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01.
arXiv (CS.AI) 2026-06-16

FragFuse: Bypassing Access Control of Large Language Model Agents via Memory-Based Query Fragmentation and Fusion

arXiv:2606.15609v1 Announce Type: cross Abstract: Large language model (LLM) agents increasingly rely on long-term memory to support complex task execution, user personalization, and domain adaptation. Meanwhile, emerging access-control mechanisms for LLM agents are being explored to block policy-violating requests and prevent misuse. We reveal a novel attack surface arising from agent memory operations: prohibited content that would trigger access control can be fragmented across interactions, stored in long-term memory in benign-appearing form, and later reconstructed through memory retrieval without appearing explicitly in the final user query. We propose FragFuse, the first attack that enables unprivileged users to bypass agent access control by exploiting this temporal channel introduced by long-term memory. FragFuse operates in three stages: (1) identifying rejection-responsive fragments via black-box adaptive querying with fragment masking; (2) injecting these fragments into memory using marker carrier queries; and (3) retrieving and fusing the stored fragments through a follow-up attack query. Although FragFuse can be instantiated manually for individual agents, we further develop a surrogate-based optimization scheme that tunes fusion instructions and marker designs, enabling automated attack generation without violating the attacker's threat-model assumptions. We evaluate FragFuse across four representative agent settings and task domains, covering three state-of-the-art agent access-control mechanisms. FragFuse achieves an average bypass success rate of 86.3% and an average end-to-end harmful task success rate of 41.1% across all settings, with only 4.4% average task-success degradation compared with configurations without access control. We also show that alternative defenses, including state-of-the-art prompt-injection detectors and perplexity detectors, do not effectively address this attack.

02.
medRxiv (Medicine) 2026-06-23

THE SILENT STRUGGLE: EXPLORING THE EFFECTS OF COMMUNICATION BREAKDOWNS IN HEALTHCARE DELIVERY IN THE NORTHERN REGION OF GHANA

Abstract Effective health communication is central to patient-centred care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing Semi-Structured interviews with purposively sampled twenty patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted Content Analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinderer patient openness and the quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact on treatment and assistive practice, specifically in culturally diverse environment and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers. Abstract Effective health communication is central to patient-centered care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing semi-structured interviews with twenty purposively sampled patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted content analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinder patient openness and quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact treatment and assistive practice, specifically in culturally diverse environments and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers.

03.
arXiv (CS.CL) 2026-06-18

Continual Adaptation for Pacific Indigenous Speech Recognition

Speech foundation models struggle with low-resource Pacific Indigenous languages because of severe data scarcity. Furthermore, full fine-tuning risks catastrophic forgetting. To address this gap, we present an empirical study adapting models to real-world Pacific datasets. We investigate the impact of data volume, adaptation strategies, and representational drift on speech foundation models for various Pacific languages. Additionally, we analyze a continual learning framework for sequential language acquisition. Empirical results across three distinct Pacific Indigenous languages demonstrate that adapting to these linguistically distant languages induces severe internal representational drift. Consequently, these models face a strict plasticity and stability dilemma. While LoRA adapts well initially, it suffers from catastrophic forgetting during sequential learning. Ultimately, this study highlights the urgent need for robust adaptation strategies tailored to underrepresented languages.

04.
arXiv (quant-ph) 2026-06-19

Fidelity bounds for adiabatic gates and other quantum operations with time-dependent dissipation

arXiv:2606.20501v1 Announce Type: new Abstract: As quantum-computing platforms are susceptible to noise, the fidelity of quantum operations is limited by decoherence. Understanding this limitation is crucial for building utility-scale quantum processors. In previous works [Phys. Rev. Lett. 129, 150504 (2022); Quantum 9, 1684 (2025)], we presented analytical formulae for the average gate fidelity of multi-qubit operations under static Markovian noise processes, including operations that temporarily leave the computational subspace. However, some quantum-computing architectures dynamically modulate qubit or coupler frequencies to implement two-qubit gates, e.g., baseband flux gates; such modulation can lead to dissipation rates varying in time. In this Letter, we therefore generalize the fidelity-reduction formulae to encompass time-dependent dissipation. Applying our generalized formula, we obtain a fidelity bound for adiabatic operations and demonstrate that flux-dependent noise sensitivity, combined with qubit-coupler hybridization, significantly reduces the fidelity of adiabatic controlled-Z (CZ) gates in superconducting quantum computers. Our work thus provides essential theoretical tools for evaluating error budgets and optimizing the design of quantum operations in tunable quantum-computing architectures, and may also find applications in quantum-sensing and quantum-communication protocols that are affected by time-dependent dissipation.

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

KGEdit: Ambiguity-Aware Knowledge Graphs for Training-Free Precise Video Generation and Editing

In recent years, training-free video generation has progressed remarkably. However, when handling complex textual instructions, existing methods still suffer from semantic ambiguity, incorrect concept binding, and cross-frame inconsistency. To address these issues, we propose KGEdit, a structured semantic control framework for text-to-video (T2V) diffusion models. Specifically, we first construct an ambiguity-aware knowledge graph (AAKG) to disentangle and disambiguate the input prompt, converting it into four types of structured semantics: identity, relation, attribute, and negative constraints. We then design a structured semantic injection module (SSIM) to inject these semantic signals into key layers of the diffusion Transformer, enabling fine-grained semantic control. In addition, we introduce a temporal-aware semantic control (TASC) module that dynamically schedules semantic objectives according to the stage-wise characteristics of the denoising process, further improving semantic alignment and temporal consistency. Experiments show that KGEdit outperforms existing methods in editing precision and temporal stability, while offering higher efficiency and controllability in text-driven interaction scenarios.

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

MirrorCheck: Efficient Adversarial Defense for Vision-Language Models

Vision-Language Models (VLMs) are increasingly susceptible to sophisticated adversarial attacks, including adaptive strategies specifically designed to bypass existing defenses. To address this vulnerability, we propose MirrorCheck, a robust and model-agnostic detection framework that operates effectively in both unimodal and multimodal settings. MirrorCheck leverages Text-to-Image (T2I) models to regenerate visual content from captions produced by the target model and assesses semantic consistency by comparing feature-space embeddings between the original and synthesized images. To enhance robustness against adaptive attacks, MirrorCheck introduces a stochastic defense strategy that randomly selects T2I generators and image encoders from a diverse model zoo. Additionally, we incorporate a novel One-Time-Use (OTU) perturbation applied to the selected encoder embeddings, regulated by a scaling factor, which decreases the effectiveness of adaptive attacks. Extensive experiments across multiple threat scenarios demonstrate that MirrorCheck consistently outperforms baseline methods, and maintains its utility even under strong adaptive adversarial conditions.

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

OneCanvas: 3D Scene Understanding via Panoramic Reprojection

Existing approaches to 3D scene understanding in Vision-Language Models (VLMs) either rely on complex, model-specific geometry encoders or large training budgets in pursuit of spatial reasoning. Instead, OneCanvas aggregates patch features from all views onto a single equirectangular panoramic canvas. Namely, each patch is unprojected to a 3D world coordinate using its depth and camera pose, then placed on the canvas at the continuous longitude and latitude of that point as seen from the canvas origin, with no rasterization or aggregation across overlapping views. A 3D position embedding of the patch's metric coordinates is added to its feature, restoring the depth lost when collapsing the world position to an angular canvas coordinate. Patches from all frames thus share one spatial coordinate system with no fusion or major architectural modifications of the backbone. The pretrained VLM consumes this representation as if it were an ordinary image. Because the canvas can be centered on any pose of interest, the same representation directly supports situated reasoning from a specific viewpoint, a common requirement in robotics and embodied AI. Thanks to this representation, we can also introduce a spatial pretraining curriculum: by procedurally placing patch features of objects, drawn from real images, at chosen 3D world positions on an otherwise empty canvas, we generate on-the-fly supervision spanning a broad range of spatial reasoning tasks, with answer distributions controlled to reduce spatial reasoning shortcuts. OneCanvas achieves state-of-the-art accuracy on SQA3D and VSI-Bench, and generalizes to out-of-distribution data on SPBench, using an order of magnitude less training compute than the strongest competing methods.

08.
medRxiv (Medicine) 2026-06-10

Frozen elephant trunk repair in heritable thoracic aortic disease: Impact of genetic aortopathy on long-term outcomes - A multicenter analysis

Aims This multicenter study aims to compare outcomes of total aortic arch replacement (TAR) using the frozen elephant trunk (FET) technique in patients with and without heritable thoracic aortic disease (HTAD) and to assess whether HTAD influences postprocedural adverse aortic events (AAEs). Methods From 06/2007 to 05/2024, aortic databases from 13 European centers were screened for HTAD patients undergoing TAR with FET. All consecutive dissection and aneurysm non-HTAD patients from the four core centers served as comparator. The primary outcome was AAE, a composite of diameter progression, distal stent graft induced new entry (dSINE), malperfusion, rupture and pseudoaneurysm at 5 years after FET implantation. Results Of 2739 FET patients, 196 (7.2%) were diagnosed with HTAD. The control group consisted of 867 non-HTAD FET patients. Marfan syndrome was the most common condition (72%), followed by Loeys-Dietz syndrome (11%), vascular Ehlers-Danlos syndrome (5.6%) and Turner syndrome (2.0%). Seventeen (8.8%) patients were diagnosed with ns-HTAD. At 5 years 46 (24%) AAEs occurred in the HTAD group, 169 (20%) in the non-HTAD group (p=0.2). Diameter progression was the most common event (10% vs. 12%; p=0.6), followed by dSINE (5.8% vs. 4.5%; p=0.5), malperfusion (4.2% vs. 3.3%; p=0.5), rupture (2.1% vs. 0.7%; p=0.09) and pseudoaneurysm (0.5% vs. 0.2%; p=0.5). Conclusions The FET technique appears safe and effective for acute and chronic aortic disease in HTAD patients, with outcomes comparable to non-HTAD cases and no increase in graft-related complications, challenging traditional concerns about stent graft use in genetically mediated aortic disease.

09.
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.

10.
bioRxiv (Bioinfo) 2026-06-12

The Geometry of Allostery: A Laplacian Minor Hierarchy for Many-Body Protein Communication

Quantifying how cooperative, many-body relationships drive allostery in protein networks remains a major challenge. To address this, we develop the Laplacian minor hierarchy, a mathematical framework that characterizes the geometric invariants of a protein network. Lower-order minors yield standard metrics including the partition function and effective distances, whereas higher-order minors define novel topological measures: cooperation indices, each bounded between zero and one, that characterize pathway correlations at increasing levels of complexity, the third-order minor determines whether allosteric pathways are correlated or uncorrelated, and the fourth-order minor quantifies how distinct pathways communicate through intermediary residues. We apply this framework to analyze the evolutionary adaptation of the PSD95pdz3 domain from Class I to Class II ligand specificity via mutations G330T and H372A. The cooperation index demonstrates a distinct evolutionary hierarchy: the G330T mutation establishes distributed pathway couplings that the H372A mutation subsequently exploits, whereas H372A alone produces minimal global changes. Furthermore, the fourth-order analysis identifies His317 as a critical intermediary node bridging the class-switching (330-372) and class-bridging (330-400) allosteric pathways. These results demonstrate that allosteric dependencies emerge only when mutations accumulate in specific combinations, with a hierarchical organization of pathways structured around position 330 and intermediary nodes His317 and Phe400. Rather than predicting allosteric mechanisms, this framework provides a mechanistic explanation for why and how allostery emerges during protein evolution.

11.
arXiv (CS.AI) 2026-06-12

Beyond Runtime Enforcement: Shield Synthesis as Defensibility Analysis for Adversarial Networks

arXiv:2606.13621v1 Announce Type: new Abstract: Shielded reinforcement learning is typically presented as a runtime safety mechanism that compiles temporal-logic specifications into automata restricting an agent's actions. We argue this is the wrong product. The same automata-theoretic machinery – specification compilation, product game construction, attractor computation, and winning-region extraction – is better read as a design-time analytical instrument whose outputs are structural insights about a system rather than runtime constraints on a deployed agent. We instantiate this through a constrained two-player safety game for network defense. The two specifications are enforced asymmetrically: the defender specification defines the unsafe region of the game, whereas the attacker specification restricts the adversary's legal actions during attractor computation. Solving the game yields a defensibility verdict – a formal certificate that a topology-specification pair is or is not defensible – with the associated winning region and shield. Beyond the binary verdict, we derive topology-level metrics from the attractor structure and combine them with post-convergence behavior from shield-constrained adversarial multi-agent reinforcement learning. Together these form a defensibility fingerprint capturing both a network's formal safety properties and its operational behavior under adaptive play. A what-if analysis shows that formal defensibility and operational effectiveness capture distinct aspects of security: small architectural changes can produce large shifts in operational outcomes while leaving formal safety margins nearly unchanged. Shield synthesis is thus most valuable not as a deployment mechanism for safe agents, but as a framework for answering architectural questions about whether, where, and how a system can be defended. The defensibility verdict is the output, not the safe policy.

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

Diffuse Interface Energies with Microscopic Heterogeneities II: Rare Events

arXiv:2606.17968v1 Announce Type: cross Abstract: We analyze Allen-Cahn functionals with stationary ergodic coefficients in the regime where the length scale $\delta$ of the heterogeneities is much smaller (microscopic) than the interface width $\epsilon$ (mesoscopic). In a companion paper, we show that if the ratio $\epsilon^{-1} \delta$ vanishes fast enough as $\epsilon \to 0$, then the functionals converge to an effective surface energy where the energy density is determined by homogenization effects originating at microscopic scales. Here we prove that if the ratio $\epsilon^{-1} \delta $ vanishes too slowly, the limit of the functional may actually be smaller than this homogenized energy. We refer to this as the rare events regime. In the case of the random checkerboard in dimension one, we use large deviations techniques to give a complete description of the rare events regime, showing that the limiting energy depends in a nontrivial way on the limit of $\epsilon^{-1} \delta | \log \epsilon |$. We further construct, in any dimension, examples of random media in which rare events become relevant at algebraic scales $\delta \approx \epsilon^{1 + \alpha}$ for an arbitrary $\alpha > 0$, as well as almost periodic examples in which atypical configurations play the same role as rare events.

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

DVD: Discrete Voxel Diffusion for 3D Generation and Editing

We introduce Discrete Voxel Diffusion (DVD), a discrete diffusion framework to generate, assess, and edit sparse voxels for SLat (Structured LATent) based 3D generative pipelines. Although discrete diffusion has not generally displaced continuous diffusion in image-like generation, we show that it can be an effective first-stage prior for sparse voxel scaffolds. By treating voxel occupancy as a native discrete variable, DVD avoids continuous-to-discrete thresholding and provides a simple framework for voxel generation, uncertainty estimation, and editing. Beyond quality gains, DVD provides more interpretable generation dynamics through explicit categorical modeling. Furthermore, we leverage the predictive entropy as a robust uncertainty metric to identify ambiguous voxel regions and complicated samples, facilitating tasks such as data filtering and quality assessment. Finally, we propose a lightweight fine-tuning strategy using block-structured perturbation patterns. This approach empowers the model to inpaint and edit voxels within a single sampling round, requiring negligible auxiliary computation and no additional model evaluations. Code is available at https://github.com/TeCai/DVD.

14.
arXiv (CS.LG) 2026-06-16

Semantic DLM+: Improving Diffusion Language Models through Bias-variance Trade-off in Transition Kernel Design

arXiv:2606.15327v1 Announce Type: new Abstract: Diffusion Language Models (DLMs) have demonstrated strong scaling capacity as alternatives to autoregressive language models. However, their performance is highly sensitive to the choice of transition kernels, and poorly designed kernels can lead to issues like training instability, slow convergence, and biased sampling. In this paper, we study this sensitivity through a principled analysis of generalization error and identify three critical factors: asymptotic bias (difficulty in approximating the posterior distribution), exposure bias (error propagation during sampling), and optimization variance induced by kernel dispersion. We further compare different transition kernels: masking diffusion yields sparse and easier posterior-approximation targets, while uniform diffusion provides stronger sampling-side repair but induces harder approximation. Motivated by this trade-off, we revisit a previously overlooked variant, semantic DLM (SemDLM), where the transition kernel corrupts tokens to neighborhoods that are semantically similar. Our theory suggests that SemDLM can serve as a plausible middle ground by reducing the posterior approximation difficulty of uniform diffusion while retaining repair ability. However, we find that SemDLM suffers from a semantic basin problem, where sampling repeatedly stays within a semantic region and produces low-diversity text. To address this, we propose SemDLM+, which adds a global transition and a semantic-frequency penalty during sampling. Experiments on LM1B and OpenWebText show that SemDLM+ improves training dynamics and achieves competitive language modeling and generation quality with satisfactory diversity.

15.
arXiv (CS.CL) 2026-06-12

C-QUERI: Congressional Questions, Exchanges, and Responses in Institutions Dataset

Questions in political interviews and hearings serve strategic purposes beyond information gathering including advancing partisan narratives and shaping public perceptions. However, these strategic aspects remain understudied due to the lack of large-scale datasets for studying such discourse. Congressional hearings provide an especially rich and tractable site for studying political questioning: Interactions are structured by formal rules, witnesses are obliged to respond, and members with different political affiliations are guaranteed opportunities to ask questions, enabling comparisons of behaviors across the political spectrum. We develop a pipeline to extract question-answer pairs from unstructured hearing transcripts and construct a novel dataset of committee hearings from the 108th–117th Congress. Our analysis reveals systematic differences in questioning strategies across parties, by showing the party affiliation of questioners can be predicted from their questions alone. Our dataset and methods not only advance the study of congressional politics, but also provide a general framework for analyzing question-answering across interview-like settings.

16.
bioRxiv (Bioinfo) 2026-06-15

SMS: Symmetric Mediation Statistics for Powerful High-Dimensional Mediation Analysis

Background: Mediation analysis of high-dimensional features, particularly molecular-level omics features, provides important opportunities to uncover biological mechanisms underlying human health and disease. However, two central statistical challenges remain: testing the composite-null hypothesis and maintaining power when the exposure-mediator and mediator-outcome associations differ substantially in statistical significance. Existing methods typically rely on accurate estimation of the proportions of the three null types or on the maximum of the two association p-values, and may not always control the FDR well and may have limited power under imbalanced significance. Methods: We propose SMS, a new statistical framework based on symmetric mediation statistics. By exploiting symmetry, SMS calibrates the composite null distribution as a whole for FDR control. It also allows flexible combinations of the two association p-values, including the maximum, and then enables construction of an omnibus test. Moreover, it permits direct use of effect-size estimates, bypassing the need to compute p-values. Results: SMS controlled the FDR across a wide range of simulation scenarios while achieving a substantial sensitivity gain, often around 20 percentage points, over existing methods including HDMT, DACT, and DEI-B. Applications to a metabolomics dataset and a DNA methylation dataset further corroborated these findings. Notably, SMS discovered five plausible mediators in the metabolomics dataset that were missed by all existing methods considered.

17.
arXiv (CS.LG) 2026-06-19

The Token Is a Group Element: On Lie-Algebra Attention over Matrix Lie Groups

arXiv:2606.20547v1 Announce Type: new Abstract: We place the attention token on the group: a token is an element $g_i$ of a matrix Lie group $G$ – a bare transformation, with no feature payload and no external action $\rho(g)$ carrying it. To our knowledge this is the first attention construction whose tokens are bare matrix Lie group elements: their score is the closed-form algebra norm of the relative pose rather than a learned kernel, and it reaches the affine full-frame groups that every irrep- or surjective-exp-based method must exclude. We call it Lie-Algebra Attention. Once tokens are group elements, the rest follows with none of the usual representation-theoretic machinery. The relative geometry of a pair is canonical, $g_i^{-1} g_j$, so the pairwise invariant $w_{ij} = \log(g_i^{-1} g_j)$ is intrinsic rather than designed; equivariance under the diagonal $G$-action is tautological, and the cocycle condition holds automatically. The attention score is the negative squared algebra norm, $s_{ij} = -\|\log(g_i^{-1} g_j)\|_\lambda^2/\tau$: the canonical proximity kernel under a block-weighted Frobenius inner product, with no irreducible representations, spherical harmonics, Clebsch-Gordan products, or learned kernel. The construction applies to any matrix Lie group on a chosen logarithm chart containing the relative poses, including the non-compact non-abelian affine groups with scale and shear that no vector-token attention method reaches: neither the irrep tradition nor surjective-exp methods. Three sequence-completion experiments, on SE(2), SO(3), and Aff(2), bear this out: the closed-form score matches a learned MLP kernel on the same invariant and outperforms it on SE(2), using 50 to 80x fewer score parameters, while a vector-token baseline breaks invariance by five to twelve orders of magnitude.

18.
medRxiv (Medicine) 2026-06-22

Sex-specific multimorbidity clusters and all-cause mortality in relatively healthy older adults: findings from the ASPREE cohort

Background: Multimorbidity is common in older adults, but sex differences in chronic condition clustering remain unclear. This study explored multimorbidity clusters and their associations with all-cause mortality among community-dwelling adults aged 70 years and over. Methods: This was a secondary analysis of data from 16,095 Australian ASPREE participants aged at least 70 years without prior dementia or cardiovascular disease. Fifteen baseline chronic conditions were grouped using latent class analysis (LCA). Observed-to-expected (O/E) ratios characterised conditions over-represented within clusters, and Cox proportional hazards models assessed associations with all-cause mortality. Results: Among 16,095 participants (mean age 74 years), 88.3% had multimorbidity at baseline; 4,217 deaths occurred over a median follow-up of 10.85 years. Five clusters were identified overall: hypertension and dyslipidemia (52.1%), gout and metabolic (14.4%), depressive symptoms, osteoporosis and frailty (10.0%), anaemia and kidney disease (10.2%), and hypotension, thyroid disorder and past cancer (13.3%). Sex-stratified analyses revealed three clusters in males and four in females. The frailty, depressive symptoms and osteoporosis cluster was associated with higher mortality in both sexes (aHR 1.56 [95% CI 1.40-1.73] in males; 1.68 [1.49-1.89] in females). Higher mortality was also observed for the metabolic, gout and kidney disease cluster in males (aHR 1.63 [1.47-1.81]) and the gout, anaemia and kidney disease cluster in females (aHR 1.96 [1.74-2.21]). Conclusions: Distinct multimorbidity clusters differed by sex and were associated with increased all-cause mortality. These findings may support risk stratification, targeted screening, and more person-centred management of older adults with multimorbidity.

19.
medRxiv (Medicine) 2026-06-16

Development of an automated, imaging-based preoperative screening model for early identification of malnutrition in an abdominal surgery cohort

Background: Clinical malnutrition affects one in five abdominal surgery patients and increases postoperative complications and mortality. Current screening occurs after admission, closing the window for preoperative nutritional intervention. No objective, scalable preoperative screening tool exists. Objective: To determine whether automated volumetric CT-based body composition analysis improves preoperative identification of surgical patients at risk for clinical malnutrition compared to clinical variables or single slice imaging alone. Methods: Retrospective cohort study of adults undergoing elective abdominal surgery at a quaternary academic medical center (2018 to 2021) with a preoperative CT scan within 90 days and complete nutrition assessment. Clinical malnutrition was diagnosed by a registered dietitian using ASPEN/AND criteria. Three sex stratified Elastic Net models were compared: (1) base clinical variables; (2) base plus L3 single slice skeletal muscle index and attenuation; and (3) base plus comprehensive 3D volumetric quantification of five muscle groups and two fat depots. Discrimination (AUROC), calibration (Brier score), and clinical utility (decision curve analysis) were assessed via 10-fold cross-validation. Results: Among 1,143 patients (52.4% female; mean age 60.5 years), 231 (20.2%) were diagnosed with malnutrition. Malnourished patients had significantly higher complication rates (36.4% vs. 15.4%, p

20.
bioRxiv (Bioinfo) 2026-06-11

STITCH links cellular morphology and gene expression in spatial transcriptomics

In situ spatial (ISS) sequencing can uncover co-variation between cellular morphology and gene expression in vivo. However, a principled and interpretable mathematical representation of morphology has not yet been applied in this context. In particular, current deep learning-based representations of cell images confound a cell's shape with its size. We present an interpretable representation of cellular boundary contours, based on tangent principal component analysis (TPCA) in a Kendall shape manifold, that captures size-independent contour shape features. This approach successfully recovers shape-perturbing genes in an RNAi screen than a previous metric geometry-based approach. We build on TPCA to develop STITCH (Shape-TranscriptomIc Correlation and Harmonization), an approach to reveal covariation between cell morphology with gene expression in ISS datasets. In a Xenium dataset, STITCH outperforms a deep learning-based approach in both recovering the layered organization of keratinocytes and a spatial gradient in nuclear eccentricity. Across samples in a melanoma CosMx dataset, STITCH reproducibly associates elongated and triangular fibroblasts with proximity to malignant cells and myofibroblast-like transcriptional program. Finally, STITCH independently recovers a known link between mesenchymal-like malignant cell states and increased cell area in two melanoma cohorts. STITCH can thus yield interpretable morphology-transcriptome relationships across cell types, patients, and spatial transcriptomics platforms.

21.
arXiv (CS.AI) 2026-06-18

Self-Evolving Multi-Agent Systems via Textual Backpropagation

arXiv:2506.09046v3 Announce Type: replace-cross Abstract: Leveraging multiple Large Language Models (LLMs) has proven effective for addressing complex, high-dimensional tasks, but current approaches often rely on static, manually engineered multi-agent configurations. To overcome these constraints, we present the Agentic Neural Network (ANN), a framework that conceptualizes multi-agent collaboration as a layered neural network architecture. In this design, each agent operates as a node, and each layer forms a cooperative team focused on a specific subtask. Our framework follows a two-phase optimization strategy: (1) Forward Phase - Drawing inspiration from neural network forward passes, tasks are dynamically decomposed into subtasks, and cooperative agent teams with suitable aggregation methods are constructed layer by layer. (2) Backward Phase - Mirroring backpropagation, we refine both global and local collaboration through iterative feedback, allowing agents to self-evolve their roles, prompts, and coordination. This neuro-symbolic approach enables our framework to create new or specialized agent teams post-training, delivering notable gains in accuracy and adaptability. Across seven benchmark datasets, our work surpasses leading multi-agent baselines under the same configurations, showing consistent performance improvements.

22.
arXiv (CS.LG) 2026-06-12

Out-of-Distribution (OOD) Detectors for Open-Set RF Fingerprinting

arXiv:2606.12718v1 Announce Type: new Abstract: Radio-frequency (RF) fingerprinting systems must operate in open-world environments where signals from unknown transmitters and temporal drift introduce distribution shift at test time. Out-of-distribution (OOD) detection provides a natural framework for this problem, yet its application to RF fingerprinting (RFF) remains limited. A key barrier to their adoption is that most OOD detectors require auxiliary OOD data for parameter tuning, an assumption that is difficult to satisfy in RF environments where representative OOD data is impractical to collect. In this work, we introduce a promising set of OOD detection methods from the machine learning literature to open-set RFF domain. We present these methods within a unified mathematical framework based on information theory, which is a natural framework for communication systems. Our framework allows for the systematic analysis of methods and development of new methods. We further demonstrate the applicability of recent work on tuning OOD detectors without given OOD tuning data for open-set RFF. We evaluate on the POWDER RF fingerprinting dataset, showing that detectors tuned without any given OOD data achieve performance comparable to baselines with access to true OOD tuning data and greatly out-perform baseline approaches without access to true OOD tuning data, showcasing the practical viability for the RFF problem.

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

Reducing the Complexity of Deep Learning Models for EEG Analysis on Wearable Devices

arXiv:2606.12742v1 Announce Type: new Abstract: Wearable healthcare devices are the fastest-growing Internet of Things (IoT) sector. Many automated healthcare services rely on two crucial biological signals, namely ECG and EEG, which reflect the activity of the heart and brain, respectively. Although deep neural networks are considered the primary way to process and analyze these signals, the very tight energy and computational power constraints in wearable devices are far below the computational, energy, and memory bandwidth demands of DNN models, thereby impeding the deployment of deep learning in many practical wearable services. This paper investigates the feasibility of deploying state-of-the-art DNN models in resource-constrained wearable devices. Notably, we explore the trade-off between accuracy and computational complexity of DNNs when parameter quantization and electrode reduction methods are used. Our investigation centers on several state-of-the-art DNN models designed for EEG signal analysis, specifically for detecting epileptic seizures. Our findings demonstrate that, when applied judiciously, these techniques can significantly reduce the complexity of the DNNs under consideration with minimal adverse effects on accuracy. These results reveal the explicit trade-offs between accuracy and complexity reduction encountered when adapting DNN-based online EEG analysis for wearable devices.

24.
arXiv (quant-ph) 2026-06-12

A Quantum Algorithm for Random Number Generation

arXiv:2606.13034v1 Announce Type: new Abstract: We present a quantum algorithm for random number generation that achieves a provable quadratic speedup over classical Markov chain mixing, building on the Diaconis-Shahshahani Fourier analysis of the top-to-random card shuffle. The algorithm integrates three quantum primitives into a unified mixing circuit: the Quantum Fourier Transform (QFT), which diagonalizes the Markov transition operator; controlled phase rotations, which encode the shuffle eigenvalue spectrum; and the Grover diffusion operator, which acts as a quantum analogue of the Aldous-Diaconis strong uniform stopping time by reflecting amplitudes about their mean at each iteration. For an n-qubit register, the mixing time is O(\sqrt{n \log n}) iterations. Extending to m qudits of local dimension d reduces this to O(\sqrt{\log_d N}) iterations, where N = d^m, compared to the classical O(n \log n) bound. The qudit formulation further reduces QFT circuit depth from O(\log^2 N) to O(\log_d^2 N) gates per layer by encoding the same N-state space using m = \log_d N subsystems instead of \log_2 N qubits. We validate both variants on IBM superconducting hardware.

25.
medRxiv (Medicine) 2026-06-10

A Heterogeneous Graph Neural Network Framework for Multi-Horizon Stroke Mortality Prediction

Background: Machine learning models for stroke mortality prediction typically treat each time horizon independently and use flat tabular features that ignore the relational structure of electronic health records (EHRs). In this pilot study, we leveraged graph-based machine learning models to predict post stroke all-cause-mortality across three different time horizons. Methods: We developed Stroke Temporal Heterogeneous Graph (StrokeTHG), a heterogeneous graph neural network model for simultaneous multi-horizon stroke mortality prediction (30-day, 90-day, 1-year) using EHR data from Penn State Health System. The model encodes various relations among EHR entities (e.g., patient, diagnosis, comorbidity) and temporal encoding of admission time to better predict stroke mortality. We compared our proposed approach against various baseline methods, including Logistic Regression, Random Forest, and XGBoost. We also performed ablation and subgroup analyses, evaluated the quality of learned graph embeddings, and assessed the importance of different edge types in the graph. Results: We included 4,144 stroke patients (mean age 69.2 years; 54.3% men), of whom 3,332 (80.4%) survived their stroke after one year. 30-day, 90-day, and 1-year mortality rates were 9.7%, 13.7%, and 19.6%, respectively. Our proposed approach, StrokeTHG, achieved AUROC of 0.872, 0.878, and 0.837 across horizons, outperforming all tabular baselines. At [≥] , 75% specificity, the model identified 5-10 percentage points more mortality cases than the best baseline at each horizon. Subgroup analysis demonstrated consistent performance across sex subgroups and the largest discriminative gains in the Age 65-80 stratum. Edge-type ablation identified phenotype-patient and admission-patient edges in the constructed EHR graph as the most influential relational edges for mortality prediction. StrokeTHG embeddings outperformed all graph and matrix factorization baselines under an identical downstream classifier, confirming that performance gains stem from representation quality rather than classifier capacity. Conclusions: StrokeTHG demonstrates that heterogeneous graph representations of EHR data provide a consistent improvement over flat tabular models for multi-horizon stroke mortality prediction, with particular advantage at clinically actionable sensitivity thresholds and novel multi-horizon monotonic prediction capability. This methodological framework may be adaptable to other EHR-based clinical research studies seeking to leverage heterogeneous relational structures for predictive modeling.