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

BrainPro: Towards Large-scale Brain State-aware EEG Representation Learning

arXiv:2509.22050v2 Announce Type: replace Abstract: Electroencephalography (EEG) reflects underlying brain states, whose activities are distributed across brain regions and manifest as spatial patterns on the scalp. Learning these spatially structured, state-related patterns requires consistent spatial representations across datasets. However, existing EEG foundation models are typically based on self-attention, which does not preserve location-specific information and struggles to align signals recorded with different channel configurations. Moreover, brain states contain both shared and state-specific regional activity, suggesting that learning neurophysiologically plausible, state-aware representations can complement the shared representations targeted by current models and improve downstream decoding. To address these limitations, we propose BrainPro, a large EEG model that combines a retrieval-based spatial learning mechanism for cross-layout spatial alignment with a brain state-decoupling module that learns both shared and state-specific representations through parallel encoders and region-aware reconstruction. Pre-trained on a large EEG corpus, BrainPro achieves state-of-the-art performance across nine public BCI datasets spanning emotion, motor, speech, stress, mental disease, and attention tasks. Analyses of spatial filters, channel-drop robustness, and encoder contributions further validate the effectiveness of its spatial alignment and state-aware pathways. These results show that BrainPro achieves improved interpretability of learned spatial patterns and produces representations that benefit diverse EEG decoding tasks.

02.
arXiv (CS.AI) 2026-06-11

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

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

03.
arXiv (CS.LG) 2026-06-16

Inference-Time Decision Calibration for Temporal Classification

arXiv:2606.16034v1 Announce Type: new Abstract: Temporal classification errors are often treated as representation failures, but they can also arise from how available evidence is converted into decisions. This paper proposes a representation–calibration decomposition for temporal classification. We keep a trained native classifier frozen and separate two inference-time interventions: a conservative residual multi-scale branch that adds auxiliary logits to the native prediction, and a post-hoc branch-aware calibrator that recombines native and residual evidence at decision time. This design distinguishes missing temporal evidence from underused decision-level evidence without retraining the backbone. Across FI-2010, PTB-XL, UCI-HAR, MHEALTH, and HARTH, we find that gains are strongly regime-dependent. Residual multi-scale evidence is most useful in noisy or representation-limited settings, especially short-horizon FI-2010 and weaker recurrent backbones, while branch-aware calibration helps when native and auxiliary logits contain complementary evidence not fully exploited by the raw decision rule. Near-saturated settings show limited gains from either intervention. These results suggest that temporal classification should be understood not only as representation learning, but also as the problem of trusting, combining, and calibrating evidence from multiple views.

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

EgoPhys: Learning Generalizable Physics Models of Deformable Objects from Egocentric Video

Humans naturally understand object physics through everyday interactions, but faithfully predicting complex deformable dynamics, such as elastic materials and fabrics, remains a major challenge for computer vision and robotics. We present EgoPhys, a framework that constructs deformable physical digital twins from egocentric RGB-only video using generalizable priors. EgoPhys overcomes the limitations of existing methods to enable controllable deformable digital twin generation from egocentric videos by distilling per-object inverse-physics solutions into a compact codebook, enabling prediction of dense spring stiffness fields for unseen objects without per-spring test-time optimization. Trained with generalizable priors from diverse egocentric interactions, EgoPhys outperforms baselines in reconstruction, future prediction, and zero-shot generalization. To support training and evaluation, we curate an egocentric interaction dataset covering diverse deformable objects, scenes, and manipulation styles. We deploy EgoPhys on a real xArm6 robot, demonstrating that a digital twin initialized from a single egocentric human play video can serve as an internal world representation to aid in deformable-object planning, highlighting egocentric RGB observations as a scalable path toward real-to-sim pipelines.

05.
arXiv (CS.LG) 2026-06-15

LapidaryEngine: Fully Conversational Crystal Generation

arXiv:2606.14215v1 Announce Type: new Abstract: The emergence of Large Language Models (LLMs) has inspired the vision of generating bespoke crystal materials directly from natural-language instructions, enabling users to design materials through intuitive, conversational interaction. Existing text-to-crystal generative models represent important early steps toward this goal, but they suffer from two critical limitations: (i) restricted input formats that require highly structured descriptions (e.g., chemical formulas), and (ii) one-directional generation, where models can map text to crystal but cannot perform the inverse. These limitations prevent fully conversational workflows and hinder alignment with users' inherently ambiguous and evolving desiderata. We address these challenges with LapidaryEngine, the first model to support fully conversational crystal generation. LapidaryEngine accepts free-form natural-language requests and performs iterative refinement and editing in a dialogue-like manner. The key innovation is a pivot representation, a third, intermediate form that enables bidirectional translation between text and crystal structures despite the absence of direct paired datasets. Leveraging this pivot allows robust interpretation of user feedback and precise structural control. We demonstrate LapidaryEngine across diverse tasks, including insulator discovery, stability optimization, compositional modification, and structural editing, showcasing its ability to align generated materials with user intent in an interactive manner.

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

uva-irlab-conv at SemEval-2026 Task 8: Multi-Turn RAG with Learned Sparse Retrieval and Listwise Reranking

This report describes our participation in SemEval-2026 Task 8 on multi-turn retrieval and question answering. The task evaluates conversational systems across four domains (finance, cloud documentation, government, Wikipedia), and includes unanswerable queries where the available collection does not contain sufficient evidence to produce a complete response. We propose a multi-turn retrieval-augmented generation pipeline that combines learned sparse retrieval with LLM-based reranking and generation. Using sparse retrieval as the primary retrieval method, we leverage its strong generalization across domains. In addition, we make use of the long-context capabilities of LLMs for conversational query rewriting, pointwise and listwise reranking, and generating the final response, each conditioned on the full conversational history. This multi-step design enables effective integration of conversational context throughout retrieval and generation, improving robustness across domains.

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

OBCache: Optimal Brain KV Cache Pruning for Efficient Long-Context LLM Inference

Large language models (LLMs) with extended context windows enable powerful applications but impose significant memory overhead, as caching all key-value (KV) states scales linearly with sequence length and batch size. Existing cache eviction methods address this by exploiting attention sparsity, yet they typically rank tokens heuristically using accumulated attention weights without considering their true impact on attention outputs. We propose Optimal Brain Cache (OBCache), a principled framework that formulates cache eviction as a layer-wise structured pruning problem. Building upon the Optimal Brain Damage (OBD) theory, OBCache quantifies token saliency by measuring the perturbation in attention outputs induced by pruning tokens, with closed-form scores derived for isolated keys, isolated values, and joint key-value pairs. Our scores account not only for attention weights but also for information from value states and attention outputs, thereby enhancing existing eviction strategies with output-aware signals. Experiments on LLaMA and Qwen models demonstrate that replacing the heuristic scores in existing works, which estimate token saliency across different query positions, with OBCache's output-aware scores consistently improves long-context accuracy. Code is available at https://github.com/DreamSoul-AI/OBCache.

08.
medRxiv (Medicine) 2026-06-22

Midlife Measures of General Cognitive Performance in the National Longitudinal Study of Adolescent to Adult Health (Add Health)

Objective: The Add Health Cognitive Assessment, Physical, and Sensory Function Protocol (Add CAPS) was developed to assess cognitive, physical, and sensory function in early midlife in a nationally representative sample in the United States. Using Add CAPS, we developed two general cognitive performance measures. Methods: The sample included 2,525 participants from Add Health Wave VI who completed an in- home assessment of cognitive performance. Confirmatory factor analysis (CFA) was used to derive two general cognitive performance (GCP) scores: (1) a five-domain score based on originally designed cognitive domains (Add CAPS GCP), and (2) a modified score aligned with the Harmonized Cognitive Assessment Protocol (HCAP) framework (Add CAPS GCP-H). We evaluated model fit using Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Comparative Fit Index (CFI) and tested factor scores for criterion validity. Results: Both models showed good fit (Add CAPS GCP: RMSEA = 0.025, SRMR = 0.031, CFI = 0.968; Add CAPS GCP-H: RMSEA = 0.027, SRMR = 0.033, CFI = 0.962), indicating that they adequately represent the underlying GCP construct. Discussion: The Add CAPS cognitive battery captures a robust, hierarchical structure of GCP across alternative domain specifications. The derived factor scores provide a valuable method for characterizing a person's cognitive baseline during midlife. Importantly, the Add CAPS GCP-H enhances comparability with the HCAP network, supporting cross-cohort analyses of cognitive aging.

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

HanDyVQA: A Video QA Benchmark for Fine-Grained Hand-Object Interaction Dynamics

Hand-object interaction (HOI) inherently involves dynamics where human manipulations produce distinct spatio-temporal effects on objects. However, existing semantic HOI benchmarks focused either on manipulation or on the resulting effects at a coarse level, lacking fine-grained spatio-temporal reasoning to capture the underlying dynamics in HOI. We introduce HanDyVQA, a fine-grained video question-answering benchmark that comprehensively covers both the manipulation and effect aspects of HOI. HanDyVQA comprises six complementary question types (Action, Process, Objects, Location, State Change, and Object Parts), totalling 11.1K multiple-choice QA pairs. Collected QA pairs recognizing manipulation styles, hand/object motions, and part-level state changes. HanDyVQA also includes 10.3K segmentation masks for Objects and Object Parts questions, enabling the evaluation of object/part-level reasoning in video object segmentation. We evaluated recent video foundation models on our benchmark and found that even the best-performing model, Gemini-2.5-Pro, reached only 73% average accuracy, which is far from human performance (97%). Further analysis shows the remaining challenges in spatial relationship, motion, and part-level geometric understanding. We also found that integrating explicit HOI-related cues into visual features improves performance, offering insights for developing future models with a deeper understanding of HOI dynamics.

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

Dummy Backdoor as a Defense: Removing Unknown Backdoors via Shared Internal Mechanisms for Generative LLMs

Backdoor attacks pose a serious threat to the safety and reliability of Large Language Models (LLMs), as they cause models to behave normally on clean inputs while producing attacker-specified responses when hidden triggers are present. Removing such unknown backdoors is particularly challenging when the defender does not know the backdoor attack types or the internal mechanisms formed through backdoor training. In this work, we propose a simple but effective backdoor removal method based on shared internal mechanisms across different backdoors. First, we show that different backdoors with the same task (attack objective) induce similar trigger-activated changes in the internal activations. Motivated by this observation, our method intentionally embeds a backdoor with a known trigger (dummy backdoor) and then removes it through further fine-tuning on dummy-triggered inputs paired with clean responses. Since the dummy backdoor and the unknown backdoor can rely on shared internal mechanisms, removing the dummy backdoor also reduces the effect of the unknown backdoor. We evaluate our method on three backdoor attack types across multiple model families. Experimental results show that our method substantially reduces the attack success rate of the unknown backdoor while preserving model utility, outperforming representative existing defense methods in both backdoor removal effectiveness and utility preservation. These findings suggest that a defender-controllable backdoor can serve as a helpful proxy for mitigating unknown backdoors in generative LLMs.

11.
arXiv (quant-ph) 2026-06-16

Morphology-resolved scrambling in a chaotic quantum billiard

arXiv:2606.16865v1 Announce Type: new Abstract: Chaotic quantum systems can retain spatial memory through scarred eigenstates, but whether these static structures control scrambling remains unclear. This work establishes a morphology-resolved connection between scarred eigenstates and eigenstate-resolved OTOCs in a peanut-shaped quantum billiard. Scalar localisation diagnostics, including differential entropy and continuum participation ratios, detect anomalous concentration but discard spatial architecture. A scale-normalised density overlap, in contrast, directly compares probability density profiles, revealing families of orthogonal eigenstates with nearly identical spatial morphology. Comparing the complete OTOC time traces of these orthogonal eigenstates reveals that morphological recurrence has dynamical content: moderate density overlap yields no universal prediction, whereas strongly recurring morphologies exhibit nearly identical OTOC growth and saturation. Thus, scarred structures act as spatial templates for operator growth, not merely static violations of ergodicity. This morphology-resolved framework turns eigenstate shape into a quantitative predictor of scrambling and provides a scale-controlled diagnostic of weak ergodicity breaking in quantum chaos.

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

Distributional Loss for Robust Classification

This paper proposes a novel loss concept for supervised classification tasks. Rather than enforcing a direct mapping from each input sample to a single assigned label, we define an optimization objective over all classifier outputs as a bimodal Gaussian distribution. This softer target formulation implicitly captures class ambiguity, mitigates overfitting, and encourages the learning of more robust decision boundaries, all without requiring additional label information. Experimental results demonstrate consistent improvements in robustness, with particularly pronounced gains in low-data regimes, while requiring only minimal modifications to standard training pipelines.

13.
medRxiv (Medicine) 2026-06-15

An epidemiological scenario for Mass Events During the World Cup

This brief work discusses potential superspreading events that may occur during the World Cup in Mexico. The study is particularly focused on the city of Guadalajara due to a large recent outbreak in January and February and insufficient vaccine coverage prior to 2026. Keywords: Superspreading; measles outbreak; branching process; individual reproduction number; World Cup

14.
arXiv (CS.CV) 2026-06-12

GeoCFNet: Geometry-Aware Confidence Field Network for Robot-Assisted Endoscopic Submucosal Dissection

Advanced surgical robotics has made robot-assisted endoscopic submucosal dissection (ESD) a promising approach for the en-bloc resection of large lesions, with the potential to reduce recurrence and improve long-term outcomes. However, the technical complexity and risk of complications in ESD demand stable and precise visual guidance to maintain an accurate dissection corridor and a safe tissue margin. Dense confidence fields provide an effective representation for this purpose by describing both the preferred dissection region and its spatial transition to surrounding tissue. However, reliable confidence field estimation remains challenging in dynamic endoscopic scenes due to smoke, specular highlights, tissue deformation, weak texture, and the thin geometric structure of the target region. To address these challenges, we formulate dissection guidance as a geometry-aware confidence field estimation problem and propose GeoCFNet, a geometry-aware confidence field network built on a pretrained DINOv3 backbone. GeoCFNet integrates a Token-Differentiated Fusion module to aggregate class-token context with dense patch representations, a SegFormer decoder for confidence regression, and Geometry-Aware Spatial Regularization (GASR) to preserve spatial coherence and local geometric transitions. Experimental results show that GeoCFNet achieves RMSE 0.0480, PSNR 27.1995, SSIM 0.3397, and CC 0.2466, indicating accurate and geometrically stable confidence field estimation for robot-assisted ESD guidance.

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

Semi-Supervised Noise Adaptation: Transferring Knowledge from Noise Domain

arXiv:2606.00558v2 Announce Type: replace Abstract: Transfer learning aims to facilitate the learning of a target domain by transferring knowledge from a source domain. The source domain typically contains semantically meaningful samples (*e.g.*, images) to facilitate effective knowledge transfer. However, a recent study observes that the noise domain constructed from simple distributions (*e.g.*, Gaussian distributions) can serve as a surrogate source domain in the semi-supervised setting, where only a small proportion of target samples are labeled while most remain unlabeled. Based on this surprising observation, we formulate a novel problem termed *Semi-Supervised Noise Adaptation* (SSNA), which aims to leverage a synthetic noise domain to improve the generalization of the target domain. To address this problem, we first establish a generalization bound characterizing the effect of the noise domain on generalization, based on which we propose a Noise Adaptation Framework (NAF). Extensive experiments demonstrate that NAF effectively leverages the noise domain to tighten the generalization bound of the target domain, leading to improved performance. The codes are available at https://github.com/AIResearch-Group/SSNA.

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

Conflict-Aware Retriever Editing for Knowledge Injection Attacks on LLM-Based RAG Systems

arXiv:2606.18310v1 Announce Type: cross Abstract: Injecting malicious knowledge into retrieval-augmented generation (RAG) systems can manipulate retrieved evidence and mislead downstream generation, posing a serious security threat for AI applications. Existing RAG injection attacks mainly rely on manipulating external knowledge bases, such as crafting malicious corpus. However, the synthetic text crafted by such data-centric methods could be detectable, leading to the failure of attacks. Beyond corpus manipulation, open-source retrievers are increasingly exposing RAG systems to model-centric attacks. In this paper, we propose conflict-aware retriever editing, i.e., CAREATTACK, a model-centric retriever attack framework for malicious knowledge injection in RAG. Specifically, CAREATTACK consists two stages of conflict-aware retriever editing and attack-preserving anchor repair. Conflict-aware retriever editing adapts efficient closed-form parameter editing to the dense retrieval model, promoting malicious knowledge above benign competing passages and resolving potential parameter conflicts through graph-based conflict detection and parameter editing projection. Then, attack-preserving anchor repair performs lightweight calibration on the edited retriever to further eliminate the impact on non-target prompts while preserving the attack effectiveness for target prompts. We instantiate CAREATTACK on Qwen3-Embedding-0.6B and BGE-M3, and conduct evaluation on three benchmark datasets. Experimental results demonstrate our method substantially promote malicious passages into the retrieved knowledge of RAG systems and can perform attacks for batches of target prompts and passages, given the access of retrieval model parameters. Since most RAG systems are built upon open-source retrieval models, this work reveals a practical attack surface in RAG systems. Codes are public accessible at https://anonymous.4open.science/r/CareAttack-3F1C.

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

Beyond Fully Random Masking: Attention-Guided Denoising and Optimization for Diffusion Language Models

Diffusion large language models (dLLMs) offer an efficient alternative to autoregressive models through parallel decoding, yet existing post-training methods largely rely on random masking strategies that overlook intrinsic token dependencies. In this work, we present an empirical analysis of attention in dLLMs and show that tokens attending more strongly to unmasked context exhibit greater generation stability and play a critical role in reasoning. Motivated by these findings, we propose AGDO, an attention-guided denoising and optimization framework that aligns both training and optimization with attention-derived dependencies. AGDO determines the denoising order based on attention structure and emphasizes attention-critical tokens during supervised fine-tuning and reinforcement learning. Experiments on mathematical and coding benchmarks demonstrate that AGDO consistently improves reasoning performance, outperforming state-of-the-art post-training methods for dLLMs.

18.
PLOS Computational Biology 2026-06-17

Combining machine learning and iterative experiments to keep pace with emerging viral variants of concern

by Thomas Sheffield, Ryan C. Bruneau, Stephen Won, Kenneth L. Sale, Brooke Harmon, Le Thanh Mai Pham Modeling and predicting viral mutations before they emerge plays a crucial role in pandemic preparedness, enabling the early identification of emerging variants of concern (VOCs) and guiding timely updates to vaccines, diagnostic tests, and therapeutic strategies. However, existing machine learning models and large-scale experiments lose their predictive power as viral variants evolve further from the original strains in sequence space. Here, we present a scalable framework that integrates random forest and neural network machine learning models with targeted high-throughput experimentation to anticipate and evaluate emerging SARS-CoV-2 receptor-binding domain (RBD) variants. Using public datasets, we trained predictive models for binding to human Angiotensin-converting enzyme 2 (ACE2), RBD expression, and antibody escape, and refined these models through iterative integration of experimental data focused on over 200 variants derived from wild-type (WT) and Omicron strains. Through an indirect transfer learning approach, our machine learning models achieved high accuracy having correlation coefficients of up to 0.79 for antibody binding. The models were also generalizable across diverse antibody types including heavy-chain-only antibodies (HCAbs) by encoding complementarity-determining regions (CDRs) as input features. This dynamic approach enables rapid assessment of emerging variants, facilities prioritization of the therapeutic strategies, and supports a proactive, data-driven response to evolving viral threats.

19.
arXiv (CS.AI) 2026-06-16

ControlMap: Controllable High-Definition Map Generation for Traffic Scenario Simulation

arXiv:2606.15930v1 Announce Type: cross Abstract: Simulation is central to validating autonomous driving systems, yet current pipelines are limited by insufficient scenario diversity due to costly High Definition (HD) map creation. Scaling HD maps requires expensive data collection and manual processing. Moreover, existing generative models lack the fine-grained control necessary to target specific road topologies during generation. This paper presents a data-driven pipeline for controllable HD map generation using latent diffusion and ControlNet for spatial conditioning. To our knowledge, we are the first to inject spatial guidance signals into a diffusion model for HD map synthesis. Furthermore, our model supports adjustable conditioning strength through classifier-free guidance and city-level style transfer via city label conditioning. To complement existing metrics, we introduce two novel metrics to evaluate adherence to the control signal and similarity to ground-truth maps. Experiments demonstrate that our model generates realistic HD maps that faithfully follow input road topologies while accurately preserving city-specific details.

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

Hybrid Diffusion Transformer for Instruction-Guided Audio Editing via Rectified Flow

arXiv:2606.20101v1 Announce Type: cross Abstract: Audio editing aims to modify specific content in an existing audio clip according to a natural language instruction while preserving the remaining acoustic content. Despite the remarkable progress of diffusion models, existing training-based editing methods mainly rely on the local inductive biases and cross-attention interaction in convolutional U-Net backbones, which often hinder long-range semantic alignment and precise understanding and localization of instructions. In contrast, diffusion transformers provide stronger global modeling and multimodal fusion, but existing editing architectures usually adopt a simple stack of MMDiT and DiT blocks. Applying joint attention over concatenated audio and text tokens in all blocks results in quadratic complexity with respect to token length. To balance editing performance and efficiency, we propose a hybrid two-stage diffusion transformer architecture for instruction-guided audio editing based on rectified flow matching. It performs joint attention over audio and text tokens to establish coarse semantic alignment at low-resolution stage, then switches to alternating joint-attention and cross-attention blocks to refine editing details at high-resolution stage. This coarse-to-fine strategy enables efficient and accurate instruction-guided audio editing. Experiments show that the proposed framework achieves notable performance gains on challenging editing tasks involving overlapping audio events and complex instructions, while substantially improving editing efficiency with a compact model.

21.
arXiv (CS.CV) 2026-06-16

Stepwise Token Selection for Efficient Multimodal Large Language Models

In multimodal large language models (MLLMs), inference cost is largely dominated by the visual token prefix rather than the language backbone, making token reduction a key factor for improving efficiency. Existing approaches typically assign independent importance scores to visual tokens and retain a fixed number of top-ranked tokens, implicitly assuming token independence and a uniform compression ratio across inputs. In this work, we reformulate visual token pruning as a sequential decision-making process. Specifically, we introduce a pointer-style selection mechanism that iteratively chooses informative tokens, conditioning each decision on previously selected ones, and dynamically determines when to stop via a learned termination action. This enables joint optimization of both the selected subset and its size. To enable end-to-end training under standard language modeling objectives, we design a differentiable relaxation based on a variance-preserving noise interpolation scheme, allowing gradients to propagate through the discrete selection process. Extensive experiments on LLaVA-v1.5-7B and Qwen2.5-VL-7B demonstrate that our approach consistently outperforms fixed-ratio baselines across different compression levels. Under aggressive pruning that removes 88.9% of visual tokens, our method preserves 94.6% of the original accuracy while achieving a 1.88x speed-up in prefill latency.

22.
medRxiv (Medicine) 2026-06-22

The direct economic impact of surgical non-response in orthopaedic hip, knee, and spine surgery for osteoarthritis: a cost-utility analysis

Background Annually, nearly 2 million hip, knee, and spinal inpatient surgeries are performed in Canada and the US for osteoarthritis (OA), costing over $37 billion in hospital expenditures. However, 15-30% of patients experience limited or no improvement, resulting in poor value for money. This study evaluated the one-year cost-utility of joint and spine procedures for OA by comparing non-responders to responders, considering various responder definitions. Methods Individual micro-costing data were collected for 1,175 elective hip, knee, and spine patients enrolled in the Longitudinal Evaluation in the Arthritis Program - Osteoarthritis (LEAP-OA) between 2014 and 2018. Quality-adjusted life years (QALYs) were derived using the SF-6D utility index. One-year incremental cost-utility ratios (ICURs) were calculated from the hospital perspective. Results Responder rates varied by definition, ranging from 78%-94% for hip replacements, 64%-90% for knee replacements, 60%-64% for spine fusions, and 50%-68% for spine decompressions. Corresponding ICURs were: $45,956-$51,773/QALY for responders versus $108,593-$485,762/QALY for non-responders for hip replacements; $54,831-$71,151/QALY for responders versus $200,486-$1,203,596/QALY for non-responders for knee replacements; $65,980-$74,422/QALY for responders versus $262,039-$729,686/QALY for non-responders for spine fusions; and $29,947-$42,168/QALY for responders versus $63,195-$662,586/QALY for non-responders for spine decompressions. Conclusions While surgical response rates were highly dependent on the responder definition, ICURs for non-responders were significantly higher than those for responders across all definitions. Beyond the negative impact on patients, there is a compelling economic argument for investment in improved pre-operative identification of patients at risk of surgical non-response. Such efforts could enable more personalized, value-based care pathways and reduce the provision of low-value surgical interventions.

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

Hybrid Classical-Quantum Variational Autoencoder for Neural Topic Modeling

Authors:

Neural topic models enable scalable semantic discovery, but their integration with quantum hardware remains largely unexplored. We present a proof-of-concept hybrid classical-quantum variational autoencoder (VAE) for topic modeling, embedding parameterized quantum circuits within the VAE inference network while retaining a classical topic-word decoder. To address the resource constraints of quantum hardware, we propose a modified Gaussian Softmax posterior that decouples latent space dimensionality from the number of topics to be extracted, enabling the model to operate with a low-resource 10-qubit quantum device. On the AgNews dataset, the hybrid VAE outperforms state-of-the-art neural topic models (NTMs), reaching a $C_v$ coherence score of 0.71 and an NPMI score of 0.20 while preserving high topic diversity. For comparison, we also construct a fully classical variant, which also outperforms state-of-the-art models on AgNews and exhibits clear class separation in the latent space. These results demonstrate that hybrid VAEs are computationally viable even on NISQ-era devices and represent a promising direction for quantum-enhanced topic modeling.

24.
medRxiv (Medicine) 2026-06-22

Regional Service-System Conditions Associated with Facility-Linked Home-Based Specialist Care in Japan: A Claims-Based Ecological Study of Home Dialysis

Authors:

Background Complex chronic care is increasingly delivered in patients' homes while remaining linked to specialist facilities for training, monitoring, and backup care. Home dialysis provides a useful case because peritoneal dialysis (PD) and home hemodialysis (HHD) share a home-facility delivery structure but differ in technical and operational requirements. This study examined regional service-system conditions associated with the presence and scale of PD and HHD in Japan. Methods This ecological study used publicly available claims, administrative, census, and geospatial data harmonized to 334 Secondary Medical Areas. Regional indicators were organized into four domains: dialysis service delivery, implementation support for home-based care, hospital backup capacity, and living and sociodemographic context. Diffusion was examined using claims-based indicators of regional presence and post-presence scale, analyzed separately for PD and HHD with Firth penalized logistic regression and zero-truncated negative binomial regression, respectively. Results PD was observed in 271 regions and HHD in 109. Patterns of associated regional conditions differed by modality and stage. PD was associated mainly with existing dialysis-service organization, whereas HHD was associated with broader regional supports, including home-care delivery, living infrastructure, transition support, and hospital-system indicators. Conditions associated with presence differed from those associated with scale. Cross-modality associations suggested that shared regional factors may shape the distribution of both modalities. Conclusions Regional conditions for home dialysis diffusion in Japan differed by modality and stage. PD was linked mainly to existing dialysis-service organization, whereas HHD was linked to multi-domain regional support for technically demanding home treatment. Under standardized reimbursement, local service-system capacity may remain important for modality- and stage-specific diffusion of home dialysis.

25.
arXiv (CS.CV) 2026-06-12

Iterative Tool Usage Exploration for Multimodal Agents via Step-wise Preference Tuning

Multimodal agents, which integrate a controller e.g., a vision language model) with external tools, have demonstrated remarkable capabilities in tackling complex multimodal tasks. Existing approaches for training these agents, both supervised fine-tuning and reinforcement learning, depend on extensive human-annotated task-answer pairs and tool trajectories. However, for complex multimodal tasks, such annotations are prohibitively expensive or impractical to obtain. In this paper, we propose an iterative tool usage exploration method for multimodal agents without any pre-collected data, namely SPORT, via step-wise preference optimization to refine the trajectories of tool usage. Our method enables multimodal agents to autonomously discover effective tool usage strategies through self-exploration and optimization, eliminating the bottleneck of human annotation. SPORT has four iterative components: task synthesis, step sampling, step verification, and preference tuning. We first synthesize multimodal tasks using language models. Then, we introduce a novel trajectory exploration scheme, where step sampling and step verification are executed alternately to solve synthesized tasks. In step sampling, the agent tries different tools and obtains corresponding results. In step verification, we employ a verifier to provide AI feedback to construct step-wise preference data. The data is subsequently used to update the controller for tool usage through preference tuning, producing a SPORT agent. By interacting with real environments, the SPORT agent gradually evolves into a more refined and capable system. Evaluation in the GTA and GAIA benchmarks shows that the SPORT agent achieves 6.41% and 3.64% improvements, underscoring the generalization and effectiveness introduced by our method. The project page is https://SPORT-Agents.github.io.