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01.
medRxiv (Medicine) 2026-06-22

Sex-specific multimorbidity clusters and all-cause mortality in relatively healthy older adults: findings from the ASPREE cohort

Background: Multimorbidity is common in older adults, but sex differences in chronic condition clustering remain unclear. This study explored multimorbidity clusters and their associations with all-cause mortality among community-dwelling adults aged 70 years and over. Methods: This was a secondary analysis of data from 16,095 Australian ASPREE participants aged at least 70 years without prior dementia or cardiovascular disease. Fifteen baseline chronic conditions were grouped using latent class analysis (LCA). Observed-to-expected (O/E) ratios characterised conditions over-represented within clusters, and Cox proportional hazards models assessed associations with all-cause mortality. Results: Among 16,095 participants (mean age 74 years), 88.3% had multimorbidity at baseline; 4,217 deaths occurred over a median follow-up of 10.85 years. Five clusters were identified overall: hypertension and dyslipidemia (52.1%), gout and metabolic (14.4%), depressive symptoms, osteoporosis and frailty (10.0%), anaemia and kidney disease (10.2%), and hypotension, thyroid disorder and past cancer (13.3%). Sex-stratified analyses revealed three clusters in males and four in females. The frailty, depressive symptoms and osteoporosis cluster was associated with higher mortality in both sexes (aHR 1.56 [95% CI 1.40-1.73] in males; 1.68 [1.49-1.89] in females). Higher mortality was also observed for the metabolic, gout and kidney disease cluster in males (aHR 1.63 [1.47-1.81]) and the gout, anaemia and kidney disease cluster in females (aHR 1.96 [1.74-2.21]). Conclusions: Distinct multimorbidity clusters differed by sex and were associated with increased all-cause mortality. These findings may support risk stratification, targeted screening, and more person-centred management of older adults with multimorbidity.

02.
bioRxiv (Bioinfo) 2026-06-16

Phylogenetic tree inference using generative models

Accurate inference of phylogenetic trees is fundamental to evolutionary biology, yet existing methods rely on complex pipelines involving multiple sequence alignment, explicit evolutionary models, and computationally intensive tree search procedures. Here, we present BetaInfer, a generative framework that reformulates phylogenetic tree inference as a sequence transduction problem. BetaInfer leverages hybrid transformer-based architectures to directly map sets of unaligned sequences to phylogenetic trees represented in Newick format. Trained on large-scale simulated evolutionary data with known ground truth, BetaInfer learns to capture complex evolutionary signals directly from sequence data. Ensemble-based generation of multiple candidate trees further improves robustness, reducing reconstruction error by over 30% relative to single predictions. Across extensive evaluations on both simulated and empirical datasets, BetaInfer achieves competitive performance relative to state-of-the-art phylogenetic pipelines, matching, and in some cases exceeding, the accuracy of established likelihood-based and distance-based methods under a wide range of conditions. Interpretability analyses reveal that BetaInfer leverages internal pairwise-distance computations to synthesize evolutionary relationships into an integrated, global representation that supports direct tree generation. Together, these results demonstrate that generative models can serve as a viable and scalable alternative to standard phylogenetic pipelines.

03.
arXiv (CS.LG) 2026-06-17

Learning Upper Lower Value Envelopes to Shape Online RL: A Principled Approach

arXiv:2510.19528v2 Announce Type: replace-cross Abstract: We investigate the fundamental problem of leveraging offline data to accelerate online reinforcement learning - a direction with strong potential but limited theoretical grounding. Our study centers on how to learn and apply value envelopes within this context. To this end, we introduce a principled two-stage framework: the first stage uses offline data to derive upper and lower bounds on value functions, while the second incorporates these learned bounds into online algorithms. Our method extends prior work by decoupling the upper and lower bounds, enabling more flexible and tighter approximations. In contrast to approaches that rely on fixed shaping functions, our envelopes are data-driven and explicitly modeled as random variables, with a filtration argument ensuring independence across phases. The analysis establishes high-probability regret bounds determined by two interpretable quantities, thereby providing a formal bridge between offline pre-training and online fine-tuning. Empirical results on tabular MDPs demonstrate substantial regret reductions compared with both UCBVI and prior methods while remaining competitive with related approaches.

04.
arXiv (CS.CL) 2026-06-11

Soft-Prompt Tuning for Fair and Efficient LLM Benchmark Evaluation

Benchmark scores often misrepresent a large language model's (LLM's) knowledge, because they rely, e.g., on the model's ability to follow specific formatting requirements. This especially penalizes base models that may know the correct answers but lack the ability – typically introduced in post-training – to structure them as instructed. To overcome this, we propose soft-prompt tuning, an efficient, fair, and architecture-agnostic model evaluation. By optimizing only 10 soft-prompt vectors (roughly 0.0006% parameters for a 7B model) over a short tuning period, we adapt models to specific benchmark formats, closing gaps in format-following and ensuring that underlying knowledge is accurately reflected in benchmark scores. This allows one to fairly compare different base models – trained with various pre-training recipes – on benchmarks without the need for full post-training. We evaluated soft-prompt tuning across 7 models and 7 datasets. The results show that (a) soft-prompt tuning saturates format-following within 80 steps (~640 samples) making it highly efficient, (b) soft-prompt tuning significantly outperforms zero- and few-shot prompting, surfacing base model knowledge that standard prompting misses, that (c) even post-trained models can benefit from soft-prompts to maximize format compliance, and that (d) soft-prompted base model performance predicts post-trained model rankings more reliably than zero- and few-shot baselines, offering a low-cost proxy for downstream model quality. Our contributions include (1) metrics which disentangle format-following and knowledge accuracy, (2) a fairer benchmarking protocol of LLM knowledge, and (3) a cost- and memory-effective recipe to identify optimal pre-training strategies early in LLM development.

05.
arXiv (CS.AI) 2026-06-15

When the Tool Decides: LLM Agents Defer Blindly to Graph Neural Network Tools, and Stronger Backbones Defer More

arXiv:2606.14476v1 Announce Type: new Abstract: A growing line of work equips large language model (LLM) agents with graph neural networks (GNNs) as callable tools, assuming the agent exercises judgment over when and how much to rely on such a tool. We test this directly. We expose a frozen GNN to a ReAct-style LLM agent as an explicit tool and measure, on node classification over a text-attributed graph (ogbn-arxiv, replicated on WikiCS), whether the agent uses the tool or merely obeys it. We find the agent does not exercise judgment: its predictions agree with the raw GNN's 97.6-99.2% of the time (5 seeds), collapsing into a GNN parrot that adopts the tool's output wholesale and bypasses its own reasoning. Sweeping backbone capability (Qwen2.5 0.5B-7B), the deference is not a weak-model artifact: among models able to invoke the tool, agreement rises with capability (0.60 to 0.98 from 1.5B to 7B). Crucially, the cost of deference does not shrink as capability grows and grows where alternatives emerge: a per-node oracle over the available actions beats the parrot by 0.09-0.18 at 3B and 0.12-0.22 at 7B, roughly doubling at high homophily, because the parrot is pinned to the frozen GNN while the agent's alternatives improve; at 7B a simple neighbour-label tool overtakes the GNN at high homophily (0.81 vs 0.71) yet the agent still defers. A simple selective-invocation gate recovers about half of that high-homophily gap (0.71 to 0.83) but yields no net global gain, and held-out estimates bound the best achievable gate over standard test-time features to at most a third of the oracle headroom: reliable selective invocation looks limited by available information, not merely router design. Our results are a cautionary measurement: evaluations of agent+tool systems cannot assume the agent adds judgment on top of the tool, and selective invocation must be designed in rather than expected to emerge from scale.

06.
bioRxiv (Bioinfo) 2026-06-16

Expanding gene regulatory networks from transcriptome data through graphical modeling with heterogeneous priors

Gene regulatory network inference is widely used to reconstruct large-scale networks and identify functional genes from transcriptome data. Meanwhile, in many biological fields, core regulatory genes have been extensively studied, leading to the establishment of small-scale gene regulatory networks, and novel genes connected to these networks remain to be identified. However, methods for expanding existing gene networks by identifying novel regulatory interactions, rather than reconstructing the entire network, are not well established. Here, we propose a method for gene network expansion that incorporates known regulatory relationships and evaluates each candidate gene individually to infer its regulatory connections to the existing network. Using simulated datasets from the DREAM4 benchmark and the PRECISE-1K experimental dataset, our method outperformed conventional methods by incorporating prior knowledge. In particular, it improved the ability to distinguish true regulatory interactions from indirect associations arising from strong correlations among genes in the existing network. The method also showed strong performance for interactions involving genes with high outdegree or centrality. Furthermore, it maintained stable performance as the size of the existing network increased and was robust to noise in prior information. These results demonstrate that our method provides an effective framework for expanding existing gene regulatory networks by leveraging prior knowledge.

07.
arXiv (quant-ph) 2026-06-12

Symmetry-Accelerated Classical Simulation of Clifford-Dominated Circuits

arXiv:2510.18977v2 Announce Type: replace Abstract: Classical simulation of quantum circuits plays a crucial role in validating quantum hardware and delineating the boundaries of quantum advantage. Among the most effective simulation techniques are those based on the stabilizer extent, which quantifies the overhead of representing non-Clifford operations as linear combinations of Clifford unitaries. However, finding optimal decompositions rapidly becomes intractable as it constitutes a superexponentially large optimization problem. In this work, we exploit symmetries in the computation of the stabilizer extent, proving that for real, diagonal, and real-diagonal unitaries, the optimization can be restricted to the corresponding subgroups of the Clifford group without loss of optimality. This ``strong symmetry reduction'' drastically reduces computational cost, enabling optimal decompositions of unitaries on up to seven qubits using a standard laptop – far beyond previous two-qubit limits. Additionally, we employ a ``weak symmetry reduction'' method that leverages additional invariances to shrink the search space further. Applying these results, we demonstrate exponential runtime improvements in classical simulations of quantum Fourier transform circuits and measurement-based quantum computations on the Union Jack lattice, as well as new insights into the nonstabilizer properties of multicontrolled phase gates and unitaries generating hypergraph states. Our findings establish symmetry exploitation as a powerful route to scale classical simulation techniques and deepen the resource-theoretic understanding of quantum advantage.

08.
arXiv (CS.AI) 2026-06-12

Can I Buy Your KV Cache?

arXiv:2606.13361v1 Announce Type: new Abstract: Right now, across the world, AI agents are repeating the same absurd act: to read one document, they each recompute it from scratch. Every agent re-runs prefill, the most compute-intensive step a large model takes, over identical text, only to rebuild a key-value (KV) cache identical to the one the agent before it just built. The same answer, computed a million times. We make a proposal that is almost offensively simple: compute it once. Let a publisher precompute a document's KV cache, and let every other agent buy the right to load it and skip prefill. It works, and it is token-exact: loading a precomputed KV and continuing matches prefilling from scratch (24/24 greedy tokens, and at the logits level), with no accuracy cost. On Qwen3-4B, reuse is 9-50x cheaper in compute than prefill, and the gap widens with length (prefill's attention scales with L^2), so a single reuse already pays it back. Then the part that matters: where the KV lives. Shipping it fails, because KV is nearly incompressible, so per-load egress costs more than the prefill it saves. Hosting it provider-side, exactly as production prompt-caching works, removes egress entirely. The size of the prize is set by our measured compute saving: serving one hot 3774-token document to 80M agents costs ~$1.5M to re-prefill but only ~$0.03M of reuse compute (49.7x less). The 0.1x cache-read tariff APIs charge passes a 10x discount to users while sitting inside this measured envelope, so the 10x is a floor that the measured ~50x compute saving clears, and the gap to the physical ~50x is provider margin: millions of dollars per popular document. We frame the resulting agent-native prefill CDN and leave lossless KV compression and a cross-party payment layer as the open problems.

09.
arXiv (CS.AI) 2026-06-11

DiffCold: A Diffusion-based Generative Model for Cold-Start Item Recommendation

arXiv:2606.12245v1 Announce Type: cross Abstract: Cold-start item recommendation remains a persistent challenge in real-world systems due to the absence of interaction histories. While prior models attempt to bridge this gap using item content features, they universally suffer from the seesaw dilemma: enhancing performance for cold items inevitably degrades performance for warm items, and vice versa. We identify that this dilemma stems from a fundamental distributional disparity: warm item embeddings occupy a complex ``behavioral manifold" shaped by rich interaction signals, whereas cold item embeddings are constrained to a ``semantic manifold" derived solely from auxiliary content. Existing methods often force a rigid mapping between these inconsistent spaces, causing the model to sacrifice the precision of warm representations to accommodate cold ones. To address this, we propose DiffCold, a diffusion-based generative model that unifies warm and cold representations. Unlike GANs or VAEs, DiffCold leverages conditional diffusion to reconstruct warm item embeddings from content, preserving the underlying manifold structure without degradation. We further tailor this paradigm with two specific designs: a Retrieval-enhanced Aggregator that initializes generation using semantically similar warm items to bypass inefficient noise, and a Simulation-based Representation Alignment module that enforces distribution consistency between generated and real embeddings via contrastive learning. Experiments on three benchmarks confirm that DiffCold resolves the seesaw dilemma, consistently outperforming state-of-the-art methods across all metrics.

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

Beyond Self-Attention: Sub-Quadratic Vision Transformers for Fast Image Captioning

Image captioning is a challenging and significant task that aims to generate coherent and semantically meaningful textual descriptions for given images. To accomplish this task, it requires a deep understanding of visual content along with the ability to express that understanding in natural language. Despite remarkable progress with transformer-based architectures, existing approaches often suffer from limitations, such as a lack of rich local feature representations and the high computational cost of quadratic self-attention. The proposed model focuses on improving computational efficiency by restructuring the vision transformer architecture. In designing this approach, the standard self-attention mechanism in Vision Transformers is replaced with a probabilistic transformer approach based on a Gaussian Mixture Model (GMM), a soft-clustering technique. Instead of computing pairwise attention among all image patches, the model groups similar patches into a fixed number of clusters using an Expectation-Maximization (EM) algorithm. This clustering-based mechanism reduces the computational complexity from quadratic O(n^2) to linear O(nK), where K

11.
arXiv (CS.LG) 2026-06-16

Petrov-Galerkin Variational Physics-Informed Neural Network Framework for Two-Dimensional Singularly Perturbed Problems

arXiv:2606.16510v1 Announce Type: cross Abstract: This study proposes a Petrov-Galerkin based Variational Physics-Informed Neural Network (VPINN) for efficiently solving two-dimensional singularly perturbed problems (SPPs) with one and two small perturbation parameters. The approach employs neural networks to construct the trial solution space, while tensor-product hat functions are adopted as test functions to enforce the variational form. To accurately resolve of sharp boundary layers, the variational form is implemented using a Petrov-Galerkin formulation. Dirichlet boundary conditions are imposed directly, while the source terms are computed using automatic differentiation. Computational experiments on standard two-dimensional problems demonstrate that the proposed method achieves high accuracy in both the maximum and L_2 norms. These results confirm the efficiency and robustness of the Petrov-Galerkin VPINN approach in accurately capturing the multiscale features of two-dimensional SPPs.

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

Concept Flow Models: Anchoring Concept-Based Reasoning with Hierarchical Bottlenecks

arXiv:2606.19489v1 Announce Type: cross Abstract: Concept Bottleneck Models (CBMs) enhance interpretability by projecting learned features into a human-understandable concept space. Recent approaches leverage vision-language models to generate concept embeddings, reducing the need for manual concept annotations. However, these models suffer from a critical limitation: as the number of concepts approaches the embedding dimension, information leakage increases, enabling the model to exploit spurious or semantically irrelevant correlations and undermining interpretability. In this work, we propose Concept Flow Models (CFMs), which replace the flat bottleneck with a hierarchical, concept-driven decision tree. Each internal node in the hierarchy focuses on a localized subset of discriminative concepts, progressively narrowing the prediction scope. Our framework constructs decision hierarchies from visual embeddings, distributes semantic concepts at each hierarchy level, and trains differentiable concept weights through probabilistic tree traversal. Extensive experiments on diverse benchmarks demonstrate that CFMs match the predictive performance of flat CBMs, while substantially mitigating information leakage by reducing effective concept usage. Furthermore, CFMs yield stepwise decision flows that enable transparent and auditable model reasoning with hierarchical class structures.

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

MNet++: Extended 2D/3D Networks for Anisotropic Medical Image Segmentation

This work demonstrates a full reproduction and extension of MNet, a hybrid 2D/3D convolutional network designed for anisotropic medical image segmentation. The original architecture was re-implemented within the nnU-Net framework to verify its reported performance and robustness to variable voxel spacing, known as anisotropy. Experiments were conducted on PROMISE prostate MRI and a controlled subset of LiTS liver CT under matched preprocessing and compute constraints. The reproduced MNet achieved a Dice similarity coefficient (DSC) of 89.0 +/- 0.9% on PROMISE, within 0.8% of the published result, and 94.3 +/- 1.9% / 54.6 +/- 3.1% for liver and tumor segmentation on LiTS, respectively. Two lightweight extensions were further introduced: (1) a learned Fusion Gating mechanism enabling adaptive 2D-3D feature blending, and (2) a VMamba state-space module for efficient long-range depth modelling. The Spatial Gating variant improved DSC by +0.8% with less than 3% inference overhead, while VMamba improved performance consistency, reducing PROMISE Dice variation to +/- 0.7% and achieving the strongest LiTS liver performance at 95.8% Dice. Both extensions preserved MNet robustness to anisotropy, with delta Dice = 1.5% across 1-4 mm voxel spacing. Overall, the study confirms MNet reproducibility and demonstrates that adaptive fusion and state-space modelling have the potential to further strengthen segmentation reliability under anisotropic conditions. However, further tests are required to provide definitive conclusions.

14.
medRxiv (Medicine) 2026-06-24

Repetitive Transcranial Magnetic Stimulation over Primary Somatosensory Cortex for Upper Limb Function in Stroke: An Exploratory Randomized Controlled Trial

Background: Stroke often causes Upper Limb (UL) functional impairments. The Primary Somatosensory Cortex (S1) plays an important role in motor learning. Repetitive Transcranial Magnetic Stimulation (rTMS) over S1 could enhance UL recovery. We aimed to explore its preliminary effects on UL motor activity and function post-stroke. Methods: An exploratory parallel-group randomized controlled trial in people with chronic stroke (>3 months) and moderate hemiparesis was conducted. Participants received 20 sessions of active or sham 5Hz rTMS over affected S1, with Robot-Assisted Therapy and Task-Oriented Training, 5 days/week for 4 weeks. The primary endpoint was UL motor activity (Action Research Arm Test, ARAT). Secondary measures were the UL Fugl-Meyer Assessment (UL-FMA) and sensory outcomes. Results: The baseline-adjusted mean difference (MD) in ARAT was 4.05 points [0.78, 7.33], favoring active stimulation. Secondary measures did not favor active stimulation (UL-FMA: MD = 2.62 [-1.51, 6.76]; sensory outcomes showed no between-group differences). Conclusion: High-frequency rTMS over S1 may enhance UL motor activity (ARAT), but no evidence for motor impairment (UL-FMA) or sensory domains was found. Compensation rather than restoration may underlie this improvement. Stimulation targets should match the intended recovery domain, although larger trials are needed to confirm these preliminary findings.

15.
arXiv (CS.CL) 2026-06-24

Towards Version-aware Operations and Transaction Memories for Multi-layer MeMo

作者:

MeMo proposes language models with explicit multi-layer correlation matrix memories (CMMs), where memorization, retrieval, and forgetting are architectural operations. This paper asks how such memories can reduce the need for retraining when knowledge changes. For changes expressible as MeMo memory associations, the model's accessible knowledge can be updated by editing explicit memories rather than retraining the whole model. We propose a version-aware operation layer in which high-level operations such as replace, obsolete, keep-history, rollback, and trace are compiled into MeMo-native primitive calls over sequences and tokens. The key observation is that a version-aware operation is rarely a single MeMo association. It is an ordered transaction of primitive edits, for example forgetting one sequence-token chain, memorizing another, preserving a historical chain, and recording an inverse program. The framework introduces two auxiliary CMMs: a Version CMM (V-CMM) for mapping version transitions to transaction handles, and a Transaction CMM (T-CMM) for storing reusable change contents and inverse programs. It supports both direct sequence-level edits and structured diff-level inputs, and outlines an evaluation route for update success, rollback, traceability, locality, and transaction reuse.

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

Distributional Loss for Robust Classification

This paper proposes a novel loss concept for supervised classification tasks. Rather than enforcing a direct mapping from each input sample to a single assigned label, we define an optimization objective over all classifier outputs as a bimodal Gaussian distribution. This softer target formulation implicitly captures class ambiguity, mitigates overfitting, and encourages the learning of more robust decision boundaries, all without requiring additional label information. Experimental results demonstrate consistent improvements in robustness, with particularly pronounced gains in low-data regimes, while requiring only minimal modifications to standard training pipelines.

17.
arXiv (CS.AI) 2026-06-15

Minim: Privacy-Aware Minimal View for Agents via Trusted Local Sanitization

arXiv:2606.13949v1 Announce Type: new Abstract: Modern LLM-powered autonomous agents increasingly rely on rich user interface (UI) state observations to achieve reliable action grounding in complex digital environments. However, many deployments transmit the full UI state to remote inference servers even when most elements are irrelevant to the current task, which can leak sensitive but unnecessary context such as authentication codes, private notifications, and background application states. We propose MINIM, a trusted local broker that performs privacy-aware minimization on the client side before any observation leaves the device. Grounded in Contextual Integrity (CI), MINIM learns a dual-score representation for each UI element by predicting an inherent sensitivity score (s) and a task-conditioned necessity score (n). These scores drive a ternary disclosure policy that keeps essential elements, abstracts sensitive attributes when needed, and removes task-irrelevant content. We optimize a CI-aware objective that penalizes necessity errors more strongly on high-risk content, enabling aggressive pruning while preserving task-critical information. Experiments on real-world UI observations derived from WebArena show that MINIM substantially reduces task-irrelevant sensitive leakage while preserving task-critical semantic context and the interactive affordances required for reliable agent actions.

18.
arXiv (CS.CL) 2026-06-15

CacheRL:Multi-Turn Tool-Calling Agents via Cached Rollouts and Hybrid Reward

We present CacheRL, a system for training small agent foundation models that achieves 92 percent process accuracy on multi-step tool-calling tasks, approaching GPT-5's 94 percent while requiring 100 times less compute. Our approach addresses three challenges in practical agent training: transferring tool-calling knowledge from large models at scale, enabling reinforcement learning without costly live tool execution, and learning robustly from noisy cached environments. CacheRL introduces three key innovations. First, a hybrid thinking trajectory pipeline augments agent trajectories with LLM-generated reasoning traces, producing training examples that teach models not only what tools to call but also why. Second, the CacheAgentLoop eliminates live execution costs through a three-tier fuzzy cache while preserving trajectory fidelity using token-level masking. Third, a cache-tier-aware reward dynamically adjusts answer-quality weights to avoid penalizing models for cache-induced limitations. Through iterative supervised fine-tuning (SFT) and Group Relative Policy Optimization (GRPO), CacheRL improves Qwen3-4B-Thinking's validation reward from 0.43 to 0.78. On public agentic tool-calling benchmarks, our model achieves competitive performance against frontier models such as GPT-5. Ablation studies show that removing knowledge transfer reduces performance by 41 percent, while cache-aware rewards contribute a 17 percent improvement. Interestingly, reinforcement learning improves training stability but yields limited gains beyond strong supervised fine-tuning, suggesting that data quality and reward design play a more important role than complex optimization methods in building practical small agent models.

19.
medRxiv (Medicine) 2026-06-17

Treatment of Multi-Drug-Resistant Tuberculosis with Second-Line All-Oral Drugs in Ghana: Incidence of Adverse Events.

Introduction: The treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging due to the toxicity of second-line medications and suboptimal treatment outcomes. This study aimed to determine the incidence of adverse events and identify factors associated with these events in patients undergoing treatment for MDR-TB with second-line all-oral drugs in Ghana. Methods: This retrospective cohort study reviewed the medical records of 384 MDR-TB patients treated with second-line all-oral drugs at selected health facilities in Ghana, including the Greater Accra Regional Hospital, Eastern Regional Hospital, and Kumasi South Hospital. Data were extracted using the Kobo Collect tool, capturing patient demographics, baseline clinical and laboratory characteristics, treatment regimens, and adverse events. The study period spanned from 2020 to August 2024. Results: The study included a total of 384 MDR-TB patients, with a mean age of 45 years (SD = 15). The majority of patients were male (65.78%), and most were within the 45-64 years age group (33.85%), followed by those aged 25-44 years (31.25%). Regionally, the highest number of cases were reported from the Greater Accra Region (39.06%), followed by the Eastern Region (31.25%) and Kumasi South Hospital (29.69%). Approximately one in four patients (25%) presented with comorbidities, with HIV being the most common (19.5%). The most frequently reported adverse events were diarrhea (14%), dizziness (13.7%), and vomiting (12.3%). Most of these were mild to moderate in severity and tended to decrease as treatment progressed. Severe adverse events, such as leukopenia and acute kidney injury, were rare, occurring in less than 5% of patients. Over the course of treatment, gastrointestinal adverse events such as vomiting and nausea showed a significant decline, indicating possible patient adaptation or improved clinical management. Results from the multivariate Poisson regression analysis revealed that age and comorbidities were significant predictors of adverse events. Patients aged 65 years and above had a 56% lower risk of developing adverse events compared to younger patients (Adjusted Risk Ratio [aRR] = 0.44, 95% CI: 0.25-0.79, p = 0.005). Conversely, patients with comorbid conditions such as diabetes or hypertension were approximately 2.6 times more likely to experience adverse events compared to those without comorbidities (aRR = 2.65, 95% CI: 1.58-4.43, p < 0.001). The effect of sex was not statistically significant after adjustment (aRR = 1.03, 95% CI: 0.70-1.50, p = 0.86). At the end of the treatment period, 74.9% of patients achieved successful outcomes, including both those who were cured and those who completed treatment without being classified as cured. However, 25.1% had unsuccessful outcomes, which included treatment failure, relapse, or death. Conclusion: In conclusion, adverse events are common in the treatment of MDR-TB with second-line All-Oral drugs, with gastrointestinal adverse events being the most prevalent. These findings highlight the importance of monitoring and managing adverse events to optimize treatment outcomes for MDR-TB patients in Ghana.

20.
arXiv (math.PR) 2026-06-25

Itô's Formula for It\^{o} processes defined with respect to a cylindrical-martingale valued measure

arXiv:2407.16086v3 Announce Type: replace Abstract: Using the authors' recently developed stochastic integration [Stoch PDE: Anal Comp, 2024], we prove an It\^{o} formula for Hilbert space-valued It\^{o} processes defined with respect to a cylindrical martingale-valued measure. We develop some tools from stochastic analysis, as are the predictable and optional quadratic variation of a stochastic integral, the continuous and purely discontinuous parts of an integral process, and a Riemann representation formula. As an application of our It\^{o} formula, we prove a Burkholder inequality for the stochastic integral defined with respect to a cylindrical martingale-valued measure. Finally, we derive It\^{o} formulas for Hilbert space-valued martingale-valued measures and for cylindrical square integrable martingales.

21.
arXiv (quant-ph) 2026-06-24

Nonlinear refractive index of warm rubidium vapor

arXiv:2606.24676v1 Announce Type: cross Abstract: The potential to precisely control both the linear and nonlinear index of refraction through optical manipulation of the atomic states has recently pushed warm alkali vapors to the forefront of research in the field of quantum sensors, quantum memories, and quantum fluids of light. Rubidium (Rb) vapor in centimeter-scale glass cells or millimeter-scale MEMS cells has proven to be a very promising platform for these applications, yet only a handful of research works have been dedicated to the investigation of the (non)linear refractive index of Rb vapor. We present results of theoretical calculations of the (non)linear refractive index of warm Rb vapor, based on the optical Bloch equations for 6-level Rb atoms interacting with a probe laser. They are compared to the experimental results obtained using an interferometric technique, showing excellent quantitative agreement. A Kerr nonlinear refractive index $n_2$ of up to $10^{-4}$ cm$^2$/W is obtained. Python scripts for all theoretical calculations presented in this work are provided, including the refractive index calculation, that can readily be used in practical implementations for simulating the (non)linear refractive index of Rb vapor including the effects of Doppler broadening, transit time broadening, pressure broadening, saturation, optical pumping, and spin-exchange collisions.

22.
arXiv (CS.AI) 2026-06-16

Phase-Aware Guidance Injection for Recurrent MAPPO in Assembly-Line Disruption Recovery

arXiv:2606.16330v1 Announce Type: new Abstract: Disruption recovery in industrial assembly lines requires timely decisions under machine faults, worker absence, and emergency orders. Existing methods either rely on rigid handcrafted recovery logic or learn adaptive policies that do not readily exploit heterogeneous external recovery knowledge at decision time to reduce abnormal recovery time (ART) and preserve on-time delivery (OTD). To address this gap, we propose a phase-aware guidance injection framework that augments a trained recurrent MAPPO (RMAPPO) scheduling policy through logit-level action bias during evaluation. The framework provides a unified decision-time interface for rule-based, replay-based, and online LLM-based guidance, while activating intervention only during abnormal and recovery phases. Experiments on a custom AssemblyLineEnv show that high-quality rule guidance yields the strongest gains, replay-based guidance degrades smoothly under imperfect availability, and online LLM guidance still provides useful intermediate improvements. These results show that decision-time guidance injection can exploit heterogeneous recovery hints without redesigning the actor.

23.
medRxiv (Medicine) 2026-06-24

Differential COVID-19 Outcomes Across Lysosomal Disorders

Background Lysosomal disorders (LDs) are a heterogeneous group of rare inherited disorders characterized by multi-system involvement and high comorbidity burden, which raises concerns about severe COVID-19 outcomes. Conversely, because SARS-CoV-2 relies on endolysosomal pathways for cellular entry and replication, certain LDs may exert a protective effect against viral pathogenesis. Prior clinical evidence investigating LDs and severe SARS-CoV-2 infection has been limited by small sample sizes and inconsistent findings. Therefore, to resolve these conflicting biological hypotheses and estimate population-level outcomes, we conducted a large-scale retrospective cohort study using nationwide U.S. harmonized electronic health record data from the National Clinical Cohort Collaborative (N3C). This design utilized longitudinal records starting January 1, 2018, to evaluate COVID-19 infections captured between January 1, 2020, and July 11, 2024. Results The study included 16,380 individuals, comprising 5,460 patients with lysosomal disorders and 10,920 matched controls. Patients with LDs had significantly higher odds of COVID-19 hospitalization compared with controls (OR = 1.86, 95% CI: 1.70-2.04). Elevated odds were observed across the evaluated categories, but varied substantially. Notably, neurodegenerative LDs such as neuronal ceroid lipofuscinosis (OR = 9.32) and metachromatic leukodystrophy (OR = 2.33) remained associated with hospitalization after adjustment for comorbidities. Contrarily, the elevated odds for Fabry disease and Gaucher disease were no longer significant after adjustment. Mortality among hospitalized patients with LDs was comparable to that of matched controls (one-year survival: 82.1% vs 82.0%), suggesting that LD status does not independently worsen survival once hospitalization occurs. Conclusions Patients with LDs were at an increased odds of COVID-19 hospitalization, driven by a combination of elevated comorbidity burden and disorder-specific effects, which vary significantly across LD categories. This study clarifies that excess risk is concentrated in the transition to hospitalization. These patients may thus require personalized clinical care to mitigate the negative consequences of COVID-19.

24.
arXiv (CS.AI) 2026-06-16

Optimal Transport for Machine Learners

arXiv:2505.06589v2 Announce Type: replace-cross Abstract: Modern machine learning repeatedly manipulates probability measures: empirical datasets, generated samples, latent distributions, class-conditional laws, particle systems, weights of wide networks and attention patterns. Optimal transport is useful in this setting because it compares such objects by asking how mass should move. It therefore combines a statistically meaningful notion of discrepancy with a geometry of interpolation, dual certificates and variational dynamics. This makes OT a common language for losses, generative modeling, domain adaptation, robust learning, barycenters, gradient flows and mean-field descriptions of learning algorithms. This book presents the main OT techniques with these machine-learning uses in mind. It starts from finite assignment and the Monge map viewpoint, passes to Kantorovich couplings and dual potentials, and then explains the algorithmic ideas that make transport usable: linear programming, semi-discrete cells, Sinkhorn scaling and low-dimensional projections. The same objects are then reused as a geometry of measures, giving Wasserstein distances, barycenters, gradient flows, dynamic formulations and Gaussian/Bures formulas. The final chapters emphasize the variants most relevant to modern ML: divergences and adversarial losses, entropic and unbalanced relaxations, robust or spectral ground geometries, Gromov and quantum extensions, and transport-based views of generative models, mean-field networks and attention dynamics. The goal is to keep the mathematics explicit while exposing the computational and geometric intuitions needed to turn OT into a working toolbox for machine learners.

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arXiv (CS.CV) 2026-06-17

SegDINO: Introducing Multi-Scale Structure into DINO for Efficient Medical Image Segmentation

Self-supervised DINO models provide strong transferable visual representations, yet applying them directly to image segmentation remains challenging. Existing approaches commonly rely on heavy decoders with complex upsampling, introducing substantial parameter and computational overhead. We observe that introducing scale into DINO features is far more critical than increasing decoder capacity. In this work, we present SegDINO, an efficient segmentation framework that integrates a DINOv3 backbone with lightweight scale modeling. SegDINO introduces Token Pyramid Adaptation (TPA) to reorganize intermediate DINO features into a pseudo multi-scale hierarchy, and Scale-Aware Decoding (SAD) for efficient intra-scale refinement and top-down multi-scale propagation. We further curate PanCT, a new CT dataset containing 284 patients with expert-annotated pancreatic tumors, to assess SegDINO's ability to handle difficult small-lesion cases. Extensive experiments on PanCT and three public benchmarks demonstrate that SegDINO achieves state-of-the-art results with high efficiency. The code is available at https://github.com/script-Yang/segdino_v2.