Academic Intelligence · Curated Daily

探索全球前沿学术脉络

AcademicHub 汇聚顶级期刊与预印本平台的实时文献。定制您的专属科研雷达,利用大语言模型自动生成交叉领域文献分析简报。

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

ExPLAIND: Unifying Model, Data, and Training Attribution to Study Model Behavior

arXiv:2505.20076v4 Announce Type: replace Abstract: Post-hoc interpretability methods typically attribute a model's behavior to its components, data, or training trajectory in isolation, and are often tied to a particular level of granularity along the local-to-global spectrum. This leads to explanations that lack a unified view and may miss key interactions. We present ExPLAIND, a theoretically grounded, unified framework that integrates model components, data, and training trajectory while supporting explanations across granularities. We generalize recent work on gradient path kernels, reformulating models trained by AdamW as kernel machines. From the resulting kernel feature maps, we derive novel parameter-wise and step-wise influence scores. We empirically validate the resulting decomposition of model behavior in several settings and apply ExPLAIND to two case studies. Our findings on a Transformer exhibiting Grokking support previously proposed learning phases, while refining the final phase as one in which outer layers align around a representation pipeline learned after memorization. For EuroLLM pretraining, ExPLAIND reveals a two-phase dynamic, with the first characterized by outer-layer MLP learning and the second by increased relative influence of intermediate attention layers. These results establish ExPLAIND as a unified framework for interpreting model behavior and training dynamics.

02.
medRxiv (Medicine) 2026-06-19

A soluble bi-specific fusion protein for the improved expansion of human CD8+ CAR-T cells

The success of Chimeric Antigen Receptor (CAR) T cell therapy is heavily dependent on the quality of the final cellular product. Current expansion protocols often rely on reagents that require removal from cell culture media, posing logistical challenges in manufacturing, and can also lead to terminal differentiation. Here, we evaluate the use of a soluble, bead-free T cell activator, T cell expansion protein (T-CEP), as a streamlined alternative for generating potent CAR-T cells. Human T cells were activated with T-CEP or known T cell activators (Dynabeads and TransAct) and transduced with either CD19 or interleukin-13 (IL-13) mutein (tetravariant-13; TV-13)-based CAR lentiviral vectors. Our results demonstrate that T-CEP supports robust CAR-T cell expansion and achieves transduction efficiencies comparable to commercial reagents for both types of CAR-T cells. Notably, T-CEP significantly favored the expansion of CD8+ T cells, yielding an enhanced CD27+ phenotype and a lower CD4:CD8 ratio compared to TransAct. Cytotoxicity assays confirmed that T-CEP-expanded CAR-T cells possess cytolytic function equivalent to commercial reagents for both CARs, while exhibiting lower levels of inflammatory cytokine secretion. In summary, T-CEP represents a competitive alternative to existing expansion agents, as it does not require its removal during CAR-T manufacturing and generates a CD8+ dominant, less-differentiated phenotype without compromising efficacy.

03.
arXiv (CS.LG) 2026-06-11

Characterizing the Impact of NVFP4 Quantization for Low-Power Edge AI Deployment

arXiv:2606.06527v3 Announce Type: replace-cross Abstract: Energy-efficient neural-network inference at the edge requires reducing arithmetic cost, memory traffic, computation energy, and storage overhead while maintaining acceptable accuracy. This paper presents an ablation-focused study of NVFP4 quantization for edge-efficient neural networks, with emphasis on the relationship between activation precision, weight precision, block-size scaling, retraining, and model accuracy. NVFP4 activations are represented using 4-bit FP4 data, an FP8 block scale, and an FP32 tensor scale, enabling ultra-low precision inference while preserving activation dynamic range. A block-size ablation over six edge-efficient models shows that block size B = 16 provides a practical accuracy/storage trade-off, requiring only 4.5078 bits per input for N = 4096. A weight precision ablation further shows that FP8 and FP16 weights provide only modest gains over FP4 weights under the same NVFP4 activation path, suggesting that activation quantization and scaling dominate much of the accuracy behavior. To isolate the benefit of the NVFP4 data type, this work compares conventional unscaled FP4 activation inference and NVFP4 activation inference with and without retraining. The results show that conventional FP4 inference collapses accuracy for most compact models, while NVFP4 without retraining already recovers substantial accuracy by restoring activation dynamic range through FP8 block scaling and FP32 tensor scaling. When combined with retraining, NVFP4 achieves the best accuracy across the evaluated models, demonstrating the effectiveness of scaling-aware FP4 (NVFP4) inference. These findings provide general design guidance for hardware-software co-design of low power edge inference across a broad range of accelerator platforms, including GPUs, Tensor Cores, FPGAs, domain-specific AI accelerators, near-memory computing systems, and emerging edge-computing architectures.

04.
arXiv (math.PR) 2026-06-16

Atypical Decay Rates for Atypical Heights in Random Recursive Trees

arXiv:2604.20139v2 Announce Type: replace Abstract: We establish the large deviation probabilities for the height of random recursive trees, revealing polynomial upper-tail decay and stretched-exponential lower-tail decay. Remarkably, the lower tail features an atypical prefactor that grows to infinity more slowly than any $n$-fold iterated logarithm.

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

RSTR: Reducing SpatioTemporal Redundancy in Diffusion Transformers

Diffusion Transformers (DiTs) have achieved remarkable success in image generation, yet their deployment is hindered by high computational costs. We identify two sources of redundancy. First, temporal redundancy: Classifier-Free Guidance (CFG) applies costly dual forward passes at every timestep, yet guidance matters only at specific steps, and variable scales at critical steps can compensate for skipping others. Second, spatial redundancy: under variable guidance, different transformer blocks exhibit heterogeneous sensitivity, yet uniform calibration across all blocks wastes computation while failing to address their varying requirements. We present RSTR, the first framework to jointly reduce spatiotemporal redundancy in diffusion transformers. Stage-1 addresses temporal redundancy through evolutionary search, discovering sparse guidance schedules with variable scales. Stage-2 addresses spatial redundancy through adaptive rank allocation, assigning calibration capacities to transformer regions based on their sensitivity. Experiments on DiT-XL/2, PixArt-$\alpha$, FLUX, and state-of-the-art Qwen-Image demonstrate 50%-70% compute savings while maintaining or improving quality. On DiT-XL/2, RSTR achieves 57% savings with 15% FID improvement; on Qwen-Image, 3.43$\times$ speedup with preserved quality.

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

Reinforcement Learning for LLM-based Event Forecasting

arXiv:2606.15917v1 Announce Type: new Abstract: We use Group Relative Policy Optimization (GRPO), a recently devised sample and memory efficient reinforcement learning method, to finetune pretrained LLMs in the range of 1.5B to 14B parameters equipped with the ability to get current information through the use of a Wikipedia revisions tool, or news summaries, to forecast real events beyond the knowledge cutoff of the LLM, as well as problems made to simulate different aspects of the dynamics of that training. We use the results of these experiments to comment on the scaling capability of LLMs for forecasting, as well as classify how judgmental forecasting fits into the verifiable/unverifiable domain taxonomy, considering the impact of the inherent aleatoric uncertainty when forecasting future events (e.g. the roll of a die). As a result of the GRPO training, we manage to bring a 1.5B parameter transformer (Qwen 2.5 1.5B) to forecasting performance superior to Claude Sonnet 3.5 over the same dataset as measured by cross entropy from the market agreed probabilities. We also discuss various dead ends on the path to this result.

08.
arXiv (CS.CV) 2026-06-16

Think Less, Act Early: Reinforced Latent Reasoning with Early Exit in Vision-Language-Action Models

Existing Vision-Language-Action (VLA) models predominantly rely on explicit Chain-of-Thought (CoT) reasoning to bridge perception and action. While effective, this paradigm suffers from high computational costs and error propagation in multi-step tasks. In this paper, we propose Adaptive Variable Alignment VLA (AVA-VLA), a novel Latent Reasoning VLA framework that models reasoning as a sequence of unobservable latent variables, bypassing the need for explicit text generation. However, latent trajectories are inherently susceptible to noise interference and misalignment with downstream objectives. To address this, we introduce a Reinforcement Learning-based Denoising mechanism that treats latent state generation as a sequential decision process, optimizing reasoning trajectories via task-level rewards. Furthermore, we incorporate an Early-Exit Strategy that adaptively terminates reasoning based on state confidence, enabling a dynamic trade-off between depth and efficiency. Extensive experiments on embodied decision benchmarks demonstrate that AVA-VLA achieves a 6x inference speedup over explicit CoT methods while attaining a 98.3% average success rate on LIBERO, improving both efficiency and long-horizon stability over full-reasoning baselines.

09.
arXiv (math.PR) 2026-06-16

Interplay of insurance and financial risks in a non Levy-Renewal environment

arXiv:2606.15596v1 Announce Type: new Abstract: In this paper we consider a multivariate risk model, with common counting process and common process of logarithmic returns for the investment portfolio. We assume that the claim-vectors, the counting process and the logarithmic returns of the investment portfolio satisfy a weak dependence structure. Further, we consider that the counting process represents an inhomogeneous renewal process, and the logarithmic returns represent a cadlag process with independent but not necessarily stationary increments. Under these conditions we provide an asymptotic expression for the infinite-time entrance probability of the discounted aggregate claims into some rare set xA, where A denotes a set from a general set family, crucial for the actuarial practice, when the common distribution of the claim vectors belong to a multivariate heavy-tailed distribution class. This result, is derived under a moment condition for the financial risks, and underlines the multivariate linear single big jump principle. When we restrict the distribution class of the claim-vectors to multivariate regular variation, we find more explicit asymptotic expressions, weakening the moment conditions on the financial risks. The asymptotic formulas, derived through double dependence solution, become more direct and practical in applications. With respect to the technical part, due to non Levy-Renewal framework, the classical Kesten-Goldie theorems are not applicable, nor their extensions. The way we make the discretization of the process of the discounted aggregate claims permits to derive uniform asymptotics with respect to the number of summands, that facilitate the approximation of the infinite sums of the main results.

10.
arXiv (CS.AI) 2026-06-17

CyberEvolver: Structured Self-Evolution for Cybersecurity Agents On the Fly

arXiv:2605.26195v2 Announce Type: replace-cross Abstract: LLM-based agents are increasingly used for cybersecurity tasks, but most existing systems rely on fixed, human-designed scaffolds that struggle to adapt across diverse targets and failure modes. We introduce \textsc{CyberEvolver}, a self-evolving cybersecurity agent framework that iteratively revises its own scaffold based on experience from failed execution attempts. Self-evolution in cybersecurity is challenging because the space of possible scaffold changes is largely unstructured, execution feedback is sparse and often obscured by the environment, and low-diversity updates can cause errors to compound over repeated iterations. \textsc{CyberEvolver} addresses these challenges with a four-layer evolvable agent architecture that decomposes scaffold optimization into structured components, a trace-to-diagnosis mechanism that converts noisy execution logs into actionable revision signals, and a population-based beam search strategy that preserves diverse agent variants during evolution. We evaluate \textsc{CyberEvolver} on CTF challenges, vulnerability exploitation, and penetration-testing tasks using four open-source LLMs. Across these settings, \textsc{CyberEvolver} improves the seed agent's success rate by $13.6$\,\% on average, and outperforms six human-designed cybersecurity agents as well as two self-improvement methods adapted from other domains. These results suggest that scaffold self-evolution is a promising direction for building adaptive LLM agents for security testing.

11.
Nature (Science) 2026-06-17

Reimagining machine vision with optical computing

作者: 未知作者

A general-purpose artificial-intelligence vision system for use in image-sensing devices has been developed by embedding fundamentals of core computer-vision operations into a light-manipulating planar material called an optical metasurface. A prototype enables accurate, real-time perception and processing across diverse tasks, suggesting that this could be a solution for rapid, low-energy, on-device vision intelligence. A specialized ‘metasurface’ can preprocess incoming scene information on image-generating devices.

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

GEASS: Gated Evidence-Adaptive Selective Caption Trust for Vision-Language Models

Vision-Language Models (VLMs) hallucinate objects that are not present, and a growing line of work tries to curb this by feeding the model its own generated caption as auxiliary evidence – assuming that a caption, once available, is something to consume. We show this fails: naively appending a caption can lower accuracy rather than raise it, dropping Qwen2.5-VL-3B$^\dagger$ on HallusionBench by nearly ten points. To understand why, we build GD-Probe, a diagnostic set that pairs a global and a detail question on the same image, so that any difference in caption effect is attributable to the question alone. Caption utility proves to be a per-query property: the same caption helps global questions and harms detail ones, through a single mechanism – an embedded caption competes with the image for attention and pulls the model's evidence onto its own text – whose sign is set by whether the caption covers the queried content. Crucially, this regime is readable from quantities the decoder already emits, with no attention access or grounding. We turn this into GEASS (Gated Evidence-Adaptive Selective Caption Trust), a training-free, logit-level module that decides per query how much of the caption to trust, gating it by the clean path's confidence, weighting it by the entropy reduction it induces, and raising the evidence bar when the two pathways disagree. Across four VLMs and two benchmarks (POPE and HallusionBench), GEASS improves over both vanilla inference and contrastive decoding under a single fixed setting, adding only two forward passes and no parameters.

13.
arXiv (CS.CL) 2026-06-16

Know Your Limits : On the Faithfulness of LLMs as Solvers and Autoformalizers in Legal Reasoning

Large Language Models (LLMs) achieve strong performance on reasoning tasks, but whether this reflects faithful logical inference or heuristic approximation remains unclear. We study this question in legal entailment by comparing three paradigms, including pure LLM classification, LLM-based Formal Reasoning, and solver-based Formal Reasoning using the Z3 SMT solver, on a re-annotated subset of ContractNLI across five LLMs. Our re-annotation reveals a systematic and measurable gap between pragmatic legal interpretation and strict formal entailment, where a substantial proportion of legally sound inferences are not formally grounded without additional unstated assumptions. While introducing formal structure improves accuracy, with LLM-based Formal Reasoning achieving the highest benchmark performance, we show that this gain does not imply faithful reasoning. We identify three recurring failure modes: scope laundering, where LLMs report solver-inconsistent classifications without executing the underlying formal reasoning, producing conclusions that appear logically grounded but are not; implicit constraint blindness, where LLMs overlook logical constraints present in formal representations; and program synthesis failures, where LLMs generate incorrect Z3 code despite structured prompting. Critically, scope laundering persists across all models, raising serious concerns about the faithfulness of LLM-based formal reasoning as a proxy for symbolic execution. These results reveal a fundamental gap between benchmark accuracy and logical faithfulness.

14.
arXiv (quant-ph) 2026-06-19

Topological Codes Based on Space Groups

arXiv:2606.20548v1 Announce Type: new Abstract: Topological codes form one of the most important classes of stabilizer codes. Most existing algebraic constructions and analyses of topological codes assume translation invariance. Here we show that topological codes can arise in more general settings by incorporating point group operations. The central construction is a class of Calderbank-Shor-Steane (CSS) codes called space-group codes, whose check operators are built from group-algebra templates over space groups that combine translations with point-group operations. We develop methods for analyzing topological properties of space-group codes using ring-modules and their invariant theory. At first glance, space-group codes might appear to complicate practical implementation; however, we find that they can exhibit greater locality than previous codes based purely on translations. Our framework thus extends the landscape of topological codes and opens up a broader design space for the co-design of topological codes with quantum computing platforms.

15.
arXiv (CS.AI) 2026-06-16

AgenticRec: A Recommendation-Oriented Agentic Framework with Progressive Tool-Integrated Reasoning Optimization

arXiv:2603.21613v2 Announce Type: replace-cross Abstract: Recommender agents built on Large Language Models offer a promising paradigm for personalized recommendation. However, existing agents typically suffer from a misalignment between their tool-integrated reasoning trajectories and recommendation feedback, limiting their ability to distinguish fine-grained user preferences. To address these challenges, we propose AgenticRec, an agentic recommendation framework that formulates recommendation as a tool-integrated reasoning process over a recommendation-oriented tool suite. Built upon this framework, we further develop a dedicated two-stage training paradigm tailored for recommender agents. In the first stage, we introduce Recommendation-Oriented Trajectory Activation, optimize the agentic recommendation ability under implicit feedback. In the second stage, Progressive Preference Refinement further refines the agent through bidirectional preference reasoning over self-bootstrapped hard pairs, progressively sharpening preference boundaries. Theoretical analysis and extensive experiments demonstrate the effectiveness of AgenticRec. Our code is available at https://anonymous.4open.science/r/AgenticRec-FB16.

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

David vs. Goliath in Next Activity Prediction: Argmax vs. LSTM, Transformer, and LLM

arXiv:2606.15868v1 Announce Type: new Abstract: Next activity prediction (NAP) is a cornerstone of predictive process monitoring (PPM), enabling organizations to move from retrospective analysis to proactive process steering. The PPM field has progressed from classical machine learning through deep learning architectures such as LSTMs and Transformers to large language models (LLMs). Despite growing model complexity, no benchmark jointly compares LLMs, Transformers, LSTMs, and simple baselines in a direct sequence modeling setting for NAP. In this paper, we fill this gap with a systematic benchmark. We compare vocabulary-adapted LLMs, Transformers trained from scratch, LLM-distilled Transformers, and LSTMs against a simple counting-based argmax baseline across seven real-life event logs. Our results tell a David vs. Goliath story: pretraining confers no consistent improvement over training from scratch, model size shows little effect on performance, and on most datasets the argmax baseline matches or approaches the performance of billion-parameter LLMs.

17.
bioRxiv (Bioinfo) 2026-06-22

Reference-guided immune recovery matching prioritizes traditional Chinese medicine ingredients

Therapeutic prioritization from single-cell transcriptomes requires a target that is closer to treatment response than disease-signature reversal. In immune diseases, post-treatment recovery may follow patient- and cell-type-specific trajectories rather than a simple return along the pretreatment disease axis. We developed ImmuneNavi, a healthy-reference-anchored recovery-matching workflow for ranking traditional Chinese medicine ingredients from paired PBMC data. The workflow maps heterogeneous PBMC cohorts to a common healthy immune coordinate system, constructs patient-cell-type disease and recovery states, and processes ITCM treated-control profiles into a fixed ingredient perturbation bank. Patient and ingredient states are represented in matched gene, pathway and transcription-factor views, allowing the model to combine local transcriptional direction with more stable program-level features. A matcher trained on one paired treatment cohort preserved recovery-aligned ingredient rankings in independent PBMC cohorts without redefining the feature space, candidate set or preprocessing procedure. This provides a reusable transcriptomic pipeline for moving from paired immune-state measurements to prioritized natural-product candidates for experimental follow-up.

18.
arXiv (math.PR) 2026-06-17

Decay of correlations and zeros for the hard-core model

arXiv:2603.17858v2 Announce Type: replace Abstract: In a recent paper the last author proved that absence of complex zeros of the partition function of the hard-core model near a parameter $\lambda>0$ implies a form of correlation decay called strong spacial mixing. In this paper we investigate the reverse implication. We introduce a strengthening of strong spatial mixing that we call very strong spatial mixing (VSSM). Our main result is that if VSSM holds at a parameter $\lambda>0$ for a family of graphs, this implies that the partition function has no zeros near that parameter for each graph in the family. We also demonstrate that a closely related variant of very strong spatial mixing does not imply zero-freeness. As a consequence of our main result, we moreover obtain that VSSM implies spectral independence. Our proof relies on transforming the problem to the analysis of an induced non-autonomous dynamical system given by Möbius transformations.

19.
arXiv (CS.LG) 2026-06-12

Detecting Explanatory Insufficiency in Learned Representations: A Framework for Representational Vigilance

arXiv:2606.13172v1 Announce Type: new Abstract: Learned representations are central to modern machine learning and are commonly evaluated through predictive performance, robustness, uncertainty estimation, or generalization. However, a learned representation may remain operationally successful while progressively failing to organize persistent residual structures that are not fully captured by conventional evaluation metrics. This article introduces VER, the Vigilant Evaluator of Representations, a conceptual framework for monitoring representational adequacy in learned representations. VER does not propose a new learning algorithm, loss function, or model architecture. Instead, it formalizes a diagnostic process through which persistent residual structures may be identified, analyzed, and interpreted as potential indicators of explanatory insufficiency. The framework distinguishes representational inadequacy from ordinary prediction error, uncertainty, noise, and distribution shift. It introduces a monitoring sequence based on representation identification, explanatory-domain delimitation, residual-structure detection, explanatory-resistance evaluation, and vigilance signaling. VER is intended as a contribution to representation diagnostics in machine learning. Its objective is not to replace existing evaluation methods but to complement them by treating representational adequacy as an explicit object of inquiry. A path toward empirical evaluation through representational-vigilance benchmarks is also outlined.

20.
arXiv (CS.LG) 2026-06-19

Self-Adaptive Scale Handling for Forecasting Time Series with Scale Heterogeneity

arXiv:2606.20010v1 Announce Type: new Abstract: Current time series forecasting (TSF) research predominantly focuses on scale-homogeneous data, where different time series share similar numerical magnitude ranges. However, in real-world industrial scenarios such as financial product sales, different time series often differ by orders of magnitude (scale heterogeneity). Since these series share similar temporal patterns, joint modeling is desirable for better data utilization, yet existing scaling methods either compress low-scale signals (global normalization) or destroy semantic discriminability and amplify inverse-scaling errors (window-based scaling). This paper proposes a self-Adaptive Scale-handling (AS) module that learns adaptive scale factors tailored to each input, preserving semantic discriminability while reducing inverse-scaling errors. AS consists of Scale Calibrating (SC), which calibrates prior mean scaling factors through neural networks, and Scaling Selection (SS), which decides whether to apply calibration or retain the original factor, avoiding over-calibration. Experiments on real-world fund sales datasets from Ant Fortune and Alipay show that AS seamlessly integrates into popular TSF models and consistently improves their performance. The code and dataset are available at the link https://github.com/Meteor-Stars/ASTSF.

21.
medRxiv (Medicine) 2026-06-15

Instrumental Activities of Daily Living in Older Adults with Epilepsy: A Cross-Sectional and Longitudinal Multicenter Study

Objective: Instrumental activities of daily living (IADLs) represent a critical but understudied measure of day-to-day function in persons with epilepsy(PWE). In the multicenter Brain Aging and Cognition in Epilepsy (BrACE) study of PWE aged greater than or equal to 55 years, we examined the proportion, clinical correlates, epilepsy-related predictors, and longitudinal trajectory of IADL impairment. Methods: IADLs were assessed using the Functional Activities Questionnaire (FAQ; range=0 to 30; higher=more impaired); a FAQ greater than or equal to 2 defines MCI-level impairment, and a FAQ greater than or equal to 5 defines dementia-level functional impairment. Multivariable logistic regression identified predictors of baseline function. Global cognition (Montreal Cognitive Assessment [MoCA]), individual cognitive measures, and quality of life (QOL) were compared between the impaired and unimpaired groups. Linear regression evaluated predictors of longitudinal functional decline. Results: Of 57 participants (mean age=66.6 years; female=52.6%), 38.6% (n=22) had MCI-level functional impairment and 17.5% (n=10) had dementia-level functional impairment. In univariate analyses, worse FAQ scores were associated with lower education, higher area deprivation index, early-onset epilepsy (EOE less than 60 years), antiseizure medication polytherapy, and epilepsy localization. In multivariable analysis, temporal lobe epilepsy (OR=4.46, 95% CI=1.09, 21.83,p=0.047), EOE(OR=7.14, 95% CI=1.16, 59.97, p=0.046), and lower education(OR=0.70,95% CI=0.49, 0.93, p=0.025) remained independently associated with baseline MCI-level functional-impairment. Lower education (OR=0.55,95% CI=0.29, 0.84, p=0.021) was the only factor associated with dementia-level IADL-impairment. IADL-impaired participants demonstrated lower verbal memory scores (adjusted p=0.041) and MoCA scores (adjusted p

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

Better Adherence, Richer Context: A Field Evaluation of LLM-Powered Conversational Voice Diaries for Sleep

arXiv:2606.18596v1 Announce Type: cross Abstract: Sleep diaries are central to behavioral sleep medicine and cognitive behavioral therapy for insomnia, yet daily completion is difficult to sustain, and static forms often provide limited context for interpreting night-to-night sleep variation. We designed an LLM-powered conversational voice diary that delivers clinically grounded morning and evening sleep diary questions through proactive smart-speaker prompts, structured conversational intake, and adaptive follow-up dialogue. We evaluated the system in a four-week between-subjects field study with 30 university students, comparing it with a text-based mobile diary using matched diary items, reporting windows, and reminder intervals. Compared with the text-based diary, the conversational voice diary showed higher adherence and elicited more detailed contextual self-report about routines, stressors, environmental conditions, and other sleep-related factors. Participants also described the voice diary as easier to integrate into daily routines, despite longer perceived completion time. However, voice-based conversational intake produced lower completeness for some structured diary fields, revealing a trade-off between expressive richness and structured precision. These findings show both the promise and the challenge of using LLM-powered conversational voice assistants for longitudinal health self-report.

23.
medRxiv (Medicine) 2026-06-19

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

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

24.
medRxiv (Medicine) 2026-06-22

Exploring the association of Obesity on Cold and Warm Autoimmune Hemolytic Anemia in San Joaquin Valley: A Retrospective Cross-Sectional Study

The relationship between obesity and specific autoimmune diseases haas been well-established, specifically due to obesity's role in promoting pro-inflammatory states. Although not much literature has been documented regarding obesity association with AIHA. As such, this study aims to assess any correlations in patients with elevated body mass index (BMI) and autoimmune hemolytic anemia (AIHA). Here we present a retrospective cross-sectional study conducted over a four-year period, across four medical centers during which a new electronic medical record was implemented. The study included 25 patients who had a previously documented history of AIHA from another facility, DAT positive with indicators of hemolysis, or DAT positive with monomer specific antisera. The patients BMI was recorded at the time of presentation to the hospital. However, for patients with a prior history of AIHA or those transferred from another facility, the BMI that was closest to the time period of when the patient was diagnosed with AIHA was used as an adjunct. Our results show that there is an association of patients with elevated BMI (>25) and AIHA; however, various other confounding variables should be taken into consideration, and further research should be done to establish a causal relationship.

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

Learning Policy from a Single Trajectory in Average-Reward Markov Decision Process

arXiv:2606.16729v1 Announce Type: new Abstract: While there is an extensive body of work characterizing the sample complexity of discounted cumulative-reward MDPs, finite sample analyses for average-reward MDPs have been limited, and most existing works rely on restrictive assumptions such as ergodicity or access to a generative model. In this work, we establish the first finite sample complexity guarantees from a single trajectory for weakly communicating average-reward MDPs. To this end, we study the dynamics of a single trajectory in weakly communicating MDPs and based on this analysis, we develop novel model-free methods. Notably, our value-based and policy-based methods provide finite sample complexity guarantees of $\widetilde{O}(1/\varepsilon^2)$ and $\widetilde{O}(1/\varepsilon^4)$ from a single trajectory in weakly communicating MDPs, respectively. Furthermore, we introduce the first model-free method that requires no prior knowledge of problem-dependent quantities for communicating MDPs.