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01.
arXiv (quant-ph) 2026-06-16

Programmable Gauge-Field Textures with Ultracold Atoms in Momentum Space

arXiv:2606.15124v1 Announce Type: cross Abstract: Synthetic gauge fields with ultracold atoms offer a route to quantum matter in which electromagnetic environments can be designed rather than merely imposed. While the Harper-Hofstadter model has been realized in several cold-atom systems, existing implementations are largely limited to spatially uniform magnetic fluxes. Here we experimentally realize a highly programmable two-dimensional momentum-state lattice of ultracold atoms with local control over the Peierls phase pattern, enabling direct implementation of Harper-Hofstadter Hamiltonians with tunable and spatially structured synthetic gauge fields. We observe a crossover from ballistic to strongly flux-modified bulk dynamics with suppressed transport. By introducing a synthetic electric field through site-dependent energy gradients, we further demonstrate Hall-type transverse drift arising from the interplay between electric and magnetic fields. In addition, we engineer a synthetic flux domain wall separating regions with opposite magnetic fluxes and observe anisotropic propagation guided along the interface. These results move cold-atom gauge-field engineering from uniform magnetic backgrounds toward designer gauge textures, providing an experimental setting for transport across programmable topological interfaces.

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

One Polluted Page Is Enough: Evaluating Web Content Pollution in Generative Recommenders

Search-augmented LLMs increasingly mediate everyday consumer recommendations by retrieving live web content. This creates a new risk: generative recommenders may consume polluted web content, such as fake reviews and promotional pages crafted to mislead recommendations. We ask: to what extent do search-augmented LLMs become unwitting promoters of fake products when consuming polluted retrieval results? To answer this, we introduce FORGE (Fake Online Recommendations in Generative Environments), a benchmark for measuring fake-product promotion under controlled web-content pollution. Given an upstream search result, FORGE locally rewrites real products in retrieved web pages into fake ones to simulate web-content pollution, and measures how often the LLM recommends the fake product. FORGE covers 225 real-world products across 15 categories and 5 consumer scenarios. Across 12 commercial and open-weights LLMs, all models are vulnerable: a single polluted page yields fooled rates of up to 27%, while the full top-3 replacement raises this to 73.8%. Vulnerability varies substantially across categories, increasing when models lack stable prior knowledge of the relevant products. Reasoning does not mitigate this vulnerability; instead, it often generates spurious social proof to justify false recommendations. We evaluate three defenses: skepticism prompting and consensus filtering (over model priors or cross-document evidence). Skepticism can exacerbate vulnerability, much like reasoning, while filtering risks suppressing legitimate products. We release FORGE at https://github.com/leoluolol/forge-benchmark.

04.
arXiv (CS.AI) 2026-06-11

Feature-Aligned Speech Watermarking for Robustness to Reconstruction Distortions

arXiv:2606.11828v1 Announce Type: cross Abstract: Audio watermarking aims to embed identifiable information into audio while remaining imperceptible. Existing methods adopt high-fidelity, low-energy designs to preserve perceptual quality, but the resulting watermarks lack robustness under suppression by speech reconstruction models. Improving robustness is challenging due to the inherent robustness-fidelity trade-off in existing designs, where increasing watermark energy improves robustness but reduces fidelity. To address this problem, we propose a feature-aligned watermarking method that aligns the watermark with the original speech feature distribution, allowing higher watermark energy to improve robustness while preserving imperceptibility. We use a pretrained speech codec to generate a pseudo-speech watermark and fuse it into the spectrogram of the input audio, with VAD loss and perceptual losses guiding embedding within voiced regions. Experiments show that our method maintains imperceptibility comparable to existing approaches while substantially improving robustness under both seen and unseen speech reconstruction models.

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

Findings of the MAGMaR 2026 Shared Task

This overview paper presents the results of the shared task for the second workshop on Multimodal Augmented Generation via Multimodal Retrieval (MAGMaR). In this shared task participants submitted systems focused on either (i) video retrieval or (ii) grounded generation of articles given retrieved videos. Teams could submit to either task. For the retrieval task, we had 2 participating teams that submitted a total of 17 systems – all of which beat a baseline derived from the winner of last year's shared task. On the generation side, we had 4 teams submit 16 systems. All teams had at least one generated report that was labeled the best by a human annotator.

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

Virtual Sensing to Enable Real-Time Monitoring of Inaccessible Locations & Unmeasurable Parameters

arXiv:2412.00107v2 Announce Type: replace-cross Abstract: Real-time monitoring of safety-critical interior states remains an open problem in energy systems where physical instrumentation is infeasible. Existing approaches rely on explicit governing equations, finite-dimensional state vectors, or per-instance retraining, which prevents mesh-independent, field-level inference at arbitrary interior coordinates under real-time constraints. We introduce operator-based virtual sensing for nuclear-grade thermal-fluid systems: we use the neural-operator framework to learn solution operators that map sparse boundary measurements to coupled internal fields in physically inaccessible regions, framing the problem class explicitly to distinguish it from classical state estimation and pointwise soft sensing. We instantiate this framework with MIMONet, a branch-trunk operator extended with three practical choices: multi-modal branch encoders for heterogeneous (scalar and function-valued) inputs; multiplicative branch fusion to preserve the bilinear PDE coupling structure; and shared-latent multi-field decoding with per-channel basis projections at the trunk's final layer. Evaluated across escalating complexity, from canonical lid-driven cavity flow to pressurized water reactor subchannels to fully coupled heat exchangers, MIMONet achieves below 5% relative errors and sub-millisecond inference on data-center accelerators (0.35 ms / 46 mJ per heat-exchanger inference on an NVIDIA H200, and sub-millisecond across the A40-H200-GH200 range), while remaining stable under 50% sensor noise. By staying accurate as geometric confinement and physics coupling intensify, MIMONet shows that operator-based virtual sensing can restore observability where physical instrumentation fails, establishing simulation-based feasibility within the evaluated operating envelopes as a step toward future experimental and cross-solver validation for safety-critical energy systems.

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

Patients With Personality: Realistic Patient Simulation through Controlled Diversity and Selective Disclosure

arXiv:2606.17441v1 Announce Type: cross Abstract: Simulating realistic patient interactions is a key requirement to testing clinical applications of LLMs at scale without time-consuming and expensive user studies. However, existing approaches often lack realism and controllability, often oversharing information unprompted, and failing to capture the wide variability of patient behavior. Here, we introduce PatientsWithPersonality (PWP), a patient simulation framework that generates realistic yet diverse virtual patient responses through explicit personality parametrization over a latent patient state. Grounded in HEXACO, a six-dimensional personality space used to quantify and parameterize human behavioral traits, our approach enables fine-grained control over conversational style, cooperativeness, and information disclosure within a unified framework. In a clinician evaluation, PWP is judged nearly as realistic as recorded human actors and clearly ahead of prior simulators, while being flagged as "too informative" far less often. Conditioning on HEXACO axes yields personas whose configured traits are recoverable by both clinicians and an autorater, span a substantially wider behavioral footprint than the closest baseline, and prevent oversharing. Altogether, our framework paves the way for more accurate and informative LLM benchmarking through our realistic and steerable patient simulator.

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

Techniques for Peak Memory Reduction for LoRA Fine-tuning of LLMs on Edge Devices

arXiv:2606.19528v1 Announce Type: cross Abstract: Fine-tuning of Large Language Models (LLMs) using Low-Rank Adaptation (LoRA) on an end-user's data offers personalized experiences while keeping data private, but faces severe memory constraints on consumer hardware. Peak memory during fine-tuning often exceeds device limits, especially for models with billions of parameters and long-context training data. This paper introduces a suite of complementary techniques to reduce memory footprint without sacrificing model quality: (1) base model quantization with on-the-fly dequantization, (2) memory-efficient checkpointing combining selective activation caching and disk offloading, (3) softmax approximation using semantically relevant token subsets, and (4) logits masking. Experiments on Llama-3.2 3B and Qwen-2.5 3B demonstrate up to $26\times$ and $28\times$ reduction in peak memory, enabling fine-tuning on resource-constrained devices.

09.
arXiv (CS.CL) 2026-06-16

Building Customer Support AI Agents at 100M-User Scale: An Evaluation-Driven Framework

The rapid rise in LLM capabilities has made AI agents increasingly viable across a broad range of tasks. Among the most promising applications is building production-ready customer-facing agents, a challenge that demands coordinated excellence in evaluation methodology, context engineering, training, and online measurement. Yet these critical pillars are typically developed in isolation, creating blind spots that only surface after deployment. In this paper, we present a unified framework that bridges offline development with online impact for customer support AI agents at Nubank, a company with 100M+ users. Our approach integrates several key components: (1) structured context engineering tailored to customer support agents, (2) systematic human-in-the-loop prompt iteration, (3) rigorous LLM judge evaluation with measured inter-rater agreement and GEPA optimization for consistency, and (4) ideation-to-production validation. A central insight is that evaluation-pipeline quality directly determines iteration velocity. We present results from five production deployments spanning distinct domains: card delivery, debt management, credit-limit support, card management, and product explanation. These deployments deliver consistent customer-satisfaction gains while substantially accelerating iteration. In our card-delivery deployment, large-scale A/B testing yields a 37 percentage-point improvement in AI transactional Net Promoter Score and a 29 percentage-point gain in self-service rate over prior agent variants, alongside a strong correlation between offline simulation metrics and online outcomes, demonstrating that eval-driven development reliably predicts production impact. On most use cases, AI satisfaction reaches within a few percentage points of expert human agents.

10.
arXiv (CS.AI) 2026-06-12

Multi-Agent Reinforcement Learning from Delayed Marketplace Feedback for Objective-Weight Adaptation in Three-Sided Dispatch

arXiv:2606.13604v1 Announce Type: new Abstract: Dispatch in three-sided marketplaces provides a natural setting for reinforcement learning from world feedback: decisions are evaluated by delayed operational outcomes such as delivery speed, courier utilization, and merchant congestion. We present a deployed reinforcement learning system at DoorDash that adapts dispatch objective weights in a large-scale food-delivery marketplace using delayed signals. Rather than replacing the combinatorial assignment optimizer, a store-level policy learned from logged marketplace data selects a discrete multiplier that shifts the dispatch optimizer's tradeoff between delivery quality and batching efficiency. This interface enables offline policy learning under noisy, delayed, and coupled feedback while preserving production feasibility constraints and operational safeguards. We train a shared value function using centralized offline data and decentralized store-level execution, with Double Q-learning targets and a conservative regularizer to reduce out-of-distribution value overestimation. In a production switchback experiment, the offline-trained policy increases batching and reduces courier-side time costs without degrading customer-facing delivery quality. Results illustrate how world feedback from a live economic and logistics system can be used to safely adapt decision policies online.

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

4DP-QA: Scalable QA for 4D Perception in Vision Language Models

Despite recent advances, Vision Language Models (VLMs) still struggle to grasp the dynamics of the world. We note that the ability to reason about a 4D scene, challenging in itself, is further complicated by two factors. First, VLMs observe motion indirectly via its projection onto 2D images. Second, existing datasets fail to disentangle object and camera motion. To address these challenges, we present a QA generation pipeline that focuses on motion-related scene understanding. We take particular care of the entanglement of camera and object motion by casting tracking in both the traditional way and in a novel, fixed reference system, dubbed True-Motion Tracking, which provides an intuitive description of motion. From this pipeline, we generate a large-scale training dataset of 400K samples, 4DP-QA (4D Perception QA), and a 2.2K-sample benchmark, 4DP-QA-Bench. Training existing models on our dataset yields performance improvements on an external benchmark, validating the effectiveness of our method.

12.
Science (Express) 2026-06-11

Chemically induced skin tumors arise from long-lived stem cells of the upper hair follicle | Science

作者: 未知作者

The identification of the cancer cell of origin is a fundamental question in cancer biology. We used fluorescent lineage tracing of independent mouse skin stem cell populations, single cell transcriptomics, and Duplex sequencing, to identify the origin of chemically induced skin tumors. Tumors arose predominantly from Lgr6+ and / or Lrig1+ stem cells of the upper hair follicle, but only very rarely from the Lgr5 + and Krt19 + hair follicle bulge. Lgr6 + stem cells initiated by dimethylbenzanthracene responded to tumor promoter treatment resulting in clonal expansion of initiated cells carrying the canonical Hras Q61L mutation. Spontaneous mutations in Kras also clonally expanded, but did not generate tumors unless the Hras gene was deleted, thus revealing a competitive interaction between Hras and Kras pathways that influences clonal selection.

13.
arXiv (CS.AI) 2026-06-19

Library-Aware Doubles and Iterative Repair for Large Language Model-Generated Unit Tests in OpenSIL Firmware

arXiv:2606.19725v1 Announce Type: cross Abstract: Validating changes in low-level C firmware is expensive because unit tests (UTs) are fragile under strict build constraints, where missing headers, unresolved symbols, and dependency mismatches frequently prevent compilation and linking. This study introduces an automated UT authoring workflow for the Open-Source Silicon Initialization Library (openSIL) firmware codebase maintained by Advanced Micro Devices (AMD) that reduces manual effort through a large language model (LLM) guided multi-agent pipeline. The workflow combines automated generation of test scaffolds, library-aware creation or reuse of stubs, mocks, and fakes, and an iterative compile-dispatch repair loop driven by build logs and line-coverage feedback. We evaluate the approach using compilation success, repair iterations, dispatch success, and line coverage, with time, cost, and token usage as secondary measures. Across 76 functions under test, the workflow generated compilable UTs for 73 functions. In a configuration without line coverage guidance or retrieval augmentation, mean line coverage reached 73.9%. On a 48-function subset evaluated under both configurations, mean line coverage reached 98.8% with line-coverage guidance alone and reached 94.7% when combined with vector-database retrieval. Results show that automated generation-and-repair pipelines can substantially improve UT creation efficiency and coverage for constrained firmware environments while reducing manual debugging effort.

14.
arXiv (CS.AI) 2026-06-16

Guiding Federated Graph Recommendation with LLM-encoded knowledge

arXiv:2606.15277v1 Announce Type: cross Abstract: Graph-based recommender systems are highly effective at extracting collaborative signals from user–item interactions, and federated learning (FL) allows these models to be trained while preserving user privacy. However, aggregating graph representations across distributed, non-IID clients remains a challenge; structural embeddings learned locally often misalign, and naive averaging fails to capture meaningful cross-client relationships. Most existing federated graph methods rely exclusively on structural aggregation, neglecting the rich, global semantic context available in large language models (LLMs). In this paper, we propose a novel framework that uses LLM-encoded knowledge to guide federated graph recommendation. Specifically, clients learn structural representations from local graphs while simultaneously summarizing their typical interaction patterns into compact semantic vectors via a frozen LLM. The central server then uses these LLM-encoded semantic signals to discover related preference patterns across clients, guiding the selective aggregation of their structural representations. This enables semantically informed cross-client collaboration without exposing raw data. Extensive experiments on standard benchmarks show that guiding structural alignment with LLM-encoded knowledge consistently improves recommendation accuracy over existing federated graph baselines.

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

A CEFR-Inspired Classification Framework with Fuzzy C-Means To Automate Assessment of Programming Skills in Scratch

arXiv:2604.00730v2 Announce Type: replace-cross Abstract: Context: Schools, training platforms, and technology firms increasingly need to assess programming proficiency at scale with transparent, reproducible methods that support personalized learning pathways. Objective: This study introduces a pedagogical framework for Scratch project assessment, aligned with the Common European Framework of Reference (CEFR), providing universal competency levels for students and teachers alongside actionable insights for curriculum design. Method: We apply Fuzzy C-Means clustering to 2008246 Scratch projects evaluated via Dr.Scratch, implementing an ordinal criterion to map clusters to CEFR levels (A1-C2), and introducing enhanced classification metrics that identify transitional learners, enable continuous progress tracking, and quantify classification certainty to balance automated feedback with instructor review. Impact: The framework enables diagnosis of systemic curriculum gaps-notably a "B2 bottleneck" where only 13.3% of learners reside due to the cognitive load of integrating Logic Synchronization, and Data Representation–while providing certainty–based triggers for human intervention.

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

The Backward Stochastic Partial Differential Integral Equations: Solvability and Comparison Principle

arXiv:2606.16237v1 Announce Type: new Abstract: The paper is concerned with the well-posedness of backward stochastic partial differential equations with jumps, also called backward stochastic partial differential integral equations. We start from the proof for the existence and uniqueness of solution to backward stochastic evolution equation with jump in the Gelfand triple framework. Then the well-posedness of both weak solution and strong solution to backward stochastic partial differential integral equation is obtained with the Gelfand triple replaced by specific Sobolev spaces. Finally, the comparison principle for backward stochastic partial differential integral equation is proved, which has potential applications in financial mathematics.

17.
arXiv (CS.LG) 2026-06-15

Beyond task performance: Decoding bioacoustic embeddings with speech features

arXiv:2606.14662v1 Announce Type: new Abstract: Pretrained audio embeddings are standard in bioacoustics, yet little is known about which acoustic features these models encode, nor which are useful for a given task. This hinders transparency and limits extension to rare species or data-scarce domains. Here we reveal which speech-like features are encoded in bioacoustic representations. Using the 88~eGeMAPS features across six taxonomic groups, we apply linear and nonlinear regression probes to quantify which acoustic properties each model captures. Results confirm a ``no free lunch'' pattern: no single model captures the full feature space. A concatenated embedding achieves the highest performance, suggesting complementary acoustic space coverage across models. Loudness features are best encoded ($R^2 = 0.76$) while F0 is hardest to recover ($R^2 = 0.33$). By cross-referencing recoverability with per-species feature salience (NMI), we derive data-driven model selection guidance for bioacoustics.

18.
medRxiv (Medicine) 2026-06-10

Trajectories of brain structure and function in young adult carriers of genetic frontotemporal dementia variants

Background and Objectives: Converging evidence hints at neurodevelopmental effects in genetic frontotemporal degeneration (FTD). In cross-sectional studies, for some genes, young adult FTD variant carriers show differences in brain volumes and cognition compared to familial non-carriers. However, longitudinal trajectories may more sensitively capture FTD-related neurodevelopmental vs. neurodegenerative changes than cross-sectional approaches. This study examined longitudinal trajectories of brain volumes, executive function, and plasma biomarkers in young adult carriers compared to familial non-carriers, as measures of neurodevelopmental and neurodegenerative outcomes of FTD-causing variants. Methods: This longitudinal cohort study comprised participants, aged 18-30 years, from the FTD Prevention Initiative across Europe, Canada, and the USA. Genetic groups included C9orf72 (47%), MAPT (30%), and GRN (23%). Linear mixed-effects models were computed to assess longitudinal outcomes across age between groups, controlling for sex, scanner (for brain volumes), and education (for executive function); random effects accounted for between-subject variability nested within family membership. Results: Variant carriers (n=147) and familial non-carriers (n=113) did not differ in age (mean{+/-}SD, 25.9{+/-}3.2 years), sex (53% female), or number of visits (2.1{+/-}1.7). Young adult C9orf72 repeat expansion carriers exhibited smaller thalamic volumes than non-carriers at the reference age of 26 years (b=-982.8mm3, SE=317.0, p=0.0046, f2=0.32), with relatively stable trajectories across ages 18-30 (i.e., no change over time). Trajectories of rostral anterior cingulate volumes differed in C9orf72 carriers and non-carriers across age, where carriers showed relatively stable trajectories and non-carriers showed age-appropriate declines (b=64.4mm3, SE=29.9, p=0.035, f2=0.07). For MAPT and GRN, there were little to no differences in total brain, cortical, or subcortical volumes between groups and over time. No longitudinal differences were observed between carriers and non-carriers in executive function, or plasma NfL or GFAP for any genetic group. Discussion: C9orf72 repeat expansions were linked to smaller average thalamic volumes and stable trajectories between ages 18 to 30, supporting potential neurodevelopmental origins. The modest evidence supporting an absence of difference in neurodegenerative biomarkers and executive function suggests minimal early neurodegeneration and functional preservation in young adulthood.

19.
arXiv (CS.AI) 2026-06-15

LLM-Powered AI Agent Systems and Their Applications in Industry

arXiv:2505.16120v3 Announce Type: replace Abstract: The emergence of Large Language Models (LLMs) has reshaped agent systems. Unlike traditional rule-based agents with limited task scope, LLM-powered agents offer greater flexibility, cross-domain reasoning, and natural language interaction. Moreover, with the integration of multi-modal LLMs, current agent systems are highly capable of processing diverse data modalities, including text, images, audio, and structured tabular data, enabling richer and more adaptive real-world behavior. This paper comprehensively examines the evolution of agent systems from the pre-LLM era to current LLM-powered architectures. We categorize agent systems into software-based, physical, and adaptive hybrid systems, highlighting applications across customer service, software development, manufacturing automation, personalized education, financial trading, and healthcare. We further discuss the primary challenges posed by LLM-powered agents, including high inference latency, output uncertainty, lack of evaluation metrics, and security vulnerabilities, and propose potential solutions to mitigate these concerns.

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

Ricci-Filtration: Boosting Retrieval-Augmented Generation Reranker to Query-Answer Tasks by Discrete Ricci Flow

arXiv:2606.15482v1 Announce Type: cross Abstract: Ricci flow is a curvature-guided diffusion process that deforms space by shrinking regions of high positive curvature and expanding those with negative curvature. Similarly, discrete Ricci flow on weighted graphs modifies edge weights by shrinking edges with positive Ricci curvature and stretching those with negative Ricci curvature, effectively increasing the separation between clusters. Inspired by these two cornerstone works, we propose a geometry-based RAG reranker enhancement procedure called Ricci-Filtration. By modeling the input query and initial retrieved chunks as a network, where the input query and chunks serve as nodes and embedding-based pairwise relations define an initial graph, Ricci-Filtration leverages discrete curvature and Ricci flow to evaluate the structural importance of each chunk with respect to the user query. The system first filters the initial chunks based on their geometric curvature relative to the query; then, a reranker processes the remaining chunks to enhance generative performance. We theoretically prove that normalized discrete Ricci flow can detect community structures by identifying distinct asymptotic behaviors in edge weights. This supports the removal of ``noisy'' document chunks characterized by large weights and negative Ricci curvature relative to the query node. Extensive experiments confirm that Ricci-Filtration outperforms several baseline reranking methods in accuracy, precision, recall, and F1 scores. Furthermore, ablation studies demonstrate that the Ricci-Filtration generally outperforms the baseline under various settings, highlighting the framework's robustness across different architectures.

21.
arXiv (math.PR) 2026-06-17

Time-dependent averages of a critical long-range stochastic heat equation

arXiv:2411.09058v2 Announce Type: replace Abstract: We study the time-dependent spatial averages of a critical stochastic partial differential equation, namely the stochastic heat equation in dimension $d\geq 3$ with noise white in time and colored in space with covariance kernel $\|\cdot\|^{-2}$. The solution to this SPDE is a singular measure and was constructed by Mueller and Tribe in [MT04]. We show that the time-dependent spatial averages of this SPDE over a ball of radius $R$ at time $t$ have different limits under different space-time scales. In particular, when $t\ll R^2$, the central limit theorem holds; when $t=R^2$, the spatial average is a non-Gaussian random variable; when $t\gg R^2$, the spatial average becomes extinct.

22.
arXiv (CS.AI) 2026-06-11

Internet of Everything in the 6G Era: Paradigms, Enablers, Potentials and Future Directions

arXiv:2604.25018v2 Announce Type: replace-cross Abstract: The Internet of Everything (IoE) represents an evolution of the Internet of Things (IoT) by integrating people, data, processes, and things into a unified intelligent ecosystem. IoE aims to enhance automation, decision-making, and service efficiency across multiple application domains such as smart cities, healthcare, industry, and next-generation wireless networks. This paper provides a structured overview of the IoE concept, its core components, architectural foundations, enabling technologies, and major research challenges. Finally, open research directions toward 6G-enabled intelligent IoE systems are discussed, with emphasis on scalability, security, privacy, and energy efficiency.

23.
medRxiv (Medicine) 2026-06-19

Extraction of Glaucoma Diagnosis, Type, and Severity from Clinical Notes using Secure Cloud-based Large Language Models

Purpose: To evaluate the performance of secure cloud-based large language models (LLMs) in extracting glaucoma diagnosis, type, and severity from free-text clinical notes in the electronic health record (EHR). Design: Retrospective chart review analysis. Participants: 1,250 subjects from the Bascom Palmer Ophthalmic Repository. Methods: Clinical notes of glaucoma-related encounters between 2014 and 2024 were extracted from the Bascom Palmer Ophthalmic Repository. Two fellowship-trained glaucoma specialists annotated clinical notes for glaucoma presence, type, and severity at the eye level. The dataset was split into development (10%), validation (10%), and test (80%) sets. Development and validation sets were used for prompt engineering and refinement, and the held-out test set was used for evaluation. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT-5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Azure AI Foundry within HIPAA-compliant containers. Model performance was assessed using standard metrics. Clinician-entered ICD-10 codes were also compared with adjudicated labels. Main Outcome Measures: Gwet AC1, accuracy, sensitivity, specificity, and F1-score. Results: Inter-grader agreement was high for glaucoma detection (Gwet AC1= 0.930 (95% CI: 0.917-0.945), type classification (Gwet AC1= 0.917 (95% CI: 0.904-0.930), and severity staging (Gwet AC1= 0.901 (95% CI: 0.884-0.916). For glaucoma diagnosis, LLMs demonstrated high overall accuracy, with Claude achieving 97.5%, DeepSeek 96.0%, GPT 96.2%, Grok 94.4%, and Qwen 95.5%. F1 scores for glaucoma detection ranged from 95.4% to 98.9% across models. For glaucoma type classification, accuracies were 97.1%, 94.2%, 94.2%, 94.0%, and 94.4% for Claude, DeepSeek, GPT, Grok, and Qwen, respectively. F1 scores for the most prevalent type (POAG) ranged from 96.3% to 98.9%. For severity staging, accuracies were 95.0%, 94.8%, 94.5%, 94.0%, and 95.2%, respectively, with F1 scores ranging from 89.7% to 96.3% across severity categories and models. ICD-10 codes demonstrated substantially lower performance for type and severity staging, with overall accuracies of 89.2% and 58.5%, respectively. Conclusions: Secure cloud-based LLMs accurately extracted glaucoma diagnosis, type, and severity information from free-text ophthalmology notes, achieving performance approaching expert clinician adjudication while substantially outperforming ICD-based phenotyping approaches, particularly for disease severity classification. These findings demonstrate the potential of LLMs to transform unstructured clinical documentation into scalable, research-ready phenotypic data for large-scale glaucoma cohort development and EHR-based ophthalmic research.

24.
medRxiv (Medicine) 2026-06-15

Reaching out-of-school girls with HPV vaccination: A qualitative evaluation in six low- and middle-income countries using the RE-AIM framework

Background Infection with human papillomavirus (HPV), the primary cause of cervical cancer, disproportionately affects women in low- and middle-income countries (LMICs). While school-based vaccination of adolescent girls against HPV is highly effective, this strategy systematically excludes out-of-school (OOS) girls. Using the RE-AIM framework, we explored strategies to reach OOS girls with HPV vaccination across six African and Asian LMICs. Methods We conducted semi-structured key informant interviews with 32 vaccination program stakeholders from Cambodia, Cameroon, Kenya, Malawi, Mozambique, and Uganda between May and September 2024. Interviews explored countries implementation successes, challenges, and strategies to reach OOS girls with HPV vaccination and sustainability considerations. Data were analyzed using a hybrid team-based thematic analysis approach guided by the RE-AIM framework. Results Community outreach-based strategies, typically integrated into routine immunization outreach, were identified as the most effective approach to reach OOS girls with HPV vaccination. Targeted strategies, such as locating outreach clinics in community venues frequented by OOS girls (e.g., churches, markets) enhanced implementation. Perceived effectiveness of these strategies varied across participants, and formal assessment of effectiveness was constrained by the absence of disaggregated vaccination coverage data by school enrollment status. Some subpopulations of OOS girls (i.e., girls in nomadic or migrant communities, urban OOS girls) were not readily reached through standard outreach approaches, prompting implementation of adapted and tailored strategies for these subpopulations. Costs associated with conducting outreach in harder-to-reach areas were major barriers to reaching OOS girls, presenting challenges to the sustainability and cost-effectiveness of these approaches. Conclusions Routine community outreach platforms were widely perceived as most effective for reaching OOS girls. Strengthening disaggregated monitoring systems, adapting outreach for harder-to-reach subpopulations of OOS girls, and financing delivery models for tailored outreach strategies will be critical to improving equitable HPV vaccine coverage among OOS girls.

25.
arXiv (CS.LG) 2026-06-15

Structured Noise Adaptation for Sequential Bayesian Filtering with Embedded Latent Transfer Operators

arXiv:2606.14195v1 Announce Type: new Abstract: Kalman filters based on the Embedded Latent Transfer Operators (ELTO) emerge as novel statistical tools for sequential state estimation. However, a critical limitation stems from their use of simplified noise models, which fail to dynamically adapt to non-stationary processes. To address this limitation, we introduce an ELTO-based Bayesian filtering approach with a new structured parameterization for the filter's noise model. This parameterization enables structured noise adaptation, which couples the data-driven learning of an optimal time-invariant noise model with dynamic parameter adaptation that responds to changes in dynamics within non-stationary processes. Empirical results show that our structured noise adaptation improves the filter's dynamic state estimation performance in noisy, time-varying environments.