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01.
medRxiv (Medicine) 2026-06-16

Care Delivery Gap framework: a proof-of-concept patient-reported measure of guideline-referenced care-process omissions in sickle cell disease

作者:
Agbalalah↗Rowaiye↗

Abstract Background:Sickle cell disease (SCD) is concentrated in sub-Saharan Africa, where delivery of guideline-referenced care remains challenging. Current evaluation approaches rely largely on access indicators and clinical outcomes, which do not directly measure care delivery. We developed the Care Delivery Gap (CDG) framework, a patient-reported approach for identifying care-process omissions, and conducted a proof-of-concept study to assess feasibility and explore variation across income strata. Methods: We conducted a cross-sectional framework-development study involving a proof-of-concept sample of 52 individuals with SCD or caregivers recruited through clinics and moderated SCD communities across Africa, North America, and Europe between June 2025 and March 2026. The CDG framework assessed patient-reported omissions in specialist involvement, follow-up continuity, cardiovascular screening, and biochemical surveillance. Analyses were descriptive. Results: Substantial multi-domain care-process omissions were identified despite high reported healthcare engagement. Across geographic income strata, cardiovascular screening was reported by 4/35 (11%) LMIC versus 16/17 (94%) HIC participants, and regular follow-up within the preceding 12 months by 14/35 (40%) versus 16/17 (94%), respectively. High CDG scores, representing 1 omissions across three or four domains, occurred in 20/35 (57%) LMIC compared with 1/17 (6%) HIC participants. Similar disparities were observed across specialist review and vitamin B12 surveillance domains. Conclusion: A structured patient-reported framework identified multi-domain omissions in guideline-referenced SCD care, including among individuals reporting healthcare access. The divergence between access indicators and reported care delivery suggests that service contact alone may not reflect care quality. The framework provides a feasible foundation for future process-level quality measurement in high-burden settings.

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02.
arXiv (CS.LG) 2026-06-12

QoS Improvement in Multi User Cellular-Symbiotic Radio Network Assisted by Active-STAR-RIS

作者:
Rahman Saadat Yeganeh↗Mohammad Javad Omidi↗Farshad Zeinali↗Mohammad Robat Mili↗Mohammad Ghavami↗

arXiv:2401.08301v2 Announce Type: replace-cross Abstract: In this article, we employ active simultaneously transmitting and reflecting reconfigurable intelligent surfaces (ASRIS) to enhance the quality of 6G cellular network services. The network integrates commensal symbiotic radio (CSR) subsystems to facilitate communication between passive Internet of Things (IoT) users and active users, referred to as symbiotic backscatter devices (SBDs) and symbiotic user equipments (SUEs), respectively. Since the SBDs are passive, transmitting information to the SUEs poses significant challenges. To overcome this challenge, we harness the capabilities of massive multiple input multiple output (MIMO) antennas within the base station (BS) to relay the information transmitted by SBDs with greater power. This scheme uses the non-orthogonal multiple access (NOMA) technique for multiple access among all users, and potential interferences are eliminated using successive interference cancellation (SIC). The primary objective is to maximize the throughput between SBDs and SUEs. To achieve this, we formulate an optimization problem involving variables such as active beamforming coefficients at the BS and ASRIS, phase adjustments of ASRIS, and scheduling parameters between CSR and cellular networks. To solve this optimization problem, we used three deep reinforcement learning (DRL) methods: proximal policy optimization (PPO), twin delayed deep deterministic policy gradient (TD3), and asynchronous advantage actor critic (A3C). These methods were simulated, and the results demonstrate that A3C, TD3, and PPO have the best convergence speeds and achieve the highest increases in network throughput, respectively. Finally, the proposed scheme was evaluated using passive simultaneously transmitting and reflecting RIS (STAR-RIS), which demonstrated poorer performance compared to ASRIS.

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03.
arXiv (CS.CV) 2026-06-12

CPAM: Context-Preserving Adaptive Manipulation for Zero-Shot Real Image Editing

作者:
Dinh-Khoi Vo↗Thanh-Toan Do↗Tam V. Nguyen↗Minh-Triet Tran↗Trung-Nghia Le↗

Editing natural images using textual descriptions in text-to-image diffusion models remains a significant challenge, particularly in achieving consistent generation and handling complex, non-rigid objects. Existing methods often struggle to preserve textures and identity, require extensive fine-tuning, and exhibit limitations in editing specific spatial regions or objects while retaining background details. This paper proposes Context-Preserving Adaptive Manipulation (CPAM), a novel zero-shot framework for complicated, non-rigid real image editing. Specifically, we propose a preservation adaptation module that adjusts self-attention mechanisms to preserve and independently control the object and background effectively. This ensures that the objects' shapes, textures, and identities are maintained while keeping the background undistorted during the editing process using the mask guidance technique. Additionally, we develop a localized extraction module to mitigate the interference with the non-desired modified regions during conditioning in cross-attention mechanisms. We also introduce various mask-guidance strategies to facilitate diverse image manipulation tasks in a simple manner. CPAM can be seamlessly integrated with multiple diffusion backbones, including SD1.5, SD2.1, and SDXL, demonstrating strong generalization across different model architectures. Extensive experiments on our newly constructed Image Manipulation BenchmArk (IMBA), a robust benchmark dataset specifically designed for real image editing, demonstrate that our proposed method is the preferred choice among human raters, outperforming existing state-of-the-art editing techniques. The source code and data will be publicly released at the project page: https://vdkhoi20.github.io/CPAM

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04.
medRxiv (Medicine) 2026-06-24

Durability and Seasonal Variation in the Effectiveness of Nirsevimab over Three Seasons in Connecticut

作者:
Xu↗Aparicio-Llorente↗Warren↗Kennedy-Shaffer↗Pitzer↗V. E↗Weinberger↗D. M↗Oliveira↗C. R↗PROVE-ID Group Authors↗

Background Nirsevimab has been widely administered in the United States since 2023 to protect infants and young children from severe disease caused by respiratory syncytial virus (RSV). Although early post-licensure studies have shown high effectiveness against medically attended RSV infection, uncertainty remains about the durability of protection, effectiveness beyond the first RSV season, and the extent to which changing RSV seasonality influences real-world effectiveness. Objective To estimate the effectiveness of nirsevimab against medically attended RSV infection across three consecutive RSV seasons and to examine how effectiveness varies by season and time since immunization. Methods We conducted a test-negative case-control study utilizing electronic health records of infants and young children tested for RSV by polymerase chain reaction in outpatient and inpatient settings within the Yale New Haven Health System between October 1, 2023, and March 1, 2026. Effectiveness of nirsevimab was estimated using multivariable logistic regression, adjusting for age, weekly RSV activity, pre-existing risk factors, and other potential confounders. Variation in effectiveness was examined by season, encounter setting, and time since immunization up to 24 months. Results Overall, 17,755 infants and young children were tested for RSV infection, of whom 2,388 (13.4%) were cases and 15,367 (86.6%) were controls. The overall effectiveness of nirsevimab was 67.3% (95% confidence interval [CI]: 59.8, 73.3%) against all medically-attended RSV infections, 60.2% (95% CI: 49.6, 68.5%) against RSV-associated outpatient visits, and 88.9% (95% CI: 82.3, 93.0%) against RSV-associated hospitalization. Effectiveness against medically attended RSV infection declined across seasons, from 76.7% (95% CI: 60.5, 86.3%) in 2023/24 to 54.4% (95% CI: 33.0, 68.9%) in 2025/26. Lower season-specific effectiveness in later seasons corresponded with progressively delayed RSV activity over. Protection against RSV-associated hospitalization declined with increasing time since immunization, from 92.5% (95% credible interval [CrI]: 85.9, 96.4%) at 1 month, to 77.2% (95% CrI: 60.4, 87.6%) at 6 months, and 39.9% (95% CrI: 2.4, 63.3%) at 12 months post-immunization, after which effectiveness plateaued. Conclusions Nirsevimab remained effective against RSV-associated hospitalization through 6 to 12 months after immunization. Delayed RSV activity was associated with lower effectiveness, highlighting the importance of aligning administration with local RSV circulation.

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

MUSE: Agentic 3D Scene Authoring via Memory-Grounded Incremental Requirement Satisfaction

作者:
Ruijie Xu↗Xinnan Zhu↗Jiayu Ying↗Daoguo Dong↗Yuzhou Ji↗Xin Tan↗

Text-driven 3D scene generation is a promising technique for digital content creation, embodied AI simulation, and interactive design, yet practical workflows often require refining, extending, or correcting existing scenes while preserving non-target content. Existing methods can produce realistic and structurally plausible scenes, but they generally lack editability with requirement-level state tracking, so part-level failures often lead to full-scene regeneration or manual intervention. To tackle this challenge, we formulate controllable 3D scene authoring as incremental requirement satisfaction, unifying construction and editing. In this paper, we present MUSE, a memory-grounded multi-agent framework in which an Architect compiles instructions into structured requirements, a Sculptor executes local scene operations, and an Inspector verifies each step while updating Working, Scene, and Skill Memory. To evaluate requirement-level controllability and preservation-aware editing, we introduce AuthorBench, offering 145 constrained construction cases and a 1,584-case preservation-aware editing pool paired with external structured checks. On full construction cases, MUSE improves All-Goal success from 37.9 to 80.7 and surface-constraint fulfillment from 35.0 to 92.6 over the strongest baseline. On a stratified 240-case editing test split, MUSE achieves 49.6 All-Goal success, 99.9 preservation rate, and only 0.6 unintended change rate. Beyond automated metrics, human evaluations on compared local-editing baselines support stronger alignment with user intent, and downstream navigation-proxy tests indicate stronger spatial stability. Combined with ablations validating our memory designs, these results establish MUSE as an effective framework for controllable 3D scene authoring.

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

Impossibility of superluminal signalling rules out causal loops in conical spacetimes

作者:
Maarten Grothus↗V. Vilasini↗

arXiv:2606.20476v1 Announce Type: cross Abstract: In PRL 129, 110401 it was shown that it is theoretically possible to have operationally detectable causal loops without violating the principle of no superluminal signalling (NSS) in (1+1)-Minkowski spacetime. Whether or not such causal loops are also possible in $d > 1$ spatial dimensions, has remained a key open question. We resolve this question by showing that in a wide class of "conical" spacetimes, including Minkowski with d > 1, NSS does rule out all operationally detectable causal loops, in classical, quantum and post-quantum theories. This establishes that the relationship between the relativistic principles of NSS and no causal loops depends inherently on the geometry of spacetime.

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

Identifiability Without Gaussianity: Symbolic World Models and Near-Infinite Temporal Consistency

作者:
Seth Dobrin↗{\L}ukasz Chmiel↗

Klindt, LeCun, and Balestriero (arXiv:2605.26379) proved that Joint-Embedding Predictive Architectures (JEPAs) achieve linear identifiability, the linear recovery of the world's true latent variables, if and only if the world's latent dynamics follow a Gaussian, stationary process. This Gaussian boundary implies a fundamental limit on temporal consistency: for any non-Gaussian physical system, the representation error of a statistical World Model grows monotonically with time. We prove that this limit is an artifact of the statistical alignment mechanism, not a property of World Models in general. We introduce the Physics-Grounded Symbolic Architecture (PGSA) and prove three results: (1) a PGSA achieves exact linear identifiability for all physical regimes, regardless of the latent distribution; (2) the per-step error of a PGSA is bounded by numerical precision alone; and (3) as a direct consequence, a PGSA maintains temporal consistency for an unbounded number of transitions, a property we term near-infinite temporal consistency. We further prove that statistical World Models cannot achieve this property for any non-Gaussian system, regardless of model capacity or the volume of training data. The algebraic cores of four of the theorems are formalized in Lean 4 with Mathlib4 v4.31.0 (zero sorry placeholders); the Klindt et al. converse is taken as an external premise. The contrast establishes that symbolic grounding in the causal generator of the world's dynamics is the sufficient condition and, in non-Gaussian regimes, the only condition for near-infinite temporal consistency.

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08.
arXiv (CS.AI) 2026-06-17

C2FL: Clustered Continual Federated Learning under Spatial and Temporal Drift

作者:
Davide Domini↗Gianluca Aguzzi↗Lorenzo Pellegrini↗Mirko Viroli↗Lukas Esterle↗

arXiv:2606.18003v1 Announce Type: cross Abstract: Collective Adaptive Systems (CAS) increasingly rely on machine learning to let each node learn from locally sensed data, aligning its behavior with the surrounding environment. Scaling this intelligence, however, raises fundamental challenges: sensed data is often privacy-sensitive, preventing centralized collection; nodes are mobile, traversing regions where nearby nodes perceive similar phenomena while distant ones observe radically different conditions, creating natural spatial clusters; and these distributions evolve over time due to mobility, introducing temporal drift that makes local models progressively stale. These dynamics arise across domains - vehicular sensing, drone-based monitoring, smartphone crowdsensing - yet the interplay of privacy, spatial heterogeneity, and temporal drift severely undermines conventional learning strategies. Therefore, we propose C2FL, a fully distributed Federated Learning (FL) approach where nodes self-organize into learning groups through spatial clustering, reflecting the geographic structure of the environment. To counteract temporal drift, each node combines experience replay with a dwell-time-aware adaptive averaging step, progressively incorporating the regional consensus as it remains longer within the same area, while preserving previously acquired knowledge under evolving distributions. We evaluate our approach on synthetic experiments that systematically reproduce spatial and temporal shifts, showing that standard federated strategies degrade significantly under these conditions and that our method restores robust collective adaptation.

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

Tracking Large-scale Shared Bikes with Inertial Motion Learning in GNSS Blocked Environments

作者:
Feng Liu↗Kejia Li↗Zhiwei Yang↗Chunwei Yang↗Qun Li↗Guobin Wu↗Qiang Ni↗Ruipeng Gao↗

arXiv:2605.07412v2 Announce Type: replace-cross Abstract: Although Global Navigation Satellite Systems (GNSS) provide a general solution for bike tracking outdoors, there still exist complex riding environments where only inertial navigation systems work, such as urban canyons. Despite decades of research, localization using only low-cost inertial sensors still faces challenges such as cumulative drifts and poor robustness caused by filtering methods. Furthermore, sensors such as visual and LiDAR could provide reliable measurements, but they are not suitable for large-scale deployment. In this paper, we propose an inertial tracking framework that integrates bicycle mechanical constraints with a mixture-of-experts model. Specifically, we leverage multiple expert modules to capture shared representations and weight them through the gating mechanism, thus improving multi-task learning performance and enabling uncertainty-aware trajectory estimation. Furthermore, based on the mechanical transmission between the pedal and the rear wheel of a bike, we explore the intrinsic relationship between the rider's periodic pedalling behaviors and acceleration variations, and convert such patterns into bike's wheel speed for dynamic calibration. Experiments with real-world riding data from shared bikes of the DiDi ride-hailing platform demonstrate that our system improves the accuracy of baselines by at least 12%, with wheel speed errors below 0.5 m/s at 95-percentile.

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10.
arXiv (CS.CV) 2026-06-18

A Prototypical Signature Approach for Writer-Independent Offline Signature Verification

作者:
Kecia G. de Moura↗Robert Sabourin↗Rafael M. O. Cruz↗

Offline handwritten signature verification aims to distinguish genuine from forged signatures using static images. Since real forgeries are rarely available, negative samples are usually randomly drawn from genuine signatures of other users to create training data. However, this random selection often lacks diversity, increases redundancy, and escalates computational cost, leading to inefficient training. We propose a data-driven strategy to generate diverse, informative negative samples using prototypical signatures, which are compact, non-identifiable summaries of genuine signature features. Based on the experiments results, we conclude that (i) prototypical signatures yield more informative negative samples, improving the detection of skilled forgeries; (ii) the proposed approach is backbone-agnostic, showing robustness across architectures; and (iii) when combined with a primal-form linear SVM, it serves as an alternative to RBF-based models while significantly improving scalability and computational efficiency. Implementation of the method is available at https://github.com/kdmoura/proto_hsv.

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11.
arXiv (math.PR) 2026-06-12

Stochastic dominations for FK percolation and sharp thinning thresholds for the Ising energy field

作者:
Paul Cahen↗Avelio Sep\'ulveda↗

arXiv:2606.13648v1 Announce Type: new Abstract: At first glance, one would imagine that the energy field of the Ising model, the set of edges whose endpoints share the same spin, is stochastically monotone as a function of the coupling constants. However, this is not generally the case. In this paper, we introduce two weaker notions of stochastic domination that make this result true: $p$–weak and $p$–weak$^\dagger$ domination. Both of these notions depend on a parameter $p$ and we find the optimal values $p$ and $p^\dagger$ so that these dominations hold. One of the key ingredient to obtain some of the results is a new stochastic domination relating FK percolations with different parameters $q,\tilde{q}\geq 1$ that is of independent interest.

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12.
arXiv (CS.CV) 2026-06-25

SPARC: Separating Perception And Reasoning Circuits for Test-time Scaling of VLMs

作者:
Niccolo Avogaro↗Nayanika Debnath↗Li Mi↗Thomas Frick↗Junling Wang↗Zexue He↗Hang Hua↗Konrad Schindler↗Mattia Rigotti↗

Despite recent successes, test-time scaling – i.e., dynamically expanding the token budget during inference as needed – remains brittle for vision-language models (VLMs). Unstructured visual reasoning chains entangle perception and reasoning, leading to long, disorganized contexts where small perceptual mistakes may cascade into completely wrong answers. Reasoning also requires expensive reinforcement learning with hand-crafted rewards. Here, we introduce SPARC (Separating Perception And Reasoning Circuits), a modular framework that explicitly decouples visual perception from reasoning. Inspired by sequential sensory-to-cognitive processing in the brain, SPARC implements a two-stage pipeline where the model first performs explicit visual search to localize question-relevant regions, then conditions its reasoning on those regions to produce the final answer. This separation enables independent test-time scaling with asymmetric compute allocation (e.g., prioritizing perceptual processing under distribution shift), and supports selective optimization (e.g., improving the perceptual stage alone when it is the bottleneck for end-to-end performance). It also accommodates compressed contexts by running global search at lower image resolutions and allocating high-resolution processing only to selected regions, thereby reducing visual token count and compute. SPARC outperforms monolithic baselines and strong visual-grounding approaches across challenging visual reasoning tasks, such as improving Qwen3VL 4B on the $V^*$ VQA benchmark by 6.7 points and surpassing "thinking with images" by 4.6 points in an OOD setting with a $200\times$ lower token budget.

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

Curvature-Guided Geometric Representation for Protein-Ligand Binding Affinity Prediction

作者:
Shuai Li↗Chuan-Xian Ren↗Yuhao Li↗Ziqi Huang↗Yue Pan↗Mingzhe Tang↗Hong Yan↗

arXiv:2606.14159v1 Announce Type: new Abstract: Protein-ligand binding affinity (PLA) prediction is critical in drug discovery. Despite the notable advancements in machine learning-based approaches, existing methods struggle to jointly characterize local geometric organization and globally coordinated cross-molecular interactions, limiting their ability to model complex binding mechanisms. Here, we propose RicciBind, a geometric representation framework that integrates curvature-guided hierarchical structure learning with optimal transport (OT)-based cross-domain alignment to model molecular interactions. Specifically, RicciBind leverages Ricci curvature to capture local interaction tightness within molecular structures, enhancing structural awareness and organizing atomic interactions into curvature-aware hierarchical representations. An OT-based cluster matching mechanism then aligns protein and ligand clusters across heterogeneous domains under geometric constraints, enabling globally consistent correspondences and revealing higher-order interaction patterns beyond local neighborhoods. By coupling curvature-guided structure encoding with OT-driven cross-domain alignment, RicciBind effectively models complex interaction semantics and substantially improves both the accuracy and interpretability of binding affinity prediction. Extensive experiments demonstrate that RicciBind achieved superior predictive performance and generalization across PLA benchmarks and virtual screening tasks. Ablation studies further confirmed the essential role of Ricci curvature in enhancing molecular interaction representations.

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14.
Nature (Science) 2026-06-24

The mutational landscape of STING-induced immunity

作者:
Bing Zhang↗

Stimulator of interferon genes (STING) is an evolutionary conserved immune signalling protein with key roles in host defence, cancer, senescence and inflammation1–3. Downstream of STING, type I interferon, inflammatory cytokine signalling and non-canonical autophagy are governed by a multilayered mechanism integrating ligand-induced structural transitions, protein–protein interactions and coordinated intracellular trafficking4–13. Despite its central role in immunity and relevance as therapeutic target14, the sequence elements that govern STING (in)activation in cells remain incompletely understood. Here we developed a massively parallel assay to systematically chart the sequence-function landscape of STING. Profiling thousands of single amino-acid variants, we identified structural and functional determinants that shape the immunostimulatory capacity of STING and its ability to translate ligand recognition into distinct signalling outputs. Cryogenic-electron microscopy structures of select STING hyperactive variants revealed new regulatory principles dictating conformational transition from inactive to signalling-competent states of STING. Mutational effects are widespread across the functional landscape and can sensitize STING towards the natural ligand 2′3′-cGAMP15–18 or decouple interferon induction from non-canonical autophagy, demonstrating a diversity of possible responses that can be accessed through single point substitutions. Finally, our data showed the clinical and evolutionary relevance of naturally occurring STING protein variants. Collectively, these findings define molecular principles that tune STING activity and chart the landscape of its functional potential across immune contexts. A massively parallel assay systematically charts the sequence-function landscape of the STING signalling protein, and the findings define molecular principles that tune STING activity and show its functional potential across immune contexts.

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15.
medRxiv (Medicine) 2026-06-17

Impact of the disposable vape ban in Great Britain: a representative interrupted time-series study 2022-2026

作者:
Tattan-Birch↗Jackson↗S. E↗Buss↗V. H↗Cox↗Shahab↗Kock↗Bauld↗Brown↗

Objective: To examine changes in vaping and smoking trends following the announcement and implementation of the disposable vape ban in Great Britain. Design: Interrupted time-series analysis of representative monthly cross-sectional data from the Smoking Toolkit Study. Setting: Great Britain. Participants: 118,946 adults ([≥]16y), including 12,042 young adults (16-24y), surveyed between Jan-2022 and Feb-2026. Main outcome measures: Changes in trends in disposable vape use among vapers, and current vaping and smoking prevalence, using seasonally-adjusted generalised additive models with comparisons against a no-ban counterfactual in which pre-announcement trends continued unchanged. Results: The proportion of vapers mainly using disposable devices began to decline following the announcement of the ban in Jan-2024, with the fall accelerating after implementation in June-2025. By Feb-2026, 5.6% (95%CI 4.6-6.9) of adult vapers and 7.1% (5.1-10.1) of young adult vapers mainly used disposables, compared with 62.0% (53.6-71.8) and 63.6% (52.7-76.7), respectively, under a no-ban counterfactual. Increases in vaping prevalence slowed post-announcement and plateaued post-implementation; by Feb-2026, prevalence was lower than the no-ban counterfactual in adults (13.6% v 18.8%; difference -5.2 percentage points, 95%CI -7.1 to -3.3) and young adults (27.8% v 39.1%; -11.3, -18.6 to -4.1). Declines in smoking prevalence stalled among adults and reversed among young adults post-announcement, before shifting downward again post-implementation; by Feb-2026, smoking prevalence was similar to the no-ban counterfactual in adults (difference +0.9 percentage points, -0.5 to +2.2) but possibly higher in young adults (+3.3, -0.5 to +7.1). Conclusions: The disposable vape ban in Great Britain was associated with substantial changes after both announcement and implementation, including a marked reduction in disposable vape use and a slowing then plateauing of growth in overall vaping prevalence. However, declines in smoking also temporarily slowed–and among young adults, reversed–after the announcement, before downward trends resumed after implementation.

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

Worst-case depth hierarchy for shallow quantum circuits

作者:
Min-Hsiu Hsieh↗Michael de Oliveira↗Sathyawageeswar Subramanian↗Xingjian Zhang↗

arXiv:2606.16425v1 Announce Type: new Abstract: Circuit depth is a central resource in complexity theory. While bounded-depth classical circuits admit well-understood hierarchy theorems, the internal structure of constant-depth quantum computation remains comparatively unexplored. We prove an explicit depth hierarchy theorem for $\mathsf{QNC}^0$. For each $d\ge 12$, we construct a family of two-round interactive problems on which no depth-$(d-1)$ quantum circuit can achieve near-perfect success, regardless of gate set, circuit size, or ancillary qubits. In contrast, we prove that our construction admits realizations by simple bounded fan-in quantum circuits of depth larger than $d$ by a small constant factor. Moreover, all bounded fan-in classical circuits of sublogarithmic depth (in the input size) fail to achieve perfect success on these tasks for every $d$, yielding a hierarchy of problems that show unconditional quantum advantage of $\mathsf{QNC}^0$ over $\mathsf{NC}^0$. A key obstacle is the scarcity of lower bound techniques for quantum circuits. To address this, we develop methods to analyze how depth affects a circuit's ability to realize nonlocal correlations amongst its output qubits in a fine-grained manner. Our approach exploits the correspondence between constraint systems and nonlocal games, translating group-theoretic constructions into rigid operator-valued constraint systems and then into non-local games. In particular, we construct constraint systems whose unique faithful operator-valued solutions require every perfect strategy, and every near-perfect strategy to a fixed precision, to implement multi-controlled phase operations. This reduces to a nonlocal unitary-synthesis problem, yielding depth lower bounds for both shallow quantum and classical circuits. These results show that increasing depth strictly increases computational power within $\mathsf{QNC}^0$, establishing a genuinely quantum hierarchy.

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17.
Nature (Science) 2026-06-17

Towards autonomous medical artificial intelligence agents

作者:
Dyke Ferber↗

Large language models (LLMs) show great potential for clinical decision-making, yet most applications remain narrow, task-specific chat tools rather than systems integrated into clinical workflows1,2. However, building physician copilots will require models that operate within the electronic health record (EHR), with governed access to patient data and the ability to initiate permitted EHR actions within defined safety constraints. Yet it remains unproven whether such a system can manage patient cases with physician-level performance. Here we show that MIRA (Medical Intelligence for Reasoning and Action), an autonomous artificial intelligence agent operating in a sandboxed EHR environment, can navigate a large clinical action space to obtain patient histories; order and interpret laboratory, imaging and microbiology tests; generate differential diagnoses; and formulate treatment plans such as prescribing medications, scheduling surgical procedures and planning admissions. In simulations on real patient cases spanning multiple diagnoses, MIRA outperformed physicians in diagnostic accuracy and made guideline-concordant, medication-safe and appropriate admission decisions. Compared with previous LLM applications that addressed isolated subtasks or provided free-text advice, these results suggest that an EHR-integrated artificial intelligence agent can turn clinical intent into structured, actionable EHR operations, possibly making it a more effective decision-support partner for physicians. Further work is needed to establish generalization, safety and governance through prospective, real-world studies. A large language model artificial intelligence agent operating in a sandboxed electronic health record system can autonomously take patient histories, order tests, interpret findings, diagnose conditions and propose treatments, outperforming experienced clinicians while adhering to safety standards and clinical guidelines.

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18.
arXiv (quant-ph) 2026-06-12

Measurement Geometry for Quantum Random Access Codes: Beyond Nayak Bound and Toward Optimality

作者:
Seiseki Akibue↗Rudy Raymond↗Suguru Tamaki↗Kosei Teramoto↗

arXiv:2606.12700v1 Announce Type: new Abstract: Quantum random access codes (QRACs) ask how well N classical bits can be encoded into M qubits while allowing any single bit to be recovered. Although the Nayak bound remains the standard general upper bound on the decoding probability, numerical evidence suggests a stronger upper bound in the small-qubit regime. In this work, we formulate the optimal decoding probability in terms of decoding measurements, reformulating QRAC design as a spectral problem for noncommuting measurements. Using this formulation, we give an elementary proof of the Nayak bound by simplifying the Chernoff-bound argument. Moreover, we refine the argument to obtain upper bounds that improve over Nayak's bound in the entire finite-size regime. The equality conditions of our bounds justify defining mutually unbiased projector-valued measurements (MUPVMs), a generalization of mutually unbiased bases. We show that decoding measurement of any two-qubit QRAC attaining the conjectured bound must form MUPVMs. We also show that any MUPVM, assisted by one ancillary qubit, yields a QRAC with optimal N-scaling decoding probability. Finally, we propose a new MUPVM-based construction for the (M+2,M)-QRAC family attaining the conjectured bound.

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19.
arXiv (CS.CL) 2026-06-25

Scale or Reason? A Compute-Equivalent Analysis of Reasoning Distillation

作者:
Nicolas Boizard↗Hippolyte Gisserot-Boukhlef↗Kevin El Haddad↗C\'eline Hudelot↗Pierre Colombo↗

Distilling reasoning traces from strong teacher models has become the standard recipe for building capable small language models. Yet reasoning traces are 5-20$\times$ longer than standard instruction fine-tuning (IFT) outputs, meaning every practitioner who chooses reasoning distillation implicitly forgoes training a larger IFT model on the same compute budget. Whether this trade-off is worthwhile remains unaddressed. We study it with a controlled experiment: a single teacher generates paired IFT and reasoning outputs for identical prompts by toggling only its reasoning mode, isolating supervision format as the sole variable. Training students at five scales (0.5B to 14B) and evaluating on 18 benchmarks, we find that at matched FLOPs, IFT lies on or near the Pareto frontier across the majority of configurations. Reasoning reaches the Pareto frontier only on open-ended tasks at 7B and above. Even there, a sequential curriculum mixing just 25-50\% reasoning data with IFT captures most of the accuracy benefit at far lower compute cost.

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20.
arXiv (quant-ph) 2026-06-17

DRAG-Compatible Leakage Suppression in Landau–Zener Control via Isoprobability Twins

作者:
Ivo S. Mihov↗Nikolay V. Vitanov↗

arXiv:2506.19572v4 Announce Type: replace Abstract: Analytically solvable models – particularly the Landau-Majorana-Stückelberg-Zener (LMSZ) and Allen-Eberly-Hioe (AEH) models – underpin many quantum-gate implementations and population-transfer protocols. However, their canonical pulse shapes are incompatible with modern leakage-suppression techniques and some systems. Most notably, the constant Rabi envelope of the LMSZ pulse prevents many leakage-suppression approaches, which require smoothness. We address both limitations by developing the concept of isoprobability twin models: distinct pairs of Rabi frequency $\Omega(t)$ and detuning $\Delta(t)$ that yield identical post-pulse transition probabilities based on the Delos-Thorson transformation. In this work, we formalise the method by experimentally demonstrating the equivalence of multiple LMSZ and AEH twin models on IBM's ibm_kyiv processor. Finally, we show a staggering leakage reduction by more than 3 orders of magnitude using a custom DRAG implementation of a cosine LMSZ isoprobability model.

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21.
medRxiv (Medicine) 2026-06-24

Repetitive Transcranial Magnetic Stimulation over Primary Somatosensory Cortex for Upper Limb Function in Stroke: An Exploratory Randomized Controlled Trial

作者:
Lerin Calvo↗Lerma Lara↗Moreno Verdu↗Herrera Rojas↗Remon Ramiro↗Lopez Tapia↗Rodriguez Martinez↗Ferrer Pena↗

Background: Stroke often causes Upper Limb (UL) functional impairments. The Primary Somatosensory Cortex (S1) plays an important role in motor learning. Repetitive Transcranial Magnetic Stimulation (rTMS) over S1 could enhance UL recovery. We aimed to explore its preliminary effects on UL motor activity and function post-stroke. Methods: An exploratory parallel-group randomized controlled trial in people with chronic stroke (>3 months) and moderate hemiparesis was conducted. Participants received 20 sessions of active or sham 5Hz rTMS over affected S1, with Robot-Assisted Therapy and Task-Oriented Training, 5 days/week for 4 weeks. The primary endpoint was UL motor activity (Action Research Arm Test, ARAT). Secondary measures were the UL Fugl-Meyer Assessment (UL-FMA) and sensory outcomes. Results: The baseline-adjusted mean difference (MD) in ARAT was 4.05 points [0.78, 7.33], favoring active stimulation. Secondary measures did not favor active stimulation (UL-FMA: MD = 2.62 [-1.51, 6.76]; sensory outcomes showed no between-group differences). Conclusion: High-frequency rTMS over S1 may enhance UL motor activity (ARAT), but no evidence for motor impairment (UL-FMA) or sensory domains was found. Compensation rather than restoration may underlie this improvement. Stimulation targets should match the intended recovery domain, although larger trials are needed to confirm these preliminary findings.

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22.
arXiv (CS.AI) 2026-06-18

Caring Without Feeling: Affective Dynamics as the Control Layer of Human-AI Agent Collaboration

作者:
Junjie Xu↗Xingjiao Wu↗Zihao Zhang↗Yujia Xu↗Yuzhe Yang↗Jin Zhu↗Luwei Xiao↗Wen Wu↗Liang He↗

arXiv:2606.18259v1 Announce Type: cross Abstract: AI agents that plan, retain memory across sessions, invoke external tools and act with partial autonomy are transforming human–AI collaboration. Research on affective computing, simulated empathy in large language models, trust in automation and AI safety has illuminated important design principles, yet these literatures remain fragmented. No integrated account explains how affective cues operate within agentic collaboration – settings in which humans delegate, monitor and correct consequential tasks. This Review synthesises computational and interactional mechanisms of affective dynamics: the processes through which affective cues, emotion-like behaviour and perceived agent affect shape trust calibration, delegation decisions, error correction, dependence and governance. We trace how model-generated affective signals enter interaction loops that govern reliance, repair and oversight, and propose a framework that treats affect not as an internal property of AI but as a coordination layer through which humans and agents negotiate capability, uncertainty and responsibility. The framework provides a foundation for calibrated measurement, purposeful design and informed governance.

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23.
arXiv (CS.AI) 2026-06-15

Learning Urban Access Costs from Origin-Destination Flows via Inverse Optimal Transport

作者:
Paula Joy B. Martinez↗

arXiv:2606.14157v1 Announce Type: cross Abstract: Cities deliver basic services through mixed public-private facility networks, including schools, clinics, transit providers, and subsidized service points. In these systems, planners often observe where households go, but not the latent cost function through which they trade off factors such as distance, price, and institutional access. We study this urban problem through school choice in the Philippines, where the country's largest national education subsidy is intended to redirect learners from congested public schools to participating private schools. Treating school-to-school enrollment flows as an entropic optimal transport plan, we recover latent choice costs using two complementary inverse optimal transport models: an interpretable distance-banded model with a subsidy term, and a neural cost model trained through a differentiable Sinkhorn forward pass. Applied to 283{,}016 learner trips across 23{,}820 observed flows in the most populated region, the framework estimates a subsidy-equivalent distance, $\lambda^{(k)}$, interpreted as the kilometers of perceived travel cost offset by the subsidy. The case demonstrates how administrative origin-destination data can be transformed into interpretable planning metrics for accessibility-aware subsidy design, facility siting, and urban service allocation.

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24.
arXiv (CS.CL) 2026-06-25

Natural Ungrokking: Asymmetric Control of Which Rules Survive Pretraining

作者:
Juliana Li↗Diya Sreedhar↗

Midway through an ordinary pretraining run, a small language model learns the pronoun-gender rule: cued with a girl's name ("Sue cried because"), it resolves the next pronoun to she, generalizing to held-out probes (0.94 by step 925). By step 3,500 the same model scores near zero on the same probes, although the rule's evidence is still in the training data. We call this within-run reversal natural ungrokking: the corpus decides, with no trace in the loss curve, which learned rules a model keeps. Which rules survive is predictable from one corpus statistic: how often the training stream shows the rule winning. Across un-intervened runs (two corpora, three budgets, three seeds), support frequency decides a rule's fate; the data-to-parameter ratio only modulates how deeply a doomed rule falls. The same emerge-then-collapse dynamics appear in public Pythia checkpoints, collapse depth ordered by model scale as predicted. The forgetting is a displacement: a competing surface pattern out-competes the rule, and the log-probability margin between them crosses zero within 100 training steps of the behavioral collapse. Control over this fate is asymmetric: the same edit that destroys a rule on demand cannot restore it. Flipping support to counter-evidence in place kills the rule with monotone dose-response in two unrelated rules; but injecting support back, even to 450 times the level that naturally sustains it, buys no recovery. Every confirmatory threshold and prediction was pre-registered before the data it governed was read.

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25.
arXiv (CS.AI) 2026-06-11

From Architecture to Output: Structural Origins of Hallucination in Large Language Models and the Amplifying Role of Data

作者:
Md. Rejaul Korim Sadi↗Toufiqur Rahman Tasin↗Golam Mostofa Naeem↗

arXiv:2606.07537v1 Announce Type: cross Abstract: Large language models hallucinate–producing fluent, confident, factually wrong outputs–with a consistency that persists across generations and scales. Existing taxonomies classify hallucination by output type, distinguishing intrinsic from extrinsic failures and faithfulness from factuality divergence. These frameworks are descriptively rigorous but do not identify which internal mechanism produced a given instance. This paper analyses hallucination as a structural consequence of three architectural decisions that together form a compound failure system. Self-attention's co-occurrence learning substitutes statistical proximity for semantic meaning and produces entity confusion, fact misattribution, and semantic drift. The maximum likelihood estimation training objective optimises next-token probability without factual constraint, rewarding statistically plausible outputs regardless of their truth value. Autoregressive decoding's permanent left-to-right commitment under exposure bias ensures that a single wrong token cascades forward through the entire output sequence without revision. Dataset pathologies–long-tail deficiencies, training bias, and synthetic pollution–amplify these vulnerabilities but do not independently cause them. We make three contributions. First, we map each mechanism to a specific output category in the Alansari and Luqman taxonomy, locating intrinsic hallucination in self-attention, extrinsic hallucination in MLE, and logical inconsistency in autoregressive decoding. Second, we show that each commonly cited dataset pathology exploits one of these mechanisms rather than originating hallucination independently. Third, we identify the diagnostic limitation of output-type-only classification and contrast it with inference-layer mitigation approaches.

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