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01.
arXiv (CS.CL) 2026-06-12

EvoBrowseComp: Benchmarking Search Agents on Evolving Knowledge

Search Agents – large language models augmented with search tools – have intensified the need for future-proof evaluation benchmarks. Existing benchmarks such as BrowseComp rely on static knowledge, making them vulnerable to test-set contamination and parametric memorization. Consequently, models can achieve high scores through fact recall rather than genuine retrieval, obscuring true browsing competence via reasoning shortcuts. In this paper, we introduce EvoBrowseComp, an evolving benchmark of 400 English and 400 Chinese contamination-free complex questions synthesized via live-web traversal. To collect these questions, we design a three-agent collaborative framework: (1) a QA synthesis agent that retrieves fresh knowledge from the live web to synthesize QA pairs; (2) an information filtering agent that filters retrieved knowledge in terms of credibility and popularity to block parametric shortcuts; and (3) a high-level guidance agent that formalizes questions into reasoning graphs to reduce logical redundancy and shortcuts in synthesized QA pairs. Because the framework supports fully automated synthesis, EvoBrowseComp can be regularly updated to prevent data contamination and maintain temporal freshness. Extensive experiments confirm its great difficulty, requiring broad horizontal search. It establishes a scalable paradigm for auto-updatable, high-difficulty benchmarking that keeps pace with both evolving world knowledge and advancing agent capabilities.

02.
arXiv (CS.LG) 2026-06-19

The Hidden Cost of Approximation in Online Mirror Descent

arXiv:2511.22283v2 Announce Type: replace Abstract: Online mirror descent (OMD) is a fundamental algorithmic paradigm that underlies many algorithms in optimization, machine learning and sequential decision-making. The OMD iterates are defined as solutions to optimization subproblems which, oftentimes, can be solved only approximately, leading to an inexact version of the algorithm. Nonetheless, existing OMD analyses typically assume an idealized error free setting, thereby limiting our understanding of performance guarantees that should be expected in practice. In this work we initiate a systematic study into inexact OMD, and uncover an intricate relation between regularizer smoothness and robustness to approximation errors. When the regularizer is uniformly smooth, we establish a tight bound on the excess regret due to errors. Then, for barrier regularizers over the simplex and its subsets, we identify a sharp separation: negative entropy requires exponentially small errors to avoid linear regret, whereas log-barrier and Tsallis regularizers remain robust even when the errors are only polynomial. Finally, we show that when the losses are stochastic and the domain is the simplex, negative entropy regains robustness-but this property does not extend to all subsets, where exponentially small errors are again necessary to avoid suboptimal regret.

03.
PLOS Medicine 2026-05-08

Optimal minimal residual disease threshold in pediatric acute myeloid leukemia: A retrospective cohort study based on the TARGET database

Authors:

by Xiong-yu Liao, Hong Zheng, Jian-pei Fang, Dun-hua Zhou, Kun-yin Qiu Background Minimal residual disease (MRD) monitoring is a cornerstone of risk stratification in pediatric acute myeloid leukemia (AML), with a threshold of 0.1% conventionally defining positivity by flow cytometry. Advances in flow cytometric technologies, enabling detection of leukemic cells with higher sensitivity and specificity, warrant a reevaluation of whether a lower threshold improves prognostic accuracy. Methods and findings We conducted a retrospective cohort study using data from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET)-AML initiative. The study population comprised 1,205 pediatric patients with de novo AML treated across Children’s Oncology Group (COG) clinical trial centers. Patients were enrolled between September 1996 and December 2016, with a median follow-up of 6.2 years (range: 0.5–20.1 years). The primary objective was to compare the prognostic performance of the traditional MRD threshold (≥0.1%) with a lower threshold (≥0.05%) after induction courses 1 and 2. The main outcome measure was 5-year event-free survival (EFS). Analyses included Kaplan−Meier survival estimates, Cox proportional hazards models to calculate hazard ratios (HR) with 95% confidence intervals (CI), receiver operating characteristic (ROC) curves, and net reclassification improvement (NRI). The optimal threshold for predicting 5-year EFS, determined by ROC analysis, was 0.05% after both induction course 1 (AUC: 0.840, 95%CI[0.76,0.88]) and course 2 (AUC: 0.854, 95%CI[0.78,0.89]). The 0.05% threshold demonstrated higher HR for the first event than the 0.1% threshold (after course 1: HR = 2.8, 95%CI[2.3,3.3]; P 

04.
arXiv (quant-ph) 2026-06-16

Fully Quantum Algorithm for the 1-dimensional linear Lattice Boltzmann Method

arXiv:2606.16514v1 Announce Type: new Abstract: A fully quantum algorithm for solving the one-dimensional linear advection-diffusion equation using the Lattice Boltzmann method as a numerical procedure is presented in this work. We start by presenting a state of the art of the current usage of quantum algorithms for solving ordinary and partial differential equations. We then describe two algorithms for the one-dimensional Lattice Boltzmann method with two degrees of freedom. The first one is an existing hybrid quantum-classical algorithm with measurements at each time step, and the second one is our improved version, viz. a fully quantum algorithm where only one measurement is needed at the end of the algorithm. The fully quantum algorithm is first executed on a quantum simulator and then compared with a classical approach. Subsequently, the fully quantum algorithm is run on a quantum system with 133 qubits to investigate the effect of noise and the depth of the circuit on the output state. We find fluctuations in the final result due to the decoherence noise of the qubits.

05.
arXiv (CS.CL) 2026-06-11

A Controlled Study of Decoding-Time Truthfulness Methods on Instruction-Tuned LLMs

Authors:

In this work, we introduce CHAIR (Classifier of Hallucination As ImproveR), a supervised framework for detecting hallucinations by analyzing internal logits from each layer of every token. Our method extracts a compact set of features such as maximum, minimum, mean, standard deviation, and slope-from the token logits across all layers, enabling effective hallucination detection without overfitting. Experiments on TruthfulQA and MMLU datasets demonstrate that CHAIR significantly improves detection accuracy, particularly in zero-shot scenarios, showcasing its robustness and generalizability. Beyond hallucination detection, CHAIR highlights the potential of using internal representations for designing advanced decoding strategies. By leveraging patterns in logits, we suggest that more sophisticated models and adaptive decoding methods could further reduce hallucinations and enhance text completion quality. CHAIR not only offers a practical solution for detecting hallucinations but also lays the groundwork for exploring richer representations in LLMs to improve their factuality and coherence.

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

Findings of the MAGMaR 2026 Shared Task

This overview paper presents the results of the shared task for the second workshop on Multimodal Augmented Generation via Multimodal Retrieval (MAGMaR). In this shared task participants submitted systems focused on either (i) video retrieval or (ii) grounded generation of articles given retrieved videos. Teams could submit to either task. For the retrieval task, we had 2 participating teams that submitted a total of 17 systems – all of which beat a baseline derived from the winner of last year's shared task. On the generation side, we had 4 teams submit 16 systems. All teams had at least one generated report that was labeled the best by a human annotator.

07.
arXiv (math.PR) 2026-06-16

Logarithmic Large Deviations for Heavy-Tailed Sums

arXiv:2606.16487v1 Announce Type: new Abstract: We establish logarithmic large-deviation bounds for sums of independent nonnegative random variables with regularly varying tails. The normalization is chosen at the extreme-value scale and the speed is $\log n$. In contrast with Cramér's theorem, the resulting rate function is determined only by the tail index. The proof transfers a maximum large-deviation principle to sums in the one-big-jump region.

08.
arXiv (CS.LG) 2026-06-16

Scalable Graph Condensation with Evolving Capabilities

arXiv:2502.17614v3 Announce Type: replace Abstract: The rapid growth of graph data creates significant scalability challenges as most graph algorithms scale quadratically with size. To mitigate these issues, Graph Condensation (GC) methods have been proposed to learn a small graph from a larger one, accelerating downstream tasks. However, existing approaches critically assume a static training set, which conflicts with the inherently dynamic and evolving nature of real-world graph data. This work introduces a novel framework for continual graph condensation, enabling efficient updates to the distilled graph that handle data streams without requiring costly retraining. This limitation leads to inefficiencies when condensing growing training sets. In this paper, we introduce GECC (\underline{G}raph \underline{E}volving \underline{C}lustering \underline{C}ondensation), a scalable graph condensation method designed to handle large-scale and evolving graph data. GECC employs a traceable and efficient approach by performing class-wise clustering on aggregated features. Furthermore, it can inherit previous condensation results as clustering centroids when the condensed graph expands, thereby attaining an evolving capability. This methodology is supported by robust theoretical foundations and demonstrates superior empirical performance. Comprehensive experiments including real world scenario show that GECC achieves better performance than most state-of-the-art graph condensation methods while delivering an around 1000$\times$ speedup on large datasets.

09.
arXiv (CS.AI) 2026-06-16

PrologMCP: A Standardized Prolog Tool Interface for LLM Agents

arXiv:2606.14935v1 Announce Type: new Abstract: Frontier reasoning-tuned language models still fail on deductive tasks at depth, and the cost of improved performance through extended internal reasoning scales poorly. Symbolic delegation offers a complementary route: a language model translates the problem, while a solver performs the inference. However, current autoformalization pipelines for logic programming are typically bespoke integrations tied to particular tasks or agents. We introduce PrologMCP, a task-agnostic, open-source server that exposes Prolog as a stateful tool through the Model Context Protocol (MCP). Its compact tool interface, structured error reporting, and per-session isolation make the translate-run-inspect-repair loop a reusable primitive for MCP-capable agents. We evaluate a formalizer agent enhanced with PrologMCP against standard and reasoning LLMs (Claude Sonnet 4.6, GPT-4.1, and o4-mini) on two subsets of PARARULE-Plus: a general-purpose sample and a more challenging one targeting a specific failure mode of natural-language reasoning. On the general sample, the formalizer matches or exceeds reasoning LLMs (accuracy 1.00 vs.\ 1.00 / 0.998), with the largest gains over standard models (0.762 for GPT-4.1). On the challenging subset, the formalizer remains near-perfect (1.00 / 0.99) while reasoning LLMs drop to 0.95 / 0.94. These results suggest that delegating inference to Prolog via MCP is a robust and inspectable alternative to extended natural-language reasoning.

10.
arXiv (CS.LG) 2026-06-12

WHAR Arena: Benchmarking the State of the Art in Efficient Wearable Human Activity Recognition

arXiv:2606.13194v1 Announce Type: new Abstract: Deep learning has become the dominant paradigm in Wearable Human Activity Recognition (WHAR), yet progress is obscured by a comparability crisis. Results are often reported using inconsistent datasets, custom data processing, and varying evaluation protocols, making state-of-the-art claims fragile. We address this with a large-scale, open-source benchmark that integrates 30 diverse datasets under standardized processing, unified model interfaces, and a shared cross-subject evaluation protocol. Evaluating 17 representative architectures across 4760 training runs, we jointly measure predictive performance alongside on-device latency, peak memory, and model size on an Android reference device. Our results reveal that the WHAR state of the art is distributed rather than dominated by a single architecture. While CNN-HAR achieves the highest mean macro-F1, top-performing models cluster tightly, indicating contemporary architectures have converged near a predictive performance ceiling. When accounting for deployment efficiency, compact neural models, such as TinierHAR, and classical Random Forests define the practically relevant Pareto frontier, whereas larger recurrent and hybrid models incur high hardware costs without corresponding performance gains. Consequently, while predictive performance has plateaued, substantial potential for future progress remains in optimizing deployment efficiency and improving adaptation to domain shifts. We release our full framework to support transparent reuse and extension.

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

Apertus LLM Family Expansion via Distillation and Quantization

arXiv:2605.29128v2 Announce Type: replace Abstract: The wide adoption of LLMs has led to their use in great variety of applications and scenarios, such as chatbot assistants and data annotation, creating the need for the models to satisfy certain budget and hardware constraints. This has led to the trend of LLMs being released in batches consisting of similar models of various sizes for the family of models to adhere to as wide of a range of constraints as possible. In this paper, we validate distillation and quantization as a cost-effective way to expand model families to new sizes and hardware formats. Based on the open-recipe Apertus 8B LLM, we produce Apertus-v1.1 - a distilled family of models with up to 4B parameters trained on 1.7T permissive license tokens. We demonstrate cost-efficiency and strong accuracy performance of our approach for covering large ranges of hardware and systems requirements.

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

Prompt, Plan, Extract: Zero-Shot Agentic LLMs Workflows for Lung Pathology Extraction from Clinical Narratives

Information extraction from pathology reports is essential for cancer staging, tumor registry population. Yet key data remains embedded in narrative reports, making manual extraction labor-intensive and error-prone. Traditional supervised Natural Language Processing pipelines address this through fully supervised Named Entity Recognition and Relation Extraction, but require expensive manual annotation and suffer cascading failures when upstream entities are missed. In this study, we developed a zero-shot, agentic workflow, and evaluated five open-source generative Large Language Models (LLMs) to populate 13 College of American Pathologists synoptic fields from lung resection pathology reports. We compared them against a state-of-the-art supervised GatorTron NER-RE baseline using a novel, registry-aligned evaluation framework. The baseline achieved Micro-F1of 0.960, while the best zero-shot model (GPT-OSS-20B) achieved Micro-F1 of 0.893 (recall: 0.949), accurately extracting complex relations like Pathologic Stage without task-specific training. These results suggest that open-source, zero-shot agentic LLMs are a low-cost solution for extracting lung pathology information.

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

Reinforcement Learning for LLM-based Event Forecasting

arXiv:2606.15917v1 Announce Type: new Abstract: We use Group Relative Policy Optimization (GRPO), a recently devised sample and memory efficient reinforcement learning method, to finetune pretrained LLMs in the range of 1.5B to 14B parameters equipped with the ability to get current information through the use of a Wikipedia revisions tool, or news summaries, to forecast real events beyond the knowledge cutoff of the LLM, as well as problems made to simulate different aspects of the dynamics of that training. We use the results of these experiments to comment on the scaling capability of LLMs for forecasting, as well as classify how judgmental forecasting fits into the verifiable/unverifiable domain taxonomy, considering the impact of the inherent aleatoric uncertainty when forecasting future events (e.g. the roll of a die). As a result of the GRPO training, we manage to bring a 1.5B parameter transformer (Qwen 2.5 1.5B) to forecasting performance superior to Claude Sonnet 3.5 over the same dataset as measured by cross entropy from the market agreed probabilities. We also discuss various dead ends on the path to this result.

14.
arXiv (quant-ph) 2026-06-19

On chip, multifunctional quantum sensing using single spins in a van der Waals crystal

arXiv:2606.19978v1 Announce Type: new Abstract: Nanoscale thermometry and magnetometry are in high demand across a wide range of scientific and technological applications. In this context, optically addressable spins in solids have emerged at the forefront of on-chip quantum sensing. However, simultaneous quantum sensing of multiple parameters (e.g., temperature and magnetic field) using the same spin sensor remains challenging due to cross-sensitivity to multiple physical quantities. Here, we demonstrate independent dual sensing of temperature and magnetic field using single quantum emitters in hexagonal boron nitride (hBN). We experimentally verify the independent response of the zero-phonon line (ZPL) position to temperature and of optically detected magnetic resonance (ODMR) to magnetic fields. Furthermore, we demonstrate local temperature sensing of a microcircuit while simultaneously measuring an external magnetic field. Our results establish quantum emitters in hBN as a robust platform for multifunctional quantum sensing under realistic operating conditions.

15.
arXiv (math.PR) 2026-06-17

Convergence Analysis of the Random Bisection Method

arXiv:2603.20483v2 Announce Type: replace-cross Abstract: We propose a generalized version of the bisection method where the cutting point between the two subintervals is chosen at random following an arbitrary distribution. We compute expected convergence rates with respect to any arbitrary a priori distribution for the position of the root in the initial interval and proved that it depends only on the the expectation $\mathbb{E}[c(1-c)]$ of the cut $c$. We also provide a generalization of the method for $K$ random cuts and study its convergence properties. Most probabilistic derivations are kept fairly simple for the ease of understanding of a larger audience. Our theoretical results are then validated numerically using statistical simulation.

16.
arXiv (CS.LG) 2026-06-18

Unlocking air traffic flow prediction through microscopic aircraft-state modeling

arXiv:2605.10083v2 Announce Type: replace Abstract: Short-term air traffic flow prediction in terminal airspace is essential for proactive air traffic management. Existing approaches predominantly model traffic flow as aggregated time series. However, traffic dynamics are governed by aircraft states and their interactions in continuous airspace. Such aggregation obscures fine-grained information, including aircraft kinematics, boundary interactions, and control intent. Here we present AeroSense, a state-to-flow modeling paradigm that predicts future traffic flow directly from instantaneous airspace situations represented as dynamic sets of aircraft states derived from ADS-B trajectories. By establishing an end-to-end mapping from microscopic aircraft states to future regional traffic flow, AeroSense preserves aircraft-level dynamics while naturally accommodating varying traffic density without relying on historical look-back windows. Experiments on a large-scale real-world dataset show that AeroSense exhibits admirable predictive accuracy and robustness over aggregation-based forecasting approaches, particularly during high-density traffic periods. These findings suggest that aircraft-state situation modeling provides a promising alternative to conventional time-series forecasting in air traffic flow management.

17.
arXiv (math.PR) 2026-06-15

Laws of Large Numbers for Non-Independent Random Variables on Hyperspaces with respect to the Hausdorff Metric

arXiv:2011.07199v5 Announce Type: replace Abstract: This paper investigates the limit behavior of the Minkowski sums for sequences of set-valued random variables. When the underlying space is finite dimensional, by using the support function, we establish the weak and strong laws of large numbers for non-independent random variables in the hyperspace with respect to the Hausdorff metric $d_H$.

18.
arXiv (quant-ph) 2026-06-15

Quantum Simulation of Spin-Dependent Electron Transfer in a Synthetic Chiral Lattice with a Trapped Ion

arXiv:2606.13930v1 Announce Type: new Abstract: Electron transfer through chiral structures can exhibit spin asymmetry, known as the chiral-induced spin selectivity effect, whose microscopic origin remains an open question. While path-interference within the chiral moiety has been proposed as a key mechanism, its experimental validation requires precise and versatile tunability of system parameters. Here we implement a programmable quantum simulation of spin-dependent electron transfer in a donor–chiral-bridge–acceptor model using a trapped ion. The bridge is encoded in internal states of the ion with tunable nearest- and next-nearest-neighbor couplings, while donor and acceptor states are coupled via a spectator bosonic motional mode. We observe spin-dependent interference within the bridge, and further reveal spin-dependence in donor-to-acceptor transfer dynamics, controlled by amplitude and phase of the coupling parameter. Our results identify interference among spin-dependent pathways as a microscopic origin of spin-dependent transfer, and open a route toward quantum simulations of complex chiral lattices with multi-level and bosonic degrees of freedom.

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

Through the PRISM: Preference Representation in Intermediate States of Video Diffusion Models

Evaluating video generation with clean, pixel-based reward models disconnects evaluation from the noisy diffusion process and incurs massive VAE decoding costs. In this paper, we challenge this paradigm by asking a fundamental question: Can a powerful video generator inherently discriminate preferences directly from noisy latents? To answer this, we introduce PRISM (Preference Representation in Intermediate States of Diffusion Models). PRISM employs a lightweight Query-based Aggregation head with a frozen video diffusion backbone to decode preference signals from noisy latents. Surprisingly, PRISM not only achieves SOTA preference accuracy but also unlocks strong noise-robustness, which enables early-stage Best-of-$N$ sampling. This allows for filtering suboptimal candidates at the very beginning of denoising, drastically reducing computation while boosting video quality. We also reveal a strong positive correlation between a backbone's generative performance and its inherent evaluative power, enabling self-improving video backbones.

20.
arXiv (quant-ph) 2026-06-12

Resourcefulness of non-classical continuous-variable quantum gates

arXiv:2410.09226v4 Announce Type: replace Abstract: In continuous-variable quantum computation, identifying key elements that enable a quantum computational advantage is a long-standing issue. Starting from the standard results on the necessity of Wigner negativity, we develop a comprehensive and versatile approach in which the techniques of $(s)$-ordered quasiprobabilities are exploited to provide rigorous statements on the simulability of photonic quantum circuits consisting of previously characterized gates and thereby identifying the contribution of each quantum gate to the potential achievement of quantum computational advantage. This is achieved by means of an analysis of the so-called transfer function, allowing us to highlight the resourcefulness of a gate set. As such this technique can be straightforwardly applied to current continuous-variables quantum circuits, while also constraining the tolerable amount of losses above which any potential quantum advantage can be ruled out. We use $(s)$-ordered quasiprobability distributions on phase-space to capture the non-classical features in the protocol, and focus our technique entirely on the ordering parameter $s$. This allows us to highlight the resourcefulness and robustness to loss of a universal set of unitary gates comprising three distinct Gaussian gates and any non-Gaussian unitary gate, providing important insight on the role of non-Gaussianity.

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

Erased but Not Forgotten: How Backdoors Compromise Concept Erasure

arXiv:2504.21072v3 Announce Type: replace-cross Abstract: The expansion of text-to-image diffusion models has raised concerns about harmful outputs, from fabricated depictions of public figures to sexually explicit imagery. To mitigate such risks, prior work has proposed concept erasure methods that aim to sever unwanted concepts from the model via fine-tuning, yet it remains unclear whether these approaches truly remove all links to the harmful concept or merely conceal superficial connections. In this work, we reveal a critical vulnerability, the Erasure Evasion Backdoor (EEB): an adversary binds a backdoor trigger to a concept slated for removal, and this malicious link survives subsequent erasure. We show that both black-box and white-box adversaries can instantiate this threat. Across six state-of-the-art erasure methods, including robust ones that explicitly search for alternative representations of the target concept, EEB consistently exposes harmful content: up to 82% success against celebrity-identity unlearning, up to 94% for object erasure, and up to 16 times amplification of explicit-content exposure. While EEB uncovers a blind spot in current erasure methods, it also provides a diagnostic tool for stress-testing future concept erasure techniques.

22.
arXiv (CS.AI) 2026-06-18

Externalizing Research Synthesis and Validation in AI Scientists through a Research Harness

arXiv:2606.18874v1 Announce Type: new Abstract: AI systems can increasingly automate scientific workflows, but the reasoning that links prior evidence, generated ideas, experiments and final claims often remains implicit inside model inference. Here we introduce Xcientist, a research harness that externalizes research synthesis and experimental validation into inspectable, contract-governed processes. Xcientist organizes literature evidence, idea states, implementation plans, ablation records and repair traces as persistent research artifacts, so that generated mechanisms can be grounded, executed, tested and revised without losing their evidential basis. We identify claim drift as a failure mode of automated research, where runnable artifacts no longer support the mechanism originally claimed. Across training-free memory systems, graph-structured traffic forecasting and multi-scale physics-informed neural networks, Xcientist preserves traceable trajectories from problem formulation to mechanism design, validation and bounded revision. These results suggest that AI scientists should be evaluated not only by their final artifacts, but by whether their synthesis and validation processes remain attributable, inspectable and scientifically accountable.

23.
arXiv (CS.LG) 2026-06-16

Learning Topological Representations for Molecular Dynamics

arXiv:2606.14737v1 Announce Type: cross Abstract: Molecular dynamics (MD) simulations generate trajectories in a high-dimensional configuration space whose analysis critically depends on molecular descriptors, typically handcrafted observables or learned kinetic embeddings. Designing descriptors that are both expressive and broadly applicable, however, remains challenging. We study persistent homology (PH) as a general-purpose representation for MD and introduce the masked Flood complex, a protein-tailored modification of a recently introduced simplicial complex construction that emphasizes inter-residue structure at low computational cost. Vectorized persistence diagrams then provide information-rich, geometry-aware summaries of protein conformations, which we evaluate on protein class prediction, frame-level observable regression, and Markov state model (MSM) estimation from learned low-dimensional coordinates in a single shared representation space. Results on the mdCATH dataset show that PH-based descriptors are competitive across tasks, with masked Flood PH yielding the most consistent overall performance. Further, when using topologically-informed MSMs as a drop-in replacement within the recent MarS-FM framework for generative modeling of protein conformations, we obtain consistently better ensemble statistics than MSMs based on physical observables. Finally, we explore the transferability of the generative model to qualitatively different, fast folding, proteins.

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

A Machine-Learned Comorbidity Index

arXiv:2606.17450v1 Announce Type: new Abstract: Traditional comorbidity scores (e.g., Charlson and Elixhauser) are widely used for risk adjustment and patient stratification, but they have two key limitations: (i) they are largely mortality-centric and do not align well with other clinical outcomes, and (ii) their linear, rule-based structure cannot capture nonlinear, outcome-specific risk relationships. We propose a Machine-Learned Comorbidity Index (MLCI) that maps diagnosis codes to a single scalar by maximizing the normalized Hilbert-Schmidt Independence Criterion (nHSIC) between the learned score and multiple clinical outcomes. MLCI captures nonlinear risk-outcome dependence and is supported by a theory that characterizes when a unified, informative admission-level ordering can be achieved across outcomes. Empirical results on multiple benchmark electronic health record (EHR) datasets show that MLCI outperforms strong baselines across multiple evaluation metrics.

25.
medRxiv (Medicine) 2026-06-15

Pulmonary extracellular vesicles drive alveolar macrophage dysfunction via microRNA transfer in Acute Respiratory Distress Syndrome

Background: Alveolar macrophage (AM) dysfunction contributes to Acute Respiratory Distress Syndrome (ARDS) pathogenesis. We investigated the role of extracellular vesicles (EVs) in mediating this dysfunction. Methods: Pulmonary EVs were isolated from broncho-alveolar lavage and non-directed bronchial lavage samples of ventilated sepsis patients with and without ARDS, and post-operative control patients via ultracentrifugation. AMs were isolated from lung tissue resections of lobectomy patients. AMs were treated with pooled EVs for 24 hours prior to functional, metabolic and autophagy profiling. EV cargo was profiled via small RNA transcriptomics and proteomics. Mechanistic role of EV microRNAs was assessed via mimic / antagomir transfection. Results: Pulmonary EVs from sepsis patients with ARDS impaired AM efferocytosis, and control EVs had no effect. ARDS EV treatment enhanced AM mitochondrial-linked respiration, but not glycolysis. ARDS EV treatment impaired LC3B-II and LAMP1 expression, indicating dysregulated AM autophagy-lysosomal machinery. Proteomics revealed downregulation of innate immune pathways in ARDS EVs. Transcriptomics revealed enrichment of 24 microRNAs in ARDS EVs; miR-652-3p was the most enriched, validated by RT-qPCR. EV miR-652-3p was associated with 90-day mortality (9.20 vs 0.59 RQ, p=0.0295) and inversely correlated with oxygenation (PaO2/FiO2). AM transfection with miR-652-3p mimic induced similar dysregulation of function and autophagy as ARDS EVs. Transfection of ARDS EVs with antagomirs to miR-652-3p prior to AM treatment partially rescued efferocytosis and autophagy. Conclusions: Targeting EV miR-652-3p may restore alveolar macrophage function and reduce excessive inflammation, thus offering a novel therapeutic strategy for patients with ARDS.