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

ROSE: Benchmarking the Perception-to-Action Gap in Multimodal Models

arXiv:2606.19965v1 Announce Type: cross Abstract: Multimodal large language models (MLLMs) are increasingly expected to act on visual information, yet the same scene may require different actions under different task contexts. How reliably can a model turn the same visual evidence into the action required by the current context? To answer this question, we introduce \textsc{ROSE} (Reference-conditioned Oddity and Symbolic Execution), a controlled benchmark that holds the visual scene fixed while varying region constraints and required symbolic outputs. Through coupled counting and coordinate-action tasks, \textsc{ROSE} tests whether models can infer an implicit majority reference and act on the resulting fine-grained visual evidence under changing contexts. Across nine recent MLLMs, performance drops by as much as 44.5 percentage points from counting-oriented tasks to region-conditioned action, despite 98.8\% human performance. The gap persists on paired scenes and regions for which the same model returns the correct count, while global-click and matched local controls show that coordinate grounding explains only part of the loss, revealing a distinct, model-dependent bottleneck in turning shared visual evidence into context-specific actions.

02.
arXiv (CS.AI) 2026-06-17

MathVis-Fine: Aligning Visual Supervision with Necessity via Progressive Dependency-Guided Training for Multimodal Mathematical Reasoning

arXiv:2606.17888v1 Announce Type: new Abstract: Chain-of-Thought (CoT) reasoning has extended from purely linguistic domains to multimodal scenarios; however, existing approaches often treat visual inputs as homogeneous or auxiliary signals, failing to capture the intricate and sample-specific dependencies between text and images in mathematical problem-solving. This gives rise to two core issues: first, the supervisory signals for visual content are generalized and coarse-grained, lacking adaptation to the actual necessity of visual information in each sample; second, training feedback becomes inaccurate when visual rewards are uniformly applied without distinguishing the complementary relationships among inputs. These limitations hinder models from achieving precise multimodal reasoning. In this work, we propose a framework for modeling fine-grained visual dependencies in mathematical reasoning. We first construct the MathVis-Fine dataset, augmenting fine-grained visual annotations with visual dependency ratings. Building upon this dataset, we introduce a two-stage progressive visual enhancement training paradigm that balances answer correctness rewards and visual grounding rewards according to the intrinsic visual dependency level of each sample, thereby mitigating reward bias and improving supervision accuracy. Extensive experiments demonstrate that the MathVis-Fine framework effectively enhances visual perception progressively based on visual dependency, offering a more precise training framework for multimodal mathematical reasoning. We will release the dataset upon acceptance.

03.
arXiv (CS.CV) 2026-06-12

VideoMDM: Towards 3D Human Motion Generation From 2D Supervision

We introduce VideoMDM, a diffusion-based framework that trains 3D human motion priors directly from accurate 2D poses extracted from monocular videos, without any 3D ground truth. A pretrained 2D-to-3D lifter provides approximate 3D pose sequences that serve as a noisy teacher: these are diffused, denoised by the model in 3D, and supervised in 2D by reprojecting the prediction and comparing against accurate keypoints. We show that, under mild assumptions, a depth-weighted 2D reprojection loss is equivalent in expectation to direct 3D supervision, and we adapt standard 3D motion regularizers - velocity consistency and over-parameterized representation alignment - to this 2D setting. Unlike methods that lift 2D to 3D only at inference, VideoMDM learns a coherent 3D motion manifold during training. On HumanML3D it nearly closes the gap to fully 3D-supervised MDM (FID 0.88 vs 0.54); On real video datasets Fit3D and NBA the method learns to generate motions consistently preferred by humans, with strong quantitative results.

04.
arXiv (CS.AI) 2026-06-19

Human-AI Agent Interaction in a Business Context

arXiv:2606.18716v1 Announce Type: cross Abstract: As AI agents are increasingly integrated into core business processes, understanding and designing effective interaction patterns between humans and AI agents becomes crucial for value creation. This study identifies and evaluates principles and criteria for a positive User Experience (UX) with AI agents, along with methods for its measurement. We identify user expectations and needs to facilitate adoption, build trust, and support user-centered decision-making by development teams. Using a mixed-methods approach that combines qualitative and quantitative techniques, we explore interaction patterns between humans and AI agents. The findings from this exploratory research serve as the basis to develop a survey experiment which evaluates the effectiveness of specific design elements on a larger scale. This foundational research contributes to the development of more intuitive and effective human-AI agent interactions in business settings.

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

DeepSWIP: Quotient-WMC Counterfactuals for Neural Probabilistic Logic Programs

arXiv:2606.20526v1 Announce Type: new Abstract: Neurosymbolic systems such as DeepProbLog combine neural perception with probabilistic logic, but standard inference is associational. Counterfactual reasoning additionally requires a causal semantics for interventions and evidence. We introduce DeepSWIP, a single-world counterfactual semantics for DeepProbLog programs. Using neural materialization, we reduce fixed-context neural predicates to ordinary ProbLog choices, apply Single World Intervention Programs (SWIPs), and compute counterfactuals by weighted model counting (WMC) over a single transformed program. Under finite grounding and unique-supported-model assumptions, DeepSWIP is exact relative to the learned materialized FCM. The standard quotient-WMC form of ProbLog conditionals identifies active neural probabilities and explains intervention cleaning, calibration sensitivity, and rare-evidence instability. Experiments on MPI3D confirm the transformation against a DeepTwin construction against 12,000 queries, as predicted and a 2.14$\times$ inference speedup from avoiding the Twin's endogenous duplication. A SUMO HOV experiment shows that neural calibration degradation biases plug-in estimates, while a correctly scoped randomized-policy AIPW estimator removes most first-order bias for population mean and ATE estimands. Code is at https://github.com/saibib/deep_SWIP.

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

Interactor: Agentic RL oriented Iterative Creation for Ad Description Generation in Sponsored Search

This paper focuses on automatically generating informative ad descriptions in sponsored search. Unlike ad titles which are usually optimized to attract user click feedbacks, ad descriptions have a longer text span and possess the potential of incorporating world knowledge to address user search intents while presenting the fine-grained selling points of the ads. We propose Interactor, a multi-turn iterative creation framework optimized with agentic RL for ad description generation. The generation model acts as a policy that interacts with a customized environment consisting of multiple generative reward models. Given initial generations by the policy, the customized GenRMs evaluate multi-dimensional qualities including knowledge capacity and landing page consistency, providing both binary signals and reasoning feedbacks. The policy then iteratively refines the descriptions based on such feedbacks to ensure continuous improvement. Experiments on industrial datasets show that the Interactor framework significantly outperforms state-of-the-art approaches in generating knowledge-rich and faithful ad descriptions. Since May 2026, it has been deployed online in a leading search ads system, contributing to both ad revenue and user experience.

07.
arXiv (CS.CV) 2026-06-12

Possibilistic Predictive Uncertainty for Deep Learning

Deep neural networks achieve impressive results across diverse applications, yet their overconfidence on unseen inputs necessitates reliable epistemic uncertainty modeling. Existing methods for uncertainty modeling face a fundamental dilemma: Bayesian approaches provide principled estimates but remain computationally prohibitive, while efficient second-order predictors lack rigorous connections between their specific objectives and epistemic uncertainty quantification. To resolve this dilemma, we introduce Dirichlet-approximated possibilistic posterior predictions (DAPPr), a principled framework grounded in possibility theory. We define a possibilistic posterior over parameters, project it to the prediction space via supremum operators, and approximate the projected posterior using learnable Dirichlet possibility functions. This projection-and-approximation strategy yields a simple training objective with closed-form solutions. Despite its simplicity, extensive experiments across diverse benchmarks show that DAPPr achieves competitive or superior uncertainty quantification performance over state-of-the-art second-order predictors while maintaining both principled derivation and computational efficiency. Code is available at https://github.com/MaxwellYaoNi/DAPPr.

08.
arXiv (CS.LG) 2026-06-15

A Longitudinal Attribute-Conditioned Neural Network for Modeling Health-State Transition Probabilities in Temporally Irregular Data: The LANTERN Framework

arXiv:2606.13880v1 Announce Type: new Abstract: Accurate estimation of long-term care transition probabilities is central to disability insurance pricing, reserving, and solvency assessment. Classical actuarial multi-state models commonly rely on Markov, semi-Markov, or proportional-hazard specifications, which provide a direct connection to cohort projection but may be restrictive for irregular longitudinal health data with nonlinear aging patterns and heterogeneous covariate histories. This paper develops a well-calibrated estimator of multi-state transition probabilities for irregular longitudinal health data. The model learns from individual health history, incorporates the time elapsed between observations, and conditions transition probabilities on demographic and socioeconomic attributes. It produces a valid probability distribution over the next observed health state, with four possible states: healthy, mild disability, severe disability, and death. Individual probabilities are aggregated by age group and origin state to form transition matrices compatible with actuarial cohort projection. Using longitudinal data from the Health and Retirement Study, we compare the proposed estimator with logistic regression, gradient-boosted trees, a recurrent neural network, and a last-state persistence benchmark. The evaluation considers probabilistic accuracy, endpoint discrimination and calibration for severe disability and death, risk concentration, and transition matrix error after aggregation. The proposed estimator improves severe disability discrimination relative to logistic regression and gradient-boosted tree benchmarks, maintains strong calibration, and yields the lowest transition matrix error among the evaluated models in the held-out test analysis. Results show that a structured machine learning estimator can support long-term care transition modeling when judged by calibration and projection fidelity, beyond discrimination.

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

Automatic Summarization of Doctor-Patient Encounter Dialogues Using Large Language Model through Prompt Tuning

Automatic text summarization (ATS) is an emerging technology to assist clinicians in providing continuous and coordinated care. This study presents an approach to summarize doctor-patient dialogues using generative large language models (LLMs). We developed prompt-tuning algorithms to instruct generative LLMs to summarize clinical text. We examined the prompt-tuning strategies, the size of soft prompts, and the few-short learning ability of GatorTronGPT, a generative clinical LLM developed using 277 billion clinical and general English words with up to 20 billion parameters. We compared GatorTronGPT with a previous solution based on fine-tuning of a widely used T5 model, using a clinical benchmark dataset MTS-DIALOG. The experimental results show that the GatorTronGPT- 20B model achieved the best performance on all evaluation metrics. The proposed solution has a low computing cost as the LLM parameters are not updated during prompt-tuning. This study demonstrates the efficiency of generative clinical LLMs for clinical ATS through prompt tuning.

10.
arXiv (CS.CV) 2026-06-17

LADBench: A Benchmark for Logical Fault Detection in Images

Large Vision Language Models (VLMs) excel at visual question answering and semantic grounding, but their capacity for autonomous logical reasoning remains underexplored. Existing anomaly benchmarks emphasize visual errors or direct prompting rather than the physical and social common sense needed for open-world deployment. To address this, we introduce LAD-bench, a benchmark of more than 1,000 curated synthetic images with logical anomalies across four domains: Residential, Urban, Collaborative, and Nature. We further propose a Tiered Prompting Protocol based on progressive disclosure, which measures how much explicit assistance a model needs to localize and reason about a logical fault. Evaluating leading foundation models reveals substantial weaknesses: even the best achieves only 70.11% overall accuracy, showing that implicit logical fault detection remains unsolved. Crucially, models often fail to identify anomalies even after receiving explicit hints in deeper tiers. By surfacing these limitations in sequential multimodal reasoning, LAD-Bench offers a rigorous framework for advancing the safety, reliability, and cognitive alignment of autonomous visual systems. Dataset and Code: https://huggingface.co/datasets/SahasraK/LADBench

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

Optimal Toffoli-Depth Multi-Controlled Toffoli Decomposition in 2D Qubit Layout

arXiv:2606.15113v1 Announce Type: new Abstract: The multi-controlled Toffoli (MCT) gate is a key primitive in quantum arithmetic, oracle construction, and quantum cryptanalysis. Although recent work has established optimal Toffoli-depth MCT decompositions under all-to-all qubit connectivity, their realization on near-term quantum hardware with restricted qubit connectivity remains largely unexplored. While general-purpose quantum mappers can route arbitrary circuits, they do not explicitly exploit the repeated interaction patterns inherent in MCT decompositions. In our present paper, we study architecture-aware mappings of optimal Toffoli-depth MCT decompositions onto restricted two-dimensional qubit layouts. We begin with a structured geometric placements that preserve the parallelism of state-of-the-art Toffoli and MCT decompositions with no additional depth overhead. We further introduce a motif-based packing framework in which decomposition layers are represented by interaction motifs derived from basic Toffoli gates. By embedding these motifs vertex-disjointly into hardware graphs, we characterize the minimum-size topologies supporting the required qubit resources and derive explicit bounds on the resulting depth overhead under tight qubit budgets. Finally, we compare these bounds with routing-aware placement heuristics and empirically evaluate the effectiveness of embedding different motifs across a range of hardware topologies.

12.
arXiv (CS.CL) 2026-06-19

TerraMARS: A Domain-Adapted Small-Language-Model Pipeline for Mars Terraforming Literature

Researchers are interested in learning about Mars so that it may eventually become habitable for humans. To achieve this, there is a need for comprehensive knowledge of the planet's atmosphere, hydrology, surface chemistry, radiation environment, and spatial features through the scientific literature. These contain valuable information and meaningful quantitative constraints that can be used in other models and studies, such as habitability assessment and future terraforming studies. We present TerraMARS, an end-to-end information extraction pipeline that combines a domain-adapted Small Language Model to answer Mars terraforming-related questions and convert unstructured Mars science text into machine-readable structured outputs in JavaScript Object Notation (JSON) format. A corpus of open-access papers is collected and processed using a multistage retrieval and chunking framework. Google Gemma 3 1B was adapted to the domain using Quantized Low-Rank Adaptation (QLoRA) fine-tuning on Mars-specific question-answering and information extraction datasets. The resulting pipeline generates both types of output and provides a foundation for integrating knowledge from scientific literature into downstream applications like digital twins and habitability modeling for Mars. The output from this pipeline looks promising, but further improvements are needed to increase extraction accuracy and factual consistency.

13.
arXiv (CS.CV) 2026-06-17

Landsat-Sentinel-2 Algal Bloom Mapping Using Vision Transformers: Model Description, Implementation, and Examples

Coastal algal bloom monitoring requires frequent, spatially detailed, and globally consistent observations, provided by Landsat-8/9 and Sentinel-2 A/B/C. Together, these missions offer over a decade of medium-resolution multispectral imagery with near-global coverage every 2-3 days, enabling the detection of fragmented bloom structures not resolvable by coarse ocean-color sensors. However, their use in aquatic environments remains challenging due to limited spectral coverage and a lack of harmonized reflectance products. As an alternative to traditional bio-optical methods, deep learning-based image classification offers a data-driven approach that can overcome many of these limitations. This study presents the first successful implementation of vision transformer-based coastal algal bloom mapping using 30-m Landsat-Sentinel-2 images. A globally distributed bloom patch dataset was generated across bloom-prone coastal hotspots worldwide. Four transformer-based architectures were compared against a standard convolutional baseline for fine-scale bloom detection, and assessed under different optical water types and atmospheric and surface conditions. All deep learning models showed strong capabilities in detecting floating bloom areas, with omission and commission errors of 8-65%. Under cloud and glint stress in a time series, the Swin Transformer outperformed traditional spectral-index approaches, which produced widespread false positives, effectively avoiding cloud- and glint-affected pixels. Comparisons with MODIS-derived products further highlighted the benefits of higher spatial resolution in detecting fragmented and irregularly affected blooms. Our findings support deep learning as a reliable tool for medium-resolution, consistent monitoring of floating algal blooms in dynamic coastal environments.

14.
arXiv (CS.AI) 2026-06-19

FundaPod: A Multi-Persona Agent Pod Platform with Knowledge Graph Memory for AI-Assisted Fundamental Investment Research

arXiv:2605.27864v4 Announce Type: replace Abstract: Large language models (LLMs) are increasingly applied in finance, yet most existing work emphasizes trading signals or financial NLP tasks centered on prediction. Institutional fundamental research, by contrast, requires human analysts or AI agents to gather evidence, identify business drivers, compare competing viewpoints, and generate investment memos. Its broader goal is not merely to predict outcomes, but to produce investment plans that are transparent, reusable, and verifiable, while contributing to the cumulative development of investment knowledge. We present FundaPod, a multi-persona agent platform for AI-assisted fundamental investment research. We argue that fundamental research is a human-centric decision-support task that is qualitatively distinct from trading-signal generation, and is therefore better served by an independence-preserving architecture. In FundaPod, AI agents with different personas, such as value investors or macro strategists, conduct research independently under a shared provenance contract. Their disagreements are then surfaced post hoc for adjudication by the human portfolio manager (PM) through a knowledge-graph memory system. This paper contributes five design principles for human-AI hybrid systems supporting fundamental research, grounded in design-science practice and theories of cognitive isolation and human-machine coordination. It also describes four architectural mechanisms: a persona distillation pipeline that turns public investor materials into deployable agents; a declarative skill registry that lets the planner derive typed task graphs; a grounded evidence model that links memo claims to verifiable sources; and a knowledge-graph "second brain" that connects tickers, memos, analysts, and themes. We demonstrate the architecture through a complete case study and a persona-based memo comparison.

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

Matrix Discrepancy for Representations of Finite Groups

arXiv:2606.12181v1 Announce Type: new Abstract: Given a finite group $G$, we prove that there exist signs $\varepsilon\in\{\pm1\}^G$ such that $$\left\| \sum_{g\in G} \varepsilon_g\rho(g) \right\|\leq C\, \sqrt{|G|},$$ where $\rho$ is the left regular representation of $G$, and $C$ is a universal constant. This special case of the Matrix Spencer conjecture was posed in [BKMZ24], where it was established for simple groups.

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

Quantum optimal control of the Dicke manifold in dipolar Rydberg atom arrays

arXiv:2606.02283v2 Announce Type: replace Abstract: The ability to engineer and control quantum states of many-body systems is a central challenge in quantum information science. For a register of $N$ qubits, the full Hilbert space dimension grows exponentially as $2^N$, rendering generic state preparation and control infeasible without exploiting structure or symmetry. A particularly important and physically motivated restriction is to the fully symmetric subspace, spanned by the Dicke states, which are simultaneous eigenstates of collective spin $J=N/2$. Ensembles of Rydberg atoms interacting via electric dipoles in two-dimensional tweezer arrays form a promising platform for achieving such control. However, the finite range of dipole-dipole interactions poses a challenge to generating and controlling the Dicke manifold because the Hamiltonian incurs leakage from the computational subspace. To counteract this leakage, we perform quantum optimal control algorithms on a truncated Hilbert space according to our newly developed method of ``irrep distillation'' (IRD), which captures the process by which the symmetric subspace couples to leakage error-spaces, using only linear-scaling Hilbert dimension. We implement gradient ascent pulse engineering (GrAPE) on control schemes with little or no local addressing, to generate resourceful states like Greenberger-Horne-Zeilinger, Dicke, and extremal quantum states. We benchmark each scheme of IRD-GrAPE for its quantum speed limit (QSL), as well as exactly testing pulse fidelities on small system sizes and predicting fidelities using higher-order IRD on larger systems.

17.
arXiv (math.PR) 2026-06-15

Trivariate Hypergeometric Series Formulas for Pure Partition Functions of Multiple $3$-SLE$_\kappa$

作者:

arXiv:2606.14038v1 Announce Type: new Abstract: Pure partition functions of multiple SLE are characterized by null-state partial differential equations, Möbius covariance, and boundary asymptotics. After quotienting by Möbius covariance, the case of three curves is the first genuinely multivariable one: the moduli space has three independent variables, naturally represented by the three unoriented cross-ratios of the three pairs of links. We solve this Möbius-normalized three-variable problem for the two basic link-pattern types of multiple \(3\)-SLE\(_\kappa\), namely the rainbow and neighbor patterns. Writing \(\beta=4/\kappa\), we construct explicit trivariate hypergeometric-series normal forms and identify them with the corresponding pure partition functions for all \(\beta>1/2\) in the rainbow case and all \(\beta\ge2/3\) in the neighbor case. Equivalently, these ranges are \(\kappa\in(0,8)\) and \(\kappa\in(0,6]\), respectively. The proof is analytic. The null-state PDEs and Möbius covariance yield recursion relations for the trivariate coefficient arrays. In the rainbow case, coefficient estimates give convergence and boundary regularity on the closed cube. In the neighbor case, Pfaff systems continue the local power series to a neighborhood of \([0,1)^3\), while side-face equations, regular normal estimates, and corner propagation give continuity on \([0,1]^3\) for \(\beta\ge2/3\). The endpoint \(\beta=2/3\), corresponding to \(\kappa=6\), requires a logarithmic normal term. The two-dimensional boundary degenerations are classical Appell \(F_1\) and Horn \(G_2\) functions. The probabilistic identification uses SLE martingale arguments and Itô calculus, together with positivity and boundary regularity. We also discuss boundary degenerations, including heuristic connections with boundary Green's functions.

18.
arXiv (quant-ph) 2026-06-19

Measuring Rényi entropy with an Echo Protocol

arXiv:2504.05237v3 Announce Type: replace Abstract: We present efficient and practical protocols to measure the second Rényi entropy, whose exponential is known as the purity. Our approach is based on expressing the purity in terms of transition probabilities generated by an echo-type forward-backward evolution sequence, making it applicable to quantum many-body systems. Notably, our approach does not rely on random-noise averaging, a feature that can be extended to protocols to measure out-of-time-order correlation functions, as we demonstrate. By way of example, we show that our protocols can be practically implemented in superconducting qubit-based platforms, as well as in cavity-QED trapped ultra-cold gases.

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

Agentomics: Economic Foundations for the Valuation, Attribution, and Pricing of AI Agents in Human-AI Workflows

作者:

arXiv:2606.14769v1 Announce Type: cross Abstract: Agentic AI systems are increasingly being deployed as productive resources in organizational workflows, yet existing evaluation methods primarily measure isolated technical performance rather than economic contribution. This paper introduces Agentomics, a workflow-based framework for valuing, attributing, and pricing human and artificial agents. The framework models a workflow as a configuration of heterogeneous agents whose collective performance determines gross value, deployment cost, reliability, and expected failure loss. Workflow value is treated as a team-level quantity that may include complementarities, substitution effects, bottlenecks, and nonlinear production; additive stage-level value is only a special case. Building on this workflow model, the paper formulates AI deployment as a coalition-formation problem and defines coalition value as the incremental net surplus generated relative to a benchmark human workflow. The Shapley value is then used to attribute economic surplus among participating AI agents, yielding a principled connection among valuation, accountability, and market pricing. The resulting Shapley pricing equilibrium provides a normative benchmark for assessing whether agent prices reflect expected marginal contribution. A security-operations case study illustrates how the framework accounts for productivity gains, deployment costs, reliability losses, and coalition-level complementarities in hybrid human–AI workflows.

20.
arXiv (CS.AI) 2026-06-16

Edu-Theater: A Data-Efficient Agent Framework for Scalable Learner Behavior Simulation through Staging Roll-Call

arXiv:2606.15225v1 Announce Type: cross Abstract: Large-scale learner-task interaction data are crucial for intelligent educational systems but are costly to collect and constrained by privacy and learner engagement. Learner simulators play a critical role in simulating scalable learner behavior without the need for continuous involvement of real learners. However, existing methods are predominantly individual-centric, pairing a simulator with each learner to iteratively infer latent knowledge states from dense interaction histories, which is both data- and computation-intensive, and fragile in cold-start scenarios. We propose a cohort-aware roll-call simulation paradigm that first constructs cohort-level proficiency priors and refines individual learner states through a small number of targeted diagnostic queries. Based on this paradigm, we introduce Edu-Theater, an LLM-powered agent system that performs cohort-aware learner simulation via a teacher agent and retrospective roll-call probing over learner logs. Edu-Theater enables scalable future behavior simulation without the need for dense per-learner histories. Experiments on two real-world datasets demonstrate that Edu-Theater achieves higher simulation accuracy with significantly fewer LLM calls, producing synthetic data that enhances downstream applications such as adaptive testing.

21.
medRxiv (Medicine) 2026-06-22

Hyperlipidemia Pharmacotherapy in Skilled Nursing Facilities: A Real-World Evidence Study

Objectives: To estimate hyperlipidemia medication order prevalence and associated variables in U.S. skilled nursing facility (SNF) residents. Design: Retrospective, observational study. Setting and Participants: Electronic Health Record data from 447,080 SNF residents with a hyperlipidemia diagnosis identified in PointClickCare's Life Sciences clinical database (January-April 2025) were reviewed. Methods: The presence and absence of medication orders for hyperlipidemia treatments recommended by the American Heart Association were assessed. Descriptive analyses summarized demographic and clinical characteristics, and a modified Poisson regression model was used to estimate risk ratios for having a medication order, adjusting for demographic, clinical, and facility characteristics. Results: Overall, 83.3% of residents diagnosed with hyperlipidemia had at least one hyperlipidemia medication order. Statins were ordered by 96.2% of active order residents, while other medication classes i.e., omega-3 fatty acids, cholesterol absorption inhibitors, fibrates were less common (

22.
medRxiv (Medicine) 2026-06-12

Immunologically Optimized Zmp1 Peptides Reveal a Translational Serological Biomarker Platform for Tuberculosis Diagnosis Across Disease Manifestations

Tuberculosis (TB) diagnosis remains challenging, particularly for extrapulmonary TB (EPTB), where invasive sampling, low bacillary burden, and suboptimal sensitivity of nucleic acid-based tests in peripheral specimens hinder timely detection. Here, we report an immunology-driven strategy for biomarker discovery and development of a peptide-based serological assay targeting Mycobacterium tuberculosis zinc metalloprotease-1 (Zmp1). Leveraging fundamental principles of adaptive immunity that antigenic regions containing overlapping B-cell and CD4 T-helper cell epitopes would preferentially generate high antibody titers through linked recognition and cognate T-cell help, we used an immunoinformatics pipeline to identify two nested immunodominant peptide regions within Zmp1 (Mtb-Zp-NT and Mtb-Zp-CT) enriched for overlapping B- and T-cell epitopes. The diagnostic potential of these peptides was evaluated through ELISA-based serological assays. A blinded pilot study (N=137) demonstrated a clear discrimination between active TB and TB-recovered individuals. The assay was subsequently validated in an expanded cohort (N=875) by screening 6,086 individuals, which identified 457 TB-positive cases. The cohort included pulmonary TB (PTB), EPTB, TB-recovered individuals, household contacts, non-specific infections, and healthy controls. Receiver operating characteristic analyses, supported by DeLong and bootstrap comparisons, revealed superior diagnostic performance of the peptide-based assays relative to full-length Zmp1. Mtb-Zp-CT exhibited the highest accuracy (AUC=0.93; specificity >90%), while Mtb-Zp-NT also demonstrated strong discriminatory power (AUC{approx}0.89). These findings establish that the immunologically optimized Zmp1 peptides are highly promising serological biomarkers for TB and EPTB. More broadly, they demonstrate how mechanistically informed epitope selection can accelerate translation of pathogen-specific immune signatures into sensitive, minimally invasive, and potentially point-of-care diagnostic platforms for resource-limited settings.

23.
medRxiv (Medicine) 2026-06-17

Sao Tome and Principe on the verge of eliminating lymphatic filariasis as a public health problem: evidence from IDA impact assessment surveys

Background Accelerated efforts to eliminate lymphatic filariasis (LF) as a public health problem have been supported by the introduction of the triple-drug regimen of ivermectin, diethylcarbamazine and albendazole (IDA) in endemic settings. In Sao Tome and Principe, nationwide mass drug administration (MDA) with diethylcarbamazine and albendazole was implemented in 2018, followed by IDA in 2019 and 2020. This study assesses progress towards elimination using post-MDA impact assessment surveys conducted after cessation of treatment. Methods Cross-sectional surveys were conducted among adults aged 20 years and older in 2022 and again between December 2024 and January 2025. Circulating filarial antigen (CFA) was detected using the filarial test strip (FTS). Individuals who tested positive were examined for microfilaremia using nocturnal calibrated thick blood smear microscopy. Additionally, programme data on MDA coverage and morbidity were obtained from national surveillance records. Results Three rounds of nationwide MDA achieved high epidemiological coverage (86.4% in 2018, 74.2% in 2019 and 80.0% in 2020). The impact assessment surveys conducted in 2022 evaluated 14 132 adults, with 21 individuals (0.15%) testing positive for CFA, while the follow-up survey conducted between December 2024 and January 2025 assessed 14 653 adults and detected seven positive cases (0.05%). No microfilariae were detected among the 28 antigen-positive individuals examined using nocturnal calibrated thick blood smears. National morbidity records documented 190 cases of lymphoedema and nine cases of hydrocoele. Conclusions Infection indicators remain well below WHO decision thresholds, suggesting that LF transmission is unlikely to be sustained. Sao Tome and Principe appears to be close to eliminating LF as a public health problem. However, strengthening morbidity management services will be essential to support the preparation of the national elimination dossier.

25.
arXiv (CS.CL) 2026-06-11

Geometry of Reason: Spectral Signatures of Valid Mathematical Reasoning

Verifying whether a language model is genuinely reasoning or pattern-matching remains an open problem: learned verifiers are expensive, and output-based heuristics are brittle. We show that valid mathematical reasoning induces a measurable, training-free spectral signature in transformer attention. By treating each attention matrix as a weighted token graph, we extract four diagnostics: Fiedler value, High-Frequency Energy Ratio (HFER), spectral entropy, and smoothness, that require no learned parameters. Experiments across seven models from four architectural families yield effect sizes up to Cohen's $d = 3.30$ ($p < 10^{-116}$), enabling $85$–$96\%$ single-threshold classification accuracy. Two findings sharpen the interpretation. First, Platonic validity: the spectral signal tracks logical coherence rather than compiler acceptance, proofs rejected for timeouts or missing imports are correctly classified as valid, a distinction confirmed by a manual audit ($\kappa = 0.82$, $n = 51$). Second, architectural determinism: Sliding Window Attention shifts the discriminative feature from HFER to smoothness ($d = 2.09$, $p < 10^{-48}$), showing that attention design governs which spectral channel encodes reasoning quality. Causal ablation confirms the signature traces induction-head circuits. The method generalises to informal chain-of-thought ($d = 0.78$, $p < 10^{-3}$), and in proof search, HFER reranking improves Best-of-16 Pass@1 by $+4.4$–$6.6$\%, matching $98\%$ of the AUC of fully supervised probes with zero labels. Spectral graph analysis is a principled, architecture-aware primitive for reasoning verification.