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01.
arXiv (CS.CL) 2026-06-16

Retrievable Gradients: Continual Post-Training Without Cumulative Weight Drift

Continual post-training enables models to absorb emerging knowledge after deployment, but repeatedly updating shared parameters can accumulate weight drift, potentially causing catastrophic forgetting and degrading general capabilities. Retrieval-augmented generation avoids such parameter drift, yet often lacks the depth of parametric knowledge integration. In this paper, we propose ReGrad (Retrievable Gradients), a new paradigm that treats gradients as retrievable units of knowledge. ReGrad pre-computes document-specific gradients offline, stores them in an indexed Gradient Bank, and retrieves only query-relevant gradients at inference time for temporary weight adaptation. However, raw language-modeling gradients are optimized for token-level document reconstruction rather than for query-driven knowledge use. We therefore introduce a bi-level meta-learning objective that reshapes document-derived gradients into generalizable adaptation signals for downstream tasks. Experiments across general and domain-specific settings show that \textsc{ReGrad} outperforms CPT and RAG baselines, enabling scalable and reversible parametric knowledge injection without accumulating weight drift.

02.
medRxiv (Medicine) 2026-06-10

Development of an Open-Access Action Observation Video Library for Upper Limb Motor Rehabilitation

Background: Occupational therapists can improve stroke survivors hand and arm movement and participation in daily activities through action observation (AO). AO involves watching another persons hand or arm complete a movement or task. While research generally supports the use of AO with stroke survivors, there are limited AO videos are available to occupational therapists which makes applying AO challenging. Objective: The purpose of this work is to develop structured and widely accessible tool to support access to AO for stroke survivors, occupational therapists, and researchers. Methods: To develop an AO video library for stroke rehabilitation, functional and non-functional upper limb task deficits were first identified through clinical observations and clinician interviews to establish a prioritized list of daily activities. In collaboration with media production specialists, healthy adult volunteers were recruited and filmed performing these tasks from both first- and third-person perspectives. The recorded videos were then systematically edited, enhanced with instructional title slides, and distributed via a public YouTube channel for clinical application and a categorized digital repository for research purposes. Results: Initial assessments revealed a complete lack of familiarity, awareness, and utilization of AO resources among local occupational therapists, despite high perceived clinical utility. To address this gap, a final library of 150 tasks was established, resulting in the production of 419 finalized, standardized videos featuring six healthy volunteers. For clinical application, these videos were hosted on a free, public YouTube channel organized into 18 functional playlists, while a parallel set was structured into distinct movement categories for research repository storage. Conclusion: By providing a structured and highly accessible tool, this repository enables clinicians, researchers, and caregivers to readily implement evidence-based action observation interventions in both clinical and home settings.

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

Privacy-Preserving Text Sanitization for Distributed Agents Collaboration via Disentangled Representations

When distributed agents exchange text across organizational boundaries, privacy leakage arises not only from explicit identifiers but also from distributional signatures such as formatting conventions, vocabulary choices, and syntactic patterns. We propose DiSan(Disentangled Sanitization), a privacy-preserving sanitization framework and a built-in component of Intern-Shannon for multi-agent collaboration. DiSan uses a two-stream encoder to factorize text into a source-invariant role subspace that preserves task semantics and a source-identifying style subspace that remains local. Federated proto-type alignment and adversarial regularization enable joint training without centralizing raw text. Experiments show that identifier-level masking is insufficient: masking 19.2% of tokens reduces TF-IDF stylometric attribution by only 18.6%. By contrast, DiSan reduces answer-level PII exposure by 20 times while maintaining 83% answer faithfulness on a distributed multi-agent RAG benchmark, and lowers Enron stylometric attribution by 73.2% under TF-IDF and 70.6% under a neural probe.

05.
arXiv (CS.LG) 2026-06-24

Posterior Sampling Reinforcement Learning with Gaussian Processes for Continuous Control: Sublinear Regret Bounds for Unbounded State Spaces

arXiv:2603.08287v2 Announce Type: replace-cross Abstract: We analyze the Bayesian regret of the Gaussian process posterior sampling reinforcement learning (GP-PSRL) algorithm. Posterior sampling is a heuristic for decision-making under uncertainty that has been used to develop successful algorithms for a variety of continuous control problems. However, theoretical work on GP-PSRL is limited. All known regret bounds either have a sub-optimal growth rate, require strong smoothness assumptions, or fail to properly account for the fact that the set of possible system states is unbounded. Through a recursive application of the Borell-Tsirelson-Ibragimov-Sudakov inequality, we show that, with high probability, the states actually visited by the algorithm are contained within a ball of near-constant radius. We then use the chaining method to control the regret suffered by GP-PSRL under weak smoothness conditions. Our main result is a Bayesian regret bound of the order $\widetilde{\mathcal{O}}(H\sqrt{\gamma_TT})$, where $H$ is the horizon, $T$ is the number of time steps and $\gamma_T$ is the expected information gain. With this result, we resolve the limitations with prior theoretical work on PSRL, and provide the theoretical foundation and tools for analyzing PSRL in complex settings.

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

Apparent Psychological Profiles of Large Language Models are Largely a Measurement Artifact

Psychological instruments designed for humans are increasingly used to assign large language models (LLMs) stable psychological profiles that affect their usability, safety assessment, and use as proxies for human participants in research. Using a formal psychometric framework, we show that these profiles are largely a measurement artifact. Administering a battery of personality and risk-preference instruments spanning self-reports and behavioral tasks to 56 instruction-tuned LLMs alongside large human reference samples, we report four findings. First, differences between models are driven not by the traits an instrument targets but by a directional response bias, a tendency to respond toward one end of the scale, or one labeled option, regardless of item content; a variance decomposition attributes 81-90% of between-model variation to this bias, against 9-16% in humans. Second, the bias declines with model capability but is not eliminated by it. Third, because bias rather than trait drives responding, an instrument's apparent reliability is almost entirely predicted by its response orthogonality, a term we coin for the proportion of items for which trait and bias point in opposite directions. Fourth, the profile a model appears to have shifts with the items used and can be manufactured through item selection. These results demonstrate that the apparent psychological profiles of LLMs are artifacts of the instrument used to measure them, not properties of the models themselves. As instruments borrowed from human psychology are rarely fully orthogonal and may inherently lack validity for LLMs, we call for dedicated assessments centered on response orthogonality.

07.
Nature Medicine 2026-06-08

Apitegromab for lean mass preservation during tirzepatide-induced weight loss: a randomized, double-blind, placebo-controlled phase 2 trial

Loss of lean mass in proportion to total weight loss is observed with incretin mimetic therapies such as tirzepatide and has the potential to adversely affect health and function. Apitegromab is an investigational, fully human monoclonal antibody that selectively inhibits myostatin activation and is, thereby, capable of increasing muscle mass. In the randomized, double-blind, placebo-controlled phase 2 EMBRAZE study, adults with overweight or obesity (n = 102) were randomized 1:1 to receive tirzepatide plus apitegromab (10 mg kg−1) or tirzepatide plus placebo. At week 24, apitegromab resulted in a least square mean (80% confidence interval (CI)) of 1.9 (1.2−2.7) kg less lean mass loss than placebo (P = 0.001), despite similar total body weight loss between groups, representing a 54.9% retention of lean mass relative to placebo. In participants receiving apitegromab, trough concentrations of apitegromab and total latent myostatin, a pharmacodynamic marker, both increased over time and reached a plateau after approximately 16 weeks. Incidence of adverse events (AEs) (% (95% CI)) was generally similar across apitegromab-treated participants and placebo-treated participants, with 39 of 51 (76% (63−86%)) and 36 of 51 (71% (57−81%)) participants experiencing an AE, respectively. Serious adverse events (SAEs) were balanced and experienced by one of 51 (2% (0−10%)) participants in each arm. In summary, this proof-of-concept study demonstrated that selective targeting of myostatin by apitegromab was well tolerated and effective in preserving lean mass when combined with tirzepatide. ClinicalTrials.gov identifier: NCT06445075 . In the phase 2 EMBRAZE study, participants receiving tirzepatide and apitegromab lost less lean mass compared to participants receiving tirzepatide and placebo.

09.
medRxiv (Medicine) 2026-06-23

Unscreenable: The Burden, Structure, and Analytic Consequences of "Unable to Assess" Delirium Documentation in the Intensive Care Unit

Objective: To quantify the burden, structure, and downstream analytic consequences of "Unable to Assess" (UTA) delirium documentation in the intensive care unit (ICU). Design: Retrospective cross-sectional and repeated-measures study. Setting: A single US academic medical center (Medical Information Mart for Intensive Care IV [MIMIC-IV], 2008-2019). Patients: 72,944 adult ICU stays with at least 1 delirium screen. Interventions: None. Measurements and Main Results: Among 610,632 screens, 130,455 (21.4%; 95% CI, 21.0%-21.8%) were recorded as UTA, exceeding the 119,052 (19.5%) scored positive. The UTA fraction rose from 2.0% at a Richmond Agitation-Sedation Scale (RASS) score of 0 to 97.8% at RASS -4; 22.0% of UTA screens occurred in arousable patients, where UTA was associated with mechanical ventilation (odds ratio [OR], 3.43; 95% CI, 3.17-3.71) and non-English primary language (OR, 3.74; 95% CI, 3.43-4.08). Building the delirium label three ways from the same patients shifted prevalence modestly (32.1% to 30.8%) and prediction (area under the curve, 0.737 to 0.719) but most affected the delirium-mortality association: in a baseline-adjusted model the OR was 4.12 (95% CI, 3.88-4.36) under complete-case handling and fell to 2.16 (95% CI, 2.06-2.27) when UTA was recoded as negative. UTA was recoverable from the observed clinical state (area under the curve, 0.95). Conclusions: In this ICU cohort, Unable to Assess was the most common recorded delirium result other than Negative, exceeding positive screens; recoding it as negative roughly halved the apparent delirium-mortality association by relabeling deeply sedated, high-mortality patients. Delirium datasets should preserve and report UTA, whose concentration among arousable non-English-speaking patients is a measurable equity target.

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

MaxProof: Scaling Mathematical Proof with Generative-Verifier RL and Population-Level Test-Time Scaling

We present MaxProof, a population-level test-time scaling framework for competition-level mathematical proof in the MiniMax-M3 series. M3 first trains three proof-oriented capabilities – proof generation, proof verification, and critique-conditioned proof repair – using a defense-in-depth generative verifier engineered for low false-positive rate. These capabilities are merged into a single released M3 model. At test time, MaxProof treats the model as a generator, verifier, refiner, and ranker, searches over a population of candidate proofs, and returns one final proof through tournament selection. With MaxProof test-time scaling, the M3 model reaches 35/42 on IMO 2025 and 36/42 on USAMO 2026, exceeding the human gold-medal threshold on both.

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

SafeSpec: Fast and Safe LLM via Dynamic Reflective Sampling

arXiv:2606.19755v1 Announce Type: cross Abstract: Speculative inference accelerates large language model (LLM) decoding but provides no inherent safety guarantees. Existing safety defenses are largely incompatible with speculative inference: they either introduce additional computation or disrupt the draft-verify mechanism, negating acceleration benefits. This reveals a fundamental incompatibility between current safety methods and speculative decoding. We propose SafeSpec, a safety-aware speculative inference framework that integrates risk estimation directly into the verification process. SafeSpec attaches a lightweight latent safety head to the target model to jointly evaluate semantic validity and safety in a single forward pass. When unsafe generations are detected, SafeSpec applies rollback and safety-guided reflective multi-sampling to recover safe continuations rather than terminating generation. We model jailbreak attacks as distributional shifts over generative trajectories, where adversarial prompts increase the probability of harmful continuations without eliminating safe ones. Under this model, SafeSpec performs risk-aware trajectory recovery within the speculative decoding process. Across multiple models and adversarial benchmarks, SafeSpec achieves a substantially improved safety-efficiency trade-off. On Qwen3-32B, SafeSpec reduces attack success rates by 15% while preserving a 2.06x inference speedup on benign workloads, demonstrating that speculative acceleration and inference-time safety can be jointly optimized.

12.
arXiv (CS.CL) 2026-06-24

A specialized reasoning large language model for accelerating rare disease diagnosis: a randomized AI physician assistance trial

Rare diseases affect millions of individuals worldwide, yet timely diagnosis remains a major public health challenge due to scarcity of specialized clinical expertise. While large language models (LLMs) show promise to support rare disease diagnosis, current models are constrained by insufficient clinical deployability, limited clinically grounded evidence, and scarcity of training data. Here we present RaDaR (Rare Disease navigatoR), an open-source, compact reasoning LLM (32B parameters) for rare disease diagnosis. RaDaR was trained with 49,170 publicly available free-text cases and 104,666 synthetic cases with reasoning-enhanced training. RaDaR showed the strongest performance among evaluated open-source models, including the 671B DeepSeek-R1, across public benchmarks and four external validation centers. In a retrospective cohort, RaDaR prioritized the final diagnosis before documented clinical suspicion in 61.06 percent of cases, corresponding to a potential lead time of 1.87 months and 50.18 percent of the within-center interval. In a randomized physician-assistance trial, RaDaR assistance improved physicians' rare-disease diagnostic accuracy by 21.44 percentage points compared with internet search alone. Synthetic-data ablations suggested that phenotype-anchored narratives provide useful training signal for long-tail rare diseases, with a monotonic scaling trend within the tested data range. Together, RaDaR and its development and validation framework provide a deployable rare-disease reasoning model and a reproducible development framework for diagnostic AI under data scarcity.

13.
arXiv (quant-ph) 2026-06-24

How rare are Markovian quantum dynamics?

arXiv:2606.24511v1 Announce Type: new Abstract: A profound understanding of decoherence and dissipation in quantum dynamics is crucial for the realistic modeling of the evolution of quantum systems. In open quantum dynamics one distinguishes between a memoryless, so-called Markovian evolution and dynamics incorporating memory effects, termed non-Markovian. In this work we study how prevalent memory effects are in the set of all such dynamics. We thus investigate how often a Markovian description is applicable. This question is approached by investigating randomly generated two-step qubit dynamics with respect to different concepts and witnesses of non-Markovianity. We observe that almost all dynamics are non-Markovian, and only a small (yet finite) fraction is Markovian. Furthermore, we study how this proportion changes when considering certain subclasses such as lower rank or mixed-unitary dynamics. Importantly, our results shed light on the relative ratios of – and interrelations between – the sets of dynamics that are non-Markovian with respect to different criteria. Finally, we investigate the fraction of dynamics in which the memory effects are necessarily of quantum nature and establish a connection between two recently developed concepts that characterize the quantumness of memory in non-Markovian dynamics.

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

Effective and Low-cost Lane-based Map Localization for Vehicle-Centric Route Generation

Driver-centric route representation plays a vital role in intuitive driving guidance systems. This paper presents OLRA, a low-cost, map-localization-based framework that derives driver-view-aligned routes by matching map-based navigation routes with camera-detected lane markings. This alignment process mutually enhances vehicle localization accuracy and visual route consistency. To bridge the evaluation gap across different paradigms, we introduce practical route evaluation metrics and benchmark OLRA against OpenPilot, a representative direct-generation approach. Experimental results on the nuScenes dataset demonstrate that OLRA outperforms OpenPilot in complex road segments and in route estimation at distance beyond 20 meters, achieving lower overall Euclidean error. This study is expected to promote future research in low-cost, maplocalization-based route generation methods.

15.
arXiv (CS.CL) 2026-06-11

Context-Driven Incremental Compression for Multi-Turn Dialogue Generation

Modern conversational agents condition on an ever-growing dialogue history at each turn, incurring redundant attention and encoding costs that grow with conversation length. Naive truncation or summarization degrades fidelity, while existing context compressors lack cross-turn memory sharing or revision, causing information loss and compounding errors in long dialogues. We revisit the context compression under conversational dynamics and empirically present its fragility. To improve both efficiency and robustness, we introduce Context-Driven Incremental Compression (C-DIC), which treats a conversation as interleaved contextual threads and stores revisable per-thread compression states in a single, compact dialogue memory. At each turn, a lightweight retrieve, revise, and write-back loop shares information across turns and updates stale memories, stabilizing long-horizon behavior. In addition, we adapt truncated backpropagation-through-time (TBPTT) to our multi-turn setting, learning cross-turn dependencies without full-history backpropagation. Extensive experiments on long-form dialogue benchmarks demonstrate superior performance and efficiency of C-DIC; notably, C-DIC shows stable inference latency and perplexity over hundreds of dialogue turns, supporting a scalable path to high-quality dialogue modeling.

16.
arXiv (CS.CL) 2026-06-24

TruncProof: A Guardrail for LLM-based JSON Generation under Token-Length Constraints

The LLM-based generation of machine-readable outputs such as JSON has attracted significant attention for integration with external systems. However, existing approaches cannot strictly enforce the maximum number of tokens to be generated, leading to infinite generation or truncated outputs that cause a system malfunction. To address this limitation, we propose TruncProof, a novel grammar-constrained generation method that enables LLMs to produce grammatically valid JSONs while adhering to a predefined token limit. By leveraging the properties of LL(1) parsers, TruncProof efficiently approximates the minimum number of tokens required to complete a grammatically valid output at each decoding step. Experiments on the Text-to-JSON instruction tasks demonstrate that TruncProof successfully generates syntactically correct outputs even under strict token constraints. Furthermore, we show that TruncProof can be effectively combined with advanced decoding strategies, resulting in outputs that are not only grammatically valid but also semantically accurate.

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

WEQA: Wearable hEalth Question Answering with Query-Adaptive Agentic Reasoning

arXiv:2606.18147v1 Announce Type: new Abstract: Language models are remarkably capable at medical question answering, in some cases surpassing the accuracy of general physicians. However, answering questions about wearable health data remains challenging and understudied, as these ubiquitous sensors produce continuous, high-dimensional, and longitudinal data, which is non-trivial to align with text-centric distributions in LLM pretraining. The diversity of sensor modalities and user intents cannot be effectively handled by a fixed reasoning workflow or a single pretrained foundation model. To address these challenges, we propose WEQA, a query-adaptive agent framework that unifies LLM reasoning with specialized wearable analytical and modeling tools. An LLM controller is employed to synthesize execution plans and dynamically route each query to the appropriate combination of sensor analysis and pretrained models, and perform grounded response auditing with external knowledge. We also curate a benchmark spanning four open wearable datasets comprising analytic and predictive tasks in three different health domains. Experiments show that our framework is 24% more accurate than LLM and agentic baselines, and a blinded study with 12 medical experts and 8 users shows substantial gains in usefulness and clinical soundness.

18.
arXiv (CS.LG) 2026-06-24

Bridging Mechanistic Interpretability and Prompt Engineering with Gradient Ascent for Interpretable Persona Control

arXiv:2601.02896v3 Announce Type: replace Abstract: Controlling emergent behavioral personas (e.g., sycophancy, hallucination) in Large Language Models (LLMs) is critical for AI safety, yet remains a persistent challenge. Existing solutions face a dilemma: manual prompt engineering is intuitive but unscalable and imprecise, while automatic optimization methods are effective but operate as "black boxes" with no interpretable connection to model internals. We propose a novel framework that adapts gradient ascent to LLMs, enabling targeted prompt discovery. In specific, we propose two methods, RESGA and SAEGA, that both optimize randomly initialized prompts to achieve better aligned representation with an identified persona direction. We introduce fluent gradient ascent to control the fluency of discovered persona steering prompts. We demonstrate RESGA and SAEGA's effectiveness across Llama 3.1, Qwen 2.5, and Gemma 3 for steering three different personas, sycophancy, hallucination, and myopic reward. Crucially, on sycophancy, our automatically discovered prompts achieve significant improvement (49.90% compared with 79.24%). By grounding prompt discovery in mechanistically meaningful features, our method offers a new paradigm for controllable and interpretable behavior modification. We release our scripts for RESGA and SAEGA in this github repo: https://github.com/HarshSaini10/RESGA_SAEGA.

19.
arXiv (quant-ph) 2026-06-12

Exploring Exotic Spin-Dependent Interactions Beyond the Standard Model: Theoretical Foundations and Experimental Investigations

arXiv:2606.13318v1 Announce Type: cross Abstract: New interactions mediated by novel particles propose solutions to several important questions in modern physics. Axions serve as examples of such particles; they are lightweight and interact weakly with ordinary matter. This category of particles, including those similar to axions-termed Axion-Like Particles (ALPs)-arises from diverse theoretical frameworks, such as the Peccei-Quinn mechanism addressing the strong CP problem, string theory, and spontaneous supersymmetry breaking. Given their light mass and weak coupling, ALPs are also possible candidates for cold dark matter. Introducing these new interactions mediated by novel particles not only tackles several challenges in modern physics but also raises a crucial question: Are there undiscovered interactions beyond the Standard Model? Many of the interactions predicted by these theories are spin-dependent, which is the primary focus of this review. In this review, we first outline the theoretical foundations for investigating exotic spin-dependent interactions, highlighting their importance in various models beyond the Standard Model. We examine the potential roles of new lightweight particles in mediating these interactions, which may enhance our understanding of dark matter. Relevant formulas derived from theoretical models are included to support experimental investigations. Following this theoretical framework, we conduct a detailed review of recent experimental efforts to detect these exotic interactions. A systematic review of current constraints on these interactions is presented, along with an assessment of various detection approaches.

20.
arXiv (CS.AI) 2026-06-17

From Brewing to Resolution: Tracing the Internal Lifecycle of Code Reasoning in LLMs

arXiv:2606.17648v1 Announce Type: new Abstract: Standard accuracy metrics cannot explain why LLMs handle variable tracking but fail on semantically equivalent loops. We study an internal lifecycle of code reasoning in which models first brew the answer, making it linearly recoverable many layers before it becomes self-decodable, and then diverge into one of four resolution outcomes: Resolved, Overprocessed, Misresolved, or Unresolved. Understanding this lifecycle matters because similar task accuracies can mask fundamentally different failure modes that surface-level evaluation cannot detect. We introduce a dual diagnostic framework pairing layer-wise linear probing with Context-Stripped Decoding (CSD) and apply it to six code-reasoning task families across 16 models spanning Qwen, Llama, and DeepSeek architectures. All four outcomes carry substantial mass in every task family: overall Resolved is only 41.5%, with multiple tasks below 30%. Controlled sweeps over structure, depth, and operators expose task-specific failure bottlenecks: Function Call Resolved plunges from 61.1% to 2.5% as call depth increases from one to three. Across architectures and scales, the brewing scaffold remains stable, with normalized brewing duration 24-42% across all 16 models, while resolution success varies with capability. This indicates that the scaffold is a stable empirical regularity across the tested decoder-only Transformer families, whereas resolution success covaries with capability, scale, and training. Code: https://github.com/euyis1019/llm-brewing

21.
arXiv (CS.LG) 2026-06-24

LoMime: Query-Efficient Membership Inference using Model Extraction in Label-Only Settings

arXiv:2602.18934v2 Announce Type: replace Abstract: Membership inference attacks (MIAs) threaten the privacy of machine learning models by revealing whether a specific data point was used during training. Existing MIAs often rely on impractical assumptions, such as access to public datasets, shadow models, confidence scores, or knowledge of the training data distribution, making them vulnerable to defenses like confidence masking and adversarial regularization. Label-only MIAs, even under strict constraints, suffer from high query requirements per sample. We propose a cost-effective label-only MIA framework based on transferability and model extraction. By querying the target model $M$ using active sampling, perturbation-based selection, and synthetic data, we extract a functionally similar surrogate model $S$ on which membership inference is performed. This shifts the query overhead to a one-time extraction phase, eliminating repeated queries to $M$. Our method matches the performance of state-of-the-art label-only MIAs while significantly reducing query costs and operating under strict black-box constraints. On benchmark tabular datasets, we show that a query budget equivalent to testing the membership of approximately $1%$ of the training samples is sufficient to extract $S$ and achieve membership inference accuracy within $\pm 1%$ of that obtained when attacking $M$ directly. We also evaluate the effectiveness of standard defenses, including DP-SGD and regularization, proposed for label-only MIAs against our attack. Finally, we present preliminary results extending our framework to deep neural networks trained on image datasets, demonstrating promising transferability and membership inference performance under label-only access while highlighting directions for further optimization.

23.
Nature (Science) 2026-06-22

Daily briefing: First-ever ‘nuclear’ clocks put atomic clocks in the shade

Authors:

Two research teams have created a new, long-awaited type of timekeeper. Plus, how backlash has saved an ocean-monitoring network targeted by Trump and how our cultural heritage is put at risk by climate change. Two research teams have created a new, long-awaited type of timekeeper. Plus, how backlash has saved an ocean-monitoring network targeted by Trump and how our cultural heritage is put at risk by climate change.

24.
medRxiv (Medicine) 2026-06-10

Frozen elephant trunk repair in heritable thoracic aortic disease: Impact of genetic aortopathy on long-term outcomes - A multicenter analysis

Aims This multicenter study aims to compare outcomes of total aortic arch replacement (TAR) using the frozen elephant trunk (FET) technique in patients with and without heritable thoracic aortic disease (HTAD) and to assess whether HTAD influences postprocedural adverse aortic events (AAEs). Methods From 06/2007 to 05/2024, aortic databases from 13 European centers were screened for HTAD patients undergoing TAR with FET. All consecutive dissection and aneurysm non-HTAD patients from the four core centers served as comparator. The primary outcome was AAE, a composite of diameter progression, distal stent graft induced new entry (dSINE), malperfusion, rupture and pseudoaneurysm at 5 years after FET implantation. Results Of 2739 FET patients, 196 (7.2%) were diagnosed with HTAD. The control group consisted of 867 non-HTAD FET patients. Marfan syndrome was the most common condition (72%), followed by Loeys-Dietz syndrome (11%), vascular Ehlers-Danlos syndrome (5.6%) and Turner syndrome (2.0%). Seventeen (8.8%) patients were diagnosed with ns-HTAD. At 5 years 46 (24%) AAEs occurred in the HTAD group, 169 (20%) in the non-HTAD group (p=0.2). Diameter progression was the most common event (10% vs. 12%; p=0.6), followed by dSINE (5.8% vs. 4.5%; p=0.5), malperfusion (4.2% vs. 3.3%; p=0.5), rupture (2.1% vs. 0.7%; p=0.09) and pseudoaneurysm (0.5% vs. 0.2%; p=0.5). Conclusions The FET technique appears safe and effective for acute and chronic aortic disease in HTAD patients, with outcomes comparable to non-HTAD cases and no increase in graft-related complications, challenging traditional concerns about stent graft use in genetically mediated aortic disease.

25.
arXiv (math.PR) 2026-06-11

On the Wasserstein distance between a hyperuniform point process and its mean

arXiv:2404.09549v3 Announce Type: replace Abstract: We study the existence of bounds on the expected $p$-Wasserstein distance between a random measure and its mean under the assumption that the $p$-th centered moments of the counting statistics are controlled uniformly in space. The average Wasserstein transport cost is shown to be bounded from above and from below by some multiples of the number of points. $D$-dimensional versions of those results are also obtained. As a corollary, we prove that for any value of $p\geq 1$ the Ginibre point process can be seen as a perturbed lattice with identically distributed perturbations with a finite $p$-th moment.