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01.
medRxiv (Medicine) 2026-06-12

Sociodemographic and health correlates of reimbursement authorizations for cannabis for medical purposes in Canadian veterans: A cross-sectional study linking the Life After Services Studies 2019 and Health Administrative Databases

Background Evidence on factors associated with cannabis for medical purposes (CMP) authorizations among Veterans Affairs Canada (VAC) clients remains limited and inconsistent, particularly concerning mental health and posttraumatic stress disorder (PTSD), a leading indication for use. We investigated demographic, clinical and service characteristics associated with VAC authorizations for CMP reimbursement. Method We linked VAC administrative CMP program data with responses from the 2019 Life After Services Studies cross-sectional survey of Regular Force veterans released between 1998 and 2018. Multivariable logistic regressions examined associations between CMP reimbursement (yes/no) and demographic, clinical and well-being factors, with analyses stratified by PTSD status. Results Among 1,289 respondents (weighted n=33,131), 18.4% were authorized for CMP reimbursement. Younger age (

02.
arXiv (CS.AI) 2026-06-16

Ranking Abuse via Strategic Pairwise Data Perturbations

arXiv:2604.17805v2 Announce Type: replace-cross Abstract: Pairwise ranking systems based on Maximum Likelihood Estimation (MLE), such as the Bradley-Terry model, are widely used to aggregate preferences from pairwise comparisons. However, their robustness under strategic data manipulation remains insufficiently understood. In this paper, we study the vulnerability of MLE-based ranking systems to adversarial perturbations. We formulate the manipulation task as a constrained combinatorial optimization problem and propose an Adaptive Subset Selection Attack (ASSA) to efficiently identify high-impact perturbations. Experimental results on both synthetic data and real-world election datasets show that MLE-based rankings exhibit a sharp phase-transition behavior: beyond a small perturbation budget, a limited number of strategic voters can significantly alter the global ranking. In particular, our method consistently outperforms random and greedy baselines under constrained budgets. These findings reveal a fundamental sensitivity of MLE-based ranking mechanisms to structured perturbations and highlight the need for more robust aggregation methods in collective decision-making systems.

03.
arXiv (quant-ph) 2026-06-16

High-fidelity two-qubit gates in a 7-qubit register for quantum networks

arXiv:2606.14847v1 Announce Type: new Abstract: Quantum networks based on optically active solid-state spins may enable quantum technologies including long-range quantum communication and distributed quantum computing. Network nodes containing multiple high-fidelity qubits can facilitate large-scale fault-tolerant operation. However, the stringent error thresholds remain out of reach for multi-qubit registers. In this work, we demonstrate high-fidelity two-qubit gates in a 7-qubit register, based on nuclear spins coupled to a nitrogen-vacancy (NV) center in diamond. We analyze crosstalk in highly connected spin systems, develop an efficient optimization procedure, and characterize the gates using gate set tomography. The two-qubit gate fidelities (best: 99.61(5)%, average: 99.18(2)%) demonstrate a multi-qubit register at the threshold for distributed quantum computation. Finally, as an example application, we perform a variational quantum eigensolver (VQE) simulation of the ground-state energy of H2 and LiH molecules. These results demonstrate one of the key prerequisites for scalable quantum networks based on solid-state spins.

04.
arXiv (math.PR) 2026-06-19

Finite-Sample Bounds for Expected Signature Estimation under Weak Dependence

arXiv:2605.20541v2 Announce Type: replace-cross Abstract: The expected signature uniquely determines the law of a random rough path under a moment-growth condition, yet finite-sample bounds for estimating its truncations from a single long dependent trajectory remain unavailable. We study a strictly stationary stochastic process equipped with a geometric rough-path lift, observed in non-overlapping blocks of equally-spaced samples, and prove a non-asymptotic mean-squared error (MSE) bound for the block-averaging estimator of its truncated expected signature. Under moment and stationarity assumptions together with a direct covariance-decay condition on block signatures – strictly weaker than $\alpha$-mixing and applicable to long-range-dependent processes – the error separates into a discretization term and a fluctuation term, with rates determined respectively by path regularity and dependence strength. A levelwise rough-factorial variance analysis keeps finite-truncation constants explicit and yields an optimal allocation rule under a fixed observation budget. We verify the assumptions for independent-coordinate fractional Ornstein–Uhlenbeck processes in three regimes: short-range (Hurst $1/41/2$. Monte Carlo experiments show empirical slopes steeper than the guaranteed upper-bound rates.

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

FISHER: A Foundation Model for Multi-Modal Industrial Signal Comprehensive Representation

arXiv:2507.16696v3 Announce Type: replace-cross Abstract: Industrial signal analysis is hindered by severe data heterogeneity, which we characterize as the M5 problem. Existing solutions rely on specialized models that lack robustness and scalability, while large-scale pre-training has rarely been investigated in this area. In this work, we derive a prioritized roadmap for the M5 problem and propose FISHER, a Foundation model for multi-modal Industrial Signal compreHEnsive Representation. To address the foremost multi-sampling-rate problem, FISHER utilizes a novel sub-band modeling approach that treats sampling rate increments as concatenated sub-band information, enabling the adaptive usage of full signal bandwidth without resampling. FISHER is pre-trained by teacher-student self-distillation over external audio and music data. We also establish the RMIS benchmark, comprising 19 datasets across four modalities. In the experiment, FISHER outperforms 24 state-of-the-art series encoders (up to 2B) with much smaller sizes (up to 16x), showcasing groundbreaking diagnostic accuracy and remarkable versatility. We further demonstrate that 1) seamless adaptation to variable sampling rates is the key to generalization 2) audio and music data provide better temporal variability, which is essential for pre-training. Both FISHER and RMIS are open-sourced.

06.
arXiv (CS.CV) 2026-06-18

Learning Patient-Specific Disease Dynamics with Latent Flow Matching for Longitudinal Imaging Generation

Understanding disease progression is a central clinical challenge with direct implications for early diagnosis and personalized treatment. While recent generative approaches have attempted to model progression, key mismatches remain: disease dynamics are inherently continuous and monotonic, yet latent representations are often scattered, lacking semantic structure, and diffusion-based models disrupt continuity with random denoising process. In this work, we propose to treat the disease dynamic as a velocity field and leverage Flow Matching (FM) to align the temporal evolution of patient data. Unlike prior methods, it captures the intrinsic dynamic of disease, making the progression more interpretable. However, a key challenge remains: in latent space, Auto-Encoders (AEs) do not guarantee alignment across patients or correlation with clinical-severity indicators (e.g., age and disease conditions). To address this, we propose to learn patient-specific latent alignment, which enforces patient trajectories to lie along a specific axis, with magnitude increasing monotonically with disease severity. This leads to a consistent and semantically meaningful latent space. Together, we present $\Delta$-LFM, a framework for modeling patient-specific latent progression with flow matching. Across three longitudinal MRI benchmarks, $\Delta$-LFM demonstrates strong empirical performance and, more importantly, offers a new framework for interpreting and visualizing disease dynamics.

07.
arXiv (CS.CV) 2026-06-15

WAM4D: Fast 4D World Action Model via Spatial Register Tokens

World action models (WAMs) have recently shown promise in jointly modeling future observations and executable robot actions. However, most existing WAMs still operate in 2D video or latent spaces, where visually plausible rollouts miss the 3D spatial constraints and occluded contact geometry required for precise manipulation. While geometric foundation models offer strong priors for recovering dense 3D structure and motion from visual observations, forcing WAMs to predict the dense 4D representation introduces costly geometric decoding and slows down causal action generation. To address the trade-off, we present WAM4D, a fast 4D world action model that uses lightweight spatial register tokens as training-time future-depth readouts to transfer pretrained geometric priors into a causal video-action transformer, then removes the register branch for lightweight action inference. To prevent non-causal shortcuts, we further design causal mixture attention for the Mixture-of-Transformers (MoT) WAM backbone, defining modality-specific visibility among video, action, and geometry tokens. Comprehensive experiments on RoboTwin 2.0 and challenging real-world manipulation tasks show that WAM4D improves spatial consistency and achieves competitive action prediction while maintaining efficient inference.

08.
arXiv (CS.CV) 2026-06-11

Global Geometry Is Not Enough for Vision Representations

A common assumption in representation learning is that globally well-distributed embeddings support robust and generalizable representations. This focus has shaped both training objectives and evaluation protocols, implicitly treating global geometry as a proxy for representational competence. While global geometry effectively encodes which elements are present, it is often insensitive to how they are composed. We investigate this limitation by testing the ability of geometric metrics to predict compositional binding across a diverse suite of vision encoders. We find that standard geometry-based statistics exhibit near-zero correlation with compositional binding. In contrast, functional sensitivity, as measured by the input–output Jacobian, reliably tracks this capability. We further provide an analytic account showing that this disparity arises from objective design, as existing losses explicitly constrain embedding geometry but leave the local input–output mapping unconstrained. These results suggest that global embedding geometry captures only a partial view of representational competence and establish functional sensitivity as a critical complementary axis for modeling composite structure.

09.
arXiv (math.PR) 2026-06-16

Testing for a Hidden Geometry in Random Graphs

arXiv:2606.16715v1 Announce Type: cross Abstract: We study the problem of detecting a faint geometric signal hidden in an otherwise random graph. Formally, we consider a hypothesis testing problem in which, under the null, the observed graph is an Erdős–Rényi random graph $\mathcal{G}(n,q)$, while under the alternative a random geometric graph $\mathcal{G}(k,q,d)$ is planted on $k\le n$ vertices. The planted subgraph is generated from independent random points on the unit sphere $\mathbb{S}^{d-1}$, with edges determined by latent geometric proximity and calibrated to have edge density $q$. Our goal is to characterize the statistical and computational limits of detecting this hidden geometry. We derive sharp information-theoretic lower bounds that identify regimes where detection is impossible and provide algorithms that achieve these limits whenever detection is feasible. We further investigate the computational complexity of the problem and determine when efficient polynomial-time tests exist. The model exhibits an easy–hard–impossible phase transition: some regimes allow efficient detection, others permit detection only with computationally intractable procedures, and still others render detection impossible even with unlimited computational power. As evidence for the computational barrier, we prove that all low-degree polynomial algorithms fail throughout the conjecturally hard regime, demonstrating a sharp gap between statistical and computational feasibility.

10.
arXiv (math.PR) 2026-06-16

Mean-field BSDEs with non-Lipschitz coefficients and double mean reflections

arXiv:2510.11228v2 Announce Type: replace Abstract: The present paper is devoted to the study of mean-field backward stochastic differential equations (MFBSDEs) with double mean reflections whose generators are not Lipschitz continuous. With the help of the Skorokhod problem and some a priori estimates for MFBSDEs, we establish the existence and uniqueness results for doubly mean reflected MFBSDEs.

11.
arXiv (quant-ph) 2026-06-17

Quantum Computing Algebra (QCA), the theory and implementation

arXiv:2606.17621v1 Announce Type: new Abstract: We present a real geometric algebra framework designed for the direct translation of the Dirac formalism into geometric algebra representations. Unlike previous approaches based on positive-definite signatures, QCA employs a split-signature construction that enables a natural realization of quantum states and operators while simplifying computational implementation. We further present an implementation of QCA using the GAALOP software and show how quantum gates and multi-qubit systems can be efficiently represented and generated computationally. As an application, we demonstrate the use of QCA in quantum game theory, where the real-algebraic formulation provides computational advantages for modeling entangled strategies and quantum interactions. The proposed framework establishes a practical bridge between the abstract formalism of quantum computation and efficient geometric algebra implementations.

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

VFACamou: View-Fused Adversarial Camouflage for Environment-Adaptive Physical Evasion

Adversarial camouflage in the physical world remains highly challenging, particularly under UAV reconnaissance where targets undergo continuous geometric changes and extreme illumination variations. Existing methods either optimize 2D digital perturbations that fail to generalize to dynamic viewpoints or produce visually unnatural textures that cannot be deployed in real scenarios. Therefore, we propose an end-to-end framework for adversarial camouflage generation that automatically produces wearable adversarial patterns and maintains stable attack performance in real physical environments with changing viewpoints, poses, and lighting conditions. Our method integrates UV-volume rendering with a diffusion-based texture generator, enabling consistent appearance under varying scales, poses, and lighting conditions. To ensure environmental realism, we propose an illumination color consistency estimator that extracts dominant background attributes and guides a natural texture loss to align the generated UV texture with the surrounding environment. A multi-scale dynamic training strategy further enhances robustness against viewpoint shifts and body deformation. Extensive experiments across multiple mainstream detectors demonstrate that our method achieves strong and stable physical attack performance while maintaining high perceptual naturalness, reducing human detection rates without introducing unnatural artifacts.

13.
arXiv (CS.AI) 2026-06-24

ATHENA: Agentic Team for Hierarchical Evolutionary Numerical Algorithms

arXiv:2512.03476v3 Announce Type: replace-cross Abstract: Progress in computational science depends on complex numerical workflows that must faithfully encode physical laws, yet translating conceptual insight into reliable code remains a major bottleneck. Although large language models can generate isolated code fragments, they lack the structured reasoning required to design, verify, and iteratively refine complete scientific pipelines. Here we introduce ATHENA, an agentic framework explicitly designed to emulate scientific research modeled as a knowledge-driven contextual bandit process. Its core loop separates conceptual policy from numerical realization through expert-derived conceptual scaffolding, enabling principled diagnosis, reformulation, and repair of computational strategies. Across scientific computing and scientific machine learning tasks, ATHENA autonomously derives and correctly applies exact analytical solutions, constructs stable numerical solvers, diagnoses ill-posed formulations, and orchestrates hybrid symbolic-numeric workflows. Quantitatively, ATHENA matches and frequently surpasses the accuracy of expert-authored reference solutions reported in the literature on canonical benchmarks. By reframing computation as an object of agentic reasoning, our framework enables autonomous orchestration of heterogeneous algorithms across scientific domains.

14.
arXiv (CS.LG) 2026-06-17

Bounded Difference Concentration for Infinitely Exchangeable Sequences with Applications to AI Benchmark Uncertainty

arXiv:2606.17426v1 Announce Type: cross Abstract: We consider the concentration properties of functions of infinitely exchangeable random variables. By conditioning on the de Finetti directing measure, we show that the deviation of any function with bounded-difference constants $c_1, \dots, c_n$ decomposes into a conditional sampling fluctuation and a latent mixture fluctuation. When this latent mixture is $\sigma_{\mathrm{mix}}^2$-subgaussian, we establish a concentration inequality with an effective variance proxy of $\frac{1}{4}\sum_i c_i^2 + \sigma_{\mathrm{mix}}^2$. Crucially, we demonstrate that for zero-sum linear contrasts, such as the difference between a subsample mean and a full population mean, the latent mixture term cancels exactly. This cancellation yields a tight, mixture-free Hoeffding-type bound that provides a direct de Finetti mechanism for the infinite-extendibility limit of recent finite-exchangeable concentration results. We apply this framework to quantify uncertainty in composite AI benchmarks, such as MMLU, where question items naturally exhibit exchangeable dependence across domains. Our results provide both a domain-stratified hierarchical model for bounding the uncertainty of accuracy scores, and a distribution-free, cost-saving statistical guarantee for accurately estimating full benchmark scores from random subsets.

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

David vs. Goliath in Next Activity Prediction: Argmax vs. LSTM, Transformer, and LLM

arXiv:2606.15868v1 Announce Type: new Abstract: Next activity prediction (NAP) is a cornerstone of predictive process monitoring (PPM), enabling organizations to move from retrospective analysis to proactive process steering. The PPM field has progressed from classical machine learning through deep learning architectures such as LSTMs and Transformers to large language models (LLMs). Despite growing model complexity, no benchmark jointly compares LLMs, Transformers, LSTMs, and simple baselines in a direct sequence modeling setting for NAP. In this paper, we fill this gap with a systematic benchmark. We compare vocabulary-adapted LLMs, Transformers trained from scratch, LLM-distilled Transformers, and LSTMs against a simple counting-based argmax baseline across seven real-life event logs. Our results tell a David vs. Goliath story: pretraining confers no consistent improvement over training from scratch, model size shows little effect on performance, and on most datasets the argmax baseline matches or approaches the performance of billion-parameter LLMs.

16.
arXiv (CS.CL) 2026-06-17

Rift: A Conflict Signature for Deception in Language Models

Authors:

A model that lies while knowing the truth is the central case ELK cannot handle with behavioral evaluation alone. We ask whether such deception leaves an internal signature distinguishing it from honest error. Our key move is a control for wrongness: we contrast a sleeper agent (knows the truth, lies on trigger) against a naive liar (fine-tuned to emit the same wrong answers with no honest training). Both produce identical wrong outputs; any difference is about knowledge conflict, not incorrectness. We find deceptive forward passes carry a conflict signature - 2.1-2.3x higher residual rank than naive-liar passes on the same wrong answer - strong enough to identify which of two responses is the lie with 100% accuracy and no labels, across GPT-2 small/medium (three seeds) and three instruct models. Across Qwen2.5-1.5B/7B and Phi-3-mini, instructed deception raises residual rank on every tested fact (18/18, 40/40, 34/34); on Phi-3, lies separate perfectly from both honest answers and hallucinations (AUC 1.0, Wilcoxon p~6e-11). The signature survives strategic self-constructed deception (model invents its own lie, AUC 1.0), active concealment attempts (AUC 1.0), and length-controlled replication (20/20, AUC 1.0, p~1e-6). Using basis-free relative representations, a probe trained on one model family detects deception in two other families zero-shot (mean AUC 0.933), surviving simultaneous architecture and format change (AUC 0.821), and transfers across five languages (AUC 1.000, length-controlled). The signature is read-only: detectable but not injectable (0/8 both directions). Honest limitations and six negative experiments are documented in full.

17.
arXiv (quant-ph) 2026-06-16

Improved Cryogenic Photodiode Optical Biasing for Low-Noise and Low-Jitter Superconducting Nanowire Single-Photon Detectors

arXiv:2606.07140v2 Announce Type: replace Abstract: We experimentally demonstrate an improved optical biasing scheme for superconducting nanowire single-photon detectors (SNSPDs), which employs a cryogenic InGaAs-InP photodiode (PD) as a local bias source. It is found that, under illumination from a stable external light source, this PD generates a stable photocurrent in a cryogenic environment (~2.3 K), with fluctuations in the photocurrent primarily attributed to fluctuations in the incident optical power. Furthermore, by screening and effectively blocking stray photons leaking from the PD, which give rise to background dark counts, we have achieved an SNSPD exhibiting an ultra-low intrinsic dark count rate of 1e-4 cps. Utilizing this improved optical biasing technique, our SNSPD achieved performance comparable to that obtained under conventional electrical biasing: a system detection efficiency of 80.7%, a background dark count rate of 32.6 cps, and a minimum timing jitter of 57.5 ps. These results indicate that cryogenic-PD-based optical biasing serves as a viable, low-noise, and low-jitter alternative to traditional electrical biasing. Moreover, this work offers useful design guidance for the future development of PD-based low-noise bias sources and for the construction of all-photonic SNSPD systems tailored for high-precision quantum photonics applications.

18.
medRxiv (Medicine) 2026-06-13

Projected population level impact and cost-effectiveness of clinic and community-based tuberculosis screening approaches

The South Africa National Department of Health have set ambitious targets to scale up TB testing, focusing primarily on clinic attendees. In the context of declining funding for TB care and prevention, the most cost-effective approaches for targeting testing should be identified. We developed a mathematical model of TB in South Africa, explicitly incorporating clinic attendance by sex and HIV/ART status. We simulated six screening approaches over 2026-2035 (individually and in combination): three clinic-based (symptom screening, intensified targeted universal TB testing [TUTT, symptom-agnostic sputum testing of clinic attendees in key risk groups], and intensified TUTT allowing saliva samples) and three targeted community-based (community radiographic screening, symptom screening, and universal Xpert Ultra testing), each implemented at a range of coverage levels. Model outputs were combined with a mechanistic cost function to estimate potential impact and cost-effectiveness from a societal perspective. The most cost-effective standalone approach was community radiographic screening at 10% annual population coverage, with an incremental cost-effectiveness ratio (ICER) of $421 per disability-adjusted life year (DALY) averted. 10/11 scenarios along the expansion path included community radiographic screening at progressively higher coverage, combined with a clinic-based approach. Combining complementary approaches to reach both groups at increased risk of TB (e.g. clinic-based screening) and groups with lower screening coverage (e.g. community-based screening) may increase cost-effectiveness of TB screening, compared to standalone approaches. When designing TB screening strategies, both population risk and existing screening coverage should be considered.

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

Building Customer Support AI Agents at 100M-User Scale: An Evaluation-Driven Framework

The rapid rise in LLM capabilities has made AI agents increasingly viable across a broad range of tasks. Among the most promising applications is building production-ready customer-facing agents, a challenge that demands coordinated excellence in evaluation methodology, context engineering, training, and online measurement. Yet these critical pillars are typically developed in isolation, creating blind spots that only surface after deployment. In this paper, we present a unified framework that bridges offline development with online impact for customer support AI agents at Nubank, a company with 100M+ users. Our approach integrates several key components: (1) structured context engineering tailored to customer support agents, (2) systematic human-in-the-loop prompt iteration, (3) rigorous LLM judge evaluation with measured inter-rater agreement and GEPA optimization for consistency, and (4) ideation-to-production validation. A central insight is that evaluation-pipeline quality directly determines iteration velocity. We present results from five production deployments spanning distinct domains: card delivery, debt management, credit-limit support, card management, and product explanation. These deployments deliver consistent customer-satisfaction gains while substantially accelerating iteration. In our card-delivery deployment, large-scale A/B testing yields a 37 percentage-point improvement in AI transactional Net Promoter Score and a 29 percentage-point gain in self-service rate over prior agent variants, alongside a strong correlation between offline simulation metrics and online outcomes, demonstrating that eval-driven development reliably predicts production impact. On most use cases, AI satisfaction reaches within a few percentage points of expert human agents.

20.
arXiv (CS.AI) 2026-06-24

CineCap: Structured Reasoning with Spatio-Temporal Anchors for Cinematographic Video Captioning

arXiv:2606.24636v1 Announce Type: new Abstract: Cinematographic captioning aims to describe how a video is filmed using professional film-language concepts such as camera movement, shot size, depth of field, composition, and shooting angle. This capability is important for fine-grained video understanding and controllable movie-quality video generation, yet remains underexplored in existing multimodal large language models. Unlike question-answering-based evaluation of cinematic understanding, cinematographic captioning requires a unified open-form description over multiple cinematographic dimensions. This task is challenging for two main reasons: the model must infer professional cinematographic concepts from subtle visual evidence, and it must generate captions that are both comprehensive and accurate. Accordingly, we propose CineCap, a framework that combines structured reasoning with spatio-temporal anchors and reinforcement learning with comprehensiveness, accuracy, and gated coverage rewards. The former grounds professional cinematographic descriptions in explicit visual evidence and organizes them into compact atomic reasoning for supervised fine-tuning, while the latter improves the balance between descriptive completeness and factual correctness. In addition, we construct CineCap Bench, a benchmark of 472 manually annotated video-caption pairs for systematic evaluation. Extensive experiments show that CineCap consistently outperforms strong proprietary and open-source baselines, establishing a new state of the art for cinematographic captioning. The code, model checkpoint, and benchmark are publicly available in https://github.com/Hectormxy/CineCap.git.

21.
arXiv (CS.CV) 2026-06-12

Selecting Samples on Graphs: A Unified Dataset Pruning Framework for Lossless Training Acceleration

The rapid growth of modern training datasets has significantly increased computational cost, motivating dataset pruning~(DP) methods which retain only a subset of informative samples to reduce training cost. Existing pruning criteria typically rely on either intrinsic signals that assess samples independently or extrinsic signals that promote diversity via pairwise relations. While effective in their own specific regimes, each captures only one aspect of sample utility and lacks robustness across different pruning ratios or data distribution. In this work, we present a unified graph-based DP framework. By modeling the dataset as a weighted graph, where node weights encode intrinsic value and edge weights encode extrinsic value, DP can be cast as a Maximum Weight Clique Problem (MWCP). Although MWCP is NP-hard, its structure admits a principled greedy solution based on sample-wise marginal gains. Under a few mild conditions, we further prove that this unified objective enjoys a formal approximation guarantee, which applies to a broad family of importance metrics and provides practical design guidelines. Extensive experiments show that our method outperforms existing DP methods while substantially reducing training cost, reducing training time by over 40\% without sacrificing accuracy on ImageNet-1k with ResNet-50.

22.
medRxiv (Medicine) 2026-06-11

Corticospinal tract risk modifies motor recovery after minimally invasive surgery for intracerebral hemorrhage: a secondary analysis of MISTIE-III

Objective: Outcome after surgical hematoma evacuation for intracerebral hemorrhage (ICH) depends on hematoma location. As corticospinal tract (CST) integrity affects motor recovery after stroke, we hypothesized that CST integrity drives heterogeneity in surgical outcomes and investigated this in a secondary analysis of MISTIE-III participants. Methods: Risk of CST injury was categorized into four levels, based on the interaction between the CST, the hematoma, and perihematomal edema (PHE) on automatically segmented stability CT: no risk, PHE infiltration, hematoma infiltration, and complete interruption of the CST. Associations with outcome were tested using multivariable linear regression for motor National Institutes of Health Stroke Scale (NIHSS) at day 180 and ordinal regression for modified Rankin Scale (mRS) at day 365, introducing an interaction term between CST risk and treatment group. Results: Day 180 motor NIHSS was significantly lower for 'no risk' ({beta}:-3.77, [95% confidence interval [CI]: -5.8 to -1.70], p=0.0003) and 'PHE infiltration' ({beta}:-2.3, [95%CI: -3.5 to -1.1]; p=0.0002) vs. 'complete interruption'. Surgery was associated with lower Day 180 motor NIHSS in participants with hematoma infiltration ({beta}:-2.07, [95%CI: -3.8 to -0.4], p=0.016). Compared to complete interruption, 'no risk' (adjusted odds ratio [aOR]:0.27, [95%CI: 0.10 to 0.74], p=0.01) and 'PHE infiltration' (aOR:0.41, [95%CI: 0.23 to 0.74]; p=0.003) were associated with lower odds of unfavorable day 365 mRS. Surgery was associated with lower mRS in participants with no risk (aOR:0.23, [95%CI: 0.05 to 0.97, p=0.045). Interpretation: Increasing CST risk is associated with worse motor recovery (day 180) and disability (day 365). CST risk modifies the effect of the MISTIE-III procedure on motor recovery and disability.

23.
arXiv (CS.AI) 2026-06-18

A Distributionally Robust Reinforcement Learning Framework for Constrained Urban EV Dispatch

arXiv:2604.25848v2 Announce Type: replace Abstract: We study city-scale control of electric-vehicle (EV) ride-hailing fleets where dispatch, repositioning, and charging decisions must respect charger and feeder limits under uncertain, spatially correlated demand and travel times. We formulate the problem as a hex-grid semi-Markov decision process (semi-MDP) with mixed actions – discrete actions for serving, repositioning, and charging, together with continuous charging power – and variable action durations. To guarantee physical feasibility during both training and deployment, the policy learns over high-level intentions produced by a masked, temperature-annealed actor. These intentions are projected at every decision step through a time-limited rolling mixed-integer linear program (MILP) that strictly enforces state-of-charge, port, and feeder constraints. To mitigate distributional shifts, we optimize a Soft Actor-Critic (SAC) agent against a Wasserstein-1 ambiguity set with a graph-aligned Mahalanobis ground metric that captures spatial correlations. The robust backup uses the Kantorovich-Rubinstein dual, a projected subgradient inner loop, and a primal-dual risk-budget update. Our architecture combines a two-layer Graph Convolutional Network (GCN) encoder, twin critics, and a value network that drives the adversary. Experiments on a large-scale EV fleet simulator built from NYC taxi data show that PD-RSAC achieves the highest net profit, reaching \$1.22M, compared with \$0.58M-\$0.70M for strong heuristic, single-agent RL, and multi-agent RL baselines, including Greedy, SAC, MAPPO, and MADDPG, while maintaining zero feeder-limit violations.

25.
medRxiv (Medicine) 2026-06-22

AI-driven Multimodal Representation Learning for Latent Mediation Structure Discovery of Socioeconomic Disadvantage, Psychosocial Factors, and Cardiometabolic Multimorbidity

Authors:

Social disadvantage is associated with multimorbidity, but the pathways linking social conditions to disease burden remain poorly understood. We developed an AI-driven multimodal mediation framework that integrates socioeconomic, psychosocial, clinical, laboratory, behavioral, and genomic data from the All of Us Research Program. Modality-specific variational autoencoders were used to derive latent representations of each data domain, and mediation analyses were subsequently performed in latent space to evaluate indirect associations between socioeconomic disadvantage, psychosocial factors, and multimorbidity. The final analytic cohort included 20,804 participants with complete multimodal data. Across 800 exposure–mediator–outcome combinations, mediation signals were concentrated within a small number of latent dimensions. The strongest indirect association linked a socioeconomic disadvantage dimension, a psychosocial vulnerability dimension, and a cardiometabolic multimorbidity dimension (NIE = 0.002517). The psychosocial dimension was characterized by poorer mental health, greater loneliness, lower social well-being, and lower health literacy, whereas the outcome dimension was associated with hypertension, diabetes, hyperlipidemia, obesity, chronic kidney disease, and heart disease. Bootstrap analyses supported the stability of the leading pathway. These findings suggest that psychosocial vulnerability may contribute to the association between socioeconomic disadvantage and cardiometabolic multimorbidity. More broadly, the proposed framework illustrates how AI-based representation learning can be used to investigate complex relationships across high-dimensional multimodal health data.