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

APEX: Adaptive Principle EXtraction A Three-Layer Self-Evolution Framework for Production AI Agents

arXiv:2606.15363v1 Announce Type: new Abstract: Self-improvement in AI agents has emerged as a key research frontier: systems that modify their own prompts, workflows, and decision rules based on accumulated operational experience. The state-of-the-art Self-Harness framework [1] achieves 14–21% improvement on Terminal-Bench-2.0 by mining failure clusters and patching the agent harness. However, Self-Harness optimises only one dimension – the prompt harness – leaving behavioural principles and workflow topology unchanged. We propose APEX (Adaptive Principle EXtraction), a three-layer co-evolution framework that simultaneously evolves: (L1) the harness via failure-mode patching, (L2) behavioural principles via success-trace distillation [2], and (L3) the agent workflow topology via structural fitness-based selection [6]. We implement APEX on Joe [13], a production-grade super AI Agent built on NVIDIA Nemotron and designed as an Edge AI Agent Factory for the NVIDIA Agent Challenge 2026, managing a 15-node compute fleet using 114 real task traces collected over 18 days. APEX achieves an APEX Health Score of 0.570 (+90% vs. baseline 0.300) in a single evolutionary run, distilling 6 novel reusable principles and selecting a research-first workflow topology scoring 0.900 (+20%). Our results demonstrate that multi-dimensional co-evolution substantially outperforms single-axis harness optimisation, at a cost of only 4 LLM calls (~270 s) on a local qwen2.5-coder:32b instance.

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

Flex4DHuman: Flexible Multi-view Video Diffusion for 4D Human Reconstruction

We present Flex4DHuman, a multi-view video diffusion model that transforms a monocular or sparse multi-view video of a dynamic subject into synchronized dense multi-view videos using only relative camera-pose conditioning. Unlike prior human-centric methods that rely on skeletons, depth maps, normals, or rendered target-view geometry, Flex4DHuman requires no explicit geometry priors and instead conditions generation through relative camera-pose positional encoding. The generated videos can be directly ingested by downstream reconstruction pipelines to create dynamic 4D Gaussian splats. Built on the Wan 2.1 1.3B text-to-video model, Flex4DHuman preserves the backbone architecture and encodes camera and view information through a five-axis positional encoding that extends spatio-temporal RoPE with view indices and continuous SE(3) relative camera geometry. A three-stage curriculum progressively trains the model for pose following, flexible reference-to-target view generation, and temporal rollout. To support temporal rollout, we train with clean historical target-view tokens. We also add multi-view captions to enable test-time text control. Combined with an off-the-shelf 4D Gaussian Splatting stage, our framework lifts monocular static-camera videos into dynamic 4D Gaussian splats. Experiments on DNA-Rendering and ActorsHQ show that Flex4DHuman surpasses prior state-of-the-art methods, while the same formulation generalizes to animal categories after mixed human-animal training. These capabilities make Flex4DHuman a practical step toward scalable 4D content creation from casual monocular videos for simulation, gaming, AR/VR, and video re-shooting.

03.
arXiv (CS.AI) 2026-06-16

Adaptive $k$NN graph model

arXiv:2601.16509v2 Announce Type: replace-cross Abstract: The $k$-nearest neighbors ($k$NN) algorithm is a cornerstone of non-parametric classification in artificial intelligence, yet its deployment in large-scale applications is persistently constrained by the computational trade-off between inference speed and accuracy. Existing approximate nearest neighbor solutions accelerate retrieval but often degrade classification precision and lack adaptability in selecting the optimal neighborhood size ($k$). Here, we present an adaptive graph model that decouples inference latency from computational complexity. By integrating a Hierarchical Navigable Small World (HNSW) graph with a pre-computed voting mechanism, our framework completely transfers the computational burden of neighbor selection and weighting to the training phase. Within this topological structure, higher graph layers enable rapid navigation, while lower layers encode precise, node-specific decision boundaries with adaptive neighbor counts. Benchmarking against eight state-of-the-art baselines across six diverse datasets, we demonstrate that this architecture significantly accelerates inference speeds, achieving real-time performance, without compromising classification accuracy. These findings offer a scalable, robust solution to the inherent inference bottleneck of $k$NN, laying an adaptive structural foundation for graph-based nonparametric learning.

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

Automated Mediator for Human Negotiation: Pre-Mediation via a Structured LLM Pipeline

arXiv:2606.11379v1 Announce Type: new Abstract: Pre-mediation, the preparatory phase preceding direct human negotiation, plays a critical role in achieving mutually beneficial agreements, yet is often omitted due to cost, time, and limited access to trained mediators. We introduce an automated mediator for human negotiation, implemented as a structured pipeline of LLM modules, that supports pre-mediation in integrative negotiation settings. The pipeline decomposes preparation into specialized modules for dialogue, preference prediction, response-level critique, and structured summarization, separating inference, generation, and evaluation to address limitations of monolithic single-prompt approaches. We use the term "agent" for each module following common LLM-systems terminology, but the components are not autonomous and do not interact peer-to-peer; outputs are passed forward in a fixed sequence. We evaluate the system in two controlled human-subject experiments comparing AI-based pre-mediation with professional human mediators in a multi-issue negotiation scenario. On short-term self-reported measures, the automated mediator achieves preparation outcomes broadly comparable to human mediators, including trust in the mediator and confidence in reaching mutually beneficial agreements, while achieving substantially lower error on the preference-inference task under our scenario and prompts (36% lower RMSE). A second study shows that targeted prompt refinements reduce excessive affirmation patterns from 36.6% to 16.8%, matching human mediator baselines. Our findings suggest that structured LLM pipelines can provide scalable, low-effort pre-mediation support broadly comparable to human mediators on short-term self-reported preparation outcomes. The pipeline's single-party design mirrors how human mediators run pre-mediation today and enables parallel deployment across all parties to a dispute, supporting scalability.

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

3D Consistency Optimization for Self-Supervised Monocular Video Depth Estimation

Reliable monocular video depth estimation is crucial for downstream 3D reasoning and embodied AI in endoscopic navigation. However, existing self-supervised approaches typically treat video frames independently or rely on weak temporal regularization. These methods, lacking a holistic perception of the underlying 3D scene, inevitably suffer from geometrically inconsistent predictions and severe cross-frame drift. To address these limitations, we introduce a new paradigm that recasts sequential video depth estimation as an unconstrained multi-view 3D reconstruction problem, enabling full exploitation of the powerful geometric priors embedded in recent 3D foundation models. The core of our approach is a 3D consistency optimization framework driven by three constraints: image-level photometric rendering, explicit world-coordinate geometric alignment, and multi-scale temporal gradient consistency. Such unified optimization elegantly anchors isolated frames to a globally coherent 3D structure. Our method has been validated in both the self-supervised training scenarios and challenging zero-shot clinical environments. Results show that the proposed approach achieves state-of-the-art spatial accuracy, outperforming the frame-based, video-based depth estimators and the multi-view 3D reconstruction baselines.

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

ATRIA: Adaptive Traceable ECG Reporting with Iterative Agents

arXiv:2606.24392v1 Announce Type: new Abstract: Existing ECG report generation is tightly coupled – interpretation and reporting fused end-to-end, so errors propagate without stage-level recourse – while agent-based systems decouple tasks but remain single-pass, never revisiting earlier outputs. Clinical ECG reporting instead unfolds iteratively, requiring progressive context integration and bidirectional editing. We present \textsc{ATRIA}, a multi-agent ECG reporting system that mirrors the clinician's iterative workflow: it binds every report claim to its supporting evidence, flags statements unsupported by that evidence, incorporates additional context mid-session, and lets clinicians verify and revise individual findings rather than accept one opaque output. Because its agents use ECG analysis models already in clinical use, the underlying findings are clinically trustworthy; and as a cloud-based web service, \textsc{ATRIA} is ready for immediate deployment. We demonstrate \textsc{ATRIA} through four interaction cases, with a live demo and video available.

07.
arXiv (CS.CL) 2026-06-17

An expressivity analysis of hierarchical modelling in deep transformers via bounded-depth grammars

Deep neural networks are widely believed to derive their expressive power from their ability to form hierarchical representations, capturing progressively more abstract and compositional features across layers. In language modeling, transformers have emerged as the dominant architecture, with early layers capturing local syntactic patterns and later layers encoding more complex clause-level dependencies. While this intuition has shaped model design, there remains a lack of rigorous theoretical work demonstrating how deep transformers represent such hierarchical structures. In this work, we analyze the expressiveness of deep transformer models through the formal lens of bounded-depth, non-recursive context-free grammars. For this class of grammars, we explicitly construct transformers with positional attention whose depth grows linearly with grammar depth, while the neuron count scales with the number of derivation-tree shapes and quadratically with the number of production rules. Our theoretical results support the linear representation hypothesis by demonstrating that these architectures possess the structural capacity to encode abstract grammatical states into low-dimensional, linearly separable subspaces within the residual stream.

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

Can Artificial Intelligence Accelerate Technological Progress? Researchers' Perspectives on AI in Manufacturing and Materials Science

arXiv:2511.14007v3 Announce Type: replace-cross Abstract: Artificial intelligence (AI) raises expectations of substantial increases in rates of technological progress, but such anticipations are often not connected to detailed ground-level studies of AI use in innovation processes. Accordingly, it remains unclear how and to what extent AI can accelerate innovation. To help to fill this gap, we explore and assess results from 32 interviews with U.S.-based academic manufacturing and materials sciences researchers experienced with AI and machine learning (ML) techniques. We found that AI was primarily used for modeling of materials and manufacturing processes, facilitating cheaper and more rapid search of design spaces for materials and manufacturing processes alike. Benefits included cost, time, and computation savings in technology development. However, AI/ML tools were unreliable outside design spaces for which dense data were already available; they required skilled and judicious application in tandem with older research techniques; and concerns were raised about the potential to detrimentally circumvent opportunities for disruptive theoretical advancement. Based on these results, we suggest there is reason for optimism about acceleration in sustaining innovations through the use of AI/ML; but that support for conventional empirical, computational, and theoretical research is required to maintain the likelihood of further disruptive advances in manufacturing and materials.

09.
medRxiv (Medicine) 2026-06-22

Level of Physical Activity and ApoE Status - Effects on Alzheimer's Disease and on Mortality

Background: Alzheimer's disease and related dementias (ADRD) affect over 7.2 million Americans aged 65 and older, with the APOE-4 allele representing the strongest known genetic risk factor. Physical activity (PA) has been associated with reduced dementia risk, but its interaction with APOE genotype remains poorly characterized in large, genomically informed cohorts. Methods: We conducted a retrospective cohort analysis using linked genomic, survey, and longitudinal electronic health record data from the VA Million Veteran Program (MVP). Veterans aged

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

Unsafer in Many Turns: Benchmarking and Defending Multi-Turn Safety Risks in Tool-Using Agents

LLM-based agents are becoming increasingly capable, yet their safety lags behind. This creates a gap between what agents can do and should do. This gap widens as agents engage in multi-turn interactions and employ diverse tools, introducing new risks overlooked by existing benchmarks. To systematically scale safety testing into multi-turn, tool-realistic settings, we propose a principled taxonomy that transforms single-turn harmful tasks into multi-turn attack sequences. Using this taxonomy, we construct MT-AgentRisk (Multi-Turn Agent Risk Benchmark), the first benchmark to evaluate multi-turn tool-using agent safety. Our experiments reveal substantial safety degradation: the Attack Success Rate (ASR) increases by 16% on average across open and closed models in multi-turn settings. To close this gap, we propose ToolShield, a training-free, tool-agnostic, self-exploration defense: when encountering a new tool, the agent autonomously generates test cases, executes them to observe downstream effects, and distills safety experiences for deployment. Experiments show that ToolShield effectively reduces ASR by 30% on average in multi-turn interactions. Our code is available at https://github.com/CHATS-lab/ToolShield.

11.
arXiv (CS.CL) 2026-06-12

Language Model Circuits Are Sparse in the Neuron Basis

The high-level concepts that a neural network uses to perform computation need not be aligned to individual neurons (Smolensky, 1986). Language model interpretability research has thus turned to techniques which decompose the neuron basis into more interpretable units of model computation, such as sparse autoencoders (SAEs). However, not all neuron-based representations are uninterpretable. For the first time, we empirically show that MLP neurons are as sparse a feature basis as SAEs. We use this finding to develop an end-to-end gradient-based attribution pipeline for circuit tracing on the MLP neuron basis, which surfaces causally effective neurons on a variety of tasks. On a standard subject-verb agreement benchmark (Marks et al., 2025), a circuit of $\approx 10^2$ MLP neurons is enough to control model behaviour. On the multi-hop city-state-capital task from (Lindsey et al., 2025), we find a circuit in which small sets of neurons encode specific latent reasoning steps (e.g. mapping a city to its state), and can be steered to change the model's output. This work thus advances automated interpretability of language models without imposing additional training costs.

12.
arXiv (quant-ph) 2026-06-24

Efficient Graph State Purification with Factorized Graph-Preserving Operations across Local Clifford Orbits

arXiv:2606.23809v1 Announce Type: new Abstract: Graph states form a broad class of multipartite entangled states underlying measurement-based quantum computation, quantum networks, and stabilizer codes. However, systematic entanglement distillation for arbitrary graph states remains challenging because the circuit design space grows rapidly with the number of parties. We introduce a group of Clifford operations that we call "factorized graph-preserving". It enables us to efficiently enumerate and optimize graph-state purification circuits at finite size for realistic noisy hardware. These operations map products of graph-basis states to products of graph-basis states, so their action can be represented as permutations of graph-basis labels. Moreover, this useful gate set admits a compact factorized description determined by simple graph-theoretic features. This structure also allows, after some initial cached precomputation, drastically lower computational complexity for simulating a gate. We further organize these operations over local-complementation (LC) orbits using minimum-edge representatives (MERs), which let us design purification circuits that apply to all locally equivalent graph states (up to a basis change). Using this framework, we optimize noisy finite-size multipartite distillation circuits for several graph-state families. Numerical results show that the resulting graph-preserving circuits can outperform standard recurrence-based purification protocols under realistic gate and measurement noise. Our results establish LC-orbit structure and factorized graph-preserving operations as practical tools for scalable, topology-aware and hardware-constrained graph-state distillation protocol design. Our work can also be interpreted as a graph-based heuristic for finding transversal gates.

13.
arXiv (CS.AI) 2026-06-24

The Measurable Majority

arXiv:2606.23853v1 Announce Type: cross Abstract: This paper studies strict majority reasoning in finite electorates using so-called $social decision frames$: finite sets of voters equipped with distinguished families of coalitions interpreted as those voting blocs evaluated to form a strict majority. A coherence criterion for qualitative majority judgments is identified and shown to give an exact characterization for representability of strict majorities by finitely additive measures. In addition, a minimal natural logic for reasoning about strict majorities is shown to be sound and complete. These developments motivate examination of associated combinatorial questions concerning incoherence in finite families of sets; partial results and a conjecture are given. Finally, the results of this paper are applied to correct a classical representation theorem for weak qualitative probability structures due to Patrick Suppes and to establish a May-type characterization for ordinary strict majority rule for social decision frames.

14.
bioRxiv (Bioinfo) 2026-06-23

EnrichViz: An Interactive R Shiny Application for Visualization of Pathway Enrichment Results from Omics Data

Pathway and functional enrichment analysis is a cornerstone of omics data interpretation, enabling researchers to map differentially expressed proteins or genes onto curated biological processes, signaling cascades, and molecular functions. While tools such as Ingenuity Pathway Analysis (IPA), g:Profiler, and Enrichr are widely used to generate ranked enrichment results, translating these tabular outputs into clear, publication-ready figures remains a time-consuming step that typically requires custom scripting and familiarity with visualization libraries, a significant barrier for researchers without a computational background. Here we present EnrichViz, a self-contained, browser-based R Shiny application that enables interactive, code-free visualization of pathway and functional enrichment results from quantitative proteomics, transcriptomics, and metabolomics experiments. EnrichViz accepts three standard CSV files as input, a normalized abundance matrix, a sample annotation or metadata file, and enrichment results from any platform that exports tabular output, and produces six complementary, publication-ready visualizations: bar and bubble plots for ranking enriched terms by significance, chord diagrams for exploring pathway-molecule connectivity, clustered heatmaps for displaying Z-score normalized expression patterns across experimental groups, and boxplots or violin plots for examining the abundance distribution of individual proteins, genes, or metabolites. The application supports both raw p-values and pre-transformed -log10(p) values through automatic detection, and all plot parameters are adjustable in real time through a graphical sidebar. Every figure can be exported as a high-resolution PNG file at 300 dpi. EnrichViz is implemented in R using the Shiny, ggplot2, pheatmap, and circlize packages, and is freely available at https://rgmilian.shinyapps.io/EnrichViz/

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

Surveying GenAI-based Automation in Printed Circuit Board Design and Test

arXiv:2606.17074v1 Announce Type: cross Abstract: Generative artificial intelligence (GenAI) is increasingly used for applications in the hardware and software domains. It purports to reduce the manual effort involved in the development and testing of complex systems before release. Within the hardware space, most tasks have focused on design automation of integrated circuits, particularly with hardware description languages. However, other types of hardware also exist! In this survey, we instead examine how GenAI has been and is being across the printed circuit board (PCB) design life cycle. This includes everything from supply chains, system specification, circuit design, layout and optimisation, validation and test, and PCB assembly and distribution. Through this lens we present a taxonomy of discovered works, categorising them according to their intent and contributions. This survey also identifies key technical challenges that GenAI faces in this space, such as domain-specific data scarcity and limited support for integration with existing PCB tools. Finally, future research directions are discussed: our survey shows that there are many opportunities remaining when considering how GenAI may be integrated into various tasks in PCB design and test.

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

Elastic ODYN: Differentiable Optimization for Infeasible Control and Learning in Robotics

arXiv:2606.16564v1 Announce Type: cross Abstract: Robotic systems routinely encounter conflicting objectives, modeling errors, and degenerate contact conditions that render quadratic programs (QPs) infeasible. Yet most optimization solvers and differentiable QP layers assume feasibility, leading to numerical failures, unstable gradients, or solver breakdown when constraints cannot be simultaneously satisfied. We present Elastic ODYN, a primal–dual non-interior-point QP solver that handles infeasibility through smooth squared-$\ell_2$ elastic relaxations. The resulting formulation remains well posed under ill-conditioning and degeneracy, supports warm starting, and converges to closest-to-feasible solutions when no feasible point exists. A lightweight refinement stage recovers physically meaningful dual variables from the elastic solution. Building on this framework, we develop Elastic OdynLayer, a differentiable QP layer with stable gradients under infeasibility, and Elastic OdynSQP, an infeasibility-aware SQP method that resolves inconsistent subproblems and intrinsically infeasible optimal control tasks through selective constraint relaxation. We evaluate the framework on benchmark QPs, singular contact mechanics, differentiable parameter identification, and quadrupedal and humanoid trajectory optimization. Across all settings, Elastic ODYN consistently outperforms state-of-the-art elastic QP solvers in robustness, warm-start performance, and convergence reliability, enabling optimization, simulation, control, and learning beyond the feasibility assumptions of existing methods.

17.
arXiv (CS.LG) 2026-06-19

A graph neural network surrogate model for mesh-based crashworthiness prediction of vehicle panel components

arXiv:2503.17386v2 Announce Type: replace-cross Abstract: Crashworthiness is a key performance measure in the design of safety-critical vehicle panel components such as B-pillars. Finite element (FE) simulations are widely used to evaluate crash responses but remain computationally expensive for large-scale, nonlinear impact scenarios, particularly when integrated into iterative design and optimisation processes. Although machine learning-based surrogate models have been developed for rapid crashworthiness analysis, they exhibit limitations in detailed representation of complex 3-dimensional components. Graph Neural Networks (GNNs) have emerged as a promising solution for processing data with complex structures. However, existing GNN models often lack sufficient accuracy and computational efficiency to meet industrial demands. This paper proposes Recurrent Graph U-Net (ReGUNet), a graph-based surrogate model for crashworthiness analysis of vehicle panel components. By representing FE meshes in graph form, the model naturally accommodates complex irregular structural geometries. Its hierarchical architecture improves computational efficiency and accuracy, while the introduction of recurrence enhances stability of temporal predictions over multiple time steps. A side-impact case study of hot-stamped steel B-pillars with varying geometries is used to generate training dataset. The trained model demonstrates high accuracy in predicting the dynamic deformation behaviour and crashworthiness indicators of previously unseen component designs. ReGUNet achieves over a 52% reduction in the average deformation prediction error relative to baseline methods, together with markedly improved computational efficiency. ReGUNet provides rapid and reliable crashworthiness assessments, which in turn accelerates the design cycle of vehicle panel components.

18.
medRxiv (Medicine) 2026-06-10

Longitudinal brain structural changes during clozapine treatment: associations with neuroreceptor architecture and clinical response

In treatment-resistant schizophrenia, clozapine treatment has been associated with longitudinal reductions in subcortical volumes, ventricular enlargement, and widespread cortical thinning. However, it is unknown how these structural changes relate to clozapines pharmacological profile and clinical efficacy. We combined five longitudinal datasets with MRI acquired before and on average 5 months after clozapine initiation in 143 individuals to quantify brain structural changes and their association with normative maps relating to neuroreceptor architecture and physiological systems, and improvement in symptom severity. Clozapine treatment was associated with grey matter volume reductions across multiple subcortical regions (including the amygdala, hippocampus, thalamus, caudate, putamen and nucleus accumbens), increases in pallidal volume, ventricular enlargement, and widespread cortical thinning. Cortical regions showing the greatest magnitude of thinning corresponded to areas with higher normative densities of serotonergic 5-HT1A, 5-HT2A and 5-HT4 receptors. Changes in subcortical volume or cortical thickness during clozapine treatment were not associated with changes in total or positive symptom severity. In addition, baseline subcortical volume, cortical thickness, or gyrification prior to starting clozapine did not predict subsequent symptom improvement. Cortical thinning may partly reflect clozapines activity at serotonergic receptors, which have been implicated in cortical network stabilisation and neuroplasticity, however structural remodelling during clozapine treatment may reflect a process independent from its clinical efficacy in improving core symptoms of psychosis.

19.
arXiv (CS.AI) 2026-06-11

CCKS: Consensus-based Communication and Knowledge Sharing

arXiv:2606.12281v1 Announce Type: cross Abstract: In Decentralized Training and Decentralized Execution (DTDE) for cooperative Multi-Agent Reinforcement Learning (MARL), action-advising-based knowledge sharing promotes interpretable and scalable cooperation among agents. However, current action advising approaches often adhere too much to the teacher's guidance without evaluating teacher-student compatibility, which causes excessive advising, suboptimal stability, and degraded performance. To overcome these challenges, this paper presents a Consensus-based Communication and Knowledge Sharing (CCKS) framework, which allows agents to adopt recommendations based on consensus-derived constraints and to follow the teacher's instructions more smartly. This mechanism enables agents to balance exploration and learning from experienced teachers, improving overall performance. The key is the consensus model construction, for which we propose to employ contrastive learning to construct consensus models based on local observations in the agents' training phase. In action selection, agents score and choose actions based on consensus and shared knowledge. Designed as a plug-and-play solution, CCKS integrates seamlessly with existing DTDE algorithms. Experiments conducted in the Google Research Football environment and the complex StarCraft II Multi-Agent Challenge demonstrate that the integration with CCKS significantly improves cooperation efficiency, learning speed, and overall performance compared with current DTDE baselines. The code is available at https://github.com/yuanxpy/CCKS.

20.
medRxiv (Medicine) 2026-06-12

Metastatic Patterns and Treatment Characteristics of Triple-Negative Breast Cancer in Nigeria: A Retrospective Cohort Study

Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype characterized by the absence of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression. It is associated with limited targeted treatment options, early relapse, and a high propensity for visceral metastasis. Data describing metastatic patterns and treatment characteristics of TNBC in Nigeria remain limited. Methods: This retrospective descriptive cohort study included 869 patients with TNBC managed at the Medserve-LUTH Cancer Center, Lagos University Teaching Hospital, Nigeria between June 2019 and June 2024. Demographic, clinicopathologic, metastatic, and treatment-related data were extracted from electronic medical records. Descriptive statistics were used to summarize patient characteristics, metastatic patterns, and treatment profiles. Associations between metastatic disease and selected clinicopathologic and treatment variables were explored using Pearsons chi-square test. Complete-case analysis was applied throughout. Results: The mean age at presentation was 52.09 {+/-} 12.26 years. Most patients were married (79.1%), postmenopausal (64.3%), and of Yoruba ethnicity (56.8%). Advanced disease predominated, with Stage III and Stage IV disease accounting for 42.9% and 35.6% of cases, respectively. Invasive ductal carcinoma was the most common histologic subtype (77.0%), while Grade II tumours constituted 51.3% of graded cases. Surgery was performed in 73.1% of patients, predominantly mastectomy (70.9% of surgical procedures). Chemotherapy was administered to 83.2% of patients, most commonly anthracycline-based regimens (41.8%), while radiotherapy was delivered to 63.5% of patients, with hypofractionated schedules of 42-43 Gy in 15-16 fractions accounting for 47.2% of radiotherapy courses. Metastatic disease was documented in 32.9% of evaluable patients. Lung metastasis was the most frequent site (62.5%), followed by bone (46.3%), regional lymph node invasion (38.5%), liver (23.0%), and brain (22.6%). Tumour grade and histologic subtype were not significantly associated with metastatic disease, whereas radiotherapy exposure demonstrated a significant association with metastatic status ({chi}{superscript 2} = 10.35, p = 0.001). Conclusion: TNBC in this Nigerian cohort was characterized by advanced-stage presentation, invasive ductal predominance, extensive use of multimodality treatment, and substantial visceral metastatic burden. Lung metastasis was the most common metastatic site. These findings provide contemporary real-world data on TNBC in Nigeria and highlight the continuing need for earlier diagnosis, timely referral, and sustained investment in comprehensive cancer care services.

21.
medRxiv (Medicine) 2026-06-18

Intra-arterial recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) thrombolysis for acute medium vessel occlusion (MeVO-TNK): Study rationale and design

Background The optimal management of acute ischemic stroke caused by medium vessel occlusion (MeVO) remains uncertain. Recent randomized trials have failed to demonstrate a clear benefit of endovascular therapy in this population, whereas intra-arterial thrombolysis (IAT) has emerged as a biologically plausible alternative. However, prospective evidence supporting IAT in MeVO is lacking, and the optimal dosing strategy for stand-alone IAT remains undefined. Aim To preliminarily evaluate the efficacy and safety of intra-arterial tenecteplase (IA-TNK) plus standard medical therapy (SMT) compared with SMT alone in patients with acute MeVO stroke, and to explore a stepwise IA-TNK dosing strategy. Design The MeVO-TNK trial is a multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE), exploratory phase II study. A total of 60 participants with imaging-confirmed MeVO will be randomized 1:1 to receive either IA-TNK plus SMT or SMT alone. Participants presenting beyond 6 hours from symptom onset must demonstrate salvageable penumbral tissue on advanced imaging. Those assigned to the intervention group will receive up to two intra-arterial boluses of tenecteplase (0.0625 mg/kg per bolus), with the second bolus administered based on angiographic assessment of reperfusion and safety. Outcomes The primary efficacy outcome is final infarct volume measured at 72{+/-}24 hours after randomization. Secondary efficacy outcomes include the proportions of patients achieving modified Rankin Scale (mRS) scores of 0-1, 0-2 and 0-3 at 90 days, a shift analysis of the mRS distribution at 90 days, early neurological deterioration, and National Institutes of Health Stroke Scale score at 7 days or discharge. The primary safety outcome is symptomatic intracranial hemorrhage within 24 hours. Conclusions This trial will provide preliminary evidence on the biological efficacy, reperfusion potential and safety of stand-alone IA-TNK for acute MeVO stroke, helping to address an important evidence gap and inform the design of future confirmatory studies.

22.
arXiv (math.PR) 2026-06-16

The Winner Takes It All

arXiv:2606.16885v1 Announce Type: cross Abstract: The winner-takes-all (WTA) process takes place on an arbitrary graph. There is an agent on each vertex of the graph, and active agents at neighboring vertices play games. In each game, a randomly chosen agent wins, while the loser is eliminated from subsequent games. The games are played at random times; each game finishes instantaneously, and the games cease when each active agent has only losers among its neighbors. On the one-dimensional lattice, the fraction of winners in the final state is $e^{-1}$, and we also determine the fractions $w_j$ of winners who won $j=0, 1, 2$ games. For the WTA process on a segment, we determine statistics of the total number of winners (the average, the variance, and all higher cumulants), the probabilities of reaching the final state with the minimum or maximum number of winners, and establish the behavior near the boundaries. For infinite regular trees with vertices of degree $d$, i.e., Bethe lattices with coordination number $d$, the fraction of winners is $(2/d)^{d/(d-2)}$.

23.
medRxiv (Medicine) 2026-06-11

Conversational Speech for Respiratory Triage in Primary Care: A Pilot Study

作者:

Background. Respiratory complaints account for a substantial share of adult ambulatory care visits, and triaging them accurately has direct consequences for antibiotic stewardship and pathogen-specific therapy. Prior work has investigated voice as a triage signal, but that literature is dominated by single-condition detection from scripted speech in crowdsourced or controlled clinical settings and has not been evaluated at primary care scale on conversational ambient audio. Methods. A dataset of 514,377 ambient-recorded primary care visits from 379,225 adult patients at a US clinic network was used, with per-visit clinically assigned ICD-10 diagnosis codes and de-identified demographic and geographic metadata. Patient audio was extracted from each doctor-patient conversation, and spectral, voice quality, and prosodic features were computed. Eleven binary classification tasks were defined, aligned with a respiratory triage cascade (e.g., acute respiratory versus acute non-respiratory illness, and lower versus upper respiratory tract infection). An acoustic model (feed-forward network) was trained independently for each task using patient-stratified five-fold cross-validation and evaluated on a held-out test set. Each task's model was also compared against six non-acoustic baselines using a single demographic, geographic, or temporal variable. The 11 trained classifiers were composed into a hierarchical cascade and illustrated as case studies on selected patients. Results. Test-set AUC across the 11 tasks ranged from 0.602 (95% CI: 0.588-0.614) to 0.745 (95% CI: 0.742-0.748), with a mean expected calibration error of 0.018. Six of eleven binaries outperformed all confounder baselines. Four binaries showed median within-stratum AUC of 0.62-0.70 when the confounder was held fixed, indicating acoustic discrimination beyond what the confounder alone explains. The exception was the pneumonia versus non-pneumonia lower respiratory tract infection binary, which failed against the patient-city confounder baseline, plausibly reflecting a clinic-level difference in ICD-10 coding. Conclusion. Conversational primary care audio carries acoustic signal that discriminates clinically meaningful respiratory contrasts. Absolute performance is moderate, but the conditions are stricter than prior work: conversational speech and differential-diagnosis contrasts among sick patients. This pilot study is a baseline for voice-based clinical AI moving beyond sick-versus-healthy detection toward differential-diagnosis panels and a proof-of-concept for hierarchical reasoning.

24.
arXiv (quant-ph) 2026-06-15

Probing Many-Body Phenomena with Atomically Thin Nuclear Spin Layers in Diamond

arXiv:2510.27374v2 Announce Type: replace Abstract: Quantum simulation aims to recreate complex many-body phenomena in controlled environments, offering insights into dynamics that are otherwise difficult to model. Existing platforms, however, are often complex and costly to scale, typically requiring ultra pure vacuum or low temperatures. Here, we introduce a platform based on a thin, strongly interacting ${}^{13}C$ nuclear spin layer in diamond that allows controlled exploration of many-body dynamics at room temperature. Nearby nitrogen-vacancy centers enable polarization, readout, and, combined with radio-frequency fields, coherent control of the nuclear spins. We demonstrate strong, tunable interactions among the nuclear spins and use the system to probe discrete time-crystalline order across varying interaction ranges. By combining ease of use with operation at ambient temperatures, our work opens new opportunities for investigating strongly correlated many-body effects.

25.
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.