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01.
arXiv (quant-ph) 2026-06-17

Fabless Quantum Chip Design and Commercial Production

arXiv:2606.17956v1 Announce Type: new Abstract: This paper proposes a fabless quantum-chip design and production architecture for superconducting quantum computing, centered on the SPICE-Q multiphysics simulation framework. The proposed ecosystem connects process-certified quantum PDKs, parameterized device cells, traceable model cards, SPICE-Q physical modeling languages, unified Q-EDA flows, foundry sign-off rules, cryogenic test feedback, and reusable quantum IP. In this model, design firms do not merely outsource fabrication; they prepare verified tape-outs under standardized process constraints and calibrated physical models. Its economic value lies in reducing repetitive device debugging, process exploration, and low-level layout effort, while its feasibility depends on PDK maturity, foundry yield, cryogenic test throughput, model-prediction accuracy, data-feedback mechanisms, and IP licensing boundaries. We argue that superconducting quantum chips can move from the current largely vertically integrated development model toward a fabless-foundry ecosystem only when hardware design is supported by standardized, verifiable, and reusable software and process interfaces. The required pillars are certified PDKs, PCell-based parameterized design, SPICE-Q cross-physics simulation, end-to-end Q-EDA automation, and a tradable quantum-IP market. By adapting lessons from the classical semiconductor industry to quantum hardware, this framework defines a path toward scalable, manufacturable, and commercially reusable superconducting quantum-chip design.

02.
arXiv (CS.CV) 2026-06-16

RealityBridge: Bridging Editable 3D Gaussian Splatting Driving Simulations and Real-World Videos

Long-tail hazardous scenarios are essential for safety-oriented autonomous driving, yet they are difficult to collect and reproduce at scale. Editable 3D Gaussian Splatting (3DGS) simulation offers a promising alternative by reconstructing real driving scenes and supporting controllable scene editing. However, edited 3DGS-rendered videos still suffer from a significant Sim-to-Real gap, including rendering artifacts, degraded foreground assets, inconsistent illumination, and temporal flickering. Existing restoration and video generation methods are insufficient for this task, as they often fail to jointly repair 3DGS-specific artifacts, improve visual realism, and ensure temporal consistency. To fill this gap, we propose RealityBridge, a structure-preserving and asset-aware Sim-to-Real framework for edited 3DGS driving videos. RealityBridge uses multimodal controls, including rendered videos, foreground masks, edge maps, and semantic masks, together with a lightweight GateNet for adaptive condition allocation across backbone layers. We further construct targeted training data and introduce autoregressive long-video training with reward-guided post-training to improve restoration quality, temporal stability, and hallucination suppression. Extensive experiments on internal and public driving datasets show that RealityBridge outperforms existing methods in artifact removal, illumination harmonization, and long-sequence temporal consistency.

03.
arXiv (CS.CL) 2026-06-19

REDACT: A Systematically Controlled Multilingual Benchmark for Personal Information Detection

Benchmark infrastructure for personally identifiable information (PII) detection remains limited: existing corpora cover few entity types, use ad hoc generation conditions, and do not show which surface conditions cause detector failures. We present REDACT, a systematically controlled multilingual PII benchmark with 13,427 records, 324,078 entity annotations, 51 entity types, 4,127 surface-form patterns, and 25 languages across 9 scripts. A strength-2 covering-array sampler controls nine generation axes: domain, format, difficulty, length, density, code-switching, language, adjacency, and co-occurrence. Three entity-level metadata fields (disclosure status, disclosure form, and a GDPR-aligned sensitivity tier) enable stratified evaluation beyond aggregate or per-type F1. From the full benchmark, we evaluate five detectors (Presidio, GLiNER, the OpenAI Privacy Filter, GPT-4.1, and Claude Sonnet 4.6) on a locked, language-stratified sample of 1,000 records. Aggregate F1 masks an architecture-dependent failure structure: the rule-based detector performs poorly on the highest-stakes data, including HIGH-sensitivity categories (recall 0.07) and non-verbatim disclosure forms, while the LLM detectors remain more robust, with the HIGH tier as their strongest sensitivity slice. A three-model reference-free LLM-as-judge assessment corroborates that sensitivity-tier assignment is the task's hardest axis. We release the benchmark, schema, prompts, and stratified evaluation harness.

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

Canonical Variates in Wasserstein Metric Space

arXiv:2405.15768v2 Announce Type: replace-cross Abstract: In this paper, we address the classification of instances represented by distributions on a vector space rather than single points. We consider classification algorithms based on pairwise distances, specifically, the Wasserstein metric between distributions. Central to our investigation is dimension reduction within the Wasserstein metric space to enhance classification accuracy. We introduce a novel approach grounded in the principle of maximizing Fisher's ratio, defined as the quotient of between-class variation to within-class variation. The directions in which this ratio is maximized are termed discriminant coordinates or canonical variates axes. In practice, both between-class and within-class variations are defined as the average squared Wasserstein distances between pairs of distributions, with the pairs either belonging to the same class or to different classes. This ratio optimization is achieved through an iterative algorithm, which alternates between optimal transport and maximization steps within the vector space. Empirical studies are conducted to assess the algorithm's convergence; and experimental results demonstrate that the dimension reduction technique substantially enhances classification performance. Moreover, the new method outperforms well-established algorithms that operate on vector representations derived from distributional data. It also exhibits robustness to variations in how instances are summarized by distributions, such as the number of components in a Gaussian mixture model (GMM) representation.

05.
medRxiv (Medicine) 2026-06-22

Image-based deep learning for emergency electrocardiogram classification

Automated electrocardiogram analysis has advanced largely through digital waveforms, yet many emergency-care workflows rely on ECGs available only as printed tracings, scanned reports, PDFs or mobile photographs. We developed an image-based deep learning system for emergency ECG classification and evaluated it in InCor-EMG, an expert-adjudicated dataset of 18,519 emergency ECGs spanning 12 ECG categories, with labels from 19 cardiologists. On the held-out test set, the final ConvNeXt ensemble achieved a macro F1-score of 0.807 (95% CI, 0.788-0.825), compared with 0.820 (95% CI, 0.805-0.832) for annotating cardiologists, and higher F1-scores than Mortara Veritas in most evaluated categories. Performance was associated more strongly with inter-reader agreement than with training sample size and remained informative across scanned and photographed ECGs, with supportive performance in model-enriched temporal and heterogeneous public-image evaluations. These findings support ECG image classification when digital waveforms are unavailable.

06.
Nature (Science) 2026-06-17

The EU needs to back its ambition to end animal testing with cash

Authors: Unknown Author

The European Union has declared that it wants to stop using animals in chemical safety testing. Its goal will need a timeline and a serious funding commitment. The European Union has declared that it wants to stop using animals in chemical safety testing. Its goal will need a timeline and a serious funding commitment.

07.
Nature (Science) 2026-06-09

People are turning to AI chatbots to plug gaps in health information

A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies. A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies.

08.
arXiv (CS.AI) 2026-06-12

The Internet of Agentic AI: Communication, Coordination, and Collective Intelligence at Scale

Authors:

arXiv:2606.12835v1 Announce Type: cross Abstract: The rapid emergence of autonomous AI agents is transforming artificial intelligence from isolated model inference into distributed systems of reasoning, communication, and action. This paper develops the vision of the Internet of Agentic AI (IoAI): an open ecosystem in which heterogeneous agents discover one another, negotiate responsibilities, exchange context, invoke tools, and execute workflows across cloud, edge, device, organizational, and cyber-physical environments. We synthesize foundations from single-agent agentic AI, multi-agent systems, distributed computing, communication networks, game theory, and security engineering to characterize the architectures and mechanisms required for scalable agent ecosystems. The paper examines agent deployment models, workflow lifecycles, communication protocols, interoperability layers, resource-management challenges, and trust architectures, with case studies in adaptive manufacturing and distributed operational coordination. The resulting framework highlights the central research challenges of controlled emergence, semantic interoperability, secure identity, incentive-compatible coordination, resource-aware orchestration, and governance for large-scale networks of autonomous agents.

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

Bridging the Usability Gap: Lessons from Interpreting Studies for Machine Interpreting Design

Machine interpreting (MI), the live, real-time branch of speech translation, has achieved remarkable progress on standard benchmarks, with some systems approaching human parity on textual fidelity. Yet the user experience remains far inferior to interpreter-mediated communication, revealing what we term the accuracy illusion: systems that appear accurate on paper but fail in practice to support smooth, goal-oriented interaction. This paper defines MI as a distinct subfield of speech translation, with its own characteristics and the need for evaluation methods grounded in communicative effectiveness rather than isolated fidelity metrics. Drawing on insights from interpreting studies, we identify critical dimensions of professional interpreting practice that are overlooked by current systems, and consolidate them into three interdependent design priorities for future MI: agency (context-sensitive initiative and repair), grounding (multimodal and discourse-level situational awareness), and experience (adaptive improvement through real interaction). Together, these priorities chart a path toward closing the usability gap and enabling systems that can sustain authentic multilingual communication in real time.

10.
arXiv (CS.AI) 2026-06-16

RollArt: Disaggregated Multi-Task Agentic RL Training at Scale

arXiv:2512.22560v2 Announce Type: replace-cross Abstract: Agentic Reinforcement Learning (RL) trains LLMs through multi-turn interactions with environments, producing workloads that mix compute-bound prefill, bandwidth-bound decoding, CPU-heavy environment execution, and bursty reward evaluation. Existing systems either colocate all stages on a single GPU cluster or decouple them only at a coarse granularity, overlooking hardware heterogeneity and incurring substantial synchronization overhead across stages. We present ROLLART, a system for multi-task agentic RL on disaggregated infrastructure. ROLLART maps each pipeline stage to best-fit hardware, routing prefill-heavy tasks to compute-optimized GPUs, decode-heavy tasks to bandwidth-optimized GPUs, and environments to CPU clusters. It decouples rollout at the trajectory level, allowing generation, environment interaction, and reward scoring to proceed independently, so that slow or failed environments never block the others. ROLLART offloads stateless reward computation to serverless infrastructure and overlaps rollout with training via staleness-bounded asynchronous weight synchronization. Our results demonstrate that ROLLART effectively improves training throughput and achieves 1.31–2.05 \(\times\) training time reduction compared to various RL systems. We also evaluated ROLLART by training a hundreds-of-billions-parameter MoE model for Qoder product on an Alibaba cluster with above 3,000 GPUs, demonstrating its stability and scalability.

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

Measuring Semantic Progress in Multi-turn Dialogue via Information Gain

Evaluating multi-turn dialogue is challenging because quality emerges across turns rather than within individual responses. We focus on a key dimension of information-seeking dialogue: semantic progress, defined as the accumulation of new, question-relevant, and non-redundant information over the course of a conversation. We formalize semantic progress as question-conditioned uncertainty reduction and introduce an information-theoretic metric that approximates it in embedding space. Our main estimator uses a tractable Gaussian formulation with closed-form updates, while a complementary maximum-entropy argument shows why log-determinant structure arises more broadly when only second-order embedding information is retained. This formulation yields desirable theoretical properties, including monotonicity, additive decomposition of total information gain across turns, and diminishing returns for redundant evidence. Unlike LLM-as-a-judge approaches, our metric requires no autoregressive inference at evaluation time and is fully reproducible for a fixed embedding model. Experiments on MT-Bench, Chatbot Arena, and UltraFeedback show that the proposed metric achieves competitive agreement with human judgments despite targeting only semantic progress, with improved alignment on MT-Bench and UltraFeedback compared to several LLM-based judges. Notably, the method remains effective with lightweight embedding models under CPU-only execution, indicating that semantic progress can be captured without reliance on large model capacity.

12.
arXiv (CS.CL) 2026-06-11

SoftMatcha 2: A Fast and Soft Pattern Matcher for Trillion-Scale Corpora

We present SoftMatcha 2, an ultra-fast and flexible search algorithm that enables search over trillion-scale natural language corpora in under 0.3 seconds while allowing semantic variations in the form of substitution, insertion, and deletion. Our approach employs string matching based on suffix arrays that scales well with corpus size, and represents words as vectors, which underpin its semantic flexibility. To mitigate the combinatorial explosion induced by the semantic relaxation of queries, our method is built on two key algorithmic ideas: dynamic corpus-aware pruning and fast exact lookup enabled by a disk-aware design. We theoretically analyze the efficiency of the proposed method, indicating that it can mitigate exponential growth in the search space. Empirically, on FineWeb-Edu (Lozhkov et al., 2024) (1.4T tokens), it attains substantially lower search latency than existing methods: infini-gram (Liu et al., 2024), infini-gram mini (Xu et al., 2025), and SoftMatcha (Deguchi et al., 2025). As a practical application, our method uncovers benchmark contamination in training corpora that existing approaches miss, and it also benefits information retrieval and paraphrase detection. We also provide an online demo of fast, soft search across corpora in seven languages.

13.
arXiv (CS.CV) 2026-06-16

CropTrack: A Tracking with Re-Identification Framework for Precision Agriculture

Multiple-object tracking (MOT) in agricultural environments presents major challenges due to repetitive patterns, similar object appearances, sudden illumination changes, and frequent occlusions. Contemporary trackers in this domain rely on the motion of objects rather than appearance for association. Nevertheless, they struggle to maintain object identities when targets undergo frequent and strong occlusions. The high similarity of object appearances makes integrating appearance-based association nontrivial for agricultural scenarios. To solve this problem we propose CropTrack, a novel MOT framework based on the combination of appearance and motion information. CropTrack integrates a reranking-enhanced appearance association, a one-to-many association with appearance-based conflict resolution strategy, and an exponential moving average prototype feature bank to improve appearance-based association. Evaluated on publicly available agricultural MOT datasets, CropTrack demonstrates consistent identity preservation, outperforming traditional motion-based tracking methods. Compared to the state of the art, CropTrack achieves significant gains in association accuracy and identification precision scores with a lower number of identity switches.

14.
arXiv (quant-ph) 2026-06-16

Readout-Induced Leakage in Superconducting Circuits with Nonlinear Couplings

arXiv:2606.16055v1 Announce Type: new Abstract: In superconducting circuits, drive-induced unwanted transitions limit the readout power, thereby constraining readout speed and fidelity. When such transitions excite the qubit into leakage states, they produce correlated errors that are particularly harmful for quantum error correction. Native nonlinear qubit-readout resonator coupling is a promising alternative to conventional linear hybridization because it provides intrinsic Purcell protection and stricter selection rules for multiphoton processes. In realistic devices, however, we show that such a coupling alone neither eliminates nor necessarily suppresses drive-induced transitions. Instead, if not appropriately engineered, these couplings often worsen the situation by introducing additional parasitic processes. Moreover, the rates of these unwanted transitions remain sensitive to the choice of readout frequency, regardless of the coupling mechanism. We demonstrate that readout-induced leakage can thus vary by orders of magnitude even when readout frequencies differ by less than ~7%. Our results establish that the benefits of native nonlinear couplings are realized only through informed device design, including the spectral placement of relevant auxiliary modes and elimination of parasitic ones.

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

Application of Artificial Intelligence and Machine Learning in Libraries: A Systematic Review

arXiv:2112.04573v2 Announce Type: replace-cross Abstract: As the concept and implementation of cutting-edge technologies like artificial intelligence and machine learning has become relevant, academics, researchers and information professionals involve research in this area. The objective of this systematic literature review is to provide a synthesis of empirical studies exploring application of artificial intelligence and machine learning in libraries. To achieve the objectives of the study, a systematic literature review was conducted based on the original guidelines proposed by Kitchenham et al. (2009). Data was collected from Web of Science, Scopus, LISA and LISTA databases. Following the rigorous/ established selection process, a total of thirty-two articles were finally selected, reviewed and analyzed to summarize on the application of AI and ML domain and techniques which are most often used in libraries. Findings show that the current state of the AI and ML research that is relevant with the LIS domain mainly focuses on theoretical works. However, some researchers also emphasized on implementation projects or case studies. This study will provide a panoramic view of AI and ML in libraries for researchers, practitioners and educators for furthering the more technology-oriented approaches, and anticipating future innovation pathways.

16.
arXiv (CS.AI) 2026-06-17

DRFLOW: A Deep Research Benchmark for Personalized Workflow Prediction

arXiv:2606.18191v1 Announce Type: new Abstract: Deep research (DR) systems are increasingly used for complex information-seeking tasks, but existing works mainly focus on generating reports and summaries. In contrast, many enterprise tasks instead require an agent to identify concrete workflows which is a sequence of action-steps. For example, rather than summarizing budgeting policies, an agent should be able to determine the steps needed to answer a question such as: "How do I request new headcount given a fixed budget?". Therefore, we introduce DRFLOW, a benchmark for evaluating personalized workflows predicted by agents from heterogeneous sources. Each task requires the agent to identify relevant evidence from scattered sources, then use that evidence to predict the correct action-step sequence for the user's task. DRFLOW contains 100 tasks across five domains, with 1,246 reference workflow steps grounded in more than 3,900 sources. We define seven diagnostic metrics covering factual grounding, step recovery, structural ordering, condition resolution, and personalization. We further present DRFLOW-Agent (DRFA), a workflow-oriented reference agent to predict personalized workflow. We show that although DRFA improves over strong baseline agents (upto 10.02% average F1 score), there is substantial room for improvement remains across these workflow metrics, indicating that predicting complete and correct personalized workflows remains a challenging frontier for deep research.

17.
arXiv (CS.AI) 2026-06-16

Decision-Aware Memory Cards: Counterfactual-Inspired Context Selection and Compression for Tool-Using LLM Agents

arXiv:2606.08151v2 Announce Type: replace Abstract: Modern large language model (LLM) agents do not simply need longer contexts; they need decision-relevant evidence at the moment of action. We study decision-aware context selection: ranking retrieved files, tests, traces, rules, and memories by their expected effect on an agent's next action rather than by semantic similarity alone. We present the Counterfactual-Inspired Context Layer (CICL), which builds an instance context graph, estimates decision-oriented utility for candidate units, and compresses selected evidence into typed memory cards. The same schema can be instantiated with hosted LLM judges, local surrogates, or lightweight rankers, making the selection protocol auditable across model choices. On 50 SWE-bench Verified file-retrieval instances, Qwen3.6-Plus reranking of BM25 top-50 candidates improves hit@1 from 0.58 to 0.78 and MRR@10 from 0.634 to 0.790, with all 2,500 judgments parseable. Controlled diagnostics show that CICL identifies action-critical evidence: removing the top-utility semantic unit reduces F1 from 0.245 to 0.000. In selected-then-compressed mode, memory cards save 44.93 tokens per query while preserving selected evidence. CICL provides a practical layer for measuring, ranking, and compressing decision-critical context for tool-using agents. Code is available at https://github.com/stephen-guan-researcher/CICL.

18.
arXiv (CS.CV) 2026-06-19

MeshPad: Interactive Sketch-Conditioned Artist-Reminiscent Mesh Generation and Editing

We introduce MeshPad, a generative approach that creates 3D meshes from sketch inputs. Building on recent advances in artist-reminiscent triangle mesh generation, our approach addresses the need for interactive mesh creation. To this end, we focus on enabling consistent edits by decomposing editing into 'deletion' of regions of a mesh, followed by 'addition' of new mesh geometry. Both operations are invoked by simple user edits of a sketch image, facilitating an iterative content creation process and enabling the construction of complex 3D meshes. Our approach is based on a triangle sequence-based mesh representation, exploiting a large Transformer model for mesh triangle addition and deletion. In order to perform edits interactively, we introduce a vertex-aligned speculative prediction strategy on top of our additive mesh generator. This speculator predicts multiple output tokens corresponding to a vertex, thus significantly reducing the computational cost of inference and accelerating the editing process, making it possible to execute each editing step in only a few seconds. Comprehensive experiments demonstrate that MeshPad outperforms state-of-the-art sketch-conditioned mesh generation methods, achieving more than 22% mesh quality improvement in Chamfer distance, and being preferred by 90% of participants in perceptual evaluations.

19.
arXiv (CS.LG) 2026-06-17

Asynchronous Decentralized Federated Learning over Lossy Wireless Links via Reception- and Age-Aware Aggregation

arXiv:2606.10774v2 Announce Type: replace Abstract: Decentralized Federated Learning(DFL) enables collaborative model training across wireless edge nodes, including IoT deployments, autonomous vehicles, UAV swarms, and satellite constellations. Operating over lossy wireless links under constraints, these systems cannot rely on retransmissions, so model parameters must be accepted as partial chunks, leading to two key failure modes, which are selection bias, where poor-quality links are systematically under-represented in gossip aggregation, and update staleness, where asynchronous nodes contribute outdated models. We prove that classical gossip aggregation introduces irreducible selection bias proportional to the link-loss rate. We propose DFL-AA (Decentralized Federated Learning with Adaptive AoI-weighted Aggregation), which corrects selection bias using Inverse Probability Weighting (IPW) with online channel estimation and mitigates staleness via Age-of-Information (AoI) decay without requiring a global clock. We prove that DFL-AA removes link-quality distortion in expectation and consistently outperforms state-of-the-art baselines across varying loss rates and heterogeneous channel conditions on fixed directed topologies.

20.
bioRxiv (Bioinfo) 2026-06-11

A quantitative coordinate system for developmental dynamics

Quantitative comparison of morphogenesis across individuals remains a fundamental challenge, as developing embryos vary in shape, orientation and developmental tempo. Moreover, real-time three-dimensional imaging generates large, heterogeneous four-dimensional datasets that are difficult to directly align. As a result, developmental variability is typically described qualitatively rather than measured. Here we introduce STERN, a quantitative framework that learns continuous spatiotemporal representations of morphogenesis directly from in vivo 4D imaging data. By embedding embryos into a shared spatiotemporal space, STERN defines a quantitative developmental coordinate system that enables direct comparison of developmental trajectories across individuals without requiring explicit registration or staging. Applied to mouse embryogenesis, STERN reveals that embryos follow conserved developmental trajectories while progressing at distinct temporal rates, providing a quantitative measure of developmental heterochrony. Extending this framework to zebrafish neural crest light-sheet timelapse imaging, we further show that developmental order is preserved across distinct imaging views even with altered anatomical coverage, supporting the generality of the learned representation across vertebrate imaging contexts. Finally, in developing mouse hearts, where morphogenesis proceeds through subtle and continuously evolving structural changes, STERN resolves fine-scale developmental dynamics at minute-scale temporal resolution that are difficult to localize reproducibly using human experts or general-purpose multimodal AI. Together, these results establish a shared quantitative coordinate system for morphogenesis, in which developmental trajectories become directly comparable across individuals and developmental variability becomes a measurable property.

21.
arXiv (CS.AI) 2026-06-19

VOiLA: Vectorized Online Planning with Learned Diffusion Model for POMDP Agents

arXiv:2606.19729v1 Announce Type: cross Abstract: Planning under uncertainty is an essential capability for autonomous robots. The Partially Observable Markov Decision Process (POMDP) provides a powerful framework for such a capability. Although POMDP-based planning has advanced significantly, its application to real-world problems is often limited by the difficulty of obtaining faithful POMDP models. We present Vectorized Online planning wIth Learned diffusion model for POMDP Agents (VOiLA), a framework that learns task-agnostic POMDP models for online planning under uncertainty. VOiLA learns transition and observation samplers using conditional diffusion models and learns observation-likelihood models for particle-based belief updates. To enable efficient online planning, the diffusion samplers are distilled into compact feedforward generators and integrated with Vectorized Online POMDP Planner (VOPP), an online POMDP planner designed to leverage GPU parallelization. Experimental results indicate the distillation strategy reduces sampling cost by up to nearly three orders of magnitude, making learned generative POMDP models practical for online planning. Evaluation of VOiLA on three benchmark problems indicate that VOiLA achieves equal or better performance than Recurrent Soft Actor Critic while using less than 10% training data, and generalizes much better to unseen environment configurations. Physical robot evaluation indicates VOiLA uses the models learned using only simulated data and generates a policy that successfully accomplish the task in 10 of 10 runs.

22.
medRxiv (Medicine) 2026-06-17

Real-World Effectiveness and Safety of Avacopan in ANCA-Associated Vasculitis: A Systematic Literature Review and Meta-analysis

Background: The efficacy and safety of avacopan in ANCA-associated vasculitis (AAV) has been established in randomized trials of of avacopan as a glucocorticoid (GC) sparing therapy. However, real world evidence (RWE) has an important role in confirming effectiveness and evaluating safety in more generalizable settings. This study aimed to synthesize RWE on the effectiveness and safety of avacopan in adults with AAV. Methods: A systematic literature review and meta analysis of non interventional real world studies was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Eligible studies included adults with AAV treated with avacopan in routine clinical practice. Pooled estimates of effectiveness and safety outcomes were calculated using random effects meta-analyses. Primary outcomes included remission at 6 and 12 months and sustained remission at 12 months. Secondary outcomes included relapse, GC use and dosing, hepatotoxicity, infections, and treatment discontinuation. Exploratory outcomes included changes in estimated glomerular filtration rate (eGFR) and dialysis related endpoints. Results: A total of 71 studies were included and contributed to quantitative analyses. Pooled remission for patients on avacopan was 87% (95% CI: 75%-94%) at 6 months and 93% (95% CI: 86%-97%) at 12 months, and sustained remission was 86% (95% CI: 74%-93%) at 12 months. Relapse at 12 months was low (7%; 95% CI: 4%-11%). GC use was 36% at both 6 and 12 months. Improvements in eGFR were observed at 6 months (18 mL/min/1.73 m2) and 12 months (18 mL/min/1.73 m2), and dialysis liberation was 66% in a limited subset. Among avacopan patients, 11% experienced any hepatotoxicity, including 7% with serious (defined as directly reported or requiring hospitalization) hepatotoxicity, while 7% experienced serious (defined as directly reported or requiring hospitalization) infection. Conclusions: In real world clinical practice, avacopan is associated with high remission rates, low relapse rates, and a consistent GC sparing effect, with effectiveness comparable to standard of care regimens. Findings support its clinical use with appropriate safety monitoring; however, the observed heterogeneity in hepatotoxicity and the limited comparative effectiveness evidence highlight areas requiring further investigation.

24.
arXiv (CS.AI) 2026-06-19

Grounded Inference: Principles for Deterministically Encapsulated Generative Models

Authors:

arXiv:2606.19753v1 Announce Type: new Abstract: The incorporation of generative models into traditional computational systems presents both enormous opportunity and tremendous peril. Although many early adopters have realized these perils at great expense, the field still requires foundational frameworks to de-risk incorporation of AI into traditional systems. This manuscript establishes this foundation through the definition of four specific primitives of AI blended architecture, designed to enable deterministic encapsulation of probabilistic models. It further establishes two overarching anti-patterns broadly represented across industry to serve as warnings for engineers in this field. This framework was designed to enable successful integration of AI into traditional systems while providing a foundation upon which generative model providers could build the next generation of generative model interfaces.

25.
arXiv (CS.CL) 2026-06-17

PACE-RAG: Patient-Aware Contextual and Evidence-Constrained RAG for Clinical Drug Recommendation

Drug recommendation requires a deep understanding of individual patient context, especially for complex conditions like Parkinson's disease. While LLMs possess broad medical knowledge, they fail to capture the subtle nuances of actual prescribing patterns. Existing RAG methods also struggle with these complexities because guideline-based retrieval remains too generic and similar-patient retrieval often replicates majority patterns without accounting for the unique clinical nuances of individual patients. To bridge this gap, we propose PACE-RAG (Patient-Aware Contextual and Evidence-Constrained RAG). Rather than directly copying frequent medications from retrieved patients, PACE-RAG personalizes recommendations by first extracting patient-specific clinical features, retrieving cases around these features, and then refining the final prescription using the patient's current symptoms, active medication history, and focus-specific prescribing tendencies. By analyzing treatment patterns tailored to specific clinical features, PACE-RAG generates patient-specific medication recommendations along with an explainable clinical summary. Evaluated on a Parkinson's cohort and the MIMIC-IV benchmark using Llama-3.1-8B and Qwen3-8B, PACE-RAG achieved state-of-the-art performance, reaching F1 scores of 80.84% and 47.22%, respectively. These results suggest that PACE-RAG is a robust and clinically grounded framework for personalized decision support. Our code is available at: https://github.com/ChaeYoungHuh/PACE-RAG.