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01.
medRxiv (Medicine) 2026-06-11

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

02.
arXiv (CS.CL) 2026-06-16

HyDRA: Hybrid Dynamic Routing Architecture for Heterogeneous LLM Pools

Production LLM deployments increasingly maintain heterogeneous model pools spanning order-of-magnitude cost differences. Existing routers make binary strong-vs-weak decisions and couple learned parameters to specific model identities, requiring retraining whenever the catalog changes. We present HyDRA (Hybrid Dynamic Routing Architecture), a framework that predicts fine-grained, multi-dimensional capability requirements per query and matches them against configuration-defined model profiles via shortfall matching. A ModernBERT encoder with K=4 independent sigmoid heads scores each query along reasoning, code generation, debugging, and tool use; a shortfall-matching algorithm then selects the cheapest model whose capabilities meet the predicted requirements. The deployed predictor runs at 86 ms median CPU inference latency in production, and is fully decoupled from the model catalog – adding or removing models requires only a configuration change, with zero retraining. On SWE-Bench Verified (5-model pool: GPT-5.4-mini, Claude Haiku 4.5, GPT-5.3 Codex, Claude Sonnet 4.6, GPT-5.4), HyDRA's tunable shortfall threshold spans three regimes: peak-quality exceeds the always-strong Claude Sonnet 4.6 baseline (75.4% vs. 74.2% resolution) at 12.9% cost savings; iso-quality matches Sonnet at 54.1% cost savings, a 6x improvement over our prior in-house binary router at 9.1%; aggressive pushes savings to 72.5% for a 3.2-point quality trade. Results generalize across LiveCodeBench, BigCodeBench, and tau-bench. HyDRA is deployed to all users in GitHub Copilot's VS Code Chat auto-mode and – to our knowledge for the first time in the LLM routing literature – demonstrates language-invariant routing across CJK, European, and other script families.

03.
medRxiv (Medicine) 2026-06-12

Effect of tenofovir on the outcomes of COVID-19 in persons with chronic hepatitis B: a nationwide cohort study in Sweden.

Background: Patients with chronic hepatitis B (CHB) may have an increased risk of severe COVID-19. Tenofovir has been hypothesized to confer protection against severe disease, but evidence is inconclusive. We evaluated the risk of severe COVID-19 among CHB patients treated with tenofovir compared with other nucleos(t)ide analogues (NAs). Methods and findings: In this nationwide, registry-based cohort study, we included all adults with CHB and laboratory-confirmed COVID-19 in Sweden between February 2020 and July 2022. Data from national health and socioeconomic registers were linked using unique personal identification numbers (PINs). Patients with HIV, hepatitis C, or hepatitis D coinfection were excluded. Exposure was defined as tenofovir versus other NA therapy. The primary outcome was severe COVID-19, defined as hospitalization >2 days or death within 30 days of diagnosis. Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI), controlling for age, sex, comorbidities, vaccination, socioeconomic status, and region of birth. Among 5,877 CHB patients with COVID-19, 672 were receiving NA therapy (437 tenofovir, 235 other NAs). Severe COVID-19 occurred in 8.0% of tenofovir-treated patients and 14.5% of those receiving other NAs (unadjusted OR 0.52; 95% CI, 0.31-0.85). After adjustment, the association was attenuated and no longer significant (aOR 0.72; 95% CI, 0.39-1.31). Older age, comorbidities, and unvaccinated status were strongly associated with severe disease. Conclusions: The apparent protective effect of tenofovir against severe COVID-19 in unadjusted analyses was largely explained by confounding factors. The risk of severe disease was primarily driven by age, comorbidities, and vaccination status. Prevention of severe COVID-19 in patients with CHB should instead focus on vaccination and management of comorbidities.

04.
arXiv (CS.AI) 2026-06-16

Where Did It Go Wrong? Process-Level Evaluation of Web Agents with Semantic State Tracking

arXiv:2606.15673v1 Announce Type: new Abstract: Web agents act through long interaction sequences, yet existing benchmarks evaluate only terminal success, discarding all process information and offering little guidance on improvement. In this work, we conduct a process-level analysis of web agents. We introduce WebStep, a benchmark of 1,800 task instances with controlled difficulty and automatic semantic state tracking. Each website exposes a deterministic semantic MDP alongside the GUI: the agent operates on the interface, while the environment records high-level states and transitions in the background, enabling fine-grained analysis without manual annotation. Based on the semantic trajectory, we first show that process metrics reveal differences invisible to outcome evaluation: three agents whose success rates cluster within 31-33% diverge in exploration reach versus execution accuracy. Then, decomposing by skill characterizes the nature of these differences, exposing opposite per-skill rankings hidden within the same website: e.g., on Housing, OpenAI CUA outperforms Qwen3.5 by 23.7% on commit actions yet underperforms it by 15.6% on filtering, pinpointing a concrete skill to improve even within a domain. Bifurcation analysis further localizes the decisive error that loses the task and shows that this error is agent-specific rather than shared. Finally, these differences widen as tasks grow harder: success rate is similar on easy tasks but separates sharply as exploration becomes more demanding. Our process-level analysis opens a new avenue in web agent evaluation, providing fine-grained and actionable insight into where and how each agent should be improved.

05.
arXiv (CS.AI) 2026-06-16

Visual-Seeker: Towards Visual-Native Multimodal Agentic Search via Active Visual Reasoning

arXiv:2606.15231v1 Announce Type: new Abstract: Multimodal large language models (MLLMs) have demonstrated impressive capabilities in many visual tasks, but they often struggle with factual grounding when confronted with complex, open-world scenarios. While recent multimodal deep search agents attempt to address this issue by utilizing external tools, the visual-native search paradigm remains underexplored. Existing methods primarily rely on simple images with explicit semantics and text-only evidence trajectories, limiting the agent's ability to perform multi-hop, cross-modal reasoning and search. To address these limitations, we propose Visual-Seeker, a visual-native multimodal deep search agent via active visual reasoning. Rather than treating vision as a static input, our agent actively attends to fine-grained visual details, dynamically harvests visual evidence throughout the search process. To unlock its visual-native potential, we design an active visual reasoning data pipeline and synthesize 5K high-quality multimodal trajectories for model training. Extensive experiments demonstrate the state-of-the-art performance across five challenging multimodal search benchmarks, even surpassing several proprietary models, validating robust visual-native reasoning and search in real-world web environments. The code and data can be accessed at: https://github.com/ZhengboZhang/Visual-Seeker.

06.
medRxiv (Medicine) 2026-06-10

Seasonality, source type, and women's water labor: A longitudinal mixed-methods study in Kenya and Honduras

Women shoulder the majority of water collection labor globally, yet how their water collection and water-related work experiences may change over time or by water source type remains insufficiently understood. We conducted a longitudinal, mixed-methods study in rural Kenya and Honduras to understand how women's experiences collecting water and performing water-related work varied between (a) two time points, (b) improved and unimproved water source types, and (c) water source location. Data were collected in 2023 and 2024 using interviews, observation, GPS-enabled watches, and scales to measure time and distance traveled, water weight and volume carried, and calories expended. 133 women participated in data collection (66 Kenya, 67 Honduras). We compared women's experience data by time point (2023 vs. 2024), source type (improved vs. unimproved), and source location (off-premises vs. on-premises) (t-test, Mann-Whitney U test). We also mapped participants' routes and activities to show which sources were visited, when, and for what activities. In Kenya, mean water collection time, distance, and caloric expenditure were significantly lower and water volume was significantly higher in 2024 when there were unexpected rains compared to 2023 when there was a persistent drought. When comparing source types during the 2023 drought, journeys to improved sources took significantly less time and energy and covered less distance than journeys to unimproved sources. These differences were not observed during the rainy conditions of 2024 when unimproved sources were closer and more accessible. In Honduras, water collection and water work burdens did not differ significantly by time point or source type. We found women with on-premises water access to still expend considerable time and caloric expenditure engaging in water work within their household compounds. Findings from Kenya suggest that water infrastructure improvements can reduce women's water collection burdens, though benefits may depend on and vary by season and source location. Findings from Honduras show that water labor does not end once water is in the household. Rather, substantial time and energy are expended carrying out water-related work even when sources are on premises, suggesting that efforts to assess water labor need to extend beyond collection alone. To meaningfully reduce burdens and ensure improved water sources are utilized during all seasons, initiatives need to consider source location, seasonal variability, and work beyond collection. Evaluations to assess infrastructure impacts on women's labor and well-being are needed and long overdue.

07.
arXiv (CS.CV) 2026-06-18

Cross-Lingual Learning within Arabic Script for Low-Resource HTR

Handwritten Text Recognition (HTR) with limited labeled data remains a challenging problem, particularly for Arabic-script languages. Although modern sequence-based recognizers perform well in high-resource settings, their accuracy degrades sharply as training data becomes scarce. Arabic-script languages share a common writing system with substantial character overlap, motivating cross-lingual learning as a strategy to mitigate data scarcity. We conduct a controlled line-level study of cross-lingual joint training for Arabic-script HTR under low-resource regimes (number of samples K = 100, 500, 1000 labeled lines) on Arabic (KHATT), Urdu (NUST-UHWR) and Persian (PHTD). CRNN and Vision Transformer-based HTR-VT models are trained on the union of multiple related Arabic-script datasets to mitigate the data scarcity and are evaluated on individual target languages. Both architectures benefit from cross-language training under low-resource conditions. CRNN remains more effective under extremely limited target-language data, whereas the benefits of cross-language training for HTR-VT become less consistent as larger amounts of target-language data become available. On Persian (PHTD), joint training achieves a Character Error Rate (CER) of 9.99 , surpassing previously reported results despite not using the full available training data. On an additional Urdu dataset (UNHD), joint training reduces CER from 17.20 to 14.45.

08.
arXiv (CS.LG) 2026-06-11

Structure-Preserving Neural Surrogates with Tractable Uncertainty Quantification

arXiv:2606.11650v1 Announce Type: new Abstract: Recent advances in scientific machine learning provide a means of near-real-time solution to partial differential equations (PDEs), but lack the theoretical underpinnings of conventional simulators that support contemporary verification and validation. In this work, we construct data-driven reduced-order models that serve as structure-preserving, real-time surrogates. Remarkably, the exterior calculus that imposes physical conservation structure also exposes topological structure that we use to build a Gaussian process (GP) representation of uncertainty in state-flux relationships, ultimately yielding a Dirichlet-to-Neumann map for quantities of interest with closed-form expressions for posterior uncertainty. We specifically propose structure-preserving $H(\mathrm{div})$–$L^2$ subspaces of conventional Raviart–Thomas and $dgP_0$ elements prescribed by a lightweight transformer. Reduced-order dynamics consistent with this subspace are learned by posing a conservation law in which a GP describes the fluxes between volumes. This work hinges on a novel interface between mixed FEM spaces and GP regression; when training is posed as the optimal recovery problem (ORP), the resulting GP regression can be written as an optimization problem with equality constraints that impose a conservation structure, amenable to a fast Schur-complement training strategy. The trained model can then be solved in real time with closed-form estimators for boundary fluxes driven by prescribed Dirichlet data. The paper includes RKHS posterior error bounds for linear functionals to support uncertainty quantification, as well as numerical experiments demonstrating the accuracy of the posterior distribution as a surrogate for error estimation.

09.
arXiv (quant-ph) 2026-06-11

Random Grover Search

arXiv:2606.11759v1 Announce Type: new Abstract: Grover's algorithm achieves a quadratic speedup for unstructured search given a global oracle for the target set. In many applications, however, the target set is specified as the intersection of multiple constraint sets. Constructing a global oracle for the intersection can be costly, whereas the individual constraint oracles are often much simpler to implement. We study a randomized Grover search algorithm that directly uses these constraint oracles. At each iteration, one of the corresponding Grover operators is selected at random. For the two-operator case with uniform sampling, we prove that the success probability approaches one after \[ \Theta \left(\frac\pi4\sqrt{\frac{N}{r}}\right) \] iterations, where $r$ is the size of the intersection. Thus, the algorithm achieves the same asymptotic query complexity as standard Grover search but without requiring a global oracle. We then generalize the analysis to arbitrary sampling distributions and an arbitrary number of Grover operators through an auxiliary operator that approximates the expected Grover evolution, while retaining the same asymptotic complexity. We further show that highly biased sampling distributions can still achieve near-unit success probability, enabling cheaper Grover operators to be used more frequently. Finally, we prove asymptotic optimality and support the theoretical results with numerical simulations.

10.
medRxiv (Medicine) 2026-06-12

A Machine Learning Pipeline for Scalable Annotation of Patient-Ventilator Dyssynchrony from Bedside Ventilator Data

Objective: Patient-ventilator dyssynchrony (PVD) is a common and clinically consequential problem in critically ill patients receiving invasive mechanical ventilation. Yet automated identification of PVD subtypes at scale remains an unmet clinical need, owing to the lack of large annotated bedside waveform datasets. Methods: We developed and validated a semi-supervised algorithm for automated annotation of PVD. In two medical ICUs at a tertiary academic center, bedside devices continuously collected airway flow and pressure waveforms from the ventilators. We developed a software interface with an information retrieval system that grouped similar breaths for expert human review, yielding 1,542,296 labeled breaths across eight categories: 2 labels for breath delivery mode, 5 labels for PVD subtypes, and 1 label denoting a normal breath. Two pulmonary physicians with expertise in ventilator training and education provided the expert reference labels. We trained an initial classification model on a model-derivation set of 771,148 breaths (divided into training and validation) and evaluated it on a hold-out test set of 771,149 breaths A semi-supervised approach was utilized to extend labeling to an additional 12,965,000 unlabeled breaths. Results: The supervised model performed well across all labels, with Macro-F1 scores between 0.96 and 1.00. Semi-supervised learning across 12 rounds expanded the training set from 771,148 to 8,563,995 breaths without significant performance degradation. Conclusion: We developed a practical and scalable system for automated PVD annotation that performed well across all subtypes. This work provides a reproducible foundation for automated PVD labeling to support the development of machine-learning-based clinical decision support systems for identifying patient-level asynchrony.

11.
arXiv (CS.CV) 2026-06-17

Heterogeneous SAR-optical fusion for near-real-time land use and land cover mapping under cloud contamination: A novel framework and global benchmark dataset

Optical remote sensing imagery is frequently degraded by cloud and cloud-shadow contamination, which limits its reliability for near-real-time land use and land cover (LULC) mapping. Although synthetic aperture radar (SAR) can provide cloud-penetrating structural information, existing SAR-optical fusion methods often assume reliable optical observations and insufficiently address the semantic uncertainty introduced by cloud contamination. To address this issue, we propose CloudLULC-Net, an end-to-end heterogeneous SAR-optical fusion framework that directly predicts LULC maps from cloud-contaminated Sentinel-2 imagery and temporally adjacent Sentinel-1 SAR observations. The proposed network incorporates optical reliability modulation to suppress unreliable optical responses, heterogeneous information adaptive aggregation to model high-order spatial-channel interactions between optical and SAR representations, and a unified semantic mapping transformer to organize fused features in a LULC-oriented latent space. A semantic anchor-guided optimization strategy is further introduced to improve the consistency of intermediate semantic representations. To support this task, we construct CloudLULC-Set, a large-scale benchmark dataset containing 40,223 curated SAR-optical-label triplets with pixel-level LULC annotations across diverse geographic regions and cloud conditions. Experimental results show that CloudLULC-Net achieves an OA of 86.60%, an F1-score of 83.29%, and an mIoU of 73.51%, outperforming representative heterogeneous reconstruction-first and end-to-end SAR-optical mapping methods. Comparisons with existing global LULC products and analyses under different cloud-cover levels further demonstrate the robustness and practical value of CloudLULC-Net for target-date LULC mapping in cloud-prone regions.The project is publicly available at: https://github.com/RSIIPAC/CloudLULC

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

MapDream: Task-Driven Map Learning for Vision-Language Navigation

Vision-Language Navigation (VLN) requires agents to follow natural language instructions in partially observed 3D environments, motivating map representations that aggregate spatial context beyond local perception. However, most existing approaches rely on hand-crafted maps constructed independently of the navigation policy. We argue that maps should instead be learned representations shaped directly by navigation objectives rather than exhaustive reconstructions. Based on this insight, we propose MapDream, a map-in-the-loop framework that formulates map construction as autoregressive bird's-eye-view (BEV) image synthesis. The framework jointly learns map generation and action prediction, distilling environmental context into a compact three-channel BEV map that preserves only navigation-critical affordances. Supervised pre-training bootstraps a reliable mapping-to-control interface, while the autoregressive design enables end-to-end joint optimization through reinforcement fine-tuning. Experiments on R2R-CE and RxR-CE achieve state-of-the-art monocular performance, validating task-driven generative map learning.

13.
arXiv (CS.CV) 2026-06-18

Learning Patient-Specific Disease Dynamics with Latent Flow Matching for Longitudinal Imaging Generation

Understanding disease progression is a central clinical challenge with direct implications for early diagnosis and personalized treatment. While recent generative approaches have attempted to model progression, key mismatches remain: disease dynamics are inherently continuous and monotonic, yet latent representations are often scattered, lacking semantic structure, and diffusion-based models disrupt continuity with random denoising process. In this work, we propose to treat the disease dynamic as a velocity field and leverage Flow Matching (FM) to align the temporal evolution of patient data. Unlike prior methods, it captures the intrinsic dynamic of disease, making the progression more interpretable. However, a key challenge remains: in latent space, Auto-Encoders (AEs) do not guarantee alignment across patients or correlation with clinical-severity indicators (e.g., age and disease conditions). To address this, we propose to learn patient-specific latent alignment, which enforces patient trajectories to lie along a specific axis, with magnitude increasing monotonically with disease severity. This leads to a consistent and semantically meaningful latent space. Together, we present $\Delta$-LFM, a framework for modeling patient-specific latent progression with flow matching. Across three longitudinal MRI benchmarks, $\Delta$-LFM demonstrates strong empirical performance and, more importantly, offers a new framework for interpreting and visualizing disease dynamics.

14.
medRxiv (Medicine) 2026-06-17

Proteomics Uncovers Cryptic JPH2 Loss in Paediatric Dilated Cardiomyopathy

Despite recent advances in next-generation sequencing, genetic diagnostic rates for dilated cardiomyopathy (DCM) remain low. Among paediatric DCM, causes are often heritable, with a greater frequency of de novo, recessive and syndromic causes of disease. Novel diagnostic methods are therefore required to solve monogenic cases. To assess the value of proteomics as a diagnostic tool for paediatric DCM, we obtained left ventricle myocardial samples from paediatric patients undergoing heart transplantation at the Royal Children's Hospital, Melbourne. We performed genome sequencing and proteomics and leveraged this multi-omics dataset to uncover the molecular cause of disease in a gene elusive proband. The proband carried a heterozygous JPH2 frameshift variant identified on clinical exome sequencing. However, proteomic analysis showed a pronounced downregulation of JPH2, suggestive of biallelic loss-of-function. Closer inspection of the genomic data revealed a large inversion (~8.34 Mb) with a breakpoint falling within intron 5 of JPH2 that displaces the 3'UTR from the coding transcript. The two variants were confirmed to be in trans using long read DNA sequencing, consistent with a diagnosis of JPH2 autosomal recessive DCM. Finally, we applied RNA sequencing with total RNA library preparation to show that transcripts containing a 3'UTR were reduced to ~10% relative to controls. As a proof-of-principle, we present the first reported use of proteomics from explanted cardiac tissue to provide a genetic diagnosis. Our methodology has broad relevance to patients with genetically unsolved Mendelian diseases, who might undergo organ transplantation as part of clinical management.

15.
bioRxiv (Bioinfo) 2026-06-18

Elucidating the Design Space of Generative Models for Single-Cell Perturbation Prediction

Next-token prediction has produced predictable scaling in language, but the recipe presumes a sequence of tokens with a meaningful order. Single-cell RNA-seq counts have no natural gene ordering, so applying the recipe directly to raw expression fails under an ill-suited left-to-right bias. We instead ask whether a learned latent can supply the structure the recipe needs. We introduce texttt{ExpressionVAE} (eVAE), a discrete-latent perturbation model that compresses each cell into a short sequence of discrete codes through a finite-scalar-quantization (FSQ) bottleneck and trains a perturbation-conditioned discrete prior over those codes. On Replogle and Parse~1M, eVAE sets a new state of the art on every distributional metric and leads on most cell-eval perturbation metrics, with Fr'echet distance and $mathrm{MMD}^2$ roughly $3$ to $20times$ lower than the strongest continuous-latent baseline. Swapping the prior between autoregressive and masked discrete diffusion leaves performance near-identical, isolating the gain to the discrete latent itself rather than the prior family. A decoder-head ablation then exposes a single design axis, the richness of the predictive distribution at inference, that splits the standard metrics into two groups, variance-sensitive and mean-sensitive, which move in opposite directions along the axis. Finally, on a held-out CRISPRi reversion benchmark of $1{,}732$ perturbations under inflammatory cytokine stress, the frozen eVAE encoder outperforms UMAP and differential expression and matches scGPT on perturbation ranking at a fraction of the data.

16.
arXiv (CS.CL) 2026-06-11

M4FC: a Multimodal, Multilingual, Multicultural, Multitask Real-World Fact-Checking Dataset

Existing real-world datasets for multimodal fact-checking have multiple limitations: they contain few instances, cover on only one or two languages, focus only on one task, or rely on external news article sets for sourcing true claims. To address these shortcomings, we introduce M4FC, a new real-world dataset comprising 4,982 images paired with 6,980 claims. The images, verified by professional fact-checkers from 22 organizations, represent a diverse range of cultural and geographic contexts. Each claim is available in one or two out of ten languages. M4FC spans six multimodal fact-checking tasks: visual claim extraction, claimant intent prediction, fake image detection, image contextualization, location verification, and verdict prediction. We provide baseline results for all tasks and analyze how combining intermediate tasks affects verdict prediction performance. We make our dataset and code publicly available.

17.
medRxiv (Medicine) 2026-06-22

Substantia Nigra and Subthalamic Nucleus Deep Brain Stimulation Exert Opposing Effects on Novelty Recognition in Parkinson's Disease

Episodic memory plays a critical role in supporting adaptive behavior; however, whether it can be causally regulated in humans via deep subcortical stimulation remains unclear. In the present study, we investigated the differential effects of substantia nigra (SN) and subthalamic nucleus (STN) stimulation on episodic memory, as well as the underlying mechanisms of its associated brain networks, using a recognition memory task combined with concurrent functional magnetic resonance imaging in patients with Parkinson's disease. SN-DBS increased recognition sensitivity and reduced false alarms at both frequencies, whereas 10 Hz STN-DBS reduced sensitivity and increased false alarms. Functional connectivity analyses in the absence of DBS stimulation identified a false recognition-related network linking nigral, pallidal, subthalamic, medial temporal, frontal, and occipital regions. SN-DBS-related false alarm reduction tracked modulation of this circuit and was marked by its baseline vulnerability state. These behavioral effects mapped onto target-dependent parieto-occipital and SN-visual retrieval pathways, supporting a model in which DBS bidirectionally regulates recognition memory through target- and frequency-dependent subcortical-cortical circuits.

18.
arXiv (CS.CL) 2026-06-17

EComAgentBench: Benchmarking Shopping Agents on Long-Horizon Tasks with Distributed Hidden Intent

As LLM-based shopping agents enter production, existing benchmarks fail to capture how a shopper's requirements arrive: stated implicitly in the query, recorded in a profile, or revealed only when the right question is asked. Benchmarks that expose full intent upfront and grade only the final choice can neither pose this long-horizon challenge nor explain which requirement an agent missed. To address this gap, we introduce EComAgentBench, a benchmark of 662 tasks grounded in real Amazon products and reviews. Each task scatters these requirements across a visible query, a tool-gated profile, and scripted clarification; an agent must uncover hidden intent, verify candidates against attributes and review evidence, and commit to a single product within 100 tool calls. Moreover, typed, source-tagged rubrics grade every task, attributing each failure to a requirement and its source. Construction is automated yet reliable, with every answer fixed in code before any text is generated and every sample validated. Our evaluation of seven models reveals that even the strongest attains only 57.1% overall accuracy, and rubric satisfaction degrades from visible to hidden sources. Overall, we believe EComAgentBench will serve as a reproducible foundation for moving shopping agents from single-query search toward dependable assistance over long horizons.

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

A Quantum Encoding of Traveling Salesperson Tours via Route Generation, Cost Phases, and a Reversible Valid-Permutation Oracle

arXiv:2603.21283v3 Announce Type: replace Abstract: For a traveling salesperson problem (TSP) of n cities, we present a compact quantum encoding based on a time-register representation of tours. A candidate route is represented as a sequence of n-1 city labels over discrete time steps, with one fixed start city and the remaining cities encoded in binary registers. We describe three ingredients of the construction: uniform route generation over the route register, a reversible validity oracle, and a phase oracle that encodes the total tour cost. The validity oracle checks both that the non-start city labels form a permutation and, for incomplete graphs, that every directed edge used by the route exists. The cost oracle then accumulates the start-edge, intermediate-transition, and return-edge costs into a tour-dependent phase for valid routes. This yields a coherent superposition of candidate routes with feasibility and tour-length information embedded directly in the quantum state. The complete construction uses O(n log n) qubits, while a naive implementation has worst-case elementary-gate complexity O(n^3 log n). The encoding is compatible with amplitude amplification or spectral filtering techniques such as the quantum singular value transform (QSVT) or Grover's algorithm. However, due to the exponentially small fraction of valid tours, the overall complexity remains exponential even when combined with amplitude amplification.

20.
arXiv (CS.CV) 2026-06-18

Automatic ply-specific analyses of CFRP micrographs using shortest-path-based ply distinction

We present an automated approach to distinguish between ply instances in semantic segmentation masks of high-resolution carbon-fiber reinforced polymer micrographs. Interpreting the segmentation mask as a graph with pixels as vertices, enables us to use a shortest-path algorithm yielding the ply-separating paths. Thereby, we bridge the gap between semantic segmentation and ply instance segmentation using global information. We successfully apply our approach on high-resolution micrographs featuring a broad range of characteristics like artificially added gaps in single or multiple plies, different stacking sequences and ply traversing cracks. Assigning each fiber pixel to a ply based on the calculated paths, allows for a comprehensive, quantitative ply analysis with respect to its microstructural properties like the local fiber volume fraction as well as locally resolved ply and interleaf layer thickness. These insights help to reveal manufacturing-induced inhomogeneities, draw conclusions on manufacturing parameters and link mechanical properties to underlying microstructural imperfections.

21.
arXiv (CS.CL) 2026-06-19

Token-Operations-Oriented Inference Optimization Techniques for Large Models

Large model inference optimization serves as a key foundation for supporting the scalable, low-cost, and highly stable operation of large model services. Centered on token-oriented inference optimization technology, this paper proposes for the first time a four-layer technical architecture consisting of Multi-model Fusion, Model Optimization, Compute-Model Fusion, and Compute-Network-Model Fusion. It systematically reviews the key technologies and current industry status across these four levels and analyzes the application value of related technologies in real-world business scenarios. This paper provides a practical technical path for reducing token production costs, improving token service efficiency, ensuring the stability of token supply, and driving the transition of large model services from being merely callable to being operable.

22.
medRxiv (Medicine) 2026-06-15

International Consensus Guideline on Management of Genitourinary Adverse Events Associated with Prostate Cancer Radiotherapy

Purpose/Objective: Genitourinary (GU) adverse events (AEs) are common during and after pelvic radiation therapy (RT) for prostate cancer and can substantially impact quality of life. We convened an international committee to establish consensus in the prevention, mitigation, and management of radiation-related acute and late GU AEs, as there are no relevant evidence-based consensus guidelines to inform treating providers. Materials/Methods: A systematic evidence review focused on mitigation and management of radiation-related acute and late GU AEs was performed in PubMed, Embase and Cochrane. The following topics were addressed: management of acute GU AEs in the intact and post-operative settings; RT techniques; bladder outlet obstruction procedures; and indications for urology referral or hyperbaric oxygen therapy (HBO). Evidence-based consensus recommendations were developed using a Delphi process. We highlight the current state of evidence and evidence gaps worthy of future study. Results: Consensus was reached for 31 key questions. For management of lower urinary tract symptoms (LUTS), most evidence comes from trials in patients without cancer and not undergoing RT. A consensus algorithm for medical management of acute GU AEs was developed with the following highlights: (a) alpha blockers as 1st-line for obstructive symptoms in the intact setting, (b) anti-spasmodics as 1st -line for irritative symptoms in the intact setting, and (c) anti-spasmodics as 1st -line in the post-operative setting. The consensus algorithm provides an ordered list of medications to offer if 1st -line options afford inadequate relief. For RT fractionation, randomized clinical trial (RCT) data are available. 40% of panelists rarely or never use standard fractionation over moderate hypofractionation for patients with baseline LUTS, but most consider moderate hypofractionation over SBRT for AUA IPSS > 15. For patients with severe obstructive LUTS (most commonly AUA IPSS >20), the panel recommends a prophylactic bladder outlet obstruction procedure and, if obstructive symptoms improve, consideration of moderate hypofractionation or SBRT, based on retrospective data. There is one RCT supporting use of HBO for late radiation cystitis. Conclusions: The consensus guideline synthesizes available evidence and expert opinion across key clinical decision points to provide practical guidance in the prevention, mitigation, and management of radiation-related acute and late GU AEs in prostate cancer RT. Envisioned as a living document with periodic updates, this guideline serves as a resource for practicing radiation oncologists by outlining expert-derived consensus recommendations of evidence-based care in areas where high-quality data is limited.

23.
arXiv (CS.AI) 2026-06-15

Adversarial Concept Search: Predicting Compositional Errors From Feature Geometry

arXiv:2606.13934v1 Announce Type: new Abstract: Humans cannot always intuit what scenarios are most challenging to LLMs. Hoping to capture challenging edge cases, developers either design problems to be difficult for humans or curate extensive benchmarks. What if we could instead anticipate which scenarios a model will fail on? In this paper, we use an LLM's representational geometry to predict which concept combinations it will fail on. We attribute this compositional failure to interference between salient features. In tasks that require systematic composition - toy programmatic settings, multihop reasoning, multilingual factual recall - we find that when a pair of concepts is encoded near-orthogonally, the model reliably composes them. When their linear encodings are close, producing interference, the model fails to compose them. Our method reliably anticipates failure modes across different compositional tasks, without evaluating specific inputs. These results lay the groundwork to use representational geometry to identify high-risk examples, construct targeted stress tests, and provide a scalable foundation for active learning in real-world deployment.

24.
arXiv (CS.CV) 2026-06-17

ERQA-Plus: A Diagnostic Benchmark for Reasoning in Embodied AI

Generalist embodied agents require more than object recognition: they must reason about spatial relations, actions, procedures, human intentions, environmental constraints, and commonsense consequences from situated visual observations. Yet existing visual and embodied question answering benchmarks often provide limited control over the reasoning dependencies being tested, making it difficult to distinguish grounded embodied reasoning from shortcut-driven visual or linguistic pattern matching. We present ERQA-Plus, a diagnostic benchmark for reasoning in embodied AI. ERQA-Plus contains 1,766 question-answer instances grounded in 711 robot-centric images and organized according to a structured taxonomy spanning perceptual, action-centric, social-interaction, navigation-environmental, and contextual commonsense reasoning. The dataset is constructed using a multi-stage generation and validation pipeline that combines taxonomy-guided question generation, automatic quality judging, iterative revision, and human assessment to improve visual grounding, answer validity, and reasoning quality. We benchmark representative general-purpose vision-language models and embodied models, including LLaVA-NeXT-8B, Prismatic-7B, MiniCPM-V-4.5-8B, Qwen3-VL, RoboRefer-8B, and RoboBrain2.5-8B. Although the strongest model, Qwen3-VL-32B, achieves 83.4% overall accuracy and 61.4 SBERT score, category-level results reveal persistent weaknesses in spatial reasoning, procedural reasoning, event prediction, and intention inference. ERQA-Plus therefore provides a fine-grained evaluation framework for measuring not only whether embodied agents answer correctly, but also which forms of embodied reasoning they can and cannot perform reliably. The dataset is available https://huggingface.co/datasets/huggingdas/erqa-plus and the project page at https://github.com/LUNAProject22/erqa-plus.

25.
arXiv (CS.LG) 2026-06-17

Informative Missingness to Generate Irregular Clinical Time Series

arXiv:2606.17106v1 Announce Type: new Abstract: Laboratory tests in electronic health records are collected irregularly, and the absence of a test order can be as informative as the measurement itself. Such missingness reflects clinicians' decisions and patient physiology, making it important to model it directly rather than treat it as a preprocessing artifact. Here we present a diffusion-based approach for generating clinical time series that jointly models laboratory values and their observation patterns using the public Data Analytics Challenge on Missing Data Imputation (DACMI) benchmark derived from MIMIC-III. To preserve realistic sampling, we align chart times into 4-hour intervals and segment admissions into 7-day windows, producing trajectories that pair each lab value with a corresponding observation indicator. Standard transformations and normalization are applied to stabilize training. Our method extends the TimeDiff framework to learn continuous lab values and discrete missingness patterns through complementary diffusion objectives. Experiments show that the generated data closely match real patient trajectories across individual lab distributions and joint value-missingness embeddings, demonstrating that diffusion models can capture clinically meaningful dependencies between patient physiology and clinicians' testing behavior under MNAR-like (missing-not-at-random) missingness. These preliminary results indicate that our model can serve as an initial component toward developing clinical foundation models. By producing synthetic priors that preserve key physiology-missingness relationships, this work motivates the subsequent training of Prior-Data Fitted Networks capable of leveraging informative missingness, which we will investigate in the extended work.