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01.
medRxiv (Medicine) 2026-06-22

GCH1 p.Ser80Asn Confers Risk for Parkinson's Disease in East Asian Populations

Introduction: GCH1 has been implicated in Parkinson's disease (PD), but its risks variants and associations are not well defined. Objectives: To investigate the clinical relevance and PD risk associated with the GCH1 p.Ser80Asn variant. Methods: We first identified a segregating GCH1 p.Ser80Asn variant in a Malaysian Chinese PD family via whole genome sequencing (WGS). We assessed its risk association using multi-ancestry WGS data from the Global Parkinson's Genetics Program (GP2) (n=22,372PD vs n=8,826Controls) and meta-analysis of East Asian (EAS) cohorts (n=4,712PD vs 38,733Controls). Clinico-demographic details of affected variant carriers were collated. Results: The GCH1 p.Ser80Asn variant was enriched in GP2 EAS PD populations (n=9/2,757; 0.33%) but not detected in other ancestries. Meta-analysis revealed increased PD risk in EAS populations (odds ratio:5.1; 95%CI:2.3-10.7; p=2.89x10-5). Affected carriers (mean age at onset:56.3+-12.5 years) had additional occurrence of dystonia, while dementia was rare. Conclusions: The GCH1 p.Ser80Asn variant is a rare, EAS-enriched risk variant for PD.

02.
arXiv (CS.CL) 2026-06-15

The Linguistics Olympiads: Towards a New Corpus for Linguistics Research?

Linguistics olympiad problems (LOPs) are a category of self-sufficient puzzles consisting of a scaled-down corpus representative of certain linguistic phenomena, from which the solver must deduce a primitive set of rules of the language and then translate a new set of elements. The linguistics olympiads (LOs) have become a worldwide phenomenon with 43 different territories taking part in the International Linguistics Olympiad (IOL) 2025. While the typology and solving strategies of LOPs have been analysed, their scientific facet and connections to academic linguistics have yet to be explored. LOPs are directly connected to many linguistic fields, e.g., linguistic typology, linguistic relativity, and linguistics fieldwork. Recently, LOPs have become a research focus as benchmarks for large language models, thus highlighting their usefulness in computational linguistics. Nevertheless, they have not yet been integrated into mainstream linguistics research. This paper attempts to open new directions of including this particular type of puzzle in academic research by offering a structured evaluation of LOPs as linguistic data sources and proposes criteria for their responsible use in academic research. Starting from a set of over 1800 LOPs, this study critically examines the potential of LOPs as a novel corpus for linguistics research by discussing their strengths and limitations as tools, as well as the areas of linguistics into which these problems could fit. This work forms the foundation for a broader initiative aimed at bridging the gap between LOs and academic linguistics, by establishing a robust theoretical framework for LOPs.

03.
medRxiv (Medicine) 2026-06-15

Prevalence and Clinical Impact of Pathogenic Variants in Cardiomyopathy Genes Among Individuals with Cardiac Conduction Disorders

Importance: Cardiac conduction disorders have traditionally been regarded as a secondary manifestation of underlying structural heart diseases. However, isolated conduction disorders may precede the onset of heart failure (HF) suggesting shared mechanisms. Objective: To evaluate the prevalence and clinical significance of pathogenic/likely pathogenic (P/LP) rare variants in cardiomyopathy genes among individuals with conduction disorders. Design, Setting, and Participants: Biobank analysis of 192,834 participants with whole genome sequence data from Vanderbilt's BioVU and 353,092 participants from the All of Us Research Program (AoU). Participants with primary conduction disorder (left bundle branch block [LBBB], right bundle branch block [RBBB], high-grade atrioventricular block [AVB]) were identified after excluding secondary causes. Exposures: P/LP variants in cardiomyopathy genes. Main Outcomes and Measures: Primary outcome was P/LP carrier status by age and HF status. Secondary outcomes included incident HF and composite ventricular arrhythmias/sudden cardiac death/mortality (VA/SCD/mortality). Results: Among 16,959 participants with conduction disorders in BioVU and 13,442 in AoU, 432 (2.6%) and 206 (1.5%) were P/LP carriers, respectively. Conduction disorder was independently associated with carrier status (BioVU p

04.
medRxiv (Medicine) 2026-06-22

Effectiveness of Stress Management to Reduce Stress Eating for Women: A Systematic Review and Meta-analysis of Intervention Studies

Objective: This systematic review and meta-analysis examined 1) the effects of stress management interventions on changes in stress eating for women, and 2) the longevity of these effects, by summarizing and assessing evidence from controlled and non-equivalent pretest-posttest intervention studies. Method: Five databases (PsycINFO, PubMed, Medline, Web of Science, CINAHL), existing sources, and grey literature were searched (February - June 2025). Studies that assessed stress eating or emotional eating, included a stress management intervention, and comprised at least 70% women were included. The primary outcome was reduction in stress eating. Data were pooled in meta-analyses using multi-level random-effects models and subset by follow-up period. Risk of bias was assessed via funnel plots and sensitivity analyses. Results: Sixty studies with 119 effect size estimates were included in the primary analysis. Pooled estimates indicated that stress management interventions significantly reduced stress eating (Hedges g = -0.4174, p < 0.001), with pre-post designs having larger effects than controlled trials. Subgroup analyses of follow-up periods found small effects in the short-term (before 3 months; Hedges g = -0.4202, p < 0.0001) and moderate effects for mid-term (3-6 months; Hedges g = -0.5886, p < 0.0001). Effects beyond 6 months were small and nonsignificant (Hedges g = -0.4370, p = 0.0660). Conclusion and Relevance: Stress management interventions appear to be effective for reducing stress eating for women, suggesting the potential to incorporate stress management in interventions targeting obesity. Effects may be only sustained 6 months post-intervention, suggesting the need for strategies to bolster long-term effectiveness.

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

Assessing Predictive Models for Fairness Based on Movement Patterns

arXiv:2605.23234v3 Announce Type: replace Abstract: Assessing the spatial fairness of predictive models involves establishing whether they are statistically penalizing (favoring) individuals associated with certain geographical locations. Literature on this topic makes the fundamental assumption that each individual is assigned to a single geographical location (e.g., place of residence). However, fairness with respect to the set of locations where one has been, i.e., their movement patterns over different regions, also matters when fairness is considered. Consequently, we argue that it is necessary to generalize the notion of spatial fairness to also include movement patterns, leading to the novel problem of assessing predictive models for fairness relative to the movements of individuals. To deal with this problem, we propose an approach that first associates the movements of individuals to certain geographic regions, considering multiple spatial partitions with different resolutions and alignments, and then employs a suitable spatial scan statistic to assess whether a predictive model is fair based on movement patterns. In the experimental evaluation, we study the performance of our approach over thousands of synthetic unfair datasets, showing that it is effective at detecting this new type of unfairness and at retrieving the set of objects treated unfairly, while localization performance exhibits a consistent multi-resolution trade-off.

06.
medRxiv (Medicine) 2026-06-24

Projected epidemiologic and economic impact of the 7-1-7 outbreak response framework in Uganda: a stochastic modelling study of Bundibugyo Ebola virus

The 7 1 7 framework (detection 7 days, notification & 1 day, response & 7 days) is a global target for epidemic preparedness, but its prospective value during an active cross border outbreak has not been quantified. Using a stochastic SEIR model parameterised for Uganda with the Bundibugyo Ebola strain and three daily importation probabilities (10%, 30%, and the observed 56%), we compared a rapid 3 1 5 response (detection 3 days, notification 1 day, response 5 days) against a delayed counterfactual (detection 11 days, notification 10 days, response 12 days). The rapid response reduced median cumulative cases by 60 to 66% (26 to 31 cases vs. 76 to 80 cases) and deaths by 62 to 63% (3 deaths vs. 8 deaths) across all import levels, with total costs of USD 29.1 to 29.9 million compared to USD 37.4 to 38.1 million for the delayed scenario. The rapid response was strictly dominant (cost saving and life saving). Variance based Sobol sensitivity analysis identified the case fatality rate, import probability, and basic reproduction number as the most influential parameters, with detection and response delays contributing through interactions. Institutionalising the 7 1 7 framework in Uganda is projected to be highly cost effective and should be supported with sustainable domestic financing, community based surveillance at unofficial border points, three consecutive PCR laboratory capacity, and multilingual risk communication.

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

Attention, not scale, drives human-AI alignment in multimodal language prediction

Humans routinely draw on visual context to predict upcoming words. To what extent current vision-language models produce comparable behaviour is unclear. Here we placed five state-of-the-art pretrained systems side-by-side with 600 human participants in a web-based Visual-World Paradigm. On each of 100 six-second movie clips, models and participants received either text only or synchronised video and text and judged how likely a specified target word was to appear next; human eye movements were tracked throughout. Adding visual context increased model-human alignment in predictability ratings across all architectures (average Delta r = 0.18) with no impact of parameter size. When visual context was informative, transformer attention significantly increased alignment. Attention maps from two transformer models corresponded with human gaze, explaining up to 70% of the inter-participant variance when the scene contained informative cues. Notably, cross-modal attention reliably tracked anticipatory human fixations on semantic cues. These results suggest that current transformer-based vision-language models can approximate human behaviour exploiting visual context during language prediction - and that selective attention to informative cues, not sheer model scale, is the principal driver of this alignment.

08.
arXiv (quant-ph) 2026-06-11

Machine-learned, finite temperature Fermi-operator expansions suitable for GPUs and AI-hardware

arXiv:2605.08523v2 Announce Type: replace Abstract: We present several finite-temperature recursive Fermi-operator expansion schemes based on the second-order spectral projection (SP2) method. Our approach builds on a previous observation that the electronic structure problem, as formulated through a recursive SP2 expansion, can be mapped onto the architecture of a deep neural network. Using this perspective, we generalize SP2 to finite electronic temperatures by constructing machine learning models that determine optimized recursive expansion coefficients. The same approach is also applied to the prediction of the electronic entropy for fractional occupation numbers. The coefficients are trained for a specified chemical potential and electronic temperature and are not available in closed analytical form. However, by employing an appropriate affine rescaling strategy to the Hamiltonian matrix, we eliminate the need to retrain the model for different temperatures and chemical potentials. Our approach avoids explicit diagonalization and relies solely on highly optimized matrix-matrix multiplication kernels. Compared to state-of-the-art diagonalization, we achieve an order-of-magnitude speedup in the single-particle finite-temperature density matrix calculation for small and moderately sized matrices on modern GPUs and dense matrix multiply units.

09.
medRxiv (Medicine) 2026-06-22

Virtual Responsive Neurostimulation Implantation: From Intracranial Connectivity to Optimized Lead Placement

Responsive neurostimulation (RNS) is an implanted device that delivers direct brain stimulation for drug-resistant focal epilepsy. Individual responses are highly variable, and no validated framework exists to predict outcome or guide lead placement before implantation. We hypothesized that this variability is partly explained by lead placement in relation to patterns of functional connectivity in brain networks. Fourty-nine patients with drug-resistant focal epilepsy who underwent pre-implantation intracranial EEG (iEEG) and RNS implantation across three independent epilepsy centers were retrospectively studied. We developed a composite functional connectivity score, based on simple Spearman correlation, combining the standard deviation and kurtosis of interictal iEEG connectivity distributions to predict the response outcome in a training cohort (HUP, n=18) and validated in two independent cohorts (NYU, n=17; UCSF, n=14). We accounted for a spatial mismatch between iEEG and RNS electrodes with a distance-based correction. The score was extended to generate patient-specific 3D maps of predicted RNS efficacy across 200 simulated, or virtual RNS, lead configurations. Accuracy of the score in predicting clinical outcome was 72% at the group level, 61% at the individual patient level, and, after distance-based optimization, 100% in patients with RNS electrodes placed close to location of iEEG electrodes. Applied to the validation cohort, the same score reached 68% accuracy (71% balanced accuracy, 55% sensitivity, 88% specificity). The spatial combination of the scores at different SEEG contacts localization gives a spatial score for each patient. Responders showed significantly higher spatial scores than non-responders, supporting that actual RNS lead placement in responders was located in map-identified favorable regions. Interictal iEEG functional connectivity predicts individual RNS response across independent epilepsy centers, and patient-specific 3D maps derived from this biomarker could prospectively guide lead implantation toward favorable network regions, opening a promising avenue toward network-informed RNS surgical planning.

10.
medRxiv (Medicine) 2026-06-15

Unveiling the Awareness of Private Health Insurance Coverage among Healthcare Professionals in Freetown, Sierra Leone: Insights Extracted from Their Perspectives.

Our study is an assessment of the knowledge, personal coverage, and related determinants of private health insurance as revealed by healthcare professionals in Freetown, the urban capital of Sierra Leone. This study stands as a precursor for Low- and Middle-Income Countries (LMICs), like Sierra Leone, seeking to establish Universal Health Coverage (UHC) to provide healthcare access and coverage through publicly arranged risk pooling, designed to help protect against unmanageable medical costs. In parallel, such countries face significant challenges with achieving sustainable universal coverage due to limited public resources, inefficient allocation systems, uneasy reliance on out-of-pocket payments, and large struggling populations. Our research sheds particular light on how healthcare professionals view their own participation with private healthcare options. A cross-sectional, analytical study was conducted, openly recruiting individuals from various facilities in Freetown. Using the Yamane Formula, a sample size of 109 participants was calculated. STATA 14.0 was used for data analysis. Our findings revealed that 96 (88.9%) participants did not have private health insurance, while 12 (11.1%) did have private coverage. However, 105 (97.2%) reported other modes of health insurance, with only 3 (2.8%) uninsured. Notably, 97.2% expressed willingness to join a private health insurance scheme. Our study found no statistically significant associations between selected indicators (demographic or socioeconomic fac tors) and current insurance coverage among study participants. These results highlight a low prevalence and understanding of private health insurance among healthcare professionals in a representative urban center in Sub-Saharan Africa (SSA), while acknowledging high willingness to enroll. The lack of any significant determinants suggests other unexamined factors, such as cost, accessibility, or awareness, capable of influencing the adoption and implementation of a universal health program.

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

A Deep Reinforcement Learning (DRL)-Based Transformer Method for Solving the Open Shop Scheduling Problem

arXiv:2606.13682v1 Announce Type: new Abstract: The open shop scheduling problem (OSSP) arises in many industrial and service settings but remains computationally challenging as the number of jobs and machines increases. While exact methods quickly become intractable, classical dispatching rules and metaheuristics may require substantial tuning to maintain solution quality at large scales. This study develops a Transformer-based scheduling policy for OSSP using an encoder-decoder architecture with multi-head attention. The model is trained on Taillard benchmark instances (4x4, 5x5, 7x7, and 10x10) using only the processing-time matrix as input and produces feasible schedules with makespans typically within 15-30% of best-known values. To evaluate scalability, the trained policy is applied without retraining to randomly generated instances from 40x40 to 100x100 and compared against classical dispatching heuristics, including SPT, LPT, MWKR, and EST. Across these large instances, the Transformer achieved average gaps of 12.89-15.12% relative to a standard lower bound. Compared with EST, the Transformer remained competitive, typically within a modest margin, while substantially outperforming SPT and LPT. These results indicate that a Transformer policy trained on small OSSP instances can generalize to substantially larger problems and provide a feature-light, learning-based alternative to classical dispatching rules.

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

Uncertainty Estimation for Molecular Diffusion Models

arXiv:2606.13451v1 Announce Type: new Abstract: Diffusion models have seen wide adoption for 3D molecular generation, yet they offer no principled signal of when a generated molecule is likely to be of low quality. We propose a post-hoc method for estimating per-sample uncertainty in pretrained molecular diffusion models. Building on a Laplace approximation of the denoising network, we measure the variability of the noise prediction across the generation trajectory. Empirically, we show that the resulting uncertainty score is informative of sample quality, exhibiting a negative correlation with established sample-level quality metrics. We further study how the proposed uncertainty score can be used to filter generated samples, improving model performance via test-time scaling.

13.
medRxiv (Medicine) 2026-06-15

The clinical utility of functional testing in fibroblasts to diagnose primary mitochondrial disease

Genome sequencing of the heterogeneous primary mitochondrial disorders (PMD) frequently reveals variants of uncertain significance that require functional tests for diagnosis, and does not identify variants in all patients. We analyzed mitochondrial enzyme assays, blue native polyacrylamide gel electrophoresis (BN-PAGE) with in-gel activity staining, complex I assembly blot, and select protein abundances in fibroblasts of a case series of 204 PMD patients divided into functional classes, in comparison to 51 controls and 53 differential diagnostic conditions. Overall, sensitivity and specificity for respiratory chain enzyme assays were 46% and 93% respectively, for BN-PAGE 40% and 98%, for complex I assembly assay 49% and 99%. The overall sensitivity of all tests was 76%, specificity 93%, with positive predictive value 96% and negative predictive value 67%. Categories with high sensitivity were isolated complex deficiencies, nuclear DNA-encoded mitochondrial protein synthesis defects, co-factor defects, and mitochondrial amino-acyl-tRNA synthetase conditions when aided by protein abundance. Mitochondrial DNA mutations and maintenance disorders showed poor sensitivities. Secondary dysfunctions were rare. A complete battery of functional tests showed strong diagnostic clinical utility in fibroblasts.

14.
medRxiv (Medicine) 2026-06-22

Reform of the intermediate level of the health system in the Democratic Republic of the Congo: Adaptations and limits in the stabilization of the personnel of the Provincial Health Division: A cohort study.

Background: Human resources are one of the pillars of health systems. Since the World Health Organization's report on human resources issues, several countries have integrated this component into the various reforms aimed at strengthening their health systems. This study aims to explore the effects of reforming the intermediate level of a health system operating in a fragile state context. Methodology Our study was conducted in the Democratic Republic of Congo (DRC). It was a cohort study of the staff of the 14 Provincial Health Divisions (PHD) out of the 26 existing in the DRC. We established a database of the staff of these 14 PHD from 2016, just after the implementation of the intermediate level reform and the allocation of this staff by the Ministry of Health. We did a recall in 2021, in each of these PHD to survey this staff through a structured questionnaire and supplemented by the files of the agents available in each PHD. Sociodemographic, economic and academic variables were collected and analyzed. Data were entered into an Excel 2016 database and processed with SPSS software version 25. The chi-square test was used for comparison of proportions with a statistical significance level of p < 0.05. Risk ratios ratios (RR) and their 95% confidence intervals were calculated as measures of association. The error threshold was set at 5%. Results A total of 657 agents with an average age of 45.2 years had been identified in 2016 at the start of the survey and in 2021, 118 or 18% of them were no longer part of the PHD agents. Among the causes of absence noted: 48% of agents placed on leave, 16% promoted to other functions within the health system, 16% desertion and dismissal and 11% cases of death. 19.8% of absentees are executives, 19.5% men against 10.3% women; 22.3% of absentees in unstable provinces against 16.6% in stable ones. The factors associated with the absence of agents in the PHD remain the reaching of retirement age [RR (95% CI) = 5.5 (1.2-24.9) ]and male agents [RR (95% CI) = 3.2 (1.3-7.9)]. Among the agents who remained, 92% kept their initial position, 6% were subject to an internal permutation accompanied by a promotion. The factors associated with the stability of human resources at the level of the Provincial Health Division are: female gender, manager with experience or seniority > 5 years, Age > 35 years, Stable province, Presence of a partner bonus. Conclusion Even in a crisis and fragile context, health system reform is possible. It is possible to organize staff recruitment through a selection process independent of the political authorities of the Ministry of Health and supported by the technical services of the Ministry and partners . Experience and the presence of a financial bonus are motivating factors for staff stability. The involvement of Technical and Financial Support Partners in the recruitment process helped the Ministry of Health to minimize political influence in the recruitment of middle-level executives.

15.
medRxiv (Medicine) 2026-06-24

Evaluation of Corneal Subbasal Nerve Plexus Alterations in ARSACS and SPG7 by In Vivo Corneal Confocal Microscopy

Purpose: To investigate corneal subbasal nerve plexus alterations using in vivo corneal confocal microscopy (IVCM) in patients with Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) and Spastic Paraplegia Type 7 (SPG7). Methods: This cross-sectional pilot study included eight ARSACS patients, five SPG7 patients, and twenty age- and sex-matched healthy controls. All participants underwent neurological and ophthalmological examination followed by central corneal imaging using IVCM. Quantitative corneal nerve parameters were analyzed with automated software, and correlations with clinical severity scales were assessed. Results: The mean age was 34.2 +/- 3.4 years in controls, 34.5 +/- 0.7 years in the ARSACS group, and 38.2 +/- 3.5 years in the SPG7 group. Corneal nerve branch density (CNBD) and corneal nerve total branch density (CTBD) were significantly lower in ARSACS and SPG7 patients compared with healthy controls. CNFD, CNFL, CNFA, CNFW, and CNFrD were lower in ARSACS and SPG7 patients compared with healthy controls; however, these differences did not reach statistical significance. No statistically significant differences in IVCM parameters were detected between ARSACS and SPG7 patients. Spearman correlation analysis did not show significant correlations between corneal nerve parameters and FARS, SARA, ADL scores, or disease duration. Conclusion: IVCM revealed reduced corneal nerve branching parameters in patients with ARSACS and SPG7. These findings indicate involvement of the corneal subbasal nerve plexus and support the potential role of corneal confocal microscopy as a non-invasive ocular imaging modality for evaluating peripheral neural alterations in hereditary spastic ataxias.

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

Re-evaluating Confidence Remasking in Masked Diffusion Language Models

arXiv:2606.12232v1 Announce Type: new Abstract: Masked diffusion language models (dLLMs) have recently emerged as a competitive alternative to autoregressive language models, with the promise of faster inference via parallel token generation. A notable limitation of the masked formulation, however, is that once a token has been unmasked it can no longer be revised, leaving dLLMs vulnerable to early sampling mistakes. To address this, a growing body of work has sought to extend masked dLLMs with self-correcting (remasking) capabilities. One appealing subset of these methods does so in a training-free, post-hoc manner based on token confidences, with encouraging early reported results. In this work, we revisit the empirical evaluation of a representative post-hoc remasking method, WINO [Hong et al., 2026], and find that under standard decoding settings (shorter block lengths) it brings little-to-no benefit over confidence-based unmasking alone [Wu et al., 2025]. Extending the evaluation to non-greedy decoding, we find that while confidence-based remasking can mitigate errors introduced by increased stochasticity to some extent, it also exacerbates the diversity collapse previously reported for confidence-based unmasking. Overall, our results show that the benefits of post-hoc confidence-based remasking are highly setting-dependent, underscoring the need for a more comprehensive evaluation framework.