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01.

arXiv (CS.CL) 2026-06-15 DOI: arXiv:2606.14391

Learning to Hear Hesitation: Continual Learning for Disfluency-Aware ASR

作者:

Henri-Leon Kordt↗Theresa Pekarek Rosin↗Jae Hee Lee↗Stefan Wermter↗

Despite advances in large-scale Automatic Speech Recognition (ASR), disfluent speech remains challenging, as state-of-the-art systems are often optimized to omit disfluencies, leading to information loss and hallucinations. Prior work has focused on verbatim transcription and the integration of disfluency markers, but adapting models on limited datasets can lead to catastrophic forgetting of general-domain knowledge. We address this gap by leveraging continual learning (CL) with explicit disfluency tokens. We first introduce these tokens into a pretrained ASR model to establish stable token mechanisms, and then continue training on additional datasets with varying disfluency distributions. Through a detailed analysis of model dynamics during training, we identify a trade-off between marker learning and ASR performance, and a consistent cross-attention head mechanism shared across CL methods.

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02.

arXiv (quant-ph) 2026-06-16 DOI: arXiv:2505.23893

A complexity theory for non-local quantum computation

作者:

Andreas Bluhm↗Simon H\"ofer↗Alex May↗Mikka Stasiuk↗Philip Verduyn Lunel↗Henry Yuen↗

arXiv:2505.23893v2 Announce Type: replace Abstract: Non-local quantum computation (NLQC) replaces a local interaction between two systems with a single round of communication and shared entanglement. Despite many partial results, it is known that a characterization of entanglement cost in at least certain NLQC tasks would imply significant breakthroughs in complexity theory. Here, we avoid these obstructions and take an indirect approach to understanding resource requirements in NLQC, which mimics the approach used by complexity theorists: we study the relative hardness of different NLQC tasks by identifying resource efficient reductions between them. Most significantly, we prove that $f$-measure and $f$-route, the two best studied NLQC tasks, are in fact equivalent under $O(1)$ overhead reductions. This result simplifies many existing proofs in the literature and extends several new properties to $f$-measure. For instance, we obtain sub-exponential upper bounds on $f$-measure for all functions, and efficient protocols for functions in the complexity class $\mathsf{Mod}_k\mathsf{L}$. Beyond this, we study a number of other examples of NLQC tasks and their relationships.

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03.

PLOS Medicine 2026-05-06 DOI: HASH:837e232cad87b00291b3b8d965686e14

Pathways of emergency care for severely ill children in Nigerian and Ugandan hospitals: A process mapping study

作者:

Rami Subhi↗

by Rami Subhi, Abiodun Sogbesan, Dan Muramuzi, Mikael Burhin, Ayobami A. Bakare, Adegoke G. Falade, Freddy E. Kitutu, Freddie Ssengooba, Carina King, Sumit Kane, Belinda Dawson-McClaren, Hamish R. Graham, the MOXY-Implementation Research Collaboration Background Child mortality remains high in countries with weak emergency care systems. Facility organisation for paediatric emergency care is heterogeneous and under-described. We examined how hospitals in Uganda and Nigeria are organised to deliver emergency care for neonates and children. Methods and findings We conducted a qualitative, multi-method study in 26 purposively selected secondary and tertiary facilities in Uganda and Nigeria from October 2023 to December 2024. Embedded researchers documented patient pathways, resources for care, and care processes for severely ill children (

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04.

arXiv (CS.LG) 2026-06-11 DOI: arXiv:2605.03065

OGPO: Sample Efficient Full-Finetuning of Generative Control Policies

作者:

Sarvesh Patil↗Mitsuhiko Nakamoto↗Manan Agarwal↗Shashwat Saxena↗Jesse Zhang↗Giri Anantharaman↗Cleah Winston↗Chaoyi Pan↗Douglas Chen↗Nai-Chieh Huang↗Zeynep Temel↗Oliver Kroemer↗…

arXiv:2605.03065v2 Announce Type: replace Abstract: Generative control policies (GCPs), such as diffusion- and flow-based control policies, have emerged as effective parameterizations for robot learning. This work introduces Off-policy Generative Policy Optimization (OGPO), a sample-efficient algorithm for finetuning GCPs that maintains off-policy critic networks to maximize data reuse and propagate policy gradients through the full generative process of the policy via a modified PPO objective, using critics as the terminal reward. OGPO achieves state-of-the-art performance on manipulation tasks spanning multi-task settings, high-precision insertion, and dexterous control. To our knowledge, it is also the only method that can fine-tune poorly-initialized behavior cloning policies to near full task-success with no expert data in the online replay buffer, and does so with few task-specific hyperparameter tuning. Through extensive empirical investigations, we demonstrate that OGPO drastically outperforms methods alternatives on policy steering and learning residual corrections, and identify the key mechanisms behind its performance. We further introduce practical stabilization tricks, including success-buffer regularization, two-sided conservative advantages, and Q-variance reduction, to mitigate critic over-exploitation across state- and pixel-based settings. Beyond proposing OGPO, we conduct a systematic empirical study of GCP finetuning, identifying the stabilizing mechanisms and failure modes that govern successful off-policy full-policy improvement.

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05.

arXiv (CS.LG) 2026-06-17 DOI: arXiv:2508.19445

On Surjectivity of Neural Networks: Can you elicit any behavior from your model?

作者:

Haozhe Jiang↗Nika Haghtalab↗

arXiv:2508.19445v3 Announce Type: replace Abstract: Given a trained neural network, can any specified output be generated by some input? Equivalently, does the network correspond to a function that is surjective? In generative models, surjectivity implies that any output, including harmful or undesirable content, can in principle be generated by the networks, raising concerns about model safety and jailbreak vulnerabilities. In this paper, we prove that many fundamental building blocks of modern neural architectures, such as networks with pre-layer normalization and linear-attention modules, are almost always surjective. As corollaries, widely used generative frameworks, including GPT-style transformers and diffusion models with deterministic ODE solvers, admit inverse mappings for arbitrary outputs. By studying surjectivity of these modern and commonly used neural architectures, we contribute a formalism that sheds light on their unavoidable vulnerability to a broad class of adversarial attacks.

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06.

Nature Biotechnology 2026-06-19 DOI: HASH:7fdd1f7d5c36769d9da105ef2851d7df

Efficient site-specific gene addition using R2 retrotransposons in tobacco and rice

作者:

Zahir Ali↗

Precise integration of multikilobase DNA fragments remains a major technical barrier in plants. Here we introduce non-long terminal repeat (non-LTR) R2 retrotransposons as a versatile system for targeted gene integration in plants. We reconstituted R2 activity in Nicotiana benthamiana and benchmarked insertion efficiency and fidelity using a TMV-based episomal reporter system. We demonstrate site-specific integration of GFP (2.2 kb) and recombinase-compatible landing pads (0.6 kb) into 28S rDNA arrays, with intact cassette insertion frequencies up to 75% and 53%, respectively. To temporally constrain donor availability and avoid DNA intermediates, we combined in planta effector expression with recombinant RNA virus-mediated donor delivery. We apply R2 retrotransposons for targeted insertion of resistance cassettes within the rDNA of rice callus, achieving integration efficiencies up to 17%. These results position R2 retrotransposons as a double-strand break-free system for RNA-templated insertion of multikilobase gene cassettes at rDNA loci, for safe-harbor trait stacking in plants with potential applications in crop improvement and synthetic biology. Retrotransposons are applied in plants for safe-harbor transgene integration.

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07.

arXiv (CS.AI) 2026-06-12 DOI: arXiv:2606.06525

Agentic Large Language Models for Automated Structural Analysis of 3D Frame Systems

作者:

Ziheng Geng↗Ian Franklin↗Santiago Martinez↗Jiachen Liu↗Yunhe Zhao↗Minghui Cheng↗

arXiv:2606.06525v2 Announce Type: replace-cross Abstract: Large language models (LLMs) have emerged as powerful foundation models with strong reasoning capabilities across domains. Beyond reactive text generation, agentic LLMs enable autonomous workflow execution through modular task decomposition and coordinated tool use. In structural engineering, recent efforts have developed agentic LLMs for automated analysis of plane frames. However, their extension to 3D frames remains underexplored due to challenges in irregular geometric representation, topological consistency, and long-horizon reasoning. This paper proposes an agentic LLM framework for automated structural analysis of 3D frames from natural language inputs. Irregular 3D frames are represented by projection onto a 2D plan, where orthogonal gridlines define spatial coordinates and a matrix of number of stories encodes vertical extrusion of each grid cell. Building on this representation, the framework establishes a multi-agent pipeline: a problem analysis agent parses input into structured JSON; a floor decomposition agent derives the spatial layout of each floor; the 3D geometry is assembled by node, girder, slab, and column agents; support and load agents assign boundary and loading conditions, and code translation agents generate executable SAP2000 script. Evaluated on ten representative 3D frames, the proposed framework achieves an average accuracy of 90% across repeated trials, demonstrating consistent and reliable performance.

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08.

arXiv (CS.CL) 2026-06-17 DOI: arXiv:2606.17339

SpeechDx: A Multi-Task Benchmark for Clinical Speech AI

作者:

Sejal Bhalla↗Larry Kieu↗Aina Merchant↗Eyal de Lara↗Alex Mariakakis↗

Speech offers a uniquely informative window into health by simultaneously engaging neurological, motor, respiratory, and vocal systems. Current clinical speech AI methods have largely progressed through isolated condition-specific studies, making results difficult to compare and generalization difficult to assess. We introduce SpeechDx, a large-scale benchmark for clinical speech AI spanning 12 datasets and 27 tasks across diverse health conditions. To enable evaluation across shared clinical mechanisms, SpeechDx structures tasks by the stage of speech production they disrupt: conceptualization, formulation, and articulation. The benchmark tests generalization by including tasks with limited labeled data and evaluating the same health condition across multiple datasets, distinguishing clinically meaningful patterns from dataset artefacts. We systematically evaluate 12 state-of-the-art audio encoders across all tasks and under zero-shot cross-condition transfer. Results show that large-scale speech models represent the strongest overall baselines, domain-specific models improve performance only on closely matched tasks, and no current representation generalizes reliably across the clinical speech landscape. SpeechDx establishes a shared evaluation framework for tracking progress toward general-purpose clinical speech representations

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09.

arXiv (quant-ph) 2026-06-19 DOI: arXiv:2506.24079

Maximum entropy principle for quantum processes

作者:

Siddhartha Das↗Ujjwal Sen↗

arXiv:2506.24079v3 Announce Type: replace Abstract: The maximum entropy principle, as applied to quantum systems, is a fundamental prescript positing that for a quantum system for which we only have partial knowledge, the maximum entropy state consistent with the partial knowledge is a valuable choice as the system's state. An intriguing result is that in case the only prior knowledge is of a fixed energy, the maximum entropy state turns out to be the thermal state, a ubiquitous state in several arenas, especially in statistical mechanics. We extend the consequences of this principle from static quantum states to dynamic quantum processes. We establish that a quantum channel attains maximal output entropy under a fixed energy constraint if and only if it is an absolutely thermalizing channel, where the fixed output is the thermal state corresponding to that energy. Our results have potential implications for understanding the informational and thermodynamic utility of quantum channels under physical constraints. As an application, we examine the consequences for private randomness distillation from fixed energy constrained quantum processes.

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10.

arXiv (CS.CV) 2026-06-17 DOI: arXiv:2606.17972

SegDINO: Introducing Multi-Scale Structure into DINO for Efficient Medical Image Segmentation

作者:

Sicheng Yang↗Hongqiu Wang↗Zhaohu Xing↗Sixiang Chen↗Qiuxia Yang↗Yize Mao↗Guang Yang↗Lei Zhu↗

Self-supervised DINO models provide strong transferable visual representations, yet applying them directly to image segmentation remains challenging. Existing approaches commonly rely on heavy decoders with complex upsampling, introducing substantial parameter and computational overhead. We observe that introducing scale into DINO features is far more critical than increasing decoder capacity. In this work, we present SegDINO, an efficient segmentation framework that integrates a DINOv3 backbone with lightweight scale modeling. SegDINO introduces Token Pyramid Adaptation (TPA) to reorganize intermediate DINO features into a pseudo multi-scale hierarchy, and Scale-Aware Decoding (SAD) for efficient intra-scale refinement and top-down multi-scale propagation. We further curate PanCT, a new CT dataset containing 284 patients with expert-annotated pancreatic tumors, to assess SegDINO's ability to handle difficult small-lesion cases. Extensive experiments on PanCT and three public benchmarks demonstrate that SegDINO achieves state-of-the-art results with high efficiency. The code is available at https://github.com/script-Yang/segdino_v2.

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11.

arXiv (CS.CL) 2026-06-19 DOI: arXiv:2606.20295

Token-Operations-Oriented Inference Optimization Techniques for Large Models

作者:

Shiguo Lian↗Kai Wang↗Zhaoxiang Liu↗Wen Liu↗Minjie Hua↗Yutong Liu↗Jiangze Yan↗Xin Wang↗Cong Wang↗Yilin Zhang↗Yi Shen↗Jieyun Huang↗…

Large model inference optimization serves as a key foundation for supporting the scalable, low-cost, and highly stable operation of large model services. Centered on token-oriented inference optimization technology, this paper proposes for the first time a four-layer technical architecture consisting of Multi-model Fusion, Model Optimization, Compute-Model Fusion, and Compute-Network-Model Fusion. It systematically reviews the key technologies and current industry status across these four levels and analyzes the application value of related technologies in real-world business scenarios. This paper provides a practical technical path for reducing token production costs, improving token service efficiency, ensuring the stability of token supply, and driving the transition of large model services from being merely callable to being operable.

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12.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2606.15234

Surrogate-Assisted Framework for SI-Compliant Interconnect Design Optimization Using the Earth Mover's Distance

作者:

Emre Ecik↗Werner John↗Julian With\"oft↗Ralf Br\"uning↗J\"urgen G\"otze↗

arXiv:2606.15234v1 Announce Type: cross Abstract: This work presents a deterministic, machine-assisted framework for SI-compliant PCB design based on the Earth Mover's Distance (EMD). In contrast to conventional surrogate-based optimization methods that rely on iterative black-box search procedures, the proposed approach follows an interpretable, sequential evaluation strategy. Neural surrogate models are first used to efficiently predict waveform describing features from topology-dependent design parameters. A decision tree then acts as a physically motivated quality gate that identifies SI-compliant waveforms according to predefined SI criteria. Within the resulting valid solution space, the Earth Mover's Distance is employed as a similarity metric to rank candidate designs according to their proximity to an ideal reference signal. This enables not only the deterministic identification of admissible parameter regions but also a transparent prioritization of physically superior solutions without inverse modeling or stochastic search procedures. The methodology is demonstrated using a large-scale set of simulated DDR3 fly-by waveforms. By combining surrogate prediction, interpretable classification, and EMD-based waveform evaluation, the framework provides an explainable and computationally efficient alternative to conventional optimization strategies for supporting PCB development with AI-based methods.

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13.

arXiv (CS.LG) 2026-06-19 DOI: arXiv:2606.19799

The Hidden Environmental Cost of Poor Coding Practices in TensorFlow and Keras Applications: A Study on Resource Leaks and Carbon Emissions

作者:

Bashar Abdallah↗Gustavo Santos↗Rola Al Bataineh↗Alain Abran↗Mohammad Hamdaqa↗

arXiv:2606.19799v1 Announce Type: cross Abstract: Efficiency and sustainability are critical considerations in the development and deployment of machine learning (ML) applications. Among the factors influencing sustainability, resource leaks in ML code can introduce hidden inefficiencies that elevate energy consumption and CO2 emissions. Despite this, empirical evidence quantifying their environmental impact remains limited. This emerging results paper presents an initial empirical investigation of two common resource-leak smells, namely Improper Model Reuse (IMR) and Unreleased Tensor References (UTR), and their impact on energy consumption and CO2 emissions in TensorFlow and Keras workloads. Controlled experiments were conducted for each smell by executing identical training tasks while comparing against a smell-free baseline. Our preliminary results show that both smells consistently increase estimated electricity usage and carbon emissions. IMR and UTR increased electricity consumption by approximately 32% and 46%, respectively, with proportional increases in CO2 emissions. Paired statistical tests indicate that these differences are systematic and statistically significant, providing initial empirical evidence that resource-leak smells may degrade ML energy efficiency and environmental sustainability. These findings suggest that resource-leak smells pose measurable risks to both software quality and sustainability, emphasizing the importance of integrating resource-lifecycle management and energy-efficiency considerations into ML development.

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14.

PLOS Medicine 2026-05-20 DOI: HASH:5b47d66d09bc5b131ec3f326f79cad8f

Prescribed hormonal contraceptive use trends in the Estonian Biobank: A longitudinal observational study

作者:

Jelisaveta Džigurski↗

by Jelisaveta Džigurski, Märt Möls, Kristi Läll, Hannah Currant, Mall Eltermaa, Estonian Biobank Research Team , Reedik Mägi, Lili Milani, Triin Laisk Background Hormonal contraceptives (HCs) are widely used and have well-documented population-level statistics. Previous studies with short follow-ups have focussed on individual HC use and side effects. However, the same aspects over longer periods, HC formulation switching, and the impact of genetic factors on HC side effects remain understudied due to the limited availability of suitable datasets. We investigated whether the Estonian Biobank (EstBB) is suitable for studying genetic risk for HC side effects. Methods and findings This is a longitudinal descriptive study combining prescribed HC purchase data collected from 2004 to 2022 with genetic and health data from 73,071 female EstBB HC users aged 15–55 at the time of purchase. HC usage was defined by the Anatomical Therapeutic Chemical (ATC) codes G02B, G03A, and G03HB01. Methods included calculating age-stratified annual user prevalence, inferring usage periods from purchases, assessing formulation switching, identifying the International Classification of Diseases, Tenth Revision (ICD-10)-based side effect-related diagnoses and thromboembolism risk factors, and assessing carrier status for Factor V Leiden (FVL, rs6025) and prothrombin G20210A (PTM, rs1799963) genetic variants as proof-of-concept. Over 19 years, 20 HC formulations with five administration routes (oral pills, transdermal patches, vaginal rings, subdermal implants, intrauterine devices) were used. In the EstBB, combined HCs were the most commonly used among users aged 15–29, while progestin-only HC use increased with age and over time, comparable to the Estonian population. Overall, 64.2% (n = 46,920) of users switched formulations at least once, with 17.7% (n = 12,929) being rapid switchers. Side effect-related diagnoses were observed in 23.1% (n = 2,982) of rapid switchers, with excessive/irregular menstrual bleeding being the most common. Genetic analysis revealed that 5.3% (n = 3,886) of users carried at least one variant previously associated with increased thrombosis risk (3.5% (n = 2,556) carried FVL only, 1.8% (n = 1,276) PTM only, and 0.07% (n = 54) both). Carriers of thrombosis-associated variants had a significantly higher percentage of thrombosis (6.5%) than non-carriers (4.2%; OR = 1.61, 95% CI [1.40, 1.84], p 

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15.

arXiv (CS.CL) 2026-06-17 DOI: arXiv:2606.17838

Environment-Grounded Automated Prompt Optimization for LLM Game Agents

作者:

Rean Clive Fernandes↗Lukas Fehring↗Theresa Eimer↗Marius Lindauer↗Matthias Feurer↗

LLM agents in interactive environments are highly sensitive to their prompts, yet prompt engineering remains a manual, task-specific process. We introduce an automated prompt optimization framework for LLM agents that decomposes the observation-to-action pipeline into a goal-conditioned descriptor agent and an action selection agent, and iteratively refines each module's prompt through an LLM-driven evolutionary loop guided by environment returns. We propose a behavior analyzer to attribute episode outcomes to specific prompt components, and a mutator to propose targeted revisions to the prompt, before validating them through environment rollouts. We evaluate on all five BabyAI tasks in the BALROG benchmark, comparing our pipeline against BALROG's RobustCoTAgent under both plain and guided prompt initializations. Optimization improves performance consistently across tasks and conditions, without requiring updates to the model weights. On PutNext, a multi-step coordination task where the RobustCoTAgent achieves 0% success, our framework reaches up to 72.5% success rate using the same underlying LLM with optimized prompts. These results suggest that a multi-agent framework, combined with automatic prompt optimization, enhances LLMs without the need for fine-tuning or extensive human supervision.

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16.

arXiv (quant-ph) 2026-06-11 DOI: arXiv:2606.10150

Towards the implementation of a quantum classifier

作者:

Lorenzo Confalonieri↗

arXiv:2606.10150v2 Announce Type: replace Abstract: In this work, we investigate the use of a quantum circuit as a binary classification model in the context of quantum machine learning. We call this model, binary quantum classifier. First, we describe fundamental concepts of quantum computing and introduce the computational tool used: Qibo, an open-source framework for efficient quantum simulations and quantum hardware control. Then, we describe how to design a binary quantum classifier for the classification of images and small arrays of variables by showing how to input data in the circuit, defining a quantum circuit model Ansatz with trainable parameters and a loss function, and implementing multiple minimizers. We test our quantum classifier with two data sets. The first one is the MNIST data set which is composed of handwritten digits (reduced to only handwritten zeros and handwritten ones for binary classification). We study the behavior of different minimizers by increasing the number of layers of the Ansatz. The second data set represents two different high energy collisions that can occur at colliders such as LHC (CERN). Due to in-time proton-proton interactions known as pile-up, we distinguish two different data sets: "without pile-up" and "with pile-up". These collisions can be represented by images of size 32x32 or by six high-level variables that we call features. By increasing the size of the training data set and the number of layers of the Ansatz, we search for the best minimizer. Splitting the data set in training set and test set, we compute: ROC curve, AUC score, confusion matrices and test set accuracy. For "with pile-up" images, we compare the results obtained with the quantum classifier with a small convolutional neural network. We conclude that is possible to build a binary quantum classifier with a quantum circuit and we highlight its performances and limitations in comparison with classical technologies.

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17.

arXiv (CS.CL) 2026-06-16 DOI: arXiv:2606.17016

TokenPilot: Cache-Efficient Context Management for LLM Agents

作者:

Buqiang Xu↗Zirui Xue↗Dianmou Chen↗Chenyang Fu↗Chiyu Wu↗Caiying Huang↗Chen Jiang↗Jizhan Fang↗Xinle Deng↗Yijun Chen↗Yunzhi Yao↗Xuehai Wang↗…

As LLM agents are deployed in long-horizon sessions, context accumulation drives up inference costs. Existing approaches utilize text pruning or dynamic memory eviction to minimize token footprints; however, their unconstrained sequence mutations alter layouts, introducing prefix mismatches and cache invalidation. This reveals a critical trade-off between text sparsity and prompt cache continuity. To address this, we present TokenPilot, a dual-granularity context management framework. Globally, Ingestion-Aware Compaction acts as a framework harness to stabilize prompt prefixes and eliminate open-world environmental noise at the ingestion gate. Locally, Lifecycle-Aware Eviction monitors the ongoing residual utility of context segments, enforcing a conservative batch-turn schedule to offload content segments only when task relevance expires. Experiments on PinchBench and Claw-Eval under both isolated and continuous modes demonstrate that TokenPilot reduces costs by 61% and 56% in isolated mode, and 61% and 87% in continuous mode, while maintaining competitive performance compared to prior systems. TokenPilot has been integrated into LightMem2 at https://github.com/zjunlp/LightMem2.

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18.

arXiv (CS.CL) 2026-06-12 DOI: arXiv:2606.12984

SkillChain: Closing the Loop on Skill Evolution for Image-Based E-Commerce AI Assistants

作者:

Yimin Hu↗Mengtao Xu↗Hao Guo↗Yuheng Song↗Xiaoyong Zhu↗Bo Zheng↗

Image-based AI assistants are now deployed at production scale on e-commerce platforms, where a single uploaded image can trigger fundamentally different user intents: product search, style recommendation, visual encyclopedia, or utility tool calls, each demanding its own response format, tool invocation, and domain knowledge. Without per-intent behavioral constraints, LLM-based systems conflate these heterogeneous modes and fall short of domain quality standards, while the breadth and dynamism of the intent space render manual engineering infeasible. To address this, we present SkillChain, which closes the production feedback loop on Skill evolution, automating the lifecycle of Skills through three stages: Skill Creator for bootstrapping from task specs and trajectories, Route Optimizer for routing alignment, and Body Refiner for iterative Skill Body refinement via dual-path LLM-Judge evaluation. Deployed on a production-scale e-commerce image assistant, SkillChain substantially improves aggregate response quality, with the strongest gains on structural compliance and content quality; a one-week online A/B experiment further confirms significant gains in user engagement, content consumption, and long-term retention.

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19.

medRxiv (Medicine) 2026-06-11 DOI: HASH:d8d224e46c4ce4852adc3a4e7792eaef

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

作者:

Lewis↗Andrews↗Laing↗

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

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20.

arXiv (quant-ph) 2026-06-15 DOI: arXiv:2606.14088

OQMD: Single-Qubit Rotation Control Improves Low-CNOT Multiclass Quantum Classification

作者:

Michael A. Magid↗Melissa Zeynep Ertem↗Jun Suzuki↗

arXiv:2606.14088v1 Announce Type: new Abstract: Near-term variational classifiers incur substantial error and latency from two-qubit gates, yet practitioners often assume that additional entangling depth is the default route to higher accuracy. This work studies Optimal Quantum Measurement Decoding (OQMD): optimizing how quantum outcomes are mapped to classical labels by training a readout layer before measurement, jointly with the variational circuit, without adding CNOTs. Experiments use trainable triple single-qubit rotations as one concrete, hardware-native realization of OQMD; other single-qubit parametrizations fit the same classical outer loop. On the Iris benchmark with a 30-point stratified test split, the best observed 0-CNOT configuration with OQMD reaches 83.33\% accuracy, with a 96\% at 9 CNOTs, exceeding the best 18-CNOT controls (56.67\%) and the best 18-CNOT configuration with OQMD (66.67\%) under a common protocol. A six-point CNOT-depth series from 0 to 18 (fixed optimizer, iteration budget, random-seed count, and ZXZ readout) shows that the highest raw scores need not occur at the largest template, so aggregate complexity is not summarized by CNOT count alone. Because run-level accuracies are discrete and non-Gaussian, we emphasize best-observed scores and, where a global comparison of pooled runs is required, Mann–Whitney $U$ tests rather than parametric tests on means. Across architectures, OQMD shows statistically consistent but magnitude-dependent gains: large peak lifts on minimal circuits coexist with a small pooled mean shift on complex 18-CNOT runs ($p\approx 0.03$) that is not ``universal'' in the sense of uniformly large practical effects.%

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21.

arXiv (CS.CL) 2026-06-18 DOI: arXiv:2606.18902

SAGE: Stochastic Prompt Optimization via Agent-Guided Exploration

作者:

Ziyi Zhu↗Luka Smyth↗Saki Shinoda↗Jinghong Chen↗

Context engineering has emerged as a primary lever for improving AI systems without parameter updates. Recent work showing that textual gradients do not function as real gradients motivates treating automatic prompt optimization (APO) as black-box search. We introduce SPO (Stochastic Prompt Optimization), a framework for stochastic search over prompt space, and compare three strategies of increasing sophistication: error-informed random search, a genetic algorithm with evolutionary operators, and SAGE (SPO via Agent-Guided Exploration), a multi-agent pipeline with diagnostic code execution. Across three benchmarks, no single strategy dominates; effectiveness depends on the interaction of landscape structure with error type. We further deploy SAGE on a mental-health chatbot under a continuous optimization paradigm, where it compounds eight cycles of individually-noisy A/B tests into a statistically robust gain in next-day retention. We argue that coupling qualitative diagnosis with quantitative validation is what makes agentic optimization effective for open-ended task-oriented dialogue.

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22.

arXiv (CS.CV) 2026-06-12 DOI: arXiv:2606.13515

MaskWAM: Unifying Mask Prompting and Prediction for World-Action Models

作者:

Hanyang Yu↗Haitao Lin↗Jingbo Zhang↗Wenyao Zhang↗Chenghao Gu↗Heng Li↗Ping Tan↗

World Action Models (WAMs) present a promising paradigm for robotic control via video prediction. However, current WAMs suffer from fundamental spatial bottlenecks: standard text inputs introduce referential ambiguity in cluttered scenes, while unstructured RGB predictions lack semantic grounding and remain biased by task-irrelevant backgrounds. To overcome these limitations, we introduce MaskWAM, an object-centric world-action model. By jointly integrating masks as both explicit inputs and predictions via a unified Mixture of Transformers (MoT), MaskWAM unlocks robust policy generalization. This design provides two key benefits: (1) predicting future masks yields object-centric semantic supervision that suppresses visual noise, significantly enhancing even standard text-conditioned WAMs; and (2) coupling this predictive supervision with first-frame visual prompts, such as target object masks, establishes a precise spatial anchor that substantially reduces language ambiguity. Crucially, as WAMs are inherently vision-driven architectures, direct mask conditioning yields substantially stronger guidance than text alone, establishing a precise and robust paradigm for manipulating unseen objects. Evaluations on LIBERO, RoboTwin, and real-world tasks demonstrate that MaskWAM significantly outperforms baselines in both language-clear and language-ambiguous tasks.

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23.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2605.03289

Imbalanced Classification under Capacity Constraints

作者:

Daniel Fraiman↗Ricardo Fraiman↗

arXiv:2605.03289v2 Announce Type: replace-cross Abstract: Detecting observations from a minority class under severe class imbalance is a central challenge in applications such as fraud detection, medical screening, and industrial quality control. In these settings, each positive prediction triggers a costly follow-up action, an MRI scan, a transaction audit, whose execution is subject to real operational constraints. This paper proposes a formal classification framework under capacity constraints: given a user-defined bound limit $b$ on the proportion of observations that can be labeled as belonging to the minority class, the goal is to find the classifier that maximizes sensitivity on that class. We characterize the optimal classifier under this constraint and establish its equivalence with the classical Bayes classifier under a reweighting of the prior probabilities. We also introduce a capacity-adjusted performance metric $M$ that accounts for the effective detection rate when the capacity constraint is binding. The framework is implemented on top of standard learning methods, k-NN, SVM, random forests, and neural networks, and statistical consistency is established for each. We further show that these methods reduce to post-hoc thresholding when no hyperparameters are oriented toward the capacity-constrained objective, and introduce a capacity-aware support vector machine that exploits the constraint during training and achieves the strongest empirical performance. Experiments on the Taiwanese credit card default dataset confirm that capacity-constrained classifiers substantially outperform both classical approaches and SMOTE under high imbalance regimes. The framework extends naturally to multiclass settings and online environments.

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24.

arXiv (CS.CV) 2026-06-17 DOI: arXiv:2606.17539

Reinforcing Dual-Path Reasoning in Spatial Vision Language Models

作者:

Yatai Ji↗An-Chieh Cheng↗Yang Fu↗Yukang Chen↗Han Zhang↗Zhaojing Yang↗Wei Huang↗Ka Chun Cheung↗Song Han↗Vidya Nariyambut Murali↗Pavlo Molchanov↗Jan Kautz↗…

Spatial VLMs have made substantial progress in geometric perception, yet complex spatial reasoning requiring multi-step inference over depth, distance, and scene relations remains challenging. Moreover, different spatial queries call for fundamentally different strategies: some are best addressed through purely linguistic, step-by-step deduction, while others require explicit 3D grounding before quantitative inference. We present Dual-Path Spatial Reasoning via Reinforcement Learning for Spatial VLMs (SR-REAL), a unified framework that equips a spatial VLM with two complementary reasoning paths: Language-Only Reasoning (LOR), which performs step-by-step linguistic deduction, and Detect-Then-Reason (DTR), which detects 3D geometric cues (e.g., centers or bounding boxes) via region tokens before explicit geometric inference. SR-REAL begins with a cold-start supervised fine-tuning stage that constructs LOR and DTR chain-of-thought supervision and exposes a region-to-3D interface, followed by RL that optimizes the policy model with accuracy and format rewards; for DTR, a discrete center-based detection reward further refines geometric alignment. Across diverse spatial benchmarks, SR-REAL significantly outperforms spatial VLM baselines: (i) a single RL-trained model supports both reasoning paths, with DTR excelling in region-aware tasks through precise 3D localization and LOR enhancing general spatial reasoning; (ii) jointly training both paths fosters mutual reinforcement; (iii) high-quality, blended cold-start data is crucial for stable RL optimization; and (iv) the model generalizes across datasets and domains without per-task tuning, demonstrating positive transfer between LOR and DTR.

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25.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2606.15155

Semantic Reasoning in Medicine: The Role of Knowledge Graphs Across Five Key Domains

作者:

Haniye Sherafatmandjoo↗Mohammad Akbari↗Zahed Rahmati↗

arXiv:2606.15155v1 Announce Type: new Abstract: Knowledge graphs (KGs) have emerged as a promising solution for integrating and reasoning over complex biomedical and clinical data in healthcare. By representing structured relationships among entities such as diseases, drugs, symptoms, and patient records, KGs provide a semantic backbone for decision-making, prediction, recommendation, and personalized care. Recent advances have demonstrated their utility across diverse medical applications–including clinical decision support systems, disease and treatment outcome prediction, health recommender systems, precision medicine, and medical question answering–where KGs often enhance interpretability, semantic coherence, and patient-specific reasoning. In parallel, a growing body of work focuses on medical KG generation itself, proposing frameworks that construct graphs from EHRs, clinical narratives, biomedical literature, and web resources using ontologies, semantic web technologies, deep-learning-based information extraction, and hybrid neuro-symbolic pipelines. Despite this progress, significant challenges remain, including limited and fragmented knowledge coverage, difficulties in aligning heterogeneous data sources, the fragility of current reasoning and representation-learning methods on dense multi-relational graphs, and unresolved issues related to privacy, bias, and accountability. This survey reviews and categorizes current research on KGs in medicine along both application-oriented and methodology-oriented dimensions, discusses their benefits and technical foundations, and outlines key limitations and open research directions. By analyzing trends, architectures, and evaluation practices, this work aims to guide future developments in KG-driven medical AI systems and support their safe and effective integration into healthcare environments.

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