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

Generative Molecular Design with Steerable and Granular Synthesizability Control

arXiv:2505.08774v2 Announce Type: replace-cross Abstract: Designing molecules that are both property-optimal and readily synthesizable is a central challenge in drug discovery. Existing works that do consider synthesizability can jointly output predicted synthesis routes for generated molecules. However, there has been minimal attention in addressing the ease of synthesis and with flexibility to incorporate desired reaction constraints. On the other hand, virtual screening searches for commercially available compounds, but imposes challenges when scaling to ultra-large (billion-size and beyond) chemical spaces. Here, we propose a generative design framework that unifies synthesis-constrained molecular design and ultra-large-scale virtual screening through steerable and granular synthesizability control. Generated molecules satisfy arbitrary multi-parameter optimization objectives with predicted synthesis routes satisfying mix-and-match constraints: including or avoiding certain reactions, incorporating specific building blocks, and minimizing synthesis route length. In an end-to-end in-house campaign targeting BRD4, we designed molecules synthesizable with specific selected reactions and building blocks, synthesized all six selected compounds, and identified two micromolar binders. We further demonstrate that reaction control enables efficient navigation of ultra-large make-on-demand chemical spaces to identify property-optimal candidates. By applying our framework to Chemspace's Freedom 4.0 make-on-demand space (142 billion molecules), we generated ~320k molecules (0.00023% of the library) on a single consumer-grade GPU (with only 8 GB GPU memory) and identified a micromolar Wee1 binder amongst 60 synthesized candidates. The single unified framework thus enables generating novel synthesizable molecules and retrieving catalogue-ready candidates, offering a flexible solution to mitigating the synthesizability bottleneck.

02.
arXiv (CS.CV) 2026-06-19

HY-WU (Part I): An Extensible Functional Neural Memory Framework and An Instantiation in Text-Guided Image Editing

Foundation models are transitioning from offline predictors to deployed systems expected to operate over long time horizons. In real deployments, objectives are not fixed: domains drift, user preferences evolve, and new tasks appear after the model has shipped. This elevates continual learning and instant personalization from optional features to core architectural requirements. Yet most adaptation pipelines still follow a static weight paradigm: after training (or after any adaptation step), inference executes a single parameter vector regardless of user intent, domain, or instance-specific constraints. This treats the trained or adapted model as a single point in parameter space. In heterogeneous and continually evolving regimes, distinct objectives can induce separated feasible regions over parameters, forcing any single shared update into compromise, interference, or overspecialization. As a result, continual learning and personalization are often implemented as repeated overwriting of shared weights, risking degradation of previously learned behaviors. We propose HY-WU (Weight Unleashing), a memory-first adaptation framework that shifts adaptation pressure away from overwriting a single shared parameter point. HY-WU implements functional (operator-level) memory as a neural module: a generator that synthesizes weight updates on-the-fly from the instance condition, yielding instance-specific operators without test-time optimization.

03.
arXiv (CS.AI) 2026-06-19

Mitigating Legibility Tax with Decoupled Prover-Verifier Games

arXiv:2602.23248v2 Announce Type: replace Abstract: As large language models become increasingly capable, it is critical that their outputs can be easily checked by less capable systems. Prover-verifier games can be used to improve checkability of model outputs, but display a degradation in accuracy compared to a baseline trained only to maximize correctness – a phenonemon named legibility tax. We propose a solution by decoupling the correctness from the checkability condition and instead training a "translator" model that turns a fixed solver model's solution into a checkable form. This allows us to first train the solver to maximize correctness, and then train the translator to translate the solver into a checkable form while retaining the solver's answer. To accommodate this new objective of translation, we formulate a decoupled prover-verifier game (DPVG) where the equilibria correspond to faithful and checkable translators.

04.
medRxiv (Medicine) 2026-06-22

The direct economic impact of surgical non-response in orthopaedic hip, knee, and spine surgery for osteoarthritis: a cost-utility analysis

Background Annually, nearly 2 million hip, knee, and spinal inpatient surgeries are performed in Canada and the US for osteoarthritis (OA), costing over $37 billion in hospital expenditures. However, 15-30% of patients experience limited or no improvement, resulting in poor value for money. This study evaluated the one-year cost-utility of joint and spine procedures for OA by comparing non-responders to responders, considering various responder definitions. Methods Individual micro-costing data were collected for 1,175 elective hip, knee, and spine patients enrolled in the Longitudinal Evaluation in the Arthritis Program - Osteoarthritis (LEAP-OA) between 2014 and 2018. Quality-adjusted life years (QALYs) were derived using the SF-6D utility index. One-year incremental cost-utility ratios (ICURs) were calculated from the hospital perspective. Results Responder rates varied by definition, ranging from 78%-94% for hip replacements, 64%-90% for knee replacements, 60%-64% for spine fusions, and 50%-68% for spine decompressions. Corresponding ICURs were: $45,956-$51,773/QALY for responders versus $108,593-$485,762/QALY for non-responders for hip replacements; $54,831-$71,151/QALY for responders versus $200,486-$1,203,596/QALY for non-responders for knee replacements; $65,980-$74,422/QALY for responders versus $262,039-$729,686/QALY for non-responders for spine fusions; and $29,947-$42,168/QALY for responders versus $63,195-$662,586/QALY for non-responders for spine decompressions. Conclusions While surgical response rates were highly dependent on the responder definition, ICURs for non-responders were significantly higher than those for responders across all definitions. Beyond the negative impact on patients, there is a compelling economic argument for investment in improved pre-operative identification of patients at risk of surgical non-response. Such efforts could enable more personalized, value-based care pathways and reduce the provision of low-value surgical interventions.

05.
arXiv (math.PR) 2026-06-12

Conditional means, vector pricings, amenability and fixed points in cones

arXiv:2512.13829v4 Announce Type: replace Abstract: We develop a generalization of conditional probability for arbitrary ordered vector spaces. A related problem is that of assigning a numerical value to one vector relative to another. We characterize the groups for which these generalized probabilities can be stationary, respectively invariant. Our results deviate from the setting of classical probability and lead to a new criterion for amenability and for fixed points in cones.

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

Multi-Granular Attention-Driven Reinforcement Learning Framework for Web Intelligent Enhancement Systems

arXiv:2606.19690v1 Announce Type: new Abstract: From the past few years, web intelligent enhancement systems increasingly rely on heterogeneous and dynamic web data to deliver personalized, context-aware services. However, traditional machine learning, deep learning, and reinforcement learning models often struggle with semantic understanding, adaptability, and scalability in continuously evolving web environments. In this research, a Multi-Granular Attention-based Reinforcement Web Intelligent Enhancement System (MGAR-WIES) is proposed to address the challenges by integrating semantic graph modeling, attention mechanisms, and adaptive reinforcement learning. Initially, heterogeneous web data comprising structured, semi-structured and unstructured sources are collected and preprocessed for generating unified feature representations. These representations are transformed into a dynamic semantic graph, where entities and their relationships are modeled by using graph embeddings enhanced by attention mechanisms for capturing both local relevance and global contextual dependencies. Subsequently, an adaptive multi-agent reinforcement learning strategy leverages the attention-aware semantic states to optimize personalized web actions like content recommendation, navigation optimization, and service adaptation. Finally, the continuous online feedback is further integrated to update graph representations and learning policies in real time by ensuring sustained adaptability and performance. The proposed MGAR-WIES acheived better results in terms of accuracy (80%) when compared with existing approaches.

07.
arXiv (CS.AI) 2026-06-12

CausalMoE: A Billion-Scale Multimodal Foundation Model for Granger Causal Discovery with Pattern-Routed Heterogeneous Experts

arXiv:2606.13024v1 Announce Type: cross Abstract: Granger Causal Discovery (GCD) is fundamental for analyzing temporal dependencies in complex systems. However, existing neural GCD methods predominantly rely on a "one-size-fits-all" paradigm, struggling to capture distribution shifts and dynamic regime changes inherent in real-world time series. This often leads to entangled representations and spurious causal graphs. In this paper, we propose CausalMoE, a billion-scale multimodal Granger causal foundation model that explicitly models patch-level heterogeneity. CausalMoE introduces a Pattern-Routed Mixture of Heterogeneous Experts, which dynamically identifies latent temporal patterns and routes patches to specialized domain experts, effectively decoupling regime-specific mechanisms from shared dynamics. To ensure interpretable graph recovery, we design a Causality-Aware Self-Attention mechanism operating across variables, yielding sparse Granger causal graphs via proximal optimization. Furthermore, CausalMoE is the first to integrate LLMs and VLMs to align numerical signals with textual and visual priors, regularizing causal estimation in complex scenarios. Extensive experiments demonstrate that CausalMoE establishes a new state-of-the-art on fully supervised benchmarks, while effectively generalizing to few-shot settings where traditional methods fail.

08.
Nature Medicine 2026-06-15

Plasma proteomic signatures of cellular aging predict human disease

Aging is asynchronous across cells and organs. Here we tested whether plasma proteomics can be used to analyze cell type-specific aging. From analyses of over 7,000 plasma proteins measured in 60,542 individuals, we developed machine learning models to estimate the biological age of over 40 cell types spanning neuronal, immune, glial, endocrine, epithelial and musculoskeletal origins. We observed that 20–25% of individuals exhibited accelerated aging in a single cell type and 1–3% in 10 or more cell types. Cellular aging signatures were associated with disease status and predicted incident disease and mortality over 15 years of follow-up. Individuals with the APOE4 genotype showed older astrocytes but younger macrophages compared to APOE3 carriers, whereas the APOE2 genotype had inverse associations. Moreover, extreme astrocyte aging tripled the risk of incident Alzheimer’s Disease in individuals with two APOE4 alleles, while youthful astrocytes reduced risk. Individuals with extremely aged compared to youthful skeletal myocytes exhibited a 12.7-fold higher risk of developing amyotrophic lateral sclerosis. In individuals who smoked, extreme respiratory epithelial cell aging was associated with a 58% higher lung cancer risk compared to smoking alone. Specific cellular vulnerabilities and cumulative cellular aging burden influenced survival, with youthful immune and neuronal cell types conferring protective effects. Finally, we developed a polycellular aging risk score that stratified mortality risk across cohorts and proteomics platforms. These findings establish a framework for quantifying human physiology at cellular resolution, revealing heterogeneous aging trajectories and their impact on disease susceptibility and resilience. The biological age of individual cell types can be evaluated using plasma proteomics, revealing diverse aging profiles across more than 40 cell types and links between the accelerated aging of specific cell types and disease.

09.
medRxiv (Medicine) 2026-06-22

Study protocol: Feasibility and clinical implications of real-time cerebral autoregulation monitoring in major noncardiac surgery with the Medtronic Cotrending algorithm (AUTOREGULATE-NONCARDIAC-COTRENDING)

Background: Perioperative hypotension is associated with postoperative organ injury. However, trials of hypotension avoidance have not found meaningful improvements in postoperative cardiovascular, renal, neurological or functional outcomes. One possible explanation is that organ perfusion depends on patients individual autoregulatory ranges. Hence, technology enabling monitoring of the autoregulatory status of vital organs, e.g. the brain, could provide a physiologic basis for personalising of blood pressure targets. However, current established methodologies for monitoring cerebral autoregulation in noncardiac surgery, e.g. the cerebral oximetry index (COx), are limited by performance and usability. The Medtronic Cotrending algorithm has been developed to provide automated, near real-time assessment of cerebral autoregulation. While feasibility was demonstrated in cardiac surgery, its applicability in major noncardiac surgery remains unknown. This study aims to evaluate the technical feasibility and clinical implications of Cotrending-based cerebral autoregulation monitoring in major noncardiac surgery. Objectives: Primary objective: To evaluate the technical feasibility of using the Medtronic Cotrending algorithm to monitor intraoperative cerebral autoregulation in real-time during major noncardiac surgery, drawing comparisons to the COx algorithm. Secondary objectives: to investigate the potential clinical implications of Cotrending-based cerebral autoregulation monitoring. Design: Single-centre, prospective cohort study. Setting: Swiss tertiary care centre Patients: Patients enrolled in AUTOREGULATE-NONCARDIAC who were monitored intraoperatively with the Medtronic INVOS(TM) 5100 near-infrared spectroscopy (NIRS) system. Outcomes: Technical feasibility outcomes include success rate of determination of the lower limit of cerebral autoregulation, intraoperative uptime, time to first estimate of the lower limit of cerebral autoregulation, sensitivity to external factors and to data artefacts; agreement of Cotrending-derived lower limit of cerebral autoregulation with COx-derived lower limit of cerebral autoregulation. Conclusions: N/A Trial registration: Clinicaltrials.gov NCT07630129

10.
arXiv (quant-ph) 2026-06-11

Superspace Concentration and Adversarial Robustness in Quantum Algorithms

arXiv:2606.11580v1 Announce Type: new Abstract: We study superspace concentration as a quantum resource, formalized through the focus measure F(\r{ho}) = {\lambda}_max(\r{ho}_super) - the largest eigenvalue of the reduced superspace state - which quantifies the capacity of a quantum system to concentrate informational weight into a preferred subspace of an extended degree-of-freedom space. We develop a complete resource-theoretic framework around this measure and validate its properties through GPU-accelerated numerical simulation. Analytic decoherence predictions are confirmed to machine precision (1.11 x 10^{-16}) for superspace dimensions dS in {2,4,8,16,32}. Focus monotonicity holds across 10,000 random states with zero violations under four focus-non-generating channels across six system configurations. Focused quantum states resist coherent unitary attacks with significantly greater resilience than standard fidelity predicts, with focus remaining above 0.9 at attack strength {\epsilon} = 0.302 versus {\epsilon} = 0.174 for fidelity. We further demonstrate that the focus measure and the U(dS)-asymmetry measure are operationally distinct: asymmetry remains near zero and provides no robustness signal under coherent and targeted attacks while focus tracks spectral concentration and remains robust until {\epsilon} > 0.3. The connection between Grover's algorithm and superspace concentration is made explicit via the identity F(|{\psi}_k>

11.
medRxiv (Medicine) 2026-06-16

Re-evaluating the Cross-Sectional Prevalence of Severe Age-Related Hearing Loss Using Extreme Value Statistics

作者:

Standard demographic models of age-related hearing loss (presbycusis) predominantly utilize symmetric functions, such as log-normal distributions for age-binned thresholds and 4-parameter logistic curves for prevalence estimates. While these models capture early-to-moderate degradation effectively, they structurally struggle to characterize the heavy tails associated with severe clinical impairment. In this study, we present a statistical critique using a secondary analysis of the historical Medical Research Council (MRC) National Study of Hearing (1980-1986) dataset. By applying Generalized Extreme Value (GEV) distribution theory, we demonstrate that as severity increases, the underlying statistical geometry of hearing loss shifts. The asymmetric, heavy-tailed GEV distribution provides a parsimonious description of severe impairment, requiring fewer parameters than standard symmetric models. However, we explicitly acknowledge that utilizing static population data to infer progression introduces an ecological fallacy. Furthermore, the dataset's historical nature embeds unquantified generational cohort effects. We conclude that while extreme value statistics offer a compelling mathematical framework for modeling the variance of severe presbycusis, true longitudinal datasets are required to isolate physiological degradation from historical cohort variance.

12.
arXiv (CS.LG) 2026-06-18

Risk Stratification for ICU Delirium using Pervasive Ambient Sensing Information

arXiv:2606.19292v1 Announce Type: new Abstract: Delirium is a common and serious complication in the Intensive Care Unit (ICU), associated with increased morbidity, prolonged hospital stays, and higher healthcare costs. Despite its prevalence, early prediction and prevention remain challenging. Environmental factors such as ambient sound and light may influence the onset of delirium, yet they are often overlooked in risk assessments. In this study, we examined whether light intensity and sound pressure levels can independently predict delirium across multiple prediction horizons. We evaluated four efficient sequential neural network models on data collected from 9 ICUs across 309 patients to predict delirium for 10 prediction-window sizes. We reported feature importance and direction of influence using Shapley Additive Explanations analysis. The convolutional model achieved the strongest discrimination, with AUC = 0.80 on sound data and on combined data. Sound features were the dominant predictors overall. Integrating sound with light improved short-term ($

13.
arXiv (CS.LG) 2026-06-15

More with LESS – Local Scene Representations for Tactile Imaging

arXiv:2606.14344v1 Announce Type: new Abstract: Tactile imaging seeks to reconstruct the internal structure of soft objects through touch sensing, with applications in medical diagnosis and robotic manipulation. Recent self-supervised learning approaches have shown promising results, but rely on global, unstructured representations and robot-controlled sensing, limiting generalization and practical use. We propose Local Encoder for Spatial Sensing (LESS), an object-centric tactile representation that exploits the local nature of touch. The tactile scene is modeled as a grid of recurrent encoders with local receptive fields, whose states are fused to reconstruct 2D or 3D images of internal structure. This compositional design enables strong generalization: models trained on single-inclusion phantoms accurately image objects with multiple inclusions and varying sizes. The local structure further supports spatial uncertainty estimation. In addition, we enable hand-held tactile imaging via external pose tracking and human-like palpation data, and extend tactile imaging to full 3D reconstruction.

14.
arXiv (CS.CL) 2026-06-17

RubricsTree: Scalable and Evolving Open-Ended Evaluation of Personal Health Agents across Health Memory and Medical Skills

The LLM-empowered personal health agents with user health (sensor) metrics have offered a promising pathway to alleviate global disparities in healthcare access. However, large-scale clinical deployment remains constrained by an open-ended evaluation bottleneck: physician annotation is reliable but costly and unscalable, while LLM-as-a-judge evaluators are scalable but subjective, inconsistent, and sometimes clinically misaligned. We introduce RubricsTree, a scalable evaluation framework with an expert-aligned hierarchical taxonomy of over 100 atomic, clinically-verifiable Boolean rubrics, evolving from the insights of 4,000 real user queries through an iterative human-in-the-loop curation protocol with an expertise panel led by an experienced physician. A context-aware adaptive router activates only the relevant auto-weighted rubric subset per query, providing the throughput needed for scalable evaluation with expert-aligned quality. Through a systematic meta-evaluation, we show that RubricsTree (i) substantially exceeds a strong large-scale evaluation baseline in expert alignment on challenging open-ended queries; (ii) reliably penalizes contextually degraded responses; and (iii) when used as structured instructions, text feedback, or training rewards for performance optimization, yields up to ~66% relative gains on HealthBench for Gemini, GPT, and Qwen model families. RubricsTree thus provides a scalable, auditable, and evolving evaluation infrastructure required for the continuous optimization of product-level personal healthcare AI.

15.
arXiv (CS.CV) 2026-06-16

Ellipse Meets Bit-Planes: A Novel Approach to RNFL based Glaucoma Detection Using Advanced Image Processing and Deep Learning

This work proposes an integrated pipeline for automatic glaucoma detection method from easily available colour fundas images based on an adaptive algorithm for ellipse-based polar transformation, to enhance the analysis of the Retinal Nerve Fiber Layer (RNFL) as the primary biomarker for observing glaucomatous changes, regardless of optic disc and macula position. Utilizing this transformation, we introduce two distinct frameworks tailored to different operational needs. The first framework, a deep learning-inspired feature fusion approach, achieves a 99.3% detection rate, ideal for settings where high precision is essential, despite higher computational demands. The second framework employs a novel image-processing algorithm based on bit-plane slicing, offering 92.31% accuracy and optimized for environments requiring rapid inference with minimal resource consumption. Both frameworks provide scalable and cost-effective solutions for early glaucoma detection. This study highlights the potential of RNFL-based diagnostic tools in addressing the global challenge of glaucoma, particularly in underserved regions.

16.
medRxiv (Medicine) 2026-06-18

Automated Airways Characterization and Assessment of Cystic Fibrosis from CT Imaging

Background Advancements in medical imaging have enabled non-invasive diagnosis and staging of cystic fibrosis (CF) using CT scans, revealing dilated airways, an increased number of visible airways, and airway generation splits in these patients. However, manual characterization of airways remains time-consuming and challenging due to the numerous structural changes, thereby limiting clinical feasibility. This study aims to develop an automated algorithm to characterize airways from segmented lung CT scans and apply this to a retrospective population. This approach reduces the time required to analyze images and obtain disease-staging results. Methods This framework consists of two stages. The first stage extracts and skeletonizes the airway tree from lung CTs, while the second stage measures lung features, including airway volumes, branch counts, generation splits, diameters, and cross-sectional areas. This permits comprehensive characterization for use in clinical assessment. Results The airways analysis was performed on 169 CT volumes ranging in age from 6 to 18 years of age, revealing substantial differences in detected airway branches, generation splits, and normalized airway volume between the control and CF groups. The framework also measures airway diameters and cross-sectional areas, revealing an increase in the number of small airways in cystic fibrosis patients, due to early bronchiectasis. These findings align with previous research and demonstrate the framework's ability to accurately quantify airway changes in patients with CF. Discussion The framework extracts entire airway trees, facilitating measurements of volume, branch count, diameters, and cross-sectional areas, which change with CF severity and/or treatment. However, partial lung atelectasis can limit the accuracy of airway detection in moderate-to-severe cases. Funding NIA U54 AG054345 and NIA R21 AG07857501

17.
medRxiv (Medicine) 2026-06-22

Anterior-superior hypothalamic enlargement as specific marker in episodic migraine: converging evidence from an independent discovery-replication design

Background: Growing evidence implicates the hypothalamus as a key structure in migraine pathophysiology; however, our understanding of its precise role and of the specific nuclei involved remains limited. We combined MRI data from our laboratory with publicly available MRI datasets from OpenNeuro to examine hypothalamic subunit volumes in episodic migraine and assess the specificity of these alterations relative to chronic pain conditions. Methods: Structural MRI combined with an automated atlas-based segmentation algorithm and a discovery-replication design was employed to investigate cross-sectional volumetric differences across 5 bilateral hypothalamic subunits in two independent migraine cohorts: DS1-MIG (DS1-MIG-base, n = 111 patients, n = 35 controls) and DS2-MIG (n = 27 patients, n = 31 controls). The adjusted volumes were compared between groups using MANOVA as an omnibus test, followed by Welch t-tests to test univariate follow-up. Longitudinal volumetric changes were additionally assessed in DS1-MIG participants with available follow-up scans using linear mixed models. To assess the specificity of findings to migraine, the same pipeline was applied to two chronic pain datasets, one including patients with fibromyalgia (DS-FM, n = 33 patients, n = 33 controls) and the other including patients with trigeminal neuralgia (n = 119 patients, n = 55 controls). Results: MANOVA revealed significant multivariate group differences in the discovery and replication migraine cohorts (DS1-MIG-base: = .006; DS2-MIG: = .008). Follow-up univariate analyses identified a consistent enlargement of the left anterior-superior subunit across both cohorts (FDR = .023 in DS1-MIG-base and FDR = .046 in DS2-MIG), representing the only cross-cohort replication finding. Beyond this shared signature, DS2-MIG exhibited additional significant enlargements of the right anterior-inferior and right tubular-inferior subunits. Longitudinal analyses in DS1-MIG showed that hypothalamic subunit volumes remained broadly stable over time within both migraine patients and control participants. No significant volumetric alterations were detected in the fibromyalgia or trigeminal neuralgia cohorts, either in multivariate or univariate analyses, underscoring migraine-specific findings. Conclusions: These findings provide evidence for subunit-specific hypothalamic structural alterations in migraine localized in the left anterior hypothalamic subunit. The stability of these differences over time and their absence in other chronic pain conditions suggest a migraine-specific structural organisation of hypothalamic circuitry.

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

From Memorization to Creation: Evaluating the Cognitive Depth of LLM-Generated Educational Questions

arXiv:2606.18257v1 Announce Type: cross Abstract: While LLMs show promise in automating educational content creation, their ability to generate questions that stimulate higher-order thinking remains understudied. This work evaluates six widely-used LLMs through a Bloom's Taxonomy lens, focusing on their capacity to transcend rote memorization and achieve cognitive leaps. Using a hybrid human–AI evaluation protocol, we generate and analyze 20{,}700 questions across computer science, K–12 math, and social-science domains. Key contributions include: (1) a fine-grained prompting strategy that reduces question repetitiveness by 24.45\% for Qwen2.5-7B-Instruct, and increases the proportion of higher-order cognitive level outputs by 11.53\% for InternLM3-8B-Instruct; (2) quantitative metrics for cognitive shift intensity (CogShift) and category drift, revealing InternLM3's superior performance in multi-level transitions; (3) an interpretability analysis revealing metric-level correlations that enhance the transparency of Chain-of-Thought prompting. Our findings highlight the importance of cognitive-aware prompt design and provide benchmarks for deploying LLMs in personalized learning systems.

19.
medRxiv (Medicine) 2026-06-22

Spatial Analysis and Multilevel Determinants of Hypertension in Zambia: Analysis of the 2017 WHO STEPS Survey

Background: Hypertension is the leading modifiable cardiovascular risk factor globally, with the fastest-growing burden in low- and middle-income countries. This study aimed to estimate national hypertension prevalence, map provincial patterns, assess spatial clustering, and identify individual and community-level determinants among Zambian adults using the 2017 WHO STEPS survey. Methods: This cross-sectional study used data from the 2017 WHO STEPS survey, a nationally representative sample of 4,301 adults aged 18-69 years. Hypertension was defined as systolic BP [&ge;]140 mmHg, diastolic BP [&ge;]90 mmHg, or current antihypertensive use. Spatial autocorrelation was assessed via Moran's I and LISA. Four nested generalised linear mixed models with PSU-level random intercepts identified individual and community-level determinants. Results: Overall weighted hypertension prevalence was 24.0%. Lusaka recorded the highest prevalence (30.2%), followed by Southern (29.9%) and Muchinga (28.3%) provinces; Western Province had the lowest (12.4%). Spatial clustering was statistically significant but modest (Moran's I = 0.0247, p < 0.001). Between-cluster variation reduced from ICC = 5.9% to 1.8% in the full model, indicating geographic differences were largely explained by individual characteristics. Age was the strongest predictor; adults aged 60-69 had nearly sevenfold higher odds than those aged 18-29 (AOR 6.92, 95% CI: 4.95-9.66). Women had lower odds than men (AOR 0.64, 95% CI: 0.52-0.79). Obesity (AOR 2.34), overweight (AOR 1.65), high cholesterol (AOR 1.40), diabetes (AOR 1.35), and single marital status (AOR 1.34) were independently significant. Western Province showed consistently lower odds than Central Province (AOR 0.48). Conclusion: Hypertension affects one in four Zambian adults, driven primarily by age, sex, obesity, dyslipidaemia, and diabetes. Geographically prioritised interventions, including community health worker-led screening programmes in Lusaka and Southern Province, would maximise population-level impact. Population-level salt reduction and alcohol policies represent cost-effective complementary strategies. Longitudinal studies with finer spatial resolution are needed to clarify causal pathways underlying observed geographic clustering and inform SDG Target 3.4 progress.

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

Augmenting Molecular Language Models with Local $n$-gram Memory

Transformer-based language models for SMILES strings suffer from a locality gap: standard character-level tokenization fragments chemically meaningful motifs, forcing models to repeatedly learn local syntax at the expense of long-range dependencies. To address this without disrupting standard tokenizers, we propose MolGram, which integrates a conditional $n$-gram memory module into molecular language models. MolGram maps local string patterns to learned embeddings via scalable hash lookups and dynamically injects this regional context into hidden states. Evaluations across three tasks, including unconditional molecule generation, forward reaction prediction, and single-step retrosynthesis, show that MolGram consistently improves performance. Crucially, our analyses demonstrate that MolGram outperforms baselines with 3$\times$ more parameters, establishing explicit local pattern memory as a highly efficient inductive bias.

21.
arXiv (quant-ph) 2026-06-12

Coarse-grained quantum thermodynamics: Observation-dependent quantities, observation-independent laws

arXiv:2507.15918v2 Announce Type: replace Abstract: In both classical and quantum thermodynamics, physical quantities are typically assigned objective values defined independently of our observations. We then refer to the 'work performed by a gas', or the 'entropy of the gas', regardless of how they are evaluated. Here, we question this conception in the context of quantum thermodynamics, estimating how the definition of pivotal thermodynamic quantities is affected by experimental instruments of limited precision. We find that the coarse-grained thermodynamic quantities frequently lead to different conclusions from those drawn in fine-grained scenarios. For instance, the irreversibility of a process, or its work payoff, can significantly vary with the instrument precision. We show nonetheless that coarse-grained thermodynamic quantities satisfy the same relations (i.e., the second law inequality, the relation between dissipation and distinguishability of a process from its time-reverse, and the quantum work fluctuation theorems) as their fine-grained counterparts. These results highlight the observation-independence of relations linking thermodynamic quantities which are themselves observation-dependent.

22.
arXiv (CS.AI) 2026-06-15

Selective Agentic Recovery for UAV Autonomy with a Persistent Mission Runtime

arXiv:2606.14219v1 Announce Type: cross Abstract: Agentic AI can support unmanned aerial vehicle (UAV) autonomy by providing high-level recovery reasoning when local waypoint- or setpoint-based execution encounters blocked passages, repeated no-progress behavior, or mission-level ambiguity. On physical UAVs, however, remote reasoning is most useful when it is invoked selectively, since each call introduces latency, resource cost, backend uncertainty, and a need to validate the returned decision. This paper presents Persistent Mission Runtime (PMR), a UAV recovery framework that keeps the mission loop and safety-critical execution local while using an external agentic reasoner only as an on-demand recovery module. The reasoner selects from predefined recovery skills, and each returned decision is parsed, verified, safety-filtered, and mapped to local executor actions before it can affect flight. PMR introduces learned Cognitive Value of Invocation (learned-CVI), a compact admission gate that estimates when remote agentic reasoning is likely to improve near-term mission progress enough to justify its operational cost. Across a fixed 400-run Gazebo/PX4 benchmark with eight scenarios, learned-CVI raises hard/ambiguous-regime success from 5.0% under local-only autonomy to 95.0%, outperforms one-shot and periodic reasoning baselines by 20.0 and 32.5 percentage points, and reduces remote-agent calls by 16.7% and logged tokens by 29.2% relative to a manually tuned rule-based invocation baseline.

23.
arXiv (CS.LG) 2026-06-17

Beyond Independent Genes: Learning Module-Inductive Representations for Single-Cell Gene Perturbation Prediction

arXiv:2602.04901v2 Announce Type: replace-cross Abstract: Predicting transcriptional responses to genetic perturbations is a central problem in functional genomics. In practice, perturbation responses are rarely gene-independent but instead manifest as coordinated, program-level transcriptional changes among functionally related genes. However, most existing methods do not explicitly model such coordination, due to gene-wise modeling paradigms and reliance on static biological priors that cannot capture dynamic program reorganization. To address these limitations, we propose scBIG, a module-inductive perturbation prediction framework that explicitly models coordinated gene programs. scBIG induces coherent gene programs from data via Gene-Relation Clustering, captures inter-program interactions through a Gene-Cluster-Aware Encoder, and preserves modular coordination using structure-aware alignment objectives. These structured representations are then modeled using conditional flow matching to enable flexible and generalizable perturbation prediction. Extensive experiments on multiple single-cell perturbation benchmarks show that scBIG consistently outperforms state-of-the-art methods, particularly on unseen and combinatorial perturbation settings, achieving an average improvement of 6.7% over the strongest baselines. The code is available at https://github.com/ttruan2426-dot/scBIG.

24.
arXiv (math.PR) 2026-06-16

Pathwise structure of the three-dimensional attractive one-point interaction diffusion

作者:

arXiv:2606.08008v2 Announce Type: replace Abstract: We study the pathwise behavior of the three-dimensional attractive one-point interaction diffusion whose law was constructed by Cranston, Koralov, Molchanov and Vainberg, corresponding to the singular Schrödinger Hamiltonian \[ \frac12\Delta+\frac{\beta}{2}\delta_0, \qquad \beta>0. \] We identify a local stochastic differential equation satisfied by the process away from the origin and use it to construct a natural submartingale whose increasing component in the Doob-Meyer decomposition is supported on the set of times at which the process visits the origin. In particular, we show that the process visits the origin with positive probability and that the law conditioned on avoiding the origin is three-dimensional Wiener measure.

25.
medRxiv (Medicine) 2026-06-16

Diurnal variation in brain-derived tau and five other blood-based biomarkers for dementia and their association with cognitive performance

Blood-based biomarkers of dementia are a promising scalable tool for early diagnosis, tracking disease progression, and evaluating therapeutic efficacy. Utility of these biomarkers will not only be dependent on the reliability of their association with pathology but also contingent on their ability to track cognitive status. Previously, we demonstrated diurnal variation in several biomarkers (amyloid beta (A{beta}) 42 and 40, 42/40 ratio, glial fibrillary acidic protein (GFAP), neurofilament light (NfL), and phosphorylated-Tau 217 (p-Tau217)) which has implications for their reliability. Here, we extend these observations to a larger cohort, include brain-derived tau (BD-Tau), which is assumed to be produced exclusively in the brain, and report endocrine measures of circadian rhythmicity. We not only assessed whether these biomarkers vary with time of day, but also whether they associate with daytime function and whether these associations vary with cognitive domain and number of repeated assessments. Data collected in 20 PLWA (72.4{+/-}5.9 years, mean{+/-}SD) and 19 controls (68.9{+/-}9.8 years) were analysed. Participants completed 14 days of home monitoring and one laboratory assessment of sleep and daytime function: mood, daytime sleepiness, reaction time, immediate and delayed memory recall, everyday memory errors. During the 27-hour residential laboratory session, 3-hourly blood samples were collected and analysed for the six blood-based biomarkers of dementia as well as melatonin and cortisol. Rhythmicity of melatonin and cortisol did not differ between groups. P-Tau217 and GFAP (p