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01.
arXiv (CS.AI) 2026-06-15

Federated Causal Inference from Multi-Site Observational Data via Propensity Score Aggregation

arXiv:2505.17961v4 Announce Type: replace-cross Abstract: Causal inference typically assumes centralized access to individual-level data. Yet, in practice, data are often decentralized across multiple sites, making centralization infeasible due to privacy, logistical, or legal constraints. We address this problem by estimating the Average Treatment Effect (ATE) from decentralized observational data via a Federated Learning (FL) approach, allowing inference through the exchange of aggregate statistics rather than individual-level data. We propose a novel method to estimate propensity scores via a federated weighted average of local scores using Membership Weights (MW), defined as probabilities of site membership conditional on covariates. MW can be flexibly estimated with parametric or non-parametric classification models using standard FL algorithms. The resulting propensity scores are used to construct Federated Inverse Propensity Weighting (Fed-IPW) and Augmented IPW (Fed-AIPW) estimators. In contrast to meta-analysis methods, which fail when any site violates positivity, our approach exploits heterogeneity in treatment assignment across sites to improve overlap. We show that Fed-IPW and Fed-AIPW perform well under site-level heterogeneity in sample sizes, treatment mechanisms, and covariate distributions. Theoretical analysis and experiments on simulated and real-world data demonstrate clear advantages over meta-analysis and related approaches.

02.
medRxiv (Medicine) 2026-06-11

Computer Vision for Real-Time Anatomical Navigation in Neurosurgery: First-in-Human Clinical Evaluation and Iterative Development (IDEAL Stage 1)

Introduction: Precise anatomical navigation is fundamental to safe endoscopic pituitary surgery, a high-stakes procedure characterised by a challenging learning curve. While traditional navigation systems often rely on workflow-disrupting probes or static preoperative imaging, advancements in computer vision AI (CVAI) now enable dynamic, real-time anatomical segmentation directly from live surgical video1-3. Our group has previously conducted a series of preclinical human-computer interaction studies to refine the system's design, alongside digital and high-fidelity physical simulations demonstrating the benefit of AI assistance in improving overall performance, training, and safety4-8. Building on this foundation, the current study represents a first-in-human application of real-time CVAI assistance in the neurosurgical operating room, serving to assess feasibility and safety, and to iteratively improve the system. Method: Guided by DECIDE-AI and IDEAL frameworks, this single-centre evaluation comprises an initial proof-of-concept phase (n=6) for endoscopic transsphenoidal pituitary surgeries. The AI model utilised a DINOv3-derived vision transformer architecture, deployed via a high-performance edge computing unit to achieve low-latency, real-time inference without reliance on cloud infrastructure2. Given the high-risk nature of the procedure and the early stage of clinical AI integration, the system was initially deployed as an educational adjunct on a secondary monitor, ensuring the primary surgical feed remains uncompromised. Functionality and safety were assessed via structured questionnaire, prospective observation, and blinded retrospective review of the recordings of the endoscopic surgical video feed and wider operating room environment. Continuous multi-stakeholder feedback through validated human factors surveys drove iterative technical refinements between cases. Results: Six patients with pituitary adenomas were enrolled. The CVAI system was successfully deployed in four cases, demonstrating acceptable real-time sella segmentation accuracy. Deployment failed pre-operatively in two cases owing to a single recurring system reboot bug. Iterative refinement between cases were driven by our experience and surgical team feedback. This resulted in the integration of additional anatomical structure segmentations (e.g., carotid arteries), enhanced model accuracy via training dataset expansion, and hardware firmware upgrades. Multi-stakeholder surveys demonstrated satisfactory system feasibility, usability, and acceptability among the surgical team. Both prospective observation and retrospective video review confirmed the absence of adverse events, including no significant distraction to the primary surgeon, and there were no AI-related clinical complications. Conclusion: This first-in-human early clinical evaluation demonstrates the feasibility, safety and iterative development of real-time, CVAI-based anatomical navigation during high-stakes neurosurgery. Future work will include a larger single-centre case series (IDEAL Stage 2a) with more surgical teams to further iterate the system and explore its impact on training and workflow. As the underpinning technology improves, deployment will transition to direct intra-operative decision support and integration with other intra-operative navigational technologies.

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

PCBSchemaGen: Reward-Guided LLM Code Synthesis for Printed Circuit Boards (PCB) Schematic Design with Structured Verification

arXiv:2602.00510v2 Announce Type: replace Abstract: Most LLM code-synthesis benchmarks rely on unit tests as the reward oracle, but PCB schematic design has none: correctness is defined by structured physical constraints over real IC packages and pin-level assignments, per-task golden references are unavailable, and SPICE simulation does not validate schematic-level correctness. We introduce PCBSchemaGen, a training-free inference-time framework that turns a frozen LLM into a verifiable, repairable PCB schematic generator. The framework induces a domain schema from IC datasheets to ground LLM decoding, pairs it with a deterministic 5-layer continuous-reward verifier with pin-level error localization, and refines candidates through a Thompson Sampling arm-acquiring bandit. We evaluate on 2 PCB benchmarks covering 227 real-IC tasks across 22 unified circuit domains, including a public-schematic-derived suite that serves as a fully held-out generalization test (verifier, KG library, and prompts frozen before any evaluation). Under our framework, an open-weight 31B model (Gemma-4-31B) passes 81.3% of PCBBench tasks on average, and the same framework transfers across both benchmarks with zero verifier code changes; a Circuitron-style inference-time prompting baseline on the same Gemma-4-31B backbone collapses on hard system-level designs. This suggests inference-time refinement under a deterministic structural verifier is a general recipe for reference-free LLM code synthesis in domains without unit-test oracles. Our benchmarks and deterministic verifier are publicly available at https://github.com/HZou9/PCBSchemaGen_v2.

04.
arXiv (CS.LG) 2026-06-18

Risk Stratification for ICU Delirium using Pervasive Ambient Sensing Information

arXiv:2606.19292v1 Announce Type: new Abstract: Delirium is a common and serious complication in the Intensive Care Unit (ICU), associated with increased morbidity, prolonged hospital stays, and higher healthcare costs. Despite its prevalence, early prediction and prevention remain challenging. Environmental factors such as ambient sound and light may influence the onset of delirium, yet they are often overlooked in risk assessments. In this study, we examined whether light intensity and sound pressure levels can independently predict delirium across multiple prediction horizons. We evaluated four efficient sequential neural network models on data collected from 9 ICUs across 309 patients to predict delirium for 10 prediction-window sizes. We reported feature importance and direction of influence using Shapley Additive Explanations analysis. The convolutional model achieved the strongest discrimination, with AUC = 0.80 on sound data and on combined data. Sound features were the dominant predictors overall. Integrating sound with light improved short-term ($

05.
arXiv (CS.AI) 2026-06-17

The Price of Anarchy in Disaggregated Inference

arXiv:2606.17081v1 Announce Type: cross Abstract: Disaggregated inference architectures physically separate prefill and decode phases onto distinct GPU pools, creating competing "agents" that share a fixed hardware budget. We provide, to our knowledge, the first formal game-theoretic analysis of this architecture, using NVIDIA Dynamo as a concrete case study. We model disaggregated serving as three coupled games: a two-player resource game between prefill and decode pools, a selfish caching game over the hierarchical KV cache, and a congestion game with positive externalities for request routing. We empirically validate the latter two; the P/D resource game is treated analytically (Section 9.2). We characterize how GPU saturation induces regime transitions that shift the game's payoff structure: below saturation, selfish behavior has bounded Price of Anarchy (PoA); at saturation, superlinear latency and cache externalities drive our empirical estimator PoA-hat (defined in Section 6.4) upward. Based on this analysis, we design an adaptive controller that detects saturation transitions in real time and adjusts routing parameters accordingly, shifting from cache-affinity exploitation to load-balanced congestion avoidance. We instantiate our framework on a 3-node NVIDIA B200 cluster running Dynamo with two models, Nemotron-4-340B (TP=8, full-node workers with cross-InfiniBand KV transfers) and Llama-3.1-70B (TP=4), and find the same three-regime PoA-hat structure with the same first post-knee grid point (C=128) on both models. Adaptive routing shifts each model to a better operating point. Our strongest result is on the 70B 1P/5D topology, where PoA-hat drops 3.1x (66.4 to 21.5) in the saturated phase at a 13% throughput cost. On the 70B 1P/2D, PoA-hat drops 2.2x and TTFT P99 drops 7.6x (see Section 8.5).

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

Conditional Latent Diffusion Model with Fourier-based Motion Modelling for Virtual Population Synthesis

In-silico trials of medical devices require the generation of virtual populations of anatomies. In cardiovascular applications, virtual anatomy is typically represented as a 3D+t mesh sampled from a generative model. However, most existing mesh generators focus on static anatomy, while sequence models often lack explicit periodicity. To this end, we propose 4D F-MeshLDM, a conditional generative framework comprising a convolutional mesh VAE to encode meshes, a structural latent space that parameterises motion using a truncated Fourier series, and a diffusion prior that learns the latent distribution over Fourier coefficient tokens. By conditioning the diffusion process on clinical covariates via affine modulation, we enable controllable synthesis. Sampling tokens and performing inverse Fourier synthesis yield cycle-consistent latent trajectories, which can be decoded into 3D+t cardiac mesh sequences. Experiments on 5,000 UK Biobank subjects demonstrate that 4D F-MeshLDM outperforms state-of-the-art baselines in anatomical fidelity and achieves near-zero cycle closure error. Furthermore, the generated cohorts accurately preserve clinical functional indices, highlighting the potential of our framework for reliable in-silico cardiac trials.

07.
arXiv (quant-ph) 2026-06-19

Applications of quantum annealing to magnetic dipole hyperfine structure constants: First results beyond energies for atoms

arXiv:2606.20166v1 Announce Type: new Abstract: We report the first results of the magnetic dipole hyperfine structure (HFS) constants of neutral $\mathrm{Li}$, Li-like $\mathrm{Be}$, neutral $\mathrm{Na}$, and Na-like $\mathrm{Mg}$ using a modified version of the Quantum Annealer Eigensolver (QAE) algorithm on D-Wave's quantum hardware. The results are benchmarked against relativistic configuration interaction with multiconfiguration Dirac Hartree-Fock (MCDHF) calculations using the General-purpose Relativistic Atomic Structure Package (GRASP), and simulated annealing. In our modified QAE, a zooming-and-sigma-annealing approach with a floating-point encoding scheme is adopted to estimate the ground-state eigenvalue and eigenvector of the relativistic Dirac-Coulomb Hamiltonian matrices ($H_{\mathrm{DC}}$) constructed from 11 or fewer configuration state functions (CSFs). For calculations with extended correlation orbital sets, we applied a CSF truncation scheme, retaining only CSFs (up to 12) that make significant contributions to the ground-state wavefunction. Our modified QAE precision is kept limited to three decimal places (up to 10 qubits). Hardware demonstrations on the D-Wave quantum processing unit (QPU) yielded results that were completely consistent with GRASP (at the chosen precision) in determining the magnetic dipole HFS constants, with accuracy varying across systems and $H_{\mathrm{DC}}$ matrix dimensions.

08.
Nature (Science) 2026-06-10

A first-in-class pulsatile FXR agonist for bile-acid-related liver diseases

作者:

Nuclear receptors are central regulators of metabolism1, yet therapeutic strategies that enforce continuous receptor activation frequently lead to reduced efficacy and unacceptable toxicity. Here we report a first-principles drug design strategy that aligns pharmacokinetics with physiological signalling cycles. We developed linafexor, a potent non-bile-acid agonist of the farnesoid X receptor (FXR)2; it is engineered for rapid systemic clearance, which enables pulsatile receptor activation that mirrors endogenous bile acid dynamics3–5. Linafexor has robust efficacy across multiple preclinical models of metabolic dysfunction-associated steatohepatitis6, liver fibrosis7, primary biliary cholangitis and primary sclerosing cholangitis8,9. Transcriptomic analyses reveal that, unlike long-acting FXR agonists10,11, linafexor preserves cyclic FXR signalling, avoids receptor downregulation and prevents broad transcriptional dysregulation. Direct manipulation of delivery patterns demonstrates that sustained FXR activation—independent of compound identity—induces severe toxicity, establishing activation duration as a determinant of therapeutic index. In phase 1 clinical studies (ClinicalTrials.gov; NCT05082779), linafexor administered once daily produces transient FXR pathway engagement, marked by (1) induction of FGF1912–14, a key endocrine mediator of bile acid feedback regulation; and (2) suppression of C415, an intermediate reflecting hepatic bile acid synthesis, with no treatment-related adverse events. Together, these findings identify pulsatile FXR activation as a mechanistically grounded and clinically translatable strategy, and establish linafexor as a first-in-class therapeutic for bile acid–related liver diseases. Linafexor is a rapidly cleared FXR agonist designed to mimic natural bile acid signalling, achieving transient receptor activation with strong efficacy and reduced toxicity in preclinical and early clinical studies.

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

CODA-BENCH: Can Code Agents Handle Data-Intensive Tasks?

Advanced agents are increasingly demonstrating the potential to operate as autonomous engineers, creating a growing demand for evaluation benchmarks that capture the complexity of real-world development. Such environments typically involve both complex code and large-scale data (i.e., file system). However, existing benchmarks usually evaluate code-centric or data-centric capabilities in isolation, leaving a clear gap with real development scenarios. In this paper, we bridge this gap by introducing CODA-BENCH, the first benchmark to jointly evaluate code and data intelligence in a data-intensive environment. We construct a data-intensive Linux sandbox based on the Kaggle ecosystem (containing hundreds of datasets), where agents must actively explore complex file hierarchies to identify relevant resources and generate code for data-driven analytical tasks. CODA-BENCH comprises 1,009 tasks spanning 31 communities, with each task environment containing an average of 980 files, simulating realistic data scale and noise. Evaluations of advanced agents reveal that even top-performing systems struggle to effectively integrate data discovery with code execution, achieving a success rate of only 61.1%. These results highlight a substantial gap in current agentic capabilities for data-intensive tasks and point to promising directions for future research.

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

PaperJury: Due-Process Review for Bounded LaTeX Revision

Pre-submission hardening of human-authored LaTeX computer science papers differs from drafting assistance because it requires adversarial whole-paper review, explicit no-fix outcomes, and bounded artifact-safe revision. Existing writing assistants, critique generators, and judge-centered loops lack durable issue identity across rounds, deterministic routing from critique to adjudication, and manuscript control that can reject invalid concerns or defer author-dependent ones. We present PaperJury, a closed-loop review-verdict-revise-verify system built on a deterministic-versus-semantic split: deterministic orchestration manages decomposition, a frozen claim spine, a durable ledger, routing, stopping, and exact-once patch application, while semantic agents are limited to bounded review, judgment, and repair. PaperJury combines bounded holistic review, contestability-based routing, a due-process trial, and risk-proportional guard chains for anchor-bounded edits, yielding terminal outcomes of invalid-drop, valid-fixable, and author-required. In a two-arm expert-review evaluation on held-out Vision, natural language processing, and machine learning papers against four baselines, we assess issue quality, verdict and routing quality, edit safety, convergence behavior, and cost, supporting the thesis that load-bearing safety and completion logic should reside in deterministic orchestration rather than model discretion. PaperJury is available at https://github.com/u7079256/paperjury.

11.
arXiv (CS.CV) 2026-06-16

Closed-Loop Triplet Synergistic Generation for Long-Form Video

Multi-shot long-form video generation remains challenging due to identity drift and compounding inconsistencies across shots. While storyboard-driven pipelines improve controllability, they are often executed in a feed-forward manner, with limited mechanisms to incorporate generated visual evidence back into subsequent conditioning. We propose CoTriSyGen, an agentic framework that formulates multi-shot long video generation as a closed-loop visual-text-memory synergy process, where planned intent, persistent memory, and generated visuals are jointly leveraged for iterative correction and long-range coherence. A vision-language-model-based analyzer reasons over this triplet and produces updates to both prompts and memory along two pathways: (i) intra-shot refinement, which triggers targeted regeneration when semantic or compositional violations are detected and refines image-to-video prompt for coherent motions; and (ii) inter-shot refinement, which rewrites subsequent-shot prompts to propagate newly manifested entities or attributes and improve prompt quality (e.g., compositional grounding and cinematic fluency) based on generated evidence. The loop is grounded in an entity-centric memory modeled as a mutable visual state that evolves as the story progresses, which is continuously updated by both the generator and the analyzer by adding new and evolved entities to reflect appearance changes, accumulated multi-view evidence, and multi-entity compositions. Experiments on our curated StoryBench benchmark demonstrate substantial improvements in cross-shot consistency, prompt adherence, and cinematic continuity over representative methods.

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

AAbAAC: An Annotated Corpus for Autoimmunity Information Extraction

arXiv:2606.13051v1 Announce Type: new Abstract: Despite advances in information extraction driven by deep learning and large language models, performance gaps remain in highly specialized biomedical fields, where domainspecific complexity poses challenges for generalist models. In this work, we focus on the domain of autoimmunity, where the main entities of interest are autoimmune diseases, autoantibodies (i.e., molecules that may mark or cause these diseases), their molecular targets, their location in the body, and their associated clinical signs. Herein, we present AAbAAC (AutoAntibodies and Autoimmunity Annotated Corpus), a corpus of 115 abstracts selected from PubMed, where we manually annotated entities and their relationships. First, AAbAAC was used to evaluate several methods on the task of named entity recognition (NER), and secondly, to fine-tune NER models. Our study demonstrates the utility of AAbAAC for information extraction in the domain of autoimmunity, showing expected improvement in NER performance after finetuning. This illustrates the value of small-scale annotation efforts for specialized domains and contributes to the computational study of autoimmunity. The AAbAAC corpus is available at https://github.com/f-maury/AAbAAC.

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

X+Slides: Benchmarking Audience-Conditioned Slide Generation

arXiv:2606.19256v1 Announce Type: new Abstract: Automatically generating slide decks from source documents is an important application of large language models (LLMs). Existing benchmarks primarily assess slide completeness and technical depth, while overlooking the target audience as a critical real-world factor. For instance, specialists demand rigorous proofs, whereas decision-makers prioritize actionable conclusions. To bridge this gap, we introduce X+Slides, a benchmark specifically designed for audience-conditioned slide generation. Built on a diverse corpus spanning 113 topics and seven presentation scenes, X+Slides employs a dynamic evaluation framework constructed from 8,133 deduplicated, source-grounded probes. By assigning audience-specific utility weights to the same source-grounded probes, X+Slides reports four complementary metrics: Audience Coverage measures how much audience-essential information is conveyed, Domain-wise Coverage shows which information types are covered, Efficiency measures delivered utility per unit of attention cost, and Correctness verifies whether slide claims are supported by the source. Experiments on DeepPresenter, SlideTailor, and NotebookLM show that current systems can recover a substantial but still incomplete part of audience-essential information: at $\tau_A=0.7$, DeepPresenter reaches a best Audience Coverage of 0.714, SlideTailor reaches 0.594, and the NotebookLM ablation reaches 0.853 while showing clear grounding differences. These results indicate that visual quality and broad topic coverage should not be treated as evidence support without source-grounded evaluation.

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

The Vision Encoder as a Privacy Boundary: Visual-Token Side Channels in Encoder-Free Vision-Language Models

A vision encoder compresses image pixels into semantic embeddings, implicitly acting as a privacy boundary by preserving semantic content while attenuating pixel-local detail required for exact text recovery. Encoder-free vision-language models (VLMs) remove this boundary by routing image patches directly into the language-model token stream, thereby exposing an architectural privacy attack surface: intermediate visual tokens become a pre-output side channel. Under a token-access adversary, decoders invert visual-token streams from two encoder-free VLMs, Gemma4 and Fuyu, recovering recognizable image structure and readable held-out access codes, whereas matched encoder-based controls localize target regions but recover no exact strings. Within-model ablations show that the operative factor is spatial sampling fidelity of the visual-token grid, especially character-direction sampling density, rather than token or value count. The leakage is not limited to exported tokens: Gemma4 layer-0 key-value cache tensors are directly invertible, placing the side channel within KV caches commonly persisted by production serving stacks for decoding efficiency. The attack survives clutter, realistic document degradation, and zero-shot transfer to public document images, and it resists value-level defenses such as additive noise and quantization. Effective mitigation must therefore reduce spatial sampling, making removal of the vision encoder a first-class privacy decision in VLM deployment.

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

A Two-Stage Statistical Framework for Evaluating Associative Interference in Large Language Models

arXiv:2606.14117v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly evaluated for bias using adaptations of human psychological paradigms, yet methodological limitations-particularly the conflation of refusal behavior with task performance-have hindered clear interpretation. Here, we adapt the Implicit Association Test (IAT) to a controlled, forced-choice framework and introduce a two-stage modeling approach that separates response compliance from task-consistent classification. Across three contemporary LLMs (Claude Sonnet-4, Gemini 2.5 Pro, and GPT-5), we evaluate associative interference, defined as reduced task-consistency in incongruent relative to congruent conditions. While compliance with the structured response format was uniformly high, interference effects varied substantially across models and domains. Claude Sonnet-4 exhibited strong interference in the Gender–Career domain (DeltaP = 0.086, 95% CrI [0.026, 0.173]) and smaller but credible effects in Gender–Science. Gemini 2.5 Pro showed attenuated interference, and GPT-5 exhibited minimal or no detectable interference across domains. These findings demonstrate that IAT-style associative asymmetries are not a universal property of LLMs, but instead depend on model-specific characteristics. By isolating interference from compliance and modeling item-level variability, this study provides a principled framework for evaluating structured response patterns in LLMs. The results highlight the importance of model-specific assessment and suggest that associative interference can be substantially mitigated in modern systems.

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

Blind Recovery of Latent Domains via Unsupervised Symmetry Discovery

arXiv:2606.17782v1 Announce Type: new Abstract: Primary motivation in blind inverse problems is to recover signals of interest from corrupted observations without knowing the obfuscating mechanism. Blind deconvolution is a prominent approach when the corruption is convolutional, but it is not applicable when general linear transformations obfuscate the domain structure. In this work, we propose an unsupervised framework for recovering latent domains and signals by discovering symmetries of the data distribution. Our framework models observations as linear measurements of signals sampled from a latent random field, and optimizes a shallow group-convolutional network by imposing stationarity and locality regularization at the model output. The model learns a latent symmetry action and an appropriate filter, thereby mapping unstructured observations to a symmetry-based representation that reveals latent signals. Experiments on stochastic processes, Ising models, shuffled and bit-scrambled images, and neural recordings show that the method recovers latent domains and signals from unstructured observations, suggesting symmetry discovery as a new direction for unsupervised structure learning and blind inverse problems.

17.
arXiv (quant-ph) 2026-06-12

SAT, MaxSAT, and SMT for QLDPC Distance Computation: A Large-Scale Empirical Study

arXiv:2606.12445v1 Announce Type: new Abstract: Exact distance computation for quantum LDPC (QLDPC) codes plays a central role in validating candidate fault-tolerant quantum-code constructions, yet the computational structure of this problem remains poorly understood. Despite substantial recent progress in QLDPC design, it remains unclear which algorithmic principles govern the practical scalability of exact distance computation and which classes of exact solvers are best suited to this task. To address these questions, we conduct a systematic study of SAT- and MaxSAT-based formulations for exact QLDPC distance computation across representative codes. We further compare these formulations against several established exact-distance approaches in order to better understand the algorithmic landscape of exact QLDPC distance computation. Our study challenges and refines several prevailing intuitions about exact QLDPC distance computation. First, despite the XOR-rich structure of QLDPC parity checks, practical scalability appears to be governed more by the handling of cardinality constraints and optimization bounds than by parity reasoning alone. Accordingly, XOR-aware reasoning does not provide a systematic advantage across our benchmark suite. Second, Brouwer-Zimmermann-style search, long regarded as the benchmark paradigm for exact distance computation in sparse classical codes, no longer maintains its traditional scalability advantage in the QLDPC setting. This finding challenges the expectation that techniques successful for sparse classical codes remain dominant for QLDPC codes. Third, substantial qualitative differences arise even among MaxSAT solvers themselves. Branch-and-bound MaxSAT significantly outperforms unsat-core-based MaxSAT on challenging benchmarks, demonstrating that solver architecture and optimization strategy play a decisive role in practical scalability.

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

LLM-as-an-Investigator: Evidence-First Reasoning for Robust Interactive Problem Diagnosis

arXiv:2606.13220v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly used as interactive assistants for technical problem solving. However, when users provide incomplete descriptions or plausible but unverified explanations, LLMs may prematurely align with these assumptions and propose solutions before collecting sufficient evidence. We refer to this behavior as user-driven sycophancy: the tendency of an LLM to reinforce a user-provided hypothesis instead of testing alternative explanations. This paper introduces LLM-as-an-Investigator, an evidence-first agentic AI methodology for robust problem diagnosis. The approach is implemented through a Solution Investigator Agent, which estimates the ambiguity of an initial problem description, generates candidate hypotheses, asks targeted clarification questions, and updates hypothesis probabilities after each answer. Rather than producing an immediate response, the agent continues the investigation until the evidence makes one candidate explanation stronger than the alternatives. To evaluate the approach, we build a benchmark from solved technical forum threads in mechanical, electrical, and hydraulic domains. We use a three-agent evaluation pipeline in which a Problem-Solution Extractor Agent converts solved threads into structured cases, a Ground-Truth Evaluator Agent simulates the user while hiding the known solution, and the tested assistant attempts to recover the solution through dialogue. The experiments compare standard assistants, reasoning-oriented LLMs, and the proposed investigator-based model across LLM backbones. In addition to diagnostic accuracy, we analyze how standard assistants follow misleading user hypotheses in diagnostic cases. The results show that the proposed approach identifies the problem more accurately than direct prompting and reasoning-only baselines, while its evidence-first protocol helps reduce user-induced conversational bias.

19.
medRxiv (Medicine) 2026-06-15

International Consensus Guideline on Management of Genitourinary Adverse Events Associated with Prostate Cancer Radiotherapy

Purpose/Objective: Genitourinary (GU) adverse events (AEs) are common during and after pelvic radiation therapy (RT) for prostate cancer and can substantially impact quality of life. We convened an international committee to establish consensus in the prevention, mitigation, and management of radiation-related acute and late GU AEs, as there are no relevant evidence-based consensus guidelines to inform treating providers. Materials/Methods: A systematic evidence review focused on mitigation and management of radiation-related acute and late GU AEs was performed in PubMed, Embase and Cochrane. The following topics were addressed: management of acute GU AEs in the intact and post-operative settings; RT techniques; bladder outlet obstruction procedures; and indications for urology referral or hyperbaric oxygen therapy (HBO). Evidence-based consensus recommendations were developed using a Delphi process. We highlight the current state of evidence and evidence gaps worthy of future study. Results: Consensus was reached for 31 key questions. For management of lower urinary tract symptoms (LUTS), most evidence comes from trials in patients without cancer and not undergoing RT. A consensus algorithm for medical management of acute GU AEs was developed with the following highlights: (a) alpha blockers as 1st-line for obstructive symptoms in the intact setting, (b) anti-spasmodics as 1st -line for irritative symptoms in the intact setting, and (c) anti-spasmodics as 1st -line in the post-operative setting. The consensus algorithm provides an ordered list of medications to offer if 1st -line options afford inadequate relief. For RT fractionation, randomized clinical trial (RCT) data are available. 40% of panelists rarely or never use standard fractionation over moderate hypofractionation for patients with baseline LUTS, but most consider moderate hypofractionation over SBRT for AUA IPSS > 15. For patients with severe obstructive LUTS (most commonly AUA IPSS >20), the panel recommends a prophylactic bladder outlet obstruction procedure and, if obstructive symptoms improve, consideration of moderate hypofractionation or SBRT, based on retrospective data. There is one RCT supporting use of HBO for late radiation cystitis. Conclusions: The consensus guideline synthesizes available evidence and expert opinion across key clinical decision points to provide practical guidance in the prevention, mitigation, and management of radiation-related acute and late GU AEs in prostate cancer RT. Envisioned as a living document with periodic updates, this guideline serves as a resource for practicing radiation oncologists by outlining expert-derived consensus recommendations of evidence-based care in areas where high-quality data is limited.

20.
arXiv (quant-ph) 2026-06-16

Adiabatically-induced Kawaguchi geometry and jerk in quantum-classical systems

arXiv:2606.16037v1 Announce Type: new Abstract: Adiabatically eliminating the quantum degrees of freedom in a mixed quantum-classical system produces an effective force in the classical equation of motion. The elimination can be made to any order in the adiabatic parameter, generating a series of higher order forces. By applying a sequence of near-identity unitary transformations to the quantum state, we derive a hierarchy of increasingly accurate effective actions for the classical variables. The third order Euler-Lagrange equation is non-Newtonian as the force depends on the jerk, the third order time derivative of position. We find that the third order terms induce a special kind of Kawaguchi geometry on the space of classical variables. This geometry is characterized by an almost symplectic structure and a differential line element that depends on the acceleration in addition to the velocity. Our results can be used to efficiently capture higher order nonadiabatic effects in molecular dynamics simulations.

21.
arXiv (quant-ph) 2026-06-12

Exceptional Points as Manifestations of Analyticity Breakdown in the 't Hooft Model

作者:

arXiv:2606.10141v2 Announce Type: replace-cross Abstract: We use the exactly-solvable t Hooft model of 1+1D large-N_c QCD as a rigorous laboratory for the breakdown of analyticity of a causal response function, the meson two-point function. A PT-symmetric deformation i gamma(x-1/2) of the light-cone meson operator, the analogue of an imaginary chemical potential, drives the lowest two mesons to an exceptional point (EP) at gamma_c. Recasting the resolvent as a Jacobi continued fraction yields gamma_c in closed form: 2 pi g^2 N_c at the two-pole level, converging to 7.966 g^2 N_c by depth five – an analytic, not numerical, threshold. The square-root exponent nu=1/2 is fixed by the 2x2 Jordan form and confirmed by finite-size scaling to N=1999. The breakdown has an unambiguous time-domain signature: the propagator norm is bounded for gamma < gamma_c, grows linearly at gamma_c (the Jordan secular law), and exponentially beyond – observable, since the deformed operator is a non-Hermitian Wannier-Stark ladder, in photonic and topolectrical analogues. The threshold is locked to confinement, gamma_c propto g^2 N_c, and recurs as a uniform EP cascade; a second, non-reciprocal deformation yields an exactly-exponential non-Hermitian skin effect. This is the first analytically-controlled instance of exceptional-point analyticity breakdown in a confining gauge theory.

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

Constitutional Value Potentials: reading and steering internal priority margins in language models

arXiv:2606.15420v1 Announce Type: cross Abstract: A constitution tells a language model what to value, but little tells us whether it does. Adherence is judged from outputs, and output evidence is most fragile on value conflicts, where what matters is not which value a model mentions but which one it is willing to sacrifice. We provide evidence that this arbitration can be read from activations in a structured margin readout. We introduce Constitutional Value Potentials (CVP). For each value we learn a scalar potential from the hidden state: an internal pressure to preserve that value, supervised not by the prompt but by an independent judge's verdict on which value the model's own response actually preserved. The signed difference of two potentials is a priority margin. A constitutional clause becomes the claim that a margin stays positive, and a single monitor score flags when it does not. The monitor predicts conflict violations with AUROC up to 0.95, beats a strong hidden-state probe, and generalizes to held-out synthetic conflicts across three Qwen2.5 scales. The signal appears as the answer begins, from the prompt tail and first response token. Read this early, the same signal reveals whether an adversarial priority hack has actually pushed the model toward a violation, rather than only whether the prompt looks adversarial. The same directions also support intervention tests: under selected steering settings, moving along a value direction shifts judged trade-offs in the intended direction. Together, these results suggest that some constitution-relevant priorities are accessible as activation-space margins, rather than only as output behavior.

23.
medRxiv (Medicine) 2026-06-15

Quality Improvement Based Implementation and Evaluation of a Decision Aid for Patients with Nephrolithiasis

Introduction Patients with nephrolithiasis face challenges in making a high-quality, preference sensitive decision. Our prior work established feasibility and patient acceptance of a software-based decision aid (DA). The objectives for this study were to identify implementation strategies for the DA in routine care and determine whether DA implementation enhances decisional quality for patients. Methods New nephrolithiasis patients were recruited from the institution Medical Center from June 2018 to April 2024 to receive a software-based pre-visit DA that measured care preferences and used decision analysis to rank treatments. The RE-AIM framework and Plan-Do-Study-Act (PDSA) cycles were used to improve implementation outcomes. Patients completed survey instruments evaluating decisional conflict, shared decision-making, care satisfaction, and treatment choice following their provider visit. These metrics were compared in the DA cohort (n=81) to those in a usual care cohort (n=78) with Wilcoxon rank-sum and Chi-square (or Fishers exact) tests. Results Implementation data revealed sustained reach and progressive improvement in fidelity. The DA cohort reported higher decisional quality relative to controls (p=0.003) and reported greater support/advice to make a choice (p=0.005). The DA cohort more often discussed options with their doctor (87.5% vs 69.2%, p=0.005) and were more likely to be promoters of their provider (p

24.
medRxiv (Medicine) 2026-06-17

The interaction between chronic hepatitis B (CHB) and Metabolic dysfunction-associated steatotic liver disease (MASLD) in a diverse central London population

Introduction: The overlap between chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health challenge. We investigated the impact of MASLD and metabolic comorbidity in a diverse London viral hepatitis clinic. Methods: This retrospective cross-sectional study (May 2018-Feb 2024) included adults with CHB having controlled attenuation parameter (CAP) measurements. MASLD was defined as CAP >264 dB/m plus [&ge;]1 cardiometabolic factor (CMF). We used univariable and multivariable models to examine MASLD's relationship with liver stiffness and hepatitis B viral load (HBV VL). Results: Among 323 individuals (67% male, median age 36), most were from Black (35%) or non-white British/Irish (29%) backgrounds. Overall, 64% had [&ge;]1 CMF, and 20% had MASLD. The CHB/MASLD group was significantly older (median 43 vs 35 years, p

25.
arXiv (CS.AI) 2026-06-12

Rethinking RAG in Long Videos: What to Retrieve and How to Use It?

arXiv:2606.13141v1 Announce Type: new Abstract: Retrieval-augmented generation is moving beyond text into long, egocentric video, where systems must select query-relevant chunks across multiple modalities and temporal granularities. Yet progress in VideoRAG is limited by two gaps: existing benchmarks allow queries to be answered without the video, obscuring retrieval errors, and prior methods apply a single modality-granularity configuration per query, ignoring chunk-level variability. We address both by introducing V-RAGBench, a benchmark of $\langle$query, evidence chunk, answer$\rangle$ triplets that enables faithful, decoupled evaluation of retrieval and generation, and CARVE, a simple method that runs parallel retrievers across configurations and employs chunk-adaptive reranking to identify the winning configuration for each chunk. Each chunk then enters the generator under its winning configuration selected during retrieval, yielding an interleaved evidence form where the chunk-level decision propagates across both stages. CARVE outperforms eight recent VideoRAG baselines, with the chunks supplied to the generator interleaving multiple configurations rather than sharing a single one, a behavior unattainable by query-level methods.