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01.
medRxiv (Medicine) 2026-06-23

Multivariate Echocardiographic Phenotyping of Hypertensive Heart Failure Using Unsupervised Machine Learning: A Pilot Study

Authors:
Onyemachi↗Maduka↗C. J↗

Background Heart failure in hypertensive patients is heterogeneous and poorly captured by traditional left ventricular ejection fraction (LVEF) based classification. Multivariate echocardiographic data combined with unsupervised machine learning may provide a more precise phenotypic characterization. This pilot study evaluated the feasibility of unsupervised clustering of routine transthoracic echocardiographic data to identify phenotypic subgroups of hypertensive heart failure. Methods This retrospective pilot study analyzed transthoracic echocardiography reports from hypertensive patients with clinical heart failure. After data cleaning and exclusion of incomplete records, 102 patients with 11 echocardiographic variables were included. Variables describing left ventricular geometry, systolic function, and diastolic performance were standardized and subjected to K-means clustering. Optimal cluster number was determined using the elbow method and silhouette analysis. Cluster characteristics were assessed using descriptive statistics and Kruskal Wallis testing. Concordance with LVEF based heart failure categories was evaluated. Results Three distinct echocardiographic phenotypes were identified. Cluster 0 (n = 50) demonstrated preserved LVEF with concentric remodeling, consistent with heart failure with preserved ejection fraction (HFpEF) phenotype. Cluster 1 (n = 37) showed marked ventricular dilation and reduced systolic function, consistent with heart failure with reduced ejection fraction (HFrEF). Cluster 2 (n = 15) exhibited concentric hypertrophy with intermediate LVEF, consistent with heart failure with mildly reduced ejection fraction (HFmrEF) like phenotype. All echocardiographic variables differed significantly across clusters (p < 0.001). While Cluster 0 showed strong concordance with HFpEF (96%), Clusters 1 and 2 demonstrated substantial overlap across LVEF categories, indicating partial discordance between structural phenotypes and LVEF based classification. Conclusion Application of unsupervised machine learning to routine echocardiographic data identifies distinct heart failure phenotypes in hypertensive patients. These phenotypes demonstrate significant structural heterogeneity beyond LVEF based classification, supporting the utility of data-driven approaches for refined cardiac phenotyping. This pilot study provides a foundation for larger prospective studies.

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02.
arXiv (CS.LG) 2026-06-18

Pointwise is Pointless? A Multimodal Ablation Study for Precipitation Nowcasting with Graph Neural Networks

Authors:
Oph\'elia Miralles↗M\'at\'e Mile↗Christoffer Artturi↗Thomas Nipen↗Ivar Seierstad↗

arXiv:2606.18436v1 Announce Type: cross Abstract: Sparse point observations are increasingly available for precipitation nowcasting, but it is unclear how much they improve dense radar-field forecasts. We partially address this question with a multimodal graph neural network nowcasting system over the Nordic radar domain. The model predicts rain rate every five minutes up to two hours ahead and is trained with different combinations of radar history, MEPS numerical weather prediction, Netatmo surface observations, MSG satellite channels, stochastic noise, and CRPS-based ensemble losses. The study is designed as an ablation of operationally relevant information sources and training objectives. We compare radar-only, NWP-informed, station-informed, satellite-informed, noise-augmented, and CRPS-based configurations using complementary diagnostics on the radar grid, at station locations, for rain onset, and through oracle, displacement, and amplitude scores. The results show that each source improves a different part of the forecast problem. MEPS stabilises radar-only extrapolation, Netatmo observations improve local station and onset diagnostics, and satellite predictors reduce some station-level biases but may activate rain too early when used deterministically. CRPS-based configurations provide the most consistent radar-grid gains, while the combined satellite and CRPS setup gives the best overall oracle/DAS score. These results do not support the conclusion that point observations are uninformative for nowcasting, but they show that local observational skill and spatially coherent radar-field skill are distinct targets. The practical implication is that sparse observations can provide useful local constraints, but their benefit for radar-like fields depends on the training loss, uncertainty representation, and how observation support is encoded in the model.

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03.
arXiv (CS.CV) 2026-06-11

RelayFormer: A Unified Local-Global Attention Framework for Scalable Image and Video Manipulation Localization

Authors:
Wen Huang↗Jiarui Yang↗Tao Dai↗Jiawei Li↗Shaoxiong Zhan↗Bin Wang↗Shu-Tao Xia↗

Visual manipulation localization (VML) aims to identify tampered regions in images and videos, a task that has become increasingly challenging with the rise of advanced editing tools. Existing methods face two central issues. The first is resolution diversity. Resizing or padding can distort subtle forensic cues and introduce unnecessary computational cost. The second is the difficulty of extending spatial models for images to spatio-temporal inputs in videos, which often results in maintaining separate architectures for the two data types. To address these challenges, we propose RelayFormer, a unified framework that adapts to varying resolutions and naturally handles both static and temporal visual data. RelayFormer partitions inputs into fixed-size sub-images and introduces Global Local Relay (GLR) tokens that propagate structured context through a relay-based attention mechanism. This design enables efficient exchange of global cues, such as semantic or temporal consistency, while preserving fine-grained manipulation artifacts. Unlike prior approaches that depend on uniform resizing or sparse attention, RelayFormer scales to variable resolutions and video sequences with minimal overhead. Experiments across diverse benchmarks demonstrate superior performance and strong efficiency, combining resolution adaptivity without interpolation or excessive padding, unified processing for images and videos, and a favorable balance between accuracy and computational cost. Code is available at~\href{https://github.com/WenOOI/RelayFormer}{https://github.com/WenOOI/RelayFormer}.

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04.
arXiv (CS.AI) 2026-06-12

Structured vs. Unstructured Pruning: An Exponential Gap

Authors:
Davide Ferre'↗Fr\'ed\'eric Giroire↗Frederik Mallmann-Trenn↗Emanuele Natale↗

arXiv:2603.02234v3 Announce Type: replace-cross Abstract: The Strong Lottery Ticket Hypothesis (SLTH) states that large, randomly initialized neural networks contain sparse subnetworks capable of approximating a target function at initialization without training, suggesting that pruning alone is sufficient. Pruning methods are typically classified as unstructured, where individual weights can be removed from the network, and structured, where parameters are removed according to specific patterns, as in neuron pruning. Existing theoretical results supporting the SLTH rely almost exclusively on unstructured pruning, showing that logarithmic overparameterization suffices to approximate simple target networks. In contrast, neuron pruning has received limited theoretical attention, despite its practical appeal for direct hardware speedups. In this work, we consider the problem of approximating a single bias-free ReLU neuron by pruning hidden units of a randomly initialized two-layer ReLU network, effectively isolating the intrinsic limitations of neuron pruning. We show that achieving an $\varepsilon$-approximation requires a starting network size of $\Omega(1/\varepsilon)$ for neuron pruning, whereas weight pruning succeeds with only $O(\log(1/\varepsilon))$ hidden units, revealing an exponential separation between the two approaches.

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05.
arXiv (CS.CL) 2026-06-25

Error-Aware TF-IDF Retrieval-Augmented Generation for ASR Error Correction

Authors:
Mohammad Aref Jafari-Raddani↗

End-to-end automatic speech recognition systems frequently hallucinate rare entities and domain-specific terms, especially in low-resource languages. While retrieval-augmented generation frameworks can mitigate these errors using large language models, current architectures face significant challenges. They either rely on standard sparse retrieval that ignores phonetic misrecognitions or utilize heavyweight cross-modal embeddings that introduce high latency. This letter proposes a highly efficient, purely lexical error-aware framework designed to explicitly resolve phonetic and loop hallucinations. Our approach integrates a symmetric text normalization module with a novel error-aware term frequency-inverse document frequency algorithm. By constructing a sparse diagonal penalty matrix based on historical errors, the retriever mathematically prioritizes corrective documents containing specific high-risk misrecognitions. Evaluated on the Persian subset of the FLEURS dataset, our method increased the error-aware hit rate from 53.7% to 90.9%. In end-to-end evaluations, the integrated framework reduced the final word error rate from 23.06% to 18.83%, achieving significant accuracy gains with near-zero inference latency.

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07.
arXiv (CS.LG) 2026-06-11

APEX: A Network-Native Time-Series Foundation Model for Forecasting and Anomaly Detection for Wireless Edge Operations

Authors:
Swadhin Pradhan↗Niloo Bahadori↗Peiman Amini↗

arXiv:2606.11553v1 Announce Type: new Abstract: Generic time-series foundation models transfer poorly to wireless network telemetry whose signals are bursty, zero-inflated, and coupled across protocol layers. We present APEX, a network-native, decoder-only transformer for forecasting enterprise AP telemetry, and evaluate it on DHCP degradation as a representative network task. APEX is pre-trained on 10-channel multivariate telemetry from ~4,500 production wireless networks (~100K AP time series, 34 metrics per AP), and is available as APEX-Large (269M, cloud) and APEX-Edge (10.5M, edge). On a 192-step (4-day) DHCP degradation benchmark, APEX-Large reduces MAE by 18% over the strongest foundation-model baseline (Toto) and 38% over SARIMA, with anomaly-detection F1 = 0.93, while APEX-Edge enables sub-second, privacy-preserving inference on AP-class edge hardware. These results suggest network-native pre-training is a practical foundation for proactive wireless operations.

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08.
arXiv (CS.CV) 2026-06-24

Multilevel Stochastic Plug-and-Play for Sparse-View CT Reconstruction

Authors:
Antoine De Paepe↗Alexandre Bousse↗Dimitris Visvikis↗

Sparse-view computed tomography (SVCT) reduces radiation exposure and acquisition time, but the limited number of projection views makes the reconstruction problem severely ill-posed and leads to streak artifacts when analytical methods are used. Plug-and-Play (PnP) methods provide an effective way to combine data fidelity with learned image priors, while stochastic PnP methods further improve robustness by matching the denoiser input distribution through re-noising. However, these methods often require many iterations to converge, which limits their practical efficiency. In this work, we propose a multilevel (ML) stochastic PnP method for SVCT that accelerates stochastic PnP reconstruction. We highlight that, in the stochastic setting, directly enforcing prior coherence across levels would require accurately estimating fine-level prior gradients through multiple denoiser function evaluations, which substantially increases the computational cost. Motivated by this observation, we perform the multilevel steps in multiresolution analysis (MRA) approximation spaces. This choice is supported by the structure of the wavelet decomposition, which causes the prior-coherence correction to vanish in expectation, thereby avoiding costly estimation of fine-level stochastic prior gradients for the coarse-level corrections. Experiments on SVCT reconstruction show that our method, called Multilevel Stochastic Plug-and-Play (ML-SPnP), achieves reconstruction quality comparable to state-of-the-art methods while substantially reducing runtime.

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09.
arXiv (quant-ph) 2026-06-19

Indefinite Quantum Causality

Authors:
Fabio Costa↗Giulia Rubino↗Cyril Branciard↗\v{C}aslav Brukner↗Marco T\'ulio Quintino↗

arXiv:2606.19438v1 Announce Type: new Abstract: In recent years, operational approaches to quantum foundations have been developed as a means of understanding the core principles and distinctive features of quantum theory. Such approaches typically view physical processes as sequences of operations, with earlier operations serving as causes of later effects. However, a growing literature is emerging on the possibility of relaxing this assumption and allowing for quantum indefiniteness in the causal order. This development stems from a variety of motivations, both fundamental and applied, including exploring the role of causality in quantum theory, the interplay between quantum theory and general relativity, and higher-order quantum computing. A prominent offshoot of this development is the emergence of indefinite causal order as a feasible resource for quantum information processing. This review provides an overview of the current state of the art in the field, covering the methodology underlying indefinite quantum causality within the so-called "process matrix formalism", outlining key results and experimental implementations, and discussing recent advances.

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10.
arXiv (CS.CL) 2026-06-25

Hitting a Moving Target: Test-Time Adaptation for AI Text Detection under Continual Distribution Shift

Authors:
Kevin Ren↗Manish Raghavan↗Nikhil Garg↗

Deployed approaches for AI text detection often rely on training-time access to labeled datasets of both human-written and AI-generated text. This approach is vulnerable to three types of distribution shifts that occur continually post-deployment, and for which labeled data is often unavailable: adversarial humanization, new LLMs being released, and temporal drift in human writing. Simultaneously, existing approaches do not leverage a key signal of LLM usage: inference-time homogeneity. We propose a test-time adaptation (TTA) approach, using semi-supervised learning, that adapts to distribution shifts by leveraging homogeneity among unlabeled samples observed at inference time. Empirically, we find that state-of-the-art supervised detectors systematically fail when they encounter distribution shifts in AI-generated and human writing, both adversarial and natural, while test-time adaptation with semi-supervised learning is largely robust; e.g., the commercial model Pangram detects just 24.1% of our adversarial AI-generated text, compared to 90.5% for our test-time approach. We establish that test-time adaptation is a promising framework for AI text detection in the wild. We publicly release our code (which includes code for model training, evaluation, and plots) at https://github.com/kkr36/llm_detection.

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11.
medRxiv (Medicine) 2026-06-23

Associations Among Changes in Inflammatory Biomarkers, Pain Intensity, and Health-Related Quality of Life Following a 12-Week Aerobic Exercise Programme in Individuals with Non-Specific Chronic Low Back Pain

Authors:
Nweke↗V. C↗Fatai↗K. E↗Madume↗A. K↗Ojukwu↗C. P↗Onyekwelu↗A. I↗Nwosu↗A. O↗…

Abstract Background: Non-specific chronic low back pain (NSCLBP) is associated with persistent pain, reduced health-related quality of life (HRQoL), and low-grade systemic inflammation. This study examined associations among changes in inflammatory biomarkers, pain intensity, and HRQoL following a 12-week aerobic exercise programme. Methods: This secondary analysis used data from a randomized controlled trial involving 41 participants with NSCLBP (intervention, n = 21; control, n = 20). Participants received either supervised aerobic exercise plus health education or health education alone for 12 weeks. Change scores for tumour necrosis factor-alpha (TNF-), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), pain intensity, and HRQoL domains were analysed using correlation and multiple regression analyses. Results: Improvements in IL-6 (r = 0.434, p = 0.005) and hs-CRP (r = 0.444, p = 0.004) were significantly associated with improvements in pain intensity. No significant associations were observed between biomarker changes and HRQoL domains. Treatment allocation was the strongest independent predictor of improvement in physical HRQoL ({beta} = 0.492, p = 0.017) and pain intensity ({beta} = -0.512, p = 0.006). Conclusions: Improvements in IL-6 and hs-CRP were associated with reductions in pain intensity but not with improvements in HRQoL. Treatment allocation was the strongest predictor of clinical improvement, suggesting that mechanisms beyond systemic inflammation may contribute to the benefits of aerobic exercise in NSCLBP. Keywords: non-specific chronic low back pain; aerobic exercise; inflammation; interleukin-6; high-sensitivity C-reactive protein; pain intensity; health-related quality of life.

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12.
arXiv (CS.CV) 2026-06-16

Uncertainty Quality of VGGT: An Analysis on the DTU Benchmark Dataset

Authors:
Markus Hillemann↗Robert Langend\"orfer↗Steven Landgraf↗Markus Ulrich↗

Visual Geometry Grounded Transformer (VGGT) has already attracted a great deal of attention in a short period of time, not least due to the Best Paper Award at CVPR-2025. Similar to DUSt3R and MASt3R, VGGT aims to bring about a paradigm shift by replacing established methods like bundle adjustment and feature matching with a simple, unified, feed-forward neural network that predicts camera poses, depth maps, and dense 3D structure directly from multiple images of a scene in a few seconds. A key aspect is its ability to process an arbitrary number of views consistently in a single forward pass without any post-processing or iterative optimization. For photogrammetry, this opens new possibilities for real-time, scalable, and accessible 3D reconstruction. In this context, not only high reconstruction accuracy but also high-quality uncertainty estimates are crucial, as they foster trust and enable robust quality assurance. This paper therefore investigates the quality of VGGT's uncertainty predictions. The analysis identifies an effective confidence threshold for filtering VGGT's raw output and demonstrates that enhancing uncertainty quality holds strong potential for improving the accuracy of its 3D reconstructions.

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13.
arXiv (CS.AI) 2026-06-19

Enhancing Generative Auto-bidding with Offline Reward Evaluation and Policy Search

Authors:
Zhiyu Mou↗Yiqin Lv↗Miao Xu↗Qi Wang↗Yixiu Mao↗Jinghao Chen↗Qichen Ye↗Chao Li↗Rongquan Bai↗Chuan Yu↗Jian Xu↗Bo Zheng↗…

arXiv:2509.15927v5 Announce Type: replace-cross Abstract: Auto-bidding is a critical tool for advertisers to improve advertising performance. Recent progress has demonstrated that AI-Generated Bidding (AIGB), which learns a conditional generative planner from offline data, achieves superior performance compared to typical offline reinforcement learning (RL)-based auto-bidding methods. However, existing AIGB methods still face a performance bottleneck due to their inherent inability to explore beyond the static dataset with feedback. To address this, we propose AIGB-Pearl (Planning with \textbf{EvaluAtor via RL}), a novel method that integrates generative planning and policy optimization. The core of AIGB-Pearl lies in constructing a trajectory evaluator to assess the quality of generated scores and designing a provably sound KL-Lipschitz-constrained score-maximization scheme to ensure safe and efficient exploration beyond the offline dataset. A practical algorithm that incorporates the synchronous coupling technique is further developed to ensure the model regularity required by the proposed scheme. Extensive experiments on both simulated and real-world advertising systems demonstrate the state-of-the-art performance of our approach.

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14.
medRxiv (Medicine) 2026-06-12

Does the method matter? Evaluating the effectiveness, efficiency and ease of hearing-aid gain self-adjustment

Authors:
Benecke↗Whitmer↗W. M↗

In conventional hearing-aid personalisation, clinicians cannot hear what their patients hear, and patients cannot often reliably detect or describe what they hear. Self-adjustment avoids this issue but requires user controls that adjust hearing-aid signal processing parameters to be effective, efficient and easy. In this study, we explored (a) the roles of interface complexity and stimulus type in the self-adjustment of hearing-aid gain, and (b) how well individuals can adjust one sound to match another to assess the same interfaces and stimuli. Adult hearing-aid users with mild to moderate symmetrical sensorineural hearing loss repeatedly adjusted the gain (a) to their preference from individual prescription (n = 41) and (b) to match their previous preferences from a random starting point (n = 32) using three interfaces representing different bass/mid/treble configurations and three stimuli (music, speech and speech-in-noise). The large interindividual variability in self-adjusted gains clustered into three patterns of deviation from initial prescription: increased relative bass, overall gain reduction, and close to initial prescription. There were no substantial effects of interface nor stimulus on self-adjustment reliability (median {sigma} = 2.8 dB), whereas absolute sound-matching error increased with increasing interface complexity and centre frequency. Neither individual matching accuracy nor questionnaire responses predicted either self-adjusted gains or reliability. Overall, these results show that many - but not all - hearing-aid users can adjust gains with reasonable reliability, and while it can be difficult to predict the behaviour from the individual, the individual applies a similar self-adjustment behaviour across different interfaces and stimuli.

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

Mixing Times for the Facilitated Exclusion Process

Authors:
James Ayre↗Paul Chleboun↗

arXiv:2402.18999v2 Announce Type: replace Abstract: The facilitated simple exclusion process (FEP) is a one-dimensional exclusion process with a dynamical constraint. We establish bounds on the mixing time of the FEP on the segment, with closed boundaries, and the circle. The FEP on these spaces exhibits transient states that, if the macroscopic density of particles is at least $1/2$, the process will eventually exit to reach an ergodic component. If the macroscopic density is less than $1/2$ the process will hit an absorbing state. We show that the symmetric FEP (SFEP) on the segment $\{1,\ldots,N\}$, with $k>N/2$ particles, has mixing time of order $N^{2}\log(N-k)$ and exhibits the pre-cutoff phenomenon. For the asymmetric FEP (AFEP) on the segment, we show that there exists initial conditions for which the hitting time of the ergodic component is exponentially slow in the number of holes $N-k$. In particular, when $N-k$ is large enough, the hitting time of the ergodic component determines the mixing time. For the SFEP on the circle of size $N$, and macroscopic particle density $\rho \in(1/2,1)$, we establish bounds on the mixing time of order $N^{2}\log N$ for the process restricted to its ergodic component. We also give an upper bound on the hitting time of the ergodic component of order $N^{2}\log N$ for a large class of initial conditions. The proofs rely on couplings with exclusion processes (both open and closed boundaries) via a novel lattice path (height function) construction of the FEP.

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16.
medRxiv (Medicine) 2026-06-10

Developing a Unified Criminal Justice Pathway into Drug and Alcohol Treatment from Police Custody: A Public Health Service Evaluation and Pathway-Design Project in Blackpool, United Kingdom

Authors:
Badmos↗A. O↗AbdulKareem↗Mills↗Gawne↗Idris↗

Introduction: Blackpool, England's most deprived local authority, has the highest drug-related death rate in the country. People in police custody with problem substance use are a key Core20PLUS5 inclusion-health group, yet referral from the police into structured drug and alcohol treatment is fragmented and relies heavily on self-report. We evaluated the current police-to-treatment route in Blackpool and designed an evidence-informed unified pathway. Materials and Methods: A mixed-methods service evaluation and pathway-design project was conducted during a six-month General Practice / Public Health rotation. Routinely collected referral data from Horizon (the local specialist drug and alcohol service) covering the 47-month period from December 2019 to October 2023 were analysed. Findings were triangulated with national policy, the Project ADDER and Liaison and Diversion evaluations, and the international evidence on police-led pre-arrest diversion. Results: Of 5,900 total referrals into Horizon over 47 months, only 269 (4.56%) originated from the police. Police referrals accounted for fewer than 5% of monthly referrals in 30 of 47 months, for 5 to 9.9% in 16 months, and for >/= 10% in only one month (10.8%, December 2022). Blackpool recorded 76 drug-misuse deaths in 2019-21 (19.4 per 100,000, approximately four times the England rate). A six-step unified pathway is proposed: Initiate Referral (opt-out, from ADDER Police and Liaison and Diversion); Initial Assessment; Tailored Treatment Plan; Continuous Support; Collaboration and Monitoring; and Evaluation and Adjustment. Conclusions: Police contact is markedly under-used as a gateway to treatment despite Blackpool having the highest drug-related mortality in England. An opt-out, multi-agency pathway anchored in Core20PLUS5 has the potential to narrow the treatment gap, reduce re-offending, and address the structural health inequalities that drive premature mortality.

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

Finite-Width Neural Tangent Kernels from Feynman Diagrams

Authors:
Max Guillen↗Philipp Misof↗Jan E. Gerken↗

arXiv:2508.11522v4 Announce Type: replace Abstract: Neural tangent kernels (NTKs) are a powerful tool for analyzing deep, non-linear neural networks. In the infinite-width limit, NTKs can easily be computed for most common architectures, yielding full analytic control over the training dynamics. However, at infinite width, important properties of training such as NTK evolution or feature learning are absent. Nevertheless, finite width effects can be included by computing corrections to the Gaussian statistics at infinite width. We introduce Feynman diagrams for computing finite-width corrections to NTK statistics. These dramatically simplify the necessary algebraic manipulations and enable the computation of layer-wise recursion relations for arbitrary statistics involving preactivations, NTKs and certain higher-derivative tensors (dNTK and ddNTK) required to predict the training dynamics at leading order. We demonstrate the feasibility of our framework by extending stability results for deep networks from preactivations to NTKs and proving the absence of finite-width corrections for scale-invariant nonlinearities such as ReLU on the diagonal of the Gram matrix of the NTK. We numerically implement the complete set of equations necessary to compute the first-order corrections for arbitrary inputs and demonstrate that the results follow the statistics of sampled neural networks for widths $n\gtrsim 20$.

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18.
medRxiv (Medicine) 2026-06-15

Artificial Intelligence-Based Detection of Airway Mucus Plugs on CT and Associations With Clinical Outcomes in COPDGene

Authors:
Oyer↗Namvar↗Hoff↗B. A↗Bosma↗Labaki↗W. L↗Kazerooni↗E. A↗Martinez↗F. J↗Hatt↗…

RATIONALE: Airway mucus plugging is a clinically relevant manifestation of airway pathology in chronic obstructive pulmonary disease (COPD) and is associated with increased mortality even in early disease; however, visual computed tomography (CT) assessment is subjective and labor intensive. OBJECTIVES: To develop an AI-based quantitative CT method for automated detection of airway mucus plugging and evaluate associations with physiologic impairment and clinical outcomes. METHODS: Inspiratory CT scans from 8,971 COPDGene Phase 1 (GOLD 0-4 and PRISm) participants were analyzed. An AI-based framework combining 3D airway segmentation discontinuities and convolutional neural network classification identified mucus plug obstructions, yielding mucus plug burden (total plug count). Associations with outcomes were evaluated using covariate-adjusted models. MEASUREMENTS AND MAIN RESULTS : Higher mucus plug burden was associated with lower post-bronchodilator FEV % predicted ({rho} = -0.41; P < 0.001), greater air trapping (LAA < -856 HU; {rho} = 0.33; P < 0.001), worse health status (SGRQ; {rho} = 0.31; P < 0.001), and shorter 6-minute walk distance ({rho} = -0.26; P < 0.001). Among GOLD 1-4 participants, mucus plug presence was independently associated with increased all-cause mortality (adjusted hazard ratio, 1.28; P < 0.005) and exacerbation frequency (adjusted incidence rate ratio, 1.32; P < 0.005). Plug presence was also associated with increased respiratory mortality across GOLD categories and cardiovascular mortality in GOLD 1-2. CONCLUSIONS: AI-based quantitative CT assessment of airway mucus plugging provides a scalable, reproducible measure associated with physiologic impairment and adverse outcomes in COPD, supporting its role in risk stratification and future therapeutic studies.

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19.
medRxiv (Medicine) 2026-06-15

Repurposing cardiovascular disease risk models to predict incident and co-occurring cardiovascular, cardiometabolic and neurocognitive outcomes.

Authors:
Quill↗Chaturvedi↗van Vugt↗Hingorani↗A. D↗Schmidt↗A. F↗

Background: Cardiovascular disease (CVD), cardiometabolic and neurocognitive conditions share risk factors and frequently co-occur. We evaluated whether four established CVD risk prediction models (QRISK3, PCE, SCORE2, SCORE2-OP) can be repurposed to predict 10-year risk of these conditions and their co-occurrence with CVD. Methods: The models were recalibrated using 20% of the UK Biobank (UKB) and evaluated in the remaining 80%. We performed external validation using data from Clinical Practice Research Datalink (CPRD) Aurum, assessing model discrimination (c-statistics) and calibration (intercept and slope). We used permuted feature importance to determine the influence of each individual predictor in the models. Results: Depending on the model, the c-statistics for incident CVD ranged from 0.71 to 0.74 in the UKB test set (16,137 events). Discrimination was equal to or higher than CVD when evaluated against non-traditional CVD outcomes: 0.74 to 0.77 for heart failure (3,471 events), 0.72 to 0.73 for atrial fibrillation (9,213 events), 0.73 to 0.75 for peripheral arterial disease (1,927 events) and 0.80 to 0.82 for abdominal aortic aneurysm (595 events). For the multimorbidity endpoints, model discrimination ranged from 0.74 for the composite of CVD and T2DM (SCORE2-OP) to 0.83 for the composite of CVD and dementia or Parkinson's disease (QRISK3). When considering the onset of any cardiovascular, cardiometabolic, or neurocognitive outcome discrimination ranged from 0.71 to 0.72. The repurposed models slightly underestimated the predicted risk in the CPRD compared to the UKB: average difference in calibration intercept was at most -0.64. After age and sex, smoking status and systolic blood pressure contributed most to model predictions. Conclusions: Repurposed CVD models can be used to identify 10-year risk of many CVD-related conditions and their multimorbidity. These may be used to support risk-based approaches to prevention and screening. The repurposed models have been made available at: https://repurposed-cvd-risk-models.shinyapps.io/cvd_cmd_dementia_app/ Keywords: Risk prediction; cardiovascular disease; cardiometabolic disease; dementia; disease prevention.

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20.
arXiv (CS.CV) 2026-06-11

On Aligning Hierarchical Standardized Embedding for Audio-visual Generalized Zero-shot Learning

Authors:
Zihan Zhang↗Jie Hong↗Siyuan Fan↗Yanghao Zhou↗Pengfei Fang↗

Audio-visual Generalized Zero-shot Learning (AV-GZSL) is a challenging task that aims to classify both seen and unseen objects or scenes by integrating data from audio and visual modalities. Recent studies primarily focus on fusing or aligning audio and visual features to generate more informative audio-visual embeddings. Also, aligning the audio-visual and textual features of most existing methods relies solely on the optimization objectives. However, those methods neglect the inherent distributional and structural differences between audio-visual and textual modalities. To address this limitation, we propose a method termed Aligning Hierarchical Standardized Embedding (AHSE), which enables hierarchical alignment of standardized audio-visual and textual embeddings within a shared embedding space. Specifically, we first apply Z-score standardization to the fused audio-visual and textual embeddings to reduce distributional mismatches. We then introduce a hierarchical alignment strategy that minimizes discrepancies at the semantic, class, and batch levels, thereby constructing a more robust and well-structured embedding space. This strategy not only preserves semantic and inter-class relationships but also maintains spatial consistency within each batch. Extensive experiments on three benchmark datasets: VGGSound-GZSL, UCF-GZSL, and ActivityNet-GZSL, demonstrate that AHSE achieves competitive performance in zero-shot learning.

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21.
arXiv (CS.CV) 2026-06-18

E-VAds: An E-commerce Short Videos Understanding Benchmark for MLLMs

Authors:
Xianjie Liu↗Yiman Hu↗Liang Wu↗Ping Hu↗Yixiong Zou↗Jian Xu↗Bo Zheng↗

E-commerce short videos represent a high-revenue segment of the online video industry characterized by a goal-driven format and dense multi-modal signals. Current models often struggle with these videos because existing benchmarks focus primarily on general-purpose tasks and neglect the reasoning of commercial intent. In this work, we first propose a multi-modal information density assessment framework to quantify the complexity of this domain. Our evaluation reveals that e-commerce content exhibits substantially higher density across visual, audio, and textual modalities compared to mainstream datasets, establishing a more challenging frontier for video understanding. To address this gap, we introduce E-commerce Video Ads Benchmark, which is the first benchmark specifically designed for e-commerce short video understanding. We curated 3,961 high-quality videos from Taobao covering a wide range of product categories and used a multi-agent system to generate 19,785 open-ended Q&A pairs, which consist of five distinct tasks. Finally, we develop E-VAds-R1, an RL-based reasoning model featuring a multi-grained reward design called MG-GRPO. This strategy provides smooth guidance for early exploration while creating a non-linear incentive for expert-level precision. Experimental results demonstrate that E-VAds-R1 achieves a 109.2% performance gain in commercial intent reasoning with only a few hundred training samples. Data is available at https://github.com/TaobaoTmall-AlgorithmProducts/E-VAds_Benchmark.

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22.
arXiv (CS.CV) 2026-06-25

Benchmarking Vision-Language Models for Microscopic Plant Image Understanding

Authors:
Tianqi Wei↗Xin Yu↗Zhi Chen↗Scott Chapman↗Zi Huang↗

Microscopic imaging provides essential visual evidence for studying plant biology and pathology at the cellular and subcellular levels. However, existing benchmarks on vision-language models primarily focus on macroscopic plant imagery, while the microscopic domain remains underexplored. To address this gap, we present PlantMicro, a comprehensive benchmark for evaluating vision-language models (VLMs) in microscopic plant imagery. PlantMicro integrates more than 5,000 images collected across diverse hosts, biological domains, and imaging modalities. Building on this diversity, we design a set of complementary tasks that capture different facets of microscopic image understanding. To support these tasks, we construct over 9,000 VQA pairs that systematically evaluate the capabilities of VLMs. Experiments on PlantMicro show that current VLMs struggle with fine-grained recognition and biologically grounded reasoning. For example, GPT-5 achieves 34.93% accuracy on the pathogen classification task, which is only modestly above the random-guessing baseline. The results highlight a significant gap in current VLMs' ability to comprehend plant microscopic images. PlantMicro provides a standardized foundation for advancing VLMs toward reliable and comprehensive microscopy-level plant understanding.

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23.
arXiv (CS.AI) 2026-06-11

Certifiable Safe RLHF: Semantic Grounding and Fixed Penalty Constraint Optimization for Safer LLM Alignment

Authors:
Kartik Pandit↗Sourav Ganguly↗Arnesh Banerjee↗Shaahin Angizi↗Arnob Ghosh↗

arXiv:2510.03520v2 Announce Type: replace-cross Abstract: Ensuring safety is a foundational requirement for large language models (LLMs). Achieving an appropriate balance between enhancing the utility of model outputs and mitigating their potential for harm is a complex and persistent challenge. Contemporary approaches frequently formalize this problem within the framework of Constrained Markov Decision Processes (CMDPs) and employ established CMDP optimization techniques. However, these methods exhibit two notable limitations. First, their reliance on reward and cost functions renders performance highly sensitive to the underlying scoring mechanism, which must capture semantic meaning rather than being triggered by superficial keywords. Second, CMDP-based training entails tuning dual-variable, a process that is both computationally expensive and does not provide any provable safety guarantee for a fixed dual variable that can be exploitable through adversarial jailbreaks. To overcome these limitations, we introduce Certifiable Safe-RLHF (CS-RLHF) that introduces a cost model trained on a large-scale corpus to assign semantically grounded safety scores. In contrast to the lagrangian-based approach, CS-RLHF adopts a rectified penalty-based formulation. This design draws on the theory of exact penalty functions in constrained optimization, wherein constraint satisfaction is enforced directly through a suitably chosen penalty term. With an appropriately scaled penalty, feasibility of the safety constraints can be guaranteed at the optimizer, eliminating the need for dual-variable updates. Empirical evaluation demonstrates that CS-RLHF outperforms state-of-the-art LLM model responses rendering at-least 5 times efficient against nominal and jail-breaking prompts

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24.
medRxiv (Medicine) 2026-06-18

Plasma proteomics reveals clinical and mechanistic heterogeneity among individuals who develop coronary artery disease

Authors:
Yang↗Tan↗Carrasco-Zanini↗Su↗C.-Y↗Zhou↗Koyama↗Natarajan↗langenberg↗Lu↗Yoshiji↗

BACKGROUND: Individuals who develop coronary artery disease (CAD) are clinically and mechanistically heterogeneous, and understanding this variation is crucial for precise risk stratification and tailored interventions. However, the molecular mechanisms that connect these two kinds of heterogeneity remain unclear, limiting progress toward biologically grounded risk stratification and targeted interventions. Here, we investigated the heterogeneity of individuals who develop CAD by leveraging plasma proteomic signatures, placed individuals along continuous metabolic gradients and revealed the molecular programs underlying these patterns, thereby linking mechanistic variation to clinical heterogeneity. METHODS AND RESULTS: From 42,803 UK Biobank participants, including 3,713 individuals who developed CAD within 10 years (incident CAD), we first identified a 320-protein panel from 2,923 baseline proteins that improved prediction of incident CAD beyond clinical risk scores. Using reverse graph embedding, we reduced the proteomic data to two dimensions and mapped each incident case onto the resulting two-dimensional latent proteomic space. These proteomic dimensions show significant associations with cardiometabolic and kidney-related clinical markers. The patterns were replicated in the EPIC-Norfolk study. Phenome-wide Cox regression analyses further linked these proteomic dimensions to 10-year incidence rates for various diseases, including type 2 diabetes, obesity, and chronic kidney disease (CKD). Furthermore, adding the proteomic dimensions to clinical variable-based Cox regression model improved prediction of 10-year incidence of CKD and other diseases, demonstrating the value of proteomic dimensions beyond conventional clinical risk factors. Moreover, individuals with prevalent CAD (diagnosed before proteomic sampling) exhibited high, metabolically adverse dimension values, indicating that these axes capture cumulative metabolic burden. Pathway enrichment analyses implicated altered extracellular matrix organization and immune programs among the proteins contributing to the proteomic dimensions. CONCLUSIONS: Our findings demonstrate that plasma proteomic signatures can dissect the heterogeneity of individuals who develop CAD in continuous phenotypic gradients, improve prediction of CAD and comorbidities, and map underlying biological mechanisms.

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25.
arXiv (math.PR) 2026-06-15

Hierarchical symmetry selects log-Poisson cascades: classification, uniqueness, and stability

Authors:
E. M. Freeburg↗

arXiv:2604.01632v2 Announce Type: replace Abstract: Within i.i.d. multiplicative cascades, a single axiom – the hierarchical symmetry, a linear contraction on incremental scaling exponents – is shown to be necessary and sufficient for the cascade multiplier to be log-Poisson. We prove: (1) a characterization theorem determining the log-Poisson law with explicit parameters, within the class of all multipliers with finite lattice moments; (2) a classification theorem locating the log-Poisson class inside the log-infinitely-divisible family and identifying the mechanism by which every rival sub-family fails the symmetry; (3) a stability theorem with sharp constants – $(1+\beta)^{1/2}$ when the limiting increment is known, $\sqrt{2}$ when it is fitted – and (4) an unconditional propagation theorem transferring the bound to the multiplier distribution at the sharp rate $\Theta(\sqrt{\varepsilon})$, with a matching lower bound. Beyond independence, the classification extends exactly at the level of asymptotic statistics (limiting cumulant generating function, large deviations, multifractal spectrum) and provably not at the level of laws: an explicit stationary ergodic Markov multiplier satisfies the symmetry exactly with a non-log-Poisson marginal, while exchangeable multipliers collapse to the i.i.d. log-Poisson cascade and finite-state Markov multipliers cannot satisfy the symmetry at all. In the continuous category of exactly scale-invariant log-infinitely-divisible multifractal random measures, no finite moment window of structure-function exponents identifies the cascade class, whereas at the level of the scale-invariance generator the symmetry selects exactly the Barral-Mandelbrot compound Poisson cascade, with scale-ratio-free stability constants. The proofs reduce to second-moment identities on [0,1] via the change of variables $u = e^{kx}$, boundedness of the multiplier, and multiplicative couplings.

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