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01.
arXiv (quant-ph) 2026-06-24

Quantum Metric Bound State of Light

arXiv:2606.22479v2 Announce Type: replace-cross Abstract: The spatial confinement of defect-induced bound states is conventionally governed by the effective mass in dispersive bands. More recently, Compact Localized States (CLSs) arising from exact destructive interference have been utilized to achieve confinement in flat bands. However, CLSs rely on pristine lattice symmetries and fine-tuned defect profiles. The introduction of a generic local impurity inevitably breaks these strict phase-matching conditions, resulting in extensive bound states whose fundamental length scale has remained an open question. Here, we establish a third regime of confinement: the quantum metric bound state. We provide a rigorous mathematical proof demonstrating that in the absence of kinetic energy and CLS protection, the exponential decay length of these states is lower-bounded by the quantum metric of the unperturbed flat band. We demonstrate the tightness of this geometric limit by constructing a family of highly tunable flat-band generators, and we verify its universality across diverse realistic architectures. Ultimately, this classification establishes the independently measurable quantum metric as a predictive design principle for engineering confined modes in synthetic wave platforms.

02.
arXiv (CS.AI) 2026-06-24

Cycle-Consistent Neural Explanation of Formal Verification Certificates

arXiv:2606.24414v1 Announce Type: new Abstract: Formal verification produces machine-checkable certificates that attest to the satisfaction or violation of temporal properties, yet these certificates remain opaque to non-specialist stakeholders. We propose a cycle-consistent neural architecture that generates faithful natural language explanations of verification certificates. A forward network NN1 maps certificates to explanations, and an inverse network NN2 reconstructs certificates from explanations; a symbolic verifier closes the loop, providing a differentiable faithfulness proxy. A pointer-generator mechanism ensures lexical grounding by copying state names directly from the certificate. We evaluate on 420 test certificates spanning six verification methods (bounded proof, k-induction, inductive invariant, lasso, reachability, witness pair) in both YES and NO verdict variants, drawn from a financial compliance domain with 207 named states. Our trained architecture, combined with a hybrid inference-time routing strategy, achieves 90.0% cycle-verified soundness, surpassing a multi- LLM few-shot baseline (76.1% for the best of 16 LLM combinations across four frontier models) by 13.9 percentage points. The neural model wins on 10 of 12 verdict/kind categories, with three categories reaching 100% soundness. The architecture offers 860x faster inference (185 ms vs. 160 s per certificate for the full multi-LLM baseline), offline operation, deterministic outputs, and zero per-inference cost. These results demonstrate that trained specialization outperforms general-purpose LLM prompting for structured certificate explanation, while eliminating the deployment constraints of cloud-based inference.

03.
arXiv (math.PR) 2026-06-15

The 1/4-phenomenon of placement probabilities of tilings in the Aztec diamond

arXiv:2512.08377v2 Announce Type: replace-cross Abstract: We consider domino tilings of the Aztec diamond. Using the Domino Shuffling algorithm introduced by Elkies, Kuperberg, Larsen, and Propp in arXiv:math/9201305, we are able to generate domino tilings uniformly at random. In this paper, we investigate the probability of finding a domino at a specific position in such a random tiling. We prove that this placement probability is always equal to $1/4$ plus a rational function, whose shape depends on the location of the domino, multiplied by a position-independent factor that involves only the size of the diamond. This result leads to significantly more compact explicit counting formulas compared to previous findings. As a direct application, we derive explicit counting formulas for the domino tilings of Aztec diamonds with $2\times 2$-square holes at arbitrary positions.

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

Incentives and Evidence in Learned Service Orchestration

arXiv:2606.16555v1 Announce Type: cross Abstract: Reinforcement learning for service orchestration has been the subject of sustained research for over a decade, yet it is not used in production at scale. The usual explanation is that learned controllers degrade under delayed and noisy telemetry, workload shifts, and uncontrolled tenants. We test whether existing evidence supports that explanation. We evaluate three highly influential RL-based orchestration systems spanning resource allocation, DAG scheduling, and autoscaling, using pre-registered predictions about comparative degradation under production-relevant perturbations and paired inference with family-wise error correction. Across the tests, most predicted performance reversals do not occur. Diagnostic analyses show that these outcomes often reflect comparator collapse, artefact limitations, or evaluation choices rather than evidence that learned controllers tolerate the perturbations. One apparent advantage under observation lag is roughly fortyfold compared to a Kubernetes HPA-equivalent controller. Another widely cited result cannot be reconstructed from its released artefact, and the strongest reproducible margin is far smaller than the published results. Conclusions also reverse under changes in perturbation magnitude and evaluation mode. Based on these results and broader patterns in the literature, we identify an institutional problem. Publication and review incentives favour benchmark gains against convenient comparators, even when those gains provide little evidence of deployment performance. We argue that the problem is not solely technical. Rather, it is institutional, so learned orchestration needs production-grade comparators, registered perturbation models, separate operational metrics, and publication criteria that reward reproducible operational evidence. Without these changes, the literature can grow without establishing whether learning improves orchestration.

05.
arXiv (CS.AI) 2026-06-16

The Proxy Knows Too Much: Sealing LLM API Routers with Attested TEEs

arXiv:2606.16358v1 Announce Type: cross Abstract: Agents increasingly access large language models (LLMs) through API routers. A router terminates the client's transport-layer security session and opens a separate upstream session, so it holds the full interaction in plaintext. This makes the router an application-layer man-in-the-middle: it can rewrite agent tool calls, swap dependencies for typosquatted packages, trigger attacks only under audit-evading conditions, and passively exfiltrate secrets. Existing client-side defenses are evadable. We propose AEGIS, a provider-transparent attested API router whose data path is a client-verified faithful passthrough. AEGISconfines plaintext handling to a small hardware-enclave component while leaving authentication, scheduling, accounting, and management on the untrusted host. The client verifies the enclave before releasing plaintext. The host can neither read nor alter the interaction, and plaintext leaves only toward destinations fixed by the measured image. We show that all four malicious-router attack classes succeed against a plaintext-access baseline and are blocked by AEGIS, including adaptive tests against the same boundary. The trusted path is $851$ lines, carries three provider-native APIs without conversion, and completes every request under real-provider workload and concurrency. In a seeded audit pilot, two commodity coding agents find eight and ten of ten planted invariant violations. The local relay overhead is about six milliseconds per request.

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

SproutRAG: Attention-Guided Tree Search with Progressive Embeddings for Long-Document RAG

Retrieval-augmented generation (RAG) systems must balance retrieval granularity with contextual coherence, a challenge that existing methods address through LLM-guided chunking, single-level context expansion, or hierarchical summarization. These approaches variously depend on costly LLM calls during indexing or retrieval, limit context aggregation to a single granularity level, or introduce information loss through summarization. We present SproutRAG, an attention-guided hierarchical RAG framework that addresses this trade-off by organizing sentence-level chunks into progressively larger but semantically coherent units, using learned inter-sentence attention to construct a binary chunking tree. Unlike prior approaches that rely on external LLMs, fixed context expansion, or lossy summarization, SproutRAG learns which attention heads and layers best capture semantic document structure, enabling multi-granularity retrieval without additional LLM calls or compressed summaries. At retrieval time, SproutRAG uses hierarchical beam search to retrieve candidates at multiple granularities, capturing multi-sentence relevance beyond flat retrieval. The framework is trained end-to-end with a joint objective that improves both embeddings and tree structure. Experiments across four benchmarks spanning scientific, legal, and open-domain settings demonstrate that SproutRAG improves information efficiency (IE) by 6.1% on average over the strongest baseline. Code is available on https://github.com/AmirAbaskohi/SproutRAG.

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

GDGU: A Gradient Difference-based Graph Unlearning Method for Cyberattack Localization in Electric Vehicle Charging Networks

arXiv:2606.19566v1 Announce Type: cross Abstract: Electric vehicle charging stations (EVCSs) can expose distribution feeders to cyberattacks. While machine learning methods, including graph neural networks, can localize which bus is compromised, significant challenges remain in data sharing and model training. For example, privacy regulations grant EVCS owners the right to delete their training data from a deployed model, yet retraining from scratch on every request is computationally prohibitive. To address this, we study graph unlearning (GU) for EVCS cyberattack localization, formulated as a feature-level unlearning problem on a graph-level multi-label classification task. Specifically, we propose gradient difference-based graph unlearning (GDGU), which removes the influence of the requested deletion data through a first-order parameter correction. The correction is computed from the gradient difference between the original training data and a modified dataset in which only the charging power features at the requested EVCS buses are unlearned. Then, a batch-normalization recalibration and a brief recovery fine-tuning step are applied to restore localization utility. We benchmark GDGU against two second-order GU baselines on the IEEE 34-bus, 123-bus, and 8500-node distribution networks across three graph neural network backbones and cumulative unlearning scenarios. GDGU matches the strongest baseline on localization utility and reaches forgetting fidelity close to full-retraining, while unlearning 10 to 12 times faster than retraining from scratch and using far less memory than the second-order GU baselines.

08.
medRxiv (Medicine) 2026-06-17

Waning protection of long-acting RSV monoclonal antibodies in infants: a Bayesian analysis of clesrovimab and nirsevimab trial data

Clesrovimab and nirsevimab are long-acting monoclonal antibodies used to prevent respiratory syncytial virus (RSV) disease in infants, but waning protection in the first year of life is incompletely characterised. We applied a published Bayesian inference framework to clesrovimab and pooled nirsevimab trial data to estimate time-varying efficacy against medically attended RSV lower respiratory tract infection (LRTI) and RSV-associated hospitalisation, accounting for differences in placebo-arm event timing between trials. Estimated clesrovimab efficacy declined from 60.7% (95% CrI: 46.3-72.6) shortly after dosing to 38.3% (8.6-52.9) at six months against medically attended RSV LRTI, and from 87.1% (71.2-96.2) to 49.6% (10.4-70.7) against RSV-associated hospitalisation. For nirsevimab, corresponding estimates declined from 86.9% (75.4-95.0) to 53.8% (27.4-69.7) against LRTI, and from 77.5% (52.6-91.8) to 49.7% (15.7-68.3) against hospitalisation. After accounting for differences in RSV exposure timing and LRTI endpoint definitions between trials, we found no evidence of a difference in efficacy or waning between clesrovimab and nirsevimab.

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

Empirical Study of Pop and Jazz Mix Ratios for Genre-Adaptive Chord Generation

Authors:

arXiv:2605.04998v2 Announce Type: replace-cross Abstract: This revision updates a pop-to-jazz chord-generation rehearsal study. Best-epoch metrics still show that modest pop rehearsal preserves pop accuracy while improving jazz prediction, but v2 corrects released-checkpoint selection: the released F1 equals Phase 0, F2 had a transcription error, and ft-pop80-v2 restores a hash-distinct jazz-adapted F1 across 3 seeds.

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

FasterPy: An LLM-based Code Execution Efficiency Optimization Framework

arXiv:2512.22827v2 Announce Type: replace-cross Abstract: Code often suffers from performance bugs. These bugs necessitate the research and practice of code optimization. Traditional rule-based methods rely on manually designing and maintaining rules for specific performance bugs (e.g., redundant loops, repeated computations), making them labor-intensive and limited in applicability. In recent years, machine learning and deep learning-based methods have emerged as promising alternatives by learning optimization heuristics from annotated code corpora and performance measurements. However, these approaches usually depend on specific program representations and meticulously crafted training datasets, making them costly to develop and difficult to scale. With the booming of Large Language Models (LLMs), their remarkable capabilities in code generation have opened new avenues for automated code optimization. In this work, we proposed FasterPy, a low-cost and efficient framework that adapts LLMs to optimize the execution efficiency of Python code. FasterPy combines Retrieval-Augmented Generation (RAG), supported by a knowledge base constructed from existing performance-improving code pairs and corresponding performance measurements, with Low-Rank Adaptation (LoRA) to enhance code optimization performance. Our experimental results on the Performance Improving Code Edits (PIE) benchmark demonstrate that our method outperforms existing models on multiple metrics. The FasterPy tool and the experimental results are available at https://github.com/WuYue22/fasterpy.

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

Frontier: Towards Comprehensive and Accurate LLM Inference Simulation

arXiv:2605.21312v2 Announce Type: replace-cross Abstract: Modern LLM serving is no longer homogeneous or monolithic. Production systems now combine disaggregated execution, complex parallelism, runtime optimizations, and stateful workloads such as reasoning, agents, and RL rollouts. Simulation is attractive for exploring this growing design space, yet existing simulators lack the architectural completeness and decision-grade fidelity it demands. Their monolithic-replica abstractions are ill-suited to disaggregated serving, while average-case analytical proxies can distort SLA predictions and even reverse optimization conclusions. We present Frontier, a discrete-event simulator for modern LLM inference serving. Frontier features a disaggregated abstraction. It captures the structure and dynamics of modern serving systems by modeling co-location, Prefill-Decode Disaggregation (PDD), and Attention-FFN Disaggregation (AFD) with role-specific cluster workers, incorporating key runtime optimizations (e.g., CUDA Graphs, speculative decoding) within the scheduler-batch-engine loop, and supporting stateful requests for emerging workloads. It further provides accurate and generalizable predictions of computation, communication, and memory costs across diverse serving scenarios with complex workload compositions. On 16-H800 GPU testbed, Frontier achieves an average throughput error below 4%. Compared with state-of-the-art simulators, it reduces end-to-end latency error from 44.9% to 6.4% under co-location and from 51.7% to 2.6% under disaggregation. It scales to over 1K GPUs on commodity CPUs and enables new use cases such as SLA-dependent Pareto frontier exploration, heterogeneous disaggregated allocation, agentic reasoning scheduling validation, and RL post-training reconfiguration. We release Frontier at https://github.com/NetX-lab/Frontier.

12.
medRxiv (Medicine) 2026-06-22

Paired plasma and EV-enriched plasma proteomics reveal nonredundant sepsis-associated host-response signatures in critical illness

Background: Plasma proteomics may identify host-response signatures in sepsis, but it is unclear whether extracellular vesicle (EV)-enriched plasma provides distinct or redundant information compared with plasma. We compared paired plasma and EV-enriched plasma proteomes in critically ill patients with sepsis and critically ill non-sepsis controls (CINS). Methods: In this prospective observational study, paired plasma and EV-enriched plasma samples were analyzed from 56 critically ill adults, including 40 patients with sepsis and 16 CINS patients. Protein abundance was quantified using liquid chromatography-tandem mass spectrometry. Analyses compared proteomic depth, protein overlap, global concordance between compartments, and differential protein abundance between CINS and sepsis. Exploratory Gene Ontology enrichment was performed as a supplementary analysis. Results: EV-enriched plasma expanded proteomic detection, identifying 2,476 filtered proteins compared with 506 in plasma. Only 386 proteins were detected in both compartments, while 2,090 were unique to EV-enriched plasma and 120 were unique to plasma. Among shared proteins, plasma and EV-enriched plasma showed modest global concordance across critically ill patients (Spearman coeff = 0.322, p = 9.19 x 10^-11), with similar findings in sepsis alone. Differential abundance analysis identified 11 sepsis-associated proteins in plasma and 22 in EV-enriched plasma. Only SAA1, SAA2, and IGFBP6 were significant in both compartments. Exploratory pathway analysis supported acute-phase and inflammatory enrichment in plasma sepsis-associated proteins, while EV-enriched signals were directionally plausible but did not meet prespecified FDR thresholds. Conclusion: Plasma and EV-enriched plasma proteomics capture related but nonredundant sepsis-associated host-response information in critically ill patients.

13.
arXiv (CS.AI) 2026-06-24

Grading the Grader: Lessons from Evaluating an Agentic Data Analysis System

arXiv:2606.24839v1 Announce Type: new Abstract: Agentic data analysis systems produce rich outputs, including code, numerical results, and verbal diagnostics. This makes them more challenging to evaluate than single-turn LLM responses. It is therefore necessary to distinguish genuine disagreement between an agent's output and a ground-truth answer from grading artifacts. We investigate how reliably automated graders assess such a system and what strategies improve grading quality by applying LAMBDA, a multi-agent data-analysis system, on 153 numerical QRData tasks from DSGym. We develop and evaluate a three-layer human-AI grading cascade: strict regex matching, LLM-based lenient grading, and snippet-based human inspection, which combines non-GenAI and GenAI strategies with different failure profiles. Both automated graders achieve 100% observed precision (0/70 false positives). The lenient grader's recall is 97% against human labels. A keyword-anchored extraction pipeline raises the strict grader's recall by 60 percentage points over a last-number heuristic; the lenient grader is architecturally parser-independent. An iterative nudge mechanism raises grading run success from 36% to 97% and lenient-pass rates from 16% to 46%; comparing nudging with and without original-question re-injection shows that re-injection offers no benefit, confirming the nudge as an answer template cue. We further observe in this case study that variable type is the task metadata field most consistently associated with grading pipeline dynamics and observed outcome grades.

14.
arXiv (quant-ph) 2026-06-25

Resonant false vacuum decay in two dimensions on a 4000-qubit quantum annealer

arXiv:2606.25889v1 Announce Type: new Abstract: From cosmology to quantum matter, metastable states often decay through the nucleation and growth of competing domains, with false vacuum decay providing the paradigmatic example of this process. Here we demonstrate a distinct regime in which domain growth outpaces nucleation by orders of magnitude and is controlled by local resonance conditions. Using a programmable quantum annealer with more than 4000 qubits, we realize a two-dimensional quantum Ising model whose metastable spin-polarized state encodes a false vacuum. At a specific value of the longitudinal field, single-spin flips at the boundary of a seeded bubble become resonant, enabling kinetically constrained expansion. Combining experiment with tensor-network simulations and stochastic circuit modeling, we observe nearly ballistic growth of true-vacuum domains with sub-ballistic interface broadening, consistent with Kardar–Parisi–Zhang universality. Our results establish a growth-dominated regime of false vacuum decay and show how large-scale quantum simulation can access nonequilibrium metastable dynamics relevant to quantum field theory, cosmology, and strongly correlated matter.

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

What Limits Does Quantization Place on Dense Top-$k$ Retrieval? A Theoretical Study

arXiv:2606.11780v1 Announce Type: cross Abstract: We establish conditions for embedding a corpus of $N$ documents as $d$-dimensional vectors such that every $k$-subset $S \subseteq [N]$ is realizable as a result of top-$k$ retrieval by some query vector. Recent work shows that $d = O(k)$ suffices for such embeddings to exist in $\mathbb{R}^d$, independently of $N$. We theoretically prove that this corpus-independent bound is specific to infinite precision. With $B$ bits per coordinate, perfect top-$k$ retrieval requires $Bd = \Omega(k \ln N)$; thus, at any fixed precision, the dimension must grow at least logarithmically with $N$. Specializing to a $\ell_2$-normalized $B$-bit uniform scalar quantization model, we also identify a threshold on the precision $B^{*} = O(\ln \ln N)$ below which no dimension suffices, together with two further regimes that bound the feasible $(B, d)$ pairs. Our result implies that in practical vector databases and dense retrieval systems where quantization is standard, the embedding dimension and possibly the precision must grow with the corpus size.

16.
arXiv (CS.AI) 2026-06-12

An Explainable AI Assistant for Introductory Programming Education: Improving Feedback Reliability with Instructor-AI Collaboration

arXiv:2606.12425v1 Announce Type: cross Abstract: Active learning is widely recognized as an effective approach for improving learning outcomes in introductory programming courses. However, insufficient instructional support often limits students' access to timely, personalized feedback, which is crucial for mastering foundational programming concepts. Although recent advances in AI, particularly large language models, offer scalable opportunities for feedback, concerns about explainability and reliability remain. In this paper, we present an AI-driven classroom assistant that leverages an explainable AI model to analyze student code, map logical errors to instructor-identified misconceptions, and deliver instructor-authored feedback, thereby grounding reliability in instructor-defined pedagogical knowledge. To evaluate the effectiveness of our framework, we conducted an expert evaluation to examine its alignment with instructor-verified feedback and deployed the system in a classroom setting to assess students' perceptions of its usability. Results indicate that the assistant can provide accurate, instructor-verified feedback to students while fostering a positive experience.

17.
Nature (Science) 2026-06-10

A first-in-class pulsatile FXR agonist for bile-acid-related liver diseases

Authors:

Nuclear receptors are central regulators of metabolism1, yet therapeutic strategies that enforce continuous receptor activation frequently lead to reduced efficacy and unacceptable toxicity. Here we report a first-principles drug design strategy that aligns pharmacokinetics with physiological signalling cycles. We developed linafexor, a potent non-bile-acid agonist of the farnesoid X receptor (FXR)2; it is engineered for rapid systemic clearance, which enables pulsatile receptor activation that mirrors endogenous bile acid dynamics3–5. Linafexor has robust efficacy across multiple preclinical models of metabolic dysfunction-associated steatohepatitis6, liver fibrosis7, primary biliary cholangitis and primary sclerosing cholangitis8,9. Transcriptomic analyses reveal that, unlike long-acting FXR agonists10,11, linafexor preserves cyclic FXR signalling, avoids receptor downregulation and prevents broad transcriptional dysregulation. Direct manipulation of delivery patterns demonstrates that sustained FXR activation—independent of compound identity—induces severe toxicity, establishing activation duration as a determinant of therapeutic index. In phase 1 clinical studies (ClinicalTrials.gov; NCT05082779), linafexor administered once daily produces transient FXR pathway engagement, marked by (1) induction of FGF1912–14, a key endocrine mediator of bile acid feedback regulation; and (2) suppression of C415, an intermediate reflecting hepatic bile acid synthesis, with no treatment-related adverse events. Together, these findings identify pulsatile FXR activation as a mechanistically grounded and clinically translatable strategy, and establish linafexor as a first-in-class therapeutic for bile acid–related liver diseases. Linafexor is a rapidly cleared FXR agonist designed to mimic natural bile acid signalling, achieving transient receptor activation with strong efficacy and reduced toxicity in preclinical and early clinical studies.

18.
arXiv (CS.CL) 2026-06-11

Teaching Diffusion to Speculate Left-to-Right

Large language models (LLMs) achieve remarkable performance across a wide range of tasks, but their autoregressive decoding process incurs substantial inference costs due to inherently sequential token generation. Speculative decoding addresses this bottleneck by employing a lightweight draft model to propose multiple future tokens that are subsequently verified in parallel by a larger target model. Recent work has demonstrated that diffusion language models are well suited for this setting, as they can generate entire blocks of draft tokens in parallel and thereby alleviate the sequential constraints of autoregressive drafting. A subtlety of this regime is that block-diffusion drafters generate tokens bidirectionally within a block, whereas verification is performed by an autoregressive target model that evaluates tokens in a strictly left-to-right manner, leaving a gap between the symmetric training-time objective and the asymmetric verification-time reward. In this work, we offer an empirical analysis of three training-time interventions that narrow this gap: token positional weighting, a first-error focal loss that targets the position that breaks the accepted prefix within each block, and a chain loss term that substitutes a differentiable surrogate for the expected accepted length. The three interventions act along orthogonal axes (position, block-conditional first error, joint prefix) and compose additively; they are likewise orthogonal to test-time alignment mechanisms such as multi-draft self-selection, with which they can in principle be combined. Across four target models and six reasoning, code, and dialogue benchmarks, the three interventions raise accepted draft length by 21-76% per benchmark over a position-uniform baseline, without adding additional forward passes and without changing the inference pipeline or the rejection-sampling exactness contract.

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

Context-Aware Optimization of Follow-Up Intervals for Type 2 Diabetes Care Using Markov Decision Processes

arXiv:2606.19092v1 Announce Type: cross Abstract: Chronic disease management relies on regular patient-provider interactions to follow-up on disease progression and control. For Type 2 Diabetes (T2D), current guidelines prescribe fixed time intervals between subsequent primary care visits for all patients, overlooking heterogeneity in clinical trajectories and patient characteristics. This study introduces a Contextual Markov Decision Process (CMDP) model to optimize subpopulation-specific follow-up interval decisions using Electronic Health Record (EHR) data from 22,154 T2D patients across 10 primary care clinics. Contexts are identified by: i) dimensionality reduction of variables representing the individual health trajectories utilizing Principal Component Analysis, and ii) assigning patients to contexts via principal components and additional patient-level features using clustering. Two distinct contexts emerged, representing a lower- and a higher-risk subpopulation. CMDP-derived policies recommend: (i) follow-up within 1 month if lab value at current visit is unmeasured; (ii) up to 3 months for elevated lab values or recent hospitalizations; and (iii) 6 to 12 months for sustained glycemic control, with shorter follow-up intervals for patients in high-risk context. The optimal policies achieved lower expected cumulative cost than benchmarks (e.g., in the higher-comorbidity context, the CMDP policy reduced cost by about 34.8%, and in the lower-comorbidity context by about 6.4%, relative to an American Diabetes Association-like fixed interval follow-up policy. These findings demonstrate how context-aware approaches can inform adaptive follow-up strategies, and have the potential to advance chronic care management in primary care by synthesizing machine learning and probabilistic decision models.

20.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

21.
arXiv (quant-ph) 2026-06-17

Practical Tests and Witnesses of Fermionic non-Gaussianity

arXiv:2605.26218v2 Announce Type: replace Abstract: Fermionic Gaussian states describe free fermions and underlie the mean-field picture of matter, from metals to superconductors; they are also efficiently simulable on classical computers. Departures from Gaussianity – the correlations produced by interactions – are therefore what make a fermionic system hard to simulate classically and useful for quantum computation, analogous to the role of magic in stabilizer-based quantum computation. Yet detecting and quantifying such non-Gaussianity at scale has remained challenging. Here we introduce practical tests and witnesses of fermionic non-Gaussianity built on fermionic antiflatness, a measure derived from the two-point covariance matrix. We estimate it with two protocols – a two-copy Bell measurement and a single-copy scheme using commuting Majorana bilinears – that determine whether a state is Gaussian or far from it at lower measurement cost than existing approaches, using only operations native to fault-tolerant hardware. For mixed states, a purity-corrected witness certifies non-Gaussianity and remains robust under strong noise; running it on the IQM quantum processor, we find that noise can both reduce and enhance non-Gaussianity. Finally, we show that preparing pseudorandom fermionic states requires extensive non-Gaussianity. Together, these tools enable the study and certification of non-Gaussian fermionic resources on present-day quantum devices.

22.
bioRxiv (Bioinfo) 2026-06-11

HoloCell: A Generative Foundation Model for Holistic Cellular Modeling

Single-cell multi-omics technologies have recently advanced to enable the profiling of epigenomic, transcriptomic, and proteomic layers within individual cells, offering new opportunities to characterize cellular states as integrated biological systems. However, developing a unified framework that can seamlessly integrate diverse omics modalities and remain robust to heterogeneous modality missingness remains challenging. Here we present HoloCell, to our knowledge the first generative foundation model for joint representation learning and generative modeling across all three major single-cell omics modalities, i.e., epigenomics, transcriptomics, and proteomics. HoloCell contains over 860 million parameters and is pretrained on the Human-Multi-Omics-Corpus, which comprises approximately 468 million single-cell profiles across these three omics layers, corresponding to over 425 billion tokens. HoloCell introduces a simple yet biologically grounded hierarchical tokenization strategy that encodes cis-regulatory elements, genes, and proteins as structured tokens within a shared modeling framework. We evaluated HoloCell across single-omics representation learning, paired multi-omics integration, unpaired multi-omics alignment, and cross-modal generation via iterative diffusion and remasking, demonstrating its superior performance and flexibility across diverse omics tasks. From a representation perspective, HoloCell provides a unified digital mapping of cellular states across multiple omics layers, capturing cell heterogeneity as an integrated system. From a generation perspective, its iterative diffusion and remasking framework accounts for the inherently unordered nature of biological features, enabling in silico simulation of multi-omics information flow. Together, these capabilities position HoloCell as a versatile foundation model toward the emerging concept of a virtual cell, offering both systematic characterization and generative simulation of cellular systems within a unified framework.

23.
arXiv (quant-ph) 2026-06-17

SPICE-Q and Large-Scale Quantum Chip Production

arXiv:2606.17907v1 Announce Type: new Abstract: We propose SPICE-Q, a SPICE-inspired design-technology co-optimization framework for superconducting quantum processors. Rather than replacing tools such as HFSS, Qiskit Metal, pyEPR, SQcircuit, SQuADDS, scqubits, or QuTiP, SPICE-Q aims to connect them through a unified, traceable data chain spanning process rules, layout, electromagnetic simulation, energy-participation-ratio and circuit quantization, Hamiltonian extraction, noise analysis, cryogenic test, and manufacturing feedback. The central mapping is from process and PDK constraints to layout geometry, electromagnetic modes, equivalent circuit parameters, effective Hamiltonians, and finally metrics such as frequency, coupling, anharmonicity, decoherence, readout performance, and yield. This flow must capture Josephson-junction variability, transmon frequency allocation, resonator and Purcell constraints, coupler crosstalk, microwave routing, 3D interconnects, material/interface loss, package modes, and wafer-scale process statistics. By introducing standardized model interfaces, statistical parameter models, model cards, version governance, and closed-loop calibration from cryogenic and fabrication data, SPICE-Q frames superconducting quantum-chip design as an engineering workflow rather than a collection of isolated simulations. We argue that scalable and fault-tolerant quantum processors will require such a continuous model chain from device physics and electromagnetic fields to quantum dynamics, noise, manufacturability, and system-level yield.

24.
medRxiv (Medicine) 2026-06-16

Adverse Childhood Experiences and Growth Outcomes in Childhood: A Longitudinal EHR-Based Study

Question Are adverse childhood experiences (ACEs) associated with altered growth trajectories in childhood? Findings In this cohort study of 412,549 children and adolescents, ACEs were associated with lower height throughout childhood, earlier pubertal timing, and shorter final stature. Height differences emerged approximately 2 years before ACE documentation and were greatest among those with earlier documentation. Meaning These findings suggest that early adversity affects physical growth in children and may serve as a measurable indicator of the biological consequences of early-life stress, especially in those with documentation of ACEs prior to the onset of typical pubertal growth. Importance Adverse childhood experiences (ACEs) are among the strongest risk factors for long-term mental and physical health complications, yet their impact on physical growth in childhood remains incompletely understood. Objective To determine the association of ACEs on childhood growth trajectories and growth dynamics. Design, Setting and Participants Retrospective cohort study using longitudinal electronic health record data. Data was collected from participants between February 1999 and August 2025. A large academic medical center biobank linked to deidentified electronic health records in the southeastern United States. A total of 412,549 individuals with at least 2 recorded height measurements between the ages of 2 and 20 were included in the primary analysis. Growth curve analyses were performed in a subset of 199,844 individuals with at least 3 height measurements spanning at least 2 years. Genetic analyses were performed in a subset of 10,114 individuals of primarily European ancestry. Exposure(s) Documented exposure to adverse childhood experiences before age 18 years identified through a natural language processing algorithm. Main Outcome(s) and Measure(s) Height-for-age z-scores across childhood, final attained height, and growth curve parameters estimated using SuperImposition by Translation and Rotation (SITAR) modeling. Results Among 412,549 participants, 18,502 (4.5%) had clinically documented ACEs during childhood. ACE documentation was associated with lower height-for-age z-scores throughout childhood and adolescence. Final attained height was significantly lower among ACE-documented individuals, with mean differences of -3.0 cm among males (174.0 cm vs 177.0 cm, p < 0.001) and -1.3 cm among females (161.8 cm vs 163.1 cm, p < 0.001). Height differences emerged approximately 2 years before clinical ACE documentation. Earlier age at first ACE documentation was associated with progressively shorter final attained height, with each year decrease in age at ACE documentation associated with a decrease in final height of -0.20 cm in females and -0.35 cm in males. Those with first ACE documented prior to pubertal age also showed the most pronounced growth dynamic differences, with males demonstrating a mean reduction in size of 5.25 cm (95% CI, -6.79 cm to -3.70 cm) and 1.26-year earlier pubertal timing (95% CI, -1.50 to -1.03 years), and females demonstrating a reduction in growth curve size of 3.62 cm (95% CI, -4.83 to -2.41 cm) and 1.14-year earlier pubertal timing (95% CI, -1.29 to -0.99 years). Conclusions and Relevance In this large clinical cohort, clinically documented ACEs were associated with time-dependent reductions in stature, earlier pubertal timing, and short final attained height. These findings suggest that early childhood adversity may have lasting effects on physical development and highlight growth trajectories as a potential marker of the biological consequences of early-life stress.

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arXiv (CS.LG) 2026-06-24

Sakana Fugu Technical Report

arXiv:2606.21228v2 Announce Type: replace Abstract: The capabilities of frontier Large Language Models (LLMs) continue to advance, with different providers increasingly specializing in distinct domains. This raises a natural next objective: how to combine the individual specializations of various LLMs into a collectively intelligent system. To this end, we report the development of Sakana Fugu, a family of orchestrator models that harness and amplify the capabilities of an LLM agent team. Fugu models are themselves language models trained to understand user queries and dynamically devise agentic scaffolds to solve them. Through these adaptive scaffolds, Fugu accesses performance beyond any individual LLM agent, achieving state-of-the-art results compared to other publicly accessible models across a range of challenging tasks, including SWE-Bench Pro, Terminal Bench, LiveCodeBench, GPQA-Diamond, Humanity's Last Exam, and CharXiv Reasoning. We release two models: Fugu, which balances performance with latency for everyday use, and Fugu-Ultra, which prioritizes answer quality on the hardest problems. We describe our training paradigm, which encompasses large-scale fine-tuning, evolutionary algorithms, and reinforcement learning approaches, along with the infrastructure and core design principles that turn these methods into a production system. We hope this report encourages further research into multi-agent systems and dynamic, query-adaptive agentic scaffolds as a path toward the next frontier of AI capabilities, accessed through collective intelligence.