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01.
arXiv (CS.LG) 2026-06-18

Unreduced Persistence Diagrams for Topological Machine Learning

arXiv:2507.07156v2 Announce Type: replace-cross Abstract: Supervised machine learning pipelines trained on features derived from persistent homology have been experimentally observed to ignore much of the information contained in a persistence diagram. Computing persistence diagrams is often the most computationally demanding step in such a pipeline, however. To explore this dynamic, we introduce several methods to generate topological feature vectors from unreduced boundary matrices and investigate their theoretical and computational properties. We compared the performance of pipelines trained on vectorizations of unreduced PDs to vectorizations of fully-reduced PDs across several data and task types. Our results indicate that models trained on PDs built from unreduced diagrams can perform on par and even outperform those trained on fully-reduced diagrams on some tasks. We also benchmarked the computational performance of an algorithm for computing unreduced diagrams, which was implemented as a heavily modified version of Ripser. These computations are parallelizable and required an order of magnitude less memory on average compared to computing full persistence diagrams. Our results suggest that machine learning pipelines which incorporate topology-based features may benefit in terms of computational cost and performance by utilizing information contained in unreduced boundary matrices.

02.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

03.
medRxiv (Medicine) 2026-06-23

Default Handling of the Non-Assessable Verbal Glasgow Coma Scale Misclassifies Illness Severity in Mechanically Ventilated Patients: A Retrospective Analysis

Background: The Glasgow Coma Scale (GCS) is a universal neurologic severity score in the intensive care unit and is incorporated into APACHE, SOFA, mortality prediction models, ICU benchmarking, and quality metrics. In mechanically ventilated patients, however, the verbal component cannot be assessed. Common conventions, including assigning a normal total GCS of 15 or excluding patients with missing verbal scores, may misclassify the sickest patients as neurologically normal or remove them from analysis. Objective: To quantify non-assessable verbal GCS examinations after acute brain injury and determine how different handling conventions affect severity scoring and mortality-model performance across two independent critical care databases. Materials and Methods: We conducted a retrospective cohort study of adults with acute brain injury during their first ICU stay in MIMIC-IV, with replication in eICU-CRD. A verbal examination was considered non-assessable when documented as No Response-ETT. We measured the burden and determinants of non-assessability, compared the MIMIC-IV derived GCS convention with a component-aware GCS, and evaluated mortality-model handling strategies. Results: Among 14,230 patients, 45.2% had a non-assessable verbal examination, and 47.5% of ventilated patients had no assessable verbal score in the first 24 hours. Non-assessability was strongly associated with mechanical ventilation and mortality. The MIMIC-IV derived GCS assigned a score of 15 to 42.9% of patients and placed 11.6% in the lowest severity category despite eye and motor findings consistent with GCS [≤]9. Complete-case handling excluded 28.5% of patients, who accounted for 50.2% of deaths. Similar distortions were observed in eICU-CRD/APACHE across 171 hospitals. Discussion: Default-to-normal scoring can make severely ill intubated patients appear neurologically normal, while complete-case analysis removes the highest-risk patients. Conclusion: Non-assessable verbal GCS in mechanically ventilated patients should be explicitly flagged and reported in ICU severity scores, risk-adjusted mortality models, and benchmarking systems.

05.
medRxiv (Medicine) 2026-06-12

Reduced nighttime smartphone use among cohabiting partners: a longitudinal study under the lens of social control of health behaviors theory

Objective: We examined the link between cohabitation with a partner and nighttime smartphone use through the social control of health behavior theory. Background: Nighttime smartphone use is a behavioral risk factor for sleep problems. While previous research has predominantly focused on individual-level risks of sleep disturbances, the role of social context remains underexplored. Theoretical frameworks, specifically the Social Control of Health Behavior, suggest that social relationships regulate health-related behaviors; however, it is unclear how far this regulation extends to modern digital behaviors among couples. Method: We analyzed survey data from three waves of the SmartSleep Study (2018, 2020, and 2023; total N = 25,028), including a longitudinal follow-up subset (N = 1,003). We tested multivariate associations between living with a partner, changes in cohabitation status and frequent nighttime smartphone use by fitting generalized linear mixed-effects models. Additionally, we mapped the complex interplay between indicators of social integration, social support, smartphone use, and sleep quality using hierarchical clustering of non-linear correlations. Results: Cohabiting participants had lower odds of frequent nighttime smartphone use compared to those living alone (OR = 0.66; 95% CI: 0.61, 0.72). This lower risk was driven primarily by cohabitation with a partner (OR = 0.49; 95% CI: 0.36, 0.66). Longitudinal analysis supported these findings, showing that sustained cohabitation was associated with less frequent nighttime use (OR = 0.56; 95% CI: 0.38, 0.82). Clustering analysis revealed that indicators of social integration and support clustered with favorable sleep quality. Conclusion: Our findings suggest that the health-protective effects of cohabitation with a partner extend to digital behaviors. Consistent with social control of health behavior theory, the presence of a partner appears to reduce frequent nighttime smartphone use, highlighting the critical importance of considering social context when addressing digital health hygiene and promoting sleep.

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

ReCal: Reward Calibration for RL-based LLM Routing

arXiv:2606.12479v1 Announce Type: cross Abstract: Large language model (LLM) routing has emerged as an effective paradigm for leveraging the complementary strengths of multiple LLMs through dynamic model and reasoning-strategy selection. Recent reinforcement learning (RL)-based routing methods further improve routing quality by optimizing routing policies from interaction feedback. However, they still struggle to provide informative and comparable learning signals under heterogeneous tasks with varying difficulty. In practice, multiple objectives (e.g., correctness, format behavior) are aggregated into a single scalar reward, leading to ambiguous credit assignment and conflicting optimization signals. Moreover, reward signals exhibit significant variability across instances, where some instances produce higher or more variable rewards, introducing optimization bias that favors trivial samples over informative ones. To address these issues, we propose ReCal, a \underline{Re}ward \underline{Cal}ibration framework for RL-based LLM routing. We first introduce a hierarchical reward decomposition mechanism with component-wise advantage estimation. We further propose a distribution-aware optimization strategy that calibrates optimization variability through variance-aware reweighting and per-dataset normalization. Experiments on seven datasets demonstrate that ReCal consistently improves routing performance, and training stability over baselines. Code is available at https://anonymous.4open.science/r/ReCal.

07.
arXiv (CS.CV) 2026-06-16

VEPHand: View-Efficient Photometric Hand Performance Capture at Scale

Robust, high-fidelity 3D hand capture, while fundamental to digital human creation, remains challenging with practical multi-view systems that balance rich photometry with the geometric ambiguities of reconstruction arising from limited viewpoint density. This paper presents an end-to-end pipeline for dynamic hand performance capture and registration, specifically designed for view-efficient setups ($\sim$20 views). We address key challenges with two primary innovations. First, to overcome reconstruction difficulties like limited view overlap and background clutter, our mask-free neural method robustly extracts detailed hand geometry and appearance from unmasked images using scene parameterization and scenario-specific density regularization. Second, addressing registration challenges such as accurately capturing non-linear skin deformations and ensuring plausible results during severe self-contact, we propose a physics-inspired framework. It aligns reconstructions to a personalized hand model by optimizing intrinsic volumetric offsets within its canonical tetrahedral mesh, alongside pose parameters. This approach, supported by robust losses and optimization, captures fine surface deformations, ensures plausible results under severe articulation and self-contact, and demonstrates strong tolerance to input noise. We demonstrate the scalability and robustness of our automated pipeline on an extensive dataset of over 12,000 sequences, from which we also derive a large-scale, high-quality synthetic 2D/3D hand dataset for training downstream tasks. This showcases its effectiveness for single hands, intricate two-hand interactions, and natural hand-object manipulations. Our method achieves state-of-the-art reconstruction fidelity in view-efficient, unmasked scenarios and highly accurate registration. Our project page are available at https://zyshen021.github.io/VEPHand/.

08.
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.

09.
arXiv (quant-ph) 2026-06-24

Quantum turbulence in the many-body regime

arXiv:2606.23822v1 Announce Type: cross Abstract: We discuss phenomenology associated with turbulent hydrodynamics in quantum fluids from a condensed-matter perspective. We begin with weakly-interacting superfluids, often modeled by a mean-field theory governed by the Gross-Pitaevskii equation. Considering the effect of quantum fluctuations beyond the mean-field approximation, we propose a study of many-body quantum effects in turbulent hydrodynamics, especially near zero temperature. We motivate examples of quantum many-body systems where such effects may be uncovered. These include bosons confined in a periodic potential in low spatial dimensions (one and two), and the associated quantum critical point of the superfluid-insulator transition, realized in present-day ultracold-atom and quantum computing platforms. We conclude by listing a set of (open) questions that may be answered using modern quantum many-body techniques. This article is part of the theme issue 'Frontiers of turbulence and statistical physics'.

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

HypOProto: Hyperbolic Ordinal Prototypes for Left Ventricular Filling Pressure Classification

Echocardiography (echo) is a widely used imaging modality for assessing cardiac function, with Left Ventricular Filling Pressure (LVFP) serving as a critical physiological marker for conditions such as heart failure. Standard LVFP classification into normal vs elevated categories relies on the Doppler-derived $E/e'$ ratio, which is operator-dependent and often unavailable in resource-limited settings, motivating methods that infer LVFP directly from B-mode echo. Existing deep learning approaches achieve high performance but remain largely black-box, limiting clinical interpretability. We propose HypOProto, a hyperbolic, ordinal prototype-based framework for interpretable LVFP classification using a frozen, explainable foundation model backbone. HypOProto arranges prototypes along the physiological $E/e'$ scale, placing borderline cases near the hyperboloid root where small angular differences separate similar cases, while normal and elevated cases occupy outward positions reflecting increasing diagnostic certainty. This hyperbolic geometry encodes clinically meaningful ordinal relationships and improves interpretability. We also introduce a novel Hyperbolic Prototype Angular Separation (HyperPAS) loss, enforcing inter-class prototype separation in hyperbolic space. HypOProto achieves SOTA performance while maintaining transparency, and highlights clinically relevant regions in visualizations. This work represents the first prototype-based framework for LVFP classification in echo. Our code can be found at https://github.com/DeepRCL/HypOProto.

11.
arXiv (CS.CV) 2026-06-16

ToaSt: Token Channel Selection and Structured Pruning for Efficient ViT

Vision Transformers (ViTs) have achieved remarkable success across various vision tasks, yet their deployment is often hindered by prohibitive computational costs. While structured weight pruning and token compression have emerged as promising solutions, they suffer from prolonged retraining and inter-layer dependencies that complicate optimization, respectively. We propose ToaSt, a decoupled framework applying specialized strategies to distinct ViT components. We apply coupled head-wise structured pruning to Multi-Head Self-Attention modules, leveraging attention operation characteristics to enhance robustness. For Feed-Forward Networks (over 60% of FLOPs), we introduce Token Channel Selection (TCS), a training-free method that filters redundant noise channels at inference time. Extensive evaluations across nine diverse models, including DeiT, ViT-MAE, and Swin Transformer, demonstrate that ToaSt achieves superior trade-offs between accuracy and efficiency, consistently outperforming existing baselines. On ViT-MAE-Huge, ToaSt achieves 88.52% accuracy (+1.64%p) with 39.4% FLOPs reduction. ToaSt also transfers effectively to diverse downstream tasks (COCO detection, ADE20K segmentation, CIFAR-100 classification), achieving 52.2 versus 51.9 mAP on COCO. Code: github.com/SHANNonLab-HUFS/ToaSt

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

Emergency hub placement with a neutral-atom quantum computer

arXiv:2606.19589v1 Announce Type: new Abstract: We study the problem of emergency operation center placement in disaster response, where a minimal number of hubs must be selected to ensure timely coverage of all affected locations. This task can be formulated as a minimum dominating set problem on a graph encoding reachability within a target response time. We propose a hybrid quantum-classical approximation framework that leverages neutral-atom quantum computers as independent set samplers. Candidate dominating sets are constructed from both small maximal independent sets and complements of large independent sets, and are subsequently refined via a lightweight classical procedure. We benchmark the approach on synthetic instances and realistic case studies, and implement it on the Fresnel quantum processor by Pasqal, solving instances of up to 100 nodes. Our results show that quantum-generated samples, despite hardware noise, enable near-optimal solutions of the placement problem. Overall, our results demonstrate that neutral-atom devices operating in analog mode can already be used to tackle graph optimization problems for real-world applications.

13.
arXiv (CS.LG) 2026-06-11

Bypassing Prompt Guards in Production with Controlled-Release Prompting

arXiv:2510.01529v4 Announce Type: replace Abstract: Ball et al. recently established that prompt filtering for AI alignment faces a fundamental barrier: under standard cryptographic assumptions, no filter running significantly faster than the protected model can universally distinguish adversarial prompts from benign ones. We investigate whether this impossibility result translates to real-world vulnerabilities in deployed large language model (LLM) systems. We answer affirmatively by introducing controlled-release prompting, a practical instantiation of the theoretical framework that exploits the resource asymmetry between lightweight input filters and the main models they protect. Unlike the theoretical construction, our attack does not require model modification: it generates malicious prompts that are indecipherable by any bounded filter yet remain tractable to the target LLM. We find our attack to be successful on four major chat platforms (Google Gemini, DeepSeek Chat, xAI Grok, and Mistral Le Chat) where baseline methods fail. Additionally, we apply our attack to extract copyrighted data from Gemini. Finally, we provide a systematic evaluation of 14 open-weight prompt guard models, revealing that even reasoning-capable filters cannot reliably detect our attack without incurring prohibitive resource overhead.

14.
arXiv (CS.CV) 2026-06-24

Full-resolution MLPs Empower Medical Dense Prediction

Dense prediction is a fundamental requirement for many medical vision tasks such as medical image restoration, registration, and segmentation. The most popular vision model, Convolutional Neural Networks (CNNs), has reached bottlenecks due to the intrinsic locality of convolution operations. Recently, transformers have been widely adopted for dense prediction for their capability to capture long-range visual dependence. However, due to the high computational complexity and large memory consumption of self-attention operations, transformers are usually used at downsampled feature resolutions. Such usage cannot effectively leverage the tissue-level textural information available only at the full image resolution. This textural information is crucial for medical dense prediction as it can differentiate the subtle human anatomy in medical images. In this study, we hypothesize that Multi-layer Perceptrons (MLPs) are superior alternatives to transformers in medical dense prediction where tissue-level details dominate the performance, as MLPs enable long-range dependence at the full image resolution. To validate our hypothesis, we develop a full-resolution hierarchical MLP framework that uses MLPs beginning from the full image resolution. We evaluate this framework with various MLP blocks on a wide range of medical dense prediction tasks including restoration, registration, and segmentation. Extensive experiments on six public well-benchmarked datasets show that, by simply using MLPs at full resolution, our framework outperforms its CNN and transformer counterparts and achieves state-of-the-art performance on various medical dense prediction tasks.

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

A Survey on Long-Term Memory Security in LLM Agents: Attacks, Defenses, and Governance Across the Memory Lifecycle

The emergence of writable, cross-session persistent memory in LLM agents introduces a qualitatively different threat landscape from conventional input-centric security concerns, characterized by three properties: persistence, statefulness, and propagation. To systematically characterize this landscape, we propose a Memory Lifecycle Framework that organizes attacks, defenses, and their cross-phase dependencies along two axes: six lifecycle phases (Write, Store, Retrieve, Execute, Share & Propagate, Forget & Rollback) and four security objectives (Integrity, Confidentiality, Availability, Governance). This analysis in turn exposes the need for formal security guarantees at the system level, motivating Verifiable Memory Governance(VMG), a framework of five architectural primitives that specifies what verifiable mechanisms a long-term-memory system must provide to maintain auditable, recoverable control over its memory state. Our analysis indicates that robust Long-Term Memory (LTM) security cannot be retrofitted at retrieval or execution time alone, but must be anchored in storage-time provenance, versioning, and policy-aware retention from the outset.

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

ScaleWoB: Guiding GUI Agents with Coding Agents via Large-Scale Environmental Synthesis

arXiv:2605.25160v2 Announce Type: replace Abstract: GUI agents powered by large language models are advancing rapidly, creating urgent needs for evaluation and training based on realistic environments. However, directly doing so in real-world environments introduces some challenges that cannot be overlooked. Real-world environments are complex and uncontrollable, making it difficult to construct verifiable rewards and to save or reset states. Existing works prioritize reproducibility but are often limited to open-source apps or file-operation tasks for reliable reward building, leaving a persistent gap from real-world usage. Furthermore, relying on virtual machines or docker images demand high resource requirements and suffer from slow response speeds, which limit the efficiency. We present \sys, a framework that could produce high-fidelity synthesized interactive environments for GUI agents across platforms with verifiable rewards. These environments behave as backend-free webpages accessible via URL, requiring near-zero setup and low resource cost, making the approach suitable for both large-scale evaluation and downstream agent training. We support multiple GUI platforms including mobile, desktop, and automotive/in-vehicle interfaces based on the same pipeline, covering 100+ environments and 1000+ verifiable tasks. Among them, 120 challenging tasks across 63 simulated mobile applications are released as a fully synthesized mobile GUI agent benchmark. Experiment results on five state-of-the-art mobile GUI agents reveal substantial headroom – the average success rate is only 27.92\%, dropping to 17.82\% on long-horizon subset – while humans reach 92.08\%. A comparison against real-world sample tasks shows that assessments made in our synthetic environments generalize to real apps. The project website is at https://scalewob.github.io.

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

Low-Latency Real-Time Audio Game Commentary System via LLM-Based Parallel Text Generation

We present a low-latency real-time audio game commentary system that generates spoken commentary directly from live gameplay video. In this end-to-end setting, a key bottleneck is accumulated waiting time; conventional pipelines capture frames, generate text, and synthesize speech sequentially for each utterance, and do not request the next generation until speech playback has completed. This strict sequentiality causes long and unnatural silence between utterances. To address this latency bottleneck, our system runs text generation in parallel with speech playback and buffers multiple candidate utterances ahead of time, enabling immediate synthesis at playback boundaries. Experiments on fast-paced game videos show that our parallel design reduces the mean inter-utterance silence from 9.6 seconds to 0.3 seconds compared to sequential baselines. It also improves similarity to professional speaking–silence timing patterns by over 40 %, and a user study with 120 experienced game players confirms significantly improved perceived speaking rhythm. Our demo video is available at: https://youtu.be/pmrRUlvav8M.

18.
arXiv (CS.AI) 2026-06-19

Bistable by Construction: Wall-Clock-Calibrated State Monitors Have No Moment-Detection Regime at Agent Cadence

arXiv:2606.19386v1 Announce Type: cross Abstract: Runtime monitors for autonomous agents commonly threshold an accumulated internal state - a behavioural baseline, a drift statistic, or, in our prior work, a modelled affective state. We previously reported a State Saturation Trap: threshold-on-state triggers over a continuous affect engine become near-constant alarms on SWE-bench debugging agents (Modgil 2026). A post-release audit found the engine received dt=0 between actions, so its exponential decay never operated: the published trap is a pure-accumulator result. We correct the record (erratum, v2) and treat the flaw as an experiment. The key variable it exposes is whether a monitor's dynamics are calibrated in sample time (per observation, as in CUSUM) or wall-clock time (half-lives in seconds, as in affect models and EMA baselines). On fixed-rate streams these coincide; on agent streams, where inter-action time varies by orders of magnitude, they do not. A pre-registered sweep over uniform intervals (dt in {0..600}s) on 20 trajectories shows the wall-clock level trigger has two regimes: at dt=60s silent. Every critical dt lies in (1,30]s. Real agent runs measure latency at median 1.53s (p90 2.33s); real coding cadence sits inside the trap regime, vindicating the empirical finding under a corrected mechanism. The structure is a property of the calibration class, not the engine: a minimal wall-clock accumulator over the raw error stream reproduces the same cliff, while a sample-time CUSUM over the identical stream is exactly dt-invariant (20/20). A rising-edge trigger with hysteresis fires 0-3 times per trajectory in every condition. We conclude that wall-clock-calibrated leaky-integrator monitors admit no regime in which they act as moment detectors on agent streams; transition detection escapes the trap at every cadence, but does not recover human intervention timing.

19.
medRxiv (Medicine) 2026-06-17

High burden of subclinical TB in Africa revealed from a postmortem cohort.

Tuberculosis (TB) is increasingly recognised as a spectrum of infection and disease, yet the prevalence of viable, asymptomatic Mycobacterium tuberculosis (M.tb) infection remains uncertain. Subclinical Tuberculosis (scTB), defined as microbiologically confirmed M.tb infection in the absence of recognised symptoms, is under detected by symptom, sputum and imaging-based approaches. We conducted postmortem examinations of 94 adults who died from non-infectious causes, none of whom were clinically suspected of TB or reported TB related symptoms prior to death. Lung and extrapulmonary tissues were cultured for M.tb. Viable M.tb was confirmed in six individuals, corresponding to a prevalence of 6.4% (95% CI: 2.4 to 13.4%). These findings provide direct tissue-based evidence that viable, asymptomatic M.tb infection can persist beyond the reach of conventional clinical detection. Our data suggest that a biologically active reservoir of infection may exist undetected within high-burden settings, with implications for surveillance strategies aimed at TB elimination.

20.
medRxiv (Medicine) 2026-06-22

AI-Assisted Longitudinal Analyses of Environmental and Psychosocial Determinants of Subjective Cognitive Difficulties

Authors:

Short-term environmental exposures have been linked to cognitive and behavioral outcomes, although many reported associations may reflect broader geographic and contextual differences. Using longitudinal data from the All of Us Research Program (2018–2024), we linked daily weather and air-pollution exposures to repeated attention-related and subjective cognitive outcomes. Associations were evaluated using pooled, fixed-effects, lagged, and event-study analyses. Additional machine-learning analyses were conducted to explore potential heterogeneity and latent psychosocial structure. Replication analyses were performed using the 2024 Behavioral Risk Factor Surveillance System (BRFSS). Several environmental exposure measures showed small associations with cognitive outcomes in pooled analyses, but most attenuated substantially after accounting for within-location temporal variation. Mediation, sensitivity, and machine-learning analyses yielded similar conclusions. In contrast, mental-health burden, loneliness, and social functioning were consistently associated with subjective cognitive difficulty and exhibited substantially larger effect sizes than environmental exposures. Similar patterns were observed in BRFSS. Exploratory AI-assisted analyses yielded findings broadly consistent with the primary longitudinal analyses. These findings suggest that short-term environmental perturbations may have limited associations with cognitive outcomes after accounting for within-location variation, whereas psychosocial factors appear to be more consistently associated with subjective cognitive burden.

21.
arXiv (CS.AI) 2026-06-16

CAP: Towards PPG Universal Representation Learning with Patient-level Supervision

arXiv:2606.15284v1 Announce Type: cross Abstract: Photoplethysmography (PPG) plays a central role in wearable health monitoring and clinical decision support. Yet existing approaches to universal PPG representation learning largely focus on signal-level objectives and often overlook patient-level health context, which limits generalization to complex clinical tasks and heterogeneous cohorts. To address this gap, we construct a large-scale paired PPG-EHR multimodal dataset by distilling fragmented medical histories and clinical records into cohesive, patient-level electronic health records (EHR). Building on this resource, we propose Clinical Anchored Pretraining for PPG (CAP). During pretraining, CAP performs cross-modal contrastive alignment that anchors PPG representations to patient-level clinical semantics, guiding the encoder beyond waveform fitting toward modeling consistency in a patient's overall physiological state. During downstream adaptation, the pretrained PPG encoder provides clinically grounded representations that strengthen inductive bias and improve robustness and transferability. Experiments demonstrate that CAP consistently outperforms strong baselines on four diverse downstream tasks. CAP achieves a particularly large gain on respiratory rate prediction (up to +87.6% relative improvement over the state-of-the-art baseline) and delivers an average relative +26.7% across all tasks. We further enhance the interpretability of our approach through comprehensive analyses, including ablations and multiple complementary visualizations of the learned representations. The code for our experiments is available at: https://github.com/gody123gody/CAP .

22.
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.

23.
arXiv (CS.LG) 2026-06-12

Distribution-Agnostic Robust Trajectory Optimization via Chance-Constrained Reinforcement Learning

arXiv:2606.13605v1 Announce Type: cross Abstract: This paper presents a distribution-agnostic robust trajectory-optimization framework based on chance-constrained reinforcement learning. The uncertainty is represented here through initial conditions and process noise, with the only requirement being that it can be sampled. A deterministic nominal trajectory is first computed offline, and reinforcement learning is then used only to robustify that baseline through a structured affine closed-loop correction law comprising a feedforward control adjustment and time-varying feedback gains. Probabilistic feasibility is enforced empirically through rollout-based upper-tail quantiles, while terminal dispersion is regulated through covariance-feasibility penalties. The framework is assessed on two materially different trajectory design problems. The flagship case study is a three-dimensional multi-impulse Earth-Mars transfer, where the learned policy is benchmarked against a recent robust trajectory-optimization reference under Gaussian uncertainty and then evaluated under bounded uniform uncertainty and under process disturbances not seen during training. The second case study is a stochastic atmospheric pinpoint rocket landing problem, used to assess portability to a short-horizon continuous-thrust setting with drag, mass depletion, and glide-slope constraints. The results show that the proposed framework can remain competitive in upper-tail fuel cost while preserving probabilistic feasibility, and that the same robustification scaffold can be carried across heterogeneous spacecraft trajectory planning problems without redesign of its core stochastic-control structure.

24.
medRxiv (Medicine) 2026-06-24

IgG2 Galactosylation is related to higher antibody dependent enhancement for dengue in cross-reactive antibodies from Sars-CoV-2

Cross-reactive antibodies against dengue virus are known to cause antibody-dependent enhancement (ADE) of infection or disease severity under specific conditions. In our previous study, we showed that primary immunization with the COVID-19 vaccine induces induces cross-reactive IgG causing ADE against dengue. In the present study, we investigated the influence of IgG Fc-glycosylation (analyzed by LC-MS/MS) on ADE mediated by cross-reactive IgG against dengue from IgG against SARS-CoV-2. We found a clear correlation between anti-DENV2 E IgG2 galactosylation and the ADE capacity of cross-reactive IgG against dengue in individuals vaccinated against COVID-19. IgG2 sialylation increased over time; however, it was not correlated with ADE capacity. This phenomenon was restricted to IgG2, whereas anti-DENV2 E IgG1 Fc-glycosylation remained stable after COVID-19 vaccination.

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

Low-Cost High-Order Singular Value Decomposition for Tensor-Based Reconstruction from Sparse Sensor Measurements: Urban Flow and Air-Quality Applications

arXiv:2606.24989v1 Announce Type: new Abstract: Urban flow and air-quality simulations generate high-dimensional datasets describing velocity and pollutant transport across multiple spatial, temporal, and physical-variable dimensions. Reconstructing these fields from sparse sensor measurements is a fundamental challenge in environmental monitoring, digital twins, forecasting, and data assimilation. Existing low-cost reconstruction approaches are commonly based on matrix decompositions, which require multidimensional datasets to be flattened into two-dimensional snapshot matrices, thereby discarding important structural information. This work introduces the low-cost High-Order Singular Value Decomposition (lcHOSVD), a novel tensor-based sparse-sensing reconstruction framework for high-dimensional environmental fields. To the authors' knowledge, this is the first methodology that combines sparse sensing and HOSVD for field reconstruction. Unlike matrix-based approaches, lcHOSVD preserves the natural tensor structure of the data, enabling the exploitation of correlations across spatial, temporal, and physical-variable dimensions while substantially reducing the computational requirements of conventional HOSVD. The methodology is applied to urban flow and air-quality datasets, where three-dimensional velocity and pollutant concentration fields are reconstructed using only 1-4% of the available spatial locations. While lcSVD provides larger computational speed-ups, lcHOSVD consistently achieves lower reconstruction errors in configurations characterized by strong multidimensional coupling and heterogeneous dynamics across dimensions. Additional sensor-anisotropy analyses demonstrate that the tensor formulation is significantly more robust to uneven sensor distributions, a common situation in practical environmental monitoring networks.