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01.
arXiv (CS.AI) 2026-06-24

Page image classifier fine-tuned on century-spanning archives of scanned documents for further content-specific processing

arXiv:2606.07558v2 Announce Type: replace-cross Abstract: Purpose: Digitization projects in the humanities produce vast, heterogeneous archives of historical documents, making manual sorting impractical at scale. This work addresses the need for an automated system to classify scanned page images based on visual content type - text, tables, and graphics - enabling content-specific downstream processing such as Optical Character Recognition (OCR) or structured data extraction. Methods: An image classification system was developed and evaluated on a dataset of over 48,000 annotated historical page images from century-old Czech archaeological archives, refined through four successive annotation stages with domain-expert review. A Random Forest Classifier baseline was established using hand-crafted image features. Subsequently, deep learning architectures were fine-tuned and compared: Convolutional Neural Networks (EfficientNetV2, RegNetY), Vision and Document Image Transformers (ViT, DiT), and multimodal CLIP models. An 11-category label scheme was designed collaboratively with domain experts and evaluated via five-fold cross-validation. Results: The feature-based baseline achieved approximately 75% accuracy. Fine-tuned CNNs and Transformers substantially outperformed it, with RegNetY-16GF achieving 99.16% and ViT-large 99.12% Top-1 accuracy on the held-out test set. CLIP ViT-B/16 reached 99.14% with optimized text descriptions. Conclusion: Image-only models, particularly RegNetY-16GF, deliver near-perfect classification accuracy and produce consistent labels across 649,508 unlabeled archival pages with over 90% inter-model agreement. Fine-tuned CLIP, despite competitive test-set accuracy, showed under 65% agreement with image-only models on unlabeled data, making it less suitable for deployment. The final models, annotated dataset, and software are publicly available under open-source licenses.

02.
medRxiv (Medicine) 2026-06-12

Metastatic Patterns and Treatment Characteristics of Triple-Negative Breast Cancer in Nigeria: A Retrospective Cohort Study

Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype characterized by the absence of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression. It is associated with limited targeted treatment options, early relapse, and a high propensity for visceral metastasis. Data describing metastatic patterns and treatment characteristics of TNBC in Nigeria remain limited. Methods: This retrospective descriptive cohort study included 869 patients with TNBC managed at the Medserve-LUTH Cancer Center, Lagos University Teaching Hospital, Nigeria between June 2019 and June 2024. Demographic, clinicopathologic, metastatic, and treatment-related data were extracted from electronic medical records. Descriptive statistics were used to summarize patient characteristics, metastatic patterns, and treatment profiles. Associations between metastatic disease and selected clinicopathologic and treatment variables were explored using Pearsons chi-square test. Complete-case analysis was applied throughout. Results: The mean age at presentation was 52.09 {+/-} 12.26 years. Most patients were married (79.1%), postmenopausal (64.3%), and of Yoruba ethnicity (56.8%). Advanced disease predominated, with Stage III and Stage IV disease accounting for 42.9% and 35.6% of cases, respectively. Invasive ductal carcinoma was the most common histologic subtype (77.0%), while Grade II tumours constituted 51.3% of graded cases. Surgery was performed in 73.1% of patients, predominantly mastectomy (70.9% of surgical procedures). Chemotherapy was administered to 83.2% of patients, most commonly anthracycline-based regimens (41.8%), while radiotherapy was delivered to 63.5% of patients, with hypofractionated schedules of 42-43 Gy in 15-16 fractions accounting for 47.2% of radiotherapy courses. Metastatic disease was documented in 32.9% of evaluable patients. Lung metastasis was the most frequent site (62.5%), followed by bone (46.3%), regional lymph node invasion (38.5%), liver (23.0%), and brain (22.6%). Tumour grade and histologic subtype were not significantly associated with metastatic disease, whereas radiotherapy exposure demonstrated a significant association with metastatic status ({chi}{superscript 2} = 10.35, p = 0.001). Conclusion: TNBC in this Nigerian cohort was characterized by advanced-stage presentation, invasive ductal predominance, extensive use of multimodality treatment, and substantial visceral metastatic burden. Lung metastasis was the most common metastatic site. These findings provide contemporary real-world data on TNBC in Nigeria and highlight the continuing need for earlier diagnosis, timely referral, and sustained investment in comprehensive cancer care services.

03.
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.

04.
medRxiv (Medicine) 2026-06-22

Association of Digoxin Use at Norwood Discharge with Fontan Completion: A Study from the Pediatric Heart Network Public Dataset

Background: Digoxin use after the Norwood procedure has been associated with improved interstage survival in hypoplastic left heart syndrome and related conditions. Whether this benefit translates into improved longer-term outcomes through staged palliation remains unknown. We aimed to determine the association of digoxin use at Norwood discharge with transplant-free survival and Fontan completion. Methods: We conducted a retrospective cohort study using the Pediatric Heart Network (PHN) Single Ventricle Reconstruction trial public dataset, including 549 infants enrolled at 15 North American centers between 2005 and 2008. Competing risk analysis was used to evaluate Fontan completion and Cox regression to assess death or transplantation within 6 years after the Norwood procedure. Mixed-effects models compared pre-Fontan hemodynamic and echocardiographic right ventricular indices between patients treated with and without digoxin after accounting for center clustering and adjustment for sex, shunt type, heart failure medications at Norwood discharge, and census block poverty level. Results: The 6-year cumulative incidence of Fontan completion was higher among patients discharged on digoxin than among those not receiving digoxin (82% vs 71%; p = 0.013). Competing-risk analysis accounting for death and transplant demonstrated a greater likelihood of Fontan completion among digoxin users (aHR 1.31; 95%CI 1.09-1.58; p = 0.005), without significant difference in the hazard of death or transplant (aHR 0.78; 95%CI 0.53-1.15; p = 0.208). No significant differences in pre-Fontan hemodynamic or echocardiographic indices were observed between groups. Initiation of digoxin post Stage II procedure was not associated with improved survival or likelihood to complete Fontan. Conclusion: Digoxin use at the time of Norwood discharge was associated with a 30% greater likelihood of Fontan completion by 6 years, without accompanying improvement in transplant-free survival. These findings extend prior observations of improved interstage outcomes associated with digoxin use and suggest that treatment may facilitate progression through staged palliation.

05.
arXiv (CS.LG) 2026-06-17

INI-VPINN: A Variational Physics-Informed Neural Network with Implicit Neumann and Interface Handling for Multi-Material Domains with Geometric Singularities

arXiv:2606.18032v1 Announce Type: cross Abstract: We propose a new weak-form Physics-Informed Neural Network approach (named INI-VPINN). INI-VPINN naturally incorporates Neumann boundary and interface conditions into the variational formulation. It removes the need for additional loss terms or multiple subdomain networks. This framework employs compact support weighting functions and integration by parts to implicitly impose flux and continuity constraints. In this way, it implicitly ensures physical consistency across material boundaries. The proposed method is tested on Poisson and Laplace problems with sharp interfaces and complex geometries. Results show that, compared with several other Physics Informed Neural Networks-based formulations, the INI-VPINN consistently achieves higher accuracy, smoother and faster convergence. The proposed framework provides a general approach for solving multimaterial problems with complex geometries and mixed Neumann-Dirichlet boundary conditions using neural networks. The implementation is publicly available in a GitHub repository.

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

DREG: A Layer-Wise Jacobian Regularization as a General-Purpose Penalty

arXiv:2606.23942v1 Announce Type: new Abstract: We present a large-scale empirical study isolating the contributions of the Derivative Regularization penalty (DREG). Across a fully-crossed factorial sweep of 960 experiments spanning 4 activations, 6 regularizers, 8 datasets, and 5 random seeds, we ask: when, where, and why does DREG work? Our results establish three principal findings. First, DREG achieves the highest overall and clean-regime accuracy among all regularizers evaluated (significantly so against the unregularized baseline, Weight Decay, and IGPen; Wilcoxon $p \leq 0.031$). It ranks second in noise robustness behind Spectral Normalization (SN) - the only two layer-wise regularizers in the study. Second, DREG is globally the best-performing regularizer under GELU, the default activation in modern transformer architectures, particularly on both messy vision and messy NLP benchmarks, suggesting direct applicability to frontier deep learning settings. Third, DREG's advantage over competing regularizers is most pronounced under data scarcity, consistent with its role as a geometric inductive bias that substitutes for the regularizing effect of data volume. Throughout, DREG is applied with a single fixed hyperparameter $\lambda = 10^{-2.5}$ and no per-dataset tuning, supporting its characterization as a plug-and-play regularizer for neural networks with nontrivial Jacobian structure. These findings are consistent with DREG's design: concentrating regularization pressure on layers where the activation derivative is largest, rather than constraining the network uniformly.

07.
arXiv (math.PR) 2026-06-18

Very large cliques in a scale-free random graph

arXiv:2606.18722v1 Announce Type: new Abstract: In this short article we consider a preferential attachment random graph model with edge steps, studied by Alves, Ribeiro and Sanchis. Starting with an initial graph $\mathbb{G}_1$ formed by a vertex with a self-loop attached to it, the model evolves as follows. At every subsequent (discrete) time step, either with probability $p$ we add a vertex to the graph and connect it to exactly one of the older vertices selected with probability proportional to its degree, or with probability $1-p$ we add one edge between two existing vertices, both selected (independently) with probability proportional to their degrees. Let $\omega(\mathbb{G})$ be the clique number of a graph $\mathbb{G}$, i.e.\ the number of vertices in a largest complete subgraph of $\mathbb{G}_{}$. Alves, Ribeiro and Sanchis showed that, for any given $\varepsilon>0$, we have $\omega(\mathbb{G}_{2t})\geq t^{\frac{1-p}{2-p}(1-\varepsilon)}$ with high probability (i.e.\ with probability tending to $1$ as $t\rightarrow \infty$). Here we strengthen this bound by showing that, for any function $f:\mathbb{N}\mapsto \mathbb{N}$ that satisfies $f(t)\rightarrow \infty$ as $t\rightarrow \infty$, with high probability \[\omega(\mathbb{G}_{2t}) = \Omega\left(t^{\frac{1-p}{2-p}}\Big(\log^{\frac{1}{2-p}}(t)f(t)\Big)^{-1}\right).\]

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

Integrating Multi-Label Classification and Generative AI for Scalable Analysis of User Feedback

arXiv:2601.23018v1 Announce Type: cross Abstract: In highly competitive software markets, user experience (UX) evaluation is crucial for ensuring software quality and fostering long-term product success. Such UX evaluations typically combine quantitative metrics from standardized questionnaires with qualitative feedback collected through open-ended questions. While open-ended feedback offers valuable insights for improvement and helps explain quantitative results, analyzing large volumes of user comments is challenging and time-consuming. In this paper, we present techniques developed during a long-term UX measurement project at a major software company to efficiently process and interpret extensive volumes of user comments. To provide a high-level overview of the collected comments, we employ a supervised machine learning approach that assigns meaningful, pre-defined topic labels to each comment. Additionally, we demonstrate how generative AI (GenAI) can be leveraged to create concise and informative summaries of user feedback, facilitating effective communication of findings to the organization and especially upper management. Finally, we investigate whether the sentiment expressed in user comments can serve as an indicator for overall product satisfaction. Our results show that sentiment analysis alone does not reliably reflect user satisfaction. Instead, product satisfaction needs to be assessed explicitly in surveys to measure the user's perception of the product.

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

On-Policy Distillation with Curriculum Turn-level Guidance for Multi-turn Agents

arXiv:2606.15912v1 Announce Type: cross Abstract: Multi-turn agents that plan, invoke tools, and interact with environments offer a promising paradigm for solving complex tasks, yet their capabilities typically rely on very large models whose inference cost is prohibitive in practice.On-Policy Distillation (OPD) is a natural recipe for transferring such capabilities to smaller students, but we find that it suffers a characteristic failure mode in this setting: small student errors compound across turns and push the trajectory out of the teacher's familiar state distribution, so the teacher's supervision becomes least reliable precisely where the student needs it most.We propose Guided On-Policy Distillation (Guided-OPD), a simple yet effective algorithm that mixes teacher- and student-generated turns within each rollout and schedules the teacher's intervention probability along a curriculum that decays to zero.Strong guidance keeps early trajectories close to the teacher distribution and is then gradually withdrawn to recover the purely on-policy regime used at inference.On ALFWorld, ScienceWorld, and WebShop, distilling Qwen3 students from a Qwen3-30B-A3B teacher, Guided-OPD improves Score by 21.1\% and Success Rate by 25.5\% over vanilla OPD on average, with larger gains on smaller students.

10.
arXiv (CS.CV) 2026-06-19

Thinking in Boxes: 3D Editing in Real Images Made Easy

Text and 2D-conditioning interfaces provide weak, ambiguous control over spatial transformations in image editing – particularly under large object motions and camera changes. Prior work has used 3D primitives such as boxes, but only as loose conditioning signals indicating approximate object location rather than specifying the transformation. We instead use 3D boxes as structured specifications: the user provides the input and output boxes of the edit, casting editing as a well-posed geometry problem. This ``thinking in boxes'' interface, where each box face is color-coded to convey 3D orientation, gives precise control over translation, rotation, scaling, and viewpoint changes in real images while preserving scene and object identity, and recovering previously unseen object regions. To ground transformations in scene appearance, we introduce a depth-aligned planar floor as a global reference frame, shaded with depth-aware cues. Conditioned on this structure, an image generator produces consistent results under large transformations. Trained in two stages – on synthetic multi-object scenes and a small set of real-world videos from Objectron – the system generalizes to complex, in-the-wild real images. Our method operates directly on real photographs and substantially outperforms recent state-of-the-art methods on large 3D edits.

11.
bioRxiv (Bioinfo) 2026-06-14

Systematic AI-Driven Drug Repurposing via Clinical Trial Data Mining: A Framework and Six Cross-Therapeutic Case Studies.

Authors:

Drug repurposing, the application of approved or shelved compounds to new therapeutic indications, offers a cost- and time-efficient alternative to de novo drug discovery. However, the systematic identification of repurposing candidates from the rapidly expanding body of clinical trial data remains a significant challenge. Here we present a publicly accessible AI-powered tool that mines the ClinicalTrials.gov registry to identify approved drugs with under-explored therapeutic potential in high-value disease areas. The tool integrates natural language processing, mechanism-of-action pathway analysis, and trial density scoring to surface candidates where biological plausibility is high and clinical trial coverage is sparse. We demonstrate the tool's utility across six cross-therapeutic case studies spanning oncology, cardiology, neurology, rare diseases, immunology, and infectious disease. Key findings include: the identification of Zonisamide as an under-explored combination candidate for obesity alongside GLP-1 receptor agonists; mechanistic validation of SGLT2 inhibitors in heart failure with preserved ejection fraction (HFpEF); and a novel cross-domain mapping of anti-TNF biologics to early-stage neurodegeneration via shared neuroinflammatory pathways. The tool is freely accessible and designed to lower the barrier for academic and industry researchers to systematically pursue repurposing opportunities.

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

Escaping the Cognitive Well: Efficient Competition Math with Off-the-Shelf Models

arXiv:2602.16793v2 Announce Type: replace Abstract: In the past year, custom and unreleased math reasoning models reached gold medal performance on the International Mathematical Olympiad (IMO). Similar performance was then reported using large-scale inference on publicly available models but at prohibitive costs (e.g., 3000 USD per problem). In this work, we present an inference pipeline that attains best-in-class performance on IMO-style math problems at an average inference cost orders of magnitude below competing methods while using only general-purpose off-the-shelf models. Our method relies on insights about grader failure in solver-grader pipelines, which we call the Cognitive Well (iterative refinement converging to a wrong solution that the solver as well as the pipeline's internal grader consider to be basically correct). Our pipeline addresses these failure modes through conjecture extraction, wherein candidate lemmas are isolated from generated solutions and independently verified alongside their negations in a fresh environment (context detachment). On IMO-ProofBench Advanced (PB-Adv), our pipeline achieves 67.1 percent performance using Gemini 3.0 Pro with an average cost per question of approximately 31 USD. At the time of evaluation, this represented the state-of-the-art on PB-Adv among both public and unreleased models, and more than doubles the success rate of the next best publicly accessible pipeline, all at a fraction of the cost.

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

Maturing Markov Decision Processes: Decision Making under Increasing Information and Shrinking Action Sets

arXiv:2606.18820v1 Announce Type: cross Abstract: Sequential decision problems often exhibit an asymmetric evolution of information and decision flexibility: as a decision cycle unfolds, the agent receives richer information while feasible actions expire due to operational cutoffs, commitments, or resource constraints. Standard MDP formulations typically flatten this structure into stage-dependent state descriptions and action masks, thereby obscuring the nested information–action asymmetry that determines which decisions are urgent and which can be deferred. We introduce Maturing Markov Decision Processes (MMDPs), a formulation built around this information–action asymmetry. We characterize one of its key consequences through an expiring-action priority principle, which identifies the actions that must be resolved before the next stage. Motivated by this structure, we develop a structure-aware reinforcement learning framework with stage-aware policy design, expiring-action abstraction, and search-augmented learning with distillation. Experiments on a controlled multi-supplier replenishment problem, simplified cash-management environments of increasing complexity, and a production-scale simulator show that explicitly modeling this asymmetry improves learning efficiency and becomes increasingly valuable as decision problems scale.

14.
arXiv (quant-ph) 2026-06-11

Super-Link Fragility in Asymmetric W-Class States under Quantum Noise

arXiv:2606.12307v1 Announce Type: new Abstract: The asymmetric three-qubit W-class state $|\overline{W_3^L}\rangle$ defines an isosceles entanglement-network geometry, (a) two vertex-base (VB) links form stronger bipartite connections, (b) while the base-base (BB) link is weaker. This suggests that concentrating entanglement into a super-link may be advantageous for quantum-network tasks. Here, we show that this intuition is incomplete. We analytically compare the bipartite concurrence dynamics of the symmetric |W> state and the asymmetric $|\overline{W_3^L}\rangle$ state, which differ both in entanglement-network geometry and excitation sector under standard noise models. In the absence of noise, the concurrence hierarchy is C_{VB} > C_W > C_{BB}$. Under phase damping, this hierarchy is preserved for all noise strengths and no entanglement sudden death occurs. Under amplitude damping, however, the hierarchy is reordered. The symmetric |W> state becomes the most robust, while the base-base concurrence of $|\overline{W_3^L}\rangle$ vanishes at the finite threshold of parameter $\gamma$. We term this reordering as the Super-Link Fragility Effect. The same structural asymmetry that produces a stronger vertex-base link also makes it more vulnerable to energy dissipation when coupled with multi-excitation amplitudes. Under depolarization, the asymmetry advantage is erased, with $C_W$ and $C_{VB}$ sharing the same sudden-death threshold for some value of the parameter p, while $C_{BB}$ disappears earlier at some other value of the parameter p. The generalized amplitude damping channel continuously connects the damping-dominated regime to the pure-excitation limit, where the initial hierarchy is restored. These results show that entanglement robustness in $W$-class resources is controlled not by initial concurrence alone, but by the joint structure of entanglement-network geometry, excitation sector, and noise symmetry.

15.
medRxiv (Medicine) 2026-06-10

Resolving Diagnostic Discordance in Group 2 Pulmonary Hypertension Through Staged Physiologic Testing: Insights From PVDOMICS

Background World Symposium on Pulmonary Hypertension (WSPH) Group 2 pulmonary hypertension (PH) is a clinically integrated phenotype attributed to left heart disease, whereas pre- versus post-capillary classification is operationalized primarily by pulmonary capillary wedge pressure (PCWP). Although current recommendations emphasize contextual interpretation and provocative testing for intermediate PCWP values, the relationship between PCWP-based classification and underlying phenotype has not been systematically evaluated. We aim to quantify phenotype-hemodynamic discordance across the PCWP spectrum and evaluate a staged physiology-guided framework incorporating inhaled nitric oxide (iNO), ventricular geometry, and provocative testing. Methods We studied 1,032 participants from the NHLBI-sponsored PVDOMICS cohort with multidisciplinary adjudicated phenotypes integrating clinical, imaging, physiologic, and hemodynamic data. Stage-specific PCWP thresholds classified pre- versus post-capillary physiology at rest, during iNO, and during provocation (fluid challenge or invasive cardiopulmonary exercise testing [iCPET]). Echocardiographic right ventricular-to-left ventricular (RV/LV) ratio was evaluated as a marker of ventricular interdependence. Restricted cubic spline and staged concordance analyses defined certainty-based PCWP ranges and incremental diagnostic yield. Results Adjudicated Group 2 phenotype was present in 37.0% of participants. Resting PCWP demonstrated good discrimination (AUC 0.86), but substantial bidirectional phenotype-hemodynamic discordance persisted across intermediate PCWP ranges. At a resting PCWP of 12 mmHg, 25% of participants classified as pre-capillary had adjudicated Group 2 PH, whereas at 18 mmHg, 35% classified as post-capillary remained discordant non-Group 2. Concordance did not approach 90% until PCWP values were 24 mmHg. Dynamic testing incrementally improved concordance within these overlap zones. Nearly half of adjudicated Group 2 PH participants (46.5%) were not identified by resting PCWP alone; incorporation of iNO and provocative testing increased cumulative Group 2 identification by 63.4% and improved sensitivity from 79.9% to 83.7%. Model discrimination improved from an AUC of 0.863 to 0.908 (likelihood-ratio P

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

Spatially Grounded Concept Bottleneck Models via Part-Factorized Attention

Concept bottleneck models (CBMs) predict a layer of human-named attributes before predicting a class, which makes their decisions auditable. On fine-grained recognition tasks the concept heads are usually free to attend anywhere in the image, so a head named for one body region can be satisfied by evidence on another. This work studies a part-factorized CBM that removes that freedom by construction. The method has three components built on a frozen DINOv3 vision transformer. A learned foreground gate, trained on DINOv3 patch features, suppresses background patches inside the part attention. A set of part queries cross-attends to patch features and each of the 312 CUB attributes is routed, through a fixed concept-to-part map, to read only from the part token its name implies. A learnable two-dimensional Gaussian prior, injected additively in log space into the attention logits, breaks the permutation symmetry among part queries; its means are initialized from the dataset-average keypoint location of each part, which requires no per-image keypoint supervision at training or test time. On CUB-200-2011 the spatial-prior model matches a fully supervised baseline (88.85% versus 88.95% top-1) while raising pointing accuracy by 16 points (52.6% versus 36.4%). Replacing bounding-box supervision with a PCA foreground target and combining it with the Gaussian prior removes all per-image supervision and reaches 88.6% top-1 at about 70% pointing accuracy. A keypoint-fraction sweep shows that 0.5% of the training set (about 27 images) suffices to initialize the prior with no measurable loss. Removing part identity entirely is the harder case: without any spatial prior, pointing accuracy collapses to $2.9\%$.

17.
arXiv (math.PR) 2026-06-17

Limit theorems for descents and inversions of shelf-shuffles

arXiv:2510.00343v2 Announce Type: replace Abstract: We prove central limit theorems for the number of descents and inversions of permutations produced by shelf-shuffles. These are a model for casino card shuffling machines. We show the asymptotic normality of the number of descents in two limiting regimes depending on the ratio of cards to shelves. On the other hand, we study the inversions by employing a modification of the techniques from Islak's analysis of the statistics of riffle shuffles. In particular, we obtain a bound for the rate of convergence for inversions that is independent of the number of shelves.

18.
PLOS Medicine 2026-05-29

Characterization of the VHH-Fc construct rimteravimab in healthy adults and patients hospitalized for mild-to-moderate COVID-19: Two Phase 1 randomized clinical trials

Authors:

by Ellen Jansen, Viki Bockstal, Florence Herschke, Per Olsson Gisleskog, Manuela Rinaldi, Angélique Boerboom, Salah Hadi, Natalia Gaibu, Michel Moutschen, Dominique Tersago Background Variable Heavy domain of Heavy chains (VHH) are innovative tools to target unique epitopes, yet few have been developed as heavy chain-only antibodies for clinical use. Rimteravimab (referred to here as XVR011) is a humanized antibody developed for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19), consisting of two identical VHHs targeting the receptor binding domain (RBD) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike, with a human immunoglobulin (Ig) G1 fragment constant of antibody (Fc), silenced for Fc effector functions. We conducted two Phase 1 studies in healthy volunteers or hospitalized COVID-19 patients to evaluate its safety, tolerability, pharmacokinetics and immunogenicity. Methods and findings A randomized, double-blinded, single-center, placebo-controlled, single ascending dose study was performed in healthy volunteers (Phase 1a, EXEVIR0102, EudraCT 2021-003707-17), in parallel to an open-label, multi-center, single ascending dose study in patients hospitalized for mild to moderate COVID-19 (Phase 1b, EXEVIR0101, EudraCT 2020-005299-36, NCT04884295). Participants received a single intravenous infusion of 250, 500 or 1,000 mg of XVR011. The primary objective for both trials was the safety and tolerability of XVR011. Pharmacokinetics were evaluated as a secondary objective in Phase 1a and as an exploratory objective in Phase 1b. Efficacy (evaluated as respiratory parameters and COVID-19 clinical status) and antiviral activity in patients were evaluated as a secondary objective in Phase 1b. Immunogenicity was evaluated as an exploratory objective. Part 2 of the EXEVIR0101 study (initially a phase 1b/2 study) was not conducted due to the loss of XVR011 potency against SARS-CoV-2 Omicron BA.2. Demographics, safety, efficacy, and immunogenicity were analyzed using descriptive statistics, while pharmacokinetics were analyzed with noncompartmental pharmacokinetics (PK) modeling.In the Phase 1a study, there were no infusion-related reactions, serious treatment-emergent adverse events (TEAEs) or TEAEs grade ≥3. 22/30 volunteers (73.3%) reported 53 TEAEs (49 Grade 1, 4 Grade 2) with none being related to XVR011. The most common TEAE was headache (n = 8, 26.7%) in various treatment groups. In the Phase 1b study, 27 hospitalized patients were enrolled, and followed up to 30 days. Seven patients (25.9%) reported a total of 15 TEAEs, the majority (80%) being mild to moderate (Grade 1–2). There were no treatment-related serious TEAEs. All TEAEs resolved by the end of the study. Peak exposure (maximal concentration, Cmax) and systemic exposure (area under the curve, AUC0-t, and AUC0-inf) for XVR011 increased dose-proportionally. Geomean half-life ranged from 15.4 to 17.0 days in Phase 1a, while individual half-life ranged from 11.4 to 15.6 days in Phase 1b. SARS-CoV-2 viral load, as detected in nasopharyngeal samples by reverse transcription and quantitative polymerase chain reaction (RT-qPCR), decreased similarly in all cohorts compared to baseline. No treatment-induced anti-drug antibodies (ADA) were detected in Phase 1a. In Phase 1b, higher XVR011 concentrations increased the likelihood of ADA formation, without impacting pharmacokinetics and pharmacodynamics. No obvious dose-response in COVID-19 clinical status or respiratory parameters was observed.Technological limitations included study size, absence of placebo for the Phase 1b, absence of repeated dosing, evolving SARS-CoV-2 variants and standard-of-care. Conclusions XVR011 displayed a favourable safety, tolerability, pharmacokinetics, and immunogenicity profile, both in healthy volunteers and in patients hospitalized for mild to moderate COVID-19. These data pave the way for the design and clinical development of VHH-Fc constructs.

19.
arXiv (CS.AI) 2026-06-18

SAE Interventions are Unreliable: Post-Intervention Recovery of Suppressed Behavior

arXiv:2606.18322v1 Announce Type: cross Abstract: Sparse Autoencoders (SAEs) decompose residual-stream activations into interpretable features. Recent latent-space defenses increasingly rely on these decompositions, assuming that identified "unsafe" SAE features serve as actionable handles for monitoring and intervention. In this paradigm, clamping a specific harmful feature is expected to reliably prevent model misbehavior. However, we show that this success may hide a recoverable failure mode: the clamp may block one visible route to a behavior without eliminating the behavior itself. We formulate this vulnerability as post-intervention recovery, a constrained residual-space optimization problem. Starting from the post-intervention residual state, we optimize residual perturbations to recover the pre-intervention behavior while preserving the post-intervention values of the targeted SAE features. Even under a strong threat model where the intervention remains active throughout optimization and generation, recovery remains possible. To rule out that recovery simply undoes the intervention, we use encoder-orthogonal updates for single-layer interventions and the corresponding feature-map Jacobian in the cross-layer setting. Across TPP, unlearning, IOI, and refusal steering experiments, this stress test reveals recoverable behavior despite successful feature-level intervention. Especially in the safety-critical refusal-steering setting, we achieve a 95.8% recovery rate on valid samples while keeping defended-feature relative drift to 0.131, substantially below suffix-based baselines. A recovery-path attribution analysis further localizes this recovery to the SAE reconstruction residual, the component left unexplained by the SAE. These results expose a gap between feature-level control and behavioral completeness: SAE features can support causal intervention, but controlling them does not guarantee control over the underlying behavior.

20.
arXiv (CS.LG) 2026-06-18

Context-Aware Optimization of Follow-Up Intervals for Type 2 Diabetes Care Using Markov Decision Processes

arXiv:2606.19092v1 Announce Type: cross Abstract: Chronic disease management relies on regular patient-provider interactions to follow-up on disease progression and control. For Type 2 Diabetes (T2D), current guidelines prescribe fixed time intervals between subsequent primary care visits for all patients, overlooking heterogeneity in clinical trajectories and patient characteristics. This study introduces a Contextual Markov Decision Process (CMDP) model to optimize subpopulation-specific follow-up interval decisions using Electronic Health Record (EHR) data from 22,154 T2D patients across 10 primary care clinics. Contexts are identified by: i) dimensionality reduction of variables representing the individual health trajectories utilizing Principal Component Analysis, and ii) assigning patients to contexts via principal components and additional patient-level features using clustering. Two distinct contexts emerged, representing a lower- and a higher-risk subpopulation. CMDP-derived policies recommend: (i) follow-up within 1 month if lab value at current visit is unmeasured; (ii) up to 3 months for elevated lab values or recent hospitalizations; and (iii) 6 to 12 months for sustained glycemic control, with shorter follow-up intervals for patients in high-risk context. The optimal policies achieved lower expected cumulative cost than benchmarks (e.g., in the higher-comorbidity context, the CMDP policy reduced cost by about 34.8%, and in the lower-comorbidity context by about 6.4%, relative to an American Diabetes Association-like fixed interval follow-up policy. These findings demonstrate how context-aware approaches can inform adaptive follow-up strategies, and have the potential to advance chronic care management in primary care by synthesizing machine learning and probabilistic decision models.

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

Intrinsic Computational Functionalism and Simulated Consciousness

arXiv:2606.15348v1 Announce Type: cross Abstract: A common objection to artificial or simulated consciousness is that a simulated brain is no more conscious than simulated water is wet. We address this from the perspective of Intrinsic Computational Functionalism (ICF): if consciousness is computationally constituted, it depends not on externally imposed descriptions but on the computational structures a system physically realizes in virtue of its own causal-dynamical organization. In previous work we developed Canonical Functionalism as a mathematically precise special case of this anti-interpretivist program, identifying functional states by their complete future input-output roles under a fixed interface. Here we argue that this input-output construction, though important, is incomplete: as a behavioral boundary case of ICF, it makes lookup tables and unfolded systems that preserve the same boundary behavior canonically equivalent. A consciousness-relevant canonical representation must instead include internal mechanisms, interventions, and joint readouts belonging to the relevant intrinsic organization. We therefore define a mechanism-enriched canonical structure and use it to formulate Intrinsic Causal-Computational Realization (ICCR), a realization relation preserving physical implementation, intrinsic state individuation, transition structure, intervention profiles, and the relevant agent-body-world boundary. The central result is conditional: if conscious properties are invariants of intrinsic causal-computational organization, then any system satisfying ICCR realizes the same consciousness-relevant properties, whether biological, artificial, or simulated. We discuss objections including biological naturalism and integrated information theory. We conclude that to deny consciousness to a simulation, one must identify a consciousness-relevant intrinsic causal-computational structure that the simulation fails to realize.

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

SMGFM: Spectral Multimodal Graph Pretraining for Multimodal-Attributed Graphs

arXiv:2606.12867v1 Announce Type: new Abstract: Multimodal-attributed graphs (MAGs) couple graph topology with node semantics from text, images, and other modalities. Traditional graph learning contextualizes node semantics by coupling topology with node features. However, this coupling design becomes troublesome in MAGs, where structure-induced and modality-intrinsic semantics may contribute differently to downstream tasks. Structure-induced semantics promote relational consistency through smooth topological variation, whereas modality-intrinsic semantics often encode local, fine-grained distinctions that should not be uniformly smoothed or aligned. Therefore, the key challenge is to identify semantic roles before cross-modal fusion. To this end, we leverage graph-frequency variation as a prior, where low-frequency components capture topology-consistent semantics and high-frequency components preserve modality-specific semantics. Based on this intuition, we propose SMGFM, a spectral multimodal graph pretraining framework that decomposes each modality-specific node signal into graph-frequency bands and assigns band-level semantic roles before cross-modal interaction. Concretely, SMGFM constructs frequency-resolved modality tokens with scalable Chebyshev filters, estimates their coupling reliability through topology-conditioned routing, and performs band-modality interaction before fusion. Its frequency-routed objectives align smooth consensus routes while preserving modality-specific routes, mitigating spatial-domain entanglement and uniform cross-modal alignment. Extensive experiments conducted on the MAG datasets demonstrate that SMGFM achieves state-of-the-art performance across graph-level and modality-level tasks.

23.
arXiv (CS.CV) 2026-06-17

GASE: Gaussian Splatting-Based Automated System for Reconstructing Embodied-Simulation Environments

Training embodied agents in the real world requires skilled operators and expensive hardware. Simulation environments offer a compelling alternative by enabling large-scale, cost-effective data augmentation. Consequently, rapidly constructing high-fidelity simulation scenes with a minimal sim-to-real gap has become a critical objective in robot learning. While reconstruction-based methods provide superior visual quality, current workflows are hindered by inefficient data acquisition and subpar foreground object extraction. We thus propose GASE, a highly automated system for simulation scene construction. GASE leverages multi-view video streams from panoramic camera arrays to enable rapid environment scanning. To ensure high-quality asset generation, our pipeline introduces a camera-pose-based strategy that robustly extracts objects across frames in the 2D domain, followed by high-fidelity scene inpainting. Foreground objects and the static background are then reconstructed independently and seamlessly imported into physics simulators for policy training. Extensive experiments demonstrate that GASE outperforms existing 3D Gaussian-based methods in segmentation accuracy by over 10\% while achieving state-of-the-art inpainting quality. Furthermore, real-robot deployments across manipulation and navigation tasks maintains a performance gap of less than 10\% compared to policies trained purely on real-world data. These results confirm that GASE provides an efficient and highly effective solution for bridging the sim-to-real gap. Code will be released.

24.
arXiv (CS.LG) 2026-06-11

OmniLoc: A Geometry-Aware Foundation Model for Anchor-Free UE Localization Across Diverse Indoor Environments

arXiv:2606.11490v1 Announce Type: new Abstract: Indoor localization from wireless measurements remains challenging in large-scale deployments due to substantial variation in building geometry, the set of detectable access points (APs), and the heterogeneity of received signals. Existing learning-based methods often perform well only in limited settings and degrade under environmental shifts, making robust anchor-free localization across diverse indoor environments notoriously difficult. In this paper, we present OmniLoc, an environment-interactive foundation model for anchor-free user equipment localization across diverse indoor environments. To the best of our knowledge, OmniLoc is the first foundation-model-based approach built directly on wireless measurements for this task. OmniLoc is built on three key designs. First, a unified input tokenization module converts heterogeneous wireless measurements into a common representation that is more amenable to learning. Second, a geometry-aware Transformer performs AP-aware feature extraction by emphasizing dominant APs while aggregating complementary evidence from supporting APs. Third, a geometry-aware location estimation module conditions regression on geometric embeddings to produce geometrically consistent location predictions. We evaluate OmniLoc on both a large-scale in-house dataset and a public benchmark dataset. Results show that OmniLoc significantly outperforms existing methods, consistently improves existing backbones when its design components are integrated, and demonstrates strong generalization in cross-environment evaluations.

25.
arXiv (CS.CV) 2026-06-19

GenTrack: A New Generation of Multi-Object Tracking

This paper introduces a novel multi-object tracking (MOT) method, dubbed GenTrack, whose main contributions include: first-a hybrid tracking approach employing both stochastic and deterministic manners to robustly handle unknown and time-varying numbers of targets, particularly in maintaining target identity (ID) consistency and managing nonlinear dynamics, second-leveraging particle swarm optimization (PSO) with some proposed fitness measures to guide stochastic particles toward their target distribution modes, enabling effective tracking even with weak and noisy object detectors, third-integration of social interactions among targets to enhance PSO-guided particles as well as improve continuous updates of both strong (matched) and weak (unmatched) tracks, thereby reducing ID switches and track loss, especially during occlusions, fourth-a GenTrack-based redefined visual MOT baseline incorporating a comprehensive state and observation model based on space consistency, appearance, detection confidence, track penalties, and social scores for systematic and efficient target updates, and five-the first ever publicly available source-code reference implementation with minimal dependencies, featuring three variants, including GenTrack Simple, Strengthen, and Super, facilitating flexible reimplementation. Experimental results have shown that GenTrack provides superior performance on standard benchmarks and real-world scenarios compared to state-of-the-art trackers, with integrated implementations of baselines for fair comparison. Potential directions for future work are also discussed. The source-code reference implementations of both the proposed method and compared-trackers are provided on GitHub: https://github.com/SDU-VelKoTek/GenTrack