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01.
arXiv (CS.AI) 2026-06-25

TRUSTMEM: Learning Trustworthy Memory Consolidation for LLM Agents with Long-Term Memory

arXiv:2606.25161v1 Announce Type: new Abstract: Large language model (LLM) agents rely on long-term memory to support extended interactions and personalized assistance beyond finite context windows. Existing memory agents actively update external memory through generated write, revise, and delete operations, but these updates may omit important information, corrupt existing memory, or introduce unsupported hallucinated content. Once stored, such errors become persistent system-state failures that can affect future reasoning and generation. In this paper, we propose TrustMem, a framework designed to improve the trustworthiness of memory consolidation. TrustMem relies on a Memory Transition Verifier to evaluate the transition process of memory updates in terms of coverage, preservation, and faithfulness. It further constructs preference pairs among candidate updates under the same memory state, enabling preference-guided reinforcement learning to directly optimize memory updating behaviors. Extensive experiments demonstrate that TrustMem improves both memory utility and reliability: it achieves state-of-the-art results across MemoryAgentBench, HaluMem, and the Mem-alpha validation set, improves HaluMem memory extraction by 12.14 F1 points, and reduces transition-level omission, corruption, and hallucination by 40.1\%, 79.1\%, and 50.0\%, respectively, compared with the strongest baseline for each error type.

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

Resource-Efficient Variational Quantum Classifier

arXiv:2511.09204v3 Announce Type: replace-cross Abstract: We introduce the unambiguous quantum classifier based on Hamming distance measurements combined with classical post-processing. The proposed approach improves classification performance through a more effective use of ansatz expressivity, while requiring significantly fewer circuit evaluations. Moreover, the method demonstrates enhanced robustness to noise, which is crucial for near-term quantum devices. We evaluate the proposed method on a breast cancer classification dataset. The unambiguous classifier achieves an average accuracy of 90%, corresponding to an improvement of 6.9 percentage points over the baseline, while requiring eight times fewer circuit executions per prediction. In the presence of noise, the improvement is reduced to approximately 3.1 percentage points, with the same reduction in execution cost. We substantiate our experimental results with theoretical evidence supporting the practical performance of the approach.

03.
arXiv (quant-ph) 2026-06-25

Forced Gap Post-Selection for Quantum LDPC Codes and their Operations

arXiv:2605.20346v2 Announce Type: replace Abstract: We develop a simple and general post-selection strategy for high-rate quantum codes that is transferrable across decoders. After an initial baseline run, the decoder is re-run once per logical observable, and forced in these latter runs to provide a solution where the given observable has the complementary outcome. Shots are rejected that find logically complementary solutions with similar likelihoods compared to the baseline. Using the Relay-BP decoder, we benchmark the strategy on the $72$-qubit and $144$-qubit bivariate bicycle codes, as well as surgery gadgets for the latter. In comparison to previous post-selection strategies, our results offer an improved logical error rate by over a factor of $4$ on the same circuit and physical error rate, and at the same rate of post-selection. Our strategies are also lightweight, relying only on FPGA-friendly belief propagation, whereas the previous best used repeated rounds of a high-latency BP-OSD decoder.

04.
arXiv (CS.CV) 2026-06-18

Learning Patient-Specific Disease Dynamics with Latent Flow Matching for Longitudinal Imaging Generation

Understanding disease progression is a central clinical challenge with direct implications for early diagnosis and personalized treatment. While recent generative approaches have attempted to model progression, key mismatches remain: disease dynamics are inherently continuous and monotonic, yet latent representations are often scattered, lacking semantic structure, and diffusion-based models disrupt continuity with random denoising process. In this work, we propose to treat the disease dynamic as a velocity field and leverage Flow Matching (FM) to align the temporal evolution of patient data. Unlike prior methods, it captures the intrinsic dynamic of disease, making the progression more interpretable. However, a key challenge remains: in latent space, Auto-Encoders (AEs) do not guarantee alignment across patients or correlation with clinical-severity indicators (e.g., age and disease conditions). To address this, we propose to learn patient-specific latent alignment, which enforces patient trajectories to lie along a specific axis, with magnitude increasing monotonically with disease severity. This leads to a consistent and semantically meaningful latent space. Together, we present $\Delta$-LFM, a framework for modeling patient-specific latent progression with flow matching. Across three longitudinal MRI benchmarks, $\Delta$-LFM demonstrates strong empirical performance and, more importantly, offers a new framework for interpreting and visualizing disease dynamics.

05.
arXiv (CS.AI) 2026-06-25

Training for the Model You Return: Improving Optimization for Iterate-Averaged Language Models

arXiv:2606.25086v1 Announce Type: cross Abstract: Many modern Language Model (LM) pipelines return an averaged model, such as an exponential moving average of the training iterates, rather than the final iterate itself. This raises a fundamental question: given that we will return an iterate average, how should we change training to improve the performance of this average? We study this question by formulating optimizer design for the iterate-average estimator as an optimal-control problem. In a continuous-time stochastic quadratic model, we solve for the control strategy that minimizes the error of the returned average subject to a penalty on the size of the intervention. A practical approximation to this controller yields PACE, a lightweight wrapper around AdamW that pulls the live weights toward their exponential moving average with a clipped, per-coordinate control strength. We prove that a stylized version of PACE converges at the standard stochastic convex optimization rate, up to a factor depending on the averaging rule, while in the quadratic setting it can strictly improve the limiting squared error of the iterate-average estimator and can do so by an arbitrarily large factor on some instances. Empirically, our results suggest that PACE improves over AdamW and EMA-evaluated AdamW in supervised fine-tuning of 1-2B parameter LMs and in GPT-2 pretraining on FineWeb for a wide range of learning rates, decay schedules, and other hyperparameters.

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

Utility-Constrained Policy Optimization

arXiv:2606.14029v1 Announce Type: new Abstract: Constrained MDPs (CMDPs) are a widely adopted framework for incorporating safety into RL agents; however, the framework does not support risk-sensitive constraints. This can be problematic: For example, CMDPs allow for optimal solutions that, in order to satisfy the risk-neutral constraints, mix infrequent catastrophic behaviors and frequent, overly conservative ones. Moreover, prior empirical results suggest that enforcing stricter, risk-sensitive constraints can improve performance even under risk-neutral evaluation. The natural framework to incorporate risk-sensitive constraints is utility-constrained MDPs (UCMDPs), but no practical solutions for this problem existed. In this work, we introduce a simple yet powerful methodology for UCMDPs and constrained RL. Besides allowing for risk-sensitive constraints, our framework does not require us to fix constraint limits in advance of training the agent, provided that a sensible range is known. This increases policy flexibility and, in practice, allows for adjustments to these limits at no extra training cost. Besides benefiting from the generality of the framework, our agent shows strong performance in practice, consistently matching or outperforming existing baselines in several Safety Gymnasium benchmark tasks.

07.
arXiv (CS.LG) 2026-06-24

Flow-Corrected Thompson Sampling for Non-Stationary Contextual Bandits

arXiv:2606.23933v1 Announce Type: cross Abstract: We study non-stationary linear contextual bandits where the reward model drifts over time, rendering classical contextual bandit algorithms brittle because historical data becomes systematically biased. We propose Flow-Corrected Thompson Sampling (fcTS), a Bayesian method that reuses experience by transporting past rewards to the present using an explicit drift model and incorporating each transported observation with a confidence weight that reflects transport reliability. This yields a unified template that specializes in (i) linear parameter drift via online slope estimation and reward correction, (ii) periodic variation via phase-aware reuse across cycles, and (iii) recurring regime switches via changepoint detection and regime-specific posterior memory. The resulting posterior updates remain closed-form under a linear Gaussian model and can be implemented efficiently with truncated, incrementally updated sufficient statistics. Across five controlled case studies and a semi-synthetic portfolio-selection benchmark with multiple overlapping non-stationarities, fcTS outperforms standard forgetting-based baselines (discounting, sliding windows, and periodic restarts), with the largest gains in settings exhibiting recurring temporal structure. These results demonstrate that when non-stationarity is structured, correcting and reweighting historical observations can be substantially more sample-efficient than uniformly discarding them.

08.
bioRxiv (Bioinfo) 2026-06-24

A comprehensive analysis of calreticulin mutants reveals distinct biophysicochemical proprieties with a potential for refined targeted therapies

Calreticulin mutations in myeloproliferative neoplasms result in the replacement of the C-terminus acidic sequence with a positively charged tail that causes pathological activation of the thrombopoietin. The two canonical variants are Type-1 and Type-2. The remaining are mainly classified as Type-1 or Type-2 like based on the wild type sequence retained. Here, we performed in silico biophysicochemical analyses of 76 CALR exon 9 frameshift variants by their sequence and predicted biophysical properties, complemented by structural modeling of the mutant homodimers. Beyond confirming the Type-1 versus Type-2 distinction, we found that the Type 1-like variants form a continuum of charge architecture along which two reproducible subgroups can be identified, rather than sharply separated classes. This work refines the conventional mechanism-based classification into a charge-resolved framework and provides testable hypotheses linking novel-tail chemistry to receptor activation in CALR-mutant neoplasms and paves the way for improved targeted therapies based on individual mutants characteristics

09.
arXiv (quant-ph) 2026-06-12

From 2D Yang-Mills to Calogero-Sutherland via a colored particle

arXiv:2606.13388v1 Announce Type: cross Abstract: We study Yang-Mills theory coupled to a particle on a cylinder, where gauge invariance and compactness reduce the dynamics to a finite dimensional quantum system. In the Abelian case, this yields a model equivalent to the Landau problem on a torus, with a degenerate ground state structure. We generalize this construction to non-Abelian gauge groups and show that, for SU(N), the system reduces to a one dimensional quantum many body problem with a singular Calogero-Sutherland-type interaction.

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

Clipping Makes Distributed and Federated Asynchronous SGD Robust to Stragglers

arXiv:2606.13287v1 Announce Type: new Abstract: In modern machine learning, parallelization of training is an important strategy for increasing scale. Asynchronous stochastic gradient descent (ASGD), which maximizes the utilization of available hardware by avoiding waiting for slow workers. However, with constant step sizes, the convergence of ASGD is nonetheless affected negatively by slow workers due to large delays in updates. At the same time, it has been empirically observed in asynchronous training of deep learning models that gradient clipping "stabilizes" training. In this work, we provide a theoretical justification for this behavior, as we show that clipping removes the dependence of the maximum delay in the oracle complexity. We employ a sub-Weibull model of gradient noise which generalizes sub-Gaussian and sub-exponential distributions to more heavy-tailed distributions, motivated by empirical observations in deep learning. We show convergence in expectation, and the first time in asynchronous optimization, convergence with high probability.

11.
medRxiv (Medicine) 2026-06-11

Conversational Speech for Respiratory Triage in Primary Care: A Pilot Study

作者:

Background. Respiratory complaints account for a substantial share of adult ambulatory care visits, and triaging them accurately has direct consequences for antibiotic stewardship and pathogen-specific therapy. Prior work has investigated voice as a triage signal, but that literature is dominated by single-condition detection from scripted speech in crowdsourced or controlled clinical settings and has not been evaluated at primary care scale on conversational ambient audio. Methods. A dataset of 514,377 ambient-recorded primary care visits from 379,225 adult patients at a US clinic network was used, with per-visit clinically assigned ICD-10 diagnosis codes and de-identified demographic and geographic metadata. Patient audio was extracted from each doctor-patient conversation, and spectral, voice quality, and prosodic features were computed. Eleven binary classification tasks were defined, aligned with a respiratory triage cascade (e.g., acute respiratory versus acute non-respiratory illness, and lower versus upper respiratory tract infection). An acoustic model (feed-forward network) was trained independently for each task using patient-stratified five-fold cross-validation and evaluated on a held-out test set. Each task's model was also compared against six non-acoustic baselines using a single demographic, geographic, or temporal variable. The 11 trained classifiers were composed into a hierarchical cascade and illustrated as case studies on selected patients. Results. Test-set AUC across the 11 tasks ranged from 0.602 (95% CI: 0.588-0.614) to 0.745 (95% CI: 0.742-0.748), with a mean expected calibration error of 0.018. Six of eleven binaries outperformed all confounder baselines. Four binaries showed median within-stratum AUC of 0.62-0.70 when the confounder was held fixed, indicating acoustic discrimination beyond what the confounder alone explains. The exception was the pneumonia versus non-pneumonia lower respiratory tract infection binary, which failed against the patient-city confounder baseline, plausibly reflecting a clinic-level difference in ICD-10 coding. Conclusion. Conversational primary care audio carries acoustic signal that discriminates clinically meaningful respiratory contrasts. Absolute performance is moderate, but the conditions are stricter than prior work: conversational speech and differential-diagnosis contrasts among sick patients. This pilot study is a baseline for voice-based clinical AI moving beyond sick-versus-healthy detection toward differential-diagnosis panels and a proof-of-concept for hierarchical reasoning.

12.
arXiv (CS.LG) 2026-06-17

Dropout Neural Network Training Viewed from a Percolation Perspective

arXiv:2512.13853v2 Announce Type: replace Abstract: In this work, we investigate the existence and effect of percolation in training deep Neural Networks (NNs) with dropout. Dropout methods are regularisation techniques for training NNs, first introduced by G. Hinton et al. (2012). These methods temporarily remove connections in the NN, randomly at each stage of training, and update the remaining subnetwork with Stochastic Gradient Descent (SGD). The process of removing connections from a network at random is similar to percolation, a paradigm model of statistical physics. If dropout were to remove enough connections such that there is no path between the input and output of the NN, then the NN could not make predictions informed by the data. We study new percolation models that mimic dropout in NNs and characterise the relationship between network topology and this path problem. The theory shows the existence of a percolative effect in dropout. We also show that this percolative effect can cause a breakdown when training NNs without biases with dropout; and we argue heuristically that this breakdown extends to NNs with biases.

13.
arXiv (CS.CV) 2026-06-18

Moving Beyond Diversity: Visual Token Pruning as Subspace Reconstruction for Efficient VLMs

Despite their remarkable performance, Vision Language Models (VLMs) incur substantial computational overhead due to the large number of visual tokens. While diversity maximization has become a dominant strategy for token reduction, existing methods rely on cosine-based normalized similarity that discards magnitude information, failing to faithfully approximate the original feature representation and leading to suboptimal performance, particularly on compositional multi-skill reasoning tasks. In this paper, we introduce SPARE, a subspace reconstruction method that reformulates token pruning as a column subset selection problem and explicitly minimizes reconstruction error. By iteratively selecting tokens with large projection residuals, SPARE performs reconstruction-driven pruning beyond angular diversity. Moreover, we reveal a counterintuitive anti-relevance phenomenon: tokens with lower image-text relevance score can better preserve contextual information. Based on this finding, we incorporate anti-relevance into SPARE as an additional selection criterion to promote context-aware token selection. Extensive experiments across multiple VLMs and benchmarks demonstrate that SPARE consistently achieves state-of-the-art performance, with strong gains on compositional tasks. When applied to LLaVA, SPARE removes up to 94% of visual tokens while retaining 95% of the baseline performance, all in a fully training-free manner.

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

Neural Architectures as Functional Priors in Physics-Informed Control Problems

arXiv:2606.19368v1 Announce Type: cross Abstract: In this work we investigate the role of neural architectures as implicit functional priors in control problems governed by ordinary differential equations. Rather than focusing on highly complex problems, our objective is to investigate architecture-dependent effects in controlled dynamical systems within the simplest physically interpretable settings possible. In particular, we study a controlled linear RLC electrical circuit and a nonlinear Duffing-type dynamical system. Both systems are analyzed first through classical optimal-control formulations and later through PINN-based approaches. We compare different combinations of multilayer perceptrons (MLPs) and Fourier-based KAN-like architectures, and analyze their influence on the resulting controls. The numerical experiments suggest that different architectural choices systematically generate qualitatively distinct controls, even under identical governing equations, loss functionals, initial and target states, training parameters and physical constraints. Significant differences appear in the spectral structure, smoothness, energy distribution, and phase-space behavior of the learned solutions. A central observation of this work is the emergence of a functional specialization phenomenon when the neural architectures are allowed sufficient freedom to shape the structure of the learned controls. More specifically, in the systems considered here, Fourier-based architectures tend to produce trajectories with richer oscillatory content, whereas smoother low-frequency-biased architectures tend to generate more regular and energetically efficient controls. This suggests that different functional components of the control problem may be handled more efficiently by different neural architectures, leading to an implicit specialization between state representation and control generation.

15.
Nature Medicine 2026-06-24

Automated reanalysis of genomic data for rare disease diagnostics at scale

Reanalysis of genomic data in rare disease is highly effective in increasing diagnostic yields but remains limited by manual approaches. Automation and optimization for high specificity will be necessary to ensure scalability, adoption and sustainability of iterative reanalysis. We developed Talos, an open-source tool that automates variant prioritization by integrating dynamically updated gene−disease and variant-level evidence with inheritance-aware filtering and validated its performance using data from 1,089 individuals with rare disease. Trio-based analysis identified 90% of known diagnoses, returning 1.3 variants per case on average. Variant burden reduced to one variant per 200 cases on iterative monthly reanalysis. Application to an unselected cohort of 4,735 undiagnosed individuals identified 241 diagnoses (5.1% yield): 78 (32%) due to new gene−disease relationships, 54 (22%) due to new variant-level evidence and 109 (45%) due to improved analysis strategies. Our automated, iterative reanalysis model demonstrates the feasibility of delivering frequent, systematic reanalysis at scale. Talos, a new tool for the automated analysis of genomic data, demonstrates the feasibility and diagnostic utility of systematic reanalyses of data in rare diseases.

16.
arXiv (CS.CL) 2026-06-12

KCSAT-ML: Probing Reasoning Models with Nationwide-Cohort Human Difficulty

Math reasoning benchmarks have proliferated, yet most lack a per-item difficulty signal grounded in actual human performance. We introduce KCSAT-ML, a decade (2014-2025) of Korean College Scholastic Ability Test (KCSAT; Suneung) mathematics: 664 problems with a 339-item core set carrying official per-item error rates from nationwide cohorts of hundreds of thousands of examinees. We pair the benchmark with Difficulty-aligned Reasoning Gain (DRG): a score-orthogonal metric that asks whether a model's mistakes concentrate on the items humans found hard, or on items humans found easy. Together they expose, across a wide range of VLMs (and LLMs via OCR), three patterns: (i) low-budget accuracy collapses on the high-human-error tail at every model size; (ii) test-time scaling (TTS) raises token use roughly linearly with cohort error rate, while accuracy gains follow a non-monotonic curve; (iii) within a single family, TTS flips between anti-scaling on the hardest items and overthinking on easier ones – two faces of the same alignment failure. On DRG, models with near-identical accuracy can sit at near-opposite values: one model gets wrong what humans also find hard, while another solves the hardest items yet fails on items humans find easy – a contrast that aggregate accuracy hides. Our code and dataset builder will be open-sourced at https://github.com/naver-ai/KCSAT-ML.

17.
arXiv (CS.AI) 2026-06-24

Beyond U-Net: A Latent-Representation-Aligned Skip-Free Backbone for Flow-Matching Speech Enhancement

arXiv:2606.24745v1 Announce Type: cross Abstract: Generative models, particularly diffusion and score-based approaches, have recently achieved strong performance in speech enhancement, but their iterative sampling process limits real-time deployment. Flow Matching offers an efficient alternative by transporting noisy speech toward clean speech through an ordinary differential equation with few function evaluations. In this work, we propose a skip-free encoder-decoder backbone for flow-matching speech enhancement, guided by Latent Representation Alignment (LRA). Instead of relying on U-Net skip connections, which may transfer noise-correlated low-level features to the decoder, the proposed model aligns its bottleneck and decoder representations with clean latent features extracted from a frozen Descript Audio Codec encoder-decoder without quantization. This codec-aligned supervision promotes compact clean-speech representations while preserving efficient few-step inference. Experiments on WSJ0-CHiME3 and VoiceBank-DEMAND show improved PESQ and perceptual quality, especially on VoiceBank-DEMAND, using only five function evaluations.

18.
arXiv (math.PR) 2026-06-16

On the empirical spectral distribution of matrix perpetuities

arXiv:2605.31054v2 Announce Type: replace Abstract: We study matrix perpetuities, that is, solutions to affine fixed-point equations of the form \[ \mathbf{X} \stackrel{d}{=} \mathbf{A}\,\mathbf{X} \,\mathbf{A}^\top+\mathbf{B},\qquad (\mathbf{A},\mathbf{B})\mbox{ and }\mathbf{X} \mbox{ are independent}, \] with particular emphasis on the empirical spectral distribution of the solution. We first establish existence and uniqueness results by relating the problem to classical vector perpetuities, and then develop tools that preserve the matrix structure under orthogonal invariance. For positive semidefinite, orthogonally invariant models, we obtain power-law tail asymptotics for the expected empirical spectral distribution and show that the tail is governed by the largest eigenvalue. We also prove that, in the subcritical regime, the expected empirical spectral distribution of matrix perpetuities converges weakly, as the dimension tends to infinity, to the distribution of the corresponding free perpetuity. Our results are illustrated by matrix Beta prime perpetuities, for which explicit limiting spectral distributions are available.

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

CODA-BENCH: Can Code Agents Handle Data-Intensive Tasks?

Advanced agents are increasingly demonstrating the potential to operate as autonomous engineers, creating a growing demand for evaluation benchmarks that capture the complexity of real-world development. Such environments typically involve both complex code and large-scale data (i.e., file system). However, existing benchmarks usually evaluate code-centric or data-centric capabilities in isolation, leaving a clear gap with real development scenarios. In this paper, we bridge this gap by introducing CODA-BENCH, the first benchmark to jointly evaluate code and data intelligence in a data-intensive environment. We construct a data-intensive Linux sandbox based on the Kaggle ecosystem (containing hundreds of datasets), where agents must actively explore complex file hierarchies to identify relevant resources and generate code for data-driven analytical tasks. CODA-BENCH comprises 1,009 tasks spanning 31 communities, with each task environment containing an average of 980 files, simulating realistic data scale and noise. Evaluations of advanced agents reveal that even top-performing systems struggle to effectively integrate data discovery with code execution, achieving a success rate of only 61.1%. These results highlight a substantial gap in current agentic capabilities for data-intensive tasks and point to promising directions for future research.

20.
arXiv (CS.AI) 2026-06-18

Structured Cognitive Loop for Behavioral Intelligence in Large Language Model Agents (Extended Revision: From Behavioral Architecture to Epistemic Accountability)

作者:

arXiv:2510.05107v5 Announce Type: replace Abstract: The central challenge for AI agents is not only performance but accountability. Agents that act through opaque prompt sequences may produce correct outputs, but they provide little basis for verifying why an action was permitted, where an error occurred, or how responsibility should be assigned. This paper presents the Structured Cognitive Loop as an architecture for accountable behavior in large language model agents. SCL separates cognition, memory, control, and action into distinct modules. The language model proposes. External memory preserves verified state. A lightweight controller checks preconditions, prevents redundant actions, and authorizes execution before tools are used. We evaluate SCL against ReAct and common LangChain agent variants across travel planning, conditional email drafting, and constraint guided image generation. Across 360 episodes, SCL achieves 86.3 percent task success compared with 70.5 to 76.8 percent for prompt based baselines. It also improves goal fidelity, reduces redundant tool calls, increases reuse of intermediate state, and lowers unsupported assertions. This extended revision situates SCL within a broader architecture of epistemic accountability. Subsequent extensions integrate context aware Human in the Loop control, Pool Gated Retrieval, and the Horizon Warrant Commitment framework. Together these components define an agent architecture in which the model proposes, structure decides, evidence is warranted before use, and human judgment is embedded in the trace rather than imposed after the fact. The result is a foundation for AI agents whose decisions are not only effective but also authorized, inspectable, and accountable.

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

Unveiling Hierarchical Invariants in Multiphoton Linear Optics

arXiv:2506.12857v2 Announce Type: replace Abstract: Linear optical networks driven by quantum states of light are important building blocks of photonic quantum technologies. They access large bosonic Hilbert spaces through multiphoton interference. At the same time, their dynamics are generated by single-particle mode transformations, thereby defining a highly structured subset of multiphoton unitaries and setting boundary on linear optics capability. To elucidate this boundary, we reveal an underlying fine-grained symmetry structure that partitions the multiphoton operator space into invariant subspaces and generates a hierarchy of invariants. We experimentally confirm the conservation of high-order invariants and demonstrate their operational utility in characterizing state reachability and the metrological capability of multiphoton probes. Our framework provides a symmetry-based perspective for understanding and harnessing structured multiphoton dynamics across photonic quantum technologies.

22.
medRxiv (Medicine) 2026-06-22

Cumulative Metabolic Exposure to Hyperglycemia and Risk of Cardiovascular and Limb Events in Peripheral Artery Disease

Background: Although diabetes is a potent risk factor for the development of peripheral artery disease (PAD), the effect of cumulative metabolic exposure to hyperglycemia on risk of cardiovascular or limb events in patients with PAD remains unclear. Methods: The Peripheral Artery Disease: Long-term Survival (PEARLS) is a longitudinal registry of Veterans with newly diagnosed PAD identified using a natural language processing approach. Included patients had ankle brachial index [≤]0.9 or toe brachial index [≤]0.7, and no history of lower extremity revascularization or major amputation. Among patients with diabetes in this cohort, we assessed cumulative exposure to hyperglycema based on a 24-month rolling average of hemoglobin (Hgb) A1c values, categorized as [≤]7%, >7% to [≤]8%, and >8%. Multivariable Cox regression models evaluated the association between categories of HgbA1c, modeled as a time-varying exposure, and risk of cardiovascular (CV: myocardial infarction or stroke) and limb (chronic limb threatening ischemia [CLTI] or major amputation) events. Results: Among 45,109 patients with new diagnosis of PAD and pre-existing diabetes, the mean HgbA1c at baseline was 7.5%, with nearly one-third (30.4%) having HgbA1c >8%. The mean age was 70.4 years, 19.8% were Black and 4% were Hispanic. Patients with baseline HgbA1c >8% were younger and compared to those with HgbA1c [≤]7%, more likely to have coronary disease, kidney disease, and obesity. Over a median follow up of 4.2 years, 8,306 (18.4%) patients experienced a CV event, and 8,199 (18.2%) experienced a limb event. The adjusted association between HgbA1c and hazard of CV events was 12% higher in patients exposed to HgbA1c >7% to [≤]8% (HR 1.12; 95%CI: 1.05-1.18) and 38% higher in those exposed to HgbA1c >8% (HR 1.38; 95%CI: 1.30-1.46), compared to HgbA1c 7% to [≤]8% (HR 1.20; 95%CI: 1.13-1.28) and HgbA1c >8% (HR 1.60; 95%CI: 1.51-1.70), respectively when compared to HgbA1c [≤]7%. These findings were consistent in subgroups based on age and severity of PAD. Conclusions: Among diabetic patients with PAD, cumulatiave metabolic exposure to hyperglycemia is associated with a markedly increased risk of clinical events, especially limb events.

23.
arXiv (CS.CV) 2026-06-11

MentisOculi: Revealing the Limits of Reasoning with Mental Imagery

Frontier models are transitioning from multimodal large language models (MLLMs) that merely ingest visual information to unified multimodal models (UMMs) capable of native interleaved generation. This shift has sparked interest in using intermediate visualizations as a reasoning aid, akin to human mental imagery. Central to this idea is the ability to form, maintain, and manipulate visual representations in a goal-oriented manner. To evaluate and probe this capability, we develop MentisOculi, a procedural, stratified suite of multi-step reasoning problems amenable to visual solution, tuned to challenge frontier models. Evaluating visual strategies ranging from latent tokens to explicit generated imagery, we find they generally fail to improve performance. Analysis of UMMs specifically exposes a critical limitation: While they possess the textual reasoning capacity to solve a task and can sometimes generate correct visuals, they suffer from compounding generation errors and fail to leverage even ground-truth visualizations. Our findings suggest that despite their inherent appeal, visual thoughts do not yet benefit model reasoning. MentisOculi establishes the necessary foundation to analyze and close this gap across diverse model families.

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

Do Large Language Models Have Emotions?

arXiv:2606.14742v1 Announce Type: cross Abstract: Do LLMs have emotions? A recent paper from Anthropic reports finding internal representations of emotion concepts in Claude Sonnet 4.5, concluding that the LLM has 'functional emotions.' We evaluate this claim against what is known about how emotions actually function in biological systems. We argue that emotions serve two core functions: the context-sensitive interpretation of situations, and the reorganization of processing across multiple systems in response to those interpretations. The Anthropic findings offer partial support for the first function, though the consistent, discrete emotional representations identified in Claude sit uneasily with affective neuroscience findings that human emotion is characterized by variable rather than uniform neural signatures. On the second function, the evidence is mixed: Claude's representations modulate output without producing the dynamic reorganization of attention, decision speed, and motivational state that defines emotion in biological systems. We close by proposing what it would take for an LLM to have emotions.

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

A Leakage-Aware Comparative Benchmark of Machine Learning, Deep Learning, and Transformer Models for Reliable Leukemia Detection

Automated classification of acute lymphoblastic leukemia (ALL) from peripheral blood smear images has often reported near-perfect performance on the C-NMC 2019 dataset. We show that such results can be inflated by patient-level data leakage caused by random image-level partitioning, where cells from the same subject may appear in both training and test folds. We establish a leakage-aware benchmark under a strict subject-disjoint protocol, comparing LightGBM, RBF-SVM, EfficientNet-B0, EfficientNet-B1, and ViT-Tiny. Models are developed using three subject-disjoint folds from 73 subjects and evaluated on an external preliminary-phase test set of 1,867 images from 28 unseen subjects with zero patient overlap. Beyond discrimination, we assess calibration using expected calibration error, Brier score, and temperature scaling. Under honest evaluation, EfficientNet-B1 achieves the best performance, with AUROC 0.913, sensitivity 0.87, specificity 0.80, and calibrated ECE 0.024. Frozen-feature classifiers and ViT-Tiny show high sensitivity but poor specificity, indicating a tendency to over-predict the malignant class. A random-versus-subject-disjoint ablation shows that random splitting inflates AUROC by about 0.04 even in the conservative frozen-feature setting. These findings caution against image-level evaluation on C-NMC 2019 and provide a reproducible, calibration-aware benchmark for future work.