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01.
arXiv (math.PR) 2026-06-16

Higher-order spectral perturbation expansions II: Kernel matrices and manifold learning

arXiv:2606.16373v1 Announce Type: cross Abstract: We study spectral concentration bounds for kernel matrices as approximation of the corresponding kernel integral operator. Results are established under weak assumptions on the data setting and the reproducing kernel relying only on a Mercer condition and a local Weyl law. This allows us to deal with key features of kernel matrices, such as large multiplicities, large effective dimension, and heavy-tailed distributions. Our results apply to infinite dimensional principal component analysis, manifold learning, and Bayesian nonparametric statistics. We illustrate this via two prototypical examples: The heat kernel on the sphere and a wavelet prior from Bayesian nonparametrics.

02.
arXiv (quant-ph) 2026-06-17

Quantum-HPC Software Stacks and the openQSE Reference Architecture: A Survey

arXiv:2604.20912v2 Announce Type: replace Abstract: Quantum resources are increasingly integrated into high-performance computing (HPC) and cloud environments, but quantum high-performance computing (QHPC) software stacks remain isolated, often proprietary, full-stack solutions lacking common interfaces across runtime, resource management, orchestration, and execution layers. This paper analyzes nine production QHPC stacks and identifies common design patterns and emerging requirements, covering deployment models, application interaction patterns, SDK support, and readiness for fault-tolerant operation. The survey exposes consistent needs in runtime abstraction, resource management, interconnect semantics, and observability. Based on these findings, we propose the open quantum-HPC software ecosystem ( openQSE) reference architecture as a first step toward unifying the state-of-the-practice. openQSE defines a set of layer boundaries that allow different implementations to interoperate while preserving deployment flexibility, and is structured to support both current noisy intermediate-scale quantum (NISQ) workloads and future fault-tolerant quantum computing (FTQC) systems without changes to upper-layer application interfaces.

03.
arXiv (quant-ph) 2026-06-16

Minimum measurements quantum protocol for band structure calculation

arXiv:2511.04389v2 Announce Type: replace Abstract: Protocols for quantum measurement are an essential part of quantum computing. Measurements are no longer confined to the final step of computation but are increasingly embedded within quantum circuits as integral components of noise-resilient algorithms. However, each observable typically requires a distinct measurement basis, often demanding a different circuit configuration. As the number of such configurations typically grows with the number of qubits, measurements constitute a major bottleneck. Focusing on electronic structure calculations in crystalline systems, we propose a measurement protocol that restricts the required measurement configurations to an absolute minimum of just three, independent of the number of qubits. This makes it one of the few known protocols that do not scale with qubit number. In particular, we derive the measurement protocol from the symmetries of tight-binding (TB) Hamiltonians and implement it within the Orthogonal-Ansatz Variational Quantum Eigensolver (OA-VQE) algorithm. We demonstrate its performance on three systems, namely a two-dimensional CuO$_2$ square lattice (3 qubits), bilayer graphene with hexagonal (Honeycomb) lattice (4 qubits) and three-dimensional diamond lattice (10 qubits). Beyond tight-binding systems, the protocol can be extended to enable efficient initial state preparation for many-body Hamiltonians, such as multi-orbital Hubbard models in a momentum space.

04.
arXiv (quant-ph) 2026-06-15

Emission of time-ordered photon pairs from a coherently-driven Kerr microcavity

arXiv:2601.06468v2 Announce Type: replace-cross Abstract: Weakly-interacting many-body systems possess remarkable quantum properties that are essential components of quantum technologies, and constitute a topic of fundamental interest. Here we show that in a solid-state nonlinear microcavity embedding discrete modes of exciton-dressed photons, we can isolate a single eigenmode of quantum fluctuations from the much brighter coherent fraction of the field. In this regime, we perform frequency- and time-resolved correlations measurements between photons on the red and blue side of the fluctuations spectrum. When the average number of fluctuation quanta is smaller than one, we observe the formation of large pairwise time-ordered correlations: red photon first and blue photon second. We show that this peculiar time-ordering correlation emerges spontaneously from the interplay between frequency-resolved detection, and the non-trivial internal quantum structure of the elementary fluctuations.

05.
arXiv (CS.CV) 2026-06-19

3D Scene Graphs: Open Challenges and Future Directions

3D Scene Graphs (3DSGs) have emerged as a powerful representation for spatial AI by combining geometric grounding with semantic and relational abstractions of the environment. Their expressiveness has made them relevant to a broad range of problems in robotics and computer vision, including manipulation, navigation, task planning, scene understanding, and many others. However, the field remains fragmented: different communities adopt distinct formulations, construction pipelines, and evaluation protocols, making it difficult to compare methods, identify common assumptions, and assess remaining challenges for robust real-world deployment. This survey provides a unified and critical review of 3DSGs, with particular emphasis on open challenges and future directions. We first formalize 3DSGs under a common definition and analyze the principal modeling choices that characterize existing formulations, including node and edge attributes, hierarchical structure, dynamic scene representations, and affordance-aware extensions. We then review how 3DSGs are built from raw sensory observations, discussing the most common terminologies, conventions, and techniques. Finally, we examine downstream applications and evaluation strategies, from intrinsic graph quality to task-level performance. To support the community, we also provide a dedicated website that organizes and extends the surveyed content, accessible at https://3dscenegraphs.com/.

06.
medRxiv (Medicine) 2026-06-18

Web-based education on Metabolism and Obesity is associated with improved lifestyle and health behaviours among Brazilian school teachers

Background: Obesity is a major global public health challenge, and teachers play a critical role in school-based health promotion. This study examined the perceived impact of a web-based educational program on metabolism and obesity delivered to Brazilian school teachers. Methods: This analytical cross-sectional study included 217 teachers who responded to the evaluation questionnaire after attending the course between 2017 and 2022. Statistical analyses included logistic regression and chi-square tests. Findings: Course completion rate was 81.98%, substantially exceeding the 5-15% typical of global MOOCs. However, ethnic disparities were observed: White respondents were 4.95 times more likely to complete the course than Black respondents (p=0.00097) and Brown respondents were 3.05 times more likely (p=0.0268) than Black respondents. Among non-completers, lack of time (64.7%) was the primary barrier. Participation was concentrated in Sao Paulo (77%), with no respondents from three northern states. Perceived difficulty showed a non-significant trend (p=0.0893) where by Black respondents had the lowest predicted difficulty; the most challenging course material was Scientific Content/Reading papers (50%). Completion was strongly associated with applying learned activities in teaching (p

07.
arXiv (CS.AI) 2026-06-15

Efficient Temporal Modeling for Mobile Sleep Staging via Lightweight Random Attention

arXiv:2606.13694v1 Announce Type: cross Abstract: Mobile sleep staging serves as a foundational infrastructure for in-home sleep monitoring and closed-loop modulation. But existing sequential models such as RNNs and Transformers are computationally expensive for mobile deployment. In this paper, we propose Random Attention (RA), a lightweight temporal modeling module based on fixed random projections, which replaces learnable sequence modeling with similarity-based aggregation. RA introduces little additional parameters beyond the epoch encoder while enabling effective temporal smoothing. We further provide a theoretical interpretation via the Random Attention Prior Kernel (RAPK), which decomposes RA into a global smoothing term and a feature similarity term, offering an interpretable view of temporal sleep structure. Experiments on Sleep-EDF-20 and Sleep-EDF-78 show that RA consistently improves epoch-wise baselines by 1-3\% in accuracy and F1 score, while achieving competitive performance compared with LSTM, GRU, and Transformer models. RA also demonstrates strong generalization across different backbone encoders and improved robustness over conventional temporal smoothing methods. These results indicate that efficient sleep staging can be achieved through lightweight similarity-based temporal aggregation, making RA suitable for real-time wearable applications.

08.
medRxiv (Medicine) 2026-06-19

Performance of family history-based colorectal cancer screening criteria by race and age at diagnosis in the Disparities and Cancer Epidemiology (DANCE) study

Importance: Family history (FH) and age are the primary criteria employed for early colorectal cancer (CRC) risk stratification. We evaluated how well these criteria identify individuals diagnosed with CRC across age and racial groups. Objective: To evaluate the performance of FH and age based screening criteria for identifying individuals with CRC, with attention to differences by race and age at diagnosis. Design, Setting, and Participants: This case control and case only analysis used data from the Disparities and Cancer Epidemiology (DANCE) cohort, a population based study of invasive CRC cases diagnosed from 2013 to 2022, recruited through the Metropolitan Detroit Cancer Surveillance System and the Louisiana Tumor Registry. Analyses included 1,158 non-Hispanic Black (NHB) and non-Hispanic White (NHW) CRC cases and 1,434 cancer-free controls from the Inflammation Health and Lung Epidemiology (INHALE) study, enrolled from the same Detroit catchment area. Data were analyzed in 2025. Exposures: Self reported cancer FH among first-degree (FD) relatives and grandparents, summarized into three FH-based screening criteria: at least one FD relative with CRC (colon early-screening criterion), any FH of Lynch syndrome related cancers, and meeting NCCN criteria for Lynch syndrome genetic testing. Main Outcomes and Measures: Proportion of cases meeting each FH based screening criterion stratified by race and age at diagnosis (

09.
arXiv (math.PR) 2026-06-18

Metastability for the Curie-Weiss-Potts model with unbounded random interactions

arXiv:2505.11260v2 Announce Type: replace Abstract: We analyse the metastable behaviour of the disordered Curie–Weiss–Potts (DCWP) model subject to a Glauber dynamics. The model is a randomly disordered version of the mean-field $q$-spin Potts model (CWP), where the interaction coefficients between spins are general independent random variables. These random variables are chosen to have fixed mean (for simplicity taken to be $1$) and well defined cumulant generating function, with a fixed distribution not depending on the number of particles. The system evolves as a discrete-time Markov chain with single spin flip Metropolis dynamics at finite inverse temperature $\beta$. We provide a comparison of the metastable behaviour of the CWP and DCWP models, when $N \to \infty$. First, we establish the metastability of the CWP model and, using this result, prove metastability for the DCWP model (with high probability). We then determine the ratio between the metastable transition time for the DCWP model and the corresponding time for the CWP model. Specifically, we derive the asymptotic tail behavior and moments of this ratio. Our proof combines the potential-theoretic approach to metastability with concentration of measure techniques, the latter adapted to our specific context.

10.
arXiv (CS.CV) 2026-06-16

Towards Global AI-Driven Cervical Cancer Screening

The global elimination of cervical cancer is a key public health goal set by the World Health Organization (WHO), with screening programs reducing mortality by up to 80%. However, access to experts and biopsy services is limited in low- to middle-income countries (LMICs). Deep learning (DL)-based algorithms offer promising support for screening, but most existing approaches have been developed and validated on private datasets from single countries. We present the first DL-based approach to cervical cancer screening validated on data from multiple countries. Technically, we phrase the problem of detecting and classifying lesions in colposcopy images as a multi-task learning problem, in which we simultaneously perform image-level classification and lesion segmentation. Our model was trained on a private data set of acid stain colposcopy images with manually generated lesion segmentation masks and corresponding histopathological results, employing extensive data augmentation to address image variability. In an in-distribution validation with pathology results serving as ground truth, our algorithm outperformed medical experts (Balanced Accuracy: 0.68 vs 0.64) in CIN1- (Cervical intraepithelial neoplasia grade 1 or lower) versus CIN2+ (grade 2 or higher) classification. External validation on four colposcopy data sets from four countries featuring radical differences in prevalence and patient characteristics yielded superior performance of our method compared to baseline methods. Performance variability across countries was high with AUC values ranging from 0.54 - 0.80. Overall, algorithm performance varied with age, transformation zone (cervical area most prone to lesion development), presence of comorbidities and pathognomonic signs, with comorbidities having by far the largest negative effect. Future work should focus on improving model robustness and generalizability.

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

Tying the Loop – Tied Expert Layers in Mixture-of-Experts Language Models

Authors:

Mixture-of-Experts (MoE) architectures efficiently scale Large Language Models (LLMs) by activating only a small fraction of their experts per token, yet the full parameter count - dominated by the expert parameters - must be held in training and inference memory. To address this, we introduce Expert Tying, an architectural modification that shares expert parameters across consecutive transformer layers while preserving independent, layer-wise routing and attention. We evaluate this approach across common, state-of-the-art architectures, including OLMoE, Qwen3, and DeepSeek-style MoEs. Our pretraining experiments demonstrate that tying experts can reduce memory footprint by almost 2x at virtually no degradation in perplexity or downstream quality. By exploiting the parameter redundancy inherent in MoE pathways, our method provides a highly favorable compute-to-memory trade-off, advancing efficient training and scaling of next-generation LLMs.

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

Apertus LLM Family Expansion via Distillation and Quantization

arXiv:2605.29128v2 Announce Type: replace Abstract: The wide adoption of LLMs has led to their use in great variety of applications and scenarios, such as chatbot assistants and data annotation, creating the need for the models to satisfy certain budget and hardware constraints. This has led to the trend of LLMs being released in batches consisting of similar models of various sizes for the family of models to adhere to as wide of a range of constraints as possible. In this paper, we validate distillation and quantization as a cost-effective way to expand model families to new sizes and hardware formats. Based on the open-recipe Apertus 8B LLM, we produce Apertus-v1.1 - a distilled family of models with up to 4B parameters trained on 1.7T permissive license tokens. We demonstrate cost-efficiency and strong accuracy performance of our approach for covering large ranges of hardware and systems requirements.

13.
arXiv (CS.LG) 2026-06-17

Discovering Functionally Selective Brain Regions with a Deep Topographic Multimodal Model

arXiv:2606.09770v2 Announce Type: replace-cross Abstract: Nearby neurons in cortex share similar response profiles, producing systematic spatial organization across sensory and cognitive systems. Recent topographic models reproduce aspects of this structure but remain unimodal and spatially constrain each layer separately, yielding fragmented maps that capture neither the contiguity of cortical processing streams nor their integration across modalities. We introduce Topo-Omni, a topographic multimodal model in which visual, auditory, and language/cognitive processing share a single contiguous in-silico sheet. Built by fine-tuning a pretrained foundation model with a spatial smoothness objective, this architecture develops clusters across modalities that are consistent with human neuroimaging, from sensory to cognitive systems. Driving or suppressing a cluster selectively biases or impairs perception, paralleling human intervention studies. Finally, we use our model to screen for novel clusters in-silico and discover new natural landscape and animal networks which we validate in human data. A single spatial principle thus organizes representations across modalities and processing stages, yielding testable hypotheses about cortical organization.

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

Entropy-Gated Latent Recursion

arXiv:2606.16620v1 Announce Type: cross Abstract: Inference-time scaling has become the dominant lever for improving language-model reasoning, but existing methods derive rollout diversity from a single source: stochastic token-level sampling. We argue that this single-axis sampling space is fundamentally limiting, and identify a second, fully deterministic and complementary axis: the layer span $L$ at which a frozen model's top decoder layers are recursively re-applied at high-uncertainty tokens. Different choices of $L$ produce distinct rollouts that solve different subsets of problems, with no stochasticity. We instantiate this axis through Entropy-Gated Latent Recursion (EGLR), a training-free decoding procedure that re-applies the top-$L$ layers for at most $K_{\max}$ iterations until the next-token distribution converges. Combined with $T$ temperature samples, EGLR turns a single-axis stochastic rollout pool into an $L\times T$ Cartesian sampling space at almost the same per-rollout cost. We characterize this space across $8$ instruction-tuned models and $6$ math reasoning benchmarks, and show that the $L$-axis is genuinely complementary to temperature: on MATH-500 with Qwen2.5-3B-Instruct, the joint $L\times T$ oracle reaches $91.6\%$, $+8.2$ percentage points beyond the temperature-only oracle ($83.4\%$) and $+10.4$ points beyond the layer-only oracle ($81.2\%$), confirming that the two axes capture genuinely complementary problems. The expanded rollout pool provides richer per-prompt candidates for any downstream procedure that consumes rollouts, including self-consistency, best-of-$N$ with verifiers, and group-relative RL training (GRPO), opening a new direction for inference-time scaling that does not rely on stochastic noise.

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

Unifying Post-hoc Explanations of Knowledge Graph Completions

arXiv:2507.22951v2 Announce Type: replace Abstract: Knowledge Graphs organize information as entity-relation-entity triples, enabling machine learning models to predict plausible missing triples in a task known as Knowledge Graph Completion (KGC). Post-hoc explainability for KGC addresses the problem of identifying which triples most influence the predictions of machine learning models. Currently, the field lacks formalization and consistent evaluations, hindering reproducibility and cross-study comparisons. This paper argues for a unified taxonomy for post-hoc explainability in KGC. First, we propose a characterization of post-hoc explanations via multi-objective optimization that unifies existing post-hoc explainability algorithms in KGC and the explanations they produce, balancing explanation effectiveness and conciseness. Next, we examine improved evaluation protocols based on popular metrics, such as Mean Reciprocal Rank and Hits@k, through illustrative experiments. Finally, we stress the importance of interpretability as the ability of explanations to address queries meaningful to end users. By unifying methods and discussing evaluation standards, this work puts forward a case for more reproducible and impactful research in KGC explainability.

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

Tabular Foundation Models for Clinical Survival Analysis via Survival-Aware Adaptation

arXiv:2606.12006v1 Announce Type: cross Abstract: Predicting time-to-event outcomes such as mortality is a fundamental task in clinical decision-making, commonly addressed through survival analysis. While classical statistical and deep learning approaches have been widely studied, they typically require task-specific training and sufficient labeled data. Recent advances in tabular foundation models offer a new paradigm by learning general-purpose representations for structured data. However, their applicability to censored time-to-event prediction in clinical settings remains underexplored, as typical applications are restricted to discrete classification rather than survival analysis tasks. In this work, we propose a lightweight adaptation approach for applying tabular foundation models to clinical survival analysis by directly training a survival-aware head on top of the pretrained representations. We study representative architectures, including TabPFN, TabDPT, and TabICL, and adapt them using a multi-task logistic regression (MTLR) head to model right-censored time-to-event outcomes. We evaluate this approach on a diverse set of public survival benchmarks and two large-scale ICU cohorts, MIMIC-IV and eICU. Our results show that this transfer learning approach achieves competitive or superior performance compared to strong baselines. On MIMIC-IV, TabDPT-FT-MTLR reaches a C-index of 0.856, corresponding to a relative improvement of +1.4% over the best non-FM baseline (DeepSurv, 0.844) and +6.7% over the best zero-shot model (0.802). On eICU, TabICL-FT-MTLR achieves 0.797, yielding gains of +1.7% (DeepSurv, 0.784) and +6.4% (0.749), respectively. These findings highlight the importance of combining pretrained tabular representations with survival-aware objectives and suggest that tabular foundation models provide a practical and effective alternative for clinical survival prediction.

17.
arXiv (CS.AI) 2026-06-11

From Consumption to Reflection: Designing Human-AI Relations for Stable Reasoning

arXiv:2606.11195v1 Announce Type: cross Abstract: Large language models (LLMs) have transformed how humans access information, but not how we reason with it. Their fluency accelerates consumption while bypassing the slow, reflective processes that underpin sound judgment. This paper introduces Relational Reflective Intelligence (RRI), an inference-time governance layer that operationalizes reflection through auditable reasoning loops. RRI operates not inside the model but around it, providing a practical structure for stable, auditable reasoning between humans and LLMs. The core premise is that LLMs inherit cognitive vulnerabilities similar to those that shape human thought: reliance on intuitive shortcuts, confusion between representation and reality, and a preference for coherence over falsification. When humans and models share these tendencies, their errors compound. We refer to this as relational drift, a failure that arises from interaction rather than from the model alone. Addressing this requires a shift from modeling relations between words to structuring relations between model outputs and human reasoning. RRI provides this missing layer through three components: the Rose-Frame, which identifies likely breakdowns in reasoning; the Architect's Pen, which introduces targeted reflection steps at critical moments; and an inference-time workflow that embeds these steps without retraining the model. Together, these elements transform human-AI interaction into a joint reasoning system with explicit checkpoints, conflict surfacing, and an auditable trail of assumptions. Rather than making machines think like humans or forcing humans to reason like machines, RRI creates a structured interaction in which both compensate for each other's limitations. It reframes AI safety as a cognitive architecture problem, where reliable decisions depend on embedding reflection directly into the interaction process.

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

Similarity-based representation factorization for revealing interpretable dimensions in representational data

The study of representations is widespread across fields, including neuroscience, psychology, and artificial intelligence. While representations are often studied and compared through similarities between stimuli, current methods provide only limited access to the dimensions that shape these representations and are often limited in interpretability. To overcome these challenges, here we introduce Similarity-Based Representation Factorization (SRF), a general computational method for recovering low-dimensional, non-negative, interpretable embeddings from similarity matrices derived from measured data. Across simulations and many neural, behavioral, and computational datasets, SRF recovers interpretable dimensions from diverse forms of representational data, even for very sparsely sampled, incomplete data. The dimensions derived from these datasets match those obtained by task-specific models, predict independent behavioral properties, improve exploratory analysis, and offer higher power for confirmatory hypothesis testing than comparing similarity matrices. Together, these results establish SRF as a general-purpose method with broad applications for uncovering, understanding, and using the dimensions underlying representations.

19.
medRxiv (Medicine) 2026-06-10

Prediction of immunotherapy response using live tumor fragments from routine clinical biopsies

Functional ex vivo assays using live tumor tissues have demonstrated strong predictive accuracy for response to immune checkpoint inhibitors (ICIs) but are not scalable, requiring manual processing of large resections collected at academic centers. Here, an ex vivo live tumor fragment (LTF) platform was developed using standard-of-care biopsies from 228 patients with suspected malignancy collected across prospective, multicenter observational trials and biobanks. Hierarchical clustering of ICI-mediated changes in cytokine production identified two groups: responders and nonresponders. A binary classifier (elive index) using 8 cytokines achieved an AUC of 0.99 for cluster prediction. elive index correctly predicted clinical benefit in 93% (26/28) of patients (P = 3.2x10-5) and accurately identified 83% (10/12) of objective responders. Critically, elive responders were identified among biomarker-negative patients, highlighting the platform as a scalable approach that complements existing companion diagnostics and expands the population of patients identified to benefit from ICI therapy.

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

Generalised Eigenvalue Geometry of Semantic Adversarial Attacks

arXiv:2606.19212v1 Announce Type: cross Abstract: Recent empirical work shows that semantically equivalent paraphrases can fool financial sentiment classifiers: although a paraphrase remains close to the original under a strong reference embedding, it may shift the target model's representation enough to change the predicted class. Existing robustness theory either assumes a single-model threat model or focuses mainly on empirical attack algorithms. We develop a continuous local model of semantic paraphrase perturbations that captures this two-model structure. We show that the worst-case local displacement of the target representation, subject to a proxy-model budget, is governed by the largest generalised eigenvalue of a matrix pencil $(A,B)$ constructed from the Jacobians of the two embedding maps. The resulting attackability index $\lambda^*(x)$ is intrinsic to the local paraphrase geometry and the chosen embedders, yields a closed-form prediction-flip condition for affine readouts, and supports conservative population and finite-sample attackability certificates. For uniform control over classes of affine readouts, we derive a distribution-free VC bound for binary attackability indicators and a scale-sensitive margin bound based on an attackability-adjusted margin that subtracts a local geometric penalty from the standard classifier margin. We also connect the continuous theory to discrete paraphrase search, identify an asymmetry between successful and unsuccessful finite searches, and give a covering condition under which the discrete and continuous settings agree. Finally, we propose an empirical verification framework using soft-token relaxations and generated paraphrase sets to assess the local eigenvalue geometry, prediction-flip condition, and finite-search approximation on a deployed financial-text classifier.

21.
arXiv (CS.CV) 2026-06-17

NTIRE 2024 Challenge on Image Super-Resolution (x4): Methods and Results

This paper reviews the NTIRE 2024 challenge on image super-resolution ($\times$4), highlighting the solutions proposed and the outcomes obtained. The challenge involves generating corresponding high-resolution (HR) images, magnified by a factor of four, from low-resolution (LR) inputs using prior information. The LR images originate from bicubic downsampling degradation. The aim of the challenge is to obtain designs/solutions with the most advanced SR performance, with no constraints on computational resources (e.g., model size and FLOPs) or training data. The track of this challenge assesses performance with the PSNR metric on the DIV2K testing dataset. The competition attracted 199 registrants, with 20 teams submitting valid entries. This collective endeavour not only pushes the boundaries of performance in single-image SR but also offers a comprehensive overview of current trends in this field.

22.
medRxiv (Medicine) 2026-06-11

The impact of pre-stroke statin use on baseline corrected infarct volume and collateral perfusion

Stroke is a leading cause of disability and mortality worldwide, with ischaemic stroke the most prevalent type. Statins, used for cholesterol management, have demonstrated benefits in reducing stroke risk and improving outcomes in preclinical studies. However, the impact of pre-stroke statin use on stroke outcomes remain inconsistent. In this study, we aim to evaluate whether pre-stroke statin use is associated with greater volume of salvaged tissue and improved cerebral collateral perfusion. A retrospective analysis was conducted using data from 281 patients presenting with acute ischemic stroke to the John Hunter Hospital between May 2015 and May 2020. Patients were grouped based on pre-stroke statin use, and clinical variables, including infarct volume and collateral perfusion, were assessed. The primary outcome was salvage volume derived from baseline perfusion lesion volume minus infarct volume at follow-up. Collateral perfusion was measured by the hypoperfusion volume defined by delay time (DT)>6 seconds divided by the hypoperfusion volume defined by DT >2 seconds. Patients on statins at admission were significantly older and had more comorbidities. No significant association was found between pre-stroke statin use and salvage volume or collateral perfusion after adjusting for covariates. Larger initial infarct core was a significant predictor of salvage volume due to larger salvageable tissue volume at baseline. These findings indicate that pre-morbid statin use is not associated with larger salvage volume or improved cerebral collateral perfusion.

23.
medRxiv (Medicine) 2026-06-17

Real-World Effectiveness and Safety of Avacopan in ANCA-Associated Vasculitis: A Systematic Literature Review and Meta-analysis

Background: The efficacy and safety of avacopan in ANCA-associated vasculitis (AAV) has been established in randomized trials of of avacopan as a glucocorticoid (GC) sparing therapy. However, real world evidence (RWE) has an important role in confirming effectiveness and evaluating safety in more generalizable settings. This study aimed to synthesize RWE on the effectiveness and safety of avacopan in adults with AAV. Methods: A systematic literature review and meta analysis of non interventional real world studies was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Eligible studies included adults with AAV treated with avacopan in routine clinical practice. Pooled estimates of effectiveness and safety outcomes were calculated using random effects meta-analyses. Primary outcomes included remission at 6 and 12 months and sustained remission at 12 months. Secondary outcomes included relapse, GC use and dosing, hepatotoxicity, infections, and treatment discontinuation. Exploratory outcomes included changes in estimated glomerular filtration rate (eGFR) and dialysis related endpoints. Results: A total of 71 studies were included and contributed to quantitative analyses. Pooled remission for patients on avacopan was 87% (95% CI: 75%-94%) at 6 months and 93% (95% CI: 86%-97%) at 12 months, and sustained remission was 86% (95% CI: 74%-93%) at 12 months. Relapse at 12 months was low (7%; 95% CI: 4%-11%). GC use was 36% at both 6 and 12 months. Improvements in eGFR were observed at 6 months (18 mL/min/1.73 m2) and 12 months (18 mL/min/1.73 m2), and dialysis liberation was 66% in a limited subset. Among avacopan patients, 11% experienced any hepatotoxicity, including 7% with serious (defined as directly reported or requiring hospitalization) hepatotoxicity, while 7% experienced serious (defined as directly reported or requiring hospitalization) infection. Conclusions: In real world clinical practice, avacopan is associated with high remission rates, low relapse rates, and a consistent GC sparing effect, with effectiveness comparable to standard of care regimens. Findings support its clinical use with appropriate safety monitoring; however, the observed heterogeneity in hepatotoxicity and the limited comparative effectiveness evidence highlight areas requiring further investigation.

24.
arXiv (math.PR) 2026-06-16

The Ornstein$-$Uhlenbeck process on $\mathscr P_2$ with a volatility operator

arXiv:2606.14917v1 Announce Type: new Abstract: We analyze a diffusion ${(\mu_t)}_{t\geq 0}$ on the $2$-Wasserstein space $\mathscr P_2$ over $\mathbb R^d$ for which \begin{equation*} |\mu_t|_2^2-|\mu_0|_2^2-2ct+2\int_0 ^t|\mu_s|_2^2\,d s,\qquad t\geq 0, \end{equation*} is a martingale, where the constant $c\in(0,\infty)$ equals the trace of a volatility operator on a Hilbert space and $|\mu_t|_2:=(\int_{\mathbb R^d}x^T x\mu_t(d x ))^{1/2}$. The invariant measure of ${(\mu_t)}_{t\geq 0}$ is a Gaussian on $\mathscr P_2$, as introduced by P. Ren and F.-Y. Wang. Moreover, the Dirichlet form and its generator are given explicitly on a dense subspace of $L^2$.

25.
arXiv (CS.CL) 2026-06-17

A Recipe for Long-Context Reasoning in Large Language Models via On-Policy Optimization and Distillation

Existing approaches to post-train models for long-context tasks face complementary limitations: (i) supervised fine-tuning (SFT) provides stable supervision but suffers from exposure bias; (ii) reinforcement learning methods such as Group Relative Policy Optimization (GRPO) train on model-generated trajectories but struggle with long-horizon credit assignment and sparse rewards; and (iii) on-policy distillation (OPD) provides dense token-level guidance but does not directly optimize task rewards. We study these complementary strategies for long-context alignment and derive a recipe that combines GRPO with OPD-style teacher guidance: the student learns from its own rollouts using outcome-level rewards, while a stronger teacher provides dense token-level regularization in place of the standard reference policy. This is especially useful when process-level supervision is difficult to obtain. To support this study, we introduce LongBlocks, a synthetic multilingual dataset spanning multi-hop reasoning, contextual grounding, and long-form generation. Through controlled ablations, we isolate the roles of cold-start initialization, teacher anchoring, and data mixing, showing that our recipe yields a more stable and effective path to long-context reasoning than GRPO or OPD while preserving short-context capabilities.