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01.
medRxiv (Medicine) 2026-06-19

Cardiometabolic multimorbidity and care experiences in primary healthcare among Brazilian adults aged 50 and over (ELSI-Brazil)

Authors:
Souza↗F. H. A. d↗Delpino↗F. M↗Batista↗S. R. R↗

Background: Population aging and the rising burden of non-communicable diseases have increased the prevalence of cardiometabolic multimorbidity (CM-MM) among older adults. Patient-reported experience measures (PREMs) are recognized as essential components of healthcare quality assessment, yet evidence on primary care experiences among individuals with CM-MM remains scarce. Objective: To analyze primary care experiences according to the presence of cardiometabolic multimorbidity among Brazilians aged 50 years and older. Methods: Cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021; n = 9,949). CM-MM was defined as the self-reported coexistence of two or more of the following conditions: hypertension, diabetes mellitus, dyslipidemia, acute myocardial infarction, and stroke. Primary care experiences were assessed using a validated 12-item instrument organized into four domains: first-contact access, longitudinality, communication, and care coordination. Associations were estimated using Poisson regression adjusted for sociodemographic, health conditions, and healthcare utilization variables, with stratified analysis by Family Health Strategy (FHS) coverage. Results: CM-MM prevalence was 25.5%, with a progressive increase by age and an inverse gradient by education. Individuals with CM-MM reported significantly more positive experiences in longitudinality (mean index 2.53 vs. 2.34; adjusted PR = 1.22; 95%CI 1.12-1.33; p < 0.001) and, to a lesser extent, in communication (mean index 2.68 vs. 2.58; adjusted PR = 1.10; 95%CI 1.00-1.20; p = 0.041). No statistically significant differences were found in first-contact access or care coordination. After stratified by FHS coverage, the observed differences in longitudinality and communication were no longer statistically significant. Conclusions: CM-MM was associated with more positive primary care experiences in longitudinality and communication. The absence of differentiated experiences in first-contact access and coordination highlights structural gaps in primary care responsiveness to individuals with greater clinical complexity. Keywords: Multimorbidity; Cardiometabolic diseases; Primary Care; Patient-reported experience measures; Older adults; ELSI-Brazil.

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02.
arXiv (CS.CV) 2026-06-15

PhysVLA: Towards Physically-Grounded VLA for Embodied Robotic Manipulation

Authors:
Namai Chandra↗Shriram Damodaran↗Lin Wang↗

Vision-Language-Action (VLA) models excel at mapping visual inputs and natural language instructions directly to robotic control policies. However, because they are trained primarily to fit behavioural demonstration data, they do not explicitly enforce fundamental physical principles such as rigid-body dynamics or contact constraints. This exposes a critical physics gap: standard temporal smoothing applied on top of single-step or chunked VLAs trades trajectory quality for added failures that short-term memory cannot resolve. To bridge this gap, we introduce PhysVLA (Physics-VLA), a plug-and-play, inference-time framework designed to wrap any frozen VLA backbone without retraining, fine-tuning, or weight access, with less than 1 ms of overhead per control step. PhysVLA intercepts the predicted control action, captures only the simulator or system state, and applies a dual-layered correction: (i) a phase-aware finite-state machine that structures discrete task segments (approach, grasp, transport, and place), and (ii) a selective Euler-Lagrange gate that activates only when a dynamics oracle detects kinodynamic inconsistency. Evaluated across OpenVLA, OpenVLA-OFT, Force-VLA, and Generalist-VLA on LIBERO-Spatial with a 7-DoF Franka Panda, the framework delivers absolute success rate increases of up to 17% and stability increases of up to 19% with no per-task regressions, improves trajectory efficiency by up to 15% across all four backbones, and shows up to a 10x improvement in trajectory jerk robustness on a Robosuite Lift cross-simulator sweep. We further validate the framework on a real Agilex Piper arm with a pick-and-place task, confirming that PhysVLA transfers to physical hardware without retraining, with success-rate improvements of up to 50%, establishing physical awareness as a composable, backbone-agnostic runtime module.

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

Enhancing Physics-Informed Neural Networks Through Feature Engineering

Authors:
Shaghayegh Fazliani↗Zachary Frangella↗Madeleine Udell↗

arXiv:2502.07209v4 Announce Type: replace Abstract: Physics-Informed Neural Networks (PINNs) seek to solve partial differential equations (PDEs) with deep learning. Mainstream approaches that deploy fully-connected multi-layer deep learning architectures require prolonged training to achieve even moderate accuracy, while recent work on feature engineering allows higher accuracy and faster convergence. This paper introduces SAFE-NET, a Single-layered Adaptive Feature Engineering NETwork that achieves orders-of-magnitude lower errors with far fewer parameters than baseline feature engineering methods. SAFE-NET returns to basic ideas in machine learning, using Fourier features, a simplified single hidden layer network architecture, and an effective optimizer that improves the conditioning of the PINN optimization problem. Numerical results show that SAFE-NET converges faster and typically outperforms deeper networks and more complex architectures. It consistently uses fewer parameters – on average, 65% fewer than the competing feature engineering methods – while achieving comparable accuracy in less than 30% of the training epochs. Moreover, each SAFE-NET epoch is 95% faster than those of competing feature engineering approaches. These findings challenge the prevailing belief that modern PINNs effectively learn features in these scientific applications and highlight the efficiency gains possible through feature engineering.

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04.
medRxiv (Medicine) 2026-06-16

Validating an Early Pregnancy HbA1c as the Screening Test for Gestational Diabetes Mellitus: Findings from PRISMA Pakistan Cohort

Authors:
Naz↗Yazdani↗Hoodbhoy↗Ghebremihael-Weldeselassie↗Mazhar↗Hotwani↗Jehan↗Nisar↗M. I↗Iqbal↗

Background: Early identification of gestational diabetes mellitus (GDM) is critical to improving maternal and neonatal outcomes, particularly in resource-constrained settings where universal oral glucose tolerance testing (OGTT) is burdensome. We assessed whether early-pregnancy HbA1c alone or combined with common risk factors can predict GDM and reduce the burden of OGTT requirements in a peri-urban cohort in Karachi, Pakistan. Methods: We conducted a secondary analysis of the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) Pakistan cohort. Women enrolled before 20 weeks' gestation with available early-pregnancy HbA1c and a 2-hour 75g OGTT at 24 to 28 weeks were included. We externally validated GDM prediction models originally developed in the STRiDE-India cohort. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). We assessed four models: HbA1c alone (Model 1a); age, BMI, and family history of diabetes mellitus (FH DM) (Model 1b); HbA1c combined with age, BMI, and FH DM (Model 2); and an extended model, i.e., Model 2 combined with socioeconomic status, gestational age, parity, systolic and diastolic blood pressure (Model 3). A dual-threshold approach was applied to assess rule-in and rule-out performance. Results: Among 2,489 women, GDM incidence was 7.5% (n=186). Models with a broader set of predictors demonstrated higher AUC values, with Model 2 achieving an AUC of 0.61 (95% CI: 0.57, 0.66). Including additional factors (Model 3) did not further improve predictive ability (AUC: 0.62; 95% CI: 0.58, 0.66). In addition, at predefined thresholds, Model 2 achieved sensitivity of 73.7% (rule-out) and specificity of 83.5% (rule-in), with the potential to reduce OGTT requirements (58.5%). Conclusions: Early-pregnancy risk stratification using HbA1c combined with simple clinical predictors offers a pragmatic approach to streamline GDM screening among high-risk pregnant women. A dual-threshold strategy using Model 2 could reduce reliance on universal OGTT while prioritizing high-risk women for confirmatory testing.

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05.
arXiv (CS.CV) 2026-06-11

Semantically-Aware Diver Activity Recognition Framework for Effective Underwater Multi-Human-Robot Collaboration

Authors:
Sadman Sakib Enan↗Junaed Sattar↗

Effective multi-human-robot collaboration is essential for expanding human-led operations in the challenging and high-risk underwater environment. For autonomous underwater vehicles (AUVs) to become true teammates, they must be able to comprehend their surroundings and recognize a diver's activities to offer assistance and ensure safety. Towards this goal, we introduce DAR-Net, a novel transformer-based framework that analyzes complex underwater scenes to classify diver activities. Our contribution lies in a semantically guided learning formulation that couples transformer-based temporal reasoning with pixel-level scene supervision. This multi-loss training strategy explicitly aligns global activity recognition with local human-robot interaction semantics, which is particularly critical in low-visibility underwater conditions. To address the significant challenge of data scarcity in this domain, we present the first-ever Underwater Diver Activity (UDA) dataset, a foundational resource containing over 2,600 annotated images with pixel-level masks. Through rigorous experimental evaluations in a controlled environment, we demonstrate that DAR-Net achieves promising accuracy in recognizing six distinct diver activities, outperforming state-of-the-art models. While this dataset provides a crucial baseline, our work serves as a pioneering step, laying the groundwork for future research and facilitating the development of more intelligent, collaborative underwater robotic systems.

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

Search Discipline for Long-Horizon Research Agents

Authors:
Adithya Srinivasan↗Devesh Paragiri↗

arXiv:2606.11522v1 Announce Type: new Abstract: Autoresearch agents now propose, evaluate, and select scientific candidates against a metric, and that metric is usually an aggregate reduced over a heterogeneous space of regions, slices, or cohorts. We show that when scientific validity lives in that disaggregated structure, the aggregate can rank the wrong candidate first. The headline number improves while the structure underneath inverts, so a decision made on the number accepts a candidate that quietly breaks the model. The failure is not domain-specific. It appears wherever a candidate's validity is multi-dimensional but its verifier is a single reduction. We demonstrate the inversion on a fire-model task in the Ecosystem Demography model. The highest-scoring candidate and a slightly lower one are within noise of each other on global score, yet the top-scoring one collapses the protected boreal regions while the other preserves them. What separates them is the per-region behavior, not the headline number. This decision should not be left to the agent that produced the candidates. The agent optimizing the score is the last party likely to catch the score being wrong, and a prompt has no remaining turn once the agent has stopped. We move the decision to an external control loop that audits each candidate on its disaggregated behavior and acts after the agent has decided. It can demote a candidate the agent would have accepted, and it can reopen a run the agent had declared finished. Our contribution is the inversion finding itself, and a search-discipline protocol that decides on reviewable candidate-effect evidence instead of the score.

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

MoECa: Aligning Feature Reuse with Expert Decomposition in Diffusion Transformers

Authors:
Maoliang Li↗Haojing Chen↗Jiayu Chen↗Zihao Zheng↗Xinhao Sun↗Hailong Zou↗Xiang Chen↗

Diffusion Transformers with Mixture-of-Experts (DiT-MoE) improve model capacity under sparse activation, but diffusion inference is still bottlenecked by redundant computation across timesteps. Existing caching methods mainly operate at the token level, which becomes suboptimal in DiT-MoE because each token update is internally decomposed into multiple routed expert branches. Our analysis shows that cross-timestep redundancy in DiT-MoE is better characterized at the expert-branch level than at the whole-token level. Based on this observation, we propose MoECa, a fine-grained caching framework that performs branch-level feature reuse across timesteps. MoECa further introduces expert-aware adaptive control and synchronized cache updates across MoE and attention paths to maintain stable intermediate states. Experiments on multiple DiT-MoE models show that MoECa consistently achieves a better speed-quality trade-off than prior caching methods, with up to 2.83$\times$ inference speedup and minimal quality degradation.

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

EgoCS-400K: An Egocentric Gameplay Dataset for World Models

Authors:
Rongjin Guo↗Dong Liang↗Yuhao Liu↗Fang Liu↗Tianyu Huang↗Gerhard P. Hancke↗Rynson W. H. Lau↗

The shift from video generation to interactive world modeling places new demands on data: beyond captioned videos, world models require temporally aligned video-action-language trajectories grounded in the actions, camera motion, states, and events that drive future scene changes. However, such data is difficult to obtain at scale. Web video datasets offer broad visual coverage but lack executable actions and reliable states; robotic datasets provide action and state supervision but are costly and limited in scene diversity; and existing simulators often lack large-scale human-driven interaction trajectories. In this paper, we introduce EgoCS-400K, a large-scale replay-grounded egocentric Counter-Strike dataset for world models, built from public professional CS and CS2 match demos that preserve human gameplay trajectories and enable parsing, replaying, rendering, and temporal alignment. We extract player states, view directions, movements, keyboard/button inputs, view-angle changes, weapon usage, game events, and round-level context, and render clean first-person videos from the same trajectories. EgoCS-400K contains over 400,000 first-person videos and 10,000 hours of gameplay from more than 1,000 matches and 40,000 rounds, covering 13 maps and 10 player viewpoints per round. It supports a range of interactive visual modeling tasks, including action-conditioned future prediction, state- and event-aware scene rollout, replay-grounded captioning, and agent egocentric action understanding. By connecting visual observations with human actions, camera motion, game states, and events at scale, EgoCS-400K serves as a practical bridge between passive web videos, controllable game simulation, and costly real-world embodied data.

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09.
arXiv (CS.CV) 2026-06-25

Pre-Warm: Input-Conditioned Weight Initialization for Convolutional Neural Networks

Authors:
Rowan Martnishn↗

We introduce Pre-Warm, a simple yet effective zero-training-cost method for data-conditioned initialization of the first convolutional layer. Before the first forward pass, Pre-Warm extracts mean-centered local patches from a single training batch, clusters them with MiniBatchKMeans, applies inverse Manhattan spatial weighting, and uses the resulting centroids to initialize half of the first-layer filters (the remainder retain Kaiming initialization). We derive closed-form rules for all hyperparameters except a single insensitive scale parameter, though we derive a Kaiming parity bound on scale from patch dimensionality. For grayscale datasets we use Otsu's foreground density; for natural color images we use the mean L2 norm of mean-centered patches. Both rules accurately predict the optimal patch count observed in grid search. Across five standard benchmarks – MNIST, Fashion-MNIST, CIFAR-10, SVHN, and CIFAR-100 – and 8-seed paired experiments, Pre-Warm yields statistically significant accuracy improvements over standard Kaiming initialization (p < 0.05 on all datasets, p = 0.0007 on SVHN with 8/8 wins, p = 0.0033 on CIFAR-100 with 7/8 wins). The method adds negligible overhead, requires no architectural changes, and integrates into existing training pipelines with only a few lines of code. Pre-Warm demonstrates that even a lightweight, input-dependent signal can meaningfully improve optimization trajectories in modern convolutional networks.

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10.
arXiv (CS.CL) 2026-06-24

CORE-BREW: LLR-Based Soft Decoding for Robust Multi-Bit LLM Watermarking

Authors:
Joeun Kim↗HoEun Kim↗Young-Sik Kim↗

Reliable provenance for LLM outputs requires multi-bit watermarks that remain robust under editing while maintaining strict false-positive control. Existing ECC-based LLM watermarks rely largely on hard-decision decoding, discarding token-level reliability information. We propose CORE-BREW, a Constant-hit-Rate Embedding extension of block-wise BREW for robust multi-bit watermarking. CORE-BREW calibrates the watermark channel by targeting a fixed hit rate p-star, yielding closed-form per-token log-likelihood ratios (LLRs) for principled soft-decision decoding. It supports two detection modes: Strict-Safe, which preserves the bounded-distance designated-codeword acceptance region, and FPR-Calibrated, which uses likelihood-based scoring and lightweight list decoding to characterize the FPR-TPR trade-off. Experiments on open-source LLMs under token-level edits and paraphrasing demonstrate improved low-FPR discrimination and robustness over prior multi-bit watermarking baselines while maintaining comparable semantic quality.

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11.
arXiv (CS.CV) 2026-06-19

InfantFace: Detecting infant faces in neonatal clinical environments

Authors:
Abdullah Bin-Obaid↗Maria M. Cobo↗Rebeccah Slater↗Lionel Tarassenko↗Mauricio Villarroel↗

Reliable localisation of the neonatal face is the first step for several video-camera based non-contact assessments such as pain and distress related facial expression analysis, pain scoring, cardiorespiratory signal extraction and cessation of breathing alerts. However, major challenges persist in neonatal clinical environments. Cluttered backgrounds, illumination changes and poor lighting conditions can reduce the accuracy of face detection models. Clinical interventions, monitoring equipment and, in some cases, medical devices can obstruct the face, making visual assessment difficult. We propose a one-stage YOLOv11m-based model tailored for face detection of infants in neonatal clinical environments. We combined multiple publicly available datasets (VGGFace2, CelebA, FDDB, WIDER FACE) to train and evaluate our proposed model. We then fine-tuned our model on a neonatal research dataset involving 228 videos from 114 recording sessions of 113 independent infants. Before fine-tuning, our model achieved an AP50 of 0.87, surpassing the performance of three state-of-the-art general face detectors. Performance improved further to an AP50 of 0.96 after clinical-domain adaptation. Evaluating face detection performance across different datasets remains a challenge due to the lack of publicly available neonatal datasets. Prioritising the creation of such datasets, while upholding appropriate privacy safeguards and ethical standards in their creation and use, would greatly support further progress in this field.

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12.
medRxiv (Medicine) 2026-06-22

Cumulative Metabolic Exposure to Hyperglycemia and Risk of Cardiovascular and Limb Events in Peripheral Artery Disease

Authors:
James↗Li↗Somisetty↗Nguyen↗Vaughan-Sarrazin↗M. S↗Lund↗Tsai↗Smolderen↗K. G↗Hoffman↗R. M↗…

Background: Although diabetes is a potent risk factor for the development of peripheral artery disease (PAD), the effect of cumulative metabolic exposure to hyperglycemia on risk of cardiovascular or limb events in patients with PAD remains unclear. Methods: The Peripheral Artery Disease: Long-term Survival (PEARLS) is a longitudinal registry of Veterans with newly diagnosed PAD identified using a natural language processing approach. Included patients had ankle brachial index [&le;]0.9 or toe brachial index [&le;]0.7, and no history of lower extremity revascularization or major amputation. Among patients with diabetes in this cohort, we assessed cumulative exposure to hyperglycema based on a 24-month rolling average of hemoglobin (Hgb) A1c values, categorized as [&le;]7%, >7% to [&le;]8%, and >8%. Multivariable Cox regression models evaluated the association between categories of HgbA1c, modeled as a time-varying exposure, and risk of cardiovascular (CV: myocardial infarction or stroke) and limb (chronic limb threatening ischemia [CLTI] or major amputation) events. Results: Among 45,109 patients with new diagnosis of PAD and pre-existing diabetes, the mean HgbA1c at baseline was 7.5%, with nearly one-third (30.4%) having HgbA1c >8%. The mean age was 70.4 years, 19.8% were Black and 4% were Hispanic. Patients with baseline HgbA1c >8% were younger and compared to those with HgbA1c [&le;]7%, more likely to have coronary disease, kidney disease, and obesity. Over a median follow up of 4.2 years, 8,306 (18.4%) patients experienced a CV event, and 8,199 (18.2%) experienced a limb event. The adjusted association between HgbA1c and hazard of CV events was 12% higher in patients exposed to HgbA1c >7% to [&le;]8% (HR 1.12; 95%CI: 1.05-1.18) and 38% higher in those exposed to HgbA1c >8% (HR 1.38; 95%CI: 1.30-1.46), compared to HgbA1c 7% to [&le;]8% (HR 1.20; 95%CI: 1.13-1.28) and HgbA1c >8% (HR 1.60; 95%CI: 1.51-1.70), respectively when compared to HgbA1c [&le;]7%. These findings were consistent in subgroups based on age and severity of PAD. Conclusions: Among diabetic patients with PAD, cumulatiave metabolic exposure to hyperglycemia is associated with a markedly increased risk of clinical events, especially limb events.

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13.
arXiv (CS.AI) 2026-06-11

Diffusing to Coordinate: Efficient Online Multi-Agent Diffusion Policies

Authors:
Zhuoran Li↗Hai Zhong↗Xun Wang↗Qingxin Xia↗Lihua Zhang↗Longbo Huang↗

arXiv:2602.18291v2 Announce Type: replace Abstract: Online Multi-Agent Reinforcement Learning (MARL) is a prominent framework for efficient agent coordination. Crucially, enhancing policy expressiveness is pivotal for achieving superior performance. Diffusion-based generative models are well-positioned to meet this demand, having demonstrated remarkable expressiveness and multimodal representation in image generation and offline settings. Yet, their potential in online MARL remains largely under-explored. A major obstacle is that the intractable likelihoods of diffusion models impede entropy-based exploration and coordination. To tackle this challenge, we propose among the first \underline{O}nline off-policy \underline{MA}RL framework using \underline{D}iffusion policies (OMAD) to orchestrate coordination. Our key innovation is a relaxed policy objective that maximizes scaled joint entropy, facilitating effective exploration without relying on tractable likelihood. Complementing this, within the centralized training with decentralized execution (CTDE) paradigm, we employ a joint distributional value function to optimize decentralized diffusion policies. It leverages tractable entropy-augmented targets to guide the simultaneous updates of diffusion policies, thereby ensuring stable coordination. Extensive evaluations on MPE and MAMuJoCo establish our method as the new state-of-the-art across $10$ diverse tasks, demonstrating a remarkable $2.5\times$ to $5\times$ improvement in sample efficiency.

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

As You Wish: Mission Planning with Formal Verification using LLMs in Precision Agriculture

Authors:
Marcos Abel Zuzu\'arregui↗Stefano Carpin↗

arXiv:2606.18519v1 Announce Type: cross Abstract: Though robotic systems are now being commercialized and deployed in various industries, many of these systems are highly specialized and often require an advanced skill set to operate and ensure they perform as instructed. To mitigate this problem, we recently introduced a mission planner leveraging LLMs to synthesize mission plans in precision agriculture based on mission descriptions provided in natural language. While the system demonstrates impressive performance, it also suffers from the inherent ambiguities of natural language. In this paper, we extend our system to address this issue by introducing multiple feedback loops in the planning architecture that leverage linear temporal logic (LTL) to ensure the mission planning system meets the specifications formulated by the user while still using natural language. To mitigate potential bias, this is achieved by using two different commercial LLMs in charge of the specification and verification subtasks. Through extensive experiments, we highlight the strengths and limitations of integrating mission verification into a fully autonomous pipeline, particularly regarding an LLM's ability to generate valuable LTL formulas, and show how our proposed implementation addresses and solves these challenges.

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15.
arXiv (math.PR) 2026-06-18

On the Singular Control of a Diffusion and its Running Infimum or Supremum

Authors:
Giorgio Ferrari↗Neofytos Rodosthenous↗

arXiv:2501.17577v2 Announce Type: replace-cross Abstract: We study a class of singular stochastic control problems for a one-dimensional diffusion $X$ in which the performance criterion to be optimised depends explicitly on the running infimum $I$ (or supremum $S$) of the controlled process. We introduce two novel integral operators that are consistent with the Hamilton-Jacobi-Bellman equation for the resulting two-dimensional singular control problems. The first operator involves integrals where the integrator is the control process of the two-dimensional process $(X,I)$ or $(X,S)$; the second operator concerns integrals where the integrator is the running infimum or supremum process itself. Using these definitions, we prove a general verification theorem for problems involving two-dimensional state-dependent running costs, costs of controlling the process, costs of increasing the running infimum (or supremum) and exit times. Finally, we apply our results to explicitly solve an optimal dividend problem in which the manager's time-preferences depend on the company's historical worst performance.

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

Quantum coherence and Leggett-Garg inequality

Authors:
A. Jalal↗S. M. Fazeli↗M. M. Ettefaghi↗

arXiv:2606.15717v1 Announce Type: new Abstract: In this paper, we attempt to establish the relationship between quantum coherence and the violation of the Leggett-Garg inequality. In particular, employing the Lindblad equation, we obtain the pseudo-density matrix for a damping system to study the effect of environment interaction on the violation of this inequality in a two-state quantum system. It is shown that the violation of the Leggett-Garg inequality can be observed as long as temporal evolution does not induce decoherence. This statement is independent of the initial state of the system. Furthermore, similar to the Horodecki criterion for the CHSH inequality (R. Horodecki et al. Phys. Lett. {\bf A200}, 340), we study necessary and sufficient conditions for violating the Leggett-Garg inequality. Hereby, under the circumstance that the inequality violation occurs, an upper bound for the time interval between consecutive measurements with respect to the time scale of interaction with the environment (the relaxation time) is obtained.

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17.
medRxiv (Medicine) 2026-06-18

Intra-arterial recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) thrombolysis for acute medium vessel occlusion (MeVO-TNK): Study rationale and design

Authors:
Deng↗Liu↗C.-C↗Wang↗Y.-H↗Ao↗D.-H↗Huang↗Xie↗Zhang↗Kong↗Q.-Q↗…

Background The optimal management of acute ischemic stroke caused by medium vessel occlusion (MeVO) remains uncertain. Recent randomized trials have failed to demonstrate a clear benefit of endovascular therapy in this population, whereas intra-arterial thrombolysis (IAT) has emerged as a biologically plausible alternative. However, prospective evidence supporting IAT in MeVO is lacking, and the optimal dosing strategy for stand-alone IAT remains undefined. Aim To preliminarily evaluate the efficacy and safety of intra-arterial tenecteplase (IA-TNK) plus standard medical therapy (SMT) compared with SMT alone in patients with acute MeVO stroke, and to explore a stepwise IA-TNK dosing strategy. Design The MeVO-TNK trial is a multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE), exploratory phase II study. A total of 60 participants with imaging-confirmed MeVO will be randomized 1:1 to receive either IA-TNK plus SMT or SMT alone. Participants presenting beyond 6 hours from symptom onset must demonstrate salvageable penumbral tissue on advanced imaging. Those assigned to the intervention group will receive up to two intra-arterial boluses of tenecteplase (0.0625 mg/kg per bolus), with the second bolus administered based on angiographic assessment of reperfusion and safety. Outcomes The primary efficacy outcome is final infarct volume measured at 72{+/-}24 hours after randomization. Secondary efficacy outcomes include the proportions of patients achieving modified Rankin Scale (mRS) scores of 0-1, 0-2 and 0-3 at 90 days, a shift analysis of the mRS distribution at 90 days, early neurological deterioration, and National Institutes of Health Stroke Scale score at 7 days or discharge. The primary safety outcome is symptomatic intracranial hemorrhage within 24 hours. Conclusions This trial will provide preliminary evidence on the biological efficacy, reperfusion potential and safety of stand-alone IA-TNK for acute MeVO stroke, helping to address an important evidence gap and inform the design of future confirmatory studies.

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

Domain-Shift Aware Neural Networks for Unbalance Characterization in Rotating Systems

Authors:
Bernardo Feij\'o Junqueira↗Claudio Kiyoshi Umezu↗Bruno Bilhar Karaziack↗Tomaz Junior↗Daniel Alves Castello↗

arXiv:2606.18882v1 Announce Type: cross Abstract: This work investigates the application of a domain-shift aware neural network for regression tasks aimed at estimating unbalance masses in rotating shafts under varying operating conditions. Experimental data were collected from a test rig in which a primary shaft, equipped with a flange carrying unbalanced masses, was driven at different rotational speeds, while a secondary shaft could be optionally activated to introduce domain discrepancy. The unbalance masses were positioned at a fixed radial distance, and the dynamic response of the system was recorded using triaxial accelerometers. The inverse problem of mass estimation is formulated within a domain adaptation framework, where the network is trained with a maximum mean discrepancy strategy to align feature representations across source and target distributions. The results demonstrate the effectiveness of explicitly addressing domain shift in improving prediction accuracy, especially when the system's physical behavior and sources of domain discrepancy are not fully known and fall outside the training conditions. These findings highlight the potential of domain-shift aware models for regression tasks in Structural Health Monitoring.

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19.
arXiv (CS.CV) 2026-06-24

Point-Voxel Absorbing Graph Representation Learning for Event Stream based Recognition

Authors:
Yuxiang Zhang↗Chengguo Yuan↗Xiao Wang↗Bo Jiang↗Jin Tang↗

Sampled point and voxel methods are usually employed to downsample the dense events into sparse ones. After that, one popular way is to leverage a graph model which treats the sparse points/voxels as nodes and adopts graph neural networks (GNNs) to learn the representation of event data. Although good performance can be obtained, however, their results are still limited mainly due to two issues. (1) Existing event GNNs generally adopt the additional max (or mean) pooling layer to summarize all node embeddings into a single graph-level representation for the whole event data representation. However, this approach fails to capture the importance of graph nodes and also fails to be fully aware of the node representations. (2) Existing methods generally employ either a sparse point or voxel graph representation model which thus lacks consideration of the complementary between these two types of representation models. To address these issues, we propose a novel dual point-voxel absorbing graph representation learning for event stream data representation. To be specific, given the input event stream, we first transform it into the sparse event cloud and voxel grids and build dual absorbing graph models for them respectively. Then, we design a novel absorbing graph convolutional network (AGCN) for our dual absorbing graph representation and learning. The key aspect of the proposed AGCN is its ability to effectively capture the importance of nodes and thus be fully aware of node representations in summarizing all node representations through the introduced absorbing nodes. Extensive experiments on multiple event-based classification benchmark datasets fully validated the effectiveness of our framework.

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20.
Nature (Science) 2026-06-24

AI tool spots antibiotics that fight drug-resistant gonorrhoea

Authors: Unknown Author

The bacterium Neisseria gonorrhoeae has evolved resistance to most antibiotics used to treat it, but a machine-learning screen reveals potential therapies. The bacterium Neisseria gonorrhoeae has evolved resistance to most antibiotics used to treat it, but a machine-learning screen reveals potential therapies.

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21.
arXiv (CS.AI) 2026-06-15

The Insurability Frontier of AI Risk: Mapping Threats to Affirmative Coverage, Silent Exposures, and Exclusions

Authors:
Alex Leung↗Rex Zhang↗Ervin Ling↗Kentaroh Toyoda↗SiewMei Loh↗

arXiv:2605.18784v2 Announce Type: replace-cross Abstract: The rapid diffusion of agentic AI has created a new coverage problem for commercial insurance: some AI-mediated losses are now affirmatively insured, some create silent-AI exposure under legacy cyber, technology errors-and-omissions (E&O), directors-and-officers (D&O), employment practices liability (EPLI), crime, and media policies, and others are being actively excluded. This paper maps that emerging boundary by coding 55 AI threat classes against 26 insurance products, endorsements, and exclusion regimes using public carrier materials and OWASP/MITRE threat catalogs. We identify a four-tier insurability frontier: affirmatively insured perils, silent-AI exposures, actively excluded perils, and perils outside conventional private insurance structures. Our coding measures publicly claimed positioning rather than executed contract wording; the headline statistics describe what carriers publicly state about coverage, not what would be paid in any specific claim. Three patterns emerge. First, affirmative AI coverage is beginning to differentiate by primary risk emphasis: public materials often position Munich Re around model performance and drift, Armilla and parts of the Lloyd's market around hallucination and broader AI liability, Tokio Marine Kiln and CFC around IP and technology E&O concerns, Apollo ibott around emerging autonomous system liability, and Coalition around deepfake and AI-enabled cyber response. Second, legacy lines retain silent-AI exposure where AI is an instrumentality rather than the legal cause of loss. Third, foundation model concentration is the clearest genuinely novel insurability frontier because upstream model failure can correlate losses across many cedents at once; the relevant market design question is which insurability constraint each candidate structure relaxes, not merely which systemic risk template exists.

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22.
arXiv (CS.CV) 2026-06-25

SeFi-Image: A Text-to-Image Foundation Model with Semantic-First Diffusion

Authors:
SeFi-Team↗

Training image generation foundation models consumes substantial resources. Previous methods have attempted to leverage semantic guidance to accelerate the training process, yet their experiments were only conducted on simple datasets such as ImageNet, at low resolutions, and with small-scale models. In this paper, we propose SeFi-Image, a text-to-image foundation model built upon semantic-first diffusion, a novel latent diffusion modeling paradigm. We instantiate SeFi-Image at three model scales, 1B, 2B, and 5B parameters, enabling systematic study of scaling behavior and flexible deployment under varying compute budgets. Notably, our largest 5B model was trained with merely 125K A800 GPU hours, corresponding to roughly 10-20% of the training compute used by Z-Image. However, it achieves results comparable to or even superior to Qwen-Image and Z-Image. Despite this modest training compute, SeFi-Image achieves strong performance on a wide range of benchmarks, including GenEval, DPG, LongTextBench, OneIG, and CVTG-2K. Moreover, we provide DMD2-distilled few-step turbo variants for each model scale to accommodate diverse hardware constraints and latency requirements. We publicly release our code, weights and hope this work offers the community useful insights into semantic-guided diffusion modeling for T2I generation, while also providing practical and readily deployable model options.

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23.
arXiv (CS.CL) 2026-06-11

Overcoming State Inertia in Full-Duplex Spoken Language Models via Activation Steering

Authors:
Cheng-Kuang Chang↗Kai-Wei Chang↗Alexander H. Liu↗James Glass↗

Full-duplex spoken language models (FD-SLMs) enable seamless speech interaction by allowing models to listen and speak simultaneously, yet the internal mechanism by which they coordinate listening and speaking remains underexplored. We analyze the predictive behavior encoded in FD-SLM hidden representations and find that they exhibit stream-specific predictive patterns: during listening, they preferentially predict the incoming user stream, whereas during speaking, they preferentially predict the model output stream. Building on this observation, we show that FD-SLMs dynamically modulate their internal predictive focus between two states: a generative state aligned with model output generation and a perceptive state aligned with incoming user input. However, this modulation can lag behind abrupt changes in conversational context. During user interruptions, the model remains transiently biased toward the generative state before transitioning into the perceptive state, causing it to miss the beginning of the incoming input. We term this delayed internal transition state inertia. To quantify its downstream impact, we introduce the Zero-Buffer Benchmark (ZBB), a diagnostic benchmark for evaluating immediate interruption comprehension when user speech begins abruptly. We evaluate this setting using response correctness and initial-word occurrence rate (IWOR). Finally, we mitigate state inertia through activation steering with a perception vector, a training-free intervention with little additional computational overhead. Across multiple state-of-the-art FD-SLMs, activation steering substantially improves interruption handling; for example, on PersonaPlex, it improves correctness from 28% to 45% and IWOR from 40% to 72% without any fine-tuning.

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

SVoT: State-aware Visualization-of-Thought for Spatial Reasoning via Reinforcement Learning

Authors:
Chao Lei↗Yanbei Jiang↗Markus Hiller↗Zhijian Zhou↗Xunye Tian↗Krista A. Ehinger↗Nir Lipovetzky↗

arXiv:2606.11770v1 Announce Type: new Abstract: Spatial reasoning remains a challenge for Multimodal Large Language Models (MLLMs), as it requires reliable multi-hop inference over both intermediate states and state transitions. Current studies often leave intermediate states unverified and treat state transitions as implicit processes, which limits reliability in multi-hop spatial reasoning. To address this, we propose State-aware Visualization-of-Thought (SVoT), a reinforcement learning framework that generates interleaved, verifiable intermediate states and visualizations. SVoT integrates transition reasoning chains into the generation processes, enabling the model to verify action preconditions and effects through interleaved textual and visual reasoning. We train SVoT via Group Relative Policy Optimization (GRPO), instantiating verification through reward design and evaluating the efficacy of different fine-grained rewards. As existing benchmarks reduce state transitions to single-variable updates, substantially simplifying the problems, we establish five domains by extending classical environments and introducing two novel domains, Pacman and Gather, that require multi-object interactions and numerical reasoning. These domains support systematic evaluation of multi-hop spatial reasoning with quantitative verification of generated intermediate states and transition reasoning. SVoT with transition-aware supervision achieves state-of-the-art performance across the introduced domains, yielding up to a 65% absolute accuracy gain on out-of-distribution test sets.

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

An iterative energy-based multimodal transformer for joint retrieval of wheat soil moisture, leaf area index, and plant height from Sentinel-1 and Sentinel-2 time series

Authors:
Shubham Kumar Singh↗Peilei Fan↗Suraj A. Yadav↗Rajendra Prasad↗Prashant K Srivastava↗

Field-scale retrieval of surface soil moisture (SM), leaf area index (LAI), and plant height (PH) is essential for precision agriculture, yet it remains an ill-posed inverse problem. Concurrent variations in soil moisture and canopy density generate substantial ambiguities in radar backscatter and spectral responses, which reduces the effectiveness of traditional feedforward regression models in heterogeneous smallholder cropping systems. This study presents the Iterative Energy-Based Transformer (iEBT) for the joint retrieval of coupled soil-canopy states from Sentinel-1 C-band SAR and Sentinel-2 multispectral time series. Instead of direct regression, iEBT embeds multi-modal predictors within a shared sequence, produces an initial state estimate, and iteratively updates the target [SM, LAI, PH] vector through normalized gradient descent to minimize a learned scalar compatibility energy function. Using 700 quality-controlled field measurements from Varanasi, India, iEBT achieved the highest learned-model performance on the random test split, with a four-seed mean R^2 of 0.854 \pm 0.012 (R_SM^2 = 0.841, R_LAI^2 = 0.905, R_PH^2 = 0.821). WCM and PROSAIL were retained as physically interpretable SAR and optical reference models for comparison. Modality ablations confirmed that Sentinel-1 drives SM retrieval, while Sentinel-2 dominates LAI, whereas PH relies on combined structural-phenological signatures. Crucially, the model's terminal energy functions as an uncalibrated post-retrieval quality diagnostic; screening the 10% highest-energy samples markedly reduced target level root-mean-square errors. While leave-one-campaign-out validation highlights persistent cross-season domain shift challenges due to localized management variations, compatibility-guided multimodal fusion offers a structured self-diagnostic path toward reliable biophysical parameter estimation

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