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01.
arXiv (math.PR) 2026-06-12

Sub-Riemannian spectral distance

arXiv:2606.12804v1 Announce Type: cross Abstract: We study eigenvalues and eigenfunctions of the ``div-grad type" sub-Laplacian with respect to Popp's volume on a compact equiregular sub-Riemannian manifold $M$. Since Popp's volume is canonically determined by the sub-Riemannian structure of $M$, the spetra of the sub-Laplacian carry geometric meanings. In this paper, we first embed $M$ into the Hilbert space of square-summable sequences using eigenfunctions and then define a spectral distance between two compact equiregular sub-Riemannian manifolds. Our result is a sub-Riemannian analogue of Berard-Besson-Gallot's classical work in the Riemannian case.

02.
arXiv (CS.CV) 2026-06-12

Mana: Dexterous Manipulation of Articulated Tools

Articulated tool manipulation remains a major challenge in dexterous robotics due to the need to coordinate internal degrees of freedom and contact-rich interactions. While prior work has largely focused on rigid objects, articulated tool use remains underexplored because of its physical complexity and the difficulty of learning functional grasping and manipulation policies. We present Mana (Manipulation Animator), a general sim-to-real framework that reinterprets dexterous manipulation as an animation problem. Inspired by computer animation, Mana employs a coarse-to-fine pipeline that transforms procedurally-generated grasp keyframes into manipulation trajectories through motion planning and reinforcement learning. The data generation process is largely automatic, requiring only a few mouse clicks to specify functional affordances (

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

The Data Manifold under the Microscope

arXiv:2606.15760v1 Announce Type: new Abstract: A significant gap exists between theory and practice in deep learning. Generalization and approximation error bounds are often derived for simplified models or are too loose to be informative. Many rely on the manifold hypothesis and on geometric regularity such as intrinsic dimension, curvature, and reach. Progress requires insight into data-manifold geometry and suitable benchmarks, yet existing options are polarized: analytic manifolds with known geometry but limited applicability, or real-world datasets where geometry is only coarsely estimable. We introduce a benchmarking framework for studying data geometry. We repurpose and extend dSprites and COIL-20 with additional transformation dimensions and dense, axis-aligned sampling, and pair them with finite-difference estimators that recover curvature, reach, and volume at near-ground-truth accuracy in a regime where general-purpose estimators are unreliable or difficult to deploy. The framework is intended as a controlled testbed, useful as a calibration environment for geometric estimators and a sandbox for probing theoretical assumptions. To illustrate its use, we present two application studies, namely assessing the scaling behavior of the bounds of Genovese et al. and Fefferman et al., and tracking the layer-wise geometry of a $\beta$-VAE, highlighting the behavior of current bounds and the value of controlled benchmarks for guiding and validating future theory. A reference implementation is available at https://github.com/koulakis/manifold-microscope.

04.
arXiv (CS.LG) 2026-06-15

Arbitrary control over multimode wave propagation for machine learning

arXiv:2402.17750v2 Announce Type: replace-cross Abstract: Controlled multimode wave propagation can enable more space-efficient photonic processors than architectures based on discrete components connected by single-mode waveguides. Instead of defining discrete elements, one can sculpt the continuous substrate of a photonic processor to perform computations through multimode interference in two dimensions. Here we designed and demonstrated a device with a refractive index that can be rapidly reprogrammed across space, allowing arbitrary control of wave propagation. The device, a two-dimensional programmable waveguide, uses parallel electro-optic modulation of the refractive index of a slab waveguide with about $10^4$ programmable spatial degrees of freedom. We implemented neural network inference on benchmark tasks with up to $49$-dimensional vectors in a single pass, without digital pre-processing or post-processing. Theoretical and numerical analyses further indicated that two-dimensional programmable waveguides may offer not only a constant-factor reduction in device area but also a scaling benefit, with the area required growing as $N^{1.5}$ rather than $N^2$.

05.
arXiv (quant-ph) 2026-06-24

Linear optical Bell state measurement for rotation-symmetric cat codes

arXiv:2606.22832v2 Announce Type: replace Abstract: Rotation-symmetric cat (RS-cat) codes are a bosonic-code platform for quantum information processing, combining finite-energy realizability with robustness against photon loss through their discrete rotational symmetry. For applications in long-distance quantum communication and fusion-based quantum computation (FBQC), efficient Bell state measurement (BSM) is a key primitive. In this work, we consider a BSM protocol for RS-cat codes using only a half beam splitter (HBS) and photon-number-resolving detectors (PNRDs). By exploiting the characteristic photon-number structure induced by the discrete rotational symmetry of RS-cat codes, our protocol extracts both photon-number modulo and phase information for Bell-state discrimination. We show that, under ideal loss-free conditions, the proposed BSM protocol becomes deterministic for arbitrary symmetry order $N$ for sufficiently large amplitudes $\alpha$. We further numerically evaluate the success probability under photon loss and identify the loss regime in which higher-order RS-cat codes provide an advantage. Finally, we show that post-selection can enhance the success probability.

06.
medRxiv (Medicine) 2026-06-22

Generative Artificial Intelligence in Psychotherapy Practice: A Global Online Survey of Mental Health Professionals' Adoption

Background: Generative artificial intelligence (GenAI) tools, including large language model (LLM)-based platforms such as ChatGPT, Google Gemini, and Microsoft Copilot, are being adopted across healthcare settings with increasing speed. Despite the increasing popularity of GenAI, empirical data on the extent and nature of adoption by mental health clinicians in routine psychotherapy practice globally remain scarce. Objective: This study aimed to characterize current use patterns of GenAI tools among a global sample of practicing mental health professionals, including prevalence of use, specific tools employed, clinical and administrative purposes served, perceived effect on workload, and the institutional context shaping adoption (e.g., encouragement, prohibition, and training). Methods: We administered a cross-sectional online survey to a global convenience sample of licensed mental health professionals who provide psychotherapy as part of the scope of their practice (i.e., psychotherapists, psychologists, counsellors, nurses, and psychiatrists). Participants were recruited via professional networks, purposely avoiding the use of social media platforms. Within the survey, we captured GenAI use behaviors in psychotherapy contexts, and demographic and professional background data. Descriptive statistics were analyzed for all variables. Multivariate logistic regression was used to examine demographic and professional predictors of GenAI use. Results: A total of 766 mental health professionals who provide psychotherapy from 30 countries completed the survey. Of these, 54.6% (n=418) reported having purposely used at least one GenAI tool in psychotherapy clinical practice. ChatGPT was the most frequently used tool (354/418, 84.7%). The most commonly reported clinical purpose was assisting with treatment planning (175/418, 41.9%), followed by managing administrative tasks (173/418, 41.4%) and generating psychoeducational materials for clients (166/418, 39.7%). 82.8% of AI users reported that these tools reduced their overall work burden. Only 18.1% (139/766) of respondents reported institutional encouragement to use AI tools, while 81.1% (621/766) reported not having received any professional training on AI use. Predictors of AI adoption included younger age and rural practice setting. Conclusions: In this global convenience sample survey, GenAI use among mental health professionals in psychotherapy settings is widespread, concentrated in a wide variety of clinical and administrative tasks. Formal training and institutional guidance substantially lag behind current adoption patterns. These findings highlight an urgent need for evidence-based competency frameworks, regulatory clarity, and professional education to support safe and ethically informed integration of AI into clinical mental health practice.

07.
Nature (Science) 2026-06-09

People are turning to AI chatbots to plug gaps in health information

A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies. A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies.

08.
arXiv (CS.AI) 2026-06-24

Real-Time Interactive Music Generation via Data-Free Streaming Consistency Distillation

arXiv:2606.24307v1 Announce Type: cross Abstract: Interactive music and live performance relies on real-time human expression, but modern generative music AI remains largely absent from this domain due to its prohibitive inference latency and offline rendering paradigm. To provide pioneer musicians with a novel medium for interactive composition, we should fundamentally change these static models into dynamic, playable instruments. In this paper, we propose a framework that bridges this gap. To achieve the low latency required for live interaction without sacrificing structural coherence, we formulate distillation within a streaming autoregressive latent space. Our approach gets rid of the need for expensive paired audio-latent datasets by utilizing prompt-only inputs to synthesize teacher-guided, chunk-wise trajectories on the fly. Because live instruments require high acoustic fidelity, we introduce music-aware consistency objectives, which combine latent, spectral, and temporal-difference losses, to preserve crucial qualities like timbre, transients, and rhythmic stability during accelerated single-step streaming generation. Implemented via parameter-efficient adaptation, our distillation reduces generation steps to achieve a low real-time factor. Crucially, by operating as a continuous autoregressive stream, the system can seamlessly assimilate dynamic human inputs on the fly, allowing users to instantly steer the musical trajectory without interrupting the audio flow. Ultimately, this work recontextualizes generative text-to-music models not as passive prompt-and-wait systems, but as responsive instruments, opening new frontiers for live human-AI musical co-creation.

09.
arXiv (CS.LG) 2026-06-15

Neural Variability Enhances Artificial Network Robustness

arXiv:2606.13801v1 Announce Type: new Abstract: Neural responses in cortex exhibit substantial trial-to-trial variability in response to repeated stimuli, while peripheral sensory neurons respond far more consistently, leading many to wonder whether stochasticity may carry meaning. Existing work has argued that noise and signal correlations may be optimized for discrimination in animals, whereas artificial neural network (ANN) studies have shown similar benefits of noise in machine learning tasks, although most ANN work has neglected the effects of correlations. Here we investigate whether correlated noise improves the robustness of artificial neural networks to adversarial attacks and naturalistic image modifications. Using the covariance of activations under modified versus clean inputs, we find that structured noise may significantly improve network robustness. Robustness to naturalistic image modifications benefits most from structure, but this structure transfers poorly across modification types. In contrast, noise structure from adversarial attacks can generalize to other kinds of attacks. These results suggest that structured noise in ANN activations generally improves robustness, establishing a biologically plausible strategy for creating robust artificial neural networks that only relies on local information.

10.
arXiv (CS.LG) 2026-06-11

Weighted Random Dot Product Graphs

arXiv:2505.03649v4 Announce Type: replace-cross Abstract: Modeling of intricate relational patterns has become a cornerstone of contemporary statistical research and related data science fields. Networks, represented as graphs, offer a natural framework for this analysis. This paper extends the Random Dot Product Graph (RDPG) model to accommodate weighted graphs, markedly broadening the model's scope to scenarios where edges exhibit heterogeneous weight distributions. We propose a nonparametric weighted (W)RDPG model that assigns a sequence of latent positions to each node. Inner products of these nodal vectors specify the moments of their incident edge weights' distribution via moment-generating functions. In this way, and unlike prior art, the WRDPG can discriminate between weight distributions that share the same mean but differ in other higher-order moments. We derive statistical guarantees for an estimator of the nodal's latent positions adapted from the workhorse adjacency spectral embedding, establishing its consistency and asymptotic normality. We also contribute a generative framework that enables sampling of graphs that adhere to a (prescribed or data-fitted) WRDPG, facilitating, e.g., the analysis and testing of observed graph metrics using judicious reference distributions. The paper is organized to formalize the model's definition, the estimation (or nodal embedding) process and its guarantees, as well as the methodologies for generating weighted graphs, all complemented by illustrative and reproducible examples showcasing the WRDPG's effectiveness in various network analytic applications.

11.
arXiv (quant-ph) 2026-06-17

Coherent Dark State Formation of a Lead-Vacancy Spin Qubit in Diamond

arXiv:2605.27841v2 Announce Type: replace Abstract: A lead-vacancy (PbV) center in diamond exhibits coherent emission above the liquid helium temperature, making it highly attractive for quantum network applications. Here, we report the magneto-optical and spin properties of PbV centers in diamond. We record a spin lifetime of 12 ms at 7.5 K under large off-axis magnetic field. Furthermore, we observe formation of the coherent dark state by coherent population trapping and estimate a spin dephasing time of 177 ns at 6.5 K. This work demonstrates the outstanding thermal robustness of the PbV spin compared to other group-IV centers above 4 K.

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

Rotation-Invariant Spherical Watermarking via Third-Order SO(3) Representation Coupling

Reliable watermarking of panoramic imagery is fundamentally challenged by arbitrary 3D rotations. As panoramas are defined on the sphere, they naturally transform under the action of $SO(3)$, rendering conventional planar representations and augmentation-based robustness strategies inadequate and devoid of theoretical guarantees. To address this, we formulate panoramas as spherical signals and leverage $SO(3)$ representation theory to derive provably rotation-invariant descriptors. While spherical harmonic coefficients transform equivariantly under rotations, the natural invariant constructions are typically limited to zeroth-order statistics which eliminate directional information and severely constrain embedding capacity. In this work, we introduce a principled third-order invariant construction by coupling higher-order $SO(3)$ irreducible representations via tensor products and projecting onto the trivial representation. This yields a spherical invariant bispectrum that preserves phase information while remaining strictly rotation-invariant. Leveraging this property, we embed watermarks into higher-order spherical harmonic coefficients and recover them from invariant bispectral scalars, enabling reliable extraction under arbitrary 3D rotations. We provide a theoretical proof of $SO(3)$ invariance for it and demonstrate experimentally its near-perfect robustness to continuous rotations while maintaining high visual fidelity.

13.
arXiv (CS.LG) 2026-06-18

Learning from Your Own Mistakes: Constructing Learnable Micro-Reflective Trajectories for Self-Distillation

arXiv:2606.18844v1 Announce Type: new Abstract: Self-distillation improves reasoning in large language models by using the model's own rollouts as training signal, typically through implicit logit-level alignment that minimizes KL divergence toward a privileged target distribution. However, because this supervision is generated via uncontrolled sampling, it provides no diagnostic insight into the model's specific errors or corrective guidance for its individual failure patterns. Consequently, the model learns to imitate a privileged distribution rather than receiving fine-grained corrections that pinpoint where and why its reasoning fails. In this paper, we propose Trajectory-Augmented Policy Optimization (TAPO), which advances self-distillation from implicit distributional alignment to explicit trajectory construction. During RL training, the model produces both correct and incorrect rollouts to the same query, and TAPO leverages this contrastive structure to construct micro-reflective corrections, new training trajectories that retain the model's erroneous reasoning up to the point of failure, then insert a natural-language diagnosis and corrected reasoning guided by a correct reference from the same sampling group. Since each trajectory is anchored in the learner's own prefix and solutions, the corrective signal preserves the model's on-policy distribution to a greater extent than the position-wise alignment imposed by KL-based methods. To integrate these trajectories, TAPO introduces difficulty-aware candidate selection at the model's capability boundary and decoupled advantage estimation to prevent gradient contamination. Experiments on AIME 2024, AIME 2025, and HMMT 2025 show that TAPO achieves consistent improvements over GRPO under the same number of training steps. Further analysis demonstrates that TAPO strengthens both first-pass reasoning and error-correction effectiveness.

14.
arXiv (CS.LG) 2026-06-12

Metriplectic Conditional Flow Matching for Dissipative Dynamics

arXiv:2509.19526v2 Announce Type: replace Abstract: Metriplectic conditional flow matching (MCFM) learns dissipative dynamics without violating first principles. Neural surrogates often inject energy and destabilize long-horizon rollouts; MCFM instead builds the conservative-dissipative split into both the vector field and a structure preserving sampler. MCFM trains via conditional flow matching on short transitions, avoiding long rollout adjoints. In inference, a Strang-prox scheme alternates a symplectic update with a proximal metric step, ensuring discrete energy decay; an optional projection enforces strict decay when a trusted energy is available. We provide continuous and discrete time guarantees linking this parameterization and sampler to conservation, monotonic dissipation, and stable rollouts. On a controlled mechanical benchmark, MCFM yields phase portraits closer to ground truth and markedly fewer energy-increase and positive energy rate events than an equally expressive unconstrained neural flow, while matching terminal distributional fit.

15.
arXiv (CS.CL) 2026-06-18

Continual Adaptation for Pacific Indigenous Speech Recognition

Speech foundation models struggle with low-resource Pacific Indigenous languages because of severe data scarcity. Furthermore, full fine-tuning risks catastrophic forgetting. To address this gap, we present an empirical study adapting models to real-world Pacific datasets. We investigate the impact of data volume, adaptation strategies, and representational drift on speech foundation models for various Pacific languages. Additionally, we analyze a continual learning framework for sequential language acquisition. Empirical results across three distinct Pacific Indigenous languages demonstrate that adapting to these linguistically distant languages induces severe internal representational drift. Consequently, these models face a strict plasticity and stability dilemma. While LoRA adapts well initially, it suffers from catastrophic forgetting during sequential learning. Ultimately, this study highlights the urgent need for robust adaptation strategies tailored to underrepresented languages.

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

Two-Electron Effects Extend High-Harmonic Generation into the keV Regime

arXiv:2606.24765v1 Announce Type: cross Abstract: Two-electron processes can generate high harmonics beyond the conventional single-active-electron cutoff. Motivated by recent experimental evidence of an extended secondary plateau in the helium high-harmonic spectrum [S. Wang et al, Optica, (2023); S. Wang et al, In Print in Nature Photon., (2026)], we present a two-electron generalisation of the strong-field approximation. We analyse the resulting expressions using the saddle-point method and determine the extended cutoff. We find good agreement with classical predictions of cutoff scalings of $4.7$ and $5.5$ times the ponderomotive energy, which significantly exceed the established single-electron scaling of 3.17. We calculate high-harmonic spectra generated via a two-electron process in helium atoms driven by an intense few-cycle infrared laser pulse. Our results demonstrate that the harmonic spectrum extends far beyond the water window, reaching photon energies up to $\approx 1.2\,\mathrm{keV}$ in the soft x-ray region. The large spectral bandwidth can support the generation of sub-attosecond soft x-ray pulses, which are of particular interest for probing ultrafast dynamics across matter, including applications in core-level spectroscopy and biological imaging.

17.
medRxiv (Medicine) 2026-06-22

Integration of lung tissue proteomics and genome-wide association data to identify lung cancer susceptibility proteins and potential drug targets

Background: Proteins directly impact disease development and act as drug targets. Therefore, we integrated genomic and lung tissue proteomics data to identify lung cancer susceptibility proteins, elucidating genetic mechanisms and candidate drug targets. Method: We profiled the proteome and genome in non-neoplastic lung tissue from 200 lung cancer patients. Using this data, we constructed genetic models to predict abundance across the proteome in lung tissue. We applied these models to genome-wide association study (GWAS) data from 55,174 lung cancer cases and 1,294,174 controls to evaluate their associations with the risk of lung cancer, overall and by major histological subtypes. Bayesian colocalization and Mendelian randomization (MR) analyses were used to prioritize putative causal proteins, which were cross-referenced with three main drug-protein databases to identify potential therapeutic targets. Results: We identified 29 proteins associated with lung cancer risk at a false discovery rate < 5%, including 25 for overall lung cancer, two (AQP3 and IL18) specifically for adenocarcinoma, and another two (HMGN2 and HLA-DMB) for squamous cell carcinoma. Of them, genes encoding 17 proteins reside at least 2Mb away from any known GWAS risk loci, including 14 for overall lung cancer (HYI, GPX1, GMPPB, DSP, HDDC2, MTCH2, SUOX, JMJD7, PDIA3, IL16, IQGAP1, SULT1A2, ARHGAP27, and TYMP) and three for subtypes (AQP3, IL18, and HMGN2). Among the 12 proteins located within the known risk loci, EPHX2, CLDN18, PSMD5, and CYP2S1 proteins showed an association independent of the proximal GWAS-identified lead variant. Colocalization and/or MR analysis suggested 11 potential causal proteins. Five of these candidate causal proteins (DSP, CLDN18, IQGAP1, IL18 and TYMP) are targeted by nine drugs already approved by the FDA or in phase III trials. Conclusion: Our study identified novel lung cancer susceptibility proteins and potential drug targets, offering valuable insights into lung cancer biology and future translational utilities.

18.
arXiv (CS.LG) 2026-06-12

Attacking the First-Principle: A Black-Box, Query-Free Targeted Mimicry Attack on Binary Function Classifiers

arXiv:2605.18231v2 Announce Type: replace Abstract: Binary function classifiers play a crucial role in maintaining the security and integrity of software systems by detecting malicious code and unauthorized modifications. However, machine learning-based classifiers are vulnerable to adversarial attacks that can evade detection. In this study, we present Kelpie, a novel framework for executing mimicry attacks, a stronger type of targeted evasion attacks, on binary function classifiers in a black-box, zero-query setting. Unlike previous approaches that rely on querying the target classifier to refine untargeted evasion attacks, Kelpie leverages code transformations that preserve the functionality of malicious payloads while causing them to be misclassified as we want. Through extensive experimentation, we demonstrate that Kelpie can successfully execute mimicry attacks against six state-of-the-art binary function classifiers representing different model architectures without requiring direct interaction with them. We further validate our approach with a practical demonstration, involving a keylogger and a wiper concealed within benign-looking functions embedded in an application. This work, to our best knowledge, is the first to demonstrate such a mimicry attack in a black-box, zero-query context, raising important questions about the reliability and security of existing machine learning-based binary function classifiers.

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

RSRCC: A Remote Sensing Regional Change Comprehension Benchmark Constructed via Retrieval-Augmented Best-of-N Ranking

Traditional change detection identifies where changes occur, but does not explain what changed in natural language. Existing remote sensing change captioning datasets typically describe overall image-level differences, leaving fine-grained localized semantic reasoning largely unexplored. To close this gap, we present RSRCC, a new benchmark for remote sensing change question-answering containing 126k questions, split into 87k training, 17.1k validation, and 22k test instances. Unlike prior datasets, RSRCC is built around localized, change-specific questions that require reasoning about a particular semantic change. To the best of our knowledge, this is the first remote sensing change question-answering benchmark designed explicitly for such fine-grained reasoning-based supervision. To construct RSRCC, we introduce a hierarchical semi-supervised curation pipeline that uses Best-of-N ranking as a critical final ambiguity-resolution stage. First, candidate change regions are extracted from semantic segmentation masks, then initially screened using an image-text embedding model, and finally validated through retrieval-augmented vision-language curation with Best-of-N ranking. This process enables scalable filtering of noisy and ambiguous candidates while preserving semantically meaningful changes. The dataset is available at https://huggingface.co/datasets/google/RSRCC.

20.
arXiv (CS.AI) 2026-06-15

When Sample Selection Bias Precipitates Model Collapse

arXiv:2606.13732v1 Announce Type: new Abstract: The proliferation of recursive training on synthetic data can alleviate data scarcity but risks model collapse, where repeated training erodes distributional tails and homogenizes outputs. Data selection is widely viewed as a remedy, yet its reliability depends critically on the reference distribution used by the verifier. We show that in low-resource verification regimes, where each verifier observes only a small, fragmented, and biased slice of the target manifold, selection itself becomes biased. This situation naturally arises in low-resource data silos such as healthcare consortia or proprietary financial institutions, where raw data cannot be pooled and local references are inherently incomplete. As a result, selection preferentially retains samples aligned with the local manifold while pruning globally relevant tail modes, turning from a safeguard against collapse into a mechanism that precipitates it. We theoretically prove that such siloed selection accelerates collapse and induces power-law diversity decay. As an initial mitigation, we construct Wasserstein proxy references from multiple silos without sharing raw data. Empirical results confirm that local-reference selection fails on skewed distributions, whereas collaborative proxy references mitigate diversity degradation, suggesting that recursive synthetic-data pipelines require particular caution when real-data coverage is fragmented or scarce.

21.
medRxiv (Medicine) 2026-06-15

Sociodemographic Disparities in Tafamidis Initiation and Clinical Outcomes in ATTR-CM Across the United States

BACKGROUND Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease. Sociodemographic factors may influence time to treatment initiation and resulting clinical outcomes, yet these relationships are poorly characterized. OBJECTIVE Assess the effects of sex and race on tafamidis initiation and subsequent outcomes and their interaction with factors such as ATTR-CM type and social deprivation measures. METHODS A retrospective cohort analysis was conducted using the US Komodo Healthcare Map (01/2016-06/2024) among patients with amyloidosis, identified by ICD-10-CM diagnosis codes. Cumulative incidence of treatment initiation and survival probabilities for cardiovascular-related hospitalization (CVH) or death were estimated by Kaplan-Meier, stratified by sex and race. Cox proportional hazards models were fitted for both endpoints to estimate hazard ratios, adjusting for demographics and clinical characteristics. RESULTS Of 11,311 patients identified, White and Black patients (n=9,223) were included in subsequent analyses. Within 12 months of diagnosis, White women had the lowest cumulative incidence of tafamidis initiation (11.4%), followed by Black women (22.0%), Black men (26.7%), and White men (31.0%). Event-free survival at 12 months was lowest in Black women (42.9%), followed by Black men (46.8%), White women (48.6%), and White men (54.4%). Median (95% CI) time to CVH or death was shortest for Black women (8.0 months [6.8-10.0]) followed by Black men (9.9 months [8.8-12.0]), White women (11.0 months [9.6-13.0]), and White men (15.0 months [14.0-16.0]). CONCLUSIONS In this large, real-world cohort of US patients with ATTR-CM, sex and race contributed to disparities in tafamidis initiation and survival, underscoring compounded disparities in both access and outcomes.

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

Beyond LoRA: Is Sparsity-Induced Adaptation Better?

arXiv:2606.13767v1 Announce Type: cross Abstract: Low-rank adaptation (LoRA) and its variants provide a memory- and compute-efficient alternative to full fine-tuning of pre-trained models. However, questions remain about the comparative generalizability of these approaches and how the structural restrictions on low-rank updates preserve effective adaptation performance. We present a historical framing, covering the past (full fine-tuning and original LoRA), the present (different variants of LoRA), and propose simpler, cheaper, parameter-efficient extensions by inducing sparsity within existing LoRA variants: Cheap LoRA (cLA), training a single low-rank factor with the other fixed (deterministically or, in its randomized variant, stochastically), and the chained circulant variant, ${c}^3$LA. We frame cLA as a structured instance of asymmetric LoRA, serving as a controlled column-subspace restriction of full fine-tuning. We derive information-theoretic generalization error bounds for these variants, marking one of the first endeavors in this area. Empirically, we evaluate 11 fine-tuning methods across 10 pre-trained models and 14 datasets, analyzing the fine-tuned models' performance and generalization using tools such as loss landscapes and spectral analysis. Despite the sensitivity of fine-tuned models to the pre-trained model, datasets, and other factors, our study suggests that restricting LoRA-based PEFT methods' adaptation to a sparse, structured column space remains competitive across tasks with their parameter-matched baselines while reducing up to 10% training time and peak GPU memory up to 15%, even with a naïve, non-optimized, sparse implementation. Our theoretical and empirical generalization measures provide a more consistent and principled approach to their cost-effective adaptation than commonly used analytical tools. Overview and code are available at: https://elicaden.github.io/Beyond_LoRA/.

23.
Nature Medicine 2026-06-11

Clinical Profile and Genomic Characterization of the 2026 Bundibugyo Virus Index Case in Uganda

Bundibugyo virus disease (BVD) remains a high-consequence threat in Eastern and Central Africa, where cross-border mobility, nonspecific early symptoms, and delayed recognition can obscure transmission. In this case report, we describe Uganda’s 2026 BVD index case: a male patient who traveled from the Democratic Republic of the Congo to Uganda and was admitted to a private hospital in Kampala on 11 May 2026 after more than two weeks of vomiting and diarrhea, with epigastric pain, weakness, and hiccups. He deteriorated rapidly, developing acute kidney injury, pulmonary edema, hepatic dysfunction, hypoxemia, delirium, atrial flutter, possible disseminated intravascular coagulation, and multiorgan failure, and died on 14 May. A posthumous EDTA whole-blood specimen tested at the Central Emergency Response and Surveillance Laboratory was positive for orthoebolavirus RNA and confirmed as Bundibugyo virus (BDBV) by RT-qPCR. Sequencing achieved 99% genome coverage at ≥100× depth. The 2026 BDBV genome formed a distinct lineage approximately equidistant from the 2007–2008 Butalya and 2012 Isiro variants, differing by 216–227 nucleotides (~1.2% sequence divergence). Here, we demonstrate the value of fatality surveillance, private-sector surveillance, diagnostic optimization through national specimen referral, and rapid molecular-genomic diagnostics for early detection, transmission chain interruption, and public health response coordination.

24.
arXiv (CS.AI) 2026-06-17

CausalT5k: Diagnosing Refusal and Failure Modes in Trustworthy Causal Reasoning Across Causal Rungs

arXiv:2602.08939v2 Announce Type: replace Abstract: Large language models increasingly produce fluent causal explanations, yet they often fail in ways aggregate accuracy cannot diagnose: confusing association with intervention, abandoning correct judgments under pressure, over-refusing valid claims, or answering when evidence is underdetermined. We introduce CTK, a diagnostic benchmark of 5,147 cases and growing, across 10 domains and all three levels of Pearl's Ladder of Causation. Unlike benchmarks that only score correctness, CTK reveals why a model failed by annotating causal rung, trap type, pressure sensitivity, refusal quality, and Utility-Safety tradeoffs. Its Sheep/Wolf taxonomy separates valid causal designs from inferential traps; paired neutral/pressure variants measure sycophantic drift through Bad Flip Rate; and Wise Refusal fields test whether a model identifies the missing information needed before endorsing a claim. CTK exposes failure modes hidden by aggregate accuracy: the Skepticism Trap, Rung Collapse under scaling, pressure-induced drift, Detection-Correction gaps, and counterfactual error modes. Rather than prescribing a correction method, it provides the diagnostic substrate for studying causal-reasoning failure profiles.

25.
arXiv (CS.AI) 2026-06-18

Forecasting what Matters: Decision-Focused RL for Controlled EV Charging with Unknown Departure Times

arXiv:2606.19199v1 Announce Type: cross Abstract: The recent growth of EV adoption poses challenges for power systems, including increased peak demand and potential grid instability. Smart control of EV charging – e.g., based on reinforcement learning (RL) – can alleviate these issues by learning temporal and contextual patterns from historical data. Yet, in real-world scenarios, key features, such as departure time, often are unavailable. This, in turn, makes it harder for an RL agent to learn and execute an effective charging policy. To mitigate this uncertainty, a trained forecaster can approximate the unknown features from available data. However, since these forecasting models are typically trained for accuracy (rather than their impact on a downstream agent's decision quality), their errors may propagate and hinder the overall performance of a controller that is using the forecasts. To avoid this, we propose a decision-focused RL (DF-RL) framework in which the forecaster is trained end-to-end, i.e., with feedback from the charging policy actions taken by the RL agent. Such joint training of both the forecaster and controller ultimately results in higher-quality actions: our proposed DF-RL method yields superior charging decisions compared to other baselines, achieving up to a 14% improvement in total reward and a 55% reduction of unsupplied energy (i.e., charging that failed to happen because the EV already left), relative to the RL method without departure time forecasting.