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01.
arXiv (CS.LG) 2026-06-16

A Multimodal Approach to Alzheimer's Diagnosis: Geometric Insights from Cube Copying and Cognitive Assessments

arXiv:2512.16184v2 Announce Type: replace Abstract: Early and accessible detection of Alzheimer's disease (AD) remains a critical clinical challenge, and cube-copying tasks offer a simple yet informative assessment of visuospatial function. This work proposes a multimodal framework that converts hand-drawn cube sketches into graph-structured representations capturing geometric and topological properties, and integrates these features with demographic information and neuropsychological test (NPT) scores for AD classification. Cube drawings are modeled as graphs with node features encoding spatial coordinates, local graphlet-based topology, and angular geometry, which are processed using graph neural networks and fused with age, education, and NPT features in a late-fusion model. Experimental results show that graph-based representations provide a strong unimodal baseline and substantially outperform pixel-based convolutional models, while multimodal integration further improves balanced classification performance and discriminative ability. SHAP-based interpretability analysis identifies specific graphlet motifs associated with corner integrity and edge continuity as key predictors, closely aligning with clinical observations of distorted cube drawings in AD. Together, these findings establish graph-based analysis of cube-copying behavior as an interpretable, non-invasive, and scalable framework for Alzheimer's disease screening.

02.
arXiv (CS.AI) 2026-06-19

FAPO: Fully Autonomous Prompt Optimization of Multi-Step LLM Pipelines

arXiv:2606.19605v1 Announce Type: cross Abstract: Multi-step LLM pipelines fail through interactions among retrieval, reasoning, and formatting steps, so prompt-only optimization can miss bottlenecks in the chain. We present FAPO (Fully Autonomous Prompt Optimization), a framework that lets Claude Code optimize an LLM pipeline inside a standardized codebase. FAPO evaluates a pipeline, inspects intermediate steps, diagnoses failures, proposes scoped changes, and validates variants repeatedly to optimize against a score function. It first tries prompt edits and, only when prompt optimization appears insufficient, changes chain structure within the permitted scope when attribution identifies a structural bottleneck. Across six benchmarks and three task models, FAPO beats the baseline GEPA in 15 of 18 model-benchmark comparisons. In 11 model-benchmark comparisons, FAPO wins with non-overlapping mean $\pm$ trial-standard-deviation ranges, and the mean FAPO-GEPA gain is +14.1 pp. In the six HoVer and IFBench comparisons where prompt-first search escalated to structural changes, FAPO wins all six with a mean gain of +33.8 pp. FAPO also improves performance on security tasks: on CTIBench-RCM, a security CVE-to-CWE task, prompt-only FAPO lifts test accuracy by +4.0 pp on GPT-5, +7.1 pp on Foundation-Sec-8B-Instruct, and +2.0 pp on Foundation-Sec-8B-Reasoning. These results position FAPO as a state-of-the-art pipeline optimization technique for both general-purpose and security-focused tasks.

03.
arXiv (CS.CV) 2026-06-15

PhysVLA: Towards Physically-Grounded VLA for Embodied Robotic Manipulation

Vision-Language-Action (VLA) models excel at mapping visual inputs and natural language instructions directly to robotic control policies. However, because they are trained primarily to fit behavioural demonstration data, they do not explicitly enforce fundamental physical principles such as rigid-body dynamics or contact constraints. This exposes a critical physics gap: standard temporal smoothing applied on top of single-step or chunked VLAs trades trajectory quality for added failures that short-term memory cannot resolve. To bridge this gap, we introduce PhysVLA (Physics-VLA), a plug-and-play, inference-time framework designed to wrap any frozen VLA backbone without retraining, fine-tuning, or weight access, with less than 1 ms of overhead per control step. PhysVLA intercepts the predicted control action, captures only the simulator or system state, and applies a dual-layered correction: (i) a phase-aware finite-state machine that structures discrete task segments (approach, grasp, transport, and place), and (ii) a selective Euler-Lagrange gate that activates only when a dynamics oracle detects kinodynamic inconsistency. Evaluated across OpenVLA, OpenVLA-OFT, Force-VLA, and Generalist-VLA on LIBERO-Spatial with a 7-DoF Franka Panda, the framework delivers absolute success rate increases of up to 17% and stability increases of up to 19% with no per-task regressions, improves trajectory efficiency by up to 15% across all four backbones, and shows up to a 10x improvement in trajectory jerk robustness on a Robosuite Lift cross-simulator sweep. We further validate the framework on a real Agilex Piper arm with a pick-and-place task, confirming that PhysVLA transfers to physical hardware without retraining, with success-rate improvements of up to 50%, establishing physical awareness as a composable, backbone-agnostic runtime module.

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

From Static Inference to Dynamic Interaction: A Survey of Streaming Large Language Models

Standard Large Language Models (LLMs) are predominantly designed for static inference with pre-defined inputs, which limits their applicability in dynamic, real-time scenarios. To address this gap, the streaming LLM paradigm has emerged. However, existing definitions of streaming LLMs remain fragmented, conflating streaming generation, streaming inputs, and interactive streaming architectures, while a systematic taxonomy is still lacking. This paper provides a comprehensive overview and analysis of streaming LLMs. First, we establish a unified definition of streaming LLMs based on data flow and dynamic interaction to clarify existing ambiguities. Building on this definition, we propose a systematic taxonomy of current streaming LLMs and conduct an in-depth discussion on their underlying methodologies. Furthermore, we explore the applications of streaming LLMs in real-world scenarios and outline promising research directions to support ongoing advances in streaming intelligence. We maintain a continuously updated repository of relevant papers at https://github.com/EIT-NLP/Awesome-Streaming-LLMs.

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

EIBench: A Simulator-Based Benchmark and Turn-Credit RL for Emotion Management

Emotional intelligence (EI) in Large Language Models (LLMs) is often evaluated through static understanding tasks or single-response dialogue generation. However, emotion management is interactive: a good model should not only recognize a user's emotion, but also improve the user's emotional and relational state over several turns. We introduce EIBench, a simulator-based benchmark for interactive emotion management. EIBench contains 2,222 scenarios, with 2,009 for training and 213 for held-out testing. The scenarios are organized by a 2x2 taxonomy covering Support, Defense, Repair, and Charm, which together capture different forms of support, boundary maintenance, trust repair, and rapport building. In each scenario, an LLM simulator plays the user, updates an emotion-relation state after each turn, and maps the final state to an anchor-based score. This design makes EIBench both an evaluation benchmark and a training environment: the final state gives the outcome reward, while the per-turn state updates provide dense feedback for RL. We evaluate 15 open- and closed-source LLMs. Current models perform well on support and rapport-building scenes, but struggle with boundary maintenance under user pressure. To improve the EI ability of LLMs, we propose Centered Turn-Credit GRPO (CTC-GRPO), a GRPO extension that reuses the simulator's per-turn state updates as dense turn-level feedback while preserving the final outcome reward. CTC-GRPO improves Qwen3-8B from -22.4 to +22.4 on EIBench and also improves on out-of-distribution evaluations including SAGE (+12.4) and EQBench3 (+20.9%). Our results show that simulator-tracked user states can support both evaluation and training for multi-turn emotion management.

07.
arXiv (CS.CL) 2026-06-11

External Experience Serving in Production LLM Systems: A Deployment-Oriented Study of Quality-Cost Trade-offs

Production LLM systems accumulate reusable operational experience, but the practical deployment issue is not merely whether such experience can help. It is how different serving strategies trade off quality against online cost under realistic constraints. Injecting external experience can improve task quality, yet it also increases prompt burden, latency, and serving pressure. We study external experience serving as a deployment-oriented quality-cost trade-off problem. We evaluate this question in a real production moderation setting, with tool-use and GPQA as supporting contrast tasks that expose different output-cost regimes. We compare no-experience baselines, random experience controls, global prompt injection, and retrieval-based selective injection, and analyze both task quality and serving cost. The results show that, once experience becomes case-dependent, selective retrieval provides a stronger operating point than unconditional global injection. They further show that retrieval quality matters more than simply increasing Top-$K$, and that the same serving policy can exhibit substantially different cost-benefit profiles across short-output and decode-heavy regimes. These findings suggest that external experience is best treated as a selective, cost-aware serving decision rather than as a universal add-on. Overall, in the settings studied here, external experience pays off only when both the serving interface and the task-specific cost structure make its quality gains worth the online cost.

08.
arXiv (CS.CL) 2026-06-19

DeFrame: Debiasing Large Language Models Against Framing Effects

As large language models (LLMs) are increasingly deployed in real-world applications, ensuring their fair responses across demographics has become crucial. Despite many efforts, an ongoing challenge is hidden bias: LLMs appear fair under standard evaluations, but can produce biased responses outside those evaluation settings. In this paper, we identify framing – differences in how semantically equivalent prompts are expressed (e.g., "A is better than B" vs. "B is worse than A") – as an underexplored contributor to this gap. We first introduce the concept of "framing disparity" to quantify the impact of framing on fairness evaluation. By augmenting fairness evaluation benchmarks with alternative framings, we find that (1) fairness scores vary significantly with framing and (2) existing debiasing methods improve overall (i.e., frame-averaged) fairness, but often fail to reduce framing-induced disparities. To address this, we propose a framing-aware debiasing method that encourages LLMs to be more consistent across framings. Experiments demonstrate that our approach reduces overall bias and improves robustness against framing disparities, enabling LLMs to produce fairer and more consistent responses.

09.
arXiv (CS.CV) 2026-06-12

OccAny: Generalized Unconstrained Urban 3D Occupancy

Relying on in-domain annotations and precise sensor-rig priors, existing 3D occupancy prediction methods are limited in both scalability and out-of-domain generalization. While recent visual geometry foundation models exhibit strong generalization capabilities, they were mainly designed for general purposes and lack one or more key ingredients required for urban occupancy prediction, namely metric prediction, geometry completion in cluttered scenes and adaptation to urban scenarios. We address this gap and present OccAny, the first unconstrained urban 3D occupancy model capable of operating on out-of-domain uncalibrated scenes to predict and complete metric occupancy coupled with segmentation features. OccAny is versatile and can predict occupancy from sequential, monocular, or surround-view images. Our contributions are three-fold: (i) we propose the first generalized 3D occupancy framework with (ii) Segmentation Forcing that improves occupancy quality while enabling mask-level prediction, and (iii) a Novel View Rendering pipeline that infers novel-view geometry to enable test-time view augmentation for geometry completion. Extensive experiments demonstrate that OccAny outperforms all visual geometry baselines on 3D occupancy prediction task, while remaining competitive with in-domain self-supervised methods across three input settings on two established urban occupancy prediction datasets. Our code is available at https://github.com/valeoai/OccAny .

10.
arXiv (CS.CL) 2026-06-11

Geometric Metrics and LLMs: What They Measure and When They Work

We present a systematic stress-test of geometric metrics for LLM evaluation. Rank-based geometric properties of internal representations have shown promise as reference-free quality signals, but the conditions under which they are reliable remain unclear. We evaluate eight commonly-used metrics: intrinsic-dimensionality estimators, spectral norms, and related quantities across six tester models (0.5-8B) and eight generators on contrasting tasks, separating genuine geometric signal from text-length effects and from what standard text statistics already capture. Three findings emerge. First, some metrics (notably Schatten Norm and MOM) mainly reflect output length, and their apparent discriminative power collapses once length is controlled. Second, geometric metrics add modest but real information beyond text statistics: combined with them, a classifier reaches 78% accuracy on 6-way generator identification versus 69% for text statistics alone. Third, rather than tracking a general notion of text quality, the metrics demonstrate only moderate association between the intrinsic-dimensionality and lexical diversity (RTTR). We give use-case-specific recommendations and identify failure detection as the most promising near-term application.

11.
arXiv (CS.CL) 2026-06-16

Semantic-Preserving Prompt Hijacking: A Black-Box Adversarial Attack on Auto-Prompt Optimization

LLMs increasingly integrate auto-suggestion optimization modules, enabling them to rewrite and display user input before generating the final response. While this design aims to enhance transparency and trust, its process of autonomously selecting a single best result from multiple candidate solutions allows attackers to hijack this optimization process by inducing subtle, imperceptible semantic shifts. To address this, we propose a semantic preservation hijacking attack method based on black-box conditions: Adaptive Greedy Local Search. This method hierarchically decomposes the input text, masks key language units, and dynamically adjusts candidate replacement words at predefined semantic checkpoints. This maximizes the deviation between the model output and the original intent while strictly maintaining semantic similarity to the original text. Experimental results on commercial and open-source LLMs demonstrate that, under the same semantic similarity constraints, this method achieves a higher attack success rate than existing attack methods in over 2400 test cases. Code is available at: https://github.com/franz-chang/DOBS

12.
arXiv (math.PR) 2026-06-18

The FBSDE approach to sine-Gordon up to $6\pi$

arXiv:2401.13648v3 Announce Type: replace-cross Abstract: We develop a stochastic analysis of the sine-Gordon Euclidean quantum field $(\cos (\beta \varphi))_2$ on the full space up to the second threshold, i.e. for $\beta^2 < 6 \pi$. The basis of our method is a forward-backward stochastic differential equation (FBSDE) for a decomposition $(X_t)_{t \geqslant 0}$ of the interacting Euclidean field $X_{\infty}$ along a scale parameter $t \geqslant 0$. This FBSDE describes the optimiser of the stochastic control representation of the Euclidean QFT introduced by Barashkov and one of the authors. We show that the FBSDE provides a description of the interacting field without cut-offs and that it can be used effectively to study the sine-Gordon measure to obtain results about large deviations, integrability, decay of correlations for local observables, singularity with respect to the free field, Osterwalder-Schrader axioms and other properties.

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

SuperCarver: Texture-Consistent 3D Geometry Super-Resolution for High-Fidelity Surface Detail Generation

Conventional production workflow of high-precision mesh assets necessitates a cumbersome and laborious process of manual sculpting by specialized 3D artists/modelers. The recent years have witnessed remarkable advances in AI-empowered 3D content creation for generating plausible structures and intricate appearances from images or text prompts. However, synthesizing realistic surface details still poses great challenges, and enhancing the geometry fidelity of existing lower-quality 3D meshes (instead of image/text-to-3D generation) remains an open problem. In this paper, we introduce SuperCarver, a 3D geometry super-resolution pipeline for supplementing texture-consistent surface details onto a given coarse mesh. We start by rendering the original textured mesh into the image domain from multiple viewpoints. To achieve detail boosting, we construct a deterministic prior-guided normal diffusion model, which is fine-tuned on a carefully curated dataset of paired detail-lacking and detail-rich normal map renderings. To update mesh surfaces from potentially imperfect normal map predictions, we design a noise-resistant inverse rendering scheme through deformable distance field. Experiments demonstrate that our SuperCarver is capable of generating realistic and expressive surface details depicted by the actual texture appearance, making it a powerful tool to both upgrade historical low-quality 3D assets and reduce the workload of sculpting high-poly meshes.

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

Divination by Prompt: LLM-Mediated Xuanxue on Chinese Social Media

arXiv:2606.12418v1 Announce Type: cross Abstract: The rapid proliferation of large language models (LLMs) has produced a striking cultural practice: using conversational AI for divination. This paper offers one of the first systematic studies of LLM-mediated divination in the context of Xuanxue, an internet-native umbrella term for mystical and spiritual practices on Chinese social media. Using a mixed-methods design, we analyze 23000+ posts and comments from Xiaohongshu and conduct 32 semi-structured interviews with users and professional diviners. Users primarily consult LLMs about pragmatic concerns - romantic relationships, careers, exams, and in-game gacha draws - via two intersecting pathways: trend-driven curiosity enabled by viral visibility and zero-cost access, and event-driven anxiety under conditions of uncertainty. A defining feature is collaborative prompt refinement, which turns users into active prompt engineers. Among commenters expressing a clear stance, perceived efficacy skews positive, with "accuracy" often justified through biographical fit and retrospective confirmation, consistent with Barnum and confirmation bias. Users also develop verification practices such as repeated trials and cross-model comparison. Professional diviners, by contrast, portray LLMs as lacking the "spiritual power" required for genuine divination, reflecting both ontological commitments and economic boundary-work. We also show how participants navigate tensions between scientific and metaphysical frames when interpreting AI-generated readings. Situating these findings in anthropological and cognitive-evolutionary theories of divination, we argue that LLM divination preserves core functions of traditional practice while introducing scalability, repeatability, and prompt-driven co-production that reshape how divinatory authority is constructed and evaluated.

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

Learning Urban Access Costs from Origin-Destination Flows via Inverse Optimal Transport

arXiv:2606.14157v1 Announce Type: cross Abstract: Cities deliver basic services through mixed public-private facility networks, including schools, clinics, transit providers, and subsidized service points. In these systems, planners often observe where households go, but not the latent cost function through which they trade off factors such as distance, price, and institutional access. We study this urban problem through school choice in the Philippines, where the country's largest national education subsidy is intended to redirect learners from congested public schools to participating private schools. Treating school-to-school enrollment flows as an entropic optimal transport plan, we recover latent choice costs using two complementary inverse optimal transport models: an interpretable distance-banded model with a subsidy term, and a neural cost model trained through a differentiable Sinkhorn forward pass. Applied to 283{,}016 learner trips across 23{,}820 observed flows in the most populated region, the framework estimates a subsidy-equivalent distance, $\lambda^{(k)}$, interpreted as the kilometers of perceived travel cost offset by the subsidy. The case demonstrates how administrative origin-destination data can be transformed into interpretable planning metrics for accessibility-aware subsidy design, facility siting, and urban service allocation.

17.
arXiv (CS.AI) 2026-06-19

RACL: Reasoning-Agent Control Layers for Continuous Metaheuristic Learning

arXiv:2606.20142v1 Announce Type: new Abstract: This paper introduces RACL, a Reasoning-Agent Control Layer for metaheuristics. RACL places a reasoning agent above an existing optimizer. The agent does not replace the optimizer and does not modify business constraints. Instead, it controls the optimizer's internal search behavior by observing operational memory, reasoning over past behavior, formulating bounded hypotheses, testing interventions, evaluating outcomes, applying guardrails, consolidating useful policies and explaining its decisions. The experiment uses vehicle routing as a testbed, but the contribution is not a new routing solver, a particular ALNS configuration or a specific set of routing rules. The contribution is the RACL method: a way for a reasoning agent to discover, validate, consolidate and explain algorithmic control rules for a metaheuristic. In the current experimental setting, RACL improves or ties the Operational Memory Policy in 21 of 21 feasible cases and improves or ties a non-reasoning Stagnation-Triggered Policy in 18 of 21 feasible cases, with an average RACL vs STP cost delta of -0.641%. In the Sevilla-9/10 runtime sample, RACL improves average cost by -8.337% versus Fixed and -1.605% versus STP without showing material computational overhead. During the proof-of-concept, Codex was used as an in-the-loop reasoning agent observing executions, interpreting logs and proposing live bounded interventions. The policy proxy was later used only to make quantitative evaluation reproducible.

18.
medRxiv (Medicine) 2026-06-11

Conversational Speech for Respiratory Triage in Primary Care: A Pilot Study

Authors:

Background. Respiratory complaints account for a substantial share of adult ambulatory care visits, and triaging them accurately has direct consequences for antibiotic stewardship and pathogen-specific therapy. Prior work has investigated voice as a triage signal, but that literature is dominated by single-condition detection from scripted speech in crowdsourced or controlled clinical settings and has not been evaluated at primary care scale on conversational ambient audio. Methods. A dataset of 514,377 ambient-recorded primary care visits from 379,225 adult patients at a US clinic network was used, with per-visit clinically assigned ICD-10 diagnosis codes and de-identified demographic and geographic metadata. Patient audio was extracted from each doctor-patient conversation, and spectral, voice quality, and prosodic features were computed. Eleven binary classification tasks were defined, aligned with a respiratory triage cascade (e.g., acute respiratory versus acute non-respiratory illness, and lower versus upper respiratory tract infection). An acoustic model (feed-forward network) was trained independently for each task using patient-stratified five-fold cross-validation and evaluated on a held-out test set. Each task's model was also compared against six non-acoustic baselines using a single demographic, geographic, or temporal variable. The 11 trained classifiers were composed into a hierarchical cascade and illustrated as case studies on selected patients. Results. Test-set AUC across the 11 tasks ranged from 0.602 (95% CI: 0.588-0.614) to 0.745 (95% CI: 0.742-0.748), with a mean expected calibration error of 0.018. Six of eleven binaries outperformed all confounder baselines. Four binaries showed median within-stratum AUC of 0.62-0.70 when the confounder was held fixed, indicating acoustic discrimination beyond what the confounder alone explains. The exception was the pneumonia versus non-pneumonia lower respiratory tract infection binary, which failed against the patient-city confounder baseline, plausibly reflecting a clinic-level difference in ICD-10 coding. Conclusion. Conversational primary care audio carries acoustic signal that discriminates clinically meaningful respiratory contrasts. Absolute performance is moderate, but the conditions are stricter than prior work: conversational speech and differential-diagnosis contrasts among sick patients. This pilot study is a baseline for voice-based clinical AI moving beyond sick-versus-healthy detection toward differential-diagnosis panels and a proof-of-concept for hierarchical reasoning.

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

Contextual Bandits for Maximizing Stimulated Word-of-Mouth Rewards

arXiv:2606.15146v1 Announce Type: new Abstract: Stimulated word-of-mouth is a strategy that promotes information sharing through prompts or incentives. Optimizing stimulated word-of-mouth through social networks requires identifying and targeting connected users who are most susceptible to spillover, a phenomenon where the influence of recommendations extends beyond the immediate audience to impact their connected users. The probability of spillover varies across individuals, and their connections, leading to heterogeneity. Understanding and accurately estimating the spillover probabilities among users in social networks is crucial for improving the effectiveness of stimulated word-of-mouth. To address this, we present a novel contextual multi-armed bandit framework that learns individual spillover probabilities and ranks connected users to maximize rewards from stimulated word-of-mouth. Experiments on real-world network datasets demonstrate that accounting for spillover heterogeneity enhances the targeting precision of top-$k$ connected users, boosting rewards and outperforming baseline methods that do not learn individual spillover effects.

20.
arXiv (CS.CL) 2026-06-18

Enhancing Decision-Making with Large Language Models through Multi-Agent Fictitious Play

Large language model (LLM)-based multi-agent systems (MAS) have demonstrated great potential in solving tasks with execution complexity, by distributing subtasks across cooperative agents. However, this divide-and-conquer paradigm falls short on decision-making tasks that are also prevalent in the real world. These tasks require simultaneous reasoning from the stances of all involved stakeholders whose decisions are mutually dependent and thus cannot be solved in isolation. We characterize this challenge as stance entanglement, a form of decision complexity distinct from execution complexity. To address it, we propose Multi-Agent Fictitious Play (MAFP), a novel MAS paradigm that represents stakeholder stances as agents and formulates decision-making as an equilibrium-seeking process. Built on the game-theoretic principle of fictitious play, MAFP iteratively updates each agent's decision by best responding to the empirical mixture of other agents' past decisions. This enables agents to expose and address one another's weaknesses, progressively improving decision quality and robustness. We evaluate MAFP on challenging decision-making tasks that test the capability of deciding strategies for competitive scenarios prior to acting. MAFP outperforms both single-round and multi-round baselines on two complementary metrics, tournament strength and robustness, demonstrating its effectiveness in addressing stance entanglement.

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

Efficient Time Series Clustering from Multiscale Reservoir Dynamics with Granular-Ball Anchoring Graph Optimization

arXiv:2606.12077v1 Announce Type: new Abstract: Time-series clustering remains challenging due to the inherent trade-off between clustering effectiveness and computational efficiency. Similarity-based methods often suffer from quadratic complexity caused by pairwise distance computations, while deep learning-based approaches typically rely on costly iterative training and a large number of trainable parameters. In this paper, we propose MSRGC-Net, an efficient time-series clustering framework that integrates multiscale reservoir computing, granular-ball-based anchoring graph construction, and consensus learning. MSRGC-Net adopts a training-free reservoir computing paradigm to extract multiscale temporal representations from raw time series without backpropagation, significantly reducing computational overhead. To capture the intrinsic structure of the resulting representations, granular-ball computing is employed to adaptively model data distributions via density-consistent regions, yielding compact and robust anchor graph representations. Furthermore, a consensus-based anchoring graph optimization strategy is introduced to effectively align multiscale reservoir representations and integrate complementary information across temporal scales. Extensive experiments on widely used univariate and multivariate benchmark datasets demonstrate that MSRGC-Net consistently outperforms state-of-the-art methods in clustering performance while maintaining superior computational efficiency.

22.
medRxiv (Medicine) 2026-06-17

Diagnostic Concordance of Immediate Versus 1-Hour Technetium-99m Hydroxydiphosphonate Scintigraphy in Suspected Transthyretin Amyloid Cardiomyopathy

Background Bone-avid tracer myocardial scintigraphy for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) has traditionally employed imaging at one or 3-hour intervals. Technetium-99m hydroxydiphosphonate (99mTc-HDP) has unique characteristics that may enable earlier imaging. We investigated the diagnostic concordance of immediate versus 1-hour acquisitions. Methods Consecutive patients with suspected ATTR-CM underwent planar imaging and SPECT/CT immediately and at 1-hour following the administration of 99mTc-HDP. Perugini grades and heart to contralateral lung (H/CL) ratios were assessed. Target-to-background ratios (TBRs) were calculated on the SPECT/CT acquisitions using the left ventricular (LV) septum and three background regions: aorta, LV blood-pool, and vertebrae. We assessed diagnostic concordance using Cohen's Kappa ({kappa}), temporal stability using paired t-tests, and correlation between timepoints using Pearson's coefficient (r). The 1-hour SPECT/CT interpretation served as the protocol reference standard. Results Forty-eight patients (83% male; median age, 80 [73-85] years) were evaluated. One-hour SPECT/CT identified 19 positive and 29 negative cases. Immediate SPECT/CT demonstrated 100% diagnostic concordance with the 1-hour reference standard ({kappa} = 1.000; 95% CI: 1.00 to 1.00; p < 0.001). The LV septum/LV Blood-Pool TBR showed the highest correlation (r = 0.956; 95% CI: 0.922 to 0.975; p < 0.001). The LV Septum/Aorta TBR demonstrated high correlation (r = 0.918; 95% CI: 0.857 to 0.953; p < 0.001) and remained stable in the ATTR-negative cohort (-0.02; 95% CI: -0.08 to 0.04; p = 0.54). Significant decrease in the LV Septum/Vertebrae TBR in the ATTR-negative (-0.55; 95% CI: -0.64 to -0.47; p < 0.001) and ATTR-positive cohorts (-1.14; 95% CI: -1.39 to -0.89; p < 0.001) was observed. Conclusions Immediate 99mTc-HDP SPECT/CT is diagnostically concordant with standard 1-hour protocols. By leveraging SPECT/CT and the favorable kinetics of 99mTc-HDP, immediate-phase imaging can accurately reproduce 1-hour acquisitions in cases of suspected ATTR-CM. This expedited approach may improve nuclear laboratory throughput and patient satisfaction.

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

Ricci-Filtration: Boosting Retrieval-Augmented Generation Reranker to Query-Answer Tasks by Discrete Ricci Flow

arXiv:2606.15482v1 Announce Type: cross Abstract: Ricci flow is a curvature-guided diffusion process that deforms space by shrinking regions of high positive curvature and expanding those with negative curvature. Similarly, discrete Ricci flow on weighted graphs modifies edge weights by shrinking edges with positive Ricci curvature and stretching those with negative Ricci curvature, effectively increasing the separation between clusters. Inspired by these two cornerstone works, we propose a geometry-based RAG reranker enhancement procedure called Ricci-Filtration. By modeling the input query and initial retrieved chunks as a network, where the input query and chunks serve as nodes and embedding-based pairwise relations define an initial graph, Ricci-Filtration leverages discrete curvature and Ricci flow to evaluate the structural importance of each chunk with respect to the user query. The system first filters the initial chunks based on their geometric curvature relative to the query; then, a reranker processes the remaining chunks to enhance generative performance. We theoretically prove that normalized discrete Ricci flow can detect community structures by identifying distinct asymptotic behaviors in edge weights. This supports the removal of ``noisy'' document chunks characterized by large weights and negative Ricci curvature relative to the query node. Extensive experiments confirm that Ricci-Filtration outperforms several baseline reranking methods in accuracy, precision, recall, and F1 scores. Furthermore, ablation studies demonstrate that the Ricci-Filtration generally outperforms the baseline under various settings, highlighting the framework's robustness across different architectures.

24.
medRxiv (Medicine) 2026-06-15

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

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

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

Active Reference Acquisition in Few-Shot Font Generation

Few-shot font generation aims to synthesize the remaining glyphs of a font given one or a few reference glyphs while preserving stylistic consistency, thereby supporting font designers in efficiently completing a typeface. Existing methods primarily focus on improving generation quality given a fixed reference set. However, when the current reference glyphs are insufficient to represent the target style, few-shot font generation may fail to produce satisfactory results. In practical scenarios, additional reference glyphs can often be obtained from the designer when necessary. Accordingly, we propose a new framework, Active Reference Acquisition in Few-Shot Font Generation, in which the model sequentially decides which character to acquire next as an additional reference. Furthermore, we propose a reference part-coverage-based acquisition function to efficiently query the designer. Motivated by the observation that font styles are well characterized by local structural parts, we represent each glyph using a histogram of local features and select query characters that maximize the expected part coverage of the reference set. By prioritizing characters that contain parts not yet covered by the current references, the proposed method progressively expands the diversity of visual parts in the reference set. As a result, generation quality is improved with fewer queries. Experiments on the Google Fonts dataset demonstrate that the proposed method achieves higher generation quality than random querying and reference-agnostic baselines. The code is available at https://github.com/matsuo-shinnosuke/ActiveRef-FontGen.