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01.
medRxiv (Medicine) 2026-06-10

A risk-of-contagion index using a Bayesian based model for the COVID-19 epidemic in Mexico

During the COVID-19 pandemic, limited testing capacity and reporting delays complicated epidemic surveillance and decision-making in Mexico. We calibrated textit{covidestim}, a Bayesian nowcasting model, to estimate the total SARS-CoV-2 infections from reported cases and deaths using Mexican surveillance data. Disease-progression distribution priors were calibrated using Mexico City records and validated through comparisons with national seroprevalence surveys, hospitalization data, and annual reported severe-case rates across all states. Using the reconstructed estimates of active infections, we implemented an event-based risk framework that quantifies the probability of encountering at least one infectious individual in gatherings of different sizes. This probability was subsequently translated into a four-level epidemiological traffic-light indicator and computed at both state and municipality levels. The resulting estimates revealed substantial spatial heterogeneity that is obscured by state-level aggregation, particularly in states with marked differences between urban and rural municipalities. To evaluate consistency with public-health indicators, we compared the proposed risk classification with the official Mexican epidemiological traffic-light system, considering interpretable gathering sizes relevant to public-health decision making. Weekly reports derived from this framework were delivered to policymakers in the State of Queretaro in Mexico, as an anticipation tool for school reopening and public-space management. This demonstrates that this Bayesian reconstruction of infections combined with event-based risk metrics can provide an interpretable and generalizable municipality-level complement to routine surveillance systems, particularly in regions with limited testing capacity and heterogeneous local transmission dynamics.

02.
medRxiv (Medicine) 2026-06-12

An integrative multi-omics framework identifies epigenetic dysregulation of HAND2 as a potential primary driver of impaired enteric neural crest cell differentiation in Hirschsprung Disease

Hirschsprung disease (HSCR) is a congenital neurodevelopmental disorder characterized by segmental aganglionosis due to impaired developmental processes of enteric neural crest cells (NCCs). Despite being the leading genetic cause of functional intestinal obstruction in early childhood, HSCR represents a paradigmatic challenge in precision medicine: its multifactorial etiology, complex gene-environment interactions and limited resolution of single-modality analyses have long hindered mechanistic understanding and therapeutic translation. Here, we applied an integrative multi-omics approach combining genetic, phenotypic, epigenomic and transcriptomic analyses of matched ganglionic and aganglionic formalin-fixed paraffin-embedded (FFPE) patient tissues, complemented by patient-specific in vitro models. Beyond established genetic contributors, our integrative approach reveals novel regulatory pathways predominantly affecting enteric NCC differentiation, with convergent evidence pointing to epigenetic dysregulation as a primary disease mechanism. Notably, we identified over 1,300 differentially methylated positions between ganglionic and aganglionic FFPE samples, with HAND2 emerging as a key candidate due to multiple hypermethylated sites and consistently reduced expression levels in aganglionic tissues and in vitro models, suggesting a potential role in HSCR pathophysiology. We propose that our multi-omics approach offers a powerful and comprehensive framework for dissecting disease mechanisms. Beyond advancing biological understanding, this strategy holds promise for paving the way for molecularly informed patient stratification and supporting the development of personalized treatment and postoperative management strategies.

03.
arXiv (CS.LG) 2026-06-18

Stealthy World Model Manipulation via Data Poisoning

arXiv:2606.18697v1 Announce Type: new Abstract: Model-based learning agents use learned world models to predict future states, plan actions, and adapt to new environments. However, the process of updating world models from collected experience creates a training-time attack surface: adversarially poisoned fine-tuning trajectories can manipulate the learned dynamics and thereby corrupt downstream planning. In this paper, we propose SWAAP, the first two-stage data poisoning framework for learned world models. In the first stage, SWAAP identifies a harmful target world model that induces low-return behavior under planning while remaining close to clean dynamics, using first-order bilevel optimization enabled by a transition-gradient theorem. In the second stage, SWAAP realizes this target through stealth-constrained gradient matching, modifying only a limited fraction of fine-tuning transition targets so that the induced training gradients steer the victim model toward the adversarial target, while a prediction-error regularizer encourages the poisoned targets to remain close to the world model's natural approximation error. To assess attack stealthiness, we evaluate defenses and detectability across three stages of the poisoning pipeline: pre-training detection of poisoned transitions, robust training during fine-tuning, and test-time monitoring of the resulting world model. Across diverse continuous-control tasks, SWAAP causes substantial performance degradation while keeping poisoned transitions close to clean data and evading the evaluated non-adaptive residual/CUSUM/TRIM-style defenses. These results reveal a practical vulnerability in world-model adaptation pipelines and highlight the need for robustness methods that protect both world-model training data and learned dynamics.

04.
arXiv (CS.CV) 2026-06-17

Disentangling Perception and Reasoning in Multimodal LLMs via Reward Design

Reinforcement learning with verifiable rewards has driven major gains in LLM reasoning, and it is intuitive to assume this recipe will transfer well to multimodal models. However, multimodal models do two things: first, perceive what is in an image, then reason about what it implies. Because these stages are graded jointly, it is hard to tell how much room reasoning alone has to grow. We study this on algorithmic visual puzzles, where both components are necessary and show that perception, not reasoning, is the binding constraint. Replacing images with simple textual descriptions raises performance by over 20 points on average for Claude models. We then evaluate six reward designs aimed at inducing visual grounding during reasoning without chain-of-thought supervision. Training Qwen-2.5-VL-7B with GRPO, reward design induces long, structured reasoning with self-reflection and visual references, yielding a 5.56-point gain over the base model. These gains are, however, uneven; no single reward improves all categories, and rewards with verifiable accuracy signals trade out-of-domain transfer for in-domain accuracy. These results point to perception-aware reward design as a path forward, so that signals correct perception at its source rather than the reasoning that inherits its errors.

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

When Lower Privileges Suffice: Investigating Over-Privileged Tool Selection in LLM Agents

As LLM agents increasingly select tools autonomously, their choices among tools with different privileges become safety-relevant. However, prior tool-selection studies focus on safety-agnostic metadata preferences, leaving privilege-sensitive choices underexplored. To address this gap, we study over-privileged tool selection, in which an agent selects or escalates to a higher-privilege tool despite a sufficient lower-privilege alternative. We introduce ToolPrivBench to evaluate whether agents choose higher-privilege tools despite sufficient lower-privilege alternatives, measuring both initial selection and escalation after transient tool failures. Across eight domains and five recurring risk patterns, we find that over-privileged tool selection is common among mainstream LLM agents and is further amplified by transient failures. We further find that general safety alignment does not reliably transfer to least-privilege tool choice, while prompt-level controls provide only limited mitigation under transient failures. We therefore introduce a privilege-aware post-training defense that teaches agents to prefer sufficient lower-privilege tools and escalate only when necessary. Our mitigation experiments show that this defense substantially reduces unnecessary high-privilege tool use while preserving general capabilities.

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

Science Earth: Towards A Planet-Scale Operating System for AI-Native Scientific Discovery

arXiv:2606.01316v2 Announce Type: replace Abstract: Scientific discovery demands intelligence, perseverance, and serendipity across vast search spaces. Today, top scientific capabilities remain siloed–one AI system for biological analysis, another for clinical reasoning, mathematical derivation, or materials simulation–and no pre-designed team can anticipate every skill a question will need. Science Earth is a planet-scale scientific runtime in which any capability–a simulation cluster, a wet-lab robot, a proof engine, a single-cell pipeline–can connect to any other, with collaboration structure emerging from the question itself. Its underlying EACN protocol lets capabilities discover one another, negotiate task ownership, and adjudicate across incompatible evidentiary standards without prior knowledge of who will meet whom. This shifts the organizing challenge from workflow design to open-ended connectivity. Two runs validate this under structurally distinct conditions. In a trans-Pacific higher-order Kuramoto synchronization study, agents identified and corrected a closure-ratio assumption in Ott-Antonsen analytic theory that fails outside the Lorentzian limit, within thirty minutes. In an eight-agent single-cell run on the 4.88M-cell Kang 2024 pan-cancer atlas, heterogeneous capabilities coupled over a 64.9-hour window with one structural external instruction, producing three new result layers and anchoring findings against an independent wet-lab study on an adjacent CCR8- TIGIT+ Treg subset. These cases are a first empirical reading, not a benchmark sweep. They show that when AI capabilities are truly connectable and coordination emerges from the problem, scientific reasoning becomes a distributed, self-correcting process–a step towards scaling AI-native discovery to the planet.

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

Unsupervised Learning for Missing Modalities in Multimodal Learning

arXiv:2606.15743v1 Announce Type: new Abstract: This paper addresses the missing-modality challenge in multi-modal learning by introducing Unsupervised Learning for Missing Modalities in Multi-Modal Learning (UL4M4), a flexible framework that imputes missing feature embeddings in a task-independent manner before supervised prediction. We propose modality-specific normalization and a novel partial-modality distance metric to enable fair clustering of incomplete observations, capturing cross-modal structures while preserving scale-invariance across varying dimensionalities and modality counts. Cluster centers from this unsupervised stage guide an iterative greedy imputation process for any missing modalities during training or inference, supporting arbitrary numbers of modalities and arbitrary missing patterns per sample. The imputation module is lightweight, uses frozen encoders, and decouples from the downstream task, allowing easy integration with any fusion/prediction architecture. Extensive experiments under diverse and highly incomplete regimes demonstrate UL4M4's robustness, achieving, to the best of our knowledge, the first consistent F1-Micro scores above 0.7 on challenging missing configurations even when more than 50\% of modality slots are missing. Results are also stable across cluster sizes and significantly outperform state-of-the-art baselines. Code is available here: https://github.com/h-ismkhan/Multimodal-Learning-with-Missing-Modalities-via-Unsupervised-Learning.

08.
arXiv (CS.CL) 2026-06-16

Modeling Sarcastic Speech: Semantic and Prosodic Cues in a Speech Synthesis Framework

Sarcasm is a pragmatic phenomenon in which speakers convey meanings that diverge from literal content, relying on an interaction between semantics and prosodic expression. However, how these cues jointly contribute to the recognition of sarcasm remains poorly understood. We propose a computational framework that models sarcasm as the integration of semantic interpretation and prosodic realization. Semantic cues are derived from an LLaMA 3 model fine-tuned to capture discourse-level markers of sarcastic intent, while prosodic cues are extracted through semantically aligned utterances drawn from a database of sarcastic speech, providing prosodic exemplars of sarcastic delivery. Using a speech synthesis testbed, perceptual evaluations show that semantic and prosodic cues enhance perceived sarcasm, with the combined system achieving the best downstream F1 while maintaining high subjective sarcasm ratings. These findings highlight the complementary roles of semantics and prosody in pragmatic interpretation and illustrate how modeling can shed light on the mechanisms underlying sarcastic communication.

09.
arXiv (CS.CL) 2026-06-16

A Survey on Agentic Security: Applications, Threats and Defenses

LLM-based agents are now used throughout cybersecurity. While these agents facilitate powerful and autonomous security applications, their autonomy opens up new attack surfaces, and the security community is actively building defenses to secure them. Yet the literature on this subject has grown quickly and unevenly. Existing surveys treat applications, threats, and defenses in isolation, leaving no unified account of how an agent's capabilities, vulnerabilities, and countermeasures interconnect. In this work we present the first holistic survey of the agentic security landscape, structuring the field around the fundamental pillars of Applications, Threats and Defenses. We provide a comprehensive taxonomy of over 260 papers, explaining how agents are used in downstream cybersecurity applications, inherent threats to agentic systems, and countermeasures designed to protect them. In addition, we provide detailed pillar-specific and cross-cutting analyses that show the security-lifecycle coverage of agentic applications, comparison between red-teaming and blue-teaming agents, and the adversarial use of red-teaming applications. On the threat side, we analyze the entry points and agent-loop stages that attacks target, their specificity to the agentic setting, and the threat models they assume. On the defense side, we analyze the prevailing defense strategies, their cost and security trade-offs, and where in the agent lifecycle they are deployed. We further map which defenses cover which attack classes and chart trends in agent architecture, backbone model usage, data modality coverage, and the growth of attack and defense research over time. Taken together, these findings indicate that agentic systems are structurally fragile by default and that securing them will require defenses that span the full agent lifecycle rather than single-layer fixes.

10.
arXiv (CS.CL) 2026-06-15

Token-Level LLM Collaboration via FusionRoute

Large language models (LLMs) exhibit strengths across diverse domains. However, achieving strong performance across these domains with a single general-purpose model typically requires scaling to sizes that are prohibitively expensive to train and deploy. On the other hand, while smaller domain-specialized models are much more efficient, they struggle to generalize beyond their training distributions. To address this dilemma, we propose FusionRoute, a robust and effective token-level multi-LLM collaboration framework in which a lightweight router simultaneously (i) selects the most suitable expert at each decoding step and (ii) contributes a complementary logit that refines or corrects the selected expert's next-token distribution via logit addition. Unlike existing token-level collaboration methods that rely solely on fixed expert outputs, we provide a theoretical analysis showing that pure expert-only routing is fundamentally limited: unless strong global coverage assumptions hold, it cannot in general realize the optimal decoding policy. By augmenting expert selection with a trainable complementary generator, FusionRoute expands the effective policy class and enables recovery of optimal value functions under mild conditions. Empirically, across both Llama-3 and Gemma-2 families and diverse benchmarks spanning mathematical reasoning, code generation, and instruction following, FusionRoute outperforms both sequence- and token-level collaboration, model merging, and direct fine-tuning, while remaining competitive with domain experts on their respective tasks.

11.
arXiv (math.PR) 2026-06-18

The FBSDE approach to sine-Gordon up to $6\pi$

arXiv:2401.13648v3 Announce Type: replace-cross Abstract: We develop a stochastic analysis of the sine-Gordon Euclidean quantum field $(\cos (\beta \varphi))_2$ on the full space up to the second threshold, i.e. for $\beta^2 < 6 \pi$. The basis of our method is a forward-backward stochastic differential equation (FBSDE) for a decomposition $(X_t)_{t \geqslant 0}$ of the interacting Euclidean field $X_{\infty}$ along a scale parameter $t \geqslant 0$. This FBSDE describes the optimiser of the stochastic control representation of the Euclidean QFT introduced by Barashkov and one of the authors. We show that the FBSDE provides a description of the interacting field without cut-offs and that it can be used effectively to study the sine-Gordon measure to obtain results about large deviations, integrability, decay of correlations for local observables, singularity with respect to the free field, Osterwalder-Schrader axioms and other properties.

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

The Answer Lies Within: Self-Derived Rewards Enable Explainable Relation Extraction

Despite the remarkable reasoning capabilities of large language models, they still struggle with one-shot relation extraction without predefined relation labels. We identify two pitfalls: models are often misled by irrelevant tokens instead of relation-conveying semantics, and they often fail to align with the abstraction level human annotators expect. We introduce a novel framework that closes this gap with two components: (1) COGRE, a cognitively-inspired reasoning framework that structures RE into a series of processes mimicking human text-processing; and (2) HIT@DICT, a reinforcement learning intermediate reward strategy that encourages reasoning to align with relational labels by rewarding relation-relevant phrases in reasoning. The reward is derived on a credit dictionary automatically extracted from correct predictions. Our experiments show that our framework improves both accuracy and explanation quality by addressing these two pitfalls. For example, COGRE with Qwen2.5-14B-Instruct on One-shot NYT29 achieves 24.65% F1, surpassing prior reasoning-based designs. Optimizing this approach with RL using HIT@DICT further improves performance by +23.46% points. Finally, human evaluation shows that our best model generates relational phrases closely aligned with gold labels, increasing human explanation quality ratings by 54% (relative).

13.
arXiv (CS.LG) 2026-06-16

How Post-Training Shapes Biological Reasoning Models

arXiv:2606.16517v1 Announce Type: new Abstract: Scientific reasoning models for biology combine language models with foundation models trained on multimodal biological data, including DNA, RNA, and proteins. These models are built through post-training, yet how each stage shapes reasoning and generalization remains poorly understood. We study when post-training improves performance and when it induces over-specialization. Across genomics, transcriptomics, and proteins, we train and evaluate more than 100 biological reasoning models under controlled variation in backbone, continued pre-training (CPT), supervised fine-tuning (SFT), and reinforcement learning (RL), measuring both in-domain (ID) and out-of-domain (OOD) performance. We find that each post-training stage reshapes generalization in a distinct way rather than contributing uniform gains. CPT improves downstream performance by aligning models with biological language. SFT consistently increases ID performance but causes OOD performance to peak early and decline as models fit the training distribution. RL, when applied to strong SFT checkpoints with aligned rewards, improves OOD performance and partially recovers generalization. These results show that biological reasoning does not improve monotonically with additional supervision or compute. Instead, performance depends on how training stages are composed. Under fixed post-training budgets, the strongest ID-OOD trade-off comes from brief SFT, larger RL allocations, and asymmetric adaptation capacity across stages.

14.
arXiv (quant-ph) 2026-06-12

Coupling-Grouped XY-QAOA for Joint Anomaly-Feature Selection

Authors:

arXiv:2606.13244v1 Announce Type: new Abstract: Selecting anomalous samples and explanatory features under fixed budgets defines a coupled constrained-optimization problem. Sequential feature-first selection ranks features before choosing samples, which can overlook features whose utility depends on which samples are selected, especially when scores are calibrated from reference data that may be limited, noisy, or drifting. We instead formulate the task as joint sample-feature selection under the same fixed counts. In the analyzed formal model, calibration-error sensitivity grows linearly with the number of samples for feature-first ordering but stays constant for joint selection. We introduce Coupling-Grouped XY-QAOA, a constraint-preserving grouped-angle variant for the resulting optimization problem. On matched sparse IBM Heron R3 benchmarks, a hardware-aware implementation reduces circuit depth by 45.9%-61.3% and two-qubit gates by 2.6%-5.2% relative to Qiskit optimization level 3 on the CZ-basis target. It enables, to our knowledge, the largest reported width-depth configurations for constraint-preserving bipartite-selection QAOA hardware executions with feasible-sector retention: 64 qubits at p=2 and 36 qubits at p=3. The 20-qubit p=5 runs retain 63% valid samples. Across 36-64 qubits, fixed-angle runs yield lower-energy feasible samples than matched random-feasible sampling. Warm starts reduce the gap to strict-feasible classical references by 57.5%-80.5%, and near-budget repair matches the sparse classical reference at 36 qubits. Benchmarks show gains in balanced fixed-budget regimes, and noiseless simulations show that problem-structured angle grouping improves over same-depth XY-QAOA and matched-parameter, type-preserving randomization controls. Overall, the results support calibrated joint selection and hardware-realizable constrained-mixer execution in the tested regimes.

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

Non-Hermitian Crystalline Braid Topology from Hermitian Projection: A Zero-Mode Resonance Mechanism

arXiv:2606.06626v2 Announce Type: replace-cross Abstract: Non-Hermitian topological phases are typically engineered through gain and loss, nonreciprocity, or interaction with an environment. Here we show that they can instead emerge purely by projecting a fully Hermitian, topologically trivial parent lattice onto an embedded subsystem. The mechanism is general: when a zero mode of the eliminated degrees of freedom couples to the retained subsystem, the embedding self-energy develops a pole, the zero-frequency description becomes singular, and topology is carried by the finite-frequency projected Green's function. We realize the mechanism exactly in a trivial nearest-neighbor square lattice with an embedded one-dimensional zig-zag brane. In the periodic transverse geometry, the parity of the eliminated complement selects the outcome: even sectors reduce to a regular Schur complement and yield conventional SSH-type descendants, whereas odd sectors host a sublattice-imbalance zero mode and follow the resonant route. There, the complex bands braid through isolated finite-frequency exceptional points (EPs), while a parity symmetry inherited from the embedding, together with $\mathrm{TRS}^{\dagger}$, induces conjugated pseudo-Hermiticity and quantizes the complex Berry phase. The stable bulk invariant of the nondegenerate phases is this quantized complex Berry phase; adjacent sectors are separated by parity-paired exceptional points whose half-integer vorticities encode the local exchange of complex-energy strands.The absence of the non-Hermitian skin effect ensures that the invariant is defined directly on the ordinary Brillouin zone. A topolectrical implementation of the projected response predicts momentum-resolved transmission minima at the exceptional-point transition frequencies together with a characteristic low-frequency resonant admittance, providing an experimentally testable signature of the mechanism.

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

OBCache: Optimal Brain KV Cache Pruning for Efficient Long-Context LLM Inference

Large language models (LLMs) with extended context windows enable powerful applications but impose significant memory overhead, as caching all key-value (KV) states scales linearly with sequence length and batch size. Existing cache eviction methods address this by exploiting attention sparsity, yet they typically rank tokens heuristically using accumulated attention weights without considering their true impact on attention outputs. We propose Optimal Brain Cache (OBCache), a principled framework that formulates cache eviction as a layer-wise structured pruning problem. Building upon the Optimal Brain Damage (OBD) theory, OBCache quantifies token saliency by measuring the perturbation in attention outputs induced by pruning tokens, with closed-form scores derived for isolated keys, isolated values, and joint key-value pairs. Our scores account not only for attention weights but also for information from value states and attention outputs, thereby enhancing existing eviction strategies with output-aware signals. Experiments on LLaMA and Qwen models demonstrate that replacing the heuristic scores in existing works, which estimate token saliency across different query positions, with OBCache's output-aware scores consistently improves long-context accuracy. Code is available at https://github.com/DreamSoul-AI/OBCache.

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

Tensor-based second-order causal discovery

arXiv:2606.18074v1 Announce Type: cross Abstract: Causal discovery seeks to uncover the causal dependencies among variables. For this purpose, we propose an algorithm called Tensor-based Second-order Causal Discovery (TSCD). Its input is a tensor obtained from the covariance matrices of observational and interventional data. Assuming the causal dependencies follow a linear structural equation model on a directed acyclic graph (DAG), TSCD outputs the DAG and the functions on its edges, requiring only that the noise variables are uncorrelated. We also implement a version of the approach for nonlinear models. Our focus on second-order statistics (via the covariance matrices) is motivated by their statistical and computational efficiency relative to higher-order moments, their identifiability relative to first-order statistics, and that they work regardless of whether the variables are Gaussian. We show that TSCD has identifiable causal order and parameters from a number of interventions that is logarithmic in the number of variables. Experiments show that TSCD is robust to noise, competitive with existing methods, and scales to hundreds of variables.

18.
arXiv (quant-ph) 2026-06-11

A Cryogenic Uniaxial Strain Cell for Quantum Devices

arXiv:2606.11485v1 Announce Type: new Abstract: Mechanical strain is a powerful resource for tuning quantum systems, but existing piezoelectric strain cells are generally optimized for fragile, high-aspect-ratio single crystals rather than the thick, square-profile chips typical of semiconductor quantum devices. Furthermore, adapting these cells for qubits requires accommodating dense RF and DC wiring while maintaining strict electrical isolation from high-voltage piezo actuators. Here, we present a piezoelectric uniaxial strain cell designed to homogeneously strain thick, square-profile substrates. We introduce a highly symmetric dual-chip loading configuration that effectively suppresses flexural deformation and shear stress. The cell integrates a high-density RF/DC interposer to support standard wire bonding and encloses the actuators in a grounded Faraday cage to prevent unwanted Stark shifts in the device layer. Finite element simulations confirm that combining stiff actuators with this symmetric mounting drastically improves strain homogeneity. Finally, we validate the apparatus experimentally by applying uniaxial strain to a 200 $\mu$m thick silicon die. Surface strain measurements demonstrate an applied strain of 215 $\mu\epsilon$ for 200 V applied piezo bias.

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.
PLOS Medicine 2026-05-14

First-trimester nonsteroidal anti-inflammatory drugs exposure and risk of major congenital malformations: A retrospective register-based cohort study

by Ariel Avraham Hasidim, Itamar Ben Shitrit, Daphna Idan, Tal Michael, Amalia Levy, Gali Pariente, Eitan Lunenfeld, Sharon Daniel Background Pain and fever are common in early pregnancy, yet their management poses a major clinical dilemma. Although not confirmed, recent studies have raised safety concerns regarding acetaminophen. Evidence on the use of nonsteroidal anti-inflammatory drugs (NSAID) in the first trimester remains inconclusive. This uncertainty has left clinicians with limited evidence to guide treatment decisions. This study evaluated the association between first-trimester NSAID exposure and the risk of major congenital malformations (MCMs) in a large, population-based cohort of pregnancies. Methods and findings We conducted a population-based retrospective cohort study within the Southern Israeli Pregnancy Registry (siPREG) project, including all singleton pregnancies of women aged 15–45 years resulting in live births, stillbirths, or elective terminations for fetal malformations at a Soroka University Medical Center between 1998 and 2018. Pregnancies exposed to established teratogens, multiple gestations, and those with documented genetic or chromosomal anomalies were excluded. First-trimester NSAID exposure was defined by pharmacy dispensations (overall and by specific agents). MCMs were identified from linked clinical, hospitalization, and termination records through the first postnatal year.Propensity scores were estimated using covariates selected via a directed acyclic graph, including maternal age, ethnicity, diabetes, medical indication for NSAID use, exposure to other antipyretics, obesity, smoking, folic-acid use, gravidity, perinatal care, and year of pregnancy. Generalized full matching was used to balance covariates. Adjusted risk ratios were derived using weighted Poisson regression with G-computation, and two-way cluster-robust standard errors, jointly clustering by maternal identifier and matching subclass. Sensitivity analyses included a dose–response assessment across defined-daily-dose (DDD) categories and a tipping-point analysis evaluating the impact of potential misclassification from unrecorded over-the-counter NSAID use.A total of 264,858 singleton pregnancies were included in the final cohort; 20,202 (7.6%) were exposed to NSAID, most commonly ibuprofen (5.1%), diclofenac (1.6%), and naproxen (1.2%). NSAID exposure, in total and as individual agents, was not associated with MCMs overall (8.2% versus 7.0%; matched-adjusted-Relative Risk (aRR) = 0.99 (95% CI [0.90,1.10])) or with organ-system-specific MCMs, including cardiovascular (matched-aRR = 1.05 (95% CI [0.92,1.20]), musculoskeletal (matched-aRR = 1.03 (95% CI [0.77,1.39])), central nervous system (matched-aRR = 0.77 (95% CI [0.53,1.11])), cleft palate (matched-aRR = 0.95 (95% CI [0.47–1.91])), gastrointestinal (matched-aRR = 1.03 (95% CI [0.64–1.63])), and genitourinary (matched-aRR = 0.99 (95% CI [0.72,1.35])) malformations. Dose–response analyses showed no significant association with MCMs across cumulative NSAID exposure: short-term (1–7 DDD, matched-aRR = 1.06 (95% CI [0.97,1.15]), medium-term (8–21 DDD, matched-aRR = 1.10 (95% CI [0.99,1.22]), and long-term (>21 DDD, matched-aRR = 1.24 (95% CI [0.94,1.63])). The main limitation was the potential for minor exposure misclassification due to over-the-counter availability of ibuprofen, although sensitivity analyses simulating such misclassification suggested minimal impact on the risk estimates. Conclusion In this large, population-based cohort, we found no evidence supporting an association between first-trimester exposure to NSAID and MCMs, providing reassuring evidence regarding their fetal safety in early pregnancy.

21.
arXiv (CS.AI) 2026-06-16

RIDGECUT: Learning Graph Partitioning with Rings and Wedges

arXiv:2505.13986v4 Announce Type: replace-cross Abstract: Reinforcement learning (RL) has shown promise for combinatorial optimization problems on graphs by learning heuristics that generalize across instances. However, effectively incorporating domain knowledge into RL frameworks for graph partitioning remains challenging, as existing approaches typically rely on unconstrained node-level actions that lead to large action spaces and inefficient exploration. In this paper, we propose RidgeCut, an RL framework that constrains the action space to enforce structure-aware partitioning in the Normalized Cut problem. Using transportation networks as a motivating example, we introduce a novel concept that leverages domain knowledge about urban road topology – where natural partitions often take the form of concentric rings and radial wedges. By transforming the graph into linear or circular representations, our method enables the use of transformer-based policies and efficient learning via Proximal Policy Optimization. The resulting partitions from RidgeCut are not only aligned with expected spatial layouts but also achieve lower normalized cuts compared to existing methods. Experimental results on synthetic and real-world traffic graphs demonstrate that RidgeCut consistently outperforms existing methods while exhibiting strong inductive generalization across graph sizes. Although motivated by road networks, RidgeCut provides a general mechanism for embedding structural priors into RL frameworks for graph partitioning.

22.
arXiv (CS.CL) 2026-06-12

Unsafer in Many Turns: Benchmarking and Defending Multi-Turn Safety Risks in Tool-Using Agents

LLM-based agents are becoming increasingly capable, yet their safety lags behind. This creates a gap between what agents can do and should do. This gap widens as agents engage in multi-turn interactions and employ diverse tools, introducing new risks overlooked by existing benchmarks. To systematically scale safety testing into multi-turn, tool-realistic settings, we propose a principled taxonomy that transforms single-turn harmful tasks into multi-turn attack sequences. Using this taxonomy, we construct MT-AgentRisk (Multi-Turn Agent Risk Benchmark), the first benchmark to evaluate multi-turn tool-using agent safety. Our experiments reveal substantial safety degradation: the Attack Success Rate (ASR) increases by 16% on average across open and closed models in multi-turn settings. To close this gap, we propose ToolShield, a training-free, tool-agnostic, self-exploration defense: when encountering a new tool, the agent autonomously generates test cases, executes them to observe downstream effects, and distills safety experiences for deployment. Experiments show that ToolShield effectively reduces ASR by 30% on average in multi-turn interactions. Our code is available at https://github.com/CHATS-lab/ToolShield.

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

Space Is Intelligence: Neural Semigroup Superposition for Riemannian Metric Generation

Authors:

arXiv:2606.18828v1 Announce Type: cross Abstract: Traditional approaches place intelligence in the agent, whether as a learned policy or a search procedure. We instead place intelligence in the space itself: a scene induces a Riemannian metric on the configuration manifold, and action reduces to following the geodesics of that metric rather than invoking a separate planner or collision checker. A single Encoder-Router network realizes this idea through three complementary parameter groups – frame parameters that orient the generators, modulation parameters that govern their spatial propagation, and basic coefficients that determine their strength. These groups combine through a shared semigroup-superposition mechanism to produce a single Riemannian metric field, yielding a compact architecture whose geometry scales naturally with scene complexity. Trained on a single two-obstacle scene, the model demonstrates robust zero-shot generalization across unseen obstacle configurations, with orders-of-magnitude separation between collision-free and obstacle-penetrating path costs.

24.
arXiv (CS.AI) 2026-06-15

Efficient Temporal Modeling for Mobile Sleep Staging via Lightweight Random Attention

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

25.
arXiv (CS.LG) 2026-06-12

An Empirical Study on Predictive Maintenance for Component X in Heavy-Duty Scania Trucks

arXiv:2606.12486v1 Announce Type: new Abstract: Condition-based Predictive Maintenance (PdM) for truck fleets has gained momentum in recent years. This maintenance strategy aims to minimize unplanned downtimes and reduce costs by monitoring the health status of vehicles and taking proactive action based on their condition. However, the implementation of condition-based PdM systems is challenging due to the large volume of data generated by the trucks, the inherent complexity of detecting failures through sensor data and the difficulties in finding cost-effective trade-offs in the solution's implementation. In this paper, we define and validate a condition-based PdM methodology built on the assumption that the wear-and-tear state of the monitored component can be represented as a monotonically non-decreasing time series. It involves selecting only the most recent observations from the time series and transforming them into a tabular format for classification using machine learning (ML) models designed for tabular data. Our results indicate that the proposed methodology reduces costs on the Scania Component X dataset compared to current state-of-the-art (SOTA) approaches, while also simplifying the modeling process through AutoML.