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01.
medRxiv (Medicine) 2026-06-24

Utility of genetic screening for the prediction of severe arrhythmic outcomes in mitral valve prolapse

Background: Cardiomyopathy and channelopathy (CC) gene variants have been linked to sudden cardiac arrest (SCA) or death (SCD) in small, selected pedigree or post-mortem studies of arrhythmic mitral valve prolapse (MVP). However, the utility of clinical whole exome sequencing (WES) panels as a risk stratification tool in unselected MVP samples is unknown. Objectives: The goal of the study was to test the utility of clinical WES panels with CC variant screening for arrhythmic risk stratification in MVP. Methods: We performed research based WES in 203 consecutive MVPs without other arrhythmic substrate. Variants were filtered for rare (

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

Polynomial-Time Mistake-Bounded Language Generation

arXiv:2606.16077v1 Announce Type: cross Abstract: In this note, we introduce a polynomial-time version of the mistake-bounded language generation (MBLG) framework due to Kleinberg, Peale, and Reingold (2026). We observe that the family of parities of variables, and the family of conjunctions of literals, are polynomial-time MBLG. Our main result states that the family of monotone Boolean functions with polynomially-many maxterms is polynomial-time MBLG. This family includes all monotone Boolean functions, computable by polynomial-size decision trees. Our technique can be presented as a new combinatorial game about writing numbers on a board.

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

Advances in 4D Representation: Geometry, Motion, and Interaction

We present a survey on 4D generation and reconstruction, a fast-evolving subfield of computer graphics whose developments have been propelled by recent advances in neural fields, geometric and motion deep learning, as well as 3D generative artificial intelligence (GenAI). While our survey is not the first of its kind, we build our coverage of the domain from a unique and distinctive perspective of 4D representations, to model 3D geometry evolving over time while exhibiting motion and interaction. Specifically, instead of offering an exhaustive enumeration of many works, we take a more selective approach by focusing on representative works to highlight both the desirable properties and ensuing challenges of each representation under different computation, application, and data scenarios. The main take-away message we aim to convey to the readers is on how to select and then customize the appropriate 4D representations for their tasks. Organizationally, we separate the 4D representations based on three key pillars: geometry, motion, and interaction. Our discourse will not only encompass the most popular representations of today, such as neural radiance fields (NeRFs) and 3D Gaussian Splatting (3DGS), but also bring attention to relatively under-explored representations in the 4D context, such as structured models and long-range motions. Throughout our survey, we will reprise the role of large language models (LLMs) and video foundational models (VFMs) in a variety of 4D applications, while steering our discussion towards their current limitations and how they can be addressed. We also provide a dedicated coverage on what 4D datasets are currently available, as well as what is lacking, in driving the subfield forward. Project page:https://mingrui-zhao.github.io/4DRep-GMI/

04.
arXiv (CS.LG) 2026-06-17

CoCoEmo: Composable and Controllable Human-Like Emotional TTS via Activation Steering

arXiv:2602.03420v2 Announce Type: replace-cross Abstract: Emotional expression in human speech is nuanced and compositional, often involving multiple, sometimes conflicting, affective cues that may diverge from linguistic content. In contrast, most expressive text-to-speech systems enforce a single utterance-level emotion, collapsing affective diversity and suppressing mixed or text-emotion-misaligned expression. While activation steering via latent direction vectors offers a promising solution, it remains unclear whether emotion representations are linearly steerable in TTS, where steering should be applied within hybrid TTS architectures, and how such complex emotion behaviors should be evaluated. This paper presents the first systematic analysis of activation steering for emotional control in hybrid TTS models, introducing a quantitative, controllable steering framework, and multi-rater evaluation protocols that enable composable mixed-emotion synthesis and reliable text-emotion mismatch synthesis. Our results demonstrate, for the first time, that emotional prosody and expressive variability are primarily synthesized by the TTS language module instead of the flow-matching module, and also provide a lightweight steering approach for generating natural, human-like emotional speech.

05.
medRxiv (Medicine) 2026-06-11

Polygenic risk scores associate with asthma phenotypes and proteomic analyses implicate IL1R1 in two family-based studies

Despite its high prevalence and the discovery of hundreds of genetic associations, the genetic determinants and heterogeneous manifestations of asthma remain incompletely understood. Incorporating polygenic risk scores (PRS) into asthma research offers a powerful approach to quantify inherited susceptibility, refine risk profiles, and advance mechanistic understanding of disease development. For this study, we leveraged whole-genome sequencing (WGS) data from two family-based cohorts of childhood asthma - the Genetics of Asthma in Costa Rica Study (GACRS) and the Childhood Asthma Management Program (CAMP) - to examine the transmission profiles of externally derived asthma PRS and their associations with clinical phenotypes in children with asthma. To further elucidate molecular mechanisms, we integrated large-scale external genome-wide association study (GWAS) summary statistics and genetic prediction models of protein abundance in a two-step proteome-wide association study (PWAS) of asthma. Our findings provide robust evidence supporting the validity of externally derived asthma PRS (asthma PRS association p-value p={10}^{-24} [GACRS and CAMP trios combined] for the Global Biobank Meta-analysis Initiative [GBMI]) and reveal consistent associations with spirometry measures and atopy markers across both studies, as 13 of 21 traits (62%) were significantly associated with the GBMI-PRS in the meta-analysis after multiple-testing correction. Moreover, the results of the integrative proteomic analysis implicate IL-1 signaling in the etiology of asthma, reinforcing the candidacy of IL1R1 antagonists for drug repurposing.

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

ESMStereo: Enhanced ShuffleMixer Disparity Upsampling for Real-Time and Accurate Stereo Matching

Stereo matching has become an increasingly important component of modern autonomous systems. Developing deep learning-based stereo matching models that deliver high accuracy while operating in real-time continues to be a major challenge in computer vision. In the domain of cost-volume-based stereo matching, accurate disparity estimation depends heavily on large-scale cost volumes. However, such large volumes store substantial redundant information and also require computationally intensive aggregation units for processing and regression, making real-time performance unattainable. Conversely, small-scale cost volumes followed by lightweight aggregation units provide a promising route for real-time performance, but lack sufficient information to ensure highly accurate disparity estimation. To address this challenge, we propose the Enhanced Shuffle Mixer (ESM) to mitigate information loss associated with small-scale cost volumes. ESM restores critical details by integrating primary features into the disparity upsampling unit. It quickly extracts features from the initial disparity estimation and fuses them with image features. These features are mixed by shuffling and layer splitting then refined through a compact feature-guided hourglass network to recover more detailed scene geometry. The ESM focuses on local contextual connectivity with a large receptive field and low computational cost, leading to the reconstruction of a highly accurate disparity map at real-time. The compact version of ESMStereo achieves an inference speed of 116 FPS on high-end GPUs and 91 FPS on the AGX Orin.

07.
arXiv (quant-ph) 2026-06-24

Rotational Vacuum Friction of Nonabsorbing Particles

arXiv:2606.24723v1 Announce Type: new Abstract: A nonabsorbing particle rotating in vacuum can lose angular momentum only by converting mechanical energy into electromagnetic radiation. Here, we develop a quantum theory of rotational vacuum friction for small lossless particles and show that axial symmetry qualitatively changes the leading dissipation channel. At zero temperature, the frictional torque scales as $M\propto\Omega^7$ with rotation frequency $\ Omega$ in anisotropic particles due to the emission of correlated photon pairs whose frequencies sum to $2\Omega$, while a contribution to the torque linear in $\ Omega$ is found at finite temperature. In contrast, axisymmetric particles are protected against photon-assisted friction regardless of temperature.

08.
arXiv (CS.CV) 2026-06-19

Addressing Detail Bottlenecks in Latent Diffusion for RGB-to-SWIR Image Translation

Latent diffusion models (LDMs) enable efficient image-to-image translation but discard fine spatial details during compression, degrading downstream perception tasks. We identify two bottlenecks: the autoencoder, which loses spatial information, and the conditioning pathway, which further degrades the source signal through naive downsampling. We propose two lightweight, backbone-agnostic fixes: a Source-Conditioned Autoencoder (SCAE) that injects high-resolution source features into the decoder via skip connections, and a Learnable Guidance Encoder (LGE) that replaces naive downsampling with a learned conditioning signal. Evaluated on RGB-to-SWIR translation for driving scenes with two denoiser backbones (U-Net and DiT), our approach improves detection mAP by up to 2x over the latent diffusion baseline, with up to 3.4x gains on small objects (COCO-small,

09.
arXiv (quant-ph) 2026-06-17

Einstein-Podolsky-Rosen correlations between mechanical oscillators revealed through SU(1,1) interferometry

arXiv:2606.18202v1 Announce Type: new Abstract: Quantum correlations are essential for achieving quantum advantage in computing, communication and sensing. Moreover, their observation challenges and constrains our fundamental understanding of nature. Mechanical oscillators in the quantum regime provide an appealing platform for preparing and investigating quantum correlations at macroscopic scales. Despite substantial progress, however, continuous-variable quantum correlations stronger than entanglement have not yet been observed in this macroscopic regime. Here, we report the experimental observation of continuous-variable Einstein-Podolsky-Rosen correlations between two spatially-separated mechanical oscillators with an effective mass of $\sim 16 \,\mu g$ each. This is achieved by coupling them to a superconducting qubit which allows for engineering a two-mode squeezing interaction when parametrically driven. Crucially, we show that this interaction can be used to witness quantum correlations through the realization of a mechanical SU(1,1) interferometer. Our results expand the toolbox of operations in circuit quantum acoustodynamics and demonstrate that quantum correlations stronger than entanglement can also be observed in macroscopic systems, thereby shedding light on the boundary between quantum and classical regimes.

10.
arXiv (CS.LG) 2026-06-15

Lower Complexity Bounds for Nonconvex-Strongly-Convex Bilevel Optimization with First-Order Oracles

作者:

arXiv:2511.19656v3 Announce Type: replace Abstract: Although upper bound guarantees for bilevel optimization have been widely studied, progress on lower bounds has been limited due to the complexity of the bilevel structure. In this work, we focus on the smooth nonconvex-strongly-convex setting and develop new hard instances that yield nontrivial lower bounds under deterministic and stochastic first-order oracle models. In the deterministic case, we prove that any first-order zero-respecting algorithm requires at least $\Omega(\kappa^{3/2}\epsilon^{-2})$ oracle calls to find an $\epsilon$-accurate stationary point, improving the optimal lower bounds known for single-level nonconvex optimization and for nonconvex-strongly-convex min-max problems. In the stochastic case, we show that at least $\Omega(\kappa^{5/2}\epsilon^{-4})$ stochastic oracle calls are necessary, again strengthening the best known bounds in related settings. Our results expose substantial gaps between current upper and lower bounds for bilevel optimization and suggest that even simplified regimes, such as those with quadratic lower-level objectives, warrant further investigation toward understanding the optimal complexity of bilevel optimization under standard first-order oracles.

11.
medRxiv (Medicine) 2026-06-11

Global population frequencies of NAT2 star alleles observed in three large biobanks

NAT2 is an important pharmacogene which encodes the N-acetyltransferase 2 enzyme that is involved in the metabolism of multiple medications, and variants in this gene can affect patient response to these medications. CPIC has published a clinical guideline for prescribing hydralazine using NAT2 genotypes. Just prior to the guideline, updated NAT2 star allele numbering and definitions were released, differing somewhat from the historical nomenclature. Clinical pharmacogenomic testing panels often test for the most common star alleles, so knowledge of the most common updated NAT2 star alleles is critical for the implementation of the CPIC NAT2/hydralazine guideline. We first determine NAT2 diplotype frequencies from UK Biobank (UKBB) 200k phased genomes, then analyzed allele, diplotype, and phenotype population frequencies from the All of Us Research program, PennMedicine BioBank (PMBB) and UKBB 500k datasets. We found that analyzing NAT2 diplotypes from phased data provides critical information for algorithms designed to predict diplotypes from unphased data. We observed that NAT2*5, *6, and *4 were the most common star alleles in that order, and the top 11 most frequent NAT2 star alleles were the same across all biobanks. However, differences in star allele frequencies across biogeographical populations were observed. The largest difference led to a higher frequency of NAT2 poor metabolizer phenotypes as compared to rapid and intermediate metabolizer phenotypes in all global populations except in the EAS population, where NAT2 poor metabolizers were in the minority.

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

TokenPilot: Cache-Efficient Context Management for LLM Agents

As LLM agents are deployed in long-horizon sessions, context accumulation drives up inference costs. Existing approaches utilize text pruning or dynamic memory eviction to minimize token footprints; however, their unconstrained sequence mutations alter layouts, introducing prefix mismatches and cache invalidation. This reveals a critical trade-off between text sparsity and prompt cache continuity. To address this, we present TokenPilot, a dual-granularity context management framework. Globally, Ingestion-Aware Compaction acts as a framework harness to stabilize prompt prefixes and eliminate open-world environmental noise at the ingestion gate. Locally, Lifecycle-Aware Eviction monitors the ongoing residual utility of context segments, enforcing a conservative batch-turn schedule to offload content segments only when task relevance expires. Experiments on PinchBench and Claw-Eval under both isolated and continuous modes demonstrate that TokenPilot reduces costs by 61% and 56% in isolated mode, and 61% and 87% in continuous mode, while maintaining competitive performance compared to prior systems. TokenPilot has been integrated into LightMem2 at https://github.com/zjunlp/LightMem2.

13.
arXiv (quant-ph) 2026-06-24

Temperature driven false vacuum decay in coherently coupled Bose superfluids

arXiv:2602.03834v2 Announce Type: replace-cross Abstract: The relaxation of a quantum field from a metastable state (false vacuum) to a stable one (true vacuum), also known as false vacuum decay, is a fundamental problem in quantum field theory and cosmology. We study this phenomenon using a two-dimensional interacting and coherently coupled Bose-Bose mixture, a platform that has already been employed experimentally to investigate false vacuum decay in one dimension. In such a mixture, it is possible to define an effective magnetization that acts as a quantum field variable. Using the Stochastic Gross-Pitaevskii equation (SGPE), we prepare thermal equilibrium states in the false vacuum and extract decay rates from the magnetization dynamics. The decay rates show an exponential dependence on temperature, in line with the thermal theory of instantons. Since the SGPE is based on complex scalar fields, it also allows us to explore the behavior of the phase, which turns out to become dynamic during decay. Our results confirm the SGPE as an effective tool for studying coupled magnetization and phase dynamics and the associated instanton physics in ultracold quantum gases.

14.
arXiv (CS.AI) 2026-06-11

PROJECTMEM: A Local-First, Event-Sourced Memory and Judgment Layer for AI Coding Agents

arXiv:2606.12329v1 Announce Type: new Abstract: AI coding assistants now support a growing share of software work, from quick scripts to production applications. Yet these agents remain largely stateless: each new session re-reads project files, re-derives prior decisions, and - most costly - may repeat debugging attempts that already failed. Reconstructing this context can consume an estimated 5,000-20,000 tokens per session; the bottleneck is often not model capability but missing project memory. We present projectmem, an open-source, local-first memory and judgment layer for AI coding agents. projectmem records development as an append-only, plain-text event log of typed events - issues, attempts, fixes, decisions, and notes - and deterministically projects that log into compact, AI-readable summaries served through the Model Context Protocol (MCP). Beyond storage, projectmem adds a deterministic pre-action gate that warns an agent before it repeats a previously failed fix or edits a known-fragile file. We frame this as Memory-as-Governance: memory that does not merely answer the agent but acts on its next action. The system runs fully offline with no telemetry; its immutable log also serves as a provenance trail for reproducible, auditable AI-assisted development. projectmem ships as a three-dependency Python package (14 MCP tools, 19 CLI commands, 37 automated tests) and is evaluated through a two-month self-study across 10 projects comprising 207 logged events. Source code: https://github.com/riponcm/projectmem.

15.
arXiv (CS.CL) 2026-06-24

MERGE: Minimal Expression-Replacement GEneralization Test for Natural Language Inference

As many benchmarks have become saturated, it has become increasingly important to create new datasets that evaluate the generalization capacity of current state-of-the-art models in reasoning. However, designing high-quality reasoning datasets is challenging, as their manual construction is costly, and their automatic generation is unreliable, often leading to synthetic data with limited scope. In this paper, we propose the Minimal Expression-Replacement GEneralization (MERGE) test that evaluates the robustness of reasoning models against non-adversarial variants of existing evaluation datasets. We automatically obtain high-quality variants from the original instances with Minimal Expression REplacement (MERE) generation, which uses Masked Language Models (MLMs) and safeguarding filters. We apply the MERGE test to Natural Language Inference (NLI), a popular task of reasoning. We generate new NLI datasets from two widely used existing ones with the MERE generation and use them to evaluate multiple strong NLI models. The results indicate that both LLMs and fine-tuned NLI models generalize poorly: they struggle to consistently and correctly classify variants minimally different in form and reasoning from the original ones. Further, we also analyze how certain aspects in variant generation, such as the word class and the source MLMs, affect model performance.

16.
medRxiv (Medicine) 2026-06-22

Understanding and Usefulness of Effect Size and Certainty of Evidence: A Cross-sectional Survey of Evidence-Based Practice Competencies Among Registered Dietitians

Introduction: Understanding of absolute and relative estimates (i.e., effect size), and certainty of evidence corresponding to those estimates, is a fundamental evidence-based practice competency to promote informed clinical decision-making. While research has been conducted in the medical profession, there is no published research on these competencies in the nutrition and dietetics profession. Methods: Among registered dietitians, our main objectives were to assess (1) their understanding and perceived usefulness of three absolute and two relative estimate approaches to assess effect size, (2) their perceived usefulness of certainty of evidence, and (3) factors influencing their understanding and perceived usefulness. We conducted a web-based, cross-sectional survey among dietitians recruited from the Academy of Nutrition and Dietetics (United States). Participants received effect estimates based on hypothetical dietary interventions vs. usual diet for reducing myocardial infarction risk. Results: Of the 11,050 dietitians who received the survey link, 210 participated (2.0% response rate), and only completers (n=114) were included in the analysis. Participants demonstrated a similar understanding of the relative (27.6%) and absolute (27.5%) estimates, with Risk Difference (30.7% correct responses) being the best understood approach and Number Needed to Treat (24.6%) being the least. The understanding of five approaches was not different than random guessing (p>0.05). While perceived usefulness scores were similar between five approaches, they were highest when data was presented as Relative Risk [mean (SD): 4.82 (1.50)]. Dietitians rated the usefulness of certainty of evidence favorably [mean (SD): 5.07 (1.83), on a 7-point scale), and no factors were associated with correct understanding. Conclusion: Dietitians may have limited understanding of how to interpret effect sizes, a finding consistent with surveys of other health professionals. To optimize informed decision-making between dietitians and clients, dietetic programs and continuing education platforms should consider additional training on interpreting effect sizes and certainty of evidence for effect sizes.

17.
arXiv (CS.AI) 2026-06-11

SkillJuror: Measuring How Agent Skill Organization Changes Runtime Behavior

arXiv:2606.11543v1 Announce Type: new Abstract: Agent Skills augment large language model (LLM) agents with procedural knowledge at inference time, but current benchmarks rarely distinguish what a Skill says from how it is organized. We study this distinction through Progressive Disclosure, where a concise root file points agents to supporting resources on demand, and compare it with a normalized flat baseline. We present SkillJuror, a framework for evaluating Skill writing paradigms through semantically controlled variants, matched multi-trial evaluations, and trajectory evidence while holding task knowledge fixed. In an 82-task SkillsBench study, Progressive Disclosure changes runtime behavior before aggregate outcomes: distinct Skill resources touched per trajectory rise from 1.18 to 3.85, and effective uptake events rise from 1.33 to 3.92. It also yields 17 additional verifier-passing trials out of 410 matched trials (+4.1%) over the normalized flat baseline. The benefit is task-dependent. Progressive Disclosure helps when supporting resources guide implementation, checking, or repair, but is weaker when success hinges on exact output conventions, numerical thresholds, or long artifact-generation pipelines. These results show that Skill organization is not mere presentation: it can change how agents search and apply procedural knowledge, while outcome gains depend on whether the exposed resources are actionable for the task. Code is available at https://github.com/zhiyuchen-ai/skill-juror.

18.
arXiv (CS.AI) 2026-06-11

"That's AI Slop, You Bot!" Studying Accusations, Evidence, and Credibility in Online Discourse Towards LLM-Generated Comments

arXiv:2606.12073v1 Announce Type: cross Abstract: Generative AI has made fluent prose cheap to produce, breaking the old promise to readers that good writing meant real thinking. How have readers responded, and what can this tell us about changing anti-AI attitudes? We analyzed 25 million comments from Hacker News and Reddit (2023-2026), combining LLM judgment on 7,500 sampled accusations of AI use, sentiment trajectories, speech-act coding of 300 confirmed accusations of AI use, and a matched-control test of accused versus non-accused parent comments. We found that the pejorative-label share of accusations rose more than tenfold on both platforms while a placebo vocabulary of pre-2022 inauthenticity terms (shill, astroturf) did not. This shift reflected a fast-growing trend of branding any suspicious or seemingly inauthentic prose as "AI slop". The slop frame now constitutes 94 percent of pejorative mentions, with the dominant comments shifting in tone from mockery toward gatekeeping and structural protest. The key surprise comes from a matched-control test which found that prose features that statistically distinguish AI from human text do not predict which human text gets accused as AI. The new accusations work as social gatekeeping of perceived authenticity without actually screening for AI. This research extends signaling theory by showing that substitute signals used socially can grow even when inaccurate if the underlying detection problem cannot be solved at the non-expert level. It shows that AI's effects on writing from the reader side are distinct from those on the production (writer) side. Detection technology cannot resolve this dynamic because the social function of accusations is increasingly to perform social gatekeeping and in-group signaling as opposed to identifying AI-generated writing.

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

LLM-Based Scientific Peer Review: Methods, Benchmarks, and Reliability Challenges

The rapid growth of scientific submissions has pushed traditional peer review toward its scalability limits, motivating the exploration of large language models (LLMs) as intelligent automated evaluation assistants. Although recent studies show that LLMs can generate fluent critiques and approximate reviewer scores, their reliability, robustness, and security as decision-support systems remain insufficiently understood. This survey offers a systems-level analysis of LLM-based scientific peer review, focusing on two core evaluative functions: critique generation and score prediction. We present a structured taxonomy of modeling approaches (including prompt-based, supervised, retrieval-augmented, and alignment-optimized approaches), and synthesize empirical findings across existing benchmarks. We analyze dataset constraints, evaluation shortcomings, and domain concentration biases that limit current assessment practices. Beyond performance metrics, we identify emerging robustness risks, including prompt injection, data poisoning, retrieval vulnerabilities, and reward hacking, which expose automated review pipelines to strategic manipulation. From a data mining perspective, we outline key open challenges in modeling subjective disagreement and cross-domain generalization. By reframing automated peer review as a high-stakes, multi-objective decision problem, this survey provides a roadmap for developing robust, transparent, and trustworthy AI-assisted scientific evaluation systems.

20.
arXiv (quant-ph) 2026-06-24

Clifford Volume and Free Fermion Volume: Complementary Scalable Benchmarks for Quantum Computers

arXiv:2512.19413v2 Announce Type: replace Abstract: As quantum computing advances toward the late-NISQ and early fault-tolerant eras, scalable and platform-independent benchmarks are essential for quantifying computational capacity in a classically verifiable manner. We introduce two volumetric benchmarks, Clifford Volume and Free Fermion Volume, that assess quantum hardware by testing the execution of random Clifford and free fermion operations. These two groups of unitaries possess a combination of properties that make them ideal for benchmarking: (i) each is individually efficient to simulate classically, enabling verification at scale; (ii) together they form a universal gate set; (iii) they serve as essential algorithmic primitives in practical applications (including shadow tomography and quantum chemistry); and (iv) their definitions are formulated abstractly, without explicit reference to hardware-specific features such as qubit connectivity or native gate sets. This framework thus enables scalable and fair cross-platform comparisons and tracks meaningful computational advancement. We demonstrate the practical feasibility of these benchmarks through extensive numerical simulations across realistic noise parameters and through experimental validation on Quantinuum's H2-1 trapped-ion quantum computer, which achieves a Clifford Volume of 34.

21.
medRxiv (Medicine) 2026-06-17

Long-term mortality and cause-specific death after non-cardiac chest pain: a multicentre cohort study of 160,245 patients in China

Abstract Background Non-cardiac chest pain (NCCP) is commonly regarded as a low-risk condition. However, long-term mortality, cause-specific death, and high-risk subgroup characteristics remain poorly defined. Methods In this multicentre registry-linked cohort study, we linked the Chest Pain Center Registry from 101 hospitals in Hunan, China, with the Mortality and Cause of Death Registry. Adults diagnosed with NCCP from Jan 1, 2017, to Dec 31, 2021, were included. We assessed 3-year all-cause, cardiovascular, and non-cardiovascular mortality using Cox, restricted cubic spline, and Fine-Gray models. Findings Among 160,245 patients, 4674 deaths occurred within 3 years (2.9%). Mortality increased sharply after 60.5 years. Age [≥] 60.5 years (adjusted hazard ratio [aHR] 7.49 [95% CI 6.89-8.14]), rural residence (time-varying aHR 1.46 [1.35-1.57] in year 1 and 1.66 [1.46-1.89] in years 1-3), and male sex (aHR 1.47 [1.38-1.57]) independently predicted death. Three-year mortality ranged from 0.3% in younger urban women to 8.4% in older rural men. Cardiovascular diseases accounted for 56.4% of deaths among older patients, whereas other non-cardiovascular causes (22.8%) and malignancy (20.8%) were the largest categories among younger decedents. Interpretation NCCP is not uniformly benign. Age, rural residence, and sex identify patients who could benefit from risk-stratified follow-up, with cardiovascular prevention prioritised for older rural men and broader non-cardiovascular assessment considered for younger patients.

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

ToaSt: Token Channel Selection and Structured Pruning for Efficient ViT

Vision Transformers (ViTs) have achieved remarkable success across various vision tasks, yet their deployment is often hindered by prohibitive computational costs. While structured weight pruning and token compression have emerged as promising solutions, they suffer from prolonged retraining and inter-layer dependencies that complicate optimization, respectively. We propose ToaSt, a decoupled framework applying specialized strategies to distinct ViT components. We apply coupled head-wise structured pruning to Multi-Head Self-Attention modules, leveraging attention operation characteristics to enhance robustness. For Feed-Forward Networks (over 60% of FLOPs), we introduce Token Channel Selection (TCS), a training-free method that filters redundant noise channels at inference time. Extensive evaluations across nine diverse models, including DeiT, ViT-MAE, and Swin Transformer, demonstrate that ToaSt achieves superior trade-offs between accuracy and efficiency, consistently outperforming existing baselines. On ViT-MAE-Huge, ToaSt achieves 88.52% accuracy (+1.64%p) with 39.4% FLOPs reduction. ToaSt also transfers effectively to diverse downstream tasks (COCO detection, ADE20K segmentation, CIFAR-100 classification), achieving 52.2 versus 51.9 mAP on COCO. Code: github.com/SHANNonLab-HUFS/ToaSt

23.
medRxiv (Medicine) 2026-06-24

Automated Text Message Outreach to Increase Diabetes Screening: A Pragmatic Randomized Trial

Background Despite evidence that early intervention can prevent or delay progression to type 2 diabetes, more than 80% of individuals with prediabetes in the United States remain undiagnosed, underscoring the need for scalable strategies to increase uptake. In this study, we evaluated whether a single text message could increase completion of HbA1c-based diabetes screening in routine clinical practice. Methods We conducted a pragmatic randomized controlled trial within Duke University Health System (DUHS). Patients aged 35 years or older who met American Diabetes Association 2022 screening criteria, had no previous diagnosis of diabetes, had not undergone HbA1c testing within the preceding 3 years, and had opted to receive text messages from DUHS were randomly assigned to receive either a single text message encouraging guideline-based diabetes screening and discussion with a primary care provider (intervention group; n=55,494) or usual care (control group; n=5,748). The primary outcome was HbA1c test completion within 24 weeks following message delivery (or no message for controls), analyzed using a Cox proportional hazards model stratified by wave. Secondary outcomes included piecewise hazard ratios for early (weeks 1-4), mid (weeks 5-12), and late (weeks 13-24) intervals and the between-group difference in cumulative testing rate. Findings Text message outreach significantly increased HbA1c test completion over 24 weeks (HR, 1.18 [95% CI, 1.07-1.03]) with the strongest effect in the first four weeks (HR, 1.48 [95% CI, 1.18-1.86]). By the end of the 24-week observation period, cumulative testing reached 9.14% in the messaged group vs 7.83% in controls (between-group difference, 1.31% [95% CI, 0.59-2.07]), corresponding to one additional HbA1c test per 76 messages delivered ($0.51 in messaging costs per additional HbA1c test performed). Rates of prediabetes and diabetes among those screened were similar between groups, indicating no selection bias of higher-risk patients. One additional dysglycemia case was identified per 213 messages sent ($1.43 per case detected).

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

Suppressing Self-Discharging of Quantum Batteries by Cavity Interactions

arXiv:2606.23999v1 Announce Type: new Abstract: We analyse a two-cavity architecture, in which a lossy cavity hosting $N$ qubits is coherently coupled to an auxiliary cavity, as a resource for the storage phase of an open quantum battery at non-zero temperature. Within a local Lindblad treatment in the resonant configuration, we find that the inter-cavity coupling enhances the suppression of self-discharging across every initial preparation, battery size, and temperature we examine, with the protection degrading smoothly as the mean thermal occupation increases. For a single qubit, the energy-basis coherence of a pure superposition leads to better long-time retention than fully excited state, highlighting the beneficial role of quantum coherence in protecting stored energy against thermal degradation. For two-qubit batteries, Bell-state preparations exhibit enhanced long-time ergotropy retention compared with the fully excited state, while the inclusion of qubit-qubit interactions produces only a weak dependence on the interaction type and strength within the parameter regime considered. Extending the analysis to multi-qubit GHZ-charged batteries with all-to-all Heisenberg interactions, we find that the normalized retained ergotropy increases monotonically with the number of qubits. This behavior is consistent with the collective enhancement of the qubit-cavity coupling in the symmetric Dicke manifold, indicating that larger quantum batteries can benefit from improved protection against self-discharge. These findings establish cavity-assisted protection as a promising strategy for mitigating self-discharging and realizing of long-lived quantum batteries in experimentally accessible platforms.

25.
arXiv (CS.CV) 2026-06-17

MODE-RAG: Manifold Outlier Diagnosis and Energy-based Retrieval-Augmented Generation Evaluation

While Multimodal Retrieval-Augmented Generation (M-RAG) enhances Large Vision-Language Models, it remains highly susceptible to cross-modal hallucinations, causal fabrications, and sycophancy. Furthermore, existing mitigation pipelines often face an intervention paradox: static rules tend to unnecessarily disrupt accurate generations, whereas leaving the multi-modal reasoning completely unguided allows existing mismatches to cascade into severe logical fabrications. To quantify and mitigate these hallucinations, we propose a Multi-Agent system, MODE-RAG, driven by Variational Free Energy (VFE) and internal attention states to dynamically gate interventions. High-risk queries are routed to five stage-specific agents, integrating Monte Carlo Tree Search (MCTS) for rigorous causal derivation and logit perturbations to penalize sycophancy. Dedicated Correction and Overseer agents ensure formatting stability and perform post-hoc factual verification. To objectively evaluate our approach, we introduce ModeVent, a challenging subset derived from the MultiVent dataset. Extensive experiments indicate that our system effectively reduces hallucination rates and logical fabrication, significantly improving the robustness of M-RAG systems.