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

Do Neural Networks Lose Plasticity in a Gradually Changing World?

arXiv:2602.09234v2 Announce Type: replace-cross Abstract: Continual learning has become a trending topic in machine learning. Recent studies have discovered an interesting phenomenon called loss of plasticity, referring to neural networks gradually losing the ability to learn new tasks. However, existing plasticity research largely relies on benchmarks with abrupt task transitions, without examining whether the abruptness itself contributes to the observed plasticity loss. In this paper, we investigate the role of transition abruptness by simulating gradually changing environments through input/output interpolation and task sampling. We perform theoretical and empirical analysis, showing that the severity of plasticity loss is closely tied to the abruptness of task transitions, and can be substantially reduced when the environment changes gradually.

02.
arXiv (quant-ph) 2026-06-17

Quantum conditional entropies from convex trace functionals

arXiv:2410.21976v4 Announce Type: replace Abstract: We study geometric properties of trace functionals that generalize those in [Zhang, Adv. Math. 365:107053 (2020)], arising from a novel family of conditional entropies with applications in quantum information. Building on new convexity results for these functionals, we establish data-processing inequalities and additivity properties for our entropies, demonstrating their operational significance. We further prove completeness under duality, chain rules, and various monotonicity properties for this family. Our proofs draw on tools from complex interpolation theory, multivariate Araki–Lieb and Lieb–Thirring inequalities, variational characterizations of trace functionals, and spectral pinching techniques.

03.
arXiv (CS.CL) 2026-06-18

SFT Overtraining Predicts Rank Inversion via Entropy Collapse Under RLVR

The standard heuristic of selecting the SFT checkpoint with the highest pass@1 for GRPO can fail when SFT compresses the rollout distribution. For binary rewards, the expected within group advantage variance is $p(1{-}p)(g{-}1)/g$; when early GRPO drives $p$ below $p^*(g)$, most groups have identical rewards and provide no group relative signal. We study SFT depth ladders for Qwen2.5-Coder-3B and DeepSeek-Coder-6.7B. We test Qwen2.5-Coder-3B across five depths and three seeds, and DeepSeek-Coder-6.7B across four matched depths and three seeds. On Qwen, pre RL pass@1 rises with SFT depth, but peak GRPO pass@10 falls from $0.806$ to $0.481$ (3 seed mean, $n{=}20$); pre RL entropy is positively associated with the GRPO outcome ($\rho{=}{+}0.69$). On DeepSeek, pass@1 remains far above $p^*(8){=}0.083$, and GRPO outcomes compress rather than invert. A two stage diagnostic, combining pre RL entropy triage with an early GRPO entropy monitor, flags high risk checkpoints and can stop failing runs early. Simple KL to reference regularisation and label smoothing variants do not rescue the collapsed Qwen checkpoint in our setting, suggesting the failure is not a trivial GRPO hyperparameter artefact.

04.
arXiv (CS.LG) 2026-06-15

Trust but Verify: Mitigating Medical Hallucinations via Post-Hoc Adversarial Auditing and Multi-Agent Feedback Loops

arXiv:2606.14149v1 Announce Type: new Abstract: Large Language Models (LLMs) are increasingly deployed in healthcare settings, yet their tendency to hallucinate poses risks when clinical decisions are involved. This study examine whether LLMs recommend recently banned or withdrawn pharmaceuticals when answering clinical questions and tests an agent-based method for reducing such errors. We developed a five-agent "Trust but Verify" system using a single LLM backbone. To measure regulatory knowledge obsolescence, we created an adversarial dataset of 103 clinical MCQs where historically correct answers now refer to banned substances. This scale ensures statistical significance across various therapeutic classes. We evaluated three open-access model families (GPT-OSS, Llama-3, Falcon-3) under vanilla and agentic conditions. Performance was measured via pointwise score, label accuracy, Hallucination Error Rate (HER), and Component Fidelity (CF) score. We also observed clinical safety regression in proprietary models. In default configurations, all models showed high hallucination rates, consistently selecting banned drugs that matched training data patterns. Our proposed agentic architecture reduced HER by approximately 53% across models. Pointwise scores shifted from -0.25 (unsafe recommendation) toward 0.0 (appropriate refusal). The safety audit intercepted dangerous outputs even when models' parametric knowledge favored the banned substance. The proposed multi-agent framework offers a model-agnostic method for enforcing regulatory compliance that prioritizes patient safety over fluent text generation. Our work demonstrates a practical approach for deploying autonomous AI systems in safety-critical healthcare settings. It shows how real-time regulatory data can be integrated into LLM pipelines to support clinical decision-making.

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

The Periodic Table of LLM Reasoning: A Structured Survey of Reasoning Paradigms, Methods, and Failure Modes

Large Language Models (LLMs) have achieved strong performance across natural language processing tasks, yet reliable reasoning remains an open challenge. Although modern LLMs show progress in structured inference, multi-step problem solving, and contextual understanding, their reasoning behavior is often inconsistent and sensitive to prompting strategies, task design, and model scale. This survey provides a systematic analysis of more than 300 recent papers from arXiv, Semantic Scholar, Google Scholar, Papers with Code, and the ACL Anthology to examine how reasoning capabilities emerge in LLMs and where they fail. We make three main contributions. First, we introduce a structured taxonomy of LLM reasoning research, covering Chain-of-Thought reasoning, multi-hop reasoning, mathematical reasoning, common sense reasoning, visual and temporal reasoning, code and algorithmic reasoning, retrieval-augmented reasoning, tool-augmented and agentic reasoning, and reinforcement learning-based reasoning. Second, we analyze methodological trends across these paradigms, including prompting methods, model architectures, training objectives, reward modeling, and evaluation benchmarks. Third, we synthesize recurring limitations and failure modes, such as reasoning hallucinations, brittle multi-step inference, weak causal abstraction, and poor cross-domain generalization. By organizing a rapidly expanding literature, this survey offers a unified view of the current capabilities and limitations of reasoning in LLMs. We also identify emerging research directions, including meta-reasoning, self-evolving reasoning frameworks, multimodal reasoning, and socially grounded reasoning. Overall, this work aims to serve as a reference for developing more robust, interpretable, and generalizable reasoning systems in future language models.

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

DataMagic: Transforming Tabular Data into Data Insight Video

arXiv:2606.20388v1 Announce Type: cross Abstract: Data videos integrate dynamic charts, voice narration, and synchronized animations to communicate data insights as temporal narratives, making them an effective medium for improving data consumption efficiency in the data management lifecycle. However, producing high-quality data videos requires expertise spanning data analysis, narrative design, and video production. Existing approaches fall short: static visualization tools (e.g., BI dashboards) lack narrative logic and animation; authoring tools require users to pre-prepare visualizations rather than working from raw data; pixel-level video generation models cannot guarantee data fidelity or provenance. We demonstrate DataMagic, an end-to-end interactive system that transforms raw tabular data and natural language queries into narrative data-insight videos. To ensure data fidelity, DataMagic introduces the declarative specification DVSpec, which binds visual and animation elements to underlying data fields through data-driven semantic references. To address the combinatorial explosion of the design space, DataMagic adopts a Generate-then-Orchestrate multi-agent architecture that generates candidate scenes in parallel and then optimizes narrative coherence through global orchestration. Leveraging DVSpec's decoupling of logic and rendering, the system further supports three interaction modes and structured provenance-based data Q&A, transforming one-way videos into explorable interactive data interfaces. Evaluation on 109 real-world samples validates the effectiveness of the DataMagic. Homepage: https://datamagic-home.github.io/

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

Learning the Context of Errors: Black-Box Online Adaptation of Time Series Foundation Models

arXiv:2606.14222v1 Announce Type: new Abstract: The rapid evolution of Time Series Foundation Models (TSFMs) has advanced zero-shot forecasting across diverse domains. Inspired by the current form of Large Language Models, future TSFMs may be offered as commercialized, closed-source API services. However, many existing online adaptation methods still rely on white-box access for parameter fine-tuning or gradient backpropagation. This paradigm mismatch raises a question: In black-box online adaptation for TSFMs, what should we learn? We answer this with an insight: the predictive errors of the base model are conditioned on both the input and output of the base model (i.e., the context of errors). To validate this insight, we propose ORCA (Online Residual Contextual Adaptation). We conduct extensive experiments across 5 state-of-the-art TSFMs and 8 datasets to demonstrate the effectiveness of our approach. Furthermore, through ablation studies, we quantitatively analyze the impact of different adapter learning hypotheses on the final adaptation performance in black-box online adaptation. Code available at https://github.com/Fifthky/ORCA.

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

LatentGym: A Testbed For Cross-Task Experiential Learning With Controllable Latent Structure

arXiv:2606.15306v1 Announce Type: cross Abstract: We envision continually learning agentic systems that become more useful over time: as they encounter sequences of related tasks, they should infer the hidden structure shared across those tasks and use it to improve future decisions. This cross-task experiential learning capability is pivotal in domains such as personalization and interactive assistance, but existing training/evaluation frameworks do not provide shared, controllable latent structures and cannot measure whether or why agents improve. We introduce LatentGym: a controllable suite in which each environment is organized around a ground-truth latent variable governing the structure across tasks. Our construction yields metrics that separate exploration (whether the agent's actions gather information about the latent) from exploitation (whether the agent uses what it has gathered). We demonstrate our suite on empirical studies addressing three questions: how and why frontier models fail to adapt across related tasks; whether post-training on related task sequences improves general cross-task adaptation, and where those gains come from; and how design choices such as inter-task feedback shape training dynamics and generalization. Together, these results establish a controlled foundation for studying how LLM agents learn from experience across tasks, and for designing agents that adapt more reliably in sequential, personalized, and interactive settings.

10.
arXiv (CS.CL) 2026-06-15

X-OPD: Cross-Modal On-Policy Distillation for Capability Alignment in Speech LLMs

While the shift from cascaded dialogue systems to end-to-end (E2E) speech Large Language Models (LLMs) improves latency and paralinguistic modeling, E2E models often exhibit a significant performance degradation compared to their text-based counterparts. The standard Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL) training methods fail to close this gap. To address this, we propose X-OPD, a novel Cross-Modal On-Policy Distillation framework designed to systematically align the capabilities of Speech LLMs to their text-based counterparts. X-OPD enables the Speech LLM to explore its own distribution via on-policy rollouts, where a text-based teacher model evaluates these trajectories and provides token-level feedback, effectively distilling teacher's capabilities into student's multi-modal representations. Extensive experiments across multiple benchmarks demonstrate that X-OPD significantly narrows the gap in complex tasks while preserving the model's inherent capabilities.

11.
arXiv (math.PR) 2026-06-16

Hua-Chen New Theory of Economic Optimization

arXiv:2504.19134v4 Announce Type: replace-cross Abstract: Between 1957-1985, Chinese mathematician Loo-Keng Hua pioneered economic optimization theory through three key contributions: establishing economic stability's fundamental theorem, proving the uniqueness of equilibrium solutions in economic systems, and developing a consumption-integrated model 50 days before his death. Since 1988, Mu-Fa Chen has been working on Hua's theory. He introduced stochastics, namely Markov chains, to economic optimization theory. He updated and developed Hua's model and came up with a new model (Chen's model) which has become the starting point of a new economic optimization theory. Chen's theory can be applied to economic stability test, bankruptcy prediction, product ranking and classification, economic prediction and adjustment, economic structure optimization. Chen's theory can also provide efficient algorithms that are programmable and intelligent. {Stochastics} is the cornerstone of Chen's theory. There is no overlap between Chen's theory, and the existing mathematical economy theory and the economics developments that were awarded Nobel Prizes in Economics between 1969 and 2024. The distinguished features of Chen's theory from the existing theories are quantitative, calculable, predictable, optimizable, programmable and can be intelligent. This survey provides a theoretical overview of the newly published monograph [5rw24]. Specifically, the invariant of the economic structure matrix, also known as the Chen's invariant, was first published in this survey.

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

Tensor-Coord: Algebraic Decomposition of Joint Plan Tensors for Conflict-Free Multi-Agent LLM Planning

arXiv:2606.16478v1 Announce Type: new Abstract: Large language models (LLMs) remain limited in multi-agent planning because independently generated plans can create coordination failures such as spatial collisions, resource contention, and temporal deadlocks. We introduce Tensor-Coord, a multilinear algebra framework that represents the joint plan of N agents as a third-order tensor \(T \in R^{N \times H \times A}\) over agents, timesteps, and actions. Canonical Polyadic (CP) and Tucker decompositions are used to identify latent coordination structure. The minimal epsilon-approximate CP rank R* defines a computable coordination complexity measure, with \(CC(Pi)=(R*-N)/N\). We prove that R*=N is necessary and sufficient for plan independence. The residual \(E=T-T_{R*}\) defines a conflict score over agent pairs, timesteps, and actions, localizing failures without domain-specific rules. Tucker factors provide interpretable agent roles, temporal phases, and action clusters that are converted into natural language constraints for iterative LLM replanning. Experiments on multi-robot delivery tasks across Easy (2 agents, 5x5 grid), Medium (3 agents, 5x5 grid), and Hard (4 agents, 5x5 grid) settings show convergence to conflict-free plans in 100% of 2-agent cases within 1.4 iterations on average, 80% of 3-agent cases within 3.2 iterations, and 60% of 4-agent cases within 4.0 iterations. CP rank scaled approximately linearly as \(R*(N) = 3.9N + 0.5\), supporting its use as a predictor of coordination complexity.

13.
arXiv (CS.LG) 2026-06-12

From Parameters to Feature Space: Task Arithmetic for Backdoor Mitigation in Model Merging

arXiv:2606.12498v1 Announce Type: cross Abstract: Model merging (MM) has gained significant attention as a cost-effective approach to integrate multiple task-specific models into a unified model. However, recent work reveals that MM is highly susceptible to backdoor attacks. Existing defenses based on task arithmetic often fail to eliminate backdoors without substantially degrading clean-task performance, owing to their reliance on direct parameter-space editing. To address this gap, we propose Linear Feature Path Minimization (LFPM), a backdoor mitigation framework for model merging, which introduces an anti-backdoor task vector into the backdoored merged model. Unlike prior approaches, LFPM formulates the backdoor robustness of the merged model from a unified feature-space perspective under the Cross-Task Linearity (CTL) framework, which leverages the approximate linearity of features across tasks. This perspective guides the optimization of the anti-backdoor task to suppress backdoors while preserving clean-task performance. Furthermore, we introduce an effective optimization mechanism based on gradient accumulation and loss path-integral, ensuring robust backdoor suppression along the interpolation path. Extensive experiments demonstrate that LFPM consistently exhibits strong robustness against backdoor attacks in both full fine-tuning and Parameter-Efficient Fine-Tuning (PEFT) settings.

15.
medRxiv (Medicine) 2026-06-15

Mucosal and Systemic Antibodies Associated with Clinical Protection in a Pertussis Controlled Human Infection Model

Background The engagement of mucosal and systemic immunity in preventing Bordetella pertussis colonization and infection in humans, the impact of prior vaccination on host immunity and protective outcomes, and the dynamics of the host response following exposure remain poorly understood. Methods Healthy adults were challenged with increasing colony-forming units (CFUs) doses, 106-108, of B. pertussis D420 intranasally (NCT05136599). Shedding (PCR and culturing) and symptom development were monitored up to 21 days post-challenge. Serum and nasal wash IgA and IgG were measured before challenge (baseline) and up to 6 months post-challenge. Findings Antibodies increased post-challenge only in infected individuals, primarily nasal IgA. Participants who remained uninfected had higher baseline levels of filamentous hemagglutinin (FHA)- specific mucosal IgA and IgG, and higher serum IgA against fimbriae 2/3 (FIM). FHA was negatively associated with bacterial load and was a key discriminator between shedders and non-shedders, up to one week post-challenge. By day 14 post-challenge, pertussis toxin (PT) IgG and FIM IgA in both serum and mucosal samples were negatively associated with bacterial colonization. The majority (96.7%) of acellular pertussis (aP) vaccine recipients (n=23, median age 2.0 years) became infected, compared to 69.4% of those who received whole-cell pertussis vaccine (n=36; median age 32.0 years), and their antibody responses remained distinct following infection. Interpretation Nasal FHA antibodies emerged as early predictors of protection against pertussis infection, while PT IgG and FIM IgA antibodies may reflect clearance after infection. aP-primed individuals were more susceptible to infection, despite their younger age and more recent vaccination. Funding CDC Contract #75D30122C15467 and CDC IPA Agreement #24IPA2417512 Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, US Department of Health and Human Services.

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

StylisticBias: A Few Human Visual Cues Drive Most Social Biases in MLLMs

Multimodal large language models (MLLMs) are increasingly deployed in personally and societally consequential settings, yet the visual cues that shape how these models judge people remain poorly understood. Prior work often compares different (groups of) individuals, making it difficult to separate appearance effects from identity differences. We introduce StylisticBias, a controlled benchmark for evaluating attribute-level social bias in MLLMs. We generate 500 photorealistic base faces and create about 50 single-attribute variations per face, producing about 25K images. This design keeps identity fixed and changes one visual attribute at a time. It lets us measure how specific cues shift model judgments. We evaluate six MLLMs across 25 binary social judgment scenarios. We find that age and body type dominate identity-level effects, while fashion style and other visual cues drive the largest attribute-level shifts. We further find that about 15 attributes account for nearly 80\% of the total variation, showing that bias is concentrated in a small set of visual cues. Sensitivity is strongest in judgments that are semantically aligned with appearance, especially socioeconomic and style-related judgments. We release StylisticBias as a benchmark for fine-grained bias evaluation in multimodal models. Code and dataset: https://github.com/timo-cavelius/StylisticBias and https://hf.co/datasets/shaghayegh/stylistic-bias-dataset.

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

ViPER: Vision-based Packing-Aware Encoder for Robust Malware Detection

Visualization-based malware detection maps raw binary bytes to grayscale images and applies learned visual classifiers, providing an evasion-resistant and disassembly-free alternative to conventional analysis pipelines. However, executable packing remains a critical failure mode: packed binaries produce high-entropy images that obscure the structural patterns these models rely on. Because packing is also prevalent in benign software (e.g., for compression or copy protection), packing state alone is not a reliable indicator of maliciousness, and existing approaches do not address this challenge within a unified supervised framework. We present ViPER, a Vision-based Packing-Aware Encoder for Robust malware detection. ViPER builds on a LoRA-adapted ViT-B/14 backbone with a dual-head architecture that jointly learns malware classification and packing detection. A packing-aware gating mechanism conditions malware predictions on the inferred packing state, enabling distinct decision boundaries for packed and unpacked inputs. To address packing label skew during training, we employ frequency-weighted losses with stratified sampling over joint class-packing strata. Evaluated on 200,000 Windows PE byteplot images, ViPER achieves a balanced accuracy of 0.8521, ROC-AUC of 0.9260, and AUPR of 0.9279, outperforming representative state-of-the-art baselines across all primary metrics, while attaining a packing detection AUC of 0.9949.

18.
bioRxiv (Bioinfo) 2026-06-20

A network approach to DNA methylation clocks

Biological age predicts health and lifespan better than chronological age, but remains difficult to measure. One leading molecular proxy for biological age is DNA methylation, which underlies age predictors known as "clocks". These clocks use penalized linear regression to predict chronological age from methylation levels using selected cytosine–guanine pairs (CpGs) along DNA. Although they predict chronological age within a few years and track mortality risk, there are several issues. Different clocks share a vanishingly small number of CpG sites, many of which show weak associations with age. Also, the clocks often do not transfer across methylation array platforms. This paper takes a network approach to better understand these issues. By using 12 public datasets from human blood, we build a co-methylation network of the sites that show the strongest age correlation. After pruning weak links, we find that it has a small number of large modules of covarying CpGs surrounded by many small modules and singleton sites. These modules are biologically interpretable, as they are associated with CpG island contexts and enriched for distinct Gene Ontology functions. We also map five established clocks onto this network (Horvath, Hannum, AltumAge, Skin & Blood, and Han) and find that they select some CpGs from the same module. This suggests that they are more similar than they appear. The network structure also suggests new ways to build clocks. A simple clock that retains one CpG per module matches the performance of established clocks. A second one, built from module-level principal components, outperforms all five established clocks in three validation cohorts and is transferable across array platforms (Illumina Infinium Methylation 450K or EPIC arrays). Overall, the network perspective shifts attention from individual CpG sites to modules of covarying sites. This perspective helps explain why DNA methylation clocks perform so well despite their differences and provides a more systematic approach for developing the next generation of aging biomarkers.

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

Context-Aware Optimization of Follow-Up Intervals for Type 2 Diabetes Care Using Markov Decision Processes

arXiv:2606.19092v1 Announce Type: cross Abstract: Chronic disease management relies on regular patient-provider interactions to follow-up on disease progression and control. For Type 2 Diabetes (T2D), current guidelines prescribe fixed time intervals between subsequent primary care visits for all patients, overlooking heterogeneity in clinical trajectories and patient characteristics. This study introduces a Contextual Markov Decision Process (CMDP) model to optimize subpopulation-specific follow-up interval decisions using Electronic Health Record (EHR) data from 22,154 T2D patients across 10 primary care clinics. Contexts are identified by: i) dimensionality reduction of variables representing the individual health trajectories utilizing Principal Component Analysis, and ii) assigning patients to contexts via principal components and additional patient-level features using clustering. Two distinct contexts emerged, representing a lower- and a higher-risk subpopulation. CMDP-derived policies recommend: (i) follow-up within 1 month if lab value at current visit is unmeasured; (ii) up to 3 months for elevated lab values or recent hospitalizations; and (iii) 6 to 12 months for sustained glycemic control, with shorter follow-up intervals for patients in high-risk context. The optimal policies achieved lower expected cumulative cost than benchmarks (e.g., in the higher-comorbidity context, the CMDP policy reduced cost by about 34.8%, and in the lower-comorbidity context by about 6.4%, relative to an American Diabetes Association-like fixed interval follow-up policy. These findings demonstrate how context-aware approaches can inform adaptive follow-up strategies, and have the potential to advance chronic care management in primary care by synthesizing machine learning and probabilistic decision models.

21.
arXiv (CS.AI) 2026-06-15

Causal Object-Centric Models for Planning with Monte Carlo Tree Search

arXiv:2606.14418v1 Announce Type: new Abstract: We introduce COMET (Causal Object-centric Model for Efficient Tree search), a model-based reinforcement learning algorithm that performs Monte Carlo Tree Search in a slot-structured latent space. COMET pairs a frozen unsupervised object-centric encoder with a transformer-based world model, in which actions are bound to objects through a novel action-slot fusion mechanism that is used in slot transition prediction. Policy and value heads use object-causal attention, modulating token interactions by learned per-slot relevance scores so that decision-making concentrates on task-relevant entities. COMET adds an explicit object-level inductive bias to MuZero-style latent planning. Across eight visually and dynamically diverse tasks from the Object-Centric Visual RL benchmark, ManiSkill, Robosuite, and VizDoom, COMET achieves a higher mean normalized score during the early stages of training compared to object-centric and monolithic baselines.

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

Quantification of Uncertainty with Adversarial Models in Medical Image Segmentation

Reliable pixel-level uncertainty quantification holds the potential to transform clinical workflows by enabling high-fidelity longitudinal monitoring and distinguishing true pathological changes from artifacts. Ideally, these models provide the stability required for critical treatment planning and surgical intervention. However, standard deep learning models often suffer from miscalibration, yielding overconfident predictions that mask underlying vulnerabilities at subtle pathological boundaries. To address this, we propose QUAM-SM, a post-hoc framework using targeted adversarial search to identify "adversarially fragile" pixels. By actively seeking perturbations that expose predictive instability, our method highlights regions where decisions are most vulnerable to being flipped. Importantly, the framework disentangles epistemic uncertainty from aleatoric uncertainty. Experiments on two public datasets with multiple expert annotations demonstrate that QUAM-SM outperforms both standard and recent uncertainty estimation approaches in terms of reliability and boundary sensitivity. Code is available at https://github.com/HanaJebril/quam_sm

23.
medRxiv (Medicine) 2026-06-10

Impact of Early Treatment on Symptom Improvement and Procedural Events among Men with BPH and Bothersome Lower Urinary Tract Symptoms: A Contemporary Analysis of the American Urological Association Quality (AQUA) Registry

PURPOSE: As the armamentarium of BPH therapies continues to expand, it remains imperative to maximize patient satisfaction and minimize decisional regret. We sought to determine the impact of time from BPH diagnosis to index treatment on symptom improvement and subsequent procedural events. MATERIALS AND METHODS: We queried the American Urological Association Quality Registry for men [&ge;] 40 years old with BPH, available IPSS data, and no receipt of prior BPH treatment. Index treatment included medication, surgery, or minimally invasive surgical therapy (MIST). Outcomes included IPSS over 3 years of follow-up, change in percentage of mild lower urinary tract symptoms (LUTS) by 3 months, and time to procedural event. Patients were stratified by time from index diagnosis to treatment by 3 years. Outcomes were compared across time-to-treatment cohorts with appropriate statistical tests with p < 0.05 as significant. RESULTS: 43,919 patients met criteria with 19,642 pursuing treatments. Patients pursued treatment at comparably lower baseline IPSS compared to prior prospective series. Patients undergoing surgery and MIST had significantly higher baseline IPSS, while medical comorbidities were significantly more common among men initiating pharmacotherapy. Early surgery and MIST were associated with significant improvement in IPSS within 6-12 months and an increase in mild LUTS by 3 months. All forms of early treatment were associated with delayed time to procedural events, including catheterization and fulguration. CONCLUSIONS: Early procedural intervention for BPH is associated with early symptom improvement and delayed time to procedural events among real-world, contemporary practice.

24.
arXiv (CS.CV) 2026-06-11

Adv-TGD: Adversarial Text-Guided Diffusion for Face Recognition Impersonation Attacks

The widespread adoption of face recognition (FR) technologies raises serious privacy concerns, as facial data can be exploited without consent. To address this challenge, we propose Adv-TGD, a generative adversarial attack framework that synthesizes photorealistic faces capable of impersonating target identities and deceiving face recognition systems. Built upon Stable Diffusion, Adv-TGD performs per-sample LoRA fine-tuning conditioned on concise textual prompts to generate natural yet adversarially manipulated identities. Unlike conventional identity-attack approaches, our method optimizes lightweight cross-attention adapters for each source-target pair within a single-step denoising process. Latent blending is constrained by a face-local heatmap mask to ensure spatially precise identity manipulation while preserving non-sensitive regions. We introduce a composite objective that integrates masked epsilon-MSE reconstruction, thresholded identity divergence in FR embedding space, directional feature alignment, and source-similarity suppression to balance adversarial attack and visual realism. Optionally, LLaVA-generated attribute prompts enhance fine-grained semantic details without reintroducing identity cues. Under the black-box evaluation protocol, Adv-TGD attains an average attack success rate (ASR) of 85.90% across IR152, IRSE50, MobileFace, and FaceNet, surpassing the semantic SOTA baseline Adv-CPG by +6.25 points, diffusion-based makeup method DiffAIM by +3 points, and noise-based P3-Mask by +16 points. Despite its strong attack efficacy, Adv-TGD preserves high visual fidelity (PSNR = 27.15 dB, SSIM = 0.981). Furthermore, we demonstrate the flexibility of our framework by successfully extending it to in-the-wild datasets (LADN), general object classification (ImageNet), and transformer-based diffusion models (FLUX.1).

25.
Nature Medicine 2026-06-12

Efficacy and target engagement of dopamine agonist pramipexole for anhedonic depression: a randomized placebo-controlled trial

Anhedonia is a core and disabling symptom of mood disorders with limited treatment options. We evaluated the efficacy and safety of the dopamine agonist pramipexole in patients with mood disorders characterized by clinically significant anhedonia. In this single-center, randomized, double-blind, placebo-controlled trial, adults with major depressive disorder, dysthymia or bipolar depression and elevated Snaith−Hamilton Pleasure Scale (SHAPS) scores were assigned (1:1) to flexible dose, once-daily oral pramipexole as add-on treatment or placebo for 9 weeks. The primary outcome was change in SHAPS score from baseline to week 9. Analyses were conducted in the modified intention-to-treat population. Eighty-five participants were randomized, and 82 were included in the analysis. The primary outcome was met: pramipexole was associated with a greater reduction in SHAPS scores compared to placebo (mean difference: −4.04, 95% confidence interval: −6.89 to −1.18, P = 0.006, Hedges’ g = 0.62). Exploratory analyses indicated that pramipexole was associated with increased light physical activity and relative preservation of reward-related ventral striatal activation. Improvements in anhedonia were sustained during a 6-month open-label extension. Pramipexole was generally well tolerated compared to placebo. Pramipexole significantly improved anhedonia and showed a favorable safety profile, supporting its potential as an augmentation strategy in mood disorders. ClinicalTrials.gov identifiers: NCT05355337 and NCT05825235 . Pramipexole, in patients with major depressive disorder, dysthymia or bipolar depression, reduced Snaith−Hamilton Pleasure Scale scores significantly compared to placebo.