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

MOSAIC: Modality-Specific Adaptation for Incremental Continual Learning in Parkinson's Disease Gait Assessment

arXiv:2606.13258v1 Announce Type: new Abstract: Gait-based Parkinson's disease assessment increasingly relies on heterogeneous sensors, but clinical systems rarely collect all modalities simultaneously. New sensors may arrive through device upgrades, protocol changes, or multi-center deployment, while historical patient data are often unavailable because of privacy and storage constraints. This modality-incremental setting faces three challenges: unreliable cross-modal distillation, modality-specific statistical shifts, and reduced plasticity after preservation. We propose MOSAIC, a compact continual learning framework. First, we identify the Toxic Teacher phenomenon and introduce Modality-Specific Warm-Up to stabilize newly learned modality representations before distillation. Second, we propose a statistics-decoupled MSBN architecture that isolates sensor statistics while maintaining a shared semantic backbone. Third, we design a curriculum-guided repulsive objective for Plasticity Recovery, preserving legacy knowledge while recovering modality-specific capacity. Experiments on three multimodal Parkinson's gait datasets show that MOSAIC improves final performance and mitigates forgetting. Project code is available at: https://github.com/minlinzeng/MOSAIC_Modality-Specific-Adaptation-for-Incremental-Continual-Learning-in-PD-Gait-Assessment.git

02.
arXiv (quant-ph) 2026-06-11

Split-Evolution Quantum Phase Estimation for Particle-Conserving Hamiltonians

arXiv:2604.14921v2 Announce Type: replace Abstract: We present a hardware demonstration and resource analysis of split-evolution quantum phase estimation (SE-QPE) on a Quantinuum System Model H2 quantum computer. SE-QPE is a modification to canonical QPE for particle-conserving Hamiltonians in which controlled time evolution is replaced by CSWAP-based interference between a target register and a reference register. For factorizations of time evolution with a shared eigenbasis, SE-QPE preserves the phase-register outcome distribution of canonical QPE and, unlike with compute–uncompute substitutions, it remains compatible with non-exact eigenstates. The substitution removes controlled-simulation overhead and enables parallel evolution on two registers, reducing the depth of each phase-kickback block. Resource analysis for Trotterized double-factorized chemistry Hamiltonians shows that the substitution becomes increasingly favorable at higher phase powers and combining QPE and SE-QPE implementations can be a useful option. Over a range of FeMoco active spaces, SE-QPE reduces time evolution resources, with asymptotic reductions of about 33% in CX count, 25% in $T$ count, and an asymptotic depth ratio of $3/N$ for CX layers. On Quantinuum H2-2, a four-qubit model ethylene demonstration with explicit inverse QFT and repeated phase-kickback steps up to 8 phase bits yields distinct energies and shows the auxiliary registers provide useful error detection filters.

03.
medRxiv (Medicine) 2026-06-15

Non-invasive intracranial pressure waveform reconstruction with deep learning

Purpose: Continuous intracranial pressure (ICP) monitoring requires invasive instrumentation, reaching only a narrow subset of critically ill patients. We tested whether deep learning models trained on routinely acquired extracranial signals can reconstruct continuous ICP waveforms at clinically relevant accuracy in an independent external cohort. Methods: In adults admitted to the ICU at a single quaternary health system, five deep learning architectures were trained on high-frequency arterial blood pressure (ABP), photoplethysmography (PPG), and electrocardiography (ECG) waveforms, using invasive (intraparenchymal) ICP as ground truth. Two fusion strategies (early and late) and three training objectives (waveform-morphology, baseline robust regression, and weighted robust regression) were evaluated. Models were externally validated on the held-out MIMIC-III Waveform Database. Performance was assessed by mean absolute error (MAE) and waveform similarity by Pearson correlation (r). Results: We analyzed data from 158 critically ill adults (~5,322 hours) across two quaternary health systems (Johns Hopkins Hospital, Baltimore; Beth Israel Deaconess Medical Center, Boston). Validation MAE ranged from 4.276 mmHg [95% CI 4.269, 4.283] (gated recurrent, late fusion) to 4.946 mmHg [95% CI 4.938, 4.956] (attention-based, early fusion), with Pearson r ranging from 0.599 [95% CI 0.599, 0.600] to 0.722 [95% CI 0.722, 0.723]. The multiscale encoder-decoder model demonstrated the most favorable MAE-correlation tradeoff. Conclusion: This is the first demonstration that continuous ICP waveform reconstruction from bedside signals generalizes across institutions at clinically relevant accuracy, establishing a foundation for non-invasive ICP monitoring and motivating validation across broader populations and ICP ranges.

04.
arXiv (CS.AI) 2026-06-16

Green SARC: Predictive Cost and Carbon Governance for Agentic AI Systems

arXiv:2606.15954v1 Announce Type: cross Abstract: Agentic AI systems act through tools and sub-agents, yet the controls meant to bound their financial and environmental cost still sit on dashboards evaluated beside or after execution. Green SARC applies the SARC governance-by-architecture framework – four enforcement sites in the agent loop – to FinOps and GreenOps, contributing the theory of what to enforce and how to predict it. We report four policy-independent results. (i) The unconstrained "State Snowball" is $\Theta(n^2)$ in loop depth; on 3,000 real multi-step plans (SWE-rebench) it holds on 100%, with median curvature $\hat{c}_2=216$ exceeding the linear-accretion prediction $p/2=134$ – real plans accrete faster than the model. (ii) On real residuals the Normal-$\sigma$ gate under-covers (92% at nominal 95%); split-conformal calibration holds (95.2%). (iii) A soft Lagrangian penalty tuned to the budget in expectation breaches it on 91.5% of seeds; the architectural gate breaches 0%. (iv) Under binding budgets the gate's over-budget incidence is 0% on synthetic and real (BurstGPT) arrivals. End-to-end token/USD/carbon savings (47–55%) are real but policy-dependent in magnitude – set by a scope-cap knob, not by gate rejections. The library is open-source, dependency-free, and ships a regeneration script for every cited number.

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

Distilling latent electrostatics from foundation machine learning interatomic potentials

arXiv:2606.15001v1 Announce Type: cross Abstract: Foundation machine learning interatomic potentials (MLIPs) have enabled atomistic simulations across broad regions of chemical and materials space, but many remain computationally expensive and lack explicit electrostatics, limiting their use for systems governed by long-range interactions and electrical response. Previously, we introduced Latent Ewald Summation (LES), which learns latent atomic charges and long-range electrostatics from density functional theory (DFT) energy and force labels alone. Here, we use LES to extract electrostatics that are latent in foundation models: energies and forces predicted by a teacher model are used to train a lightweight LES-augmented student MLIP, with optional fine-tuning on additional DFT data. The resulting models reduce computational cost while providing access to Born effective charge tensors, and infrared spectra. We benchmark student models distilled from a broad set of foundation MLIPs, including UMA, MACE, Orb, eSEN, GemNet-OC, PET, and EquiformerV2-based models, against experimental infrared spectra for liquid water, concentrated hydrochloric acid, and the anatase TiO2(101)-water interface. Across these systems, electrostatic response can be extracted from most foundation MLIPs. The benchmark further shows that the underlying DFT level and dataset used to train the teacher model play a larger role than architecture in determining electrostatic and spectroscopic accuracy. For the TiO2-water interface, fine-tuning with a modest amount of higher-level DFT data improves structural and infrared predictions. LES-based distillation therefore provides a practical route for converting foundation MLIPs into efficient, electrically responsive models, while also testing the physical fidelity encoded in foundation models.

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

World Tracing: Generative Pixel-Aligned Geometry Beyond the Visible

Image-to-3D methods often trade off faithfulness and completeness: depth estimators are anchored to input pixels but stop at the visible surface, while image-to-3D models generate complete shapes that are often misaligned with the input. We introduce World Tracing, a generative pixel-aligned geometry representation that predicts 3D points aligned with observed pixels while completing geometry beyond the visible surface. For each input pixel, World Tracing predicts an ordered stack of camera-space 3D points, where the first layer represents the visible surface and subsequent layers represent front-to-back intersections with occluded surfaces. We instantiate this representation with a world-tracing diffusion transformer, WT-DiT, which treats multiple geometry layers as separate denoising tokens coupled through factorized and global attention. WT-DiT is trained with pixel-space flow matching and a mixed noise schedule that balances visible-surface reconstruction with occluded-geometry generation. World Tracing achieves strong performance on visible-surface reconstruction and complete geometry generation across object, scene, and dynamic benchmarks, outperforming both depth predictors and image-to-3D generators. It also preserves 2D-to-3D correspondence, enabling text-driven 3D scene editing, geometry-conditioned novel-view video synthesis, and training-free integration with textured-mesh generators.

07.
arXiv (quant-ph) 2026-06-15

New Identity for Cayley's First Hyperdeterminant with Applications to Symmetric Tensors and Entanglement

Authors:

arXiv:2512.03093v3 Announce Type: replace Abstract: In this article, a new formula for computing Cayley's first hyperdeterminant in terms of the Levi-Civita symbol is given. It is then shown that this formula can be used to compute the hyperdeterminant of symmetric tensors in polynomial time with respect to their order (assuming fixed side length). Applications to quantifying the entanglement of states of bosonic quantum systems are then discussed. Additionally, in order to obtain the fast calculation of the hyperdeterminant on symmetric tensors, generalized elimination and duplication matrices are defined and their explicit formulas are derived.

08.
arXiv (quant-ph) 2026-06-15

Dose-efficient Quantum Phase Estimation in Lossy Optical Interferometry

arXiv:2606.14254v1 Announce Type: new Abstract: Optical interferometry is a cornerstone technique for precise phase measurements across various fields. In many applications, for example, biological imaging, it often necessitates stringent limits on light intensity to prevent adverse effects on light-sensitive samples, a condition known as dose-limited regimes. Maximizing the precision per dose is therefore crucial. In quantum metrology, quantum correlations enable high precision in phase estimation while adhering to dose constraints. Nevertheless, photon loss, including absorption by a sample, substantially diminishes the benefits of quantum enhancement in interferometry. In this work, we experimentally investigate a dose-efficient approach to quantum phase estimation using sequential strategies in the presence of loss. Performance of sequential strategies with and without control is evaluated through quantum Fisher information (QFI) per dose. Experimental results show that both sequential strategies exceed the classical limit and outperform the parallel strategy using unbalanced N00N states. Notably, the control-enhanced sequential strategy attains superior QFI per dose, approaching the quantum limit. These results highlight the promise of sequential strategy for imaging and sensing in resource-constrained scenarios, marking a significant step toward practical and efficient quantum metrology in lossy environments.

09.
arXiv (quant-ph) 2026-06-15

Resurgence of the Thermal Transition between Bounce and Sphaleron

arXiv:2606.13778v1 Announce Type: cross Abstract: We study the thermal transition between the bounce and the sphaleron in quantum mechanics with a metastable vacuum from the viewpoint of Borel resurgence. For two models representing a second-order and a first-order transition, we compute the perturbative expansion of the thermal free energy to high orders and extract the leading Borel singularity data $(A,b,S)$ as functions of temperature. The Borel singularity location $A$ reproduces the on-shell action of the dominant saddle on both sides of the transition, joining smoothly in the second-order case and developing a kink in the first-order case. The characteristic exponent $b$ jumps between $0$ and $1/2$ across the transition, counting the zero modes of the corresponding saddle. The Stokes constant $S$ matches the one-loop determinant around the saddle. The perturbative expansion around the false vacuum thus determines the transition temperature, the order of the transition, and the decay rate including the one-loop prefactor without relying on semiclassical inputs.

10.
bioRxiv (Bioinfo) 2026-06-10

When batch correction corrupts gene expression: uncovering distortions in correlation structures

Batch correction is essential for integrating datasets and enabling population-level insights into health and disease. Embedding-based approaches are among the most widely used solutions, but here we highlight a critical, overlooked limitation: these methods can distort feature-to-feature (e.g., gene gene) relationships, potentially undermining downstream analyses. We investigate this issue and introduce a novel metric to quantify it.

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

A New Perspective on Precision and Recall for Generative Models

arXiv:2511.02414v3 Announce Type: replace Abstract: With the recent success of generative models in image and text, the question of their evaluation has recently gained a lot of attention. While most methods from the state of the art rely on scalar metrics, the introduction of Precision and Recall (PR) for generative model has opened up a new avenue of research. The associated PR curve allows for a richer analysis, but their estimation poses several challenges. In this paper, we present a new framework for estimating entire PR curves based on a binary classification standpoint. We conduct a thorough statistical analysis of the proposed estimates. As a byproduct, we obtain a minimax upper bound on the PR estimation risk. We also show that our framework extends several landmark PR metrics of the literature which by design are restrained to the extreme values of the curve. Finally, we study the different behaviors of the curves obtained experimentally in various settings.

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

Finsler Geometry, Graph Neural Networks, and You

arXiv:2606.17185v1 Announce Type: new Abstract: Graph neural network architectures based on the graph Laplacian approximate the Laplace-Beltrami operator, thus limiting their application to isotropic operators. As a nonlinear alternative to the Laplace-Beltrami operator, we consider estimates of the Finsler Laplacian on point clouds sampled from a manifold. We prove that these discrete estimates converge to the true operator on the manifold as the number of point samples grows. Moreover, we show that this operator can be expressed as a graph neural network layer, which we use to define a family of Finslerian graph neural networks constrained to express Finsler geometry. We show that Finslerian graph neural networks recover the geometry underlying nonlinear diffusion equations in practice.

13.
arXiv (quant-ph) 2026-06-12

Certifying Nonclassical Proper-Time Histories with a Quantum Clock

Authors:

arXiv:2606.12755v1 Announce Type: new Abstract: Quantum clocks can acquire relativistic phases from motional or gravitational proper-time differences, but reduced clock dephasing alone does not certify nonclassical proper-time histories. We formulate this distinction as a channel-certification problem. First, we show that any two-level single-time dephasing signal, including one generated by an effective quantum proper-time label, admits a classical random proper-time representation. We then define the convex set of classical mixtures of experimentally specified proper-time histories and prove a Choi-rank separation criterion for conditioned coherent history recombination. A two-branch Ramsey protocol gives explicit bright- and dark-port population witnesses outside this classical set. The certification is operational and relative to the specified history set: it rules out classical mixtures of the same implemented proper-time histories, not arbitrary classical protocols with different histories or controls.

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

PI-Hunter: Automated Red-Teaming for Exposing and Localizing Prompt Injections

arXiv:2606.12737v1 Announce Type: cross Abstract: Large Language Models (LLMs) are rapidly evolving into agentic systems that interact with external tools and environments, introducing new security risks such as indirect prompt injection attacks through untrusted external sources. Existing defenses mainly focus on blocking malicious content at inference time, and current red-teaming methods primarily optimize attack success. As a result, developers have limited visibility into how latent prompt injections emerge and propagate through agents. We propose PI-Hunter, an automated agentic auditing framework for proactive vulnerability exposure in LLM agents. PI-Hunter constructs realistic source-aware test cases and iteratively evolves them through feedback-driven exploration to induce agents to retrieve and reveal latent malicious instructions embedded within external environments. Extensive experiments across multiple benchmarks, agent architectures, attacks, and defenses demonstrate that PI-Hunter substantially improves vulnerability exposure and attack-surface coverage over strong automated red-teaming baselines, while remaining effective under existing prompt injection defenses.

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

Discrimination-free Insurance Pricing with Privatized Sensitive Attributes

arXiv:2504.11775v3 Announce Type: replace-cross Abstract: Fairness has become an important concern in insurance pricing as insurers increasingly rely on machine learning models to predict expected losses. At the same time, regulatory and privacy constraints often restrict insurers' ability to access or use sensitive attributes such as gender or race. Recent actuarial research addresses fairness in this context through the concept of the discrimination-free premium, which removes both the direct and indirect effects of sensitive attributes while preserving actuarial consistency. However, implementing this approach typically requires access to the sensitive attributes themselves, which may not be available in practice. This paper studies the estimation of discrimination-free insurance premiums when sensitive attributes are observed only in privatized or noise-perturbed form. We consider a multi-party data setting in which insurers observe non-sensitive attributes and outcomes, while a trusted third party holds privatized sensitive attributes generated through a privacy mechanism. Within this framework, we develop statistical methods for estimating discrimination-free premiums using only the privatized attributes. We study two settings of practical relevance: when the privacy mechanism is known and when its noise level is unknown. For both cases, we establish theoretical guarantees for the proposed estimators. Numerical experiments and empirical applications demonstrate that the proposed approach enables fair insurance pricing while respecting privacy and regulatory constraints.

16.
arXiv (CS.AI) 2026-06-12

HarnessBridge: Learnable Bidirectional Controller for LLM Agent Harness

arXiv:2606.12882v1 Announce Type: new Abstract: Large language models are increasingly deployed as agents for long-horizon tasks, yet their performance is shaped not only by model capability and environment design, but also by the harness that mediates agent–environment interaction. Existing harnesses are largely manually engineered, making them difficult to scale as trajectories grow longer and interactions become more complex. In this work, we ask whether harness can be generated by a learnable plug-in module that can be trained in an end-to-end fashion. We introduce HarnessBridge, a lightweight learnable harness controller that parameterizes the agent–environment interface as a bidirectional projection. HarnessBridge learns two bidirectional projections: observation projection, which distills raw trajectories into compact, decision-relevant states, and action projection, which converts proposed actions into executable transitions or trajectory-grounded rejections. We train HarnessBridge on a harness supervision dataset via unified instruction tuning. On Terminal-Bench~2.0 and SWE-bench Verified, HarnessBridge matches or surpasses strong specialized harnesses while substantially reducing token usage and trajectory length, and generalizes from smaller generators to larger commercial models.

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

Service-Induced Congestion in Memory-Constrained LLM Serving

arXiv:2606.15555v1 Announce Type: cross Abstract: In large language model (LLM) serving, each request accumulates persistent graphics processing unit (GPU) memory during service as its key-value cache grows with every generated token. Under high concurrency, aggregate memory usage therefore increases endogenously over time: the service process itself creates future capacity pressure. When memory capacity is exceeded, systems evict active requests, discarding cached state and restarting them later, which wastes computation and reduces throughput. We develop a discrete-time dynamical model of memory-constrained LLM inference that captures admission, memory growth, and eviction under continuous batching. In the saturated-input regime, the system admits both eviction-free fixed points and limit cycles with evictions. For homogeneous workloads, we show that the eviction-free equilibrium is unstable and that, except for a Lebesgue-measure-zero exact-capture set, the system converges to a unique worst-case limit cycle that is asymptotically stable outside this exceptional set, with throughput losses as large as 50%. For heterogeneous workloads, we prove a stability criterion in the two-class common-input setting and explain how the survival-polynomial mechanism generalizes to multiple classes and heterogeneous-input lengths. Under an input-dominated scaling regime, coprime decoding lengths stabilize the eviction-free equilibrium, while non-coprime lengths create synchronized modes that drive instability. These results characterize when workload heterogeneity desynchronizes completions and helps stabilize memory-constrained serving. More broadly, we identify service-induced congestion as a structural instability mechanism and derive scheduling design principles for sustaining high throughput.

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

PIVOT: Bridging Black-Scholes Implied-Volatility and Price Objectives via Differentiable Jäckel Operator

arXiv:2606.17065v1 Announce Type: cross Abstract: Modern option-learning systems operate in two coordinates: price space, where markets quote and no-arbitrage constraints are most naturally enforced, and implied volatility (IV) space, where volatility surfaces are smoothed, regularized, and evaluated. The bottleneck is interface, not approximation: Jäckel's seminal "Let's Be Rational" (LBR) solver already inverts the Black-Scholes price to machine precision efficiently. What is missing is a differentiable layer that preserves LBR in the forward pass and avoids backpropagating through its branch logic. Such a layer must also confront the unavoidable singularity of the inverse map in the low-vega regime, where the sensitivity 1/vega diverges as vega -> 0. We close this gap with PIVOT, the Price-Implied-Volatility Objective Translator. PIVOT keeps the LBR forward pass intact and supplies the backward pass by implicit differentiation through the smooth Black-Scholes/Black-76 price map, with an explicit gating contract: invalid domains return NaN, well-conditioned rows receive the exact 1/vega gradient, and low-vega rows are attenuated rather than silently regularized. On a single H100, a fused Triton kernel reaches 1.79e9 IV/s at machine precision (9.3e-14 max relative error vs. the reference C solver); end-to-end label generation sustains 48.9M/s on synthetic chains and 16.6M/s on SPX OptionMetrics. In a HyperIV-style one-day reproduction on SPX, PIVOT-augmented objectives Pareto-dominate the baselines, reducing held-out price MAE by up to 43.4% and the strongest three-seed gated objective improving price MAE by 38.8% and IV MAE by 21.3% jointly; cross-asset results on RUT, VIX, and NDX show directional price-MAE gains of 40.1%, 24.2%, and 16.7%, while an ungated IV-roundtrip control collapses to a degenerate near-zero surface, confirming the gate as a correctness contract rather than a tuning knob.

19.
bioRxiv (Bioinfo) 2026-06-19

Tox21mer, A transformer foundation model for Tox21 high-throughput concentration-response curves data

The U.S. Tox21 collaboration has generated a large reference library of high-throughput concentration-response assays. Here we present Tox21mer, a 43.5-million-parameter transformer that encodes each Tox21 concentration-response curve together with assay metadata into a 768-dimensional representation. Tox21mer was pretrained on ~2.5 million curves from 102 assay protocols and 6,727 compounds using masked-response reconstruction as the primary objective, with low-weight auxiliary supervision on assay outcome and AC50. To evaluate the learned representation, we trained lightweight probes on frozen embeddings from concentration-response curves of held-out compounds. The representation supported a macro-F1 of 0.985 for three-class outcome prediction (agonist, antagonist, inactive), a binary F1 of 0.994 for active/inactive prediction, and an R2 of 0.87 for log10(AC50). The learned embeddings formed coherent groupings by curve-class category. A masked-only pretraining variant retained near-baseline probe performance, indicating that the representation is learned largely from the self-supervised objective rather than from auxiliary labels. Ablation analyses further showed that predictive performance depends mainly on curve-level response-value distributions conditioned on assay context, with limited reliance on detailed within-curve ordering. Tox21mer thus provides a reusable foundation representation for Tox21 concentration-response data that can support extrapolation to untested compounds through integration with chemical features or distillation into chemistry-only student models for large-scale external screening.

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

Self-Supervised Learning of Iterative Solvers for Constrained Optimization

arXiv:2409.08066v3 Announce Type: replace Abstract: The real-time solution of parametric optimization problems is critical for applications that demand high accuracy under tight real-time constraints, such as model predictive control. To this end, this work presents a learning-based iterative solver for constrained optimization, comprising a neural network predictor that generates initial primal-dual solution estimates, followed by a learned iterative solver that refines these estimates to reach high accuracy. We introduce a novel loss function based on Karush-Kuhn-Tucker (KKT) optimality conditions, enabling fully self-supervised training without pre-solved optimizer solutions. Theoretical guarantees ensure that the training loss function attains minima exclusively at KKT points. A convexification procedure enables application to nonconvex problems while preserving these guarantees. Experiments on two nonconvex case studies demonstrate speedups of up to one order of magnitude compared to state-of-the-art solvers such as IPOPT, while achieving orders of magnitude higher accuracy than competing learning-based approaches.

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

3-Key-Input: Exploring the Theoretical Minimum Keys for Text Entry

Authors:

How far can we reduce the number of physical keys if we endow an ambiguous keyboard with modern language models? Fewer keys increase hardware design freedom in constrained settings such as assistive devices and mobile form factors. This paper systematically evaluates text entry systems using 2-5 physical keys combined with language-model-based disambiguation. On a 300-sentence English corpus (100 sentences each for Business / Conversational / Technical), we compare key counts (2-5), letter-to-key mappings (layout-based / frequency-based / intentionally worst-case), and decoders (Trie-only, GPT-2 beam search, GPT-4o selection). We find that 3 keys + GPT-4o achieves character error rate (CER) 9.46% and word error rate (WER) 12.20%, reducing CER by 59% relative to 2 keys (CER 23.3%). At 3 keys, the key-stream entropy is 1.54 bits/char; while increasing to 5 keys improves accuracy (CER 5.4%), the marginal gains diminish. Mapping choice has a small impact under standard designs ({\Delta}CER < 0.5 pp), and even an intentionally worst mapping degrades CER by only +0.5 pp, whereas Technical sentences yield roughly twice the error rate of Business. These results suggest that, in our evaluated offline setting under a strong LM prior, 3 keys are a practical minimum for general English.

22.
medRxiv (Medicine) 2026-06-16

Upper airway disease in primary ciliary dyskinesia: Clinical management and factors influencing decision-making, a multicentre analysis

Background Upper airway disease is common in primary ciliary dyskinesia (PCD), but management evidence is limited. We aimed to describe management practices and identify factors influencing management decisions. Methods Using data from the Ear-Nose-Throat (ENT) Prospective International Cohort of patients with PCD (EPIC-PCD) and an ENT-specialist survey across participating centres, we described management practices recorded at routine follow-up. We assessed clinical factors associated with practices via mixed-effects logistic regression models. In a subgroup of patients, we assessed factors associated with initiation or discontinuation of practices. Results We included 579 patients: median age 15 years, 46% female. Nasal rinsing (54%) and nasal corticosteroids (22%) were most frequently prescribed. Among 466 patients with available data, 47 had grommets (10%) and 42 hearing aids (9%). Nasal corticosteroids and rinsing were more frequently prescribed in patients with polyps (odds ratio [OR] 3.74, 95% confidence interval [CI] 1.80-7.76; OR 3.39, 95% CI 1.37-8.37) or turbinate hypertrophy (OR 1.89, 95% CI 1.03-3.47; OR 2.89, 95% CI 1.55-5.38), and upper airway nebulisation in patients with frequent nasal symptoms (OR 2.86, 95% CI 1.11-7.39). Management practices differed between centres, as seen also by the specialists survey responses. In 177 patients with multiple visits, initiation of nasal rinsing was associated with frequent nasal symptoms (OR 3.18, 95% CI 1.24-8.18) and turbinate hypertrophy (OR 3.21, 95% CI 1.20-8.59). Conclusion Upper airway disease management in PCD varies and is partly guided by symptom burden and clinical findings. This variation across centres highlights the need for care standardisation and PCD-specific management guidelines.

23.
arXiv (CS.CV) 2026-06-16

Unified Multimodal Model for Brain MRI Imputation and Understanding

Multimodal large language models (MLLMs) hold great potential for medicine, as they inherit knowledge from LLM and allow multiple data modalities to be integrated, analysed and interpreted in natural language. However, the field of medical MLLMs is constrained by non-trivial challenges, notably the scarcity of high-quality training data and the frequent occurrence of missing data in the real-world clinical setting. Here, we propose a novel unified multimodal model, UniBrain, for brain magnetic resonance image (MRI) analysis. To address potential missing brain MRI modalities, we employ a unified training strategy to perform joint imaging modality imputation and brain image understanding. During training, an interleaved and description-enriched data flow is constructed to train the model in an autoregressive manner, enabling medical reasoning with generated multimodal data. A self-alignment strategy is introduced to leverage dense image embeddings to learn fine-grained anatomical features without requiring detailed image captions. Furthermore, we propose a dynamic hidden state mechanism to alleviate the exposure bias during long-context multimodal inference. Extensive experiments on multi-disease brain MRI dataset demonstrate that UniBrain achieves high performance for brain image imputation, understanding, and disease diagnosis under various extents of modality incompleteness.

24.
arXiv (CS.CL) 2026-06-16

Metacognitive Myopia in Large Language Models

Large Language Models (LLMs) exhibit potentially harmful biases that reinforce culturally embedded stereotypes, influence moral judgments, or amplify positive evaluations of majority groups. We propose metacognitive myopia as a cognitive-ecological framework accounting for a conglomerate of established and emerging LLM biases. Our theoretical framework posits that biased samples in the information environment cause five symptoms of metacognitive myopia in LLMs: integration of invalid embeddings, susceptibility to redundant information, neglect of base rates in conditional computation, decision rules based on frequency, and inappropriate higher-order statistical inference for nested data structures. Moreover, it posits that the two main components of metacognition, monitoring and control, could account for these five symptoms. Accordingly, we further outline how monitoring and control could be approximated technically, for instance, through hidden parallel reasoning histories that allow interactive LLMs to evaluate risks of myopic inference before generating overt responses. Our theoretical framework provides a novel perspective on flawed human-machine interactions and agentic AI and raises significant ethical concerns regarding the implementation of LLMs in organizational structures and high-stakes decisions.

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

On the Adversarial Robustness of Multimodal LLM Judges

Multimodal Large Language Models (MLLMs) are increasingly used as automated judges, e.g., for image quality and safety assessment. However, their adversarial robustness remains largely unexplored, threatening the fairness and reliability of automated judging. To bridge this gap, we introduce RobustMLLMJudge, the first general framework for evaluating the adversarial robustness of general-purpose MLLMs when functioning as judges. It covers diverse attacks against popular judge approaches across quality and safety evaluation scenarios. Using RobustMLLMJudge, we reveal that i) different MLLM judges are highly vulnerable to score-inflating adversarial attacks; and ii) although effective, these attack methods face a critical challenge due to unique constraints in the evaluation protocols of MLLM judges. We further propose MGSIA, namely Manifold-Guided Semantic Induction Attack, a novel method that bypasses these constraints to enable more effective and transferable attacks on MLLM judges. The core idea of MGSIA is to combine affirmative semantic induction with high-score manifold alignment: it maximizes the probability that judges yield affirmative responses (e.g., "Yes") to binary semantic queries, while regularizing adversarial representations toward high-score centers estimated from proxy protocols. Together, these objectives yield transferable score-inflating perturbations. Extensive experiments demonstrate the superiority and generalizability of MGSIA in deceiving advanced MLLM judges under different evaluation scenarios, highlighting the need for robust MLLM judges. Code and data will be made available at https://github.com/mala-lab/RobustMLLMJudge.