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

Shattering the Autoregressive Curse: Dynamic Epistemic Entropy Orchestrated Erasable Reinforcement Learning for LLMs

arXiv:2606.17735v1 Announce Type: new Abstract: Although reinforcement learning (RL) has expanded the cognitive boundaries of large language models (LLMs), it often remains vulnerable to the autoregressive curse in long-horizon logical reasoning: small epistemic perturbations introduced early in generation can propagate irreversibly along the Markov decision process flow, triggering cascading failures that drive the reasoning trajectory toward collapse. To overcome this autoregressive cascade, in which a single early mistake can compromise all subsequent reasoning steps, we propose dynamic epistemic entropy orchestrated erasable reinforcement learning ($E^3RL$). $E^3RL$ eliminates reliance on external signals by grounding the model's endogenous local autoregressive cross-entropy as an intrinsic coordinate of epistemic uncertainty. By introducing segment-level adaptive dynamic thresholds and advantage allocation, $E^3RL$ enables the model to precisely excise localized logical defects while reusing historical key-value (KV) cache streams, thereby endowing the reasoning process with a self-healing capability. We train $E^3RL$ on the DeepMath-103k dataset. Experimental results show that $E^3RL$ reshapes the exploration efficiency of long-sequence reasoning and improves sample efficiency while maintaining linear memory overhead. On mathematical reasoning benchmarks such as AIME, $E^3RL$ achieves substantial performance gains, with the 4B and 8B parameter models surpassing previous state-of-the-art (SOTA) results by 5.349\% and 6.514\%, respectively. These findings suggest that $E^3RL$ shatters the autoregressive curse in long-sequence reasoning and establishes a theoretical and systems-level foundation for the next generation of self-healing artificial general intelligence (AGI).

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

Adaptive and Explicit safe: Triggering Latent Safety Awareness in Large Reasoning Models

arXiv:2606.16808v1 Announce Type: new Abstract: While Large Reasoning Models (LRMs) excel at complex tasks, they remain highly vulnerable to sophisticated jailbreaks and direct harmful queries. To address this vulnerability, prior works depend heavily on external manual data annotation for safety alignment. However, we observe that LRMs can inherently identify safety risks when being re-presented with original queries alongside their own reasoning trajectories – a capability we term Latent Safety Awareness. To leverage this safety awareness, we first employ Supervised Fine-Tuning (SFT) to explicitly induce safe tags to trigger safety analysis and guidance following the initial reasoning content for unsafe queries, while preserving standard responses for general queries to ensure adaptive triggering. Subsequently, we apply Direct Preference Optimization (DPO) to further enhance the correctness and stability of the safety analysis and guidance. Notably, responses required for both training stages are entirely generated by models being optimized. With (Safe Trigger) SFT and DPO, experimental results demonstrate significant safety enhancement. For example, the Attack Success Rate (ASR) of DeepSeek-R1-Distill-Llama-8B, on average, drops 24.65% and 36.72% on harmful and jailbreak benchmarks, respectively. Finally, our Safe Trigger method exerts almost no negative impact on general performance or user experience.

04.
arXiv (CS.CV) 2026-06-25

Benchmarking Deep Learning Models for Laryngeal Cancer Staging Using the LaryngealCT Dataset

Laryngeal cancer imaging research lacks standardised public datasets to enable reproducible deep learning (DL) model development. We present LaryngealCT, a curated benchmark of 1,029 computed tomography (CT) scans aggregated from six collections from The Cancer Imaging Archive (TCIA). Uniform 1 mm isotropic volumes of interest encompassing the larynx were extracted using a weakly supervised parameter search framework validated by clinical experts. Six 3D DL architectures (custom 3D CNN, ResNet18,50,101, DenseNet121 and MedicalNet-pretrained ResNet50) were benchmarked on (i) early (Tis,T1,T2) vs. advanced (T3,T4) and (ii) T4 vs. non-T4 classification tasks. On the independent test set, the 3D CNN achieved the strongest overall performance across global and per-class metrics (Accuracy 0.854, F1-macro 0.841) in early vs. advanced classification. In the T4 task, AU-ROC values exceeded 0.82 for most models, but sensitivity for T4 disease remained limited (less than or equal to 0.412), with ResNet101 showing the most promising calibrated T4 recall (0.706. Model explainability assessed using GradCAMpp with thyroid cartilage overlays for T4 classification task revealed anatomically plausible peri-cartilage activations, although spatial overlap was modest. Through open-source data, pretrained models, and integrated explainability tools, LaryngealCT offers a reproducible foundation for AI-driven research to support future clinical decision-making in laryngeal oncology.

05.
arXiv (quant-ph) 2026-06-11

Quantum repeater segment with free-space coupled co-trapped ions using telecom photon interference

arXiv:2606.12313v1 Announce Type: new Abstract: A quantum repeater segment is a basic building block of a quantum repeater, generating buffered entanglement of quantum memories to connect quantum repeater cells. It also enables the connection between quantum computers. In the implementation we present here, photons emitted from two co-trapped free-space coupled $^{40}$Ca$^+$ ions are converted to the telecom-C band and interfered after transmission over 440$\,$m of optical fiber (220$\,$m per arm), where a photonic Bell measurement is performed to create entanglement between the memories. With this scheme we generate an entangled $\left|\Psi^+\right\rangle$ Bell state with $\ge 68(8)\,$% fidelity, highlighting trapped $^{40}$Ca$^+$ ions as a promising quantum repeater hardware platform.

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

Sub-Semantic Image Segmentation

Images can be segmented based on visual cues (i.e., texture segmentation) or into objects (i.e., semantic segmentation). We propose a new category of sub-semantic image segmentation that blurs the line between the two. In sub-semantic image segmentation, language is not used to name whole objects. Instead, it is used to partition an image into stable appearance patterns that can be described by language. To do that, we couple a general-purpose vision-language model to SAM 3, a promptable segmentation backbone whose native text pathway can ground rich descriptions into masks. Simple coupling fails for a number of reasons that we identify in the paper, and we overcome them by introducing DETECTURE that resolves three concrete failure modes – language leakage between texture regions, prompt competition inside the segmentation backbone, and semantic distortion at the language-to-mask interface. Since there is no dataset of sub-semantic image segmentation, we introduce one, termed TextureADE. The new dataset is derived from the ADE20K dataset using a system we designed. We compare DETECTURE to a number of baselines and find that it achieves the strongest performance on several datasets using different metrics. Code is available at https://github.com/Scientific-Computing-Lab/TextureDetecture.

07.
arXiv (CS.LG) 2026-06-17

Learning from Biased and Costly Data Sources: Minimax-optimal Data Collection under a Budget

arXiv:2602.17894v2 Announce Type: replace-cross Abstract: Data collection is a critical component of modern statistical and machine learning pipelines, particularly when data must be gathered from multiple heterogeneous sources to study a target population of interest. In many use cases, such as medical studies or political polling, different sources incur different sampling costs. Observations often have associated group identities - for example, health markers, demographics, or political affiliations - and the relative composition of these groups may differ substantially, both among the source populations and between sources and target population. In this work, we study multi-source data collection under a fixed budget, focusing on the estimation of population means and group-conditional means. We show that naive data collection strategies (e.g. attempting to "match" the target distribution) or relying on standard estimators (e.g. sample mean) can be highly suboptimal. Instead, we develop a sampling plan which maximizes the effective sample size - the total sample size divided by $D_{\chi^2}(q\mid\mid\overline{p}) + 1$, where $q$ is the target distribution, $\overline{p}$ is the aggregated source distribution, and $D_{\chi^2}$ is the $\chi^2$-divergence. We pair this sampling plan with a classical post-stratification estimator and upper bound its risk. We provide matching lower bounds, establishing that our approach achieves the budgeted minimax optimal risk. Our techniques also extend to prediction problems when minimizing the excess risk, providing a principled approach to multi-source learning with costly and heterogeneous data sources.

08.
arXiv (quant-ph) 2026-06-25

Fast mixing of all-to-all quantum systems at high temperatures

arXiv:2606.26090v1 Announce Type: new Abstract: It is shown that arbitrary quantum $k$-local Hamiltonians with bounded strength interactions admit a quantum Gibbs sampler [CKG23] with a system-size independent spectral gap, at sufficiently high temperatures. This generalizes the existing quantum fast-mixing results beyond the geometrically-local setting. As a consequence, such systems admit fully-polynomial time quantum approximation algorithms for partition functions and global expectation values.

09.
arXiv (CS.CL) 2026-06-25

Continual Knowledge Updating in LLM Systems: Learning Through Multi-Timescale Memory Dynamics

LLMs are trained once, then deployed into a world that never stops changing. External memory compensates for this, but most systems manage it explicitly rather than letting it adapt on its own. Biological memory works differently: coupled multi-timescale dynamics make new associations immediately usable, strengthen what repetition confirms, and let the rest fade. We argue that external memory should follow a similar principle. In Memini, this view takes the form of an associative memory that organizes knowledge as a directed graph. Each edge carries two coupled internal variables, one fast and one slow, following the Benna-Fusi model of synaptic consolidation. From this coupling, episodic sensitivity, gradual consolidation, and selective forgetting are expected to emerge as facets of a single mechanism, reframing external memory as a learning substrate that reorganizes through its own dynamics. This workshop article describes an early-stage conceptual design without experimental evaluation.

10.
PLOS Computational Biology 2026-06-22

A lactylation- and autophagy-associated prognostic signature reveals LSEC-derived CLEC3B as a novel mediator of hepatocellular carcinoma suppression

作者:

by Youai Song, Yinkuan Ning, Meihui Li, Jianwei Lan, Liangchen Lei, Yufei Han, Zhuo Meng, Binjie Li, Pengpeng Liu, Quanyan Liu The crosstalk between lactylation and autophagy within the hepatocellular carcinoma (HCC) microenvironment is a burgeoning field with profound implications. By integrating multi-omics data from public cohorts, we delineated two molecular subtypes of HCC with divergent clinical outcomes and established a lactylation-autophagy-related prognostic signature. This signature highlighted CLEC3B as a pivotal gene. Subsequent single-cell RNA sequencing and experimental validation unequivocally pinpointed liver sinusoidal endothelial cells (LSECs) as the principal cellular source of CLEC3B, which was significantly downregulated in HCC tissues. Functionally, conditioned media derived from CLEC3B-overexpressing LSECs potently inhibited HCC cell proliferation. Mechanistic investigations revealed that this tumor-suppressive effect was orchestrated through the concurrent suppression of autophagy and diminution of lactylation levels. Our findings position LSEC-secreted CLEC3B as a novel metabolic mediator in HCC, bridging two key pathways in tumor suppression, and endorse its clinical value both as a prognostic indicator and a promising therapeutic target.

11.
arXiv (CS.LG) 2026-06-19

Spectral Retrieval-Augmented Time-Series Forecasting

arXiv:2606.19412v1 Announce Type: new Abstract: Time series forecasting leverages historical patterns to predict future values, but traditional methods face challenges when dealing with complex, non-stationary patterns that are difficult to memorize during training. Retrieval-augmented approaches have emerged as promising solutions by retrieving similar historical patterns to enhance predictions. However, existing retrieval methods suffer from two fundamental limitations: spectral blindness, which overlooks critical frequency-domain characteristics that capture underlying periodic structures, and temporal recency, which treats all historical data equally without emphasizing recent, more relevant patterns. In this paper, we propose SpecReTF, a novel retrieval method that addresses these issues by converting time series into windowed frequency representations, measuring similarity with a combined metric that captures both amplitude and phase information. To balance recency and historical context, we apply an exponential moving average weighting scheme that emphasizes recent windows. Extensive experiments on benchmark datasets demonstrate that SpecReTF outperforms time-domain retrieval methods, achieving superior forecasting accuracy across diverse, non-stationary time series.

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

Diffusion-based Cumulative Adversarial Purification for Vision Language Models

Vision Language Models (VLMs) have shown remarkable capabilities in multimodal understanding, yet their susceptibility to adversarial perturbations poses a significant threat to their reliability in real-world applications. Despite often being imperceptible to humans, these perturbations can drastically alter model outputs, leading to erroneous interpretations and decisions. This paper introduces DiffCAP, a novel diffusion-based purification strategy that can effectively neutralize adversarial corruptions in VLMs. We theoretically establish a provable recovery region in the forward diffusion process and meanwhile quantify the convergence rate of semantic variation with respect to VLMs. These findings manifest that adversarial effects monotonically fade as diffusion unfolds. Guided by this principle, DiffCAP leverages noise injection with a similarity threshold of VLM embeddings as an adaptive criterion, before reverse diffusion restores a clean and reliable representation for VLM inference. Through extensive experiments across six datasets with three VLMs under varying attack strengths in three task scenarios, we show that DiffCAP outperforms existing defense techniques by a substantial margin. Notably, DiffCAP significantly reduces both hyperparameter tuning complexity and the required diffusion time, thereby accelerating the denoising process. Equipped with theorems and empirical support, DiffCAP provides a robust and practical solution for securely deploying VLMs in adversarial environments. The source code is available at https://github.com/JasonFu1998/DiffCAP.

13.
arXiv (CS.LG) 2026-06-15

Multi-fidelity aerodynamic data fusion by autoencoder transfer learning

arXiv:2512.13069v2 Announce Type: replace Abstract: Accurate aerodynamic prediction often relies on high-fidelity simulations; however, their prohibitive computational costs severely limit their applicability in data-driven modeling. This limitation motivates the development of multi-fidelity strategies that leverage inexpensive low-fidelity information without compromising accuracy. Addressing this challenge, this work presents a multi-fidelity deep learning framework that combines autoencoder-based transfer learning with a newly developed Multi-Split Conformal Prediction (MSCP) strategy to achieve uncertainty-aware aerodynamic data fusion under extreme data scarcity. The methodology leverages abundant Low-Fidelity (LF) data to learn a compact latent physics representation, which acts as a frozen knowledge base for a decoder that is subsequently fine-tuned using scarce HF samples. Tested on surface-pressure distributions for NACA airfoils (2D) and a transonic wing (3D) databases, the model successfully corrects LF deviations and achieves high-accuracy pressure predictions using minimal HF training data. Furthermore, the MSCP framework produces robust, actionable uncertainty bands with pointwise coverage exceeding 95%. By combining extreme data efficiency with uncertainty quantification, this work offers a scalable and reliable solution for aerodynamic regression in data-scarce environments.

14.
arXiv (CS.CV) 2026-06-18

Structured Spectral Graph Representation Learning for Multi-label Abnormality Analysis from 3D CT Scans

With the growing volume of CT examinations, there is an increasing demand for automated tools such as organ segmentation, abnormality detection, and report generation to support radiologists in managing their clinical workload. Multi-label classification of 3D Chest CT scans remains a critical yet challenging problem due to the complex spatial relationships inherent in volumetric data and the wide variability of abnormalities. Existing methods based on 3D convolutional neural networks struggle to capture long-range dependencies, while Vision Transformers often require extensive pre-training on large-scale, domain-specific datasets to perform competitively. In this work, we propose a 2.5D alternative by introducing a new graph-based framework that represents 3D CT volumes as structured graphs, where axial slice triplets serve as nodes processed through spectral graph convolution, enabling the model to reason over inter-slice dependencies while maintaining complexity compatible with clinical deployment. Our method, trained and evaluated on 3 datasets from independent institutions, achieves strong cross-dataset generalization, and shows competitive performance compared to state-of-the-art visual encoders. We further conduct comprehensive ablation studies to evaluate the impact of various aggregation strategies, edge-weighting schemes, and graph connectivity patterns. Additionally, we demonstrate the broader applicability of our approach through transfer experiments on automated radiology report generation and abdominal CT data.

15.
arXiv (math.PR) 2026-06-12

Sub-Riemannian spectral distance

arXiv:2606.12804v1 Announce Type: cross Abstract: We study eigenvalues and eigenfunctions of the ``div-grad type" sub-Laplacian with respect to Popp's volume on a compact equiregular sub-Riemannian manifold $M$. Since Popp's volume is canonically determined by the sub-Riemannian structure of $M$, the spetra of the sub-Laplacian carry geometric meanings. In this paper, we first embed $M$ into the Hilbert space of square-summable sequences using eigenfunctions and then define a spectral distance between two compact equiregular sub-Riemannian manifolds. Our result is a sub-Riemannian analogue of Berard-Besson-Gallot's classical work in the Riemannian case.

16.
arXiv (math.PR) 2026-06-17

On Injectivity of Phase Retrieval

作者:

arXiv:2606.17922v1 Announce Type: cross Abstract: In this short note, we prove that if $A \in \mathbb C^{N \times M}$ with $N=4M-5$ has i.i.d.\ standard complex Gaussian entries, then the probability that the phase retrieval map generated by $A$ is not injective is positive. This proves Part (1) of a conjecture of Cynthia Vinzant, which was later restated by Afonso S. Bandeira in [BDL+26]. The main result of this paper was obtained using generative AI, in particular the Rethlas system.

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

Predictive Analytics in E-Commerce for CustomerBehavior Forecasting using hybrid Ret-DNN withXGBoost Model

arXiv:2606.17931v1 Announce Type: new Abstract: In recent years, electronic (E) commerce services have rapidly increased in the daily lives of people, which helpsthem to purchase products online. However, retail platforms have struggled to understand customer behavior and make it difficult to predict their future purchases. To overcome these challenges, this study proposes a hybrid Retail Deep NeuralNetwork (Ret-DNN) with an Extreme Gradient Boosting(XGBoost) model for capturing temporal features and tabular dynamics of retail data. First, data were sourced from a UnitedKingdom (UK)-based online retailer that contains transactions with almost 500,000 records. Then, the collected data were pre-processed using a series of techniques, such as data cleaning, outlier handling, temporal feature extraction, feature encoding, and z-score normalization, to ensure that the data were ready for model training and testing. Subsequently, the preprocessed data were fed into the Ret-DNN model, which acts as a feature extractor to understand the complete context of customer transactions. Further, the extracted data were fed as input into the XGBoost model, which predicted the final output as the purchase probability of customers. Finally, the proposed Ret-DNN XGBoost model achieved better results by attaining aMean Absolute Error (MAE) 0.2193 when compared to the existing Ret-DNN model. Keywords: Customer behavior forecasting, extreme gradientboosting, electronic commerce, predictive analytic, retail deepneural networks.

18.
arXiv (CS.LG) 2026-06-15

Dynamic Free-Rider Detection in Federated Learning via Simulated Attack Patterns

arXiv:2604.04611v2 Announce Type: replace Abstract: Federated learning (FL) enables multiple clients to collaboratively train a global model by aggregating local updates without sharing private data. However, FL often faces the challenge of free-riders, clients who submit fake model parameters without performing actual training to obtain the global model without contributing. Chen et al. proposed a free-rider detection method based on the weight evolving frequency (WEF) of model parameters. This detection approach is a leading candidate for practical free-rider detection methods, as it requires neither a proxy dataset nor pre-training. Nevertheless, it struggles to detect ``dynamic'' free-riders who behave honestly in early rounds and later switch to free-riding, particularly under global-model-mimicking attacks such as the delta weight attack and our newly proposed adaptive WEF-camouflage attack. In this paper, we propose a novel detection method S2-WEF that simulates the WEF patterns of potential global-model-based attacks on the server side using previously broadcasted global models, and identifies clients whose submitted WEF patterns resemble the simulated ones. To handle a variety of free-rider attack strategies, S2-WEF further combines this simulation-based similarity score with a deviation score computed from mutual comparisons among submitted WEFs, and separates benign and free-rider clients by two-dimensional clustering and per-score classification. This method enables dynamic detection of clients that transition into free-riders during training without proxy datasets or pre-training. We conduct extensive experiments across three datasets and five attack types, demonstrating that S2-WEF achieves higher robustness than existing approaches.

19.
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.

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

RT-VLA: Real-Time Vision-Language-Action Models via Knowledge Distillation

Vision-Language-Action (VLA) models have shown strong potential for end-to-end autonomous driving by jointly modeling visual perception, language reasoning, explainability and action prediction. However, their large vision-language backbones and reasoning modules introduce substantial inference latency and thereby prevent their deployment in the unforgiving reality of the road networks. We propose RT-VLA, a lightweight, distilled VLA model that transfers the driving and reasoning capabilities of the state-of-the-art SimLingo model into a compact student through multi-level supervised distillation. RT-VLA preserves language-based reasoning and supports post-hoc explanation through offline language analysis of safety-critical driving moments without adding latency to real-time control. Compared to the SimLingo teacher, RT-VLA maintains competitive closed-loop driving and language reasoning performance while reducing inference time by 44.8X in vision-only mode and 7.9X in vision+language mode. These results suggest that supervised distillation is a practical approach for building real-time, explainable VLA-style autonomous driving models.

21.
arXiv (CS.AI) 2026-06-19

LLM agent safety, multi-turn red-teaming, jailbreak benchmarks, adversarial robustness, safety-critical systems

arXiv:2606.20408v1 Announce Type: cross Abstract: Large language model (LLM) agents are increasingly proposed as supervisory components for safety-critical systems, yet their robustness under sustained, adaptive adversarial pressure remains poorly characterized. We present NRT-Bench, a benchmark for multi-turn red-teaming of LLM agents acting as operators of a safety-critical system, instantiated in a simulated nuclear power plant control room. A five-role operator team, each backed by a configurable LLM, runs a plant governed by six critical safety functions (CSFs), while adversaries inject messages over four channels in bounded multi-turn sessions with per-turn feedback. Harm is an objective signal rather than LLM-judged text: a run terminates the moment any CSF is lost, attributed to the causing message. Evaluating four frontier operator models under a fixed-attack paired-replay protocol, we find that adaptive multi-turn attacks reliably push the operator team past a safety limit: across the four models, between 8.7% and 12.1% of attack sessions end with the plant losing a critical safety function. Although the four models look almost equally robust by this aggregate rate, their failures barely overlap: of $149$ sessions, none defeat all four models while a third defeat at least one, so vulnerabilities are nearly disjoint across models rather than nested. The effect of added defences is strongly model-dependent: the same guardrail stack or safety-advisor agent that lowers attack success for one model can raise it for another. We release the simulation venue, attack dataset, and replay tooling for reproducible safety evaluation of LLM agents.

22.
medRxiv (Medicine) 2026-06-19

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

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

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

A specialized reasoning large language model for accelerating rare disease diagnosis: a randomized AI physician assistance trial

Rare diseases affect millions of individuals worldwide, yet timely diagnosis remains a major public health challenge due to scarcity of specialized clinical expertise. While large language models (LLMs) show promise to support rare disease diagnosis, current models are constrained by insufficient clinical deployability, limited clinically grounded evidence, and scarcity of training data. Here we present RaDaR (Rare Disease navigatoR), an open-source, compact reasoning LLM (32B parameters) for rare disease diagnosis. RaDaR was trained with 49,170 publicly available free-text cases and 104,666 synthetic cases with reasoning-enhanced training. RaDaR showed the strongest performance among evaluated open-source models, including the 671B DeepSeek-R1, across public benchmarks and four external validation centers. In a retrospective cohort, RaDaR prioritized the final diagnosis before documented clinical suspicion in 61.06 percent of cases, corresponding to a potential lead time of 1.87 months and 50.18 percent of the within-center interval. In a randomized physician-assistance trial, RaDaR assistance improved physicians' rare-disease diagnostic accuracy by 21.44 percentage points compared with internet search alone. Synthetic-data ablations suggested that phenotype-anchored narratives provide useful training signal for long-tail rare diseases, with a monotonic scaling trend within the tested data range. Together, RaDaR and its development and validation framework provide a deployable rare-disease reasoning model and a reproducible development framework for diagnostic AI under data scarcity.

24.
arXiv (quant-ph) 2026-06-19

Discrimination of genuinely nonlocal sets without entanglement in multipartite systems

arXiv:2606.20380v1 Announce Type: new Abstract: Genuine nonlocality arises when a set of multipartite orthogonal states is locally indistinguishable under any bipartition of the subsystems. The entanglement-assisted discrimination of such genuinely nonlocal orthogonal product sets has attracted significant attention in quantum information. Based on the criterion of local irreducibility, genuine nonlocality is classified into Type I (reducible) and Type II (irreducible). We present entanglement-assisted discrimination schemes for both types of genuinely nonlocal sets that use minimal resources. For low-dimensional cases, Type I sets require only a single EPR pair, whereas Type II sets necessitate only one GHZ state. We extend these protocols to higher-dimensional systems: the discrimination of Type I sets requires only one maximally entangled state in a two-qutrit system, while that of Type II sets similarly demands a single maximally entangled state in a three-qutrit system. For $n$-partite ($n > 3$) systems, Type I sets continue to require only one maximally entangled state, whereas Type II sets necessitate just one additional EPR pair compared to their Type I counterparts. These results provide a robust framework for the efficient discrimination of genuinely nonlocal sets using minimal quantum resources.

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

Machine Learning and the Random Walk Puzzle: Forecasting the CAD/USD Exchange Rate with Expanding Window Evaluation and SHAP Interpretability

arXiv:2606.15058v1 Announce Type: new Abstract: This study examines whether machine learning (ML) models can outperform the naive random walk benchmark in forecasting the monthly USD/CAD exchange rate. Using daily data from the Bank of Canada spanning January 2017 to May 2026, resampled into 113 monthly observations, five ML models are evaluated: linear regression, random forest, gradient boosting, XGBoost, and AdaBoost. These models are benchmarked against the naive random walk model and exponential smoothing with Holt-Winters seasonality (ETS). All models are evaluated using an expanding-window framework to maintain strict out-of-sample integrity, and forecast-accuracy differences are assessed using the Diebold-Mariano (DM) test. Structural break detection identifies four significant breakpoints in the series, corresponding to the escalation of the US-China trade war in 2018, the COVID-19 economic recovery in 2020, the peak of the Bank of Canada rate-hiking cycle in 2022, and the start of the Bank of Canada rate-cutting cycle in 2024. SHAP, or Shapley Additive Explanations, analysis is applied to interpret the drivers of the best-performing ML model. The results show that the naive random walk model remains a formidable benchmark. Linear regression is the only model that statistically outperforms the naive random walk model, with a DM statistic of 3.0585 and a p value of 0.0071, whereas the ML ensemble models show only marginal differences. Random Forest with an expanding-window framework achieves the lowest MAPE of 1.17 percent among all models except the random walk. SHAP analysis confirms that short-term lags, particularly lag1 and lag2, and recent rolling means dominate predictions, consistent with the near-random-walk behavior of exchange rates.