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01.
medRxiv (Medicine) 2026-06-17

County Year Informatics Model for Annual and Cumulative Unique Lung Cancer Screening Eligibility in Maryland, 2026 to 2045

Purpose: Population-level lung cancer screening programs require denominators that reflect age, smoking history, geography, and changing eligibility over time. We estimated annual prevalent and 20-year cumulative unique low-dose computed tomography screening eligibility for Maryland residents under alternative screening criteria. Methods: We built a deterministic cohort-cell stock-flow simulation using Maryland county-equivalent jurisdiction projections by age, sex, and race/ethnicity, with ACS socioeconomic/nativity covariates and smoking-history priors for ever-smoked status, pack-years, and quit-years. Scenarios included USPSTF 2013 legacy, USPSTF 2021, ACS 2023/2024, a risk-model-expanded sensitivity, and ever-smoked-only capacity stress tests. Cumulative unique eligibility counted people once at first eligibility rather than summing annual prevalent person-years. Results: Under USPSTF 2021, an estimated 238,346 Maryland residents were eligible in 2026 and 245,326 in 2045. The 20-year cumulative unique denominator was 768,668, whereas naively summing annual prevalent counts produced 4,850,735 person-years, a 6.31-fold overcount. ACS 2023/2024 expanded annual eligibility to 314,616 in 2026 and cumulative unique eligibility to 902,796 by adding remote former smokers. Ever-smoked-only adult eligibility was 1,957,699 in 2026 and 3,383,683 cumulative unique over 20 years. Conclusion: A Maryland statewide screening initiative should plan from cumulative unique eligibility and county-equivalent jurisdiction-specific burden rather than annual prevalence alone. Explicit pack-year and quit-year modeling materially changes statewide and county allocation compared with current-smoking proxy models.

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

Traits Run Deeper: Trait-Specific Asymmetric Fusion for Personality Assessment

Personality assessment aims to infer stable personality traits from dynamic behaviors across language, voice, and facial cues. Since different personality dimensions are revealed through distinct behavioral perspectives, modeling trait-specific evidence is challenging. However, most existing approaches adopt a uniform multimodal fusion strategy across all dimensions, assuming identical modality contributions. This overlooks trait-specific modality preferences and introduces cross-modal interference. To address this issue, we propose a novel personality assessment framework called Traits Run Deeper, which consists of three components. Specifically, the Multimodal Foundation Representation (MFR) module constructs personality-oriented multimodal inputs and leverages psychology-informed semantic templates as anchors, enabling foundation models to capture trait-relevant information. Building upon MFR, the Trait-Specific Modality Fusion (TSMF) module acts as an asymmetric fusion mechanism, allowing each dimension to selectively exploit different modality pathways from modality-specific modeling to complementary fusion. Thus, TSMF captures heterogeneous modality preferences while reducing cross-modal contamination. Furthermore, the Distribution-Calibrated Personality Regression (DCPR) module mitigates label imbalance and central tendency bias through target distribution calibration, improving robustness and stability. Experimental results on the AVI Challenge 2026 validation set demonstrate the effectiveness of the proposed framework, reducing mean squared error (MSE) by approximately 25% compared with the baseline. Consistent improvements are observed on the official test set, where our method achieves the best performance and ranks first in the Personality Assessment Track. The source code will be made available at https://github.com/MSA-LMC/AVI2026.

03.
medRxiv (Medicine) 2026-06-12

Effect of tenofovir on the outcomes of COVID-19 in persons with chronic hepatitis B: a nationwide cohort study in Sweden.

Background: Patients with chronic hepatitis B (CHB) may have an increased risk of severe COVID-19. Tenofovir has been hypothesized to confer protection against severe disease, but evidence is inconclusive. We evaluated the risk of severe COVID-19 among CHB patients treated with tenofovir compared with other nucleos(t)ide analogues (NAs). Methods and findings: In this nationwide, registry-based cohort study, we included all adults with CHB and laboratory-confirmed COVID-19 in Sweden between February 2020 and July 2022. Data from national health and socioeconomic registers were linked using unique personal identification numbers (PINs). Patients with HIV, hepatitis C, or hepatitis D coinfection were excluded. Exposure was defined as tenofovir versus other NA therapy. The primary outcome was severe COVID-19, defined as hospitalization >2 days or death within 30 days of diagnosis. Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI), controlling for age, sex, comorbidities, vaccination, socioeconomic status, and region of birth. Among 5,877 CHB patients with COVID-19, 672 were receiving NA therapy (437 tenofovir, 235 other NAs). Severe COVID-19 occurred in 8.0% of tenofovir-treated patients and 14.5% of those receiving other NAs (unadjusted OR 0.52; 95% CI, 0.31-0.85). After adjustment, the association was attenuated and no longer significant (aOR 0.72; 95% CI, 0.39-1.31). Older age, comorbidities, and unvaccinated status were strongly associated with severe disease. Conclusions: The apparent protective effect of tenofovir against severe COVID-19 in unadjusted analyses was largely explained by confounding factors. The risk of severe disease was primarily driven by age, comorbidities, and vaccination status. Prevention of severe COVID-19 in patients with CHB should instead focus on vaccination and management of comorbidities.

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

Application and quantum properties of superpositions of oppositely squeezed states

arXiv:2511.03204v2 Announce Type: replace Abstract: We show that superpositions of oppositely squeezed states – non-Gaussian Schr{\"{o}}dinger-cat-like states – exhibit enhanced nonclassical features and provide an entanglement advantage in the small-squeezing regime. These states possess photon-number structures distinct from conventional coherent-state cat states, and we analyze their Wigner functions and the entanglement generated when they are injected into a 50-50 beam splitter. As a practical application, we demonstrate that they enable a high-quality heralded single-photon source whose second-order intensity correlation function is smaller than that obtained from a pure two-mode squeezed vacuum state. We further propose a linear-optical heralding scheme that approximates these superpositions without requiring strong Kerr nonlinearities. Our results indicate that the superposition of oppositely squeezed states is a promising non-Gaussian resource for quantum information processing, particularly for single-photon generation.

05.
arXiv (quant-ph) 2026-06-16

Quantum enhancement and Doppler suppression of Kasevich-Chu atom interferometer with motional squeezing states

arXiv:2606.16632v1 Announce Type: new Abstract: Hybridization of internal and external atomic degrees of freedom in a Kasevich-Chu interferometer enables the possibility to enhance the sensitivity significantly even under quantum-standard limit. By introducing motional squeezing state as an input, we systematically derive the computational framework of quantum and classical Fisher information of two measurement protocols for arbitrary strength of Doppler effects. Through maximizing the corresponding classical Fisher information, we obtain the optimal control parameters and the corresponding quantum Fisher information. For population measurement, the largest sensitivity can be as large as four times than the semi-classical limit through enlarging the atom coherence length. For joint measurement of population and position, the competition between quantum enhancement and Doppler suppression induces two three behaviors, in one regime, the quantum enhancement dominates even in presence of strong Doppler broadening effects where the sensitivity is significantly enhanced; while in another regime, an optimal squeezing parameter is observed where the classical Fisher information reaches the maximum. Our results clearly demonstrate the robustness of external quantum enhancement against Doppler suppression. Our proposal can be readily applied to gravimeter of mobile platform where decoherence from noise will damage the many-body entanglement of internal spin squeezing.

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

C2FL: Clustered Continual Federated Learning under Spatial and Temporal Drift

arXiv:2606.18003v1 Announce Type: cross Abstract: Collective Adaptive Systems (CAS) increasingly rely on machine learning to let each node learn from locally sensed data, aligning its behavior with the surrounding environment. Scaling this intelligence, however, raises fundamental challenges: sensed data is often privacy-sensitive, preventing centralized collection; nodes are mobile, traversing regions where nearby nodes perceive similar phenomena while distant ones observe radically different conditions, creating natural spatial clusters; and these distributions evolve over time due to mobility, introducing temporal drift that makes local models progressively stale. These dynamics arise across domains - vehicular sensing, drone-based monitoring, smartphone crowdsensing - yet the interplay of privacy, spatial heterogeneity, and temporal drift severely undermines conventional learning strategies. Therefore, we propose C2FL, a fully distributed Federated Learning (FL) approach where nodes self-organize into learning groups through spatial clustering, reflecting the geographic structure of the environment. To counteract temporal drift, each node combines experience replay with a dwell-time-aware adaptive averaging step, progressively incorporating the regional consensus as it remains longer within the same area, while preserving previously acquired knowledge under evolving distributions. We evaluate our approach on synthetic experiments that systematically reproduce spatial and temporal shifts, showing that standard federated strategies degrade significantly under these conditions and that our method restores robust collective adaptation.

07.
medRxiv (Medicine) 2026-06-15

Modelling the public-health impact of indoor air quality interventions on respiratory virus transmission

Respiratory virus transmission occurs in indoor settings where ventilation, occupancy, and dwell time determine exposure levels. Improving indoor air quality (IAQ) therefore could help reduce disease burden associated with respiratory viruses, yet its population-level impact remains poorly quantified. Here, we develop an individual-based transmission modelling framework that links within-location airborne dynamics to individual infection risk and population-level spread, whilst explicitly incorporating heterogeneity in ventilation and baseline indoor air quality across locations. We use this modelling approach to evaluate IAQ-improving interventions (air-quality interventions or AQIs), using hypothetical endemic and pandemic pathogen archetypes with properties similar to SARS-CoV-2 and influenza, and evaluate how effects on key epidemiological metrics (such as annualized incidence and epidemic final size) depend on AQI coverage, efficacy and allocation strategy. At 20% AQI intervention coverage and 80% efficacy, annualized incidence was reduced by approximately 7.2% for an endemic 'SARS-CoV-2-like' respiratory virus, and 17.0% for an endemic 'influenza-like' virus; at 60% coverage (80% efficacy) the reductions were 26.3% and 56.4%, respectively. Targeting AQI installation to the highest-risk locations outperformed random allocation: for SARS-CoV-2-like transmission, 20% coverage at 80% efficacy cut absolute incidence by 10.8% when targeted versus 7.2% when random; for influenza-like transmission, this comparison was 28.9% versus 17.0%. In epidemic scenarios, random installation at 40% coverage and 60% efficacy reduced final size by 23.7% (influenza-like) versus 6.3% (SARS-CoV-2-like). These results support treating clean indoor air as core public-health infrastructure and prioritising risk-based deployment of IAQ-improving interventions to maximise population-level benefit within budgetary and operational constraints.

08.
arXiv (CS.LG) 2026-06-12

A Unified Latent Space Disentanglement VAE Framework with Robust Disentanglement Effectiveness Evaluation

arXiv:2603.11242v2 Announce Type: replace-cross Abstract: Evaluating and interpreting latent representations, such as variational autoencoders (VAEs), remains a significant challenge for diverse data types, especially when ground-truth generative factors are unknown. To address this, we unify several state-of-the-art disentangled VAE approaches for latent space disentanglement into one framework – bfVAE. To assess the effectiveness of a disentangled VAE model and enhance latent space interpretability, we propose Feature Variance Heterogeneity via Latent Traversal (FVH-LT) and Dirty Block Sparse Regression in Latent Space (DBSR-LS). To ensure robust interpretability of learned latent space, we develop a greedy alignment strategy (GAS) that mitigates label switching and aligns latent dimensions across runs to set the foundation of result aggregation. We also introduce a convenient scalar latent space separation index (LSSI) based on the GAS-aligned outputs of FVH-LT and DBSR-LS to summarize the overall latent structural separation without knowledge of the ground-truth generative factors. We compare bfVAE to five VAE models and validate the effectiveness FVH-LT, DBSR-LS, and LSSI in on seven tabular and image datasets. Under our examined experimental settings, bfVAE provides a more flexible disentanglement framework achieves more favorable overall trade-off between disentanglement and reconstruction than the benchmark VAE models; FVH-LT and DBSR-LS reliably uncover semantically meaningful and domain-relevant latent structures and generally yield consistent results; and LSSI makes an effective quantitative summary of latent structural separation.

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

GASE: Gaussian Splatting-Based Automated System for Reconstructing Embodied-Simulation Environments

Training embodied agents in the real world requires skilled operators and expensive hardware. Simulation environments offer a compelling alternative by enabling large-scale, cost-effective data augmentation. Consequently, rapidly constructing high-fidelity simulation scenes with a minimal sim-to-real gap has become a critical objective in robot learning. While reconstruction-based methods provide superior visual quality, current workflows are hindered by inefficient data acquisition and subpar foreground object extraction. We thus propose GASE, a highly automated system for simulation scene construction. GASE leverages multi-view video streams from panoramic camera arrays to enable rapid environment scanning. To ensure high-quality asset generation, our pipeline introduces a camera-pose-based strategy that robustly extracts objects across frames in the 2D domain, followed by high-fidelity scene inpainting. Foreground objects and the static background are then reconstructed independently and seamlessly imported into physics simulators for policy training. Extensive experiments demonstrate that GASE outperforms existing 3D Gaussian-based methods in segmentation accuracy by over 10\% while achieving state-of-the-art inpainting quality. Furthermore, real-robot deployments across manipulation and navigation tasks maintains a performance gap of less than 10\% compared to policies trained purely on real-world data. These results confirm that GASE provides an efficient and highly effective solution for bridging the sim-to-real gap. Code will be released.

10.
arXiv (math.PR) 2026-06-16

Effective Resistances and Commute Times in Sparse Random Geometric Graphs

arXiv:2606.14895v1 Announce Type: new Abstract: The commute time between two nodes in a network - the expected number of steps for a random walk to travel from one node to the other and then return - is a metric of broad importance arising in community detection, network routing, dimensionality reduction, and diffusion modeling. For random geometric graphs (RGGs), in which nodes are placed at random in a spatial domain and connected pairwise wherever their Euclidean distance is below a threshold radius, the relationship between commute times and the embedding geometry remains poorly understood outside very dense settings (where the role of the geometry disappears and commute times degenerate to a sum of inverse degrees). We develop and numerically validate a model for approximating commute times in sparse RGGs on a torus by combining theoretically motivated geometric contributions with an inverse degree sum. The geometric terms include a universal logarithmic contribution from the Laplacian, a quadratic correction encoding the compact topology of the torus, and a quartic angular term reflecting the square anisotropy of the domain. We fit this model to samples of node pairs across a range of graph sizes and mean degrees, demonstrating good predictive performance and that the geometric terms contribute significantly to model fit. We then study the continuous perturbation of the model from a regular square lattice to a fully random geometric graph, further validating the functional model form through this transition and showing how commute times in sparse RGGs retain meaningful geometric information about the embedding space.

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

Beyond Benchmarks: Continuous Edge Inference for Fine-Grained Roadside Perception

Continuous AI inference on resource-constrained edge hardware introduces deployment effects that are largely invisible to conventional benchmark evaluation, including temporal instability in streaming video, thermal throttling under sustained load, and workload-dependent performance variability. We present Edge-TSR, a deployment-oriented continuous edge inference system for sustained roadside perception on the NVIDIA Jetson Orin Nano. Edge-TSR integrates detection, tracking, fine-grained classification, and a lightweight track-aware temporal stabilization mechanism that improves streaming inference consistency with negligible computational overhead. Our central finding is that benchmark-centric evaluation systematically overstates deployed edge inference performance. Across three state-of-the-art baselines, we observe consistent 20-30% relative degradation when transitioning from static-image evaluation to real-world streaming deployment. Edge-TSR addresses this gap through temporal inference stabilization, recovering up to 10.16% classification accuracy over per-frame inference baselines while maintaining sustained real-time performance under continuous operation. We evaluate the complete system under diverse real-world deployment conditions, jointly characterizing inference quality, latency, throughput, and thermal behavior during long-duration operation. A 55-minute vehicular deployment over a 26 km route demonstrates sustained operation at 16.18 FPS within safe thermal limits on a single embedded device without cloud offload. Our findings show that deployment-aware evaluation and temporal inference stabilization are necessary components of continuously operating edge AI systems intended for real-world sensing deployments. We release a sample annotated streaming video evaluation dataset and full system implementation to support reproducible deployment-centric evaluation.

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

A Controlled Study of Decoding-Time Truthfulness Methods on Instruction-Tuned LLMs

作者:

In this work, we introduce CHAIR (Classifier of Hallucination As ImproveR), a supervised framework for detecting hallucinations by analyzing internal logits from each layer of every token. Our method extracts a compact set of features such as maximum, minimum, mean, standard deviation, and slope-from the token logits across all layers, enabling effective hallucination detection without overfitting. Experiments on TruthfulQA and MMLU datasets demonstrate that CHAIR significantly improves detection accuracy, particularly in zero-shot scenarios, showcasing its robustness and generalizability. Beyond hallucination detection, CHAIR highlights the potential of using internal representations for designing advanced decoding strategies. By leveraging patterns in logits, we suggest that more sophisticated models and adaptive decoding methods could further reduce hallucinations and enhance text completion quality. CHAIR not only offers a practical solution for detecting hallucinations but also lays the groundwork for exploring richer representations in LLMs to improve their factuality and coherence.

13.
Nature Medicine 2026-06-22

Biological aging and generational shifts in early-onset cancer risk

作者:

Incidence of early-onset cancer is rising globally in recent generations, which underscores the need to elucidate the influence of emerging generational risk factors. Systemic and organ-specific aging reflects the cumulative impact of exposures and may provide an integrative and complementary approach to understand early-onset cancer risk. Here among 154,169 young adults from the United Kingdom Biobank, systemic aging measured by PhenoAge increased across birth cohorts, with 23% s.d. increase for those born 1965–1974 versus 1950–1954, and was associated with early-onset solid cancer risk (hazard ratio (HR)per s.d. 1.08; 95% confidence interval (CI), 1.03–1.13), driven by lung, gastrointestinal and uterine cancers, independent of genetic risks of aging and cancer. Patterns were consistent using alternative systemic aging measures, including the Klemera–Doubal method-defined age gap and metabolomic-based age gap. These findings were validated partially among 10,262 participants in the United States All of Us Research Program. Proteomics-based organ-specific aging analyses linked immune aging with early-onset lung cancer (HRper s.d. 1.89; CI, 1.20–2.97) and adipose tissue aging to early-onset colorectal cancer (HR 1.60; CI, 1.11–2.32). Greater age gap, reflecting more advanced biological aging relative to chronological age, may serve as a driver associated with risk of early-onset solid cancers, highlighting the importance of uncovering underlying mechanisms to guide effective prevention strategies. Analyses of population cohorts found that young adults exhibited earlier systemic and organ-specific aging, which was associated with increased risk of early-onset cancer compared with older adults born decades earlier.

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

Exploring Multi-Modal Large Language Models and Two-Stage Fine-Tuning for Fashion Image Retrieval

Composed image retrieval retrieves a target image using a composed query of a reference image and a modified text description. In the fashion domain, this task requires understanding subtle attribute variations such as color, pattern, and texture. However, existing approaches face limitations due to scarce annotated data and simplistic negative sampling. We propose a novel framework that integrates a multi-modal large language model (LLaVA) to generate attribute-aware triplets and introduces a two-stage fine-tuning strategy to enhance contrastive learning. We leverage pretrained vision-language models, such as CLIP-ViT/B32, to generate and concatenate sentence-level prompts with the relative caption and to scale the number of negatives using static representations. Experimental results demonstrate enhanced compositional reasoning and improved fine-grained retrieval behavior, underscoring the feasibility and potential of the proposed framework for fashion retrieval.

15.
arXiv (CS.CL) 2026-06-19

From 50K to 8.2 Million in 24 Hours: Vozinha's Algorithmic Consecration and the Multilingual Making of World Cup Visibility

We present a multilingual computational discourse analysis of how language constructed the algorithmic consecration of Vozinha, the 40-year-old Cape Verde goalkeeper, after Spain 0-0 Cape Verde at the 2026 FIFA World Cup. The study contributes a multilingual corpus in Portuguese, Spanish, English, and French; a nine-frame narrative taxonomy with cue-based frame annotation; a reproducible annotation pipeline combining LLM-assisted suggestion with human validation; and an analysis of cross-lingual narrative diffusion across discourse phases. We treat the platform follower count itself, narrated as "50k to 8M", as a linguistic object: a circulating and narratable proof of visibility rather than a mere measurement. The follower-growth timeline is used only as contextual metadata: we reconstruct a conservative phase structure, not a continuous API-native series, and type every datapoint by value class, confidence, and evidence type. The only exact primary scraper anchor is 8,235,652 followers at 2026-06-16 15:47 UTC; all other figures are reported as estimated ranges or thresholds, including an estimated pre-match baseline of 45k-56k. Findings suggest that distinct languages carried distinct frames: Portuguese mobilization, Spanish crisis, English nation-making, and a shared platform-metric spectacle through which peripheral athletic performance became globally visible. As a v0.1 pilot, the paper releases the corpus schema, frame taxonomy, annotation guidelines, hashed visual-evidence log, and typed timeline, while flagging full double annotation and inter-annotator agreement as planned work.

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

ProductConsistency: Improving Product Identity Preservation in Instruction-Based Image Editing via SFT and RL

Recent advances in instruction-based image editing have enabled models to perform complex visual edits from natural language instructions. However, in product-centric scenarios where preserving product features, branding, and textual elements are critical, current open and closed source models often struggle to maintain this fine-grained object identity. This issue is further compounded by the lack of datasets for instruction-based product image editing with text fidelity constraints, leaving it largely treated as an implicit capability of instruction-based image editing models. In this work, we introduce the ProductConsistency dataset which is designed to improve product-centric image editing. Our approach includes a supervised fine-tuning (SFT) dataset of 87k samples for product editing, a reinforcement learning (RL) dataset with 869 unique product images, and a new benchmark dataset, the ProductConsistency Benchmark, to allow rigorous and standardized evaluation of editing models. To guide RL training, we propose a Cyclic Consistency reward that enforces semantic preservation of product identity by using caption similarity between the original product description and captions generated from the edited image. We fine-tune both Qwen-Image-Edit-2511 and Flux.1-Kontext-dev using our dataset and demonstrate consistent improvements over baseline models in OCR and Perceptual metrics, and MLLM-based evaluations as well, indicating stronger product consistency, text rendering, and overall visual quality; with the Qwen-Image-Edit-2511 model achieving a 5x reduction in the character error rate. The code and pipeline is available at https://anonymous.4open.science/r/ProductConsistency-6FCC/README.md

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

CAF-Gen: A Multi-Agent System for Enriching Argumentation Structures

Formalizing complex reasoning from natural text is one of the central challenges in computational linguistics. It requires systems to understand not just keywords but also the context and complex reasoning embedded in a text. Current Argument Mining (AM) techniques identify basic claims and premises, yet they often struggle to capture the richer structural information required by advanced schemas such as the Carneades Argumentation Framework (CAF), which incorporates features such as premise types, proof standards, and argument schemes. We address this limitation by introducing CAF-Gen, an automated multi-agent framework designed to enrich shallow argument structures into CAF-compliant argument models. By employing an iterative Creator-Reviewer pipeline, a creator agent's output is validated by a critical agent to ensure structural integrity. This multi-agent collaboration is crucial for mitigating the structural instability typical of single-pass generative models. Our experiments demonstrate that the iterative feedback loop improves the quality of the resulting data and achieves strong alignment with the original annotations, while producing structurally richer models. Our findings show that the multi-agent system can overcome the limitations of single-pass generation, providing a robust methodology for the automated modeling of formal argumentation.

18.
arXiv (CS.LG) 2026-06-17

Geodesic Calculus on Implicitly Defined Latent Manifolds

arXiv:2510.09468v3 Announce Type: replace Abstract: Latent manifolds of autoencoders provide low-dimensional representations of data, which can be studied from a geometric perspective. We propose to describe these latent manifolds as implicit submanifolds of some ambient latent space. Based on this, we develop tools for a discrete Riemannian calculus approximating classical geometric operators. These tools are robust against inaccuracies of the implicit representation often occurring in practical examples. To obtain a suitable implicit representation, we propose to learn an approximate projection onto the latent manifold by minimizing a denoising objective. This approach is independent of the underlying autoencoder and supports the use of different Riemannian geometries on the latent manifolds. The framework in particular enables the computation of geodesic paths connecting given end points and shooting geodesics via the Riemannian exponential maps on latent manifolds. We evaluate our approach on various autoencoders trained on synthetic and real data.

19.
medRxiv (Medicine) 2026-06-15

A More-Than-Human Approach to Designing for Mental Health: Remixing Prototypes for the Contexts of Complex Healthcare Infrastructures

Digital mental health tools (DMHTs) often fail to be successfully implemented in clinical settings. While user- and human-centred design frameworks are frequently proposed for developing effective tools, they are insufficient to address the sociotechnical complexity of healthcare environments. This paper addresses this limitation by detailing the application of a more-than-human design framework to incorporate wider contextual factors into design decisions. To demonstrate the application of this more-than-human design framework, we present a case study showcasing the design of one specific feature within a DMHT intended to support Health Improvement Practitioners (HIPs) in New Zealand's Integrated Primary Mental Health and Addictions (IPMHA) service. Our process blends usage-context storyboards with interface prototypes, using think-aloud interviews to test the contextual fit of our prototypes. The initial design concept failed due to contextual factors such as inconsistent wait times and the administrative burden on clients and clinic staff. This led to a pivot to a more context-appropriate, practitioner-focused, in-session concept for digital psychometric administration and automated scoring. This case study demonstrates that for DMHTs to be viable within complex healthcare environments, design must focus on more than the needs of a single user, incorporating multiple stakeholders and contextual variables across the wider service-delivery context.

20.
medRxiv (Medicine) 2026-06-12

Home-based binocular serious games in virtual reality to treat visual acuity and stereovision in residual amblyopia: AMBER study

Objectives: Amblyopia is a pediatric visual disorder traditionally treated by patching the fellow eye, though many patients retain residual amblyopia post-treatment. Increasing evidence suggests that visual plasticity allows treat-ment beyond the classical therapeutic window. AMBER evaluated the efficacy of binocular serious games in virtual reality (VR) in residual amblyopia. Methods and Analysis: The monocentric, prospective, randomized, crossover trial (reported as case series) includ-ed 14 anisometropic, strabismic, or mixed residual amblyopia patients (6-35 years; 5 children, 9 adults). Participants underwent two 2-month intervention phases: optical correction (standard care) and standard care plus VR games (2.5 h/week), each with a 2-month follow-up. Best-corrected visual acuity (BCVA), stereoacuity, and reading speed were assessed (5 timepoints) using the Sloan and Landolt charts, the Titmus, TNO, Lang II, Asteroid, and Mnread tests. Compliance and adverse events (AE) were recorded. Results: VR training improved BCVA in 10 amblyopic eyes (Landolt and Sloan), with more pronounced effects in anisometropic patients. Six patients showed improved stereoacuity (Titmus; 4x mixed, 1x anisometropic, 1x stra-bismic amblyopia), persistent only in children (1x strabismic, 1x mixed amblyopia). Four improvements were ob-served with TNO (1x), Lang II (1x), Asteroid (0x), and MNread (1x). Despite positive trends, when comparing re-sults of individual patients, between both eyes, and with standard treatment, consistency of improvements cannot be conclusively demonstrated. One non-severe AE (dizziness) was reported. Conclusions: Following individual cases, VR training improved BCVA and stereoacuity, particularly in children and patients with high compliance. However, considering the cohort as a whole, consistency of effects has to be confirmed in larger groups. Thus, the methodologically sophisticated AMBER study revealed differences in VR treatment efficacy between amblyopia types, children/adults, endpoints and tests, offering precious data for the design of meaningful future studies. It shows that neurovisual plasticity gauged by VR-games offers safe, engaging treatment options for residual amblyopia.

21.
arXiv (CS.CL) 2026-06-11

Measuring Semantic Progress in Multi-turn Dialogue via Information Gain

Evaluating multi-turn dialogue is challenging because quality emerges across turns rather than within individual responses. We focus on a key dimension of information-seeking dialogue: semantic progress, defined as the accumulation of new, question-relevant, and non-redundant information over the course of a conversation. We formalize semantic progress as question-conditioned uncertainty reduction and introduce an information-theoretic metric that approximates it in embedding space. Our main estimator uses a tractable Gaussian formulation with closed-form updates, while a complementary maximum-entropy argument shows why log-determinant structure arises more broadly when only second-order embedding information is retained. This formulation yields desirable theoretical properties, including monotonicity, additive decomposition of total information gain across turns, and diminishing returns for redundant evidence. Unlike LLM-as-a-judge approaches, our metric requires no autoregressive inference at evaluation time and is fully reproducible for a fixed embedding model. Experiments on MT-Bench, Chatbot Arena, and UltraFeedback show that the proposed metric achieves competitive agreement with human judgments despite targeting only semantic progress, with improved alignment on MT-Bench and UltraFeedback compared to several LLM-based judges. Notably, the method remains effective with lightweight embedding models under CPU-only execution, indicating that semantic progress can be captured without reliance on large model capacity.

22.
arXiv (CS.CL) 2026-06-16

A Survey on Agentic Security: Applications, Threats and Defenses

LLM-based agents are now used throughout cybersecurity. While these agents facilitate powerful and autonomous security applications, their autonomy opens up new attack surfaces, and the security community is actively building defenses to secure them. Yet the literature on this subject has grown quickly and unevenly. Existing surveys treat applications, threats, and defenses in isolation, leaving no unified account of how an agent's capabilities, vulnerabilities, and countermeasures interconnect. In this work we present the first holistic survey of the agentic security landscape, structuring the field around the fundamental pillars of Applications, Threats and Defenses. We provide a comprehensive taxonomy of over 260 papers, explaining how agents are used in downstream cybersecurity applications, inherent threats to agentic systems, and countermeasures designed to protect them. In addition, we provide detailed pillar-specific and cross-cutting analyses that show the security-lifecycle coverage of agentic applications, comparison between red-teaming and blue-teaming agents, and the adversarial use of red-teaming applications. On the threat side, we analyze the entry points and agent-loop stages that attacks target, their specificity to the agentic setting, and the threat models they assume. On the defense side, we analyze the prevailing defense strategies, their cost and security trade-offs, and where in the agent lifecycle they are deployed. We further map which defenses cover which attack classes and chart trends in agent architecture, backbone model usage, data modality coverage, and the growth of attack and defense research over time. Taken together, these findings indicate that agentic systems are structurally fragile by default and that securing them will require defenses that span the full agent lifecycle rather than single-layer fixes.

23.
arXiv (CS.CL) 2026-06-19

PsyScore: A Psychometrically-Aware Framework for Trait-Adaptive Essay Scoring and ZPD-Scaffolded Feedback

Effective Automated Essay Scoring (AES) are expected to support both reliable assessment and actionable instructional feedback. However, existing approaches often treat scoring and feedback as separate components: neural scoring models provide limited interpretability, while Large Language Model (LLM)-based feedback is typically insensitive to learners proficiency levels. To address this fragmentation, this work proposes PsyScore, a psychometrically-aware framework that integrates diagnostic assessment with instructional scaffolding through a shared latent ability representation. PsyScore comprises three key modules: a Trait-Adaptive Neural IRT Scorer that incorporates the Graded Partial Credit Model (GPCM) into a neural architecture, enabling the precise estimation of student ability while maintaining psychometric interpretability, a ZPD-Scaffolded Feedback Generator, which conditions multi-agent feedback strategies on the diagnosed ability parameter to adapt instructional focus across different proficiency levels, and a Multi-Perspective Feedback Evaluation Strategy that assesses feedback quality via pairwise preference judgements and student revision simulations. Experiments on the ASAP++ dataset demonstrate that PsyScore achieves competitive scoring performance while providing more pedagogically aligned feedback.

24.
arXiv (CS.CL) 2026-06-15

Multi-component Causal Tracing in Large Language Models

Causal tracing systematically intervenes on a large language model's (LLM's) internal representations to uncover and quantify the causal pathways linking specific inputs or computations to specific metrics of interest, quantifying the LLM's behavior. Building on previous single-component or single-layer studies, this paper presents a unified framework for causally tracing multiple components simultaneously. This framework systematically identifies the subsets of components (e.g., attention heads and multi-layer perceptron neurons) most critical to a desired target performance metric (e.g., accuracy and fairness). This is achieved by incorporating flexible interventions applied to a wide range of desired metrics. To address the combinatorial complexity of the multi-component problem, an efficient algorithm is designed that leverages soft interventions and a carefully designed metric transformation, converting the combinatorial search problem into a continuous one that can be solved efficiently under proper constraints, thereby generating proper binary decisions for selecting components. Experimental results demonstrate that the proposed method efficiently identifies subsets of the model's components that have a high impact on the target metric, outperforming existing baseline approaches. Our code is available at https://github.com/ZiruiYan/multi-component-causal-tracing.

25.
arXiv (CS.AI) 2026-06-16

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

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