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01.
arXiv (CS.LG) 2026-06-12

Is Spurious Correlation Removal Always Learnable?

arXiv:2606.12930v1 Announce Type: new Abstract: Invariant learning can fail even when the invariant structure is statistically identifiable. We show a conditional computational barrier: under a black-box samplable supervised sparse recovery primitive motivated by average-case sparse-recovery reductions, there exist samplable multi-environment instances with a one-dimensional predictive invariant subspace ($k=1$) that are learnable with polynomial samples by exhaustive search, while any polynomial-time constant-accuracy recovery algorithm would contradict the primitive. We further quantify environment diversity by a separation parameter $\gamma$, which controls identifiability and the curvature of invariance objectives. Under sufficient diversity and local Gaussian regularity, the minimax risk is $\mathbb{E}[\dist(\hat{V},V_{\mathrm{inv}})^2]=\Theta(k(d-k)/(n|\mathcal{E}|))$, and under label-induced shifts a phase transition occurs at $n^*\propto k(d-k)/(|\mathcal{E}|\gamma^2)$ with refined estimation error scaling proportional to $1/\gamma^2$. Synthetic and real datasets illustrate the predicted gaps and transitions and motivate simple diversity diagnostics.

02.
medRxiv (Medicine) 2026-06-15

Long-read sequencing enables high-accuracy mitochondrial heteroplasmy detection in Parkinson's disease

Background: Low-frequency heteroplasmic mitochondrial DNA (mtDNA) variants are associated with aging and neurological diseases, including Parkinson's disease (PD). Targeted deep mtDNA sequencing using PacBio HiFi long reads has the potential to resolve heteroplasmy across the full mitochondrial genome with high accuracy. Methods: To validate Vega PacBio sequencing for detecting mtDNA heteroplasmy, we analyzed four predefined mixtures of two mtDNA haplotypes. We generated a single long-range PCR amplicon covering the entire mitochondrial genome. These amplicons were mixed at predefined ratios (minor mixture haplotype component: 5%, 2%, 1%, and 0.1%). Variant calling was performed using Mutserve2, and accuracy was assessed by calculating the F1 score from comparisons between expected and detected variants. Full-length mtDNA PacBio sequencing was applied to investigate heteroplasmy across fibroblast passages derived from five LRRK2 p.Gly2019Ser variant carriers (n=3 affected with PD and n=2 unaffected carriers). Changes in mtDNA heteroplasmy level and variant load were assessed longitudinally using a linear mixed model. Results: The single-amplicon approach enabled full-length haplotype resolution without amplification bias associated with overlapping PCR strategies. The F1 score of the predefined mixtures was 1.0 for heteroplasmy levels between 5% and 1% and remained high (0.91) at 0.1%. We detected n=10/62 variants discordant with the Illumina reference at the 0.1% mixture, but sensitivity remained very high at 1.00 in that mixture. Detected minor variants closely matched expected heteroplasmy levels, with average variant levels of 0.057 (5%), 0.022 (2%), 0.011 (1%), and 0.001 (0.1%). Across twelve fibroblast passages, we observed fewer mtDNA heteroplasmic variants ({beta}=-3.2, p=0.026). Increased heteroplasmic variant load over time was also associated with older age ({beta}=1.50, p=0.001) and PD affection status ({beta}=5.0, p=1.0 x 10-4) in LRRK2 variant carriers. Notably, we observed distinct patterns of heteroplasmic variants that either increased or decreased in heteroplasmy level across passages. Conclusion: PacBio HiFi sequencing, combined with a single-amplicon strategy, enables accurate full-length mtDNA heteroplasmy detection and longitudinal analysis, providing a valuable tool for studying mitochondrial variation and dynamics in disease.

03.
arXiv (quant-ph) 2026-06-11

Quantum repeater segment with free-space coupled co-trapped ions using telecom photon interference

arXiv:2606.12313v1 Announce Type: new Abstract: A quantum repeater segment is a basic building block of a quantum repeater, generating buffered entanglement of quantum memories to connect quantum repeater cells. It also enables the connection between quantum computers. In the implementation we present here, photons emitted from two co-trapped free-space coupled $^{40}$Ca$^+$ ions are converted to the telecom-C band and interfered after transmission over 440$\,$m of optical fiber (220$\,$m per arm), where a photonic Bell measurement is performed to create entanglement between the memories. With this scheme we generate an entangled $\left|\Psi^+\right\rangle$ Bell state with $\ge 68(8)\,$% fidelity, highlighting trapped $^{40}$Ca$^+$ ions as a promising quantum repeater hardware platform.

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

Many-body chirality of topological stabilizer states

arXiv:2606.20472v1 Announce Type: new Abstract: A defining feature of chirality is the distinction between a system and its mirror image. Despite extensive experimental observations of chiral phases and theoretical advances, a quantum-information theoretic characterization of chirality based solely on the entanglement structure of many-body quantum states remains elusive. Here, we introduce the notion of many-body chirality by formulating it as an obstruction to transforming a quantum state into its complex conjugate through finite-depth local operations. We rigorously establish many-body chirality for stabilizer realizations of $\mathbb{Z}_d^{(k)}$ anyon theories, proving that complex conjugation can be implemented by local quantum channels if and only if the underlying anyon data are mirror invariant. This reveals forms of chirality that evade conventional diagnostics, including examples with vanishing modular commutator, vanishing chiral central charge, and commuting-projector realizations. We further show that this obstruction is intrinsically four-partite, while invisible to tripartite entanglement structure. Finally, we prove that $\mathbb{Z}_d^{(k)}$ states with $d>2$ possess intrinsic many-body imaginarity: their complex phase structure cannot be removed by finite-depth local unitaries. Remarkably, this includes states that are not many-body chiral.

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

Structuring and Tokenizing Distributed User Interest Context for Generative Recommendation

arXiv:2606.20554v1 Announce Type: cross Abstract: Generative recommendation is an emerging paradigm that has shown promise in industrial recommendation systems, aiming to predict users' next interactions from their historical behaviors. At the core of generative recommendation lies item tokenization, which bridges item semantics and recommendation models. However, existing methods often struggle to effectively organize and inject complex user-behavioral and item-semantic contexts into recommendation models simultaneously. On the one hand, existing graph-based integration methods, such as graph serialization and graph neural networks, either suffer from scalability issues or exploit only local graph information. On the other hand, existing semantic tokenization methods typically rely on heuristics and lack explicit supervision signals, which may lead to inaccurate or suboptimal semantic representations. To address these limitations in user interest context modeling, we propose G2Rec, a scalable framework that unifies holistic graph-based user co-engagement modeling with semantic tokenization for industrial-scale generative recommendation. Overall, G2Rec enables recommendation models to capture holistic and semantically grounded user interest prototypes without requiring ground-truth user interests, thereby providing more comprehensive and accurate modeling of user behavior contexts in industrial sequential recommendation. Online deployment across product surfaces and extensive experiments on public datasets demonstrate the superiority of G2Rec over existing methods.

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

Variational Learning for Insertion-based Generation

arXiv:2606.02133v3 Announce Type: replace-cross Abstract: Non-monotonic sequence generation methods, such as masked diffusion models, provide a flexible alternative to left-to-right autoregressive modeling by allowing tokens to be generated in non-fixed and prescribed orders. Despite their practical advantages, most existing non-monotonic models are order-agnostic and rely on a fixed-length grid, limiting their ability to support variable-length generation and adaptive insertion order. In this work, we introduce a probabilistic framework for learning insertion order in variable-length insertion models. We formalize a bijective correspondence between insertion trajectories and permutations, which enables an exact reparameterization of the data likelihood as a sum over permutations. Building on this result, we propose the Insertion Process (IP), a stochastic generative model that jointly learns where to insert, what to insert, and when to terminate, trained via permutation-based variational inference. Unlike prior fixed-canvas approaches, IP natively supports variable-length generation and learns data-driven preferences over insertion orders. Experiments on goal-conditioned planning and molecular string generation demonstrate that learning insertion order improves both modeling quality and generalization in domains without a canonical left-to-right structure.

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

Adaptive and Explicit safe: Triggering Latent Safety Awareness in Large Reasoning Models

arXiv:2606.16808v1 Announce Type: new Abstract: While Large Reasoning Models (LRMs) excel at complex tasks, they remain highly vulnerable to sophisticated jailbreaks and direct harmful queries. To address this vulnerability, prior works depend heavily on external manual data annotation for safety alignment. However, we observe that LRMs can inherently identify safety risks when being re-presented with original queries alongside their own reasoning trajectories – a capability we term Latent Safety Awareness. To leverage this safety awareness, we first employ Supervised Fine-Tuning (SFT) to explicitly induce safe tags to trigger safety analysis and guidance following the initial reasoning content for unsafe queries, while preserving standard responses for general queries to ensure adaptive triggering. Subsequently, we apply Direct Preference Optimization (DPO) to further enhance the correctness and stability of the safety analysis and guidance. Notably, responses required for both training stages are entirely generated by models being optimized. With (Safe Trigger) SFT and DPO, experimental results demonstrate significant safety enhancement. For example, the Attack Success Rate (ASR) of DeepSeek-R1-Distill-Llama-8B, on average, drops 24.65% and 36.72% on harmful and jailbreak benchmarks, respectively. Finally, our Safe Trigger method exerts almost no negative impact on general performance or user experience.

09.
arXiv (CS.AI) 2026-06-19

AI Economist Agent: An Agentic Framework for Model-Grounded Economic Analysis with RAG, Knowledge Graphs, and Large Language Models

arXiv:2606.20041v1 Announce Type: cross Abstract: We propose a model-grounded RAG-based AI economist with an agentic framework for economic scenario analysis using large language models (LLMs) and knowledge graphs. While LLMs can generate fluent economic narratives, economists are often required to make economic claims grounded by economic theory and real-world data. Based on this motivation, this study proposes an RAG-based AI economist, which utilizes knowledge graphs including economic data and theory and LLM-based agents to plan the analysis, retrieve relevant evidence, select appropriate models, and generate reports. In our framework, we do not produce quantitative claims directly with the language model alone; instead, we generate narratives grounded in explicit model-based computations and linked to the retrieved evidence via AI agents. We refer to our framework as an AI economist agent. We evaluate the AI economist agent in two applications: economist report generation for U.S. inflation persistence and Federal Reserve policy, and bank stress-test narrative generation for U.S. commercial real estate refinancing stress. The results illustrate how grounding the generated reports improves their economic coherence and traceability.

10.
PLOS Computational Biology 2026-06-02

Data-driven model reveals increased stability of CAG-expanded <i>huntingtin</i> RNA due to MID1 binding

作者:

by Yuhong Liu, Annika Reisbitzer, Domagoj Dorešić, Jan Hasenauer, Sybille Krauß, Tatjana Tchumatchenko RNA-binding proteins (RBP) are important regulators of RNA metabolism. In neurodegenerative disorders such as Huntington’s Disease (HD), disrupted RBP-RNA interactions contribute to neuronal dysfunction. One such RBP, Midline 1 (MID1), has been shown to aberrantly associate with mutant huntingtin (Htt) RNA, enhancing its translation, yet the mechanism driving this effect remains unknown. Here, we develop a computational model to understand the role of MID1. Based on previously published data, our model predicts that MID1 increases the stability of the Htt RNA. We experimentally validate this prediction, showing that overexpression of MID1 significantly prolongs the half-life of mutant Htt RNA. Furthermore, we evaluate model refinements, including clustering of MID1-bound RNA, which allow capturing all key observations in the data. Together, we provide a data-driven framework that underlines the importance of RBP-RNA interaction in post-transcriptional regulation. This framework also shows how individual molecular reactions jointly determine RNA stability and protein levels in HD.

11.
medRxiv (Medicine) 2026-06-15

Population-scale genomics reveals divergent pathogenicity of variant classes across paralogous collagen IV genes

Monoallelic pathogenic or likely pathogenic variants in COL4A3 and COL4A4 occur in approximately 1 in 106 individuals, yet whether these paralogous genes confer equivalent pathogenicity for the same variant classes has not been tested at population scale. Using whole-genome sequencing data from the UK Biobank (UKB; n = 500,000), with replication in the All of Us Research Program (n = 414,000), we performed per-variant association testing, gene-based collapsing analyses and phenome-wide association studies (PheWAS) across haematuria, proteinuria and chronic kidney disease. We identified 64 COL4A3 and 92 COL4A4 rare variants significantly associated with haematuria or proteinuria, generating a quantitative allelic series for clinical variant interpretation. Glycine substitutions within collagenous domains conferred similar risks in both genes. In contrast, truncating and non-collagenous domain (NC1) missense variants were strongly associated with haematuria and proteinuria in COL4A4 carriers but showed substantially attenuated or absent associations in COL4A3 carriers despite comparable carrier frequencies and predicted pathogenicity scores. These findings were independently replicated in All of Us. Genome-wide association analysis identified the COL4A3/COL4A4 locus as the dominant genetic determinant of haematuria, with the signal attributable to the aggregate effects of rare coding variants and no evidence of independent common variant or trans-acting modifier effects. These findings demonstrate substantial gene-specific differences in tolerance to truncating and NC1 variants between COL4A3 and COL4A4, challenging assumptions of equivalent pathogenicity across paralogous collagen IV genes. Gene identity and not variant class alone, should inform risk stratification, variant interpretation and genetic counselling in individuals carrying collagen IV risk genotypes.

12.
arXiv (CS.LG) 2026-06-17

Continual Self-Improvement with Lightweight Experiential Latent Memories

arXiv:2606.17803v1 Announce Type: new Abstract: Large language models achieve strong reasoning performance by scaling inference-time compute, yet remain fundamentally stateless, discarding the rich, self-produced reasoning traces generated during this process. We investigate whether models can instead learn online from this experience, converting transient computation (reasoning traces) into persistent reusable knowledge, and without external supervision or access to future data. We show that In-Context Learning (ICL) over raw reasoning traces fails to generalize, reflecting a fundamental limitation of token-level reuse: individual traces lack the abstraction needed for transfer, even after refinement (e.g. self-reflection). In contrast, drawing inspiration from recent works on unsupervised reinforcement learning, we find that lightweight per-instance training with self-generated test-time signals (majority voting) as rewards yields substantial gains, often surpassing full-dataset offline training, motivating a shift from raw traces to learned latent representations. Building on this insight, we propose an online method that distills inference-time compute spent on encountered problems into compact modular latent memories capturing the underlying reasoning structure. These memories are stored and retrieved for future inputs, enabling continual improvement while avoiding catastrophic forgetting through modular design. Importantly, our method is highly efficient, parametrized as extremely lightweight soft prompt memories (~0.001% of model parameters) and trained with only a few gradient steps, yet achieving performance competitive with full parametric updates and offline training. Across challenging mathematical reasoning benchmarks, our approach significantly outperforms zero-shot and raw data ICL baselines, while transferring effectively across datasets.

13.
arXiv (CS.CL) 2026-06-16

A Practical Evaluation Method for Long-Form Simultaneous Speech-to-Speech Translation

Simultaneous speech-to-speech translation (SimulS2ST) enables real-time cross-lingual communication, but existing evaluation has focused largely on short or pre-segmented speech rather than long-form, continuous input. Prior approaches are difficult to reproduce and make assumptions that do not hold for end-to-end systems. We present a practical evaluation method for long-form SimulS2ST. Given source speech, pre-segmented source transcripts, and reference translations, we run automatic speech recognition (ASR) and forced alignment on the generated target speech to recover token-level timestamps, then apply a sentence-embedding-based aligner to match the target text to its corresponding source sentences. This enables sentence-level computation of latency and quality metrics, including YAAL and xCOMET, which are then aggregated into final system-level scores. Experiments on representative SimulS2ST systems show that the method is effective in practice and reveal that current systems suffer from substantial latency accumulation on long speech.

14.
arXiv (CS.AI) 2026-06-12

LoRA-Muon: Spectral Steepest Descent on the Low-Rank Manifold

arXiv:2606.12921v1 Announce Type: cross Abstract: Low-Rank Adaptation (LoRA) significantly reduces compute and memory costs for finetuning Deep Learning models but is often harder to tune than dense training: when using factor-wise optimizers such as AdamW, it is sensitive to initialization choices, its optimal learning rates transfer poorly across ranks, and it often fails to beat dense baselines. We derive LoRA-Muon by applying the Muon optimizer's spectral steepest-descent rule to the low-rank setting. Along with our split weight-decay rule, our main claim is that LoRA-Muon is a good low-rank proxy for full-rank Muon and Shampoo-family optimizers. Its optimal learning rates transfer across rank, width, depth, and factor-rescaling. In our compute-matched TinyShakespeare study, a rank-$2$ proxy recovers the dense best tested learning rate, and a rank-$32$ LoRA-Muon run attains lower mean validation loss than the dense baseline in the seed-averaged sweep. We further show that the Spectron optimizer depends on arbitrary factor scaling, so it would likely be a poor fit when finetuning starts from badly imbalanced factors, and that LoRA-RITE's simplified QR-coordinate core implements the same spectral update. LoRA-Muon computes that update without QR-decomposition and avoids storing second moments, making it more accelerator-friendly and memory-efficient.

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

CAP: Towards PPG Universal Representation Learning with Patient-level Supervision

arXiv:2606.15284v1 Announce Type: cross Abstract: Photoplethysmography (PPG) plays a central role in wearable health monitoring and clinical decision support. Yet existing approaches to universal PPG representation learning largely focus on signal-level objectives and often overlook patient-level health context, which limits generalization to complex clinical tasks and heterogeneous cohorts. To address this gap, we construct a large-scale paired PPG-EHR multimodal dataset by distilling fragmented medical histories and clinical records into cohesive, patient-level electronic health records (EHR). Building on this resource, we propose Clinical Anchored Pretraining for PPG (CAP). During pretraining, CAP performs cross-modal contrastive alignment that anchors PPG representations to patient-level clinical semantics, guiding the encoder beyond waveform fitting toward modeling consistency in a patient's overall physiological state. During downstream adaptation, the pretrained PPG encoder provides clinically grounded representations that strengthen inductive bias and improve robustness and transferability. Experiments demonstrate that CAP consistently outperforms strong baselines on four diverse downstream tasks. CAP achieves a particularly large gain on respiratory rate prediction (up to +87.6% relative improvement over the state-of-the-art baseline) and delivers an average relative +26.7% across all tasks. We further enhance the interpretability of our approach through comprehensive analyses, including ablations and multiple complementary visualizations of the learned representations. The code for our experiments is available at: https://github.com/gody123gody/CAP .

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

LongWebBench: Evaluating Structural and Functional Webpage Generation in Long-Horizon Settings

arXiv:2606.17727v1 Announce Type: new Abstract: Recent vision-language models (VLMs) have shown promising progress in generating webpages from visual inputs, yet existing evaluations mainly focus on short, single-screen, and largely static webpages. We introduce LongWebBench, a benchmark for evaluating long-horizon webpage generation from both structural and functional perspectives. LongWebBench contains 490 real-world long webpages for structural fidelity evaluation and 507 goal-oriented interaction tasks over 129 webpages for functional evaluation. It employs two complementary protocols: a multi-dimensional VLM-based metric for assessing long-range structural coherence, and a DOM-augmented agent-based pipeline for end-to-end functional verification. We further examine the automatic evaluation protocols through human agreement analysis. Experiments with state-of-the-art open-source and proprietary VLMs under single-image and multi-image settings reveal that structural fidelity degrades as webpage length increases, while visually plausible generations often fail to support executable multi-step interactions. These results highlight the need to evaluate long webpage generation beyond visual similarity, with executable interaction as a core criterion. Our code and data are available at https://github.com/zheny2751-dotcom/LongWebBench.

17.
arXiv (CS.AI) 2026-06-12

GeoDial: A Multimodal Conversational Tutoring Dataset for Geometry Problem-Solving with Visual Tutor Turns

arXiv:2606.12419v1 Announce Type: cross Abstract: Several educational domains rely heavily on diagrams and visual cues, yet most existing tutoring datasets are limited to text-only interactions. This limits the development of AI tutors that can teach in visually grounded ways used by human instructors. Thus, we introduce GeoDial, a multimodal tutoring dataset of over 1.3K teacher-student dialogs in the domain of geometry collected from experienced math teachers, where instructional turns are explicitly grounded in diagram highlights. We propose a scalable annotation protocol that integrates dialog acts, visual highlighting, and feedback, enabling fine-grained supervision of both language and visual tutoring behavior. To illustrate the challenges posed by this setting, we fine-tune several vision-language models on GeoDial and evaluate their ability to generate tutoring utterances and diagram highlights. While supervised fine-tuning substantially improves the quality of generated dialog, it struggles to produce accurate diagram highlights, revealing a key limitation of current methods and highlighting the need for approaches that more effectively integrate visual reasoning with pedagogical interaction.

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

Repurposing a Speech Classifier for Guided Diffusion-Based Speech Generation

arXiv:2606.20457v1 Announce Type: cross Abstract: Classifier guidance is a way to control diffusion generation by using a noise-conditioned classifier to steer the sampling process toward a target class. One drawback of classifier guidance is that it requires two separately trained models: a classifier and a diffusion model. We therefore study a more compact alternative in which a conventionally trained speech classifier is repurposed as the backbone for diffusion generation. Starting from a frozen noise-conditioned classifier in log-Mel space, we attach a lightweight subnetwork that reuses intermediate classifier representations and train only this subnetwork under a Denoising Score Matching objective. Our work shows that a pretrained classifier can be repurposed for conditional generation, providing an appealing bridge between discriminative modeling and conditional speech synthesis resulting in high speech quality within a single-backbone model, with reduced memory footprint and computational cost.

19.
arXiv (quant-ph) 2026-06-12

Accidental Symmetry in the Tavis-Cummings Model via the Schwinger Boson Representation

arXiv:2606.12813v1 Announce Type: new Abstract: The Jaynes-Cummings (JC) Hamiltonian is a paradigmatic model of light-matter interaction and, more generally, qubit-boson interactions, widely used across atomic, optical, and superconducting qubit platforms. In the multi-qubit setting, where n qubits are identically coupled to a single boson mode, this interaction is known as the Tavis-Cummings (TC) Hamiltonian. The structure of the TC model is usually understood in terms of two standard symmetries: permutation invariance of the qubits and a U(1) symmetry associated with conservation of the total excitation number. Here we identify an additional, independent "accidental" symmetry of the TC Hamiltonian and construct the corresponding conserved observable. We show that, for n>2 qubits, this symmetry imposes strong constraints on the realizable unitary transformations. These constraints persist in the presence of the global $J_z$ Hamiltonian, but are removed by adding $J_z^2$, even though $J_z^2$ preserves both permutation invariance and the U(1) symmetry. Finally, we explain the origin of this previously unnoticed symmetry using Schwinger's boson representation of angular momentum. These restrictions have important implications for controllability of the TC system and for its applications to quantum computing, which are investigated further in a companion paper.

20.
arXiv (CS.CL) 2026-06-12

Agents' Last Exam

Recent AI systems have achieved strong results on a wide range of benchmarks, yet these gains have not translated into economically meaningful deployment across many professional domains. We argue that this gap is largely an evaluation problem: widely used benchmarks lack sustained performance measurement on real and economically valuable workflows. This paper introduces Agents' Last Exam (ALE), a benchmark designed to evaluate AI agents on long horizon, economically valuable, real world tasks with verifiable outcomes. Developed in collaboration with 250+ industry experts, ALE covers non-physical industries defined with reference to O*NET / SOC 2018 (the U.S. federal occupational taxonomy). It is organized around a task taxonomy with 55 sub fields grouped into 13 industry clusters covering 1K+ tasks. Current results show that the hardest tier remains far from saturated: across mainstream harness and backbone configurations, the average full pass rate is below 1%. ALE is designed as a living benchmark: its task pool grows continuously as new workflows and industries are onboarded. More broadly, ALE is intended not merely as another leaderboard, but as an instrument for closing the gap between benchmark success and GDP relevant impact.

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

Towards Responsibly Non-Compliant Machines

arXiv:2606.12147v1 Announce Type: new Abstract: We consider the problem of engineering autonomous intelligent agents that are capable to responsibly not comply with user requests. We argue that machine non-compliance comes in many different forms, and sketch the issues we should pursue on the road of accomplishing responsibly non-compliant intelligent machines. We anchor responsible non-compliance in justifications for task refusal, pathways to override the non-compliance, as well as careful tracking of security risks and liability transfers.

22.
medRxiv (Medicine) 2026-06-15

Supporting people to access social security payments through the Special Rules for End of Life: a qualitative study of the perspectives of patients, carers and health care professionals

Background: People living with terminal illness face a double financial burden from additional costs and loss of earning for themselves and their carers. Social security benefits are intended to help alleviate some of this financial pressure, and in the UK and other countries people are eligible for fast-tracked access to financial support via the Special Rules for End of Life. One in 3 people who are eligible miss out on this support, yet there is limited evidence on the reasons for this take-up deficit. Objectives: The aim of this study is to understand the barriers and facilitators to claiming benefits for terminally ill people from the perspectives of patients, carers, and health care professionals. Methods: This is a qualitative study combining i) focus groups with healthcare professionals recruited via professional networks and social media, and ii) interviews with patients and carers recruited in hospital and hospice settings. We analysed the data using Practical Thematic Analysis Results: Fifty-five multidisciplinary healthcare professionals participated in 11 focus groups, and we interviewed 10 patients and carers. We constructed five descriptive themes to summarise the data: Navigating priorities and uncertainty; positive impacts alongside a sense of shame and stigma; talking about money, difficulties and dividends; everybodys, yet nobodys, responsibility; and sticking points in the system. Conclusion: The themes reveal several challenges that may contribute to people not taking up this financial support. However, discussions about access to benefits were also seen as a core part of holistic care, a positive way to offer support and a gateway to other discussions about end-of-life care preferences and decisions. Recommendations for policy and practice include evaluating the adoption of a diagnostic rather than a prognostic eligibility criteria, integrating discussions about benefits into existing processes such as advance care planning, and improving education and support for clinicians.

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

Efficient and Sound Probabilistic Verification for AI Agents

arXiv:2606.20510v1 Announce Type: cross Abstract: Securing AI agents that operate in complex digital environments has become a critical need, and runtime monitoring approaches that formulate and enforce policies expressed in a formal language like Datalog offer a promising solution. However, existing approaches are restricted to deterministic policies. In many practical applications of AI agents, there is a need to enforce security policies in the face of ambiguity, leading to probabilistic predicates or state transitions (for example, a declassifier or Personally Identifiable Information (PII) detector that has some failure probability on each invocation). Furthermore, in many such applications, one cannot easily make the independence assumptions necessary to invoke prior work on probabilistic inference in Datalog. We address this by introducing a sound and efficient framework for such verification based on distributionally robust optimization, computing sound upper bounds on the probability of policy violation regardless of possible correlations between predicates. On standard benchmarks for terminal and tool calling agents, we demonstrate that our approach outperforms prior art and improves the security-utility trade-off while ensuring rigorous bounds on the probability of policy violation.

24.
medRxiv (Medicine) 2026-06-17

Frequency-dependent cognitive effects of Deep Brain Stimulation in Parkinson's Disease: A Systematic Review and Meta-Analysis

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) improves levodopa-induced motor complications and cardinal motor symptoms of Parkinson's disease (PD), but stimulation frequency may differentially shape outcomes. This is evident for axial and gait symptoms, which may respond differently to lower-frequency stimulation. Whether frequency-dependent effects extend to cognition remains unclear. Objective: To investigate the cognitive effects of DBS at distinct frequencies in PD. Methods: We conducted a systematic review and meta-analysis (PROSPERO - CRD42024618253). PubMed, Web of Science, and EMBASE were searched for studies assessing cognitive outcomes under different stimulation frequencies. Eight cognitive domains were defined: verbal fluency, cognitive flexibility, executive control, working memory, attention, processing speed, episodic memory, and time processing. Multilevel random-effects meta-analyses were performed, with effect sizes expressed as Hedges' g. Results: Forty-three studies met the inclusion criteria, the majority (n = 31) involving STN-DBS. Twenty-one STN-DBS studies, including 355 patients, were included in the meta-analysis. Compared with HFS ([&ge;] 130 Hz), lower frequencies (4-80 Hz) were associated with better verbal fluency (g = 0.27) and cognitive flexibility (g = 0.38), with consistent effects across sensitivity and leave-one-out analyses. Accuracy-based executive control measures also favored lower-frequency stimulation. OFF-stimulation comparisons showed a concordant pattern. Evidence for other targets (PPN and NBM) was limited. Conclusions: Lower-frequency STN-DBS was associated with modest benefits in specific cognitive domains compared with HFS. These findings highlight the need for future research to determine how frequency interacts with stimulation location and symptom-specific networks to shape cognitive and cognitive-motor outcomes in PD.

25.
medRxiv (Medicine) 2026-06-16

Ranking-optimized survival models can underperform fixed-horizon clinical prediction: a SUPPORT2 reanalysis of machine learning, attending-physician judgment, and the original SUPPORT model at 60- and 180-day mortality

Machine-learning survival models are increasingly proposed for intensive-care mortality prediction and are almost always selected and reported using the concordance index, a ranking metric averaged over follow-up. Yet most bedside decisions hinge on a probability at a specific time, such as 60- or 180-day mortality. We asked whether ranking-optimized models remain competitive at fixed clinical horizons against two reference points clinicians actually rely on: unaided attending-physician judgment and the original 1995 SUPPORT logistic model. Reanalyzing the SUPPORT2 cohort (9,105 critically ill adults from five United States centers, 1989-1994) under a stratified 70/15/15 split, we compared a gradient-boosted survival model, the physician's recorded prognosis, and the 1995 model at 60 and 180 days, alongside several alternative learners. The survival model achieved competitive ranking concordance (0.705) yet underperformed both comparators at fixed horizons: at 60 days its area under the ROC curve was 0.750, against 0.808 for physicians on the matched sample and 0.827 for the 1995 model, a gap that held across eight independent data splits and remained statistically reliable after multiplicity correction. The shortfall was not miscalibration, since post-hoc recalibration left discrimination unchanged, nor limited capacity, since neural networks, a deep ranking model, and two timepoint-aware discrete-time models also failed to close it; replacing the ranking objective with timepoint-matched binary training recovered roughly half the gap, pointing to an objective-horizon mismatch. Discrimination was equitable across sex, race, and age, but leave-one-disease-out validation exposed severe failure for disease groups absent from training, and the physician advantage was conditional on a physician electing to provide an estimate. We recommend reporting timepoint-specific discrimination alongside concordance, timepoint-matched training when fixed-horizon predictions drive care, leave-one-subgroup validation, and distribution-free prediction intervals to support selective deployment.