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01.
arXiv (CS.AI) 2026-06-12

ToolSense: A Diagnostic Framework for Auditing Parametric Tool Knowledge in LLMs

arXiv:2606.12451v1 Announce Type: new Abstract: Large language models deployed as agents over large tool catalogs face a critical tool-retrieval bottleneck. As embedding-based retrieval approaches rely on compact encoders that may under-capture specialized tool semantics, parametric tool retrieval addresses this by encoding each tool as a virtual token appended to the LLM vocabulary, fine-tuned in two stages (memorization then retrieval SFT) to use the LLM as a retriever, achieving strong performance on standard ToolBench retrieval benchmarks. Yet these benchmarks use verbose, fully-specified queries, and their evaluation applies constrained decoding that restricts outputs to valid token paths, neither reveals whether the model actually understands its tools. We introduce ToolSense, an open-source LLM-powered diagnostic framework that takes any tool catalog as input and automatically generates three benchmarks: a Realistic Retrieval Benchmark (RRB) with queries at three ambiguity tiers, an MCQ probing benchmark, and a QA probing benchmark. Applying ToolSense to ToolBench (~47k tools) and evaluating five parametric model training configurations reveals a knowledge-retrieval dissociation: on RRB queries, several configurations collapse by ~50-64 percentage points compared to fully-specified ToolBench benchmarks, falling below the embedding-model baseline. Additionally, despite strong retrieval performance, some models score near-random on factual probes, suggesting a knowledge-retrieval dissociation. We open-source the ToolSense framework and the ToolBench diagnostic benchmarks at https://github.com/SAP/toolsense.

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

AIPatient Arena: EHR-grounded evaluation of large language models in end-to-end clinical consultation workflows

Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care. Here, we propose AIPatient Arena, an EHRs-grounded evaluation framework for assessing the clinical utility of LLMs across eight dimensions of clinical competence. The framework integrates EHR data into patient-specific knowledge graphs, enabling multi-turn physician-patient interactions. We applied AIPatient Arena on a primary cohort of 437 patients and two out-of-distribution validation cohorts of 119 and 67 patients. We observe that LLMs performed well in medical interview questioning skills (QS; mean scores, 4.43-4.99/5), ethical and professional conduct (ET; 4.38-4.93/5), and clarity and transparency of clinical explanations (EX; 3.80-4.72/5). Performance was moderate in information integration (II; 3.19-4.21/5) and medication safety and justification (MS; 3.13-3.78/5), but persistent weaknesses were observed in handling of ambiguous patient responses (HR; 2.57-3.32/5), information coverage (IC; 2.08-3.02/5), and diagnostic accuracy and reasoning (Dx; 2.63-3.55/5). Process-based evaluation revealed recurrent interaction failures, including repetitive questioning, omission of past medical history, and inadequate handling of uncertainty. Richer conversational context improved diagnostic reasoning but yielded limited gains in treatment planning. These findings indicate that final-answer accuracy alone is insufficient for evaluating clinical readiness and highlight the importance of assessing how models gather, interpret, and communicate information throughout a consultation. AIPatient Arena provides an EHR-grounded framework for workflow-oriented pre-deployment evaluation of medical LLMs.

03.
arXiv (CS.CV) 2026-06-16

EdgeZSAD: Practical Zero-Shot Anomaly Detection on Edge Devices

Industrial inspection needs zero-shot anomaly detection (ZSAD) that remains useful under edge deployment constraints. Recent methods often rely on ViT-L foundation backbones (~300M parameters), which exceed the memory and operator budget of typical embedded hardware. We study this regime through EdgeZSAD, a compact reference system built around a TinyViT-21M-512 backbone, an asymmetric global-local readout (EdgeGLR), and a reproducible source-side training recipe (Real-IAD-DR). We train a single checkpoint in a source-trained, target-unseen protocol and evaluate it across six industrial benchmarks. Across three independent runs, the resulting model reaches an average image AUROC of 91.6 on MVTec-AD and 88.2 on VisA, while remaining directly deployable on Jetson Orin Nano Super (TensorRT FP16) and RB5 Gen2 (QNN GPU FP16). Across the six device-rescored benchmarks, image-AUROC drift stays below 0.2 points, indicating that the exported graph preserves host-side ranking behavior in the evaluated deployment setting.

04.
arXiv (CS.CV) 2026-06-16

Gaussian Spatial Priors for Anatomy-Aware Object Detection in Surgical Videos

Detecting anatomical structures in surgical video is essential for intraoperative safety frameworks such as the Critical View of Myopectineal Orifice (CVMPO) in inguinal hernia repair. While prominent structures like the Cooper's Ligament and Triangle of Doom are reliably detected by standard methods, smaller structures such as the epigastric vessels remain challenging due to their visual ambiguity and intermittent visibility. We observe that the spatial relationship between structures is anatomically constrained, and propose a Gaussian Spatial Prior (GSP) module that encodes this relationship as a compact, parametric bias injected into the self-attention of a DAB-DETR decoder. The prior is computed offline from training annotations as a small set of frozen Gaussian parameters and recomputed at each decoder layer using the iteratively refined reference points. On a dataset of inguinal hernia repair videos with 5-fold cross-validation, GSP improves dependent class detection by $+33.5\%$ ($AP_{50}$) over DAB-DETR and $+53.9\%$ over YOLOv26, while also improving anchor detection by $+6.0\%$. These gains are statistically significant across all folds ($p=0.012$, paired $t-$test).

05.
arXiv (CS.CL) 2026-06-11

EverydayGPT: Confidence-Gated Routing for Efficient and Safe Hybrid GPT-RAG Conversational QA

Standard Retrieval-Augmented Generation (RAG) pipelines route every query through retrieval and generation unconditionally, incurring unnecessary computation and propagating low-quality context to the generator. We introduce EverydayGPT, a lightweight conversational QA system built around a Confidence-Gated Routing (CGR) mechanism that formalises the routing decision as a joint policy over retrieval distance and extraction adequacy. The backbone is a 205M-parameter GPT trained from scratch on 10B tokens of FineWeb-Edu. CGR avoids invoking the costly GPT pathway (~5.9s) for 85 percent of queries by resolving them via fast RAG extraction (~45 ms), yielding over 120x latency reduction on the majority of queries while maintaining answer quality. On a 500-question in-domain benchmark, the system achieves F1 = 0.226 +/- 0.004 compared to 0.171 for GPT-only and 0.210 for unconditional RAG. Gains over strong baselines are modest but consistent, while efficiency improvements are substantial (6.3x mean latency reduction). A structured grounding audit finds no unsupported claims in the sampled set, with explicit scope limitations. We position this work as a study of routing strategies under resource constraints rather than a claim of state-of-the-art performance.

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

HydraHead: From Head-Level Functional Heterogeneity to Specialized Attention Hybridization

The quadratic complexity of attention poses a critical bottleneck for long-context processing, spurring interest in hybrid attention designs. Most open-source hybrid models adopt a layer-wise strategy. Yet, prior work has noted the inherent difficulty of integrating Linear Attention (LA) with Full Attention (FA), suggesting that the design space of attention hybridization remains underexplored. To probe this space, we conduct interpretability analysis and observe that layers exhibit block-wise functional similarity, while individual heads within the same layer display distinct functional specialization despite sharing input features. This head-level heterogeneity suggests that the head dimension provides a natural and principled granularity for fusing heterogeneous attention signals. Building on this insight, we introduce HydraHead, a novel architecture that hybridizes FA and LA along the head axis. HydraHead features two key innovations: (1) an interpretability-driven selection strategy that identifies retrieval-critical heads and preserves FA only for them, and (2) a scale-normalized fusion module that reconciles the distributional gap between FA and LA head outputs. By leveraging a three-stage transfer pipeline with parameter reuse and distillation, we achieve high-performance hybrid models with minimal training overhead. Under a unified training setup, HydraHead outperforms other hybrid designs in long-context tasks while maintaining strong general reasoning. With interpretability-driven head selection, it matches a 3:1 layer-wise hybrid's long-context performance at a 7:1 LA-to-FA ratio. Crucially, trained on only 15B tokens, HydraHead achieves over 69% improvement over the baseline at 512K context length, approaching Qwen3.5, a leading model of comparable size with a native context length of 256K. This highlights the significant scaling potential of head-level hybridization.

07.
arXiv (CS.CV) 2026-06-12

BrainDINO: A Brain MRI Foundation Model for Generalizable Clinical Representation Learning

Brain MRI underpins a wide range of neuroscientific and clinical applications, yet most learning-based methods remain task-specific and require substantial labeled data. Here we show that a single self-supervised representation can generalize across heterogeneous brain MRI endpoints. We trained BrainDINO, a self-distilled foundation model, on approximately 6.6 million unlabeled axial slices from 20 datasets encompassing broad variation in population, disease, and acquisition setting. Using a frozen encoder with lightweight task heads, BrainDINO supported transfer across tumor segmentation, neurodegenerative and neurodevelopmental conditions classification, brain age estimation, post-stroke temporal prediction, molecular status prediction, MRI sequence classification, and survival modeling. Across tasks and supervision regimes, BrainDINO consistently equaled or exceeded natural-image and MRI-specific self-supervised baselines, with particularly strong advantages under label scarcity. Representation analyses further showed anatomically organized and pathology-sensitive feature structure in the absence of task-specific supervision. Our findings indicate that large-scale slice-wise self-supervised learning can yield a unified brain MRI representation that supports diverse neuroimaging tasks without volumetric pretraining or full-network fine-tuning, establishing a scalable foundation for robust and data-efficient brain imaging analysis. Code is available at https://github.com/mclwu22/BrainDINO

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

PhysVLA: Towards Physically-Grounded VLA for Embodied Robotic Manipulation

Vision-Language-Action (VLA) models excel at mapping visual inputs and natural language instructions directly to robotic control policies. However, because they are trained primarily to fit behavioural demonstration data, they do not explicitly enforce fundamental physical principles such as rigid-body dynamics or contact constraints. This exposes a critical physics gap: standard temporal smoothing applied on top of single-step or chunked VLAs trades trajectory quality for added failures that short-term memory cannot resolve. To bridge this gap, we introduce PhysVLA (Physics-VLA), a plug-and-play, inference-time framework designed to wrap any frozen VLA backbone without retraining, fine-tuning, or weight access, with less than 1 ms of overhead per control step. PhysVLA intercepts the predicted control action, captures only the simulator or system state, and applies a dual-layered correction: (i) a phase-aware finite-state machine that structures discrete task segments (approach, grasp, transport, and place), and (ii) a selective Euler-Lagrange gate that activates only when a dynamics oracle detects kinodynamic inconsistency. Evaluated across OpenVLA, OpenVLA-OFT, Force-VLA, and Generalist-VLA on LIBERO-Spatial with a 7-DoF Franka Panda, the framework delivers absolute success rate increases of up to 17% and stability increases of up to 19% with no per-task regressions, improves trajectory efficiency by up to 15% across all four backbones, and shows up to a 10x improvement in trajectory jerk robustness on a Robosuite Lift cross-simulator sweep. We further validate the framework on a real Agilex Piper arm with a pick-and-place task, confirming that PhysVLA transfers to physical hardware without retraining, with success-rate improvements of up to 50%, establishing physical awareness as a composable, backbone-agnostic runtime module.

10.
arXiv (math.PR) 2026-06-11

Convergence of a Critical Multitype Bellman–Harris Process with One Infinite-Mean Lifetime

arXiv:2606.11511v1 Announce Type: new Abstract: We study a critical multitype Bellman–Harris branching particle system in $\mathbb R^N$ with a finite type space $\mathbb K=\{1,\dots,K\}$. Particles of type $i$ move according to a symmetric $\alpha_i$-stable process and reproduce according to a critical offspring law whose mean matrix is irreducible and stochastic. The lifetime distribution of type $1$ is assumed to have infinite mean with regularly varying tail $$ 1-F_1(t)\sim c_1t^{-\gamma},\, 0 \frac{\gamma}{\beta}, $$ and a local increment condition on the heavy lifetime distribution, we prove convergence of the system to a Poisson random measure concentrated on the infinite-mean type.

11.
arXiv (CS.CL) 2026-06-16

Metacognitive Myopia in Large Language Models

Large Language Models (LLMs) exhibit potentially harmful biases that reinforce culturally embedded stereotypes, influence moral judgments, or amplify positive evaluations of majority groups. We propose metacognitive myopia as a cognitive-ecological framework accounting for a conglomerate of established and emerging LLM biases. Our theoretical framework posits that biased samples in the information environment cause five symptoms of metacognitive myopia in LLMs: integration of invalid embeddings, susceptibility to redundant information, neglect of base rates in conditional computation, decision rules based on frequency, and inappropriate higher-order statistical inference for nested data structures. Moreover, it posits that the two main components of metacognition, monitoring and control, could account for these five symptoms. Accordingly, we further outline how monitoring and control could be approximated technically, for instance, through hidden parallel reasoning histories that allow interactive LLMs to evaluate risks of myopic inference before generating overt responses. Our theoretical framework provides a novel perspective on flawed human-machine interactions and agentic AI and raises significant ethical concerns regarding the implementation of LLMs in organizational structures and high-stakes decisions.

12.
arXiv (CS.AI) 2026-06-15

AdaTKG: Adaptive Memory for Temporal Knowledge Graph Reasoning

arXiv:2605.07121v2 Announce Type: replace Abstract: Temporal knowledge graphs (TKGs) represent time-stamped relational facts and support a wide range of reasoning tasks over evolving events. However, existing methods produce entity representations that are static at the entity level, in that each representation is a function of learned parameters only and retains no trace of the interactions in which the entity has participated. In this paper, we depart from this static view and propose that each entity be modeled as an adaptive process whose representation is refined every time the entity participates in a fact. To this end, we propose AdaTKG, which maintains a per-entity memory that is updated with every observed interaction, with the memory accumulating online and predictions improving as more interactions arrive. Specifically, we instantiate the memory update as a learnable exponential moving average governed by a single shared scalar instead of using learnable parameters for each entity, enabling AdaTKG to handle entities unseen during training. Extensive experiments confirm consistent gains over TKG baselines, demonstrating the effectiveness of adaptive memory. Code is available at: https://github.com/seunghan96/AdaTKG

13.
arXiv (CS.CV) 2026-06-11

An Electric Potential-Augmented Benchmark Dataset for Physics-Guided Image Reconstruction of Electrical Capacitance Tomography

While deep learning has significantly advanced image reconstruction of Electrical Capacitance Tomography (ECT), most data-driven methods map directly between capacitance and permittivity distribution, treating the sensor as a black box. This overlooks the electric potential field – the fundamental physical link governing the nonlinear and ill-posed ``soft-field'' effect. To address this, we propose an electric potential-augmented ECT benchmark dataset designed to explicitly integrate latent physics behind ECT into the learning process. Generated via a COMSOL-MATLAB pipeline for an eight-electrode sensor as an example, the dataset comprises 20,000 randomized samples across four typical flow patterns. Crucially, alongside the conventional capacitance vectors and permittivity distributions depicted as images, each sample preserves eight excitation-wise full-field potential maps. Beyond data release, we provide illustrative evaluation protocols for both forward and inverse problems of ECT. Through comprehensive testing on both in-distribution (IID) and out-of-distribution (OOD) scenarios, we systematically demonstrate how the inclusion of electric potential maps enhances modeling accuracy and robustness. Fundamentally, the explicit inclusion of latent field information significantly lowers the barrier to integrating physical laws into ECT modeling, thereby establishing a standardized foundation for future physics-guided machine learning of ECT image reconstruction.

14.
arXiv (quant-ph) 2026-06-12

A ribbon ZX calculus for gauge theory

arXiv:2606.13551v1 Announce Type: cross Abstract: ZX calculus provides a graphical formalism for reasoning about quantum processes, built from two interacting Frobenius algebras associated with the Z and X bases of a qubit. While it has found widespread application in quantum information and computing, its relationship to quantum field theory has only recently begun to be explored. In this work, we further develop this connection by providing a generalization of ZX calculus to two-dimensional Yang Mills theory with a compact gauge group. The key observation is that both frameworks can be organized around the Hopf Frobenius algebraic structure associated with a group algebra, which can in turn be described by the diagrammatics of two dimensional topological quantum field theory. Given the well known relationship between gauge theory and gravity in two and three dimensions, our work paves the way for applications of ZX to low dimensional gravity.

15.
medRxiv (Medicine) 2026-06-12

Effect of tenofovir on the outcomes of COVID-19 in persons with chronic hepatitis B: a nationwide cohort study in Sweden.

Background: Patients with chronic hepatitis B (CHB) may have an increased risk of severe COVID-19. Tenofovir has been hypothesized to confer protection against severe disease, but evidence is inconclusive. We evaluated the risk of severe COVID-19 among CHB patients treated with tenofovir compared with other nucleos(t)ide analogues (NAs). Methods and findings: In this nationwide, registry-based cohort study, we included all adults with CHB and laboratory-confirmed COVID-19 in Sweden between February 2020 and July 2022. Data from national health and socioeconomic registers were linked using unique personal identification numbers (PINs). Patients with HIV, hepatitis C, or hepatitis D coinfection were excluded. Exposure was defined as tenofovir versus other NA therapy. The primary outcome was severe COVID-19, defined as hospitalization >2 days or death within 30 days of diagnosis. Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI), controlling for age, sex, comorbidities, vaccination, socioeconomic status, and region of birth. Among 5,877 CHB patients with COVID-19, 672 were receiving NA therapy (437 tenofovir, 235 other NAs). Severe COVID-19 occurred in 8.0% of tenofovir-treated patients and 14.5% of those receiving other NAs (unadjusted OR 0.52; 95% CI, 0.31-0.85). After adjustment, the association was attenuated and no longer significant (aOR 0.72; 95% CI, 0.39-1.31). Older age, comorbidities, and unvaccinated status were strongly associated with severe disease. Conclusions: The apparent protective effect of tenofovir against severe COVID-19 in unadjusted analyses was largely explained by confounding factors. The risk of severe disease was primarily driven by age, comorbidities, and vaccination status. Prevention of severe COVID-19 in patients with CHB should instead focus on vaccination and management of comorbidities.

16.
arXiv (CS.CV) 2026-06-11

FronTalk: Benchmarking Front-End Development as Conversational Code Generation with Multi-Modal Feedback

We present FronTalk, a benchmark for front-end code generation that pioneers the study of a unique interaction dynamic: conversational code generation with multi-modal feedback. In front-end development, visual artifacts such as sketches, mockups and annotated creenshots are essential for conveying design intent, yet their role in multi-turn code generation remains largely unexplored. To address this gap, we focus on the front-end development task and curate FronTalk, a collection of 100 multi-turn dialogues derived from real-world websites across diverse domains such as news, finance, and art. Each turn features both a textual instruction and an equivalent visual instruction, each representing the same user intent. To comprehensively evaluate model performance, we propose a novel agent-based evaluation framework leveraging a web agent to simulate users and explore the website, and thus measuring both functional correctness and user experience. Evaluation of 20 models reveals two key challenges that are under-explored systematically in the literature: (1) a significant forgetting issue where models overwrite previously implemented features, resulting in task failures, and (2) a persistent challenge in interpreting visual feedback, especially for open-source vision-language models (VLMs). We propose a strong baseline to tackle the forgetting issue with AceCoder, a method that critiques the implementation of every past instruction using an autonomous web agent. This approach significantly reduces forgetting to nearly zero and improves the performance by up to 9.3% (56.0% to 65.3%). Overall, we aim to provide a solid foundation for future research in front-end development and the general interaction dynamics of multi-turn, multi-modal code generation. Code and data are released at https://github.com/shirley-wu/frontalk

17.
arXiv (CS.CL) 2026-06-15

Non-Parametric Machine Text Detection via Multi-View Gaussian Processes

Adversarial conditions such as paraphrasing and targeted style transfer sharply degrade the accuracy of machine text detectors. A document, however, carries multiple complementary signals (e.g., stylistic features, likelihood and rank-order features, and structural features), and an attack that suppresses one may leave others intact. While a parametric classifier can learn to combine these features given sufficient supervision, classifiers are prone to making confidently incorrect predictions when the distribution shifts (e.g., novel attacks or unseen language models). To address this, we propose a multi-view, non-parametric detection framework that extracts complementary feature views from the same document and aggregates per-view evidence through a Gaussian process ensemble. By aggregating evidence across views, an adversary must simultaneously defeat multiple independent axes of detection, substantially raising the cost of evasion. The Gaussian process formulation additionally provides calibrated probabilities and principled abstention on out-of-distribution inputs, supporting reliable deployment in high-stakes settings. We evaluate on three benchmarks spanning diverse generators and attacks: the DetectRL and RAID benchmarks, and the PAN2025 shared task and demonstrate that our multi-view detector maintains strong performance under the considered attacks, outperforming existing approaches against held out attacks.

18.
arXiv (math.PR) 2026-06-12

Scaling limit of additive functionals for reversible non-gradient exclusion process: critical cases

arXiv:2606.13442v1 Announce Type: new Abstract: For the reversible speed-change exclusion process $(\eta_t)_{t \geq 0}$ in $\mathbb{Z}^d$, we study the scaling limit of additive functionals ${\Gamma_t(f) = \int_0^t f(\eta_s)\, \mathrm{d} s}$. Concerning the local centered function $f$, the previous work [Commun. Math. Phys. 104, 1-19, 1986] by Kipnis and Varadhan and [Comm. Pure Appl. Math., 66: 649-677, 2013] by Gon{ç}alves and Jara respectively covered the cases $d \geq 3$ and $d=1$. The present paper completes the missing part $d=2$, and also develops the theory for functions with higher degree. The novelty is a quantitative homogenization of the resolvent, which allows to overcome the obstacle of correlation function in non-gradient models.

19.
arXiv (quant-ph) 2026-06-17

Robust Spin Splitting and Strain-Controlled Optical Response in Monolayer CrC2N4 for Valleytronic and Optoelectronic Applications

arXiv:2606.17329v1 Announce Type: cross Abstract: Monolayer CrC2N4 recently emerged as a promising two-dimensional semiconductor, yet its spin-orbit-coupled (SOC) physics and strain-tunable optical response remained largely unexplored. Here, we investigated the electronic, valley, charge-transfer, and optical properties of pristine and biaxially strained monolayer CrC2N4 using first-principles calculations. The monolayer exhibited a direct band gap at the K/K' valleys. SOC produced valley contrasting out-of-plane spin polarization, yielding a moderate valence band spin splitting of 51.9 meV and a small conduction band spin splitting of 1.7 meV. Orbital-resolved analysis showed that the edge states were mainly governed by Cr-d and N-p hybridization, while Bader analysis indicated polar-covalent bonding through charge transfer toward N atoms. Biaxial strain in the range of -4% to +4% tuned the band gap from 1.987 to 1.421 eV and drove an indirect-to-direct gap transition near -1% strain. Tensile strain enhanced the Berry curvature and red-shifted the optical response toward the visible-near-infrared region. These results suggested monolayer CrC2N4 as a promising platform for strain-engineered valleytronic and optoelectronic device applications.

20.
arXiv (CS.LG) 2026-06-17

NoiseTilt: Noise-Tilted Reverse Kernels for Diffusion Reward Alignment

arXiv:2606.18066v1 Announce Type: new Abstract: We introduce the Noise-Tilted Reverse Kernel (NTRK), a reward-guided diffusion sampler that injects reward gradients through the noise term, leaving the pretrained reverse kernel unchanged and requiring only a single sample per step. Reward-guided sampling at inference time has greatly expanded the versatility of pretrained diffusion models. Yet existing methods face a trade-off. Gradient-based guidance shifts the reverse mean, steering generation but pushing intermediate states outside the region that the model was trained on and degrading quality. Search-based methods preserve quality but gain no gradient signal. No prior method achieves both. NTRK resolves this by keeping the reverse mean fixed and biasing the noise term toward high reward. We introduce a whitening operator, the central mechanism behind NTRK, that makes the reward gradient safe to inject as noise without losing its guiding signal. Across various reward alignment tasks, NTRK outperforms recent state-of-the-art baselines without losing sample quality. Remarkably, on aesthetic generation, NTRK surpasses the reward of the best baseline at 500 NFEs using only 25 NFEs, a 20$\times$ reduction in compute.

21.
arXiv (CS.AI) 2026-06-16

JADE: Expert-Grounded Dynamic Evaluation for Open-Ended Professional Tasks

arXiv:2602.06486v2 Announce Type: replace Abstract: Evaluating agentic AI on open-ended professional tasks faces a fundamental dilemma between rigor and flexibility. Static rubrics provide rigorous, reproducible assessment but fail to accommodate diverse valid response strategies, while LLM-as-a-judge approaches adapt to individual responses yet suffer from instability and bias. Human experts address this dilemma by combining domain-grounded principles with dynamic, claim-level assessment. Inspired by this process, we propose JADE, a two-layer evaluation framework. Layer 1 encodes expert knowledge as a predefined set of evaluation skills, providing stable evaluation criteria. Layer 2 performs report-specific, claim-level evaluation to flexibly assess diverse reasoning strategies, with evidence-dependency gating to invalidate conclusions built on refuted claims. Experiments on BizBench show that JADE improves evaluation stability and reveals critical agent failure modes missed by holistic LLM-based evaluators. We further demonstrate strong alignment with expert-authored rubrics and effective transfer to HealthBench and DR.BENCH, covering medical and 10-domain professional evaluation settings. Code and data are available at https://github.com/smiling-world/JADE.

22.
arXiv (quant-ph) 2026-06-19

Indefinite Quantum Causality

arXiv:2606.19438v1 Announce Type: new Abstract: In recent years, operational approaches to quantum foundations have been developed as a means of understanding the core principles and distinctive features of quantum theory. Such approaches typically view physical processes as sequences of operations, with earlier operations serving as causes of later effects. However, a growing literature is emerging on the possibility of relaxing this assumption and allowing for quantum indefiniteness in the causal order. This development stems from a variety of motivations, both fundamental and applied, including exploring the role of causality in quantum theory, the interplay between quantum theory and general relativity, and higher-order quantum computing. A prominent offshoot of this development is the emergence of indefinite causal order as a feasible resource for quantum information processing. This review provides an overview of the current state of the art in the field, covering the methodology underlying indefinite quantum causality within the so-called "process matrix formalism", outlining key results and experimental implementations, and discussing recent advances.

23.
Nature Medicine 2026-06-15

Plasma proteomic signatures of cellular aging predict human disease

Aging is asynchronous across cells and organs. Here we tested whether plasma proteomics can be used to analyze cell type-specific aging. From analyses of over 7,000 plasma proteins measured in 60,542 individuals, we developed machine learning models to estimate the biological age of over 40 cell types spanning neuronal, immune, glial, endocrine, epithelial and musculoskeletal origins. We observed that 20–25% of individuals exhibited accelerated aging in a single cell type and 1–3% in 10 or more cell types. Cellular aging signatures were associated with disease status and predicted incident disease and mortality over 15 years of follow-up. Individuals with the APOE4 genotype showed older astrocytes but younger macrophages compared to APOE3 carriers, whereas the APOE2 genotype had inverse associations. Moreover, extreme astrocyte aging tripled the risk of incident Alzheimer’s Disease in individuals with two APOE4 alleles, while youthful astrocytes reduced risk. Individuals with extremely aged compared to youthful skeletal myocytes exhibited a 12.7-fold higher risk of developing amyotrophic lateral sclerosis. In individuals who smoked, extreme respiratory epithelial cell aging was associated with a 58% higher lung cancer risk compared to smoking alone. Specific cellular vulnerabilities and cumulative cellular aging burden influenced survival, with youthful immune and neuronal cell types conferring protective effects. Finally, we developed a polycellular aging risk score that stratified mortality risk across cohorts and proteomics platforms. These findings establish a framework for quantifying human physiology at cellular resolution, revealing heterogeneous aging trajectories and their impact on disease susceptibility and resilience. The biological age of individual cell types can be evaluated using plasma proteomics, revealing diverse aging profiles across more than 40 cell types and links between the accelerated aging of specific cell types and disease.

24.
medRxiv (Medicine) 2026-06-11

Corticospinal tract risk modifies motor recovery after minimally invasive surgery for intracerebral hemorrhage: a secondary analysis of MISTIE-III

Objective: Outcome after surgical hematoma evacuation for intracerebral hemorrhage (ICH) depends on hematoma location. As corticospinal tract (CST) integrity affects motor recovery after stroke, we hypothesized that CST integrity drives heterogeneity in surgical outcomes and investigated this in a secondary analysis of MISTIE-III participants. Methods: Risk of CST injury was categorized into four levels, based on the interaction between the CST, the hematoma, and perihematomal edema (PHE) on automatically segmented stability CT: no risk, PHE infiltration, hematoma infiltration, and complete interruption of the CST. Associations with outcome were tested using multivariable linear regression for motor National Institutes of Health Stroke Scale (NIHSS) at day 180 and ordinal regression for modified Rankin Scale (mRS) at day 365, introducing an interaction term between CST risk and treatment group. Results: Day 180 motor NIHSS was significantly lower for 'no risk' ({beta}:-3.77, [95% confidence interval [CI]: -5.8 to -1.70], p=0.0003) and 'PHE infiltration' ({beta}:-2.3, [95%CI: -3.5 to -1.1]; p=0.0002) vs. 'complete interruption'. Surgery was associated with lower Day 180 motor NIHSS in participants with hematoma infiltration ({beta}:-2.07, [95%CI: -3.8 to -0.4], p=0.016). Compared to complete interruption, 'no risk' (adjusted odds ratio [aOR]:0.27, [95%CI: 0.10 to 0.74], p=0.01) and 'PHE infiltration' (aOR:0.41, [95%CI: 0.23 to 0.74]; p=0.003) were associated with lower odds of unfavorable day 365 mRS. Surgery was associated with lower mRS in participants with no risk (aOR:0.23, [95%CI: 0.05 to 0.97, p=0.045). Interpretation: Increasing CST risk is associated with worse motor recovery (day 180) and disability (day 365). CST risk modifies the effect of the MISTIE-III procedure on motor recovery and disability.

25.
medRxiv (Medicine) 2026-06-11

Incremental costs of transitioning from four to eight WHO-recommended antenatal care visits in Uganda: A costing analysis from a societal perspective

Background In 2016, the World Health Organization revised its antenatal care (ANC) recommendation from four to eight visits. For low- and middle-income countries like Uganda, where achieving even four visits remains a challenge, this transition has significant cost implications for both the health system and households. This study estimated the incremental costs of adopting the eight-visit model from a societal perspective. Methods The study was conducted in six government health facilities in southwestern Uganda. A micro-costing approach estimated health facility costs (personnel, equipment, consumables, and overhead). Costs incurred at patients end (transport, ultrasound, medical expenses, and time) were collected from 785 women using a questionnaire, with all costs in 2025 USD. Results For an average of 4.3 visits, total cost per woman was $100.1: facility costs $43.7 (43.7%), and patient costs $56.4 (56.3%). Transitioning to eight visits would increase total cost by $57.8 (57.8%), of which $36.4 (63.0%) would fall on households, equivalent to 68.8% of average monthly household income. Total costs would rise by 55.4% ($115.5 to $179.5) at Health Center IVs and 64.3% ($102.3 to $168.1) at Health Center IIIs, with facility costs up 43.4% and 62.9% and patient costs up 61.2% and 65.7%, respectively. Conclusion Transitioning to eight ANC visits would impose a large financial burden on households, with the incremental patient cost equivalent to more than two-thirds of average monthly household income. Equitable implementation requires improving availability of medicines and diagnostics, subsidizing transport, exploring telemedicine or community-based models, and improving efficiency at lower-tier health centers.