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01.
arXiv (quant-ph) 2026-06-16

Simulation of Non-Hermitian Hamiltonians with Bivariate Quantum Signal Processing

arXiv:2605.12450v2 Announce Type: replace Abstract: We achieve query-optimal quantum simulations of non-Hermitian Hamiltonians $H_{\mathrm{eff}} = H_R + iH_I$, where $H_R$ is Hermitian and $H_I \succeq 0$, using a bivariate extension of quantum signal processing (QSP) with non-commuting signal operators. The algorithm encodes the interaction-picture Dyson series as a polynomial on the bitorus, implemented through a structured multivariable QSP (M-QSP) circuit. A constant-ratio condition guarantees scalar angle-finding for M-QSP circuits with arbitrary non-commuting signal operators. A degree-preserving sum-of-squares spectral factorization permits scalar complementary polynomials in two variables. Angles are deterministically calculated in a classical precomputation step, running in $\mathcal{O}(d_R \cdot d_I)$ classical operations. Operator norms $\alpha_R\,,\beta_I$ contribute additively with query complexity $\mathcal{O}((\alpha_R + \beta_I)T + \log(1/\varepsilon)/\log\log(1/\varepsilon))$ matching an information-theoretic lower bound in the separate-oracle model, where $H_R$ and $H_I$ are accessed through independent block encodings. The postselection success probability is $e^{-2\beta_I T}\|e^{-iH_{\mathrm{eff}}T}|\psi_0\rangle\|^2\cdot (1 - \mathcal{O}(\varepsilon))$, decomposing into a state-dependent factor $\|e^{-iH_{\mathrm{eff}}T}|\psi_0\rangle\|^2$ from the intrinsic barrier and an $e^{-2\beta_I T}$ overhead from polynomial block-encoding.

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

VietMed-MCQ: A Consistency-Filtered Data Synthesis Framework for Vietnamese Traditional Medicine Evaluation

Large Language Models (LLMs) have demonstrated remarkable proficiency in general medical domains. However, their performance significantly degrades in specialized, culturally specific domains such as Vietnamese Traditional Medicine (VTM), primarily due to the scarcity of high-quality, structured benchmarks. In this paper, we introduce VietMed-MCQ, a novel multiple-choice question dataset generated via a Retrieval-Augmented Generation (RAG) pipeline with an automated consistency check mechanism. Unlike previous synthetic datasets, our framework incorporates a dual-model validation approach to ensure reasoning consistency through independent answer verification, though the substring-based evidence checking has known limitations. The complete dataset of 3,190 questions spans three difficulty levels and underwent validation by one medical expert and four students, achieving 94.2 percent approval with substantial inter-rater agreement (Fleiss' kappa = 0.82). We benchmark seven open-source models on VietMed-MCQ. Results reveal that general-purpose models with strong Chinese priors outperform Vietnamese-centric models, highlighting cross-lingual conceptual transfer, while all models still struggle with complex diagnostic reasoning. Our code and dataset are publicly available to foster research in low-resource medical domains.

03.
arXiv (CS.AI) 2026-06-16

Model Graph Inductive Learning for Knowledge Graph Completion

arXiv:2606.16509v1 Announce Type: new Abstract: Link prediction in knowledge graphs fundamentally depends on the quality of learned embeddings for entities and relations. However, most existing methods derive these embeddings by aggregating only the local neighborhood of each entity, neglecting the global structure of the knowledge graph. This limited view prevents models from capturing higher-level structural patterns that are essential for accurate and generalizable link prediction. To address these limitations, we introduce Model Graph Inductive Learning (MGIL), a framework that constructs a model graph by clustering entities based on the similarity of their incoming and outgoing relational structures or their entity types. A GNN is then applied to this model graph to produce embeddings that capture the global view of the knowledge graph. These embeddings subsequently serve as high-quality initial features %embeddings for the original knowledge graph, replacing random initialization and leading to more stable and expressive representations. Extensive experiments on standard and recently proposed inductive benchmarks demonstrate that MGIL achieves state-of-the-art or highly competitive performance in inductive link prediction, highlighting its effectiveness across diverse graph settings.

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

Clinically Aware Synthetic Image Generation for Concept Coverage in Chest X-ray Models

Deep learning models for chest X-ray diagnosis are constrained by limited coverage of clinically meaningful concept combinations in publicly available training datasets. While synthetic image generation has been explored to increase data diversity, existing methods rarely enforce clinical or anatomical constraints, limiting utility for improving model reliability. We propose CARPA, a clinically aware and anatomically grounded framework for synthetic chest X-ray generation that applies targeted perturbations to clinical concept vectors while preserving anatomical structure. By producing anatomically faithful synthetic images with controlled concept insertions and deletions, CARPA expands clinically relevant concept coverage. We evaluate CARPA across seven backbone architectures by fine-tuning models on synthetic subsets and testing on a held-out MIMIC-CXR benchmark. Compared to prior concept perturbation approaches, fine-tuning on CARPA-generated images consistently improves precision-recall performance, reduces predictive uncertainty, and improves model calibration. Structural and semantic analyses demonstrate high anatomical fidelity, strong concept alignment, and low semantic uncertainty. Evaluation by two expert radiologists further confirms realism and clinical agreement. Together, these results show that anatomically grounded concept perturbations enable more effective use of synthetic data, improving both performance and reliability of chest X-ray classification models and supporting safer clinical deployment.

05.
bioRxiv (Bioinfo) 2026-06-11

AGZArank: Investigating epitope-conditioned antibody binder ranking with structure-derived synthetic supervision

Computational antibody design methods can generate large libraries of candidate binders for a target epitope, but prioritizing which candidates to test experimentally remains a major bottleneck. Existing scoring approaches, including physics-based affinity estimators, structure-prediction-derived confidence measures, and inverse-folding likelihood models, provide useful proxy signals but are not explicitly optimized for early enrichment of binders among many structurally similar candidates. Here we investigate epitope-conditioned antibody binder ranking as a dedicated learning problem and introduce AGZArank, a geometric deep learning framework trained with structure-derived synthetic supervision based on normalized pseudo-energy targets. On a benchmark of 45 experimentally validated antibody-antigen interfaces, AGZArank recovered the true binder within the top ten candidates in 44.4% of cases and showed stronger generalization on post-2021 structures than ProteinMPNN, ESM-IF, and PRODIGY. Ablation experiments indicate that ranking performance depends primarily on training scale and alignment between the optimization objective and retrieval-based evaluation, rather than architectural complexity alone. These results support candidate prioritization as a distinct and tractable problem in computational antibody design.

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

The Information-Theoretic Benefit of Shared Representations under Orthogonality Constraints

arXiv:2606.16028v1 Announce Type: new Abstract: Modern deep learning architectures are increasingly multi-task and multi-modal, using a pretrained foundation model combined with task-specific, fine-tuned models. Empirically, exploiting similarity across different problems, instead of solving them individually, can significantly improve overall performance. While the generalization and sample complexity properties of multitask learning have been widely studied, the parametric complexity of joint approximation in comparison to separate approximation remains less well understood. The question is particularly relevant in modern deep learning, where models are increasingly required to satisfy structural constraints such as equivariance, conservation laws, or orthogonality. We prove lower and upper bounds on the description-length for separate and joint approximation classes, respectively, in uniform norm. We build a class of orthogonal functions by composing a shared hard feature, realized by a Rademacher-Haar wavelet series, with Sawtooth-Walsh readouts to enforce orthogonality of output coordinates. The dyadic tree structure of the Rademacher-Haar wavelet concentrates the approximation hardness in the common feature component, while the readouts act as task-specific heads. Using an information-theoretic framework, we obtain a sharp gap between the optimal approximation rates achievable by joint and separate coding. Finally, we realize this separation in a neural network model using Heaviside activations via reduction to triangle-wave approximation. Our results show that even under an orthogonality constraint joint approximation requires strictly fewer bits in compositional architectures, provided the tasks share a latent hard feature. This provides theoretical insight into the description-length-efficiency of compositional multi-output architectures and clarifies how neural networks can retain expressivity under geometric constraints.

07.
arXiv (CS.AI) 2026-06-17

First Proof Second Batch

arXiv:2606.18119v1 Announce Type: new Abstract: To assess the ability of current AI systems to correctly solve research-level mathematics problems, we tested several AI systems on a set of ten problems in a broad range of mathematical fields; these problems arose naturally in the research process of the contributors. This document includes the problems, our methodology, and the results of our testing. We provide links to supplementary documents including the human solutions, the AI-generated solutions, and the referee reports and logs for the AI-generated solutions. The ten problems were contributed by the following mathematicians: (1) Dariusz Kaloci\'nski and Theodore A. Slaman, (2) Richard Schwartz, (3) Aleksa Milojevic and Benny Sudakov, (4) Larry Guth, (5) Oleg Butkovsky, Jonathan Mattingly, and Lorenzo Zambotti, (6) Joshua Evan Greene and Duncan McCoy, (7) Sucharit Sarkar, (8) Sam Payne and Jidong (Jayden) Wang, (9) Sylvie Corteel and John Lentfer, (10) Srivatsav Kunnawalkam Elayavalli.

08.
arXiv (CS.AI) 2026-06-17

Multiple cyclicity and Wavelet Decomposition with Channel Correlation for Long-term Time Series Forecasting

arXiv:2606.17996v1 Announce Type: cross Abstract: Cyclicity and trend are important components of time series data and many studies based on cyclicity and trend have achieved good results in long-term time series forecasting. However, we believe that current work neglects the influence of real-world inter-channel correlations in time series data which leads to suboptimal predictions. Furthermore, these models rely on complex designs to capture diverse information so that resulting in low computational efficiency. To address this challenge, we propose McWC, a long-term time series forecasting model that separately models the cyclicity, trend, and inter-channel correlations. Specifically, McWC first decouples cyclical information from data using a multi-layer cyclicity construction module. Then, it extracts inter-channel correlations using multi-layer perceptron. Next, it models and fuses the multi-layer high-frequency and low-frequency information from data using a multi-level wavelet decomposition module. Finally, it aggregates the results of different components to obtain the output. Simultaneously, we decouple intra-channel autocorrelations by calculating a loss function in the frequency domain. Experiments on six real-world datasets demonstrate that McWC achieves state-of-the-art performance, exhibiting excellent computational efficiency and historical information extraction capabilities.

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

Delta-Based Target Reformulation for Short-Term Electricity Load Forecasting Using LSTM and Transformer Models

作者:

arXiv:2606.17692v1 Announce Type: new Abstract: Accurate short-term electricity load forecasting is critical for the reliable and economic operation of modern power systems, under non-stationarity arising from weather variability, calendar effects, and evolving consumption patterns. While deep learning models such as LSTMs and Transformers show promising performance, most existing studies focus on direct absolute load prediction without explicitly addressing target non-stationarity. Motivated by classical time-series differencing techniques in ARIMA models, this paper investigates a delta-based target reformulation for short-term electricity load forecasting using deep learning. Instead of directly predicting absolute load values, the proposed formulation trains models to predict the change in load between consecutive time steps, with final forecasts reconstructed using the last observed load. This aims to stabilize the learning target and reduce forecasting difficulty. Using multi-year, hourly real-world electricity load data from India, augmented with meteorological variables from the NASA POWER project and calendar features, this study evaluates LSTM and Transformer models under both formulations, benchmarking them against LightGBM. Experiments are conducted for hour-ahead and day-ahead horizons, assessing performance via Mean Absolute Error (MAE) and Mean Absolute Percentage Error (MAPE). Results show that delta-based reformulation consistently improves forecasting accuracy for hour-ahead prediction across all evaluated models, yielding MAPE reductions of over 50% compared to absolute formulations. For day-ahead forecasting, delta targets specifically benefit deep sequence models (LSTM and Transformer), while LightGBM remains competitive under the absolute formulation. These findings indicate that while delta reformulation is a powerful inductive bias for neural networks, its efficacy is model- and horizon-dependent.

10.
medRxiv (Medicine) 2026-06-18

Cost-effectiveness of a virtual fracture clinic versus traditional in-person fracture clinic care for adults with acute simple fractures: a protocol for a health economic evaluation within the RECITAL trial

ABSTRACT Introduction Traditional in-person fracture clinics are often overcrowded and inconvenient for patients. Virtual fracture clinics aim to address some of these concerns by improving the efficiency of the orthopaedic service and reducing unnecessary interventions while maintaining safety and quality of care. The RECITAL trial is a non-inferiority randomised controlled trial comparing follow-up care provided at a virtual fracture clinic for people with acute simple fractures to follow-up care provided at an in-person fracture clinic. This study describes the protocol for an economic evaluation of RECITAL where the primary aim is to investigate the cost-effectiveness of a virtual fracture clinic compared with traditional in-person fracture clinic care from a health system perspective. Methods and analysis The RECITAL trial recruited 312 participants with acute simple fractures and randomised them to receive follow-up care provided at a virtual fracture clinic or follow-up care provided at an in-person fracture clinic. We will conduct a within-trial analysis from a health system perspective (primary analysis), as well as a health service, patient and societal perspective. The economic evaluation will estimate the difference in the cost of resource inputs on an intention to treat basis used by participants in the two arms of the trial, allowing comparisons to be made between the in-person and virtual fracture clinics. Data for intervention costs and healthcare utilisation will be collected from trial records, hospital electronic medical records and district performance units. The results of the economic evaluation will be expressed in terms of incremental cost per utility weight gained at 12 weeks and will be plotted on a cost-effectiveness plane. Bootstrapping by resampling will be used to estimate 95% confidence intervals around costs and outcomes, and to calculate the confidence intervals around the incremental cost-effectiveness ratio. A cost-effectiveness acceptability curve (CEAC) will be plotted, which will provide information about the probability that an intervention is cost-effective, given the level of a decision makers willingness to pay for each additional outcome. Ethics and Dissemination The trail was approved by the SLHD Ethics Review Committee (RPAH Zone) (X23-0200 and 2023/ETH01038). The findings will be disseminated through a peer-reviewed journal and conference presentations. Trial registration number The trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR; 12623000934640)

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

Fast Adiabatic Quantum Gates via Hyperfine Intermediate States

arXiv:2606.11655v1 Announce Type: new Abstract: The appeal of adiabatic quantum computing lies in its intrinsic robustness against various technical imperfections, making it attractive for many quantum information applications. However, it faces a fundamental challenge: accelerating the adiabatic operations while preserving adiabaticity within the qubit coherence time. In this article, we propose an electromagnetically induced transparency-based adiabatic CNOT gate protocol which harnesses atomic hyperfine intermediate states (HISs) to speed up the adiabatic evolution. The HISs, naturally-existed in two-photon transitions, often need to be suppressed due to their significant decay errors. In contrast, this paper introduces a novel method that utilizes appropriately chosen HISs not only to enhance the adiabaticity in STAY pathway but also to accelerate the population transfer in TRANSFER pathway. Through pulse optimization, we achieve adiabatic gate fidelities exceeding 0.9991 within 0.3903 {\mu}s in realistic Cs atomic setups. To demonstrate the generality of protocol we further assess the impact of decays from multiple HIS and extend our model to arbitrary number of states, providing a practical route toward fast and robust adiabatic quantum gates in Rydberg-atom platforms.

12.
arXiv (CS.AI) 2026-06-15

A Temporal Planning Framework for Disruption Aware Dynamic Route Optimization in Heterogeneous Railway Systems

arXiv:2606.14582v1 Announce Type: new Abstract: Efficient route optimization play a vital role in ensuring both safety and punctuality in railway operations. It is very crucial particularly in heterogeneous multi-gauge railway networks with varying train speed, stopping pattern, infrastructure compatibility constraints increase coordination complexity. In single-track systems these challenges are further intensify due to all trains to share the same track and requires frequent track switching.Stochastic disruptions events including blocked tracks, blocked trains, engine failure and speed slowdowns introduces additional unpredictability in operations and deviate the timetable. However, existing studies predominantly focuses on high-level timetabling, omitting operational details such as track switching coordination. As a result leaving decision to human operators, increasing safety risks into railway operations. This study proposes a framework based on temporal planning for dynamic route optimization and disruption management in heterogeneous railway systems. The framework formulates railway operations as a temporal planning problem using PDDL 2.1 with explicitly modeling gauge compatibility constraints and diverse disruption scenarios. It generates conflict-free timestamped operational plans specifying both optimized schedules and executable action sequences. To evaluate the proposed framework, we developed a benchmark problem set with 200 instances using up to 1,000 track points and 120 trains. Two state-of-the-art temporal planners and a plan validator were employed to assessed the framework. The experimental results demonstrate that the framework effectively generates temporal operational plans for heterogeneous railway systems and handles multi-gauge constraints, disruptions, and reduces dependence on manual decision making.

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

Scaling LLM Reasoning from Minimal Labels: A Semi-Supervised Framework with a Lightweight Verifier

For the development of Large language models (LLMs), recent approaches to generating pseudo intermediate reasoning have shown remarkable progress. But they typically rely on large numbers of correctly annotated answers to assess reasoning quality. This paper presents a semi-supervised framework that scales reasoning learning from minimal supervision, turning reasoning verification itself into a data creation mechanism. We train a lightweight reasoning-correctness classifier on only a few labeled samples, which judges whether intermediate reasoning traces generated by an LLM are valid. Furthermore, an entropy-based confidence threshold filters out unreliable samples, and the remaining high-confidence reasoning traces are used to fine-tune the model. Experiments on Verifiable Math Problems (Orca-Math subset) and Question Answering on Image Scene Graphs (GQA) with Visual Programming show that our method achieves accuracy comparable to using 10-15x more labeled data. Ablation analyses confirm that both the classifier and entropy filtering are essential for scalable and noise-resistant pseudo-labeling. By replacing expensive answer-level supervision with lightweight reasoning verification, our method provides a practical path toward constructing large-scale reasoning resources and paves the way for future autonomous reasoning systems that learn from minimal human input.

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

LiteOdyssey: A Lightweight Reasoning AI Agent for Interpretable Rare-Disease Diagnosis

arXiv:2606.16149v1 Announce Type: new Abstract: Most medical AI systems improve by scaling additional machinery: more fine-tuning data, more agents, and/or larger retrieval databases. In rare-disease diagnosis, however, such scaling can produce systems that are difficult to deploy, audit, and maintain. We asked whether state-of-the-art diagnostic performance could instead be achieved by extending the reasoning chain of a single AI agent: guiding it with a diagnostic policy, developed through human-AI collaboration and augmenting with freely available biomedical tools. We introduce LiteOdyssey, a lightweight rare-disease diagnostic framework that guides reasoning language model through a clinical genetics workflow. This framework was developed through Policy Iteration with Human Feedback (PIHF) and uses dynamic access to public biomedical tools. On two challenging benchmarks that provide only patient clinical features, LiteOdyssey achieved state-of-the-art performance, with an overall disease Recall@1 of 59.3% over the combined 1,243 cases of LIRICAL (n = 370) and the PhenoPacket Store (n = 873). Both benchmarks have a high proportion of ultra-rare disease (a prevalence below 1 in 1,000,000, with ultra-rare shares of approximately 45% and 52.8%, respectively). On the more difficult PhenoPacket subset, where causal diseases were not mapped to Orphanet in our rarity-mapping pipeline, LiteOdyssey achieved 60.7% Recall@1, compared with 10.7% for the same baseline model (GPT-5.4) without tools. This performance was achieved without fine-tuning, multi-agent ensembles, or a large case-retrieval database. Gains were also observed in the following: on cases never seen during development, on a private cohort of real-world rare disease patients, and on a smaller open-weights model. LiteOdyssey suggests a path toward rare-disease AI systems that are accurate, easier to deploy, and more transparent for physician review.

15.
arXiv (CS.AI) 2026-06-11

PermDoRA – Understanding Adapter Interference in Language Models: Limits of Parameter-Space Geometry

arXiv:2606.11262v1 Announce Type: cross Abstract: Access control in large language models (LLMs) requires modular mechanisms to enable domain-specific behavior without retraining or cross-domain interference. A common hypothesis is that interference during adapter composition arises from overlap in linear parameter updates, suggesting that enforcing orthogonality or directional independence should improve multi-domain performance. We test this hypothesis using DoRA-RBAC, a hierarchical adapter composition framework based on weight-decomposed low-rank adaptation. We compare conventional Euclidean merging with a geometry-aware Riemannian-inspired merging strategy that approximates the Frechet mean via normalized directional averaging across multiple QA benchmarks (GPQA, PubMedQA, SimpleQA, WMDP) on LLaMA-3.1-8B and Mistral-7B. Our results show that while single-domain performance matches LoRA, geometry-aware merging provides no consistent advantage over standard averaging in multi-domain settings.Diagnostic analysis further reveals that angular alignment and orthogonality of adapter updates are weak predictors of composition performance. These findings suggest that adapter interference is not governed primarily by parameter-space geometry, but is instead consistent with interactions in shared nonlinear representations.

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

Towards an Agent-First Web: Redesigning the Web for AI Agents

arXiv:2606.19116v1 Announce Type: new Abstract: The World Wide Web was built on an assumption held for three decades: the primary consumer of web content is a human being. This permeates every layer; its access model presumes human visitors, its economics rest on human attention, and its content targets human perception. The rapid emergence of AI agents as intermediaries between humans and web content invalidates this assumption. Yet the web resists agents through blanket blocking, CAPTCHA-based exclusion, and economic models that treat agent access as extraction rather than legitimate interaction. This paper proposes a principled redesign across three layers. At the access layer, agents acting for humans should inherit equivalent access rights, governed by rate limiting and agent identification metadata in HTTP requests, analogous to browser headers, alongside a dual-layer architecture serving human-readable and agent-optimized content from the same domain. At the economic layer, we propose an intent-based tier framework grounded in the agent-as-human-proxy principle: an agent's economic obligation mirrors that of the human it represents. A token-based subscription model meters content in tokens rather than pageviews, alongside a commissioned content economy anchoring AI content production in human intentionality. At the content layer, we identify epistemic recursion, the self-referential loop in which AI-generated content is consumed by agents to produce further content, progressively detaching web knowledge from human ground truth. We propose the Agent Text Markup Language (ATML), a four-level human supervision tier model, and a cryptographic provenance chain to counter this threat. Together these constitute ten design principles for an agent-first internet, one in which agents are first-class citizens whose integration requires renegotiating the web's foundational social contract across access, economics, and content.

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

Charting the Future of Scholarly Knowledge with AI: A Community Perspective

arXiv:2509.02581v2 Announce Type: replace-cross Abstract: Despite the growing availability of tools designed to support scholarly knowledge extraction and organization, many researchers still rely on manual methods, sometimes due to unfamiliarity with existing technologies or limited access to domain-adapted solutions. Meanwhile, the rapid increase in scholarly publications across disciplines has made it increasingly difficult to stay current, further underscoring the need for scalable, AI-enabled approaches to structuring and synthesizing scholarly knowledge. Various research communities have begun addressing this challenge independently, developing tools and frameworks aimed at building reliable, dynamic, and queryable scholarly knowledge bases. However, limited interaction across these communities has hindered the exchange of methods, models, and best practices, slowing progress toward more integrated solutions. This manuscript identifies ways to foster cross-disciplinary dialogue, identify shared challenges, categorize new collaboration and shape future research directions in scholarly knowledge and organization.

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

Adaptive $k$NN graph model

arXiv:2601.16509v2 Announce Type: replace-cross Abstract: The $k$-nearest neighbors ($k$NN) algorithm is a cornerstone of non-parametric classification in artificial intelligence, yet its deployment in large-scale applications is persistently constrained by the computational trade-off between inference speed and accuracy. Existing approximate nearest neighbor solutions accelerate retrieval but often degrade classification precision and lack adaptability in selecting the optimal neighborhood size ($k$). Here, we present an adaptive graph model that decouples inference latency from computational complexity. By integrating a Hierarchical Navigable Small World (HNSW) graph with a pre-computed voting mechanism, our framework completely transfers the computational burden of neighbor selection and weighting to the training phase. Within this topological structure, higher graph layers enable rapid navigation, while lower layers encode precise, node-specific decision boundaries with adaptive neighbor counts. Benchmarking against eight state-of-the-art baselines across six diverse datasets, we demonstrate that this architecture significantly accelerates inference speeds, achieving real-time performance, without compromising classification accuracy. These findings offer a scalable, robust solution to the inherent inference bottleneck of $k$NN, laying an adaptive structural foundation for graph-based nonparametric learning.

20.
medRxiv (Medicine) 2026-06-15

Toward a National Registry for Inborn Errors of Immunity in Peru: A Qualitative Implementation Study

Background: Peru lacks an integrated information system for patients with Inborn Errors of Immunity (IEI). Although disease registries are essential tools for data management and health planning, their success depends on implementation science approaches that account for local contextual factors. This study reports Phase I of a three-phase mixed-methods implementation project to design and develop a national IEI registry. Methods: Phase I consisted of a phenomenological qualitative study exploring stakeholder perspectives. Semi-structured focus groups and in-depth interviews were conducted with 29 key stakeholders across four groups: policy-makers, clinical experts, end-users (immunologists, residents, allied health personnel), and patient organization representatives. Interviews followed a guide structured around four a priori domains (structure, navigation, feasibility, and perception of existing systems). Discussions were conducted in Spanish, audio-recorded, transcribed verbatim, and coded using ATLAS.ti. A hybrid thematic analysis combining deductive and inductive coding was performed. Data elements proposed for the registry were triangulated with qualitative findings. Results: Thirty-six initial codes were consolidated into 15 categories, which were further integrated into four overarching themes conceptualized as pathways toward intention to use: (1) Environment, where governance, regulatory backing, and sustainable financing were identified as key enablers, while limited interoperability emerged as a structural barrier; (2) Technical Dimension, emphasizing usability, alignment with clinical workflow, and a hierarchical data architecture (demographic, clinical, therapeutic); (3) Users, highlighting clinical leadership, protected time, digital readiness, and perceived usefulness as stronger motivators than financial incentives; and (4) Patients, underscoring data protection, transparency, trust, and advocacy as essential for legitimacy and sustainability. Conclusions: A national IEI registry in Peru is perceived as necessary and feasible if implemented with strong regulatory foundations, interoperable design, robust data security, and user-centered architecture. These findings informed the development of an initial functional prototype and the operational plan for Phase II, focused on usability evaluation.

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

Whose hotel does the AI recommend? An algorithm audit of reputation signals in LLM-assisted hotel selection

Travelers increasingly ask large language model (LLM) assistants which hotel to book, making these systems gatekeepers of property visibility – yet what moves their recommendations is undocumented. We conduct a pre-specified algorithm audit using a randomized choice-based conjoint: across personas, prompt templates, and twelve open-weight and proprietary models, assistants choose among five hotels whose guest rating, review volume and recency, management response, chain affiliation, price, eco-certification, and list position are independently randomized. We estimate the average marginal component effect of each signal on the probability of recommendation. Guest rating and price dominate (a top rating raises selection by 31.6 percentage points; a high price lowers it by 30.0), reproducing human valence-and-price primacy but over-weighting eco-certification and ignoring management response. List position – a content-free artifact – shifts recommendations causally, worth about \$12 per night. Stated reasons track revealed weights imperfectly. The findings ground generative engine optimization and the accountability of AI infomediaries in causal evidence.

23.
arXiv (CS.CL) 2026-06-18

TopBench: A Benchmark for Implicit Predictive Reasoning in Tabular Question Answering

Large Language Models (LLMs) have advanced Table Question Answering, where most queries can be answered by extracting information or simple aggregation. However, a common class of real-world queries is implicitly predictive, requiring the inference of unobserved answers from historical patterns rather than mere retrieval. These queries introduce two challenges: recognizing latent intent and reliable predictive reasoning over massive tables. To assess LLMs in such Tabular questiOn answering with implicit Prediction tasks, we introduce TopBench, a benchmark consisting of 779 samples across four sub-tasks, ranging from single-point prediction to decision making, treatment effect analysis, and complex filtering, requiring models to generate outputs spanning reasoning text and structured tables. We evaluate diverse models under both text-based and agentic workflows. Experiments reveal that current models often struggle with intent recognition, defaulting to just lookups. Deeper analysis identifies that accurate intent disambiguation serves as the prerequisite for leading these predictive behaviors. Furthermore, elevating the upper bound of prediction precision requires the integration of more sophisticated modeling or reasoning capabilities.

24.
medRxiv (Medicine) 2026-06-11

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

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

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

Beyond Runtime Enforcement: Shield Synthesis as Defensibility Analysis for Adversarial Networks

arXiv:2606.13621v1 Announce Type: new Abstract: Shielded reinforcement learning is typically presented as a runtime safety mechanism that compiles temporal-logic specifications into automata restricting an agent's actions. We argue this is the wrong product. The same automata-theoretic machinery – specification compilation, product game construction, attractor computation, and winning-region extraction – is better read as a design-time analytical instrument whose outputs are structural insights about a system rather than runtime constraints on a deployed agent. We instantiate this through a constrained two-player safety game for network defense. The two specifications are enforced asymmetrically: the defender specification defines the unsafe region of the game, whereas the attacker specification restricts the adversary's legal actions during attractor computation. Solving the game yields a defensibility verdict – a formal certificate that a topology-specification pair is or is not defensible – with the associated winning region and shield. Beyond the binary verdict, we derive topology-level metrics from the attractor structure and combine them with post-convergence behavior from shield-constrained adversarial multi-agent reinforcement learning. Together these form a defensibility fingerprint capturing both a network's formal safety properties and its operational behavior under adaptive play. A what-if analysis shows that formal defensibility and operational effectiveness capture distinct aspects of security: small architectural changes can produce large shifts in operational outcomes while leaving formal safety margins nearly unchanged. Shield synthesis is thus most valuable not as a deployment mechanism for safe agents, but as a framework for answering architectural questions about whether, where, and how a system can be defended. The defensibility verdict is the output, not the safe policy.