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01.
arXiv (math.PR) 2026-06-18

Probabilistic representation and classical solutions of wave equations with complex polynomial nonlinearities

arXiv:2606.18919v1 Announce Type: cross Abstract: We review the probabilistic representation of solutions of wave equations with polynomial nonlinearities in spatial dimensions d=1,2,3 using stochastic branching processes. Under regularity assumptions on the initial data, we derive conditions ensuring the integrability of the corresponding Monte Carlo estimator, and the existence and smoothness of mild and classical solutions. We also present numerical results and comparisons with grid-based algorithms for the solution of nonlinear wave equations.

02.
medRxiv (Medicine) 2026-06-22

Starting, stopping and restarting. Patterns of Methylphenidate Use over 14 years in a large public health system

Background Persistence with stimulant medication is poor in children and adolescents with ADHD, and the evidence base is derived predominantly from high-income countries. We describe methylphenidate utilisation patterns and predictors of 12-month retention across 14 years in a large South African public health service. Methods Retrospective cohort study using routine pharmacy data from the Western Cape provincial health service (2011-2024). Children aged 5-18 at first prescription were included. Treatment episodes were defined as continuous prescription sequences with no gap exceeding 90 days and classified as initiations or restarts. Logistic regression modelled 12-month retention against early visit frequency and formulation type as pre-specified exposures. Findings 421,925 prescription events for 23,243 children across 115 facilities generated 65,885 treatment episodes. Median age at first prescription was 10 years (IQR 8-12); 77.6% were male. Kaplan-Meier 12-month survival was 28.2% for initiations and 15.4% for restarts, substantially below high-income country comparators. A quarter of all initiating prescriptions were not followed by a subsequent dispensing event; nearly 40% of patients had three or more treatment episodes. Early visit frequency was the strongest predictor of 12-month retention (high vs low: OR 2.85, 95% CI 2.65-3.06). The sustained-release formulation effect was present but attenuated on multivariable adjustment. Treatment re-initiations showed a marked seasonal pattern consistent with the South African school calendar. Interpretation Twelve-month retention was markedly lower than high-income country rates. Against a backdrop of high attrition, both early visit frequency and sustained-release formulation access predicted persistence; clinical engagement and reducing structural barriers to access are modifiable factors in this setting. Funding None.

03.
arXiv (CS.LG) 2026-06-19

Marginal Advantage Accumulation for Memory-Driven Agent Self-Evolution

arXiv:2606.20475v1 Announce Type: new Abstract: In batch-style trace distillation, the same memory operation may receive contradictory feedback across different batches. Existing methods lack a cross-batch, operation-level evidence accumulation mechanism, making it impossible to distinguish stably effective operations from accidental hits. This paper formalizes the requirement as two structural conditions, alignability and comparability, and proposes Marginal Advantage Accumulation (MAA). MAA constructs differential signals to make them comparable across batches, accumulates signed evidence per operation via EMA, and ensures cross-batch traceability through semantic identity merging. As a post-processing architecture, MAA achieves the best results in 14 out of 16 settings across 4 benchmarks and 4 target models, consistently outperforming existing batch-level distillation baselines and matching or surpassing online alternatives in most settings, while reducing optimization-phase token consumption by approximately 75%.

04.
arXiv (math.PR) 2026-06-16

A Tail-Respecting Splitting Numerical Scheme for Lévy-Driven SDEs With Superlinear Drifts

arXiv:2504.07255v3 Announce Type: replace Abstract: We present an explicit numerical approximation scheme, denoted by $\{X^n\}$, for the effective simulation of solutions $X$ to a multivariate stochastic differential equation (SDE) with a superlinearly growing $\kappa$-dissipative drift, where $\kappa>1$, driven by a multiplicative heavy-tailed Lévy process that has a finite $p$-th moment, with $p>0$. We show that the strong $L^{p_X}$-convergence $\sup_{t\in[0,T]}\mathbf E \|X^n_t-X_t\|^{p_X}=\mathcal O (h_n^{\gamma})$ holds for any $p_X\in (0,p+\kappa-1)$, which is exactly the range where the $p_X$-moment of the solution is known to be finite. Additionally, for any $p_X\in (0,p)$ we establish strong uniform convergence: $\mathbf E\sup_{t\in[0,T]} \|X^n_t-X_t\|^{p_X}=\mathcal{O} ( h_n^{\delta} )$. In both cases we determine the convergence rates $\gamma$ and $\delta$. In the special case of SDEs driven solely by a Brownian motion, our numerical scheme preserves super-exponential moments of the solution. The scheme $\{X^n\}$ is realized as a combination of a well-known Euler method with a Lie-Trotter type splitting technique.

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

PhysMetrics.Weather: An Evaluation Framework for Physical Consistency in ML Weather Models

arXiv:2606.10642v2 Announce Type: replace Abstract: Machine learning weather prediction (MLWP) models have achieved impressive forecasting performance at a small fraction of the computational costs required for traditional physics-based methods. However, they are primarily (1) data-driven and (2) evaluated using pixel-wide error metrics (e.g., RMSE), so there are no guarantees that their forecasts are consistent with known physical laws. We introduce PhysMetrics$.$Weather, an evaluation framework that assesses the physical realism of MLWP models across three types of metrics: conservation, spectral, and dynamical. By quantifying physical realism, this tool guides the development of physics-informed architectures and helps evaluate whether MLWP models are reliable for operational use. Our framework is available on Github at https://github.com/Emmakast/PhysMetrics.Weather.

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

AI for Maritime Security: Comparative Evaluation of CNN and Vision Transformer Architectures for Maritime Object Detection

This study aims to enhance maritime security by using advanced Artificial Intelligence (AI) and Computer Vision (CV) techniques. For this purpose, it was designed and assessed intelligent object detection systems that can detect the presence of ships on the sea surface under different real-time environments. To achieve this goal, a maritime image dataset with 6,468 images was used, covering different weather conditions like cloudy, foggy, rainy, and sunny environments. Six deep learning architectures were evaluated, including a base Convolutional Neural Network (CNN) model, four transfer learning models (Xception, VGG16, MobileNetV2, and EfficientNetV2L), and a Vision Transformer (ViT) model. The models were compared using multiple performance indicators, including accuracy, Type I and Type II errors, model size, and video processing time. The results show that model performance varies depending on computational constraints and deployment conditions. While lightweight architectures are suitable for resource-limited devices, the ViT achieved the best overall performance, reaching 100% accuracy with the lowest error rates and the fastest video processing time. The findings highlight the potential of AI-driven computer vision systems for maritime surveillance, border protection, and autonomous navigation.

08.
arXiv (CS.AI) 2026-06-18

Equivariant Graph Neural Networks Improve Optical Spectra Prediction for Materials Screening

arXiv:2606.19133v1 Announce Type: cross Abstract: Scalable prediction of optical spectra is a critical component of high-throughput materials screening for optoelectronic applications such as solar cells. Existing surrogate models are trained on spectra computed from lower levels of theory or rely on rotation-invariant scalar features, limiting their geometric expressiveness. We explore the use of equivariant graph neural networks for optical spectra prediction, adapting GotenNet to this task and evaluating it on multiple datasets including a recently published collection of 10,533 structures with spectra computed at the level of the random phase approximation (RPA). The proposed model outperforms the current state of the art, with the largest gains in the 0-8 eV range and on predicting the static real permittivity, both of particular relevance for thin-film optics.

09.
arXiv (CS.LG) 2026-06-12

$\alpha$-fair heterogeneous agent reinforcement learning

arXiv:2606.13076v1 Announce Type: cross Abstract: Cooperation in multi-agent systems is typically optimized through utilitarian objectives that maximize overall efficiency but fail to account for reward distribution, often resulting in inequitable "leader-follower" dynamics. While fairness-based approaches encourage pro-social behaviors where every agent benefits from cooperation, many current algorithms - including those utilizing reward shaping - break the stationarity of Markov Games or lack rigorous theoretical guarantees. This creates a critical gap between fair objective methods and theoretically safe learning frameworks. We propose a novel framework that bridges $\alpha$-fairness with Heterogeneous-Agent Trust Region Learning (HATRL), ensuring monotonic improvement and convergence toward Nash Equilibria. Our approach leverages a fair advantage function that dynamically weights agent utilities based on their expected returns, allowing the global objective to transition from purely utilitarian efficiency to $\alpha$-fairness welfare based on the parameter $\alpha$. We introduce two practical algorithms, $\alpha$-fair HATRPO and $\alpha$-fair HAPPO, and demonstrate through experiments in sequential social dilemmas like CleanUp and CommonHarvest that they perform better than HATRL's algorithms from a utilitarian point of view while achieving socially higher outcomes.

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

Interactor: Agentic RL oriented Iterative Creation for Ad Description Generation in Sponsored Search

This paper focuses on automatically generating informative ad descriptions in sponsored search. Unlike ad titles which are usually optimized to attract user click feedbacks, ad descriptions have a longer text span and possess the potential of incorporating world knowledge to address user search intents while presenting the fine-grained selling points of the ads. We propose Interactor, a multi-turn iterative creation framework optimized with agentic RL for ad description generation. The generation model acts as a policy that interacts with a customized environment consisting of multiple generative reward models. Given initial generations by the policy, the customized GenRMs evaluate multi-dimensional qualities including knowledge capacity and landing page consistency, providing both binary signals and reasoning feedbacks. The policy then iteratively refines the descriptions based on such feedbacks to ensure continuous improvement. Experiments on industrial datasets show that the Interactor framework significantly outperforms state-of-the-art approaches in generating knowledge-rich and faithful ad descriptions. Since May 2026, it has been deployed online in a leading search ads system, contributing to both ad revenue and user experience.

11.
arXiv (quant-ph) 2026-06-12

Experiment-compatible measurement–feedback quantum state preparation with reinforcement learning

arXiv:2606.13005v1 Announce Type: new Abstract: Ground-state preparation is a critical task in quantum simulation and quantum computing, as it enables the study of correlated phases and the generation of entangled resource states. While measurement–feedback control has emerged as a promising route to state preparation, existing schemes either rely on handcrafted, task-specific policies or are designed using full quantum-state information that is unavailable in real experiments and becomes impractical for large many-body systems. Here we develop an adaptive measurement–feedback protocol based on reinforcement learning under partial observability. The controller uses only the history of experimentally accessible measurement outcomes to choose both the measurement operator and the feedback action in real time. To make training compatible with experiments, we introduce a stochastic terminal reward built from one-shot measurements of randomly sampled Hamiltonian components, avoiding unphysical full-state reconstruction while remaining an unbiased estimator of the target energy. We demonstrate the method by preparing ground states of the Bose–Hubbard model and by generating GHZ states, establishing a scalable and hardware-compatible route to quantum state preparation.

12.
medRxiv (Medicine) 2026-06-22

Clinical-grade Cuffless Blood Pressure Monitoring via Deep-tissue Diffuse Speckle Pulsatile Flowmetry

Blood pressure (BP) is a vital sign which is measured to diagnose and manage hypertension. However, current methods to measure BP use inflatable cuffs which cause discomfort and limit the frequency at which measurements can be made, or intra-arterial catheters which are invasive and pose infection risks. Here, we propose and evaluate the use of Diffuse Speckle Pulsatile Flowmetry (DSPF) as a cuffless BP measurement method to address these limitations. DSPF is a laser speckle-based technique which simultaneously records blood flow rate and blood volume (i.e. photoplethysmography or PPG) signals from relatively deep vascular tissue. Using information from these signals, we studied DSPFs effectiveness in measuring systolic BP (SBP) and diastolic BP (DBP) through an outpatient study in which 133 patients were recruited, and in measuring beat-to-beat BP waveforms through an inpatient study in which two patients were recruited. In the outpatient study, the DSPF method was able to achieve mean absolute errors (MAEs) of 4.17 mmHg and 2.42 mmHg for SBP and DBP respectively compared to conventional cuff-based methods. It was also able to fulfil the requirements of the AAMI/ESH/ISO 81060-2:2018 standard for BP measurement devices and attain an "A" grade according to the British Hypertension Society grading scheme. For the inpatient study, it produced BP waveforms which had MAEs of 2.35 mmHg and 3.06 mmHg compared to arterial-line measurements for the two patients, respectively. Compared to PPG which has been studied more extensively as a cuffless BP measurement method, we found through ablation studies that DSPF was able to reach significantly lower MAEs and hence better accuracies. DSPF augments the performance of PPG-only methods by leveraging additional information from the blood flow rate signal, and we therefore find it to be a superior cuffless BP measurement method which can potentially be used in outpatient, inpatient, and remote settings.

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

Counterfactual Optimization of Baseball Pitch Sequences and Estimation of Its Impact on Season-Level Statistics

arXiv:2606.17345v1 Announce Type: cross Abstract: Although pitch sequencing is a central topic in baseball analytics, previous studies have primarily focused on optimizing the final pitch within a single plate appearance, leaving the role of preceding setup pitches and their impact on long-term season-level performance insufficiently examined. To address these issues, this study conducted counterfactual analyses using MLB Statcast data. A Transformer-based machine-learning model was trained to predict whether a target pitch would result in an in-play outcome or swing-out. Counterfactual pitch sequences were then generated by replacing either the final pitch or the preceding setup pitch with alternative pitch types and locations while keeping the surrounding contextual information fixed. Optimal counterfactual selections were defined as those that minimized the predicted in-play probability, and their expected effects on pitchers' seasonal statistics were estimated using regression models linking model outputs to season statistics. The results suggest that the optimization of both final and setup pitches may substantially influence season-level performance, including improvements of more than 1.0 in K/9. The analyses also provided several practical insights, including velocity-band-specific effective locations, the importance of pitch commands, and the expansion of pitch-selection options through middle-velocity pitches. These findings quantitatively support the strategic importance of pitch sequencing in baseball.

14.
arXiv (CS.CL) 2026-06-11

SOMA-SQL: Resolving Multi-Source Ambiguity in NL-to-SQL via Synthetic Log and Execution Probing

Natural language interfaces to databases aim to translate user questions into executable SQL, yet remain brittle in real-world settings where questions are underspecified and schemas are large and ambiguous. Ambiguity across user questions, database schemas, and model interpretations are central failure modes in NL2SQL, leading to misaligned intent, incorrect schema grounding, and erroneous SQL generation. Existing approaches rely on human clarification or treat ambiguity as a schema representation problem, but these do not scale nor resolve ambiguity autonomously. We propose SOMA-SQL to automatically resolve ambiguity via targeted synthetic query log and ambiguity-driven probing. SOMA-SQL constructs synthetic query log to ground schema interpretation and guide candidate SQL generation; it then executes targeted probing queries, driven by a structured ambiguity taxonomy and candidate disagreements, to produce disambiguation evidence for final SQL selection and repair. This active approach to ambiguity discovery and resolution generalizes across unseen schemas and query distributions without human-in-the-loop. Experiments on six public benchmarks demonstrate that SOMA-SQL improves execution accuracy by 13.0% on average over state-of-the-art baselines, with gains of up to 16.7% on ambiguous questions.

15.
arXiv (CS.CL) 2026-06-12

MaxProof: Scaling Mathematical Proof with Generative-Verifier RL and Population-Level Test-Time Scaling

We present MaxProof, a population-level test-time scaling framework for competition-level mathematical proof in the MiniMax-M3 series. M3 first trains three proof-oriented capabilities – proof generation, proof verification, and critique-conditioned proof repair – using a defense-in-depth generative verifier engineered for low false-positive rate. These capabilities are merged into a single released M3 model. At test time, MaxProof treats the model as a generator, verifier, refiner, and ranker, searches over a population of candidate proofs, and returns one final proof through tournament selection. With MaxProof test-time scaling, the M3 model reaches 35/42 on IMO 2025 and 36/42 on USAMO 2026, exceeding the human gold-medal threshold on both.

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

A Comprehensive Survey of Knowledge-Based Vision Question Answering Systems: The Lifecycle of Knowledge in Visual Reasoning Task

Knowledge-based Vision Question Answering (KB-VQA) extends general Vision Question Answering (VQA) by not only requiring the understanding of visual and textual inputs but also extensive range of knowledge, enabling significant advancements across various real-world applications. KB-VQA introduces unique challenges, including the alignment of heterogeneous information from diverse modalities and sources, the retrieval of relevant knowledge from noisy or large-scale repositories, and the execution of complex reasoning to infer answers from the combined context. With the advancement of Large Language Models (LLMs), KB-VQA systems have also undergone a notable transformation, where LLMs serve as powerful knowledge repositories, retrieval-augmented generators and strong reasoners. Despite substantial progress, no comprehensive survey currently exists that systematically organizes and reviews the existing KB-VQA methods. This survey aims to fill this gap by establishing a structured taxonomy of KB-VQA approaches, and categorizing the systems into main stages: knowledge representation, knowledge retrieval, and knowledge reasoning. By exploring various knowledge integration techniques and identifying persistent challenges, this work also outlines promising future research directions, providing a foundation for advancing KB-VQA models and their applications.

17.
arXiv (CS.AI) 2026-06-19

Overcoming Labelled Data Scarcity for Defect Classification in Scanning Tunneling Microscopy

arXiv:2506.01678v2 Announce Type: replace-cross Abstract: Scanning tunnelling microscopy (STM) is a powerful technique for imaging surfaces with atomic resolution, providing insight into physical and chemical processes at the level of single atoms and molecules. A regular task of STM image analysis is the identification and labelling of features of interest against a uniform background. Performing this manually is a labour-intensive task, requiring significant human effort. To reduce this burden, we propose an automated approach to the segmentation of STM images that uses both few-shot learning and unsupervised learning. Our technique offers greater flexibility compared to previous supervised methods; it removes the requirement for large manually annotated datasets and is thus easier to adapt to an unseen surface while still maintaining a high accuracy. We demonstrate the effectiveness of our approach by using it to recognise atomic features on three distinct surfaces: Si(001), Ge(001), and TiO$_2$(110), including adsorbed AsH$_3$ molecules on the silicon and germanium surfaces. Our model exhibits strong generalisation capabilities, and following initial training, can be adapted to unseen surfaces with as few as one additional labelled data point. This work is a significant step towards efficient and material-agnostic, automatic segmentation of STM images.

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

A Unified Approach to Beta Moments, Combinatorial Identities, and Random Walks

arXiv:2605.05420v2 Announce Type: replace Abstract: The study of random walks has increasingly been popular across diverse disciplines such as statistics, mathematics, quantum physics, where they are used to model paths consisting of successive random steps in a mathematical space. A fundamental quantity of interest is the probability that a simple symmetric random walk returns to the origin after 2n steps. In this paper, we develop a unified probabilistic approach that connects the return probabilities in arbitrary dimensions with moment representations. Using this framework, we provide probabilistic proofs of several combinatorial identities involving beta and gamma functions, and derive new combinatorial identities in general dimensions.

19.
arXiv (CS.AI) 2026-06-16

Guiding Federated Graph Recommendation with LLM-encoded knowledge

arXiv:2606.15277v1 Announce Type: cross Abstract: Graph-based recommender systems are highly effective at extracting collaborative signals from user–item interactions, and federated learning (FL) allows these models to be trained while preserving user privacy. However, aggregating graph representations across distributed, non-IID clients remains a challenge; structural embeddings learned locally often misalign, and naive averaging fails to capture meaningful cross-client relationships. Most existing federated graph methods rely exclusively on structural aggregation, neglecting the rich, global semantic context available in large language models (LLMs). In this paper, we propose a novel framework that uses LLM-encoded knowledge to guide federated graph recommendation. Specifically, clients learn structural representations from local graphs while simultaneously summarizing their typical interaction patterns into compact semantic vectors via a frozen LLM. The central server then uses these LLM-encoded semantic signals to discover related preference patterns across clients, guiding the selective aggregation of their structural representations. This enables semantically informed cross-client collaboration without exposing raw data. Extensive experiments on standard benchmarks show that guiding structural alignment with LLM-encoded knowledge consistently improves recommendation accuracy over existing federated graph baselines.

20.
arXiv (quant-ph) 2026-06-15

Resolving the Edge of a Quantum Pyramid

arXiv:2606.14698v1 Announce Type: new Abstract: Standing on the shoulders of giants, we resolve the quantum pyramids conjecture, confirming the globally information-optimal measurement for an ensemble of equiangular equiprobable pure states, as conjectured by Englert and \v{R}eháček (arXiv:0905.0510). We do so by proving the remaining entropy inequalities of Holevo and Utkin (arXiv:2506.06700), which certify optimality for obtuse and flat pyramids. For obtuse pyramids, our key contribution is a rigorous proof that local minimizers of the corresponding entropy inequality cannot have three distinct coordinate values. We show that eliminating this family can be reduced to a neat algebraic reciprocal inequality relating branches of the Lambert $W$ function, which may be of independent interest. For flat pyramids, we prove a tight $\ell^p$ inequality for zero-sum vectors that was recently conjectured, proved analytically in dimension $d=3$, and computationally verified for $d\leq 200$ by Holevo and Utkin (arXiv:2603.24017). We prove this bound for all $d\geq 2$ via a technique in symmetric inequalities known as the equal variables method.

21.
arXiv (math.PR) 2026-06-16

Structure preserving properties of higher order moment closures for TASEP

arXiv:2604.15925v2 Announce Type: replace-cross Abstract: The totally asymmetric simple exclusion process (TASEP) is a stochastic model for the unidirectional flow of interacting particles on a 1D-lattice that is much used in systems biology and statistical physics. Its master equation describes the evolution of the probability distribution on the configuration space. The size of the master equation grows exponentially with the length of the lattice. It is known that the complexity of the system may be reduced using mean-field approximations. We provide a rigorous definition of a family of such models using moments of any order and an extension to the pair approximation for obtaining closures for the system. The dimension of these models grows linearly with the lattice size and exponentially in the order of the approximation. Moreover, we show that the states of these models still have a probabilistic interpretation and that basic structural properties of the master equation are preserved. This extends known results on the Ribosome Flow Model which can be viewed as the first order approximation for TASEP.

22.
arXiv (CS.CV) 2026-06-15

C-MambaPose: A Physics-Informed Complex Mamba Framework for Cross-Environment WiFi Human Pose Estimation

Authors:

Human pose estimation (HPE) utilizing wireless WiFi signals has emerged as a promising technology owing to its device-free nature, privacy preservation, and robustness against occlusion and poor lighting. However, existing methods often overlook the physical complex phase information of WiFi signals and fail to generalize across diverse environments due to severe domain shifts. In this paper, we present C-MambaPose, a physics-informed complex-valued Mamba-GraFormer hybrid framework for robust cross-environment WiFi-based 3D HPE. Our framework first sanitizes raw WiFi Channel State Information (CSI) phase errors and constructs a phase-preserving complex-valued representation. We then employ a Spatiotemporal Complex Mamba encoder with a dynamic selective receptive field to capture fine-grained phase dynamics. A cross-attention joint-query mapper maps the unstructured sequence tokens to human joints, which are decoded by a Graph Convolutional Network (GCN) to predict anatomically coherent 3D coordinates. Extensive evaluations on the MM-Fi dataset show that C-MambaPose achieves competitive or superior performance to state-of-the-art baselines across all settings, setting a new state-of-the-art specifically on the challenging cross-environment split, requiring only 3.78 M parameters-an 83.1\% reduction compared to GraphPose-Fi[chen2026graph] and an 85.7\% reduction compared to MetaFi++[zhou2023metafi++], while maintaining a comparable size to DT-Pose[chen2025towards] (which is only 18\% smaller) but achieving significantly superior performance without requiring any pretraining. Our code is publicly available at https://github.com/phucngvinuni/cmampose.git.

23.
medRxiv (Medicine) 2026-06-18

Cost analysis of overseas versus domestic vaccination of US-bound refugees

Context: To ensure healthy resettlement and protect US health security, the Vaccination Program for US-bound Refugees (VPR) offers some recommended vaccines to refugees overseas before resettlement to the United States. The selected vaccines and number of doses vary by country of departure. VPR was found to be cost-saving in 2018 but had since expanded to more sites. Objective: Assess VPR's current costs and impact on post-arrival domestic vaccination needs and costs. Setting and Participants: A model-based analysis of the Federal government costs for VPR and post-arrival (US) vaccination of resettled refugees separated across five regions: Africa, Asia, the Middle East and North Africa/Republic of Turkiye and Middle East, Europe, and the Americas using fiscal year 2024 data. Design: We quantified and compared full vaccination costs for refugees under two scenarios: (1) 'No VPR' and (2) 'VPR'. Refugees would receive no vaccines overseas and be fully vaccinated after US arrival under 'No VPR'. Under 'VPR', refugees receive one or two doses of selected vaccines overseas before completing vaccination schedules after arrival. Main Outcomes: Costs were reported in 2023 US dollars for 'VPR' and 'No VPR' scenarios and further subdivided by grouping countries/sites depending on whether the International Organization for Migration (IOM) provides vaccination services for refugees (IOM sites) versus non-IOM providers (non-IOM sites). Results: 'VPR' resulted in average net cost savings of $147 per person or $14.7 million per 100,000-refugee cohort compared to providing all vaccines after US arrival ('No VPR'). 'VPR' was cost-saving across most regions, except for IOM sites in Europe, where a net cost of $44 per person was observed. Net cost savings per person were highest for IOM sites in Africa ($333). Conclusions: VPR remains a cost-saving strategy, while protecting US-bound refugees' health and US health security by preventing disease outbreaks during resettlement.

24.
Nature Medicine 2026-06-08

Post-adjuvant chemotherapy in ctDNA-positive patients with resected colorectal cancer: a randomized phase 3 trial

Authors:

Tumor-informed circulating tumor DNA (ctDNA) enables detection of molecular residual disease (MRD) after curative resection of colorectal cancer (CRC), but whether early intervention improves outcomes remains uncertain. ALTAIR was a randomized, double-blind, phase 3 trial embedded in the CIRCULATE-Japan platform evaluating a post-adjuvant ctDNA surveillance strategy with treatment initiation upon molecular recurrence. Patients with resected stage 0–IV CRC who became ctDNA positive after completion of standard-of-care therapy and had no radiological evidence of disease were randomly assigned (1:1) to receive trifluridine/tipiracil (FTD/TPI) or placebo for 6 months. The primary endpoint was investigator-assessed disease-free survival (DFS). Between July 2020 and June 2023, 243 patients were randomized to FTD/TPI (n = 122) or placebo (n = 121). Median DFS was 9.30 months with FTD/TPI and 5.55 months with placebo (hazard ratio = 0.79, 95% confidence interval: 0.60–1.05, P = 0.107), and the primary endpoint was not met. FTD/TPI increased grade 3 or higher hematologic adverse events (73.0% versus 3.3%) without new safety signals. These findings indicate that post-adjuvant intervention with FTD/TPI did not significantly improve DFS in ctDNA-positive patients without radiological disease. ClinicalTrials.gov identifier: NCT04457297 . In the randomized, double-blind phase 3 ALTAIR trial, patients with resected colorectal cancer who became positive for circulating tumor DNA during post-adjuvant surveillance received trifluridine/tipiracil hydrochloride therapy, which did not significantly prolong disease-free survival compared with placebo.

25.
arXiv (CS.LG) 2026-06-16

Drivers, Receivers, and Dynamic Linkages: The Directed Structure of SDG Interdependence, 2000–2024

arXiv:2601.20875v2 Announce Type: replace-cross Abstract: Governments with limited fiscal and administrative capacity need to know which Sustainable Development Goals (SDGs) propagate progress through the goal system and how quickly. We map the directed interdependence structure of all seventeen goals using a balanced panel of 114 countries observed annually from 2000 to 2024. The goal series are persistent, trending, and cross-sectionally dependent, so we apply two estimators matched to this regime: a Dumitrescu-Hurlin panel Granger non-causality test, run on first-differenced series, to recover the directed interaction network, and panel local projections with Driscoll-Kraay standard errors to measure the dynamic magnitude of 31 theory-derived indicator linkages. Of 272 directed goal pairs, 84 linkages survive false-discovery control (40 synergies, 44 trade-offs; network density 0.31). Synergies and trade-offs occur at comparable strength, so no single goal behaves as a universal accelerator, and the goal-level hierarchy itself is fragile. Driver-receiver rankings correlate weakly across lag orders and centrality metrics, and under a country bootstrap only two roles are distinguishable from zero: peace and strong institutions as the clearest net receiver, and poverty reduction as the most probable effect-size-weighted driver. The supported linkages are dynamic, accruing over four to five years: sanitation and poverty improvements are the strongest predictors of lower child mortality, and the education-child-health association is corroborated in independent World Development Indicators data across 183 countries. These results caution against rankings-based accelerator policy and support adaptive portfolios built on supported, time-lagged linkages monitored through constituent indicators.