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

A Quantitative Analysis of Multimodal Biomarkers in Alzheimer's Disease

Despite increasing adoption of multimodal approaches in Alzheimer's Disease (AD) research – aimed at integrating molecular, structural, clinical, and genetic biomarkers to enhance disease characterization – the relationships among these modalities remain poorly understood. A systematic analysis of their dynamic interaction is essential for improving disease modeling, identifying redundant assessments, and reducing patient burden and acquisition costs. In this paper, we present a quantitative analysis of multimodal AD biomarkers by integrating tau-PET, structural MRI, cognitive scores (MMSE and CDR), and APOE4 data from 789 subjects drawn from the ADNI dataset. In our analyses, we (A) quantify cross-modal mutual information and explained variance to assess redundancy and predictive dependencies; (B) examine associations between tau topologies and structural atrophy across brain regions to select informative ROIs; (C) perform a statistical decomposition of the tau-cognition association into atrophy-related and atrophy-independent components; (D) and identify a dominant neurodegenerative trajectory that aligns with cognitive decline. This study provides a systematic characterization of cross-modal relationships, improving the interpretability and selection of biomarkers in AD. Code is publicly available at: https://github.com/antonioscardace/Multimodal-AD.

02.
arXiv (CS.LG) 2026-06-11

REACH: Interpretability-Driven Feature Identification and Architecture Compression for Multi-Channel Vehicular Channel Estimation

arXiv:2606.11857v1 Announce Type: cross Abstract: Multi-channel mixed-SNR training improves out-of-distribution (OOD) generalisation of deep learning channel estimators for IEEE 802.11p vehicular communications, yet the internal mechanism responsible for this remains unexplained. This work presents REACH (Relevance-based Explanation and Architectural Compression for cHannel estimators), a gradient-based interpretability framework that operates at two levels. Input-level attribution identifies a subset of time-frequency features consistently relevant across all evaluated channel conditions, enabling input dimensionality reduction with minimal performance loss. Filter-level attribution reveals a near-universal internal representation, providing a representational account of the observed OOD generalisation. Guided by the resulting filter taxonomy, relevance-guided architecture compression substantially reduces both the number of parameters and the number of floating-point operations (FLOPs) with sub-1 dB normalised mean square error (NMSE) degradation, and OOD generalisation degrades more slowly than within-distribution accuracy under increasing compression.

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

Policy Regret for Embedding Model Routing: Contextual Bandits with Low-Rank Experts

arXiv:2606.14929v1 Announce Type: cross Abstract: Modern recommendation systems increasingly rely on dynamically routing diverse queries to multiple embedding models. Despite its practical significance, this problem remains poorly understood under realistic conditions like adversarial queries, bandit feedback, and limited observability of models. We formalize embedding model routing as an adversarial contextual linear bandit with low-rank experts, where contexts are queries, actions are items, and experts are the embedding models working on low-rank latent representation spaces. We first establish that standard regret notions suffer from structural misspecification or statistical intractability, and we identify a log-quadratic policy class that is expressive enough to capture query-dependent model routing, yet structured enough to allow efficient online learning. Second, we propose a policy gradient algorithm called Hypentropy Policy Gradient (HPG). It provably adapts to the unknown low-rank structure under incomplete information and attains $\tilde{\mathcal O}(s\sqrt{M T})$ linearized policy regret – where $s, M$, and $T$ are the intrinsic rank of the experts, the number of models, and the number of rounds – thus avoiding a curse of dimensionality. Finally, we also provide an computationally efficient and parameter-free implementation of HPG.

04.
arXiv (CS.LG) 2026-06-19

Data Bias Mitigation under Coverage Constraints & The Price of Fairness

arXiv:2606.20461v1 Announce Type: new Abstract: Machine learning models have been shown to exhibit discriminatory outcomes or degraded performance for individuals at the intersection of multiple sensitive attributes, such as race and gender. This stems in part from two interrelated challenges: the lack of principled measures for quantifying bias (potentially intersectional), and insufficient representation of intersectional subgroups in training data. We extend a recent bias mitigation framework to incorporate coverage constraints that enforce sufficient representation across groups, including intersectional subgroups. Since achieving exactly zero bias for all groups may not be data efficient (meaning it may require large amounts of data), our solution trades small approximation errors in bias for greater data efficiency while satisfying coverage constraints. We also formulate bias mitigation as an integer linear program that optimizes over all mitigation strategies, and characterize the price of fairness, the minimum data modification cost, as a function of fairness tolerance. This is essential both for legal compliance, where regulations may mandate specific fairness thresholds, and for data governance, enabling practitioners to make informed trade-offs between bias reduction and data modification (particularly, data purchasing) costs. We evaluate our techniques on publicly available datasets, demonstrating that bias mitigation via our framework preserves predictive accuracy across multiple classifiers, and that coverage constraints, while motivated by statistical considerations, are essential for preserving downstream ML performance.

05.
arXiv (CS.CL) 2026-06-12

From Isolation to Entanglement: When Do Interpretability Methods Identify and Disentangle Known Concepts?

A goal of interpretability is to recover disentangled representations of latent concepts (features) from the activations of neural networks. The quality of features is typically evaluated in isolation, and under implicit independence assumptions that may not hold in practice. Thus, it is unclear to what extent common featurization methods such as sparse autoencoders (SAEs) and probes disentangle one concept from another. We propose a multi-concept evaluation setting using concepts including sentiment, domain, voice, and tense. We evaluate how well featurizers produce disentangled representations of each concept, observing that features are typically sensitive to only one concept, but also that concepts are distributed across many features. Then, we steer these features, measuring whether each concept is independently manipulable, and whether features interact. Even in idealized settings, steering a feature often affects many concepts, despite a near absence of interaction effects. These results suggest that correlational metrics are insufficient to establish steering selectivity, and that demonstrating that two features operate in separate spaces is insufficient to claim that they will be selective for one concept. These results underscore the importance of multi-concept evaluations in interpretability research.

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

Let Them Steal: Trapping Large Language Model Extraction Attacks with Knowledge Honeypot

arXiv:2606.15810v1 Announce Type: cross Abstract: Large language models deployed as commercial APIs are vulnerable to model extraction attacks, while existing defenses either act too late or degrade utility for legitimate users. We propose Knowledge Trap, a defense that redirects extraction attacks toward low-transferability knowledge through a Honeypot Knowledge Graph (HKG) and breadcrumb-guided exploration. Instead of blocking queries or perturbing outputs, Knowledge Trap consumes the attacker's limited query budget on knowledge with negligible downstream utility while preserving benign-user performance. Experiments in medical and financial domains show that Knowledge Trap reduces surrogate Agreement by 6.2\% on average without degrading legitimate-user accuracy, outperforming existing defenses that impose measurable user impact. These results suggest that defending knowledge-space traversal is a practical direction for mitigating LLM extraction attacks.

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

Misinformation Propagation in Benign Multi-Agent Systems

Multi-agent systems, in which multiple large language model agents solve problems through turn-based interaction, are increasingly deployed in high-stakes settings such as medical diagnosis, legal analysis, and forensic decision-making. Their reliability can be at risk when single agents reason from incorrect or misleading context, e.g., from tool calls, since errors may propagate through agent interactions. This work studies this risk by injecting intent-based misinformation into benign single-agent and multi-agent systems across reasoning, knowledge, and alignment tasks. We find that misinformation can degrade single-agent performance and persists across multi-agent debate, with agents often retaining answers introduced by misinformed peers. Nevertheless, multi-agent debate reduces the resulting performance degradation compared to single-agent prompting, especially when most agents are not exposed to misinformation. Robustness depends on group composition and decision protocol. Consensus can be more stable than voting under peer pressure, while majorities can often steer misinformed agents back toward correct answers. Our results show that misinformation robustness in multi-agent systems depends on the underlying model and also on how agents exchange information and aggregate decisions.

08.
arXiv (CS.LG) 2026-06-17

A Generalized Sinkhorn Algorithm for Mean-Field Schrödinger Bridge

arXiv:2604.06531v3 Announce Type: replace-cross Abstract: The mean-field Schrödinger bridge (MFSB) problem concerns designing a minimum-effort controller that guides a diffusion process with nonlocal interaction to reach a given distribution from another by a fixed deadline. Unlike the standard Schrödinger bridge, the dynamical constraint for MFSB is the mean-field limit of a population of interacting agents with controls. It serves as a natural model for large-scale multi-agent systems. The MFSB is computationally challenging because the nonlocal interaction makes the problem nonconvex. We propose a generalization of the Hopf-Cole transform for MFSB and, building on it, design a Sinkhorn-type recursive algorithm to solve the associated system of integro-PDEs. Under mild assumptions on the interaction potential, we discuss convergence guarantees for the proposed algorithm. We present numerical examples with repulsive and attractive interactions to illustrate the theoretical contributions.

09.
medRxiv (Medicine) 2026-06-22

A Randomized, Controlled, Double Blind Clinical Study to Evaluate Use of Hydron Alkaline Ionised Water (HAIW) in Healthy Participants

Background and Objectives: Alkaline Ionized Water (AIW) is considered among the highest quality healthy drinking water worldwide and is widely discussed for its various health benefits. Hydron Alkaline Ionized Water (HAIW) is produced through electrolysis, resulting in a stable pH of approximately 9.5 with a negative Oxidation Reduction Potential (ORP), making it an antioxidant beverage. The objective of this study was to evaluate the safety of HAIW and its effects on digestion, sleep, energy, and overall quality of life in healthy participants compared to Packaged Drinking Water (PDW). Materials and Methods: A randomized, controlled, double blind, prospective clinical study was conducted in which a total of 24 healthy participants between the age group of 21 to 40 years were randomized in a 1:1 ratio to either HAIW Group or Packaged Drinking Water Group with equal gender distribution. Participants were hospitalized for 7 days and asked to consume at least 3 litres of the assigned water daily. Primary outcomes were safety-related laboratory parameters and adverse event monitoring. Secondary outcomes included assessment of digestion (appetite, digestion, bowel habits), urine parameters, sleep quality, freshness after waking, fatigue, energy/stamina/strength, quality of life, and global assessment Results: All 24 participants completed the study with no dropouts. Baseline demographics were comparable between the two groups. Assessment of primary safety-related laboratory parameters including Complete Blood count, liver function tests, renal function tests, blood sugar, Electrocardiogram and serum electrolytes showed non-significant change from baseline to 7 days and remained within normal limits in both groups, with non-significant difference between groups (p>0.05). HAIW showed significantly better improvement in appetite, digestion, and bowel habits from Day 2 onwards compared to Packaged drinking water. Sleep quality and freshness after waking up showed significant improvement from Day 3 and Day 2 respectively in the HAIW and PDW group, with significantly better improvement in HAIW group. Fatigue scores showed significant reduction at Day 6 and 7 in both groups with non-significant difference between groups. A total of 5 adverse events were reported (3 in HAIW, 2 in PDW), all unrelated to study products and were mild in nature. Global assessment showed excellent to good overall safety and tolerability in both groups. Conclusion: HAIW was well tolerated by all participants without any adverse effects. All laboratory safety parameters remained within normal range. HAIW demonstrated significant improvements in digestive function (appetite, digestion, bowel habits), sleep quality, and freshness after waking as compared to PDW. The study concludes that HAIW can be safely consumed. HAIW improves digestive and sleep-related functions.

10.
arXiv (CS.AI) 2026-06-12

A Mathematical Forum Platform for Collaborative Problem Solving and Dataset Generation for AI Reasoning

arXiv:2606.12976v1 Announce Type: new Abstract: Sharing mathematical content in online forums remains a significant friction point for students and educators: writing raw LATEX is error-prone, standalone optical character recognition tools require platform switching, and current forum software offers no integrated path from a photograph of a formula to a rendered post. We present a unified system that eliminates this friction by embedding an image to LATEX conversion pipeline directly inside a forum posting interface. A user uploads or captures an image of a mathematical expression; the system routes it through the Mathpix OCR API, detects whether the returned output is LATEX or plain text containing inline math, applies the appropriate delimiter normalisation, and renders a live preview in either LATEX or Markdown mode before the post is committed to the database. The architecture is organized in three loosely coupled layers: image processing, rendering, and storage, and supports both desktop and mobile clients. A provisional US patent application has been filed covering the core methods. We describe the full system design, each component in detail, the data schema, and the key technical innovations, and we position the work against existing standalone tools and forum platforms to demonstrate the practical gap it closes. Beyond immediate usability, we argue that a deployed platform of this kind constitutes a continuously growing, community-validated dataset of mathematical problems and step-by-step solutions, a resource that can be used to train and benchmark AI systems for accurate mathematical reasoning

11.
arXiv (CS.CV) 2026-06-16

ActiveSAM: Image-Conditional Class Pruning for Fast and Accurate Open-Vocabulary Segmentation

Segment Anything Model 3 (SAM 3) provides a strong frozen backbone for concept-prompted segmentation, but applying it directly to open-vocabulary semantic segmentation (OVSS) is inefficient: full-resolution decoding is typically run over the entire dataset vocabulary, whereas each image contains only a small active subset of classes. We introduce ActiveSAM, a training-free, zero-shot inference framework that turns SAM 3 into an active-vocabulary segmenter. ActiveSAM first canonicalizes and expands class prompts, then estimates an image-conditioned active set from a low-resolution presence preview. Only the retained classes are decoded at full resolution, using bucketed prompt multiplexing with the frozen SAM 3 decoder. The preview stage uses only class-presence evidence and skips unnecessary segmentation-head computation, while the final stage applies margin-aware background calibration to suppress low-confidence pixels. ActiveSAM requires no target-dataset training, no weight updates, and no oracle class-presence labels. Across eight OVSS benchmarks, ActiveSAM improves the speed-accuracy tradeoff of training-free open-vocabulary semantic segmentation, outperforming the current state-of-the-art SegEarth-OV3 by approximately +1.4 mIoU on average while running up to 5.5x faster on large-vocabulary datasets. ActiveSAM also demonstrates the strongest robustness under image corruption that simulates real-world distribution shift, making it well-suited for deployment in noisy-input domains such as autonomous driving and embodied AI. Code is available at https://github.com/VILA-Lab/ActiveSAM.

12.
arXiv (CS.CL) 2026-06-17

RepSelect: Robust LLM Unlearning via Representation Selectivity

Making large language models (LLMs) deeply forget specific knowledge and values without sacrificing general capabilities remains a central challenge in unlearning. However, current methods are easily reversed by fine-tuning or few-shot prompting, suggesting their forgetting is only shallow. We identify the root cause. Existing methods target representations shared with both the retain set and the subspace recovered by a fine-tuning attacker, making unlearning both disruptive to general capabilities and easy to reverse. We propose RepSelect (Representation Selectivity), isolates forget-set-specific representations by collapsing top principal components of weight gradients before each update, leaving general capabilities intact while limiting what fine-tuning can recover. We evaluate across two forget categories, biohazardous knowledge and abusive tendencies, and four model families spanning dense and Mixture-of-Experts architectures (Llama 3, Qwen 3.5, Gemma 4 E4B, DeepSeek V2 Lite). Compared to five popular baselines (GradDiff, NPO, SimNPO, RMU, UNDIAL), RepSelect achieves a 4-50x larger reduction in post-relearning answer accuracy than the strongest baseline, and is near-perfectly robust to few-shot prompting attacks. Targeting selective representations is thus an important step towards deep and robust LLM forgetting.

13.
medRxiv (Medicine) 2026-06-15

Non-invasive intracranial pressure waveform reconstruction with deep learning

Purpose: Continuous intracranial pressure (ICP) monitoring requires invasive instrumentation, reaching only a narrow subset of critically ill patients. We tested whether deep learning models trained on routinely acquired extracranial signals can reconstruct continuous ICP waveforms at clinically relevant accuracy in an independent external cohort. Methods: In adults admitted to the ICU at a single quaternary health system, five deep learning architectures were trained on high-frequency arterial blood pressure (ABP), photoplethysmography (PPG), and electrocardiography (ECG) waveforms, using invasive (intraparenchymal) ICP as ground truth. Two fusion strategies (early and late) and three training objectives (waveform-morphology, baseline robust regression, and weighted robust regression) were evaluated. Models were externally validated on the held-out MIMIC-III Waveform Database. Performance was assessed by mean absolute error (MAE) and waveform similarity by Pearson correlation (r). Results: We analyzed data from 158 critically ill adults (~5,322 hours) across two quaternary health systems (Johns Hopkins Hospital, Baltimore; Beth Israel Deaconess Medical Center, Boston). Validation MAE ranged from 4.276 mmHg [95% CI 4.269, 4.283] (gated recurrent, late fusion) to 4.946 mmHg [95% CI 4.938, 4.956] (attention-based, early fusion), with Pearson r ranging from 0.599 [95% CI 0.599, 0.600] to 0.722 [95% CI 0.722, 0.723]. The multiscale encoder-decoder model demonstrated the most favorable MAE-correlation tradeoff. Conclusion: This is the first demonstration that continuous ICP waveform reconstruction from bedside signals generalizes across institutions at clinically relevant accuracy, establishing a foundation for non-invasive ICP monitoring and motivating validation across broader populations and ICP ranges.

14.
arXiv (CS.LG) 2026-06-18

Enhanced Graph Neural Networks using K-Hop Gaussian Diffusion

arXiv:2606.18317v1 Announce Type: new Abstract: Most graph neural network (GNN) cores rely on graph convolutions, typically implemented as message passing between direct (single-hop) neighbors. In many real-world graphs, edges can be noisy or poorly defined, limiting information propagation to local neighborhoods. Existing diffusion kernels, such as Personalized PageRank (PPR) and Heat Kernel, alleviate this issue through global propagation, but still struggle with complex local structures and distant node noise. To address these limitations, we propose a K-Hop Gaussian (KHG) diffusion kernel as a preprocessing module for graph data. KHG introduces multi-hop diffusion with Gaussian weighting for remote nodes, balancing local and global information propagation before applying standard GNNs. Experiments on multiple benchmark datasets demonstrate that KHG significantly outperforms traditional message-passing GNNs, as well as PPR and Heat Kernel diffusion, particularly in noisy or structurally complex graphs.

15.
arXiv (CS.CV) 2026-06-17

Learning a Maximum Entropy Model for Visual Textures using Diffusion

Visual textures – spatially homogeneous image regions containing repeated elements (e.g. a field of grass, the bark of a tree) – are ubiquitous in visual scenes and provide important cues for recognizing and analyzing materials and objects. A number of existing texture models extract essential statistics from a single texture image, and can then generate high-quality samples that are visually similar to the original by matching these statistics. However, their statistics are either hand-designed or based on a network pretrained for another purpose (e.g., object recognition). Here, we develop the first principled method for unsupervised learning of a set of statistics that are used to constrain a maximum entropy probability model. We leverage methods developed for generative diffusion models to derive training and sampling procedures, and compare these to the traditional method of sampling via matching the statistics. Despite the compactness of our trained model (512 statistics), it generates texture images whose quality is as good as or better than the current state-of-the-art model (~177k statistics). A more direct comparison of the two models, obtained by synthesizing images that are indistinguishable for one model but maximally different for the other, reveals their relative strengths and weaknesses. Finally, we show that unlike previous statistical texture models, a straight trajectory in the representation space of our model generates homogeneous texture samples that interpolate smoothly between the features of the two end points.

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

Closed-loop discovery of out-of-distribution processing protocols by evolutionary search and uncertainty-aware learning

arXiv:2606.13859v1 Announce Type: cross Abstract: Many materials and chemical systems exhibit history-dependent responses, where functional outcomes are governed not only by final-state variables but by the time-dependent sequence of fields, temperatures, or chemical potentials applied during operation. Discovering new processing protocols is therefore a high-dimensional search problem in which the control variable is an entire waveform or sample history, and conventional strategies either remain confined to conservative interpolative families or become prohibitively measurement intensive. Here, a closed-loop workflow is introduced that couples evolutionary search over a compact waveform representation with uncertainty-aware deep kernel learning to generate, rank, and experimentally validate candidate protocols. Applied to ferroelectric thin films, with the scanning-probe tip-bias waveform as the protocol and the nonlinear electromechanical response as the reward, the workflow discovers waveform families that enhance nonlinearity by de-aging the film. Spatially resolved before/after measurements show that the best-performing waveforms selectively activate pre-existing, weakly pinned domain-wall segments, whereas the worst drive long-range irreversible switching. This framework reframes protocol tuning as out-of-distribution discovery, generalizable to synthesis and annealing trajectories, battery formation protocols, and other high-dimensional control problems.

17.
arXiv (CS.CV) 2026-06-16

MMDiff: Extending Diffusion Transformers for Multi-Modal Generation

Diffusion transformers have demonstrated remarkable generative capabilities, yet the rich perceptual representations computed across their denoising trajectory are discarded once the content is rendered. We present MMDiff, a framework that transforms a frozen diffusion transformer into a multi-modal generative system that jointly produces images alongside any combination of dense perceptual modalities using lightweight decoder heads. Our central finding is that perceptual information is temporally distributed along the denoising trajectory, and that multi-timestep feature fusion with spatially varying aggregation weights is essential, improving semantic segmentation results by up to 28.7% mIoU over single-timestep extraction. We further adopt concept-driven attention extraction for interpretable spatial guidance, and show that frozen diffusion features are competitive with and complementary to state-of-the-art encoders such as DINOv3. By training only lightweight decoder heads on a frozen backbone, we achieve strong performance in semantic segmentation, salient object detection, and depth estimation, and demonstrate that this framework enables effective synthetic data generation at scale.

18.
arXiv (CS.LG) 2026-06-16

Asymptotically Optimal Sequential Testing with Markovian Data

arXiv:2602.17587v3 Announce Type: replace-cross Abstract: We study one-sided and $\alpha$-correct sequential hypothesis testing for data generated by an ergodic, finite-state Markov chain. The null hypothesis is that the unknown transition matrix belongs to a prescribed set $P$ of stochastic matrices, and the alternative corresponds to a disjoint set $Q$. We establish a non-asymptotic instance-dependent lower bound on the expected stopping time of any valid sequential test under the alternative, which is asymptotically tight. Our novel analysis improves the existing lower bounds, which are either asymptotic or provably sub-optimal in this setting. Our lower bound incorporates both the stationary distribution and the transition structure induced by the unknown Markov chain. We further propose an optimal test whose expected stopping time matches this lower bound asymptotically as $\alpha \to 0$. We illustrate the usefulness of our framework through applications to sequential detection of model misspecification in Markov Chain Monte Carlo and to testing structural properties, such as the linearity of transition dynamics, in Markov decision processes. Our findings yield a sharp and general characterization of optimal sequential testing procedures under Markovian dependence.

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

Learning Cardiac Electrophysiology Digital Twins Through Agentic Discovery of Hybrid Structure

arXiv:2606.18154v1 Announce Type: new Abstract: Building personalized cardiac electrophysiology (EP) digital twins requires identifying the appropriate model structure for each patient, not merely fitting parameters. Traditional methods rely on experts to manually prescribe hybrid physics-neural architectures, which requires deep domain expertise and does not transfer across patients. Recent works have applied large language models (LLMs) to generate or act as hybrid models. However, despite their promising generalization capacity, these LLM-based methods lack the structural priors needed for stable cardiac simulations. Hence, we propose LEADS, a framework that formulates cardiac EP domain knowledge as a structured action space and utilizes an LLM agent to discover hybrid models. The agent follows an iterative reasoning-and-action loop to select, combine, and refine hybrid models, whilst gradient descent handles parameter fitting. The proposed LEADS designs every candidate model towards physically grounded, interpretable, and numerically stable, while allowing open-ended architectural discovery. We validate LEADS on synthetic data with three ground-truth reaction models and on real cardiac EP data, demonstrating that it outperforms both human-designed hybrid models and other LLM-based hybrid modeling.

20.
Nature Medicine 2026-06-17

General-purpose chatbots outperform clinical AI tools on physicians’ real-world questions

Authors: Unknown Author

Specialized clinical AI tools are entering medical practice with little independent testing. In a head-to-head evaluation across two public benchmarks and real questions from physicians, three general-purpose frontier large language models outperformed two leading clinical AI tools, which performed no better than Google search AI overview.

21.
medRxiv (Medicine) 2026-06-17

Long-term mortality and cause-specific death after non-cardiac chest pain: a multicentre cohort study of 160,245 patients in China

Abstract Background Non-cardiac chest pain (NCCP) is commonly regarded as a low-risk condition. However, long-term mortality, cause-specific death, and high-risk subgroup characteristics remain poorly defined. Methods In this multicentre registry-linked cohort study, we linked the Chest Pain Center Registry from 101 hospitals in Hunan, China, with the Mortality and Cause of Death Registry. Adults diagnosed with NCCP from Jan 1, 2017, to Dec 31, 2021, were included. We assessed 3-year all-cause, cardiovascular, and non-cardiovascular mortality using Cox, restricted cubic spline, and Fine-Gray models. Findings Among 160,245 patients, 4674 deaths occurred within 3 years (2.9%). Mortality increased sharply after 60.5 years. Age [≥] 60.5 years (adjusted hazard ratio [aHR] 7.49 [95% CI 6.89-8.14]), rural residence (time-varying aHR 1.46 [1.35-1.57] in year 1 and 1.66 [1.46-1.89] in years 1-3), and male sex (aHR 1.47 [1.38-1.57]) independently predicted death. Three-year mortality ranged from 0.3% in younger urban women to 8.4% in older rural men. Cardiovascular diseases accounted for 56.4% of deaths among older patients, whereas other non-cardiovascular causes (22.8%) and malignancy (20.8%) were the largest categories among younger decedents. Interpretation NCCP is not uniformly benign. Age, rural residence, and sex identify patients who could benefit from risk-stratified follow-up, with cardiovascular prevention prioritised for older rural men and broader non-cardiovascular assessment considered for younger patients.

22.
medRxiv (Medicine) 2026-06-11

Genetic Susceptibility to Incisional Hernia: Evaluation of Hernia Polygenic Risk Scores

Objectives: Incisional hernia (IH) affects 13-30% of people after abdominal surgery, resulting in substantial morbidity and costs. While clinical risk factors have been studied extensively, genomic risk for IH is incompletely understood. We aimed to evaluate the impact of polygenic risk scores (PRS) on IH risk prediction. Methods] We created and evaluated three PRS for abdominal hernia, ventral hernia and latent hernia susceptibility for prediction of IH in an institutional biobank. The primary outcome was defined as the diagnosis or repair of an IH based on ICD-9/10-CM/PCS and CPT codes. Clinical covariates included age, sex, body mass index (BMI), smoking status, index procedure type, and perioperative surgical site infection. A phenome-wide association study (PheWAS) was performed to assess clinical associations with increased PRS. We then tested the ability of the PRS to improve prediction for IH by modeling clinical covariates with and without PRS in patients who underwent abdominal surgery. Model performance was assessed using 10 iterations of 5-fold cross-validation to estimate Brier scores and area under the receiver operating characteristic curve (AUROC), which were compared using cross-model Bayesian analysis of variance. Results: In 55,809 subjects, assessed PRS was significantly associated with incisional, umbilical, and ventral hernia on PheWAS, with 1.19 greater odds of developing IH per 1-SD increase in PRS (95% CI: 1.13-1.25, P < 0.001). Of 9,909 subjects who underwent qualifying abdominal surgery, 706 developed IH. In this cohort, the latent hernia susceptibility PRS was associated with a 16% increased hazard of developing IH per 1-SD increase (HR 1.16; 95% CI: 1.07-1.26; P < 0.001). Compared to a predictive model using clinical covariates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC = 0.660, 95% CI: 0.653-0.666), addition of the PRS showed similar Brier score and AUROC estimates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC: 0.667, 95% CI: 0.661-0.673) at five years. Cross-model Bayesian analysis demonstrated >99% probability of practical equivalence when trying to detect a difference of [&ge;] 0.02. Conclusion: All three PRS for hernia were independently associated with IH, suggesting that genomic factors contribute significantly to IH development. However, none of the three PRS meaningfully improved clinical IH risk prediction in patients who underwent abdominal surgery. This suggests that clinical comorbidities and surgical techniques may be equally as important as genomic architecture.

23.
arXiv (CS.LG) 2026-06-16

Generative Molecular Design with Steerable and Granular Synthesizability Control

arXiv:2505.08774v2 Announce Type: replace-cross Abstract: Designing molecules that are both property-optimal and readily synthesizable is a central challenge in drug discovery. Existing works that do consider synthesizability can jointly output predicted synthesis routes for generated molecules. However, there has been minimal attention in addressing the ease of synthesis and with flexibility to incorporate desired reaction constraints. On the other hand, virtual screening searches for commercially available compounds, but imposes challenges when scaling to ultra-large (billion-size and beyond) chemical spaces. Here, we propose a generative design framework that unifies synthesis-constrained molecular design and ultra-large-scale virtual screening through steerable and granular synthesizability control. Generated molecules satisfy arbitrary multi-parameter optimization objectives with predicted synthesis routes satisfying mix-and-match constraints: including or avoiding certain reactions, incorporating specific building blocks, and minimizing synthesis route length. In an end-to-end in-house campaign targeting BRD4, we designed molecules synthesizable with specific selected reactions and building blocks, synthesized all six selected compounds, and identified two micromolar binders. We further demonstrate that reaction control enables efficient navigation of ultra-large make-on-demand chemical spaces to identify property-optimal candidates. By applying our framework to Chemspace's Freedom 4.0 make-on-demand space (142 billion molecules), we generated ~320k molecules (0.00023% of the library) on a single consumer-grade GPU (with only 8 GB GPU memory) and identified a micromolar Wee1 binder amongst 60 synthesized candidates. The single unified framework thus enables generating novel synthesizable molecules and retrieving catalogue-ready candidates, offering a flexible solution to mitigating the synthesizability bottleneck.

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

From Correspondence to Actions: Human-Like Multi-Image Spatial Reasoning in Multi-modal Large Language Models

While multimodal large language models (MLLMs) have made substantial progress in single-image spatial reasoning, multi-image spatial reasoning, which requires integration of information from multiple viewpoints, remains challenging. Cognitive studies suggest that humans address such tasks through two mechanisms: cross-view correspondence, which identifies regions across different views that correspond to the same physical locations, and stepwise viewpoint transformation, which composes relative viewpoint changes sequentially. However, existing studies incorporate these mechanisms only partially and often implicitly, without explicit supervision for both. We propose Human-Aware Training for Cross-view correspondence and viewpoint cHange (HATCH), a training framework with two complementary objectives: (1) Patch-Level Spatial Alignment, which encourages patch representations to align across views for spatially corresponding regions, and (2) Action-then-Answer Reasoning, which requires the model to generate explicit viewpoint transition actions before predicting the final answer. Experiments on three benchmarks demonstrate that HATCH consistently outperforms baselines of comparable size by a clear margin and achieves competitive results against much larger models, while preserving single-image reasoning capabilities.

25.
arXiv (CS.AI) 2026-06-11

AI4Land: Scalable Deep Learning for Global High-Resolution Land Use Reconstruction

arXiv:2606.11793v1 Announce Type: cross Abstract: Uncertainty in the terrestrial carbon cycle remains a major constraint in climate projections, partly driven by the uncertainties affecting the land surface representation and variability in Earth system models. To address this limitation, we present a data-driven framework AI4Land, for generating high-resolution historical reconstructions and future projections of key land surface variables. The framework follows a two-phase approach using a U-Net architecture. In the first phase, which is the focus of this work, it reconstructs annual land use and land cover by integrating coarse-resolution scenario data with static geophysical features. In a planned second phase, the resulting high-resolution maps will be used to predict dynamic biophysical variables, particularly leaf area index, at finer temporal scales. Trained on Earth observation data, the models learn to reproduce spatially explicit and physically consistent land surface patterns, extending temporal coverage to periods lacking direct observations. AI4Land was developed and trained on MareNostrum5, demonstrating how GPU-accelerated HPC infrastructure enables global-scale climate AI pipelines. The final product is a suite of open-source emulators designed for real-time coupling with digital twin platforms, such as those developed under the Destination Earth initiative. By delivering realistic and evolving land surface conditions on demand, this work aims to reduce critical uncertainties and improve the predictive power of next-generation climate simulations.