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

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

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

02.
medRxiv (Medicine) 2026-06-15

Unveiling the Awareness of Private Health Insurance Coverage among Healthcare Professionals in Freetown, Sierra Leone: Insights Extracted from Their Perspectives.

Our study is an assessment of the knowledge, personal coverage, and related determinants of private health insurance as revealed by healthcare professionals in Freetown, the urban capital of Sierra Leone. This study stands as a precursor for Low- and Middle-Income Countries (LMICs), like Sierra Leone, seeking to establish Universal Health Coverage (UHC) to provide healthcare access and coverage through publicly arranged risk pooling, designed to help protect against unmanageable medical costs. In parallel, such countries face significant challenges with achieving sustainable universal coverage due to limited public resources, inefficient allocation systems, uneasy reliance on out-of-pocket payments, and large struggling populations. Our research sheds particular light on how healthcare professionals view their own participation with private healthcare options. A cross-sectional, analytical study was conducted, openly recruiting individuals from various facilities in Freetown. Using the Yamane Formula, a sample size of 109 participants was calculated. STATA 14.0 was used for data analysis. Our findings revealed that 96 (88.9%) participants did not have private health insurance, while 12 (11.1%) did have private coverage. However, 105 (97.2%) reported other modes of health insurance, with only 3 (2.8%) uninsured. Notably, 97.2% expressed willingness to join a private health insurance scheme. Our study found no statistically significant associations between selected indicators (demographic or socioeconomic fac tors) and current insurance coverage among study participants. These results highlight a low prevalence and understanding of private health insurance among healthcare professionals in a representative urban center in Sub-Saharan Africa (SSA), while acknowledging high willingness to enroll. The lack of any significant determinants suggests other unexamined factors, such as cost, accessibility, or awareness, capable of influencing the adoption and implementation of a universal health program.

03.
arXiv (quant-ph) 2026-06-24

Quantum Adaptive Self-Attention for Quantum Transformer Models

arXiv:2504.05336v4 Announce Type: replace Abstract: A recurring weakness in quantum machine learning (QML) is that reported ``quantum advantages'' are seldom tested against a capacity-matched classical control, leaving it unclear whether a gain comes from the quantum substrate or from the architectural change that accompanies it. Our primary contribution is methodological: a protocol for attributing such gains honestly – a capacity-matched classical bottleneck of identical parameter budget, transparent reporting of where quantum does not help, and validation on real quantum hardware – which we develop and apply through a concrete case study. That case study is Quantum Adaptive Self-Attention (QASA), a hybrid Transformer that replaces the value projection of a single encoder layer with a 36-parameter parameterized quantum circuit (PQC), keeping all other layers classical. Across nine synthetic benchmarks and the real-world ETTh1 dataset, QASA improves on a full-capacity classical Transformer for chaotic and trend-dominated signals. To ask whether this is a genuinely quantum effect, we introduce a control rarely applied in quantum machine learning – a capacity-matched classical bottleneck with the same parameter budget – and find that it matches the PQC on the error metrics. The gain is therefore attributable to the low-rank value-projection bottleneck (an architectural parsimony principle), not to quantumness; adding further quantum layers only degrades performance and trainability. We accordingly position the quantum layer not as a source of accuracy advantage but as a competitive instantiation of this principle: its low-rank compression onto the signal's intrinsic dimensionality is matched by a classical bottleneck, so the gain is architectural rather than quantum.

04.
arXiv (CS.CV) 2026-06-19

OTCHA: Optimal Transport-driven Confidence-aware Latent Hub Alignment for Multi-View Medical Image Classification

Multi-view imaging, such as mammography and chest radiography, is a standard component of clinical practice. However, medical images are often unregistered and contain view-specific artifacts or irrelevant background cues that can obscure diagnostically relevant findings. Many existing methods directly fuse per-view representations, allowing such irrelevant content to contaminate the fused embedding and reducing robustness under varying view configurations. We propose OTCHA, a confidence-aware latent hub token alignment module based on optimal transport (OT) that refines patch tokens before fusion for multi-view classification. OTCHA introduces a set of learnable latent hub tokens shared across views. For each view, we compute an OT plan between patch tokens and hub tokens that jointly considers feature similarity and geometry, and augment the OT formulation with token-conditional dustbins to enable partial matching and discard irrelevant tokens. The resulting transport plan provides token-wise matching confidence, which gates hub-mediated message passing and weights a novel optimal-transport-based representation alignment loss to stabilize refinement. Experiments on three multi-view medical image datasets demonstrate consistent improvements over competing baselines across diverse anatomies and view configurations. Our code is available at https://github.com/labhai/OTCHA.

05.
arXiv (CS.CV) 2026-06-17

MeiBRD: Meta-Learning Intraoperative Biomechanical Residual Deformation

Accurate intraoperative liver registration is challenging due to substantial soft-tissue deformation yet sparse intraoperative measurements. Biomechanical models regularize this ill-posedness with prior knowledge but exhibit persistent prediction bias due to simplifying assumptions, while data-driven learning solutions struggle with data efficiency, generalization, and physical plausibility. We propose a hybrid registration framework that adapts a biomechanical prior using sparse intraoperative correspondences. Rather than learning a full deformation field, we learn a residual deformation function that corrects linear biomechanical predictions, modeled as a graph neural diffusion function with geometry-aware attention over the 3D liver mesh. To enable long-range information transfer of sparse observations, we take a novel perspective of sparse intraoperative measurements as context samples where input-output pairs of the residual deformation function are fully observed, casting the problem into learning-to-learn this residual function from intraoperative context samples with feedforward meta-learners. Experiments on a deformable liver phantom dataset demonstrate improved registration accuracy and generalization compared to rigid, biomechanical, and data-driven baselines, particularly for out-of-distribution geometries and deformations.

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

AfriqueLLM: How Data Mixing and Model Architecture Impact Continued Pre-training for African Languages

Large language models (LLMs) are increasingly multilingual, yet open models continue to underperform relative to proprietary systems, with the gap most pronounced for African languages. Continued pre-training (CPT) offers a practical route to language adaptation, but improvements on demanding capabilities such as mathematical reasoning often remain limited. This limitation is driven in part by the uneven domain coverage and missing task-relevant knowledge that characterize many low-resource language corpora. We present \texttt{AfriqueLLM}, a suite of open LLMs adapted to 20 African languages through CPT on 26B tokens. We perform a comprehensive empirical study across five base models spanning sizes and architectures, including Llama 3.1, Gemma 3, and Qwen 3, and systematically analyze how CPT data composition shapes downstream performance. In particular, we vary mixtures that include math, code, and synthetic translated data, and evaluate the resulting models on a range of multilingual benchmarks. Our results identify data composition as the primary driver of CPT gains. Adding math, code, and synthetic translated data yields consistent improvements, including on reasoning-oriented evaluations. Within a fixed architecture, larger models typically improve performance, but architectural choices dominate scale when comparing across model families. Moreover, strong multilingual performance in the base model does not reliably predict post-CPT outcomes; robust architectures coupled with task-aligned data provide a more dependable recipe. Finally, our best models improve long-context performance, including document-level translation. Models and code have been released on [Huggingface](https://huggingface.co/collections/McGill-NLP/afriquellm) and [Github](https://github.com/McGill-NLP/AfriqueLLM).

07.
arXiv (CS.CV) 2026-06-16

On the Adversarial Robustness of Multimodal LLM Judges

Multimodal Large Language Models (MLLMs) are increasingly used as automated judges, e.g., for image quality and safety assessment. However, their adversarial robustness remains largely unexplored, threatening the fairness and reliability of automated judging. To bridge this gap, we introduce RobustMLLMJudge, the first general framework for evaluating the adversarial robustness of general-purpose MLLMs when functioning as judges. It covers diverse attacks against popular judge approaches across quality and safety evaluation scenarios. Using RobustMLLMJudge, we reveal that i) different MLLM judges are highly vulnerable to score-inflating adversarial attacks; and ii) although effective, these attack methods face a critical challenge due to unique constraints in the evaluation protocols of MLLM judges. We further propose MGSIA, namely Manifold-Guided Semantic Induction Attack, a novel method that bypasses these constraints to enable more effective and transferable attacks on MLLM judges. The core idea of MGSIA is to combine affirmative semantic induction with high-score manifold alignment: it maximizes the probability that judges yield affirmative responses (e.g., "Yes") to binary semantic queries, while regularizing adversarial representations toward high-score centers estimated from proxy protocols. Together, these objectives yield transferable score-inflating perturbations. Extensive experiments demonstrate the superiority and generalizability of MGSIA in deceiving advanced MLLM judges under different evaluation scenarios, highlighting the need for robust MLLM judges. Code and data will be made available at https://github.com/mala-lab/RobustMLLMJudge.

08.
arXiv (CS.CL) 2026-06-18

Dual Dimensionality for Local and Global Attention

Decoder-only Transformers compute attention over the KV cache of preceding tokens. Keys (and Values) are typically represented with the same dimensionality, regardless of its distance from the prediction target. In natural language, however, the next word is most strongly influenced by the immediately preceding tokens. We hypothesize that local and distant tokens impose asymmetric demands on representational capacity: local tokens are more critical for predicting immediate outputs and thus require richer representations, whereas distant tokens primarily serve as long-range memory, for which lower-dimensional representations may suffice. We formalize this idea as Distance-Adaptive Representation (DAR), implemented in a controlled setting that preserves full-dimensional representations within a local context window while assigning reduced-dimensional representations (e.g. 1/4 of the original dimensionality) to tokens beyond that window. Across multiple pretraining scales (70M to 410M parameters), as well as continued supervised fine-tuning on a 1B-scale model, this approach closely matches the performance of full-dimensional baselines. In contrast, uniformly reducing dimensionality across all token positions leads to worse performance. These results challenge the common assumption that key and value dimensionality should be uniform across token positions. Our findings suggest a new direction for designing attention architectures that adaptively allocate representational capacity across sequences, enabling further reductions in KV cache during inference.

09.
arXiv (CS.AI) 2026-06-11

Sovereign Assurance Boundary: Certificate-Bound Admission for Agentic Infrastructure

arXiv:2606.11632v1 Announce Type: cross Abstract: Agentic infrastructure introduces a critical control-plane authorization problem: non-deterministic reasoning systems can propose high-stakes mutations to production resources, yet existing security mechanisms – such as identity and access management (IAM), policy engines, consensus protocols, and audit logs – either enforce static, context-unaware permissions or merely record actions post-execution. This paper introduces the Sovereign Assurance Boundary (SAB), a certificate-bound runtime admission layer for autonomous execution authority. SAB intercepts agent proposals at an assurance airlock, compiles them into typed execution contracts $C$, and binds these contracts to cryptographic evidence digests $H(E)$ and policy versions. The contracts are then routed through consequence-aware certification paths. Upon successful admission, the system emits a signed Sovereign Assurance Certificate ($\Omega$) that is strictly scoped to a specific execution identity, revocation epoch, and validity window. Finally, a sovereign execution broker verifies $\Omega$ and performs fresh pre-execution revocation and drift checks before invoking infrastructure APIs. We detail the airlock-broker architecture, formalize its admission and revocation invariants, and report preliminary feasibility measurements from a Go prototype evaluated over 2,500 admission attempts. Ultimately, this broker-enforced model prevents autonomous reasoning from directly mutating state, transforming delegated execution authority into a cryptographically verifiable, evidence-bound, revocable, and replayable runtime artifact.

10.
arXiv (CS.CL) 2026-06-11

Self-Prompting Small Language Models for Privacy-Sensitive Clinical Information Extraction

Clinical named entity recognition from dental progress notes is challenging because documentation is highly unstructured, domain-specific, and often privacy-sensitive. We developed a locally deployable framework that enables small language models to self-generate, verify, refine, and evaluate entity-specific prompts for extracting multiple clinical entities from dental notes. Using 1,200 annotated notes, we evaluated candidate open-weight models with multi-prompt ensemble inference and further adapted selected models using QLoRA-based supervised fine-tuning and direct preference optimization. Model performance varied substantially, highlighting the need for task-specific evaluation rather than reliance on generic benchmarks. Qwen2.5-14B-Instruct achieved the strongest baseline performance. After DPO, Qwen2.5-14B-Instruct and Llama-3.1-8B-Instruct achieved micro/macro F1 scores of 0.864/0.837 and 0.806/0.797, respectively. These findings suggest that automated prompt optimization combined with lightweight preference-based post-training can support scalable clinical information extraction using locally deployed small language models.

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

Querying Counterfactuals on Tissue Graphs with Supervised Disentanglement

arXiv:2606.08493v2 Announce Type: replace-cross Abstract: Tissue graph counterfactuals ask how a cell's expression would change under altered spatial neighbor contexts. Such queries are central to predicting cell behavior in tissues, but lack a unified definition, with existing methods targeting specific intervention types or treating cells as i.i.d. In this work, we first formalize tissue graph counterfactuals as a class of spatial interventions that either rewire connections between cells (edge perturbation) or modify the expression of their neighbors (node perturbation). We then introduce Cellina (https://cellina.readthedocs.io) - a framework that uses supervised disentanglement to decompose a cell's intrinsic state from its spatial context, using the latter as a conditioning input for counterfactual predictions. Across benchmarks spanning over 2.5 million spatially-resolved cells in colorectal cancer and mouse brain, Cellina outperforms spatially-informed and non-spatial competitors in in-silico graph perturbations, disentanglement, and scalability. Additionally, we show that Cellina reveals biologically distinct cancer subdomains in an unsupervised manner and enables targeted neighbor perturbation simulations.

12.
arXiv (quant-ph) 2026-06-16

Quantum Measurement and Continuous Markov Processes

arXiv:2606.15958v1 Announce Type: new Abstract: These are the lecture notes for a course on diffusive quantum measuring instruments. They were prepared and delivered at the Perimeter Institute on Mondays and Thursdays, from 2:30 to 4:00 PM, beginning October 27th, 2025 and ending December 11th, 2025. These lectures were recorded and can be found at https://pirsa.org/c25038.

13.
medRxiv (Medicine) 2026-06-17

The Unreliable Judges: Assessing Reproducibility and Self-Preference Bias of LLMs as Free-Text Evaluators

Large Language Models (LLMs) are transforming clinical practice and research, but their adoption requires rigorous evaluation. While human assessment is ideal, its cost has driven the widespread use of LLMs as evaluators. We introduce an open-source reciprocal framework comparing 71 human experts against six LLMs. AI evaluators show a strong self-preference bias, yet neither group reliably identified whether a response was human- or AI-generated. AI scores correlated with surface features such as length and lexical diversity, whereas human scores did not. By probing the evaluator's hidden states and applying targeted steering, we show that verbosity is a major causal driver of the bias. Moreover, shuffling question-response pairings shows that long responses keep high scores even when they no longer answer the question, whereas short ones do not, demonstrating that AI judges reward verbosity largely independently of content alignment. Finally, API-based and batch inference inflate stochasticity, underscoring the need for controlled deployment.

14.
arXiv (math.PR) 2026-06-12

Scaling limit of additive functionals for reversible non-gradient exclusion process: critical cases

arXiv:2606.13442v1 Announce Type: new Abstract: For the reversible speed-change exclusion process $(\eta_t)_{t \geq 0}$ in $\mathbb{Z}^d$, we study the scaling limit of additive functionals ${\Gamma_t(f) = \int_0^t f(\eta_s)\, \mathrm{d} s}$. Concerning the local centered function $f$, the previous work [Commun. Math. Phys. 104, 1-19, 1986] by Kipnis and Varadhan and [Comm. Pure Appl. Math., 66: 649-677, 2013] by Gon{ç}alves and Jara respectively covered the cases $d \geq 3$ and $d=1$. The present paper completes the missing part $d=2$, and also develops the theory for functions with higher degree. The novelty is a quantitative homogenization of the resolvent, which allows to overcome the obstacle of correlation function in non-gradient models.

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

Dissociating Decodability and Causal Use in Bracket-Sequence Transformers

When trained on tasks requiring an understanding of hierarchical structure, transformers have been found to represent this hierarchy in distinct ways: in the geometry of the residual stream, and in stack-like attention patterns maintaining a last-in, first-out ordering. However, it remains unclear whether these representations are causally used or merely decodable. We examine this gap in transformers trained on the Dyck language (a formal language of balanced bracket sequences), where the hierarchical ground truth is explicit. By probing and intervening on the residual stream and attention patterns, we find that depth, distance, and top-of-stack signals are all decodable, yet their causal roles diverge. Specifically, masking attention to the true top-of-stack position causes a sharp drop in long-distance accuracy, while ablating low-dimensional residual stream subspaces has comparatively little effect. These results, which extend to a templated natural language setting, suggest that even in a controlled setting where the relevant hierarchical variables are known, decodability alone does not imply causal use.

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

deFOREST: Fusing Optical and Radar satellite data for Enhanced Sensing of Tree-loss

arXiv:2510.14092v2 Announce Type: replace-cross Abstract: In this paper we develop a deforestation detection pipeline that incorporates optical and Synthetic Aperture Radar (SAR) data. A crucial component of the pipeline is the construction of anomaly maps of the optical data, which is done using the residual space of a discrete Karhunen-Lo\'{e}ve (KL) expansion. Anomalies are quantified using a concentration bound on the distribution of the residual components for the nominal state of the forest. This bound does not require prior knowledge on the distribution of the data. This is in contrast to statistical parametric methods that assume knowledge of the data distribution, an impractical assumption that is especially infeasible for high dimensional data such as ours. Once the optical anomaly maps are computed they are combined with SAR data, and the state of the forest is classified by using a Hidden Markov Model (HMM). We test our approach with Sentinel-1 (SAR) and Sentinel-2 (Optical) data on a $92\,km \times 92\,km$ region in the Amazon forest. The results show that both the hybrid optical-radar and optical only methods achieve high accuracy that is superior to the recent state-of-the-art hybrid method. Moreover, the hybrid method is significantly more robust in the case of sparse optical data that are common in highly cloudy regions.

17.
arXiv (CS.CL) 2026-06-16

Are Online Skill and Memory Modules Always Worth Their Tokens? A Budget-Constrained Study of Web Agents

Online web agents often augment a base actor with memory, workflow, or skill modules. These modules can improve performance, but they also consume test-time tokens, a cost rarely reported alongside the actor's inference cost. We study online augmentation, where this overhead is paid on every task, and re-evaluate its benefits under a fixed total inference budget. We compare AWM, ASI, and ReasoningBank with a token-matched vanilla baseline that uses the same budget for additional actor steps. Across three WebArena domains and three models, Gemini 3 Flash, GPT-5.4-mini, and Qwen 3.6-27B, the vanilla baseline matches or surpasses all three augmentation methods in aggregate success rate while often using fewer total tokens. We observe a similar trend on WorkArena-L1 with Qwen 3.6-27B, indicating that the effect extends to enterprise knowledge-work tasks. Our results suggest that skills and workflow memory can be useful in specific domains, but their apparent gains often vanish against a budget-matched actor. We further show that run-to-run variance materially affects outcomes and should be reported as a core evaluation criterion for online web agents.

18.
arXiv (CS.CV) 2026-06-16

Clinically Aware Synthetic Image Generation for Concept Coverage in Chest X-ray Models

Deep learning models for chest X-ray diagnosis are constrained by limited coverage of clinically meaningful concept combinations in publicly available training datasets. While synthetic image generation has been explored to increase data diversity, existing methods rarely enforce clinical or anatomical constraints, limiting utility for improving model reliability. We propose CARPA, a clinically aware and anatomically grounded framework for synthetic chest X-ray generation that applies targeted perturbations to clinical concept vectors while preserving anatomical structure. By producing anatomically faithful synthetic images with controlled concept insertions and deletions, CARPA expands clinically relevant concept coverage. We evaluate CARPA across seven backbone architectures by fine-tuning models on synthetic subsets and testing on a held-out MIMIC-CXR benchmark. Compared to prior concept perturbation approaches, fine-tuning on CARPA-generated images consistently improves precision-recall performance, reduces predictive uncertainty, and improves model calibration. Structural and semantic analyses demonstrate high anatomical fidelity, strong concept alignment, and low semantic uncertainty. Evaluation by two expert radiologists further confirms realism and clinical agreement. Together, these results show that anatomically grounded concept perturbations enable more effective use of synthetic data, improving both performance and reliability of chest X-ray classification models and supporting safer clinical deployment.

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

FedRot-LoRA: Mitigating Rotational Misalignment in Federated LoRA

arXiv:2602.23638v3 Announce Type: replace-cross Abstract: Federated LoRA provides a communication-efficient mechanism for fine-tuning large language models on decentralized data. In practice, however, a discrepancy between the factor-wise averaging used to preserve low rank and the mathematically correct aggregation of local updates can cause significant aggregation error and unstable training. We argue that a major source of this problem is rotational misalignment, arising from the rotational invariance of low-rank factorizations – semantically equivalent updates can be represented in different latent subspaces across clients since $(B_i R_i)(R_i^\top A_i) = B_i A_i$. When such misaligned factors are averaged directly, they interfere destructively and degrade the global update. To address this issue, we propose FedRot-LoRA, a federated LoRA framework that aligns client updates via orthogonal transformations prior to aggregation. This alignment preserves the semantic update while reducing cross-client subspace mismatch, without increasing communication cost or restricting model expressivity. We provide a convergence analysis that examines the aggregation error induced by factor-wise averaging and shows how rotational alignment yields a tighter upper bound on this error. Extensive experiments on natural language understanding and generative tasks demonstrate that FedRot-LoRA consistently outperforms existing federated LoRA baselines across a range of heterogeneity levels and LoRA ranks.

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

CacheMuon: Using Temporal Preconditioning To Approximate Polar Factor

arXiv:2606.16371v1 Announce Type: new Abstract: Muon is an optimizer that computes updates using the polar factor of the momentum matrix and has shown strong empirical performance across a range of training settings. A key component of Muon is the Newton-Schulz iteration used to compute this polar factor. Although this avoids the cost of an exact singular value decomposition, it remains expensive in practice because it is applied at every optimization step. At the same time, the momentum matrix changes smoothly over training, suggesting strong temporal correlation in the corresponding polar factors. In this paper, we exploit this structure and propose CacheMuon, a temporal preconditioning method that reuses information from previous optimization steps to approximate the polar factor at the current step. This reduces redundant orthogonalization computation across iterations. We analyze CacheMuon as an inexact Muon update, with error controlled by fresh-solver error and cache staleness. Empirically, CacheMuon provides a controllable quality-efficiency frontier: conservative thresholds closely match fresh Muon on language-model and vision training while reducing orthogonalization FLOPs, whereas more aggressive thresholds yield larger arithmetic savings at the cost of modest validation-quality degradation.

21.
arXiv (CS.LG) 2026-06-18

Structural MRI Synthesis for Alzheimer's Disease via Conditional Diffusion on Anatomical Masks

arXiv:2606.18354v1 Announce Type: cross Abstract: Recent advances in generative machine learning models have significantly improved medical imaging, offering promising solutions for data augmentation, privacy preservation, and improved model generalization. However, synthesizing high-quality structural MRI data for Alzheimer's Disease (AD) remains challenging due to the subtle, region-specific, and progressive anatomical changes associated with neurodegeneration. In this paper, we extend the Med-DDPM conditional diffusion model – originally designed for brain tumor synthesis – to generate 3D structural MRIs specifically tailored to AD. We adopted Med-DDPM due to its established stability and structural fidelity compared to other generative models, which makes it particularly suitable for capturing the subtle anatomical changes characteristic of AD. Our approach conditions the diffusion process on anatomical segmentation masks derived from the ADNI dataset, incorporating key AD-relevant brain structures into the generation process. We systematically evaluate the quality and utility of the synthetic images by training segmentation models on real, synthetic, and hybrid (mixed) datasets. Experimental results demonstrate that segmentation models trained exclusively on synthetic data achieve comparable Dice scores (0.6532) to those trained on real data (0.6513), while exhibiting significantly enhanced recall. Notably, models trained on hybrid datasets (mixing real and synthetic images) outperform both real and synthetic-only baselines, achieving a Dice score of 0.7244. These findings underscore the successful use of conditional diffusion models for generating anatomically accurate, AD-specific synthetic MRIs, and highlight their potential for enhancing training data availability, improving diagnostic accuracy, and promoting research reproducibility in neuroimaging studies.

22.
medRxiv (Medicine) 2026-06-15

Beyond the Apnea-Hypopnea Index: Physiological and Demographic Predictors of Excessive Daytime Sleepiness in Obstructive Sleep Apnea

Excessive daytime sleepiness (EDS) is a common but inconsistently predicted symptom of obstructive sleep apnea (OSA). OSA is typically diagnosed with polysomnography (PSG), and the current standard for severity assessment is the apnea-hypopnea index (AHI). AHI has many limitations, including its inability to explain physiological mechanisms or reflect variability in patient symptoms, such as EDS. This retrospective study aims to find physiological and demographic parameters that better predict EDS in patients with OSA and to evaluate whether these parameters outperform AHI using PSG data from the Mount Sinai Integrative Sleep Center. Clinical variables used to predict EDS included arousal index (AI), average oxygen desaturation during sleep, average heart rate during sleep, and AHI, along with demographic variables including age, sex, and BMI. Hypothesis tests, logistic regression models, and decision tree classifier models were performed on the data to discriminate sleepy from nonsleepy patients as determined by an Epworth Sleepiness Scale (ESS) score [≥] 10. AI and oxygen desaturation were found to be the most predictive physiological variables, and sex and BMI were found to be the most predictive demographic variables. The final decision tree model with these four variables outperformed the AHI in predicting EDS. These findings suggest that daytime sleepiness in OSA can be better explained by measures of apnea burden, oxygenation impairment, and patient demographics than by AHI alone, although these remain only modestly predictive. Future studies should focus on investigating more comprehensive physiological markers, multi-night sleep data, and more objective assessments of sleepiness.

23.
arXiv (CS.CL) 2026-06-12

PRISM: Prosody-Integrated Multi-Agent Reasoning Framework for Empathetic Spoken Dialogue

Empathetic spoken dialogue systems require not only semantically appropriate responses but also emotionally aligned prosodic expression. However, cascade pipelines often discard acoustic cues during speech-to-text conversion, while end-to-end speech models lack interpretable control over emotion and knowledge integration. To address these challenges, we propose PRISM, a multi-agent framework for empathetic spoken dialogue that decouples speech perception, response generation, and speech synthesis into coordinated components. PRISM introduces a prosody-to-language translation mechanism to stabilize large language model reasoning and enables on-demand invocation of external knowledge tools for empathetic dialogue generation. Experimental results demonstrate that PRISM achieves consistent improvements in empathy, prosodic appropriateness, and text response generation quality across objective and subjective metrics. Our code is available at: https://github.com/Bxzfrm/PRISM.

24.
arXiv (quant-ph) 2026-06-12

Semi-Device-Independent Certification for Nonlocality without Entanglement

arXiv:2606.13667v1 Announce Type: new Abstract: In this work, we investigate maximum-confidence discrimination, which encompasses minimum-error and unambiguous discrimination, for ensembles of separable states by considering global and separable measurements. We demonstrate that global measurements outperform separable ones, thereby establishing nonlocality without entanglement (NLWE) in terms of confidence in a detection event, a fine-grained state-identification strategy that maximizes the probability of a correct guess given a measurement outcome. Conversely, verifying achievable confidence in measurement outcomes can certify global measurements, namely, semi-device-independent certification of NLWE. Our results make it feasible to experimentally demonstrate NLWE using present-day quantum measurement devices, even with non-unit detection efficiencies, since maximum-confidence measurements rely only on detected measurement outcomes.

25.
arXiv (quant-ph) 2026-06-24

Discovery of connectivity-trainability trade-off of IQP Circuits for Hamiltonian Optimization

arXiv:2606.24264v1 Announce Type: cross Abstract: Instantaneous Quantum Polynomial-time (IQP) circuits are promising candidates for near-term quantum advantage due to the conjectured classical hardness of their sampling task. However, their capabilities for optimization remain largely unexplored. We present a systematic investigation of the performance and trainability of IQP circuits for Hamiltonian optimization. Our results reveal a trade-off between optimization performance and circuit connectivity, demonstrating that the circuit structure plays a key role in determining the ability of IQP circuits to reach low-energy states.