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01.
arXiv (quant-ph) 2026-06-11

Fermions are fundamentally more nonlocal than Bosons

arXiv:2606.12363v1 Announce Type: new Abstract: Bell's theorem shows that entangled quantum particles can exhibit correlations that classical particles cannot reproduce without an additional nonlocal resource, such as communication. In this sense, quantum particles are fundamentally more nonlocal than classical ones, and entanglement becomes unavoidable in physics. Here we prove the analogous result within quantum theory itself: indistinguishable fermions transmitted through a quantum network can generate correlations that distinguishable particles or indistinguishable bosons cannot reproduce without additional communication. In the same sense, fermions are fundamentally more nonlocal than bosons or distinguishable particles, motivating fermionic anticommutation and indistinguishability as unavoidable operational resources. Our result further implies that fermions can strictly surpass all qubit-based protocols for certain distributed computing tasks, demonstrating that a complete understanding of information processing requires going beyond qubits to fermionic information carriers - febits.

02.
arXiv (CS.AI) 2026-06-17

SSIL: Self-Supervised Imitation Learning for End-to-End Driving

arXiv:2308.14329v4 Announce Type: replace-cross Abstract: In autonomous driving, the end-to-end (E2E) driving approach that predicts vehicle control signals directly from sensor data is rapidly gaining attention. To learn a safe E2E driving system, one needs an extensive amount of driving data and human intervention. Vehicle control data is constructed by many hours of human driving, and it is challenging to construct large vehicle control datasets. Often, publicly available driving datasets are collected with limited driving scenes, and collecting vehicle control data is only available by vehicle manufacturers. To address these challenges, this paper proposes the first self-supervised learning framework, Self-Supervised Imitation Learning (SSIL), for E2E driving. The proposed SSIL framework can learn vision-based E2E driving networks without using driving command data or a pre-trained model. To construct pseudo steering angle data, proposed SSIL predicts a pseudo target from the vehicle's poses at the current and previous time points that are estimated with light detection and ranging sensors. In addition, we propose a new cross-attention-based conditioning approach (CACA) for a vision encoder in E2E driving, where a high-level instruction serves as the conditioning signal for visual information. Our numerical experiments with three different benchmark datasets demonstrate that the proposed SSIL framework achieves very comparable E2E driving accuracy with the supervised learning counterpart. Furthermore, the proposed pseudo-label predictor outperformed an existing one using proportional integral derivative controller, and proposed CACA achieved superior performance over existing conditioning approaches.

03.
arXiv (CS.LG) 2026-06-17

Public transit gains and spatially uneven travel demand changes after NYC congestion pricing

arXiv:2606.17530v1 Announce Type: cross Abstract: New York City implemented the nation's first cordon-based congestion pricing program in January 2025, providing an opportunity to evaluate how system-wide urban mobility responds to large-scale pricing interventions. Because such policies generate spillovers across modes and locations, credible control groups are difficult to construct. We address this challenge using time series foundation models to generate probabilistic counterfactual demand forecasts with calibrated uncertainty. Applying this framework to bus, subway, and aggregate trip volume data, we find that post-policy bus and subway ridership increased significantly relative to expected no-policy demand, while overall travel demand decreased modestly. The effects are spatially heterogeneous: while reductions in overall travel demand are concentrated within the Congestion Relief Zone, transit gains extend beyond Manhattan's core. Socio-demographic analyses further reveal uneven adaptation across neighborhoods, highlighting spatial equity implications. Our framework provides a scalable approach for the uncertainty-aware evaluation of system-wide urban interventions when clean control groups are unavailable.

04.
arXiv (CS.LG) 2026-06-11

Scaling Laws of Global Weather Models

arXiv:2602.22962v2 Announce Type: replace Abstract: Data-driven models are revolutionizing weather forecasting. To optimize training efficiency and model performance, this paper analyzes empirical scaling laws within this domain. We investigate the relationship between model performance (validation loss) and three key factors: model size ($N$), dataset size ($D$), and compute budget ($C$). Across a range of models, we find that Aurora exhibits the strongest data-scaling behavior: increasing the training dataset by 10x reduces validation loss by up to 3.2x. GraphCast demonstrates the highest parameter efficiency, yet suffers from limited hardware utilization. Our compute-optimal analysis indicates that, under fixed compute budgets, allocating resources to more total training data yields greater performance gains than increasing model size. Furthermore, we analyze model shape and uncover scaling behaviors that differ fundamentally from those observed in language models: weather forecasting models consistently favor increased width over depth. These findings suggest that future weather models should prioritize wider architectures and larger effective training datasets to maximize predictive performance.

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

Marked random graphs with given degree sequence: large deviations on the local topology

arXiv:2401.00351v2 Announce Type: replace Abstract: We investigate the behavior of the empirical neighborhood distribution of marked graphs in the framework of local weak convergence. Here we extend known results by considering uniform random graphs with given degree sequences and i.i.d. marks on half-edges and vertices. We establish a large deviation principle for such families of empirical measures. The proof builds on Bordenave and Caputo's seminal 2015 paper, and Delgosha and Anantharam's 2019 introduction of BC entropy, relying on combinatorial lemmas that allow one to construct suitable approximations of measures supported on marked trees. Possible applications of these results are in the study of interacting diffusions on top of random graphs.

07.
arXiv (CS.CL) 2026-06-16

SkillsVote: Lifecycle Governance of Agent Skills from Collection, Recommendation to Evolution

Long-horizon LLM agents generate traces that could become reusable experience, but raw trajectories are noisy, local, and hard to govern. Agent Skills offer a structured artifact for combining procedural guidance, executable resources, and applicability boundaries. Yet open skill ecosystems contain redundant, uneven, environment-sensitive artifacts, and indiscriminate updates can pollute future context. We present SkillsVote, a lifecycle-governance framework for Agent Skills across collection, recommendation, attribution, and evolution. SkillsVote profiles a million-scale open source corpus for environment requirements, quality, and verifiability, and synthesizes tasks for verifiable skills. Before execution, it performs agentic library search over structured skill folders to expose instructional context. After execution, it decomposes trajectories into skill-linked subtasks, attributes outcomes to skill-guided execution, agent exploration, environment, and result signals, and admits only successful reusable discoveries to evidence-gated updates. Experiments on Terminal-Bench 2.0 and SWE-Bench Pro show that SkillsVote improves agent performance on challenging agentic coding benchmarks. The gains arise from two complementary pathways: online evolution over task streams at test time and offline transfer via frozen libraries built from either historical trajectories or curated open source skills.

08.
arXiv (quant-ph) 2026-06-12

Quantum Error Correction Codes for Truncated SU(2) Lattice Gauge Theories

Authors:

arXiv:2511.13721v2 Announce Type: replace Abstract: We construct two quantum error correction codes for pure SU(2) lattice gauge theory in the electric basis truncated at the electric flux $j_max=1/2$, which are applicable on quasi-1D plaquette chains, 2D honeycomb and 3D triamond and hyperhoneycomb lattices. The first code converts Gauss's law at each vertex into a stabilizer while the second only uses half of the vertices and is locally the carbon code. Both codes are able to correct single-qubit errors. The electric and magnetic terms in the SU(2) Hamiltonian are expressed in terms of logical gates in both codes. The logical-gate Hamiltonian in the first code exactly matches the spin Hamiltonian for gauge singlet states found in previous work.

09.
arXiv (quant-ph) 2026-06-17

Approximately Decoding the Colour Code

Authors:

arXiv:2606.18035v1 Announce Type: new Abstract: Recently we showed that minimum weight decoding in the (6.6.6 planar) colour code is NP-hard. However, it remained an open question as to whether it was possible to approximate the minimum weight decoding arbitrarily closely in polynomial time. In this paper we prove that it is possible: for any $\varepsilon>0$ there is an polynomial time algorithm that, given a syndrome, can find an error-set generating that syndrome whose weight is at most $1+\varepsilon$ times the weight of the minimum weight decoding. As a consequence we see that, for any $\varepsilon>0$, there is a polynomial time algorithm that can correct all errors of weight up to $(1-\varepsilon)d/2$ in the distance $d$ colour code (so almost up to the theoretical $d/2$ limit). The polynomial we give is impractically large, but it does open the door for sensible polynomial time algorithms that approximate minimum weight decoding and, in particular, shows that approximate decoding is not NP-hard.

10.
arXiv (math.PR) 2026-06-18

The FBSDE approach to sine-Gordon up to $6\pi$

arXiv:2401.13648v3 Announce Type: replace-cross Abstract: We develop a stochastic analysis of the sine-Gordon Euclidean quantum field $(\cos (\beta \varphi))_2$ on the full space up to the second threshold, i.e. for $\beta^2 < 6 \pi$. The basis of our method is a forward-backward stochastic differential equation (FBSDE) for a decomposition $(X_t)_{t \geqslant 0}$ of the interacting Euclidean field $X_{\infty}$ along a scale parameter $t \geqslant 0$. This FBSDE describes the optimiser of the stochastic control representation of the Euclidean QFT introduced by Barashkov and one of the authors. We show that the FBSDE provides a description of the interacting field without cut-offs and that it can be used effectively to study the sine-Gordon measure to obtain results about large deviations, integrability, decay of correlations for local observables, singularity with respect to the free field, Osterwalder-Schrader axioms and other properties.

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

Atypical Decay Rates for Atypical Heights in Random Recursive Trees

arXiv:2604.20139v2 Announce Type: replace Abstract: We establish the large deviation probabilities for the height of random recursive trees, revealing polynomial upper-tail decay and stretched-exponential lower-tail decay. Remarkably, the lower tail features an atypical prefactor that grows to infinity more slowly than any $n$-fold iterated logarithm.

12.
arXiv (quant-ph) 2026-06-19

Operational Tube-Sector Theory of Quantum State Distinguishability Under Generalized Symmetries

Authors:

arXiv:2606.19678v1 Announce Type: cross Abstract: A variational principle for quantum-state distinguishability is established in many-body systems with generalized symmetries, including noninvertible cases described by fusion categories. Standard fidelity and symmetry-resolved diagnostics emerge as coarse-grained limits of a more refined operational structure. When symmetry actions terminate at entanglement cuts, distinguishability is governed by boundary tube algebras within a symmetry-constrained measurement resource theory. The physically admissible instruments are characterized by complete positivity, entanglement-cut locality, boundary-module covariance, and sequential stability. The resulting optimal measurement structure is uniquely fixed by the center of the boundary tube algebra, $\mathcal{A}_{\mathrm{phys}} = Z\!\left(\mathrm{Tube}_{\mathcal{C}}(\mathcal{M}_A)\right)$, whose primitive idempotents define tube-sector probabilities that refine fidelity-based and symmetry-resolved descriptions. The associated tube positive-operator-valued measures (POVM) are extremal and yield optimal one-shot hypothesis-testing distinguishability under symmetry constraints. The construction is universal across fusion categories and independent of microscopic realization.

13.
arXiv (CS.AI) 2026-06-19

PiDR: Physics-Informed Inertial Dead Reckoning for Autonomous Platforms

arXiv:2601.03040v2 Announce Type: replace-cross Abstract: A fundamental requirement for full autonomy is the ability to sustain accurate navigation in the absence of external data, such as GNSS signals or visual information. In these challenging environments, the platform must rely exclusively on inertial sensors, leading to pure inertial navigation. However, the inherent noise and other error terms of the inertial sensors in such real-world scenarios will cause the navigation solution to drift over time. Although conventional deep-learning models have emerged as a possible approach to inertial navigation, they are inherently black-box in nature. Furthermore, they struggle to learn effectively with limited supervised sensor data and often fail to preserve physical principles. To address these limitations, we propose PiDR, a physics-informed inertial dead-reckoning framework for autonomous platforms in situations of pure inertial navigation. PiDR offers transparency by explicitly integrating inertial navigation principles into the network training process through the physics-informed residual component. PiDR plays a crucial role in mitigating abrupt trajectory deviations even under limited or sparse supervision. We evaluated PiDR on real-world datasets collected by a mobile robot and an autonomous underwater vehicle. We obtained more than 29% positioning improvement in both datasets, demonstrating the ability of PiDR to generalize different platforms operating in various environments and dynamics. Thus, PiDR offers a robust, lightweight, yet effective architecture and can be deployed on resource-constrained platforms, enabling real-time pure inertial navigation in adverse scenarios.

14.
arXiv (CS.LG) 2026-06-18

Unsupervised Diffusion Solver for Combinatorial Optimization via Combinatorial Adjoint Matching

arXiv:2605.30920v2 Announce Type: replace Abstract: Diffusion-based neural solvers have shown strong promise for combinatorial optimization (CO), but existing methods typically rely on supervised training with large collections of near-optimal solutions. In this work, we extend adjoint-based trajectory optimization methods to discrete combinatorial domains. We formulate diffusion-based CO as a stochastic control problem over Continuous-Time Markov Chains and introduce discrete adjoint dynamics for propagating optimization signals through discrete generative trajectories. Building on this formulation, we propose Combinatorial Adjoint Matching (CAM), an unsupervised training framework for discrete diffusion solvers with structured and low-variance trajectory-level optimization signals. Empirically, CAM consistently outperforms existing unsupervised diffusion baselines and achieves performance competitive with strong supervised diffusion solvers and even traditional solvers across diverse combinatorial optimization problems. Our code is available at https://github.com/Shengyu-Feng/CAM.

15.
arXiv (CS.CV) 2026-06-18

Structured Spectral Graph Representation Learning for Multi-label Abnormality Analysis from 3D CT Scans

With the growing volume of CT examinations, there is an increasing demand for automated tools such as organ segmentation, abnormality detection, and report generation to support radiologists in managing their clinical workload. Multi-label classification of 3D Chest CT scans remains a critical yet challenging problem due to the complex spatial relationships inherent in volumetric data and the wide variability of abnormalities. Existing methods based on 3D convolutional neural networks struggle to capture long-range dependencies, while Vision Transformers often require extensive pre-training on large-scale, domain-specific datasets to perform competitively. In this work, we propose a 2.5D alternative by introducing a new graph-based framework that represents 3D CT volumes as structured graphs, where axial slice triplets serve as nodes processed through spectral graph convolution, enabling the model to reason over inter-slice dependencies while maintaining complexity compatible with clinical deployment. Our method, trained and evaluated on 3 datasets from independent institutions, achieves strong cross-dataset generalization, and shows competitive performance compared to state-of-the-art visual encoders. We further conduct comprehensive ablation studies to evaluate the impact of various aggregation strategies, edge-weighting schemes, and graph connectivity patterns. Additionally, we demonstrate the broader applicability of our approach through transfer experiments on automated radiology report generation and abdominal CT data.

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

BioDivergence: A Benchmark and Evaluation Framework for Hidden Contextual Contradictions in Biomedical Abstracts

Biomedical findings often seem to conflict across studies, but many of these differences are context-dependent rather than true contradictions. Variations in cohort, geography, assay protocol, disease subtype, and clinical setting can make both claims locally valid. Existing NLI and scientific claim-verification benchmarks reduce such cases to entailment, contradiction, or neutral, failing to capture the contextual structure behind divergence. To address this, we introduce BioDivergence, an evaluation framework with a six-class conflict taxonomy, a 13-axis divergence ontology, and four structured outputs per claim pair: conflict type, divergence axes, dominant confounder, and reconciliation explanation. We release BioDivergence-Silver-v1.0, an article-disjoint silver benchmark of 11,865 claim pairs across five biomedical domains, alongside a legacy deduplicated variant for comparison. Results show notable ranking differences between the two variants, with the fine-tuned reference model dropping about 12 points under the article-disjoint setting, while Mistral-7B-Instruct-v0.3 achieves 0.5523 accuracy and 0.3894 contextual-F1 on the 842-example primary test set. BioDivergence offers a more faithful way to distinguish contextual divergence from direct contradiction and to separate article-level memorization from genuine task learning.

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

ScoutVLA: UAV-Centric Active Perception via a Dual-Expert VLA Model for Open-World Embodied Question Answering

Aerial Embodied Question Answering (EQA) requires Unmanned Aerial Vehicles (UAVs) to actively perceive the environment and answer natural language questions. Existing outdoor EQA systems usually stop once the target enters the UAV's field of view, leaving the fine-grained viewpoint adjustment needed for evidence-seeking questions largely unresolved. To address this issue, we introduce FG-EQA, a fine-grained active perception EQA benchmark with more than 40K simulated trajectories and 1K real-world trajectories. Drawing inspiration from the ``waggle dance'' of scout bees, which iteratively adjust their flight paths to verify target information, we propose ScoutVLA, an evidence-driven Vision-Language-Action model for outdoor EQA. To emulate this active exploration behavior, ScoutVLA features a decoupled dual-expert architecture: a vision-language expert infers the semantic intent to identify missing evidence, while an independent action expert employs high-DoF flow matching to generate continuous viewpoint-refinement trajectories. To balance the competing demands of continuous control and semantic reasoning, we devise a decoupled training strategy with a knowledge insulation mechanism that prevents the action gradients from erasing the model's multimodal reasoning ability. Extensive simulated experiments and a qualitative real-world field study both verify the superiority of ScoutVLA over the state-of-the-art baselines, demonstrating a 10.48$\boldsymbol{\times}$ higher average strict success rate and a 7.72$\boldsymbol{\times}$ higher average QA correctness.

18.
arXiv (quant-ph) 2026-06-16

Spectrally Corrected Polynomial Approximation for Quantum Singular Value Transformation

arXiv:2603.03998v2 Announce Type: replace Abstract: Quantum Singular Value Transformation (QSVT) provides a unified framework for applying polynomial functions to the singular values of a block-encoded matrix. QSVT prepares a state proportional to $\bA^{-1}\bb$ with circuit depth $O(d\cdot\mathrm{polylog}(N))$, where $d$ is the polynomial degree of the $1/x$ approximation and $N$ is the size of $\bA$. Current polynomial approximation methods are over the continuous interval $[a,1]$, giving $d = O(\sqrt{\kap}\log(1/\varepsilon))$, and make no use of any properties of $\bA$. We observe here that QSVT solution accuracy depends only on the polynomial accuracy at the eigenvalues of $\bA$. When all $N$ eigenvalues are known exactly, a pure spectral polynomial $p_{S}$ can interpolate $1/x$ at these eigenvalues and achieve unit fidelity at reduced degree. But its practical applicability is limited. To address this, we propose a spectral correction that exploits prior knowledge of $K$ eigenvalues of $\bA$. Given any base polynomial $p_0$, such as Remez, of degree $d_0$, a $K\times K$ linear system enforces exact interpolation of $1/x$ only at these $K$ eigenvalues without increasing $d_0$. The spectrally corrected polynomial $p_{SC}$ preserves the continuous error profile between eigenvalues and inherits the parity of $p_0$. QSVT experiments on the 1D Poisson equation demonstrate up to a $5\times$ reduction in circuit depth relative to the base polynomial, at unit fidelity and improved compliance error. The correction is agnostic to the choice of base polynomial and robust to eigenvalue perturbations up to $10\%$ relative error. Extension to the 2D Poisson equation suggests that correcting a small fraction of the spectrum may suffice to achieve fidelity above $0.999$.

19.
arXiv (CS.AI) 2026-06-16

GIST-CMTF: Goal-State Inference for Causal Minimal Tool Filtering in LLM Agents

arXiv:2606.16813v1 Announce Type: new Abstract: Tool-augmented LLM agents rely on runtime filtering to decide which tools should be visible at each step. Causal Minimal Tool Filtering (CMTF) reduces tool-choice confusion by exposing only the next causally necessary tool frontier, but it assumes that the user request has already been mapped to a symbolic goal state. In practice, requests such as "handle my appointment" or "take care of this email" may correspond to multiple possible goals. This creates wrong-goal execution, where an agent follows a valid causal tool path for an unintended objective. We introduce GIST-CMTF, a goal-state inference layer that predicts candidate symbolic goals over the same state-transition vocabulary used by CMTF, estimates ambiguity, and either applies CMTF or exposes clarification as a causal action that produces missing goal or state variables. We evaluate GIST-CMTF across seven model backends, six filtering methods, and 120 controlled tool-use tasks. GIST-CMTF achieves 97.0% task success, compared with 80.1% for top-goal CMTF and 82.9% for semantic-goal CMTF. It reduces wrong-goal execution from 19.4% under top-goal CMTF to 2.5%, while preserving the one-tool exposure of causal filtering and using substantially fewer tokens than all-tools exposure. These results suggest that reliable tool-augmented agents should validate goal state, not only tool relevance, before exposing external actions.

20.
arXiv (CS.CV) 2026-06-15

Schrödinger's Navigator: Imagining an Ensemble of Futures for Zero-Shot Object Navigation

Zero-shot object navigation (ZSON) requires robots to find target objects in unseen environments without task-specific fine-tuning or pre-built maps, a key capability for general-purpose service robots. Yet methods that perform well in simulation often degrade in cluttered real-world scenes with severe occlusion and latent hazards, where large unseen regions make single-scene inference brittle and unsafe. We propose Schrödinger's Navigator, a belief-aware framework that reasons at inference time over multiple trajectory-conditioned imagined 3D futures. Given candidate paths, a trajectory-conditioned 3D world model predicts hypothetical observations and maintains a superposition of plausible scene realizations rather than committing to one map. An adaptive occluder-aware sampler directs imagination to uncertainty-critical regions, while a Future-Aware Value Map (FAVM) aggregates imagined futures for robust, proactive action selection. Experiments in simulation and on a physical Go2 quadruped show that Schrödinger's Navigator outperforms strong ZSON baselines, improving hidden-target discovery and risk-aware waypoint selection in occlusion-heavy navigation scenarios. These results highlight imagined 3D futures as a scalable and generalizable strategy for zero-shot navigation in uncertain real-world environments.

21.
arXiv (math.PR) 2026-06-11

The Geometry of Admissible Short Selling in Discrete-Time Stochastic Portfolio Theory

arXiv:2606.11191v1 Announce Type: cross Abstract: While discrete-time Stochastic Portfolio Theory (SPT) provides a robust framework for market analysis, existing work on functional generation has predominantly focused on long-only portfolios defined on the entire unit simplex. This paper extends the geometric framework of functional generation to the broader class of bankruptcy-proof long-short portfolios defined on local market state spaces. We establish that, within this admissible setting, pseudo-arbitrage is fully characterized by the concavity of the generating function on the market state space, thereby relaxing the usual global domain requirement. A central contribution of this work is a geometric characterization of the short-selling mechanism. We prove that the presence of short selling is equivalent to the negativity of the maximal concave extension of the generating potential. This phenomenon is linked to the steepness of the logarithmic gradient as the market approaches a zero boundary nested inside the simplex. To systematically exploit this mechanism, we introduce the barycentric scaling transformation, a constructive methodology that maps classical long-only generating functions onto restricted domains to engineer admissible strategies with controlled short-selling exposure. Finally, through the analysis of specific shrunken portfolios, we identify a geometric phase transition: under suitable boundary conditions, admissible strategies exhibit a long-only core and a short-selling region in a qualitative sense (without asserting an exact partition of the state space). This provides a unified geometric perspective on relative arbitrage beyond the long-only constraint.

22.
Nature (Science) 2026-06-09

Daily briefing: Trial to ‘de-age’ cells treats first person

Authors:

The gene-therapy trial aims to treat glaucoma by rejuvenating cells in the optic nerve. Plus, the mystery of how things freeze and encouragement to go out into the sunlight. The gene-therapy trial aims to treat glaucoma by rejuvenating cells in the optic nerve. Plus, the mystery of how things freeze and encouragement to go out into the sunlight.

23.
medRxiv (Medicine) 2026-06-12

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

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

24.
medRxiv (Medicine) 2026-06-15

Quality Improvement Based Implementation and Evaluation of a Decision Aid for Patients with Nephrolithiasis

Introduction Patients with nephrolithiasis face challenges in making a high-quality, preference sensitive decision. Our prior work established feasibility and patient acceptance of a software-based decision aid (DA). The objectives for this study were to identify implementation strategies for the DA in routine care and determine whether DA implementation enhances decisional quality for patients. Methods New nephrolithiasis patients were recruited from the institution Medical Center from June 2018 to April 2024 to receive a software-based pre-visit DA that measured care preferences and used decision analysis to rank treatments. The RE-AIM framework and Plan-Do-Study-Act (PDSA) cycles were used to improve implementation outcomes. Patients completed survey instruments evaluating decisional conflict, shared decision-making, care satisfaction, and treatment choice following their provider visit. These metrics were compared in the DA cohort (n=81) to those in a usual care cohort (n=78) with Wilcoxon rank-sum and Chi-square (or Fishers exact) tests. Results Implementation data revealed sustained reach and progressive improvement in fidelity. The DA cohort reported higher decisional quality relative to controls (p=0.003) and reported greater support/advice to make a choice (p=0.005). The DA cohort more often discussed options with their doctor (87.5% vs 69.2%, p=0.005) and were more likely to be promoters of their provider (p

25.
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.