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01.
bioRxiv (Bioinfo) 2026-06-16

Super Learner Ensemble Modeling of CPTAC Proteomic Data for Survival Prediction in Head and Neck Squamous Cell Carcinoma

Survival analysis in head and neck squamous cell carcinoma (HNSCC) is traditionally performed using Cox proportional hazards models, alongside some exploration into black-box machine learning methods. The Super Learner (SL) algorithm addresses this model selection dilemma by combining diverse candidate algorithms into a weighted ensemble to perform comparably to the best candidate method. This study evaluates the performance of SL in HNSCC. Proteomic features as well as clinical covariates from 96 CPTAC HNSCC samples were modeled with three candidate algorithms (Cox LASSO, Cox Ridge, and Random Survival Forest) as well as the ensemble SL method. Models were optimized via Uno's time-dependent Concordance Index (C-index) and tested at 1- and 3-year time horizons using 2000 bootstrap resamples. The Cox Ridge regression model achieved the highest predictive accuracy among the four total methods. However, the SL demonstrated stable performance over both time horizons (1-year C-index: 0.985; 3-year C-index: 0.960). Variable importance analysis of the Cox Ridge model successfully identified malignant proteins (ATR, MAML1, MIEN1) alongside novel potential prognostic indicators (ZNF800, KERA). This analysis emphasizes the statistical necessity for larger cohorts for ensemble learning, while providing a benchmark of proteomic indicators in HNSCC.

02.
arXiv (quant-ph) 2026-06-17

Active Quantum Reservoir Engineering: Using a Qubit to Manipulate its Environment

arXiv:2505.16898v4 Announce Type: replace Abstract: Quantum reservoir engineering leverages dissipative processes to achieve desired behavior, with applications ranging from entanglement generation to quantum error correction. Therein, a structured environment acts as an entropy sink for the system and no time-dependent control over the system is required. We develop a theoretical framework for active reservoir engineering, where time-dependent control over a quantum system is used to manipulate its environment. In this case, the system may act as an entropy sink for the environment. Our framwork captures the dynamical interplay between system and environment, and provides an intuitive picture of how finite-size effects and system-environment correlations allow for manipulating the environment by repeated initialization of the quantum system. We illustrate our results with two examples: a superconducting qubit coupled to an environment of two-level systems and a semiconducting quantum dot coupled to nuclear spins. In both scenarios, we find qualitative agreement with previous experimental results, illustrating how active control can unlock new functionalities in open quantum systems.

03.
arXiv (CS.AI) 2026-06-16

Discovering Lattice Reduction Strategies via Self-Play

arXiv:2606.15301v1 Announce Type: cross Abstract: The Lenstra-Lenstra-Lovász (LLL) algorithm is a seminal contribution to computer science used for lattice basis reduction, yet its polynomial-time outputs produce bases that are far from optimal as the dimension grows. We show that deep reinforcement learning can discover strictly superior, generalizable reduction strategies by interacting with the primitive action space of LLL. We formulate lattice reduction as a single-player Markov Decision Process (MDP) and train a deep residual network using an AlphaZero-style self-play pipeline augmented with adaptive-horizon MCTS (Monte Carlo Tree Search), which couples multi-step network predictions with an entropy-gated expansion mechanism. The resulting policy, DeltaStar, is trained exclusively on small $8$-dimensional $q$-ary lattices and requires fewer primitive row operations than LLL. Crucially, it generalizes zero-shot to unseen moduli and higher dimensions up to $n=32$ without retraining.

04.
arXiv (CS.CL) 2026-06-24

Poster: Exploring the Limits of Audio-Based Detection of Turkish Phone Call Scams

Scam phone calls exploit vulnerable communities worldwide, yet research on detection has focused almost exclusively on English and other high-resource languages. In low-resource settings such as Turkish, detection is especially difficult, as annotated data is scarce and technological defenses remain limited. This research investigates how large language models (LLMs) can support scam detection in Turkish by introducing the first public multi-modal dataset of 100 aligned audio-transcript pairs of scam and benign conversations. We evaluate seven LLMs spanning three model families: Gemini 2.5 (Flash, Flash-Lite, Pro), GPT-4o, and Qwen (Max, Plus, Turbo), under three input conditions: raw audio, automatic speech-to-text transcripts, and transcripts refined by a native speaker. Our results suggest that transcript-based inputs consistently outperform direct audio processing, while human-corrected and uncorrected transcripts perform comparably. By centering a low-resource language and real world threat, this work highlights the urgent need for culturally and linguistically inclusive AI safety research and more robust multi-modal systems for fraud prevention.

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

Progressive Knowledge-Guided Large Language Model Framework for Bearing Fault Diagnosis

Vibration-based bearing fault diagnosis requires resolving three interrelated measurement challenges, including the trade-off between global statistical feature efficiency and local transient signal fidelity, insufficient traceability of measurement features to underlying fault physics, and ineffective multi-source measurement information fusion across diagnostic scales. This paper presents a progressive physics-guided multi-scale vibration signal processing framework that addresses all three challenges within a unified diagnostic pipeline. An 81-dimensional measurement descriptor, derived from bearing kinematic theory and characteristic defect frequencies, establishes a physically traceable feature space enabling real-time fault screening at approximately 20 ms per sample. A fault-adaptive signal segmentation mechanism then directs analytical attention toward fault-relevant waveform regions guided by physics-based priors, without manual feature engineering. Structured fault mechanism knowledge is further encoded implicitly in model parameters during training, enabling autonomous multi-scale measurement fusion without external knowledge dependencies at inference. Validated on four public benchmark datasets under diverse operating conditions, the framework achieves 98.49% diagnostic accuracy with a 12.6-fold reduction in computational cost relative to signal-level baselines. Interpretability analysis confirms that diagnostic feature activations align with established bearing fault mechanics, supporting measurement traceability in safety-critical industrial systems.

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

OmniDrive: An LLM-Choreographed Multi-Agent World Model with Unified Latent Co-Compression for Multi-View Driving Video Generation

Generative world models for autonomous driving face two unresolved tensions: heterogeneous control injection, where free-form language, HD-maps, trajectories, and camera poses reside in incompatible representational spaces, and post-hoc cross-view fusion, where per-camera latents fail to encode global 3-D geometry. We trace both to a single root cause: the absence of a shared symbolic interlingua aligning language, geometry, and pixels at the latent-token level. We present DRIVE-CHOREO, an LLM-choreographed multi-agent world model that recasts controllable multi-view video generation as latent choreography. Three Qwen2.5-VL agents - a Director parsing user intent into a structured WorldScript, a Cartographer grounding it into spatially-anchored layout tokens, and an Auditor feeding cross-view critiques back as auxiliary supervision - jointly author a single position-aware token sequence. This sequence is co-compressed with the multi-view video via a view-time permutation that enforces inter-camera geometry within the convolutional receptive field of a 3-D VAE. On nuScenes, DRIVE-CHOREO sets new state-of-the-art multi-view consistency and BEV mAP (21.6) with competitive FVD (45.7); a detector trained purely on our synthetic data gains +2.4 NDS on the real validation split, validating downstream utility.

07.
arXiv (CS.LG) 2026-06-12

Earth Science Foundation Models: From Perception to Reasoning and Discovery

arXiv:2605.12542v2 Announce Type: replace-cross Abstract: Large foundation models (FMs) are transforming Earth science by integrating heterogeneous multimodal data, such as multi-platform imagery, gridded reanalysis data, diverse geophysical and geochemical observations, and domain-specific text, to support tasks ranging from basic perception to advanced scientific discovery. This paper provides a unified review of Earth science foundation models (Earth FMs) through two complementary dimensions: depth, which traces the evolution of model capabilities from perception to multimodal reasoning and agentic scientific workflows, and breadth, which summarizes their expanding applications across the atmosphere, hydrosphere, lithosphere, biosphere, anthroposphere, and cryosphere, as well as coupled Earth system processes. Using this framework, we review representative multimodal Earth foundation models and compile more than 200 datasets and benchmarks spanning diverse Earth science tasks and modalities. We further discuss key challenges in multimodal data heterogeneity, scientific reliability and continual updating, scalability and sustainability, and the transition from foundation models to agentic and embodied Earth intelligence, and outline future directions toward more integrated, trustworthy, and actionable AI Earth scientists. Overall, this paper offers a structured roadmap for understanding the development of Earth foundation models from both capability depth and application breadth.

09.
arXiv (quant-ph) 2026-06-15

Quantum Simulation of Spin-Dependent Electron Transfer in a Synthetic Chiral Lattice with a Trapped Ion

arXiv:2606.13930v1 Announce Type: new Abstract: Electron transfer through chiral structures can exhibit spin asymmetry, known as the chiral-induced spin selectivity effect, whose microscopic origin remains an open question. While path-interference within the chiral moiety has been proposed as a key mechanism, its experimental validation requires precise and versatile tunability of system parameters. Here we implement a programmable quantum simulation of spin-dependent electron transfer in a donor–chiral-bridge–acceptor model using a trapped ion. The bridge is encoded in internal states of the ion with tunable nearest- and next-nearest-neighbor couplings, while donor and acceptor states are coupled via a spectator bosonic motional mode. We observe spin-dependent interference within the bridge, and further reveal spin-dependence in donor-to-acceptor transfer dynamics, controlled by amplitude and phase of the coupling parameter. Our results identify interference among spin-dependent pathways as a microscopic origin of spin-dependent transfer, and open a route toward quantum simulations of complex chiral lattices with multi-level and bosonic degrees of freedom.

10.
arXiv (CS.AI) 2026-06-17

Shattering the Autoregressive Curse: Dynamic Epistemic Entropy Orchestrated Erasable Reinforcement Learning for LLMs

arXiv:2606.17735v1 Announce Type: new Abstract: Although reinforcement learning (RL) has expanded the cognitive boundaries of large language models (LLMs), it often remains vulnerable to the autoregressive curse in long-horizon logical reasoning: small epistemic perturbations introduced early in generation can propagate irreversibly along the Markov decision process flow, triggering cascading failures that drive the reasoning trajectory toward collapse. To overcome this autoregressive cascade, in which a single early mistake can compromise all subsequent reasoning steps, we propose dynamic epistemic entropy orchestrated erasable reinforcement learning ($E^3RL$). $E^3RL$ eliminates reliance on external signals by grounding the model's endogenous local autoregressive cross-entropy as an intrinsic coordinate of epistemic uncertainty. By introducing segment-level adaptive dynamic thresholds and advantage allocation, $E^3RL$ enables the model to precisely excise localized logical defects while reusing historical key-value (KV) cache streams, thereby endowing the reasoning process with a self-healing capability. We train $E^3RL$ on the DeepMath-103k dataset. Experimental results show that $E^3RL$ reshapes the exploration efficiency of long-sequence reasoning and improves sample efficiency while maintaining linear memory overhead. On mathematical reasoning benchmarks such as AIME, $E^3RL$ achieves substantial performance gains, with the 4B and 8B parameter models surpassing previous state-of-the-art (SOTA) results by 5.349\% and 6.514\%, respectively. These findings suggest that $E^3RL$ shatters the autoregressive curse in long-sequence reasoning and establishes a theoretical and systems-level foundation for the next generation of self-healing artificial general intelligence (AGI).

11.
medRxiv (Medicine) 2026-06-22

Effect of Lowering the Drink-Driving Blood Alcohol Limit in Scotland on Road Traffic Crashes: a Synthetic Difference-in-Differences Study

Objective: To evaluate the road safety impact arising from Scotlands 2014 reduction in the legal blood alcohol concentration (BAC) limit for drivers, and to assess whether the effect of the reform varied across different spatial contexts. Design: A quasi-experimental statistical longitudinal study using a Synthetic Difference-in-Differences (SDID) approach. Setting: Small-area panel data for Great Britain, with areas (Middle-layer Super Output Areas, MSOAs, in England and Wales and Intermediate Zones, IZs, in Scotland) classed into control and treatment groups according to whether they were exposed to Scotlands BAC reform. The control and treatment groups comprise 7088 spatial units in England and Wales and 852 spatial units in Scotland, respectively, observed over the period 2008-2019. Participants: The study primarily analyses police-reported road traffic collision data from the UK Department for Transports STATS19 system. Data were analysed at the MSOA/IZ level. This is a secondary dataset, and we therefore did not involve patients or the public in formulating the research question, determining outcome measures, or designing and conducting the study. Main Outcome Measures: The main outcome measures were log-transformed rates of total road traffic crashes, and (weekend) night-time crashes (22:00-04:00) per 100,000 population. The latter is used as a proxy measure for drunk driving. Results: Our results indicate that the reduction in the legal BAC limit led to statistically significant declines in road traffic crash rates. Aggregate estimates suggest reductions of 12.0% (95% confidence interval (CI): [-13.7%, -10.3%]) in total crashes, 15.6% (95% CI: [-20.7%, -10.2%]) in night-time crashes, and 12.4% (95% CI: [-16.7%, -7.9%]) in weekend night-time crashes. We also find substantial heterogeneity in treatment effects across spatial contexts. Effects were strongest in rural and less densely populated areas, where reductions exceeded 16% (95% CI: [-18.7%, -13.9%]) for total crashes and reached up to 29.6% (95% CI: [-35.8%, -22.8%]) for night-time and 21.4% (95% CI: [-28.3%, -13.9%]) for weekend night-time crashes. Moderate but statistically significant effects were also observed in dense urban areas, whereas effects in suburban and transitional areas were smaller and not statistically significant. Conclusions: Our analysis suggests that lowering the legal BAC limit in Scotland led to meaningful reductions in road traffic crashes, particularly during higher-risk periods and in rural areas. The findings further suggest that the effectiveness of BAC regulation may vary across local contexts, highlighting the importance of accounting for spatial heterogeneity when evaluating road safety policies.

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

Limited Marginal Benefit of Reasoning-Heavy LLM Deployment in ESG Narrative Scoring: A 4-Model Consensus Study on Japanese Listed Firms

arXiv:2606.13693v1 Announce Type: cross Abstract: Automated scoring of ESG narrative disclosures with large language models (LLMs) is gaining traction, yet whether reasoning-heavy frontier models add value commensurate with their cost remains empirically unsettled. We evaluate this question on a corpus of ten Japanese listed firms across three rubric axes – quantitative targets, progress-tracking infrastructure, and external-standard alignment – using a four-model consensus design that combines a reasoning-on frontier model with three reasoning-off contemporaries. Across 120 firm x axis x model scores, the pooled mean absolute deviation between the reasoning-on model and each reasoning-off counterpart is 0.38 on a 5-point scale; only 2% of pairwise comparisons reach a two-point deviation, and none exceeds two points. Per-firm cost accounting shows the reasoning-on arm alone costs roughly 5.6x as much as the three-provider reasoning-off ensemble, for outcomes that differ only within small margins. We conclude that in span-based ESG narrative scoring, reasoning-heavy deployment does not materially improve outcomes relative to reasoning-off consensus, while substantially increasing operational cost. We discuss implications for cost-effective ESG auto-scoring pipelines and LLM deployment governance in applied accountability settings. An earlier version of this work is available on SSRN (Abstract ID 6683303).

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

Exploring Dualistic Meta-Learning to Enhance Domain Generalization in Open Set Scenarios

arXiv:2606.23758v1 Announce Type: cross Abstract: Domain generalization learns from multiple source domains to generalize to unseen target domains. However, it often neglects the realistic case of label mismatch between source and target. Open set domain generalization is then proposed to recognize unseen classes in unseen domains. A simple approach trains one-vs-all classifiers to separate each class and detect outliers as unknown. Yet, the imbalance between few positive samples and many negative samples skews the decision boundary towards the positive ones, leading the model to over-reject out-of-distribution data, even from known classes in unseen domains. In this paper, we propose a novel meta-learning stategy called dualistic MEta-learning with joint DomaIn-Class matching (MEDIC), which considers implicit gradient matching towards inter-domain and inter-class task splits simultaneously to find optimal boundaries balanced for both domains and classes. Experimental results show that MEDIC not only outperforms prior methods in open set scenarios, but also maintains competitive close set generalization ability.

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

DPC-VQA: Decoupling Quality Perception and Residual Calibration for Video Quality Assessment

Recent multimodal large language models (MLLMs) have shown promising performance on video quality assessment (VQA) tasks. However, adapting them to new scenarios remains expensive due to large-scale retraining and costly mean opinion score (MOS) annotations. In this paper, we argue that a pretrained MLLM already provides a useful perceptual prior for VQA, and that the main challenge is to efficiently calibrate this prior to the target MOS space. Based on this insight, we propose DPC-VQA, a decoupling perception and calibration framework for video quality assessment. Specifically, DPC-VQA uses a frozen MLLM to provide a base quality estimate and perceptual prior, and employs a lightweight calibration branch to predict a residual correction for target-scenario adaptation. This design avoids costly end-to-end retraining while maintaining reliable performance with lower training and data costs. Extensive experiments on both user-generated content (UGC) and AI-generated content (AIGC) benchmarks show that DPC-VQA achieves competitive performance against representative baselines, while using less than 2% of the trainable parameters of conventional MLLM-based VQA methods and remaining effective with only 20% of MOS labels. The code will be released upon publication.

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

Real-Time Execution with Autoregressive Policies

arXiv:2606.13355v1 Announce Type: cross Abstract: Real-time execution, enabled by asynchronous inference that ensures both smooth action trajectories and fast reactivity, is critical for realistic deployments of large-scale Vision-Language-Action models. However, recent work on real-time execution primarily focuses on variants of diffusion policies, even though it is more critical for autoregressive policies given their slower rollout speed in synchronous inference. In contrast, we demonstrate that autoregressive policies can achieve real-time execution by adjusting the tokenization horizon and applying constrained decoding, thereby guaranteeing strict latency bounds that enable multi-trajectory decoding to maximize performance. Across simulated and real-world environments, we find that the autoregressive policy consistently outperforms its equivalent-level flow-matching policy counterpart while achieving significantly improved task completion speeds from synchronous inference. Coupled with the inherent advantages of autoregressive policies, such as faster convergence and better generalizability in instruction-following, these results confirm that autoregressive policies can remain a competitive policy type supporting real-time execution.

16.
arXiv (CS.CL) 2026-06-25

Beyond Next-Observation Prediction: Agent-Authored World Modeling for Sequential Decision Making

Recent studies on world modeling for Large Language Model (LLM) agents typically formulate the learning objective as next-observation prediction. However, this objective ties supervision to what a transition happens to reveal, which may omit the dynamics most relevant to the agent's current decision. To bridge this gap, we propose Agent-Authored World Modeling (AAWM), a training procedure that constructs supervision from the policy's own decision needs. Specifically, at each state, the agent identifies what it needs to understand about the environment before acting. These needs drive the retrieval of relevant transition evidence across trajectories, which is then synthesized into training targets that capture decision-oriented dynamics instead of reconstructing the next observation. This aligns the training objective with the dynamics the policy needs before acting, not with the contents of the next observation. Experimental results validate the effectiveness of AAWM across multiple environments and training settings. These results show that decision-aware world-model targets provide a more effective learning signal than next-observation prediction.

17.
arXiv (CS.CV) 2026-06-15

ViT-Up: Faithful Feature Upsampling for Vision Transformers

Vision Transformers (ViTs) have become a dominant architecture for visual representation learning, providing exceptionally strong and broadly reusable backbone features. However, ViTs are commonly operated on relatively small patch-token grids due to the quadratic cost of global self-attention, which creates a persistent bottleneck for dense prediction tasks such as semantic segmentation and depth estimation. This has motivated the development of task-agnostic feature upsamplers. While recent state-of-the-art methods produce visually sharp dense representations, their reliance on shallow image encoders for guided upsampling can introduce feature leakage, fragmentation, and blur. We introduce ViT-Up, an implicit feature upsampling framework that replaces external image guidance with layer-wise query construction from intermediate ViT hidden states. This enables feature prediction at arbitrary continuous image coordinates while preserving alignment with the backbone feature space. Experiments demonstrate that ViT-Up consistently outperforms state-of-the-art image-guided upsamplers across dense prediction and semantic correspondence. On DINOv3-S+, ViT-Up improves over prior methods by up to +2.07 mIoU on Cityscapes and +4.17 PCK@0.10 on SPair-71k. With the larger DINOv3-B backbone, these gains increase to +3.36 mIoU and +8.09 PCK@0.10, demonstrating that ViT-Up scales favorably with backbone capacity.

18.
arXiv (quant-ph) 2026-06-24

Fractional squeezing: spectra and dynamics from generalized squeezing Hamiltonian with fractional orders

Authors:

arXiv:2601.15693v2 Announce Type: replace Abstract: We generalize the generalized-squeezing problem to include fractional values of the squeezing order $n$. This approach allows us to determine the locations of critical points at which qualitative changes in behaviour occur and accurately predict the behaviour at these critical points, which are challenging for conventional computational methods. Based on our numerical calculations, we identify with a high degree of confidence the point at which the spectrum turns from continuous to discrete and the point at which oscillations turn from having asymptotically infinite amplitudes to having finite amplitudes. Furthermore, we numerically investigate the behaviour in the large $n$ regime and provide an intuitive explanation for the numerical results.

19.
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.

20.
arXiv (quant-ph) 2026-06-16

Efficient Implementation of a Single-Qutrit Gate Set via Coherent Control

arXiv:2507.06860v2 Announce Type: replace Abstract: Qutrits offer the potential for enhanced quantum computation by exploiting an enlarged Hilbert space. However, the synthesis of high-fidelity and fast qutrit gates, particularly for single qutrits, remains an ongoing challenge, as it involves overcoming intrinsic constraints in quantum platforms. Here, we develop a novel framework for the efficient implementation of a single-qutrit gate set via coherent control, leveraging SU(3) dynamics while obviating platform-specific constraints such as those arising from the selection rule. As a proof-of-principle demonstration, we realize 35-ns qutrit Hadamard and X gates using a superconducting transmon, achieving an average fidelity of 99.5\%, as verified by randomized benchmarking. We further demonstrate two paradigmatic quantum circuits, which can be naturally extended to scalable qudit algorithms for phase estimation and parity check. In addition, we propose an SU(3)-based decomposition strategy for an arbitrary single-qutrit gate and numerically demonstrate its substantial efficiency improvement over conventional SU(2)-based protocols. By addressing the challenge of efficiently implementing single-qutrit gates, our protocol paves the way for realizing high-performance qutrit processors in diverse quantum platforms.

21.
medRxiv (Medicine) 2026-06-24

ADVISE: A Machine Learning Framework for Early Recognition of a Surrogate Marker for Ventilator-Associated Pneumonia Using Routinely Collected Critical Care Data

Background Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in critical care, affecting 20-36% of mechanically ventilated patients. Early prediction is hampered by the absence of a reliable, objective diagnostic standard. We developed ADVISE (Automated Dudley Ventilation Infection Series Evaluation), a machine learning model to predict physiological deterioration consistent with developing VAP using routinely collected electronic health record data from a UK NHS intensive care unit. Methods Retrospective observational study of admissions at Russell's Hall Hospital ICU (2008-2026). Following National Data Opt-Out exclusion (158 admissions, 4.2%), 3,566 admissions generated 33,208 candidate 48-hour observation blocks. Six temporal variables - FiO2, ventilator mode, P:F ratio, procalcitonin (PCT), secretion amount, and secretion description - were extracted across the baseline window (hours 1-24). A composite VAP-surrogate outcome required concurrent P:F ratio decline (>=5%) and PCT rise (>=0.5 ng/mL) across the outcome window (hours 25-48). After sequential quality filters, 2,134 blocks (18 positive, 0.84% prevalence) were retained. An XGBoost classifier was trained using nested 5-fold cross-validation with scale_pos_weight=114.0 and ROC-based hyperparameter optimisation on 1,495 training blocks, evaluated on 639 held-out test blocks. Performance was assessed via AUROC, AUPRC, and calibration (Brier score). Bootstrap resampling (1,000 iterations) generated 95% confidence intervals. Results On the held-out test set (n=639, 5 positive outcomes), ADVISE achieved AUROC 0.874 [95% CI: 0.771-0.939] and AUPRC 0.031 [0.008-0.069], representing a 4.0-fold improvement over the no-skill baseline. Nested cross-validation mean AUROC was 0.844 +/- 0.078 (range 0.716-0.915). At the Youden-optimal threshold, sensitivity was 0% with specificity 97.8%, reflecting extreme class imbalance (0.78% test prevalence). A threshold targeting 80% sensitivity achieved sensitivity 80.0% [33.3-100.0%], specificity 87.4% [84.8-89.9%], positive predictive value 4.8% [1.1-9.9%], and negative predictive value 99.8% [99.4-100.0%], detecting 4 of 5 VAP cases with approximately 80 false alarms (12.6% false positive rate). Brier score was 0.0078. Feature importance identified baseline P:F ratio as the dominant predictor (41.3% total gain), followed by ventilator mode (26.1%), secretion amount (13.2%), secretion description (9.1%), procalcitonin (5.9%), and FiO2; (4.5%). Conclusions ADVISE demonstrates that baseline oxygenation trajectory and ventilatory support patterns - derived exclusively from routinely charted ICCA variables - can identify admissions at risk of VAP-related physiological deterioration with meaningful discrimination (AUROC 0.874) despite severe class imbalance. The 80% sensitivity operating point offers a clinically actionable alert rate (12.6% FPR), supporting integration into existing ICU workflows. This proof-of-concept study establishes feasibility; multi-site prospective validation is required before clinical deployment.

22.
arXiv (quant-ph) 2026-06-17

Response kinetic uncertainty relation for Markovian open quantum systems

arXiv:2501.04895v2 Announce Type: replace Abstract: Response uncertainty relations in stochastic thermodynamics extend precision bounds to the sensitivity of observables under external perturbations. Here we derive a quantum response kinetic uncertainty relation for continuously monitored Markovian open quantum systems in the steady state of the Lindblad master equation. The response precision of a measured trajectory observable is bounded by two contributions: the conventional quantum dynamical activity and a perturbation-induced intersubspace transition term. The latter is absent in the classical limit and captures a genuinely quantum part of the response cost. We identify simple conditions under which either contribution vanishes, and we further clarify the structure of the intersubspace term through a symmetry-resolved decomposition and exact sector-selection rules. The bound and its structure are illustrated in a driven two-level atom.

23.
medRxiv (Medicine) 2026-06-18

Hospital staff views on the visibility, role and impact of Acute Learning Disability Liaison Services in Wales: a service evaluation

People with a learning disability experience marked health inequalities. In Wales, Acute Learning Disability Liaison Services (ALDLS) are delivered by specialised learning disability services, and all roles within them are undertaken by Learning Disability Liaison Nurses (LDLN). These services aim to enable access to, and delivery of, secondary care by supporting reasonable adjustments, facilitating communication, and coordinating care for people with learning disability during hospital encounters. However, independent evidence of the impact of ALDLS on patient care remains limited. This evaluation tries to address this evidence gap by examining hospital staff perceptions of the visibility, role, and impact of ALDLS across Welsh Health Boards, with the aim of informing service design and development and improving secondary care access and care for people with learning disability. The service evaluation used a qualitative approach involving interviews and a focus group with hospital staff across the seven Welsh Health Boards who had experience working with or interacting with ALDLS staff to care for patients with learning disability. Findings cover six key areas including i) visibility and delivery of ALDLS, ii) Barriers and challenges to effective ALDLS delivery, iii) Enablers of effective ALDLS delivery, iv) Positive impacts for patients with learning disability, v) Negative impacts and unintended consequences when the service is absent or limited, and vi) Participants recommendations for future improvements of ALDLS. To synthesise the findings, we developed an overview diagram, which illustrates how ALDLS may influence care quality in acute hospitals. The overview places the liaison service at the centre, showing how organisational enablers and barriers shape its delivery, and how its core functions support improvements in safety, timeliness, effectiveness, efficiency, equity, and patient-centred care. From the findings we have identified recommendations for practice and policy. These include that ALDLS should be recognised as a core, safety-critical component of acute hospital care for people with a learning disability, rather than an optional add-on. In practice, services should be more visibly embedded within routine pathways, with consistent site-based presence, clear referral criteria, early identification through electronic flagging and notification systems, and routine involvement in multidisciplinary planning for complex admissions and procedures. At policy level, ALDLS provision should be recognised within equality and patient safety frameworks as an essential service requiring sustained investment, national minimum configuration standards, adequate staffing, and better-integrated digital systems to support continuity, equitable access, and person-centred care.

24.
medRxiv (Medicine) 2026-06-12

The Acceptability of Three Co-Created Peer Support Interventions for People Living with Leprosy Reactions in Indonesia: A Mixed-Methods Pilot Study

Background: Leprosy reactions (LR) are immune-mediated complications associated with disability, emotional distress, and social isolation. We identified a gap in affected-individual-informed interventions that aim to improve the management of LR in healthcare settings. To address this gap, we assessed the acceptability of three peer-support interventions co-created with people affected by LR in Indonesia. Methods: Using an interactive learning and action approach, we co-created peer counselling, telesupport groups, and participatory video interventions which were piloted in an urban hospital and 13 rural community clinics. A mixed-methods design was applied with interviews, focus group discussions, and pre-post assessments involving four participant groups. Data were analyzed thematically using an acceptability framework. Results: One hundred participants were enrolled, and 92 completed the pilot intervention between November 2022 and July 2023. Qualitative findings showed that all interventions were acceptable. Peer counselling provided emotional reassurance through shared experiences and was perceived as trustworthy and supportive. Perceived burdens differed by setting, with time constraints in urban facilities and geographical barriers in rural clinics. Knowledge improved significantly among participants of peer counselling and telesupport groups in rural settings. Telesupport groups facilitated connection, information exchange, and continuity of care. Digital access and literacy limited participation for some, particularly in rural areas. The participatory video was perceived as reassuring and informative. Improvements in knowledge, attitude, practices, and mental well-being domain scores were observed among urban participants, but responses in rural settings showed less change. Participants and co-implementers reported increased self-efficacy, participants confidence to perform required behaviors within peer support interventions, with effects shaped by intervention and setting. Conclusions: The three co-created peer-support interventions were acceptable for individuals with LR in diverse healthcare settings. These outcomes highlight the importance and effectiveness of selective, and context-sensitive implementation of one or more peer-support modalities.

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

TRUSTMEM: Learning Trustworthy Memory Consolidation for LLM Agents with Long-Term Memory

arXiv:2606.25161v1 Announce Type: new Abstract: Large language model (LLM) agents rely on long-term memory to support extended interactions and personalized assistance beyond finite context windows. Existing memory agents actively update external memory through generated write, revise, and delete operations, but these updates may omit important information, corrupt existing memory, or introduce unsupported hallucinated content. Once stored, such errors become persistent system-state failures that can affect future reasoning and generation. In this paper, we propose TrustMem, a framework designed to improve the trustworthiness of memory consolidation. TrustMem relies on a Memory Transition Verifier to evaluate the transition process of memory updates in terms of coverage, preservation, and faithfulness. It further constructs preference pairs among candidate updates under the same memory state, enabling preference-guided reinforcement learning to directly optimize memory updating behaviors. Extensive experiments demonstrate that TrustMem improves both memory utility and reliability: it achieves state-of-the-art results across MemoryAgentBench, HaluMem, and the Mem-alpha validation set, improves HaluMem memory extraction by 12.14 F1 points, and reduces transition-level omission, corruption, and hallucination by 40.1\%, 79.1\%, and 50.0\%, respectively, compared with the strongest baseline for each error type.