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

Fault Lines: Navigating Ethics and Responsible AI Where National Policy Meets Local Practice in Public Sector Transformation

arXiv:2606.13039v1 Announce Type: cross Abstract: The UK government has adopted a pro-AI stance to help transform public service delivery in the face of severe financial pressures, but the path to translate this vision into responsible AI practice remains ill-defined. While UK policy is often set at the national level, local authorities are responsible for most public service delivery, and the rapid advance of AI-first narratives in the public sector is exposing fault lines in knowledge and practice at this national-local interface. This paper examines how responsible AI is interpreted and implemented at the interface between the UK's central government and local authorities, taking the high-stakes area of Special Educational Needs and Disabilities (SEND) as a case study. We present a thematic analysis of 17 semi-structured interviews with policymakers, practitioners, and third-sector professionals to identify barriers and enabling conditions for responsible AI where national policy meets local practice. We identify five interconnected challenges facing local authorities: shadow usage of AI and data privacy risks, market-government asymmetry in AI provision, insufficient workforce readiness, a lack of standardised definitions and measurements, and gaps in human accountability. For each, participants proposed actionable steps, from strengthening data protection frameworks and rebalancing the market-government relationship to enhancing workforce capacity. Our examination of SEND brings these challenges into sharper focus, showing how high-stakes decisions affecting vulnerable children and families intensify tensions around accountability, fairness, and human oversight, exposing the limits of a principle-based regulatory approach. We argue that responsible public sector AI requires both national policy adjustments and structural reforms to institutional capacity, values, and governance mechanisms at the local level.

02.
medRxiv (Medicine) 2026-06-17

Cross-Device Adaptation of Mirai for Mammography-Based Breast Cancer Risk Prediction

Fine-tuning can adapt pretrained medical imaging models to new clinical datasets, but device-specific domain shifts may limit generalizability. We evaluated Mirai, a mammography-based deep learning model for breast cancer risk prediction, in a large screening cohort containing Hologic and General Electric (GE) full-field digital mammography systems, including GE Premium View (GE PV) and Tissue Equalization (GE TE) post-processing software. Native Mirai showed lower performance on TE images than on Hologic or PV images. Fine-tuning on TE images improved TE performance, particularly for short-term risk prediction, but substantially reduced performance on Hologic images, consistent with catastrophic forgetting. To mitigate this effect, we developed a device-invariant model using interleaved multi-device sampling and conditional adversarial training. This approach largely restored Hologic performance while maintaining improved TE performance, providing better robustness across heterogeneous imaging platforms. Comparison of cumulative and annual risk AUCs over a five-year time horizon further showed that performance gains were driven mainly by short- and intermediate-term predictions. These findings highlight both the value and dangers of device-specific fine-tuning and support balanced domain-adaptation strategies for deploying mammography-based risk models across diverse clinical imaging environments.

03.
arXiv (CS.LG) 2026-06-18

Enhanced Graph Neural Networks using K-Hop Gaussian Diffusion

arXiv:2606.18317v1 Announce Type: new Abstract: Most graph neural network (GNN) cores rely on graph convolutions, typically implemented as message passing between direct (single-hop) neighbors. In many real-world graphs, edges can be noisy or poorly defined, limiting information propagation to local neighborhoods. Existing diffusion kernels, such as Personalized PageRank (PPR) and Heat Kernel, alleviate this issue through global propagation, but still struggle with complex local structures and distant node noise. To address these limitations, we propose a K-Hop Gaussian (KHG) diffusion kernel as a preprocessing module for graph data. KHG introduces multi-hop diffusion with Gaussian weighting for remote nodes, balancing local and global information propagation before applying standard GNNs. Experiments on multiple benchmark datasets demonstrate that KHG significantly outperforms traditional message-passing GNNs, as well as PPR and Heat Kernel diffusion, particularly in noisy or structurally complex graphs.

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

ChronoSurv: A Clinical Pathway-Guided Graph Framework for Multimodal Survival Analysis

arXiv:2606.19140v1 Announce Type: new Abstract: Accurate survival prediction is essential for personalized treatment planning in head and neck cancer, yet remains challenging due to the heterogeneous and high-dimensional nature of multimodal clinical data. While deep survival models have improved predictive performance over classical statistical approaches, existing methods typically rely on static fusion strategies or temporally agnostic modeling, limiting their ability to capture structured clinical workflows. In this work, we propose ChronoSurv, a heterogeneous hierarchical directed graph framework for multimodal survival analysis. ChronoSurv represents patient care as a progression-aware clinical trajectory using directed graphs aligned with key diagnostic steps. A hierarchical topology incorporates fine-grained, coarse, and global representations, further supporting flexible adaptation to missing modalities, while heterogeneous message passing models complex and asymmetric relationships across modalities and clinical steps. Experimental results on two public datasets demonstrate that ChronoSurv achieves state-of-the-art discriminative performance while maintaining statistically reliable calibration. Comprehensive ablation studies further confirm the contribution of each architectural component, highlighting the potential of trajectory-aware graph modeling for multimodal survival prediction.

05.
arXiv (CS.CL) 2026-06-24

An Approach to Simultaneous Acquisition of Real-Time MRI Video, EEG, and Surface EMG for Articulatory, Brain, and Muscle Activity During Speech Production

Speech production is a complex process spanning neural planning, motor control, muscle activation, and articulatory kinematics. While the acoustic speech signal is the most accessible product of the speech production act, it does not directly reveal its causal neurophysiological substrates. We present the first simultaneous acquisition of real-time (dynamic) MRI, EEG, and surface EMG, capturing several key aspects of the speech production chain: brain signals, muscle activations, and articulatory movements. This multimodal acquisition paradigm presents substantial technical challenges, including MRI-induced electromagnetic interference and myogenic artifacts. To mitigate these, we introduce an artifact suppression pipeline tailored to this tri-modal setting. Once fully developed, this framework is poised to offer an unprecedented window into speech neuroscience and insights leading to brain-computer interface advances. The source code and data are available.

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

RegimeVGGT: Layer-Wise Spatially Preserving Redundancy Removal for Visual Geometry Grounded Transformer

Visual Geometry Grounded Transformer (VGGT) recovers dense 3D scene structure from multi-view images in one forward pass, but quadratic cross-frame attention limits its scalability. Existing training-free accelerators reduce computation uniformly along one axis, missing layer heterogeneity. Our spectral, probing, and causal analyses reveal three regimes: shallow layers lack cross-view structure, middle layers drive cross-view alignment, and deep layers are redundant for dense geometry yet their cross-frame attention remains essential for pose. RegimeVGGT applies layer-wise U-shaped compression along two axes: Saliency-Guided Banded Merging protects geometry- and edge-salient tokens, while Selectively Protected K/V Downsampling preserves cross-frame spatial coverage and the pose-critical path through a phase-shifted spatial grid, a reference-frame anchor, and uncompressed camera/register tokens. Training-free, RegimeVGGT achieves a 6.7x speedup over VGGT* at matched reconstruction quality.

07.
medRxiv (Medicine) 2026-06-16

MRMU: A New Paradigm for Mendelian Randomization by Accounting for Measured Covariates and Unmeasured Confounders

Mendelian randomization (MR) is a powerful approach for causal inference, however, its reliability is frequently compromised by unadjusted covariates and unmeasured confounders, such as unmeasured pleiotropy and sample structure. To address these challenges, we introduce MRMU, a novel paradigm for the MR framework. Unlike traditional single-variable or multivariable MR methods, MRMU selects instrumental variables only from the exposure of interest and estimates one exposure effect at a time, while jointly accounting for measured covariates and unmeasured confounders. This design improves the reliability of MR analyses. In simulations and real data, MRMU achieved better type I error control, higher statistical power, and more accurate effect estimation than existing MR methods. Applying to coronary artery disease (CAD), MRMU identified robust cardiometabolic risk factors, including LDL-C, APOB, systolic blood pressure, body mass index, and smoking initiation, with consistent evidence across multiple CAD datasets. In contrast, traits such as HDL-C, height, and educational attainment, which were found to be significant by existing MR methods, were no longer supported by MRMU. MRMU further supported blood pressure-related traits, rather than lipid traits, as the more relevant pathway linking urate to CAD. Finally, by integrating large-scale plasma proteomics data, MRMU identified candidate CAD drug targets beyond established HMGCR- and PCSK9-related pathways, highlighting its utility for therapeutic target prioritization.

08.
medRxiv (Medicine) 2026-06-24

Developing and Evaluating an Online Educational Program for Falls Prevention Care in Community Optometric Primary Care Settings: A Pilot Study

Introduction Globally, falls are the leading cause of injury hospitalisation, with vision being a significant falls risk factor. Community optometrists, as primary eye care professionals, are well positioned to contribute to falls prevention care. However, scant studies have evaluated if education could enable optometrists to incorporate falls prevention care into practice. This two-phase pilot study aimed to design and develop an online education program for community optometrists to deliver primary falls prevention care and to evaluate optometrists reaction to, and learning from, the education. Methods In phase one, an education program was designed by optometrists and falls experts and published online. In phase two, community optometrists were recruited through convenience sampling to undertake the education. Guided by the New World Kirkpatrick model(R) of training evaluation, reaction and learning were evaluated using pre/post surveys. Quantitative data were analysed using Wilcoxon sign-rank tests and McNemar Exact Tests and qualitative responses using inductive content analysis. Results Participants (n=13) reported high levels of satisfaction and engagement with the online education and unanimously endorsed its relevance to clinical practice. Participants demonstrated significantly improved knowledge and awareness of falls prevention post-education, compared to pre-education and were significantly more confident to enact falls prevention care. Perceived enablers to providing falls prevention care included having access to practical resources and ongoing education. Time constraints during consultation and cost to patients for further care if subsequent referrals were made were identified as possible barriers to providing falls prevention care. Conclusion Online education improved community optometrists knowledge and confidence to provide falls prevention care. Further research that evaluates the effectiveness of continuing education for optometrists to enact falls prevention care into practice is required.

09.
arXiv (CS.CL) 2026-06-15

Decoupled Mixture-of-Experts for Parametric Knowledge Injection

Knowledge injection aims to equip large language models (LLMs) with external, domain-specific, or time-sensitive knowledge. Existing approaches typically face a trade-off between flexibility and integration: retrieval-augmented generation keeps knowledge outside the model but only provides prompt-level augmentation, whereas post-training based methods encode new knowledge into shared parameters but may introduce catastrophic forgetting, knowledge conflict, and costly updates. In this paper, we propose Decoupled Mixture-of-Experts (DMoE), a modular architecture for parametric knowledge injection that decouples both experts and the router from the base model. DMoE converts external knowledge corpora into independently updatable expert modules and uses a lightweight uncertainty-aware router to activate relevant experts only when the base model lacks sufficient knowledge during generation. To support efficient auto-regressive inference, DMoE attaches experts only to the final-layer feed-forward network, preserving KV-cache reuse while enabling parameter-level knowledge augmentation. Experiments on knowledge-intensive benchmarks show that DMoE consistently improves answer quality over retrieval and adapter-based baselines.

10.
arXiv (CS.CV) 2026-06-16

SceneCraft: Interactive System for Image Editing via Scene Graph

Recent advances in generative AI have enabled natural language-driven image editing, yet existing systems often fail in complex scenes with multiple interacting objects because they rely heavily on users crafting precise text prompts. To address the absence of structured control, we propose SceneCraft, a novel interactive framework that bridges user intent and model execution by representing images as editable scene graphs. Instead of guessing text prompts through trial and error, users interact directly with a visual graph to perform complex spatial and relational operations. These graph modifications are automatically translated into precise, context-aware editing prompts, effectively eliminating linguistic ambiguity. To ensure robust and diverse results, structured prompts are dispatched to multiple state-of-the-art generative models. Evaluations across diverse editing scenarios show that SceneCraft provides a more intuitive control mechanism, significantly reducing the cognitive burden of manual prompt engineering while generating outputs that users consistently rate as higher in quality and fidelity.

11.
arXiv (quant-ph) 2026-06-15

Quantum-Classical Hierarchical Equations of Motion

作者:

arXiv:2606.14363v1 Announce Type: new Abstract: We develop a quantum-classical hierarchical equations of motion (QC-HEOM) approach for simulating non-Markovian open quantum systems. The method combines the ensemble-averaged classical path reference of the quantum-classical path integral formalism with a hierarchy of auxiliary quantum influence functionals. By incorporating thermal fluctuations through an ensemble average over reference trajectories, the hierarchy is required to represent only the residual quantum memory associated with the imaginary part of the bath response function. Consequently, unlike conventional hierarchical equations of motion, QC-HEOM does not require Matsubara or Padé expansions of the thermal kernel and exhibits only weak temperature dependence of the hierarchy size. Furthermore, because thermal fluctuations are supplied through reference classical trajectories, the framework naturally extends beyond harmonic baths and enables the incorporation of anharmonic and molecular environments through externally generated trajectories. We derive the formalism and demonstrate its exactness for a harmonic bath. Applications to an asymmetric spin-boson model and the seven-site Fenna–Matthews–Olson complex illustrate the accuracy of QC-HEOM. It reproduces benchmark quasi-adiabatic path integral and hierarchical equations of motion results while requiring substantially fewer auxiliary objects, particularly at low temperatures. These results establish QC-HEOM as an efficient framework for treating residual quantum memory in quantum-classical descriptions of open-system dynamics. The separation of thermal fluctuations from residual quantum memory through the use of Wigner trajectories provides an approximate route toward hierarchical treatments of complex anharmonic environments that are inaccessible to conventional HEOM approaches.

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

LentiAvatar: Pseudo-Multiview Reconstruction and Subpixel Prism Rendering for Real-Time Stereoscopic Communication

Real-time stereoscopic video communication has long been a goal of immersive telepresence, yet practical systems still require specialized capture rigs or reduce remote users to a single portrait view. We present LentiAvatar, a Gaussian head-avatar system that connects monocular avatar capture with subpixel-encoded glasses-free lenticular display for real-time autostereoscopic communication. From a monocular portrait video, LentiAvatar reconstructs a controllable head avatar and optimizes it for the lateral viewing zones induced by the display. The method uses natural head turns as pseudo-multiview (PMV) supervision to constrain regions that are otherwise weakly observed in monocular training, including hair, ears, jaw contours, and neck boundaries. Reliable side frames are yaw-binned, aligned to virtual cameras, and supervised within a strict head-and-hair domain; contour-aware losses and staged regularization further suppress ghosting, alpha leakage, and depth instability while preserving lateral detail. At runtime, LentiAvatar renders 32 virtual views and encodes them into a 4K lenticular raster with calibrated subpixel-routing masks. The live-tracker prototype sustains 10.65 FPS, and a subject-specific distilled driver raises the same display pipeline to 38.49 FPS.

13.
medRxiv (Medicine) 2026-06-24

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

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.

14.
arXiv (quant-ph) 2026-06-25

Exact Leg-Cut Influence Functional and Emergence of Gaussian Entanglement Theory in a Statistical-Dressing Ladder Model

arXiv:2606.25669v1 Announce Type: new Abstract: The emergence of Gaussian effective field theories in low-dimensional quantum systems is traditionally understood through top-down frameworks such as bosonization and Luttinger-liquid theory. However, these approaches typically focus on the long-wavelength degrees of freedom in ways that do not directly track how non-Gaussian lattice-scale correlations are progressively discarded under coarse-graining. In this work, we present an exact lattice formulation from which this phenomenon emerges analytically. We analyze a two-leg hard-core ladder under a leg bipartition, where non-local statistical strings cross the entanglement cut. We construct an exact lattice influence-functional representation showing that the reduced state factorizes strictly into a product-state amplitude and a full-counting-statistics functional. By introducing a commuting linked-cluster superoperator hierarchy that bypasses Baker-Campbell-Hausdorff ordering ambiguities, we prove that the first mixedness-generating sector is strictly density-density in character. Under a specific systematic coarse-graining procedure, we analytically derive the suppression of higher-order corrections, providing a controlled, closed-form framework showing how highly non-Gaussian lattice states evolve toward their quadratic continuum form under coarse-graining. We corroborate these analytical predictions through finite-size exact diagonalization and entanglement-spectrum diagnostics.

15.
medRxiv (Medicine) 2026-06-22

Dengue and chikungunya virus transmission in Kinshasa, Democratic Republic of the Congo

Dengue (DENV) and chikungunya (CHIKV) are understudied in the Democratic Republic of the Congo (DRC) and across Africa despite evidence of transmission. We measured DENV and CHIKV IgG seroprevalences in Kinshasa Province, DRC, by antigen-capture ELISA, using dried blood spots from 2021. Force of infection (FOI) was estimated from age-stratified seroprevalences using Bayesian catalytic modeling. Among 1,250 participants, DENV IgG seroprevalence was 38.1% (95% CI: 34.5%-41.8%), increasing with age, and highest within peri-urban Kimpoko sites (54.9%). CHIKV IgG seroprevalence was 24.2% (95% CI: 21.1%-27.6%), increasing with age and comparable between peri-urban Kimpoko and rural Bu, with few seropositives in the city-center. DENV-CHIKV IgG co-occurrence was detected in 12.8% of participants. Time-varying FOI models provided best fit to age-stratified seroprevalences, with spatial variation detected. Sustained DENV and CHIKV circulation across Kinshasa highlights an under-appreciated transmission risk and underscores the need for strengthened arboviral surveillance in the DRC and surrounding region.

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

Few shot chain-of-thought driven reasoning to prompt LLMs for open ended medical question answering

In this paper, we propose a modified version of the MedQA-USMLE dataset, named MEDQA-OPEN, which contains open-ended medical questions without options to mimic clinical scenarios, along with clinician-approved reasoned answers. Additionally, we implement a prompt driven by Chain of Thought (CoT) reasoning, CLINICR, to mirror the prospective process of incremental reasoning, reaching a correct response to medical questions. We empirically demonstrate how CLINICR outperforms the state-of-the-art 5-shot CoT-based prompt (Liévin et al., 2022). We also present an approach that mirrors real-life clinical practice by first exploring multiple differential diagnoses through MCQ-CLINICR and subsequently narrowing down to a final diagnosis using MCQ-ELIMINATIVE. Finally, emphasizing the importance of response verification in medical settings, we utilize a reward model mechanism, replacing the elimination process performed by MCQ-ELIMINATIVE.

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

Experimental Characterization and Modeling of Measurement-Induced State-Transitions in a Fluxonium Superconducting Qubit

arXiv:2606.17866v1 Announce Type: new Abstract: Superconducting qubits are most often measured using dispersive readout, which, ideally, implements a projective quantum non-demolition (QND) measurement. While a larger readout drive can increase the signal and, thus, reduce discrimination errors in the readout, strong microwave drives may also cause non-QND errors by driving the qubit to a state outside the computational subspace. In this work, we experimentally characterize measurement-induced state transitions (MIST) in a fluxonium qubit over its full external flux range. We further numerically calculate the MIST errors, and find that the theory accurately predicts eleven experimentally identified regions with increased MIST. In addition to transitions to higher fluxonium levels, we also find that, at certain flux points, MIST errors are dominated by transitions that include the transmission-line-like array modes of the fluxonium's superinductor. The excellent match between theory and experiment validates that the models accurately predict the occurrence of MIST in these systems, and further highlights the influence of array modes in fluxonium readout.

18.
arXiv (CS.AI) 2026-06-24

Female-RHINO: A Real-Time Scanner-Integrated Framework for Automated Quantitative Uterine MRI Analysis and Structured Reporting

arXiv:2606.24390v1 Announce Type: cross Abstract: Standardized assessment of uterine MRI remains challenging due to anatomical variability, observer dependence, and the lack of workflow-integrated automated analysis tools. This work presents Female-RHINO: (R)eproductive (H)ealth (I)maging A(N)alysis T(O)ol, a real-time AI-assisted framework for automated quantitative uterine MRI analysis and structured reporting during image acquisition. We present an end-to-end system that integrates inline communication with the MRI scanner and deep learning-based analysis to derive quantitative uterine biomarkers from sagittal T2-weighted pelvic MRI. The framework combines segmentation and anatomical landmark detection models trained and evaluated on more than 500 multi-center datasets spanning diverse protocols, vendors, and patient populations. It performs volumetry, detects and quantifies common incidental findings such as fibroids and Nabothian cysts, and extracts six anatomical landmarks for biometric assessment. Results are compiled into a structured clinician-oriented report with integrated visualizations, without manual interaction. Evaluation on independent retrospective and prospective cohorts demonstrated robust performance across varying acquisition settings. Mean Dice similarity coefficients were 0.82 for the uterus and 0.80 for fibroids, with lower but consistent agreement for Nabothian cysts. Landmark detection achieved a mean radial error of 3.7 mm. End-to-end processing was completed in under 70 seconds, enabling availability of results during the ongoing scan. Prospective deployment yielded immediate, standardized, and reproducible analyses supported by inter-observer agreement. The proposed system enables real-time scanner-integrated AI for automated uterine MRI analysis and reporting, with potential to improve standardization, efficiency, and clinical workflow in pelvic imaging.

19.
arXiv (quant-ph) 2026-06-25

A Contactless Heat Engine Driven by Nonreciprocal Fluctuation-Induced Torques

arXiv:2606.25053v1 Announce Type: new Abstract: We describe a contactless heat engine in which quantum and thermal electromagnetic fluctuations act as the working medium. The setup consists of two concentric cylinders held at different temperatures. The inner cylinder stably levitates within the outer one due to repulsive nonequilibrium Casimir forces. The chirality of the setup is broken by using nonreciprocal dielectric materials, akin to application of a magnetic field along the common cylinder axis. Using Rytov fluctuational electrodynamics, we show that heat transfer and torque can be expressed in terms of an angular-momentum-resolved heat flux density, $\Phi_n(\omega)$: each exchanged photon carries energy $\hbar \omega$ and angular momentum $\hbar n$. In reciprocal media contributions from modes $n$ and $-n$ cancel and there is no net torque; nonreciprocity breaks this symmetry and powers rotation of the inner cylinder. Even in the absence of contact, electromagnetic fluctuations produce a frictional torque opposing rotation that we compute. This enables computation of characteristic steady state rotations, and estimation of the engine efficiency (which remains bounded by the Carnot limit). The cylindrical setup provides a natural realization of fluctuation-induced angular-momentum transfer and a possible route toward nanoscale contactless engines.

20.
arXiv (CS.AI) 2026-06-16

MedCollab: IBIS-Guided Multi-Agent Collaboration with Hierarchical Disease Relation Chains for Clinical Diagnosis

arXiv:2603.01131v3 Announce Type: replace-cross Abstract: Clinical diagnosis is a gradual process of evidence integration, in which physicians move from symptoms and medical history to examinations, competing hypotheses, disease relations, and treatment decisions. Large language models have advanced medical text understanding and generation. Yet their clinical use remains limited by weak evidence grounding, opaque reasoning, and inconsistent links among differential diagnosis, final diagnosis, diagnostic basis, and treatment planning. We introduce MedCollab, a multi-agent framework for full-cycle clinical diagnosis and report generation. MedCollab coordinates specialist and examination agents according to patient records. It structures agent deliberation with an Issue-Based Information System (IBIS) protocol, so that each diagnostic position is supported by patient-specific evidence and medical knowledge. It also builds Hierarchical Disease Relation Chains (HDRC) to connect accepted hypotheses through progression, complication, and comorbidity relations. During multi-round deliberation, a verifier-guided consensus module evaluates evidence support, medical plausibility, and logical conflicts. It then adjusts agent contributions and filters unsupported reasoning. Experiments on ClinicalBench and MIMIC-IV show that MedCollab outperforms leading LLMs and medical multi-agent baselines in diagnostic accuracy, evidence consistency, and clinical reasoning quality. These results indicate that structured and auditable collaboration can produce more faithful and clinically coherent diagnostic reports.

21.
arXiv (CS.CV) 2026-06-24

Systematic Exploration of 4-Expert Heterogeneous Mixture-of-Experts via Automated Pipeline Search

We present an automated large-scale search pipeline for heterogeneous 4-Expert Mixture-of-Experts (MoE4) architectures within the LEMUR neural network dataset ecosystem. Building on a hand-crafted heterogeneous MoE reference model, we replace manual design with a deterministic code-assembly generator that systematically combines base architecture families drawn from the LEMUR database into MoE4 ensembles, each governed by a convolutional gating network with temperature scaling, mixup augmentation, and cosine-annealed learning rate scheduling. Over a 28-day campaign on an NVIDIA RTX 4090, the pipeline generated 4,463 candidate models across 197 batches, of which 1,021 were evaluated successfully. A critical finding emerged from the campaign: due to alphabetical enumeration via itertools.combinations, the entire explored search space (4.8% of the theoretical 23,751 possible 4-family combinations) is anchored to a single family, AirNet. We characterise this coverage bias precisely, identify the root cause in the generator, and propose a stratified random sampling fix. Within the AirNet anchored scope, ShuffleNet and MobileNetV3 consistently co-produce the highest-accuracy ensembles (mean accuracy up to 0.632), while FractalNet and MNASNet are identified as low-yield families warranting exclusion in future campaigns. The pipeline, analysis artefacts, and corrected generator are released as part of the open-source NNGPT project at https://github.com/ABrain-One/nn-gpt

22.
arXiv (CS.AI) 2026-06-15

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

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.

23.
PLOS Medicine 2026-06-24

Cardiovascular outcomes and safety associated with statin therapy for primary prevention in older adults with type 2 diabetes: A target trial emulation study

作者:

by Linda Chan, Wanchun Xu, Esther W. Y. Chan, Eric Yuk Fai Wan Background There is limited evidence on the use of statins for primary prevention of cardiovascular disease (CVD) in older adults with type 2 diabetes due to underrepresentation of this population in randomized controlled trials (RCTs). We aimed to determine the effectiveness and safety of statin therapy for primary CVD prevention among type 2 diabetes patients aged ≥75 years. Methods and findings In this cohort study, territory-wide electronic health records (EHRs) from the Hospital Authority Clinical Management System in Hong Kong were used to emulate a sequence of nested target trials. Eligible patients were included in a rolling basis in each calendar month from January 2009 to December 2015, and thus we emulated 84 ‘nested monthly trials’. In each monthly trial, all type 2 diabetes patients aged ≥60 years with elevated low-density lipoprotein cholesterol (≥2.6 mmol/L) in the baseline calendar month were included; patients with a history of type 1 diabetes, CVDs, cancers, muscle-related disorders, or liver dysfunction were excluded from analysis. Eligible individuals were classified into statin initiators or noninitiators based on whether they initiated statin therapy at the time of enrollment. They were categorized into various age groups (60–74, 75–84, ≥85 years) for analysis, with those aged 60–74 years forming a benchmark group to test the validity of the emulated target trial. Patients were followed up until the outcome of interest, death, or the administrative end (December 2018), whichever occurred first. We estimated hazard ratios (HRs) comparing statin use versus nonuse for CVDs, all-cause mortality, muscle-related adverse events (AEs), and liver dysfunction using pooled logistic models, with inverse probability weighting to adjust for time-varying confounders related to treatment adherence, under the assumption of no unmeasured confounding. Propensity score matching was performed on eligible person-trials at baseline, incorporating demographic characteristics, clinical and laboratory parameters, comorbidities, medication history, and healthcare utilization as matching variables. Among 30,804 matched person-trials aged 75–84 years, a significant reduction in the incidence of CVDs (HR 0.69 (95% CI [0.65, 0.75]; p 

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

Attractive and Repulsive Pattern Control in Sequence Generation

arXiv:2606.24911v1 Announce Type: cross Abstract: Variable-order Markov models preserve local symbolic syntax by adapting context length, but long continuations can enter recurring high-order "tunnels": repeated suffixes, locally periodic passages, or copied fragments longer than the formal Markov order. This paper introduces signed pattern control for variable-order Markov generation with BP-Regular sampling. A weighted recurrence automaton computes an activation R for a chosen family of target patterns, and belief propagation samples exactly from P_beta(x) proportional to P_0(x) exp(beta R(x)). Negative coupling makes the target patterns costly during sampling; positive coupling rewards the same patterns and turns them into controlled attractors. The target family may be mined online from overactive generated material, supplied by a score or style vocabulary, or designed as an experimental probe. The main experiments use the online homeostatic case, choosing patterns that become overactive in the sampling history. On six duration-bearing monophonic sources, including Bach and Telemann material, the negative branch reduces generated 8-gram self-reuse, increases the effective number of generated 8-grams, and increases coverage of training-supported 4-gram contexts while preserving substantial lower-order support. A pitch-sequence replication on five Weimar Jazz Database solos gives the same anti-reuse signature outside Baroque material. The same signed mechanism also provides a positive branch for probing attractor basins, phase transitions, and hysteresis in the underlying variable-order model.

25.
medRxiv (Medicine) 2026-06-11

Electrical signatures of divergent connectivity in the human subgenual cingulate cortex

Background: Major depressive disorder remains a leading cause of disability. While subgenual cingulate cortex (sgCC) deep brain stimulation (DBS) shows promise for medically refractory depression, clinical outcomes have been heterogeneous, suggesting that individual differences in neural circuitry engagement may critically influence therapeutic efficacy. We aimed to define the electrophysiological signatures of sgCC efferent connectivity using single-pulse electrical stimulation (SPES) with intracranial stereo-EEG (sEEG) to inform rational targeting and physiological biomarkers for sgCC-DBS. Methods: In four patients undergoing clinically indicated sEEG for seizure mapping, SPES was delivered through sgCC pairs, while distributed brain stimulation-evoked potentials (BSEPs) were recorded across cortical and subcortical sites. Responses were characterized using Canonical Response Parameterization to extract reproducible waveforms and per-trial reliability. Results: sgCC stimulation elicited reproducible, spatially organized BSEPs across frontal, limbic, and paralimbic networks, aligning with known anatomical pathways. Frontal recruitment featured robust, lateralized orbitofrontal activation favoring the ipsilateral central, medial OFC and bilateral ventromedial prefrontal responses. Limbic effects demonstrated bilateral cingulate activation with stronger ipsilateral recruitment and lateralized amygdala and hippocampal responses. Paralimbic engagement included insular responses with subject-specific anterior predominance and bi-hemispheric temporal-polar slow-wave deflections. Conclusion: These findings provide direct electrophysiological evidence of distributed, lateralized sgCC divergent network connectivity in the human brain, offering physiologic confirmation of its role in affective circuitry. The observed topography and laterality have direct applications for sgCC-DBS targeting and implicate BSEP signatures as candidate biomarkers to guide patient-specific therapy.