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01.
medRxiv (Medicine) 2026-06-17

Postoperative Cognitive Decline in Older Patients with Cardiovascular Disease and Preoperative Mild Cognitive Impairment

Objective. Older adults undergoing cardiac surgery may be vulnerable to postoperative cognitive decline. However, no studies have examined postoperative cognitive outcomes in older patients with cardiovascular disease (CVD) according to preoperative mild cognitive impairment (MCI). This study examined 12-month postoperative cognitive outcomes in older CVD patients according to preoperative MCI diagnosis and explored predictors of postoperative cognitive decline. Method. Twenty-two older CVD patients ([≥]65 years) and twenty-five controls were included. Neuropsychological assessment was conducted at baseline in both groups and repeated 12 months after surgery in the CVD group. MCI was diagnosed using current clinical criteria. Postoperative cognitive change was examined across preoperative MCI groups. Results. Fifty percent of patients met criteria for postoperative MCI, showing high diagnostic stability relative to preoperative frequency (45.5%). The preoperative CVD-MCI group showed a decline in working memory, executive functions, visual memory, and naming, whereas CVD-nMCI group declined only in verbal memory. Furthermore, CVD-MCI showed more heterogeneous postoperative cognitive trajectories of change than CVD-nMCI, who showed stability. Estimated IQ, APACHE-II score, and postoperative frailty were important variables in predicting the postoperative pattern. Conclusions. MCI frequency remained high and stable in older CVD patients across the preoperative and one-year postoperative period. However, this apparent diagnostic stability masks subclinical cognitive decline, particularly among patients with preoperative MCI, who showed greater susceptibility to further impairment. Estimated IQ, APACHE-II score, and postoperative frailty may be considered relevant predictors of outcome. These results highlight the value of preoperative neuropsychological assessment for characterizing postoperative cognitive risk in older CVD patients.

02.
arXiv (quant-ph) 2026-06-16

Optimizing resource bounds in direct fidelity estimation

arXiv:2606.16336v1 Announce Type: new Abstract: Direct fidelity estimation provides a way to estimate the fidelity between an experimentally prepared state and a desired pure target state without performing full tomography. Two influential formulations were introduced in 2011 by Flammia and Liu and by da Silva, Landon-Cardinal, and Poulin. In these protocols, the total estimation error is controlled through two distinct probabilistic steps: first, the fidelity is approximated using randomly sampled Pauli observables; second, each sampled expectation value is estimated from finitely many measurement outcomes. In this work we show that additional structural information about the noise can substantially sharpen the corresponding resource bounds. In particular, for some canonical channels the effective number of sampled Pauli settings can be reduced, leading to lower measurement cost both in the general pure-state setting and in the case of a stabilizer state. These results illustrate a broader point: worst-case confidence bounds in direct fidelity estimation can be significantly conservative when experimentally relevant structure is ignored. As a technical ingredient, we also revisit the allocation of the total accuracy and confidence budgets between the two probabilistic steps. Reformulating the analysis in terms of separate error parameters yields a constrained optimization problem whose solution lowers the average number of measurements in the general pure-state setting. Numerical simulations based on quantum circuits implemented in Qiskit illustrate both the improvement obtained under structured-noise assumptions and the conservativeness of the original worst-case bounds.

03.
arXiv (CS.AI) 2026-06-24

E-MRL: Cross-view Aligned Evidence-driven Multimodal Reinforcement Learning for Reliable 3D Tumor Analysis

arXiv:2606.23888v1 Announce Type: cross Abstract: While Vision-Language Models (VLMs) show great promise in volumetric medical report generation, they frequently suffer from visual hallucinations and a lack of grounding in 3D CT data. Current Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL) strategies typically optimize text fidelity alone, essentially rewarding correct diagnoses derived from language priors rather than genuine visual perception. To address this, we propose cross-view aligned Evidence-driven Multimodal Reinforcement Learning (Evidence-MRL, noted as E-MRL), a reliable RL reasoning framework that formulates the generation process as a Markov Decision Process of "diagnosis-localization-verification". Unlike standard approaches, our model is explicitly trained to identify a "key evidence slice" alongside the global diagnostic report, grounding its findings in verifiable visual evidence. Crucially, we introduce a novel cross-view consistency reward, which validates the semantic alignment between the golden-standard report and a local visual re-query of the selected key slice, providing additional rewards for correctly-localized reasoning. Experiments on large-scale 3D CT tumor datasets demonstrate that E-MRL significantly reduces hallucinations and improves diagnostic accuracy compared to SFT and RL baselines, offering a clinically interpretable solution for visually-grounded and tumor analysis.

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

Overcoming Rank Collapse in Feedback Alignment

arXiv:2606.11123v2 Announce Type: replace Abstract: Backpropagation (BP) is widely viewed as biologically implausible, in part because it requires feedback weights to be the transpose of forward weights for error propagation. Interestingly, when training a network with fixed random feedback weights to circumvent this issue, learning aligns the forward weights with the feedback weights, leading the backpropagated error signal to become an approximation of the standard gradient used by BP. This process, called Feedback Alignment (FA), occurs in MLPs and very shallow CNNs but does not scale well to deeper architectures. In this work, we first investigated differences between BP and FA models, trained on CIFAR10, specifically focusing on the effective rank of the signal. We found that the FA error has a considerably lower rank and hence is constrained to a lower-dimensional subspace compared to BP, limiting exploration of the parameter space. Motivated by this observation, we evaluated two mechanisms for increasing the effective dimensionality of FA: Muon, an optimiser that orthogonalises weight updates; and hidden activity normalisation, which promotes activation orthogonality. Across larger architectures and benchmarks, we find that these methods consistently improve over FA baselines, for example, on CIFAR100 with a Resnet-18, accuracy increases by 9 percentage points. Our results identify low-dimensional gradient dynamics as a key obstacle to scaling FA and suggest that inducing higher-dimensional update geometry is a promising route toward scaling alternatives to backpropagation.

05.
arXiv (CS.AI) 2026-06-19

The Hidden Evolution of Disguised Visual Context inside the VLM

arXiv:2606.20077v1 Announce Type: cross Abstract: Visual tokens enter Large Language Models (LLMs) as raw, foreign signals. How they are transformed into meaningful representations and interact with the language space depends entirely on the integration architecture. Whether by treating visual tokens as in-context prompts within the input sequence or injecting them directly into the LLM's intermediate layers. A controlled comparison and understanding of how these architectural choices affect visual information and its internal transformation to integrate with the LLM remains underexplored. We provide a fair comparison by evaluating in-context and layer-wise injection VLM integration paradigms under identical training conditions across single image, multi-image, and video benchmarks. In doing so, we uncover a hidden evolution where visual tokens enter the LLM as disguised visual context, raw representations lacking linguistic structure, but are progressively reshaped depending on the integration paradigm, each capturing fundamentally different frequency characteristics of the visual signal. We show that this evolution inside the LLM determines what visual features the VLM can utilize effectively, how visual representations align with the language space, and ultimately how each paradigm performs across different tasks. We further demonstrate that attention allocation alone is insufficient, and that performance is driven by the quality of visual representations at each layer.

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

DiverseDiT: Towards Diverse Representation Learning in Diffusion Transformers

Recent breakthroughs in Diffusion Transformers (DiTs) have revolutionized the field of visual synthesis due to their superior scalability. To facilitate DiTs' capability of capturing meaningful internal representations, recent works such as REPA incorporate external pretrained encoders for representation alignment. However, the underlying mechanisms governing representation learning within DiTs are not well understood. To this end, we first systematically investigate the representation dynamics of DiTs. Through analyzing the evolution and influence of internal representations under various settings, we reveal that representation diversity across blocks is a crucial factor for effective learning. Based on this key insight, we propose DiverseDiT, a novel framework that explicitly promotes representation diversity. DiverseDiT incorporates long residual connections to diversify input representations across blocks and a representation diversity loss to encourage blocks to learn distinct features. Extensive experiments on ImageNet 256x256 and 512x512 demonstrate that our DiverseDiT yields consistent performance gains and convergence acceleration when applied to different backbones with various sizes, even when tested on the challenging one-step generation setting. Furthermore, we show that DiverseDiT is complementary to existing representation learning techniques, leading to further performance gains. Our work provides valuable insights into the representation learning dynamics of DiTs and offers a practical approach for enhancing their performance.

07.
arXiv (CS.LG) 2026-06-15

D2H-AD: A Hybrid Model Utilizing Hyperdimensional Computing for Advanced Anomaly Detection

arXiv:2606.13754v1 Announce Type: new Abstract: Anomaly detection is a fundamental component of intelligent systems with applications in healthcare, cybersecurity, smart grids, and IoT environments. Although conventional machine learning and deep learning methods have demonstrated effectiveness in identifying anomalies, they often rely on large labeled datasets, incur high computational costs, and face scalability challenges in edge and high-dimensional settings. This paper presents D2H-AD, a novel anomaly detection framework based on Hyperdimensional Computing (HDC), a brain-inspired paradigm that represents information using high-dimensional distributed vectors. Unlike existing HDC-based methods, D2H-AD integrates distance-based similarity and density-aware encoding within a unified framework, improving anomaly representation and detection performance. Ablation studies show that hyperdimensional encoding alone yields up to 5.4% higher ROC-AUC than applying the same density-distance scoring directly in the original feature space. Furthermore, D2H-AD consistently outperforms five established baselines, namely HDAD, ODHD, One-Class SVM, Isolation Forest, and Autoencoders, across all evaluated datasets. The framework is lightweight, interpretable, and computationally efficient, making it suitable for resource-constrained and real-time applications. We validate D2H-AD on five benchmark datasets and demonstrate superior F1-score and ROC-AUC performance, together with robustness to class imbalance, noise, and data complexity. In addition to improved accuracy, D2H-AD offers scalability, a small memory footprint, and low-latency operation enabled by binary computations and a compact design. These properties make it particularly attractive for TinyML and edge AI deployments. The proposed framework highlights the potential of HDC for accurate, interpretable, and energy-efficient anomaly detection in dynamic environments.

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

BRDFusion: Physics Meets Generation for Urban Scene Inverse Rendering

Inverse rendering of urban scenes from captured videos enables numerous applications, including content creation and autonomous driving simulation. Physically-based rendering methods follow and control lighting physics, but suffer from reconstruction and rendering artifacts. While generative models produce realistic videos, they offer limited consistency and controllability. We present BRDFusion, a unified framework that combines two complementary models for inverse and forward rendering. Specifically, BRDFusion recovers explicit, consistent scene properties with physical modeling and alleviates optimization ambiguity with generative priors. During forward rendering, the physical model provides controllable rendering from the scene configuration, and the generative model denoises and fixes artifacts. Therefore, our method produces high-quality videos while allowing precise control, outperforming baselines in real and synthetic scenes. Moreover, BRDFusion supports novel-view relighting, night simulation, and dynamic object insertion/editing. Project page: https://shigon255.github.io/brdfusion-page/

09.
arXiv (CS.LG) 2026-06-19

Constrained hybrid modelling to predict microbial dynamics and organic matter turnover in soil systems

arXiv:2606.20329v1 Announce Type: new Abstract: Soil microorganisms control organic matter cycling and largely determine how soil systems can cope with and mitigate climate change and environmental threats. Representing microbial dynamics in process-based soil models is therefore critical to predict carbon cycling in soils, albeit highly challenging to inform from data. One promising approach to improve their parametrisation is the integration of genomic data, yet modelling the complex and unknown relationship between genomes and the processes the microbes are driving is an unsolved problem. In this work, we present the first hybrid modeling framework for deriving biokinetic parameter values of a process-based soil organic matter turnover model from metagenome-inferred functional traits based on DNA sequencing data. Our model predicts biokinetic parameters of the process-based model from genomic trait data with a neural network and integrates constraints from ecological theory and literature to ensure realistic behavior, even of non-observed state variables. We evaluate our method on synthetic genomic trait datasets of varying complexity and on real data, showing that our approach improves performance over multiple baselines and learns the dynamics of unmeasurable components of the process-based model effectively, even for small training datasets.

10.
arXiv (CS.LG) 2026-06-11

Restless bandits with imperfect binary feedback: PCL-indexability analysis and computation

arXiv:2606.11192v1 Announce Type: new Abstract: We study restless bandits with binary latent states and imperfect binary feedback, motivated by opportunistic spectrum access with sensing errors. For the associated belief-state model, we develop a partial conservation laws (PCL)-based analytical and computational framework for establishing indexability and evaluating the Whittle index, building on a verification theorem for real-state discounted restless bandits. The framework analyzes the stochastic dynamics via an associated deterministic skeleton, renewal decompositions, and combinatorics on words. It yields tractable expressions for discounted reward and resource metrics in several threshold regimes, enabling full verification of the PCL-indexability conditions there. For the remaining regime, where a complete analytic verification is not achieved in this paper, we derive efficient numerical schemes for computing the relevant marginal metrics and the marginal productivity (MP) index, which equals the Whittle index when those conditions hold. Extensive computational experiments provide strong evidence that these conditions also hold in that regime across broad parameter ranges and without the stringent parameter restrictions imposed in prior work. The experiments further show that theMP index policy typically outperforms standard benchmark policies, often by a substantial margin.

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

MixSD: Mixed Contextual Self-Distillation for Knowledge Injection

Supervised fine-tuning (SFT) is widely used to inject new knowledge into language models, but it often degrades pretrained capabilities such as reasoning and general-domain performance. We argue this forgetting arises because fine-tuning targets from humans or external systems diverge from the model's autoregressive distribution, forcing the optimizer to imitate low-probability token sequences. To address this problem, we propose MixSD, a simple external-teacher-free method for distribution-aligned knowledge injection. Instead of training on fixed targets, MixSD constructs supervision dynamically by mixing tokens from two conditionals of the base model itself: an expert conditional that observes the injected fact in context, and a naive conditional that reflects the model's original prior. The resulting supervision sequences preserve the factual learning signal while remaining substantially closer to the base model's distribution. We evaluate MixSD on two synthetic corpora that we construct to study factual recall and arithmetic function acquisition in a controlled setting, together with established benchmarks for open-domain factual question answering and knowledge editing. Across multiple model scales and settings, MixSD consistently achieves a better memorization-retention trade-off compared to SFT and on-policy self distillation baselines, retaining up to 100% of the base model's held-out capability while maintaining near-perfect training accuracy, whereas standard SFT retains as little as 1%. We further show that MixSD produces substantially lower-NLL supervision targets under the base model and reduces harmful movement along Fisher-sensitive parameter directions. These results suggest that aligning supervision with the model's native generation distribution is a simple and effective principle for knowledge injection that mitigates catastrophic forgetting.

12.
arXiv (CS.CL) 2026-06-19

CacheWeaver: Cache-Aware Evidence Ordering for Efficient Grounded RAG Inference

Retrieval-Augmented Generation (RAG) improves factual grounding, but it also lengthens prompts and raises prefill cost. Prefix caching in serving engines such as vLLM reduces this cost only when requests share the same token prefix. In grounded generation, however, adjacent queries may retrieve overlapping evidence in different orders, so set overlap does not become reusable prefix overlap. We present CacheWeaver, a lightweight prompt-layer method for cache-aware evidence ordering. The method keeps a prefix tree over recently served evidence sequences and uses a greedy walk to place the most reusable prefix first, while leaving the serving engine and retrieved evidence set unchanged. Across three vLLM configurations, the method lowers median time-to-first-token (TTFT) by about 20-33 percent relative to retrieval-order prefix caching, without hurting answer quality in our QA tests. The greedy policy reaches 97.5 percent of the median TTFT gain from oracle ordering, indicating that most reusable prefix locality can be recovered by a simple scheduling layer between retrieval and inference.

13.
arXiv (CS.CL) 2026-06-24

AGORA: An Archive-Grounded Benchmark for Agentic Workplace Document Reasoning

Large language models are increasingly deployed as agents that reason over documents rather than answer from parametric knowledge. We study archive-grounded reasoning: locating sparse evidence across a large, messy collection of workplace files, reconciling inconsistent terminology, units, and time conventions, and computing an answer. Existing benchmarks address only parts of this setting and none jointly stresses archive-groundedness, agentic exploration, and cross-domain coverage. We introduce Agora, a benchmark pairing 362 questions with eight domain collections of 9,664 authentic documents and 372M tokens, far exceeding any model's context window, so agents must explore deliberately rather than scan exhaustively. Agora is built by an agentic pipeline combining cross-document task synthesis, leakage-preventing obfuscation, and difficulty filtering. Evaluating eight models, we find the task far from solved: even the strongest reaches only 59.4% accuracy, with notable variation across domains.

14.
arXiv (quant-ph) 2026-06-12

Positive Conserved Quantities in the Klein-Gordon Equation

Authors:

arXiv:2410.04666v3 Announce Type: replace Abstract: We introduce an embedding of the Klein-Gordon equation into a pair of coupled equations that are first-order in time. The existence of such an embedding is based on a positivity property exhibited by the Klein-Gordon equation. These coupled equations provide a more satisfactory reduction of the Klein-Gordon equation to first-order differential equations in time than the Schrodinger equation. Using this embedding, we show that the ``negative probabilities" associated with the Klein-Gordon equation do not need to be resolved by introducing matrices as Dirac did with his eponymous equation. For the case of the massive Klein-Gordon equation, the coupled equations are equivalent to a forward Schrodinger equation in time and a backward Schrodinger equation in time, respectively, corresponding to a particle and its antiparticle. We show that there are two positive integrals that are conserved (constant in time) in the Klein-Gordon equation and thus provide a concrete resolution of the historical puzzle regarding the previously supposed lack of a probabilistic interpretation for the field governed by the Klein-Gordon equation. A significant consequence is that the Schrodinger equation is given a relativistic formulation, which does not require creation and annihilation operators, i.e. quantum fields. Physically, this corresponds to a theory in which the positive and negative energy parts do not directly interact, hence there will be no annihilation events–for example, particle-antiparticle collisions which do not result in photon emission. Thus, one practical consequence of this relativistically consistent theory is a simple explanation for dark matter.

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

Counterfactual Explanations for Deep Two-Sample Testing

arXiv:2606.04009v2 Announce Type: replace-cross Abstract: Two-sample testing is a fundamental tool for detecting distributional differences across scientific domains, but classical tests (including kernel-based tests) can be ineffective on high-dimensional structured data such as images. Recent deep two-sample tests improve sensitivity in these settings by learning informative representations, yet they provide limited insight into which data features drive rejection of the null hypothesis $H_0$. To address this issue, we propose a counterfactual explanation framework for deep two-sample testing that generates sample-level edits moving observations from a source group toward a target group while explicitly reducing the discrepancy measured by the test. Our method combines a diffusion autoencoder with a pretrained deep two-sample test model and optimizes a maximum mean discrepancy (MMD) objective in the test model's representation space to produce plausible counterfactuals. We quantify distribution-level effects through changes in the test statistic and the resulting two-sample p-values. We evaluate the method on synthetic 2D shape datasets and two MRI cohorts. Across both settings, the counterfactual transformations consistently increase p-values relative to the original samples, indicating that the edited source set becomes statistically closer to the target distribution under the test. We measure minimality using LPIPS to ensure the counterfactuals remain close to the original samples. The resulting edits provide interpretable evidence of the features associated with the detected group differences. On MRI, the localized changes are consistent with known anatomical differences between cohorts.

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

Graph Learning Should Move Beyond Restrictive Views of Spectral and Message-Passing GNNs

arXiv:2602.10031v2 Announce Type: replace Abstract: Graph neural networks (GNNs) are commonly divided into message-passing neural networks (MPNNs) and spectral GNNs, reflecting two largely separate research traditions in machine learning and signal processing. While MPNNs have a precise definition, there is no widely accepted criterion for what makes a mapping a spectral GNN. Most existing work restricts spectral GNNs to layered architectures based on linear spectral filters. Under this restriction, we show that spectral and spatial GNNs have largely equivalent expressive power. To promote progress in the field, we propose a precise definition of spectral GNNs based on eigenbasis symmetries, in contrast to the definition of MPNNs via neighborhood permutation symmetries. We further argue that the two perspectives offer complementary strengths. MPNNs provide a natural language for discrete structure and expressivity analysis through tools from logic and graph isomorphism, while the spectral perspective offers principled tools for understanding smoothing, bottlenecks, stability, and community structure. Overall, we argue that progress in graph learning will be accelerated by clarifying the similarities and differences between these perspectives and by moving toward a unified theoretical framework.

17.
arXiv (math.PR) 2026-06-11

Delta-Epsilon-Common Knowledge and Quantitative Agreement Theorems

arXiv:2606.11902v1 Announce Type: cross Abstract: Aumann defined common knowledge mathematically and established his now famous Agreement Theorem. We present a novel approach to quantifying how close individuals are to commonly knowing events, $(\delta,\epsilon)$-common knowledge, which is defined for any (and not just countable) probability spaces, and provide quantitative versions of the key results in this field. Specifically, we do this for Aumann's Agreement Theorem and Nielsen's extension thereof to random variables, as well as for the setting in which posteriors are communicated back and forth between individuals. Our results apply in particular to noisy communication settings.

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

Why Tree-Style Branching Matters for Thought Advantage Estimation in GRPO

Group Relative Policy Optimization (GRPO) trains Chain-of-Thought reasoning with verifiable rewards, but estimating thought-level advantages without value functions often suffers from high variance. Although tree-style branching is used in practice to reduce variance, it lacks a theoretical explanation of why it works and whether it is important or potentially necessary. We study thought-level advantage estimation in GRPO from a variance perspective under a minimal tree-style setting where multiple continuations are sampled for each thought. Using the multivariate delta method, we reveal a sampling-dimension asymmetry. Increasing sampled thoughts ($K$) leaves a strictly positive estimation-variance floor, whereas increasing continuations per thought ($M$) drives the leading-order estimation variance to zero at rate $1/M$. This implies that, within the fixed-temperature GRPO-style estimator without value models studied here, accurate thought-level advantage estimation cannot be achieved by scaling thought sampling alone, making continuation-level branching a principled and potentially necessary mechanism rather than a heuristic. Experiments further provide empirical evidence for its effectiveness and potential necessity, demonstrating improved optimization stability, training efficiency, and final performance not only in math but also across vision domains and under different model architectures and sizes.

19.
arXiv (CS.AI) 2026-06-16

MimicIK: Real-Time Generative Inverse Kinematics from Teleoperation with FK Consistency

arXiv:2606.15148v1 Announce Type: cross Abstract: Inverse kinematics (IK) remains a critical bottleneck for real-time robot manipulation. Classical numerical solvers achieve high geometric precision but often suffer from discontinuous branch switching and unstable behavior near kinematic singularities during closed-loop deployment. Meanwhile, learned IK approaches frequently struggle to balance spatial accuracy, motion smoothness, and real-time efficiency, particularly when trained on noisy human teleoperation data. We present MimicIK, a real-time generative inverse kinematics framework that learns smooth and robust joint-space motion priors from teleoperation demonstrations through conditional flow matching. Given the current joint configuration and a target end-effector pose, MimicIK predicts continuous delta-joint commands using an efficient two-step iterative refinement process based on a Minimal Iterative Policy (MIP) backbone. To enforce physical consistency, we further introduce an FK consistency loss, a differentiable forward-kinematics regularization that penalizes task-space deviations from the target pose during training. We evaluate MimicIK on a real-world 6-DOF robot dataset containing 8,848 teleoperation demonstrations. MimicIK achieves a mean position error of 4.65 mm, a 10 mm success rate of 92.01\%, and a trajectory spike rate of only 7.99\%. Compared with a UNet diffusion baseline, our method improves both spatial accuracy and motion smoothness while reducing inference latency from 21.66 ms to 6.74 ms. Furthermore, unlike deterministic MLP baselines that catastrophically diverge under out-of-distribution deployment, MimicIK remains stable near singular configurations and enables robust 20 Hz real-time control on deployment hardware.

20.
PLOS Computational Biology 2026-06-22

A lactylation- and autophagy-associated prognostic signature reveals LSEC-derived CLEC3B as a novel mediator of hepatocellular carcinoma suppression

Authors:

by Youai Song, Yinkuan Ning, Meihui Li, Jianwei Lan, Liangchen Lei, Yufei Han, Zhuo Meng, Binjie Li, Pengpeng Liu, Quanyan Liu The crosstalk between lactylation and autophagy within the hepatocellular carcinoma (HCC) microenvironment is a burgeoning field with profound implications. By integrating multi-omics data from public cohorts, we delineated two molecular subtypes of HCC with divergent clinical outcomes and established a lactylation-autophagy-related prognostic signature. This signature highlighted CLEC3B as a pivotal gene. Subsequent single-cell RNA sequencing and experimental validation unequivocally pinpointed liver sinusoidal endothelial cells (LSECs) as the principal cellular source of CLEC3B, which was significantly downregulated in HCC tissues. Functionally, conditioned media derived from CLEC3B-overexpressing LSECs potently inhibited HCC cell proliferation. Mechanistic investigations revealed that this tumor-suppressive effect was orchestrated through the concurrent suppression of autophagy and diminution of lactylation levels. Our findings position LSEC-secreted CLEC3B as a novel metabolic mediator in HCC, bridging two key pathways in tumor suppression, and endorse its clinical value both as a prognostic indicator and a promising therapeutic target.

21.
medRxiv (Medicine) 2026-06-12

The Acceptability of Three Co-Created Peer Support Interventions for People Living with Leprosy Reactions in Indonesia: A Mixed-Methods Pilot Study

Background: Leprosy reactions (LR) are immune-mediated complications associated with disability, emotional distress, and social isolation. We identified a gap in affected-individual-informed interventions that aim to improve the management of LR in healthcare settings. To address this gap, we assessed the acceptability of three peer-support interventions co-created with people affected by LR in Indonesia. Methods: Using an interactive learning and action approach, we co-created peer counselling, telesupport groups, and participatory video interventions which were piloted in an urban hospital and 13 rural community clinics. A mixed-methods design was applied with interviews, focus group discussions, and pre-post assessments involving four participant groups. Data were analyzed thematically using an acceptability framework. Results: One hundred participants were enrolled, and 92 completed the pilot intervention between November 2022 and July 2023. Qualitative findings showed that all interventions were acceptable. Peer counselling provided emotional reassurance through shared experiences and was perceived as trustworthy and supportive. Perceived burdens differed by setting, with time constraints in urban facilities and geographical barriers in rural clinics. Knowledge improved significantly among participants of peer counselling and telesupport groups in rural settings. Telesupport groups facilitated connection, information exchange, and continuity of care. Digital access and literacy limited participation for some, particularly in rural areas. The participatory video was perceived as reassuring and informative. Improvements in knowledge, attitude, practices, and mental well-being domain scores were observed among urban participants, but responses in rural settings showed less change. Participants and co-implementers reported increased self-efficacy, participants confidence to perform required behaviors within peer support interventions, with effects shaped by intervention and setting. Conclusions: The three co-created peer-support interventions were acceptable for individuals with LR in diverse healthcare settings. These outcomes highlight the importance and effectiveness of selective, and context-sensitive implementation of one or more peer-support modalities.

22.
arXiv (CS.AI) 2026-06-19

TeleMorpher: Toward Robust Simultaneous Motion-Location Editing

arXiv:2606.19676v1 Announce Type: cross Abstract: Diffusion models have achieved remarkable success in image and video generation and editing. While recent studies have extended these efforts toward motion editing, simultaneously transforming both motion and location-despite its practical importance-remains largely unexplored. To better understand robust motion-location editing, we first analyze the fundamental factors that degrade its quality. Based on this analysis, we propose TeleMorpher, one of the first one-shot frameworks to the best of our knowledge, for simultaneous motion-location editing. Our approach leverages motion priors, a target motion-centric video generated from an off-the-shelf model as motion-editing guidance, and the ground truth motion to enable more controllable and precise motion-location editing. Via this, our framework works as follows: (1) we first disentangle the protagonist and the background via pre-trained segmentation and inpainting models. (2) Then, we introduce a training-free pose warping that edits the protagonist's motion with the motion prior as the guidance. (3) The result of warped motion video is directly injected into a baseline motion editor during inference, mitigating the difference between source and target motions while preserving the appearance of the source video. (4) To enhance the reliability of quantitative evaluations, we propose two new LPIPS-based metrics that measure the background consistency before and after the motion editing and the fidelity of motion editing performance via measuring the difference between the extracted protagonist's skeletons from source and target videos. Experiments with in-the-wild videos and the TaiChi dataset demonstrate that TeleMorpher achieves superior performance across both quantitative and qualitative measurements (real-human evaluation), underscoring its effectiveness.

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

Decision-Aware Memory Cards: Counterfactual-Inspired Context Selection and Compression for Tool-Using LLM Agents

arXiv:2606.08151v2 Announce Type: replace Abstract: Modern large language model (LLM) agents do not simply need longer contexts; they need decision-relevant evidence at the moment of action. We study decision-aware context selection: ranking retrieved files, tests, traces, rules, and memories by their expected effect on an agent's next action rather than by semantic similarity alone. We present the Counterfactual-Inspired Context Layer (CICL), which builds an instance context graph, estimates decision-oriented utility for candidate units, and compresses selected evidence into typed memory cards. The same schema can be instantiated with hosted LLM judges, local surrogates, or lightweight rankers, making the selection protocol auditable across model choices. On 50 SWE-bench Verified file-retrieval instances, Qwen3.6-Plus reranking of BM25 top-50 candidates improves hit@1 from 0.58 to 0.78 and MRR@10 from 0.634 to 0.790, with all 2,500 judgments parseable. Controlled diagnostics show that CICL identifies action-critical evidence: removing the top-utility semantic unit reduces F1 from 0.245 to 0.000. In selected-then-compressed mode, memory cards save 44.93 tokens per query while preserving selected evidence. CICL provides a practical layer for measuring, ranking, and compressing decision-critical context for tool-using agents. Code is available at https://github.com/stephen-guan-researcher/CICL.

24.
medRxiv (Medicine) 2026-06-22

COVID-19 containment policies and hyperglycemia in pregnancy: correlation with the Stringency Index in a nationwide Belgian cohort

Background During the COVID-19 pandemic, gestational diabetes (GD) prevalence showed variable changes across regions, with most reporting increases and others decreases; however, its association with perinatal outcomes in Belgium remains unknown. We aimed to compare the prevalence of hyperglycemia in pregnancy (HIP) in 2020 versus 2019 and examined the correlation between HIP prevalence and pandemic-related restrictions measured by the Stringency Index (SI) and evaluate neonatal weight percentiles changes. Methods: We included all singleton live births in Belgium in 2019 and 2020 from Belgian birth registry data. We compared monthly proportions of HIP prevalence and Small for gestational age (SGA) and Large for gestional age (LGA) newborns in 2019 and 2020. Crude and adjusted odds ratios (ORs, aORs) were estimated with logistic and multinomial regression. The Spearman correlation coefficient was used to assess the correlation between the monthly average SI and the monthly aORs of HIP. Results: For deliveries from January to June 2020, no significant differences in HIP prevalence were observed compared with 2019. From July to December 2020, there was a significant increase in HIP, with peaks in July (GD screening in April) (aOR 1.41, 1.26-1.58) and November (GD screening in August) (aOR 1.33, 95% CI 1.18-1.49). There was no significant change in neonatal weight percentiles. The Spearman correlation coefficient between the SI and HIP aORs was 0.86 (p = 0.02). Conclusion During the pandemic, we observed an increase in the prevalence of HIP, compared to 2019, without a measurable impact on LGA or SGA newborns. The aOR of HIP in a given month was strongly correlated with the corresponding SI.

25.
arXiv (CS.CL) 2026-06-16

StagePilot: Stage-Level Planning for Long-Horizon Dialogue Simulation in Cybergrooming

Cybergrooming is an evolving threat to youth, requiring proactive educational interventions. We address this by modeling dialogue progression as a structured planning problem over stage-wise interactions. We propose StagePilot, a dialogue framework that separates stage-level planning from response generation, in which the model selects the next stage under constrained transitions and generates responses conditioned on it, enabling coherent and realistic progression. Reinforcement learning is used to learn stage-level policies from offline data, optimizing for both emotional alignment and goal-consistent progression. Our empirical experiments show that StagePilot generates more structured, coherent dialogue trajectories and reduces conversational stagnation compared to baselines; notably, the IQL+AWAC variant reaches the final stage more often while maintaining over 70% positive or neutral responses, yielding a 43% relative improvement.