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01.
medRxiv (Medicine) 2026-06-15

Supporting people to access social security payments through the Special Rules for End of Life: a qualitative study of the perspectives of patients, carers and health care professionals

Background: People living with terminal illness face a double financial burden from additional costs and loss of earning for themselves and their carers. Social security benefits are intended to help alleviate some of this financial pressure, and in the UK and other countries people are eligible for fast-tracked access to financial support via the Special Rules for End of Life. One in 3 people who are eligible miss out on this support, yet there is limited evidence on the reasons for this take-up deficit. Objectives: The aim of this study is to understand the barriers and facilitators to claiming benefits for terminally ill people from the perspectives of patients, carers, and health care professionals. Methods: This is a qualitative study combining i) focus groups with healthcare professionals recruited via professional networks and social media, and ii) interviews with patients and carers recruited in hospital and hospice settings. We analysed the data using Practical Thematic Analysis Results: Fifty-five multidisciplinary healthcare professionals participated in 11 focus groups, and we interviewed 10 patients and carers. We constructed five descriptive themes to summarise the data: Navigating priorities and uncertainty; positive impacts alongside a sense of shame and stigma; talking about money, difficulties and dividends; everybodys, yet nobodys, responsibility; and sticking points in the system. Conclusion: The themes reveal several challenges that may contribute to people not taking up this financial support. However, discussions about access to benefits were also seen as a core part of holistic care, a positive way to offer support and a gateway to other discussions about end-of-life care preferences and decisions. Recommendations for policy and practice include evaluating the adoption of a diagnostic rather than a prognostic eligibility criteria, integrating discussions about benefits into existing processes such as advance care planning, and improving education and support for clinicians.

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

SpikeDecoder: Realizing the GPT Architecture with Spiking Neural Networks

arXiv:2606.12287v1 Announce Type: cross Abstract: The Transformer architecture is widely regarded as the most powerful tool for natural language processing, but due to a high number of complex operations, it inherently faces the issue of high energy consumption. To address this issue, we consider Spiking Neural Networks (SNNs), which are an energy-efficient alternative to conventional Artificial Neural Networks (ANNs) due to their naturally event-driven approach to processing information. However, this inherently makes them difficult to train. Often, many SNN-based models circumvent this issue by converting pre-trained ANNs. More recently, attempts have been made to design directly trainable SNN-based adaptations of the Transformer model structure. Although the results showed great promise, the application field was computer vision. Moreover, the proposed model incorporates only encoder blocks. In this paper, we propose SpikeDecoder, a fully SNN-based implementation of the Transformer decoder block, for applications in natural language processing. In a series of experiments, we analyze the impact of exchanging different blocks of the ANN model with spike-based alternatives to identify trade-offs and significant sources of performance loss. We further investigate the role of residual connections and the selection of SNN-compatible normalization techniques. Besides the work on the model architecture, we formulate and compare different embedding methods to project text data into spikes. Finally, we demonstrate that our proposed SNN-based decoder block reduces the theoretical energy consumption by 87% to 93% compared to the ANN baseline.

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

Auditing Machine Unlearning: A Systematic Research on Whether Models Truly Forget

arXiv:2606.16110v1 Announce Type: new Abstract: Machine unlearning has been extensively studied in response to growing privacy concerns and regulatory requirements. However, auditing whether unlearning algorithms have truly erased the influence of specific data remains an open challenge. The lack of reliable and practical auditing mechanisms can lead to critical privacy risks, such as residual information leakage. This paper initiates a systematic investigation into whether existing unlearning algorithms can truly forget the designated data. We propose the first practical and general-purpose auditing framework for machine unlearning, inspired by the concept of proof of ignorance. Our framework addresses the key practicality limitations of existing methods by eliminating the need for retraining-from-scratch baselines, avoiding the training of large numbers of shadow models, and requiring no intrusive intervention in the original training process. To evaluate the effectiveness of our framework, we first conduct validation experiments to verify its soundness and completeness. We then perform comprehensive experiments across six datasets and ten representative unlearning methods. The results demonstrate that our framework reliably distinguishes between successful and failed unlearning. In particular, we observe that retraining-based and fine-tuning-based methods can achieve effective unlearning, even when the target data remain in the original dataset. In contrast, de-optimization-based methods fail to achieve true unlearning and instead degrade the model's performance. Fisher/Hessian-based methods also fail to unlearn requested data, even formal certification is provided. Moreover, we show that our framework is robust against fake unlearning attempts and generalizes well to large language models.

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

BigPower: Hierarchical Source-Level Module Power Estimation for CPUs with Large Language Models

arXiv:2606.13747v1 Announce Type: cross Abstract: Accurate power estimation is important for understanding and optimizing CPU power behavior, yet practical workflows often rely on simulation-derived information or post-silicon analysis. In this work, we present BigPower, a hierarchical source-level surrogate model for fine-grained module-level power estimation during CPU design. BigPower leverages large language model-based representations together with architectural hierarchy, module connectivity, configuration parameters, and workload context to estimate module-level power consumption directly from source-level design information, without requiring additional simulation during inference. Experimental results in the open-source XiangShan processor family demonstrate practical fine-grained power estimation across diverse configurations and workloads, offering an efficient alternative to conventional simulation-based workflows.

05.
arXiv (CS.CV) 2026-06-16

Contrastive Learning for Seismic Horizon Tracking with Domain-Specific Priors

Unsupervised 3D seismic horizon tracking faces a key limitation: signal-based propagators provide accurate trace-level alignment but often fail near faults, whereas texture-driven deep models are more robust to discontinuities, typically at the cost of labeled data requirements and reduced trace-level precision. We propose a self-supervised fusion of both paradigms in which signal-derived local horizon correspondences act as domain-specific priors to train a texture-based deep learning model. Specifically, we estimate reliable trace-to-trace flows from reflector slopes and use them to form positive pairs in a contrastive objective, while restricting training to high-confidence neighborhoods, optionally augmented with a fault mask. The objective is not to infer ambiguous correspondences close to discontinuities, but to preserve horizon identity across them. As a result, the network learns voxel-wise embeddings that preserve local signal continuity while enabling horizon propagation beyond discontinuities through similarity search. Experiments on the public F3 dataset and a faulted synthetic dataset achieve lower mean absolute error (MAE) than unsupervised baselines and competitive performance against a semi-supervised method using a single labeled slice.

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

HemExp: Clinically-Guided Latent Diffusion for Modeling Hematoma Expansion

Hematoma expansion (HE) after spontaneous intracerebral hemorrhage (ICH) is a major determinant of acute triage and treatment decisions in neurosurgical care. However, most existing methods provide either a binary expansion risk or a single follow-up volume, limiting uncertainty-aware decisions. We introduce HemExp, a clinically-guided latent diffusion model that generates patient-specific follow-up non-contrast CT images, along with segmentations of intraparenchymal and intraventricular hemorrhage. Generation is conditioned on baseline imaging, clinical variables, and an explicit expansion indicator, enabling controllable simulation of realistic clinical scenarios. HemExp uses a hemorrhage-aware multi-head variational autoencoder and models progression as the difference between baseline and follow-up latent representations with a conditional diffusion model. The model is trained on paired scans from 450 patients across multiple centers and evaluated on 107 patients from a held-out institution. HemExp produces spatial HE probability maps by generating multiple synthetic follow-up images per patient to estimate distributions of plausible follow-up hematoma volumes. Perturbing clinical inputs such as symptom-onset-to-imaging time or anticoagulant status shifts the predicted follow-up volume distribution. HemExp extends binary predictors and demonstrates robust estimation of clinically relevant outcomes in the imaging space, such as hematoma volume, intraventricular involvement, and mass effects. Overall, our results support controllable latent diffusion as a promising direction for uncertainty-aware modeling of early ICH progression.

07.
arXiv (CS.LG) 2026-06-12

A Unified Latent Space Disentanglement VAE Framework with Robust Disentanglement Effectiveness Evaluation

arXiv:2603.11242v2 Announce Type: replace-cross Abstract: Evaluating and interpreting latent representations, such as variational autoencoders (VAEs), remains a significant challenge for diverse data types, especially when ground-truth generative factors are unknown. To address this, we unify several state-of-the-art disentangled VAE approaches for latent space disentanglement into one framework – bfVAE. To assess the effectiveness of a disentangled VAE model and enhance latent space interpretability, we propose Feature Variance Heterogeneity via Latent Traversal (FVH-LT) and Dirty Block Sparse Regression in Latent Space (DBSR-LS). To ensure robust interpretability of learned latent space, we develop a greedy alignment strategy (GAS) that mitigates label switching and aligns latent dimensions across runs to set the foundation of result aggregation. We also introduce a convenient scalar latent space separation index (LSSI) based on the GAS-aligned outputs of FVH-LT and DBSR-LS to summarize the overall latent structural separation without knowledge of the ground-truth generative factors. We compare bfVAE to five VAE models and validate the effectiveness FVH-LT, DBSR-LS, and LSSI in on seven tabular and image datasets. Under our examined experimental settings, bfVAE provides a more flexible disentanglement framework achieves more favorable overall trade-off between disentanglement and reconstruction than the benchmark VAE models; FVH-LT and DBSR-LS reliably uncover semantically meaningful and domain-relevant latent structures and generally yield consistent results; and LSSI makes an effective quantitative summary of latent structural separation.

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

InvDesMobility: a reliability-gated first-principles feedback framework for closed-loop materials discovery

arXiv:2606.16133v1 Announce Type: cross Abstract: Inverse materials design starts from target functionality and searches for structures that can realize it. Its value in closed-loop discovery depends not only on prediction performance, but also on whether expensive first-principles results are independently validated, provenance-recorded, and admitted as feedback only when evidence is sufficient. This is especially important for composite properties such as carrier mobility, where a final scalar value hides intermediate quantities, fit quality, convergence history, and workflow assumptions. Here we present InvDesMobility, a reliability-gated first-principles feedback framework that integrates multi-agent automated DFT, evidence stratification, generative structure proposal, acquisition ranking, and auditable release. Using 516 2DMatPedia-derived candidates, the workflow produced 280 QC-passed materials and 573 retained carrier-direction seed channels after channel-level reliability gating. These records were split into two feedback objects: relaxed structures updated the generative model, while retained mobility channels trained the acquisition model and set validation priority. Over multiple iterations, InvDesMobility screened 2.4 x 10^6 structures, submitted 102 candidates for DFT validation, and retained 86 reliability-gated generated channels across 41 formulas. Overall, the main contribution is not a fixed list of high-mobility materials, but a transferable feedback contract that makes closed-loop inverse design both useful and auditable when learning from expensive calculated properties. All source data, retained feedback records, and workflows are available at https://github.com/DreamLufei/invDesMobility, with an accompanying evidence website at https://dreamlufei.github.io/invDesMobility/.

09.
arXiv (quant-ph) 2026-06-12

Path integral control of open quantum systems

arXiv:2410.18635v4 Announce Type: replace Abstract: We investigate open-loop quantum state preparation for a class of open quantum systems whose dynamics follow a Gorini-Kossakowski-Lindblad-Sudarshan (GKLS) master equation that admits a trajectory-based stochastic representation. The deterministic control objective is reformulated as a stochastic optimal control problem – interpreting stochasticity as a methodological tool akin to stochastic Schrödinger equation unravelings – which situates the problem within the path integral control framework. For the class of GKLS generators under consideration, this reformulation leads to an explicit expression for the optimal control as a weighted average over stochastic quantum trajectories, thereby eliminating the need for gradient evaluations. Building on this theoretical result, we derive a control update rule for piecewise-constant control pulses and demonstrate that adaptive importance sampling progressively enhances the control estimator during optimization, culminating in the algorithm we term Path integral Quantum Control (PiQC). We further introduce an annealed variant of PiQC, wherein a synthetic noise schedule gradually steers open-system trajectories toward closed-system dynamics, enabling high-fidelity unitary state preparation. Numerical studies on a dissipative single-qubit system and a multi-qubit Nuclear Magnetic Resonance model verify that PiQC yields precise open-loop controls and displays robustness to Hamiltonian perturbations. We propose PiQC as a trajectory-based alternative to gradient-based approaches, which might offer a viable solution in quantum control problems where gradient computation is infeasible or computationally demanding.

10.
arXiv (CS.CV) 2026-06-16

Transformation-driven generation of comparable projection images from multimodal anatomical scenes

This work addresses the computational problem of generating reproducible projection-space observations from heterogeneous anatomical scenes whose components may undergo independent spatial transformations. We propose a transformation-driven framework for synthetic projection imaging from multimodal anatomical data and demonstrate it on mandibular-motion scenarios. In contrast to conventional Digitally Reconstructed Radiograph (DRR) approaches primarily designed for registration, projection realism, or rendering efficiency, the proposed formulation treats projection imaging as an observation process operating on an explicitly represented anatomical scene. Independently transformable volumetric and surface-based anatomical objects are embedded within a shared scene representation and propagated directly into projection space through explicit transformations. Projection geometry, acquisition modelling, material interpretation, and image presentation remain explicitly separated, enabling controlled exploration of methodological assumptions while preserving reproducibility and direct comparability between generated projections. Particular emphasis is placed on transformation-driven anatomical scenarios relevant to craniofacial analysis, including mandibular motion and therapeutic repositioning. Using a shared anatomical reference scene composed of CT/CBCT volumes, segmented structures, surface models, and auxiliary anatomical or therapeutic objects, the framework enables generation of directly comparable VirtualRTG projections from multiple anatomical configurations while preserving identical imaging assumptions. Rather than aiming at fully physically faithful radiographic simulation, the proposed approach provides a controllable and reproducible methodological environment for studying anatomy–projection relationships, motion observability, and transformation-aware imaging workflows.

11.
arXiv (math.PR) 2026-06-19

The t-Split Two-Periodic Aztec Diamond Model

Authors:

arXiv:2606.19507v1 Announce Type: new Abstract: In this work we consider an Aztec diamond model split into two unequal regions which are asymptotically fixed in size. Each region is weighted with a distinct two-periodic weighting. We refer to this model as the t-split two-periodic Aztec diamond, to signify its difference from the previous work title Split Two-Periodic Aztec Diamond, where the model was split into two equal regions. We derive an integral expression for the correlation kernel of the model and give a partial description of the scaling limit behavior, along with a conjecture for the remainder. We refer to the larger and smaller sides of the model as the dominant and non-dominant sides, and to the location of the weight change as the interface. The dominant side exhibits a limit shape that depends only on its own weighting and is identical to that of the two-periodic Aztec diamond, while the non-dominant side appears to have a novel limit shape that depends on both weightings and the location of the interface. Lastly, we consider the complete limit shape in the case where the dominant side two-periodic parameter goes to 0.

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

CyberEvolver: Structured Self-Evolution for Cybersecurity Agents On the Fly

arXiv:2605.26195v2 Announce Type: replace-cross Abstract: LLM-based agents are increasingly used for cybersecurity tasks, but most existing systems rely on fixed, human-designed scaffolds that struggle to adapt across diverse targets and failure modes. We introduce \textsc{CyberEvolver}, a self-evolving cybersecurity agent framework that iteratively revises its own scaffold based on experience from failed execution attempts. Self-evolution in cybersecurity is challenging because the space of possible scaffold changes is largely unstructured, execution feedback is sparse and often obscured by the environment, and low-diversity updates can cause errors to compound over repeated iterations. \textsc{CyberEvolver} addresses these challenges with a four-layer evolvable agent architecture that decomposes scaffold optimization into structured components, a trace-to-diagnosis mechanism that converts noisy execution logs into actionable revision signals, and a population-based beam search strategy that preserves diverse agent variants during evolution. We evaluate \textsc{CyberEvolver} on CTF challenges, vulnerability exploitation, and penetration-testing tasks using four open-source LLMs. Across these settings, \textsc{CyberEvolver} improves the seed agent's success rate by $13.6$\,\% on average, and outperforms six human-designed cybersecurity agents as well as two self-improvement methods adapted from other domains. These results suggest that scaffold self-evolution is a promising direction for building adaptive LLM agents for security testing.

13.
arXiv (quant-ph) 2026-06-11

Fundamental Limitations of QAOA on Constrained Problems and a Route to Exponential Enhancement

arXiv:2511.17259v4 Announce Type: replace Abstract: We study fundamental limitations of the generic Quantum Approximate Optimization Algorithm (QAOA) on constrained problems where valid solutions form a low dimensional manifold inside the Boolean hypercube, and we present a provable route to exponential improvements via constraint embedding. Focusing on permutation constrained objectives, we show that the standard generic QAOA ansatz, with a transverse field mixer and diagonal r local cost, faces an intrinsic feasibility bottleneck: even after angle optimization, circuits whose depth grows at most sublinearly with n cannot raise the total probability mass on the feasible manifold much above the uniform baseline suppressed by the size of the full Hilber space. Against this envelope we introduce a minimal constraint enhanced kernel (CE QAOA) that operates directly inside a product one hot subspace and mixes with a block local XY Hamiltonian. For permutation constrained problems, we prove an angle robust, depth matched exponential enhancement where the ratio between the feasible mass from CE QAOA and generic QAOA grows exponentially in $n^2$ for all depths up to a linear fraction of n, under a mild polynomial growth condition on the interaction hypergraph. Thanks to the problem algorithm co design in the kernel construction, the techniques and guarantees extend beyond permutations to a broad class of NP-Hard constrained optimization problems.

14.
arXiv (CS.LG) 2026-06-16

Surrogate-Assisted Framework for SI-Compliant Interconnect Design Optimization Using the Earth Mover's Distance

arXiv:2606.15234v1 Announce Type: cross Abstract: This work presents a deterministic, machine-assisted framework for SI-compliant PCB design based on the Earth Mover's Distance (EMD). In contrast to conventional surrogate-based optimization methods that rely on iterative black-box search procedures, the proposed approach follows an interpretable, sequential evaluation strategy. Neural surrogate models are first used to efficiently predict waveform describing features from topology-dependent design parameters. A decision tree then acts as a physically motivated quality gate that identifies SI-compliant waveforms according to predefined SI criteria. Within the resulting valid solution space, the Earth Mover's Distance is employed as a similarity metric to rank candidate designs according to their proximity to an ideal reference signal. This enables not only the deterministic identification of admissible parameter regions but also a transparent prioritization of physically superior solutions without inverse modeling or stochastic search procedures. The methodology is demonstrated using a large-scale set of simulated DDR3 fly-by waveforms. By combining surrogate prediction, interpretable classification, and EMD-based waveform evaluation, the framework provides an explainable and computationally efficient alternative to conventional optimization strategies for supporting PCB development with AI-based methods.

15.
Science (Express) 2026-05-28

A Hormone Cell Atlas maps the human endocrine system at cellular resolution | Science

Authors: Unknown Author

Hormones act across tissues and organs to coordinate physiological functions. Drawing inspiration from the Human Cell Atlas, we analyzed expression of 379 hormone and receptor genes in a transcriptomic dataset comprising 14 million single cells and nuclei across 47 human tissues. Using hormone2cell, we mapped putative hormone-producing and hormone-receiving cell types, defining tissue-specific and cross-tissue endocrine signatures. We predicted non-classical sites of hormone expression, including secretin in plasmacytoid dendritic cells, inferred convergent hormone action and endocrine feedback loops, and implicated cell populations in monogenic endocrine disorders. In a cross-tissue integration of adipocyte datasets, we uncovered dynamic endocrine programs across depots, within adipocyte subtypes and through adipogenic differentiation. Cumulatively, the Hormone Cell Atlas ( hormonecellatlas.org.uk ) provides a comprehensive framework for dissecting hormonal impact on health and disease.

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

Running the Gauntlet: Re-evaluating the Capabilities of Agents Beyond Familiar Environments

arXiv:2606.14397v1 Announce Type: new Abstract: As agentic systems continue to evolve and are widely deployed in real-world scenarios, there is a growing demand to faithfully evaluate their capabilities. However, current benchmarks are typically built on popular applications with relatively simple tasks and focus on a narrow set of capabilities while overlooking broader dimensions, resulting in saturated performance on modern agents and failing to probe their limitations. To this end, we introduce GauntletBench, a web-based benchmark for evaluating agent generalisation in challenging scenarios, focusing on three underexplored capabilities (temporal perception, graphical understanding, and 3D reasoning), across five less-covered professional applications (Video Editor, Workflow Builder, 3D Modeller, Flight Analyser, and Circuit Designer), each with 20 vision-intensive tasks (100 in total). Our benchmark provides a modular pipeline that comprises an environment compatible with both open- and closed-source agent frameworks, a controlled web-based application, a well-structured task suite, and an automated evaluation engine with diverse metrics. Contrary to widespread expectations, our empirical results reveal that frontier agentic systems remain far from achieving human-level performance. Even the state-of-the-art agent achieves only a 19.1% success rate on our GauntletBench, highlighting the limitations in these overlooked capabilities and generalisation. By comparison, non-expert human annotators achieve over 80% success on our challenging yet feasible tasks, revealing the substantial gap between current agent capabilities and those required for complex real-world scenarios.

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

Automating SKILL.md Generation for Computer-Using Agents via Interaction Trajectory Mining

arXiv:2606.20363v1 Announce Type: new Abstract: Explicit skill libraries make computer-using agents easier to inspect, but it remains unclear whether such libraries can be mined from interaction data in a way that improves downstream policies. We study this question through a three-stage pipeline that segments GUI trajectories, clusters segments into candidate skills, and trains a skill-aware policy from the resulting annotations. The mined clusters are readable on the source benchmark: five of eight clusters have at least 0.95 purity against InteraSkill Workflows labels. However, readability does not imply transfer. GRPO improves IW skill-step accuracy only from 18.5\% to 20.5\%, leaves BrowseComp+ essentially unchanged, and underperforms trivial frequency priors on key source-domain metrics. We therefore present the method as a diagnostic study: trajectory mining can expose inspectable skill structure, but the current boundary detector, orderless segment representation, and offline reward model are insufficient for reliable cross-domain policy improvement.

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

Learning Visually Interpretable Oscillator Networks for Soft Continuum Robots from Video

Learning soft continuum robot (SCR) dynamics from video offers flexibility but existing methods lack interpretability or rely on prior assumptions. Model-based approaches require prior knowledge and manual design. We bridge this gap by introducing: (1) The Attention Broadcast Decoder (ABCD), a plug-and-play module for autoencoder-based latent dynamics learning that generates pixel-accurate attention maps localizing each latent dimension's contribution while filtering static backgrounds, enabling visual interpretability via spatially grounded latents and on-image overlays. (2) Visual Oscillator Networks (VONs), a 2D latent oscillator network coupled to ABCD attention maps for on-image visualization of learned masses, coupling stiffness, and forces, thereby enabling mechanical interpretability. We validate our approach on single- and double-segment SCRs, demonstrating that ABCD-based models significantly improve multi-step prediction accuracy with 5.8x error reduction for Koopman operators and 3.5x for oscillator networks on a two-segment robot. VONs autonomously discover a chain structure of oscillators. This fully data-driven approach yields compact, mechanically interpretable models with potential relevance for future control applications.

20.
arXiv (CS.CL) 2026-06-16

An Empirical Study on Learning Latent Representations for Emotional Speech Synthesis

For the last couple of years, the field of speech synthesis has improved dramatically thanks to deep learning. There are more and more deep learning-based TTS systems developed to make it possible to produce voices with high intelligibility and naturalness. Meanwhile, controlling the expressiveness is yet a big deal, generating speech in different styles or manners has received a lot of attention from community recently. This paper aims to give our solutions to deal with the task emotional speech synthesis (ESS) at VLSP 2022 which allows to generate humanlike natural-sounding voice from a given input text with desired emotional expression. By integrating speaker embedding, prosody bottleneck into FastSpeech 2, our systems can promisingly generate emotional speech of a single speaker (Sub-task 1), transfer speaking styles from another speaker to the target speaker with neutral non-expressive data while retaining the target speaker's identity (Sub-task 2).

21.
PLOS Medicine 2026-05-27

Sequential chemo-immunotherapy followed by standard versus reduced thoracic radiotherapy for older and/or frail stage III non-small-cell lung cancer: A randomized open-label cohort trial

Authors:

by Wei-Xiang Qi, Shuyan Li, Mengdi Wang, Huan Li, Feifei Xu, Lei Yao, Biao Yu, Linlin Chen, Gang Cai, Cheng Xu, Xianwen Sun, Zhiyao Bao, Jiayi Chen, Yi Xiang, Shengguang Zhao Background The appropriateness of concurrent chemoradiotherapy (cCRT) for older or clinically vulnerable stage III unresectable non-small-cell lung cancer (NSCLC) patients remains contentious. Furthermore, the survival implications of de-escalating thoracic radiotherapy (RT) intensity in this population have not been conclusively elucidated. Methods and findings We conducted a phase II randomized, open-label, two-cohort (non-comparative) trial at a tertiary hospital in China (NCT05557552). Between September 30, 2022 and April 30, 2024, we enrolled 56 older and/or frail patients with stage III NSCLC who were ineligible for cCRT. The primary endpoint was the 1-year progression-free survival (PFS) rate estimated using the Kaplan–Meier method. Secondary endpoints included objective response rate (ORR), overall survival (OS), and safety. In the intention-to-treat (ITT) set, which included all 56 randomized patients who received at least one dose of study treatment, the 1-year PFS was 84.3% (95% confidence interval [CI] [70.3%, 98.3%]) in the standard RT group and 70.7% (95% CI [54.3%, 87.1%]) in the reduced RT group. In the per-protocol set (53 patients), the 1-year PFS was 82.9% (95% CI [68.9%, 98.8%]) in the standard RT group and 73.4% (95% CI [58.3%, 92.4%]), with a median follow-up of 24 months. Among 56 patients in the safety analysis set, 71.4% of patients experienced grade 3/4 adverse events (AEs) in the standard RT group and 53.6% in the reduced RT group. One patient (3.6%) in the reduced RT and three patients (10.7%) in the standardized RT experienced grade 5 AEs. The main limitations are the non-comparative design, small sample size, and lack of power to establish non-inferiority or superiority. Conclusion The current study suggested that reduced RT combined with sequential chemo-immunotherapy might be feasible for older/frail patients intolerant to cCRT, showing numerically similar survival outcomes. These exploratory findings warrant confirmation in larger, adequately powered randomized trials. Trial registration The trial had been registered on ClinicalTrials.gov on Sep 30, 2022.ClinicalTrials.gov NCT05557552

22.
medRxiv (Medicine) 2026-06-12

Crimean-Congo haemorrhagic fever virus transmission: exploring perceptions of human-animal-tick interactions across six districts in Uganda

Crimean-Congo haemorrhagic fever virus (CCHFV) causes a viral zoonotic disease transmitted through tick bites and direct contact with infected blood or tissue of infected animals. Socio-ecological and behavioural risk factors for CCHFV exposure in Uganda remain poorly understood, which can lead to the omission of key risk factors in quantitative survey design and limit our wider understanding. In this study, we explored human-animal-tick interaction transmission risks in Uganda. We conducted 24 focus group discussions (FGDs) and 31 key-informant interviews (KIIs) across six environmentally and socio-ecologically diverse districts, between October 2023 and March 2024. Study sites were selected using K-prototype analysis, which combined environmental and socio-ecological variables to identify distinct clusters within Uganda. FGDs were conducted separately with groups of community leaders, men, women and teenagers with stratified purposive sampling. Medical doctors, veterinarians, traditional healers, district surveillance officers, and herdsmen were individually interviewed as key informants and purposively sampled. Data were transcribed and translated into English, and analysed thematically using iterative categorisation in NVivo 14. Most participants reported tick bites, some as frequently as every day. Close contact with animals was common, including sleeping next to them in the same building, largely due to concerns about animal theft. Less frequent but notable practices included slaughtering animals for consumption or sacrifice and interactions with wild animals during hunting. Slaughtering and butchering an animal which was sick or had died was reportedly performed by participants in most districts. Plucking and roasting engorged ticks was a practice described in the Kaabong and Arua districts of Northern Uganda. These practices and behaviours highlight potential key risks of CCHFV transmission and underscore the need for future studies to address specific behaviours, to quantify if, and to what extent, they present an exposure risk. Further work should include underlying reasons for the behaviours, which would help ensure that culturally appropriate interventions are targeted.

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

Agentic AI-based Framework for Mitigating Premature Diagnostic Handoff and Silent Hallucination in Healthcare Applications

arXiv:2606.18068v1 Announce Type: new Abstract: Recent advances in Large Language Models (LLMs) and multi-agent systems have driven the rise of Agentic AI, showing promise for medical reasoning. However, open-ended conversational agents remain prone to two critical failure modes: premature diagnostic handoff and silent clinical hallucinations that may go undetected before reaching the patient. In this work, we propose a multi-agent framework that addresses both issues by replacing ``LLM-as-a-judge'' routing with deterministic orchestration constraints. The framework incorporates two safety mechanisms. First, a neuro-symbolic state-tracking gate enforces completeness of the OLDCARTS clinical protocol (Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, and Severity) by blocking diagnostic transitions until all required dimensions are collected. Second, an epistemic uncertainty quantification (UQ) gate computes semantic entropy (H) across K=5 independent diagnostic samples to identify and intercept divergent outputs before delivery. We evaluate the system using simulated patient agents powered by the llama-3.1-70b-instruct model on 150 test cases. The full architecture achieves 49.3% diagnostic precision, representing an absolute improvement of 11.3 percentage points over an unconstrained baseline. Additionally, we observe a statistically significant negative correlation (r = -0.181, p < 0.05) between OLDCARTS completeness (\sigma) and semantic entropy (H), suggesting that structured information gathering is associated with reduced diagnostic uncertainty.

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

Prior-Informed Flow Matching for Graph Reconstruction

arXiv:2601.22107v2 Announce Type: replace Abstract: We introduce Prior-Informed Flow Matching (PIFM), a conditional flow model for graph reconstruction. Reconstructing graphs from partial observations remains a key challenge; classical embedding methods often lack global consistency, while modern generative models struggle to incorporate structural priors. PIFM bridges this gap by integrating embedding-based priors with continuous-time flow matching. Grounded in a permutation equivariant version of the distortion-perception theory, our method first uses a prior, such as GraphSAGE or node2vec, to form an informed initial estimate of the adjacency matrix based on local information. It then applies rectified flow matching to refine this estimate, transporting it toward the true distribution of clean graphs and learning a global coupling. Experiments on different datasets demonstrate that PIFM consistently enhances classical embeddings, outperforming them and state-of-the-art generative baselines in reconstruction accuracy.

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

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

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.