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01.
arXiv (CS.AI) 2026-06-19

IHBench: Evaluating Post-Interruption Recovery in Voice Agents with Structured Workflows

arXiv:2606.19595v1 Announce Type: cross Abstract: Voice agents deployed in structured workflows (customer service, healthcare scheduling, account management) must handle frequent user interruptions while maintaining progress through multi-step procedures. Existing benchmarks for speech-capable models focus on the timing of interruptions: barge-in detection, endpointing, and turn-taking dynamics. They leave unmeasured what happens after the interruption: does the agent resume the workflow at the correct step? Does it address the user's interjection? Does it avoid re-delivering content the user already heard? We introduce IHBench (Interruption Handling Benchmark), a benchmark that evaluates post-interruption recovery in voice agents executing state-machine-driven workflows across 10 enterprise domains. Six interruption types are injected at controlled points mid-utterance, with per-interruption evaluation rubrics generated alongside the data. Each interruption is scored on two axes: task fulfillment and recovery quality. We evaluate 27 audio-language model configurations from OpenAI, Google, and the open-weight community. Models vary widely, and recovery quality depends strongly on the interruption type. Across our experiments, closed-weight models are consistently more robust to interruptions than open-weight ones: they win far more often on task fulfillment, degrade roughly 3.3x more slowly as conversations grow longer, and show no audio-versus-text modality gap, whereas the open-weight models lose ground on all three. A human study validates the LLM judge against human annotators, and a cross-benchmark analysis against AudioMultiChallenge indicates that recovery quality is a largely distinct capability axis.

02.
arXiv (quant-ph) 2026-06-11

Towards the implementation of a quantum classifier

arXiv:2606.10150v2 Announce Type: replace Abstract: In this work, we investigate the use of a quantum circuit as a binary classification model in the context of quantum machine learning. We call this model, binary quantum classifier. First, we describe fundamental concepts of quantum computing and introduce the computational tool used: Qibo, an open-source framework for efficient quantum simulations and quantum hardware control. Then, we describe how to design a binary quantum classifier for the classification of images and small arrays of variables by showing how to input data in the circuit, defining a quantum circuit model Ansatz with trainable parameters and a loss function, and implementing multiple minimizers. We test our quantum classifier with two data sets. The first one is the MNIST data set which is composed of handwritten digits (reduced to only handwritten zeros and handwritten ones for binary classification). We study the behavior of different minimizers by increasing the number of layers of the Ansatz. The second data set represents two different high energy collisions that can occur at colliders such as LHC (CERN). Due to in-time proton-proton interactions known as pile-up, we distinguish two different data sets: "without pile-up" and "with pile-up". These collisions can be represented by images of size 32x32 or by six high-level variables that we call features. By increasing the size of the training data set and the number of layers of the Ansatz, we search for the best minimizer. Splitting the data set in training set and test set, we compute: ROC curve, AUC score, confusion matrices and test set accuracy. For "with pile-up" images, we compare the results obtained with the quantum classifier with a small convolutional neural network. We conclude that is possible to build a binary quantum classifier with a quantum circuit and we highlight its performances and limitations in comparison with classical technologies.

03.
medRxiv (Medicine) 2026-06-15

Mucosal and Systemic Antibodies Associated with Clinical Protection in a Pertussis Controlled Human Infection Model

Background The engagement of mucosal and systemic immunity in preventing Bordetella pertussis colonization and infection in humans, the impact of prior vaccination on host immunity and protective outcomes, and the dynamics of the host response following exposure remain poorly understood. Methods Healthy adults were challenged with increasing colony-forming units (CFUs) doses, 106-108, of B. pertussis D420 intranasally (NCT05136599). Shedding (PCR and culturing) and symptom development were monitored up to 21 days post-challenge. Serum and nasal wash IgA and IgG were measured before challenge (baseline) and up to 6 months post-challenge. Findings Antibodies increased post-challenge only in infected individuals, primarily nasal IgA. Participants who remained uninfected had higher baseline levels of filamentous hemagglutinin (FHA)- specific mucosal IgA and IgG, and higher serum IgA against fimbriae 2/3 (FIM). FHA was negatively associated with bacterial load and was a key discriminator between shedders and non-shedders, up to one week post-challenge. By day 14 post-challenge, pertussis toxin (PT) IgG and FIM IgA in both serum and mucosal samples were negatively associated with bacterial colonization. The majority (96.7%) of acellular pertussis (aP) vaccine recipients (n=23, median age 2.0 years) became infected, compared to 69.4% of those who received whole-cell pertussis vaccine (n=36; median age 32.0 years), and their antibody responses remained distinct following infection. Interpretation Nasal FHA antibodies emerged as early predictors of protection against pertussis infection, while PT IgG and FIM IgA antibodies may reflect clearance after infection. aP-primed individuals were more susceptible to infection, despite their younger age and more recent vaccination. Funding CDC Contract #75D30122C15467 and CDC IPA Agreement #24IPA2417512 Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, US Department of Health and Human Services.

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

CRAG: Can 3D Generative Models Help 3D Assembly?

Most existing 3D assembly methods treat the problem as pure pose estimation, rearranging observed parts via rigid transformations. In contrast, human assembly naturally couples structural reasoning with holistic shape inference. Inspired by this intuition, we reformulate 3D assembly as a joint problem of assembly and generation. We show that these two processes are mutually reinforcing: assembly provides part-level structural priors for generation, while generation injects holistic shape context that resolves ambiguities in assembly. Unlike prior methods that cannot synthesize missing geometry, we propose CRAG, which simultaneously generates plausible complete shapes and predicts poses for input parts. Extensive experiments demonstrate state-of-the-art performance across in-the-wild objects with diverse geometries, varying part counts, and missing pieces. Project Page: https://ai4ce.github.io/CRAG/

05.
arXiv (math.PR) 2026-06-16

A Tail-Respecting Splitting Numerical Scheme for Lévy-Driven SDEs With Superlinear Drifts

arXiv:2504.07255v3 Announce Type: replace Abstract: We present an explicit numerical approximation scheme, denoted by $\{X^n\}$, for the effective simulation of solutions $X$ to a multivariate stochastic differential equation (SDE) with a superlinearly growing $\kappa$-dissipative drift, where $\kappa>1$, driven by a multiplicative heavy-tailed Lévy process that has a finite $p$-th moment, with $p>0$. We show that the strong $L^{p_X}$-convergence $\sup_{t\in[0,T]}\mathbf E \|X^n_t-X_t\|^{p_X}=\mathcal O (h_n^{\gamma})$ holds for any $p_X\in (0,p+\kappa-1)$, which is exactly the range where the $p_X$-moment of the solution is known to be finite. Additionally, for any $p_X\in (0,p)$ we establish strong uniform convergence: $\mathbf E\sup_{t\in[0,T]} \|X^n_t-X_t\|^{p_X}=\mathcal{O} ( h_n^{\delta} )$. In both cases we determine the convergence rates $\gamma$ and $\delta$. In the special case of SDEs driven solely by a Brownian motion, our numerical scheme preserves super-exponential moments of the solution. The scheme $\{X^n\}$ is realized as a combination of a well-known Euler method with a Lie-Trotter type splitting technique.

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

Measuring Curriculum Alignment across Topical Coverage, Competency, and Cognitive Depth: A Longitudinal Framework Applied to CS2013 and CS2023

arXiv:2606.19469v1 Announce Type: new Abstract: Undergraduate computer science is governed by international curricular guidelines revised about once a decade, yet programs lack a reliable, reproducible way to measure how completely they cover the current guidelines and how that coverage shifts when the guidelines are restructured. We address this with a human-in-the-loop pipeline that measures a program's coverage of an external body of knowledge, applied longitudinally to one accredited BSc in Computer Science against Computer Science Curricula 2013 (CS2013) and 2023 (CS2023). The pipeline represents the program and each guideline as structured corpora, generates candidate course-to-knowledge-unit matches by semantic retrieval, and confirms them through human judgment under an explicit coverage definition. Of seven benchmarked retrievers, a reciprocal-rank-fusion ensemble was strongest, and a reputed long-context model underperformed a small sentence model, so retriever choice must be measured. Both maps were validated by an independent second rater (Cohen's kappa 0.64 for CS2023, 0.69 for CS2013). The program covers 49.7% of CS2023 and 50.9% of CS2013 knowledge units, near-constant across a decade. Extending the same retrieve-then-confirm design to competency articulation and cognitive depth shows that the program articulates the competency for ~88% of covered units under each guideline, yet delivers it at the recommended depth for 76% of present units under CS2023 against 95% under CS2013, a gap reflecting the newer guideline's raised expectations, not the program. The longitudinal comparison separates persistent structural gaps (parallel and distributed computing, foundations of programming languages, systems fundamentals), uncovered against both guidelines and ABET, from differences that reflect the standard's evolution. The instrument is reusable and available from the authors on request.

07.
arXiv (CS.AI) 2026-06-17

Temporal Motif-aware Graph Test-time Adaptation for OOD Blockchain Anomaly Detection

arXiv:2605.29526v2 Announce Type: replace-cross Abstract: Ever-evolving transaction patterns have significantly hindered anomaly detection on emerging cryptocurrency blockchains due to the vast number of addresses and diverse anomalous behaviors. Recently, advanced Graph Anomaly Detection (GAD) approaches applied to blockchains have faced two critical challenges: adversarial pattern evolution by malicious actors and the out-of-distribution (OOD) problem caused by varied transaction semantics on blockchains. To address these challenges, we propose a novel framework termed TEmporal Motif-aware Graph Test-Time Adaptation (TEMG-TTA). First, we comprehensively capture the 3-node temporal motif distribution of each active address using an efficient computational mechanism, enabling downstream temporal motif-aware graph learning. Second, we design a simple yet effective test-time adaptation strategy to facilitate the sharing of common patterns between training and testing graphs. Extensive experiments on 5 real-world datasets demonstrate that our proposed TEMG-TTA outperforms state-of-the-art GAD approaches by an average of 54.88\%. A further case study on interpretable motif patterns reveals that TEMG-TTA explicitly characterizes the complex transaction patterns of anomalous addresses, thereby verifying the effectiveness of our technical designs. Our code is publicly available at https://github.com/LuoXishuang0712/TEMG-TTA/.

08.
arXiv (CS.LG) 2026-06-16

One-Step Generalization Ratio Guided Optimization for Domain Generalization

arXiv:2606.16301v1 Announce Type: new Abstract: Domain Generalization (DG) aims to train models that generalize to unseen target domains but often overfit to domain-specific features, known as undesired correlations. Gradient-based DG methods typically guide gradients in a dominant direction but often inadvertently reinforce spurious correlations. Recent work has employed dropout to regularize overconfident parameters, but has not explicitly adjusted gradient alignment or ensured balanced parameter updates. We propose GENIE (Generalization-ENhancing Iterative Equalizer), a novel optimizer that leverages the One-Step Generalization Ratio (OSGR) to quantify each parameter's contribution to loss reduction and assess gradient alignment. By dynamically equalizing OSGR via a preconditioning factor, GENIE prevents a small subset of parameters from dominating optimization, thereby promoting domain-invariant feature learning. Theoretically, GENIE balances convergence contribution and gradient alignment among parameters, achieving higher OSGR while retaining SGD's convergence rate. Empirically, it outperforms existing optimizers and enhances performance when integrated with various DG and single-DG methods.

09.
arXiv (quant-ph) 2026-06-16

On-Demand Coherent Mapping of Telecom Optical States onto Erbium Hyperfine Spins

arXiv:2606.15009v1 Announce Type: new Abstract: Optical quantum memories operating directly at telecom wavelengths are a key enabling technology for long-distance quantum networks, yet on-demand storage onto long-lived ground-state spins in this spectral region has remained elusive due to the challenge of coherently transferring optical excitations to hyperfine spin states. Here we demonstrate spin-wave storage in $^{167}$Er$^{3+}$:Y$_2$SiO$_5$ at 0.8 K and 1.1 T, establishing the core operational primitive required for on-demand telecom quantum memories. Using classical optical control pulses, we coherently transfer collective optical excitations to erbium hyperfine states with transfer efficiency exceeding 12%, enabling on-demand retrieval. We measure a hyperfine population lifetime of 25 s and demonstrate spin-wave storage for up to 25 $\mu$s. By identifying hyperfine inhomogeneous broadening as the dominant present limitation, our measurements define a clear pathway toward second-scale storage through improved spectral tailoring and dynamical decoupling. The results highlight the application of erbium-based solid-state memories for scalable fiber-compatible quantum repeater architectures.

10.
arXiv (CS.AI) 2026-06-12

Emotional regulation improves deep learning-based image classification

arXiv:2606.13081v1 Announce Type: cross Abstract: Emotion significantly influences cognition, enhancing memory and learning under certain conditions. Drawing on this principle, emotion-augmented deep learning investigates how affective states can improve neural network architectures and learning paradigms, achieving better generalization than non-emotional models. However, existing methods often rely solely on objective neurophysiological factors, neglecting the role of subjectivity in emotion. To bridge this gap, the present study introduces Emotional Regulation, a novel framework for modeling emotion in deep learning through artificial subjective experience. The method employs pre-training based on affective stimuli, balancing non-emotional and emotionally-influenced responses in downstream task optimization. Extensive experimentation was conducted in image classification, pre-training ResNet and ViT architectures on four emotional datasets, using CIFAR-10 and -100 as target benchmarks. Results reveal improvements over the aforementioned backbones, providing evidence of Emotional Regulation as a promising method for defining emotion-augmented deep learning through artificial subjective experience. Furthermore, the proposed approach overcomes the related work in image classification based on CIFAR, revealing Emotional Regulation as the new state-of-the-art in emotion-augmented deep learning for large-scale vision datasets. The study also enforces evidence of the impact of affective states in improving machine learning tasks' optimization, encouraging further investigation on emotion-inspired architectures.

11.
arXiv (math.PR) 2026-06-15

Hierarchical symmetry selects log-Poisson cascades: classification, uniqueness, and stability

arXiv:2604.01632v2 Announce Type: replace Abstract: Within i.i.d. multiplicative cascades, a single axiom – the hierarchical symmetry, a linear contraction on incremental scaling exponents – is shown to be necessary and sufficient for the cascade multiplier to be log-Poisson. We prove: (1) a characterization theorem determining the log-Poisson law with explicit parameters, within the class of all multipliers with finite lattice moments; (2) a classification theorem locating the log-Poisson class inside the log-infinitely-divisible family and identifying the mechanism by which every rival sub-family fails the symmetry; (3) a stability theorem with sharp constants – $(1+\beta)^{1/2}$ when the limiting increment is known, $\sqrt{2}$ when it is fitted – and (4) an unconditional propagation theorem transferring the bound to the multiplier distribution at the sharp rate $\Theta(\sqrt{\varepsilon})$, with a matching lower bound. Beyond independence, the classification extends exactly at the level of asymptotic statistics (limiting cumulant generating function, large deviations, multifractal spectrum) and provably not at the level of laws: an explicit stationary ergodic Markov multiplier satisfies the symmetry exactly with a non-log-Poisson marginal, while exchangeable multipliers collapse to the i.i.d. log-Poisson cascade and finite-state Markov multipliers cannot satisfy the symmetry at all. In the continuous category of exactly scale-invariant log-infinitely-divisible multifractal random measures, no finite moment window of structure-function exponents identifies the cascade class, whereas at the level of the scale-invariance generator the symmetry selects exactly the Barral-Mandelbrot compound Poisson cascade, with scale-ratio-free stability constants. The proofs reduce to second-moment identities on [0,1] via the change of variables $u = e^{kx}$, boundedness of the multiplier, and multiplicative couplings.

12.
arXiv (math.PR) 2026-06-17

How long does it take to train an Elephant Random Walk

作者:

arXiv:2509.15049v2 Announce Type: replace Abstract: We study how conditioning on the first $k$ steps, which we think of as training, affects the long-term behavior of the Elephant Random Walk. When the elephant is conditioned to be at position $k$ at time $k$, the first return time to the origin scales as $k^{(4-4p)/(3-4p)}$ in the diffusive regime, and grows exponentially in the critical regime. We loosely interpret this as a measurement of the rate at which the elephant forgets its training.

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

AGDN: Learning to Solve Traveling Salesman Problem with Anisotropic Graph Diffusion Network

arXiv:2606.19185v1 Announce Type: new Abstract: The Traveling Salesman Problem (TSP) is a cornerstone of combinatorial optimization and arises in many practical scenarios. Although graph-based learning approaches have been explored for TSP, the question of how to exploit graph structure more effectively remains open. We present the Anisotropic Graph Diffusion Network (AGDN), a new Graph Neural Network framework designed to solve TSP. Our method tackles two central difficulties: (1) the lack of informative topological prior in fully connected TSP graphs, and (2) losing connected nodes in the optimal solution after the commonly used graph sparsification techniques. To overcome these issues, we construct a MixScore transition matrix that merges node similarity with pairwise distance, and we develop an anisotropic graph diffusion strategy that supports efficient information exchange across multiple hops. Comprehensive experiments spanning diverse instance sizes and node distributions show that AGDN consistently outperforms existing methods while keeping computation time competitive. Furthermore, AGDN generalizes well to problem sizes and distributions beyond those seen during training. The implementation is publicly available at: https://github.com/LabRAI/AGDN.

14.
bioRxiv (Bioinfo) 2026-06-15

RepGene: Toward a Unified Gene Representation Space Robust to Missing Biological Views

Genes can be described through multiple heterogeneous biological views, including genomic sequence, transcript sequence, protein sequence, textual knowledge, and single-cell expression context, yet existing gene embeddings remain largely modality-specific and difficult to compare or reuse when many views are unavailable. We study a narrower but practically important question: whether pretrained embeddings from these distinct sources can be organized into a shared gene representation interface that remains usable under severe missing-modality conditions. To investigate this question, we introduce RepGene, a lightweight single-branch framework that combines modality adapters, a shared encoder, presence-aware fusion, and self-supervised cross-view objectives to map five biological views into one latent space. Our goal is not to claim a new multimodal learning principle or to establish superiority over all simpler fusion strategies, but to provide an initial technical instantiation for testing whether such a shared interface is feasible in a fixed-feature setting. Under a two-stage protocol in which RepGene is trained self-supervised on frozen upstream embeddings and evaluated by downstream linear probing, we find preliminary evidence that the learned representation is broadly competitive in the full-modality setting and remains informative when only partial modality subsets are observed at inference time. The strongest signal in our study is robustness under missing views: average performance changes are often limited when one modality is removed, and even single-view inference remains non-trivial in the evaluated benchmark regime.These results do not resolve unified biological representation learning, and they should be interpreted in light of incomplete simple-fusion baselines, limited architectural ablation, benchmark dependence, and possible upstream feature exposure. We therefore position RepGene as a feasibility study and a starting point for stronger comparisons, broader benchmarks, and leakage-aware validation.

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

Classifying by Proxy: Explainable and Reproducible Ensemble of Proxy Tasks for Child Sexual Abuse Imagery Classification

Child Sexual Abuse Imagery (CSAI) classification systems are needed solutions for lessening the psychological impacts often felt by law enforcement agents responsible for evaluating these materials and for efficient removal of these materials from the web. However, due to the nature of the task, researching and developing such systems is not a trivial endeavor. The images are highly sensitive, and the related datasets are under restrictive access regimes, which means most studies in the area are not reproducible or distributable and are therefore hard to compare and validate. More concerning still, most models for this task today lack an aspect often desired by law enforcement agents: explainability. In this paper, we apply an ensemble of Proxy Tasks – tasks that correlate to CSAI classification – yielding improvements in reproducibility, explainability, and security for distribution. This concept is applied for the first time to real CSAI, with a novel selection of relevant Proxy Tasks (selected from the CSAI literature) and training adaptations to the original framework. Our final model achieves competitive results, yielding 91.9% balanced accuracy on the RCPD dataset with the best Proxy Task combination. We furthermore contrast these results with the best-in-class representation learning model, DINO, and show that our ensemble improves accuracy and provides explanations for its classification results, a feature that a single deep learning model can seldom provide.

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

Brep2Shape: Boundary and Shape Representation Alignment via Self-Supervised Transformers

arXiv:2602.07429v2 Announce Type: replace-cross Abstract: Boundary representation (B-rep) is the industry standard for computer-aided design (CAD). While deep learning shows promise in processing B-rep models, existing methods suffer from a representation gap: continuous approaches offer analytical precision but are visually abstract, whereas discrete methods provide intuitive clarity at the expense of geometric precision. To bridge this gap, we introduce Brep2Shape, a novel self-supervised pre-training method designed to align abstract boundary representations with intuitive shape representations. Our method employs a geometry-aware task where the model learns to predict dense spatial points from parametric Bézier control points, enabling the network to better understand physical manifolds derived from abstract coefficients. To enhance this alignment, we propose a Dual Transformer backbone with parallel streams that independently encode surface and curve tokens to capture their distinct geometric properties. Moreover, the topology attention is integrated to model the interdependencies between surfaces and curves, thereby maintaining topological consistency. Experimental results demonstrate that Brep2Shape offers significant scalability, achieving state-of-the-art accuracy and faster convergence across various downstream tasks.Code is available at this repository: https://github.com/thuml/Brep2Shape.

17.
medRxiv (Medicine) 2026-06-16

Cross-sectional study of the association between depressive symptoms and attentional bias to emotional stimuli in patients with acute stroke: Study protocol

Post-stroke depression affects approximately 30% of patients after stroke and is associated with delayed recovery in activities of daily living, reduced rehabilitation effectiveness, and poorer quality of life. Attentional bias modification may provide a low-burden, nonpharmacological approach for patients in the acute phase of stroke. However, before such an intervention can be implemented in clinical practice, it is necessary to clarify whether attentional bias is present in patients with acute stroke and depressive symptoms, whether cognitive function influences the manifestation of this bias, and which task and stimulus formats are most appropriate for assessment. This multicenter, cross-sectional observational study will enroll patients with acute stroke between 7-30 days after stroke onset. Depressive symptoms will be assessed using the depression subscale of the Hospital Anxiety and Depression Scale. Attentional bias will be measured under four task conditions based on the dot-probe task and the cue-target task, using face and word stimuli. Secondary assessments will include cognitive function, anxiety symptoms, activities of daily living, health-related quality of life, and clinical background variables. The aims of this study are to investigate the association between depressive symptoms and attentional bias in patients with acute stroke, compare attentional bias characteristics across task and stimulus types, and examine the potential influence of cognitive function on this association. The findings are expected to provide an empirical basis for designing future attentional bias modification protocols targeting post-stroke depression in the acute phase. This study has been registered with the UMIN Clinical Trials Registry (UMIN000059166).

18.
arXiv (CS.CV) 2026-06-19

SAFE-Cascade: Cost-Adaptive Vision-Language Routing for Chart Question Answering

Vision-language models (VLMs) are powerful for chart question answering, but invoking a VLM for every query can be unnecessarily expensive when many questions are answerable from OCR text and lightweight language reasoning. We demonstrate SAFE-Cascade, an interactive system for cost-adaptive chart question answering. Given a chart image and a natural-language question, SAFE-Cascade first extracts chart text with OCR, obtains a provisional answer from a text-only language model, and then uses a learned router to decide whether to accept the text answer or escalate to a VLM. The demo exposes this decision process to users: OCR evidence, text-only answer, routing probability, escalation decision, final answer, estimated cost, and estimated latency are shown side by side. SAFE-Cascade is designed as a transparent interface for understanding when visual grounding is actually needed. Users can upload or select charts, ask questions, inspect the evidence used by each pathway, compare text-only and VLM answers, and adjust the escalation threshold to explore the accuracy-cost frontier. The system is implemented with Azure Document Intelligence for OCR, gpt-5-mini as the text-only model, gemini-2.5-flash-image as the VLM, and a Random Forest router trained on inference-time features. On a held-out ChartQA test split of 375 examples from a 2,500-example experiment, SAFE-Cascade achieves 69.1% unified accuracy with 73.1% VLM invocation, compared with 67.7% accuracy and 100% VLM invocation for the full-VLM baseline. The observed +1.4 percentage-point difference is statistically uncertain, so we interpret SAFE-Cascade as matching full-VLM performance while reducing VLM calls by 26.9% and estimated cost by 9.3%. The demonstration shows how selective modality routing can make multimodal knowledge systems more transparent, tunable, and cost-aware.

20.
medRxiv (Medicine) 2026-06-19

Extraction of Glaucoma Diagnosis, Type, and Severity from Clinical Notes using Secure Cloud-based Large Language Models

Purpose: To evaluate the performance of secure cloud-based large language models (LLMs) in extracting glaucoma diagnosis, type, and severity from free-text clinical notes in the electronic health record (EHR). Design: Retrospective chart review analysis. Participants: 1,250 subjects from the Bascom Palmer Ophthalmic Repository. Methods: Clinical notes of glaucoma-related encounters between 2014 and 2024 were extracted from the Bascom Palmer Ophthalmic Repository. Two fellowship-trained glaucoma specialists annotated clinical notes for glaucoma presence, type, and severity at the eye level. The dataset was split into development (10%), validation (10%), and test (80%) sets. Development and validation sets were used for prompt engineering and refinement, and the held-out test set was used for evaluation. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT-5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Azure AI Foundry within HIPAA-compliant containers. Model performance was assessed using standard metrics. Clinician-entered ICD-10 codes were also compared with adjudicated labels. Main Outcome Measures: Gwet AC1, accuracy, sensitivity, specificity, and F1-score. Results: Inter-grader agreement was high for glaucoma detection (Gwet AC1= 0.930 (95% CI: 0.917-0.945), type classification (Gwet AC1= 0.917 (95% CI: 0.904-0.930), and severity staging (Gwet AC1= 0.901 (95% CI: 0.884-0.916). For glaucoma diagnosis, LLMs demonstrated high overall accuracy, with Claude achieving 97.5%, DeepSeek 96.0%, GPT 96.2%, Grok 94.4%, and Qwen 95.5%. F1 scores for glaucoma detection ranged from 95.4% to 98.9% across models. For glaucoma type classification, accuracies were 97.1%, 94.2%, 94.2%, 94.0%, and 94.4% for Claude, DeepSeek, GPT, Grok, and Qwen, respectively. F1 scores for the most prevalent type (POAG) ranged from 96.3% to 98.9%. For severity staging, accuracies were 95.0%, 94.8%, 94.5%, 94.0%, and 95.2%, respectively, with F1 scores ranging from 89.7% to 96.3% across severity categories and models. ICD-10 codes demonstrated substantially lower performance for type and severity staging, with overall accuracies of 89.2% and 58.5%, respectively. Conclusions: Secure cloud-based LLMs accurately extracted glaucoma diagnosis, type, and severity information from free-text ophthalmology notes, achieving performance approaching expert clinician adjudication while substantially outperforming ICD-based phenotyping approaches, particularly for disease severity classification. These findings demonstrate the potential of LLMs to transform unstructured clinical documentation into scalable, research-ready phenotypic data for large-scale glaucoma cohort development and EHR-based ophthalmic research.

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

Mix-QVLA: Task-Evidence-Aware Mixed-Precision Quantization of Vision-Language-Action Models

We propose Mix-QVLA, a task-evidence-aware mixed-precision PTQ framework for VLA models. Mix-QVLA anchors each quantized variant to the full-precision action-token reference decision and evaluates whether quantization preserves task-relevant evidence across key VLA functional boundaries. It computes normalized gradient-weighted task-evidence maps from boundary activations and compares full-precision and quantized maps using evidence-mass and attribution-distribution distortion, capturing changes in both the strength and allocation of decision-supporting evidence. A soft-bottleneck objective aggregates boundary-level degradation into layer-wise sensitivity scores. Mix-QVLA further models sensitivity throughout task execution, capturing phase-dependent shifts in layer importance rather than assuming a fixed sensitivity profile. The resulting evidence- and time-aware scores guide mixed-precision bit allocation under model-size and BitOps budgets. Extensive evaluations on OpenVLA-style policies show that Mix-QVLA improves the accuracy-efficiency trade-off of low-bit VLA deployment. On LIBERO, Mix-QVLA reduces OpenVLA-OFT memory from 15.4 GB to 4.1 GB, retains 96.3 average success compared with 97.1 for the BF16 model, and achieves a 1.52x inference speedup.

22.
medRxiv (Medicine) 2026-06-15

Prevalence and Clinical Impact of Pathogenic Variants in Cardiomyopathy Genes Among Individuals with Cardiac Conduction Disorders

Importance: Cardiac conduction disorders have traditionally been regarded as a secondary manifestation of underlying structural heart diseases. However, isolated conduction disorders may precede the onset of heart failure (HF) suggesting shared mechanisms. Objective: To evaluate the prevalence and clinical significance of pathogenic/likely pathogenic (P/LP) rare variants in cardiomyopathy genes among individuals with conduction disorders. Design, Setting, and Participants: Biobank analysis of 192,834 participants with whole genome sequence data from Vanderbilt's BioVU and 353,092 participants from the All of Us Research Program (AoU). Participants with primary conduction disorder (left bundle branch block [LBBB], right bundle branch block [RBBB], high-grade atrioventricular block [AVB]) were identified after excluding secondary causes. Exposures: P/LP variants in cardiomyopathy genes. Main Outcomes and Measures: Primary outcome was P/LP carrier status by age and HF status. Secondary outcomes included incident HF and composite ventricular arrhythmias/sudden cardiac death/mortality (VA/SCD/mortality). Results: Among 16,959 participants with conduction disorders in BioVU and 13,442 in AoU, 432 (2.6%) and 206 (1.5%) were P/LP carriers, respectively. Conduction disorder was independently associated with carrier status (BioVU p

23.
medRxiv (Medicine) 2026-06-11

Ferritin across long-term conditions in England: cross-sectional primary care study

Background Iron deficiency (ID) is a readily treatable condition once identified. Ferritin is the primary diagnostic marker, but cut-offs vary and inflammation complicates interpretation in patients with long-term conditions (LTCs). Aim To describe ferritin distribution and the prevalence of threshold-defined low ferritin in adults with and without LTCs in primary care. Design and setting Cross-sectional observational study using routinely collected electronic health records from a national primary care database in England (1st January 2015 to 31st December 2021). Method Adults with >1 ferritin test in Clinical Practice Research Datalink (CPRD) Aurum were included. LTCs were identified using validated primary-care code lists. Outcomes included ferritin distribution and threshold-defined ID prevalence using World Health Organization (WHO) (

24.
arXiv (CS.LG) 2026-06-18

Unsupervised Diffusion Solver for Combinatorial Optimization via Combinatorial Adjoint Matching

arXiv:2605.30920v2 Announce Type: replace Abstract: Diffusion-based neural solvers have shown strong promise for combinatorial optimization (CO), but existing methods typically rely on supervised training with large collections of near-optimal solutions. In this work, we extend adjoint-based trajectory optimization methods to discrete combinatorial domains. We formulate diffusion-based CO as a stochastic control problem over Continuous-Time Markov Chains and introduce discrete adjoint dynamics for propagating optimization signals through discrete generative trajectories. Building on this formulation, we propose Combinatorial Adjoint Matching (CAM), an unsupervised training framework for discrete diffusion solvers with structured and low-variance trajectory-level optimization signals. Empirically, CAM consistently outperforms existing unsupervised diffusion baselines and achieves performance competitive with strong supervised diffusion solvers and even traditional solvers across diverse combinatorial optimization problems. Our code is available at https://github.com/Shengyu-Feng/CAM.

25.
arXiv (CS.CL) 2026-06-18

Towards Scalable Customization and Deployment of Multi-Agent Systems for Enterprise Applications

Large language model (LLM)-based multi-agent systems demonstrate strong performance on complex reasoning and task execution, enabling broad enterprise applications. However, production deployment remains challenging due to domain-specific customization requirements and high latency and inference costs in agentic workflows. We propose a unified framework for customization and efficient deployment of multi-agent systems in real-world settings. The first stage, Agentic Model Customization, combines continual pretraining, supervised fine-tuning, and preference optimization to adapt a compact model to specialized domains while retaining strong agentic capabilities. The second stage, Inference Optimization, integrates speculative decoding and FP8 quantization with targeted calibration to enable cost-efficient serving with minimal quality loss. Across enterprise workloads, our framework enables rapid domain adaptation and achieves a 4.48x speedup in throughput while maintaining performance and improving robustness on long-tail scenarios.