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01.
arXiv (quant-ph) 2026-06-11

Tensor-Network-Based Distributed Quantum Dynamics on Independent Quantum Computers

arXiv:2606.11579v1 Announce Type: new Abstract: We present an approach based on tensor networks for distributed quantum computing simulation of chemical wavepacket dynamics in a continuous variable representation. The central idea is that the tensor-network representation of the multidimensional time-evolution operator naturally induces an elevated Hilbert space where the dynamics decomposes into a set of independent lower-dimensional propagations. This transformation converts an entangled quantum evolution into a set of parallel computational tasks that can be executed asynchronously across heterogeneous quantum and classical computing architectures. The resulting formalism establishes a direct connection between tensor-network decompositions, uniformly controlled quantum circuits, and asynchronous distributed quantum computing. The approach is developed with a goal towards hybrid quantum/classical implementation, and is appropriate for a general heterogeneous mixture of quantum hardware systems. The experimental realization of the asynchronously distributed quantum processes that arise from the tensor-network decomposition are carried out on the Sandia National Laboratories' trapped-ion quantum computer, where the circuits are compiled using native partial-entangling $XX(\theta)$ gates, reducing the expected two-qubit gate infidelity by more than 30\% relative to conventional fully entangling decompositions. We demonstrate the methodology by quantum computing the vibrational spectra of a small protonated water cluster that shows critical quantum nuclear behavior. Such water cluster systems have been found to be challenging for experimental action spectroscopy and for theory, and here, for the first time, we provide results for vibrational spectroscopy that are in agreement with the respective classical results to within 4cm$^{-1}$, thus allowing for the potential for spectroscopic accuracy from quantum computations.

02.
medRxiv (Medicine) 2026-06-11

Computer Vision for Real-Time Anatomical Navigation in Neurosurgery: First-in-Human Clinical Evaluation and Iterative Development (IDEAL Stage 1)

Introduction: Precise anatomical navigation is fundamental to safe endoscopic pituitary surgery, a high-stakes procedure characterised by a challenging learning curve. While traditional navigation systems often rely on workflow-disrupting probes or static preoperative imaging, advancements in computer vision AI (CVAI) now enable dynamic, real-time anatomical segmentation directly from live surgical video1-3. Our group has previously conducted a series of preclinical human-computer interaction studies to refine the system's design, alongside digital and high-fidelity physical simulations demonstrating the benefit of AI assistance in improving overall performance, training, and safety4-8. Building on this foundation, the current study represents a first-in-human application of real-time CVAI assistance in the neurosurgical operating room, serving to assess feasibility and safety, and to iteratively improve the system. Method: Guided by DECIDE-AI and IDEAL frameworks, this single-centre evaluation comprises an initial proof-of-concept phase (n=6) for endoscopic transsphenoidal pituitary surgeries. The AI model utilised a DINOv3-derived vision transformer architecture, deployed via a high-performance edge computing unit to achieve low-latency, real-time inference without reliance on cloud infrastructure2. Given the high-risk nature of the procedure and the early stage of clinical AI integration, the system was initially deployed as an educational adjunct on a secondary monitor, ensuring the primary surgical feed remains uncompromised. Functionality and safety were assessed via structured questionnaire, prospective observation, and blinded retrospective review of the recordings of the endoscopic surgical video feed and wider operating room environment. Continuous multi-stakeholder feedback through validated human factors surveys drove iterative technical refinements between cases. Results: Six patients with pituitary adenomas were enrolled. The CVAI system was successfully deployed in four cases, demonstrating acceptable real-time sella segmentation accuracy. Deployment failed pre-operatively in two cases owing to a single recurring system reboot bug. Iterative refinement between cases were driven by our experience and surgical team feedback. This resulted in the integration of additional anatomical structure segmentations (e.g., carotid arteries), enhanced model accuracy via training dataset expansion, and hardware firmware upgrades. Multi-stakeholder surveys demonstrated satisfactory system feasibility, usability, and acceptability among the surgical team. Both prospective observation and retrospective video review confirmed the absence of adverse events, including no significant distraction to the primary surgeon, and there were no AI-related clinical complications. Conclusion: This first-in-human early clinical evaluation demonstrates the feasibility, safety and iterative development of real-time, CVAI-based anatomical navigation during high-stakes neurosurgery. Future work will include a larger single-centre case series (IDEAL Stage 2a) with more surgical teams to further iterate the system and explore its impact on training and workflow. As the underpinning technology improves, deployment will transition to direct intra-operative decision support and integration with other intra-operative navigational technologies.

03.
arXiv (CS.CV) 2026-06-16

FairGen: Preference-Aligned Diffusion for Demographically Equitable Medical Image Synthesis

Medical imaging is central to modern diagnostics, and artificial intelligence (AI) systems are increasingly used to support image-based analysis by improving efficiency, accuracy, and access to care. However, inequities in healthcare access and differential disease prevalence create severe demographic imbalances in clinical image data. Such imbalances are compounded by the fact that diseases can manifest with distinct features across demographic groups, rendering certain phenotypic presentations naturally rare. AI models trained on such imbalanced data risk perpetuating diagnostic bias and widening healthcare disparities. Here we introduce FairGen, a fairness-aware diffusion framework that synthesizes demographically balanced medical images while preserving pathology-relevant visual features. By embedding physician-aligned preferences into the generation process, FairGen improves subgroup coverage during synthesis and downstream classification. Applied to dermatology, radiology, and neuroimaging benchmark tasks, FairGen achieves fairness improvements of 95.9% for skin images, 80.0% for chest radiography, and 35.2% for brain MRI, while maintaining competitive diagnostic accuracy relative to models trained on original clinical data. Clinician-facing expert review and external validation on independent cohorts further support that these gains extend beyond standard fidelity metrics and are not confined to the original in-distribution datasets.

04.
arXiv (quant-ph) 2026-06-16

High-performance gates on trapped ion qubits using counterpropagating pulse-shaped laser beams

arXiv:2606.15672v1 Announce Type: new Abstract: Highly-localized light-matter interactions are necessary for scaling trapped-ion architectures. In hyperfine qubits, counterpropagating beams generate entangling gates by coupling with motion, but this effect is undesirable during single-qubit operations. For that reason, single-qubit gates are traditionally implemented with copropagating beams, and the coexistence of two beam geometries adds hardware and computational overhead. In an effort towards collective performance improvement with minimal overhead, we design and implement pulse-amplitude and dephasing robust dynamically corrected gates using Space Curve Quantum Control (SCQC) and compare them against the constant-amplitude gate implementation. We perform gate set tomography on a four-qubit trapped-ion register, and we discover more than 50% error reduction when robust pulses are used. We find that counterpropagating robust gates often outperform their copropagating counterparts and reach error rates as low as $(3.59 \pm 1.25)\cdot 10^{-3}$, using diamond distance as a metric. This value establishes a laser-driven-gate error reference and is merely an order of magnitude higher than the best reported $microwave$ gate on a $single$ ion. Additional experiments reveal that robust pulses can effectively suppress non-Markovian errors that grow during runtime. Our work challenges the widely accepted belief that copropagating gates should be preferred for their weak motional coupling and invites the adoption of high-performance robust pulses that suppress multiple noise sources of the trapped-ion error budget.

05.
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.

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

Low-power analogue neural networks with trainable nonlinear connections for continuous control

arXiv:2606.23742v1 Announce Type: cross Abstract: Physical neural networks promise low-power machine learning by computing directly with analogue device physics, but most architectures force nonlinear device responses to act as scalar weights. Inspired by Kolmogorov-Arnold networks, we place trainable nonlinear functions on the connections, making each physical connection a learnable computational element. Realising these functions as analogue band-pass filters on field-programmable analogue arrays, we find that the benefit is task-dependent and follows from the smoothness of the physical basis: the networks represent smooth, continuously valued targets, including robotic kinematics, continuous control, and photovoltaic maximum-power-point tracking, with far fewer nodes and connections than multilayer perceptrons, but offer no parameter-efficiency advantage on classification-like decision boundaries. Trained networks transfer to hardware across approximately 35,000 connections with quantified fidelity, and a dedicated CMOS implementation is projected to operate at approximately 30 microwatts. A memristive realisation reproduces the same behaviour in simulation, indicating that the advantage comes from placing trainable nonlinearity on connections, rather than from a particular device.

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

Architectural Wisdom: A Framework for Governing Optimization in AI Systems

arXiv:2606.16319v1 Announce Type: new Abstract: Modern AI systems exhibit structural failures that capability scaling alone does not reliably fix: they optimize under-specified objectives with no architectural mechanism to question whether the objective should be optimized at all. Engagement maximization can amplify harmful pathways; tool-using agents can commit irreversible actions; preference-trained language models can become sycophantic. We argue that this failure is a wisdom problem, not an intelligence problem. We use "wisdom" in a deliberately architectural sense, not as a claim about virtue, consciousness, or moral omniscience. Intelligence accepts a goal and optimizes within it; wisdom interrogates whether the goal should be optimized at all. The two are separable architectural properties. We propose architectural wisdom as a corrigible objective-governance layer above the optimization substrate. The layer makes three structural commitments explicit and nondegenerate before any action: temporal horizon, relational boundary, and irreversibility. It is realized by four components (Structural Utility Transform, Moral Admissibility Interface, Arbitration and Escalation Controller, Value Revision Channel) that compute a six-coordinate wisdom tuple over horizon, relational coverage, irreversibility, admissibility, value revision, and auditability. We motivate the architecture by eight cases drawn from contemporary AI failures, secular wisdom traditions, and hard ethical situations, and defend the distinction against the intelligence-completeness thesis using goal-questioning over goal-taking, Bostrom's orthogonality, structural separation in our exemplar cases, and persistent failure modes despite capability scaling. The framework is the conceptual contract for a larger architecture whose formal specifications and empirical validation are developed in subsequent work.

08.
arXiv (CS.CV) 2026-06-11

From Simulation to Real-World: An In-Field 6D Pose Dataset and Baseline for Robotic Strawberry Harvesting

Robotic strawberry harvesting requires precise 6D pose estimation; however, collecting 6D pose ground truth in real agricultural fields is inherently challenging. Existing 6D pose estimation methods have therefore relied solely on synthetic data that lacks scene-level realism, leaving their performance under real agricultural field conditions unquantified. In this work, we present, to the best of our knowledge, the first real-world 6D pose ground truth dataset of strawberries collected in actual agricultural fields (12,040 images). We also introduce a synthetic dataset rendered in NVIDIA Isaac Sim, featuring scene-level realism and domain randomization. Nevertheless, our experiments reveal that a significant sim-to-real gap persists, underscoring the necessity of real agricultural field data for reliable evaluation. We further quantify the sim-to-real gap through baseline 6D pose estimation results across backbone encoders, serving as a reference for future work. The real-world dataset will be made available upon acceptance.

09.
arXiv (CS.AI) 2026-06-19

Emyx: Fast and efficient all-atom protein generation

arXiv:2606.19377v1 Announce Type: cross Abstract: Computational enzyme design requires generating proteins that scaffold catalytic residues and ligands, a task that demands both geometric accuracy and structural diversity from the underlying generative model. Current all-atom generators inherit expensive architectures from structure prediction, leading to high training costs and limited sample diversity. We argue that much of this complexity is unnecessary for generators, which condition on sparse geometric constraints rather than rich co-evolutionary signals. Emyx is a 140M-parameter conditional flow matching model that concentrates capacity within standard transformer blocks, replacing heavy embedding stacks with lightweight conditional representations and sparse connectivity. We additionally derive an exact reparametrisation of the flow matching interpolant into the EDM noise-level framework, bridging flow matching training efficiency with state-of-the-art sampling methods designed for diffusion models without retraining. Despite being the smallest model, Emyx outperforms both Proteína-Complexa and RFdiffusion3 against the AME enzyme design benchmark across success rate under strict evaluation requiring both global fold recovery and catalytic geometry accuracy, structural novelty, scaffold diversity, and geometric validity, while training in just $682$ GPU-hours, roughly $4\times$ less than RFdiffusion3.

10.
arXiv (CS.CV) 2026-06-17

Adversarial Attacks Leverage Interference Between Features in Superposition

Why do adversarial examples exist, and why do they transfer between models? Existing explanations appeal to high-dimensional geometry, non-robust patterns in the input, and decision boundary structure, but none provides a representation-level mechanism that explains why specific perturbations succeed and why attacks transfer between models. In this paper, we show that adversarial vulnerability can stem from efficient information encoding in neural networks. Specifically, vulnerability can arise from superposition - the phenomenon where networks represent more concepts than they have dimensions, forcing non-orthogonal representation and thus interference. This interference causes perturbations targeting one representation to affect others, creating vulnerabilities determined by interference patterns. In synthetic settings with precisely controlled superposition, we establish that superposition suffices to create adversarial vulnerability. The resulting attacks are predictable: PGD-discovered perturbations align with theoretically optimal perturbations derived from the interference geometry. Models trained on similar data develop similar interference patterns, explaining attack transferability. We then show that successful attacks on image classifiers exhibit the structure predicted by our proposed mechanism. These findings reveal that adversarial vulnerability can be a byproduct of networks' representational compression, complementing existing explanations based on data properties or architectural factors.

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

First Proof Second Batch

arXiv:2606.18119v1 Announce Type: new Abstract: To assess the ability of current AI systems to correctly solve research-level mathematics problems, we tested several AI systems on a set of ten problems in a broad range of mathematical fields; these problems arose naturally in the research process of the contributors. This document includes the problems, our methodology, and the results of our testing. We provide links to supplementary documents including the human solutions, the AI-generated solutions, and the referee reports and logs for the AI-generated solutions. The ten problems were contributed by the following mathematicians: (1) Dariusz Kaloci\'nski and Theodore A. Slaman, (2) Richard Schwartz, (3) Aleksa Milojevic and Benny Sudakov, (4) Larry Guth, (5) Oleg Butkovsky, Jonathan Mattingly, and Lorenzo Zambotti, (6) Joshua Evan Greene and Duncan McCoy, (7) Sucharit Sarkar, (8) Sam Payne and Jidong (Jayden) Wang, (9) Sylvie Corteel and John Lentfer, (10) Srivatsav Kunnawalkam Elayavalli.

12.
medRxiv (Medicine) 2026-06-15

A controlled human infection model for symptomatic pertussis in North America using the pertactin-producing clinical isolate D420

Background Despite widespread vaccination, pertussis remains a poorly controlled disease globally and results in substantial annual morbidity and mortality, particularly in young children. Controlled human infection models (CHIMs) using the causative agent Bordetella pertussis are promising systems to enable the study of pertussis disease pathogenesis and immunology and to rapidly assess vaccines and therapeutics. While a pertussis CHIM that produces asymptomatic infection has been established in Europe, the development of a CHIM that leads to symptomatic illness would be advantageous for evaluating vaccine efficacy against both infection and disease. Methods Healthy participants 18-40 years of age were inoculated intranasally with one of eight doses (ranging from 104 to 108 colony forming units (CFU)) of the pertactin-producing B. pertussis isolate D420 at the challenge facility within the Canadian Center for Vaccinology (Nova Scotia, Canada). The study occurred in two stages. In stage one, the B. pertussis dose was escalated in cohort groups of five to six participants until reaching an endpoint where 70-90% of participants exhibited mild (non-severe, Grade 1 or 2) symptomatic infection, defined as the Human Infectious Dose 70-90 (HID70-90). In stage two, additional challenges were conducted for doses below, at, and above the identified HID70-90 to characterize the emerging pertussis model. For all challenge doses, participants were closely monitored during an inpatient stay of up to 24 days and post-discharge for laboratory-confirmed infection, pertussis symptoms, safety, and IgG antibody responses to four B. pertussis antigens including pertussis toxin, filamentous hemagglutinin, fimbriae, and pertactin. All participants received a five-day course of azithromycin, where timing of initiation depended on B. pertussis testing and symptoms. The study was conducted between July 4, 2022 and March 19, 2025. Findings Seventy-five participants were inoculated with one of the eight B. pertussis D420 challenge doses and completed the inpatient stay. From the stage-one dose escalation, we found that 107 CFU of B. pertussis D420 was the lowest dose that achieved the HID70-90, where 9 of 12 participants (75.0%) exhibited mild symptomatic infection. Following stage-two challenges, 16 of 22 total participants at 107 CFU (72.7%) developed mild symptomatic infection, thus verifying the HID70-90. The symptomatic infection rate below the HID70-90 at 5x106 CFU of D420 was 20.0% and above the HID70-90 at 5x107 and 108 CFU were 58.3% and 55.6%, respectively. Symptoms with elevated frequency for symptomatic infection (relative to background symptoms in non-infected) included nasal congestion, runny nose, fatigue, malaise, and cough. At the HID70-90, 50% of symptomatic infections included cough. Serological analyses of the four highest (stage-two) challenge doses (5x106, 107, 5x107, 108 CFU) revealed that antibody titres increased over time post-challenge. Seroconversion for at least one of the four studied antibodies was nearly twice as common for symptomatic (70.0%) than asymptomatic (35.7%) infection and was absent (0%) for non-infected. All infections were cleared following azithromycin treatment (100%) and there were no study-related serious adverse events. Interpretation A safe and reproducible symptomatic pertussis CHIM was achieved, providing a model for research on pertussis disease pathogenesis and immunology and for assessing vaccines and therapeutics. (Clinicaltrials.gov, NCT05136599).

13.
arXiv (CS.AI) 2026-06-19

Secure Coding Drift in LLM-Assisted Post-Quantum Cryptography Development: A Gamified Fix

arXiv:2606.19474v1 Announce Type: cross Abstract: The transition to Post Quantum Cryptography (PQC) introduces considerable implementation complexity, requiring strict adherence to constant-time execution, side channel resistance, and precise parametrisation. Simultaneously, large language models (LLMs) are heavily embedded in software development workflows, including cryptographic engineering. While LLMs improve productivity, evidence shows that they frequently generate insecure or suboptimal code, particularly in security critical domains. This paper introduces Secure Coding Drift in PQC, a novel socio technical vulnerability model capturing the gradual degradation of secure coding practices due to sustained reliance on LLM-generated code. Unlike prior work that focuses on static vulnerabilities, we conceptualise security risk as a longitudinal behavioural phenomenon rising from human AI interaction. To mitigate this, we propose a gamified, LLM augmented secure coding framework that embeds adversarial evaluation, behavioural feedback, and security scoring into development workflows. Our approach reframes LLMs from passive assistants into active security co-pilots, contributing toward safer PQC implementation in AI mediated environments.

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

Next-Latent Prediction Transformers Learn Compact World Models

arXiv:2511.05963v4 Announce Type: replace Abstract: Transformers replace recurrence with a memory that grows with sequence length and self-attention that enables ad-hoc lookups over past tokens. Consequently, they lack an inherent incentive to compress history into compact latent states with consistent transition rules. This often leads to learning solutions that generalize poorly. We introduce Next-Latent Prediction (NextLat), which extends standard next-token training with self-supervised predictions in the latent space. Specifically, NextLat trains a transformer to learn latent representations that are predictive of its next latent state given the next token. Theoretically, we show that these latents provably converge towards belief states, compressed information about the history necessary to predict the future. This simple auxiliary objective injects a recurrent inductive bias into transformers while leaving their architecture, parallel training efficiency, and inference unchanged. NextLat effectively encourages transformers to form compact internal world models with coherent belief states and transition dynamics – crucial properties not guaranteed by standard next-token prediction alone. Empirically, across benchmarks in world modeling, reasoning, planning, and language modeling, NextLat demonstrates significant gains over standard next-token prediction and other baselines in downstream accuracy, representation compression, and lookahead planning. Furthermore, NextLat enables variable-length self-speculative decoding, accelerating inference by up to 3.3x in language modeling. NextLat offers a simple yet effective paradigm for learning compact, predictive representations in transformers that generalize better. Our code is available at https://github.com/JaydenTeoh/NextLat.

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

Formalizing and Mitigating Structural Distortion in LLM Attention for Zero-Shot Graph Reasoning

arXiv:2606.15633v1 Announce Type: new Abstract: Large Language Models (LLMs) have shown promise for reasoning over Text-Attributed Graphs (TAGs). However, applying LLMs to graphs requires linearizing their structure into sequences, introducing distortion rooted in the graph bandwidth problem. While this distortion has been shown to degrade performance, it is often attributed to prompt design or model scale, leaving the underlying mechanism unclear. In this work, we show how rotary positional embeddings turn graph linearization into bandwidth-dependent attention decay, suppressing attention between graph-adjacent nodes that are forced far apart in the serialized sequence. This shifts the focus of LLM-based graph reasoning from prompt engineering and scaling toward correcting attention misalignment. Motivated by this analysis, we propose Graph-aligned Language Attention (GaLA), a lightweight, inference-time modification for LLMs. GaLA biases attention toward graph-adjacent nodes while preserving the LLM's sequential inductive biases. Across TAG benchmarks, GaLA improves performance with negligible overhead, demonstrating that distortion is a correctable bottleneck in LLM-based graph reasoning.

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

TimeLAVA: Learning-Agnostic Data Valuation for Time Series

arXiv:2606.18729v1 Announce Type: cross Abstract: Data valuation quantifies the intrinsic quality of individual samples to enable principled data curation, quality control, and robust learning. For time series in critical domains such as healthcare, finance, and industrial monitoring, effective valuation methods are essential yet fundamentally lacking. Existing approaches are either model-dependent, limiting their generalizability, or designed for i.i.d. data and thus fail to capture temporal dependencies, multi-scale patterns, and non-stationary dynamics inherent to sequential data. We introduce TimeLAVA, a learning-agnostic framework that values temporal segments by their marginal contribution to minimizing distributional discrepancy between evaluated and reference data. At its core is a novel Selective Wavelet-based Wasserstein discrepancy combining multi-scale wavelet transforms for temporal localization with unbalanced optimal transport for robustness to distributional shifts. Segment values are efficiently computed via sensitivity analysis without requiring model training and aggregated into point-wise scores. We provide theoretical guarantees linking valuation to model-agnostic generalization and prove bounded sensitivity to outlier contamination. Extensive experiments across anomaly detection, data pruning, and label noise detection demonstrate that TimeLAVA produces significantly more informative value scores than existing methods on diverse real-world datasets.

18.
medRxiv (Medicine) 2026-06-15

Wellbeing After Stroke-2 (WAterS-2): a feasibility study with process evaluation exploring inclusive, accessible, online psychological support after stroke

Objectives: Explore feasibility and acceptability of upskilling a workforce to deliver a co-developed intervention, based on Acceptance and Commitment Therapy (ACT), to support psychological adjustment post-stroke targeting underserved groups. Design: Multi-site, single-arm feasibility study with embedded mixed-methods process evaluation (ISRCTN17628580). Setting: Four NHS community stroke services across England. Participants: 1. Stroke survivors [≥]18 years of age, [≥]4 months post-stroke, reporting psychological difficulties adjusting to stroke, able to consent and access remote group sessions in English; 2. Group facilitators from NHS stroke services, not ACT specialists. Intervention: WAterS-2: an eight-session, remotely-delivered ACT-informed group intervention. Outcome measures: Recruitment, fidelity, safety, acceptability and perceived value were assessed using fidelity checklists, post-intervention surveys and semi-structured interviews with stroke survivors and facilitators. Clinical outcomes including mood (HADS), wellbeing (ONS4), psychological flexibility (AAQ-ABI), measured post-group and three-months later. Results: Nineteen stroke survivors recruited (mean 9.6 months post-stroke; n=5 (26%) minoritised ethnicities; n=10 (52%) with aphasia). Thirteen facilitators - including two peer support workers - delivered the intervention with fidelity following structured training across four services. Drop-out was low (2/19; 11%); with 15 (79%) attending [≥]5/8 sessions. Remote data collection was feasible (79% follow-up completion), with no adverse events recorded. Acceptability was high: survivors valued peer connection, grounding and mindfulness practices. ACT metaphors were helpful for some but challenging for others, including some with aphasia. Online delivery was suitable but limited informal connection. Facilitators reported increased capability, incorporating ACT skills into routine care. NHS workforce pressures and geographically-constrained referral pathways limited recruitment reach. Conclusions: WAterS-2 is feasible, safe, acceptable and inclusive. A mixed workforce, including NHS peer support workers, can be upskilled to deliver with fidelity. Inclusion of underserved groups is achievable but requires active strategies beyond standard NHS referral routes. Findings inform a provisional logic model and a future pragmatic trial.

19.
medRxiv (Medicine) 2026-06-15

ICD-10 Code Ambiguity Obscures Treatment-Eligible Adults with Spinal Muscular Atrophy: A Single-Center Chart Review and Patient Outreach Study

Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.

20.
medRxiv (Medicine) 2026-06-16

Diurnal variation in brain-derived tau and five other blood-based biomarkers for dementia and their association with cognitive performance

Blood-based biomarkers of dementia are a promising scalable tool for early diagnosis, tracking disease progression, and evaluating therapeutic efficacy. Utility of these biomarkers will not only be dependent on the reliability of their association with pathology but also contingent on their ability to track cognitive status. Previously, we demonstrated diurnal variation in several biomarkers (amyloid beta (A{beta}) 42 and 40, 42/40 ratio, glial fibrillary acidic protein (GFAP), neurofilament light (NfL), and phosphorylated-Tau 217 (p-Tau217)) which has implications for their reliability. Here, we extend these observations to a larger cohort, include brain-derived tau (BD-Tau), which is assumed to be produced exclusively in the brain, and report endocrine measures of circadian rhythmicity. We not only assessed whether these biomarkers vary with time of day, but also whether they associate with daytime function and whether these associations vary with cognitive domain and number of repeated assessments. Data collected in 20 PLWA (72.4{+/-}5.9 years, mean{+/-}SD) and 19 controls (68.9{+/-}9.8 years) were analysed. Participants completed 14 days of home monitoring and one laboratory assessment of sleep and daytime function: mood, daytime sleepiness, reaction time, immediate and delayed memory recall, everyday memory errors. During the 27-hour residential laboratory session, 3-hourly blood samples were collected and analysed for the six blood-based biomarkers of dementia as well as melatonin and cortisol. Rhythmicity of melatonin and cortisol did not differ between groups. P-Tau217 and GFAP (p

21.
arXiv (CS.AI) 2026-06-15

Think Fast: Estimating No-CoT Task-Completion Time Horizons of Frontier AI Models

arXiv:2606.07157v2 Announce Type: replace Abstract: Many efforts to ensure frontier AI models are safe rely on monitoring their chain-of-thought (CoT) reasoning. If models become able to perform sufficiently complex reasoning internally, without explicit thinking tokens, this would undermine such oversight. We measure how well frontier models reason without CoT across a suite of over 30,000 questions spanning 43 benchmarks in domains including math, coding, puzzles, causality, theory-of-mind, and strategic reasoning. To compare models against humans, we estimate the $50\%$-task-completion time horizon (TH): the human time required for tasks a model completes with $50\%$ success rate. We complement this with a $50\%$ reasoning token horizon: the minimum number of o3-mini reasoning tokens needed for tasks a model solves with $50\%$ success rate. We find that the no-CoT $50\%$ TH of frontier models has been doubling roughly every year over the past six years, with GPT-5.5's TH reaching over 3 minutes and reasoning token horizon exceeding 1,500 tokens. Our median estimates predict that frontier no-CoT THs could exceed 7 minutes by 2028, and 25 minutes by 2030, though these projections carry substantial uncertainty. We recommend frontier developers track this explicitly.

22.
medRxiv (Medicine) 2026-06-22

Longitudinal multi-omics characterization of the malignant evolution in multirelapsing glioblastoma

Linking glioblastoma (GBM) evolution to clinical progression is challenged by multiple factors, including tumor location for repeated sample collection, and short patient survival. In a single individual, we collected and analysed samples from 11 operations distributed across 31 months of multi-relapsing and multifocal GBM, including terminal leptomeningeal progression. All samples shared genomic ancestry of the retinoblastoma protein 1 (RB1) and neurofibromin 1 (NF1) mutations while advanced progression and extracranial metastases featured mutations of tuberous sclerosis complex 2 (TSC2), PBRM1, CD22 and Fanconi anemia supplementation group I (FANCI), correlated with clinical resistance to immunotherapies and DNA-damaging agents. Single-cell analytics revealed distinct yet reversible shifts in response to the precision medicine arsenal. GBM parenchymal dissemination and extracranial progression were associated with strengthening of neuron-like cell phenotypes. Our multidimensional study describes GBM evolution over a rarely reported time scale, and provides a valuable resource linking genetic, molecular, cellular and clinical progressions.

23.
arXiv (CS.LG) 2026-06-18

ThousandWorlds: A benchmark for climate emulation of potentially habitable exoplanets

arXiv:2606.18338v1 Announce Type: new Abstract: The search for life beyond Earth will depend on detecting faint signatures in the atmospheres of potentially habitable exoplanets. Interpreting those signatures requires understanding the host planet's climate: the same molecule may signal life on one planet and abiotic chemistry on another. Global climate models (GCMs) provide this understanding, but individual runs can require up to millions of core-hours and substantial domain expert time. Machine-learning emulators could remove this bottleneck, but progress has been limited by the absence of a curated, multi-model exoclimate dataset. We introduce ThousandWorlds, an ML-ready benchmark for exoclimate emulation and for the broader regime of low-data, multi-simulator, parameter-to-field regression. The dataset contains approximately 1800 simulations from five GCMs, mapping eight planet parameters to 3D atmospheric fields including temperature, humidity, winds, clouds, and radiation. Three nested subsets define progressively harder challenges: single-simulator regression, multi-simulator regression with complete observations, and multi-simulator regression with structured missingness. We propose two evaluation protocols: one for ranking methods, and one that measures performance relative to the disagreement between GCMs themselves. We evaluate seven baselines spanning simple methods, deep learning, and Gaussian processes. GP-based methods perform best, suggesting that ThousandWorlds exposes a regime where off-the-shelf deep learning does not yet succeed. Data: https://doi.org/10.57967/hf/8695. Code: https://github.com/edstevenson/ThousandWorlds.

24.
arXiv (CS.LG) 2026-06-18

From Mechanistic to Compositional Interpretability

arXiv:2605.08934v2 Announce Type: replace Abstract: Mechanistic interpretability aims to explain neural model behaviour by reverse-engineering learned computational structure into human-understandable components. Without a formal framework, however, mechanistic explanations cannot be objectively verified, compared, or composed. We introduce compositional interpretability, a category-theoretic framework grounded in the principles of compositionality and minimum description length. Compositional interpretations are pairs of syntactic and semantic mappings that must commute to enforce consistency between a model's decomposition and its observed behaviour. We deconstruct explanation quality into measures of faithfulness and complexity to cast interpretability as a constrained optimisation problem, and introduce compressive refinement to systematically restructure models into simpler parts without altering their function. Finally, we derive a parsimony criterion under which syntactic compression theoretically guarantees more concise, human-aligned explanations. Our framework situates prominent mechanistic methods as subclasses of refinement, and clarifies why their compressibility heuristics tend to align with human interpretability. Our work provides a measurable, optimisable blueprint for automating the discovery and evaluation of mechanistic explanations.

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medRxiv (Medicine) 2026-06-15

Data-Driven Stochastic Model for Detecting Patientswith Alzheimer's Disease

Alzheimer s disease (AD) is a critical neurological disorder that causes the brain to shrink and leads to the eventual death of brain cells, adversely affecting a person s ability to function. AD is a fast-growing disease in the United States and was the fifth leading cause of death among Americans 65 years of age or older in 2023. In the United States 6.9 million people aged 65 or older were diagnosed with AD, along with a high rate of undiagnosed patients. Thus, the objective of our study is to develop a real data-driven predictive model to identify a patient with AD based on eight risk factors: Age, Gender, ADAS-Cog13, Entorhinal, Fusiform, Intracranial Volume (ICV), Amyloid-Beta, and Tau Protein, with a high degree of accuracy. The quality of the model was evaluated using well-established and sophisticated statistical measures: the area under the receiver operating characteristic curve, calibration plot, Hosmer-Lemeshow goodness-of-fit test, and K-fold cross-validation. If a patient is given information on the above risk factors, our proposed binary logistic regression model can classify the patient as having AD or not with at least 98% accuracy.