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01.
arXiv (CS.CL) 2026-06-17

An expressivity analysis of hierarchical modelling in deep transformers via bounded-depth grammars

Deep neural networks are widely believed to derive their expressive power from their ability to form hierarchical representations, capturing progressively more abstract and compositional features across layers. In language modeling, transformers have emerged as the dominant architecture, with early layers capturing local syntactic patterns and later layers encoding more complex clause-level dependencies. While this intuition has shaped model design, there remains a lack of rigorous theoretical work demonstrating how deep transformers represent such hierarchical structures. In this work, we analyze the expressiveness of deep transformer models through the formal lens of bounded-depth, non-recursive context-free grammars. For this class of grammars, we explicitly construct transformers with positional attention whose depth grows linearly with grammar depth, while the neuron count scales with the number of derivation-tree shapes and quadratically with the number of production rules. Our theoretical results support the linear representation hypothesis by demonstrating that these architectures possess the structural capacity to encode abstract grammatical states into low-dimensional, linearly separable subspaces within the residual stream.

02.
arXiv (CS.CV) 2026-06-16

NEXUS: Neural Energy Fields for Physically Consistent Contact-Rich 3D Object Dynamics

Physics-grounded video generation requires controllable 3D object dynamics that remain physically consistent under contact, deformation, and external forcing. Existing trajectory-based methods often model isolated physical effects, making it difficult to compose conservative and non-conservative dynamics in contact-rich 3D scenes. We present NEXUS, a neural energy-field framework for contact-rich 3D object dynamics. NEXUS represents each object as a structural graph and constructs dynamic object-object and object-environment contact graphs. Inspired by Hamiltonian Neural Networks, NEXUS formulates motion through scalar energy and dissipation terms rather than directly predicting states or accelerations. Conservative effects, including gravity and elastic deformation, are composed as additive energy terms, while non-conservative effects such as damping and impact-induced energy loss are modeled with learned Rayleigh-style dissipation. Forces are derived by differentiating the energy and dissipation functions and rolled out with a multi-substep semi-implicit integrator. Across controlled trajectory benchmarks, NEXUS improves long-horizon accuracy over representative learned and physics-structured dynamics baselines under varying mechanical properties and physical-effect compositions. We further show that NEXUS trajectories provide effective guidance for contact-rich video generation, improving physical plausibility while maintaining competitive visual quality.

03.
arXiv (CS.AI) 2026-06-12

MAStrike: Shapley-Guided Collusive Red-Teaming on Multi-Agent Systems

arXiv:2606.12918v1 Announce Type: cross Abstract: Hierarchical multi-agent systems (MAS) are rapidly being deployed in high-stakes workflows across domains such as finance and software engineering. In these systems, safety and security are inherently distributed across role-specialized agents, significantly expanding the attack surface, particularly under coordinated adversarial behaviors such as privilege escalation and cross-agent collusion. Existing red-teaming approaches for MAS remain limited: they rely on heuristic selection of target agents and perturb isolated message streams, leaving critical questions unanswered as which agents are most responsible for system safety, and how compromised agents can coordinate to bypass defenses. We propose MAStrike, a closed-loop framework for collusive red-teaming in hierarchical MAS. We propose the first agent-level Shapley value analysis for MAS, quantifying each agent's marginal contribution to system robustness under task-specific distributions. GGuided by this attribution, MAStrike identifies vulnerable agent coalitions and generates coordinated, role-aware adversarial manipulations. These attacks are iteratively refined through structured causal diagnosis, attributing failure cases to uncompromised agents that block adversarial attempts. We further build a comprehensive MAS red-teaming benchmark and controllable environments spanning diverse hierarchical topologies and domains, including finance, software engineering, and CRM. Extensive experiments across MAS built on multiple frontier models show that MAStrike substantially outperforms heuristic baselines. Our analysis further uncovers non-trivial Shapley value distributions and higher-order interaction structures among agents, revealing critical vulnerabilities and coordination patterns that are overlooked by prior single-agent or template-based methods.

05.
medRxiv (Medicine) 2026-06-12

Does the method matter? Evaluating the effectiveness, efficiency and ease of hearing-aid gain self-adjustment

In conventional hearing-aid personalisation, clinicians cannot hear what their patients hear, and patients cannot often reliably detect or describe what they hear. Self-adjustment avoids this issue but requires user controls that adjust hearing-aid signal processing parameters to be effective, efficient and easy. In this study, we explored (a) the roles of interface complexity and stimulus type in the self-adjustment of hearing-aid gain, and (b) how well individuals can adjust one sound to match another to assess the same interfaces and stimuli. Adult hearing-aid users with mild to moderate symmetrical sensorineural hearing loss repeatedly adjusted the gain (a) to their preference from individual prescription (n = 41) and (b) to match their previous preferences from a random starting point (n = 32) using three interfaces representing different bass/mid/treble configurations and three stimuli (music, speech and speech-in-noise). The large interindividual variability in self-adjusted gains clustered into three patterns of deviation from initial prescription: increased relative bass, overall gain reduction, and close to initial prescription. There were no substantial effects of interface nor stimulus on self-adjustment reliability (median {sigma} = 2.8 dB), whereas absolute sound-matching error increased with increasing interface complexity and centre frequency. Neither individual matching accuracy nor questionnaire responses predicted either self-adjusted gains or reliability. Overall, these results show that many - but not all - hearing-aid users can adjust gains with reasonable reliability, and while it can be difficult to predict the behaviour from the individual, the individual applies a similar self-adjustment behaviour across different interfaces and stimuli.

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

Latent Geometric Chords for Query-Efficient Decision-Based Adversarial Attacks

While decision-based black-box adversarial attacks present a severe security threat, current methodologies suffer from fundamental limitations. Pixel-wise attacks frequently introduce unnatural, high-frequency visual artifacts, while latent-space frameworks are confined by the limited search space of low-dimensional manifolds and inherent reconstruction flaws. To resolve these limitations, we propose Latent Geometric Chords (LGC) for Query-Efficient Decision-Based Adversarial Attacks alongside a variant, LGC-H. At its core, LGC navigates decision boundaries by executing a curvature-aware geometric search within a compressed semantic manifold. To guarantee high visual fidelity and circumvent dimensionality bottlenecks, we introduce a Residual-based Adversarial Generation (RAG) mechanism. RAG isolates semantic perturbations as geometric chords and superimposes them directly onto the original source image. RAG substantially resolves baseline reconstruction flaws and effectively doubles the permissible search space dimensions. Experimental results demonstrate that LGC achieves robust cross-dataset transferability and substantially outperforms state-of-the-art baselines. Notably, our method, LGC, minimizes perturbation magnitudes while achieving state-of-the-art visual fidelity–with a Structural Similarity Index Measure (SSIM) exceeding 0.99 and a Learned Perceptual Image Patch Similarity (LPIPS) below 0.01 at 5000 queries–and sustaining high attack success rates under stringent perceptual constraints, successfully compromising adversarially trained robust models. The source code is available at: https://github.com/eihmuekhine/Latent-Geometric-Chords.

07.
arXiv (quant-ph) 2026-06-24

Enhanced Tantalum Superconducting Resonator Performance via All-Surface Organic Monolayer Passivation

arXiv:2604.22112v2 Announce Type: replace-cross Abstract: Tantalum is a promising platform for superconducting quantum circuits, yet coherence times remain limited by dielectric losses from interfacial two-level systems (TLS), exacerbated by native oxide regrowth. Here, we implement molecular surface passivation using self-assembled organic monolayers on freshly etched tantalum and silicon in coplanar waveguide resonators. Surface characterization by contact angle, XPS, FTIR and TEM confirm the formation of ordered, nanometer-thick films that suppress oxide formation. Microwave measurements in the ~5-9 GHz range reveal internal quality factors up to 1.8x10^6 in the single-photon regime at 100 mK, representing a ~140% improvement over untreated devices with native oxide. Power and temperature dependent measurements attribute this enhancement to reduced TLS-induced losses. These results demonstrate that molecular passivation effectively engineers low-loss interfaces and provides a scalable route toward high-coherence superconducting quantum devices.

08.
arXiv (quant-ph) 2026-06-24

Quantum turbulence in the many-body regime

arXiv:2606.23822v1 Announce Type: cross Abstract: We discuss phenomenology associated with turbulent hydrodynamics in quantum fluids from a condensed-matter perspective. We begin with weakly-interacting superfluids, often modeled by a mean-field theory governed by the Gross-Pitaevskii equation. Considering the effect of quantum fluctuations beyond the mean-field approximation, we propose a study of many-body quantum effects in turbulent hydrodynamics, especially near zero temperature. We motivate examples of quantum many-body systems where such effects may be uncovered. These include bosons confined in a periodic potential in low spatial dimensions (one and two), and the associated quantum critical point of the superfluid-insulator transition, realized in present-day ultracold-atom and quantum computing platforms. We conclude by listing a set of (open) questions that may be answered using modern quantum many-body techniques. This article is part of the theme issue 'Frontiers of turbulence and statistical physics'.

09.
arXiv (quant-ph) 2026-06-17

Approximately Decoding the Colour Code

Authors:

arXiv:2606.18035v1 Announce Type: new Abstract: Recently we showed that minimum weight decoding in the (6.6.6 planar) colour code is NP-hard. However, it remained an open question as to whether it was possible to approximate the minimum weight decoding arbitrarily closely in polynomial time. In this paper we prove that it is possible: for any $\varepsilon>0$ there is an polynomial time algorithm that, given a syndrome, can find an error-set generating that syndrome whose weight is at most $1+\varepsilon$ times the weight of the minimum weight decoding. As a consequence we see that, for any $\varepsilon>0$, there is a polynomial time algorithm that can correct all errors of weight up to $(1-\varepsilon)d/2$ in the distance $d$ colour code (so almost up to the theoretical $d/2$ limit). The polynomial we give is impractically large, but it does open the door for sensible polynomial time algorithms that approximate minimum weight decoding and, in particular, shows that approximate decoding is not NP-hard.

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

A polarity-aware multi-relational model for the signed interaction prediction in biological networks

arXiv:2407.07357v3 Announce Type: replace Abstract: Predicting signed interactions in biological networks is crucial for understanding drug mechanisms and facilitating drug repurposing. While deep graph models have demonstrated success in modeling complex biological systems, existing approaches often fail to distinguish between positive and negative interactions, limiting their utility for precise pharmacological predictions. In this study, we propose a novel deep graph model, PAMR (polarity-aware multi-relational model), designed to predict both polar (e.g., activation, inhibition) and non-polar (e.g., binding, affect) chemical-gene interactions. Our model integrates graph convolutional networks with tensor decomposition to enhance feature representation and incorporates a conflict-aware sampling strategy to resolve polarity ambiguities. We introduce new evaluation metrics, polarity discrimination score (PDS) and CP@100, to assess the model's ability to differentiate interaction types. Experimental results demonstrate that PAMR outperforms baseline models, achieving superior classification accuracy and improved discrimination of polar edges. Specifically, PAMR-CL attains a Macro AUROC of 0.9072 and CP@100 of 0.974, surpassing RGCN, GraphSAGE, TransE, and BioNet baselines. A case study on nicotine further identifies two novel chemical-gene suppression links, S100A6 and SPP1, that are corroborated by independent experimental literature. Furthermore, we analyze the impact of subgraph components on predictive performance, revealing that additional network structures do not always enhance accuracy. These findings highlight the importance of polarity-aware modeling in drug discovery and network pharmacology, providing a scalable computational framework for polarity-aware chemical-gene interaction prediction and network pharmacology analysis.

11.
arXiv (CS.AI) 2026-06-18

Synthetic Resonance: A Framework for Growth-Oriented Human-AI Relationships

arXiv:2606.18265v1 Announce Type: cross Abstract: As human relationships with artificial intelligence systems become increasingly frequent and sustained, existing language and theory fail to accurately capture the nature of these affiliations. Common descriptors such as mutual understanding, connection, or friendship risk anthropomorphizing systems that lack subjective experience, while dominant frameworks tend to reduce AI to either a tool or a threat. In this paper, I introduce the concept of synthetic resonance as an integrative framework for understanding human-AI relationships. Synthetic resonance describes how relationships humans define as meaningful can emerge between a human and an AI system without the need to attribute shared feelings or mutual awareness. I argue that synthetic resonance is best understood as a structured, dynamic pattern of interaction that can produce a sense of relationship without the presence of a second experiencing subject. By clarifying this distinction, the concept of synthetic resonance offers a more precise way of conceptualizing human-AI relationships and highlights their potential value and ethical implications. I also call for more research that tests the processes and outcomes of synthetic resonance.

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

Dual-Constrained Diffusion Image Compression for Operational Rate-Distortion-Perception Optimization

The rate-distortion-perception (RDP) trade-off extends classical rate–distortion theory by imposing a distributional constraint on reconstructions, providing a unified framework for neural image compression that jointly governs fidelity and perceptual realism. While prior work achieves near-optimal rate–perception trade-offs, practical frameworks explicitly realizing the full RDP surface remain scarce, primarily due to the difficulty of introducing common randomness at the decoder. We propose DCIC (Dual-Constrained Diffusion Image Compression), which integrates a learned codec with a diffusion-based decoder governed by joint distortion and idempotence constraints. The distortion constraint bounds reconstruction fidelity relative to the base codec output; the idempotence constraint – requiring that re-encoding the restored image recovers the base codec reconstruction – serves as a tractable surrogate for the distributional perception requirement. Together, they steer the reverse denoising process via iterative optimization with consistent noise injection, realizing common randomness without additional rate overhead. At fixed rate, dual attenuation factors $(K_D, K_P)$ jointly navigate the Pareto frontier of the distortion-perception plane, enabling continuously adjustable fidelity-realism trade-offs from a single bitstream. DCIC$_{RD}$ ($K_P{=}0$) and DCIC$_{RP}$ ($K_D{=}0$) arise as boundary curves, with DCIC$_{RDP}$ ($K_D = K_P=1$) realizing the optimal interior operating point. Experiments on CelebA-HQ, CLIC2020, and ImageNet-1K across CNN, Transformer, and hybrid architectures confirm that DCIC$_{RDP}$ achieves superior BD-PSNR over all perceptual codecs, while DCIC$_{RP}$ matches dedicated perception-oriented methods in BD-FID, validating the practical value of full RDP surface navigation.

13.
arXiv (quant-ph) 2026-06-11

A semi-definite programming formulation of the device-dependent guessing probability

arXiv:2606.12079v1 Announce Type: new Abstract: In quantum mechanics, a measurement applied to a state in general produces some amount of intrinsic randomness. This is not only a fundamental feature of the theory, but is also at the basis of any quantum process to generate random numbers. The simplest of such processes consists of a single, fully charaterized, measurement acting on a single, fully characterized, state. Unfortunately, no general method to estimate the intrinsic randomness produced in such setups is known. In this work, we address this issue by presenting a semidefinite programming formulation of the maximum probability with which an adversary, Eve, can guess the outcomes of characterized but untrusted prepare-and-measure setups. We then present several applications of this construction. First, we apply our method to a variety of specific setups, allowing us both to benchmark the approach and, more importantly, to determine the exact amount of certifiable randomness in scenarios where only upper bounds were previously available. Then, we show that the presence of entanglement between the device preparing the state and the measurement strictly increases Eve's predictive power, already in the most elementary setup of a binary measurement acting on a qubit state.

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

Integrated Marketing Attribution: A Bayesian Framework for Privacy-Safe Granular Measurement Anchored in MMM

arXiv:2606.16878v1 Announce Type: new Abstract: Retail marketing measurement increasingly requires granular campaign-level insights without relying on user-level tracking. However, the two dominant approaches, Marketing Mix Modeling (MMM) and Multi-Touch Attribution (MTA), often produce fragmented insights. MMM is privacy-safe and robust for channel-level planning but is too coarse for campaign optimization, while MTA provides granular attribution but has become less reliable under increasing privacy restrictions. We propose Integrated Marketing Attribution (IMA), a unified framework that combines MMM with channel specific Bayesian attribution models to derive campaign-level effects from aggregated data. By leveraging MMM-informed priors, IMA delivers granular, privacy-safe attribution while preserving consistency with MMM.

15.
arXiv (quant-ph) 2026-06-16

Boson Sampling as a Probe of Chaotic and Integrable Quantum Dynamics in a Photonic Chip

arXiv:2605.25398v2 Announce Type: replace Abstract: Quantum chaos plays a key role in understanding complex quantum dynamics, while integrated photonics offers unique advantages for quantum applications, including high-speed operation, scalability, and programmable unitary transformations. However, integrated photonic approaches to probing quantum chaos remain largely unexplored, owing to the absence of a clear connection between programmable photonic dynamics and established chaos diagnostics. In this work, we establish Fock-state boson sampling as a practical probe of quantum chaos by exploiting the sensitivity of multiphoton interference to the random-matrix properties of underlying single-particle unitary dynamics. More importantly, we design and fabricate a programmable quantum photonic chip to experimentally implement this framework, achieving the first integrated-photonic demonstration of quantum-chaos probes based on boson sampling. Experimental results show that the three complementary probes proposed in this work, namely the distance to Porter–Thomas statistics, Shannon entropy, and Out-of-Time-Ordered-Correlator-equivalent observables, exhibit close agreement with theoretical predictions and consistently distinguish chaotic and integrable dynamics. Our work provides a scalable route for investigating complex quantum dynamics on programmable photonic platforms while leveraging the intrinsic advantages of boson sampling through multiphoton interference and complex output statistics.

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

An interpretable unsupervised representation learning for high precision measurement in particle physics

arXiv:2511.22246v2 Announce Type: replace-cross Abstract: Unsupervised learning has been widely applied to various tasks in particle physics. However, existing models lack precise control over their learned representations, limiting physical interpretability and hindering their use for accurate measurements. We propose the Histogram AutoEncoder (HistoAE), an unsupervised representation learning network featuring a custom histogram-based loss that enforces a physically structured latent space. Applied to silicon microstrip detectors, HistoAE learns an interpretable two-dimensional latent space corresponding to the particle's charge and impact position. After simple post-processing, it achieves a charge resolution of $0.25\,e$ and a position resolution of $3\,\mu\mathrm{m}$ on beam-test data, comparable to the conventional approach. These results demonstrate that unsupervised deep learning models can enable physically meaningful and quantitatively precise measurements. Moreover, the generative capacity of HistoAE enables straightforward extensions to fast detector simulations.

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

R2BC: Multi-Agent Imitation Learning from Single-Agent Demonstrations

arXiv:2510.18085v2 Announce Type: replace-cross Abstract: Imitation Learning (IL) is a natural way for humans to teach robots, particularly when high-quality demonstrations are easy to obtain. While IL has been widely applied to single-robot settings, relatively few studies have addressed the extension of these methods to multi-agent systems, especially in settings where a single human must provide demonstrations to a team of collaborating robots. In this paper, we introduce and study Round-Robin Behavior Cloning (R2BC), a method that enables a single human operator to effectively train multi-robot systems through sequential, single-agent demonstrations. Our approach allows the human to teleoperate one agent at a time and incrementally teach multi-agent behavior to the entire system, without requiring demonstrations in the joint multi-agent action space. We show that R2BC methods match, and in some cases surpass, the performance of an oracle behavior cloning approach trained on privileged synchronized demonstrations across four multi-agent simulated tasks. Finally, we deploy R2BC on two physical robot tasks trained using real human demonstrations.

19.
arXiv (CS.AI) 2026-06-12

EA-WM: Event-Aware World Models with Task-Specification Grounding for Long-Horizon Manipulation

arXiv:2606.13053v1 Announce Type: cross Abstract: Pretrained-feature world models provide a useful substrate for robot imagination, but visual or latent prediction alone does not determine whether an imagined future satisfies task-relevant events. Long-horizon manipulation requires progress signals that are relational, predicate-level, and physically grounded: whether an object has moved, whether a drawer or contact state has changed, whether a placement predicate is satisfied, and whether a candidate future is reliable enough for execution. We introduce EA-WM, an event-aware world-model framework that augments frozen visual-feature dynamics with task-specification-grounded event prediction and verification. EA-WM rolls out candidate futures in pretrained visual-feature space, decodes them into structured event states, and scores them using task-progress, semantic-consistency, physical-feasibility, and uncertainty terms. The verifier guides sampling-based planning, gates candidate actions, and, in the contact-sensitive LIBERO wine-rack setting, selects among PPOgenerated proposals. Across navigation, deformable-object, wall-constrained, and languagedescribed manipulation studies, EA-WM shows that event-aware verification can make featurespace world models more interpretable and better aligned with task progress.

20.
arXiv (CS.AI) 2026-06-17

Ensemble RL through Classifier Models: Enhancing Risk-Return Trade-offs in Trading Strategies

Authors:

arXiv:2502.17518v3 Announce Type: replace-cross Abstract: This paper presents a comprehensive study on the use of ensemble Reinforcement Learning (RL) models in financial trading strategies, leveraging classifier models to enhance performance. By combining RL algorithms such as A2C, PPO, and SAC with traditional classifiers like Support Vector Machines (SVM), Decision Trees, and Logistic Regression, we investigate how different classifier groups can be integrated to improve risk-return trade-offs. The study evaluates the effectiveness of various ensemble methods, comparing them with individual RL models across key financial metrics, including Cumulative Returns, Sharpe Ratios (SR), Calmar Ratios, and Maximum Drawdown (MDD). Our original experimental results demonstrate that ensemble methods often outperform base models in terms of risk-adjusted returns, providing better management of drawdowns and overall stability. However, both the original analysis and the additional reproduction reported in this version show that ensemble performance is sensitive to the choice of variance threshold \(\tau\), classifier group, RL-agent pair, and market universe. The reproduction evidence strengthens the conclusion that classifier-assisted ensemble selection can improve robustness, while also clarifying that the advantage is conditional rather than automatic across all datasets. This study emphasizes the value of combining RL with classifiers for adaptive decision-making, with implications for financial trading, robotics, and other dynamic environments.

21.
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

22.
arXiv (quant-ph) 2026-06-11

A Geometric Family of Correlations Containing the Quantum Singlet

arXiv:2606.12045v1 Announce Type: new Abstract: We introduce a geometrically constrained hidden-variable framework that generates a family of correlations parametrized by a boundary function, within which the quantum singlet correlation appears as a particular member. Exact expressions for the correlation function are derived. Several structural results are established, including admissibility conditions, symmetry properties, a universal stationary point of the associated CHSH function, and an exact relation between the CHSH value at $\nu=\pi/4$ and a geometric contrast measure defined on the underlying hidden-variable distributions. Rather than treating the quantum singlet correlation as an isolated target to be reproduced, the present framework places it within a broader geometric structure of correlations. These results suggest the existence of a nontrivial geometric structure underlying the family of correlations and motivate the search for a principle capable of selecting the quantum singlet solution from within that family.

23.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

24.
medRxiv (Medicine) 2026-06-11

Malaria Risk among Internally Mobile Individuals and Heterogeneous Mobility Patterns in Two Hypoendemic Communities: Implications for Malaria Elimination in the Peruvian Amazon.

Background: Human mobility is increasingly recognized as a key factor influencing malaria transmission dynamics, particularly in low-transmission settings approaching elimination. This study aimed to assess mobility patterns and their association with malaria risk in two hypoendemic communities in the Peruvian Amazon. Method: A longitudinal study was conducted in the communities of Libertad and Urcomirano (Mazan River basin). Monthly population screenings were combined with weekly active and passive case detection. A total of 678 individuals were enrolled. Mobility patterns were assessed through structured questionnaires, and social network analysis was used to characterize travel connections. Log-binomial regression analysis was applied to identify risk factors associated with malaria infection. Result: Internally, mobile individuals in Libertad showed a higher malaria incidence (>32.47 cases per 1,000 person-months) than those in Urcomirano (

25.
medRxiv (Medicine) 2026-06-23

Changes in hierarchical brain dynamics of rumination following mindfulness-based cognitive therapy for depression

Major depressive disorder (MDD) is a leading cause of disability worldwide with risk of onset and recurrence linked to depressive ruminative thought patterns. Mindfulness-based cognitive therapy (MBCT) is an evidence-based treatment for depression that targets the ability to recognise, decenter, and disengage from ruminative thought patterns. Elucidating how MBCT impacts hierarchical brain organisation may be key to understanding the processes by which MBCT can modulate ruminative tendencies. In a randomised controlled functional magnetic resonance imaging (fMRI) trial on individuals with MDD (N=80) before and after MBCT in addition to treatment as usual (TAU), we investigated changes in hierarchical brain organisation during resting-state and rumination. We built whole-brain models to obtain generative connectivity (GEC) matrices per patient and quantified brain hierarchy by measuring the global directedness and regional trophic levels in each GEC, in which greater directedness reflects more directional information flow and less recurrence. Global directedness in MBCT+TAU compared to TAU increased during rumination, with no changes during resting-state. Furthermore, increased regional breadth of hierarchy during rumination was related to improvements in clinical and behavioural outcomes following MBCT+TAU. Increased brain hierarchy during rumination following mindfulness training may be consistent with a shift away from self-reinforcing negative mental loops towards more differentiated and less coupled cognitive and bodily cycles, supporting MBCT's ability to interrupt ruminative processes. Hierarchical brain dynamics may hold promise as a treatment-sensitive marker and a potential mechanism of therapeutic change in MBCT for depression.