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

SemanticXR: Low Power and Real-time Queryable Semantic Mapping with an Object-Level Device-Cloud Architecture

Semantic mapping is a core service that enables grounded interactions in emerging Extended Reality (XR) applications such as AI assistants and spatial object search. Deploying this capability on mobile XR devices requires a system that is open-vocabulary, real-time, and low-power. Existing approaches are compute-intensive and assume server-class resources. Cloud offloading offers a practical path, but no existing system splits semantic mapping across the device-cloud boundary or manages its communication, execution, and memory footprint. We present SemanticXR, the first device-cloud system for real-time, open-vocabulary semantic mapping and querying under XR power, bandwidth, and memory constraints. Our key insight is to elevate semantically identifiable objects to first-class units of communication, execution, and memory across the device and server. On the server, object-level parallelism and geometry downsampling improve mapping latency, while object-level depth-mapping co-design reduces upstream bandwidth. On the device, an object-level sparse local map with incremental updates and update prioritization enables network-robust querying with bounded memory and downstream bandwidth. Object-level configurable resource usage vs. quality trade-offs let applications and the system adapt mapping to application requirements and operating conditions, respectively. Against a device-cloud baseline with the same perception models, object-level organization improves server-side mapping latency by 2.2X at equal semantic quality. Depth-mapping co-design maintains upstream bandwidth under 2.5 Mbps. On the device, SemanticXR sustains sub-100 ms query latency for up to 10,000 objects even under network drops, supports tens of thousands of objects within 500 MB, and scales downstream bandwidth with map changes, not total scene size. The system adds only 2% device power during normal operation.

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

HiGR: Industrial-Scale Hierarchical Generative Slate Recommendation Framework in Tencent

arXiv:2512.24787v4 Announce Type: replace-cross Abstract: Slate recommendation, which presents users with a ranked item list in a single display, is ubiquitous across mainstream online platforms. While recent generative recommendation methods have shown strong potential in modeling item sequences with semantic IDs, directly applying them to industrial-scale slate recommendation faces a fundamental disconnect: entangled SID spaces confound high-level list planning, fine-grained autoregressive decoding over long sequences limits semantic planning efficiency, and token-level objectives misalign with holistic slate quality. In this paper, we propose HiGR, an industrial-scale hierarchical generative framework for slate recommendation that bridges this disconnect through a co-designed pipeline. First, HiGR learns structured SIDs via a Prefix-Contrastive Residual Quantized VAE (PCRQ-VAE). By enforcing high-level prefixes to capture shared semantics, PCRQ-VAE creates a controllable discrete space that acts as a prerequisite for efficient planning. Leveraging this structured space, our Hierarchical Slate Decoder (HSD) shifts autoregressive modeling from entangled token-level decoding to coarse-grained preference embeddings. This design significantly reduces inference latency while allowing explicit global slate structure planning. Finally, this stable planning space enables an ORPO-based listwise alignment mechanism to optimize triple-objective implicit feedback-ranking fidelity, genuine user interest, and diversity. Extensive offline experiments show that HiGR outperforms state-of-the-art baselines by over 10% in offline recommendation quality while achieving a $5\times$ inference speedup. Online A/B tests on Tencent platforms further improve watch time by 1.22% and video plays by 1.73%. HiGR has been deployed on multiple Tencent platform surfaces, serving hundreds of millions of users and proving its industrial-scale applicability.

03.
arXiv (CS.LG) 2026-06-19

Distributionally Robust Set Representation Learning Under Inference-Time Element Corruption

arXiv:2605.30089v2 Announce Type: replace Abstract: Standard Set Representation Learning methods typically excel on curated data but often overlook the challenge of inference-time element corruption. This refers to scenarios where deployed models encounter element-level degradations, such as outliers or missing components, that may distort set representation and degrade performance. We propose SW-DRSO, a distributionally robust optimization framework tailored for sets. Rather than minimizing loss solely on observed training data, SW-DRSO optimizes a tractable surrogate of the worst-case expected loss over a family of plausible inference-time variations. We introduce a barycentric adversary that approximates the intractable search over corrupted sets by a differentiable training-time optimization over simplex weights. Extensive experiments across four tasks demonstrate that SW-DRSO effectively enhances robustness against corruption while maintaining high overall performance.

04.
arXiv (CS.LG) 2026-06-12

Estimating Individualized Treatment Effects in Acute Ischemic Stroke with Causal Transformation Models (TRAM-DAG): A Multi-Centre Observational Study with External RCT Validation

arXiv:2606.12623v1 Announce Type: cross Abstract: Personalized medicine in acute ischemic stroke requires moving beyond average treatment effects (ATE) to individualized treatment effect (ITE) estimates to support treatment decisions. In acute ischemic stroke, mechanical thrombectomy has been shown to be more effective on average than lysis in randomized controlled trials (RCTs), such as the MR CLEAN study. We aim to identify which individual patients benefit most from mechanical thrombectomy compared to lysis. The outcome of interest is the modified Rankin Scale (mRS) at three months, an ordinal measure of functional disability (0: no symptoms, 6: death). We demonstrate that causal transformation models on directed acyclic graphs (TRAM-DAG) can be used for ITE estimation after being fitted on observational MAGIC multi-center stroke patient data. To ensure comparability with the MR CLEAN population, which we use for validation, we train the TRAM-DAG on a MAGIC sub-population with NIHSS at admission >= 6, corresponding to one inclusion criterion of MR CLEAN. The fitted model is then used to estimate ITEs for stroke patients in the MR CLEAN population. While these ITE estimates cannot be confirmed experimentally, we show that their average is consistent with the trial's reported ATE. Furthermore, the ITE estimates correctly rank trial patients by their observed frequency of a good outcome (mRS at three months

05.
arXiv (CS.LG) 2026-06-19

Learning universal approximations for partial differential equations with Physics-Informed Broad Learning System

arXiv:2606.19754v1 Announce Type: new Abstract: Partial differential equations (PDEs) play a central role in modeling complex physical, biological, and engineering systems. While traditional numerical solvers are robust, they often incur prohibitive computational costs due to mesh dependencies, whereas recent Physics-Informed Neural Networks (PINNs) offer a mesh-free alternative but frequently suffer from slow convergence and optimization instability. To bridge this gap, this article proposes the Physics-Informed Broad Learning System (PIBLS), a novel backpropagation-free framework that reformulates PDE solving as a direct least-squares optimization. We improved an algorithm within this framework to handle nonlinear PDEs efficiently and provide a rigorous mathematical proof establishing the universal approximation property of PIBLS for these equations. Experiments on linear and nonlinear PDEs demonstrate that PIBLS is one to three orders of magnitude faster than conventional PINNs while achieving significantly higher solution accuracy. This framework provides a computationally efficient paradigm for scientific machine learning, offering a practical, high-speed alternative for real-time simulation and design optimization tasks.

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

MENTOR: Reinforcement Learning via Flexible Teacher-Optimized Rewards for Tool-Use Distillation

Distilling the tool-use capabilities of large language models (LLMs) into small language models (SLMs) is essential for their practical application. The predominant approach, supervised fine-tuning (SFT), suffers from poor out-of-domain (OOD) generalization due to its rigid alignment with static teacher trajectories. While reinforcement learning (RL) offers an alternative, the capacity limitations of SLMs pose a severe dilemma: sparse outcome rewards provide insufficient guidance, whereas strict trajectory matching imposes overly restrictive constraints. To bridge this capacity-driven gap, we propose MENTOR, which introduces a flexible yet process-aware reward structure. Instead of enforcing rigid replication, MENTOR uses the teacher's reference to guide tool-use behavior, balancing behavioral alignment with downstream performance. Extensive experiments on controlled executable-tool benchmarks demonstrate that MENTOR improves OOD tool-use performance compared to SFT and strict RL baselines. Our findings suggest that within verifiable tool-use environments, flexible tool-use alignment offers a more effective approach than strict trajectory replication for developing adaptable small models.

07.
arXiv (CS.CL) 2026-06-11

External Experience Serving in Production LLM Systems: A Deployment-Oriented Study of Quality-Cost Trade-offs

Production LLM systems accumulate reusable operational experience, but the practical deployment issue is not merely whether such experience can help. It is how different serving strategies trade off quality against online cost under realistic constraints. Injecting external experience can improve task quality, yet it also increases prompt burden, latency, and serving pressure. We study external experience serving as a deployment-oriented quality-cost trade-off problem. We evaluate this question in a real production moderation setting, with tool-use and GPQA as supporting contrast tasks that expose different output-cost regimes. We compare no-experience baselines, random experience controls, global prompt injection, and retrieval-based selective injection, and analyze both task quality and serving cost. The results show that, once experience becomes case-dependent, selective retrieval provides a stronger operating point than unconditional global injection. They further show that retrieval quality matters more than simply increasing Top-$K$, and that the same serving policy can exhibit substantially different cost-benefit profiles across short-output and decode-heavy regimes. These findings suggest that external experience is best treated as a selective, cost-aware serving decision rather than as a universal add-on. Overall, in the settings studied here, external experience pays off only when both the serving interface and the task-specific cost structure make its quality gains worth the online cost.

08.
medRxiv (Medicine) 2026-06-18

Device assessed 24-hour movement behaviour and cardiovascular disease mortality amongst cancer survivors.

Background: Cancer survivors face elevated risks of mortality from cardiovascular disease (CVD). The potential importance of physical activity (PA) and other behaviours across the 24-hour day (e.g. sedentary behaviour (SB) and sleep) for CVD-mortality risk is not well understood in this at-risk population. Objectives: To assess the importance of 24-hour movement behaviour, using a compositional approach, for mitigating CVD-mortality amongst cancer survivors. Methods: Participants with a prior cancer diagnosis were drawn from the UK Biobank accelerometry sub-study (n=6,158). Accelerometer-derived movement (moderate-to-vigorous PA (MVPA), vigorous PA (VPA), moderate PA (MPA), light PA (LPA), SB, sleep) was examined in relation to CVD-mortality, identified from health record linkage data (using Fine-Gray Cox proportional-hazards models adjusted for demographic, health, lifestyle covariates). Results: Median follow-up was 8.0 years (Q1-Q3: 7.4-8.5), with n=500 (8.2%) deaths (CVD-deaths: n=118). Greater MVPA, in place of any other behaviour, was inversely associated with CVD-mortality with e.g. 10% lower hazard if MVPA theoretically replaced 7 minutes (mins)/day SB (Hazard ratio (HR): 0.91, (95% Confidence Interval: 0.86-0.95)), 9 mins/day LPA (HR: 0.90, 0.83-0.97), or 11 mins/day sleep (HR: 0.90, 0.83-0.97). The VPA component of MVPA proved critical, requiring only ~1-2 additional mins/day for equivalent hazard reduction. Sleep duration, was also inversely associated with CVD-mortality. A 10% lower hazard required replacing 29 mins/day of SB with sleep (HR: 0.90, 0.84-0.96); no other behavioural replacement amongst SB, sleep or LPA could provide an equivalent risk reduction. Conclusions: Among cancer survivors, the most potent reduction in CVD-mortality followed theoretically reallocating time to higher intensity movement.

09.
arXiv (CS.LG) 2026-06-17

Characterizing Nash Equilibria in Zero-Sum Games: A Physics-Inspired, Parallelizable Approach with a Linear Number of Gradient Queries

arXiv:2507.11366v2 Announce Type: replace-cross Abstract: We study online optimization methods for zero-sum games, a fundamental problem in adversarial learning in machine learning, economics, and many other domains. Traditional methods approximate Nash equilibria (NE) using either regret-based methods (time-average convergence) or contraction-map-based methods (last-iterate convergence). We propose a new method based on Hamiltonian dynamics in physics and prove that it can characterize the set of NE in a finite (linear) number of iterations of alternating gradient descent in the unbounded setting, modulo degeneracy, a first in online optimization. Unlike standard methods for computing NE, our proposed approach can be parallelized and works with arbitrary learning rates, both firsts in algorithmic game theory. Experimentally, we support our results by showing our approach drastically outperforms standard methods.

10.
arXiv (CS.AI) 2026-06-16

Phase-Aware Guidance Injection for Recurrent MAPPO in Assembly-Line Disruption Recovery

arXiv:2606.16330v1 Announce Type: new Abstract: Disruption recovery in industrial assembly lines requires timely decisions under machine faults, worker absence, and emergency orders. Existing methods either rely on rigid handcrafted recovery logic or learn adaptive policies that do not readily exploit heterogeneous external recovery knowledge at decision time to reduce abnormal recovery time (ART) and preserve on-time delivery (OTD). To address this gap, we propose a phase-aware guidance injection framework that augments a trained recurrent MAPPO (RMAPPO) scheduling policy through logit-level action bias during evaluation. The framework provides a unified decision-time interface for rule-based, replay-based, and online LLM-based guidance, while activating intervention only during abnormal and recovery phases. Experiments on a custom AssemblyLineEnv show that high-quality rule guidance yields the strongest gains, replay-based guidance degrades smoothly under imperfect availability, and online LLM guidance still provides useful intermediate improvements. These results show that decision-time guidance injection can exploit heterogeneous recovery hints without redesigning the actor.

11.
arXiv (CS.CV) 2026-06-15

Temporal Backtracking Search for Test-time Generative Video Reasoning

While test-time scaling has revolutionized reasoning in large language models, generative video reasoning remains bottlenecked by a single-shot paradigm. We demonstrate that searching over denoising steps cannot rescue logically flawed rollouts because spatial trajectories commit early in the diffusion process. Root-level Best-of-N (BoN) sampling is similarly inefficient: reasoning errors cluster early in the temporal axis, and resampling blindly discards verified upstream progress. To unlock effective test-time scaling for video models, we introduce Temporal Backtracking Search (TBS), which shifts the search space to the temporal axis. TBS transforms video generation into an iterative generate-verify-restart loop via three core mechanisms: (1) variable-K conditioning to resume generation from arbitrary clean prefixes; (2) temporal process verification to localize failures and extract valid restart anchors; and (3) prefix-based search to reallocate compute toward extending correct trajectories rather than root resampling. Across algorithmic, navigation, and robotics domains, TBS Pareto-dominates matched-budget BoN. In a strict out-of-distribution setting where one-shot generation collapses (0.7% for BoN), TBS achieves 22.7%, with every solved episode stemming from a restarted branch. Ultimately, TBS reveals that the local reasoning competence of video models far exceeds what single-shot rollouts indicate, providing a scalable test-time framework to unlock it.

12.
arXiv (CS.CL) 2026-06-18

DreamReasoner-8B: Block-Size Curriculum Learning for Diffusion Reasoning Models

Block diffusion language models accelerate decoding through parallel block-wise denoising, yet whether they can be reliably scaled for long chain-of-thought (CoT) reasoning remains unresolved. To this end, we develop DreamReasoner-8B, an open-source block diffusion reasoning model, and conduct a systematic study of how training and inference block sizes affect long-CoT reasoning. Our analysis reveals a stark performance disparity: training with large block sizes yields remarkably poor reasoning, whereas small block sizes preserve effective reasoning. To bridge this granularity gap, we propose block-size curriculum learning, which gradually transitions training from fine-grained to coarse-grained block sizes, thereby overcoming this limitation and enabling strong reasoning performance that generalizes across diverse inference block sizes. On mathematical and code reasoning benchmarks, DreamReasoner-8B achieves results competitive with leading open autoregressive models such as Qwen3-8B. This work establishes a practical foundation for efficient, reasoning-capable diffusion language models. We release our model at https://github.com/DreamLM/DreamReasoner.

13.
arXiv (CS.AI) 2026-06-16

Large Language Models as Optimizers: A Survey of Direct vs. Tool-Augmented Approaches and Their Performance Frontiers

arXiv:2606.15577v1 Announce Type: new Abstract: Large Language Models (LLMs) are increasingly involved in complex mathematical optimization, even if the pragmatic user who triggers them is unaware of it. After all, many real-world problems reduce to the search for better or the best solutions. The field of LLM-as-optimizer has three paradigms: direct optimization, tool-augmented optimization, and tool-creating optimization. Direct optimization uses iterative prompting and heuristic generation to navigate solution spaces. Tool-augmented optimization translates natural language problems into formal specifications and orchestrates external solvers. Tool-creating optimization goes further, using LLMs to discover reusable algorithms or heuristics that can be deployed at zero marginal LLM cost. We describe current performance frontiers based on the benchmarks from the literature. We identify the critical reasoning gap in current architectures and argue for trade-offs between the future potential of direct optimization and the auditability of tool-augmented optimization. Even future, more powerful models might opt for tool-making to improve operational efficiency for repetitive families of problems.

14.
medRxiv (Medicine) 2026-06-15

Comparative Analysis of Machine Learning Models vs. Traditional Clinical Calculators for Cardiovascular Risk Prediction

Background: Cardiovascular diseases (CVD) remain the leading global cause of mortality, responsible for approximately 31% of all deaths worldwide in 2021. Traditional risk calculators, including Framingham, ASCVD, SCORE, and SCORE2, have long constituted the cornerstone of primary prevention strategies; however, they were derived predominantly from high-income European and North American populations, thereby limiting their predictive accuracy in diverse epidemiological contexts, particularly among Hispanic/Latino communities. Machine learning (ML) offers an alternative to capture the non-linear interactions inherent in biomedical data. Objective: The present study develops and validates ML-based models for cardiovascular mortality prediction using the National Health and Nutrition Examination Survey (NHANES) 1999-2018 dataset, and systematically compares their discriminative performance against eleven conventional clinical CVD risk calculators. Materials and Methods: A dedicated software platform, "CardioPrediQ," was designed to integrate multiple CVD calculators with ML-based risk assessment. A cohort of 12,847 participants with 16 predictor variables was derived from NHANES. Six algorithms (Logistic Regression, Cox Proportional Hazards, Gradient Boosting, AdaBoost, Random Forest, and Extra Trees) were trained in combination with six class-balancing strategies, yielding 36 model configurations. All models were trained on a stratified 70/30 split and calibrated using the Saerens prior probability adjustment method. Performance was evaluated using AUC-ROC, sensitivity, specificity, F1-score, and a weighted composite score. DeLong's test was employed to assess the statistical significance of AUC differences between the best-performing ML model and each conventional calculator. Results: Gradient Boosting with 2:1 oversampling and Saerens calibration achieved the best overall performance (AUC = 0.8934; composite score = 0.7904), outperforming all traditional calculators in composite ranking. The top six positions were occupied exclusively by ML and statistical models. The mean age of cardiovascular decedents was 67.43 years compared with 47.74 years among survivors. DeLong's test confirmed statistical superiority over six traditional CVD calculators (p < 0.05), whereas the difference against the top-performing calculators (ASCVD, HEARTS Caribbean, ASCVD Colombia, SCORE2, HEARTS North America) did not reach statistical significance. Age dominated feature importance at 41.2% relative weight, followed by systolic blood pressure (18.7%). Saerens calibration reduced the Brier score from 0.1286 to 0.1158, substantially improving probability calibration. Conclusions: ML models demonstrated superior composite performance over traditional calculators. The statistical equivalence with the highest-performing conventional calculators in the NHANES cohort is context-dependent and validates the methodological pipeline. The CardioPrediQ platform addresses the critical need for integrated, scalable CVD risk assessment tools, which is particularly relevant for Latin American populations where calculator validation remains limited. These findings support the integration of calibrated ML-based risk prediction into clinical practice while underscoring the importance of probability calibration for informed clinical decision-making.

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

Low-Burden LLM-Based Preference Learning: Personalizing Assistive Robots from Natural Language Feedback for Users with Paralysis

arXiv:2604.01463v2 Announce Type: replace-cross Abstract: Physically Assistive Robots require personalized behaviors to ensure user safety and comfort. However, traditional preference learning methods, like exhaustive pairwise comparisons, cause substantial physical and cognitive fatigue for users with severe motor impairments. To solve this, we propose a low-burden, offline framework that translates unstructured natural language feedback directly into deterministic robotic control policies. To safely bridge the gap between ambiguous human speech and robotic code, our pipeline uses Large Language Models (LLMs) grounded in the Occupational Therapy Practice Framework. This clinical reasoning decodes subjective user reactions into explicit physical and psychological needs, which are then mapped into transparent decision trees. Before deployment, an automated "LLM-as-a-Judge" verifies the code's structural safety. We validated this system in a simulated meal preparation study with 10 adults with paralysis. Results show our natural language approach significantly reduces user workload compared to traditional baselines. Additionally, occupational therapists confirmed the generated policies are safe and accurately reflect user preferences.

16.
arXiv (quant-ph) 2026-06-19

Emergency hub placement with a neutral-atom quantum computer

arXiv:2606.19589v1 Announce Type: new Abstract: We study the problem of emergency operation center placement in disaster response, where a minimal number of hubs must be selected to ensure timely coverage of all affected locations. This task can be formulated as a minimum dominating set problem on a graph encoding reachability within a target response time. We propose a hybrid quantum-classical approximation framework that leverages neutral-atom quantum computers as independent set samplers. Candidate dominating sets are constructed from both small maximal independent sets and complements of large independent sets, and are subsequently refined via a lightweight classical procedure. We benchmark the approach on synthetic instances and realistic case studies, and implement it on the Fresnel quantum processor by Pasqal, solving instances of up to 100 nodes. Our results show that quantum-generated samples, despite hardware noise, enable near-optimal solutions of the placement problem. Overall, our results demonstrate that neutral-atom devices operating in analog mode can already be used to tackle graph optimization problems for real-world applications.

17.
arXiv (CS.CL) 2026-06-12

Causal Inference with Generative Artificial Intelligence: Application to Texts as Treatments

In this paper, we demonstrate how to enhance the validity of causal inference with unstructured high-dimensional treatments like texts, by leveraging the power of generative Artificial Intelligence (GenAI). Specifically, we propose to use a deep generative model such as large language models (LLMs) to efficiently generate treatments and use their internal representation for subsequent causal effect estimation. We show that the knowledge of this true internal representation helps disentangle the treatment features of interest, such as specific sentiments and certain topics, from other possibly unknown confounding features. Unlike existing methods, the proposed GenAI-Powered Inference (GPI) methodology eliminates the need to learn causal representation from the data, and hence produces more accurate and efficient estimates. We formally establish the conditions required for the nonparametric identification of the average treatment effect, propose an estimation strategy that avoids the violation of the overlap assumption, and derive the asymptotic properties of the proposed estimator through the application of double machine learning. Finally, using an instrumental variables approach, we extend the proposed GPI methodology to the settings in which the treatment feature is based on human perception. The GPI is also applicable to text reuse where an LLM is used to regenerate existing texts. We conduct simulation and empirical studies, using the generated text data from an open-source LLM, Llama 3, to illustrate the advantages of our estimator over state-of-the-art causal representation learning algorithms.

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

Question-Aware Evidence Ledgers for Video Relational Reasoning

The VRR-QA challenge evaluates visual relational reasoning in videos, where answers often depend on implicit spatial relations, event boundaries, target identity, and dialogue context rather than a single salient frame. We present a test-time reasoning pipeline built around a strong GPT-5.5 video QA solver and a set of question-aware evidence ledgers. The initial solver answers each question from a uniform video representation, while routed ledgers are prompted to make the required targets, count units, reference frames, and temporal or spatial scope explicit for counting, spatial, endpoint, viewpoint, and dialogue reasoning. External tools such as open-vocabulary detection, depth cues, pair crops, ASR, and scene-graph ledgers are used only as evidence sources. A conservative gate keeps the current answer unless independent evidence uniquely supports a different option. The final evidence-gated pipeline achieves 92.95% overall accuracy and 93.79% macro accuracy on the challenge test split.

19.
medRxiv (Medicine) 2026-06-15

Dysplasia-Stratified Management of Barrett's Esophagus: An Incidence-Based U.S. Cost-Effectiveness Analysis

作者:

Background and Aims Barrett's esophagus (BE) is the principal precursor of esophageal adenocarcinoma (EAC), whose incidence has risen sharply in Western countries since the 1960s. Effective, dysplasia stratified surveillance strategies are needed to prevent progression. This study evaluated the cost effectiveness of dysplasia stratified surveillance intervals and endoscopic eradication therapy (EET) across the BE spectrum. Methods We developed an incidence-based Markov state transition model of BE progression calibrated to U.S. epidemiologic data from a healthcare sector perspective over a lifetime horizon. Four hypothetical cohorts of 50-year-old individuals with short segment BE (SSBE), nondysplastic BE (NDBE), low grade dysplasia (LGD), or high-grade dysplasia (HGD) were evaluated. Strategies included no surveillance; surveillance at 1-, 2-, 3-, 4-, 5-, or 10-year intervals; standard or AI assisted endoscopy; non endoscopic screening (sponge, breath, miRNA tests); and EET for LGD and HGD. Outcomes included costs, quality adjusted life years (QALYs), incremental cost effectiveness ratios (ICERs), net monetary benefits (NMBs), EAC cases, and EAC-related deaths. Sensitivity analyses used a willingness to pay threshold of US$100,000 per QALY. Results No surveillance was the most cost-effective strategy for SSBE and NDBE. For LGD, upfront EET was more cost effective than all surveillance strategies, with results sensitive to EAC incidence and recurrence. For HGD, EET was cost saving and yielded the greatest QALYs, with findings robust in 99.9% of simulations. EET prevented 12,614 and 44,295 EAC related deaths per 100,000 individuals with LGD and HGD, respectively. Conclusion Dysplasia-stratified management is essential for optimizing surveillance and treatment strategies in BE. Any degree of dysplasia should receive EET followed by targeted post-treatment monitoring, establishing EET as the central therapeutic pathway for dysplastic BE.

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

QueryGaussian: Scalable and Training-Free Open-Vocabulary 3D Instance Retrieval

arXiv:2606.19733v1 Announce Type: cross Abstract: Efficiently retrieving specific 3D instances from large-scale scenes via natural language prompts remains a formidable challenge in multimedia analysis. Existing approaches predominantly follow a "scene-level embedding" paradigm, which requires distilling high-dimensional semantic features into every 3D primitive. This strategy suffers from a fundamental architectural bottleneck: memory and computational costs scale linearly with scene complexity, inevitably triggering out-of-memory (OOM) failures in city-scale environments. To address this barrier, we propose QueryGaussian, a training-free framework for expeditious and scalable open-vocabulary 3D instance retrieval. Unlike holistic semantic distillation, QueryGaussian employs an instance-level query mechanism that decouples semantic understanding from geometric representation. Specifically, we leverage pre-trained 2D vision models to interpret user prompts and lift segmentation masks into 3D via a concurrent maximum-weight association strategy, ensuring semantic-visual consistency. To mitigate projection ambiguity, we introduce a temporal fusion module with multi-stage adaptive density clustering. Experimental results demonstrate that QueryGaussian not only matches the accuracy of state-of-the-art methods but also delivers a decisive efficiency leap, reducing GPU memory usage by over 70% and accelerating inference by 180x. Crucially, QueryGaussian enables expeditious instance retrieval on city-scale scenes containing tens of millions of Gaussians using consumer-grade hardware.

21.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

22.
arXiv (quant-ph) 2026-06-17

Practical Tests and Witnesses of Fermionic non-Gaussianity

arXiv:2605.26218v2 Announce Type: replace Abstract: Fermionic Gaussian states describe free fermions and underlie the mean-field picture of matter, from metals to superconductors; they are also efficiently simulable on classical computers. Departures from Gaussianity – the correlations produced by interactions – are therefore what make a fermionic system hard to simulate classically and useful for quantum computation, analogous to the role of magic in stabilizer-based quantum computation. Yet detecting and quantifying such non-Gaussianity at scale has remained challenging. Here we introduce practical tests and witnesses of fermionic non-Gaussianity built on fermionic antiflatness, a measure derived from the two-point covariance matrix. We estimate it with two protocols – a two-copy Bell measurement and a single-copy scheme using commuting Majorana bilinears – that determine whether a state is Gaussian or far from it at lower measurement cost than existing approaches, using only operations native to fault-tolerant hardware. For mixed states, a purity-corrected witness certifies non-Gaussianity and remains robust under strong noise; running it on the IQM quantum processor, we find that noise can both reduce and enhance non-Gaussianity. Finally, we show that preparing pseudorandom fermionic states requires extensive non-Gaussianity. Together, these tools enable the study and certification of non-Gaussian fermionic resources on present-day quantum devices.

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

Operadic consistency: a label-free signal for compositional reasoning failures in LLMs

Detecting LLM reasoning failures at inference time without ground-truth labels has motivated a wide range of confidence baselines, including self-consistency, semantic entropy, and P(True), built on within-question sampling and self-evaluation. Operad theory, the formalism for systems built by iterated substitution, suggests a complementary diagnostic: a model's direct answer to a compositional query should agree with the answer it produces by composing a stated decomposition of the same query. We instantiate this idea as operadic consistency (OC), a per-question signal. Across twelve instruction-tuned LLMs (4B to 671B parameters, open-weights and closed-source) on four multi-hop QA datasets, OC is strongly correlated with accuracy on every dataset (Pearson $r \in [0.86, 0.94]$, all $p \leq 0.0004$), and is the only signal we evaluate with $r \geq 0.85$ uniformly across all four datasets. Chain-of-thought self-consistency (CoT-SC; Wang et al., 2023) matches OC on HotpotQA and DROP ($r = 0.93, 0.87$) but drops to $r \approx 0.45$ on MuSiQue and StrategyQA. At the per-question level, OC contributes information beyond CoT-SC and semantic entropy on every dataset (cluster-robust $p \leq 10^{-16}$ for the OC coefficient), and the conclusion is robust to additionally controlling for constructed decomposition-aware baselines ($p \leq 10^{-13}$). The same signal yields selective-prediction improvements (accuracy at fixed coverage) over a tuned CoT-SC baseline at the equal-cost $K = 3$ budget (AUARC lifts of +0.086 to +0.096 and AUROC lifts of +0.092 to +0.164; 95% CIs exclude zero on every cell). On five frontier thinking models, where the decomposition is extracted from the model's own chain of thought, the same equal-cost comparison gives positive selective-prediction point-estimate lift on all 16 (dataset, budget, metric) cells tested, with 95% CIs excluding zero on 12 of the 16.

24.
arXiv (CS.CV) 2026-06-19

JanusMesh: Fast and Zero-Shot 3D Visual Illusion Generation via Cross-Space Denoising

Creating 3D visual illusions, a single 3D mesh that reveals entirely different semantics from various viewing angles, is a fascinating but tough challenge. Existing optimization-based methods are slow and can produce oversaturated colors. In contrast, naive stitching approaches fail to produce geometrically coherent objects. This results in visible unnatural seams and semantic leaks. In this paper, we present a fast and training-free framework for generating text-driven 3D visual illusions. Our approach decouples the generation into two stages. First, we propose a cross-space dual-branch denoising process. This process dynamically decodes 3D latents into voxel space for CLIP-guided orientation alignment and Signed Distance Field (SDF) blending, which ensures seamless geometric fusion. Second, we introduce a view-conditioned texture synthesis module that projects and aggregates view-specific 2D diffusion priors onto the fused geometry. Extensive experiments demonstrate that our method generates highly realistic, dual-semantic 3D illusions in just 3-5 minutes. It significantly outperforms existing methods in geometric integrity, semantic recognizability, and efficiency. Project page: https://siang1105.github.io/JanusMesh.github.io/

25.
arXiv (math.PR) 2026-06-16

Plateau Gaps of Poisson Correctors Encode Metastable Reaction Rates

arXiv:2606.14789v1 Announce Type: cross Abstract: Metastable reaction rates are commonly inferred from transition-state fluxes, mean first-passage times, or fitted kinetic models. We show that they are directly encoded in the plateau gap of an occupation-time Poisson corrector. For a centered basin-occupation observable, the Poisson corrector develops metastable plateaus in the reactant and product basins, and their separation determines the forward and backward transition rates. This construction requires only the generator, stationary measure, and metastable partition, and therefore does not rely on a predefined transition-state surface. In overdamped and underdamped double-well dynamics, the plateau-gap rate recovers the Kramers, Grote-Hynes, and Pollak-Grabert-Hänggi hierarchy. The same corrector-martingale decomposition yields a reactive-noise density, revealing where stochastic forcing contributes to transitions in configuration or phase space. Thus, reaction rates and their fluctuation sources emerge from a single corrector field.