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01.
medRxiv (Medicine) 2026-06-22

Agentic Artificial Intelligence for Hospital Readmission Review: A Single-Center Blinded Evaluation and Exploratory Qualitative Analysis

Authors:
Gensheimer↗M. F↗Adhikari↗Parmer-Chow↗Liu↗Ma↗Shieh↗

Background: Manual review of 30-day hospital readmissions can identify actionable quality and safety problems, but it is labor-intensive. We developed and evaluated an agentic AI workflow for evidence-grounded readmission review. Materials and methods: We studied adult patients with unplanned 30-day readmission after discharge from a medicine hospitalist service at a single academic health system. An AI agent using a large language model queried a database containing notes, encounters, procedures, laboratory results, and other clinical data, and completed the same structured readmission-review rubric used by physicians. In the primary comparative evaluation, 20 randomly selected readmissions from 2025 were each reviewed by two physicians and the AI system. Blinded physician evaluators rated review quality. After rubric refinement, the AI workflow was applied to 100 recent readmissions in an exploratory expanded-cohort analysis of recurring improvement opportunities. Results: In the primary comparative evaluation, the AI classified 9/20 readmissions (45%) as preventable, compared with 19/40 physician reviews (47.5%). Blinded overall quality ratings were similar for AI and physician reviews (4.35 vs. 4.20 on a 1-5 scale; mean difference 0.15, 95% CI -0.20 to 0.48; p=0.49), as were factuality/support and usefulness/actionability ratings. No AI hallucinations were identified during factuality review. Agreement on preventability and primary readmission category was low for both AI-human and human-human comparisons. The AI system cost $0.23 per chart; physician reviewers took a median of 15 minutes, corresponding to an estimated $42.43 per chart. In the exploratory expanded-cohort analysis, AI-assisted review identified recurring vulnerabilities in post-discharge follow-up plans, incomplete inpatient workups, medication-safety transitions, and indwelling-device transitions. Conclusions: Agentic AI produced readmission reviews with similar blinded quality ratings to physician reviews in this small single-center primary comparative evaluation and supported identification of recurring quality-improvement themes in the exploratory expanded-cohort analysis. Preventability judgments remained variable among both AI and physicians, underscoring the need for human oversight and prospective evaluation before operational use.

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

Multimodal Speaker Identification in Classroom Environments

Authors:
Michael L. Chrzan↗Meghavarshini Krishnaswamy↗Robert Gibboni↗Katie Wetstone↗Wei Ai↗Jing Liu↗

Automated analysis of K-12 classroom dynamics faces challenges due to background noise and variable child speech, often confounding acoustic-only models. This study evaluates a multimodal speaker identification framework anchoring acoustic embeddings with LLM-derived semantic context. Using a subset of the EDSI dataset (8 math classrooms, N = 2,801 utterances), we found an acoustic baseline (ECAPA-TDNN) achieved only 39.0% accuracy. By integrating transcript-based "contextual anchoring" into a gradient boosting classifier, our multimodal approach raised student identification to 50.3%. Performance also improved for utterances over 5 seconds, reaching 76.9% accuracy (vs. 64.9% baseline) with a 90.9% Top-3 accuracy. Additionally, the model distinguished teacher vs. student roles with 99.3% accuracy. This approach advances the feasibility of automated feedback systems capable of considering individual student participation, a crucial step for supporting equitable instruction at scale.

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03.
arXiv (CS.AI) 2026-06-11

WeaveBench: A Long-Horizon, Real-World Benchmark for Computer-Use Agents with Hybrid Interfaces

Authors:
Wanli Li↗Bowen Zhou↗Yunyao Yu↗Zhou Xu↗Yifan Yang↗Dongsheng Li↗Caihua Shan↗

arXiv:2606.09426v2 Announce Type: replace Abstract: Computer-use agents (CUAs) increasingly operate in runtimes that combine visual desktop control, command-line execution, code editing, browsers, and external tools. Existing benchmarks, however, often evaluate these interfaces as separable capabilities, leaving long-horizon cross-interface orchestration under-tested. Thus, we introduce WeaveBench, a long-horizon hybrid-interface benchmark with 114 tasks across 8 real-world work domains, grounded in real user requests and publicly verifiable artifacts. Each task requires agents to combine GUI observations/actions with CLI/code operations within a single trajectory. We evaluate these tasks on a real Ubuntu desktop inside deployed CLI-agent runtimes, augmented with a minimal desktop-control plugin. We also propose a companion trajectory-aware judge that inspects deliverables, files, screenshots, logs, and action traces, while detecting shortcut behaviors such as fabricated visual evidence or hard-coded metrics. Across frontier model-runtime pairings, the best PassRate reaches only 41.2%, showing the benchmark remains far from saturated. The trajectory-aware judge further reveals that outcome-only grading substantially overestimates agent performance. Overall, WeaveBench exposes a critical gap in CUA evaluation and provides an effective testbed to measure whether agents can orchestrate GUI, CLI, and code operations across long-horizon real-world tasks.

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04.
arXiv (CS.CV) 2026-06-11

Bridging Day and Night: Unsupervised Cross-Domain Re-Identification with Synergistic Prompt and Prototype Learning

Authors:
Jiyang Xu↗Rui Liu↗Hang Dai↗

Cross-domain day-night re-identification (ReID) is fundamentally challenged by the substantial visual appearance discrepancies between daytime and nighttime scenes. Existing fully supervised methods rely heavily on labor-intensive annotations, which are costly and exhibit limited generalization across domains. In this work, we investigate unsupervised day-night ReID and propose a novel framework that synergistically combines prompt learning and prototype-based representation learning to associate identities across domains without requiring manual labels. Our approach follows a progressive two-stage training strategy. In the first stage, we exploit the vision-language model to generate instance-specific textual prompts in an annotation-free manner. We employ an instance-level alignment mechanism to embed visual features and textual prompts into a unified semantic space, aligning unlabeled day/night images with learnable prompts via instance-aware dynamic-bias adaptation. In the second stage, we construct domain-specific prototype memory banks and introduce two complementary modules: i) an intra-domain identity association module to enhance feature discriminability within each domain, and ii) a cross-domain prototype matching module to reliably identify positive and negative prototype pairs, thereby establishing robust identity correspondences across day and night. Extensive experiments on public benchmarks validate the effectiveness of our method. Under the unsupervised setting, our framework attains Rank-1 accuracy comparable to state-of-the-art fully supervised methods.

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05.
arXiv (quant-ph) 2026-06-11

Exact Dynamics of Topological Order Across a CDW–SPT Transition

Authors:
Pradip Kattel↗Yicheng Tang↗Natan Andrei↗

arXiv:2606.11303v1 Announce Type: cross Abstract: We investigate the nonequilibrium dynamics of a one-dimensional interacting system across a transition from a charge-density-wave (CDW) phase to a symmetry-protected topological (SPT) phase. Starting from a CDW initial state, we study both sudden quenches and slow ramps into the SPT regime. While the CDW order melts under both protocols, the fate of topological order is sharply different. Following a sudden quench, long-range SPT order does not emerge because the post-quench state contains a finite density of excitations above the topological ground state. In contrast, slow ramps allow the system to follow the instantaneous ground state away from the critical region, enabling the buildup of SPT order with deviations governed by Kibble-Zurek defect production. The dynamics is solvable via a unitary mapping to a quadratic fermionic Hamiltonian, allowing us to compute the Loschmidt echo, correlation functions, and string correlator. The Loschmidt rate function exhibits cusps signaling dynamical quantum phase transitions, while the correlation dynamics reveal the contrasting mechanisms governing quenches and ramps across the transition. These results demonstrate that entering the topological regime is not sufficient for the emergence of topological order; the decisive factor is the suppression of excitation production during the evolution.

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

Where Does Texture Evidence Live in SAM? Features, Proposal Masks, and Texture Segmentation

Authors:
Nadav Orenstein↗Aviad Cohen Zada↗Shai Avidan↗Gal Oren↗

Texture segmentation stresses foundation segmentation because meaningful regions are defined by material or repeated appearance rather than object identity. Segment Anything Models (SAMs) often fail by default on such texture-defined partitions, but this failure is ambiguous: the texture evidence may be absent, missing from the proposal bank, or present but selected or assembled incorrectly by an object-centric readout. We ask what texture-relevant evidence is already preserved in frozen SAM before adaptation. We study two frozen evidence spaces: multiscale features, probed with a minimal clustering readout, and the automatic proposal bank, treated as evidence for a supervised consolidation readout. SAM is frozen throughout; we do not fine-tune the backbone or retrain the proposal generator. Across RWTD, STLD, an ADE20K-selected refined-crop complement, and a ControlNet-stitched PTD bridge archive, frozen SAM is not a texture segmenter by default, but its failures are not simple texture blindness. Coarse frozen features preserve texture organization, and proposal banks often contain texture-aligned masks or fragments. Natural scenes more often require assembly and commitment over fragments, while cleaner synthetic cases more often reduce to selecting an already coherent proposal. Default mask failure should therefore be decomposed into representation evidence, proposal-bank support, readout mismatch, and commitment failure.

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07.
arXiv (CS.AI) 2026-06-24

THEIA: Learning Complete Kleene Three-Valued Logic in a Pure-Neural Modular Architecture

Authors:
Augustus Haoyang Li↗

arXiv:2604.11284v5 Announce Type: replace-cross Abstract: We present THEIA, a 2.75M-parameter modular neural architecture that learns the complete Kleene three-valued logic (K3) truth table from task data without external symbolic inference or hand-encoded K3 gate primitives. Across 5 seeds it passes all 39 K3 rules at >99% per-rule accuracy. K3 learnability is not the central finding: Transformer baselines also pass all 39 rules, and flat MLPs match THEIA on Phase-1 accuracy within 0.04pp. The contributions are two properties of the learned system. (1) Uncertainty-verdict asymmetric propagation. THEIA preserves Has-Unknown at every upstream boundary (80.0/91.1/90.8/99.7% across Arith/Order/Set/Logic vs. ~52% majority) while final-verdict decodability stays at or below a 73.4% U-vs-non-U oracle reference under linear and nonlinear probes. Activation patching on non-absorbent T->U cases flips 4,898/4,898 OR and 4,719/4,719 AND pairs across 5 seeds, ruling out residual shortcuts. (2) Reliability spectrum under discretized end-to-end training, on tasks decomposable along the engine boundaries. A mod-3 sequential composition task generalizes from 5- to 500-step evaluation at 99.96+-0.04% (5 seeds). Under identical Gumbel-softmax training, flat MLPs collapse to chance by 50 steps; a 2x2 ResMLP grid reaches >=99% on only 3/20 (config, seed) trials; a pre-LN Transformer reaches 99.24+-0.34%. Straight-through discretization prevents 0.999^500 compounding; the architectural separator is sustaining Phase-1 accuracy under Phase-3 training, where flat MLPs fail. Auxiliary: under per-architecture development defaults (not optimizer-controlled), THEIA reaches 12/12 Kleene coverage 6.5x faster than a parameter-comparable 8L Transformer; this narrows to ~3.6x with Transformer-standard tuning and 4.93x with the same recipe on both. Ratios are config-specific, not asymptotic.

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08.
Nature (Science) 2026-06-09

Good recycling starts at home — and benefits the world

Authors: Unknown Author

New research supports the value of household-level waste separation. But policies must also carefully consider consumer behaviours to maximize the quality of material collected. New research supports the value of household-level waste separation. But policies must also carefully consider consumer behaviours to maximize the quality of material collected.

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09.
arXiv (CS.AI) 2026-06-24

A global log for medical AI

Authors:
Ayush Noori↗Aaron E. Boussina↗Hai Ho Bich↗James Anibal↗Julia Maslinski↗Manuel Burger↗Martin Faltys↗Adam Rodman↗Alan Karthikesalingam↗Alessandro Blasimme↗Annelia Itwaru↗Ben Kaplan↗…

arXiv:2510.04033v2 Announce Type: replace Abstract: Modern computer systems rely on syslog, a universal protocol that records critical events across heterogeneous infrastructure. Medicine's rapidly growing AI stack has no equivalent. As medicine deploys AI tools at scale, there is no standard way to record how, when, by whom, and for whom these models are used. Without such records, it is difficult to measure real-world performance and outcomes, detect adverse events, or identify bias and dataset drift. Here we introduce MedLog, a protocol for event-level logging of medical AI. Each time an AI model interacts with a human, another algorithm, or an automated workflow, MedLog creates a record. Each record contains nine core fields: header, model, user, target, inputs, artifacts, outputs, outcomes, and feedback. We apply MedLog across four deployments in the US, Switzerland, and Vietnam: ICU deterioration prediction, tetanus progression monitoring from wearable signals, automated sepsis quality reporting, and patient attendance prediction. MedLog records capture model behavior, workflow interactions, and downstream outcomes, including AI performance degradation during severe weather events in patient attendance prediction and increased laboratory testing after ICU deterioration alerts. MedLog limits the data footprint through risk-based sampling, lifecycle-aware retention policies, and write-behind caching, enabling deployment in low-resource settings. It also supports detailed traces for complex, agentic, or multi-stage workflows, creating a foundation for continuous monitoring, auditing, and improvement of medical AI.

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

TreeGRNG: Binary Tree Gaussian Random Number Generator for Efficient Probabilistic AI Hardware

Authors:
Jonas Crols↗Guilherme Paim↗Shirui Zhao↗Marian Verhelst↗

arXiv:2606.16599v1 Announce Type: cross Abstract: Bayesian Neural Networks (BNNs) offer opportunities for greatly enhancing the trustworthiness of conventional neural networks by monitoring the uncertainties in decision-making. A significant drawback for BNN inference at the extreme edge, however, is the imperative need to incorporate Gaussian Random Number Generators (GRNG) within each neuron. State-of-the-art GRNG algorithms heavily depend on multiple arithmetic operations and the use of extensive look-up tables, posing significant implementation challenges for ultra-low power hardware implementations. To overcome this, this paper presents an innovative binary tree random number generator (TreeGRNG) allowing the use of ultra-low-cost constant comparators instead of arithmetic units. We further enhance the TreeGRNG proposal with a set of hardware-aware optimizations exploiting the Gaussian properties. The optimized TreeGRNG surpasses the State-of-the-Art (SoTA) in terms of distribution accuracy while achieving a 3.7$\times$ reduction in energy per sample and boosting the throughput per unit area by 5.8$\times$. Moreover, our TreeGRNG proposal possesses a distinct advantage over the current SoTA in terms of flexibility, as it easily enables designers to adjust the shape of the sampled probability distribution, extending beyond the capabilities of traditional GRNGs, opening the horizon towards future probabilistic AI designs. The TreeGRNG design is available open-source in the link

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

A Low-Rank Subspace Analysis of LLM Interventions

Authors:
Angira Sharma↗Christian Schroeder de Witt↗Philip Torr↗Anisoara Calinescu↗Jialin Yu↗

arXiv:2606.14388v1 Announce Type: new Abstract: Interventions designed to modify a particular behavior in LLMs, such as refusal or sycophancy, often produce unintended changes in other behaviors. This lack of targeted control makes it difficult to design and implement reliable safety controls. To understand these side-effects, we introduce a diagnostic framework for analyzing interacting behaviors in LLMs. We model behaviors as low-rank subspaces in activation space, and study how interventions influence across behaviors. Across multiple instruction-tuned models (7B-70B) and across refusal, jailbreak, and sycophancy settings, we find that different behaviors share internal representations, and intervening on one behavior alters others in asymmetric ways. Some behaviors act as upstream control points whose interventions propagate broadly across other behaviors, while others remain more isolated. We relate these effects to two geometric quantities: (i) the overlap between behavior subspaces, measured as the average squared cosine of principal angles, and (ii) the angle between each behavior subspace and the decision subspace (capturing the model's final decision e.g., refuse vs. comply). Empirically, intervention effects on other behaviors tend to be larger for behavior pairs with higher subspace overlap, and for source behaviors whose subspaces lie closer (smaller angle) to the decision subspace. These findings highlight a challenge for targeted behavior control: behaviors are difficult to modify independently, as interventions can propagate through shared representations and asymmetric interactions.

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

TMR-GGNN: Credit Card Fraud Detection based on Time-Aware Multi-Relational Guided Graph Neural Network

Authors:
Rohit Tewari↗Shubhankar Shilpi↗Navin Chhibber↗Devendra Singh Parmar↗Sunil Khemka↗Piyush Ranjan↗

arXiv:2606.18444v1 Announce Type: cross Abstract: In recent years, credit card fraud detection has faced significant challenges due to highly imbalanced data, evolving fraud patterns, and complex relational structures among transaction entities. To address these issues, this research proposes a novel framework called Timeaware Multi Relational Guided Graph Neural Network (TMR GGNN). Particularly, the proposed TMR GGNN extends the encoder decoder Graph Neural Network GNN architecture by modeling heterogeneous interactions across customers, merchants, devices, and IPs over temporal windows. Subsequently, the proposed TMR GGNN approach constructs a dynamic, multi relational graph and incorporates a time aware relational attention mechanism within the encoder to adaptively weigh the transaction relevance based on temporal proximity and semantic context. Consequently, the decoder employs a contrastive learning module to distinguish between real and synthesized transaction patterns, while improving the models generalization of rare fraud cases. Additionally, to effectively manage severe class imbalances and emphasize discriminative learning, a composite loss function combining Information Noise Contrastive Estimation (InfoNCE) based contrastive loss with Focal Loss is introduced. This integration assists in improving fraud identification while mitigating false negatives.

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

Let Them Steal: Trapping Large Language Model Extraction Attacks with Knowledge Honeypot

Authors:
Yuyang Dai↗Yushun Dong↗

arXiv:2606.15810v1 Announce Type: cross Abstract: Large language models deployed as commercial APIs are vulnerable to model extraction attacks, while existing defenses either act too late or degrade utility for legitimate users. We propose Knowledge Trap, a defense that redirects extraction attacks toward low-transferability knowledge through a Honeypot Knowledge Graph (HKG) and breadcrumb-guided exploration. Instead of blocking queries or perturbing outputs, Knowledge Trap consumes the attacker's limited query budget on knowledge with negligible downstream utility while preserving benign-user performance. Experiments in medical and financial domains show that Knowledge Trap reduces surrogate Agreement by 6.2\% on average without degrading legitimate-user accuracy, outperforming existing defenses that impose measurable user impact. These results suggest that defending knowledge-space traversal is a practical direction for mitigating LLM extraction attacks.

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14.
medRxiv (Medicine) 2026-06-23

Innate immunity associates with protection from pneumococcal colonisation, but colonisation does not confer capsule-independent protection

Authors:
Connor↗Mitsi↗Cheliotis↗K. S↗German↗E. L↗Gonzalez-Dias↗Pojar↗Nikolaou↗Jochems↗S. P↗Pennington↗…

Nasopharyngeal colonisation with Streptococcus pneumoniae is a prerequisite for transmission and disease and represents an important immunising event. While colonisation induces serotype-specific immunity, the mechanisms underlying heterologous protection remain unclear. We developed a controlled human infection model using pneumococcal serotype 15B and investigated colonisation dynamics, immunogenicity, and cross-protection against subsequent heterologous challenge with serotype 6B. Fifty-four healthy adults were intranasally inoculated with 15B at escalating doses. Colonisation rates peaked at 31.4% with 8 x 10 CFU per naris, lower than those historically observed with 6B and 3 strains. Density was also lower than previously observed with other strains. In vitro assays demonstrated that 15B adhered more readily to epithelial cells than 6B, but was less efficiently internalised, potentially reducing attack rates and colonisation density. Colonisation with 15B induced capsular polysaccharide-specific serum IgG, but baseline humoral immune measures did not predict protection from acquisition. Prior colonisation with 15B did not reduce acquisition of 6B upon re-challenge. Analysis of nasal microbiopsy samples revealed distinct innate activation signatures. Resistance to colonisation was associated with elevated baseline MIP-1 and MIP-1{beta} responses upon in vitro stimulation, whereas carriage was associated with enhanced chemokine and IL-6 responses. Local innate immune activation, rather than circulating antibody responses alone, may therefore contribute to colonisation control. We demonstrate that experimental colonisation with 15B does not confer heterologous protection against 6B and highlight the importance of mucosal innate immune conditioning in serotype-independent defence. Strategies enhancing nasal innate immune recruitment and activation may be required for broader protection against pneumococcal colonisation.

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15.
arXiv (CS.LG) 2026-06-18

INDEQS: Informed Neural controlled Differential EQuationS

Authors:
Michael Detzel↗Gabriel Nobis↗Kristiyan Blagov↗Juri Schubert↗Jackie Ma↗Wojciech Samek↗

arXiv:2606.19138v1 Announce Type: new Abstract: Neural Controlled Differential Equations (NCDE) provide a powerful continuous-time framework for forecasting time series, but standard graph-based extensions typically learn spatial structure purely from data, even in settings where a directed graph structure is known a priori. We introduce Informed Neural controlled Differential EQuationS (INDEQS), a graph-based NCDE forecasting method that incorporates prior knowledge of a directed graph at distinct architectural positions. INDEQS separates inner mixing of hidden states across graph nodes from outer mixing between vector field and control, and offers both a lightweight graph-constrained variant and a more expressive variant, learning additional graph connections from data via adaptive graph convolutions. To systematically study when graph informedness is beneficial in forecasting, we devise a continuous advection simulation on directed graphs, yielding synthetic spatio-temporal datasets with known ground-truth flow structure. We then evaluate INDEQS on two real-world tasks: river discharge forecasting on a hydrological network and traffic flow prediction on PeMS08. Across these synthetic and real-world benchmarks, outer informedness consistently improves mean absolute error over an uninformed NCDE with comparable parameter count, particularly on larger graphs, while inner informedness offers a more parameter-efficient alternative when strict adherence to a known adjacency is desired. A comparison of discrete convolutional and continuous-time decoders further shows that continuous decoders yield better accuracy and greater temporal flexibility on real-world tasks. An implementation of INDEQS and the advection simulation is available at https://github.com/Mitchi1/indeqs.

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16.
bioRxiv (Bioinfo) 2026-06-18

fuzzyfold: a high-performance framework for stochastic RNA folding kinetics

Authors:
Badelt↗

The analysis of nucleic acid secondary structures is overwhelmingly dominated by methods that analyze the thermodynamic equilibrium distribution and which ignore all dynamic aspects of nucleic acid folding. Yet, there are numerous popular examples of nucleic acid folding that rely on kinetic models, such as RNA riboswitches or DNA strand displacement systems. Here, I am presenting fuzzyfold, a Rust-based software package for nucleic acid secondary structure analysis with an explicit focus on stochastic modeling. The framework introduces three-way and four-way shift moves with a biophysically motivated rate-model parameterization, and it is developed with an emphasis on both model flexibility and performance, e.g. allowing for the generation of single co-transcriptional trajectories for thousand-nucleotide long RNA molecules in just a few minutes. The main strength of the fuzzyfold package, however, is its focus on user and developer interfaces for long-term development. It provides easily installable command-line interfaces, e.g. for aggregating data from multiple parallel trajectories efficiently into an ensemble-level dynamic analysis. For developers, the code-base supports straight-forward substitution of thermodynamic and kinetic free-energy models, and a flexible library interface with Python bindings, enabling integration of individual components into custom computational workflows.

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17.
medRxiv (Medicine) 2026-06-16

Exercise Training Improves Skeletal Muscle Insulin Sensitivity and Reprograms the Adipose Transcriptome in Heavier Monozygotic Twins

Authors:
Hentila↗Ullrich↗Ojala↗Lietzen↗M. S↗Heiskanen↗M. A↗Van der Stede↗Honkala↗Helmio↗Rajander↗Eskola↗…

Exercise training improves skeletal muscle insulin sensitivity, yet its effects on white adipose tissue remain incompletely understood. We investigated how adiposity and exercise training influence insulin-stimulated glucose uptake in skeletal muscle and abdominal subcutaneous adipose tissue (ASAT), alongside adaptations in gene expression and DNA-methylation. Ten monozygotic twin pairs discordant for BMI underwent [18F]FDG-PET/CT imaging of skeletal muscle (vastus lateralis, VL) and ASAT during a euglycemic-hyperinsulinaemic clamp before and after six months of exercise training. VL and ASAT biopsies were analyzed using mRNA-sequencing and reduced representation bisulfite sequencing. Exercise training improved whole-body and VL insulin sensitivity in leaner and heavier co-twins (p

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18.
medRxiv (Medicine) 2026-06-16

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

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

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

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19.
medRxiv (Medicine) 2026-06-23

Association between the hemoglobin albumin lymphocyte and platelet score and chronic kidney disease: insights from patient data and animal models

Authors:
Zhang↗Wang↗Ye↗Chen↗Zhao↗

Introduction The hemoglobin, albumin, lymphocytes and platelets (HALP) score, a novel nutritional and inflammatory biomarker, has been used in various chronic disease studies. However, the relationship between the HALP score and chronic kidney disease (CKD) remains poorly elucidated. This study aimed to explore the possible association between the HALP score and CKD. Methods Our analysis encompassed 25,160 adult participants drawn from NHANES cycles spanning 2009 through 2018. Weighted multivariable logistic regression and generalized additive models (GAMs) were employed to evaluate the independent associations between the HALP score and CKD, albuminuria, and low-estimated glomerular filtration rate (eGFR). Threshold effects were examined using two-piecewise linear regression. Subgroup and sensitivity analyses were performed to assess robustness. Receiver operating characteristic (ROC) curve analyses were applied to compare the discriminative capacity of the HALP score with the prognostic nutritional index (PNI), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). The clinical findings were further validated in a 5/6 nephrectomy rat model. Results After adjustment for multiple confounders, higher HALP scores were inversely associated with the risk of CKD (OR = 0.97, 95% CI: 0.94-0.99) and albuminuria (OR = 0.97, 95% CI: 0.93-0.99). However, after full adjustment for demographic characteristics, physical examination indices and laboratory parameters (Model 3), the correlation between the HALP score and low-eGFR was no longer statistically significant. Non-linear analyses revealed a threshold effect, with CKD risk declining as the HALP score increased up to an inflection point of 52.43 (OR = 0.97, 95% CI: 0.95-0.99), beyond which no further protective effect was observed. A similar threshold effect was identified for albuminuria. Subgroup and interaction analyses indicated no meaningful effect modification by age, sex, BMI, hypertension, or diabetes. Sensitivity analyses confirmed the robustness of the results. ROC analysis demonstrated that the HALP score showed superior discriminative ability for CKD and albuminuria compared with PNI, SII, LMR, and PLR. In the animal experiment, CKD model rats exhibited significantly lower HALP scores than controls. Inverse correlations were observed between the HALP score and serum creatinine (Scr), blood urea nitrogen (BUN), and urinary albumin-to-creatinine ratio (UACR), with UACR showing the strongest correlation, which was consistent with the clinical findings. Conclusion Lower HALP scores are independently associated with increased prevalence of CKD and albuminuria. As an affordable and readily measurable biomarker, the HALP score may facilitate CKD risk assessment.

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20.
Nature (Science) 2026-06-08

Distributed control circuits across a brain-and-cord connectome

Authors:
Alexander S. Bates↗

Just as genomes revolutionized molecular genetics, connectomes (maps of neurons and synapses) are transforming neuroscience. To date, the only organisms with complete connectomes are worms1–3, sea squirts4, and comb jellies5 (103–104 synapses). By contrast, the fruit fly is more complex (108 synaptic connections), with a brain that supports learning and spatial memory6,7 and an intricate ventral nerve cord analogous to the vertebrate spinal cord8–12. Here we report the first densely-reconstructed adult fly connectome that unites the brain and ventral nerve cord, and we leverage this resource to investigate principles of neural control. We show that effector neurons (motor neurons, endocrine cells, and efferent neurons targeting the viscera) are primarily influenced by sensory neurons in the same body part, forming local feedback loops. These local loops are linked by long-range circuits involving ascending and descending neurons organized into behavior-centric modules. Single ascending and descending neurons are often positioned to influence the voluntary movements of multiple body parts, together with the endocrine cells or visceral organs that support those movements. Brain regions involved in learning and navigation supervise these circuits. These results reveal an architecture that is distributed, parallelized, and embodied, reminiscent of distributed control architectures in engineered systems13,14.

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21.
arXiv (CS.AI) 2026-06-11

Federated continual learning: A comprehensive survey on lifelong and privacy-preserving learning over distributed and non-stationary data

Authors:
Masoume Gholizade↗Fabrizio Ruffini↗Pietro Ducange↗Francesco Marcelloni↗

arXiv:2606.11272v1 Announce Type: cross Abstract: Federated Learning (FL) enables collaborative and privacy-preserving model training across distributed clients, but most existing FL systems implicitly assume data stationarity. In real-world settings-such as healthcare, industrial IoT (IIOT), cybersecurity, and smart cities-data streams are inherently non-stationary, leading classical FL methods to suffer from performance degradation, instability, and catastrophic forgetting. Continual Learning (CL) addresses learning under evolving data distributions but has been largely studied in centralized settings, overlooking key constraints of federated systems, including privacy, limited communication, and client heterogeneity. Federated Continual Learning (FCL) emerges at the intersection of FL and CL, aiming to support lifelong, adaptive, and privacy-aware learning over distributed and non-stationary data. This survey provides a comprehensive and systematic overview of FCL. We first present a formal definition of the FCL problem and clarify its distinctive characteristics. We then analyze the limitations of classical FL under non-stationary conditions, highlighting how CL principles support long-term adaptation. To organize the rapidly growing literature, we propose a multi-dimensional taxonomy of FCL approaches. Furthermore, we review representative application domains and data modalities, summarize commonly used evaluation metrics, and discuss experimental perspectives for assessing long-term performance and forgetting. Finally, we highlight key open challenges, including handling extreme heterogeneity under temporal drift, designing scalable and privacy-preserving memory mechanisms, and establishing standardized benchmarks. This survey aims to serve as a reference and a roadmap for advancing FCL toward robust and deployable real-world systems.

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

Fast Human Attention Prediction for Fixation-guided Active Perception in Autonomous Navigation

Authors:
Fatma Youssef Mohammed↗Grzegorz Malczyk↗Kostas Alexis↗

Human visual attention relies on structured scanpaths to efficiently process scenes, yet instilling this behavior into robot autonomy is in its infancy and hindered by the high,computational costs of existing predictive models. To address this, we introduce GazeLNN, a computationally lightweight,scanpath prediction model that leverages Liquid Neural Networks as its recurrent engine and employs MobileNetV3 for feature extraction. Operating auto-regressively, the architecture predicts sequential fixation heatmaps conditioned on the current visual stimulus and fixation history. Despite requiring only 0.61 GFLOPs, GazeLNN achieves state-of-the-art performance on the MIT Low Resolution dataset achieving 0.47 ScanMatch score. It outperforms existing recurrent baselines across diverse evaluation metrics, while reducing computational costs by 99.40% and accelerating inference by up to six times. To investigate the role of human attention modeling in robot autonomy and demonstrate the practical utility of this highly efficient architecture, we integrate GazeLNN into an active camera-robot control policy trained via Reinforcement Learning. This integration enables human-fixation-guided perception during autonomous navigation, validated through successful real-world deployments on an aerial robot.

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

OPD-Evolver: Cultivating Holistic Agent Evolver via On-Policy Distillation

Authors:
Guibin Zhang↗Xun Xu↗Yanwei Yue↗Zikun Su↗Wangchunshu Zhou↗Xiaobin Hu↗Shuicheng Yan↗

Memory has become a standard substrate for self-evolving agents, yet retaining experience is not the same as learning how to evolve through it. Existing memory agents can store trajectories, retrieve reflections, or accumulate skills, but often lack the holistic competence to select useful experience, act on it, write reusable knowledge, and maintain a growing repository. We introduce OPD-Evolver, a slow-fast co-evolution framework that cultivates such an agent evolver through on-policy self-distillation. In the fast loop, OPD-Evolver interacts with a four-level memory hierarchy to read, use, write, and maintain experience for rapid test-time evolution. In the slow loop, outcome-calibrated memory attribution and privileged hindsight distill these four abilities into the deployable policy. Across multi-domain benchmarks, OPD-Evolver surpasses memory systems such as ReasoningBank by up to 11.5%, and training-based methods such as Skill0 by ~5.8%. Further analysis shows that OPD-Evolver internalizes high-value experience and memory management, enabling OPD-Evolver-9B to challenge giant counterparts such as Qwen3.5-397B-A17B and Step-3.5-Flash, pointing beyond memory-augmented agents toward genuinely qualified agent evolvers.

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24.
arXiv (CS.CV) 2026-06-17

ProCUA-SFT Technical Report

Authors:
Jaehun Jung↗Ximing Lu↗Brandon Cui↗Muhammad Khalifa↗Shaokun Zhang↗Hao Zhang↗Jin Xu↗Amala Sanjay Deshmukh↗Karan Sapra↗Andrew Tao↗Yejin Choi↗Jan Kautz↗…

Training computer-use agents (CUAs) – models that interact with graphical desktops through screenshots and keyboard/mouse actions – requires large-scale, diverse trajectory data collected in full desktop environments. The largest public resource, AgentNet (22.5K human trajectories), leads to negative transfer when used for supervised fine-tuning (SFT): continuing training UI-TARS 7B on AgentNet causes OSWorld success rate to fall from 26.3% to 8-10%. We present ProCUA-SFT, a dataset of 3.1M step-level SFT samples distilled from 93K synthetic trajectories across 2,484 application combinations. The dataset is produced by a fully automated pipeline that (i) synthesizes grounded tasks on live desktops seeded with real-world content – 912 spreadsheets from SpreadsheetBench, approximately 10K permissively-licensed presentations from Zenodo10K, and multi-application OSWorld configs – and (ii) verifies each task's feasibility through binary precondition checking before rollout. A single VLM (Kimi-K2.5) serves as goal generator, precondition judge, and trajectory executor, eliminating planner-actor capability gaps. Each trajectory is expanded into step-prefix samples that exactly reproduce the context layout seen at inference time. Fine-tuning UI-TARS 7B on ProCUA-SFT for one epoch yields 45.0% on OSWorld – an 18.7 percentage-point improvement over the base model and over 35% above AgentNet-trained counterparts. A subset of ProCUA was incorporated into the training data for the Nemotron 3 Nano Omni model, contributing to its computer-use capabilities.

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25.
arXiv (CS.CV) 2026-06-11

RelayFormer: A Unified Local-Global Attention Framework for Scalable Image and Video Manipulation Localization

Authors:
Wen Huang↗Jiarui Yang↗Tao Dai↗Jiawei Li↗Shaoxiong Zhan↗Bin Wang↗Shu-Tao Xia↗

Visual manipulation localization (VML) aims to identify tampered regions in images and videos, a task that has become increasingly challenging with the rise of advanced editing tools. Existing methods face two central issues. The first is resolution diversity. Resizing or padding can distort subtle forensic cues and introduce unnecessary computational cost. The second is the difficulty of extending spatial models for images to spatio-temporal inputs in videos, which often results in maintaining separate architectures for the two data types. To address these challenges, we propose RelayFormer, a unified framework that adapts to varying resolutions and naturally handles both static and temporal visual data. RelayFormer partitions inputs into fixed-size sub-images and introduces Global Local Relay (GLR) tokens that propagate structured context through a relay-based attention mechanism. This design enables efficient exchange of global cues, such as semantic or temporal consistency, while preserving fine-grained manipulation artifacts. Unlike prior approaches that depend on uniform resizing or sparse attention, RelayFormer scales to variable resolutions and video sequences with minimal overhead. Experiments across diverse benchmarks demonstrate superior performance and strong efficiency, combining resolution adaptivity without interpolation or excessive padding, unified processing for images and videos, and a favorable balance between accuracy and computational cost. Code is available at~\href{https://github.com/WenOOI/RelayFormer}{https://github.com/WenOOI/RelayFormer}.

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