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01.
arXiv (quant-ph) 2026-06-12

Approximate quantum error correction theory of non-isometric codes

arXiv:2606.13559v1 Announce Type: new Abstract: Non-isometric encoding arises in various important contexts in quantum error correction, most notably in the finite-energy, non-ideal codewords inevitable in experimental realizations of continuous-variable codes, and holographic quantum gravity. In this work, we present a general and systematic theory of non-isometric quantum error-correcting codes. In particular, we employ the approximate quantum error correction framework to quantitatively study the fundamental limitations imposed by non-isometric encodings on the accuracy of quantum error correction and implementation of logical operations. We apply our theory to analyze GKP and tiger codes under energy constraints, and discuss the implications to holography.

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

ZeroSyl: Simple Zero-Resource Syllable Tokenization for Spoken Language Modeling

Pure speech language models aim to learn language directly from raw audio without textual resources. A key challenge is that discrete tokens from self-supervised speech encoders result in excessively long sequences, motivating recent work on syllable-like units. However, methods like Sylber and SyllableLM rely on intricate multi-stage training pipelines. We propose ZeroSyl, a simple training-free method to extract syllable boundaries and embeddings directly from a frozen WavLM model. Using L2 norms of features in WavLM's intermediate layers, ZeroSyl achieves competitive syllable segmentation performance. The resulting segments are mean-pooled, discretized using K-means, and used to train a language model. ZeroSyl outperforms prior syllabic tokenizers across lexical, syntactic, and narrative benchmarks. Scaling experiments show that while finer-grained units are beneficial for lexical tasks, our discovered syllabic units exhibit better scaling behavior for syntactic modeling.

03.
arXiv (CS.AI) 2026-06-12

DCD: Domain-Oriented Design for Controlled Retrieval-Augmented Generation

arXiv:2604.07590v2 Announce Type: replace-cross Abstract: Retrieval-Augmented Generation (RAG) is widely used to ground large language models in external knowledge sources. However, when applied to heterogeneous corpora and multi-step queries, Naive RAG pipelines often degrade in quality due to flat knowledge representations and the absence of explicit workflows. In this work, we introduce DCD (Domain-Collection-Document), a domain-oriented design to structure knowledge and control query processing in RAG systems without modifying the underlying language model. The proposed approach relies on a hierarchical decomposition of the information space and multi-stage routing based on structured model outputs, enabling progressive restriction of both retrieval and generation scopes. The architecture is complemented by smart chunking, hybrid retrieval, and integrated validation and generation guardrail mechanisms. We describe the DCD architecture and workflow and discuss evaluation results on synthetic evaluation dataset, highlighting their impact on robustness, factual accuracy, and answer relevance in applied RAG scenarios.

04.
arXiv (quant-ph) 2026-06-16

Neural network inverse design of nanophotonic scintillators

arXiv:2606.16309v1 Announce Type: cross Abstract: Scintillators are materials converting high-energy radiation into optical light, essential in a range of technologies such as medical imaging systems and security scanners. Scintillator development and optimization have remained limited by the complexity of their underlying physics, involving stochastic cascades of electron-electron, electron-phonon, and electron-photon interactions. Such processes are typically modeled by non-differentiable Monte Carlo simulations, limiting the applicability of machine learning for scintillator development. Here we present a physics-informed neural network that learns the scintillation cascade process from the incident high-energy particle to photon emission, substantially accelerating scintillator design and optimization. Combining this neural network with photonic simulations enables end-to-end differentiable optimization of the scintillator geometry. This allows us to optimize for arbitrary figures of merit, such as specific target emission patterns.. We demonstrate the concept and characterize it relative to previous approaches by inverse design of nanophotonic scintillators for X-ray imaging.

05.
arXiv (quant-ph) 2026-06-16

Generalized Kerr-Cat Qubit Codes

arXiv:2606.14901v1 Announce Type: new Abstract: We present a systematic study of Schrödinger cat codes constructed from Kerr-type coherent states, including displaced Kerr coherent states and Barut–Girardello Kerr coherent states, each admitting two distinct families determined by the sign of the Kerr nonlinearity. By tuning the Kerr parameter and coherent-state amplitude, these states interpolate between $\mathfrak{su}(2)$, $\mathfrak{su}(1,1)$ coherent states, providing a unified and versatile foundation for this type of bosonic quantum error correction. Unlike standard two-component Schrödinger cat codes, where a single photon-loss event induces an uncorrectable bit-flip, the nonlinear phase-space structure of Kerr cat states enables simultaneous detection and correction of both photon-loss and dephasing errors within a unified recovery framework, with optimal recovery operations determined via convex optimization. We demonstrate that Kerr cat encodings significantly outperform conventional cat codes under combined loss and dephasing noise, and that judicious parameter optimization can suppress both error channels to a level that reduces the overhead of additional error correction layers. We further show that Kerr-deformed coherent-state manifolds under engineered two-photon driving emerge as effective steady states of driven-dissipative dynamics, with single-photon decoherence strongly suppressed and leakage outside the protected manifold appearing only as higher-order corrections in the deformation strength. Our extended formalism identifies generalized Kerr Schrödinger cat codes as promising candidates for fault-tolerant bosonic quantum computation in experimental platforms such as nonlinear photonics.

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

Non-commutative Law of iterated logarithm

arXiv:2509.22037v2 Announce Type: replace-cross Abstract: We prove optimal non-commutative analogues of the classical Law of Iterated Logarithm (LIL) for both martingales and sequences of independent (non-commutative) random variables. The classical martingale version was established by Stout [Sto70b] and the independent case by Hartman-Wintner [HW41]. Our approach relies on a key exponential inequality essentially due to Randrianantoanina [Ran24] that improves that from Junge and Zeng [JZ15]. It allows to derive an optimal non-commutative Stout-type LIL just as in [Zen15], from that martingale result we then deduce a non-commutative Hartman-Wintner type LIL for independent sequences of random variables.

07.
arXiv (CS.AI) 2026-06-18

TxBench-PP: Analyzing AI Agent Performance on Small-Molecule Preclinical Pharmacology

arXiv:2606.19245v1 Announce Type: new Abstract: Artificial intelligence (AI) agents promise to accelerate drug discovery by compressing interpretation and decision-making loops, but practical deployment requires trusted evaluation on realistic program decisions. We introduce TherapeuticsBench Preclinical Pharmacology (TxBench-PP), a verifiable benchmark for small-molecule preclinical pharmacology and the first focused slice of a broader TherapeuticsBench effort across drug-discovery stages and therapeutic modalities. TxBench-PP tests whether agents can recover accurate conclusions from real-world assay data rather than memorized facts from literature. The benchmark contains 100 evaluations indexed by program stage, assay type, and task structure, spanning mechanism-of-action (MoA) and pharmacodynamic (PD) reasoning, compound-target engagement, causal target validation, developability and safety, and translational efficacy. Agents receive realistic workflow snapshots, inspect files in a coding environment, and return structured answers graded deterministically. Across 16 model-harness configurations, comprising 11 models and 4,800 trajectories, no system reliably recovered preclinical pharmacology decisions. The strongest configuration, Claude Opus 4.8 / Pi, passed 59.3\% of endpoint attempts (178/300; 95\% CI, 51.1-67.6), followed by GPT-5.5 / Pi at 55.3\% (166/300; 47.0-63.6).

08.
arXiv (CS.AI) 2026-06-16

MuVAP: Multimodal Multiparty Voice Activity Projection for Turn-taking Prediction in the Wild

arXiv:2606.16731v1 Announce Type: cross Abstract: Current multiparty turn-taking models often rely on complex microphone arrays or multi-camera setups, limiting their applicability in human-robot interaction scenarios. We introduce MuVAP, a causal multimodal framework that extends Voice Activity Projection by grounding acoustic predictions in face tracks, enabling speaker-aware turn-taking predictions from a monaural audio stream and a single camera view. To address the combinatorial complexity of modeling multiple speakers, we propose Role-Relative Projection, which maps any N-speaker interaction onto a fixed current versus next floor-holder state. Because existing audiovisual datasets contain disruptive editing cuts that break causal tracking, we introduce the Audio-Visual Conversation Corpus, a 31-hour dataset of unedited, single-camera multiparty conversations. Evaluations demonstrate that MuVAP outperforms strong baselines on Shift-Hold and next-speaker prediction tasks across two- and three-speaker settings.

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

RegMix-D: Dynamic Data Mixing via Proxy Training Trajectories

Data mixture selection is critical for Large Language Model pretraining. Existing methods such as RegMix select a single static mixture by fitting a regression model on small-scale proxy runs. We propose RegMix-D, a simple extension of RegMix to dynamic mixing. Our key observation is that proxy runs produce not only endpoint losses, but also full loss trajectories, which can be used to further improve data mixture. By training regression model on these trajectories, we can predict optimal mixtures at multiple training stages. RegMix-D supports two deployment modes: an offline variant that generates a complete mixture schedule before target training, and an online variant that adapts the mixture during training using observed loss. Experiments on 25B tokens of the Pile dataset with a 1B parameter target model show that RegMix-D consistently improves over RegMix and DoReMi across 13 downstream tasks while remaining proxy-efficient: it surpasses RegMix even with only 128 proxy models (25% of RegMix's proxy compute budget).

10.
arXiv (quant-ph) 2026-06-17

Canonical regularization of the stationary Coulomb problem and an Aufbau-like spectral ordering

arXiv:2606.17359v1 Announce Type: new Abstract: The stationary hydrogen atom has Coulomb degeneracy across orbital levels, whereas the Aufbau/Madelung ordering is an empirical, many-electron rule established in atomic physics. We examine the hydrogen atom through a regularized de Broglie–Bohm representation, in which stationary amplitude current constraints generate separable Sturm–Liouville branches. In this formulation, the radial, orbital, and magnetic sectors acquire canonical Langer-like inverse square corrections. The modified boundary value problems allow analytical solutions and produce a hydrogen-like spectrum with regularized radial and angular indices. Consequently, radial Coulomb quantization acquires an orbital dependent shift, lifting the Coulomb degeneracy and producing a spectral ordering that follows the Aufbau/Madelung sequence. On this basis, we construct the ordering of the regularized de Broglie–Bohm states and show that the spectral structure retains the standard degenerate Rydberg sequence in the l=0 sector. The separated amplitudes are represented by generalized special function branches, including the associated Laguerre, Legendre, and Bessel functions with non-integral parameters arising from regularized separation. Therefore, the treatment is intended as an analytical examination of spectral ordering in a regularized one center Coulomb problem rather than as a replacement for the many electron atomic structure theory. Keywords: de Broglie–Bohm representation; Coulomb spectrum; canonical regularization; Langer correction; Sturm–Liouville equations; Aufbau principle; Madelung ordering; associated Legendre functions; associated Laguerre functions; Bessel functions.

11.
arXiv (CS.CV) 2026-06-17

Detail++: Training-Free Detail Enhancer for Text-to-Image Diffusion Models

Recent advances in text-to-image (T2I) generation have led to impressive visual results. However, these models still face significant challenges when handling complex prompt, particularly those involving multiple subjects with distinct attributes. Inspired by the human drawing process, which first outlines the composition and then incrementally adds details, we propose Detail++, a training-free framework that introduces a novel Progressive Detail Injection (PDI) strategy to address this limitation. Specifically, we decompose a complex prompt into a sequence of simplified sub-prompts, guiding the generation process in stages. This staged generation leverages the inherent layout-controlling capacity of self-attention to first ensure global composition, followed by precise refinement. To achieve accurate binding between attributes and corresponding subjects, we exploit cross-attention mechanisms and further introduce a Centroid Alignment Loss at test time to reduce binding noise and enhance attribute consistency. Extensive experiments on T2I-CompBench and a newly constructed style composition benchmark demonstrate that Detail++ significantly outperforms existing methods, particularly in scenarios involving multiple objects and complex stylistic conditions.

13.
bioRxiv (Bioinfo) 2026-06-12

Generalisable tissue-wide molecular reconstruction from histology

Spatial transcriptomics technologies measure gene expression within intact tissues but remain difficult to scale across large tissue sections and patient cohorts. Consequently, many studies rely on tissue microarrays (TMAs) or sparse spatial profiling designs, where molecular measurements are available for only limited tissue regions and are often generated using heterogeneous gene panels. Existing H&E to spatial gene expression prediction methods remain challenged by sparse molecular measurements, partially overlapping gene panels and tissue-wide reconstruction across heterogeneous spatial datasets. Here, we present GHIST+, a framework for tissue-wide reconstruction of single-cell molecular states from H&E histology. GHIST+ integrates cellular morphology, local tissue context and shared tissue representations to extend sparse molecular measurements into tissue-wide molecular maps across heterogeneous spatial datasets. Across multiple cancer types and GTEx breast tissues, GHIST+ reconstructs biologically meaningful tissue-wide molecular organisation from sparse TMA-derived measurements while preserving spatial tissue structure, cell-type organisation and age-associated tissue states across cancer and non-cancer settings. GHIST+ establishes a scalable framework for transforming sparse spatial profiling experiments into tissue-wide molecular maps, enabling cohort-scale molecular reconstruction from routine histology under heterogeneous spatial transcriptomic settings.

14.
arXiv (CS.AI) 2026-06-12

HD-Prot: A Protein Language Model for Joint Sequence-Structure Modeling with Continuous Structure Tokens

arXiv:2512.15133v3 Announce Type: replace-cross Abstract: Proteins inherently possess a consistent sequence-structure duality. The abundance of protein sequence data, which can be readily represented as discrete tokens, has driven fruitful developments in protein language models (pLMs). A key remaining challenge, however, is how to effectively integrate continuous structural knowledge into pLMs. Current methods often discretize protein structures to accommodate the language modeling framework, which inevitably results in the loss of fine-grained information and limits the performance potential of multimodal pLMs. In this paper, we argue that such concerns can be circumvented: a sequence-based pLM can be extended to incorporate the structure modality through continuous tokens, i.e., high-fidelity protein structure latents that avoid vector quantization. Specifically, we propose a hybrid diffusion protein language model, HD-Prot, which embeds a continuous-valued diffusion head atop a discrete pLM, enabling seamless operation with both discrete and continuous tokens for joint sequence-structure modeling. It captures inter-token dependencies across modalities through a unified absorbing diffusion process, and estimates per-token distributions via categorical prediction for sequences and continuous diffusion for structures. Extensive results demonstrate that HD-Prot achieves competitive performance in unconditional sequence-structure co-generation, motif-scaffolding, protein structure prediction, and inverse folding tasks. Furthermore, our method can perform on par with state-of-the-art multimodal pLMs, despite being developed under limited computational resources (i.e., less than one-tenth the budget for modality extension fine-tuning). It highlights the viability of simultaneously estimating categorical and continuous distributions within a unified language model architecture, offering a promising alternative direction for multimodal pLMs.

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

Temporal Conductance and Bounds on the Voter Model for Dynamic Networks

arXiv:2606.13374v1 Announce Type: cross Abstract: The voter model is a classical stochastic process that models how opinions might spread through a network: at each step, every node lazily adopts the opinion of a random neighbour; eventually all nodes share the same opinion (consensus). Stronger connectivity should yield faster consensus. Berenbrink, Giakkoupis, Kermarrec, and Mallmann-Trenn (ICALP 2016) make this precise via the network's conductance: if the network has $m$ edges, minimum degree $d_{\min}$, and conductance at least $\phi$, then the voter model reaches consensus in expected $O(m/(d_{\min}\phi))$ steps. Their results extend to dynamic networks with fixed vertex degrees by considering the network's conductance at each time step. We introduce temporal conductance $\Phi$, a more general connectivity measure for dynamic networks. Unlike static conductance, which collapses to $0$ whenever some snapshot is disconnected, $\Phi$ captures connectivity through edges that appear at different times. We generalise the results of Berenbrink et al. from static conductance to temporal conductance, showing that the expected consensus time of the standard voter model is at most $O(m/(d_{\min}\Phi))$. Moreover, we prove that this bound is tight up to constant factors. We expect temporal conductance to be a useful primitive for analysing other dynamics on temporal networks, and potentially time-inhomogeneous Markov chains more generally.

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

Escaping the Cognitive Well: Efficient Competition Math with Off-the-Shelf Models

arXiv:2602.16793v2 Announce Type: replace Abstract: In the past year, custom and unreleased math reasoning models reached gold medal performance on the International Mathematical Olympiad (IMO). Similar performance was then reported using large-scale inference on publicly available models but at prohibitive costs (e.g., 3000 USD per problem). In this work, we present an inference pipeline that attains best-in-class performance on IMO-style math problems at an average inference cost orders of magnitude below competing methods while using only general-purpose off-the-shelf models. Our method relies on insights about grader failure in solver-grader pipelines, which we call the Cognitive Well (iterative refinement converging to a wrong solution that the solver as well as the pipeline's internal grader consider to be basically correct). Our pipeline addresses these failure modes through conjecture extraction, wherein candidate lemmas are isolated from generated solutions and independently verified alongside their negations in a fresh environment (context detachment). On IMO-ProofBench Advanced (PB-Adv), our pipeline achieves 67.1 percent performance using Gemini 3.0 Pro with an average cost per question of approximately 31 USD. At the time of evaluation, this represented the state-of-the-art on PB-Adv among both public and unreleased models, and more than doubles the success rate of the next best publicly accessible pipeline, all at a fraction of the cost.

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

Watching a Superconducting Coplanar Waveguide Heat Up with a Single Color Center

arXiv:2606.15398v1 Announce Type: new Abstract: Single color centers in diamond offer a local probe of their cryogenic environment, providing a direct way to quantify heating in spin-control hardware. Here, we establish a single spectrally stable tin-vacancy (SnV) center as an on-chip thermometer for a diamond membrane and use it to characterize microwave- and radio-frequency-induced heating in a superconducting coplanar waveguide patterned on the same chip. We first calibrate the temperature dependence of the optical C-transition frequency and linewidth from $20\,\mathrm{K}$ down to the few-kelvin regime. At lower temperatures, where the optical response becomes weakly temperature dependent, we use the spin-lattice relaxation time $T_1$ as a complementary thermometer and tune its sensitivity with the transverse magnetic-field component. Applying this local thermometer to a niobium coplanar waveguide, we observe magnetic-field-dependent superconducting breakdown under GHz drive, accompanied by abrupt heating of the diamond. In contrast, at $20\,\mathrm{MHz}$ and $400\,\mathrm{mT}$, relevant for nuclear-spin control, we detect no measurable heating up to the breakdown threshold of $9.4\,\mathrm{dBm}$, corresponding to $B_\mathrm{ac}\sim1.2\,\mathrm{mT}$. These results define a safe operating window for superconducting microwave and RF control structures in diamond-based quantum nodes.

19.
arXiv (CS.AI) 2026-06-15

Can LLMs Accurately Score Medical Diagnoses and Clinical Reasoning?

arXiv:2604.14892v3 Announce Type: replace-cross Abstract: Evaluating medical AI systems using expert clinician panels is costly and slow, motivating the use of large language models (LLMs) as alternative adjudicators. Here, we evaluate an LLM Jury, composed of three frontier AI models, for scoring 3334 diagnoses on 300 real-world low- and middle-income country (LMIC) hospital cases. Both LLM- and clinician-generated diagnoses are scored against expert panel diagnoses across four dimensions: diagnosis, differential diagnosis, clinical reasoning, and negative treatment risk. The LLM Jury scores are compared with expert and independent re-scoring panel scores to assess error metrics, inter-rater agreement, severe-risk errors, and the effect of post hoc calibration using isotonic regression. In our data, we find that: (i) the uncalibrated LLM Jury scores preserve ordinal agreement with the expert clinician panel scores, but are systematically lower; (ii) the probability of severe-risk errors is lower for the LLM Jury than the human expert re-score panels; (iii) the LLM Jury combined with LLM diagnoses can be used to identify diagnoses at high risk of error, enabling targeted expert review and improved panel efficiency; (iv) the calibrated LLM Jury scores and rankings of diagnosing agents show excellent agreement with those of the primary expert panels; (v) LLM Jury models show no self-preference bias, they did not score diagnoses generated by their own underlying model or models from the same vendor more (or less) favourably than those generated by other models. Together, these results provide evidence that a calibrated LLM Jury is a trustworthy and reliable proxy for expert clinician evaluation in medical AI benchmarking. Confirming these findings in other clinical settings is an important direction for future work.

20.
arXiv (quant-ph) 2026-06-12

Simple analytical flux-tuned iSWAP pulses for leakage suppression

arXiv:2606.13052v1 Announce Type: new Abstract: Fast, high-fidelity two-qubit gates are a key requirement for fault-tolerant quantum computation. Tunable coupler architectures provide a flexible approach for implementing entangling gates through flux control with large on-off ratios, but fast flux modulation can induce diabatic transitions and population leakage to non-computational states, limiting gate performance. Here we present an analytical flux control method enabling derivative removal by adiabatic gate ($\Phi$-DRAG) for suppressing leakage in flux tunable two-qubit gates. We show that $\Phi$-DRAG differs fundamentally from conventional microwave implementations and derive modified flux modulation protocols that suppress leakage below $10^{-4}$ for fast entangling gates. The method remains effective across a range of asymmetry between qubit anharmonicities and different circuit parameters, enabling high-fidelity two-qubit gates within the fifteen nanosecond range.

21.
arXiv (CS.CV) 2026-06-11

Right Predictions, Misleading Explanations: On the Vulnerability of Vision-Language Model Explanations

Explanation mechanisms are increasingly used to support transparency and trust in vision-language models (VLMs), particularly in settings where model decisions require human oversight. However, the robustness of these explanations remains insufficiently understood. In this work, we investigate whether explanation heatmaps in VLMs, particularly CLIP-based models, faithfully reflect model reasoning under adversarial conditions. We show that explanation maps can be systematically manipulated while preserving the model's original prediction, revealing a disconnect between predictive behavior and explanation faithfulness. To study this vulnerability, we introduce X-Shift, a novel grey-box attack that perturbs patch-level visual representations to redirect explanation heatmaps toward semantically irrelevant regions without altering the predicted output. Unlike conventional adversarial attacks that aim to induce misclassification, X-Shift specifically targets the integrity of the explanation process itself. The attack operates without modifying model parameters and generalizes across multiple CLIP architectures and explanation methods. We evaluate the proposed approach on ImageNet-1k, MS-COCO, and Flickr30K, demonstrating consistent degradation in explanation alignment under imperceptible perturbations while maintaining prediction stability. Furthermore, standard prediction-oriented adversarial attacks fail to reproduce the same explanation-shifting behavior even under substantially larger perturbation budgets. Our findings highlight a fundamental limitation of current explanation mechanisms in VLMs and raise concerns about their use as reliable indicators of model trustworthiness in high-impact applications.

22.
arXiv (CS.CV) 2026-06-11

BiWM: Advancing Open-Source Interactive Video World Models with Bidirectional Autoregression

Transitioning bidirectional video diffusion models into an autoregressive paradigm improves the interactivity of video world models, but existing causal pipelines need many stages (control fine-tuning, autoregressive training, causal initialization, few-step distillation) and still trail bidirectional models in quality due to error accumulation. Recent world models such as Yume-1.5 and Matrix-Game-3.0 instead adopt a bidirectional autoregressive approach, gaining fidelity and stable long-horizon rollout from self-correcting error propagation, yet open-source frameworks (e.g., minWM) support only causal models. We present BiWM, the first full-stack framework for interactive video world models under the bidirectional autoregressive paradigm, jointly optimizing generation quality and inference speed. From a pretrained video backbone, BiWM injects camera control by fine-tuning, then runs a few-step Distribution Matching Distillation (DMD) stage that turns the backbone into an action/camera-controllable world model: just two training stages instead of four in minWM, converging in a few hundred steps on 8xH200 GPUs. A single recipe spans Wan2.1-1.3B, Wan2.2-5B, HunyuanVideo-1.5-8B, and LTX-2.3-22B, and also supports secondary fine-tuning of existing bidirectional models. BiWM enables real-world camera control where minWM loses controllability, integrates pluggable history compression (FramePack-style and PackForcing-style) for long rollouts, and offers an optional NVFP4 4-bit training/inference pipeline. To counter DMD's mode-seeking degradation, we add GAN and mass-covering forward-KL objectives that preserve scene dynamics. We open-source BiWM for resource-constrained research and high-fidelity environment simulation.

23.
arXiv (CS.AI) 2026-06-15

VeriGeo: Controllable Geometry Question Generation with Numerical and Analytical Verification

arXiv:2606.14176v1 Announce Type: new Abstract: Geometry problem generation is useful for AI-assisted education and multimodal mathematical reasoning, but reliable synthesis remains difficult because the problem statement, diagram, constraints, and solution should be mutually consistent. Existing methods often trade off controllability and reliability: seed-based rewriting is flexible but weakly verifiable, whereas diagram-first construction improves validity but is less suited to arbitrary user-specified constraints. We introduce VeriGeo, a controllable geometry generation framework grounded in executable reasoning traces. Given user constraints such as target concepts and difficulty, an Author agent generates a problem and diagram, and a Solver agent produces a proof-aligned solution. Both agents use a shared action sequence that connects natural language, diagrams, geometric constraints, and proof steps into a verifiable representation. A three-stage pipeline checks numerical consistency, analytical realizability, and global consistency, using verification-guided reflection to repair recoverable failures and reject unrecoverable ones. Across five LLM backbones, raw generations frequently fail these checks, while VeriGeo repairs a substantial fraction of the invalid attempts. Supervised fine-tuning on 8.7k examples generated by VeriGeo achieves the best reported GeoQA performance among end-to-end multimodal LLM-based solvers, and obtains strong results on PGPS9K and MathVista-GPS, demonstrating the effectiveness of verified synthetic data for improving multimodal geometry reasoning.

24.
medRxiv (Medicine) 2026-06-22

Agentic Artificial Intelligence for Hospital Readmission Review: A Single-Center Blinded Evaluation and Exploratory Qualitative Analysis

Background: Manual review of 30-day hospital readmissions can identify actionable quality and safety problems, but it is labor-intensive. We developed and evaluated an agentic AI workflow for evidence-grounded readmission review. Materials and methods: We studied adult patients with unplanned 30-day readmission after discharge from a medicine hospitalist service at a single academic health system. An AI agent using a large language model queried a database containing notes, encounters, procedures, laboratory results, and other clinical data, and completed the same structured readmission-review rubric used by physicians. In the primary comparative evaluation, 20 randomly selected readmissions from 2025 were each reviewed by two physicians and the AI system. Blinded physician evaluators rated review quality. After rubric refinement, the AI workflow was applied to 100 recent readmissions in an exploratory expanded-cohort analysis of recurring improvement opportunities. Results: In the primary comparative evaluation, the AI classified 9/20 readmissions (45%) as preventable, compared with 19/40 physician reviews (47.5%). Blinded overall quality ratings were similar for AI and physician reviews (4.35 vs. 4.20 on a 1-5 scale; mean difference 0.15, 95% CI -0.20 to 0.48; p=0.49), as were factuality/support and usefulness/actionability ratings. No AI hallucinations were identified during factuality review. Agreement on preventability and primary readmission category was low for both AI-human and human-human comparisons. The AI system cost $0.23 per chart; physician reviewers took a median of 15 minutes, corresponding to an estimated $42.43 per chart. In the exploratory expanded-cohort analysis, AI-assisted review identified recurring vulnerabilities in post-discharge follow-up plans, incomplete inpatient workups, medication-safety transitions, and indwelling-device transitions. Conclusions: Agentic AI produced readmission reviews with similar blinded quality ratings to physician reviews in this small single-center primary comparative evaluation and supported identification of recurring quality-improvement themes in the exploratory expanded-cohort analysis. Preventability judgments remained variable among both AI and physicians, underscoring the need for human oversight and prospective evaluation before operational use.

25.
medRxiv (Medicine) 2026-06-22

The impact of changes in age-based eligibility criteria on seasonal influenza vaccine uptake in England between 2019 and 2024: A retrospective cohort study

Objectives: To examine changes in seasonal influenza vaccine uptake among clinical risk groups over periods of differing age-based eligibility. Design: Retrospective cohort study. Setting: Individuals in England registered in the Clinical Practice Research Datalink Aurum. Participants: Between 1,239,802 (2019/20) and 1,289,330 (2023/24) individuals aged 40-69 years in clinical risk groups. Interventions: Natural experiment involving temporary expansion of age-based eligibility for influenza vaccination to include 50-64-year-olds from 2020/21 to 2022/23. Main outcome measures: Influenza vaccine uptake from 1st September to 28th February, incidence rate ratio (IRR) of vaccine uptake across consecutive seasons within age groups, and the ratio of IRRs between age groups. Results: Influenza vaccine uptake increased in all age groups in 2020/21 relative to 2019/20. The increase was larger in individuals aged 50-64 years (13.3%; IRR 1.50, 95% CI 1.50-1.51) compared with those aged 40-49 years (8.3%; IRR 1.35, 95% CI 1.34-1.35) and 65-69 years (6.8%; IRR 1.34, 95% CI 1.33-1.35). From 2020/21 to 2022/23, vaccine uptake decreased, with a more pronounced decline among those aged 40-49 years (-5.4%) compared with age-eligible groups (50-64 years: -3.0%; 65-69 years: -3.1%). The reversion of age eligibility in 2023/24 was associated with a larger decrease in uptake among those aged 50-64 years (-9.6% vs 2022/23; IRR 0.79, 95% CI: 0.79-0.79) compared with those aged 40-49 years (-4.9%; IRR 0.87, 95% CI: 0.87-0.88) and 65-69 years (-3.3%; IRR 0.97, 95% CI: 0.96-0.97). Patterns were broadly consistent across clinical risk groups. Conclusions: The COVID-19 pandemic saw a general increase in seasonal influenza vaccine uptake in clinical risk groups. This increase was larger and more sustained in 50-64 year-olds who had also become eligible based on age. Our findings highlight the potential gains in vaccine coverage among clinical risk groups based on expanded age-based eligibility.