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01.
Nature (Science) 2026-06-17

Optical fibre gripper for high-performance 3D micromanipulation

Authors:

Optical tweezers offer precise, non-contact control, but operate in a limited force regime and impose strict requirements on the characteristics of the targets as well as the environmental conditions1–4. Millimetre-scale mechanical tweezers can offer higher gripping force but are not suitable for precise manipulations5–11. Integrating microgrippers directly at the optical fibres provides a new approach for precise micromanipulation. However, existing fibre-integrated tweezers still face challenges in achieving high-performance manipulation of micro-objects (for example, single cells) within narrow spaces, mainly due to simplified architectures, constrained designs and millimetre-scale footprints12–14. Here we report a three-dimensional (3D) optical fibre gripper (OFG), which is fabricated by two-step, two-photon polymerization. The OFG consists of rigid photoresist microclaws and soft thermoresponsive hydrogel muscle doped with silver nanoparticles, and its size is only 38 × 38 × 61 μm3. The OFG exhibits a force-to-mass ratio of about 340 μN mg−1, outperforming previously reported fibre-integrated tweezers by one to two orders of magnitude. The OFG can manipulate opaque particles, irregular micromechanical components and diverse single-cell types. We further demonstrated its potential in 3D microassembly of complex microdevices (bearings, shafts and gearboxes) and biomimetic sampling in the narrow environment (<300 μm). These results position the OFG as a compact fibre-tip manipulator for 3D micromanipulation, offering reversible and tunable gripping in an intermediate force regime between optical field trapping and millimetre-scale mechanical tweezers. A miniature three-dimensional optical fibre gripper enables powerful, precise micromanipulation of particles and single cells in confined spaces, bridging the gap between optical and mechanical tweezers.

02.
arXiv (CS.CL) 2026-06-25

ConPress: Learning Efficient Reasoning from Multi-Question Contextual Pressure

Large reasoning models (LRMs) typically solve reasoning-intensive tasks by generating long chain-of-thought (CoT) traces, leading to substantial inference overhead. We identify a reproducible inference-time phenomenon, termed Self-Compression: when multiple independent and answerable questions are presented within a single prompt, the model spontaneously produces shorter reasoning traces for each question. This phenomenon arises from multi-question contextual pressure during generation and consistently manifests across models and benchmarks. Building on this observation, we propose ConPress (Learning from Contextual Pressure), a lightweight self-supervised fine-tuning approach. ConPress constructs multi-question prompts to induce self-compression, samples the resulting model outputs, and parses and filters per-question traces to obtain concise yet correct reasoning trajectories. These trajectories are directly used for supervised fine-tuning, internalizing compressed reasoning behavior in single-question settings without external teachers, manual pruning, or reinforcement learning. With only 8k fine-tuning examples, ConPress reduces reasoning token usage by 59% on MATH500 and 33% on AIME25, while maintaining competitive accuracy.

03.
arXiv (CS.CL) 2026-06-18

Mitigating Scoring Errors and Compensating for Nonverbal Subtests in Speech-Based Dementia Assessment

Early detection of cognitive impairment relies on neuropsychological tests to minimize subjectivity by assessing multiple cognitive domains. Speech-based evaluation can support diagnostics and improve accessibility, but transcription errors and the omission of nonverbal subtests (e.g., motor skills) limit accuracy. Beyond conventional test scores, speech-derived features can provide additional insights into cognitive status. This study investigates the speech-based evaluation of the German "Syndrom-Kurz-Test," a standardized dementia screening test comprising verbal and motor subtests. We train models that integrate transcript-derived scores and Whisper embeddings per verbal subtest to reduce scoring errors. To compensate for missing motor subtests, we then leverage these fused representations to approximate expert overall ratings. Despite omitting subtests, our models strongly correlate with expert ratings and efficiently and accurately discriminate between cognitive status groups.

04.
arXiv (math.PR) 2026-06-16

A non-asymptotic bound on the TV distance between a Wishart matrix and an appropriately scaled GOE matrix

arXiv:2606.16018v1 Announce Type: new Abstract: In this note, we prove a non-asymptotic version of a theorem by Bubeck, Ding, Eldan, and Rácz, showing that a Wishart matrix is close in total variation to an affine transformation of a GOE matrix. The proof mirrors the proof given by Bubeck et al., with some changes made to make it non-asymptotic.

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

When Similar Means Different: Evaluating LLMs on Arabic–Hebrew Cognates

Arabic and Hebrew, as closely related Semitic languages, share a substantial lexicon of true cognates, misleading false friends, and modern loanwords. This overlap poses a challenge for cross-lingual semantic understanding in large language models (LLMs). To evaluate this capability, we introduce SemCog Bench, a curated benchmark of 1,858 Arabic–Hebrew word pairs with sentence-level annotations for cognate identification and semantic disambiguation. We evaluate open-source and commercial LLMs across multiple input representations (raw, diacritized, Romanized, and phonetic) and reveal a critical gap in cross-lingual reasoning. While models achieve high accuracy on true cognates, performance drops sharply on false friends and loanwords, reflecting a strong reliance on surface-form similarity. Furthermore, sentence-level context yields only modest improvements, suggesting that contextual cues alone are insufficient to overcome misleading form-based signals. These findings reveal a fundamental limitation of current LLMs in resolving cross-lingual form–meaning conflicts and establish SemCog Bench as a rigorous benchmark for multilingual semantic reasoning. Our code and data are publicly available.

06.
medRxiv (Medicine) 2026-06-22

How knowledge shapes community stigma and social support for women seeking abortion in the Democratic Republic of Congo: A cross-sectional study.

Background The Democratic Republic of Congo (DRC) bears one of the highest maternal mortality ratios globally (746 per 100,000 live births), with nearly 11% of deaths attributable to complications of unsafe abortion. Despite ratification of the Maputo Protocol and related national policies, access to safe abortion remains limited, largely due to entrenched stigma. Social support, encompassing emotional, informational, and instrumental assistance, is critical in shaping womens abortion-seeking behaviors and health outcomes. This study examines the influence of community-level knowledge on stigma and social support for women seeking abortion care. Methods A cross-sectional survey was conducted from May 2024 to June 2024 among 1,715 adults in Kinshasa and North Kivu provinces. Analyses focused on a sub-sample of 574 respondents reporting familiarity with women who had undergone abortion. Structural Equation Modeling (SEM) was applied to estimate direct and indirect pathways linking community knowledge, stigma, and social support. Results Two core knowledge indicators, recognition of abortion as a safe medical procedure and awareness of legal conditions for access, were significantly associated with outcomes. A one-unit increase in knowledge corresponded to a 0.39-point increase in social support and a 0.19-point reduction in stigma. Enhanced knowledge promoted empathetic attitudes, reinforced practical support, and mitigated moralizing judgments toward women seeking abortion. Conclusions Strengthening community knowledge emerges as a strategic lever to reduce abortion-related stigma and enhance social support in the DRC. These findings underscore the importance of integrating stigma-reduction and knowledge-enhancement interventions into reproductive health programs to improve womens access to safe and dignified abortion care.

07.
arXiv (CS.AI) 2026-06-25

GUI agent: Guided Exploration of User-Sensitive Screens

arXiv:2606.25705v1 Announce Type: new Abstract: LLM agents are increasingly being used to automate tasks for users within an open GUI environment. They inevitably encounter screens containing user-sensitive information, for which takeover of task execution by the user is highly desirable or even necessary. State-of-the-art LLM-driven agents are usually fine-tuned to complete tasks regardless of the safety implications of their actions. This makes their real-world deployment difficult and adversely affects the reliability. Therefore, it is crucial to identify and categorize user-sensitive states and define user-sensitive queries. This dataset would be to engineers to recognize and request handover to the user in critical scenarios. This short paper develops an explorer agent that systematically explores the query space starting from one demonstrated task to identify queries that, if executed, would lead to user-sensitive states in a GUI environment.

08.
bioRxiv (Bioinfo) 2026-06-10

GEOAgent: An AI-driven Autonomous Framework for Intelligent GEO Data Retrieval and Standardized Preprocessing

Datasets in the Gene Expression Omnibus (GEO) remain difficult to reuse at scale because sample annotations are heterogeneous and raw sequencing data require assay-specific preprocessing. We present GEOAgent, an AI-driven autonomous framework designed for intelligent dataset retrieval and standardized preprocessing by coupling autonomous semantic governance with an automated Nextflow pipeline named bioStream. Metadata from 181,760 sequencing series and 84,756 associated PubMed records were organized in a relational database and semantic index to support natural-language dataset retrieval. The framework automatically determines assay modalities, resolves experimental design pairings, and standardizes sample naming to minimize manual curation overhead. Based on these parsed attributes, the framework generates deployment-ready manifests to automatically execute containerized workflows across bulk and single-cell omics modalities. In expert-curated benchmarks, the workflow achieved 96% retrieval precision alongside 100% accuracy in assay classification and sample relationship resolution. The web platform is publicly accessible, while the source code and associated databases are openly available via GitHub and Zenodo.

09.
arXiv (CS.CL) 2026-06-18

Phonikud: Overcoming Phonetic Underspecification for Hebrew Text-To-Speech

Text-to-speech (TTS) for Modern Hebrew is challenged by the language's orthographic complexity, with existing solutions ignoring underspecified phonetic features such as stress. We present a framework for more phonetically accurate Hebrew TTS with four contributions: (1) Phonikud, an open-source Hebrew grapheme-to-phoneme (G2P) system that outputs fully-specified International Phonetic Alphabet (IPA) transcriptions, designed by augmenting a base diacritizer. (2) The ILSpeech corpus of paired Hebrew audio, text, and expert IPA annotations. (3) A benchmark for the previously unmeasured task of Hebrew G2P conversion. (4) Hebrew audio-to-IPA models capturing previously disregarded phonetic details for automatic TTS evaluation. Our results show that Phonikud more accurately predicts Hebrew phonemes than prior methods, and that small, local TTS models with phonetic input from Phonikud approach large proprietary systems. We release our code, data, and models at https://phonikud.github.io.

10.
medRxiv (Medicine) 2026-06-12

Integrative Mechanisms of Early Clinical and Research Training (ECART) in Orthopaedic Medical Education: A Qualitative Single-Case Study

Background: Early clinical exposure and student participation in research are important components of medical training. They may support learning motivation, evidence literacy, and self-directed learning. In many programmes, however, clinical training and research training remain separated. Few studies have explained, within a real teaching team, how learners turn clinical phenomena into researchable questions and how research participation can reshape their clinical understanding. Early Clinical and Research Training (ECART) is a clinical-research integration approach developed by an orthopaedic team at the Second Hospital of Shandong University. Methods: We conducted a theory-informed, interpretivist qualitative single-case study. The case was an orthopaedic clinical-research team at the Second Hospital of Shandong University. Participants included medical undergraduates, academic degree graduate students, professional degree graduate students, clinical teachers, and research platform leads. We used purposive sampling with maximum variation. Data were collected through semi-structured interviews and de-identified teaching documents. Data were analysed using the framework method and were interpreted with a Context-Activity-Mechanism-Outcome (CAMO) logic. Results: The analysis showed that ECART was not simply early entry into the clinic or early entry into the laboratory. It was a team-based learning process centred on real medical problems. Four themes were identified. First, early clinical exposure helped learners make real problems visible and nameable, rather than merely increasing exposure. Second, clinical-research connection followed different pathways. Professional degree graduate students often started from clinical uncertainties in residency training and case management, and moved toward evidence-informed small projects. Academic degree graduate students often started from literature gaps, experimental findings, and mechanistic hypotheses, and then used clinical feedback to calibrate meaning. Third, research training, through literature reading, group meetings, experimental design, data review, and mentor questioning, helped learners move from completing tasks to explaining problems. Fourth, sustained ECART depended on a tiered team ecology formed by clinical teachers, research mentors, research platforms, and senior peers. Based on these findings, we refined the ECART programme theory: real medical problems are translated through explanation, searching, experimentalisation, and feedback-based reinterpretation into research questions that learners can understand, discuss, and test. This process supports problem formation, evidence awareness, mechanistic reasoning, translational judgement, and career clarification. Conclusion: ECART is best understood as a clinical-research integrated learning ecology that emerges from real team practice, rather than as a fixed standardised course. Its educational value lies in a recurring cycle of real problems, research translation, multi-source feedback, and clinical reinterpretation. This framework may inform the design, evaluation, and contextual adaptation of clinical-research integration pathways in medical education.

11.
arXiv (math.PR) 2026-06-16

A uniform-in-time weakly convergent explicit numerical method for the underdamped Langevin equation with polynomial potentials

Authors:

arXiv:2606.15175v1 Announce Type: cross Abstract: The underdamped Langevin equation is a fundamental model in statistical mechanics for sampling Gibbs measures and simulating molecular dynamics, for which numerical methods with uniform-in-time weak convergence are essential for accurately reproducing long-time statistical observables and invariant measures of the underlying dynamics. Currently, such uniform-in-time weak convergence is established for implicit schemes, but remains unknown for explicit ones under polynomially growing potentials. To improve efficiency in long-time simulations, we propose the first explicit numerical method for the underdamped Langevin equation with polynomially growing potentials that is proven to achieve uniform-in-time weak convergence. The explicit numerical method is constructed by introducing a dissipativity on the scalar auxiliary variable (SAV), which we call the DSAV method. The proposed DSAV method enables the approximation of the invariant measure for the underdamped Langevin equation with a precision of $\varepsilon$ at a significantly reduced computational cost of $\mathcal{O}(\varepsilon^{-1} \log(\varepsilon^{-1}))$. In addition, we establish the existence and positivity of the density function of the numerical solution without using the Malliavin calculus. Numerical experiments are performed to verify the theoretical findings and demonstrate the long-time stability of the proposed numerical method.

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

LLM-as-an-Investigator: Evidence-First Reasoning for Robust Interactive Problem Diagnosis

arXiv:2606.13220v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly used as interactive assistants for technical problem solving. However, when users provide incomplete descriptions or plausible but unverified explanations, LLMs may prematurely align with these assumptions and propose solutions before collecting sufficient evidence. We refer to this behavior as user-driven sycophancy: the tendency of an LLM to reinforce a user-provided hypothesis instead of testing alternative explanations. This paper introduces LLM-as-an-Investigator, an evidence-first agentic AI methodology for robust problem diagnosis. The approach is implemented through a Solution Investigator Agent, which estimates the ambiguity of an initial problem description, generates candidate hypotheses, asks targeted clarification questions, and updates hypothesis probabilities after each answer. Rather than producing an immediate response, the agent continues the investigation until the evidence makes one candidate explanation stronger than the alternatives. To evaluate the approach, we build a benchmark from solved technical forum threads in mechanical, electrical, and hydraulic domains. We use a three-agent evaluation pipeline in which a Problem-Solution Extractor Agent converts solved threads into structured cases, a Ground-Truth Evaluator Agent simulates the user while hiding the known solution, and the tested assistant attempts to recover the solution through dialogue. The experiments compare standard assistants, reasoning-oriented LLMs, and the proposed investigator-based model across LLM backbones. In addition to diagnostic accuracy, we analyze how standard assistants follow misleading user hypotheses in diagnostic cases. The results show that the proposed approach identifies the problem more accurately than direct prompting and reasoning-only baselines, while its evidence-first protocol helps reduce user-induced conversational bias.

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

Physics-conforming Latent Twins

arXiv:2606.15053v1 Announce Type: new Abstract: Surrogate models are central to scientific machine learning, where they enable fast prediction, simulation, inference, and control for complex physical systems. For time-dependent problems, however, accurate interpolation of training trajectories is not sufficient: reliable surrogates should also respect the conservation laws, invariants, admissibility conditions, and dissipative structures that give those trajectories physical meaning. We introduce Physics-conforming Latent Twins, a framework for learning latent surrogate solution operators whose dynamics satisfy selected physical principles by design. The method builds on the Latent Twin formulation by jointly learning an encoder, a decoder, and a latent flow map between arbitrary time-indexed states, while constraining the latent dynamics to preserve or dissipate prescribed structural quantities. We develop a constraint-transfer viewpoint that connects physical structure in the original state space with compatible constraints in latent space, and prove structure-preservation bounds showing how latent enforcement improves control of physical defects after decoding. We also derive algebraic conditions for latent flow maps that preserve linear and quadratic invariants or enforce dissipative inequalities. Numerical experiments on representative ODE and PDE benchmarks demonstrate improved constraint satisfaction, structural fidelity, and qualitative long-time behavior while maintaining accurate surrogate prediction.

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

Where Did It Go Wrong? Process-Level Evaluation of Web Agents with Semantic State Tracking

arXiv:2606.15673v1 Announce Type: new Abstract: Web agents act through long interaction sequences, yet existing benchmarks evaluate only terminal success, discarding all process information and offering little guidance on improvement. In this work, we conduct a process-level analysis of web agents. We introduce WebStep, a benchmark of 1,800 task instances with controlled difficulty and automatic semantic state tracking. Each website exposes a deterministic semantic MDP alongside the GUI: the agent operates on the interface, while the environment records high-level states and transitions in the background, enabling fine-grained analysis without manual annotation. Based on the semantic trajectory, we first show that process metrics reveal differences invisible to outcome evaluation: three agents whose success rates cluster within 31-33% diverge in exploration reach versus execution accuracy. Then, decomposing by skill characterizes the nature of these differences, exposing opposite per-skill rankings hidden within the same website: e.g., on Housing, OpenAI CUA outperforms Qwen3.5 by 23.7% on commit actions yet underperforms it by 15.6% on filtering, pinpointing a concrete skill to improve even within a domain. Bifurcation analysis further localizes the decisive error that loses the task and shows that this error is agent-specific rather than shared. Finally, these differences widen as tasks grow harder: success rate is similar on easy tasks but separates sharply as exploration becomes more demanding. Our process-level analysis opens a new avenue in web agent evaluation, providing fine-grained and actionable insight into where and how each agent should be improved.

15.
medRxiv (Medicine) 2026-06-22

Characteristics and Outcomes of Gene-Elusive Dilated Cardiomyopathy

Background and Aims Genetic testing in dilated cardiomyopathy (DCM) guides risk stratification and family screening. Likely pathogenic or pathogenic (LP/P) variants are identified in approximately one-third of patients, leaving many without a genetic diagnosis. Cohort studies suggest that "gene-elusive" patients have a lower risk of adverse events. This study aims to better characterise this group and identify factors associated with adverse outcomes. Methods Consecutive and unrelated DCM patients undergoing genetic testing and returning no LP/P variants were retrospectively recruited and compared to two control cohorts of DCM patients carrying LP/P variants in LMNA and TTN for a primary composite endpoint of end-stage heart failure (ESHF) or malignant ventricular arrhythmia (MVA). Results Among patients without prior MVA, the composite endpoint occurred in 36/423 (8.5%) gene-elusive, 14/39 (35.9%) LMNA and 11/100 (11%) TTN cardiomyopathy patients (log-rank p

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

Filtered Conformal Ellipsoids for Graph-Native Time Series

arXiv:2606.17014v1 Announce Type: new Abstract: Joint prediction sets for multivariate time series should control a single event while adapting to cross-coordinate dependence. We study filtered conformal ellipsoids: a frozen state-space filter emits a one-step predictive mean and covariance, and split-conformal calibration is applied to the resulting Mahalanobis scores. The filter is used to choose the ellipsoid shape; conformal calibration chooses the scalar radius, so the construction benefits from a learned predictive covariance without relying on Gaussian tail probabilities for coverage. The main difficulty is that filtered scores are dependent and learned recurrent filters need not contract in their raw hidden state; we therefore analyse contraction in an observable predictive-law quotient that identifies hidden states producing the same future sequence of emitted Gaussian laws. Under a stable Bayes Gaussian-projection filter, covariance bounds, and a finite-horizon observability Fisher condition, small excess Gaussian negative log-likelihood implies contraction of the learned emitted laws. Combined with a threshold-autocovariance envelope this yields a Chebyshev-type approximate coverage bound for filtered split-conformal prediction under dependence; a sharper Bernstein-type bound requires an additional geometric-mixing concentration assumption. Under Gaussian oracle realisability we also obtain a near-oracle log-volume comparison within the class of conditionally valid Gaussian ellipsoid rules. We instantiate the framework with a GCN-GRU filter with diagonal-plus-low-rank covariance. On moderate-size graph-native traffic benchmarks (METRLA-$20$ and PEMSBAY-$50$), the learned filter gives sharper at-target ellipsoids than static-covariance and non-filter baselines; at full-graph scale and on non-graph-native datasets, factor and copula baselines can be stronger.

17.
Nature (Science) 2026-06-10

Daily briefing: Ancient ground squirrels ate like ‘zombies of the Pleistocene’

Authors:

Evidence from fossilized poo reveals the diverse diet of ancient ground squirrels. Plus, the science behind the peptide craze and our innate tendency to wander anticlockwise. Evidence from fossilized poo reveals the diverse diet of ancient ground squirrels. Plus, the science behind the peptide craze and our innate tendency to wander anticlockwise.

18.
medRxiv (Medicine) 2026-06-15

Modelling the public-health impact of indoor air quality interventions on respiratory virus transmission

Respiratory virus transmission occurs in indoor settings where ventilation, occupancy, and dwell time determine exposure levels. Improving indoor air quality (IAQ) therefore could help reduce disease burden associated with respiratory viruses, yet its population-level impact remains poorly quantified. Here, we develop an individual-based transmission modelling framework that links within-location airborne dynamics to individual infection risk and population-level spread, whilst explicitly incorporating heterogeneity in ventilation and baseline indoor air quality across locations. We use this modelling approach to evaluate IAQ-improving interventions (air-quality interventions or AQIs), using hypothetical endemic and pandemic pathogen archetypes with properties similar to SARS-CoV-2 and influenza, and evaluate how effects on key epidemiological metrics (such as annualized incidence and epidemic final size) depend on AQI coverage, efficacy and allocation strategy. At 20% AQI intervention coverage and 80% efficacy, annualized incidence was reduced by approximately 7.2% for an endemic 'SARS-CoV-2-like' respiratory virus, and 17.0% for an endemic 'influenza-like' virus; at 60% coverage (80% efficacy) the reductions were 26.3% and 56.4%, respectively. Targeting AQI installation to the highest-risk locations outperformed random allocation: for SARS-CoV-2-like transmission, 20% coverage at 80% efficacy cut absolute incidence by 10.8% when targeted versus 7.2% when random; for influenza-like transmission, this comparison was 28.9% versus 17.0%. In epidemic scenarios, random installation at 40% coverage and 60% efficacy reduced final size by 23.7% (influenza-like) versus 6.3% (SARS-CoV-2-like). These results support treating clean indoor air as core public-health infrastructure and prioritising risk-based deployment of IAQ-improving interventions to maximise population-level benefit within budgetary and operational constraints.

19.
Nature (Science) 2026-06-10

The Amazon can be saved — with concerted action inside and outside Brazil

Authors: Unknown Author

As deforestation in the Amazon falls, fresh evidence shows that the rainforest can withstand global warming, but only if there is a worldwide effort to stop cutting it down. As deforestation in the Amazon falls, fresh evidence shows that the rainforest can withstand global warming, but only if there is a worldwide effort to stop cutting it down.

20.
medRxiv (Medicine) 2026-06-19

Cardiometabolic multimorbidity and care experiences in primary healthcare among Brazilian adults aged 50 and over (ELSI-Brazil)

Background: Population aging and the rising burden of non-communicable diseases have increased the prevalence of cardiometabolic multimorbidity (CM-MM) among older adults. Patient-reported experience measures (PREMs) are recognized as essential components of healthcare quality assessment, yet evidence on primary care experiences among individuals with CM-MM remains scarce. Objective: To analyze primary care experiences according to the presence of cardiometabolic multimorbidity among Brazilians aged 50 years and older. Methods: Cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021; n = 9,949). CM-MM was defined as the self-reported coexistence of two or more of the following conditions: hypertension, diabetes mellitus, dyslipidemia, acute myocardial infarction, and stroke. Primary care experiences were assessed using a validated 12-item instrument organized into four domains: first-contact access, longitudinality, communication, and care coordination. Associations were estimated using Poisson regression adjusted for sociodemographic, health conditions, and healthcare utilization variables, with stratified analysis by Family Health Strategy (FHS) coverage. Results: CM-MM prevalence was 25.5%, with a progressive increase by age and an inverse gradient by education. Individuals with CM-MM reported significantly more positive experiences in longitudinality (mean index 2.53 vs. 2.34; adjusted PR = 1.22; 95%CI 1.12-1.33; p < 0.001) and, to a lesser extent, in communication (mean index 2.68 vs. 2.58; adjusted PR = 1.10; 95%CI 1.00-1.20; p = 0.041). No statistically significant differences were found in first-contact access or care coordination. After stratified by FHS coverage, the observed differences in longitudinality and communication were no longer statistically significant. Conclusions: CM-MM was associated with more positive primary care experiences in longitudinality and communication. The absence of differentiated experiences in first-contact access and coordination highlights structural gaps in primary care responsiveness to individuals with greater clinical complexity. Keywords: Multimorbidity; Cardiometabolic diseases; Primary Care; Patient-reported experience measures; Older adults; ELSI-Brazil.

21.
arXiv (CS.AI) 2026-06-24

Accuracy and Satisfaction in Multi-Turn LLM Dialogues for NFR Assessment

arXiv:2606.24834v1 Announce Type: new Abstract: LLM-based dialogue assistants have become mainstream tools for software developers, yet current evaluation benchmarks focus exclusively on functional correctness. This leaves a critical gap in assessing the quality and accuracy of these conversations when handling Non-Functional Requirements (NFRs), which are inherently vague, context-dependent, and involve many parts of a program. Evaluating how well these systems support collaborative reasoning about NFRs requires methods that go beyond single-turn accuracy to capture both the correctness of the system's outputs and the quality of the multi-turn interaction. In this paper, we investigate the accuracy and quality of multi-turn conversations between developers and an LLM-based agent in the domain of Health Insurance Portability and Accountability Act (HIPAA) regulatory compliance. We hired 49 programmers to interact with GitHub Copilot to assess 148 HIPAA-derived NFRs against the iTrust codebase, a system designed to comply with HIPAA regulations, across three dimensions: requirement satisfaction level, reasoning, and code localization. We find that developers tend to agree with LLM assessments, but accuracy against expert ground truth is low. We model user satisfaction and find that longer system responses and more information-providing turns negatively affect user satisfaction, whereas proactive interactions positively affect it. Our findings provide insights for designing LLM-based dialogue systems that support NFR assessment.

22.
arXiv (CS.AI) 2026-06-12

Valid Inference with Synthetic Data via Task Exchangeability

arXiv:2606.13629v1 Announce Type: cross Abstract: There is a proliferation of work arguing for the use of synthetic data in scientific research. For example, social scientists are arguing for the use of LLM-generated "silicon samples" in pilot studies; AI evaluations increasingly rely on "LLM-as-a-judge" outputs; and proteomics research is accelerated by generative models that produce synthetic protein structures. These developments raise an intriguing possibility: synthetic data may help researchers ask more questions, run more studies, and accelerate discovery. But they also raise a fundamental concern: synthetic data can be biased, noisy, and misspecified. In this work, we propose statistical principles for using synthetic data in scientific research with provable validity guarantees. The key insight is a new technical condition that we call task exchangeability. Informally, this is a requirement that the researcher can identify historical tasks, for which real data is available, such that their current task of interest is exchangeable with the historical tasks in an appropriate mathematical sense. We develop methods for valid inference under task exchangeability, together with extensions that provide guarantees even beyond exchangeability. We demonstrate the framework on public opinion surveys with silicon samples and AI evaluation with autoraters.

23.
arXiv (CS.AI) 2026-06-12

Brick: Spatial Capability Routing for the Mixture-of-Models (MoM) Paradigm

arXiv:2606.13241v1 Announce Type: new Abstract: Defining query difficulty is one of the hardest problems in deployment engineering. Existing LLM routers rely on surface features such as domain labels, keywords, and token count, ignoring the within-domain variance that actually determines model success. Frontier models cost ten to one hundred times more than local open-weight models, so at production scale even small per-request savings become a direct cloud-bill lever. We present Brick, a multimodal router that scores each model on six capability dimensions, combines this with a per-query difficulty estimate, and dispatches via a cost-penalized geometric rule. A continuous preference knob lets operators slide between max-quality and max-saving profiles at deploy time. On a benchmark of 5,504 queries, Brick at max-quality reaches 76.98% accuracy, beating the best single model (75.02%) and all tested routers. At a neutral cost-quality profile, Brick achieves 74.11% accuracy at 4.71x lower cost than always using the strongest model. At min-cost, it cuts cost 22.15x with 11.85 points accuracy loss. Median latency drops from 51.2s to 22.8s.

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

A Unified Definition of Hallucination: It's The World Model, Stupid!

Despite numerous attempts at mitigation since the inception of language models, hallucinations remain a persistent problem even in today's frontier LLMs. Why is this? We review existing definitions of hallucination and fold them into a single, unified definition wherein prior definitions are subsumed. We argue that hallucination can be unified by defining it as simply inaccurate (internal) world modeling, in a form where it is observable to the user. For example, stating a fact which contradicts a knowledge base OR producing a summary which contradicts the source. By varying the reference world model and conflict policy, our framework unifies prior definitions. We argue that this unified view is useful because it forces evaluations to clarify their assumed reference "world", distinguishes true hallucinations from planning or reward errors, and provides a common language for comparison across benchmarks and discussion of mitigation strategies. Building on this definition, we also connect our framework to HalluWorld, a complementary benchmark that instantiates fully specified reference world models for stress-testing model hallucinations.

25.
medRxiv (Medicine) 2026-06-23

Clinical Characteristics and Predictors of Delayed Cerebral Ischemia in High-Altitude Aneurysmal Subarachnoid Hemorrhage

Background and Purpose-Aneurysmal subarachnoid hemorrhage (aSAH) remains a devastating cerebrovascular event, with delayed cerebral ischemia (DCI) representing its most feared complication. High-altitude environments induce profound cerebrovascular adaptations, yet no study has systematically examined aSAH outcomes in chronically hypoxic populations. We characterized clinical features and identified DCI predictors among aSAH patients on the Tibetan Plateau. Methods-This single-center retrospective cohort included 256 consecutive aSAH patients admitted at a tertiary neurosurgical center in Tibet (altitude 2,330-4,920 m) between 2013 and 2015. The primary outcome was DCI per consensus criteria. Multivariable logistic regression identified independent predictors; receiver operating characteristic analysis evaluated model performance. Altitude and hemoglobin were specifically evaluated as altitude-related risk factors. Results-DCI occurred in 26 patients (10.2%). In-hospital mortality was 1.6%. Most patients presented with good-grade aSAH (Hunt-Hess I-II, 73.0%; Fisher I-II, 73.1%). On multivariable analysis, only Fisher grade independently predicted DCI (odds ratio, 3.63 [95% CI, 1.14-11.52]; P=0.029). Neither altitude (P=0.697) nor hemoglobin concentration (P=0.858) was associated with DCI risk. The predictive model achieved an area under the curve of 0.812. At 1-year follow-up, 77.8% achieved favorable functional outcomes (modified Rankin Scale 0-2). Conclusions-Fisher grade is the sole independent predictor of DCI in high-altitude aSAH patients, while chronic hypoxia and compensatory hemoglobin elevation do not significantly modify DCI risk. Established sea-level prognostic frameworks remain valid in high-altitude settings, supporting their continued use for clinical risk stratification. Keywords: aneurysmal subarachnoid hemorrhage; high altitude; delayed cerebral ischemia; Fisher grade; Tibetan Plateau; prognosis