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01.
medRxiv (Medicine) 2026-06-18

Empirical Validation and Predictive Utility of the Perinatal Grief Scale in Men after Perinatal Loss

Authors:
Ravaldi↗Mosconi↗Nespoli↗Fumagalli↗Vannacci↗

Background. The Perinatal Grief Scale (PGS) is a widely used instrument for assessing grief following pregnancy loss, yet no study has validated it specifically in men despite documented use in several studies. This gap is critical given fathers' persistent underrepresentation in perinatal bereavement research and the absence of empirically supported screening thresholds for this population. Methods. This cross-sectional validation study used data from the OPALE project (Observatory on PerinatAL hEalth) conducted by the CiaoLapo Foundation in Italy. Among 276 fathers who experienced stillbirth or miscarriage, we examined criterion validity by testing the association between PGS scores and trauma-related symptomatology assessed via three validated instruments: the Revised Impact of Event Scale (RIES, n=103), National Stressful Events Survey Short Scale (NSESSS, n=95), and SCL-90 (n=173). We systematically tested multiple threshold combinations to identify optimal discriminative performance. Results. The PGS demonstrated excellent criterion validity. The optimal threshold (PGS >=92) showed sensitivity 81.0%, specificity 81.8%, and Youden's J index 0.628. Fathers scoring >=92 had 19.12 times the odds of high trauma symptoms (95% CI: 9.35 to 39.14, p

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

The Missing Knowledge Layer in Cognitive Architectures for AI Agents

Authors:
Micha\"el Roynard↗

arXiv:2604.11364v2 Announce Type: replace Abstract: The two most influential cognitive architecture frameworks for AI agents, CoALA [21] and JEPA [12], both lack an explicit Knowledge layer with its own persistence semantics. This gap produces a category error: systems apply cognitive decay to factual claims, or treat facts and experiences with identical update mechanics. We survey persistence semantics across existing memory systems and identify eight convergence points, from Karpathy's LLM Knowledge Base [10] to the BEAM benchmark's near-zero contradiction-resolution scores [22], all pointing to related architectural gaps. We propose a four-layer decom position (Knowledge, Memory, Wisdom, Intelligence) where each layer has fundamentally different persistence semantics: indefinite supersession, Ebbinghaus decay, evidence-gated revision, and ephemeral inference respectively. Companion implementations in Python and Rust demonstrate the architectural separation is feasible. We borrow terminology from cognitive science as a useful analogy (the Knowledge/Memory distinction echoes Tulving's trichotomy), but our layers are engineering constructs justified by persistence-semantics requirements, not by neural architecture. We argue that these distinctions demand distinct persistence semantics in engineering implementations, and that no current framework or system provides this.

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

WEQA: Wearable hEalth Question Answering with Query-Adaptive Agentic Reasoning

Authors:
Yuwei Zhang↗Tong Xia↗Bianca Emmerich↗Yu Yvonne Wu↗Dimitris Spathis↗Xin Liu↗Daniel McDuff↗Cecilia Mascolo↗

arXiv:2606.18147v1 Announce Type: new Abstract: Language models are remarkably capable at medical question answering, in some cases surpassing the accuracy of general physicians. However, answering questions about wearable health data remains challenging and understudied, as these ubiquitous sensors produce continuous, high-dimensional, and longitudinal data, which is non-trivial to align with text-centric distributions in LLM pretraining. The diversity of sensor modalities and user intents cannot be effectively handled by a fixed reasoning workflow or a single pretrained foundation model. To address these challenges, we propose WEQA, a query-adaptive agent framework that unifies LLM reasoning with specialized wearable analytical and modeling tools. An LLM controller is employed to synthesize execution plans and dynamically route each query to the appropriate combination of sensor analysis and pretrained models, and perform grounded response auditing with external knowledge. We also curate a benchmark spanning four open wearable datasets comprising analytic and predictive tasks in three different health domains. Experiments show that our framework is 24% more accurate than LLM and agentic baselines, and a blinded study with 12 medical experts and 8 users shows substantial gains in usefulness and clinical soundness.

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04.
arXiv (CS.LG) 2026-06-19

DF-ExpEnse: Diffusion Filtered Exploration for Sample Efficient Finetuning

Authors:
Calvin Luo↗Chen Sun↗Shuran Song↗

arXiv:2606.19656v1 Announce Type: cross Abstract: A natural recipe for intelligent robotic decision-making is initializing from pretrained generative control policies, which have summarized offline experience, and adapting them to self-collected online experience. We present DF-ExpEnse, an exploration technique that improves the quality of online experience collection, thus increasing finetuning sample-efficiency. DF-ExpEnse leverages the multimodal modeling capabilities of the generative control policy to create an expressive and tractably evaluatable candidate set. It then utilizes an ensemble of critics to identify the action that best balances quality with high exploration interest. In fleet settings, DF-ExpEnse further enables cross-agent communication to facilitate collaborative exploration as a group. DF-ExpEnse can be seamlessly integrated with existing strategies that finetune pretrained generative control policies via reinforcement learning. We experimentally validate consistent sample-efficiency benefits through DF-ExpEnse across a variety of manipulation and locomotion tasks, compared to default finetuning and alternative action selection schemes. Project can be found at https://df-expense.github.io.

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

A Text Recognition Dataset from Sahidic Coptic Ancient Manuscripts

Authors:
Fabio Quattrini↗Carmine Zaccagnino↗Costanza Bianchi↗Silvia Cascianelli↗Rita Cucchiara↗

In this work, we target Handwritten Text Recognition (HTR) in low-resource scenarios, which arise from underrepresented languages, rare scripts, and degraded visual conditions typical of historical documents. We introduce SCAM (Sahidic Coptic Ancient Manuscripts), a new line-level dataset built from digitized ancient manuscripts written in the extinct Sahidic Coptic dialect. The dataset reflects a realistic and challenging setting, as it combines heterogeneous acquisition conditions across libraries with typical manuscript degradations such as ink fading, bleed-through, and material deterioration. In addition to visual complexity, SCAM poses significant linguistic challenges due to the scarcity of resources for Sahidic Coptic, its uncommon alphabet, and dialect-specific diacritics. To support research in low-resource HTR, we benchmark several state-of-the-art approaches based on different paradigms, highlighting their limitations and strengths in this setting. Our results underline the gap between current HTR performance on well-resourced modern scripts and historically grounded, low-resource scenarios, thus providing a reference point for future developments.

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

Low-Cost Neuromorphic Fall Detection Using Synthetic Event Data and Hybrid SNNs

Authors:
Guillermo Rojas↗Gonzalo Soto↗Daniel Yunge↗

This work presents the development of hybrid models that integrate spiking neural networks (SNNs) with components of convolutional neural networks (CNNs) to learn from simulated event-based camera data (Dynamic Vision Sensor, DVS) generated from conventional smartphone videos. Aimed primarily at human fall detection, the approach leverages the energy efficiency and spatio-temporal processing capabilities of SNNs by converting video frames into event-based data. The proposed models are evaluated through simulations on multiple datasets, comparing their performance to that of traditional machine learning models. Results demonstrate significant gains in efficiency without sacrificing accuracy, underscoring the potential of combining SNNs and DVS technology for complex tasks in real-world environments.

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07.
arXiv (CS.LG) 2026-06-15

Recipe-Controlled Decoder Audit for Structural Knowledge-Graph Completion

Authors:
Xihang Shan↗Ye Luo↗

arXiv:2606.14492v1 Announce Type: new Abstract: We present a recipe-controlled decoder audit (RCDA) for structural transductive knowledge-graph completion (KGC). The audit asks a simple reporting question: before attributing gains to an encoder or training recipe, what changes when the decoder is swapped under the same recipe? Using ComplEx and DistMult as the primary controlled pair, with targeted RotatE/TransE spot-checks, we evaluate seven benchmarks. On five standard KGs, ComplEx-vs-DistMult differences are modest but consistent under our recipe (+0.005 to +0.012 MRR), whereas CompGCN-style encoder effects vary more by dataset. On small KGs, decoder effects become the main diagnostic: Kinship shows a stable ComplEx advantage of +0.143 MRR (6 seeds), while UMLS favours ComplEx by +0.022 MRR in a clean 6-seed server rerun but reverses in an earlier provenance variant. We therefore treat small-KG decoder choice as recipe- and provenance-sensitive rather than as a fixed dataset winner. We further show that decoder choice interacts with encoder depth on WN18RR, and that under our recipe L=0 ComplEx on YAGO3-10 reaches 0.6971 +/- 0.0048 MRR at d=128. The result is a compact audit protocol: report matched decoder rows, log small-KG provenance, and sweep decoder x depth before making encoder-level claims.

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

Variance Reduction for Non-Log-Concave Sampling with Applications to Inverse Problems

Authors:
M. Berk Sahin↗Ahmet Ege Tanriverdi↗Behzad Sharif↗Abolfazl Hashemi↗

arXiv:2606.16257v1 Announce Type: cross Abstract: Sampling from high-dimensional, non-log-concave distributions with unnormalized densities is a fundamental challenge in machine learning, particularly when the exact gradient of the potential is unavailable and must be approximated via stochastic gradients that exhibit high variance under a fixed budget of gradient computations per iteration. Although variance reduction techniques such as SGD with momentum, STORM, and PAGE have demonstrated improved convergence properties in non-convex optimization, their implications for sampling from non-log-concave distributions remain largely unexplored. In this work, we develop the first unified analysis of these estimators for sampling from non-log-concave distributions. We establish improved non-asymptotic convergence rates in $\varepsilon$-relative Fisher information and, under a Poincaré inequality assumption, in squared total variation distance, and further prove weak convergence to the target distribution. We extend our analysis to solving inverse problems with score-based generative priors. We empirically validate our theory and demonstrate that, under a fixed gradient computations per iteration, variance-reduction techniques consistently improve sample quality in two standard imaging applications.

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09.
arXiv (CS.AI) 2026-06-16

ToolMenuBench: Benchmarking Tool-Menu Filtering Strategies for Reliable and Efficient LLM Agents

Authors:
Rahul Suresh Babu↗Laxmipriya Ganesh Iyer↗

arXiv:2606.15508v1 Announce Type: new Abstract: Tool-augmented large language model agents increasingly operate over large tool libraries, but existing evaluations often focus on whether a model can call a tool correctly rather than how the visible tool menu shapes reliability, efficiency, and safety-relevant risk exposure. We introduce ToolMenuBench, a benchmark for evaluating tool-menu construction in multi-step LLM agents. ToolMenuBench varies tool-menu size, distractor type, state-dependent task structure, and risk exposure, and reports both filter-level and downstream agent metrics, including visible-tool count, risky-tool exposure, task success, wrong-tool calls, premature actions, and token usage. In a controlled evaluation across seven model backends, three tool-menu sizes, six filtering methods, and seven evaluation settings, CMTF improves task success from 32.1% under all-tools exposure to 85.7%, while reducing average token usage by roughly 98%. Causal minimal tool filtering achieves the strongest overall tradeoff, reducing visible tools, wrong-tool calls, premature actions, and risky-tool exposure relative to unfiltered exposure, lexical filtering, state-aware filtering, and broader causal-path baselines. ToolMenuBench provides a reusable evaluation framework for studying the agent-interface problem: which tools should be visible, when they should be visible, and under what cost or risk constraints.

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

Normative Robustness as a Frontier for Non-Verifiable Reasoning in LLMs

Authors:
Elizaveta Tennant↗Benjamin Henke↗Anita Keshmirian↗Murray Shanahan↗Verena Rieser↗Kristian Lum↗Sydney Levine↗Julia Haas↗

arXiv:2606.12731v1 Announce Type: new Abstract: As LLMs increasingly serve in advisory and deliberative roles, users rely on them for non-verifiable reasoning in domains lacking objective ground truths. However, traditional evaluations of LLM reasoning focus almost exclusively on fact-based domains, such as mathematics and science, leaving uncertainty over whether and to what degree models can handle ambiguous, subjective, or value-laden problems over time. To address this concern, we propose moral reasoning as a paradigmatic subdomain of non-verifiable reasoning. We define moral robustness as a model's capacity to exhibit sound moral reasoning across time and contexts, and we introduce a scalable, adversarial, multi-turn evaluation framework to empirically measure this capability. We simulate 48,000 user-agent moral deliberations across four frontier LLMs, varying premise relevance, premise order, conversation duration, and the user's stated moral view. We find that models successfully ignore morally-irrelevant distractors, but shift their reasoning by up to 6.5%, on average, towards the user's stated preferred moral view, and varying their reasoning depending on factors such as order (altering moral judgments by order in 13-22% of the cases) and duration (altering moral judgments between single-turn and multi-turn in 10-24% of the cases). Our analysis indicates that models tailor not just their final verdicts but their underlying justifications to align with a user's moral viewpoint - a failure mode we characterize as moral deliberative sycophancy.

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

Q-Fold: Query-Aware Focus-Context Spatio-Temporal Folding for Long Video Understanding

Authors:
Biao Tang↗Xu Chen↗Shuxiang Gou↗Jingyi Yuan↗Yuhan Zhang↗Chenqiang Gao↗

Long-video understanding remains challenging for multimodal large language models, because temporally extended videos often contain thousands of frames and are therefore expensive to process exhaustively. Existing methods usually construct compact visual inputs from long videos under a limited visual budget. However, most of them still follow a frame-centric paradigm and apply similar representations to retained content regardless of its importance. This makes it difficult to preserve both high-fidelity visual evidence and broad temporal coverage. To address this issue, we propose Q-Fold, a training-free input construction framework for long-video understanding. Instead of treating isolated frames as the basic modeling unit, Q-Fold operates on contiguous temporal segments and constructs a heterogeneous Focus–Context representation under query guidance. Query-relevant segments are preserved as high-fidelity Focus Frames, while less relevant segments are folded into chronology-preserving contextual layouts. In this way, Q-Fold preserves critical visual evidence and broad temporal coverage, while better maintaining local temporal continuity within short segments. Experiments on four long-video benchmarks with multiple Video-MLLMs show that Q-Fold consistently improves performance without increasing the input budget. Notably, it achieves gains of up to 9.1 percentage points on an ultra-long video benchmark. Code will be made publicly available.

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

LLMs+Graphs: Toward Graph-Native, Synergistic AI Systems

Authors:
Arijit Khan↗Longxu Sun↗Xin Huang↗

arXiv:2606.11560v1 Announce Type: cross Abstract: Large Language Models (LLMs) have advanced rapidly, but their limitations in structured and multi-hop reasoning underscore the need for graph-native, synergistic artificial intelligence (AI) systems. Graph-structured data underpins critical applications across social, biological, financial, transportation, web, and knowledge domains, making it essential to understand how LLMs can leverage graph computation for grounded, context-rich inference. Three complementary synergies are emerging: LLMs augmented with graph computation for retrieval and reasoning; bidirectional integration between LLMs and knowledge graphs (KGs), where LLMs support KG construction and curation while KGs enforce semantic constraints and factual consistency; and AI agents strengthened by graph algorithms for planning, decision making, and multi-step reasoning. In parallel, LLMs introduce new capabilities for graph data management and graph machine learning (ML) through natural language interfaces and hybrid LLM-graph neural network (GNN) pipelines. This tutorial synthesizes the algorithms, systems, and design principles driving these converging directions, offering data science and data mining researchers a unified perspective on integrating LLMs, graph data management, graph mining, graph ML, and agentic computation into next-generation graph-native AI systems.

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

Multi-Head Attention-Based Feature Extractor Integration with Soft Actor-Critic for Porosity Prediction and Process Parameter Optimization in Additive Manufacturing

Authors:
Kianoush Aqabakee↗Leonardo Stella↗

arXiv:2606.20087v1 Announce Type: new Abstract: Additive manufacturing process optimization requires precise parameter control to minimize defects such as porosity. Traditional reinforcement learning (RL) approaches using discrete action spaces suffer from slow convergence and susceptibility to local optima, limiting their effectiveness for high-precision manufacturing tasks. This study addresses these limitations by employing a continuous action space combined with a novel architecture that integrates a multi-head attention mechanism with the Soft Actor-Critic (SAC) algorithm. The attention-based feature extractor enhances the agent's ability to capture subtle variations in low-dimensional input features, enabling more effective exploration-exploitation balance for navigating value spaces with local minima. We validate our approach on porosity prediction and process parameter optimization in laser powder bed fusion, demonstrating faster convergence and higher final reward values compared to standard RL methods including DQN, PPO, TD3, and vanilla SAC. The proposed methodology achieves a convergence value of 322.79 within 14 episodes, outperforming existing approaches while maintaining stability throughout training.

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

V2P-Manip: Learning Dexterous Manipulation from Monocular Human Videos

Authors:
Kaihan Chen↗Yanming Shao↗Haifeng Ji↗Xiaokang Yang↗Yao Mu↗

Achieving autonomous robotic dexterous manipulation requires precise, human-like action sequences at scale. As a scalable supplement to costly teleoperation data, extracting trajectories with both visual fidelity and physical plausibility from monocular videos represents a promising frontier in embodied AI. To this end, we introduce V2P-Manip, an efficient framework designed to learn dexterous manipulation policies directly from human demonstration videos. We establish an efficient, integrated pipeline encompassing 3D asset acquisition, trajectory estimation, and dexterous policy learning. To bridge the gap between visual perception and physical constraints, we introduce a two-stage refinement process to enforce spatial alignment and physical consistency. Evaluations on the TACO and OakInk benchmarks demonstrate that our approach significantly outperforms previous methods in pose accuracy, adaptability to unstructured environments, and training efficiency. Ultimately, experimental results confirm an average success rate of over 75% across multiple synthetic manipulation tasks and validate the adaptability of the extracted manipulation priors across diverse dexterous hand embodiments.

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

A Neuromorphic Reinforcement Learning Framework for Efficient Pathfinding in Robotic Mobile Fulfillment Systems

Authors:
Junzhe Xu↗Zecui Zeng↗Lusong Li↗Yuetong Fang↗Renjing Xu↗

arXiv:2606.20031v1 Announce Type: cross Abstract: Dynamic environmental changes, confined workspaces, and stringent real-time constraints make pathfinding in Robotic Mobile Fulfillment Systems (RMFS) a challenging problem for conventional search- and rule-based methods, which typically suffer from high computational complexity and long decision latency. While reinforcement learning (RL) has emerged as a powerful alternative, deploying learned policies with extreme energy efficiency on resource-constrained hardware remains an open challenge. We present SDQN-RMFS, an end-to-end framework that achieves high-fidelity deployment of an RL-trained policy from a full-precision artificial neural network (ANN) through to a neuromorphic chip. By computing only when triggered by sparse events, this framework unlocks ultra-low-power RMFS pathfinding. Our full-stack pipeline operates as follows: an ANN policy is first efficiently trained via a collision-allowing strategy to densify informative trajectories, and then converted into a spiking neural network (SNN) via a hard-label knowledge distillation approach. This effectively addresses the output distribution mismatch, preserving policy capability across the ANN-to-SNN pipeline while substantially reducing inference latency. Hardware experiments demonstrate up to 11,281$\times$ energy savings and a nearly two-fold reduction in latency compared to a high-performance GPU baseline, while maintaining decision quality on par with the original trained policy. These results establish physical neuromorphic inference as a practical and energy-sustainable pathway for large-scale RMFS operations.

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16.
medRxiv (Medicine) 2026-06-22

Efficacy and safety of semaglutide for obesity and hyperphagia in adults with Prader-Willi syndrome

Authors:
Ahmed↗Bridges↗Goldstone↗A. P↗

Context: Prader-Willi syndrome is a genetic neurodevelopmental disorder characterized by hyperphagia and early-onset obesity from hypothalamic dysfunction with endocrinopathies and learning disability. Management is challenging with strict control of the food environment needed. While newer glucagon-like peptide-1 receptor agonists, such as semaglutide, have efficacy in non-PWS obesity, there have been limited case reports in PWS. Objective/Design/Setting: Retrospective records review of 12 adults with PWS and overweight/obesity treated with semaglutide at a UK academic hospital centre specialist clinic. Patients: mean +/- SD age 28.3 +/- 10.1 years, 83% female, BMI 46.6 +/- 8.2kg/m2, 75% type 2 diabetes mellitus. Intervention: Median follow-up 17.2 months (range 8.7-36.1) with median semaglutide dose 2.4mg once weekly (1.0-2.4). Results: Although there was no significant weight loss on semaglutide, there was stabilisation of the weight gain prior to treatment over previous 12.4 months (7.6-23.0) (post -3.1 +/- 9.9% vs. pre +5.7 +/- 5.6%: d -0.72, P=0.037). There was a significant decrease in hyperphagia on semaglutide from hyperphagia questionnaire for clinical trials (n=11, -7.3 +/- 6.1 (max 36), d -1.19, P=0.003), having been stable before treatment. HbA1c improved in those with elevated baseline levels (n=6, -4.2 +/- 4.9%, d -0.74, P=0.13). Mild gastrointestinal side effects were seen in 25% but did not lead to discontinuation. Conclusions: In adults with PWS, semaglutide produced weight maintenance, reduced hyperphagia, and improved glycaemic control, with good tolerability. Larger placebo-controlled trials are needed to confirm these findings in adults and adolescents with PWS, especially in those without T2DM, where efficacy may be greater.

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

How far have we gone in Generative Image Restoration? A study on its capability, limitations and evaluation practices

Authors:
Xiang Yin↗Jinfan Hu↗Zhiyuan You↗Kainan Yan↗Yu Tang↗Chao Dong↗Jinjin Gu↗

Generative Image Restoration (GIR) has achieved impressive perceptual realism, but how far have its practical capabilities truly advanced compared with previous methods? To answer this, we present a large-scale study grounded in a new multi-dimensional evaluation pipeline that assesses models on detail, sharpness, semantic correctness, and overall quality. Our analysis covers diverse architectures, including diffusion-based, GAN-based, PSNR-oriented, and general-purpose generation models, revealing critical performance disparities. Furthermore, our analysis uncovers a key evolution in failure modes that signifies a paradigm shift for the perception-oriented low-level vision field. The central challenge is evolving from the previous problem of detail scarcity (under-generation) to the new frontier of detail quality and semantic control (preventing over-generation). We also leverage our benchmark to train a new IQA model that better aligns with human perceptual judgments. Ultimately, this work provides a systematic study of modern generative image restoration models, offering crucial insights that redefine our understanding of their true state and chart a course for future development.

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19.
arXiv (CS.LG) 2026-06-12

How Far Can Chord-Symbol Time-Series Adaptation Carry Genre Identity? Capabilities and Boundaries in Multi-Genre Chord-Symbol Modeling

Authors:
Jinju Lee↗

arXiv:2606.07334v2 Announce Type: replace-cross Abstract: This report treats chord-symbol sequences as an interpretable, controllable time series for genre-local harmonic modeling. The frozen Music Transformer base - released as a pop-jazz fine-tune endpoint but verified in this revision weight-identical to the pop-only Phase-0 baseline, so all gains are measured over a pure-pop prior (see Changes in v2) - is extended to eleven target genres: blues, bossa nova, Bach chorales, country, electronic, folk, funk, gospel, hip-hop, R&B/soul, and rock. The main evaluation compares LoRA, IA3, BitFit, prefix tuning, and full fine-tuning over 11 genres and 3 seeds, a complete 165-cell grid. All five methods improve over the frozen base on held-out chord prediction (macro gains +2.89 to +3.61 percentage points); LoRA and IA3 score highest, but pairwise Wilcoxon tests with Holm and Benjamini-Hochberg correction do not support a decisive winner. A matched-data-size control sharpens this: at a common corpus size IA3 stays on top while LoRA drops to last, so the small method gaps are partly data-driven rather than representational. A control-token baseline is also strong, and wrong-genre adapters often beat the frozen base, suggesting the adaptation effect is largely lightweight conditioning over a reusable harmonic base rather than genre-specific adapter memory. Further diagnostics (rank sweeps, wrong-genre rotation, a base-checkpoint ablation that v2 reinterprets as a same-weights control, chord-only genre classification, output-distribution statistics, real-song evaluation, duplicate analysis) support a bounded conclusion: chord-symbol adaptation reliably improves genre-local harmonic prediction, but chord symbols alone do not carry complete genre identity. Perceived genre authenticity and musical quality are left to controlled listener evaluation.

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20.
PLOS Medicine 2026-05-21

U = U for all: Advancing equity in HIV prevention

Authors:
Thiago S. Torres↗

by Thiago S. Torres, Paula M. Luz Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U = U). However, U = U literacy remains unevenly understood and shared, and stigmas persist. Equitable and accurate awareness of U = U requires culturally tailored interventions, improved provider education, and supportive policy environments beyond biomedical evidence alone. Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U=U). However, U=U literacy remains unevenly understood and shared, and stigmas persist. In this Perspective, Thiago Torres and Paula Luz outline what is needed to improve equity and accuracy in global awareness and education of U=U.

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21.
medRxiv (Medicine) 2026-06-17

Postoperative Cognitive Decline in Older Patients with Cardiovascular Disease and Preoperative Mild Cognitive Impairment

Authors:
Mata Gonzalez↗Gonzalez-Colaco Harmand↗Prada-Arrondo↗P. C↗Dominguez-Rodriguez↗Barroso↗Galtier↗

Objective. Older adults undergoing cardiac surgery may be vulnerable to postoperative cognitive decline. However, no studies have examined postoperative cognitive outcomes in older patients with cardiovascular disease (CVD) according to preoperative mild cognitive impairment (MCI). This study examined 12-month postoperative cognitive outcomes in older CVD patients according to preoperative MCI diagnosis and explored predictors of postoperative cognitive decline. Method. Twenty-two older CVD patients ([≥]65 years) and twenty-five controls were included. Neuropsychological assessment was conducted at baseline in both groups and repeated 12 months after surgery in the CVD group. MCI was diagnosed using current clinical criteria. Postoperative cognitive change was examined across preoperative MCI groups. Results. Fifty percent of patients met criteria for postoperative MCI, showing high diagnostic stability relative to preoperative frequency (45.5%). The preoperative CVD-MCI group showed a decline in working memory, executive functions, visual memory, and naming, whereas CVD-nMCI group declined only in verbal memory. Furthermore, CVD-MCI showed more heterogeneous postoperative cognitive trajectories of change than CVD-nMCI, who showed stability. Estimated IQ, APACHE-II score, and postoperative frailty were important variables in predicting the postoperative pattern. Conclusions. MCI frequency remained high and stable in older CVD patients across the preoperative and one-year postoperative period. However, this apparent diagnostic stability masks subclinical cognitive decline, particularly among patients with preoperative MCI, who showed greater susceptibility to further impairment. Estimated IQ, APACHE-II score, and postoperative frailty may be considered relevant predictors of outcome. These results highlight the value of preoperative neuropsychological assessment for characterizing postoperative cognitive risk in older CVD patients.

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22.
arXiv (CS.LG) 2026-06-16

Schattor: Schatten-family methods for deep learning optimization

Authors:
Bohao Ma↗Junyu Zhang↗Chuan He↗

arXiv:2606.15702v1 Announce Type: cross Abstract: Modern deep learning optimization features heterogeneous parameter structures, noisy gradients, and highly nonconvex landscapes, posing significant challenges for both algorithm design and theoretical analysis. Motivated by the limitations of SGD and the success of adaptive optimizers, we propose {\it Schattor}, a family of adaptive first-order methods based on Schatten norms. Schattor unifies SGD and the recently proposed matrix-variate adaptive optimizer Muon within a single Schatten-norm-based framework. We establish dimension-free stationarity guarantees for methods in the Schattor family for stochastic matrix optimization problems via a novel matrix martingale moment bound. We also develop multi-block extensions that adaptively balance block-wise optimization progress and prove dimension-free stationarity guarantees in this more general setting.

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23.
arXiv (CS.AI) 2026-06-19

Beyond Static Endpoints: Tool Programs as an Interface for Flexible Agentic Web Services

Authors:
Mugeng Liu↗Shuoqi Li↗Yixuan Zhang↗Yun Ma↗

arXiv:2606.19992v1 Announce Type: cross Abstract: In the agentic web era, LLM-based agents increasingly invoke web services as tools, yet most interfaces remain static endpoints that poorly express long-horizon workflows with loops, conditionals, joins, and retries. We present ToolPro, which represents an agent's tool intent as an executable tool program that compactly encodes multi-step service interactions with explicit effect types. ToolPro combines constraint-guided program construction, effect-aware replay for exactly-once state-modifying calls, and a profile-driven policy that decides when program execution outperforms stepwise calling. We instantiate ToolPro over MCP-style services with WebAssembly sandboxing and evaluate it on diverse workflows of real-world applications. ToolPro reduces end-to-end latency by up to 53.4\% and client-side traffic by up to 96.1\%, with larger gains under higher network latency and workflow complexity.

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

The Quality-Utility Paradox: Why High-Reward Data Impairs Small Model Mathematical Reasoning

Authors:
Haolong Qian↗Xianliang Yang↗Yinuo ma↗Lirong Che↗Feng Lu↗Ye Guo↗Lei Song↗Jiang Bian↗Chun Yuan↗

arXiv:2606.16152v1 Announce Type: new Abstract: Knowledge distillation from powerful reasoning models is widely used to improve Small Language Models (SLMs) on mathematical reasoning, often assuming that traces with higher reward model scores provide more useful supervision. We identify a counterintuitive Quality-Utility Paradox in mathematical reasoning distillation. Data refined or synthesized by a stronger Oracle obtains higher perceived quality according to reward models, yet consistently underperforms traces generated by the SLM itself and selected through rejection sampling across Qwen2.5, LLaMA-3, and DeepSeek families. Our analysis shows that Oracle refinement couples logical repair with distributional drift away from the SLM's native reasoning distribution. This drift increases the learner's adaptation cost and can outweigh the benefit of improved reasoning logic. To test this mechanism, we introduce Style-Aligned Refinement, which preserves the native trajectory of the SLM while retaining logical repair from the Oracle. This intervention lowers adaptation cost and restores downstream utility. These findings suggest that effective mathematical reasoning distillation should jointly optimize perceived solution quality and learner-data compatibility, rather than relying solely on reward-model scores. The datasets and code are available at https://github.com/Dracoqhl/Quality-Utility-Paradox.

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

Transfer Learning for FHIR Questionnaire Terminology Binding

Authors:
Maxim Gorshkov↗

Electronic prior authorization workflows require FHIR Questionnaire items to carry LOINC codes, yet most items in the HL7 Da Vinci CDS-Library lack these bindings. We treat this as a retrieval problem: given a Questionnaire item's text, find the correct LOINC code in a pool of 97,314 active codes. We compare six methods (TF-IDF, frozen MiniLM, BioBERT, BioLORD, contrastively fine-tuned MiniLM, and a TF-IDF+GPT reranker) on a 54-item evaluation set spanning three query styles (natural question, medium, and terse). No single method wins on every metric. BioLORD, a frozen encoder pre-trained on biomedical ontology definitions, has the best top-rank accuracy (R@1 = 0.185, MRR = 0.246) despite seeing no task-specific data, while a contrastive fine-tune on raw LHC-Forms pairs takes R@5 (0.389) and R@10 (0.426). A distribution-shift ablation shows why the fine-tune in our main table is not the strongest one: adding GPT-generated paraphrases to the raw pairs drops R@5 from 0.389 to 0.296, so the augmented union underperforms raw-only training on every metric except R@1. Performance peaks at 5k training pairs. Error analysis on BioLORD's R@1 failures shows that wrong-specificity and ambiguous-text cases together account for 59% of errors.

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