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

Effective Resistances and Commute Times in Sparse Random Geometric Graphs

arXiv:2606.14895v1 Announce Type: new Abstract: The commute time between two nodes in a network - the expected number of steps for a random walk to travel from one node to the other and then return - is a metric of broad importance arising in community detection, network routing, dimensionality reduction, and diffusion modeling. For random geometric graphs (RGGs), in which nodes are placed at random in a spatial domain and connected pairwise wherever their Euclidean distance is below a threshold radius, the relationship between commute times and the embedding geometry remains poorly understood outside very dense settings (where the role of the geometry disappears and commute times degenerate to a sum of inverse degrees). We develop and numerically validate a model for approximating commute times in sparse RGGs on a torus by combining theoretically motivated geometric contributions with an inverse degree sum. The geometric terms include a universal logarithmic contribution from the Laplacian, a quadratic correction encoding the compact topology of the torus, and a quartic angular term reflecting the square anisotropy of the domain. We fit this model to samples of node pairs across a range of graph sizes and mean degrees, demonstrating good predictive performance and that the geometric terms contribute significantly to model fit. We then study the continuous perturbation of the model from a regular square lattice to a fully random geometric graph, further validating the functional model form through this transition and showing how commute times in sparse RGGs retain meaningful geometric information about the embedding space.

02.
arXiv (CS.CL) 2026-06-17

LVLMs and Humans Ground Differently in Referential Communication

For generative AI agents to partner effectively with human users, the ability to accurately predict human intent is critical. But this ability to collaborate remains limited by a critical deficit: an inability to model common ground. We present a referential communication experiment with a factorial design involving director-matcher pairs (human-human, human-AI, AI-human, and AI-AI) that interact with multiple turns in repeated rounds to match pictures of objects not associated with any obvious lexicalized labels. We show that LVLMs cannot interactively generate and resolve referring expressions in a way that enables smooth communication, a crucial skill that underlies human language use. We release our corpus of 356 dialogues (89 pairs over 4 rounds each) along with the online pipeline for data collection and the tools for analyzing accuracy, efficiency, and lexical overlap.

03.
arXiv (CS.LG) 2026-06-25

Explaining a probabilistic prediction on the simplex with Shapley compositions

arXiv:2408.01382v4 Announce Type: replace Abstract: Originating in game theory, Shapley values are widely used for explaining a machine learning model's prediction by quantifying the contribution of each feature's value to the prediction. This requires a scalar prediction as in binary classification, whereas a multiclass probabilistic prediction is a discrete probability distribution, living on a multidimensional simplex. In such a multiclass setting the Shapley values are typically computed separately on each class in a one-vs-rest manner, ignoring the compositional nature of the output distribution. In this paper, we introduce Shapley compositions as a well-founded way to properly explain a multiclass probabilistic prediction, using the Aitchison geometry from compositional data analysis. We prove that the Shapley composition is the unique quantity satisfying linearity, symmetry and efficiency on the Aitchison simplex, extending the corresponding axiomatic properties of the standard Shapley value. We demonstrate this proper multiclass treatment in a range of scenarios.

04.
arXiv (CS.AI) 2026-06-18

Bayesian Anytime Pareto Set Identification for Multi-Objective Multi-Armed Bandits

arXiv:2606.18785v1 Announce Type: cross Abstract: Identifying Pareto optimal solutions is critical to support multi-objective decision-making. We introduce the first anytime Multi-Objective Multi-Armed Bandit algorithm for the Pareto Set Identification problem, taking a Bayesian approach: Top-Two Pareto Front Thompson Sampling (TTPFTS). We benchmark TTPFTS against state-of-the-art fixed-budget Pareto Set Identification algorithms on synthetic environments. Next, we demonstrate its practical utility in a challenging multi-objective molecular discovery setting by efficiently exploring an ultra-large synthesis-on-demand molecular library. Furthermore, we introduce a novel uncertainty quantification metric that estimates our algorithm's confidence in the predicted Pareto set. We demonstrate that this metric effectively proxies true performance, yielding a robust methodology for monitoring learning progress in complex settings. Finally, we complement these empirical findings with a theoretical proof of the algorithm's asymptotic correctness.

05.
arXiv (math.PR) 2026-06-25

Mean-field games with rough common noise: the linear-quadratic case

arXiv:2602.19210v3 Announce Type: replace Abstract: Motivated by mean-field games (MFG) with common noise on the one hand and pathwise stochastic control theory on the other, we formulate here a linear-quadratic (LQ) MFG with rough common noise, along with a satisfactory well-posedness theory for the linear-quadratic case. A novel Volterra-type (or mild) formulation allows to keep technical (rough-stochastic) consideration to a minimum. We derive a characterization of the optimal state and optimal control through a rough forward-backward SDE (rough FBSDE), and provide an existence and uniqueness result under the usual assumptions. Our theory is accompanied by stability estimates with respect to initial data and common noise while we also establish continuity of what we call the Itô-Lions-Lyons map for rough mean-field games. Finally, we discuss randomization of the rough common noise under appropriate conditions on the coefficients. When the latter is given by the Stratonovich lift of a Brownian motion independent of the idiosyncratic noise, we show that solutions of the rough LQ MFG coincide with those obtained by conditioning on the common noise.

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

QCI Connect: A Modular Full-Stack Quantum Computing Platform

arXiv:2606.14456v1 Announce Type: new Abstract: In a world of various competing quantum computing architectures, hardware-agnostic, full-stack platforms are necessary to bring the full power of quantum computing hardware to domain experts via the cloud. QCI Connect and its Software Development Kit provide a reference architecture for a full-stack platform with a modular design and open-source interface definitions, built to facilitate a community-driven application ecosystem. Here, we present its overall design and features, central interfaces, and lessons learned, both for users of the platform and as a reference guide for future developments.

07.
arXiv (CS.AI) 2026-06-24

On the Smallness of the Large Language Models Scaling Exponents

arXiv:2606.24504v1 Announce Type: new Abstract: We discuss reasons why the scaling exponents of current Large Language Models (LLMs) applications are indicating an unsustainable regime in terms of energy resources. We further show that attributing the smallness of such exponents to a numerical bias due to the neglect of a non-zero value of the loss function in the limit of infinite data (``pedestal effect") does not remove the unsustainability issue. Finally, the effects of the smoothness (roughness) of the data on the scaling exponents is commented upon based on an analogy with phenomenological models of fluid turbulence.

08.
arXiv (quant-ph) 2026-06-16

Orbital-optimized spin-adapted multistate contracted VQE for excited states and properties on quantum hardware

arXiv:2606.15489v1 Announce Type: new Abstract: We introduce the orbital-optimized multistate contracted variational quantum eigensolver (oo-MC-VQE) method with spin-adapted operators for the computation of ground and excited states, as well as state-specific and transition properties. The use of spin-adapted operators ensures that the spin symmetry of the reference states is conserved throughout the VQE optimization. In multistate variational approaches, achieving a balanced description of an increasing number of electronic states places growing demands on the expressibility of the underlying ansatz, thereby introducing a fundamental trade-off between accuracy and circuit complexity. We consider the effects of this trade-off explicitly and find that the number of circuit parameters required to obtain accurate results is reported to scale approximately linearly in the number of states. We further present an explicit quantum-circuit implementation of the oo-MC-VQE method and demonstrate its integration with quantum error mitigation techniques. Finally, we execute the method on real quantum devices to compute absorption spectra for two benchmark molecular systems.

09.
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.

10.
arXiv (quant-ph) 2026-06-24

Auxiliary Schmidt Rank as a Resource for Photonic Bell Measurements

arXiv:2606.24591v1 Announce Type: new Abstract: In quantum communication and fusion-based quantum computation, photonic Bell measurements are fundamentally limited when only passive linear optics is employed. While for qubits, some Bell states can be unambiguously identified with static beam splitters and no extra photons or entanglement, additional auxiliary photons or at least additional auxiliary degrees of freedom with a certain level of additional entanglement are needed to approach or attain a complete, deterministic Bell measurement. Here, we prove an exact resource threshold when the same two photons carry system qudits of dimension $d$ and a fixed auxiliary entangled state $\Phi$, possibly distributed over several additional degrees of freedom, with total Schmidt rank $r_\Phi$. We show that a single conclusive Bell-label functional can occur for $r_\Phi\geqslant\lceil d/2\rceil$, but deterministic discrimination of all $d^2$ Bell-state labels requires $r_\Phi\geqslant d$. A maximally entangled rank-$d$ auxiliary state achieves the bound by local Bell-basis sorting between each photon's system and auxiliary degrees of freedom. Thus, the auxiliary Schmidt rank is a certified resource for ancilla-photon-free, embedded photonic Bell measurements.

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

Detecting undisclosed LLM-generated content in parliamentary texts

In this paper, we evaluate the extent of undisclosed LLM-generated content in texts from the parliaments of the United Kingdom and Sweden. In many areas, such as in journalism or in academic writing, there are often requirements to clearly disclose whether AI tools, such as LLMs, have been used. In the case of parliamentary texts, the guidelines on disclosure of AI use are more vague. However, in order to maintain transparency and retain public trust, it is generally recommended that parliamentarians should state whether or not they have used AI when writing texts, such as parliamentary motions. Here, we train an interpretable (glass-box) text classifier using pre-LLM parliamentary texts and LLM-generated versions of such texts. We then apply the classifier to a test set containing recent parliamentary texts, finding a steady increase in undisclosed LLM use, in both parliaments, from 2022 onwards.

12.
arXiv (CS.CV) 2026-06-16

MeshLoom: Feed-Forward Non-Rigid Registration of Mesh Sequences

We present MeshLoom, a feed-forward registration network that directly reconstructs vertex deformations across mesh sequences. Our approach advances non-rigid registration beyond existing models, which are typically constrained by costly per-instance optimization, narrow object categories, pairwise-only inputs, or merely intermediate outputs. The network is simple and efficient, registering multiple meshes within seconds. At its core lies a topology-aware encoder–decoder design. Specifically, we first introduce a topology-aware point representation that encodes the anchor (reference) mesh's topology into its per-vertex features. This representation strengthens the network's understanding of the anchor-mesh geometry and disambiguates points that are Euclidean-close yet geodesically distant. We then propose a multi-modal encoder that fuses this anchor-mesh representation with complementary cues from each frame, such as shape latents and image features. These multi-source signals are compressed into a compact global motion embedding that captures dense inter-frame correspondence. A lightweight decoder then queries this global embedding with the anchor-mesh point representation, retrieving per-vertex deformations at target timestamps. Through extensive experiments across diverse motions and object categories, we show that MeshLoom achieves state-of-the-art results on non-rigid registration. In addition, we find that our global embedding-then-query paradigm naturally enables the network to generate deformations at intermediate timestamps, which extends MeshLoom to motion interpolation and mesh morphing. Project page: https://meshloom.github.io/ .

13.
arXiv (quant-ph) 2026-06-24

Picosecond Schrödinger cat states for ultrafast optical quantum processing

arXiv:2606.24002v1 Announce Type: new Abstract: Non-Gaussian states are essential resources for universal, fault-tolerant optical quantum computing, but their generation rate remains limited by low heralding probabilities and operation in nanosecond temporal modes. Here, we demonstrate multi-photon generalized photon subtraction in picosecond optical wave packets, establishing the state-generation capability required for high-rate operation by addressing the temporal-mode bottleneck that has constrained the achievable rate. Two interfering ultrashort squeezed vacua are heralded by photon-number-resolving detection with a high-speed transition-edge sensor and characterized by pulsed homodyne detection matched to 10-ps temporal modes at a 5-MHz pump repetition rate. We reconstruct Wigner functions without loss correction that exhibit up to four distinct negative regions for four-photon heralding, together with an effective cat-state amplitude of $\alpha_{\mathrm{eff}} = 1.69$. This amplitude approaches the range of practical relevance for fault-tolerant cat-code architectures and for adaptive breeding toward logical-qubit generation, while the picosecond temporal mode establishes a platform compatible with high-rate, scalable time-multiplexed photonic architectures.

14.
arXiv (math.PR) 2026-06-17

Diffuse Interface Energies with Microscopic Heterogeneities II: Rare Events

arXiv:2606.17968v1 Announce Type: cross Abstract: We analyze Allen-Cahn functionals with stationary ergodic coefficients in the regime where the length scale $\delta$ of the heterogeneities is much smaller (microscopic) than the interface width $\epsilon$ (mesoscopic). In a companion paper, we show that if the ratio $\epsilon^{-1} \delta$ vanishes fast enough as $\epsilon \to 0$, then the functionals converge to an effective surface energy where the energy density is determined by homogenization effects originating at microscopic scales. Here we prove that if the ratio $\epsilon^{-1} \delta $ vanishes too slowly, the limit of the functional may actually be smaller than this homogenized energy. We refer to this as the rare events regime. In the case of the random checkerboard in dimension one, we use large deviations techniques to give a complete description of the rare events regime, showing that the limiting energy depends in a nontrivial way on the limit of $\epsilon^{-1} \delta | \log \epsilon |$. We further construct, in any dimension, examples of random media in which rare events become relevant at algebraic scales $\delta \approx \epsilon^{1 + \alpha}$ for an arbitrary $\alpha > 0$, as well as almost periodic examples in which atypical configurations play the same role as rare events.

15.
arXiv (CS.LG) 2026-06-19

Meta Flow Maps enable scalable reward alignment

arXiv:2601.14430v2 Announce Type: replace-cross Abstract: Controlling generative models is computationally expensive. This is because optimal alignment with a reward function–whether via inference-time steering or fine-tuning–requires estimating the value function. This task demands access to the conditional posterior $p_{1|t}(x_1|x_t)$, the distribution of clean data $x_1$ consistent with an intermediate state $x_t$, a requirement that typically compels methods to resort to costly trajectory simulations. To address this bottleneck, we introduce Meta Flow Maps (MFMs), a framework extending consistency models and flow maps into the stochastic regime. MFMs are trained to perform stochastic one-step posterior sampling, generating arbitrarily many i.i.d. draws of clean data $x_1$ from any intermediate state. Crucially, these samples provide a differentiable reparametrization that unlocks efficient value function estimation. We leverage this capability to solve bottlenecks in both paradigms: enabling inference-time steering without inner rollouts, and facilitating unbiased, off-policy fine-tuning to general rewards. Empirically, our single-particle steered-MFM sampler outperforms a Best-of-1000 baseline on ImageNet across multiple rewards at a fraction of the compute.

16.
arXiv (quant-ph) 2026-06-24

A Quantum Non-Gaussianity Criterion Based on Photon Correlations $g^{(2)}$ and $g^{(3)}$

arXiv:2511.08488v2 Announce Type: replace Abstract: Quantum non-Gaussian states, which cannot be written as mixtures of Gaussian states, are necessary to achieve a quantum advantage in continuous variable systems. They represent an important benchmark for the realization of an advanced quantum light source, as they cannot be made by simple means such as displacement and squeezing. We introduce an attenuation-resistant sufficient criterion for quantum non-Gaussian states based on the second- and third-order correlation functions, $g^{(2)}$ and $g^{(3)}$. The general non-linear bound for classical mixtures of Gaussian states is $\sqrt{g^{(3)}} + 3 \sqrt{g^{(2)}} \geq 2$. Any mixture of Gaussian states must fulfill this inequality, thus, the violation of it represents a direct confirmation of quantum non-Gaussianity. We experimentally show the non-Gaussianity of the state produced by a quantum dot single-photon source, where we obtain $\sqrt{g^{(3)}} + 3 \sqrt{g^{(2)}} = 0.174 (13)$, which represents a statistical significance of more than $100$ standard deviations.

17.
arXiv (quant-ph) 2026-06-16

Quantum Nonlocal Games on Graph Ensembles

arXiv:2606.16784v1 Announce Type: new Abstract: Quantum entanglement is one of the most striking discoveries in all of science. This effect allows, for instance, two spatially separated agents to coordinate their actions, without communication, to an extent that is both counter-intuitive, and provably impossible by any other physical means. A recently discovered example is that of mobile agents (players) performing spatial coordination tasks such as rendezvous, where the agents aim to meet on a network without communication. Until now, demonstrations of this advantage have relied on highly idealized conditions: agents are assumed to have complete knowledge of the topography, and experiments have been restricted to simulations using data generated by qubits within a single quantum processor. Here we address both limitations by developing a theory for graph ensembles that capture topographical uncertainty and by experimentally demonstrating the advantage in rendezvous scenarios between physically separated ion-trap systems with access to remote entanglement. Moreover, we simulate a broader set of problems on superconducting hardware. Surprisingly, when players are given the ability to gather more local information the quantum advantage increases – a feat impossible by classical means. Our findings establish a concrete route toward practical quantum advantages in motion coordination problems. More broadly, they point to a new way of using portable quantum devices to enhance collective decision-making in uncertain environments.

18.
bioRxiv (Bioinfo) 2026-06-22

PanRes: A database of latent and acquired antimicrobial resistance allowing 3D-based protein homology search

Antimicrobial resistance databases are central to genomic surveillance, but resistance determinants remain distributed across resources with different scopes, structures, and annotations. We developed PanRes, a curated resistance database of 11,717 genes integrating acquired and latent determinants of antibiotic, biocide, and metal resistance within a unified ontology. We predicted representative protein structures and clustered them by structural similarity, grouping proteins into 598 structurally conserved clusters coherent despite sequence divergence. Their structure-guided alignments were used to build Hidden Markov Models (HMMs) for remote homology search. In wastewater metagenomes from seven European cities, PanRes 3D-based HMMs expanded detection beyond high-confidence BLAST, with 35.2% of retained hits identified only by the HMMs and generally showing greater divergence from known proteins. For beta-lactamases, several proteins retained beta-lactamase-like folds and catalytic geometry despite weak sequence similarity. PanRes is available through an interactive web platform (https://panres.rambio.dk/), a structure-informed resource for exploring the whole resistome.

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

Comparing Linear Probes with Mahalanobis Cosine Similarity

arXiv:2606.19603v1 Announce Type: new Abstract: Linear probes are widely used in interpretability research and often compared by cosine similarity. The Mahalanobis cosine similarity (MCS) between two directions, which reweights the inner product by test data covariance, is a natural task-aware refinement. Ying et al. (2026) report that a probe's MCS to a reference probe trained on the out-of-distribution (OOD) data near-perfectly linearly predicts the probe's OOD AUROC (R^2 = 0.98). Here, we extend this empirical finding across models, layers, and concept domains, and prove this general phenomenon in closed form: For balanced classes whose projections are Gaussian, OOD AUROC and MCS to the reference probe are linear because both are sigmoid-shaped functions of the probe's signal-to-noise ratio (SNR) on the test data. The theory also predicts when this linearity fails, which we verify empirically. MCS offers a theoretically grounded and empirically effective alternative to Euclidean cosine similarity for comparing linear probes.

20.
arXiv (CS.LG) 2026-06-16

SILAGE: Memory-Efficient, Full-Gradient-Free Nonconvex Optimization for Nested Finite Sums

arXiv:2606.15832v1 Announce Type: new Abstract: Empirical risk minimization on massive datasets naturally exhibits a nested double finite-sum structure, where $N=nm$ total samples are logically or physically partitioned into $n$ blocks of size $m$ (e.g., in pooled data silos, out-of-core learning, or deliberate stratification). While variance-reduced methods achieve optimal oracle complexities for nonconvex objectives, they suffer from severe scaling bottlenecks in this centralized regime. Recursive estimators, such as PAGE, require periodic global full-gradient refreshes over all $nm$ samples, which are computationally expensive. Conversely, single-loop methods, such as SILVER, avoid such refreshes but require an impractical $\mathcal{O}(nm)$ memory footprint to store a control variate for every sample. In this paper, we propose SILAGE, a variance-reduced algorithm that addresses this trade-off. By actively exploiting the double-sum structure, SILAGE eliminates periodic global full-gradient refreshes over all $nm$ components (evaluating at most one local group gradient per iteration) while requiring only $\mathcal{O}(n)$ memory. Furthermore, we provide a tight convergence analysis that avoids pessimistic worst-case Lipschitz constants. Instead, SILAGE's complexity natively adapts to the underlying data geometry via nested functional similarities: across-group ($\delta_1$) and within-group ($\delta_2$) heterogeneity. Our results improve existing state-of-the-art bounds in several practically relevant regimes.

22.
arXiv (quant-ph) 2026-06-19

Recursive perturbation approach to time-convolutionless master equations: Explicit construction of generalized Lindblad generators for arbitrary open systems

arXiv:2506.04095v2 Announce Type: replace Abstract: We develop a recursive perturbative expansion for the time-convolutionless (TCL) generator of an open quantum system in a generalized Lindblad form. This formulation provides a systematic approach to derive the generator at arbitrary order while preserving a Lindblad-like structure, without imposing assumptions on the system or environment beyond an initially uncorrelated state. The generator is written, at all orders, in a canonical form, which also corresponds to the minimal dissipation condition, which uniquely specifies the decomposition of the generator into Hamiltonian and dissipative contributions. To validate the method and show its effectiveness in addressing non-Markovian dynamics and strong-coupling effects, we compute the generator explicitly up to fourth order.

23.
arXiv (CS.CV) 2026-06-17

Predicting Immune Biomarkers with MultiModal Mixture-of-Expert Pathology Foundation Models Empowers Precision Oncology

Predicting immune biomarkers associated with the tumor immune microenvironment (TIME) is critical for advancing precision oncology, yet existing approaches are largely limited to single image modalities and suffer from insufficient resolution and incomplete utilization of complementary clinical and biological information. Here we introduce MixTIME, a multimodal foundation model that leverages a mixture-of-experts (MoE) architecture to integrate pathology foundation models trained across distinct modalities: image only (UNIv2), image text (CONCHv1.5), and image transcriptomic (STPath) representations for pixel-level and slide-level prediction of multiplex immunofluorescence (mIF) protein expression from hematoxylin and eosin (HE) whole-slide images. MixTIME employs a learnable router to dynamically weight expert contributions and is trained with a distribution- and tendency-aware loss function. Benchmarked on two datasets of different scales, MixTIME achieves state-of-the-art performance across 17 protein markers as measured by correlation metrics. The predicted mIF profiles substantially enhance downstream tasks, including spatial domain identification, survival prediction, and AI-assisted pathology report generation validated by expert pathologists from multiple institutes across the world. Furthermore, MixTIME enables longitudinal tracking of protein expression dynamics across clinical time points and reveals protein gene interaction patterns linked to drug resistance and immune suppression in tumor microenvironments. Collectively, MixTIME provides a scalable framework for multimodal biomarker discovery and clinical translation in computational pathology.

24.
arXiv (quant-ph) 2026-06-19

Quantum-Accelerated Self-Consistent Field: A Hybrid Algorithm

arXiv:2606.20176v1 Announce Type: new Abstract: We present the Grover adaptive search self-consistent field (GAS-SCF) algorithm. GAS-SCF leverages quantum arithmetic to construct an efficient oracle that marks target states (Fock states) which improve upon some initial classical energy estimate. Amplitude amplification then increases the probability of measuring these states. This approach offers a theoretical quadratic speed-up for the optimization problem encountered in SCF quantum chemistry and establishes a baseline against which structured optimization algorithms, such as QAOA and DQI may be compared. In this work, we classically simulate three examples as proofs of concept of the algorithm, the largest consisting of 26 qubits. We then extend our analysis to two larger systems, with O3 representing the largest case at 330 qubits. These examples are chosen to probe classically challenging SCF regimes. Achieving chemically relevant applications of GAS-SCF will require large-scale, fault-tolerant quantum hardware.

25.
medRxiv (Medicine) 2026-06-17

Cardio Heart Connect: Protocol for a Randomized Trial of a Commercially Available mHealth Fitness Intervention for Cardiac Rehabilitation After Transcatheter Aortic Valve Replacement

Background: Despite ample evidence of the benefits of cardiac rehabilitation (CR), few transcatheter aortic valve replacement (TAVR) patients participate. Commercially available mobile health offers an opportunity to deliver activity-promotion content to populations that are challenged to participate in CR. This study aims to test the efficacy of clinically controlled, commercially available fitness programming for improving physical activity and cardiovascular health outcomes designed to be initiated while patients are on waitlists for traditional CR. Methods: The Cardio Heart Connect study is a hybrid type I effectiveness-implementation trial aiming to enroll N=200 patients who have been placed on a cardiac rehab waitlist following a TAVR procedure from the University of Colorado Hospital Heart and Vascular Center. Participants will be randomized 1:1 to the Cardio Heart Connect intervention with commercially available fitness or attention control, designed to control for technology access. At baseline, post-intervention (8 weeks), and follow-up (12 months), we will assess the primary outcome of participants? daily steps as measured by smartwatch accelerometer and secondary outcomes of interest including functional capacity (Duke Activity Status Index; VO2max), quality of life (Kansas City Cardiomyopathy Questionnaire), and cardiovascular health status (Life Essential 8). In addition, we will use mixed methodologies to evaluate the implementation of intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Conclusions: Commercially available fitness programs have the potential to provide more accessible opportunities for patients recovering from TAVR to engage in physical activity and may be preferred due to their customizability, convenience, and ease of scheduling. Overall, this study will provide insight into the use of commercial mHealth to promote activity following TAVR.