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01.
arXiv (CS.LG) 2026-06-19

Compositionality Emerges in a Narrow Depth-Connectivity Regime: Architecture Constraints and Solution Manifolds

arXiv:2606.19941v1 Announce Type: new Abstract: Compositionality is believed to be the foundation for generalization, enabling models to reuse meaningful primitives in novel combinations. Yet, models trained with standard gradient-based optimization rarely, and often only weakly, exhibit compositional internal structure, and it remains unclear how or why such compositionality forms. In this work, we show that compositionality emerges in a narrow connectivity-depth sweet spot. Along the connectivity axis, compositionality only appears in some specifically sparse networks, heavily depends on which connections remain rather than on weights' sparsity alone. Along the depth axis, compositionality emerges within a narrow, target-dependent regime, peaking at specific depths, while both shallower and deeper networks fail. When either the depth or connectivity condition is violated, gradient descent silently converges to fractured solutions rather than compositional ones. To discover and exploit this emergence, we introduce (i) similarity-based pruning (SP) to recover compositional connectivity and (ii) a heuristic depth predictor to estimate where compositionality is most likely to appear. Finally, we support these empirical findings with a theoretical framework based on compositional sparsity, volume-ratio arguments, and feature-interference bounds, explaining why compositional solutions are reachable only in a narrow depth-connectivity regime.

02.
arXiv (math.PR) 2026-06-15

Scaling limits of multitype Bienaymé trees

arXiv:2507.23241v2 Announce Type: replace Abstract: We consider critical multitype Bienaymé trees that are either irreducible or possess a critical irreducible component with attached subcritical components. These trees are studied under two distinct conditioning frameworks: first, conditioning on the value of a linear combination of the numbers of vertices of given types; and second, conditioning on the precise number of vertices belonging to a selected subset of types. We prove that, under a finite exponential moment condition, the scaling limit as the tree size tends to infinity is given by the Brownian Continuum Random Tree. Additionally, we establish strong nonasymptotic tail bounds for the height of such trees. Our main tools include a flattening operation applied to multitype trees and sharp estimates regarding the structure of monotype trees with a given sequence of degrees.

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

PROTECT-90: A Fault Dataset for Power System Protection

arXiv:2606.24298v1 Announce Type: cross Abstract: The increasing interest in data-driven methods for power system protection is accompanied by a lack of standardized, publicly available high-voltage waveform datasets that enable transparent and reproducible evaluation. To address this gap, this paper introduces the PROTECT-90 dataset, an open electromagnetic transient (EMT)-simulated reference benchmark for high-voltage fault studies with consistent digital-fault-recorder-like measurements, publicly released with this work. The dataset comprises 9,022 physically consistent short-circuit simulation episodes generated on a standardized 90 kV double-line topology with systematically documented domain randomization of grid operating points, line parameters, and fault conditions. For each episode, synchronized three-phase voltage and current waveforms are recorded at eight measurement locations and released together with structured, machine-readable metadata describing fault type, fault location, inception time, and operating conditions. All modeling assumptions, parameter ranges, and data-generation procedures are explicitly documented to ensure transparency and cross-study comparability. By combining physically grounded EMT simulation, balanced scenario coverage, and open accessibility, PROTECT-90 establishes a standardized foundation for reproducible benchmarking of protection-oriented signal processing and learning-based methods.

04.
bioRxiv (Bioinfo) 2026-06-10

Bias-mitigated microbiome inference refines coronary artery disease signature

Authors:

Roughly half the cells in the human body are microbial, and changes in these communities are increasingly implicated in cardiovascular, metabolic, and oncological diseases. Yet identifying which taxa truly differ in abundance, differential abundance (DA), is distorted by four major sources of bias: loss of total microbial load, taxa measurement efficiencies, arbitrary pseudocounts required to handle pervasive zeros, and contamination which has recently driven retractions. No existing DA method accounts for all four. Here we introduce BootDA, a non-parametric bootstrap-based method that explicitly models each bias source without data transformations, pseudocounts, parametric assumptions, or assuming that most taxa are non-DA. In semi-parametric simulations preserving the sparsity (>70% zeros) and correlation structure of real 16S amplicon data, BootDA achieved the highest sensitivity among tested methods, including ANCOM-BC2, LinDA, MaAsLin 3, and Wilcoxon tests, while controlling the false discovery rate. Performance was retained in low biomass settings when contamination contributed ~50% of counts, and without negative controls, indicating de novo decontamination capability. Applied to a coronary artery disease cohort, BootDA refined the original signature to two co-enriched genera, Klebsiella and Gemmiger, and excluded likely contaminants. BootDA is available as an R package and could generalise to other sparse, high dimensional biological data.

05.
arXiv (quant-ph) 2026-06-19

Quantifying Imaginarity in Neutrino Systems

arXiv:2412.01871v2 Announce Type: replace-cross Abstract: It is a fundamental question why quantum mechanics employs complex numbers rather than solely real numbers. In this work, we conduct the first analysis of imaginarity quantification in neutrino flavor and spin-flavor oscillations. As quantum systems in coherent superposition, neutrinos are ideal candidates for quantifying imaginarity within the resource theoretic framework, using measures such as the $\ell_1$-norm and the relative entropy of imaginarity. We show that in the case of two-flavor mixing, these measures of imaginarity are nonzero. The measures of imaginarity reach their extreme values when the probabilistic features of quantum theory are fully maximized, i.e., both the transitional and survival probabilities are approximately equal. Our study reveals that the imaginarity, as a resource, can be harnessed not solely from the presence of a complex phase in the mixing matrix but also from the intrinsic quantum dynamics of time evolution itself. We further extend our analysis to explore the dynamics of three-flavor neutrino mixing, incorporating the effects of a nonzero $CP$ phase.

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

Combining Retrieval-Augmented Text Generation with LLMs for Reading Content Recommendations

arXiv:2606.14817v1 Announce Type: cross Abstract: This work presents the design, implementation, and evaluation of a system for generating personalized reading content using Large Language Models (LLMs) combined with Retrieval-Augmented Generation (RAG). The proposed architecture consists of four modules: Input, RAG, Generation, and Judging and enables users to specify both a question and a target reading content complexity. RAG is employed to retrieve relevant information from the Internet, enriching and grounding the content produced by three modern LLMs: Meta LLaMA 4 Scout, LLaMA 3.1 8B Instant, and Google Gemma2 9B. Reading materials are generated using three prompting strategies (Chain-of-Thought, zero-shot, and few-shot), and the LLM-as-a-Judge module automatically evaluates answer quality and alignment with the desired readability level. Experimental results show that RAG consistently improves system performance across all models and prompting techniques, increasing relevance and particularly groundedness by up to 26-35 percentage points. Overall, the findings demonstrate that the RAG-augmented architecture effectively produces reading content tailored to user queries and desired textual complexity.

07.
arXiv (math.PR) 2026-06-11

Percolation on hierarchical lattices

arXiv:2606.11503v1 Announce Type: new Abstract: We consider independent Bernoulli percolation on top of sequences of hierarchical graphs. Given a graph $G_{1}$ with two distinguished vertices $a_{1}$ and $b_{1}$, the hierarchical graph with seed $G_{1}$ is the sequence $\big( G_{k} \big)_{k \geq 1}$ resulting from the inductive procedure, where the graph $G_{k+1}$ is obtained from $G_{k}$ by replacing each of its edges with a copy of $G_{1}$, attached by the vertices $a_{1}$ and $b_{1}$. We prove that, under sharp hypotheses, percolation on these graphs presents a unique phase transition. Second, we establish the existence of several critical exponents in this context, such as the critical exponents for the correlation length $\nu$, the surface tension $\mu$, the one-arm exponent $\alpha_{1}$. Several results are also obtained for their infinite counterpart $G_\infty$, which is the Benjamini-Schramm limit of $G_k$: uniqueness of the infinite cluster, continuity of $\theta(p)$, existence of the percolation-probability exponent $\beta$ and scaling relations for the critical exponents $\alpha_1$, $\nu$ and $\beta$. Furthermore, we analyze noise sensitivity for crossing functions in $G_{k}$ and establish sharp noise sensitivity in this setting. Finally, we propose a setup where it is possible to verify the locality hypothesis, stating that the critical threshold for percolation is a local property, while critical exponents are determined by the global geometry of the graph. As a consequence of the techniques developed here, we also provide a necessary and sufficient condition for the existence of a unique fixed point for the map $p \mapsto \mathbb{E}_p[g]$ in $(0,1)$, where $g:\{0,1\}^n \to \{0,1\}$ is a nontrivial monotone Boolean function.

08.
arXiv (CS.CV) 2026-06-17

Bridging Spatial And Frequency Views For Disaster Assessment: Benefits And Limitations

Rapid assessment of building damage from satellite imagery is essential for effective disaster response and recovery. While most deep learning methods rely on spatial-domain features, frequency-domain representations can capture complementary structural cues such as debris patterns and collapse-induced textures. This study presents a controlled comparison of spatial-domain, frequency-domain, and dual-domain deep learning approaches for multi-class building damage classification using post-disaster imagery from the xView2 (xBD) dataset. To ensure fairness, all models are built on an EfficientNet-B0 backbone and trained under identical settings, differing only in their input representations and fusion strategies. Performance is evaluated using accuracy, macro F1-score, per-class metrics, and confusion matrices. Results show that dual-domain models provide measurable improvements over single-domain approaches. The dual spatial configuration achieves the highest test accuracy (0.4688) and lowest loss, while the spatial-only model attains the best macro F1-score (0.4254), indicating more balanced class performance. In contrast, frequency-only models perform worst and exhibit overfitting, suggesting limited generalization. Despite these gains, all models struggle to detect subtle damage levels, particularly the Minor class, due to class imbalance and fine-grained visual ambiguity. While dual-domain approaches improve detection of severe damage, challenges remain. These findings highlight the benefits and limitations of hybrid representations and motivate future work on data balancing, advanced fusion, and regularization.

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

An LLM-based Two-Stage Transformer Framework for Cross-Domain Bearing Fault Diagnosis with Limited Data

Bearing fault diagnosis faces critical challenges when dataset heterogeneity, operating condition variations, and limited labeled data occur simultaneously in industrial environments. Existing approaches address these issues in isolation and rely on implicit feature alignment, limiting effectiveness under concurrent challenges. This paper proposes a knowledge-guided two-stage transfer learning framework that employs a lightweight GPT-2-style Transformer with causal self-attention for hierarchical feature extraction from vibration signals, establishing explicit pathways where pre-trained encoder weights and fault prototype embeddings serve as knowledge carriers from multi-source pre-training to target adaptation. The framework addresses the dual-shift challenge through multi-source learning for generalizable representations, prototype-based knowledge modulation for target adaptation, and taxonomy-adaptive classification for seamless transfer across heterogeneous fault categories. Experimental validation on four real-world datasets demonstrates 92.61% average accuracy with only 10% labeled target data, outperforming state-of-the-art methods by 17.24 percentage points, establishing a practical pathway toward cost-effective predictive maintenance in Industry 4.0 applications.

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

Triangular Consistency as a Universal Constraint for Learning Optical Flow

arXiv:2606.19938v1 Announce Type: cross Abstract: We propose triangular consistency as a first-principled constraint for optical flow, which is agnostic to network architecture, supervision type, and dataset, and applies to both image-pair and multi-frame settings. This simple but powerful constraint is to compose two flows to induce a third flow and enforce consistency among the three. The composed flows may arise from (i) image pairs, yielding cycle consistency; (ii) multiple video frames, producing longer-range motion through temporal chaining; or (iii) image pairs combined with controlled synthetic transformations, which becomes data augmentation. This triangular consistency introduces negligible computational overhead and requires no additional annotations. Since it is derived directly from the geometry of optical flow, it does not rely on model-specific assumptions and serves as a ``universal'' plug-and-play component for optical flow training. Experiments show consistent improvement across supervised, unsupervised, and transfer learning settings.

11.
medRxiv (Medicine) 2026-06-15

Using wastewater surveillance to explore community-level dietary intake in sewered and non-sewered sanitation systems in Malawi, Africa

Wastewater can be used to measure biomarkers that reflect population-level dietary intake and diversity; however, how this approach may apply in a low-income country remains a knowledge gap. This study aims to evaluate whether select dietary-related metabolites can be detected in wastewater and environmental surveillance (WES) samples from both sewered and non-sewered sanitation systems in Malawi, Africa. Fourteen WES samples were collected and analyzed from two university campuses in Mzuzu and Thyolo, Malawi. Four targets were analyzed: N-methyl-2-pyridone-5-carboxamide (2PY; a biomarker of vitamin B3), 4-pyridoxic acid (4-PA; a biomarker of vitamin B6), as well as enterodiol and enterolactone (biomarkers of dietary fiber and polyphenol consumption). An 18-question survey, paired spatiotemporally with the WES measurements, assessed self-reported daily dietary intake, food insecurity, and nutrient deficiency symptoms among 500 respondents. Among the 14 WES samples, 2PY, 4-PA, and enterolactone were detected, while enterodiol was not detected above the method limit (

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

Entity Binding Failures in Speech LLM Reasoning: Diagnosis and Chain-of-Thought Intervention

Speech Large Language Models (SLLMs) underperform their text counterparts on complex reasoning. We reveal that this gap is not a uniform cognitive deficit. Evaluating two architecturally diverse SLLMs, we show speech-to-text (S2T) matches or exceeds text-to-text (T2T) on spatial, syntactic, and factual tasks. Yet on logical tasks requiring entity tracking, S2T accuracy collapses to chance. We diagnose this as an entity binding failure: continuous speech features blur precise entity-property associations during implicit reasoning. To validate this diagnosis, we introduce Entity-Aware Chain-of-Thought (EA-CoT), a lightweight inference-time intervention forcing SLLMs to enumerate entities and bind them to claims before reasoning. EA-CoT bridges the gap, even when spoken names are misrecognized, yielding up to a 24.4 percentage-point accuracy gain. Ablations confirm the gains stem from explicit semantic binding, reframing the gap as an elicitation failure rather than a missing capability.

13.
bioRxiv (Bioinfo) 2026-06-21

DeepCDS: Ab initio coding sequence prediction in prokaryotic short reads

Accurate coding sequence prediction in short prokaryotic metagenomic reads remains challenging due to sequence fragmentation, unknown sequence origins, and sequencing errors. Here we introduce DeepCDS, a deep learning-based ab initio coding sequence predictor trained on short prokaryotic sequences with and without simulated Illumina-like sequencing errors. DeepCDS integrates ESM-2 protein language model embeddings with nucleotide-level information to predict complete and fragmented coding sequence regions. Benchmarking on 215 phylogenetically diverse prokaryotic organisms demonstrates that DeepCDS consistently outperforms current state-of-the-art methods in coding sequence detection, start and stop codon localization, and robustness to different sequencing error profiles, while remaining operational at shorter sequence lengths than existing tools support. These findings demonstrate that protein language models capture distinct signals relevant for nucleotide-level coding sequence detection, especially at very short lengths. Ultimately, DeepCDS may help uncover the functional potential of the vast microbial diversity that remains genomically uncharacterized.

14.
arXiv (quant-ph) 2026-06-17

Stochastic signal sensing with finite energy and dead time at the fundamental quantum limit

arXiv:2606.18133v1 Announce Type: new Abstract: State preparation, measurement, and reset operations take finite time and use finite energy in realistic experiments, yet the impact of this on optimal quantum metrological protocols is not properly understood. We study the effect on sensing a stochastic signal, relevant for the detection of ultralight dark matter and other searches for fundamental physics. We prove that two-mode squeezed vacuum is the optimal probe state given a finite mean-energy constraint for a family of incoherent sensing problems, including noise sensing and quantum illumination. For estimating a gain independent of a loss, we show that entanglement is a required resource to achieve the fundamental quantum limit and observe a non-Gaussian to Gaussian transition in the optimal unentangled state as the dead time increases. We apply our results to bulk acoustic wave resonators.

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

Semantic Reasoning in Medicine: The Role of Knowledge Graphs Across Five Key Domains

arXiv:2606.15155v1 Announce Type: new Abstract: Knowledge graphs (KGs) have emerged as a promising solution for integrating and reasoning over complex biomedical and clinical data in healthcare. By representing structured relationships among entities such as diseases, drugs, symptoms, and patient records, KGs provide a semantic backbone for decision-making, prediction, recommendation, and personalized care. Recent advances have demonstrated their utility across diverse medical applications–including clinical decision support systems, disease and treatment outcome prediction, health recommender systems, precision medicine, and medical question answering–where KGs often enhance interpretability, semantic coherence, and patient-specific reasoning. In parallel, a growing body of work focuses on medical KG generation itself, proposing frameworks that construct graphs from EHRs, clinical narratives, biomedical literature, and web resources using ontologies, semantic web technologies, deep-learning-based information extraction, and hybrid neuro-symbolic pipelines. Despite this progress, significant challenges remain, including limited and fragmented knowledge coverage, difficulties in aligning heterogeneous data sources, the fragility of current reasoning and representation-learning methods on dense multi-relational graphs, and unresolved issues related to privacy, bias, and accountability. This survey reviews and categorizes current research on KGs in medicine along both application-oriented and methodology-oriented dimensions, discusses their benefits and technical foundations, and outlines key limitations and open research directions. By analyzing trends, architectures, and evaluation practices, this work aims to guide future developments in KG-driven medical AI systems and support their safe and effective integration into healthcare environments.

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

TurboGS: Accelerating 3D Gaussian Splatting via Error-Guided Sparse Pixel Sampling and Optimization

Consumer-level applications require fast optimization of 3D Gaussian Splatting (3DGS) with high-fidelity novel view rendering. However, existing 3DGS acceleration approaches still incur substantial computation on redundant pixels while sacrificing fine details. In this paper, we present TurboGS, an error-guided training framework that accelerates 3DGS by concentrating optimization on perceptually informative pixels. TurboGS is built upon four core components: (1) a tile-wise sparse pixel sampling, which, driven by multi-view reconstruction errors during training, prioritizes challenging regions and skips well-reconstructed ones to avoid redundant gradient computation; (2) a tile-wise structure-aware loss with sparse Normalized Cross-Correlation, which provides sparse yet effective supervision to preserve fine details and stabilize training; (3) an error-driven Gaussian density control strategy, which dynamically allocates model capacity and removes redundant primitives; and (4) a tailored hybrid optimizer that couples Hessian-informed updates with Adam moment damping to stabilize and improve convergence under sparse supervision. Experiments on standard benchmarks demonstrate that TurboGS can deliver on par or superior rendering quality within 100 seconds on a single RTX 5090 GPU card (up to 10x training speedup over vanilla 3DGS).

17.
arXiv (CS.CL) 2026-06-25

BiPACE: Bisimulation-Guided Policy Optimization with Action Counterfactual Estimation for LLM Agents

Stepwise group-based RL is an attractive way to train long-horizon LLM agents without a learned critic: it reuses multiple sampled rollouts to estimate local advantages. Its weakness is less visible but more fundamental: every group-relative estimator assumes that the steps it compares are equivalent for credit assignment. We show that current agentic variants violate this assumption through a state-action credit mismatch. The observation-hash partition is overly fine on the state side, creating singleton groups with zero step-level signal, while a single within-group mean is too coarse on the action side, mixing state-value estimation with action-specific credit. We introduce BiPACE (Bisimulation-Guided Policy Optimization with Action Counterfactual Estimation), a drop-in advantage estimator that fixes both sides without adding a critic, auxiliary loss, or extra rollouts. BiGPO clusters steps by cosine distance in the actor's own hidden-state geometry, an empirical policy-induced proxy for bisimulation that substantially lowers the singleton rate left by observation hashing. PACE then recenters returns within each behavioral cluster using action-conditioned peer baselines; its Q-style instance estimates a local Q(s,a)-V(s) nonparametrically. On ALFWorld/Qwen2.5-7B, BiPACE_Q raises overall validation success from GiGPO's 90.8 to $97.1\pm0.9$ over three seeds, and crosses the 95% threshold on every seed, which GiGPO never does within the same budget. On Qwen2.5-1.5B it reaches $93.5\pm1.2$ versus GiGPO's 86.7, and on WebShop and TextCraft it improves over GRPO and GiGPO at both model scales. The measured BiPACE-specific overhead is 11.3% of a single training-step wall time. Yet it changes the estimator's comparison unit from surface identity to approximate behavioral equivalence plus action-side counterfactuals. The code is available at https://github.com/TianxiangZhao/BiPACE.

18.
arXiv (math.PR) 2026-06-12

Conditional means, vector pricings, amenability and fixed points in cones

Authors:

arXiv:2512.13829v4 Announce Type: replace Abstract: We develop a generalization of conditional probability for arbitrary ordered vector spaces. A related problem is that of assigning a numerical value to one vector relative to another. We characterize the groups for which these generalized probabilities can be stationary, respectively invariant. Our results deviate from the setting of classical probability and lead to a new criterion for amenability and for fixed points in cones.

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

Pantheon360: Taming Digital Twin Generation via 3D-Aware 360{\deg} Video Diffusion

Generating complete digital twins from videos requires precise camera control, global scene coverage, and strict spatial-temporal consistency constraints that remain challenging for perspective video generators due to their limited field of view (FoV). Their narrow FoV forces long or multi-view trajectories, amplifying cross-view inconsistency and temporal drift. We argue that 360{\deg} video generation offers a natural solution: panoramic coverage simplifies trajectory design and provides a strong global context for maintaining coherence. We introduce Pantheon360: Taming Digital Twin Generation via 3D-Aware 360{\deg} Video Diffusion, a controllable 360{\deg} video generation framework that synthesizes high-fidelity videos from sparse 360{\deg} inputs. The key idea is an explicit 3D Cache, reconstructed from the input, which serves as a geometric scaffold for any user-defined camera path. This allows the diffusion model to focus on photorealistic texture refinement while the 3D Cache enforces global geometric consistency. Experiments show that Pantheon360 achieves superior visual quality and unmatched geometric coherence, enabling reliable and flexible 360{\deg} scene generation for downstream simulation and digital-twin applications.

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

3D Consistency Optimization for Self-Supervised Monocular Video Depth Estimation

Reliable monocular video depth estimation is crucial for downstream 3D reasoning and embodied AI in endoscopic navigation. However, existing self-supervised approaches typically treat video frames independently or rely on weak temporal regularization. These methods, lacking a holistic perception of the underlying 3D scene, inevitably suffer from geometrically inconsistent predictions and severe cross-frame drift. To address these limitations, we introduce a new paradigm that recasts sequential video depth estimation as an unconstrained multi-view 3D reconstruction problem, enabling full exploitation of the powerful geometric priors embedded in recent 3D foundation models. The core of our approach is a 3D consistency optimization framework driven by three constraints: image-level photometric rendering, explicit world-coordinate geometric alignment, and multi-scale temporal gradient consistency. Such unified optimization elegantly anchors isolated frames to a globally coherent 3D structure. Our method has been validated in both the self-supervised training scenarios and challenging zero-shot clinical environments. Results show that the proposed approach achieves state-of-the-art spatial accuracy, outperforming the frame-based, video-based depth estimators and the multi-view 3D reconstruction baselines.

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

STEAM: Squeeze and Transform Enhanced Attention Module

Channel and spatial attention mechanisms introduced in earlier work enhance the representational capabilities of deep convolutional neural networks (CNNs) but often increase parameter and computational costs. While recent approaches focus solely on efficient feature context modeling for channel attention, we aim to model both channel and spatial attention comprehensively with minimal parameters and reduced computation. Leveraging the principles of relational modeling in graphs, we introduce a constant-parameter module, STEAM: Squeeze and Transform Enhanced Attention Module, which integrates channel and spatial attention to enhance the representation power of CNNs. To our knowledge, we are the first to propose a graph-based approach for modeling both channel and spatial attention, utilizing concepts from multi-head graph transformers. Additionally, we introduce Output Guided Pooling (OGP), which efficiently captures spatial context to further enhance spatial attention. We extensively evaluate STEAM for large-scale image classification, object detection and instance segmentation on standard benchmark datasets. STEAM achieves a \(2\%\) increase in accuracy over the standard ResNet-50 model with only a meager increase in GFLOPs. Furthermore, STEAM outperforms the leading modules, ECA and GCT, in terms of accuracy while achieving a threefold reduction in GFLOPs. The code will be made available upon acceptance.

22.
medRxiv (Medicine) 2026-06-15

Sociodemographic Disparities in Tafamidis Initiation and Clinical Outcomes in ATTR-CM Across the United States

BACKGROUND Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease. Sociodemographic factors may influence time to treatment initiation and resulting clinical outcomes, yet these relationships are poorly characterized. OBJECTIVE Assess the effects of sex and race on tafamidis initiation and subsequent outcomes and their interaction with factors such as ATTR-CM type and social deprivation measures. METHODS A retrospective cohort analysis was conducted using the US Komodo Healthcare Map (01/2016-06/2024) among patients with amyloidosis, identified by ICD-10-CM diagnosis codes. Cumulative incidence of treatment initiation and survival probabilities for cardiovascular-related hospitalization (CVH) or death were estimated by Kaplan-Meier, stratified by sex and race. Cox proportional hazards models were fitted for both endpoints to estimate hazard ratios, adjusting for demographics and clinical characteristics. RESULTS Of 11,311 patients identified, White and Black patients (n=9,223) were included in subsequent analyses. Within 12 months of diagnosis, White women had the lowest cumulative incidence of tafamidis initiation (11.4%), followed by Black women (22.0%), Black men (26.7%), and White men (31.0%). Event-free survival at 12 months was lowest in Black women (42.9%), followed by Black men (46.8%), White women (48.6%), and White men (54.4%). Median (95% CI) time to CVH or death was shortest for Black women (8.0 months [6.8-10.0]) followed by Black men (9.9 months [8.8-12.0]), White women (11.0 months [9.6-13.0]), and White men (15.0 months [14.0-16.0]). CONCLUSIONS In this large, real-world cohort of US patients with ATTR-CM, sex and race contributed to disparities in tafamidis initiation and survival, underscoring compounded disparities in both access and outcomes.

23.
arXiv (math.PR) 2026-06-17

Large deviation principle for friendship-biases in Galton–Watson trees

arXiv:2606.17381v1 Announce Type: new Abstract: In this paper we consider the friendship-bias of the vertices in an infinite rooted Galton–Watson tree. The friendship-bias of a vertex is the difference between the average degree of the neighbours of the vertex and the degree of the vertex itself. A vertex is said to be of type $\chi \in S$, with $S = \{-,0,+\}$, when its friendship-bias is, respectively, strictly negative, zero or strictly positive. We consider the fractions $f_l^\chi$ of vertices of type $\chi \in S$ along a random downward path up to branching depth $l \in \mathbb{N}$ and derive a large deviation principle (LDP) for the triple $(f_l^\chi)_{\chi \in S}$ as $l\to\infty$. The branching depth of a vertex counts the number of branchings that occur along the path that connects the vertex to the root of the tree. The rate in the LDP is $l$, while the rate function in the LDP is identified in terms of a variational formula minimising a relative entropy under a linear constraint. We focus on the case of binary branching, for which the rate function is already quite involved. We identify the qualitative properties of the rate function and show how it can be computed numerically. We briefly indicate how to proceed for more general branching and for vertex types along a tree consisting of a finite number of random downward paths. Our paper is the first to consider large deviations of vertex types.

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

ArogyaSutra: A Multi-Agent Framework for Multimodal Medical Reasoning in Indic Languages

Multimodal Large Language Models (MLLMs) have shown promising reasoning capabilities in general domains, yet their performance remains limited in specialized settings such as healthcare, especially in multilingual and low-resource scenarios. This gap is critical in regions like rural India, where patients often express complex medical queries in native Indic languages and rely on multimodal inputs such as medical images. Existing English-centric MLLMs struggle to support such use cases, limiting equitable access to AI-driven healthcare assistance. To address this challenge, we introduce ArogyaBodha, a large-scale multilingual multimodal medical question-answer dataset constructed from eight heterogeneous sources, covering 31 body systems, six imaging modalities, and 21 clinical domains across English and seven major Indian languages. We further propose ArogyaSutra, an actor-critic-based multi-agent framework that integrates tool grounding with dual-memory mechanisms for step-wise, reasoning-aware decision making, and uses stored actor-critic simulation trajectories for distillation. Experiments show that our dataset and framework improve multilingual medical reasoning accuracy across all Indic languages, with ablations validating the contribution of each component. The source code and dataset are available at: https://iitp-cse.github.io/ ArogyaSutra/

25.
Nature Medicine 2026-06-10

Dual-target gene therapy in Parkinson’s disease: a multicenter phase 1 trial

Authors:

Restoring striatal dopamine synthesis is a promising gene therapy strategy for Parkinson’s disease. Previous adeno-associated virus-mediated aromatic L-amino acid decarboxylase (AADC) monotherapies remain dependent on exogenous levodopa, whereas multigene delivery is constrained by strict adeno-associated virus packaging limits. A ‘dual approach’ targeting the two rate-limiting enzymes, tyrosine hydroxylase (TH) and AADC, offers the potential for autonomous dopamine synthesis. We report the 12-month primary safety and tolerability outcomes of a multicenter, open-label, dose-escalation, phase 1 trial evaluating BBM-P002, a new adeno-associated virus vector—AAVT42—codelivering constitutively active TH and AADC. Ten participants with moderate-to-advanced Parkinson’s disease were enrolled and received bilateral intraputaminal infusions across doses of 4.0 × 1011 vg (Cohort 1; n = 1), 6.0 × 1011 vg (Cohort 2; n = 2), 1.0 × 1012 vg (Cohort 3; n = 2) and 1.2 × 1012 vg (Cohort 4; n = 5). The trial achieved its primary outcome, as BBM-P002 demonstrated a favorable safety and tolerability profile within 12 months post-treatment. No dose-limiting toxicities or drug-related serious adverse events occurred. A total of 23 adverse events were reported, all judged unrelated to BBM-P002 and primarily mild and transient. Systemic toxicity and clinically meaningful immunogenicity were absent. In conclusion, intraputaminal delivery of BBM-P002 was safe and well tolerated in this phase 1 trial, supporting continued clinical development. ClinicalTrials.gov registration: NCT05822739 . Phase 1 results reveal that BBM-P002, a dual-target gene therapy co-delivering TH and DDC, is safe and well tolerated in Parkinson’s disease, with 12-month motor improvements signaling therapeutic potential.