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01.
medRxiv (Medicine) 2026-06-22

Midlife Measures of General Cognitive Performance in the National Longitudinal Study of Adolescent to Adult Health (Add Health)

Authors:
Aiello↗A. E↗Rob↗F. I↗Gross↗A. L↗Bennett↗D. A↗Manly↗J. J↗Plassman↗B. L↗…

Objective: The Add Health Cognitive Assessment, Physical, and Sensory Function Protocol (Add CAPS) was developed to assess cognitive, physical, and sensory function in early midlife in a nationally representative sample in the United States. Using Add CAPS, we developed two general cognitive performance measures. Methods: The sample included 2,525 participants from Add Health Wave VI who completed an in- home assessment of cognitive performance. Confirmatory factor analysis (CFA) was used to derive two general cognitive performance (GCP) scores: (1) a five-domain score based on originally designed cognitive domains (Add CAPS GCP), and (2) a modified score aligned with the Harmonized Cognitive Assessment Protocol (HCAP) framework (Add CAPS GCP-H). We evaluated model fit using Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Comparative Fit Index (CFI) and tested factor scores for criterion validity. Results: Both models showed good fit (Add CAPS GCP: RMSEA = 0.025, SRMR = 0.031, CFI = 0.968; Add CAPS GCP-H: RMSEA = 0.027, SRMR = 0.033, CFI = 0.962), indicating that they adequately represent the underlying GCP construct. Discussion: The Add CAPS cognitive battery captures a robust, hierarchical structure of GCP across alternative domain specifications. The derived factor scores provide a valuable method for characterizing a person's cognitive baseline during midlife. Importantly, the Add CAPS GCP-H enhances comparability with the HCAP network, supporting cross-cohort analyses of cognitive aging.

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02.
arXiv (CS.LG) 2026-06-17

Adaptable Method for Crystal Design across Diverse Constraints and Objectives with Pretrained Property Predictors

Authors:
Akihiro Fujii↗Yoshitaka Ushiku↗Koji Shimizu↗Anh Khoa Augustin Lu↗Satoshi Watanabe↗

arXiv:2410.08562v5 Announce Type: replace-cross Abstract: Advanced crystal design can accelerate materials discovery across applications from photovoltaics to spintronics. Practical design must satisfy multiple properties and physical constraints, yet existing machine-learning-based approaches to such design often depend on large datasets, retraining, or task-specific generators. Here, we show that direct predictor-guided gradient optimization enables data-efficient, constraint-rich crystal design by combining off-the-shelf predictors with site-wise element masks, template initialization, and task-specific losses. In perovskites, it outperformed generative and Bayesian baselines under three targets – band gap, formation energy, and tolerance factor – and two hard constraints. DFT assessment further showed band-gap targeting competitive with a leading generative model despite using predictors trained on roughly one-tenth of the data. By flexibly combining pretrained predictors with application-oriented masks and custom losses, the same framework supported half-metal design. Such modularity could help researchers and engineers translate diverse application requirements directly into optimized candidate crystals with minimal computational cost.

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

TRIDENT: Breaking the Hybrid-Safety-Physics Coupling for Provably Safe Multi-Agent Reinforcement Learning

Authors:
Zijie Meng↗Ziwei Li↗Yufei Liu↗Zhiyu Li↗Jiyuan Liu↗Wenhua Nie↗Bingcai Wei↗Miao Zhang↗

arXiv:2606.18308v1 Announce Type: cross Abstract: Safe coordination in networked cyber-physical systems forces learning algorithms to simultaneously handle hybrid discrete-continuous actions, hard training-time safety constraints, and physics-governed dynamics. We show that these three features form a directed cycle of biases that defeats any naive composition of off-the-shelf modules, and formalize this as a three-way coupling lemma. We then introduce TRIDENT, the first MARL framework whose three components are co-designed to cancel each leak: a Richardson-Romberg gradient correction reducing Gumbel-Softmax bias from O(tau) to O(tau^2), a Lyapunov-constrained sequential trust-region update enforcing per-iterate feasibility, and a physics-informed residual critic that decomposes value rather than reward. We prove an O~(1/sqrt(K)) convergence rate to a constrained Nash equilibrium and an O(sqrt(K)) cumulative-violation bound. On multi-UAV mobile-edge computing, autonomous intersection management, and a hybrid SMAC variant, TRIDENT cuts training-time violations by 95.5% over MADDPG and 76.3% over MACPO, while improving reward by 13.5% over the strongest unconstrained baseline.

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04.
arXiv (CS.AI) 2026-06-16

Upper Bounds on the Generalization Error of Deep Learning Models via Local Robustness and Stability

Authors:
Abdul-Rauf Nuhu↗Parham M. Kebria↗Vahid Hemmati↗Mahmoud N. Mahmoud↗Edward Tunstel↗Abdollah Homaifar↗

arXiv:2606.16883v1 Announce Type: cross Abstract: Generalization is a critical property of data-driven models, particularly deep learning models deployed in safety-critical applications. Robustness-based generalization bounds have gained attention as a principled way to link robustness properties to generalization performance, often in a data-dependent manner. However, most existing bounds suffer from vacuousness in practical settings, yielding loose upper bounds that greatly exceed the actual error rates and limiting their usefulness for real-world evaluation. While this issue is often attributed to the uncertainty term, a substantial part of the problem originates from the robustness term itself, particularly for the 0-1 loss. Existing approaches typically treat the robustness term as a global measure, ignoring its variation across different sub-regions of the input space. In this work, we propose a generalization bound that addresses this limitation by scaling the robustness term according to the number of stable and unstable samples within each sub-region. Our bounds incorporate both data- and model-dependent factors while maintaining practical relevance (yielding tighter upper bounds on true error). Experiments on models trained on the ImageNet dataset show that our bounds remain consistently non-vacuous and achieve the tightest estimates among existing methods, closely aligning with empirical performance across a range of robust deep neural networks.

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05.
arXiv (math.PR) 2026-06-11

Improved Amenability Bounds for Local Coordination Games

Authors:
Ron Peretz↗Dean Kraizberg↗

arXiv:2606.01963v2 Announce Type: replace-cross Abstract: We study local pure coordination games on finite social networks, continuing the framework of Hutchcroft, Rospuskova, and Tamuz. They showed that low inefficiency in local coordination forces the underlying graph to be amenable, with a square-root loss in the amenability parameter. We improve this loss in the binary unbiased setting. Using Shapley values of a mutual-information game associated with the players' local outputs, we prove that if the average disagreement is at most $\varepsilon$, then the graph is $(O(\varepsilon\log(1/\varepsilon)),r)$-amenable. This gives a sharper quantitative converse between local coordination and graph amenability.

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

ARIADNE: Agnostic Routing for Inference-time Adapter DyNamic sElection

Authors:
Enrico Cassano↗Micha{\l} Brzozowski↗Zuzanna Dubanowska↗Paolo Mandica↗Neo Christopher Chung↗

arXiv:2606.19079v1 Announce Type: new Abstract: The increasing deployment of parameter-efficient fine-tuning (PEFT) has led to model ecosystems in which a single backbone is paired with many task-specialized adapters. In this setting, inference-time queries often arrive without task labels, requiring the system to automatically select the most appropriate adapter from a growing and heterogeneous adapter pool. Existing routing methods either depend on access to adapter internals, such as weight decompositions or gradient-based statistics, or require additional router training, which limits scalability and portability as new adapters are added. We introduce ARIADNE, a training-free, adapter-agnostic routing framework for dynamic adapter selection at inference time. ARIADNE represents each adapter through a set of centroids computed from embeddings of its training set, capturing the data distribution associated with that adapter. Given an unlabeled input, it selects an adapter by measuring proximity to these centroids in latent space. Because routing is performed entirely in the input embedding space, ARIADNE is compatible with arbitrary PEFT methods and requires no modification to the adapters or training procedures. Primarily evaluated with Llama 3.2 1B Instruct on 23 diverse NLP tasks, ARIADNE recovers 97.44% of the upper bound performance. Scaling to 44 tasks, it achieves 89.7% average selection accuracy, without additional training or access to adapter internals.

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07.
medRxiv (Medicine) 2026-06-11

Global population frequencies of NAT2 star alleles observed in three large biobanks

Authors:
Sangkuhl↗Whirl-Carrillo↗Woon↗Venkatesh↗Keat↗Whaley↗Ritchie↗M. D↗Klein↗T. E↗

NAT2 is an important pharmacogene which encodes the N-acetyltransferase 2 enzyme that is involved in the metabolism of multiple medications, and variants in this gene can affect patient response to these medications. CPIC has published a clinical guideline for prescribing hydralazine using NAT2 genotypes. Just prior to the guideline, updated NAT2 star allele numbering and definitions were released, differing somewhat from the historical nomenclature. Clinical pharmacogenomic testing panels often test for the most common star alleles, so knowledge of the most common updated NAT2 star alleles is critical for the implementation of the CPIC NAT2/hydralazine guideline. We first determine NAT2 diplotype frequencies from UK Biobank (UKBB) 200k phased genomes, then analyzed allele, diplotype, and phenotype population frequencies from the All of Us Research program, PennMedicine BioBank (PMBB) and UKBB 500k datasets. We found that analyzing NAT2 diplotypes from phased data provides critical information for algorithms designed to predict diplotypes from unphased data. We observed that NAT2*5, *6, and *4 were the most common star alleles in that order, and the top 11 most frequent NAT2 star alleles were the same across all biobanks. However, differences in star allele frequencies across biogeographical populations were observed. The largest difference led to a higher frequency of NAT2 poor metabolizer phenotypes as compared to rapid and intermediate metabolizer phenotypes in all global populations except in the EAS population, where NAT2 poor metabolizers were in the minority.

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08.
medRxiv (Medicine) 2026-06-24

Topical fresh Taraxacum mongolicum wet dressing as an adjunct to ceftriaxone for localized skin and soft tissue infections: A single-center assessor-blinded randomized controlled trial

Authors:
Wang↗Xian↗Nie↗Ma↗Yang↗

Background: Localized skin and soft tissue infections may need systemic antibacterials, but local inflammation can delay symptom recovery. We evaluated whether topical fresh Taraxacum mongolicum wet dressing added to ceftriaxone was associated with short-term benefit in selected clinically stable adults. Methods: In this single-center, assessor-blinded, three-arm randomized trial, 180 adults aged 18-74 years were randomized 1:1:1 to topical T. mongolicum plus intravenous ceftriaxone, topical T. mongolicum alone, or ceftriaxone alone for 7 days. The primary outcome was day-7 clinical response assessed by blinded independent assessors using prespecified global clinical improvement criteria. Analyses followed the intention-to-treat principle; sensitivity analyses assessed robustness. Results: Day-7 clinical response rates were 91.67% (55/60), 76.67% (46/60), and 68.33% (41/60) in the combined, T. mongolicum, and ceftriaxone groups, respectively (overall P = 0.006). Compared with ceftriaxone alone, combined therapy had a higher response rate (risk difference, 23.3 percentage points; 95% CI, 9.6 to 37.0; risk ratio, 1.34; 95% CI, 1.11 to 1.62). Sensitivity analyses were directionally consistent. Secondary outcomes and bacterial clearance favored the combined group. No serious adverse events were reported. Conclusions: In selected clinically stable adults with localized skin and soft tissue infections, adjunctive topical fresh T. mongolicum plus ceftriaxone was associated with improved short-term outcomes compared with ceftriaxone alone. Findings require cautious interpretation because this was a single-center, partially blinded trial without a placebo dressing control. The dressing should not replace antibiotics, drainage, or urgent care when indicated. Trial registration: International Traditional Medicine Clinical Trial Registry, ITMCTR2026000549.

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

SplitZip: Ultra Fast Lossless KV Compression for Disaggregated LLM Serving

Authors:
Yipin Guo↗Siddharth Joshi↗

arXiv:2605.01708v3 Announce Type: replace-cross Abstract: Contemporary systems serving large language models (LLMs) have adopted prefill-decode disaggregation to load-balance between the compute-bound prefill phase and the memory-bound decode phase. Under this design, prefill workers generate a KV cache that must be transferred to decode workers before generation can begin. With these workers residing on different physical systems, this transfer becomes a significant bottleneck to serving LLMs at scale, especially for long-input and agentic workloads. Existing lossless codecs are unsuitable here as they primarily target offline weight compression, run on CPUs, or use variable-length coding whose compression cannot keep up with KV production during prefill. We introduce SplitZip, a GPU-friendly lossless compressor for KV cache transfer that preserves KV tensors bitwise and integrates into existing serving frameworks without modifying model execution. SplitZip exploits redundancy in floating-point exponents of KV activations, encoding frequent exponent values with fixed-length codes and routing rare exponents through a sparse escape stream of (position, value). A calibrated top-16 exponent codebook eliminates online histogramming, while the regular dense path and sparse escape correction make both encoding and decoding efficient on GPUs. On real BF16 activation tensors, SplitZip achieves $613.3$ GB/s compression throughput and $2181.8$ GB/s decompression throughput, outperforming prior lossless compressors on the critical codec path. End-to-end transfer experiments show up to $1.32\times$ speedup for BF16 KV cache transfer, $1.30\times$ speedup for TTFT, and $1.23\times$ increase in Request Throughput. The same approach extends to FP8 KV caches, providing up to $1.14\times$ compression over native E5M2. Code is available at https://github.com/Intelligent-Microsystems-Lab/SplitZip

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

Training-Free Metrics for Synthetic Object Detection Data: A Proxy for Detector Performance

Authors:
Myeongseok Nam↗Donghoon Yeo↗Seungwook Kim↗

With the recent advent of image generative models, synthetic data are increasingly being used to supplement limited real datasets for training computer vision models. However, not all synthetic datasets improve performance equally, and their effectiveness can only be assessed by training a downstream model, which is computationally expensive and time-consuming. This problem is pronounced in the task of object detection, where the required annotations are much more dense due to bounding boxes. In this paper, we propose a pre-computable metric family, dubbed Conditional-Composition Domain Match (CCDM), which serves as a proxy for the relative utility of candidate synthetic training sets for downstream detection. Experiments on the VisDrone-DET dataset show that the CCDM metric families achieve a Spearman correlation of 1.0 with the downstream performance of YOLOv8, clearly outperforming existing metrics for synthetic image evaluation.

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

Environment-Adaptive Covariate Selection: Learning When to Use Spurious Correlations for Out-of-Distribution Prediction

Authors:
Shuozhi Zuo↗Yixin Wang↗

arXiv:2601.02322v2 Announce Type: replace-cross Abstract: A common approach to out-of-distribution prediction restricts models to causal or invariant covariates to avoid spurious associations that may change across environments. Despite its theoretical appeal, this strategy can underperform empirical risk minimization when only a subset of the causal parents of the outcome is observed. In such settings, non-causal covariates can serve as proxies for unobserved causal parents and improve prediction when the proxy relationship is stable, but they can hurt when shifts disrupt that relationship. Thus, the optimal covariate set can depend on the specific shift encountered. Because different shifts leave signatures in the unlabeled covariate distribution, we propose an environment-adaptive covariate selection algorithm that maps environment-level summaries to environment-specific covariate sets. These summaries may be hand-crafted or learned from multi-environment data, and prior causal knowledge can be incorporated as constraints. Across simulations and applied datasets, the proposed method improves over static causal, invariant, and other non-adaptive rules under diverse shifts.

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

Graph Diffusion Residuals for Control-Function Instrumental Variables

Authors:
Rui Wu↗Zongyuan Chen↗Hong Xie↗Defu Lian↗Enhong Chen↗

arXiv:2606.14636v1 Announce Type: new Abstract: Control-function instrumental variable estimators need a first-stage residual, not merely a first-stage prediction. High-capacity first stages can interpolate treatment and leave too little residual information for the outcome equation. We study Adaptive Anisotropic Instrumental Heat Flow (A-IHF), a deterministic graph-diffusion residual extractor for flexible control functions. A-IHF treats treatment as a signal on a graph of first-stage features, uses pilot diffusion to detect large treatment jumps, attenuates conductance across those jumps, and computes the generated control with a sparse graph resolvent. Its observational selection rule uses only $(Z,X)$, combining graph generalized cross-validation, roughness, residualized-treatment relevance, and graph-admissibility filtering. The analysis decomposes error into structural leakage, residual attenuation, and residualized treatment variation, yielding finite-sample bounds, graph-admissibility rates under latent piecewise-smooth geometry, and finite-path selection calibration. Across 54 synthetic benchmark cells with tuned graph, kernel, tree, boosting, series, and neural control-function baselines, guarded observational A-IHF has the lowest average structural-response MSE; the A-IHF family beats the best non-A-IHF baseline in 32 cells. Performance is strongest when the graph captures piecewise-smooth first-stage structure.

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

CREST: Deployment-Realistic Hardware-in-the-Loop NAS for Embedded Sensing Systems

Authors:
Joseph Q. Zales↗Pragya Sharma↗Mani Srivastava↗

arXiv:2606.15004v1 Announce Type: cross Abstract: Deploying neural networks on low-power microcontrollers (MCUs) requires selecting model architectures under tight memory, latency, and energy constraints. Existing workflows often simplify this process along one or more axes: static proxy costs such as FLOPs or parameters, treating one MCU as representative, and continuous-inference tests instead of deployed sensing schedules. These assumptions can mis-rank Pareto-front candidates, miss infeasible deployments, and obscure schedule-dependent energy. We present CREST (Cross-platform Runtime Evaluation and Search Tool), a deployment-realistic hardware-in-the-loop (HIL) neural architecture search (NAS) framework for MCU sensing systems. CREST keeps the optimizer, HIL measurement boundary, logging, and replay workflow fixed while exposing workload, model family, target backend, schedule, quantization, and scoring policy as configurable axes. This makes deployment effects experimentally separable within one reusable workflow. We evaluate CREST on inertial odometry and audio classification across three Arm Cortex-M targets. For inertial odometry, measured-energy HIL search reduces median per-inference energy by 41.7% versus FLOPs-based selection and 40.8% versus memory-traffic-based selection at similar error. FLOPs-based selection also chooses infeasible deployments on memory-constrained targets. On the STM32 N657 target, continuous-inference and duty-cycled searches produce different Pareto frontiers. For audio classification, the same application-level policy selects different DS-CNN architectures on different boards, and cross-board replay changes deployment cost substantially. Overall, CREST shows that deployment-realistic MCU NAS must jointly optimize model architecture, target platform, runtime schedule, and deployment policy rather than relying only on static proxy costs or continuous-inference measurements.

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14.
arXiv (quant-ph) 2026-06-25

Expanding the Neutral Atom Gate Set: Native iSWAP and Exchange Gates from Dipolar Rydberg Interactions

Authors:
Pedro Ildefonso↗Andrew Byun↗Aleksei Konovalov↗Javad Kazemi↗Michael Schuler↗Wolfgang Lechner↗

arXiv:2512.05037v2 Announce Type: replace Abstract: We present a native realization of iSWAP and parameterized exchange gates for neutral-atom quantum processing units. Our approach leverages strong dipole-dipole interactions between two different dipole-coupled Rydberg states, employing optimal control techniques to design high-fidelity, time-efficient gate pulses. To minimize experimental complexity, we utilize global driving fields acting identically on all atoms and apply pulse smoothing techniques. While detrimental van-der-Waals interactions pose a significant challenge, we demonstrate that for both $^{133}$Cs, as a representative alkali atom, and $^{88}$Sr, an alkaline-earth species, high-fidelity pulses can nevertheless be obtained over a broad range of parameters. We identify candidate protocols with reduced susceptibility to noise and analyze their performance under realistic conditions, accounting for atomic motion, Rydberg decay, and experimentally motivated laser frequency and intensity noise. Crucially, we demonstrate that in both Alkali and alkaline-earth-based systems, we can obtain fast iSWAP gates with fidelities of $99.9\%$ under realistic experimental conditions. These results pave the way for expanding the neutral-atom gate set beyond conventional Rydberg-blockade-based entangling gates.

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

Anticipating the Optimism Gap: Predicting Distribution-Shift Degradation of RF-Impairment Detectors from In-Distribution Statistics

Authors:
Chakshu Baweja↗

arXiv:2606.22054v2 Announce Type: replace-cross Abstract: Detectors for GNSS radio-frequency impairments (jamming, spoofing, multipath) are usually reported with a single AUC measured on the distribution they were tuned on. That number falls once conditions move, and the size of the drop is rarely known in advance because labelled field data is scarce. We ask whether this optimism can be predicted before any out-of-distribution data is seen. On an open, parameter-grounded synthetic testbed with a tunable severity shift, we evaluate thirteen detectors (five physics baselines, full-feature logistic regression and multilayer perceptrons, and single-feature learned controls) across four impairment classes. The optimism gap, the difference between in-distribution and shifted AUC, grows monotonically as the shift deepens (mean Spearman correlation 0.50). It is driven by how many observables a detector uses rather than by whether it is learned, and it varies systematically by class. Centrally, a ridge model built only from in-distribution score statistics predicts the gap for a detector it has never seen (R^2 = 0.47) and for an impairment class it has never seen (R^2 = 0.46); both are significant against a 2000-fold permutation null (p < 0.001) and survive removing the feature that is, by construction, part of the target. The headline findings are synthetic. We then run the pre-registered protocol on three open field corpora: on Jammertest 2024 the cross-detector prediction holds (R^2 = 0.11, p = 0.009), and on SatGrid, whose spoofer power sweep gives a calibrated severity axis, in-distribution AUC overstates higher-severity AUC by up to 0.22 and to the point of sign inversion, with in-distribution AUC and realised gap perfectly rank-correlated (Spearman rho = 1.0). The mechanism survives contact with real data, at smaller magnitude than in simulation. We release the testbed, a software-receiver front end, the ingest adapters and the protocol.

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

Starter-Iterator Neural Operator: A Unified Architecture for High-Fidelity Forward and Inverse PDE Problems

Authors:
Kuilin Qin↗Lianfang Wang↗Xu Sun↗Jiwei Jia↗Yu Wang↗Yong Wang↗Yuping Duan↗

arXiv:2606.18305v1 Announce Type: cross Abstract: Operator learning is an emerging interdisciplinary field that integrates machine learning with scientific computing. By mapping infinite-dimensional function spaces, this approach provides an efficient surrogate modeling framework for high-dimensional partial differential equations (PDEs). Compared to traditional numerical solvers, it achieves a superior trade-off between computational complexity and approximation accuracy, demonstrating significant advantages in many-query tasks such as real-time prediction and parameter sweeps. Given the stringent accuracy requirements of both forward simulation and inverse inference, as well as the precision bottlenecks of existing operator learning methods in handling complex boundaries or long-term evolution, we propose the Starter-Iterator Neural Operator (SINO). Our framework reinterprets the initialization strategies and iterative formats of traditional iterative methods through neural networks, establishing an efficient approach for spectral-spatiotemporal collaborative modeling. Specifically, the frequency-domain initialization module captures globally stable low-frequency features, while the time-domain learning module focuses on optimizing local solution residuals, thereby effectively overcoming the inherent limitations of conventional single-domain modeling approaches. Extensive experiments on typical dynamical systems such as the Navier-Stokes equations and acoustic wave equations, as well as practical applications including super-resolution imaging and weather forecasting, demonstrate that SINO achieves outstanding performance in numerical accuracy, generalization capability, and robustness.

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17.
arXiv (quant-ph) 2026-06-16

Learning ground state observables from quantum computing experiments

Authors:
Ben Jaderberg↗Freya Shah↗Minjun Jeon↗M. Emre Sahin↗Christa Zoufal↗Kunal Sharma↗

arXiv:2606.15983v1 Announce Type: new Abstract: Recent theoretical progress has established conditions under which machine learning models can efficiently predict ground-state properties of gapped local Hamiltonians when trained on quantum-generated data. Previous experimental demonstrations in this paradigm, however, have largely been limited to small systems or highly structured states, due to the difficulty of preparing many-body ground states on quantum processors. In this work, we demonstrate learning from experimental quantum data generated from approximate ground states of the two-dimensional Heisenberg XXZ model with system sizes up to 115 qubits. We construct a dataset of single-site expectation values, two-point correlations, and 12-body loop correlations across the antiferromagnetic phase. We then train neural networks on this data and show that they can accurately predict spatially resolved observables for previously unseen Hamiltonian parameters, both within the training distribution and in an out-of-distribution regime approaching the phase boundary. Our results demonstrate the practical realization of learning from quantum data for an interacting two-dimensional many-body system at scale, motivating a path toward regimes where quantum processors could provide training data beyond the reach of classical approximation methods.

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18.
medRxiv (Medicine) 2026-06-15

Modelling the public-health impact of indoor air quality interventions on respiratory virus transmission

Authors:
Howes↗Jeyapragasan↗Williamson↗Carel↗Koos↗Swett↗J. L↗Montavon↗Belenky↗Lietar↗Fitzjohn↗Charles↗…

Respiratory virus transmission occurs in indoor settings where ventilation, occupancy, and dwell time determine exposure levels. Improving indoor air quality (IAQ) therefore could help reduce disease burden associated with respiratory viruses, yet its population-level impact remains poorly quantified. Here, we develop an individual-based transmission modelling framework that links within-location airborne dynamics to individual infection risk and population-level spread, whilst explicitly incorporating heterogeneity in ventilation and baseline indoor air quality across locations. We use this modelling approach to evaluate IAQ-improving interventions (air-quality interventions or AQIs), using hypothetical endemic and pandemic pathogen archetypes with properties similar to SARS-CoV-2 and influenza, and evaluate how effects on key epidemiological metrics (such as annualized incidence and epidemic final size) depend on AQI coverage, efficacy and allocation strategy. At 20% AQI intervention coverage and 80% efficacy, annualized incidence was reduced by approximately 7.2% for an endemic 'SARS-CoV-2-like' respiratory virus, and 17.0% for an endemic 'influenza-like' virus; at 60% coverage (80% efficacy) the reductions were 26.3% and 56.4%, respectively. Targeting AQI installation to the highest-risk locations outperformed random allocation: for SARS-CoV-2-like transmission, 20% coverage at 80% efficacy cut absolute incidence by 10.8% when targeted versus 7.2% when random; for influenza-like transmission, this comparison was 28.9% versus 17.0%. In epidemic scenarios, random installation at 40% coverage and 60% efficacy reduced final size by 23.7% (influenza-like) versus 6.3% (SARS-CoV-2-like). These results support treating clean indoor air as core public-health infrastructure and prioritising risk-based deployment of IAQ-improving interventions to maximise population-level benefit within budgetary and operational constraints.

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19.
PLOS Computational Biology 2026-06-24

A new cancer progression model: From synthetic tumors to real data and back

Authors:
Daniela Volpatto↗

by Daniela Volpatto, Sandro Gepiro Contaldo, Simone Pernice, Marco Beccuti, Francesca Cordero, Roberta Sirovich Intratumor heterogeneity (ITH) arises from the combined effects of genetic alterations, clonal interactions, and environmental constraints, and plays a central role in therapeutic resistance and disease progression. While ITH has been extensively documented in empirical tumor data, the scientific debate regarding the biological mechanisms underlying this heterogeneity remains complex, highlighting the need for cancer evolution models that are sufficiently flexible and sophisticated to reproduce the observed behaviors and to give insights on the unobserved ones. Here, we present a stochastic modelling framework for tumor evolution that integrates genotypic inheritance with phenotype driven functional traits and resource mediated competition. Mutational events are associated with functional capabilities such as altered proliferation, increased mutation rates, limit evasion potential or enhanced control over shared resources, allowing multiple genotypes to converge on similar phenotypes. The model explicitly tracks subclonal lineages while incorporating environmental constraints that modulate growth and competition. The framework is defined through a mathematically rigorous construction and is accompanied by an efficient simulation algorithm. To facilitate exploration and reproducibility, we provide an open-source graphical user interface that allows users to configure model parameters, run simulations, and inspect clonal genealogies and population dynamics without requiring direct interaction with the underlying code. Using this model, we illustrate how ecological feedbacks can shape clonal dynamics over time, supporting an interpretation in which early tumor growth is dominated by stochastic expansion, while later evolution increasingly reflects selection for traits that alleviate environmental constraints. Rather than constituting a new evolutionary paradigm, this behaviour demonstrates how well-documented biological patterns can emerge naturally from a unified stochastic and ecological description. Overall, our approach offers a flexible and extensible platform for investigating how chance, functional traits, and environmental interactions jointly govern tumor heterogeneity.

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20.
medRxiv (Medicine) 2026-06-17

Characterisation of disease progression in hantavirus haemorrhagic fever with renal syndrome

Authors:
Armstrong↗Rus↗Knap↗Drousiotis↗Eyers↗Buchan↗I. E↗Avsic-Zupanc↗Hiscox↗J. A↗Korva↗

Hantaviruses can cause haemorrhagic fever with renal syndrome (HFRS). This is a clinically variable disease in which severe outcomes are hypothesized to arise from dysregulated host responses. To characterise this, longitudinal, label-free plasma proteomics was used to compare disease progression in a unique well-defined cohort of patients infected with either Dobrava virus (DOBV) or Puumala virus (PUUV) hantaviruses. Patients were stratified by clinical severity. The average viral load in the first available sample from hospitalized patients was higher in those who went on to have severe infection, and higher in patients infected with DOBV. There was marked separation of infected patients from controls across early, mid and late disease, including after viral RNA clearance, suggesting a sustained systemic host-response signature. Proteomic signatures were consistent with a strong acute-phase response in both mild and severe disease. There was evidence of activation of the adaptive humoral response at later stages. Hierarchical clustering identified severity-associated pathways linked to endothelial dysfunction, thrombocytopenia, vascular leakage and renal injury. These findings define a durable plasma proteomic signature of hantavirus disease and support a model in which severe HFRS is driven by persistent inflammatory, complement and platelet/coagulation pathway activation rather than viral burden alone.

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21.
medRxiv (Medicine) 2026-06-15

Quality Improvement Based Implementation and Evaluation of a Decision Aid for Patients with Nephrolithiasis

Authors:
Lee↗Kazemi↗Wilson↗Thaker↗Kwan↗Cabri↗Li↗Dunn↗Yaghoubian↗Elkhoury↗Scotland↗Saigal↗…

Introduction Patients with nephrolithiasis face challenges in making a high-quality, preference sensitive decision. Our prior work established feasibility and patient acceptance of a software-based decision aid (DA). The objectives for this study were to identify implementation strategies for the DA in routine care and determine whether DA implementation enhances decisional quality for patients. Methods New nephrolithiasis patients were recruited from the institution Medical Center from June 2018 to April 2024 to receive a software-based pre-visit DA that measured care preferences and used decision analysis to rank treatments. The RE-AIM framework and Plan-Do-Study-Act (PDSA) cycles were used to improve implementation outcomes. Patients completed survey instruments evaluating decisional conflict, shared decision-making, care satisfaction, and treatment choice following their provider visit. These metrics were compared in the DA cohort (n=81) to those in a usual care cohort (n=78) with Wilcoxon rank-sum and Chi-square (or Fishers exact) tests. Results Implementation data revealed sustained reach and progressive improvement in fidelity. The DA cohort reported higher decisional quality relative to controls (p=0.003) and reported greater support/advice to make a choice (p=0.005). The DA cohort more often discussed options with their doctor (87.5% vs 69.2%, p=0.005) and were more likely to be promoters of their provider (p

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22.
arXiv (CS.AI) 2026-06-16

Communication-Efficient Verifiable Attention for LLM Inference

Authors:
Ziqun Chen↗Ming Wu↗Michael Heinrich↗Jason Zeng↗Huiying Lan↗Tianwei Zhang↗Rui Tan↗

arXiv:2606.16352v1 Announce Type: cross Abstract: Computation integrity of remote large language model (LLM) serving can be questionable. For conventional deep neural networks (DNNs), the existing TEE-shielded DNN partitioning (TSDP) approach uses Trusted Execution Environment (TEE) to compute non-linear components and verify the integrity of linear components offloaded to an untrusted GPU. However, directly applying TSDP to Transformer-based LLMs incurs significant TEE computation and TEE-GPU communication overhead. This paper presents Communication-efficient TEE-GPU Attention (\textsc{VeriAttn}) for accelerating verifiable LLM inference. \textsc{VeriAttn} offloads both linear and non-linear computations of attention to the GPU, while TEE performs verification. Moreover, for prefill, \textsc{VeriAttn} uses a two-level pipeline to overlap data movement, TEE pre-/post-processing, and GPU computation. For decoding, when the key-value cache exceeds available GPU memory, \textsc{VeriAttn} partitions attention across TEE and GPU to reduce repeated key-value transfers. Evaluation on an Intel TDX platform shows that \textsc{VeriAttn} achieves 2.60-3.38$\times$ and 3.86-5.42$\times$ acceleration over TSDP for 6k-token prompts and 10k-token outputs during prefill and decoding, respectively.

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24.
Nature (Science) 2026-06-24

Detection of anisotropic cosmic structures on a gigaparsec scale

Authors:
Francesco Sylos Labini↗

Galaxy redshift surveys map the cosmic web and provide a key observational test of whether the Universe becomes statistically homogeneous and isotropic on sufficiently large scales, as assumed by the cosmological principle underpinning the standard cosmological model1. In this framework, beyond the nonlinear regime of structure formation, inhomogeneous and anisotropic features are expected to fade rapidly, reflecting the near-isotropic primordial density field and its subsequent gravitational evolution. Although supported by the small amplitude of cosmic microwave background anisotropies2, this view is increasingly challenged by the complex network of large-scale structures and voids in the galaxy distribution3–6, as well as by independent probes reporting possible large-scale deviations from statistical homogeneity7 and isotropy8,9. Here we show that the galaxy distribution exhibits persistent anisotropic structures extending to scales on the order of one gigaparsec. Using the Angular Distribution of Pairwise Distances (ADPD)10, a parameter-free statistic that measures directional correlations, we detect anisotropy signals exceeding those in isotropic controls and geometry-matched ΛCDM mock catalogues with conservative significance greater than 3σ. These results provide direct evidence that directional coherence persists to larger scales than predicted in the standard framework, challenging the assumption of large-scale isotropy. They call for a reassessment of how homogeneity and isotropy are realized in the observed Universe and motivate new tests of cosmological models based on directional statistics. Using the parameter-free Angular Distribution of Pairwise Distances for measuring directional correlations, evidence is found&nbsp;for coherent anisotropic structures extending over gigaparsec scales, challenging the assumption that the Universe becomes statistically isotropic on sufficiently large scales.

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25.
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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