetic and prosodic information at both local and global granularities. These representations are selectively injected into transformer blocks via learnable level selectors, enabling both accurate lip synchronization and natural expressive motion. To achieve natural head movements, we further introduce a novel reward-free reinforcement learning scheme into flow-matching training to discourage perceptually implausible motion without relying on handcrafted synchronization metrics or reward models, or the high cost of human preference annotation. Extensive experiments demonstrate that ReFree-S2V achieves state-of-the-art performance, significantly outperforming existing methods in both quantitative lip-sync accuracy and qualitative human evaluations of naturalness and expressivity.

03.
arXiv (math.PR) 2026-06-18

Functional central limit theorems for non-local branching Markov processes

arXiv:2502.19382v2 Announce Type: replace Abstract: The aim of this paper is to study the fluctuations of a general class of supercritical branching Markov processes with non-local branching mechanisms. We establish functional central limit theorems and show that the limiting behaviour falls into three regimes, determined by the size of the spectral gap associated with the first-moment semigroup of the branching process. The main novelty is to develop a unified functional fluctuation theory for spatial branching Markov processes with non-local reproduction, allowing a general finite-dimensional spectral structure for the first-moment semigroup, including non-simple leading eigenvalues and nilpotent Jordan-type components. In doing so, we extend the classical small, critical and large fluctuation trichotomy beyond the finite-type and local spatial settings, and obtain limiting processes that capture the covariance structure induced by non-local offspring displacement.

04.
arXiv (CS.CL) 2026-06-19

MENTOR: Reinforcement Learning via Flexible Teacher-Optimized Rewards for Tool-Use Distillation

Distilling the tool-use capabilities of large language models (LLMs) into small language models (SLMs) is essential for their practical application. The predominant approach, supervised fine-tuning (SFT), suffers from poor out-of-domain (OOD) generalization due to its rigid alignment with static teacher trajectories. While reinforcement learning (RL) offers an alternative, the capacity limitations of SLMs pose a severe dilemma: sparse outcome rewards provide insufficient guidance, whereas strict trajectory matching imposes overly restrictive constraints. To bridge this capacity-driven gap, we propose MENTOR, which introduces a flexible yet process-aware reward structure. Instead of enforcing rigid replication, MENTOR uses the teacher's reference to guide tool-use behavior, balancing behavioral alignment with downstream performance. Extensive experiments on controlled executable-tool benchmarks demonstrate that MENTOR improves OOD tool-use performance compared to SFT and strict RL baselines. Our findings suggest that within verifiable tool-use environments, flexible tool-use alignment offers a more effective approach than strict trajectory replication for developing adaptable small models.

05.
medRxiv (Medicine) 2026-06-15

Mucosal and Systemic Antibodies Associated with Clinical Protection in a Pertussis Controlled Human Infection Model

Background The engagement of mucosal and systemic immunity in preventing Bordetella pertussis colonization and infection in humans, the impact of prior vaccination on host immunity and protective outcomes, and the dynamics of the host response following exposure remain poorly understood. Methods Healthy adults were challenged with increasing colony-forming units (CFUs) doses, 106-108, of B. pertussis D420 intranasally (NCT05136599). Shedding (PCR and culturing) and symptom development were monitored up to 21 days post-challenge. Serum and nasal wash IgA and IgG were measured before challenge (baseline) and up to 6 months post-challenge. Findings Antibodies increased post-challenge only in infected individuals, primarily nasal IgA. Participants who remained uninfected had higher baseline levels of filamentous hemagglutinin (FHA)- specific mucosal IgA and IgG, and higher serum IgA against fimbriae 2/3 (FIM). FHA was negatively associated with bacterial load and was a key discriminator between shedders and non-shedders, up to one week post-challenge. By day 14 post-challenge, pertussis toxin (PT) IgG and FIM IgA in both serum and mucosal samples were negatively associated with bacterial colonization. The majority (96.7%) of acellular pertussis (aP) vaccine recipients (n=23, median age 2.0 years) became infected, compared to 69.4% of those who received whole-cell pertussis vaccine (n=36; median age 32.0 years), and their antibody responses remained distinct following infection. Interpretation Nasal FHA antibodies emerged as early predictors of protection against pertussis infection, while PT IgG and FIM IgA antibodies may reflect clearance after infection. aP-primed individuals were more susceptible to infection, despite their younger age and more recent vaccination. Funding CDC Contract #75D30122C15467 and CDC IPA Agreement #24IPA2417512 Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, US Department of Health and Human Services.

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

A Multi-Center Benchmark for Abdominal Disease Diagnosis and Report Generation from Non-Contrast CT

Multiphasic contrast-enhanced CT (CECT) is widely used for abdominal lesion characterization, yet it carries inherent risks of contrast-induced nephropathy, escalates acquisition burden, and heavily contributes to radiologist workload. To address these challenges, we introduce a novel multi-center benchmark for multi-organ abdominal disease diagnosis and automated radiology report generation, which learns to synthesize contrast-enhanced findings from single-phase non-contrast CT (NCCT). To support this, we curated a large-scale dataset of paired NCCT-CECT studies and their corresponding contrast-enhanced radiology reports from two centers, partitioned into internal sets and an external validation cohort. Under a unified evaluation protocol, we benchmarked five contemporary deep learning architectures encompassing chest-specific, abdomen-specific, and general-purpose multimodal domains. Extensive experiments demonstrate that NCCT retains diagnostic signals, achieving an average multi-organ AUC of 69.1% on the internal cohort and 63.1% on the external cohort, respectively. By releasing this dataset and standardized benchmark publicly, this study aims to catalyze future research into safer, resource-efficient, and globally accessible contrast-free abdominal imaging workflows. Code is available at: https://github.com/xmed-lab/TriALS-Report.

07.
bioRxiv (Bioinfo) 2026-06-22

Drug-Prot: A query system for statistical inference of drug effects and interactions in dynamic proteomic networks

Understanding drug effects and drug-drug interactions is essential for developing combination therapies. We present Drug-Prot, a computational framework that leverages large-scale perturbation proteomics to quantify causal drug effects, drug-drug interactions, and dynamic protein relationships. Using data from 63 single drugs and 59 drug combinations applied to 18 breast cancer cell lines at 6, 24, and 48 hours, Drug-Prot estimates drug effects on protein expression and reconstructs directed temporal protein dependency networks. The publicly available software enables targeted analyses of user-defined protein sets, substantially reducing the multiple-testing burden. Through an interactive web application, users obtain corrected p-values for single-drug and combination effects, directed temporal dependency networks, and downloadable results without requiring access to the underlying proteomic dataset. As a use case, we apply invariance-regularized Random Forests to triple-negative breast cancer cell lines to identify proteins associated with drug response. Querying these proteins in Drug-Prot reveals drug-specific and interaction effects at the protein-network level, illustrating how the framework links candidate causal protein features to actionable drug combinations.

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

Conditional Multi-Event Temporal Grounding in Long-Form Video

Multimodal large language models have made rapid progress in video temporal grounding, yet real-world applications routinely require localizing every event that satisfies compositional temporal and spatial conditions. Existing benchmarks fall short: they localize only a single moment per query, count without temporal conditions, or treat grounding and counting as disjoint tasks. We introduce CoMET-Bench for Conditional Multi-Event Temporal Grounding in long-form video, comprising 2789 queries over 600 videos averaging 33.8 minutes across five real-world domains, with each query composed from 4 temporal conditions, 3 spatial conditions, and a dedicated negative-query subset. We further propose a unified evaluation protocol jointly measuring counting, grounding, and negative-query recognition, including a new Rejection-F1 metric that prevents trivial gaming by lazy "always-empty" models. Benchmarking a broad suite of MLLMs, agent-based, and grounding-specialized methods reveals that existing approaches remain far from solving this task. Building on these findings, we propose CoMET-Agent, a training-free agentic framework that reformulates the task as structured search-and-aggregate, improving F1@0.5 by 6.1% over GPT-5 purely through structural reasoning. Failure analysis further surfaces three open directions: fine-grained entity tracking, position-uniform retrieval, and causal event pairing.

09.
arXiv (math.PR) 2026-06-17

Absolute continuity, supports and idempotent splitting in categorical probability

arXiv:2308.00651v5 Announce Type: replace Abstract: Markov categories have recently turned out to be a powerful high-level framework for probability and statistics. They accommodate purely categorical definitions of notions like conditional probability and almost sure equality, as well as proofs of fundamental results such as the Hewitt–Savage 0/1 Law, the de Finetti Theorem and the Ergodic Decomposition Theorem. In this work, we develop additional relevant notions from probability theory in the setting of Markov categories. This comprises improved versions of previously introduced definitions of absolute continuity and supports, as well as a detailed study of idempotents and idempotent splitting in Markov categories. Our main result on idempotent splitting is that every idempotent measurable Markov kernel between standard Borel spaces splits across another standard Borel space, and we derive this as an instance of a general categorical criterion for idempotent splitting in Markov categories.

10.
arXiv (CS.AI) 2026-06-25

Agentic Software Engineering: Foundational Pillars and a Research Roadmap

arXiv:2509.06216v3 Announce Type: replace-cross Abstract: Agentic Software Engineering (SE 3.0) represents a new era where intelligent agents are tasked not with simple code generation, but with achieving complex, goal-oriented SE objectives. To harness these new capabilities while ensuring trustworthiness, we must recognize a fundamental duality within the SE field in the Agentic SE era, comprising two symbiotic modalities: SE for Humans and SE for Agents. This duality demands a radical reimagining of the foundational pillars of SE (actors, processes, tools, and artifacts) which manifest differently across each modality. We propose two purpose-built workbenches to support this vision. The Agent Command Environment (ACE) serves as a command center where humans orchestrate and mentor agent teams, handling outputs such as Merge-Readiness Packs (MRPs) and Consultation Request Packs (CRPs). The Agent Execution Environment (AEE) is a digital workspace where agents perform tasks while invoking human expertise when facing ambiguity or complex trade-offs. This bi-directional partnership, which supports agent-initiated human callbacks and handovers, gives rise to new, structured engineering activities (i.e., processes) that redefine human-AI collaboration, elevating the practice from agentic coding to true agentic software engineering. This paper presents the Structured Agentic Software Engineering (SASE) vision, outlining several of the foundational pillars for the future of SE. The paper culminates in a research roadmap that identifies a few key challenges and opportunities while briefly discussing the resulting impact of this future on SE education. Our goal is not to offer a definitive solution, but to provide a conceptual scaffold with structured vocabulary to catalyze a community-wide dialogue, pushing the SE community to think beyond its classic, human-centric tenets toward a disciplined, scalable, and trustworthy agentic future.

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

Pixels to Proofs: Probabilistically-Safe Latent World Model Control via Parallel Conformal Robust MPC

We present SLS^2, a framework for safe feedback motion planning from pixels using robust model predictive control (MPC) in learned latent world models. Our approach trains an action-conditioned joint-embedding world model with compact Markovian latent states, enabling efficient gradient-based trajectory optimization through learned latent dynamics. To enforce safety for the true system despite imperfect latent predictions, we inform a GPU-accelerated system level synthesis (SLS) robust MPC scheme with conformal prediction to obtain calibrated latent error bounds and robust latent-space constraint sets. We further learn and conformalize a latent constraint checker, allowing the SLS planner to impose probabilistic safety constraints during closed-loop execution. We evaluate our method on vision-based control tasks, where it improves both goal-reaching performance and safety over latent world-model and safe-planning baselines.

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

Estimating condition number with Graph Neural Networks

arXiv:2603.10277v3 Announce Type: replace Abstract: In this paper, we propose a fast method for estimating the condition number of sparse matrices using graph neural networks (GNNs). For efficient deployment of GNNs, we introduce a graph feature construction with $\mathrm{O}(\mathrm{nnz} + n)$ complexity, where $\mathrm{nnz}$ is the number of non-zero elements in the matrix and $n$ denotes the matrix dimension. We propose two schemes for estimating the matrix condition number using GNNs; One follows by decomposing the condition number and predicts the relatively more computationally intensive part $\|\mathbf{A}^{-1}\|$, without explicitly forming the inverse, while the other is to predict the whole condition number $\kappa$. Our approach can be extended to an arbitrary norm. Extensive experiments are conducted for the estimation of the 1-norm and 2-norm condition numbers, which show that our method achieves a significant speedup over the traditional numerical estimation methods. Our software for GNN condition number estimator is made publicly available at https://github.com/inEXASCALE/sparse-kappa.

13.
arXiv (CS.AI) 2026-06-17

PIVOT: Bridging Black-Scholes Implied-Volatility and Price Objectives via Differentiable Jäckel Operator

arXiv:2606.17065v1 Announce Type: cross Abstract: Modern option-learning systems operate in two coordinates: price space, where markets quote and no-arbitrage constraints are most naturally enforced, and implied volatility (IV) space, where volatility surfaces are smoothed, regularized, and evaluated. The bottleneck is interface, not approximation: Jäckel's seminal "Let's Be Rational" (LBR) solver already inverts the Black-Scholes price to machine precision efficiently. What is missing is a differentiable layer that preserves LBR in the forward pass and avoids backpropagating through its branch logic. Such a layer must also confront the unavoidable singularity of the inverse map in the low-vega regime, where the sensitivity 1/vega diverges as vega -> 0. We close this gap with PIVOT, the Price-Implied-Volatility Objective Translator. PIVOT keeps the LBR forward pass intact and supplies the backward pass by implicit differentiation through the smooth Black-Scholes/Black-76 price map, with an explicit gating contract: invalid domains return NaN, well-conditioned rows receive the exact 1/vega gradient, and low-vega rows are attenuated rather than silently regularized. On a single H100, a fused Triton kernel reaches 1.79e9 IV/s at machine precision (9.3e-14 max relative error vs. the reference C solver); end-to-end label generation sustains 48.9M/s on synthetic chains and 16.6M/s on SPX OptionMetrics. In a HyperIV-style one-day reproduction on SPX, PIVOT-augmented objectives Pareto-dominate the baselines, reducing held-out price MAE by up to 43.4% and the strongest three-seed gated objective improving price MAE by 38.8% and IV MAE by 21.3% jointly; cross-asset results on RUT, VIX, and NDX show directional price-MAE gains of 40.1%, 24.2%, and 16.7%, while an ungated IV-roundtrip control collapses to a degenerate near-zero surface, confirming the gate as a correctness contract rather than a tuning knob.

14.
arXiv (CS.CV) 2026-06-16

PoseGAM: Robust Unseen Object Pose Estimation via Geometry-Aware Multi-View Reasoning

6D object pose estimation, which predicts the transformation of an object relative to the camera, remains challenging for unseen objects. Existing approaches typically rely on explicitly constructing feature correspondences between the query image and either the object model or template images. In this work, we propose PoseGAM, a geometry-aware multi-view framework that directly predicts object pose from a query image and multiple template images, eliminating the need for explicit matching. Built upon recent multi-view-based foundation model architectures, the method integrates object geometry information through two complementary mechanisms: explicit point-based geometry and learned features from geometry representation networks. In addition, we construct a large-scale synthetic dataset containing more than 190k objects under diverse environmental conditions to enhance robustness and generalization. Extensive evaluations across multiple benchmarks demonstrate our state-of-the-art performance, yielding an average AR improvement of 5.1% over prior methods and achieving up to 17.6% gains on individual datasets, indicating strong generalization to unseen objects. Project page: https://windvchen.github.io/PoseGAM/ .

15.
bioRxiv (Bioinfo) 2026-06-19

Perturbation Curve models continuous transcriptional response trajectories and improves prediction of genetic modulations

Single-cell CRISPR screens, Perturb-seq, have revolutionized functional genomics by revealing biological causality. However, although perturbation assignments are typically represented as discrete labels, the cell-level effective strength of perturbations is often continuous and diverse. Current analytical frameworks struggle to decouple the variability in perturbation strength from the diversity of downstream responses. Here, we present Perturbation Curve (PertCurve), a nonlinear, curve-based computational framework that models the trajectories of transcriptomic responses by explicitly incorporating diverse perturbation magnitudes and strengths. By ordering cells by perturbation strength, we demonstrate that PertCurve accurately recapitulates the response magnitudes and reveals the distinct modularity and asynchrony patterns of downstream gene behaviors. These patterns are categorized into archetypes, including proportional, sensitive, and threshold responses. By applying this framework across CRISPRi/a modalities, we identify universal response patterns in viral infection, apoptosis, and proliferation genes, and reveal previously overlooked context-specific regulatory features in cell differentiation. Finally, incorporating PertCurve into perturbation prediction models and evaluation metrics enhances predictive performance, delivering actionable insights for refining established models.

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

A Multi-Modal Sensor Fusion Instrument for Measuring Regional Human Mobility: The Distributed Human Data Engine (DHDE)

arXiv:2603.21639v2 Announce Type: replace-cross Abstract: Accurately estimating human mobility in peripheral regional economies presents a fundamental measurement challenge: physical ground-truth sensors are sparse, behavioral intent signals are heterogeneous, and environmental friction introduces systematic bias into demand inference. We introduce the Distributed Human Data Engine (DHDE), a multi-modal sensor fusion architecture that addresses this challenge by integrating physical instrumentation (Edge-AI cameras), digital intent signals (route search impression metrics), behavioral records (90,350 spending records, 97,719 standardized survey responses), and meteorological data across four geographically distributed nodes in Fukui, Japan. The primary measurement-science contribution is the design, deployment, and cross-node validation of the DHDE as a sparse-sensor compensation instrument: a heterogeneous sensor fusion architecture that anchors non-stationary digital intent signals to concurrent physical ground-truth counts, correcting for systematic bias introduced by meteorological planning friction. The instrument is implemented as an ensemble inference pipeline (Random Forest and Ordinary Least Squares with Newey-West robust inference), calibrated across 397 daily observations and validated by chronological holdout replication across four geographically distinct node types. The primary OLS specification achieved an in-sample explanatory power of R2 = 0.810 and a chronological out-of-sample predictive performance of R2 = 0.683. Results identify an Under-Vibrancy Paradox where macro-regional visitor satisfaction correlates positively with crowd density (Spearman rank correlation rs = +0.150, p = 0.002). We estimate an annual proxy gap of 865,917 intent-implied visits, corresponding to JPY 11.96 billion (USD 72.6 million) in foregone revenue.

17.
arXiv (CS.AI) 2026-06-12

Rethinking RAG in Long Videos: What to Retrieve and How to Use It?

arXiv:2606.13141v1 Announce Type: new Abstract: Retrieval-augmented generation is moving beyond text into long, egocentric video, where systems must select query-relevant chunks across multiple modalities and temporal granularities. Yet progress in VideoRAG is limited by two gaps: existing benchmarks allow queries to be answered without the video, obscuring retrieval errors, and prior methods apply a single modality-granularity configuration per query, ignoring chunk-level variability. We address both by introducing V-RAGBench, a benchmark of $\langle$query, evidence chunk, answer$\rangle$ triplets that enables faithful, decoupled evaluation of retrieval and generation, and CARVE, a simple method that runs parallel retrievers across configurations and employs chunk-adaptive reranking to identify the winning configuration for each chunk. Each chunk then enters the generator under its winning configuration selected during retrieval, yielding an interleaved evidence form where the chunk-level decision propagates across both stages. CARVE outperforms eight recent VideoRAG baselines, with the chunks supplied to the generator interleaving multiple configurations rather than sharing a single one, a behavior unattainable by query-level methods.

18.
arXiv (math.PR) 2026-06-19

Theory of uncertain probability: can we derive the probability density function of uncertain random experiments with continuously changing conditions?

Authors:

arXiv:2606.20169v1 Announce Type: new Abstract: This paper aims to explore the formation mechanism of probability distribution in situations where the differences among random experiments are distinguishable, and these differences continue to evolve along with the dynamic changes in conditions and their mechanisms of action. To this end, we are motivated to devise a new theoretical system – theory of uncertain probability (TUP) with Kolmogorov's system and nonlinear theories as special cases. TUP develops a novel model that integrates probability and uncertainty as well as the known and unknown to more accurately depict numerous typical random phenomena under more realistic assumptions, and thus provides appropriate tools for greater variety of real needs. It also allows for pioneering interpretation of the causal mechanisms underlying many important distributional characteristics and incorporation of pathwise property to distribution model.

19.
bioRxiv (Bioinfo) 2026-06-23

CellOS: Learning a World Model of Cellular State through Joint Embedding Prediction

Foundation models learned from single-cell transcriptomes are central to the prospect of AI virtual cell that can represent, query and predict cellular state. However, most current single-cell foundation models learn from a single view of gene expression and are optimized primarily through reconstruction or next-token prediction. As a result, they capture expression abundance but can-not explicitly reconcile complementary views of cellular state. Here we present CellOS, a multi-view foundation model that learns cellular representations from paired expression and perception views. CellOS integrates complementary views through a scalable three-stage training strategy that combines causal cell-sentence language modelling, function-preserving dense-to-mixture-of-experts expansion and latent-space alignment via an LLM-JEPA objective. Using this framework, we trained a 12-billion-parameter model on 390.5 million single-cell transcriptomes. Across diverse benchmarks spanning cell-state annotation, batch integration and perturbation-response prediction, CellOS consistently outperformed state-of-the-art single-cell foundation models in cell-state annotation and perturbation-response prediction while preserving robust batch integration. Together, these results suggest that predictive alignment between complementary cellular views provides a scalable path toward representation-centric cellular world models and transferable AI virtual cells.

20.
medRxiv (Medicine) 2026-06-23

Unscreenable: The Burden, Structure, and Analytic Consequences of "Unable to Assess" Delirium Documentation in the Intensive Care Unit

Objective: To quantify the burden, structure, and downstream analytic consequences of "Unable to Assess" (UTA) delirium documentation in the intensive care unit (ICU). Design: Retrospective cross-sectional and repeated-measures study. Setting: A single US academic medical center (Medical Information Mart for Intensive Care IV [MIMIC-IV], 2008-2019). Patients: 72,944 adult ICU stays with at least 1 delirium screen. Interventions: None. Measurements and Main Results: Among 610,632 screens, 130,455 (21.4%; 95% CI, 21.0%-21.8%) were recorded as UTA, exceeding the 119,052 (19.5%) scored positive. The UTA fraction rose from 2.0% at a Richmond Agitation-Sedation Scale (RASS) score of 0 to 97.8% at RASS -4; 22.0% of UTA screens occurred in arousable patients, where UTA was associated with mechanical ventilation (odds ratio [OR], 3.43; 95% CI, 3.17-3.71) and non-English primary language (OR, 3.74; 95% CI, 3.43-4.08). Building the delirium label three ways from the same patients shifted prevalence modestly (32.1% to 30.8%) and prediction (area under the curve, 0.737 to 0.719) but most affected the delirium-mortality association: in a baseline-adjusted model the OR was 4.12 (95% CI, 3.88-4.36) under complete-case handling and fell to 2.16 (95% CI, 2.06-2.27) when UTA was recoded as negative. UTA was recoverable from the observed clinical state (area under the curve, 0.95). Conclusions: In this ICU cohort, Unable to Assess was the most common recorded delirium result other than Negative, exceeding positive screens; recoding it as negative roughly halved the apparent delirium-mortality association by relabeling deeply sedated, high-mortality patients. Delirium datasets should preserve and report UTA, whose concentration among arousable non-English-speaking patients is a measurable equity target.

21.
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.

22.
arXiv (CS.CV) 2026-06-16

Visual Generation in the New Era: An Evolution from Atomic Mapping to Agentic World Modeling

Recent visual generation models have made major progress in photorealism, typography, instruction following, and interactive editing, yet they still struggle with spatial reasoning, persistent state, long-horizon consistency, and causal understanding. We argue that the field should move beyond appearance synthesis toward intelligent visual generation: plausible visuals grounded in structure, dynamics, domain knowledge, and causal relations. To frame this shift, we introduce a five-level taxonomy: Atomic Generation, Conditional Generation, In-Context Generation, Agentic Generation, and World-Modeling Generation, progressing from passive renderers to interactive, agentic, world-aware generators. We analyze key technical drivers, including flow matching, unified understanding-and-generation models, improved visual representations, post-training, reward modeling, data curation, synthetic data distillation, and sampling acceleration. We further show that current evaluations often overestimate progress by emphasizing perceptual quality while missing structural, temporal, and causal failures. By combining benchmark review, in-the-wild stress tests, and expert-constrained case studies, this roadmap offers a capability-centered lens for understanding, evaluating, and advancing the next generation of intelligent visual generation systems.

23.
arXiv (CS.CL) 2026-06-19

SIGMA: Search-Augmented On-Demand Knowledge Integration for Agentic Mathematical Reasoning

Solving mathematical reasoning problems requires not only accurate access to relevant knowledge but also careful, multi-step thinking. However, current retrieval-augmented models often rely on a single perspective, follow inflexible search strategies, and struggle to effectively combine information from multiple sources. We introduce SIGMA (Search-Augmented On-Demand Knowledge Integration for AGentic Mathematical reAsoning), a unified framework that orchestrates specialized agents to independently reason, perform targeted searches, and synthesize findings through a moderator mechanism. Each agent generates hypothetical passages to optimize retrieval for its analytic perspective, ensuring knowledge integration is both context-sensitive and computation-efficient. When evaluated on challenging benchmarks such as MATH500, AIME, and PhD-level science QA GPQA, SIGMA consistently outperforms both open- and closed-source systems, achieving an absolute performance improvement of 7.4%. Our results demonstrate that multi-agent, on-demand knowledge integration significantly enhances both reasoning accuracy and efficiency, offering a scalable approach for complex, knowledge-intensive problem-solving. We will release the code upon publication.

24.
arXiv (CS.CV) 2026-06-17

Graph Neural Networks for Semi-Supervised Image Classification with Multi-Feature Aggregation

Feature extraction involves the identification and extraction of salient characteristics or patterns, including edges, textures, shapes, and color attributes. Contemporary feature extractors predominantly leverage deep learning architectures, such as Convolutional Neural Networks (CNNs) and Vision Transformers (VITs). The availability of diverse feature extractors in the literature provides a wide range of feature representations. Features extracted from an image depend on the specific application, the chosen extractor, and its configuration. Therefore, integrating complementary information by combining distinct extractors offers a promising way to enhance performance. Graph Neural Networks (GNNs), particularly Graph Convolutional Networks (GCNs), have emerged as powerful and widely adopted approaches for semi-supervised image classification, as they effectively leverage both labeled and unlabeled data while exploiting the underlying graph structures that capture relationships among samples. This study proposes a novel approach for GNNs in scenarios where labeled data is scarce, by integrating diverse sets of feature and graph representations derived from various extractors in classification scenarios. Experimental investigations were conducted, encompassing combinations of distinct feature and graph extractors, as well as rank aggregation strategies. The primary contributions of this work are underscored by the experimental findings, which demonstrate that the strategic combination of feature and graph representations, coupled with the application of manifold learning for graph processing, leads to significant improvements in classification accuracy across the majority of experimental conditions. Furthermore, the utilization of rank aggregation techniques to integrate features from different extractors was shown to enhance classification accuracy.

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

EHRNote-ChatQA: A Benchmark for Evidence-Grounded Multi-Turn Clinical Question Answering over Longitudinal Discharge Summaries

Discharge summaries are crucial clinical documents containing the context of a patient's overall hospital stay, and are routinely reviewed by medical experts for patient readmission, ongoing care, and diagnostic decision-making. When reviewing them, medical experts often must iteratively synthesize information across multiple summaries while verifying the evidence supporting each answer. Although large language models (LLMs) are increasingly explored for clinical question answering, existing benchmarks do not sufficiently reflect this setting: they often evaluate exam-style medical knowledge or focus on single-turn question answering with limited evidence-grounding evaluation. We introduce EHRNote-ChatQA, the first benchmark for evidence-grounded multi-turn clinical question answering over patients' multiple discharge summaries. Built from de-identified MIMIC-IV discharge summaries, EHRNote-ChatQA contains 967 patient-level multi-turn samples spanning one to five notes and 16,072 medical-expert-verified QA pairs (8,036 content questions, each paired with an evidence-grounding question) across eight clinical categories. The benchmark is constructed through an expert-informed pipeline combining discharge-summary structuring schema, expert-curated multi-turn QA templates, and LLM-based generation, followed by review and revision of every single QA sample by 11 medical experts. Benchmarking 22 open- and closed-source LLMs reveals several challenges, including that LLMs struggle more with evidence grounding than content answering, multi-turn errors compound across turns, and single-turn clinical QA performance does not reliably transfer to this setting. These findings establish EHRNote-ChatQA as a rigorous and practical benchmark for evaluating clinical QA systems. The dataset will be made publicly available through PhysioNet credentialed access.