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01.
arXiv (CS.LG) 2026-06-17

Half a Link can Be Enough to Predict a Whole Link: Understanding Generalization in Knowledge Graph Foundation Models

arXiv:2606.18001v1 Announce Type: new Abstract: Knowledge graph (KG) foundation models (KGFMs) are zero-shot generalizers: trained once, they can predict links on unseen graphs without retraining. However, understanding when and how they can robustly generalize across KGs is still an open question. In this paper, we shed some light on their generalization mechanisms highlighting how their performance on unseen KGs is not uniform when it comes to partially seen links, which we call half-links. In fact, we show that to predict a test triple $(h,r,t)$ it might suffice in practice to have observed the half-link $(h,r)$ or $(r,t)$ in the inference graph. This yields a taxonomy of four scenarios when combinations of these half-links are observed or not. In a rigorous stratified analysis over these scenarios, we reveal that SoTA KGFMs use seen half links for predictions, while unseen half-links pose different challenges. As such, our finer-grained taxonomy can be a diagnostic protocol for robust KGFM generalization and highlights where novel KGFMs can improve.

02.
arXiv (CS.CL) 2026-06-16

Let LLMs Judge Each Other: Multi-Agent Peer-Reviewed Reasoning for Medical Question Answering

Objective: To enhance the accuracy, interpretability, and robustness of large language models (LLMs) in medical question answering (MedQA). Method: We designed a multi-agent peer-reviewed reasoning method in which multiple LLM agents independently generate chain-of-thought reasoning with candidate answers, then act as peer reviewers to evaluate each other's reasoning for factual correctness and logical soundness. The highest-rated reasoning chain is selected to produce the final answer. Experiments were conducted with five state-of-the-art LLMs (Llama-3.1-8B, Qwen2.5-7B, Phi-4, DeepSeek-LLM-7B, GPT-oss-20B) on three benchmark datasets: HeadQA, MedQA-USMLE, and PubMedQA. Performance was compared against single-model chain-of-thought reasoning and chain-of-thought-based majority voting. Results: Peer-reviewed reasoning consistently outperformed both baselines. The best model combination achieved an average accuracy of 0.820 across datasets, exceeding the strongest single model (0.777) and majority voting ensembles (up to 0.789). The method also scaled effectively with more participating models, while peer assessments reliably distinguished high- from low-quality reasoning chains. Conclusion: The proposed multi-agent peer-reviewed reasoning method enables LLMs to act as both solvers and evaluators, yielding superior performance in MedQA. By emphasizing reasoning quality rather than answer agreement alone, this approach improves accuracy, interpretability, and robustness, offering a promising direction for trustworthy biomedical AI systems.

03.
arXiv (CS.CV) 2026-06-12

Mana: Dexterous Manipulation of Articulated Tools

Articulated tool manipulation remains a major challenge in dexterous robotics due to the need to coordinate internal degrees of freedom and contact-rich interactions. While prior work has largely focused on rigid objects, articulated tool use remains underexplored because of its physical complexity and the difficulty of learning functional grasping and manipulation policies. We present Mana (Manipulation Animator), a general sim-to-real framework that reinterprets dexterous manipulation as an animation problem. Inspired by computer animation, Mana employs a coarse-to-fine pipeline that transforms procedurally-generated grasp keyframes into manipulation trajectories through motion planning and reinforcement learning. The data generation process is largely automatic, requiring only a few mouse clicks to specify functional affordances (

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

Filtered Conformal Ellipsoids for Graph-Native Time Series

arXiv:2606.17014v1 Announce Type: new Abstract: Joint prediction sets for multivariate time series should control a single event while adapting to cross-coordinate dependence. We study filtered conformal ellipsoids: a frozen state-space filter emits a one-step predictive mean and covariance, and split-conformal calibration is applied to the resulting Mahalanobis scores. The filter is used to choose the ellipsoid shape; conformal calibration chooses the scalar radius, so the construction benefits from a learned predictive covariance without relying on Gaussian tail probabilities for coverage. The main difficulty is that filtered scores are dependent and learned recurrent filters need not contract in their raw hidden state; we therefore analyse contraction in an observable predictive-law quotient that identifies hidden states producing the same future sequence of emitted Gaussian laws. Under a stable Bayes Gaussian-projection filter, covariance bounds, and a finite-horizon observability Fisher condition, small excess Gaussian negative log-likelihood implies contraction of the learned emitted laws. Combined with a threshold-autocovariance envelope this yields a Chebyshev-type approximate coverage bound for filtered split-conformal prediction under dependence; a sharper Bernstein-type bound requires an additional geometric-mixing concentration assumption. Under Gaussian oracle realisability we also obtain a near-oracle log-volume comparison within the class of conditionally valid Gaussian ellipsoid rules. We instantiate the framework with a GCN-GRU filter with diagonal-plus-low-rank covariance. On moderate-size graph-native traffic benchmarks (METRLA-$20$ and PEMSBAY-$50$), the learned filter gives sharper at-target ellipsoids than static-covariance and non-filter baselines; at full-graph scale and on non-graph-native datasets, factor and copula baselines can be stronger.

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

HAFMat: Hybrid Priors Guided Adaptive Fusion for Single-Image Human Material Estimation

Physically based rendering (PBR) material estimation is a fundamental appearance decomposition task with broad applications in virtual content creation, relighting, and digital human rendering. However, estimating PBR materials from a single human image remains highly ill-posed, since illumination, geometry, and reflectance are heavily entangled in the observed appearance. To mitigate this ambiguity, we propose HAFMat, a hybrid-prior-guided framework for single-image human material estimation. Our method introduces guidance maps that encode complementary cues, including appearance, body geometry, structure, and prior material predictions from pre-trained models. A key observation is that these guidance cues are heterogeneous: some cues mainly provide texture-level constraints, while others convey higher-level semantic information. To exploit this property, we design a Multi-layer Adaptive Feature Fusion Mechanism, which adaptively fuses guidance features with decoder features at different stages. This design enables texture-dominant and semantic-dominant cues to guide material decoding at appropriate levels, leading to more accurate and physically plausible material estimation. Extensive experiments on both synthetic and real data demonstrate that our method achieves state-of-the-art performance in material estimation and downstream relighting.

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

ArogyaSutra: A Multi-Agent Framework for Multimodal Medical Reasoning in Indic Languages

Multimodal Large Language Models (MLLMs) have shown promising reasoning capabilities in general domains, yet their performance remains limited in specialized settings such as healthcare, especially in multilingual and low-resource scenarios. This gap is critical in regions like rural India, where patients often express complex medical queries in native Indic languages and rely on multimodal inputs such as medical images. Existing English-centric MLLMs struggle to support such use cases, limiting equitable access to AI-driven healthcare assistance. To address this challenge, we introduce ArogyaBodha, a large-scale multilingual multimodal medical question-answer dataset constructed from eight heterogeneous sources, covering 31 body systems, six imaging modalities, and 21 clinical domains across English and seven major Indian languages. We further propose ArogyaSutra, an actor-critic-based multi-agent framework that integrates tool grounding with dual-memory mechanisms for step-wise, reasoning-aware decision making, and uses stored actor-critic simulation trajectories for distillation. Experiments show that our dataset and framework improve multilingual medical reasoning accuracy across all Indic languages, with ablations validating the contribution of each component. The source code and dataset are available at: https://iitp-cse.github.io/ ArogyaSutra/

07.
arXiv (CS.LG) 2026-06-16

Polynomial-Time Mistake-Bounded Language Generation

arXiv:2606.16077v1 Announce Type: cross Abstract: In this note, we introduce a polynomial-time version of the mistake-bounded language generation (MBLG) framework due to Kleinberg, Peale, and Reingold (2026). We observe that the family of parities of variables, and the family of conjunctions of literals, are polynomial-time MBLG. Our main result states that the family of monotone Boolean functions with polynomially-many maxterms is polynomial-time MBLG. This family includes all monotone Boolean functions, computable by polynomial-size decision trees. Our technique can be presented as a new combinatorial game about writing numbers on a board.

08.
medRxiv (Medicine) 2026-06-22

Impact of Antidiabetic Medications on IgG and Plasma Protein N-Glycosylation in Type 2 Diabetes Patients

Introduction. Diabetes is a growing global health challenge, necessitating effective management strategies. Glycosylation, a highly regulated post-translational protein modification, has emerged as a pivotal factor in diabetes pathophysiology. However, the modulation of protein glycosylation by antidiabetic treatment is still largely unknown. This study explored the longitudinal effects of four distinct antidiabetic therapies - metformin, insulin, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and glucagon-like peptide-1 receptor agonists (GLP-1RA) - on plasma protein and immunoglobulin G (IgG) glycosylation in patients with type 2 diabetes (T2D). Research Design and Methods. Plasma protein and IgG N-glycans were enzymatically released, purified and chromatographically profiled in a cohort of 124 patients, examined at four time points, to assess therapy-induced glycan alterations. Linear mixed models adjusting for covariates and multiple testing (FDR

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

Akasha 2: Hamiltonian State Space Duality and Visual-Language Joint Embedding Predictive Architectur

作者:

We present Akasha 2, a state-of-the-art multimodal architecture that integrates Hamiltonian State Space Duality (H-SSD) with Visual-Language Joint Embedding Predictive Architecture (VL-JEPA). The system leverages the Mamba-3 Selective State Space Model (SSM) augmented by a Sparse Mixture of Hamiltonian Experts (SMoE-HE) that enforces latent physical conservation laws through symplectic integration. For visual synthesis, we introduce Hamiltonian Flow Matching (HFM) and persistent 3D Gaussian Splatting (3DGS), enabling ultra-low latency (

10.
arXiv (CS.AI) 2026-06-15

Learning Developmental Scaffoldings to Guide Self-Organisation

arXiv:2605.14998v3 Announce Type: replace Abstract: From subcellular structures to entire organisms, many natural systems generate complex organisation through self-organisation: local interactions that collectively give rise to global structure without any blueprint of the outcome. Yet a significant portion of the information driving such processes is not produced by self-organisation itself, instead, it is often offloaded to initial conditions of the system. Biological development is a prime example, where maternal pre-patterns encode positional and symmetry-breaking information that scaffolds the self-organising process. From maternal morphogen gradients in early embryogenesis to tissue-level morphogenetic pre-patterns guiding organ formation, this transfer of information to initial conditions, analogous to a memory-compute trade-off in computational systems, is a fundamental part of developmental processes. In this work, we study this offloading phenomenon by introducing a model that jointly learns both the self-organisation rules and the pre-patterns, allowing their interplay to be varied and measured under controlled conditions: a Neural Cellular Automaton (NCA) paired with a learned coordinate-based pattern generator (SIREN), both trained simultaneously to generate a set of patterns. We provide information-theoretic analyses of how information is distributed between pre-patterns and the self-organising process, and show that jointly learning both components yields improvements in robustness, encoding capacity, and symmetry breaking over purely self-organising alternatives. Our analysis further suggests that effective pre-patterns do not simply approximate their targets; rather, they bias the developmental dynamics in ways that facilitate convergence, pointing to a non-trivial relationship between the structure of initial conditions and the dynamics of self-organisation.

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

Optimal Spatio-Temporal Decoupling for Bayesian Conformal Prediction

arXiv:2605.00432v2 Announce Type: replace Abstract: Online conformal prediction must balance fast adaptation to distribution shift against stable coverage: feedback-driven methods react quickly but become volatile, while strongly discounted Bayesian methods lag and inflate intervals at tight coverage. We introduce State-Adaptive Bayesian Conformal Prediction (SA-BCP), which forms the predictive quantile as a gated convex combination of long-term temporal inertia and local spatial evidence from a kernel density estimate, controlled by a single interpretable evidence threshold $K$. We establish three results: (i) asymptotic marginal validity of the resulting intervals; (ii) a closed-form expression for the MSE-optimal threshold, $K^*_{\mathrm{MSE}}=\alpha(1-\alpha)/M^{\mathcal{T}}$, trading the coverage-indicator (Bernoulli) variance against the temporal structural bias $M^{\mathcal{T}}$; and (iii) a rolling-origin procedure for selecting $K$ online – consistent under stationarity, with $O(\sqrt{T\log N})$ regret against the best fixed $K$ and, for a segmented variant, a sublinear dynamic-regret bound under bounded drift. Across four financial-volatility and weather datasets, three target coverage levels, and eight baselines (including the strongest recent conditional-quantile methods, SPCI and KOWCPI), SA-BCP attains at-or-above-nominal coverage in most settings while producing substantially sharper intervals – up to roughly $3\times$ lower Winkler score than discounted Bayesian CP at the tightest coverage – and a coverage-matched audit confirms these efficiency gains are not an artifact of under-coverage. We disclose one principal limitation: a volatility-specialized conformal-GARCH competitor remains more efficient on its home volatility-base series, though it does not transfer across domains.

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

CoRA: Confidence-Rationale Alignment for Reliable Chain-of-Thought Reasoning

Chain-of-thought (CoT) reasoning can improve LLM performance, but high answer confidence may be misleading when the accompanying CoT rationale is plausible yet incomplete or poorly supported. We study confidence–rationale alignment: whether a model's confidence in its committed answer is justified by its generated rationale. We introduce a GRPO-based reinforcement learning framework that jointly rewards answer correctness, committed-answer probability, and rubric-based rationale support, where the rubric assesses grounding, coherence, task match, and connection to the selected answer without revealing the gold answer to the judge. Across MedQA, MathQA, and OpenBookQA using three open-weight LLMs, our method reduces the confidence–rationale alignment error by up to 26.51% compared with untuned checkpoints, SFT, and correctness-only GRPO, while maintaining competitive accuracy and often improving calibration. These results show that reliable CoT reasoning requires not only confident answers, but rationales that substantively support them.

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

A Link between Shock-wave Theory and Symmetry-reduced Stochastic Gradient Descent for Artificial Neural Networks

arXiv:2606.18303v1 Announce Type: cross Abstract: We develop a mathematically explicit link between shock-wave theory and the symmetry-quotiented learning dynamics of stochastic gradient descent, drawing on differential geometry, Lie group theory, and fluid mechanics. Specifically, after quotienting parameter symmetries and applying local-entropy coarse-graining, the effective dynamics satisfy a viscous Hamilton–Jacobi equation on the quotient manifold. Moreover, under the assumption that the raw parameter dynamics can be summarized by a gradient field on the quotiented space, the gradient of the coarse-grained loss function obeys a Burgers-type equation, and shock formation can be established rigorously. We apply our theory to multilayer perceptrons, convolutional neural networks, Transformers, and mean-field networks, and show that they obey the Hamilton–Jacobi or Burgers-type equations. We conjecture that this framework also yields practical diagnostics for deep learning. In architectures such as Transformers, raw parameter norms are often distorted by symmetry redundancy and may therefore be misleading, whereas symmetry-corrected quotient observables provide a principled basis for monitoring, forecasting, and controlling training-phase transitions.

14.
bioRxiv (Bioinfo) 2026-06-11

EditorForge: An Active-Site-Aware Framework for Inverse-Folding-Based Protein Redesign

Inverse-folding models can rapidly generate protein sequences compatible with a supplied backbone, but unconstrained redesign is poorly suited to enzyme and genome-editor-associated domains, where catalytic, substrate-proximal, and conserved structural regions must remain protected. In this paper, we present EditorForge, a modular constraint-and-audit suite for editor-domain protein redesign that wraps fixed-backbone inverse folding with explicit design masks, fixed-position enforcement, active-site-proximity auditing, active-site-shielded regeneration, and downstream structural quality control. Using full-length Moloney murine leukemia virus reverse transcriptase structure 4MH8 (MMLV RT 4MH8) as a demonstration target, EditorForge first restricted redesign to a bounded 25-position envelope while fixing 428 residues. An initial audit detected active-site-proximal failure modes despite fixed-position integrity. Later, the Active Site Shield module then removed five unsafe design positions, replaced them with lower-contact alternatives, and regenerated candidates under stricter constraints. Post Shield Audit evaluated 24 regenerated candidates, all of which satisfied the hard sequence/mask and active-site-shield constraints. For the eight candidates that were selected or returned for structure-prediction/refolding quality control. Enhanced RefoldQC found that all 8 evaluated predicted structures passed the computational structure-QC screen. That said, the selected 8 candidates passed the computational structure-QC screen, with global C RMSD values of 1.2061–1.5555~[A], active-site C RMSD values of 0.4098–1.8397~[A], mutation-neighborhood C RMSD values of 1.3155-1.6848~[A], and average pLDDT-like confidence values of 94.87-95.11. In short, EditorForge provides a reproducible triage layer that converts general inverse-folding output into constrained and editor-specific candidate sets for downstream structural and biological review on top of existing structural prediction tools.

15.
arXiv (CS.CV) 2026-06-18

iTryOn: Mastering Interactive Video Virtual Try-On with Spatial-Semantic Guidance

Video Virtual Try-On (VVT) aims to seamlessly replace a garment on a person in a video with a new one. While existing methods have made significant strides in maintaining temporal consistency, they are predominantly confined to non-interactive scenarios where models merely showcase garments. This limitation overlooks a crucial aspect of real-world apparel presentation: active human-garment interaction. To bridge this gap, we introduce and formalize a new challenging task: Interactive Video Virtual Try-On (Interactive VVT), where subjects in the video actively engage with their clothing. This task introduces unique challenges beyond simple texture preservation, including: (1) resolving the semantic ambiguity of interactions from standard pose information, and (2) learning complex garment deformations from video where interactive moments are sparse and brief. To address these challenges, we propose iTryOn, a novel framework built upon a large-scale video diffusion Transformer. iTryOn pioneers a multi-level interaction injection mechanism to guide the generation of complex dynamics. At the spatial level, we introduce a garment-agnostic 3D hand prior to provide fine-grained guidance for precise hand-garment contact, effectively resolving spatial ambiguity. At the semantic level, iTryOn leverages global captions for overall context and time-stamped action captions for localized interactions, synchronized via our novel Action-aware Rotational Position Embedding (A-RoPE). Extensive experiments demonstrate that iTryOn not only achieves state-of-the-art performance on traditional VVT benchmarks but also establishes a commanding lead in the new interactive setting, marking a significant step towards more dynamic and controllable virtual try-on experiences.

16.
arXiv (quant-ph) 2026-06-19

Benchmark of quantum algorithms for ground state preparation in the presence of noise

arXiv:2606.20551v1 Announce Type: new Abstract: We compare the performance of representative cooling, adiabatic, and optimization algorithms for ground-state preparation in the presence of noise. Using an exactly solvable family of quadratic fermionic Hamiltonians subject to depolarizing noise, we derive the scaling of the achievable relative energy as a function of the noise rate and support these results with numerical simulations. The Hamiltonian exhibits two phases, separated by a quantum phase transition. As expected, the performance of the different algorithms depends on the phase: adiabatic evolution is favorable in the trivial phase, while a multi-frequency cooling algorithm, as proposed in [1], becomes competitive or superior in the topological phase, where gap-closing limits adiabatic protocols. We further present numerical results for the quantum approximate optimization algorithm [2], showing that it performs competitively with cooling in the trivial phase but is typically outperformed in the topological regime. Finally, we show that for this model the cooling protocol exhibits enhanced robustness to parameter imperfections, highlighting its potential advantage for realistic implementations of noisy quantum state preparation. The analytical approach developed here, in conjunction with numerical validation, establishes an extendable approach to benchmarking ground-state preparation algorithms.

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

Domain-Guided Prompting of the Segment Anything Model for Seismic Interpretation: The Role of Attributes, Visualization, and Hybrid Prompts

The advent of large pretrained foundation models for computer vision has significantly improved the efficiency of visual data interpretation. The Segment Anything Model (SAM), in particular, offers powerful zero shot segmentation capabilities through prompt based interaction, thus making it a promising tool for seismic interpretation. However, most existing applications of SAM rely on fine tuning for specific geological targets, which requires extensive labeled data, incurs high computational cost, and often compromises the model's generalization capability. In this study, we introduce a principled framework for zero shot adaptation of foundation models to seismic data. The framework is built on two key components: (1) aligning seismic attributes and visualization choices (e.g., colormaps) with the geological target of interest, and (2) employing a hybrid prompting strategy that combines sparse user defined point prompts with dense mask prompts derived from SAM's internal feature activations. We systematically evaluate this framework across multiple geological targets, datasets, prompt configurations, and seismic attribute representations. Our results demonstrate that geologic target aware selection of seismic attributes and colormaps, combined with hybrid prompting, enhances the separability of geological features and improves boundary delineation and segmentation accuracy relative to point based prompting alone. Our findings show that, when these components are jointly applied, SAM can achieve competitive segmentation performance in a fully zero shot setting, thereby eliminating the need to retrain SAM for each geologic feature. This work establishes a practical and scalable pathway to leverage foundation models in seismic interpretation, reducing reliance on labeled data while preserving model generality.

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

LaME: Learning to Think in Latent Space for Multimodal Embedding via Information Bottleneck

Reasoning-driven universal multimodal embedding has advanced rapidly by introducing Chain-of-Thought (CoT) reasoning into the embedding pipeline. Despite the strong performance across both general and complex tasks, this paradigm suffers from two core limitations: (i) autoregressive CoT reasoning incurs high computational cost, making it impractical for low-latency retrieval; and (ii) embedding performance is heavily coupled with CoT annotation quality, making large-scale training unreliable. These raise fundamental questions: Is textual CoT the optimal form of reasoning for embedding, and can effective embedding reasoning be accomplished in latent space? To this end, we propose LaME (Latent Reasoning Multimodal Embedding), which formulates embedding-oriented latent reasoning as a weakly supervised information bottleneck. LaME employs K learnable reason tokens as a fixed-capacity bottleneck, completing all reasoning within a single forward pass. The two weak supervision signals structurally decouple contrastive from autoregressive objectives and eliminate dependence on CoT annotations, while a two-stage training pipeline ensures stable convergence. Experiments on MMEB-v2 and MRMR show that LaME achieves competitive performance, surpassing some explicit CoT-based models, while delivering 60x faster inference than explicit CoT methods and 2x faster than latent baselines with throughput comparable to discriminative embedding models. Code will be released.

19.
arXiv (CS.AI) 2026-06-16

Gaming-Resistant Insurance Contracts for Autonomous AI Agents: Strategy-Proof Toll Mechanism Design

arXiv:2606.16326v1 Announce Type: cross Abstract: Paper A defines a time-consistent actuarial runtime that prices each side-effect-bearing action against a contractually fixed safe default and gates execution against a reserve budget. It treats the operator as passive. This paper makes the operator strategic. We characterise a five-attack space for autonomous AI-agent insurance contracts and prove when the actuarial runtime is gaming-resistant. Two attack surfaces – post-toll safe-default selection and within-boundary action splitting – are closed by Paper A's minimal-authority and no-splitting clauses. The remaining three require new contract clauses. First, common-control aggregation prevents cross-boundary re-routing from reducing toll below the boundary potential applied to total exposure. Second, interface failures such as invalid JSON are contract-relevant events, not safety wins: treating them as zero-toll safe defaults can reward unreliable models, while escalation fees reverse the incentive. We validate this interface-compliance theorem on committed cross-model traces from the companion empirical paper. Third, a model-identity menu with a componentwise-minimum penalty schedule makes truthful reporting of the deployed model weakly dominant. We then compose these clauses with Paper A's runtime guarantees to obtain joint incentive compatibility over the five-attack space. Finally, a two-parameter premium family discharges operator individual rationality and weak budget balance at the truthful equilibrium. The result is an incentive-compatibility layer for actuarial control of autonomous-agent side effects.

20.
medRxiv (Medicine) 2026-06-22

Cumulative Metabolic Exposure to Hyperglycemia and Risk of Cardiovascular and Limb Events in Peripheral Artery Disease

Background: Although diabetes is a potent risk factor for the development of peripheral artery disease (PAD), the effect of cumulative metabolic exposure to hyperglycemia on risk of cardiovascular or limb events in patients with PAD remains unclear. Methods: The Peripheral Artery Disease: Long-term Survival (PEARLS) is a longitudinal registry of Veterans with newly diagnosed PAD identified using a natural language processing approach. Included patients had ankle brachial index [≤]0.9 or toe brachial index [≤]0.7, and no history of lower extremity revascularization or major amputation. Among patients with diabetes in this cohort, we assessed cumulative exposure to hyperglycema based on a 24-month rolling average of hemoglobin (Hgb) A1c values, categorized as [≤]7%, >7% to [≤]8%, and >8%. Multivariable Cox regression models evaluated the association between categories of HgbA1c, modeled as a time-varying exposure, and risk of cardiovascular (CV: myocardial infarction or stroke) and limb (chronic limb threatening ischemia [CLTI] or major amputation) events. Results: Among 45,109 patients with new diagnosis of PAD and pre-existing diabetes, the mean HgbA1c at baseline was 7.5%, with nearly one-third (30.4%) having HgbA1c >8%. The mean age was 70.4 years, 19.8% were Black and 4% were Hispanic. Patients with baseline HgbA1c >8% were younger and compared to those with HgbA1c [≤]7%, more likely to have coronary disease, kidney disease, and obesity. Over a median follow up of 4.2 years, 8,306 (18.4%) patients experienced a CV event, and 8,199 (18.2%) experienced a limb event. The adjusted association between HgbA1c and hazard of CV events was 12% higher in patients exposed to HgbA1c >7% to [≤]8% (HR 1.12; 95%CI: 1.05-1.18) and 38% higher in those exposed to HgbA1c >8% (HR 1.38; 95%CI: 1.30-1.46), compared to HgbA1c 7% to [≤]8% (HR 1.20; 95%CI: 1.13-1.28) and HgbA1c >8% (HR 1.60; 95%CI: 1.51-1.70), respectively when compared to HgbA1c [≤]7%. These findings were consistent in subgroups based on age and severity of PAD. Conclusions: Among diabetic patients with PAD, cumulatiave metabolic exposure to hyperglycemia is associated with a markedly increased risk of clinical events, especially limb events.

21.
medRxiv (Medicine) 2026-06-15

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

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

22.
arXiv (CS.CV) 2026-06-11

Finding Sparse Subnetworks in One Training Cycle via Progressive Magnitude-Based Pruning

Neural network pruning reduces model size by removing less important parameters while aiming to preserve predictive performance. Although the Lottery Ticket Hypothesis (LTH) shows that sparse subnetworks can match dense networks when trained from suitable initializations, its iterative pruning procedure requires multiple complete training cycles. This work evaluates progressive magnitude-based pruning as a single-cycle alternative. The method gradually increases sparsity during training using a linear schedule and updates pruning masks based on active weight magnitudes. We conduct systematic experiments on CIFAR-10 and MNIST across ResNet, VGG-style, and LeNet architectures, comparing the proposed method with representative iterative and initialization-based pruning baselines, including LTH, SNIP, and GraSP. On CIFAR-10, the method achieves 95.12\% accuracy on ResNet-18 at 72.9\% sparsity, compared with 90.5\% reported for LTH. At extreme sparsity, it achieves 93.13\% accuracy on a VGG-like architecture at 97\% sparsity, compared with approximately 92.0\% for SNIP, and 93.44\% accuracy on VGG-19 at 97.97\% sparsity, compared with 92.19\% for GraSP at 98\% sparsity. A sparsity-accuracy analysis on ResNet-18 further shows that accuracy remains within 0.1 percentage points of the dense baseline across 70–85\% sparsity. These results indicate that progressive magnitude-based pruning provides an effective single-cycle approach for neural network sparsification under the evaluated settings.

23.
arXiv (CS.AI) 2026-06-17

Blueprint First, Model Second: A Framework for Deterministic LLM Workflow

arXiv:2508.02721v2 Announce Type: replace-cross Abstract: While powerful, the inherent non-determinism of large language model (LLM) agents limits their application in structured operational environments where procedural fidelity and predictable execution are strict requirements. This limitation stems from current architectures that conflate probabilistic, high-level planning with low-level action execution within a single generative process. To address this, we introduce the \textsc{Source Code Agent} framework, a new paradigm built on the ``Blueprint First, Model Second'' philosophy that decouples workflow logic from the generative model. An expert-defined operational procedure is first codified into a source code-based Execution Blueprint, which is then executed by a deterministic engine. The LLM is strategically invoked as a specialized tool to handle bounded, complex sub-tasks within the workflow, but never to decide the workflow's path. We evaluate on the TravelPlanner benchmark for constraint-aware travel planning. The \textsc{Source Code Agent} achieves a 35.56\% final pass rate, a 97.6\% improvement over the state-of-the-art ATLAS baseline (18.00\%) on the same Claude-Sonnet-4 backbone. Critically, it reduces constraint violations by 96.0\% (11 vs 275) while improving execution efficiency by 27.1\% (10.2$\pm$0.7 steps vs 14.0). Two production incident-diagnosis deployments and additional results on ScienceWorld and ALFWorld confirm that the architecture transfers beyond travel planning to procedurally well-defined, constraint-intensive workflows. Our work enables the verifiable and reliable deployment of autonomous agents in applications governed by strict procedural logic.

24.
PLOS Medicine 2026-06-09

Molecular Tumor Boards clinical impact on patient care and structural features: A systematic review and meta-analysis

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by Luigi Russo, Erika Giacobini, Nicolò Lentini, Tommaso Osti, Maud Kamal, Stefania Boccia, Roberta Pastorino Background Molecular Tumor Boards (MTBs) bring together multidisciplinary experts to translate genomic data into clinical decisions in oncology, however, their overall clinical impact remains unclear. The aim of this systematic review is to assess the clinical impact of MTB-recommended therapies on patients with cancer outcomes. Methods and findings In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and CENTRAL up to July 2025. We included studies of any design, both single-arm studies and studies with a comparator group, that reported the clinical impact of MTBs in patients who received MTB-guided therapy. Meta-analyses were performed separately by study design, using hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), relative risks (RRs) for objective response rate (ORR) and disease control rate (DCR), and pooled proportions for PFS ratio ≥1.3. All meta-analyses were conducted using random-effects models based on the inverse variance method. We evaluated the risk of bias using the RoB 2.0 for RCTs and ROBINS-I for non-randomized studies.From 6,846 records, 78 studies (9,195 patients; 4,569 treated per MTB recommendations) were included. MTB-guided therapies were associated with reduced risk of death (HR 0.87; 95% CI [0.76, 1.01]; p = 0.069; I2 = 0.0% in RCTs; 0.62 in retrospective studies) and disease progression (HR 0.73; 95% CI [0.64, 0.84]; p 

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arXiv (CS.CL) 2026-06-16

Modeling Sarcastic Speech: Semantic and Prosodic Cues in a Speech Synthesis Framework

Sarcasm is a pragmatic phenomenon in which speakers convey meanings that diverge from literal content, relying on an interaction between semantics and prosodic expression. However, how these cues jointly contribute to the recognition of sarcasm remains poorly understood. We propose a computational framework that models sarcasm as the integration of semantic interpretation and prosodic realization. Semantic cues are derived from an LLaMA 3 model fine-tuned to capture discourse-level markers of sarcastic intent, while prosodic cues are extracted through semantically aligned utterances drawn from a database of sarcastic speech, providing prosodic exemplars of sarcastic delivery. Using a speech synthesis testbed, perceptual evaluations show that semantic and prosodic cues enhance perceived sarcasm, with the combined system achieving the best downstream F1 while maintaining high subjective sarcasm ratings. These findings highlight the complementary roles of semantics and prosody in pragmatic interpretation and illustrate how modeling can shed light on the mechanisms underlying sarcastic communication.