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01.
medRxiv (Medicine) 2026-06-17

County Year Informatics Model for Annual and Cumulative Unique Lung Cancer Screening Eligibility in Maryland, 2026 to 2045

Authors:
Adebamowo↗S. N↗

Purpose: Population-level lung cancer screening programs require denominators that reflect age, smoking history, geography, and changing eligibility over time. We estimated annual prevalent and 20-year cumulative unique low-dose computed tomography screening eligibility for Maryland residents under alternative screening criteria. Methods: We built a deterministic cohort-cell stock-flow simulation using Maryland county-equivalent jurisdiction projections by age, sex, and race/ethnicity, with ACS socioeconomic/nativity covariates and smoking-history priors for ever-smoked status, pack-years, and quit-years. Scenarios included USPSTF 2013 legacy, USPSTF 2021, ACS 2023/2024, a risk-model-expanded sensitivity, and ever-smoked-only capacity stress tests. Cumulative unique eligibility counted people once at first eligibility rather than summing annual prevalent person-years. Results: Under USPSTF 2021, an estimated 238,346 Maryland residents were eligible in 2026 and 245,326 in 2045. The 20-year cumulative unique denominator was 768,668, whereas naively summing annual prevalent counts produced 4,850,735 person-years, a 6.31-fold overcount. ACS 2023/2024 expanded annual eligibility to 314,616 in 2026 and cumulative unique eligibility to 902,796 by adding remote former smokers. Ever-smoked-only adult eligibility was 1,957,699 in 2026 and 3,383,683 cumulative unique over 20 years. Conclusion: A Maryland statewide screening initiative should plan from cumulative unique eligibility and county-equivalent jurisdiction-specific burden rather than annual prevalence alone. Explicit pack-year and quit-year modeling materially changes statewide and county allocation compared with current-smoking proxy models.

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02.
arXiv (CS.LG) 2026-06-11

Few-Shot Resampling for Scalable Statistically-Sound Data Mining

Authors:
Leonardo Pellegrina↗Fabio Vandin↗

arXiv:2606.11235v1 Announce Type: new Abstract: A key step in knowledge discovery is the evaluation of data mining results. In several applications, including pattern mining, graph analysis, and others, this step includes the evaluation of the statistical significance of the results, to avoid spurious discoveries due only to noise or random fluctuations in the data. While specialized procedures have been developed for some specific applications, resampling-based approaches are widely used, in particular for complex analyses where analytical results cannot be derived. However, current resampling-based approaches require the generation and analysis of thousands of resampled datasets, and are therefore impractical for large datasets or computationally intensive analyses. In this paper, we introduce FewRS, a simple and effective resampling-based approach to assess the statistical significance of data mining results with rigorous guarantees on the probability of false discoveries. Our approach can be used in every situation where resampling-based approaches are applied. FewRS builds on our derivation of a novel bound to the supremum deviation of test statistics representing the quality of data mining results. We prove that FewRS needs to generate and analyze an extremely small number of resampled datasets, leading to a highly scalable approach with wide applicability. We test our approach on common tasks such as pattern mining and network analysis. In all cases, our approach results in a reduction of up to two orders of magnitude in running time compared to the state of the art, while preserving high statistical power, enabling the statistical validation of data mining results on large-scale real-world datasets.

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03.
arXiv (CS.AI) 2026-06-24

FedSteer: Taming Extreme Gradient Staleness in Federated Learning with Corrective Projections and Caching

Authors:
Haoran Zhang↗Cain\~a Figueiredo Pereira↗Marie Siew↗Xutong Liu↗Carlee Joe-Wong↗Rachid El-Azouzi↗

arXiv:2606.10124v2 Announce Type: replace-cross Abstract: Federated learning (FL) is often subject to aggregation variance if clients do not consistently participate in training rounds. While reusing stale model updates from inactive clients is a common technique to reduce this variance, we find that with skewed client participation, the resulting update staleness can become severe enough to destabilize training. To remedy this, we propose FedSteer, a novel method that constructs a gradient subspace from a cache of recent client gradients to serve as a low-dimensional representation of the current optimization landscape. FedSteer projects an active client's true gradient onto this subspace to find a set of optimal coordinates. For an inactive client, FedSteer reuses these coordinates with the now-evolved subspace drifted by other active clients. This process effectively "steers" outdated gradients toward the current global objective. This is complemented by a selective caching strategy that identifies a representative client subset to form the subspace, reducing server memory. Experiments demonstrate that FedSteer significantly outperforms baselines, preventing performance collapse in challenging scenarios while delivering accuracy gains of over 7% in others.

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

Policy-driven Conformal Prediction for Trustworthy QoT Estimation

Authors:
Kiarash Rezaei↗Omran Ayoub↗Paolo Monti↗Carlos Natalino↗

arXiv:2606.12501v1 Announce Type: new Abstract: We propose Conformal QoT, a policy-driven framework that combines statistically guaranteed QoT estimation with operational decision policies, enabling reliable lightpath-feasibility predictions under domain shift and improving accuracy from 92\% to 99.6\% on open datasets.

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05.
arXiv (CS.AI) 2026-06-12

Who Pays the Price? Stakeholder-Centric Prompt Injection Benchmarking for Real-world Web Agents

Authors:
Zihao Wang↗Yiming Li↗Yutong Wu↗Zheyu Liu↗Kangjie Chen↗Fok Kar Wai↗Pin-Yu Chen↗Vrizlynn L. L. Thing↗Bo Li↗Dacheng Tao↗Tianwei Zhang↗

arXiv:2606.13385v1 Announce Type: cross Abstract: Web agents driven by large language models (LLMs) are increasingly deployed in real-world environments, where they operate over untrusted web content and execute actions with direct consequences. This makes them vulnerable to prompt-injection attacks, in which seemingly benign content embeds adversarial instructions that manipulate agent behaviour. Existing security benchmarks adopt an attack-centric perspective, focusing on the technical feasibility of injections while overlooking the nuanced distribution of resulting harms. In practice, however, prompt-injection risk is victim-dependent: a single exploit can produce asymmetric consequences for different stakeholders, and the same attack pattern may exhibit substantially different effectiveness depending on whom it targets. To capture these properties, we introduce \sysname, a stakeholder-centric benchmark to systematically categorize and attribute harm in real-world web agent systems. It distinguishes between affected entities (e.g., user, seller, platform), decomposes the attacks into concrete objectives, and evaluates each case with complementary outcome- and process-level metrics. Our results reveal substantial and heterogeneous vulnerabilities: not a single attack objective is reliably resisted by current agents, and failures distribute across qualitatively distinct modes ranging from stealthy parasitism (attack succeeds without disrupting the user's delegated task) to misaligned disruption (task disrupted without attack success) and compounded failure (both adversarial objective and task integrity simultaneously violated). These patterns are missed by conventional evaluation, highlighting the need for stakeholder-aware assessment of LLM-based agents in real-world deployments. Benchmark is available at https://github.com/StakeBench/SBC.

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

Traits Run Deeper: Trait-Specific Asymmetric Fusion for Personality Assessment

Authors:
Jia Li↗Qian Chen↗Wei Wang↗Xinyu Li↗Zhenzhen Hu↗Dongsheng Shao↗Richang Hong↗Meng Wang↗

Personality assessment aims to infer stable personality traits from dynamic behaviors across language, voice, and facial cues. Since different personality dimensions are revealed through distinct behavioral perspectives, modeling trait-specific evidence is challenging. However, most existing approaches adopt a uniform multimodal fusion strategy across all dimensions, assuming identical modality contributions. This overlooks trait-specific modality preferences and introduces cross-modal interference. To address this issue, we propose a novel personality assessment framework called Traits Run Deeper, which consists of three components. Specifically, the Multimodal Foundation Representation (MFR) module constructs personality-oriented multimodal inputs and leverages psychology-informed semantic templates as anchors, enabling foundation models to capture trait-relevant information. Building upon MFR, the Trait-Specific Modality Fusion (TSMF) module acts as an asymmetric fusion mechanism, allowing each dimension to selectively exploit different modality pathways from modality-specific modeling to complementary fusion. Thus, TSMF captures heterogeneous modality preferences while reducing cross-modal contamination. Furthermore, the Distribution-Calibrated Personality Regression (DCPR) module mitigates label imbalance and central tendency bias through target distribution calibration, improving robustness and stability. Experimental results on the AVI Challenge 2026 validation set demonstrate the effectiveness of the proposed framework, reducing mean squared error (MSE) by approximately 25% compared with the baseline. Consistent improvements are observed on the official test set, where our method achieves the best performance and ranks first in the Personality Assessment Track. The source code will be made available at https://github.com/MSA-LMC/AVI2026.

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

Modeling Day-Long ECG Signals to Predict Heart Failure Risk with Explainable AI

Authors:
Eran Zvuloni↗Ronit Almog↗Michael Glikson↗Shany Brimer Biton↗Ilan Green↗Izhar Laufer↗Offer Amir↗Joachim A. Behar↗

arXiv:2601.00014v2 Announce Type: replace-cross Abstract: Heart failure (HF) affects 11.8% of adults aged 65 and older, reducing quality of life and longevity. Preventing HF can reduce morbidity and mortality. We hypothesized that artificial intelligence (AI) applied to 24-hour single-lead electrocardiogram (ECG) data could predict the risk of HF within five years. To research this, the Technion-Leumit Holter ECG (TLHE) dataset, including 69,663 recordings from 47,729 patients, collected over 20 years was used. Our deep learning model, DeepHHF, trained on 24-hour ECG recordings, achieved an area under the receiver operating characteristic curve of 0.80 that outperformed a model using 30-second segments and a clinical score. High-risk individuals identified by DeepHHF had a two-fold chance of hospitalization or death incidents. Explainability analysis showed DeepHHF focused on arrhythmias and heart abnormalities. This study highlights the feasibility of deep learning to model 24-hour continuous ECG data, capturing paroxysmal events essential for reliable risk prediction. Artificial intelligence applied to single-lead Holter ECG is non-invasive, inexpensive, and widely accessible, making it a promising tool for HF risk prediction.

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

V2P-Manip: Learning Dexterous Manipulation from Monocular Human Videos

Authors:
Kaihan Chen↗Yanming Shao↗Haifeng Ji↗Xiaokang Yang↗Yao Mu↗

Achieving autonomous robotic dexterous manipulation requires precise, human-like action sequences at scale. As a scalable supplement to costly teleoperation data, extracting trajectories with both visual fidelity and physical plausibility from monocular videos represents a promising frontier in embodied AI. To this end, we introduce V2P-Manip, an efficient framework designed to learn dexterous manipulation policies directly from human demonstration videos. We establish an efficient, integrated pipeline encompassing 3D asset acquisition, trajectory estimation, and dexterous policy learning. To bridge the gap between visual perception and physical constraints, we introduce a two-stage refinement process to enforce spatial alignment and physical consistency. Evaluations on the TACO and OakInk benchmarks demonstrate that our approach significantly outperforms previous methods in pose accuracy, adaptability to unstructured environments, and training efficiency. Ultimately, experimental results confirm an average success rate of over 75% across multiple synthetic manipulation tasks and validate the adaptability of the extracted manipulation priors across diverse dexterous hand embodiments.

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09.
medRxiv (Medicine) 2026-06-12

Cancer care disruption during the COVID-19 pandemic in Ontario, Canada: A sequential mixed-methods study

Authors:
Timilshina↗Jacobson↗Birze↗Wodchis↗W. P↗Kuluski↗Strumpf↗Ammi↗

Introduction The COVID-19 pandemic profoundly disrupted healthcare delivery worldwide, with cancer care among the most affected services. Prior studies documented delays in referrals, reduced specialist access, and increased provider burden. However, the extent to which these experiences were reflected at the system level remains unclear. Objective To document cancer care experiences and examine whether these experiences were reflected in population-level health system indicators across Ontario, Canada. Methods We used an exploratory sequential mixed-methods design. Qualitative data were collected through focus groups and semi-structured interviews with 32 participants, including patients with cancer (n=8), caregivers (n=5), healthcare providers (n=14), and decision-makers (n=5) across two hospital settings in Ontario, Canada. Emergent themes informed the development of quantitative indicators. We then conducted a retrospective population-based analysis of linked administrative health databases for cancer patients in Ontario (n=87,786) to assess the prevalence of identified themes. Results Four themes emerged: (I) delays in diagnosis and screening; (II) disrupted access to primary care; (III) barriers to specialist and mental health services; and (IV) fragmented care for patients with multimorbidity. Quantitative findings corroborated major themes. Screening rates declined for cervical (64.8% to 57.5%) and breast cancer (64.5% to 57.2%). While in-person primary care shifted almost entirely to virtual modalities (8.5% to 95.4%), overall visit volumes remained stable. Specialist care showed uneven patterns, with increased oncology visits but declines in cardiology and mental health services. Patients with multiple comorbidities experienced the largest reductions in non-oncology specialist care. Conclusion The pandemic disrupted key components of cancer care, particularly screening, access to certain specialist services, and care for patients with complex needs. Integrating qualitative and quantitative evidence highlights areas of system vulnerability and underscores the need for coordinated, resilient cancer care capable of maintaining essential services during future crises.

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10.
arXiv (CS.LG) 2026-06-18

Riemannian MeanFlow for One-Step Generation on Manifolds

Authors:
Zichen Zhong↗Haoliang Sun↗Yukun Zhao↗Yongshun Gong↗Yilong Yin↗

arXiv:2603.10718v3 Announce Type: replace Abstract: Flow Matching enables simulation-free training of generative models on Riemannian manifolds, yet sampling typically still relies on numerically integrating a probability-flow ODE. We propose Riemannian MeanFlow (RMF), extending MeanFlow to manifold-valued generation where velocities lie in location-dependent tangent spaces. RMF defines an average-velocity field via parallel transport and derives a Riemannian MeanFlow identity that links average and instantaneous velocities for intrinsic supervision. We make this identity practical in a log-map tangent representation, avoiding trajectory simulation and heavy geometric computations. For stable optimization, we decompose the RMF objective into two terms and apply conflict-aware multi-task learning to mitigate gradient interference. RMF also supports conditional generation via classifier-free guidance. Experiments on spheres, tori, SO(3), and SE(3) demonstrate competitive one-step sampling with improved quality-efficiency trade-offs and substantially reduced sampling cost.

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

RAMEN: Resolution-Adjustable Multimodal Encoder for Earth Observation

Authors:
Nicolas Houdr\'e↗Diego Marcos↗Hugo Riffaud de Turckheim↗Dino Ienco↗Laurent Wendling↗Camille Kurtz↗Sylvain Lobry↗

Earth observation (EO) data spans a wide range of spatial, spectral, and temporal resolutions, from high-resolution optical imagery to low resolution multispectral products or radar time series. While recent foundation models have improved multimodal integration for learning meaningful representations, they often expect fixed input resolutions or are based on sensor-specific encoders limiting generalization across heterogeneous EO modalities. To overcome these limitations we introduce RAMEN, a resolution-adjustable multimodal encoder that learns a shared visual representation across EO data in a fully sensor-agnostic manner. RAMEN treats the modality and spatial and temporal resolutions as key input data features, enabling coherent analysis across modalities within a unified latent space. Its main methodological contribution is to define spatial resolution as a controllable output parameter, giving users direct control over the desired level of detail at inference and allowing explicit trade-offs between spatial precision and computational cost. We train a single, unified transformer encoder reconstructing masked multimodal EO data drawn from diverse sources, ensuring generalization across sensors and resolutions. Once pretrained, RAMEN transfers effectively to both known and unseen sensor configurations and outperforms larger state-of-the-art models on the community-standard PANGAEA benchmark, containing various multi-sensor and multi-resolution downstream tasks. Our code and pretrained model are available at https://github.com/nicolashoudre/RAMEN.

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

Cost-Optimal LLM Routing with Limited User Feedback under User Satisfaction Guarantees

Authors:
Herbert Woisetschl\"ager↗Arastun Mammadli↗Ryan Zhang↗Shiqiang Wang↗

arXiv:2606.19376v1 Announce Type: cross Abstract: Inference costs for large language model (LLM) applications are rapidly growing, driven by surging demand and rising infrastructure cost. Users expect high-quality responses, and in commercial settings this is formally codified in Service Level Agreements (SLAs), creating a fundamental tension between cost and quality. Recent progress on cost-aware LLM request routing has shown potential to resolve this tension, but existing approaches rely on complete feedback signals, offline training, extensive per-workload tuning, and most lack SLA guarantees or inference-time adaptivity. We introduce SLARouter, an online routing algorithm that learns a cost-optimal policy from the sparse, one-sided user feedback available in production systems. SLARouter provides theoretical guarantees for both cost optimality and strict SLA compliance. Experiments across a wide range of LLM benchmarks show that SLARouter satisfies SLA constraints without the need for per-benchmark tuning, reducing operating cost by up to 2.2x over existing baselines.

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

Impact of Hand Impairment and Occlusions on Hand Pose Estimation Accuracy in Augmented Reality Applications

Authors:
Damian M. Manzone↗Mathew Szymanowski↗Olga Taran↗Shuo Cai↗Melissa Marquez-Chin↗Tammy Zeng↗Hardeep Singh↗Cesar Marquez-Chin↗Jos\'e Zariffa↗

Mixed reality applications can be designed for hand rehabilitation. Augmented reality (AR) head mounted displays (HMDs) specifically allow for ecologically valid tasks because individuals can see their real environment and interact with real objects while receiving additional cues on the HMD. While these applications rely on accurate hand pose estimation, there is a gap in investigating the influence of hand impairment or occlusion from real-object interactions on pose estimation accuracy. Further, comparisons between AR HMD predictions and state-of-the-art pose estimation methods have not been established. The current study assessed pose estimation accuracy of the HoloLens 2 HMD and state-of-the-art pose estimation algorithms (WiLoR, HaMeR, WildHands, and MediaPipe) while individuals with cervical spinal cord injury (cSCI; n = 13, Neurological Level of Injury: C3-C6; American Spinal Injury Association Impairment Scale: A-D) and 15 uninjured controls interacted with clear and opaque objects. Ground truth estimates of 3D joint positions were generated via triangulation from a multi-camera setup. Pose estimation accuracy did not differ between the cSCI and uninjured control groups suggesting that 3D joint predictions from the HoloLens 2 and pose estimation algorithms can generalize to populations with hand impairment. Further, clear objects provided a small accuracy advantage over opaque objects (0.1 mm) and predictions from both WiLoR and HaMeR were slightly more accurate than the HoloLens 2 (2 mm). Overall, these results suggest that the HoloLens 2 may be viable for hand rehabilitation applications and the dataset generated can be used to refine pose estimation methods for hand-impaired populations.

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14.
arXiv (quant-ph) 2026-06-24

Gate-Controlled Spin Qubits in Confined Altermagnets

Authors:
Hamed Vakili↗

arXiv:2606.24150v1 Announce Type: cross Abstract: We propose gate-defined spin qubits in electrostatically confined altermagnetic quantum dots. Elliptical confinement of the $d$-wave altermagnetic structure produces a low-energy doublet with opposite spin polarization. For the range of parameters used here, the qubit states energy gap lies in the microwave range while the leakage gap remains in the meV range. Even without spin-orbit coupling, time-dependent simulations show that a phase-controlled quadrupolar gate drive about a fixed bias point implements $X_{\pi/2}$ and $X_\pi$ rotations by resonantly modulating the confinement anisotropy. We extend the study to two-qubits using a double quantum dot. We show that the double quantum dot spectrum can be cleanly projected onto isolated quantum dot product states with a nonzero nonlocal Pauli block in the effective logical two-qubit Hamiltonian. Resonant central-barrier modulation then drives the logical two-qubit component close to a maximally entangled state. These calculations show anisotropic altermagnetic quantum dots as a route to locally gate-controlled spin qubits without requiring spin-orbit coupling.

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15.
arXiv (CS.AI) 2026-06-19

Wisdom of Committee: Diverse Distillation from Large Foundation Models and Domain Experts

Authors:
Zichang Liu↗Qingyun Liu↗Yuening Li↗Liang Liu↗Anshumali Shrivastava↗Shuchao Bi↗Lichan Hong↗Ed H. Chi↗Zhe Zhao↗

arXiv:2402.14035v4 Announce Type: replace-cross Abstract: Knowledge distillation from foundation models to compact domain models is challenging due to substantial gaps in capacity, architecture, and modality. For example, in our experiments, distilling from a 76M-parameter language model to a 2M-parameter recommender closes less than 40% of the performance gap between the undistilled student and the teacher. We show that introducing domain-specific experts – which share the student's architectural characteristics – alongside the foundation model as a diverse teacher committee significantly improves transfer. However, standard multi-teacher methods fail to exploit this diversity: naively combining heterogeneous teachers can degrade performance below single-teacher distillation. To address this, we propose DiverseDistill, an interactive distillation framework that employs a learnable Question-Answer mechanism to generate teacher-conditioned queries and align heterogeneous teacher outputs into the student's representation space. Unlike methods requiring gradient-based co-optimization or architectural modification of teachers, DiverseDistill operates with frozen teachers using only forward-pass inference through their intermediate layers: no parameter updates, no co-training, and no architectural surgery. A dynamic teacher importance mechanism further reduces training cost by filtering low-relevance teachers per sample (e.g., ~30% fewer forward passes with no quality loss for recommendation tasks), while the entire Distillation Module is discarded after training, adding zero inference overhead. Evaluations on recommendation (38x compression) and vision (3.6x compression) tasks demonstrate that DiverseDistill recovers 73-114% of the teacher-student performance gap, consistently outperforming all single- and multi-teacher baselines.

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

Security and Privacy Prompts in the Wild: What Users Ask LLMs and How LLMs Respond

Authors:
Hobin Kim↗Xiaoyuan Wu↗Omer Akgul↗Lujo Bauer↗Nicolas Christin↗

Large language models (LLMs) are widely used to fulfill users' information needs; users ask LLMs about the weather, pose educational questions, and consult them for legal assistance. One particularly understudied area is digital security and privacy (S&P), where users may seek LLMs' help on how to secure their online accounts or protect their computers from cyber attacks. To the best of our knowledge, no prior study has collected or analyzed the S&P questions users ask LLMs; prior research on LLM response quality relied on expert-authored S&P misconceptions or FAQs rather than user queries. Drawing from WildChat, a dataset of 3.2M user-LLM conversations collected in the wild, our study identifies 14,727 S&P prompts and categorizes them into nine categories covering a wide range of S&P topics. From the S&P prompts, we sampled 450 and performed a thematic analysis to characterize the S&P questions users ask LLMs. Separate from the thematic analysis, we curated 270 advice-seeking S&P prompts, where users ask for recommendations, guidance, or specific S&P information. We measured LLM response quality and consistency when posing the prompt to LLMs 10 times. We found that commercial LLMs outperform open-weight models (GPT 5.5 provided "good enough" responses on 98% of prompts; Llama 4 on 47%). However, among prompts that received high-quality responses on average, commercial models sometimes produce contradictory responses across runs, risking confusing or misleading users.

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17.
medRxiv (Medicine) 2026-06-18

Effectiveness and Safety of Bempedoic Acid Across Clinically Relevant Subgroups: Insights from the CLEAR Taiwan Study

Authors:
Wu↗Y.-W↗Chen↗D.-Y↗Chu↗C.-S↗Chang↗Y.-Y↗Tzeng↗B.-H↗Huang↗T.-C↗…

Background Despite available lipid-lowering therapies (LLT), many patients fail to achieve low-density lipoprotein cholesterol (LDL-C) targets. This gap persists across clinically relevant subgroups. Bempedoic acid has demonstrated effective LDL-C lowering with a favorable safety profile in the CLEAR Taiwan study; however, its effects across subgroups in Asian populations remains limited. Methods The phase IV CLEAR Taiwan study (NCT06925100) enrolled patients with inadequately controlled hypercholesterolemia who received bempedoic acid for 12 weeks in addition to background LLT. This analysis evaluated changes in lipid parameters, high-sensitivity C-reactive protein (hsCRP), and safety outcomes in clinically relevant subgroups, including cardiovascular risk, diabetes, age, statin tolerance, and sex. Results A total of 180 patients were included. Bempedoic acid achieved significant LDL-C reductions in all subgroups. Numerically greater LDL-C reductions were observed in primary prevention, statin-intolerant, younger (< 65 years), and female patients, while comparable reductions were observed across diabetes status. Reductions in non-high-density lipoprotein cholesterol, total cholesterol, and apolipoprotein B were consistent with LDL-C findings. Significant decreases in hsCRP were observed in all subgroups, with numerically greater reductions in patients aged < 65 years and those without diabetes. Bempedoic acid was well tolerated, with a low incidence of adverse events and no new safety signals identified. Changes in liver enzymes, renal function, and uric acid were minimal within subgroups. Conclusion Subgroup analyses from the CLEAR Taiwan study demonstrate consistent efficacy and safety of bempedoic acid across clinically relevant subgroups and support its use as a flexible option to address residual gaps in lipid management.

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18.
medRxiv (Medicine) 2026-06-23

Timing of S. aureus-related mortality in a large randomized clinical trial: Implications for future study design

Authors:
Lee↗T. C↗Butler-Laporte↗Cheng↗M. P↗Mertz↗Somayaji↗Afra↗Bai↗Chagla↗Daneman↗Grant↗…

Background: Longer follow-up periods in clinical trials for S. aureus bacteremia (SAB) may capture unrelated deaths, adding random noise that risks biasing trial results towards the null. Objective: To evaluate the timing and infection-relatedness of deaths within a large SAB clinical trial platform. Design: Blinded duplicate adjudication of trial deaths using a modified 7-point Likert-Scale. A third reviewer settled disagreements. Setting: 37 Canadian hospitals participating in the S. aureus Network Adaptive Platform (SNAP) Trial. Participants: 1515 adult patients recruited to SNAP between February 2022 and May 2026. Measurements: Timing and relatedness of 90-day deaths categorized as at least possibly SAB-related not likely to be SAB-related. Optimal follow-up cut-off was determined using Youden's index and graphically. Results: 247 deaths occurred; 97 (39.3%) were adjudicated as at least possibly SAB-related and 150 (60.7%) as not likely related. For probably/definitely related deaths, interrater agreement was 85.0% (Gwet's AC 0.73, substantial); for at least possibly related, it was 77.3% (Gwet's AC 0.55, moderate). Median survival was significantly shorter for SAB-related deaths (12 vs. 30.5 days; difference: 19 days earlier, 95% CI: 12-26, p

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19.
arXiv (CS.CV) 2026-06-15

A Lightweight Fiducial-Based Pipeline for 3D Hyperspectral Mapping of ex-vivo Lumpectomy Specimens

Authors:
Anna Bicchi↗Alberto Rota↗Leonardo Passoni↗Nicola Ancellotti↗Andrea Peroni↗Lorenzo Vinco↗Dario Polli↗Elena De Momi↗

Hyperspectral Imaging (HSI) is a promising modality for intraoperative assessment of resection margins in Breast-Conserving Surgery (BCS), but its clinical translation requires aligning the inherently 2D spectral information onto the 3D shape of the excised tissue so that suspicious regions can be precisely localized for targeted follow-up. We present a fully automated, calibration-free pipeline that produces a 3D hyperspectral point cloud of an ex-vivo lumpectomy specimen from a set of consumer-camera RGB images and a single top-down HSI acquisition. The 3D geometry is reconstructed with a deep-learning Structure-from-Motion backbone, stabilized in a metric reference frame by a custom bundle adjustment that enforces consistency on the corners of four ArUco markers placed around the specimen. The HSI cube is then registered to the reconstruction without recovering the HSI camera pose: the markers, visible in both modalities, define 16 corner correspondences that drive a planar homography, and 3D coordinates are recovered by lookup on an orthographically rendered depth map. Evaluated on two ex-vivo lumpectomy specimens, the pipeline achieves a median 3D registration error below 1~mm and a 2D reprojection error below 0.02 mm, with a total per-specimen processing time under 4 minutes on accelerated hardware. These results support the feasibility of integrating HSI-guided spatial localization into intraoperative margin assessment workflows for breast-conserving surgery.

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20.
arXiv (CS.AI) 2026-06-19

Contagion Networks: Evaluator Bias Propagation in Multi-Agent LLM Systems

Authors:
Zewen Liu↗

arXiv:2606.20493v1 Announce Type: cross Abstract: When large language models serve as evaluators in multi-agent systems, their systematic evaluation biases propagate through the agent network. We introduce Contagion Networks, a formal framework for measuring how evaluator biases spread across interacting LLM agents. In a controlled 3-agent experiment using DeepSeek-chat with three distinct evaluator bias profiles (structured, balanced, evidence-based), we measure the Cross-Agent Contagion Matrix Gamma_3 and find that evaluator biases consistently propagate between agents (gamma in [0.157, 0.352]), even within the same underlying model. We identify three propagation regimes governed by the spectral radius rho(Gamma_N), and demonstrate that homogeneous-model agents produce contagion coefficients 3-5x weaker than cross-model coefficients observed in prior work (MM-EPC: gamma approx 0.85-1.3), placing them in the suppression regime. We show that increasing evaluator committee size from k=1 to k=3 reduces effective contagion by 72.4%, providing an actionable mitigation strategy. We release the open-source Contagion Network experimental framework.

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21.
arXiv (CS.CL) 2026-06-11

Factions Within, Uncertain Across: Within-Document Reader Sub-Groups in Social Highlighting

Authors:
Kazuki Nakayashiki↗Keisuke Watanabe↗

When many people highlight the same document, is the crowd a single consensus, or is it internally structured into reader sub-groups that mark different things – and is that structure a stable property of a reader or of the document? Building on prior work showing an individual's within-document highlighting signal is a whisper while individuality lives in selection, we ask the group-level question on a co-readership platform using a margin-preserving curveball null. Experiment 1: within a document, readers form strong sub-groups – pairs agree far beyond what shared salience, mark density, and sentence popularity predict (nearest-neighbour agreement z=+6.3, significant in 88% of documents). Under an eight-block region-preserving null, shared engagement with the same coarse regions of the document accounts for about 40% of this excess; the majority survives as finer reader-specific agreement (z=+3.6, 77% significant). So the within-document crowd is, in a descriptive sense, factional. Experiment 2: is that grouping a stable reader trait? Here we are honest about power. The cross-document split-half reproducibility of a pair's agreement is near zero pooled (+0.078 and 0.000 in two separately drawn samples), and a power calibration shows the test is informative only for pairs that co-read many documents. In the only informative high-overlap subset (k>=4), point estimates are positive but small-sample, imprecise across the separately drawn samples, never significant, and attenuate under the region-preserving null. We therefore leave cross-document stability unresolved: the data is consistent with anything from situational grouping to a weak-to-moderate stable reader trait. The crowd is factional within a document; whether its factions follow the reader across documents is, honestly, beyond our reach.

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22.
arXiv (CS.CL) 2026-06-18

RegMix-D: Dynamic Data Mixing via Proxy Training Trajectories

Authors:
Kaiyan Zhao↗Zhongtao Miao↗Akiko Aizawa↗Yoshimasa Tsuruoka↗

Data mixture selection is critical for Large Language Model pretraining. Existing methods such as RegMix select a single static mixture by fitting a regression model on small-scale proxy runs. We propose RegMix-D, a simple extension of RegMix to dynamic mixing. Our key observation is that proxy runs produce not only endpoint losses, but also full loss trajectories, which can be used to further improve data mixture. By training regression model on these trajectories, we can predict optimal mixtures at multiple training stages. RegMix-D supports two deployment modes: an offline variant that generates a complete mixture schedule before target training, and an online variant that adapts the mixture during training using observed loss. Experiments on 25B tokens of the Pile dataset with a 1B parameter target model show that RegMix-D consistently improves over RegMix and DoReMi across 13 downstream tasks while remaining proxy-efficient: it surpasses RegMix even with only 128 proxy models (25% of RegMix's proxy compute budget).

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23.
arXiv (CS.CV) 2026-06-16

Efficient Reinforcement for Visual-Textual Thinking with Discrete Diffusion Model

Authors:
Yoonjeon Kim↗Yuhta Takida↗Chieh-Hsin Lai↗Eunho Yang↗Yuki Mitsufuji↗

RL-based post-training has been widely adopted to enable interleaved visual and textual reasoning in unified multimodal models capable of both text and image generation. However, most existing approaches are built upon autoregressive (AR) unified models, which require full image regeneration during visual reasoning. In this work, we demonstrate that multimodal discrete diffusion models are effective alternatives to AR models for reinforcement learning in interleaved reasoning, owing to their ability to perform efficient visual rollouts via localized visual editing rather than full image-token regeneration. This reduces rollout computation during GRPO by 26.9\% compared to AR baselines, with minimal performance drop. Despite the improved efficiency, we find that joint reward assignment, which employs a shared reward signal across modalities, introduces cross-modal interference between unrelated image and text token sequences during RL updates. To address this issue, we propose factorized reward assignment, a strategy that assigns rewards independently to text and vision segments. With factorized reward assignment, our RL approach achieves an 11.2% improvement over joint reward assignment and a 38.04% improvement over the base model.

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24.
arXiv (CS.CV) 2026-06-16

ReportQA: QA-Based Radiology Report Evaluation

Authors:
Yiming Shi↗Shaoshuai Yang↗Xi Chen↗Haolin Li↗Hengyu Zhang↗Che Jiang↗Kaiwen Wang↗Xun Zhu↗Dong Xie↗Fei Wang↗Dejing Dou↗Miao Li↗…

Radiology report evaluation is essential for advancing automated report generation. Natural language generation metrics have limited clinical relevance. Clinical efficacy (CE) metrics evaluate important medical findings, but focus mainly on presence and cover only a limited set of entities. Due to heavy reliance on manual annotations, it is difficult for CE metrics to extend clinical entities or attributes. In clinical practice, radiology reports serve as a medium for information transfer. Clinicians use them to perform downstream diagnostic tasks without directly inspecting images. Based on this insight, we propose ReportQA, a clinical-related and flexible radiology report evaluation framework, supporting detailed quantitative analysis of radiology report generation systems. We first collect datasets covering multiple imaging modalities and anatomical regions. We then construct knowledge trees of clinical entities and attributes with radiologist guidance, and use large language models (LLMs) to extract structured information from raw reports. Next, we generate QA pairs from predefined templates and apply quality control through self-filtering and report-based filtering. During evaluation, the report is treated as context, and an LLM acts as a judge model to answer the QA pairs. Based on the resulting QA accuracy, we introduce QAScore metric. Compared with existing metrics, QAScore shows better alignment with radiologist judgments. Experiments on multiple state-of-the-art vision-language models reveal that current report-based inference paradigms struggle to learn fine-grained clinical representations and exhibit strong negative prior biases. In contrast, question-driven inference provides a more effective alternative. For reproducibility and extensibility, we release the knowledge trees, structured reports, and QA pairs, along with the pipeline code for QA construction and evaluation.

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25.
arXiv (quant-ph) 2026-06-16

Noise-induced shallow circuits and absence of barren plateaus

Authors:
Antonio Anna Mele↗Armando Angrisani↗Soumik Ghosh↗Sumeet Khatri↗Jens Eisert↗Daniel Stilck Fran\c{c}a↗Yihui Quek↗

arXiv:2403.13927v3 Announce Type: replace Abstract: Motivated by realistic hardware considerations of the pre-fault-tolerant era, we comprehensively study the impact of uncorrected noise on quantum circuits. We first show that in the task of estimating observable expectation values any noise truncates most quantum circuits to effectively logarithmic depth. We then prove that quantum circuits under any non-unital noise do not exhibit barren plateaus for cost functions composed of local observables. However, by using the effective shallowness, we also design an efficient classical algorithm to estimate observable expectation values within any constant additive accuracy, with high probability over the choice of the circuit, in any circuit architecture. Taken together, our results establish that, unless we carefully engineer quantum circuits to take advantage of the noise, noisy quantum circuits are unlikely to offer an advantage over shallow ones for algorithms that output observable expectation value estimates, such as many variational quantum machine learning proposals.

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