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01.
arXiv (CS.CV) 2026-06-16

CRIS: Cross-Plane Self-Supervised Isotropic Restoration for Anisotropic Volumetric Imaging Across Modalities

Anisotropic volumetric acquisitions are common in clinical MRI and volume electron microscopy (vEM), where sparse through-plane sampling creates thick slices or sections that degrade orthogonal reformats and downstream analysis. We present CRIS, a cross-plane self-supervised framework for isotropic restoration without paired isotropic ground truth. CRIS casts 3D restoration as 2D stripe completion on orthogonal reformats of an isotropic grid: high-resolution in-plane slices are synthetically degraded and periodically masked for training, while at inference blank slices define the isotropic grid, two orthogonal reformats are restored, and predictions are fused by multi-view averaging. We evaluate CRIS on two MRI cohorts and two microscopy benchmarks up to 8x anisotropy. On brain MRI, CRIS achieves 32.921 +/- 0.436 dB PSNR and 0.9631 +/- 0.0027 SSIM, outperforming interpolation, SMORE4, SIMPLE, SA-INR, and ATME, and gives the best segmentation consistency (Dice 0.940 +/- 0.004, ASSD 0.245 +/- 0.014 mm, HD99 1.275 +/- 0.061 mm). On reference-free abdominal MRI, CRIS reduces FID/KID to 48.714/0.023. On vEM, CRIS outperforms interpolation, NIIV, and vEMINR, reaching 29.133 dB/0.834 3D PSNR/SSIM at 4x, 27.123 dB/0.734 on EPFL at 8x, and 21.915 dB/0.699 on noisy hemibrain data. In a robustness experiment, one variable-gap CRIS model evaluated across gap factors 3–7 and coronal, axial, and sagittal degradations maintained higher PSNR/SSIM than interpolation (36.36–31.14 dB and 0.977–0.932 vs. 33.07–27.85 dB and 0.951–0.853). These results support CRIS as a modality-flexible route to isotropic restoration without paired isotropic targets or configuration-specific retraining. Code is available at https://github.com/adi-hatav/CRIS.

02.
arXiv (CS.CV) 2026-06-12

GeoWorld-VLM: Geometry from World Models for Vision-Language Models

Modern Vision-Language Models (VLMs) achieve strong semantic recognition, yet remain brittle on elementary spatial relations such as left of, on, behind, and between. One cause of this failure arises before language reasoning begins: the visual pathway may compress or discard critical 3D structural cues during feature extraction, so the language model receives image representations that are already insufficient for reliable spatial judgment. We introduce GeoWorld-VLM, a VLM-side distillation framework that transfers geometric structure from frozen camera-conditioned video world models into VLMs. GeoWorld-VLM fine-tunes only the image encoder and multimodal projector, aligning post-projector image features with intermediate world-model representations while leaving the main backbone frozen. Given images, a prompt, and a sampled camera trajectory, the world-model teacher converts static visual input into a synthetic multi-view spatial signal. Training combines spatial answer supervision, teacher-student feature alignment, and a preservation anchor to the original VLM. Since the language model remains frozen, GeoWorld-VLM preserves the original model's linguistic capabilities while attributing spatial improvements to the enhanced visual pathway. To evaluate the effectiveness and generality of the proposed method, we apply GeoWorld-VLM to two distinct VLM architectures and observe consistent improvements across both backbones. GeoWorld-VLM improves performance by approximately 4 percent on both the What'sUp and VSR benchmarks, suggesting that world-model-guided visual alignment generalizes across model structures and spatial reasoning datasets.

03.
arXiv (CS.CL) 2026-06-24

CORE-Bench: Fostering the Credibility of Published Research Through a Computational Reproducibility Agent Benchmark

AI agents have the potential to aid users on a variety of consequential tasks, including conducting scientific research. To spur the development of useful agents, we need benchmarks that are challenging, but more crucially, directly correspond to real-world tasks of interest. This paper introduces such a benchmark, designed to measure the accuracy of AI agents in tackling a crucial yet surprisingly challenging aspect of scientific research: computational reproducibility. This task, fundamental to the scientific process, involves reproducing the results of a study using the provided code and data. We introduce CORE-Bench (Computational Reproducibility Agent Benchmark), a benchmark consisting of 270 tasks based on 90 scientific papers across three disciplines (computer science, social science, and medicine). Tasks in CORE-Bench consist of three difficulty levels and include both language-only and vision-language tasks. We provide an evaluation system to measure the accuracy of agents in a fast and parallelizable way, saving days of evaluation time for each run compared to a sequential implementation. We evaluated two baseline agents: the general-purpose AutoGPT and a task-specific agent called CORE-Agent. We tested both variants using two underlying language models: GPT-4o and GPT-4o-mini. The best agent achieved an accuracy of 21% on the hardest task, showing the vast scope for improvement in automating routine scientific tasks. Having agents that can reproduce existing work is a necessary step towards building agents that can conduct novel research and could verify and improve the performance of other research agents. We hope that CORE-Bench can improve the state of reproducibility and spur the development of future research agents.

04.
arXiv (CS.CV) 2026-06-24

FlowDec: Temporal Conditional Flow Decorruptor for Robust Continuous Vision-Language Navigation

Vision-and-Language Navigation in Continuous Environments (VLN-CE) requires agents to follow natural-language instructions in unseen scenes. While Large Models (LMs) have advanced VLN-CE, their performance remains severely degraded by real-world visual corruptions, a critical yet underexplored domain constraint. We introduce Temporal Conditional Flow Decorruptor (FlowDec), a novel image restoration framework tailored for LM-based VLN-CE. FlowDec integrates a hybrid temporal conditioning strategy to align the generative flow path with historical context and employs action-centroid guided filtering to dynamically assess and integrate outputs. Extensive experiments demonstrate that FlowDec outperforms state-of-the-art decorruption methods in both navigation accuracy and generation latency. Our approach establishes a robust, efficient paradigm for resilient embodied navigation in unpredictable real-world conditions.

05.
arXiv (CS.CV) 2026-06-16

MIRAGE: Runtime Scheduling for Multi-Vector Image Retrieval with Hierarchical Decomposition

To effectively leverage user-specific data, retrieval augmented generation (RAG) is employed in multimodal large language model (MLLM) applications. However, conventional retrieval approaches often suffer from limited retrieval accuracy. Recent advances in multi-vector retrieval (MVR) improve accuracy by decomposing queries and matching against segmented images. They still suffer from sub-optimal accuracy and efficiency, overlooking alignment between the query and varying image objects and redundant fine-grained image segments. In this work, we present an efficient scheduling framework for image retrieval - MIRAGE. First, we introduce a novel hierarchical paradigm, employing multiple intermediate granularities for varying image objects to enhance alignment. Second, we minimize redundancy in retrieval by leveraging cross-hierarchy similarity consistency and hierarchy sparsity to minimize unnecessary matching computation. Furthermore, we configure parameters for each dataset automatically for practicality across diverse scenarios. Our empirical study shows that, MIRAGE not only achieves substantial accuracy improvements but also reduces computation by up to 3.5 times over the existing MVR system.

06.
medRxiv (Medicine) 2026-06-24

Model-based Detection of Spatial Disease Boundaries Using Amortized Bayesian Inference

Disease boundary analysis identifies abrupt changes in health outcomes across geographic boundaries, guiding targeted public health interventions and outbreak surveillance. Current implementations often adopt a Bayesian "wombling" approach and largely rely on Markov Chain Monte Carlo (MCMC) posterior sampling, presenting scalability issues for large-scale disease surveillance. We leverage amortized Bayesian inference (ABI) to accelerate the detection of spatial health disparities between neighboring US counties by embedding neural posterior estimation within a Bayesian areal wombling framework. Exploiting the computational efficiency of ABI, we further introduce the Residual Disparity Elimination Target, a metric for the required reduction in mortality or prevalence for a region to eliminate a significant disparity with its neighbor. We analyze tracheal, bronchus, and lung cancer mortality rates across mainland US counties and achieve results concordant with MCMC analysis while scaling areal wombling to hundreds of outcomes and translating disparity detection into interpretable policy objectives.

08.
arXiv (quant-ph) 2026-06-12

Symmetry and Topology of Monitored Quantum Dynamics

arXiv:2412.06133v4 Announce Type: replace-cross Abstract: The interplay between unitary dynamics and quantum measurements induces diverse phenomena in open quantum systems with no counterparts in closed quantum systems at equilibrium. Here, we generally classify Kraus operators and their effective non-Hermitian dynamical generators, thereby establishing the tenfold classification for symmetry and topology of monitored free fermions. Our classification elucidates the role of topology in measurement-induced phase transitions and identifies potential topological terms in the corresponding nonlinear sigma models. Furthermore, we establish the bulk-boundary correspondence in monitored quantum dynamics: nontrivial topology in spacetime manifests itself as topologically nontrivial steady states and gapless boundary states in Lyapunov spectra, such as Lyapunov zero modes and chiral edge modes, leading to the topologically protected slowdown of dynamical purification.

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

MixTeX: Data-Efficient LaTeX OCR via Synthetic Pretraining and Limited Fine-Tuning

LaTeX OCR converts scientific document images into editable LaTeX code. Existing systems rely on large paired datasets, which are costly to collect and limited for low-resource languages. This paper presents MIXTEX, a data-efficient system using synthetic pretraining without real LaTeX sources. Unlike Nougat that depends on arXiv datasets, we generate training data by randomly pairing grammatical Wikipedia text with LaTeX formulas, requiring only syntactic correctness. This eliminates dependency on real document collections, enables scalable data generation (120M tokens), and supports low-resource languages. Following synthetic pretraining, adaptation requires only 400 real samples. Evaluation on a 977-sample benchmark with printed and handwritten English and Chinese shows that this two-stage strategy outperforms methods trained on large real datasets while requiring less human effort and computation. Data, code, and models are publicly available.

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

CogCanvas: A Benchmark for Evaluating Multi-Subject Reference-Based Image Generation

Multi-subject reference-based image generation requires jointly preserving multiple human identities, binding per-person objects and fashion items, and respecting a specified background scene, a regime where current diffusion models remain brittle. Existing benchmarks evaluate only one axis at a time and none jointly captures multi-identity composition with human-object interaction, background grounding, and spatial plausibility. We introduce CogCanvas, a benchmark of 1,952 curated reference images spanning 100 celebrity identities, 115 distinctive objects and fashion items, and 29 real-world background scenes including landmarks, from which we construct 1,361 compositional prompts covering 2-5 person group sizes. The curation pipeline combines DINOv2-based deduplication, two-stage aesthetic filtering, and automated derivation of structured interaction and position graphs that serve as ground-truth supervision. CogCanvas supports three tasks, reference-based multi-human-object generation (primary), text-to-image compositional generation, and reference retrieval, under a unified six-axis evaluation protocol. We introduce two metrics tailored to the multi-reference setting: BG-Sim, which scores background fidelity on SAM 3-masked regions via DINOv3 feature similarity, and Attr-VQA, which uses a multimodal LLM to verify per-subject attribute binding and inter-person interactions against the structured graphs. Benchmarking five SOTA methods reveals that every model degrades substantially as group size grows from 2 to 5, with near-complete failure on object/fashion binding beyond three subjects.

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

Multiple Poisson-Dirichlet diffusions on generalized Kingman simplices

arXiv:2602.20266v2 Announce Type: replace Abstract: We construct a new class of infinite-dimensional diffusions with values in a generalized Kingman simplex with finitely many marks. The model describes the temporal evolution of the relative frequencies of infinitely many types that are labeled by a finite number $H$ of marks, but unlabeled within each mark. We first establish a blockwise skew-product representation for a finite-type Wright-Fisher diffusion, extending the aggregation-renormalization self-similarity property of Dirichlet laws. The decomposition separates an $H$-dimensional Wright-Fisher diffusion governing the evolving random mark masses, from $H$ Wright-Fisher diffusions, each run on its own random clock, which describe the evolution of the relative frequencies within each mark. After ranking the within-mark frequencies in decreasing order, we identify the distributional limit as the number of types per mark tends to infinity and we derive an explicit form of its infinitesimal generator on a suitable domain. The limiting diffusion admits the multiple Poisson-Dirichlet distribution as a stationary distribution; it recovers the infinitely-many-neutral-alleles diffusion when all types share the same mark and yields a diffusion on the Thoma simplex when there are two marks.

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

Stepwise Token Selection for Efficient Multimodal Large Language Models

In multimodal large language models (MLLMs), inference cost is largely dominated by the visual token prefix rather than the language backbone, making token reduction a key factor for improving efficiency. Existing approaches typically assign independent importance scores to visual tokens and retain a fixed number of top-ranked tokens, implicitly assuming token independence and a uniform compression ratio across inputs. In this work, we reformulate visual token pruning as a sequential decision-making process. Specifically, we introduce a pointer-style selection mechanism that iteratively chooses informative tokens, conditioning each decision on previously selected ones, and dynamically determines when to stop via a learned termination action. This enables joint optimization of both the selected subset and its size. To enable end-to-end training under standard language modeling objectives, we design a differentiable relaxation based on a variance-preserving noise interpolation scheme, allowing gradients to propagate through the discrete selection process. Extensive experiments on LLaVA-v1.5-7B and Qwen2.5-VL-7B demonstrate that our approach consistently outperforms fixed-ratio baselines across different compression levels. Under aggressive pruning that removes 88.9% of visual tokens, our method preserves 94.6% of the original accuracy while achieving a 1.88x speed-up in prefill latency.

13.
medRxiv (Medicine) 2026-06-22

Accounting for uncertainty in the expected treatment effect substantially increases the sample size required for randomised trials: implications for the feasibility of clinical trials in anaesthesia and critical care

Background Multicentre trials in anaesthesia and critical care report low rates of statistically significant differences. This finding may partly reflect conventional sample size methods, which assume a fixed treatment effect. Assurance methods use a design prior to represent uncertainty in the expected treatment effect, which may provide a more realistic way of estimating sample sizes. Methods We calculated power curves across a range of effect sizes, design priors, and sample sizes using frequentist and Bayesian assurance methods and compared the sample sizes required to achieve 80% and 90% power to the conventional method. We standardised the design priors across effect sizes using the coefficient of variation. We derived a theoretical limit for achievable power. We validated a normal approximation to the Bayesian posterior distribution. Results Frequentist and Bayesian assurance methods produced similar power curves across all scenarios. At a coefficient of variation of 0.5 - reflecting realistic prior uncertainty in the expected effect size - both methods required sample sizes that were approximately 1.5 to 3.5 times larger than the conventional method. The theoretical power limit depends only on the coefficient of variation of the design prior and holds true across all effect sizes. The normal approximation to the Bayesian posterior distribution matched the results obtained from Markov chain Monte Carlo sampling. Conclusions Incorporating clinical uncertainty in the expected effect size substantially increases the sample size required to achieve adequate power, which has important implications for the feasibility of randomised trials in anaesthesia and critical care.

14.
bioRxiv (Bioinfo) 2026-06-14

Generative design of antigen-specific T-cell receptor sequences with a conditional diffusion model

T cell receptor (TCR)-based immunotherapy holds immense potential for treating cancers and infectious diseases, where highly antigen-specific TCR recognition is crucial for adaptive immunity against tumors and pathogens. Engineering or de novo generation of the complementarity-determining region 3 (CDR3) loops of TCRs using artificial intelligence offers a powerful alternative to designing reactive TCRs rather than laborious experimental screening. However, current in silico approaches are constrained by weak conditional guidance, limited flexibility, and a lack of rigorous functional validation. To address these limitations, we introduce TCRDiff, a generative diffusion framework for designing antigen-specific TCRs conditioned on peptide-MHC (pMHC) targets and germline-encoded variable genes. By leveraging pre-trained knowledge from massive T-cell repertoires and TCR-pMHC recognition data, TCRDiff generates CDR3{beta} sequences with state-of-the-art fidelity to native binding TCRs through a denoising diffusion process. Furthermore, incorporating the interface geometry features generated TCR-pMHC complexes with superior structural plausibility. As a proof of concept, we deployed TCRDiff in a systematic pipeline to design candidate TCRs for immunotherapy. In vitro activation assays validated that TCRDiff-generated TCRs specifically recognize the MAGE-A3 epitope with minimized off-target cross-reactivity. Together, TCRDiff establishes a powerful, validated computational paradigm to accelerate the development of TCR-based immunotherapies.

15.
Nature (Science) 2026-06-23

Daily briefing: NASA to launch satellite-rescue mission

作者:

The space agency will lift the orbit of a falling satellite by around 200 kilometres. Plus, Europe’s efforts to take on the US and China as a science superpower and the narcissism of bosses who want to nix remote working. The space agency will lift the orbit of a falling satellite by around 200 kilometres. Plus, Europe’s efforts to take on the US and China as a science superpower and the narcissism of bosses who want to nix remote working.

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

A Multi-Level Architecture for Reusable Materials Ontologies – The OntoCrafter Ceramics Ontology (OCO) as Reference Implementation

arXiv:2606.14814v1 Announce Type: cross Abstract: The Materials Science and Engineering ontology landscape is fragmented along multiple axes simultaneously. Horizontally: a recent survey identified 94 ontologies of which over 40 are structurally incompatible; each new application domain – ceramics, polymers, batteries, smart materials – typically restarts ontology design from scratch. Vertically: EU regulation (CSRD, CSDDD, PPWR, CBAM, R2R, AI Act, ESPR) forces material, manufacturing, supply-chain, and lifecycle data into integrated digital product passports, leaving ontologies that only address horizontal fragmentation incomplete for any contemporary consumer. And mechanistically: a vocabulary that records that BNT-BT has $d_{33} \approx 580$ pC/N stores a fact but cannot surface why – Bi-6s$^2$ lone-pair stereo-activity, anomalous Born effective charges, soft modes, defect chemistry – without a systematic explanation skeleton. We propose a multi-level modular architecture with two independent classification axes – level of abstraction (L0 bridges, L1 material-agnostic laboratory-notebook, L2 material-class-specific, L3 categorical reasoning) and consumer audience (material vs. compliance) – in which the material-specific level is internally organised by a seven-tier mechanistic-explanation skeleton (Symmetry, Energy/DFT, Thermo/CALPHAD, Kinetics, Microstructure, Defect chemistry, Bonding) applicable to any crystalline ionic oxide. The level-and-audience modularity dissolves the horizontal fragmentation, the compliance audience absorbs the vertical regulation pressure, and the seven-tier organisation of Level 2 delivers the mechanistic explanation depth. We instantiate the architecture as the OntoCrafter Ceramics Ontology (OCO v0.94): 5,196 classes across 44 modules; 167,348 OWL axioms (40,454 logical); 1,674 properties; 829 cross-ontology bridge mappings; 1,172 SHACL shapes; 163 published competency questions.

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

HAPI-EP: Towards Hybrid, Adaptive, and Predictive Digital Twins of Cardiac Electrophysiology

arXiv:2606.15637v1 Announce Type: new Abstract: A digital twin (DT) of a patient-specific heart offers significant potential in personalized medicine. However, its rapid and dynamic adaptation to an individual's live data and its predictive capability after adaptation remains central challenges. We examine this challenge from its two building blocks: DT formulation where mechanistic and data-driven models show competing merits and limitations, and DT optimization strategies that are largely driven by a reconstruction objective leading to un-identifiable models. We address both bottlenecks via HAPI – an AI framework for building hybrid, adaptive, and predictive DTs with three key enablers. First, HAPI constructs a physics-integrated gray-box model in which an interpretable mechanistic backbone is augmented by a neural component that models its residual to the observed data. Second, rather than attempting to pre-encode all possible variations in a static hybrid model, HAPI enables rapid on-the-fly adaptation of the hybrid model to few-shot live data, achieved by feedforward meta-learners realizing amortized inference of both mechanistic and neural parameters of the hybrid model trained with predictive objectives. Finally, we show that this adaptivity corresponds to the construction of a conditional generative model (i.e., the hybrid DT) that endows it with theoretical identifiability and thus strong performance in predictive scenarios. We demonstrate the proof-of-concept of HAPI in cardiac electrophysiology using a hybrid monodomain model with mechanistic reaction kinetics and neural graph diffusion. Across synthetic and real-data studies, we show that HAPI's mechanistic-neural hybridization and predictive adaptation are critical for obtaining identifiable DTs with strong predictive and out-of-distribution capabilities.

18.
arXiv (CS.CV) 2026-06-24

Learning Ego-Centric BEV Representations from a Perspective-Privileged View: Cross-View Supervision for Online HD Map Construction

Bird's-eye-view (BEV) representations derived from multi-camera input have become a central interface for online high-definition (HD) map construction. However, most approaches rely solely on ego-centric supervision, requiring large-scale scene structure to be inferred from incomplete observations, occlusions, and diminishing information density at long range, where perspective effects and spatial sparsity hinder consistent structural reasoning. We introduce Cross-View Supervision (CVS), a representation learning paradigm that transfers geometric and topological priors from an ego-aligned overhead perspective into camera-based BEV encoders. Rather than adding auxiliary semantic losses, CVS aligns representations in a shared BEV feature space and distills globally consistent structural knowledge from a perspective-privileged teacher into the ego-centric backbone. This supervision enhances structural coherence without modifying the inference architecture or requiring overhead input at test time. Experiments on nuScenes using ego-aligned aerial imagery from the AID4AD cross-view extension demonstrate consistent improvements over StreamMapNet while maintaining identical camera-only inference. CVS yields +3.9mAP in the standard $60\times30\,\mathrm{m}$ region and +9.9mAP in the extended $100\times50\,\mathrm{m}$ setting, corresponding to a 44% relative gain at long range. These results highlight perspective-privileged structural supervision as a promising training principle for improving BEV representation learning in HD map construction.

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

Fair Online Resource Allocation

arXiv:2606.18679v1 Announce Type: cross Abstract: We study the problem of fair online resource allocation, motivated by applications such as refugee resettlement and airline scheduling, where agents arrive sequentially and must be assigned to facilities with limited capacities. We introduce a model that maximizes the overall welfare subject to resource constraints and a Lipschitz fairness requirement, which ensures that similar agents arriving in the same batch receive similar expected outcomes. We first analyze the offline problem, proving that the value of the optimal fair allocation is at least an $\Omega(1/\gamma)$ fraction of the optimal unfair allocation, where $\gamma$ is the fairness coefficient, thereby bounding the price of fairness. For the online setting, we propose an algorithm based on dual mirror descent that enforces fairness constraints within batches while estimating optimal dual variables. We prove that this algorithm achieves sublinear regret relative to the optimal offline fluid benchmark. Finally, we validate our theoretical results using real-world data from the Refugee Economies Programme, demonstrating the algorithm's performance and examining the trade-offs between welfare maximization and fairness enforcement.

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

Correcting Sensor-Induced Distribution Drift with Wasserstein Adversarial Learning

arXiv:2606.18561v1 Announce Type: cross Abstract: The quality of recorded data depends on the stability of the sensor system that acquires it. Sensor motion and aging can degrade the performance and stability of downstream data-driven methods. We present a Wasserstein-GAN-inspired approach for unsupervised inference of physically interpretable transformation parameters that map a changed detector response distribution back to a nominal reference distribution. In contrast to standard generative modeling, the generator is used as a learnable calibration transformation whose trainable weights represent the sought parameters, while the critic provides a distributional distance signal via the Wasserstein objective. We validate the approach on a tracking-detector toy model with controlled layer shifts and demonstrate its application on high-granularity Geant4-simulated calorimeter data with cell-wise aging effects. The method recovers aging coefficients for individual cells with correlation to ground truth and improves agreement between calibrated and reference energy-sum distributions, while exhibiting the expected degradation at increasing channel-to-channel noise levels. These results indicate that adversarial distribution matching can serve as a data-driven component of calibration strategies in settings where direct labels for degradation parameters are unavailable.

22.
bioRxiv (Bioinfo) 2026-06-16

Super Learner Ensemble Modeling of CPTAC Proteomic Data for Survival Prediction in Head and Neck Squamous Cell Carcinoma

Survival analysis in head and neck squamous cell carcinoma (HNSCC) is traditionally performed using Cox proportional hazards models, alongside some exploration into black-box machine learning methods. The Super Learner (SL) algorithm addresses this model selection dilemma by combining diverse candidate algorithms into a weighted ensemble to perform comparably to the best candidate method. This study evaluates the performance of SL in HNSCC. Proteomic features as well as clinical covariates from 96 CPTAC HNSCC samples were modeled with three candidate algorithms (Cox LASSO, Cox Ridge, and Random Survival Forest) as well as the ensemble SL method. Models were optimized via Uno's time-dependent Concordance Index (C-index) and tested at 1- and 3-year time horizons using 2000 bootstrap resamples. The Cox Ridge regression model achieved the highest predictive accuracy among the four total methods. However, the SL demonstrated stable performance over both time horizons (1-year C-index: 0.985; 3-year C-index: 0.960). Variable importance analysis of the Cox Ridge model successfully identified malignant proteins (ATR, MAML1, MIEN1) alongside novel potential prognostic indicators (ZNF800, KERA). This analysis emphasizes the statistical necessity for larger cohorts for ensemble learning, while providing a benchmark of proteomic indicators in HNSCC.

23.
medRxiv (Medicine) 2026-06-15

Sociodemographic Disparities in Tafamidis Initiation and Clinical Outcomes in ATTR-CM Across the United States

BACKGROUND Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease. Sociodemographic factors may influence time to treatment initiation and resulting clinical outcomes, yet these relationships are poorly characterized. OBJECTIVE Assess the effects of sex and race on tafamidis initiation and subsequent outcomes and their interaction with factors such as ATTR-CM type and social deprivation measures. METHODS A retrospective cohort analysis was conducted using the US Komodo Healthcare Map (01/2016-06/2024) among patients with amyloidosis, identified by ICD-10-CM diagnosis codes. Cumulative incidence of treatment initiation and survival probabilities for cardiovascular-related hospitalization (CVH) or death were estimated by Kaplan-Meier, stratified by sex and race. Cox proportional hazards models were fitted for both endpoints to estimate hazard ratios, adjusting for demographics and clinical characteristics. RESULTS Of 11,311 patients identified, White and Black patients (n=9,223) were included in subsequent analyses. Within 12 months of diagnosis, White women had the lowest cumulative incidence of tafamidis initiation (11.4%), followed by Black women (22.0%), Black men (26.7%), and White men (31.0%). Event-free survival at 12 months was lowest in Black women (42.9%), followed by Black men (46.8%), White women (48.6%), and White men (54.4%). Median (95% CI) time to CVH or death was shortest for Black women (8.0 months [6.8-10.0]) followed by Black men (9.9 months [8.8-12.0]), White women (11.0 months [9.6-13.0]), and White men (15.0 months [14.0-16.0]). CONCLUSIONS In this large, real-world cohort of US patients with ATTR-CM, sex and race contributed to disparities in tafamidis initiation and survival, underscoring compounded disparities in both access and outcomes.

24.
medRxiv (Medicine) 2026-06-16

AI-assisted continuous-time modelling of metastatic breast cancer reveals subtype-specific spatiotemporal organ interactions

Metastatic breast cancer is one of the leading causes of premature mortality among women worldwide. A major barrier to optimal care is the marked heterogeneity in both the temporal dynamics of metastatic spread and the organ-specific spatial distribution of metastases. Existing analyses do not adequately capture this complexity, as they either neglect temporal dependencies or assume independence between metastasic sites. As a result, it remains unclear how established metastases influence subsequent organ-specific dissemination. We address this question using patient-level longitudinal trajectories from a large multicentre real-world metastatic breast cancer registry, combined with an AI-assisted disease-progression modelling framework based on continuous-time Markov chains that represent combinations of metastatic sites and the non-uniform and practice-driven timing of radiologic response assessments, as encountered in routine clinical care. We present a stochastic model determined by progression rates, which are parameterised to capture baseline organ-specific transition risks, patient-level covariates, and pairwise inter-organ interaction effects. High-dimensional treatment information is incorporated using an large language model based encoding. We find that metastatic spread follows non-independent, subtype-specific spatiotemporal patterns, with subtype-specific inter-organ interaction patterns that shape progression. Visceral metastases, particularly lung and liver metastasis, are associated with an increased hazard of subsequent brain metastasis, with effects varying across hormone receptor-positive, HER2-positive, and triple-negative subtypes. Together, these findings define a clinically relevant spatiotemporal architecture of metastatic progression in breast cancer. This framework enables refined mechanism-informed risk stratification and provides a data-driven rationale for targeted and risk-adapted – rather than symptom-triggered – surveillance strategies.

25.
arXiv (CS.CL) 2026-06-12

Why Sampling Is Not Choosing: Intentionality, Agency, and Moral Responsibility in Large Language Models

Recent advances in large language models (LLMs) have prompted claims that such systems exhibit agency or qualify as moral agents. This paper argues that these attributions are misguided. We maintain that moral responsibility requires commitment-bearing agency grounded in intrinsic intentionality and self-attributed action, and that such agency constitutes the form of free will relevant to responsibility. Although LLMs generate coherent and normatively evaluable outputs, their operation is fully characterized by probabilistic input-output mappings learned from data. Their apparent intentionality is derived rather than intrinsic, and their outputs are neither owned as commitments nor guided by reasons. Variability introduced by stochastic sampling does not amount to choice or authorship. We address objections from the intentional stance, functionalism, compatibilism, and the presence of moral reasoning in model outputs, arguing that none suffice to establish genuine agency.