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01.
arXiv (CS.CV) 2026-06-17

SegDINO: Introducing Multi-Scale Structure into DINO for Efficient Medical Image Segmentation

Self-supervised DINO models provide strong transferable visual representations, yet applying them directly to image segmentation remains challenging. Existing approaches commonly rely on heavy decoders with complex upsampling, introducing substantial parameter and computational overhead. We observe that introducing scale into DINO features is far more critical than increasing decoder capacity. In this work, we present SegDINO, an efficient segmentation framework that integrates a DINOv3 backbone with lightweight scale modeling. SegDINO introduces Token Pyramid Adaptation (TPA) to reorganize intermediate DINO features into a pseudo multi-scale hierarchy, and Scale-Aware Decoding (SAD) for efficient intra-scale refinement and top-down multi-scale propagation. We further curate PanCT, a new CT dataset containing 284 patients with expert-annotated pancreatic tumors, to assess SegDINO's ability to handle difficult small-lesion cases. Extensive experiments on PanCT and three public benchmarks demonstrate that SegDINO achieves state-of-the-art results with high efficiency. The code is available at https://github.com/script-Yang/segdino_v2.

02.
arXiv (CS.LG) 2026-06-15

IntSeqBERT: Learning Arithmetic Structure in OEIS via Modulo-Spectrum Embeddings

arXiv:2603.05556v2 Announce Type: replace Abstract: Integer sequences in the OEIS span values from single-digit constants to astronomical factorials and exponentials, making prediction challenging for standard tokenised models that cannot handle out-of-vocabulary values or exploit periodic arithmetic structure. We present IntSeqBERT, a dual-stream Transformer encoder for masked integer-sequence modelling on OEIS. Each sequence element is encoded along two complementary axes: a continuous log-scale magnitude embedding and sin/cos modulo embeddings for 100 residues (moduli $2$–$101$), fused via FiLM. Three prediction heads (magnitude regression, sign classification, and modulo prediction for 100 moduli) are trained jointly on 274,705 OEIS sequences. At the Large scale (91.5M parameters), IntSeqBERT achieves 95.85% magnitude accuracy and 50.38% Mean Modulo Accuracy (MMA) on the test set, outperforming a standard tokenised Transformer baseline by $+8.9$ pt and $+4.5$ pt, respectively. An ablation removing the modulo stream confirms it accounts for $+15.2$ pt of the MMA gain and contributes an additional $+6.2$ pt to magnitude accuracy. A probabilistic Chinese Remainder Theorem (CRT)-based Solver converts the model's predictions into concrete integers, yielding a 7.4-fold improvement in next-term prediction over the tokenised-Transformer baseline (Top-1: 19.09% vs. 2.59%). Modulo spectrum analysis reveals a strong negative correlation between Normalised Information Gain (NIG) and Euler's totient ratio $\varphi(m)/m$ ($r = -0.851$, $p < 10^{-28}$), providing empirical evidence that composite moduli capture OEIS arithmetic structure more efficiently via CRT aggregation.

03.
arXiv (quant-ph) 2026-06-11

Global vs. Local Discrimination of Locally Implementable Multipartite Unitaries

arXiv:2509.10430v2 Announce Type: replace Abstract: We study single-shot distinguishability of locally implementable multipartite unitaries under Local Operations and Classical Communication (LOCC) and global operations. As unitary discrimination depends on both the choice of probing states and the measurements on the evolved states, we classify LOCC and global distinguishability into two categories: adaptive strategies, where probing states are chosen based on measurement outcomes from other subsystems, and restricted strategies, where probing states remain fixed. Our findings uncover three surprising features in the bipartite setting and establish new structural limits for unitary discrimination: (i) Certain pairs of unitaries are globally distinguishable with restricted strategies but indistinguishable under LOCC, even with adaptive strategies. (ii) There exist sets of four unitaries that are distinguishable via LOCC, yet remain globally indistinguishable with restricted strategies. (iii) Some sets of unitaries are globally indistinguishable under adaptive strategies, when probed with separable states, but become distinguishable via LOCC.

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

Select to Think: Unlocking SLM Potential with Local Sufficiency

Small language models (SLMs) offer efficient deployment, yet they often lag behind their larger counterparts (LLMs) in reasoning. Existing remedies either invoke an LLM at points of reasoning divergence, incurring substantial latency and cost, or rely on standard distillation, which is limited by the SLM's capacity to accurately mimic the LLM's complex generative distribution. We address this dilemma by identifying local sufficiency: at divergence points, the LLM's preferred token often resides within the SLM's top-K next-token predictions, even when failing to emerge as the SLM top-1 choice. We therefore propose Select to Think (S2T), which reframes the LLM's role from open-ended generation to selection among the SLM's proposals, simplifying the supervision signal to discrete candidate rankings. Leveraging this, we introduce S2T-Local, which distills the selection logic into the SLM, empowering it to perform autonomous re-ranking without inference-time LLM dependency. Empirically, a 1.5B SLM's top-8 candidates contain the 32B LLM's choice with a 95% hit rate, and S2T-Local improves the 1.5B SLM's Math Avg. over greedy decoding by 24.1% relative gain, matching the efficacy of 8-path self-consistency with single-trajectory efficiency.

05.
arXiv (math.PR) 2026-06-19

Optimal Sparsification of Gaussian Processes

arXiv:2606.19763v1 Announce Type: new Abstract: We prove an optimal dimension-free sparsification theorem for suprema of centered Gaussian processes. Given a bounded set $T\subseteq\mathbb{R}^n$, we show that the supremum of the canonical Gaussian process on $T$ can be $L^2$-approximated by the supremum of a shifted subprocess indexed by only $\exp(O(1/\varepsilon^2))$ points, with error at most $\varepsilon$ times the Gaussian width of $T$. In particular, the size of the approximating process is independent of both the ambient dimension and the cardinality of the original index set. This improves a recent sparsification theorem of De, Nadimpalli, O'Donnell, and Servedio (2026) by an exponential factor, and we show that the dependence on $\varepsilon$ is tight up to constants in the exponent. As consequences, we obtain an exponentially improved junta theorem for norms over Gaussian space and sharpen results on learning, property testing, and polyhedral approximation of convex sets under the Gaussian measure. The proof is based on an interpolation argument that combines Sudakov's minoration with the Brascamp–Lieb inequality.

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

When Good Verifiers Go Bad: Self-Improving VLMs Can Regress on New Tasks

Authors:

arXiv:2606.14629v1 Announce Type: cross Abstract: Verifier-driven self-DPO is a common recipe for self-improving production visual-language models. In this setup, a frozen verifier scores candidate generations, the top- and bottom-scoring candidates form a preference example, and DPO updates the learner. The deployment-time assumption is monotone: a stronger verifier should yield a stronger student. We show that this assumption can fail because verifier quality is highly task-specific. On a four-rung open-source verifier ladder across MathVista, MMMU, and BLINK, the same verifiers that are above-threshold and improve a Qwen-3-VL-2B student on MathVista become sub-threshold on MMMU, where their task-rubric accuracy drops to 8% to 23%. In this regime, every verifier we tested silently regresses the student, producing drops of 3.4 to 10.9 percentage points below the frozen baseline while the DPO training loss continues to decrease. The regression replicates on a second student, Qwen-2.5-VL-3B. Moreover, within the failure regime, damage is confidence-inverted: the more accurate-but-still-wrong verifier causes larger regression than a near-random verifier, suggesting that progress-gated replay amplifies confidently wrong preference pairs. We give a compact mechanistic explanation via a variance theorem for progress-gated replay and its direction-mismatch failure mode. The deployment message is operational rather than purely diagnostic: before running any verifier-driven loop, teams should measure target-task rubric accuracy, rank verifiers by target-task rubric quality rather than parameter count, and treat diminishing returns in above-threshold regimes as a verifier-side compute budget cap.

07.
arXiv (quant-ph) 2026-06-12

Quantum metrology via partial quantum error correction

arXiv:2605.08341v2 Announce Type: replace Abstract: We introduce a method for error-corrected quantum metrology where only partial quantum error correction (QEC) is needed to suppress local noise and maintain the probe states' super-standard-quantum-limit (super-SQL) sensing performance. This stands in contrast to the existing QEC-assisted sensing schemes in Phys. Rev. Lett. 112, 080801 (2014) and Phys. Rev. Lett. 112, 150802 (2014), where a probe state is encoded into the logical subspace of a quantum code and error correction involves measurements on all checks of the code. Here, we encode the probe states into superpositions of energetically different states of the underlying quantum code. For our probe states, error correction using a subset of checks is enough to suppress noise both before and after phase imprinting. We analyze the tradeoff in noise suppression. For noise parallel to our phase imprinter of weight $l$, we achieve a suppression of $p^\delta$ where $p$ is the noise strength and $\delta = \lfloor (l+1)/2 \rfloor$. We propose an adaptive imprinter weight increasing strategy to maintain super-SQL performance as we scale up the system. In all our examples, checks and phase imprinters are chosen to be local operators avoiding non-local connectivity.

08.
medRxiv (Medicine) 2026-06-16

Re-evaluating the Cross-Sectional Prevalence of Severe Age-Related Hearing Loss Using Extreme Value Statistics

Authors:

Standard demographic models of age-related hearing loss (presbycusis) predominantly utilize symmetric functions, such as log-normal distributions for age-binned thresholds and 4-parameter logistic curves for prevalence estimates. While these models capture early-to-moderate degradation effectively, they structurally struggle to characterize the heavy tails associated with severe clinical impairment. In this study, we present a statistical critique using a secondary analysis of the historical Medical Research Council (MRC) National Study of Hearing (1980-1986) dataset. By applying Generalized Extreme Value (GEV) distribution theory, we demonstrate that as severity increases, the underlying statistical geometry of hearing loss shifts. The asymmetric, heavy-tailed GEV distribution provides a parsimonious description of severe impairment, requiring fewer parameters than standard symmetric models. However, we explicitly acknowledge that utilizing static population data to infer progression introduces an ecological fallacy. Furthermore, the dataset's historical nature embeds unquantified generational cohort effects. We conclude that while extreme value statistics offer a compelling mathematical framework for modeling the variance of severe presbycusis, true longitudinal datasets are required to isolate physiological degradation from historical cohort variance.

09.
arXiv (CS.CV) 2026-06-17

Heterogeneous SAR-optical fusion for near-real-time land use and land cover mapping under cloud contamination: A novel framework and global benchmark dataset

Optical remote sensing imagery is frequently degraded by cloud and cloud-shadow contamination, which limits its reliability for near-real-time land use and land cover (LULC) mapping. Although synthetic aperture radar (SAR) can provide cloud-penetrating structural information, existing SAR-optical fusion methods often assume reliable optical observations and insufficiently address the semantic uncertainty introduced by cloud contamination. To address this issue, we propose CloudLULC-Net, an end-to-end heterogeneous SAR-optical fusion framework that directly predicts LULC maps from cloud-contaminated Sentinel-2 imagery and temporally adjacent Sentinel-1 SAR observations. The proposed network incorporates optical reliability modulation to suppress unreliable optical responses, heterogeneous information adaptive aggregation to model high-order spatial-channel interactions between optical and SAR representations, and a unified semantic mapping transformer to organize fused features in a LULC-oriented latent space. A semantic anchor-guided optimization strategy is further introduced to improve the consistency of intermediate semantic representations. To support this task, we construct CloudLULC-Set, a large-scale benchmark dataset containing 40,223 curated SAR-optical-label triplets with pixel-level LULC annotations across diverse geographic regions and cloud conditions. Experimental results show that CloudLULC-Net achieves an OA of 86.60%, an F1-score of 83.29%, and an mIoU of 73.51%, outperforming representative heterogeneous reconstruction-first and end-to-end SAR-optical mapping methods. Comparisons with existing global LULC products and analyses under different cloud-cover levels further demonstrate the robustness and practical value of CloudLULC-Net for target-date LULC mapping in cloud-prone regions.The project is publicly available at: https://github.com/RSIIPAC/CloudLULC

10.
arXiv (CS.CV) 2026-06-11

RSTR: Reducing SpatioTemporal Redundancy in Diffusion Transformers

Diffusion Transformers (DiTs) have achieved remarkable success in image generation, yet their deployment is hindered by high computational costs. We identify two sources of redundancy. First, temporal redundancy: Classifier-Free Guidance (CFG) applies costly dual forward passes at every timestep, yet guidance matters only at specific steps, and variable scales at critical steps can compensate for skipping others. Second, spatial redundancy: under variable guidance, different transformer blocks exhibit heterogeneous sensitivity, yet uniform calibration across all blocks wastes computation while failing to address their varying requirements. We present RSTR, the first framework to jointly reduce spatiotemporal redundancy in diffusion transformers. Stage-1 addresses temporal redundancy through evolutionary search, discovering sparse guidance schedules with variable scales. Stage-2 addresses spatial redundancy through adaptive rank allocation, assigning calibration capacities to transformer regions based on their sensitivity. Experiments on DiT-XL/2, PixArt-$\alpha$, FLUX, and state-of-the-art Qwen-Image demonstrate 50%-70% compute savings while maintaining or improving quality. On DiT-XL/2, RSTR achieves 57% savings with 15% FID improvement; on Qwen-Image, 3.43$\times$ speedup with preserved quality.

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

GRACE: Boosting Video MLLMs with Grounded Action-Centric Evidence for Viewer Sentiment Prediction

Viewer sentiment prediction in video advertisements aims to infer the latent affective response evoked in the audience. To bridge the gap between what is shown and what is felt, models must deduce hidden viewer emotions from explicit visual narratives, concrete character-object interactions, and visible textual cues. However, standard Multimodal Large Language Models (MLLMs) typically rely on holistic frame representations, which leave these fine-grained, affect-relevant events implicit and complicate precise emotional reasoning. To address this, we propose a grounded action-centric evidence augmentation framework that enhances video MLLMs' clue extraction and comprehension by introducing explicit event structure and localized visual evidence. Our method extracts temporally ordered subject-verb-object (SVO) triplets and auxiliary visible textual cues from action-centric video descriptions, grounds subject and object entities as visual entity crops, and then enables the MLLM to perform clue-enhanced emotional reasoning based on these extracted structured clues. In this way, action triplets specify "what happens", while grounded visual entity crops anchor "who or what participates in each event" to concrete visual evidence. Experiments on the Pitts dataset show consistent improvements over Qwen2.5-VL and Qwen3-VL baselines. Ablation studies, cross-dataset evaluation on AdsQA, and transfer experiments on an emotion-focused TVQA subset further support the effectiveness and generalization of our approach.

12.
arXiv (CS.CV) 2026-06-15

Rethinking Global Average Pooling: Your Classifier Is Secretly a Multi-Instance Learner

Authors:

Modern image classifiers widely adopt global average pooling (GAP) followed by a linear classification head. This linearity ensures that the image-level logits equal the average of logits obtained by applying the classification head pointwise to the feature grid prior to GAP. Consequently, standard classifiers may inherently retain spatial class evidence that remains recoverable even when the image-level prediction is incorrect. This structure naturally suggests a multiple-instance learning (MIL) interpretation, where an image is viewed as a bag of spatial instances. Within this formulation, we demonstrate that standard classifiers trained with a single label per image can still learn the intended classification task in multi-object scenes. We further exploit this property to decompose image-level logits into a prediction grid, providing a post-hoc diagnostic to extract spatial class evidence that GAP otherwise obscures. Our systematic evaluation reveals that off-the-shelf models consistently recover the ground-truth class within foreground regions. The MIL interpretation further suggests that common classifier failures reflect known limitations of mean aggregation.

13.
arXiv (CS.CL) 2026-06-12

Agentic MPC for Semantic Control System Resynthesis

While MPC effectively handles structured, diverse, and low-level specifications, it lacks the capability to dynamically incorporate high-level contextual information such as social norms, user intent, or natural language instructions. To address this limitation, this manuscript introduces an agentic MPC framework that enables context-aware, semantically adaptive control synthesis by integrating with large language model-based agents. The agent interprets heterogeneous inputs, including natural language messages, environmental observations, and external knowledge, to resynthesize the control specifications. The effectiveness of the framework is demonstrated in an autonomous driving scenario, where the system aligns with personal preferences or responds to social situations such as emergency vehicle yielding.

14.
medRxiv (Medicine) 2026-06-12

Reduced nighttime smartphone use among cohabiting partners: a longitudinal study under the lens of social control of health behaviors theory

Objective: We examined the link between cohabitation with a partner and nighttime smartphone use through the social control of health behavior theory. Background: Nighttime smartphone use is a behavioral risk factor for sleep problems. While previous research has predominantly focused on individual-level risks of sleep disturbances, the role of social context remains underexplored. Theoretical frameworks, specifically the Social Control of Health Behavior, suggest that social relationships regulate health-related behaviors; however, it is unclear how far this regulation extends to modern digital behaviors among couples. Method: We analyzed survey data from three waves of the SmartSleep Study (2018, 2020, and 2023; total N = 25,028), including a longitudinal follow-up subset (N = 1,003). We tested multivariate associations between living with a partner, changes in cohabitation status and frequent nighttime smartphone use by fitting generalized linear mixed-effects models. Additionally, we mapped the complex interplay between indicators of social integration, social support, smartphone use, and sleep quality using hierarchical clustering of non-linear correlations. Results: Cohabiting participants had lower odds of frequent nighttime smartphone use compared to those living alone (OR = 0.66; 95% CI: 0.61, 0.72). This lower risk was driven primarily by cohabitation with a partner (OR = 0.49; 95% CI: 0.36, 0.66). Longitudinal analysis supported these findings, showing that sustained cohabitation was associated with less frequent nighttime use (OR = 0.56; 95% CI: 0.38, 0.82). Clustering analysis revealed that indicators of social integration and support clustered with favorable sleep quality. Conclusion: Our findings suggest that the health-protective effects of cohabitation with a partner extend to digital behaviors. Consistent with social control of health behavior theory, the presence of a partner appears to reduce frequent nighttime smartphone use, highlighting the critical importance of considering social context when addressing digital health hygiene and promoting sleep.

15.
arXiv (CS.CV) 2026-06-16

HSQ-VLM: A Novel Spatially-Constrained Quadrant Segmentation VLM Model for Explainability in Diabetic Retinopathy

Authors:

Diabetic Retinopathy (DR) is an aggressive retinal disease and a leading cause of global blindness, yet its clinical management is currently hindered by the black-box nature of diagnostic AI. While deep learning models achieve high classification accuracy, there is a critical lack of explainability methods capable of detailing the exact anatomical landmarks and lesion distributions that lead to a clinical decision for DR. Therefore, we propose HSQ-VLM, a novel quadrant segmentation pipeline on fundus images that utilizes a Landmark-Anchored Cartesian Cross-Attention mechanism to unify visual feature extraction with structured clinical reasoning. Unlike traditional methods that rely on arbitrary image partitioning, our pipeline implements 4-quadrant Topological Latent Partitioning (TLP) to dynamically align retinal features with a fovea-centered coordinate system. This allows the Vision-Language Model to generate natural language reports that quantify pathology with anatomical precision. On a dataset of 3,500 high-resolution fundus images, this innovative methodology achieved a lesion detection sensitivity of 99.6% for hemorrhages and 96.4% for microaneurysms, while demonstrating a significant reduction in boundary-ambiguity errors compared to standard segmentation baselines.

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

EnvRL: Learn from Environment Dynamics in Agentic Reinforcement Learning

Reinforcement learning (RL) has emerged as a powerful paradigm for training Large Language Models (LLMs) as agents. However, conventional RL methods for long-horizon agentic tasks often struggle with sparse outcome rewards. Intuitively, this overlooks the rich environment dynamics information contained in rollout interaction trajectories. We argue that the interaction experience inherently serves as an implicit supervision signal, reveals the underlying transition mechanisms of the environment, and enables the agent to construct a more accurate internal model of the environment.. Therefore, in this work, we investigate how to leverage this additional signal to improve policy learning. Specifically, we propose EnvRL, a framework that incorporates environment dynamics learning into agentic RL via two auxiliary objectives: state prediction and inverse dynamics. By jointly optimizing with the primary RL objective, we encourage the agent to internalize environment dynamics from its own interaction experience. Extensive experiments on two long-horizon agentic benchmarks demonstrate that EnvRL achieves significant improvements on success-rates over RL-only baselines, e.g., when trained with GRPO, lifting Qwen-2.5-1.5B-Instruct from 72.8% to 77.4% on ALFWorld, and from 56.8% to 67.0% on WebShop.

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

Advancing DialNav through Automatic Embodied Dialog Augmentation

arXiv:2606.19948v1 Announce Type: new Abstract: For embodied agents capable of physical interaction, the capability to create and understand dialog is crucial to ensure both safety and effectiveness. While DialNav[han2025dialnav] provides a framework for holistic evaluation of the dialog–execution loop in photorealistic indoor navigation, its performance remains limited by a critical scarcity of training data (2K episodes). To address this, we propose an automatic generation pipeline, and construct the RAINbow dataset, a large-scale training dataset with 238K episodes for DialNav. Our pipeline converts existing VLN datasets into multi-turn dialog and creates cost-efficient and high-quality dataset. Then, we introduce two additional complementary advances to unlock the data's full potential: (1) Dual-Strategy Training, a navigation training scheme to align the navigation training with the dynamic dialog-navigation loop, and (2) a localization model that leverages VLN knowledge. By combining these complementary solutions, our model substantially outperforms the baseline in success rate on both Val Seen (58.24, +89\%) and Val Unseen (29.05, +100\%) splits, establishing a new state of the art.

18.
medRxiv (Medicine) 2026-06-15

Therapeutic efficacy study on shoulder impingement syndrome in swimmers: a network meta-analysis

Shoulder impingement syndrome (SIS), including subacromial impingement and rotator cuff tendinitis, is commonly caused by repetitive swimming movements and associated shoulder joint dysfunction. Despite numerous available treatment options, no consensus exists on the most effective treatment option. Therefore, this systematic review and network meta-analysis aimed to investigate treatment methods for SIS in swimmers. Using a frequentist framework and Cochrane PICOS principles, we compared SIS treatments, constructed network evidence diagrams, and assessed heterogeneity. A total of 45 studies were included in the qualitative synthesis, and 42 contributed to the network meta-analysis, comprising 1752 participants, 9 treatment categories, and outcome measures. For pain outcomes, some adjunctive interventions combined with exercise showed favorable ranking probabilities, although several estimates were accompanied by wide confidence intervals. For shoulder range-of-motion outcomes, taping, acupuncture, manual therapy, and sport-specific training showed favorable effects in selected comparisons, particularly for external and internal rotation. According to surface under the cumulative ranking curve (SUCRA) rankings, exercise combined with medium-frequency therapy ranked highly for pain reduction, whereas exercise combined with acupuncture or extracorporeal shock wave therapy ranked highly for shoulder flexion. Exercise combined with taping ranked highly for external rotation, and exercise combined with manual therapy ranked highly for internal rotation. However, the interpretation of ranking results should remain cautious because uncertainty and inconsistency were present in some comparisons. Exercise-based rehabilitation appears to remain central to the management of SIS in swimmers. Several adjunctive interventions showed favorable findings for selected outcomes, especially pain relief and shoulder rotational function. However, the available evidence was affected by heterogeneity, inconsistency, and imprecision across some treatment comparisons. More rigorously designed swimmer-specific randomized controlled trials are needed before firm treatment hierarchies can be established. Trial registration: The protocol for this systematic review is registered with PROSPERO (www.crd.york.ac.uk/PROSPERO; registration number: CRD42024498851). The first submission of PROSPERO was on January 15, 2024, and it was revised and updated on March 25, 2026.

19.
medRxiv (Medicine) 2026-06-18

From Paper Letters to an Integrated Digital Workflow: Improving Efficiency, Reliability, and Engagement in Health Guidance

Background: Post-checkup health guidance in Japan has traditionally relied on paper-based communication and manual administrative processes. These workflows are time-consuming, prone to transcription errors, and can delay timely engagement with health guidance recipients. Objective: To assess whether replacing a paper-based workflow with an integrated digital system using Microsoft Access, robotic process automation (RPA), and web-based responses could improve administrative efficiency, operational reliability, and engagement among health guidance recipients. Methods: This single-site quality improvement initiative redesigned the existing letter-based workflow. Access served as a central interface for managing recipients and generating guidance letters. RPA (EzRobot) automated repetitive clerical and billing-related tasks. A web form accessed via a QR code enabled recipients to respond digitally. Outcomes included manual administrative handling time per case, occurrence of transcription-related errors, health guidance completion rate, and guidance duration distribution. Results: Following implementation, staff active handling time per case decreased from approximately 10 minutes to less than 1 minute (approximately 30 seconds), while automated RPA execution typically required about 4-5 minutes per case without staff input. No transcription-related errors were detected during the post-implementation observation period. Health guidance completion rates improved from 28.3% to 39.2% (chi-square test, P=200 days decreased from 30.5% to 20.9% and cases with >=240 days decreased from 13.6% to 8.9% (R4 n=59, R5 n=158). Conclusion: An integrated Access-RPA-Web workflow was associated with improvements in administrative efficiency and operational reliability in post-checkup health guidance while retaining human verification and exception handling. This pragmatic, non-AI-dependent approach may offer a useful model for process-level improvement in preventive care settings.

20.
medRxiv (Medicine) 2026-06-16

A Poisson Process Life Expectancy framework for optimising patient lifetime during chemotherapy

Cancer therapy balances between two competing objectives - treatment efficacy against the tumour and the risk of treatment related severe adverse events, including patient death. Most existing optimal control theory (OCT) formulations rely on optimising heuristic cost functionals that lack direct clinical interpretability. In clinical practice treatment efficacy and patient tolerability are primarily assessed through survival metrics and adverse event rates. Here we introduce the Continuous Lifetime Payoff (CLP), a novel OCT objective functional that directly links treatment decisions to patient survival. It explicitly incorporates tumour dynamics, tumour eradication, and patient mortality from tumour progression, drug-related toxicity and age. We fit age-related mortality from life tables and infer parameters from simulated survival data. The CLP provides a clinically grounded framework for optimising chemotherapy regimens.

21.
medRxiv (Medicine) 2026-06-11

Parent and physiotherapist perceptions about movement skills of young children with juvenile idiopathic arthritis

Objective: The onset of juvenile idiopathic arthritis (JIA) in the early years ([&le;]5 years) may negatively impact movement skill (encompassing related concepts of gross motor skills, fundamental movement skills, and functional ability) development. Few studies have explored the perceptions and needs of parents and physiotherapists towards children's difficulty with these movement skills, essential to identify potential areas for added support. The objective of this study is to understand the perceptions of physiotherapists and parents towards movement skills of children with JIA. Methods: Seventeen parents and 24 physiotherapists completed an online questionnaire consisting of multiple choice and open-ended questions about the movement skills of young children with JIA. Demographic and multiple choice questions were quantitively analysed using descriptive statistics. Open-ended responses were analyzed using qualitative conventional content analysis. Results: About half (47%) of parents perceived their children to have movement difficulties, and 75% of physiotherapists described the movement skills of children with JIA as worse than other children of the same age. Our qualitative analysis revealed three general themes including: functional task difficulties; clinical variability in movement skills; and psychosocial components of movement skill difficulties. Conclusion: This study provides an analysis of perceptions of physiotherapists and parents towards the movement skills of young children with JIA. A significant proportion of parents and physiotherapists identify movement difficulties among children with JIA that impact daily life. Future interventions co-designed with both parents and care providers targeting movement skills are needed.

22.
medRxiv (Medicine) 2026-06-18

Urinary Creatine Riboside Complements PSA to Improve Disease Detection in the Diagnostic Gray Zone of Prostate Cancer

Circulating prostate-specific antigen (PSA) discriminates poorly in the diagnostic gray zone (3.0-9.99 ng/mL), where ~75% of biopsies yield no clinically significant prostate cancer (PCa). We evaluated whether urinary creatine riboside (CR), a tumor-derived metabolite excreted through the prostatic urethra, complements PSA for gray-zone detection and independently predicts prostate-cancer-specific mortality (PCSM). In the NCI-Maryland PCa Case-Control Study (951 cases, 962 controls; 47.6% African American men; median follow-up 11.5 years), urinary CR was quantified by UPLC-MS/MS. Within the PSA gray zone (n = 668), urinary CR was complementary to PSA, with markedly higher single-marker discrimination than PSA (AUC 0.93, 95% CI 0.88-0.98 vs 0.77, 0.66-0.89) and additive when combined ({Delta}AUC +0.17, p < 0.001; 91.4% sensitivity at 80% specificity). After adjustment for 11 clinical and sociodemographic covariates, urinary CR independently predicted PCSM complementary to PSA (Fine-Gray SHR 1.72, 1.35-2.19 for CR; 1.35, 1.08-1.68 for PSA; Harrell's C 0.85 for CR + PSA vs 0.77 for PSA alone), with strongest signal in African American men (SHR 2.43, 1.57-3.75 for CR). We conclude that urinary CR is a candidate non-invasive biomarker complementary to PSA - improving gray-zone triage and predicting PCSM; prospective validation in biopsy-referred cohorts is warranted.

23.
arXiv (quant-ph) 2026-06-16

Linear algebra at exponential scale via tensor network dimension reduction

arXiv:2606.15350v1 Announce Type: cross Abstract: Many problems in modern scientific computing are challenging because of a curse of dimension, where their mathematical formulation involves objects whose dimension is exponential in the nominal "size" of the problem. Tensor networks can provide a compact representation for exponentially large vectors and matrices that arise in applications, but these representations do not always lead to reliable algorithms. This paper develops and analyzes techniques for randomized dimension reduction of tensor network data. These techniques support a suite of efficient algorithms for provably solving exponential-scale linear algebra problems, including trace estimation and eigenvalue approximation. The paper includes several stylized illustrations from quantum many-body physics with ambient dimension up to $2^{200}$.

24.
bioRxiv (Bioinfo) 2026-06-11

Pillbox: A Leakage-Aware Foundation-Model Predictor and Lineage-Ceiling Diagnostic for Cancer Drug Response

We present Pillbox, a predictor whose pipeline is audited against the six Asiaee leakage modes with the one residual pathway shown by per-fold ablation to be non-load-bearing on hard splits. Our model combines CpGPT methylation embeddings, CLAMP drug embeddings, and per-fold-fit gene-expression principal components which are fused by Feature-wise Linear Modulation (FiLM)-conditioned graph attention on the STRING v12 protein-protein interaction graph. Then we alpha-ensemble the model against a histogram-based gradient boosting regressor baseline. On GDSC GSE68379 (987 cell lines, 375 drugs) across seeds 42, 7, and 123, the ensemble reaches test R-Squared of 0.78, 0.77, and 0.76 on random, histology-blind, and site-blind splits respectively, with cell-aware lifts above the drug-mean floor of +0.054, +0.060, and +0.037. As a quantitative diagnostic for feature-stack saturation we propose the cross-architecture residual correlation, calibrated against a same-architecture-different-initialization control. On histology-blind splits the cross-architecture value of 0.939 falls short of the same-architecture ceiling of 0.974 by approximately 0.03 in residual correlation, a gap we interpret as the headroom available to architecture choice on top of the current foundation-model representation and consistent with the long-established observation that tissue lineage dominates cell-line drug response. We integrated curated mutation, methylation, and drug-target-expression channels, but these do not improve prediction once foundation-model embeddings are in place. Cross-screen validation against PRISM matches the GDSC-to-PRISM measurement reproducibility ceiling within 0.01 Spearman.