Author Correction: Plasticity and language in the anaesthetized human hippocampus
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arXiv:2606.17059v1 Announce Type: cross Abstract: Prefix caching can reduce LLM inference latency by reusing KV caches across requests with shared prompts, but cluster-scale reuse is challenging because caches are partitioned across nodes. We propose a decentralized, prefix-cache-aware routing scheme for peer-to-peer LLM serving. Each node maintains a local radix tree of its own cached prefixes and asynchronously refreshed estimates of peer caches using periodic anti-entropy. Requests are routed to the node with the longest estimated prefix match, without centralized coordination or KV-cache transfer. Stale metadata only causes cache misses, not incorrect outputs, making weak consistency sufficient for correctness. Evaluation on simulated MMLU workloads show that decentralized routing improves latency under low communication delay and skewed prefix distributions, while high network latency and affinity-induced hotspots limit its benefits.
Training psychotherapists in evidence-based interventions such as Acceptance and Commitment Therapy (ACT) requires repeated practice with meaningful feedback, yet opportunities for safe, standardized training are limited by ethical, logistical, and resource constraints. We introduce a system designed to support ACT-oriented psychotherapy training through spoken dialogue with an embodied virtual patient. The system uses large language models to simulate patient behavior conditioned on profiles derived from real therapy sessions and configurable clinical scenarios, while a separate automated evaluator provides turn-by-turn feedback on therapist responses based on established ACT fidelity criteria. Rather than aiming to replace supervision, the system is intended to support deliberate practice by enabling experimentation, reflection, and immediate feedback in low-risk settings. Expert evaluation with practicing psychologists confirmed high realism in patient behavior and demonstrated that immediate turn-by-turn ACT feedback increased therapists' awareness of intervention choices and enabled effective experimentation with alternative responses. Quantitative evaluation across 49 therapy transcripts identified GPT-4o-mini as the optimal feedback model, achieving the lowest mean absolute error (MAE = 6.12) in replicating human supervisor ACT fidelity ratings with statistically significant agreement. This work demonstrates the potential of fidelity-aware simulated patients as a scalable complement to psychotherapy training.
Maritime situational awareness often relies on Automatic Identification System (AIS) transmissions to track vessel movements. However, in operational or conflict scenarios, these data may be unavailable due to signal loss, deliberate deactivation, or intentional spoofing. In such conditions, synthetic aperture radar (SAR) imagery becomes a critical sensing alternative for wide-area maritime monitoring, despite providing only static scene snapshots. This work introduces HARBOR (Heading Analysis and Reconstruction from Behavioral Observation and Radar), a complete pipeline for transforming a single SAR image into predictive motion information without requiring any auxiliary data source at inference time. The method begins with SAR image preprocessing to enhance and segment vessel candidates, followed by automatic detection, size-based classification, and heading estimation using skeleton geometry and local intensity patterns. AIS data are used exclusively during an offline calibration phase to derive vessel-type-dependent motion parameters, which are then applied to generate probabilistic heatmaps of candidate future vessel positions. A case study using real COSMO-SkyMed SAR imagery demonstrates the pipeline on a maritime scene in southern Brazil, showing its ability to extract motion tendencies and generate probabilistic projections of vessel positions in data-denied environments.
arXiv:2606.19873v1 Announce Type: new Abstract: Quantum error-correcting codes (QECs) are essential components quantum computation and have deep connections to quantum phases of matter. A key obstruction to passive self-correcting QECs is the presence of string logical operators, which can generate logical errors through constant-energy-barrier processes. Haah's Codes (fracton codes) showed that three-dimensional stabilizer codes can forbid such string logical operators, but their translation-invariant structure supports self-similar fractal logical operators with a logarithmic energy barrier. We introduce the qutrit random cubic codes, a family of local qutrit Calderbank-Shor-Steane stabilizer Hamiltonians with similar cube-check structure as Haah's Code 1 but built from spatially varying stabilizers. We prove that these models retain the no-string property and numerically observe that they have properties distinct from translation-invariant fracton codes: the smallest ground-state degeneracy exponent is $k=2$ for odd $L$ and $k=4$ for even $L$; noncontractible plane-logical operators span the entire logical space; and charge-push diagnostics show that the self-similar fractal operators are absent. These results demonstrate that constrained randomness can fundamentally change the nature of stabilizer codes and improve their self-correction properties. They further point to broader families of quantum error-correcting codes and quantum phases beyond canonical topological and fracton orders.
Byte-level tokenization enables language models to handle any Unicode input, but models can generate invalid UTF-8 sequences when encountering rare or unseen characters. We investigate the relationship between training scale and UTF-8 generation reliability with a 355M parameter model trained on 80B tokens from a balanced multilingual corpus of English, Japanese, Korean, and Chinese. We introduce multiple evaluation protocols that isolate UTF-8 structural validity from language modeling. UTF-8 validity convergence lags perplexity by a roughly a factor of two: perplexity stabilizes after 2.1B tokens, but UTF-8 validity requires 4.2B tokens. In context-free generation, rare characters achieve higher structural validity than common characters, suggesting over-specialization of frequent character representations. Through experiments, we observed that reliable UTF-8 generation is a distinct capability requiring evaluation beyond perplexity.
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.
Preference alignment is a critical step in making Large Language Models (LLMs) useful and aligned with (human) preferences. Existing approaches such as Reinforcement Learning from Human Feedback or Direct Preference Optimization typically require curated data and expensive optimization over billions of parameters, and eventually lead to persistent task-specific models. In this work, we introduce Preference alignment of Large Language Models via Residual Steering (PaLRS), a training-free method that exploits preference signals encoded in the residual streams of LLMs. From as few as one hundred preference pairs, PaLRS extracts lightweight, plug-and-play steering vectors that can be applied at inference time to push models toward preferred behaviors. We evaluate PaLRS on various small-to-medium-scale open-source LLMs, showing that PaLRS-aligned models achieve consistent gains on mathematical reasoning and code generation benchmarks while preserving baseline general-purpose performance. Moreover, when compared to models aligned with DPO and SimPO, they perform better with great time-savings. Our findings highlight that PaLRS offers an effective, much more efficient and flexible alternative to standard preference optimization pipelines, offering a training-free, plug-and-play mechanism for alignment with minimal data.
arXiv:2512.08211v2 Announce Type: replace Abstract: Large language models (LLMs) are moving from cloud-centric services toward on-device embedded AI, where models interact with private, longitudinal signals sensed from users and their physical environments. Mobile phones are a natural platform for such applications because they are continuously carried by users, connected to wearable sensors, and deeply integrated with daily mobile applications. However, practical LLM fine-tuning on commodity phones remains difficult. Existing fine-tuning frameworks are largely Python-based and server-oriented, making them hard to deploy inside mobile applications. We present MobileFineTuner, a mobile-native open-source framework for end-to-end LLM fine-tuning on commodity mobile phones. MobileFineTuner is implemented in C++ and provides a reusable training stack. To make fine-tuning feasible under mobile resource constraints, MobileFineTuner integrates a resource-aware training runtime with memory-efficient attention, activation checkpointing, gradient accumulation, parameter sharding, and energy-aware scheduling. We evaluate MobileFineTuner on real mobile phones using GPT-2, Gemma 3, and Qwen2.5 models across multiple fine-tuning tasks. The results show that MobileFineTuner reproduces standard Full-FT and LoRA fine-tuning behavior, substantially reduces memory pressure and improves executability on memory-constrained phones. We further demonstrate MobileFineTuner through a private campus health-agent application, where a local LLM is fine-tuned on user-specific wearable-sensing records to provide more personalized responses while keeping raw records on the phone. These results establish MobileFineTuner as a practical toolkit for studying and building on-device LLM fine-tuning applications in embedded AI and sensing systems.
arXiv:2606.12805v1 Announce Type: cross Abstract: Collaboration is widely recognized as a cornerstone of 21st-century education, yet teachers still encounter persistent challenges in fostering productive peer interaction. LLM conversational peer agents introduce new possibilities for mediating in-person group work, raising questions about how persona design, particularly their voice characteristics, shapes learners' perceptions, trust, and interactional dynamics. While prior work has examined agent accent effects in one-to-one settings, little is known about how these effects manifest in groups. We conducted a between-subjects mixed-methods study with 33 teachers examining how a GenAI voice agent with different accents (British, Indian, and African American) influenced collaboration and agent perception. Across surveys, group interaction analyses, and artifacts, we find that accent shaped participants' mental models and the roles the agent assumed in group interaction. The British-accented agent was largely treated as a tool and engaged in detached, utility-based ways, whereas Indian- and African American-accented agents were more readily anthropomorphized and integrated as peers. These role expectations influenced trust, engagement, and reliance over time. This work advances understanding of how GenAI's sociolinguistic design features shape group dynamics in CSCL, with implications for designing culturally inclusive AI partners in group learning.
Modeling long-range dependencies remains a central challenge in natural language processing. Transformer architectures achieve strong performance via self-attention but scale quadratically ($O(N^2)$) with sequence length, while State Space Models (SSMs) scale linearly ($O(N)$) but suffer from a selective recall bottleneck, struggling to retrieve precise information from compressed states. This creates a fundamental tradeoff between efficiency and perplexity. To tackle these challenges, we propose the Parallel Hybrid Architecture (PHA), which runs Gated State Spaces (GSS), Grouped Query Attention (GQA), and Feed-Forward Networks (FFNs) as independent parallel branches fused by a learnable mixing mechanism. Instead of forcing SSMs to approximate attention or serializing the two paradigms, PHA allows each branch to specialize: GSS captures global context, while attention performs selective retrieval, with FFN providing complementary processing. On WikiText-103, PHA achieves 16.51 PPL at 125M parameters, outperforming Hedgehog (16.70) and H3-125M (23.70). Scaling to 180M parameters yields 16.42 PPL, which gives comparable results with the pure attention baseline while delivering 24\% higher throughput and up to 40\% lower memory usage at long contexts. On OpenWebText, our 125M model achieves 19.72 PPL, outperforming standard Transformers (20.60) and GSS hybrid baselines (19.80). These results demonstrate that separating sequence modeling paradigms into parallel specialists enables Transformer-level perplexity with substantially improved efficiency for long-context language modeling.
arXiv:2606.15276v1 Announce Type: cross Abstract: We study collapsibility in the multiparametric models of random simplicial complexes, namely the lower and upper models. In the upper model, we improve upon a result of Farber and Nowik, and assert that the homology is a.a.s concentrated in a single dimension by proving that the complex collapses to that \di. In the lower model, we prove that the complex a.a.s collapses to the \di\ with maximal non-trivial cohomology. We then compare this threshold to the ones derived previously for the special cases of the clique complex (by Kahle) and the Linial-Meshulam model.
Cross-view geo-localization (CVGL) is fundamental for precise localization and navigation in GPS-denied environments, aiming to match ground or UAV imagery with satellite views. Existing approaches often rely on global feature alignment, but they suffer from substantial domain shifts induced by varying regional textures and weather conditions. This issue becomes even more pronounced in UAV-based scenarios, where the broader perspective inevitably introduces dense, fine-grained objects, creating significant visual clutter. To address this, we draw inspiration from Object-Centric Learning (OCL) and propose InfoGeo, an information-theoretic framework designed to enhance robustness and generalization. InfoGeo reformulates the optimization as an information bottleneck process with two core objectives: (i) maximizing view-invariant information by aligning the object-centric structural relations across views, and (ii) minimizing view-specific noisy signals through cross-view knowledge constraints. Extensive evaluations across diverse benchmarks and challenging scenarios demonstrate that InfoGeo significantly outperforms state-of-the-art methods.
by Eric Jauniaux, Helena C. Bartels, Yalda Afshar Placenta accreta spectrum (PAS) is a serious pregnancy complication caused by abnormal placental attachment to the uterus. In this Perspective, Eric Jauniaux and colleagues discuss emerging evidence that challenges our long-held pathophysiological understanding of PAS, and argue that a critical reassessment of definition, diagnosis, and management is overdue. In this Perspective, Jonathan Evans and colleagues discuss why restricting access to joint replacement surgery based on BMI alone is not supported by evidence, and highlight how such rest rictions risk exacerbating stigma, inequity and avoidable harm to those who would benefit from surgery.
arXiv:2606.11343v1 Announce Type: new Abstract: Multiparameter quantum estimation faces two fundamental obstacles: sloppiness, i.e., anisotropy of the quantum Fisher information matrix (QFIM) that renders some parameter directions insensitive, and incompatibility, the non-commutativity of optimal measurements for different parameters. The trade-off bound $C_T$ captures their joint impact on precision, but it has remained unclear how the distribution of incompatibility across parameter planes affects its overall cost. Here we separate the total amount of incompatibility from its location. We introduce a dimensionless quantity $G_n^{(F)}$ that measures the alignment between the incompatibility distribution and the eigenvalues of the QFIM, and show how the Frobenius scale of the incompatibility contribution factorizes. We obtain a bound and prove the incompatibility cost lies between this bound and a rank-dependent multiple thereof. We also prove that at fixed sloppiness, or equivalently fixed Fisher volume, concentrating incompatibility into a single parameter plane reduces the optimized trade-off cost because the Fisher geometry can then be reshaped to allocate more Fisher area to that plane. A qutrit $SU(2)$ encoding numerically confirms that states with larger incompatibility strength can nevertheless incur a smaller cost if the matching factor $G$ is sufficiently small. Our results establish that the distribution of incompatibility relative to the Fisher eigenbasis is a central diagnostic for multiparameter estimation, beyond the total incompatibility strength.
arXiv:2603.04895v2 Announce Type: replace-cross Abstract: Overparameterized ML models, including neural networks, typically induce underdetermined training objectives with multiple global minima. The implicit bias refers to the limiting global minimum that is attained by a common optimization algorithm, such as gradient descent (GD). In this paper, we characterize the implicit bias of GD for training a shallow ReLU model with the squared loss on high-dimensional random features. Prior work (Vardi and Shamir, 2021) showed that the implicit bias does not exist in the worst-case, or corresponds exactly to the minimum-$\ell_2$-norm interpolating solution under exactly orthogonal data (Boursier et al., 2022). Our work interpolates between these two extremes and shows that, for sufficiently high-dimensional random data, the implicit bias approximates the minimum-$\ell_2$-norm solution with high probability with a gap on the order $\Theta(\sqrt{n/||\lambda||_1})$, where $n$ is the number of training examples and $\lambda$ denotes the spectrum of the data covariance matrix. Our results are obtained through a novel primal-dual analysis that carefully tracks the evolution of predictions, data-span coefficients, as well as their interactions, and show that the ReLU activation pattern quickly stabilizes with high probability over random data.
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.
arXiv:2511.08288v2 Announce Type: replace-cross Abstract: We study the large-$N$ asymptotics of the central trace of the heat kernel on compact classical groups. For every classical family $G_N\subset \mathrm{GL}_N(\C)$, we prove a full large-$N$ asymptotic expansion, using a highest weights/partitions correspondence adapted to the large-rank regime, under which the eigenvalues of the Laplace–Beltrami operator stabilize as observables in the algebra of shifted symmetric functions. Then, we prove a random surface representation of the trace in terms of ramified coverings of the torus. We provide two independent applications: an explicit large-rank counting law for the Casimir spectrum, with exponential Hardy–Ramanujan-type growth in contrast with the polynomial behavior of Weyl's law at fixed rank, and a rigorous probabilistic formulation of the Yang–Mills/Hurwitz duality on a two-dimensional torus initiated by Gross and Taylor, completing a previous work of the authors. We also extend this duality to a Yang–Mills/Gromov–Witten duality by expressing the coefficients of the central heat trace as explicit functionals of the generating function of Gromov–Witten invariants.
arXiv:2606.06525v2 Announce Type: replace-cross Abstract: Large language models (LLMs) have emerged as powerful foundation models with strong reasoning capabilities across domains. Beyond reactive text generation, agentic LLMs enable autonomous workflow execution through modular task decomposition and coordinated tool use. In structural engineering, recent efforts have developed agentic LLMs for automated analysis of plane frames. However, their extension to 3D frames remains underexplored due to challenges in irregular geometric representation, topological consistency, and long-horizon reasoning. This paper proposes an agentic LLM framework for automated structural analysis of 3D frames from natural language inputs. Irregular 3D frames are represented by projection onto a 2D plan, where orthogonal gridlines define spatial coordinates and a matrix of number of stories encodes vertical extrusion of each grid cell. Building on this representation, the framework establishes a multi-agent pipeline: a problem analysis agent parses input into structured JSON; a floor decomposition agent derives the spatial layout of each floor; the 3D geometry is assembled by node, girder, slab, and column agents; support and load agents assign boundary and loading conditions, and code translation agents generate executable SAP2000 script. Evaluated on ten representative 3D frames, the proposed framework achieves an average accuracy of 90% across repeated trials, demonstrating consistent and reliable performance.
The rapid progress of multimodal large language models (MLLMs) has led to increasing interest in agent-based systems. While most prior work in medical imaging concentrates on automating routine clinical workflows, we study an underexplored yet clinically significant setting: distinguishing visually hard-to-separate diseases in a zero-shot setting. We benchmark representative agents on two imaging-only proxy diagnostic tasks, (1) melanoma vs. atypical nevus and (2) pulmonary edema vs. pneumonia, where visual features are highly confounded despite substantial differences in clinical management. We introduce a multi-agent framework based on contrastive adjudication. Experimental results show improved diagnostic performance (an 11-percentage-point gain in accuracy on dermoscopy data) and reduced unsupported claims on qualitative samples, although overall performance remains insufficient for clinical deployment. We acknowledge the inherent uncertainty in human annotations and the absence of clinical context, which further limit the translation to real-world settings. Within this controlled setting, this pilot study provides preliminary insights into zero-shot agent performance in visually confounded scenarios.
arXiv:2507.17012v2 Announce Type: replace Abstract: Reducing the rapidly growing environmental impact of the computing industry requires assessing the emissions of electronics at scale. However, a traditional life cycle assessment (LCA) of an electronic device, which maps materials and processes to environmental impacts, often requires proprietary or unavailable data. Here, we reimagine conventional sustainability assessment by introducing a multimodal multi-agent AI system that emulates the collaborative process between LCA professionals and stakeholders (such as product managers and engineers) to automatically estimate the carbon footprint of electronic devices. The agents iteratively construct a complete life-cycle inventory by leveraging a structured data abstraction and software tools that mine information from the public internet, including repair communities and government regulatory databases. This reduces data gaps and data collection from weeks or months of expert time to under one minute. The system can calculate carbon footprint within 19% of expert LCAs with zero proprietary data (typical of the variation between human LCAs). We also show that by encoding domain-specific knowledge, environmental impact estimation can be reframed as a data-driven prediction task, in which both unknown products and emission factors are represented as weighted combinations of similar ones with known emissions.
arXiv:2606.12301v1 Announce Type: new Abstract: The Ising framework maps the decoding problem in quantum error correction onto ground-state optimization of a classical Hamiltonian, in which $X$-$Z$ error correlations enter as cross terms. Under phenomenological depolarizing noise, the exact joint formulation contains up to 8-body interactions for the toric code and 10-body for the $6.6.6$ color code. These high-order terms degrade solver convergence, inflate runtime, and raise the auxiliary spin overhead when embedding into native 2-body Ising hardware. In this work, we propose the iterative low-order decoding (ILOD) algorithm, which alternates between $X$- and $Z$-type sub-Hamiltonians, approximating cross-type correlations through Bayesian priors that reweight each type's couplings using the other type's inferred error configuration. This halves the maximum body count of interaction terms in the Hamiltonian, accelerating the solver, restoring convergence at larger code distances, and reducing the total spin count for 2-body embedding by a factor of $2.5$. For the toric code, ILOD attains a threshold of $4.73%$ versus $4.83%$ for the joint formulation, with the empirical runtime ratio scaling as $(0.81)^d$. For the $6.6.6$ color code, their thresholds agree within statistical uncertainty for small code distances, and ILOD remains convergent for larger distances where the joint formulation fails to converge despite a larger annealing budget.
3D content inherently encompasses multi-modal characteristics and can be projected into different modalities (e.g., RGB images, RGBD, and point clouds). Each modality exhibits distinct advantages in 3D asset modeling: RGB images contain vivid 3D textures, whereas point clouds define fine-grained 3D geometries. However, most existing 3D-native generative architectures either operate predominantly within single-modality paradigms-thus overlooking the complementary benefits of multi-modality data-or restrict themselves to 3D structures, thereby limiting the scope of available training datasets. To holistically harness multi-modalities for 3D modeling, we present TriMM, the first feed-forward 3D-native generative model that learns from basic multi-modalities (e.g., RGB, RGBD, and point cloud). Specifically, 1) TriMM first introduces collaborative multi-modal coding, which integrates modality-specific features while preserving their unique representational strengths. 2) Furthermore, auxiliary 2D and 3D supervision are introduced to raise the robustness and performance of multi-modal coding. 3) Based on the embedded multi-modal code, TriMM employs a triplane latent diffusion model to generate 3D assets of superior quality, enhancing both the texture and the geometric detail. Extensive experiments on multiple well-known datasets demonstrate that TriMM, by effectively leveraging multi-modality, achieves competitive performance with models trained on large-scale datasets, despite utilizing a small amount of training data. Furthermore, we conduct additional experiments on recent RGB-D datasets, verifying the feasibility of incorporating other multi-modal datasets into 3D generation.
We have developed single-cell spatial pharmacobiology (SSP), which combines in situ imaging of a systemically infused fluorescent therapeutic antibody with high-plex spatial proteomics. Applied to head and neck and pancreatic tumors from patients treated in phase 1 trials, SSP revealed marked spatial heterogeneity in antibody delivery and target engagement, which was shaped by conserved stromal barriers.
Background. Chronic kidney disease (CKD) affects 10-13% of adults worldwide but remains largely undiagnosed until advanced stages. Hospitalization provides an opportunity for early detection through opportunistic urine albumin-to-creatinine ratio (UACR) measurement. Methods. We conducted a prospective three-arm study of opportunistic CKD screening in general internal medicine wards at Hadassah Mt. Scopus (MS), Hadassah Ein Kerem (EK), and Shaare Zedek Medical Center (SZMC) in Jerusalem (Protocol HMO-23-0300). Adult inpatients without known CKD or recent UACR were enrolled. Pathological UACR was defined as [≥]30 mg/g. Confirmed CKD required two pathological measurements [≥]90 days apart (KDIGO-compatible). eGFR was computed using the 2021 CKD-EPI race-free equation. Pooled proportions were estimated by fixed-effects logit meta-analysis; odds ratios by DerSimonian-Laird random-effects models. Results. A total of 158 patients were enrolled (MS n=50, EK n=57, SZMC n=51). Pathological first UACR was identified in 43/158 patients (27.2%; 95% CI 21.3-34.1%; I2=0% across centers). Of 24 patients with a second UACR available, 14 (58%) confirmed CKD, yielding a pooled confirmed-CKD rate of 8.9% of all screened patients. In-hospital mortality was significantly higher among patients with pathological UACR (9.3% vs ~2%; Fisher's exact p=0.012). In per-center multivariate logistic regression, three predictors reached pooled significance: BUN (OR 1.10 per mg/dL, 95% CI 1.04-1.17, p=0.002, I2=0%), heart failure (OR 3.21, 95% CI 1.34-7.70, p=0.009, I2=0%), and diabetes mellitus (OR 2.54, 95% CI 1.11-5.82, p=0.028, I2=17%). Cardiac/vascular admissions had the highest pathological UACR rate (~42%); GI/hepatic admissions had 0%. Conclusions. Opportunistic inpatient UACR screening identifies previously unrecognized CKD in approximately 9% of general internal medicine patients, with consistent results across three independent centers. BUN elevation, heart failure, and diabetes are the strongest independent predictors. Pathological UACR carries significant short-term mortality risk, supporting integration of routine screening into inpatient care pathways.