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01.
arXiv (quant-ph) 2026-06-11

An Introduction to the Foundations and Interpretations of Quantum Mechanics

arXiv:2603.09818v2 Announce Type: replace Abstract: This article surveys a selection of key conceptual and interpretational developments in quantum mechanics, tracing the theory from its foundational postulates to contemporary discussions of measurement, nonlocality, and the emergence of classicality. Beginning with the structure of Hilbert space and the postulates governing state evolution and measurement, the epistemic stance of the Copenhagen interpretation and its modern reformulations are examined. The Einstein-Podolsky-Rosen argument, Bell's theorem, and Hardy's paradox are then discussed as probes of locality and realism, alongside the deterministic but explicitly nonlocal de Broglie-Bohm theory. The measurement problem and the implications of contextuality are analyzed in relation to objective collapse models, which introduce new physical dynamics to account for definite outcomes. Finally, the role of decoherence in the suppression of interference and the emergence of classical behavior is explored, together with the interpretational frameworks of many-worlds and consistent histories. This material aims to provide a coherent introductory overview of how several of the most prominent interpretations address the central concern of what quantum mechanics tells us about the nature of physical reality.

02.
medRxiv (Medicine) 2026-06-17

Clinician knowledge and self-efficacy in snakebite management: A cross-sectional assessment in Northern Uganda

Background: Snakebite envenomation (SBE) is a major public health crisis in rural Uganda, yet it remains a neglected tropical disease. Effective management is often compromised by systemic barriers and a lack of clinician training. This study assessed clinician self-efficacy and objective knowledge regarding SBE management in Northern Uganda. Methods: A descriptive, cross-sectional study was conducted between February and July 2025 among 379 healthcare workers in Gulu, Omoro, and Pader districts. A validated questionnaire was used to collect data on socio-demographics, self-reported efficacy (scale 1-10), and objective knowledge. Knowledge scores [&ge;]70% were categorized as adequate. Multivariable logistic regression identified independent predictors of adequate knowledge, and Spearmans correlation ({rho}) assessed the relationship between knowledge and self-efficacy. Results: The participants had a mean age of 35.6 years (SD {+/-}7.3), were predominantly female (56.5%, 214/379), and most (83.6%, 317/379) practiced at Health Centre III level facilities. While 53.8% (204/379) reported prior training, 48.3% (183/379) of these had not received an update in over 10 years. Adequate knowledge was demonstrated by 51.5% (195/379) of participants. In the multivariable analysis, practicing in Omoro (adjusted odds ratio [aOR]: 0.3, 95% CI: 0.1-0.6, p < 0.001) or Pader (aOR: 0.2, 95% CI: 0.1-0.4, p < 0.001) was associated with lower odds of adequate knowledge compared to Gulu district. Prior training significantly increased the odds of adequate knowledge (aOR: 2.3, 95% CI: 1.3-4.2, p = 0.006). A moderate positive correlation was observed between self-efficacy and objective knowledge (Spearmans {rho} = 0.33, p < 0.0001). Conclusion: Approximately half of the frontline healthcare workers in Northern Uganda lack adequate knowledge on SBE management, with significant geographic differences and outdated training. The gap between clinician self-efficacy and objective knowledge poses a risk to patient safety. Regular, mandatory refresher training and targeted educational outreach to remote districts are required to reduce SBE-related morbidity and mortality.

03.
medRxiv (Medicine) 2026-06-10

Healthy Heart Actions Right Time (HHART): Co-design priorities to connect Aboriginal and Torres Strait Islander community and clinic activities for healthy hearts

Aim: Healthy Heart Actions Right Time (HHART) is a multi-phased research project that seeks to identify, implement and evaluate strategies to connect community and clinical activities to reduce the burden of heart disease for Aboriginal and Torres Strait Islander people. The aim in Phase One was to identify priority activities for two participating services. Background: The ongoing effects of colonisation drive a disproportionate burden of heart disease for Aboriginal and Torres Strait Islander people. Clinical and community groups both have established strengths in reducing the risk of heart disease, but these are not always well connected. Methods: Using a case study methodology in two locations we partnered in a 12-month co-design process to identify priority activities to connect clinical and community activities. Findings: Three priorities emerged from the Phase One co-design process: (i) community-led gardening as a strategy to promote heart health through connection and healthy lifestyles; (ii) community days to increase engagement in heart checks and strengthen community-clinic relationship; and (iii) clinic-led development of culturally relevant education resources to promote clinician confidence and community heart health knowledge.

04.
arXiv (CS.CV) 2026-06-19

DeepForestVisionV2: Ecology-Driven Taxonomy Expansion for Camera-Trap Monitoring in African Tropical Forests

Camera-trap monitoring in African tropical forests increasingly extends beyond closed-canopy interiors to riverbanks, clearings, and park edges. Among available open tools for African forest camera-trap classification, DeepForestVision is the only one providing a matched offline workflow for both photographs and videos, and previous work showed that it outperformed other available baselines on a comparable benchmark. However, it was designed for closed-canopy, ground-level forest interiors and uses a 35-class prediction space that becomes too coarse when deployments encounter arboreal primates, birds, semi-aquatic taxa, or human-associated confounders such as livestock. We present DeepForestVisionV2, an ecology-driven expansion from 35 to 64 prediction classes (61 animal classes plus human, vehicle, and blank) designed to address three recurrent deployment gradients: vertical stratification, scene openness, and anthropogenic interfaces. DeepForestVisionV2 retains the same offline workflow and is trained on 1,535,010 photographs and 243,354 videos from multi-country African tropical-forest projects. Evaluation combines a cross-country cropped-photo validation set, used to assess robustness across sites and camera-trap settings, with three held-out Uganda video benchmarks spanning the targeted gradients. On the validation set, DeepForestVisionV2 reaches 0.86 accuracy, 0.82 macro-F1, and 0.81 balanced accuracy. On the deployment benchmarks, it preserves or improves baseline accuracy despite its harder classification task, while increasing the number of identified taxa from 22 to 29 in forest-interior videos and from 4 to 9 at riverbanks. In the park-edge use case, it raises accuracy from 0.62 to 0.86 and reduces false alarms from 11 to 0. These results show that DeepForestVisionV2 materially improves field utility while preserving robustness across sites, habitats, and camera-trap settings.

05.
arXiv (CS.AI) 2026-06-17

Adaptive Domain Models: Bayesian Evolution, Warm Rotation, and Principled Training for Geometric and Neuromorphic AI

arXiv:2603.18104v5 Announce Type: replace Abstract: Prevailing AI training assumes reverse-mode automatic differentiation over IEEE-754 arithmetic. The memory overhead of training relative to inference, optimizer complexity, and structural degradation of geometric properties through training are consequences of this arithmetic substrate. This paper develops an alternative training architecture grounded in three prior results: the Dimensional Type System and Deterministic Memory Management framework (Haynes 2026), which establishes stack-eligible gradient allocation and exact quire accumulation as design-time verifiable properties; the Program Hypergraph (Haynes 2026), which establishes grade preservation through geometric algebra computations as a type-level invariant; and the b-posit bounded-regime design (Jonnalagadda et al. 2025), which makes posit arithmetic tractable across hardware targets conventionally considered inference-only. Their composition enables depth-independent training memory bounded to approximately twice the inference footprint, grade-preserving weight updates, and exact gradient accumulation, applicable uniformly to loss-function-optimized and spike-timing-dependent neuromorphic models. We introduce *Bayesian distillation*, a mechanism by which the latent prior structure of a general-purpose model is extracted through the ADM training regime, resolving the data-scarcity bootstrapping problem for domain-specific training. For deployment, we introduce *warm rotation*, an operational pattern in which an updated model transitions into an active inference pathway without service interruption, with correctness formalized through PHG certificates and signed version records. The result is a class of domain-specific AI systems that are smaller and more precise than general-purpose models, continuously adaptive, verifiably correct with respect to the physical structure of their domains, and initializable from existing models.

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

Benchmarking Web Agent Safety under E-commerce Deceptive Interfaces

As autonomous web agents are increasingly deployed to perform real-world tasks, ensuring their safety has become a critical concern. In this work, we study web agent behavior under realistic deceptive interfaces in the e-commerce domain. We introduce WebDecept, a lightweight and configurable plugin framework that enables controlled injection of deceptive interface patterns into existing web environments. Using WebDecept, we instantiate seven deceptive patterns commonly observed on the open web, including targeted advertisements, domain redirection, and shopping manipulation. By injecting these patterns into the frontend during task execution, we perform controlled evaluation of multiple multimodal web agents. Our results show that current web agents are highly susceptible to multiple classes of deceptive interfaces, and that prompt-based constraints are often insufficient to mitigate these failures. We further analyze how the design choices of deceptive patterns influence the success of such manipulations. These findings highlight safety challenges that should be addressed as web agents are scaled toward real-world deployment.

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

CLoVE: Personalized Federated Learning through Clustering of Loss Vector Embeddings

arXiv:2506.22427v2 Announce Type: replace-cross Abstract: We propose CLoVE (Clustering of Loss Vector Embeddings), a novel algorithm for Clustered Federated Learning (CFL). In CFL, clients are naturally grouped into clusters based on their data distribution. However, identifying these clusters is challenging, as client assignments are unknown. CLoVE utilizes client embeddings derived from model losses on client data, and leverages the insight that clients in the same cluster share similar loss values, while those in different clusters exhibit distinct loss patterns. Based on these embeddings, CLoVE is able to iteratively identify and separate clients from different clusters and optimize cluster-specific models through federated aggregation. Key advantages of CLoVE over existing CFL algorithms are (1) its simplicity, (2) its applicability to both supervised and unsupervised settings, and (3) the fact that it eliminates the need for near-optimal model initialization, which makes it more robust and better suited for real-world applications. We establish theoretical convergence bounds, showing that CLoVE can recover clusters accurately with high probability in a single round and converges exponentially fast to optimal models in a linear setting. Our comprehensive experiments comparing with a variety of both CFL and generic Personalized Federated Learning (PFL) algorithms on different types of datasets and an extensive array of non-IID settings demonstrate that CLoVE achieves highly accurate cluster recovery in just a few rounds of training, along with state-of-the-art model accuracy, across a variety of both supervised and unsupervised PFL tasks.

08.
arXiv (CS.AI) 2026-06-19

On the Limitations of Ray-Tracing for Learning-Based RF Tasks in Urban Environments

arXiv:2507.19653v2 Announce Type: replace-cross Abstract: We study the realism of Sionna v1.0.2 ray-tracing for outdoor cellular links in central Rome. We use a real measurement set of 1,664 user-equipments (UEs) and six nominal base-station (BS) sites. Using these fixed positions we systematically vary the main simulation parameters, including path depth, diffuse/specular/refraction flags, carrier frequency, as well as antenna's properties like its altitude, radiation pattern, and orientation. Simulator fidelity is scored for each base station via Spearman correlation between measured and simulated powers, and by a fingerprint-based k-nearest-neighbor localization algorithm using RSSI-based fingerprints. Across all experiments, solver hyper-parameters are having immaterial effect on the chosen metrics. On the contrary, antenna locations and orientations prove decisive. By simple greedy optimization we improve the Spearman correlation by 5% to 130% for various base stations, while kNN-based localization error using only simulated data as reference points is decreased by one-third on real-world samples, while staying twice higher than the error with purely real data. Precise geometry and credible antenna models are therefore necessary but not sufficient; faithfully capturing the residual urban noise remains an open challenge for transferable, high-fidelity outdoor RF simulation.

09.
arXiv (quant-ph) 2026-06-17

Superconductor-"Metal" Transition of One-dimensional Interacting Bosons with Ohmic Quantum Dissipation

arXiv:2605.30746v2 Announce Type: replace-cross Abstract: The phase diagram of a system of interacting bosons (Cooper pairs) hoping on a one-dimensional (1D) lattice with onsite phase dissipation describing the Josephson tunneling to a nearby diffusive normal-metal electrode is studied. Starting from the system at commensurate lattice filling, it is shown by a combination of analytical techniques that the phase diagram contains two quantum phases: A dissipative Bose-Einstein condensate (D-BEC) or superconductor with long-range phase coherence, and a dissipative Mott insulator (D-Mott) or "metal" with exponentially decaying phase correlations in space and local imaginary-time correlations decaying as the local pairing correlations of the electrode. The D-Mott/metal phase can be described as a 1D array of dissipative boson puddles, weakly coupled by Josephson tunneling. The puddle size roughly corresponds to the length scale beyond which phase slips suppress phase coherence. The dissipative time-dependent Ginsburg-Landau theory phenomenologically used by Sachdev, Werner, and Troyer [Phys. Rev. Lett. {\bf 92} 237003 (2004)] for the superconductor-metal transition in quasi-1D wires is derived from this microscopic puddle picture. Thus, the criticality of the D-Mott/D-BEC transition is shown to belong to the Wilson-Fisher universality class with dynamical exponent $z\approx 2$. At small doping, the D-Mott/metal phase remains stable due to its finite compressibility, which is computed to leading order in a perturbation expansion of the dissipation strength and the inter-puddle Josephson coupling. At larger doping, using a mapping to a pseudospin chain combined with bosonization, the D-BEC/superconductor phase is the ground state for non-vanishing but arbitrarily small dissipation. Similarities and differences with deconfinement transition of an array 1D bosonic Mott insulators in anisotropic optical lattices are also discussed.

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

Information Gap and Feasibility-Aware Inference in Binomial Logistic Mixtures

arXiv:2606.15665v1 Announce Type: cross Abstract: This paper studies the information gap between mixture detection and label recovery in binomial logistic mixtures. Standard likelihood-based criteria such as the Bayesian information criterion (BIC) can detect the presence of two components, but this does not guarantee that the corresponding labels are recoverable. We show that this gap is intrinsic to binomial logistic mixtures with a fixed number of trials: observed-data evidence for mixture structure and per-observation information for label recovery have different local orders in the component separation, and only the former accumulates with the sample size. As a result, there exists a detectable-but-unrecoverable regime in which BIC selects two components while the posterior labels remain essentially uninformative. To address this issue, we propose two feasibility-aware inference procedures: a recoverability-aware BIC with a posterior-entropy penalty and an entropy-regularized estimator that mitigates the tendency of the maximum likelihood estimator to produce overly separated components and overly concentrated posterior responsibilities. Numerical experiments confirm the predicted gap and demonstrate that the proposed methods avoid misleading component selections and improve the calibration of posterior label probabilities.

11.
arXiv (CS.CL) 2026-06-17

Incumbent Advantage: Brand Bias and Cognitive Manipulation Dynamics in LLM Recommendation Systems

Large language models (LLMs) are becoming a major way for consumers to find products, but we do not yet understand how brands compete in this new channel. We study brand dynamics in LLM recommendations using skincare products – a category where consumers cannot easily judge quality before buying and must rely on brand reputation – across three commercial LLMs (GPT-4o-mini, Claude Sonnet, Gemini 3 Flash), with a robustness check on search goods. In three experiments, we find: (1) a Conditional Monopoly where well-known brands get recommended 100% of the time (IAI = 10.0) when all products have the same specifications, but this dominance disappears with less than a +0.1-star rating advantage for a competitor; (2) authority-style marketing language, including fabricated clinical-evidence claims, breaks this monopoly at a Bias Surplus Value equal to +0.17 rating points, with each model responding differently; and (3) a social dilemma in multi-brand GEO competition: when all brands adopt the same optimization strategy, individual payoff falls from +0.802 to +0.007 in our payoff proxy, and non-participating brands receive zero recommendations in our tests. Our results suggest that generative engine optimization (GEO) should be studied not only as a security risk, but also as an emerging marketing practice that shapes market competition.

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

The Long Delay to Arithmetic Generalization: When Learned Representations Outrun Behavior

arXiv:2604.13082v2 Announce Type: replace-cross Abstract: Grokking in transformers trained on algorithmic tasks is characterized by a long delay between training-set fit and abrupt generalization, but the source of that delay remains poorly understood. In encoder-decoder arithmetic models, we argue that this delay reflects limited access to already learned structure rather than failure to acquire that structure in the first place. We study one-step Collatz prediction and find that the encoder organizes parity and residue structure within the first few thousand training steps, while output accuracy remains near chance for tens of thousands more. Causal interventions support the decoder bottleneck hypothesis. Transplanting a trained encoder into a fresh model accelerates grokking by 2.75 times, while transplanting a trained decoder actively hurts. Freezing a converged encoder and retraining only the decoder eliminates the plateau entirely and yields 97.6% accuracy, compared to 86.1% for joint training. What makes the decoder's job harder or easier depends on numeral representation. Across 15 bases, those whose factorization aligns with the Collatz map's arithmetic (e.g., base 24) reach 99.8% accuracy, while binary fails completely because its representations collapse and never recover. The choice of base acts as an inductive bias that controls how much local digit structure the decoder can exploit, producing large differences in learnability from the same underlying task.

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

Think-at-Hard: Selective Latent Iterations to Improve Reasoning Language Models

Improving the reasoning abilities of Large Language Models (LLMs), especially under parameter constraints, is crucial for real-world applications. Looped transformers address this by performing multiple latent iterations to refine each token beyond a single forward pass. However, we identify a latent overthinking phenomenon: most token predictions are already correct after the first pass, but are sometimes revised into errors in later iterations. We ask whether selectively skipping latent iterations can improve accuracy, and reveal significant potential with an oracle iteration policy that boosts performance by up to 7.3%. Motivated by this, we propose Think-at-Hard (TaH), a looped transformer optimized for selective iteration. TaH employs a lightweight neural decider to trigger latent iteration, only at tokens likely to be incorrect after the standard forward pass. During latent iterations, depth-aware Low-Rank Adaptation (LoRA) modules shift the objective from general next-token prediction to focused hard-token refinement. A duo-causal attention mechanism extends attention from the token sequence dimension to an additional iteration depth dimension, enabling cross-iteration information flow with full sequential parallelism. Experiments on nine benchmarks show consistent gains across math, QA, and coding tasks. With identical parameter counts, TaH outperforms always-iterate baselines by 3.8-4.4% while skipping iterations on 93% of tokens, and exceeds single-iteration Qwen3 baselines by 3.0-3.8%. When allowing

14.
arXiv (CS.CL) 2026-06-19

Think Again or Think Longer? Selective Verification for Budget-Aware Reasoning

Test-time reasoning is increasingly used as a serving-time control knob, but extra reasoning is not uniformly valuable: it can repair failed attempts, waste compute on already-correct answers, or introduce harmful answer changes. We study this as a deployment allocation problem rather than a new-verifier problem. We introduce \sevra, Selective Verification for Reasoning Allocation, a serving-layer controller that decides whether to preserve a frozen solver's initial answer or invoke active verification. Using a frozen Qwen3-4B solver, we log intervention outcomes and train recoverability-aware gates from serving-visible attempt state. On \mathfive, selective verification reaches 76.3\% accuracy, compared with 75.5\% for always verifying, while reducing post-generation tokens by 26.8\% and harmful flips from 2.2\% to 1.0\%. However, an 8,192-token initial solve reaches 76.0\% accuracy with 28\% fewer total model tokens, showing that selective recovery is useful but not the best tested cost frontier. In frozen transfer to \gsm, the selective policy verifies only 3.0\% of examples, improves accuracy from 93.4\% to 94.5\%, and reduces verification tokens by 91.2\% relative to always verifying; again, a longer initial solve matches its accuracy with fewer realized tokens. On CommonsenseQA, always-on verification hurts, while Self-Consistency@5 improves accuracy at about five times the realized token cost. The resulting deployment rule is: tune the initial budget first, then use selective recovery when explicit checks, bounded retries, auditability, or regression-risk control matter.

15.
arXiv (CS.CL) 2026-06-19

Improving Alignment Between Human and Machine Codes: An Empirical Assessment of Prompt Engineering for Construct Identification in Psychology

Due to their architecture and vast pre-training data, large language models (LLMs) demonstrate strong text classification performance. However, LLM output - here, the category assigned to a text - depends heavily on the wording of the prompt. While literature on prompt engineering is expanding, few studies focus on classification tasks, and even fewer address domains like psychology, where constructs have precise, theory-driven definitions that may not be well represented in pre-training data. We present an empirical framework for optimizing LLM performance for identifying constructs in texts via prompt engineering. We experimentally evaluate five prompting strategies – codebook-guided empirical prompt selection, automatic prompt engineering, persona prompting, chain-of-thought reasoning, and explanatory prompting - with zero-shot and few-shot classification. We find that persona, chain-of-thought, and explanations do not fully address performance loss accompanying a badly worded prompt. Instead, the most influential features of a prompt are the construct definition, task framing, and, to a lesser extent, the examples provided. Across three constructs and two models, the classifications most aligned with expert judgments resulted from a few-shot prompt combining codebook-guided empirical prompt selection with automatic prompt engineering. Based on our findings, we recommend that researchers generate and evaluate as many prompt variants as feasible, whether human-crafted, automatically generated, or ideally both, and select prompts and examples based on empirical performance in a training dataset, validating the final approach in a holdout set. This procedure offers a practical, systematic, and theory-driven method for optimizing LLM prompts in settings where alignment with expert judgment is critical.

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

Robustness without Wrinkles: Parallel Simulation and Robust MPC for Certified Deformable Manipulation

arXiv:2606.14188v1 Announce Type: cross Abstract: We present CORD-SLS, a real-time control method for safe deformable object manipulation, with a focus on ropes and cloth. At its core is a GPU-parallel differentiable simulator with contact smoothing which enables efficient gradient-based planning through intermittent contact. To robustly satisfy constraints under model and sensing uncertainty, we develop a real-time, GPU-parallel output-feedback robust model predictive control (MPC) algorithm that plans with this simulator. We further show that the simulator accelerates model-based RL for training neural manipulation policies. To improve real-world robustness, we use conformal prediction to calibrate visual-feedback and perception-error bounds for MPC, producing reachable tubes that enable high-probability safe control. We evaluate CORD-SLS on high-dimensional, contact-rich rope and cloth manipulation tasks in simulation and hardware, including obstacle avoidance, routing, folding, and smoothing. Across settings, CORD-SLS achieves millisecond-speed planning, exceeding baselines in safety, speed, and task success.

17.
arXiv (CS.CV) 2026-06-11

DeceptionX: Explainable Deception Detection with Multimodal Large Language Models

Deception detection is a critical and highly challenging task within affective computing and behavioral analysis. Existing deep learning methods typically treat this task as a straightforward classification problem; however, this black-box approach lacks interpretability and fails to capture the complex logical deduction processes utilized by human experts when identifying lies. While Multimodal Large Language Models (MLLMs) have shown potential, applying them effectively requires a bridge between low-level audiovisual cues and high-level logical reasoning. In this paper, we propose DeceptionX, a novel MLLM framework that shifts the paradigm of deception detection from black-box classification to an interpretable Observe-Think-Summarize reasoning process. To address the scarcity of high-quality reasoning data, we first constructed DeceptChain, a high-quality dataset developed through a human-in-the-loop process. This dataset synthesizes fine-grained visual and auditory evidence (such as micro-expressions and vocal tremors) into structured chain-of-thought reasoning data. Furthermore, we propose a three-stage training pipeline and a Discrepancy-Aware Redundancy Elimination~(DARE) strategy for DeceptionX to further enhance the model's generalization capabilities. Extensive experiments demonstrate that DeceptionX not only outperforms existing MLLM baselines and state-of-the-art methods on standard real-world benchmarks but also provides transparent, expert-level reasoning paths, bridging the critical gap between accuracy and interpretability in multimodal deception detection.

18.
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.

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

Allure of Craquelure: A Variational-Generative Approach to Crack Detection in Paintings

Recent advances in imaging technologies, deep learning and numerical performance have enabled non-invasive detailed analysis of artworks, supporting their documentation and conservation. In particular, automated detection of craquelure in digitized paintings is crucial for assessing degradation and guiding restoration, yet remains challenging due to the possibly complex scenery and the visual similarity between cracks and crack-like artistic features such as brush strokes or hair. We propose a hybrid approach that models crack detection as an inverse problem, decomposing an observed image into a crack-free painting and a crack component. A deep generative model is employed as powerful prior for the underlying artwork, while crack structures are captured using a Mumford–Shah-type variational functional together with a crack prior. Joint optimization yields a pixel-level map of crack localizations in the painting.

20.
Nature Medicine 2026-06-08

Effects of SGLT2 inhibition on incident heart failure in carriers of cardiomyopathy-associated genetic variants

Although the beneficial effects of sodium–glucose cotransporter 2 (SGLT2) inhibition in heart failure (HF) have been well established, it is unknown whether SGLT2 inhibition confers benefit in carriers of rare variants in cardiomyopathy-associated genes. Here we evaluated whole-exome sequencing data from the randomized DECLARE-TIMI 58 trial, in which adults with type 2 diabetes and increased cardiovascular risk were randomized to dapagliflozin or placebo treatment. Pathogenic or likely pathogenic variants (P/LP) in high-confidence cardiomyopathy genes were identified, and treatment effects on hospitalization for HF (HHF) were compared between carriers of such variants and noncarriers. Among 12,685 patients for whom sequence data were obtained, 121 carried a cardiomyopathy variant (76 dilated cardiomyopathy, 25 hypertrophic cardiomyopathy and 25 arrhythmogenic cardiomyopathy). Over a median follow-up of 4.2 years, dapagliflozin lowered the risk of HHF more strongly in carriers (hazard ratio 0.18, 95% confidence interval 0.04–0.86) than in noncarriers (hazard ratio 0.70, 95% confidence interval 0.57–0.86; P interaction 0.03). Absolute risk reduction was 13.0% in carriers and 1.0% in noncarriers (P interaction 0.03). Most carriers (82%) had no prior HF, and in carriers without prior HF, treatment with dapagliflozin reduced the absolute risk of HHF by 12.8%, compared with a reduction of 0.6% in noncarriers (P interaction 0.01). The findings from this cohort of older and high-risk patients raise the possibility that SGLT2 inhibitor treatment should be started early to prevent HF in individuals who carry P/LP cardiomyopathy variants. These results need to be confirmed in a prospective, dedicated trial of preventive HF treatments in carriers of P/LP cardiomyopathy-associated variants. In a whole-exome sequencing analysis, the beneficial effects of the SGLT2 inhibitor dapagliflozin in reducing the risk of future heart failure hospitalization in individuals with type 2 diabetes were markedly greater in individuals who carried a cardiomyopathy-associated genetic variant compared with noncarriers, suggesting a personalized preventative therapy based on genetic information.

21.
arXiv (quant-ph) 2026-06-19

Entanglement Scaling and Problem Structure in Quantum Approximate and Adiabatic Optimization Algorithms

arXiv:2606.19502v1 Announce Type: new Abstract: Entanglement is widely regarded as a key resource underlying the power of quantum algorithms and their potential to achieve quantum advantage. With the emergence of variational quantum algorithms, however, questions have arisen regarding how entanglement relates to problem structure and algorithmic performance in near-term quantum applications. Here, we examine this relationship through the Quantum Approximate Optimization Algorithm (QAOA), a specific class of variational algorithms, applied to the MaxCut problem. We show that suboptimal variational parameter training can significantly modify the observed entanglement profile, obscuring its scaling behavior. By employing a high-performance optimizer, we find empirical evidence that QAOA exhibits entanglement scaling consistent with that of fermionic Gaussian states (up to a scaling factor) across a broad range of MaxCut instances. We further compare these results with adiabatic quantum computation, observing annealing-schedule-dependent entanglement profiles whose scaling behavior differs markedly from that of QAOA. Together, these findings provide new insight into how entanglement manifests in and distinguishes these two algorithmic paradigms, highlighting its connection to both computational performance and application structure.

22.
PLOS Medicine 2026-06-16

The data transparency crisis in research: Lessons from systematic reviews and meta-analyses

by Saul Martin-Rodriguez, Rodrigo Fernandez-Gonzalo, David Moher Summary points Systematic reviews and meta-analyses underpin clinical guidelines and health policy, yet their validity may be compromised by limited access to underlying datasets and associated analytical code. Reliance on incomplete or inconsistently reported summary statistics forces researchers to use imputation and unverifiable assumptions, which can distort effect estimates and mislead clinical decision-making. The consequences extend beyond methodology: flawed evidence synthesis can influence treatment recommendations, healthcare spending, and patient safety, as illustrated by historical cases such as hormone replacement therapy. Despite widespread data-sharing policies, compliance remains low, enforcement weak, and monitoring almost non-existent, with many datasets remaining unavailable or inaccessible. This Policy Forum argues for strengthening enforceable data-sharing mechanisms, including clearer enforcement and pragmatic verification approaches within editorial workflows.

23.
medRxiv (Medicine) 2026-06-17

Sao Tome and Principe on the verge of eliminating lymphatic filariasis as a public health problem: evidence from IDA impact assessment surveys

Background Accelerated efforts to eliminate lymphatic filariasis (LF) as a public health problem have been supported by the introduction of the triple-drug regimen of ivermectin, diethylcarbamazine and albendazole (IDA) in endemic settings. In Sao Tome and Principe, nationwide mass drug administration (MDA) with diethylcarbamazine and albendazole was implemented in 2018, followed by IDA in 2019 and 2020. This study assesses progress towards elimination using post-MDA impact assessment surveys conducted after cessation of treatment. Methods Cross-sectional surveys were conducted among adults aged 20 years and older in 2022 and again between December 2024 and January 2025. Circulating filarial antigen (CFA) was detected using the filarial test strip (FTS). Individuals who tested positive were examined for microfilaremia using nocturnal calibrated thick blood smear microscopy. Additionally, programme data on MDA coverage and morbidity were obtained from national surveillance records. Results Three rounds of nationwide MDA achieved high epidemiological coverage (86.4% in 2018, 74.2% in 2019 and 80.0% in 2020). The impact assessment surveys conducted in 2022 evaluated 14 132 adults, with 21 individuals (0.15%) testing positive for CFA, while the follow-up survey conducted between December 2024 and January 2025 assessed 14 653 adults and detected seven positive cases (0.05%). No microfilariae were detected among the 28 antigen-positive individuals examined using nocturnal calibrated thick blood smears. National morbidity records documented 190 cases of lymphoedema and nine cases of hydrocoele. Conclusions Infection indicators remain well below WHO decision thresholds, suggesting that LF transmission is unlikely to be sustained. Sao Tome and Principe appears to be close to eliminating LF as a public health problem. However, strengthening morbidity management services will be essential to support the preparation of the national elimination dossier.

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

Memory as a Wasting Asset: Pricing Flash Endurance for Embodied Agents, and the Limits of Doing So

arXiv:2606.18144v1 Announce Type: new Abstract: A robot's flash endurance is a non-renewable stock: every persisted write spends one of a few thousand program/erase cycles and never refills, yet no fielded robot memory system prices which memories are worth an erase cycle. We treat embodied memory as depreciating capital and price that stock with a single endurance shadow price $\eta$, which makes cost-minimizing placement across a RAM / on-board NVM / cloud hierarchy a threshold in a wear-augmented per-byte index. The index is cost-optimal whatever the sign of the value-write association $\chi$; only when $\chi > 0$ does the optimum turn non-monotone, sending a robot's most valuable memories off its flash. The pivot is thus empirical, and we measure $\chi$ on real robot logs at a pre-specified gate: its sign is a property of the deployment regime – positive on recurrent long-horizon manipulation ($\hat{\chi} \approx +1.0 \times 10^{-3}$, replicated at full power), null on a shorter-horizon suite, and negative on non-recurrent teleoperation. Two boundaries scope the result. The endurance budget is dormant on premium 3,000-P/E TLC at datasheet prices and binding on the commodity QLC/eMMC ($\sim$1,000 P/E) that cheaper edge robots run. And where it binds, a learned wear-aware controller only ties price-based routing on task value, because realized value is tier-invariant across RAM, NVM, and cloud: the rent governs device lifetime and cost, not task performance. Whether wear-aware placement improves task value remains open – $\chi$ is measured against a value proxy, and the non-monotone optimum, while proven, is not yet observed in data.

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

Coercivity and Local Convergence of Physical Learning in Linear Circuits

arXiv:2606.15443v1 Announce Type: cross Abstract: Physical learning methods train physical networks to perform computational tasks using only local update rules, exploiting the physics of the system to handle the global transfer of information. We provide the first local convergence analysis of three such methods – Equilibrium Propagation (EP), Coupled Learning (CL), and a new method we call Adjoint Coupled Learning (AL) – for linear circuits, in the limit of small-nudging for both discrete and continuous time. EP and AL perform gradient descent on a natural loss function, while CL follows modified dynamics with an additional cubic correction. Assuming the existence of a solution, we identify a coercivity condition, expressed as a rank condition on a matrix built from the network's incidence structure, under which the training loss decays exponentially and the parameters converge to the solution manifold. We show that coercivity can fail by exhibiting a kite circuit in which a symmetry causes the coercivity constant to degenerate on the solution manifold, but prove using Sard's theorem that such degeneracies are non-generic: coercivity holds at every point of the solution manifold for almost every choice of desired output.