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

Optimization of Secret Key Rate for BB84 under Collective Rotation Noise

arXiv:2605.21140v3 Announce Type: replace Abstract: Practical quantum key distribution (QKD) systems operate under noise, but security of most protocols have been analyzed under ideal noiseless scenarios. In this work, we investigated security performance of BB84 protocol under effect of collective rotation noise. Using theoretical quantum information frameworks, we analyzed key security parameters including quantum bit error rate (QBER), mutual information and secret key rate (SKR). Security of protocol is studied under various eavesdropping scenarios based on intercept and resend attacks. Our results show that collective rotation noise has a significant impact on the information shared between the two parties. Particularly, we extended prior treatments by suggesting a noise engineering strategy where we identified a non-zero noise range where information accessed by Eve is minimized while corresponding SKR degradation remains relatively small. This analysis provide insights into robustness of BB84 protocol under realistic noisy channels and may contribute towards development of more resilient QKD systems.

02.
arXiv (CS.LG) 2026-06-18

Generative models for decision-making under distributional shift

arXiv:2604.04342v2 Announce Type: replace Abstract: Many data-driven decision problems are formulated using a nominal distribution estimated from historical data, while performance is ultimately determined by a deployment distribution that may be shifted, context-dependent, partially observed, or stress-induced. This tutorial presents modern generative models, particularly flow- and score-based methods, as mathematical tools for constructing decision-relevant distributions. From an operations research perspective, their primary value lies not in unconstrained sample synthesis but in representing and transforming distributions through transport maps, velocity fields, score fields, and guided stochastic dynamics. We present a unified framework based on pushforward maps, continuity, Fokker-Planck equations, Wasserstein geometry, and optimization in probability space. Within this framework, generative models can be used to learn nominal uncertainty, construct stressed or least-favorable distributions for robustness, and produce conditional or posterior distributions under side information and partial observation. We also highlight representative theoretical guarantees, including forward-reverse convergence for iterative flow models, first-order minimax analysis in transport-map space, and error-transfer bounds for posterior sampling with generative priors. The tutorial provides a principled introduction to using generative models for scenario generation, robust decision-making, uncertainty quantification, and related problems under distributional shift.

03.
arXiv (math.PR) 2026-06-16

Stochastic control with dividend payments and capital injections for Markov additive processes

Authors:

arXiv:2604.00190v4 Announce Type: replace Abstract: Motivated by de Finetti's optimal dividend problem with capital injections, we study a stochastic control problem for the additive component of a Markov additive process (MAP). In contrast to previous studies, the modulating component is allowed to be a general right process on a Radon space, so the model is not restricted to finite-state regime switching and cannot in general be reduced to a finite collection of Lévy process control problems. Capital injections are allowed at arbitrary times. We first consider the case in which dividend payments are allowed only at prescribed discrete times and establish necessary and sufficient conditions for the optimality of a strategy. These conditions then yield the optimality of a class of Markov-modulated periodic–classical barrier strategies. Combining this optimality result with an approximation argument, we obtain insight into the possible form of optimal strategies in the case where dividend payments, like capital injections, may be made at arbitrary times. Because of the generality of the MAPs considered here, the proof techniques used in previous studies of similar problems are not directly applicable. We therefore develop an alternative argument based on the additive structure of MAPs and dynamic programming between dividend opportunities. The argument also suggests a possible approach to other stochastic control problems involving general MAPs.

04.
arXiv (quant-ph) 2026-06-25

Quantum Optimal Control Using MAGICARP: Combining Pontryagin's Maximum Principle and Gradient Ascent

arXiv:2505.21203v2 Announce Type: replace Abstract: We introduce the MAGICARP algorithm, a numerical optimization method for quantum optimal control problems that combines the structure provided by Pontryagin's Maximum Principle (PMP) and the robustness of gradient ascent techniques, such as GRAPE. MAGICARP is formulated as a "shooting technique", aiming to determine the appropriate initial adjoint momentum to realize a target quantum gate. This method naturally incorporates time and energy optimal constraints through a PMP-informed pulse structure. We demonstrate MAGICARP's effectiveness through illustrative numerical examples, comparing its performance to GRAPE and highlighting its advantages in specific scenarios.

05.
medRxiv (Medicine) 2026-06-22

Sex-specific multimorbidity clusters and all-cause mortality in relatively healthy older adults: findings from the ASPREE cohort

Background: Multimorbidity is common in older adults, but sex differences in chronic condition clustering remain unclear. This study explored multimorbidity clusters and their associations with all-cause mortality among community-dwelling adults aged 70 years and over. Methods: This was a secondary analysis of data from 16,095 Australian ASPREE participants aged at least 70 years without prior dementia or cardiovascular disease. Fifteen baseline chronic conditions were grouped using latent class analysis (LCA). Observed-to-expected (O/E) ratios characterised conditions over-represented within clusters, and Cox proportional hazards models assessed associations with all-cause mortality. Results: Among 16,095 participants (mean age 74 years), 88.3% had multimorbidity at baseline; 4,217 deaths occurred over a median follow-up of 10.85 years. Five clusters were identified overall: hypertension and dyslipidemia (52.1%), gout and metabolic (14.4%), depressive symptoms, osteoporosis and frailty (10.0%), anaemia and kidney disease (10.2%), and hypotension, thyroid disorder and past cancer (13.3%). Sex-stratified analyses revealed three clusters in males and four in females. The frailty, depressive symptoms and osteoporosis cluster was associated with higher mortality in both sexes (aHR 1.56 [95% CI 1.40-1.73] in males; 1.68 [1.49-1.89] in females). Higher mortality was also observed for the metabolic, gout and kidney disease cluster in males (aHR 1.63 [1.47-1.81]) and the gout, anaemia and kidney disease cluster in females (aHR 1.96 [1.74-2.21]). Conclusions: Distinct multimorbidity clusters differed by sex and were associated with increased all-cause mortality. These findings may support risk stratification, targeted screening, and more person-centred management of older adults with multimorbidity.

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

Achieving Heisenberg limit under noisy conditions with quantum Zeno dynamics and dynamical decoupling

arXiv:2606.13205v1 Announce Type: new Abstract: Quantum Zeno dynamics (QZD) and dynamical decoupling (DD) are useful tools that enable the effective suppression of noise in quantum systems. We consider the problem of when (i) noise can be suppressed and (ii) Heisenberg limit (HL) can be achieved in quantum metrology, and prove necessary and sufficient conditions for when QZD and DD are useful for achieving these two goals. We also show that in the Markovian regime, there are scenarios where preventing errors using QZD/DD may enable HL to be achieved where current QEC methods may not. Finally, we demonstrate that the combination of both techniques can allow individually imperfect QZD and DD strategies to saturate HL.

07.
arXiv (quant-ph) 2026-06-11

Logical error estimation from syndrome data of surface-code experiments

arXiv:2606.11496v1 Announce Type: new Abstract: Decoders for quantum error correction (QEC) experiments rely on detector error models (DEMs), which encode, for each error, its probability and the detectors and logical observables it flips. Here we show that estimating DEM event probabilities from experimental syndromes is feasible, avoids independent device benchmarking, and produces useful decoder priors for estimating and reducing decoded logical error probabilities. We evaluate our methods using open-source data from surface-code memory experiments performed on Google's Willow chip, and we carry out analogous surface-code experiments on IBM's \texttt{ibm\_miami} processor. Despite the different physical error scales of the Google and IBM devices, in both cases our estimated DEMs improve logical error probabilities relative to baseline device-informed DEMs, typically at the $5\%-10\%$ level and with larger gains in some IBM cases, without additional calibration circuits, decoder fine-tuning, or supervised fitting to logical outcomes.

08.
arXiv (CS.LG) 2026-06-15

An Attention-based Model for Robust Forecasting with Missing Modality

arXiv:2606.13970v1 Announce Type: cross Abstract: Learning with missing modalities is a fundamental challenge in multimodal robot learning, as real-world robotic systems often operate in environments with incomplete sensor data. Attention-based models are appealing for processing multimodal data because they can handle multiple modalities with a single backbone network. However, most multimodal models assume that all modalities are available during both training and inference, limiting their applicability in robotic perception and decision-making. In this paper, we introduce a multimodal model designed to handle missing modalities during both training and inference. The model is formulated as a conditional variational autoencoder (CVAE) and incorporates a transformer-based architecture that leverages attention mechanisms to learn a unified, fixed-dimensional representation, even when some modalities are missing. We show that our proposed model can be trained with missing modalities while approximating a robust representation of all modalities. We evaluate our approach on five multimodal datasets across two robot learning tasks: human trajectory prediction and robot manipulation forecasting. Experimental results demonstrate that our model effectively learns from incomplete data and is superior to prior multimodal fusion approaches.

09.
arXiv (math.PR) 2026-06-25

Particle Filtering for Non-Deterministic Electrocardiographic Imaging

arXiv:2509.19404v2 Announce Type: replace-cross Abstract: Electrocardiographic imaging (ECGI) aims to non-invasively reconstruct activation maps of the heart from temporal body surface potentials. While most existing approaches rely on inverse and optimization techniques that may yield satisfactory reconstructions, they typically provide a single deterministic solution, overlooking the inherent uncertainty of the problem stemming from its very ill-posed nature, the poor knowledge of biophysical features and the unavoidable presence of noise in the measurements. The Bayesian framework, which naturally incorporates uncertainty while also accounting for temporal correlations across time steps, can be used to address this limitation. In this work, we propose a low-dimensional representation of the activation sequence that enables the use of particle filtering, a Bayesian filtering method that does not rely on predefined assumptions regarding the shape of the posterior distribution, in contrast to approaches like the Kalman filter. This allows to produce not only activation maps but also probabilistic maps indicating the likelihood of activation at each point on the heart over time, as well as pseudo-probability maps reflecting the likelihood of a point being part of an earliest activation site. Additionally, we introduce a method to estimate the probability of the presence of a conduction lines of block on the heart surface. Combined with classical reconstruction techniques, this could help discriminate artificial from true lines of block in activation maps. We support our approach with a numerical study based on simulated data, demonstrating the potential of our method.

10.
arXiv (CS.LG) 2026-06-12

SMGFM: Spectral Multimodal Graph Pretraining for Multimodal-Attributed Graphs

arXiv:2606.12867v1 Announce Type: new Abstract: Multimodal-attributed graphs (MAGs) couple graph topology with node semantics from text, images, and other modalities. Traditional graph learning contextualizes node semantics by coupling topology with node features. However, this coupling design becomes troublesome in MAGs, where structure-induced and modality-intrinsic semantics may contribute differently to downstream tasks. Structure-induced semantics promote relational consistency through smooth topological variation, whereas modality-intrinsic semantics often encode local, fine-grained distinctions that should not be uniformly smoothed or aligned. Therefore, the key challenge is to identify semantic roles before cross-modal fusion. To this end, we leverage graph-frequency variation as a prior, where low-frequency components capture topology-consistent semantics and high-frequency components preserve modality-specific semantics. Based on this intuition, we propose SMGFM, a spectral multimodal graph pretraining framework that decomposes each modality-specific node signal into graph-frequency bands and assigns band-level semantic roles before cross-modal interaction. Concretely, SMGFM constructs frequency-resolved modality tokens with scalable Chebyshev filters, estimates their coupling reliability through topology-conditioned routing, and performs band-modality interaction before fusion. Its frequency-routed objectives align smooth consensus routes while preserving modality-specific routes, mitigating spatial-domain entanglement and uniform cross-modal alignment. Extensive experiments conducted on the MAG datasets demonstrate that SMGFM achieves state-of-the-art performance across graph-level and modality-level tasks.

11.
arXiv (CS.CL) 2026-06-19

A BART-based approach with hierarchical strategy for Vietnamese abstractive multi-document summarization

In this technical report, we focus on solving the challenge of Vietnamese multi-document abstractive summarization, introduced in the International Workshop on Vietnamese Language and Speech Processing (VLSP) 2022. We choose to follow the popular hierarchical approach, i.e. condensing each document followed by aggregation and summarization. We propose a novel yet simple strategy to shorten documents that is driven by the golden summary, thus ensuring high correlation between stages of the hierarchical approach. Our method achieves a ROUGE2-F1 score of 0.2468 on the VLSP's public test set, and can produce fluent and concise summaries. Additionally, we utilize external sources for extra data, which greatly enhances the quantity of data for Vietnamese multi-document summarization. The additional data is made available for the community.

12.
arXiv (math.PR) 2026-06-16

Collapsibility in Multiparametric Models of Random Simplicial Complexes

Authors:

arXiv:2606.15276v1 Announce Type: cross Abstract: We study collapsibility in the multiparametric models of random simplicial complexes, namely the lower and upper models. In the upper model, we improve upon a result of Farber and Nowik, and assert that the homology is a.a.s concentrated in a single dimension by proving that the complex collapses to that \di. In the lower model, we prove that the complex a.a.s collapses to the \di\ with maximal non-trivial cohomology. We then compare this threshold to the ones derived previously for the special cases of the clique complex (by Kahle) and the Linial-Meshulam model.

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

Will AI Agents Free Us From Meaningless Work? A Human-Centered Analysis

arXiv:2606.12430v1 Announce Type: cross Abstract: Some claim that AI agents will free workers from the boring parts of their jobs, yet little is known about how workers themselves identify which tasks should be automated. Prior research focuses on occupations, overlooking that workers experience varying levels of meaning across tasks within the same role. We address this gap with a task-level analysis grounded in Graeber's theory of bullshit jobs. Using ratings from 202 workers on 171 workplace tasks, we (1) validate a five-item scale of perceived bullshitness, (2) show that perceived bullshitness strongly predicts desire for AI delegation, and (3) find that such tasks are also seen as requiring less human oversight. Together, these findings suggest that tasks perceived as bullshit are natural candidates for AI delegation, aligning worker preferences with perceived feasibility.

14.
arXiv (CS.CL) 2026-06-19

Proactive Conversational Assistant for a Procedural Manual Task based on Audio and IMU

Real-time conversational assistants for procedural manual tasks often depend on video input, which can be computationally expensive and compromise user privacy. For the first time, we propose a real-time conversational assistant that provides comprehensive guidance for procedural manual tasks using only lightweight privacy-preserving modalities such as audio and IMU inputs from a user's wearable device to understand the context. Using a furniture assembly task and a cooking task, we show how this assistant proactively communicates step-by-step instructions to a user performing a procedural task, and answers user questions. We illustrate the data generation method and the system design to achieve such an assistant. On observing that an off-the-shelf language model is a talkative assistant but is not always able to answer questions correctly, we demonstrate how finetuning the model improves its ability to limit unnecessary dialogues with a 50% increase in the precision, while also improving its ability to answer questions correctly, measured by a 150% increase in the recall of answers. We further describe how such an assistant is implemented on an edge device with no dependence on the cloud.

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

Moebius: 0.2B Lightweight Image Inpainting Framework with 10B-Level Performance

While 10B-level industrial foundation models have pushed the boundaries of image inpainting, their prohibitive computational costs severely hinder practical deployment. Constructing a highly optimized task-specific specialist offers a promising solution; however, extreme structural compression inevitably triggers a severe representation bottleneck. To conquer this, we propose Moebius, a highly efficient lightweight inpainting framework. We systematically reconstruct the diffusion backbone by introducing the Local-$\lambda$ Mix Interaction ($L\lambda MI$) block. Comprising Local-$\lambda$ and Interactive-$\lambda$ modules, it elegantly summarizes spatial contexts and global semantic priors into fixed-size linear matrices, preserving complex latent interactions while drastically shedding parameters. Furthermore, to unlock the full representational capacity of this highly compact architecture, we synergistically pair it with an adaptive multi-granularity distillation strategy. Operating strictly within the latent space to avoid expensive pixel-space decoding, this strategy dynamically balances multiple gradient-based losses to achieve high-fidelity alignment. Extensive experiments across natural and portrait benchmarks demonstrate that this optimal synergy enables Moebius to rival or even surpass the generation quality of the 10B-level industrial generalist FLUX.1-Fill-Dev. Remarkably, Moebius achieves this using less than 2\% of the parameters (0.22B vs. 11.9B) while delivering a $>15\times$ acceleration in total inference time, setting a new efficiency standard for high-fidelity inpainting. Project page at https://hustvl.github.io/Moebius.

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

SURGELLM: Rethinking Multi-Task Evaluation through Task-Aware Feature Gating with Class-Balanced Normalization

Fine-tuned encoders deployed across heterogeneous NLP tasks face three compounding problems: mismatched inductive biases, class-imbalance corruption of feature statistics, and no mechanism to condition attention on external lexical knowledge. We introduce \surgellm, a unified transformer framework that addresses each with a dedicated lightweight module: a surgical feature gate (learned per-dimension sigmoid over curated lexical indicators and \texttt{[CLS]}; provably degenerates to identity when features are uninformative), task-conditioned prefix tokens (quantized feature values and task identity prepended to every input), and Instance-Weighted Normalization (IWN; removes class-prior bias from gate statistics). We prove an excess-risk bound linking gate benefit to surgical feature alignment. Across four tasks, SST-2, multi-hop retrieval, LLM-prompt attribution, and authorship detection, covering 17,830 examples and eleven model variants over three seeds, the IWN variant achieves macro-F1 0.940 ($+0.036$ over the strongest non-IWN baseline; $+0.130$ on authorship detection). A random-vocabulary control ($-0.028$ avg.\ F1) confirms gains are lexical, not parametric. Code, vocabularies, and a $99.5\%$-recovery auto-extraction recipe are released.

17.
arXiv (CS.CL) 2026-06-18

As Easy as Rocket Science: Assessing the Ability of Large Language Models to Interpret Negation in Figurative Language

Figurative language and negation are two areas that challenge current language models, however, both are widely used throughout written and spoken language. Large language models (LLMs) are also widely used in everyday contexts where they cannot necessarily be tuned for a specific dataset. It is therefore essential to understand the ability of LLMs to correctly interpret text that includes both negation and figurative language. To investigate this, we develop a set of new annotations to an existing dataset of figurative language, and test a range of language models on the dataset. We find that the combination of negation and figurativeness can present a particular challenge, and that performance overall and across different negation types is particularly dependent on the prompt style used.

18.
arXiv (CS.AI) 2026-06-17

Cluster-Aware Dual-Level Test Specification Generation for Large-Scale Automotive Software Requirements

arXiv:2606.17197v1 Announce Type: cross Abstract: Generating test specifications that satisfy Automotive SPICE SWE.6 requirements becomes increasingly challenging and time-consuming as projects scale to thousands of requirements. Because this manual process often consumes weeks of engineering effort, automation becomes a critical necessity. However, standard Large Language Model (LLM) approaches struggle at scale: processing requirements individually discards vital inter-requirement dependencies, while feeding entire corpora at once exceeds context-window limits, leading to incomplete integration coverage and redundant test cases. This paper presents a novel "Cluster-then-Summarize" pipeline that addresses these limitations through three-stages. Requirements are embedded using sentence transformers and grouped using UMAP dimensionality reduction followed by HDBSCAN density-based clustering. This grouping utilizes an automatic minimum cluster size selection driven by a quality criterion combining normalized Silhouette and Calinski-Harabasz scores. A multi-level map-reduce summarization algorithm then distills each cluster into concise, domain-conformant descriptions while preserving quantitative thresholds and safety integrity levels. The pipeline exploits the derived cluster topology to generate test specifications at two levels: individual requirement verification and cluster-level integration tests that verify cross-requirement feature behavior. A nearby-cluster context mechanism provides bounded cross-feature awareness during each LLM call, and Retrieval-Augmented Generation grounds all outputs in ISO 26262 and ASPICE standards. Evaluation on automotive requirement datasets of varying scale demonstrates that the cluster-aware approach improves integration test coverage and maintains summarization fidelity compared to baseline methods while scaling efficiently to thousands of requirements.

19.
arXiv (CS.CL) 2026-06-19

CATCH-ME if you RAG: a dataset of Contextually Annotated multi-Turn Counterspeech against Hate and Misinformation Exchanges

Online hate speech and misinformation frequently overlap, yet NLP research has mainly treated them in isolation. While LLMs represent a scalable solution for assisting humans in the generation of counterspeech for both threats, zero-shot models frequently generate repetitive and vague responses, underscoring the need for high-quality examples to steer model generation. However, existing counterspeech datasets against the overlap of hate and misinformation are scarce and limited to single-turn English dialogues, while real-life interactions span across multiple turns and languages. To bridge this gap, we introduce the first large-scale, expert-curated, multilingual dataset of dialogues tackling the intersection of hate and misinformation. To ensure factual grounding, the dialogues are also anchored in verified external knowledge (i.e., fact-checking articles and NGO reports) and include document- and chunk-level span annotations, making it directly applicable for RAG systems. Covering five languages and targeting hate directed at seven marginalized groups, this novel resource enables the training and evaluation of more persuasive, factually grounded counterspeech models.

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

Communication Complexity of Distributed Unitary Synthesis

arXiv:2511.04250v2 Announce Type: replace Abstract: We study space-bounded communication complexity for unitary implementation in distributed quantum processors, where we restrict the number of qubits per processor to ensure practical relevance and technical non-triviality. We model distributed quantum processors using distributed quantum circuits with nonlocal two-qubit gates, defining the distributed communication complexity of a unitary as the minimum number of such nonlocal gates required for its realization, up to permutations of data qubit positions. Our contributions are twofold. First, for general $n$-qubit unitaries, we improve upon the trivial $O(4^n)$ communication bound. Considering $k$ pairwise-connected processors (each with $n/k$ data qubits and $m$ ancillas), we prove the communication complexity satisfies $O\left(\max\{4^{(1-1/k)n - m}, n\}\right)$ – for example, $O(2^n)$ when $m=0$ and $k=2$ – and establish the tightness of this upper bound. We further extend the analysis to approximation models and general network topologies. Second, for special unitaries, we show that both the Quantum Fourier Transform (QFT) and Clifford circuits admit linear upper bounds on communication complexity in the exact model, outperforming the trivial quadratic bounds applicable to these cases. In the approximation model, QFT's communication complexity reduces drastically from linear to logarithmic, while Clifford circuits retain a linear lower bound. These results offer fundamental insights for optimizing communication in distributed quantum unitary implementation, advancing the feasibility of large-scale DQC systems.

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

Fermionic Hamiltonian engineering with local control

arXiv:2606.17158v1 Announce Type: new Abstract: Quantum simulators enable the exploration of complex quantum phenomena in condensed-matter systems by reproducing their dynamics on controllable quantum devices. However, experimental constraints often restrict the class of Hamiltonians that can be realized natively. Hamiltonian engineering addresses this limitation by expanding the set of accessible target Hamiltonians from a fixed system Hamiltonian defined by the hardware. We introduce a new framework for fermionic Hamiltonian engineering based on conjugating free evolution under the system Hamiltonian with sequences of experimentally feasible local fermionic unitaries. The required sequences and free-evolution times are obtained efficiently via a linear program. By interleaving system evolution with these local unitaries, our method realizes effective time evolution under a broad class of target Hamiltonians, with intrinsic robustness to finite-pulse-time errors. In particular, we demonstrate that arbitrary complex tunnelling coefficients can be realized, constrained only by the connectivity of the underlying system Hamiltonian. We illustrate this capability by engineering the dynamics of the non-interacting Harper-Hofstadter model on a 1088-mode lattice and an interacting Fermi-Hubbard chain with complex tunnelling coefficients. By construction, our approach avoids the continuous energy absorption inherent to Floquet engineering.

22.
arXiv (math.PR) 2026-06-24

REM universality and Poisson-Dirichlet Gibbs weights for linear random energy

arXiv:2606.07757v2 Announce Type: replace Abstract: We study the Hamiltonian $H_n(h,\sigma)=\sum_{i=1}^n h_i(\sigma_i-m), $ where $(h_i)$ are i.i.d.\ real random variables and $(\sigma_i)$ are i.i.d.\ Ising spins. We consider the energy levels obtained after an independent thinning that retains an exponential number of configurations ($e^{O(n)}$). We prove that, after an $(h_i)$-dependent centering, the resulting point process converges in distribution to a Poisson point process with exponential intensity. Thus, the energy levels asymptotically has the one of the Random Energy Model (REM). Our results extend previous ones, where REM universality for this model was established only either for energy fluctuations of order $e^{-O(n)}$ or for $e^{o(\sqrt n)}$ randomly selected configurations. We also identify the limiting Gibbs weights, which converge to a Poisson–Dirichlet law, and the quenched free energy, which exhibits a freezing transition at $\beta=\tilde\lambda$. The proofs are presented here in compressed form; full details are given in the companion preprint.

23.
arXiv (CS.AI) 2026-06-25

SycoEval-EM: Sycophancy Evaluation of Large Language Models in Simulated Clinical Encounters for Emergency Care

arXiv:2601.16529v3 Announce Type: replace Abstract: Large language models (LLMs) deployed in clinical decision support may acquiesce to patient requests for care that conflicts with evidence-based guidelines. We developed SycoEval-EM, a multi-agent simulation framework to evaluate LLM robustness to adversarial patient persuasion in emergency medicine. Across 19 contemporary LLMs and 1,425 simulated clinical encounters spanning three Choosing Wisely scenarios, acquiescence rates ranged from 0% to 100%, revealing a bimodal distribution. Seven models maintained near-perfect guideline adherence, while six acquiesced in the majority of encounters. Vulnerability varied substantially across clinical scenarios. Acquiescence was highest for CT imaging requests, intermediate for antibiotic prescriptions for sinusitis, and lowest for opioid prescriptions for acute back pain. Model scale, recency, and performance on static medical benchmarks did not consistently predict robustness. All five persuasion tactics produced similar acquiescence rates, with no statistically significant differences after correction for multiple comparisons, suggesting a generalized susceptibility rather than tactic-specific weaknesses. LLM-as-judge evaluation was validated against two independent physician raters across 95 matched conversations and demonstrated near-perfect agreement for the primary outcome of acquiescence (Cohens kappa = 0.957). These findings indicate that static medical benchmarks are insufficient to predict safety performance under sustained social pressure and support incorporating multi-turn adversarial testing into clinical AI evaluation. Notably, two models achieved perfect guideline adherence across all encounters, demonstrating that robustness to patient pressure is attainable without sacrificing effective clinical communication.

24.
medRxiv (Medicine) 2026-06-22

Burden of Cardiovascular Disease in Brazil, 1996-2023: A Retrospective Descriptive Study of the Epidemiology and Impact on Public Healthcare with Emphasis on Acute Myocardial Infarction

Background Cardiovascular diseases (CVD) are the leading cause of death worldwide, and their epidemiology is correlated with genetic predisposition, exposure to risk factors, sex, age, access to medical care, and other sociodemographic characteristics. Brazil is a developing country with a vast territory, which leads to structural inequalities. Estimates of CVD in Brazil, in its regions, and in its population are poorly evaluated and analysed. Methods We obtained CVD-related data from the Brazilian Unified Health System (SUS) and analysed mortality and morbidity from 1996 to 2023 by sex, race/ethnicity, age, and region. We calculated the risk of death from the most prevalent diseases, the average length of hospital stay, and the costs associated with heart transplantation. Findings In Brazil, acute myocardial infarction was the pathology that led to the highest number of deaths across all variables analysed during the evaluated period. Other CVD were also related to causes of death and morbidity, such as hypertensive diseases and heart failure. Interpretation Brazil presents a serious challenge to the public health system due to the high number of deaths and the progressive mortality rate. This study represents a fundamental contribution to the basis for formulating public health policies aimed at reducing the growing impact associated with these diseases. Funding CNPq, CAPES, FAPEMIG, INCT

25.
arXiv (CS.CV) 2026-06-18

Efficient Image-to-Image Schrödinger Bridge for CT Field of View Extension

Computed tomography (CT) is a cornerstone imaging modality for non-invasive, high-resolution visualization of internal anatomical structures. However, when the scanned object exceeds the scanner's field of view (FOV), projection data are truncated, resulting in incomplete reconstructions and pronounced artifacts near FOV boundaries. Conventional reconstruction algorithms struggle to recover accurate anatomy from such data, limiting clinical reliability. Deep learning approaches have been explored for FOV extension, with diffusion generative models representing the latest advances in image synthesis. Yet, conventional diffusion models are computationally demanding and slow at inference due to their iterative sampling process. To address these limitations, we propose an efficient CT FOV extension framework based on the image-to-image Schrödinger Bridge (I$^2$SB) diffusion model. Unlike traditional diffusion models that synthesize images from pure Gaussian noise, I$^2$SB learns a direct stochastic mapping between paired limited-FOV and extended-FOV images. This direct correspondence yields a more interpretable and traceable generative process, enhancing anatomical consistency and structural fidelity in reconstructions. I$^2$SB achieves superior quantitative performance, with root-mean-square error (RMSE) values of 49.8 HU on simulated noisy data and 152.0 HU on real data, outperforming state-of-the-art diffusion models such as conditional denoising diffusion probabilistic models (cDDPM) and patch-based diffusion methods. Moreover, its one-step inference enables reconstruction in just 0.19 s per 2D slice, representing over a 700-fold speedup compared to cDDPM (135 s) and surpassing DiffusionGAN (0.58 s), the second fastest. This combination of accuracy and efficiency indicates that I$^2$SB has potential for real-time or clinical deployment.