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01.
medRxiv (Medicine) 2026-06-18

Consistency of sleep timing and duration are associated with more physical activity and favorable heart rate metrics in a naturalistic cohort

Background: Regularity of sleep patterns over time has increasingly gained traction as an important axis of sleep health. Since sleep habits are under some degree of behavioral control, understanding such patterns in naturalistic settings is particularly important. We quantified sleep variability and tested the hypothesis that regularity correlates with physical activity, resting heart rate (rHR), and heart rate variability (HRV). Methods: We analyzed real-world digital health data from over 81,000 participants (over 18 million nights) who provided informed consent to participate in the Apple Heart and Movement Study and elected to contribute sleep, activity, and heart rate data to the study. Variability was quantified using the standard deviation (SD) computed from total sleep time (TST), sleep start time (S-start), end time (S-end), and midpoint time (MP), as well as the Sleep Regularity Index (SRI). Results: The SD-based variability metrics correlated with one another (R values 0.74-0.92), and with the SRI metric (R values 0.62-0.64). More consistent sleep, by any metric, was associated with more activity and better rHR and HRV. The most consistent tertile for TST variability had higher median TST (6.9 vs 5.9 hours), more daily exercise (32.8 vs 20.4 minutes), lower rHR (62.4 vs 65.6 beats per minute), and higher HRV (40.6 vs 37.3), all p

02.
arXiv (CS.AI) 2026-06-16

SDS-LoRA: Overcoming Anisotropic Gradient Scaling in Low-Rank Adaptation

arXiv:2606.16454v1 Announce Type: cross Abstract: Low-Rank Adaptation (LoRA) enables efficient adaptation of large pre-trained models to downstream tasks by parameterizing weight updates with low-rank matrices. In this paper, we investigate the limitations of the LoRA parameterization from a geometric perspective. Specifically, we show that when a full fine-tuning gradient is backpropagated to the low-rank matrices, it undergoes anisotropic scaling driven by their singular values. We argue that this phenomenon is undesirable because it distorts the full fine-tuning gradient by skewing it toward dominant singular directions while suppressing others. Our analyses demonstrate that anisotropic gradient scaling reduces the effective rank of the low-rank matrices' gradients and results in suboptimal alignment between the full fine-tuning gradient and its low-rank approximation in LoRA, thereby exacerbating the gap to full fine-tuning. To address these limitations, we propose a new low-rank parameterization, SDS-LoRA, which structurally decouples singular values from the backward pass. Our method ensures that the full fine-tuning gradient backpropagates only through the orthonormal bases of the low-rank matrices' subspaces, independent of their scales. Convergence analysis demonstrates that while LoRA's convergence rate degrades with the condition number of the low-rank matrices, SDS-LoRA remains independent of it. Experimental results across natural language and vision benchmarks show that SDS-LoRA improves loss convergence and reduces the gap to full fine-tuning, significantly enhancing adaptation performance.

03.
arXiv (CS.AI) 2026-06-15

CisTransCell: Single-Cell Perturbation Prediction via Gene Function, Regulatory Control, and Cellular Context

arXiv:2606.13713v1 Announce Type: cross Abstract: Predicting cellular transcriptional responses to genetic perturbations is a central problem in single-cell biology, especially in the zero-shot setting where the perturbed gene or gene combination is unseen during training. A major difficulty is that perturbation effects are not determined by expression state alone: they depend on how the perturbed gene product influences other genes and proteins, how those downstream factors act on cis-regulatory elements, and which regulatory programs are active in the current cell state. To better capture this biological complexity, we propose CisTransCell, a cell-conditioned multi-modal framework for single-cell perturbation prediction that augments each gene with two complementary priors: a regulatory-sequence prior that captures how the gene is controlled, and a coding-sequence prior that captures what the gene product does. By integrating these priors with cellular expression state, CisTransCell models perturbation response as a cascade from gene function to regulatory control to downstream transcriptional change. Experiments on benchmark single-cell perturbation datasets show that CisTransCell achieves strong performance in zero-shot perturbation prediction.

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

MotifGen: Spatiotemporal interpolation of misaligned satellite images via multi-source generative modeling, in an application to tropical cyclones

Microwave satellite imagery plays a crucial role in monitoring tropical cyclone precipitation and intensity worldwide, but suffers from long revisit times, potentially missing rapid storm evolution phases. While this raises the need for an interpolation method, it is made challenging by the high level of heterogeneity of microwave data coming from different instruments. In this work, we introduce the first generative model that can be applied to multiple geospatial sources that change across samples, occur at irregular time intervals, are misaligned geographically, and come from instruments with varying characteristics. We apply this model to the case of spatio-temporal interpolation of tropical cyclone microwave images from other microwave and infrared instruments. We train using a self-supervised task in which a random source is masked and reconstructed, and show that it leads to a significant decrease in Continuous Ranked Probability Score over supervised training. We show a further improvement by combining infrared and microwave data compared to microwave only. Using these improvements, the generative model produces an ensemble mean on par with that of a deterministic model, while generating a power spectrum significantly closer to that of true observations. To the best of our knowledge, this is the first generative model that interpolates microwave images of cyclones by combining multiple microwave instruments and infrared observations at irregular time intervals.

05.
arXiv (CS.LG) 2026-06-15

Recursively Trained Diffusion Models: Limiting Collapse Distribution and Spectral Characterization

arXiv:2606.13796v1 Announce Type: cross Abstract: Recursive training of generative models on their own outputs can lead to model collapse, a compounding drift away from the true data distribution. Existing theoretical works bound finite-round error accumulation in the context of diffusion models, but two questions remain open:~what distribution does the recursion converge to, and how fast? We answer both, isolating a mechanism distinct from imperfect learning: even with perfect score estimation and exact sampling, the early stopping of the reverse diffusion (required for numerical stability) drives a progressive drift away from the data distribution. We prove that this recursion converges geometrically to a unique limiting distribution, which admits a closed-form characterization as an infinite mixture of increasingly Gaussian-smoothed versions of the data distribution. A Hermite spectral decomposition of this limit reveals that recursive training acts as a low-pass filter: higher-order modes, which encode fine non-Gaussian structure, are attenuated much more strongly than coarse modes. This spectral picture motivates annealed truncation schedules that progressively shrink truncation times across retraining rounds; we prove that any schedule converging to $0$ asymptotically eliminates recursive compounding. Finally, we show our idealized characterization is robust: in the presence of discretization and score estimation errors, the learned distribution remains in a Wasserstein-2 ball around the ideal limit, with mode-dependent contraction rates that contract high-order errors faster than low-order ones. We validate the theory on synthetic Gaussian mixtures and CIFAR-10.

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

CareTransition-Audit: A Benchmark to Audit Discharge Summaries for Efficient Care Transitions

arXiv:2604.05435v2 Announce Type: replace Abstract: Incomplete or inconsistent discharge documentation drives care fragmentation and avoidable readmissions. Despite its critical role in patient safety, auditing discharge summaries relies on manual review and does not scale. We propose an automated framework for auditing discharge summaries using large language models (LLMs). Our approach operationalizes the DISCHARGED framework into a checklist of 46 questions. Using 50 summaries from the MIMIC-IV database, with clinician ground-truth labels, we benchmark 11 LLMs. Model-assessed mean documentation completeness ranges from 54.9% to 74.2%, and the best-performing models achieve a Cohen's kappa values around 0.5 against clinician labels, indicating moderate agreement. All models struggle to identify ambiguous documentation (Unclear), highlighting a key gap in current automated auditing. This work provides a clinician-validated benchmark and zero-shot baselines for systematic quality improvement in clinical documentation.

07.
arXiv (quant-ph) 2026-06-12

Quantum-Driven Neuromorphic Computing for Million-Qubit-Scale Workloads

arXiv:2606.12968v1 Announce Type: new Abstract: We introduce Apollo, a 10000 node p-qubit neuromorphic processor fabricated in 16 nm mixed signal CMOS and operating fully at room temperature with a typical analog core power envelope of about 0.5 W. Its fundamental element, the p-qubit, is a bistable stochastic unit whose continuous time state fluctuations are driven by integrated quantum entropy units that inject true quantum derived randomness. This enables ultrafast stochastic transitions at low energy while preserving a classical state representation. Apollo combines these p-qubits with a high degree Hyperion 256 interconnect topology, allowing efficient embedding of dense Ising and QUBO problems with substantially reduced minor embedding overhead compared with sparse annealing platforms. We show that, through the Suzuki Trotter correspondence, the equilibrium statistics and annealing dynamics of the p-qubit network reproduce key properties of transverse field quantum annealing without cryogenic cooling, long lived coherence, or microwave control. Beyond device level validation, Apollo is evaluated on a three dimensional spin glass benchmark previously used to study quantum advantage in superconducting annealers. Across 300 disorder realizations, Apollo reaches substantially lower ground state energies than reported cryogenic quantum annealing hardware, while remaining distinct from classical simulated annealing and simulated quantum annealing. A 350 nm release candidate device experimentally validates the core p-qubit dynamics, thermodynamic sampling correctness, and continuous time annealing behavior. These results establish Apollo as a room temperature, industrially scalable platform for quantum driven energy based optimization, probabilistic inference, generative modeling, and hybrid classical quantum workflows.

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

FedSPC: Shared Parameter Correction for Personalized Federated Learning

arXiv:2606.13748v1 Announce Type: new Abstract: Personalized federated learning (PFL) is one of the important approaches in federated learning for addressing statistical heterogeneity while enabling client-specific adaptation. Many PFL methods split the model into shared and personalized parameters, which are jointly trained on each client. However, this creates an optimization issue: shared parameters are updated by clients optimizing different local objectives, which can lead to inconsistent shared updates and weaken the shared representation. To address this problem, we propose Federated Shared Parameter Correction (FedSPC), a modular correction method for PFL. FedSPC applies control-variate correction only to the shared parameters of a given PFL method, while leaving personalized parameters unchanged. It can be integrated into three common PFL settings: shared feature extractors, shared classifiers, and fully shared models with local regularization. Experiments on CIFAR-100 and Tiny-ImageNet with ViT, ResNet-34, and VGG-11 show that FedSPC improves performance across representative PFL methods, including FedPer, FedRep, FedBABU, LG-FedAvg, and Ditto.

09.
arXiv (CS.AI) 2026-06-11

Towards an Inferentialist Account of Information Through Proof-theoretic Semantics

arXiv:2605.05368v5 Announce Type: replace-cross Abstract: Information is one of the most widely-discussed concepts of the current era. However, a great deal of insightful work notwithstanding, it is yet to be given wholly convincing logical or mathematical foundations. Without them, we lack adequate reasoning tools for understanding the complex ecosystems of systems upon which the society depends. We seek to rectify this by taking a first step towards developing an inferentialist semantic theory of information. There are three key interacting components. First, conceptual analysis: the metaphysics of information. Dretske expressed the key concepts of information in terms of intentionality, truth, and transmissibility. We replace truth with inferability, and trace the consequences of this replacement. Second, logic: proof-theoretic semantics (P-tS) provides a mathematical-logical realization of inferentialist reasoning. Using P-tS, we develop the first steps towards a mathematical-logical theory of an inferentialist primitive unit of information, the 'inferon'. This proof-theoretic approach counterpoints the model-theoretic view of information articulated in situation theory. Furthermore, we argue that it facilitates addressing all three components of van Benthem and Martinez's categorization of the understandings of information, as range, as correlation, and as code. Our focus is on information-as-correlation. Third, systems: the P-tS tools we develop provide the basis for a mathematical account of distributed systems modelling – a key tool from informatics for understanding the organization of information processing systems. This yields a reasoning-based theory of information flow in models of distributed systems. Overall, we seek to give a conceptually rigorous mathematical-logical account of information and its role within informatics, grounded in inference and reasoning.

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

SeamEdit: A Black-Box VLM-Agnostic Pipeline for Large-Image Semantic Editing

Semantic region editing for large images must satisfy two requirements at the same time: high generative quality and natural integration with surrounding content. Some related methods rely on white-box models and leave the strong generation capability of closed-source models underexplored. Directly applying closed-source models to tiled editing, however, introduces several failure modes: semantic deformation, canvas-level alignment drift, and visible seam artifacts. This paper presents SeamEdit, a training-free and model-agnostic pipeline that treats any VLM with inpainting capability as a black-box oracle. SeamEdit mitigates these issues through a five-stage post-hoc pipeline: overlay-based tile decomposition, black-box VLM inpainting, geometric and color-consistency correction, seam-risk-based multi-candidate ranking, and dynamic-programming curved seam fusion. The pipeline reduces seam visibility and supports semantic modification of arbitrary tile regions.

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

Detecting Sensitive Personal Information in Japanese Pre-Training Corpora for Large Language Models

Sensitive personal information can appear in large-scale pre-training corpora for large language models (LLMs). Detecting and filtering such information is therefore essential to ensure compliance with privacy regulations and prevent unintended information leakage. However, in contrast to English and other languages, research into sensitive personal information has been limited in the Japanese language. In this study, we focus on sensitive personal data defined as special care-required personal information (SCPI) under Japan's Act on the Protection of Personal Information (APPI). We construct an SCPI dataset using LLM-based annotation and train machine learning models to rapidly detect SCPI in text. As a result, our SCPI classifier can effectively identify information related to SCPI. This study is the first to explore SCPI detection in Japanese text corpora, highlighting the challenges of accurate detection.

12.
arXiv (CS.CV) 2026-06-11

Density Ridge Selective Prediction for LLM and VLM Hallucination Detection under Calibration Label Scarcity

Hallucination detection in large language and vision-language models is increasingly framed as selective prediction, where a detector assigns a confidence score and abstains when confidence is low. Unsupervised sampling detectors (Semantic Entropy) avoid labels but plateau in quality, while supervised probes attain stronger in-distribution scores yet degrade sharply when calibration labels are scarce. We recover the response manifold of an LLM as the density ridge of a kernel density estimate built on a six-dimensional kinematic feature map of hidden state generation trajectories. A test generation is scored by the negated Euclidean distance from its projected feature point to the nearest ridge vertex, yielding a low-dimensional geometric skeleton of the stochastic output distribution. We evaluate against Semantic Entropy, topological methods, and log-probability on six QA benchmarks (HaluEval-QA, TriviaQA, GSM8K, POPE, ScienceQA, A-OKVQA) using eight text and vision LLMs in a deliberately label-scarce protocol ($n_{cal}{=}200$ queries, $N{=}5$ generations). Our ridge-based score beats on AUROC with 5-20 points gain, while demonstrating tempered degradation under calibration-label scarcity.

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

Maestro Order: A Model-Agnostic Orchestration Harness

Authors:

arXiv:2606.23983v1 Announce Type: cross Abstract: A single forward pass of a capable model is a fast, fluent, and unreliable problem-solver: it is right often enough to be useful and wrong often enough to be dangerous; in language models, such confident errors are known as hallucinations. We present Maestro Order, a model-agnostic orchestration harness that turns unreliable solvers into reliable problem-solving systems by composing them according to four structural primitives (decompose, ensemble, verify, and recurse) and a budget-aware controller that decides where to spend compute. The harness treats any model as a black-box base solver behind a uniform interface, layers a verifier ensemble whose discrimination is measured online, and allocates verification and voting to the stages with the highest marginal reliability per unit cost. We give the architecture, the message and state schema, the controller algorithm, and the engineering that makes it deterministic, observable, and fault-tolerant. We then specify an evaluation methodology (reliability at fixed cost, coverage, calibration, and ablations) and report results from a faithful Monte Carlo simulation of the harness over a parameterized solver/verifier model. The simulation reproduces the predicted laws quantitatively: verification amplifies reliability geometrically (e.g. $0.55\to0.98$ with two gates, $\to0.999$ with four), voting helps only above chance and is limited by shared errors, and a budget-aware controller reaches a target reliability at a small fraction of the cost of voting alone by selecting the cheapest mechanism for each regime. We close with failure modes (verifier gaming, correlated errors, and decomposition error compounding) and concrete guidance: build robust checkers, diversify solvers, and let the controller put compute where the information is.

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

Binary Tracking for Spatial QA and Navigation with Open Vision-Language Models

arXiv:2606.16902v1 Announce Type: cross Abstract: This work addresses spatial question answering for service robots traversing long egocentric routes. Given a query such as "where can I find a dry cleaner on the way back home?", the system returns a metric coordinate that downstream navigation components can act on. Prior Spatial Question Answering approaches leverage retrieval-augmented agents built on closed-source models such as GPT-4o for path exploration. However, robots operating in the real world often cannot reliably depend on online closed-source models due to network instability, communication latency, and deployment cost. It creates a need for open-source based Spatial Question Answering approaches that can run onboard the robot, yet prior research in this direction remains limited. This work proposes BinTrack, a simple yet effective, fully open-source spatial-localization agent that leverages the temporal ordering of a robot's trajectory. BinTrack performs a binary search over the trajectory segments between two anchor landmarks identified from a query. It improves overall accuracy by up to 22.8% over other open-source implementations and even matches the reported closed-source model result on the global category of the SpaceLocQA benchmark, the most challenging setting that has so far required strong reasoning agents such as GPT-4o. Furthermore, its optimized inference strategy consistently yields more than a 1.5x inference speedup over previous approaches. Finally, this work releases GangnamLoop, a novel and practical multi-trip outdoor benchmark collected by deploying a real quadruped robot on public streets with the anonymization policy. It revisits the same locations under different outdoor conditions and pairs the robot's low viewpoint with the human owner's. The source codes and datasets are publicly available at https://github.com/ndb796/BinaryTracking

15.
arXiv (CS.AI) 2026-06-16

UrbanWell: Benchmarking Multimodal Large Language Models for Spatio-Temporal Urban Wellbeing Analytics

arXiv:2606.15890v1 Announce Type: new Abstract: Understanding urban wellbeing from multimodal data requires integrating heterogeneous spatial and temporal signals, posing significant challenges for current multimodal large language models (MLLMs). We introduce UrbanWell, a large-scale benchmark designed to systematically evaluate the spatio-temporal reasoning capabilities of MLLMs for urban wellbeing analytics through joint modeling of satellite and street view imagery. UrbanWell spans 38 cities across multiple years and includes diverse indicators covering (1) environmental conditions (CO$_2$, NO$_2$, PM${2.5}$, and Normalized Difference Vegetation Index), (2) spatial accessibility (minimum distance to supermarkets and restaurants), (3) urban form (road length, road density, and land use), (4) urban vitality (population, economic activity diversity, and land use diversity), and (5) subjective perception attributes (e.g., safety, beauty, liveliness, wealth, and quietness). All indicators are aligned at grid level to enable standardized evaluation. Beyond static prediction, UrbanWell defines temporal reasoning tasks, including future value forecasting from historical observations and temporal trend classification. We benchmark 15 state-of-the-art representative MLLMs in a zero-shot setting, providing a comprehensive comparative evaluation across spatial and temporal dimensions. Experimental results indicate that while MLLMs capture salient spatial and perceptual cues, their performance varies substantially across heterogeneous urban indicators spanning environment and subjective perception. UrbanWell serves as a unified benchmark for evaluating multimodal spatial and temporal reasoning in urban wellbeing analytics, offering a standardized testbed for systematic assessment and future research on multimodal urban intelligence. Our codes and datasets are accessible via https://github.com/axin1301/UrbanWell-Benchmark.

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

Amortized mean-shift interacting particles

Authors:

arXiv:2606.15871v1 Announce Type: cross Abstract: Bayesian inference for inverse problems is run to evaluate integrals – posterior expectations, tail probabilities, and risks – across a stream of observations. The standard estimate averages the integrand over posterior samples, a Monte-Carlo average whose error decays only as the square root of the sample size, so accuracy demands many samples – prohibitive when each one calls a partial-differential-equation forward model. Mean-shift interacting particles need far fewer: they return a small set of signed-weight nodes – a deterministic quadrature whose weighted averages estimate those integrals. Finding the nodes, however, is a per-observation optimization that, in its most accurate form, reads the posterior score at every step – returning the cost it meant to save. We introduce amortized mean-shift interacting particles, a learned map that emits the weighted nodes from an observation and a few posterior samples in a single forward pass. Training asks only for joint parameter-observation samples and a posterior to draw from – a conditional normalizing flow, an empirical conditional, or any reference the user can sample – and the map learns to integrate that posterior from samples alone, evaluating neither its density nor its score. Once trained, it generalizes to unseen observations and integrands at any node budget and improves on independent samples in two ways: by reweighting them, provably no worse than the equal weights of Monte-Carlo; and by moving them, which empirically lowers it further. Across closed-form, sampled, learned, and physics-based posteriors – up to a thousand-coefficient groundwater field – it integrates more accurately than the same number of samples at every budget, and a posterior-whitened, dimension-aware kernel removes the high-dimensional wall. The result is a Pareto improvement on Monte-Carlo integration, not a competitor to drawing more samples.

17.
arXiv (CS.CV) 2026-06-19

SAM3 Self-Distillation for Fine-Grained GOOSE 2D Semantic Segmentation

Authors:

We describe our 4th-place entry to the ICRA 2026 GOOSE 2D Fine-Grained Semantic Segmentation Challenge, which reached a composite mean Intersection-over-Union (mIoU) of 69.73% on the official 1,815-image test set. Our model adapts the image encoder of a recent visual foundation model, Segment Anything Model 3 (SAM3), with a lightweight decoder. Beyond this, we contribute two techniques and one empirical finding: (i) a self-distillation scheme that re-uses SAM3 itself, prompted with ground-truth boxes, as a teacher on the classes where it outperforms our own model; (ii) an image-level multi-scale test-time augmentation scheme that restores multi-scale inference for a fixed-input-size model by rescaling the image rather than the model input; and (iii) the finding that an aggressive photometric distortion from a winning 2025 GOOSE 2D entry, transplanted onto our pipeline, is its single largest source of improvement.

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

Spectator-transition crosstalk in a spin-3/2 silicon vacancy qudit in silicon carbide revealed by broadband Ramsey interferometry

arXiv:2601.15559v3 Announce Type: replace Abstract: Color center spins in 4H-SiC offer a rare combination of wafer-scale materials maturity with long spin coherence and chip-level photonics, making them promising building blocks for scalable quantum technologies. In particular, the silicon vacancy hosts an S=3/2 ground state, a native qudit that enables compact encodings and subspace-selective control, but also introduces spectator transitions: short, detuned pulses can coherently drive non-addressed level pairs and create crosstalk. Here we use broadband Ramsey interferometry to reveal and quantify such spectator-transition crosstalk. Experimentally, the Ramsey Fourier spectra display multiple lines beyond the addressed single-quantum transition. Analytically, we map each line to a pairwise energy difference between qudit levels of the rotating-frame Hamiltonian and assign its weight via compact amplitudes set by the prepared state and the microwave pulse parameters, predicting a deterministic six-branch structure. Numerical time-domain propagation with the experimental sampling reproduces the detuning map, and the measured peak positions coincide with the analytic branch lines without frequency fitting. Together these results provide a practical, spectator-aware framework for multilevel control in the silicon vacancy qudit. The approach offers clear guidance to suppress crosstalk or, conversely, to exploit spectator lines, for example as additional constraints for in situ pulse calibration and for phase-sensitive quantum state and process estimation.

19.
medRxiv (Medicine) 2026-06-19

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

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

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

YeasierAgent: Agentic Social Sandbox as a Canvas for Intent-Driven Creation of Platform-Agnostic Symbiotic Agent-Native Applications

Authors:

arXiv:2606.13722v1 Announce Type: new Abstract: This paper introduces YeasierAgent, an application-building paradigm based on symbiotic agents, narrative worlds, and scene-aware interaction. It challenges the conventional device-coupled model of software by redefining applications as collaborative spaces among users, agents, and worlds. We present a system architecture that achieves two primary contributions: (1) enabling the rapid, cross-platform construction of agent-native applications by utilizing platform-agnostic interactive units (agents, scenes, dialogue) rather than fixed graphical layouts; and (2) unifying the emotional companionship and practical tool execution attributes of intelligent agents within a single experiential sandbox. By integrating automated generation, user-created worlds, and spatial multi-agent collaboration, YeasierAgent formalizes the category of Symbiotic Agent-Native Applications, demonstrating a shift from isolated, tool-specific chatbots toward cohesive, socially embedded computational environments.

21.
arXiv (CS.AI) 2026-06-17

Understanding LLMs in Title-Abstract Screening: From Disagreements to Recommendations

arXiv:2606.17588v1 Announce Type: cross Abstract: Several studies have examined the use of large language models (LLMs) for title-abstract screening in systematic reviews (SRs), reporting mixed accuracy. However, questions of reliability remain largely unaddressed. In this study, we go beyond quantitative LLM-human agreement metrics and qualitatively investigate how and why LLMs fail. We also propose actionable recommendations. We analyzed disagreements between LLMs and researchers across six software engineering SRs and over 1,000 primary study papers. For each SR, papers were screened independently by human experts and LLMs in zero-shot mode, resulting in Kappa values ranging from 0.52 to 0.77. Qualitative analysis suggests that human-LLM disagreement results from recurring, identifiable causes, such as boundary ambiguity in key terms, keyword overemphasization, and incorrect topic inference. Based on these findings, we propose recommendations such as validating semantic understanding before deployment, running multiple LLMs, and focusing validation efforts on borderline cases. Future studies are needed to validate the impact of our recommendations, and community efforts are needed to develop normative guidelines on LLM usage in SRs.

22.
arXiv (quant-ph) 2026-06-16

Comparative Performance Analysis of NIST PQC Standards: From STM32 Software Limitations to FPGA-SoC Acceleration

arXiv:2606.15744v1 Announce Type: new Abstract: The rapid advancement of quantum computing poses a significant threat to classical public-key cryptographic systems, necessitating the transition to Post-Quantum Cryptography (PQC). This study investigates the implementation challenges of NISTstandardized signature schemes on resource-constrained embedded hardware. We present a comparative analysis of SPHINCS+ and CRYSTALS-Dilithium on an ARM Cortex-M4 (STM32F407G) microcontroller. Our findings reveal that SPHINCS+ is practically unusable in this software-only environment, with impractical execution times. Furthermore, the reference Dilithium implementation failed to execute entirely on the MCU due to severe RAM and timing constraints. To overcome these hardware limitations, we integrated a hardware-accelerated Dilithium core onto a Xilinx Zynq-7000 ZedBoard SoC. By implementing a specialized Number Theoretic Transform (NTT) accelerator in the FPGA fabric, we achieved successful execution with performance rates for key generation and signature generation at millisecond levels. These results demonstrate that while pure software PQC is non-viable for standard microcontrollers, a hardware-software codesign approach provides the necessary efficiency for quantumresistant embedded systems.

23.
arXiv (CS.CV) 2026-06-24

Quantum CT via Dynamic Interval Encoding and Prior-Balanced QUBO Reconstruction

Quadratic unconstrained binary optimization (QUBO)-based quantum computed tomography (CT) casts reconstruction as a binary quadratic problem for quantum annealing and hybrid quantum–classical solvers. For grayscale CT, however, image encoding is constrained by the binary-variable budget: fixed global bit-plane encodings increase QUBO size and coupling complexity as gray-level precision improves, whereas low-bit encodings introduce quantization error. We propose a QUBO-based grayscale CT reconstruction framework that combines dynamic interval encoding with prior-balanced optimization. Each refinement round encodes active pixels only within local gray-level intervals around the current estimate, and a boundary-hit-guided update rule adaptively switches between search expansion and local refinement. To improve optimization stability, the method balances projection-domain data consistency and an edge-preserving quadratic prior before forming the final QUBO. Sparse-view and limited-angle fan-beam CT experiments show that the proposed method recovers structures and gray-level distributions more faithfully than the evaluated analytic, iterative, variational, and representation-based baselines. Expressivity analysis and ablation studies further indicate that the improvement mainly arises from effective gray-level representation through dynamic local encoding and more stable data-fidelity–prior coupling. Experiments on the D-Wave hybrid binary quadratic model (BQM) solver further demonstrate that the formulation is executable on a hardware-backed hybrid quantum–classical backend.

24.
arXiv (CS.AI) 2026-06-18

Guava: An Effective and Universal Harness for Embodied Manipulation

arXiv:2606.18363v1 Announce Type: cross Abstract: Language models trained on large-scale vision-language data have demonstrated strong potential for embodied agents. Harnessing models through embodied tools use offers a promising alternative to end-to-end vision-language-action systems by combining high-level reasoning with external modules for perception, planning, and control. However, it remains unclear what makes an effective harness for embodied manipulation, and to what extent such a harness can unlock embodied capabilities in a wide range of reasoning models. In this work, we present Guava, a harness framework for embodied tool use developed through systematic exploration of the design space of agent workflows, action spaces, and observation spaces. Our study identifies three key ingredients for effective embodied agents: iterative perception-reasoning-action loops, semantic action abstractions, and multimodal observations. To understand whether these design principles are universal even to small models, we develop an end-to-end training pipeline that distills embodied manipulation capabilities into a 4B open-source model using fewer than 2K trajectories collected entirely in simulation. Experimental results in both simulation and real-world environments show performance comparable to frontier proprietary models while exhibiting strong generalization to unseen objects, novel instructions, and long-horizon tasks. Results suggest that a well-designed harness can serve as a scalable, model-agnostic interface for embodied manipulation, enabling strong emergent embodied capabilities in compact open-source models with minimal training data.

25.
medRxiv (Medicine) 2026-06-23

Default Handling of the Non-Assessable Verbal Glasgow Coma Scale Misclassifies Illness Severity in Mechanically Ventilated Patients: A Retrospective Analysis

Background: The Glasgow Coma Scale (GCS) is a universal neurologic severity score in the intensive care unit and is incorporated into APACHE, SOFA, mortality prediction models, ICU benchmarking, and quality metrics. In mechanically ventilated patients, however, the verbal component cannot be assessed. Common conventions, including assigning a normal total GCS of 15 or excluding patients with missing verbal scores, may misclassify the sickest patients as neurologically normal or remove them from analysis. Objective: To quantify non-assessable verbal GCS examinations after acute brain injury and determine how different handling conventions affect severity scoring and mortality-model performance across two independent critical care databases. Materials and Methods: We conducted a retrospective cohort study of adults with acute brain injury during their first ICU stay in MIMIC-IV, with replication in eICU-CRD. A verbal examination was considered non-assessable when documented as No Response-ETT. We measured the burden and determinants of non-assessability, compared the MIMIC-IV derived GCS convention with a component-aware GCS, and evaluated mortality-model handling strategies. Results: Among 14,230 patients, 45.2% had a non-assessable verbal examination, and 47.5% of ventilated patients had no assessable verbal score in the first 24 hours. Non-assessability was strongly associated with mechanical ventilation and mortality. The MIMIC-IV derived GCS assigned a score of 15 to 42.9% of patients and placed 11.6% in the lowest severity category despite eye and motor findings consistent with GCS [&le;]9. Complete-case handling excluded 28.5% of patients, who accounted for 50.2% of deaths. Similar distortions were observed in eICU-CRD/APACHE across 171 hospitals. Discussion: Default-to-normal scoring can make severely ill intubated patients appear neurologically normal, while complete-case analysis removes the highest-risk patients. Conclusion: Non-assessable verbal GCS in mechanically ventilated patients should be explicitly flagged and reported in ICU severity scores, risk-adjusted mortality models, and benchmarking systems.