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

p-PSO: A Penalized Particle Swarm Optimization Technique for Finding D-Optimal Designs with Mixed Factors in Generalized Linear Models

arXiv:2606.15962v1 Announce Type: cross Abstract: Finding D-optimal designs for generalized linear models (GLMs) is challenging due to the dependence of the Fisher information matrix on unknown parameters and the lack of closed-form solutions, particularly when input factors include both discrete and continuous variables. Although classical algorithms and recent metaheuristic approaches have offered partial solutions, there remains a need for robust and computationally efficient methods. In this paper, we propose a penalized Particle Swarm Optimization (PSO) approach, named $p$-PSO. Here we introduce a new, general-purpose penalty formulation for constrained optimization and demonstrate its effectiveness in optimal design problems. The formulation is algorithm-agnostic and applicable to a broad class of black-box optimization methods. Results show that the method is highly efficient, with its primary contribution being a penalty formulation that enables the direct use of an off-the-shelf PSO algorithm and extends naturally to more general constrained optimization tasks.

02.
arXiv (CS.CV) 2026-06-16

Cross-Modal Registration Between 3D and 2D Fingerprints via Pose-Aware Unwrapping and Point-Cloud Fusion

Three-dimensional (3D) fingerprints preserve global finger geometry and local ridge structure while avoiding contact-induced deformation, but they remain difficult to integrate with legacy two-dimensional (2D) fingerprint systems. This paper addresses the intermediate stage between 3D acquisition and cross-modal matching, and presents a unified framework for 3D fingerprint preprocessing and registration across contactless and contact-based 2D modalities. The framework combines four components: 1) a nonparametric visualization and unwrapping method that converts a 3D fingerprint point cloud into a rolled-equivalent 2D representation without relying on a global finger-shape model; 2) a point-cloud fusion pipeline that registers and mosaics multiple partial 3D captures into a more complete fingerprint model; 3) an ellipse-based pose normalization method for canonical finger alignment; and 4) a pose-aware cross-modal registration strategy that improves compatibility between 3D fingerprints and both contactless and contact-based 2D fingerprints. Experiments on a self-collected multimodal fingerprint database containing 150 fingers show that the proposed framework achieves ridge-level 3D registration accuracy, robust pose estimation, and consistent gains in 2D compatibility. In particular, the 3D fusion error is concentrated around 0.09 mm, contactless 2D–3D registration reaches ridge-scale projection accuracy, and pose-aware unwrapping improves genuine matching scores relative to generic 3D unwrapping. These results support the use of 3D fingerprints as an effective geometric bridge across heterogeneous fingerprint modalities. The baseline implementation has been publicly released at https://github.com/XiongjunGuan/3DFpVisual.

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

MedPCFM: Improving Medical Point Cloud Completion by Integrating Point Transformers and Flow Matching

arXiv:2606.24433v1 Announce Type: cross Abstract: Medical point cloud completion is important for anatomical reconstruction and downstream clinical workflows, yet generative modeling in this setting remains insufficiently studied. We investigate completion through continuous-time generative modeling and introduce PCFM, a PTv3-backed flow matching approach for medical point cloud completion. We evaluate on SkullFix and SkullBreak, and additionally on the more recent Mandibular Defect dataset. We build strong baselines by adapting PTv3 to a deterministic encoder-decoder completion model and by instantiating diffusion completion (PCDiff) with both PVCNN and PTv3 denoisers. PCFM with PTv3 is competitive with the deterministic PTv3 baseline and achieves state-of-the-art generative performance across datasets, while requiring substantially fewer sampling steps than diffusion. At the best operating points, PTv3 also yields clear throughput gains, providing up to a 7$\times$ speed-up for PCFM compared to a PVCNN backbone. Finally, we study empirical scaling trends by varying model size and point cardinality, showing consistent gains with higher point resolution and informative trade-offs across model scales.

04.
arXiv (CS.AI) 2026-06-18

A CEFR-Inspired Classification Framework with Fuzzy C-Means To Automate Assessment of Programming Skills in Scratch

arXiv:2604.00730v2 Announce Type: replace-cross Abstract: Context: Schools, training platforms, and technology firms increasingly need to assess programming proficiency at scale with transparent, reproducible methods that support personalized learning pathways. Objective: This study introduces a pedagogical framework for Scratch project assessment, aligned with the Common European Framework of Reference (CEFR), providing universal competency levels for students and teachers alongside actionable insights for curriculum design. Method: We apply Fuzzy C-Means clustering to 2008246 Scratch projects evaluated via Dr.Scratch, implementing an ordinal criterion to map clusters to CEFR levels (A1-C2), and introducing enhanced classification metrics that identify transitional learners, enable continuous progress tracking, and quantify classification certainty to balance automated feedback with instructor review. Impact: The framework enables diagnosis of systemic curriculum gaps-notably a "B2 bottleneck" where only 13.3% of learners reside due to the cognitive load of integrating Logic Synchronization, and Data Representation–while providing certainty–based triggers for human intervention.

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

Prompt Disentanglement via Language Guidance and Representation Alignment for Domain Generalization

Domain Generalization (DG) seeks to develop a versatile model capable of performing effectively on unseen target domains. Notably, recent advances in pre-trained Visual Foundation Models (VFMs), such as CLIP, have demonstrated considerable potential in enhancing the generalization capabilities of deep learning models. Despite the increasing attention toward VFM-based domain prompt tuning within DG, the effective design of prompts capable of disentangling invariant features across diverse domains remains a critical challenge. In this paper, we propose addressing this challenge by leveraging the controllable and flexible language prompt of the VFM. Noting that the text modality of VFMs is naturally easier to disentangle, we introduce a novel framework for text feature-guided visual prompt tuning. This framework first automatically disentangles the text prompt using a large language model (LLM) and then learns domain-invariant visual representation guided by the disentangled text feature. However, relying solely on language to guide visual feature disentanglement has limitations, as visual features can sometimes be too complex or nuanced to be fully captured by descriptive text. To address this, we introduce Worst Explicit Representation Alignment (WERA), which extends text-guided visual prompts by incorporating an additional set of abstract prompts. These prompts enhance source domain diversity through stylized image augmentations, while alignment constraints ensure that visual representations remain consistent across both the original and augmented distributions. Experiments conducted on major DG datasets, including PACS, VLCS, OfficeHome, DomainNet, and TerraInc, demonstrate that our proposed method outperforms state-of-the-art DG methods.

06.
arXiv (math.PR) 2026-06-18

Cramér-Type Moderate Deviations for Engel's Series via a Martingale Approach

arXiv:2606.18866v1 Announce Type: new Abstract: Let $x$ be uniformly distributed on $(0,1)$, and let $(q_n)_{n\geq1}$ be the digits of its Engel series expansion. We establish a Cramér-type moderate deviation expansion for $(\log q_n-n)/\sqrt n$. The proof is based on a martingale decomposition and asymptotic results for martingales. As consequences, we obtain a moderate deviation principle over the full range of scales between the central limit theorem and the law of large numbers, without the additional lower rate restriction required in several earlier works. We also derive a uniform Berry–Esseen bound of order $(\log n)/\sqrt n$.

07.
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.

08.
arXiv (CS.AI) 2026-06-17

Skill-Constrained Model Predictive Control for Resilient Manufacturing Supply Chains

arXiv:2606.17269v1 Announce Type: new Abstract: In skill-constrained production-inventory systems, the qualified human capacity available tomorrow depends on training decisions made today: production requires certified workers, certifications decay unless maintained, and training consumes the same scarce worker hours that production needs now. We study a closed-loop skill-constrained model predictive controller that, at every shift, solves a finite-horizon mixed-integer program over production, inventory, backlog, and training, with binary predicted certification, hard production eligibility, and an interpretable terminal value that prices certified-capacity gaps at the horizon boundary; only the first-period action is applied before replanning. On synthetic, seed-controlled SkillChain-Gym scenarios - announced and surprise new-skill shocks, demand shocks, absenteeism, forecast- and availability-quality modes, capacity-boundary and training-rate sweeps, and negative controls - we evaluate the controller against production-only and maintenance-only ablations, static cross-training insurance plans, and a strong reactive heuristic, under an ex-ante locked configuration and paired statistics. The result is regime dependence, not superiority: no policy class dominates. Predictive control helps when skill or labor bottlenecks are forecastable early enough for training to complete; lean static insurance remains hard to beat under surprise shocks, near the demand-capacity boundary, and wherever pre-shock slack makes insurance cheap. Attribution ablations separate certification maintenance, re-acquisition of lapsed certifications, and greenfield skill acquisition. Forecastability, not adaptivity per se, decides when predictive control pays.

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

Forecasting Bacterial Antimicrobial Resistance Trends Using Machine Learning on WHO GLASS Surveillance Data: A Retrieval-Augmented Generation Approach for Policy Decision Support

arXiv:2602.22673v2 Announce Type: replace Abstract: Background: Antimicrobial resistance (AMR) is a global health threat. While the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) provides standardized data, population-level machine learning forecasting of resistance trends remains limited. Translating computational forecasts into policy requires transparent interpretation mechanisms. Methods: Surveillance data (2021-2023) comprising 5,909 observations across 44 countries and five WHO regions were processed. A rigorous temporal split prevented data leakage. Six models (Naive, Linear, Ridge, XGBoost, LightGBM, LSTM) were benchmarked to forecast one-year-ahead resistance rates using features including prior-year resistance and antibiotic consumption. Evaluation metrics (MAE, RMSE, sMAPE) were computed, with 95% bootstrap confidence intervals for MAE. A local Retrieval-Augmented Generation (RAG) system utilizing Gemma 4 was implemented to translate forecast findings into policy guidance grounded in retrieved WHO documents. Results: XGBoost achieved the best performance (test MAE = 6.13% [95% CI: 5.83-6.44]), an 85.3% error reduction versus the naive baseline (MAE = 41.79%). SHAP analysis identified prior-year resistance as the dominant predictor (50.5% gain), confirming strong autoregressive behavior. Regional forecast error tracked closely with surveillance coverage, ranging from 3.65% in the European Region to 8.61% in South-East Asia. The RAG pipeline generated accurate, source-attributed policy responses without fabricated citations. Conclusion: Short-term AMR resistance rates exhibit strong temporal autocorrelation that can be accurately forecasted using gradient boosting. Coupling these forecasts with a hallucination-resistant RAG system provides a scalable, evidence-based decision-support framework for AMR governance.

10.
arXiv (CS.CV) 2026-06-25

Neural Network Quantization by Learning Low-Loss Subspaces

Neural network quantization aims to find a discrete representation of parameters that preserves the performance of a full-precision (FP) model as faithfully as possible. Enforcing discrete constraints perturbs parameters away from a well-optimized minimum, generally resulting in performance degradation. Recent studies indicate that low-loss FP solutions are not isolated, but instead belong to connected low-loss subspaces of the loss landscape, where the loss maintains nearly the same minimum value. Models sampled from these subspaces are diverse and retain high accuracy. This raises the question: can a quantized model be constructed to lie within a low-loss subspace of the FP model, thereby automatically preserving performance? We address this question by learning quantization-aware linear paths in weight space optimized to minimize loss. We demonstrate that the midpoint of the resulting subspace is, by design, quantization-friendly and that its direct quantization yields performance comparable to that of quantization-aware training. The proposed procedure offers a novel perspective on weight quantization and, in contrast to conventional methods, neither relies on the straight-through estimator nor involves explicit discretization during training.

11.
arXiv (CS.LG) 2026-06-17

Sign-Rank, Index, and List Replicability: Connections and Separations

arXiv:2606.18236v1 Announce Type: new Abstract: In learning theory, the sign rank of a binary concept class captures the smallest dimension in which it can be represented by points and halfspaces. Despite tremendous interest, lower bounds on sign rank are notoriously difficult to come by. Two recent approaches to the problem establish lower bounds on sign rank by measures that are easier to analyze: the $\mathbb{Z}_2$-index and the list replicability number. We order these measures, showing that the $\mathbb{Z}_2$-index is upper-bounded by a linear function of the list replicability number. As a main consequence, we obtain a strong separation between sign rank and $\mathbb{Z}_2$-index, thereby resolving a question of Frick, Hosseini, and Vasileuski. This motivates a thorough study of list replicability, the stronger of the two lower-bounding measures. We establish upper bounds on the list replicability number by two combinatorial measures: height and minimum star number. We also prove a fundamental composition result, showing that the product of two concept classes has list replicability number bounded by the sum of the list replicability numbers of the two classes.

13.
arXiv (CS.CL) 2026-06-11

Beyond Fully Random Masking: Attention-Guided Denoising and Optimization for Diffusion Language Models

Diffusion large language models (dLLMs) offer an efficient alternative to autoregressive models through parallel decoding, yet existing post-training methods largely rely on random masking strategies that overlook intrinsic token dependencies. In this work, we present an empirical analysis of attention in dLLMs and show that tokens attending more strongly to unmasked context exhibit greater generation stability and play a critical role in reasoning. Motivated by these findings, we propose AGDO, an attention-guided denoising and optimization framework that aligns both training and optimization with attention-derived dependencies. AGDO determines the denoising order based on attention structure and emphasizes attention-critical tokens during supervised fine-tuning and reinforcement learning. Experiments on mathematical and coding benchmarks demonstrate that AGDO consistently improves reasoning performance, outperforming state-of-the-art post-training methods for dLLMs.

14.
arXiv (CS.CL) 2026-06-18

Improving Medical Communication using Rubric-Guided Counterfactual Recommendations

Text-based telemedicine increasingly relies on lightweight patient feedback, however, such feedback primarily reflects perceived communication quality rather than medical accuracy. We introduce an LM-guided counterfactual recommendation pipeline that discovers and refines interpretable communication features such as tone, personalization, actionability and completeness in addressing patient concerns, without interfering with the medical content. These features are used together with patient-doctor interaction metadata to estimate positive feedback. At inference time, the system searches over low-cost ordinal feature changes and recommends minimal communication changes predicted to increase the probability of positive feedback, while independent auditor models test whether these gains generalize beyond the selection model. Across interactions, recommendations yield a mean +6.41% gain in predicted positive feedback probability under independent auditors, and are non-negative for 93.31% of recommendations. These results suggest that small, interpretable communication changes can capture most predicted gains while preserving the doctor's control over medical reasoning and final wording.

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

PEARL: Self-Evolving Assistant for Time Management with Reinforcement Learning

Overlapping calendar invitations force busy professionals to repeatedly decide which meetings to attend, reschedule, or decline. We refer to this preference-driven decision process as calendar conflict resolution. Automating this decision process is crucial yet challenging. Scheduling logistics can drain hours, and human delegation often fails at scale, which motivates us to ask: Can we trust large language models (LLMs) or language agents to manage time? To enable a systematic study of this question, we introduce CalConflictBench, a benchmark for long-horizon calendar conflict resolution. In CalConflictBench, conflicts are presented to agents round-by-round over a calendar year, requiring them to infer and adapt to user preferences progressively. Our experiments show that current LLM agents perform poorly with high error rates, e.g., Qwen-3-30B-Think has an average error rate of 35%. To address this gap, we propose PEARL, a reinforcement-learning framework that (i) augments the language agent with an external preference memory that stores and updates inferred strategies (e.g., attendee priorities, topic importance, time/location preferences), and (ii) optimizes the agent with round-wise rewards that directly supervise decision correctness, ranking quality, and memory usage across rounds. Experiments on CalConflictBench show that PEARL achieves an error reduction rate of 0.76 and a 55% improvement in average error rate compared to the strongest baseline.

16.
arXiv (quant-ph) 2026-06-15

All about quantum error correction: distillation, mitigation, self-correction and beyond

作者:

arXiv:2606.14034v1 Announce Type: new Abstract: In this work, it is shown that many quantum error-manipulating techniques, such as distillation, error mitigation, and dynamical decoupling, are special cases of the most general framework for quantum error correction. This unifying perspective is achieved by extending quantum error correction to include state-adaptive and channel-adaptive settings, as well as multi-stage coding scenarios. Based on this insight, a model of self-correcting quantum memory is also proposed. This work clarifies the relationship among these techniques and illustrates, through explicit constructions, how the unified perspective can guide the design of reliable quantum information systems.

17.
arXiv (quant-ph) 2026-06-19

Proposal of quantum arrival-time measurement with a Bose-Einstein condensate

arXiv:2606.20278v1 Announce Type: new Abstract: This work shows how a Bose-Einstein condensate of ultracold atoms could be used to address a long-standing question in quantum theory: how much time does it take for a particle to reach a detector? To this end, we propose a realistic experimental setup, whose key idea is not to measure arrival times directly, but the arrival flux on the detector as a function of its position. This novel approach not only solves practical issues with having a detector close to the system, but also results in signals that allow to unambiguously distinguish different theoretical predictions. This proposal raises prospects for resolving the decades-old debate on this fundamental issue.

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

ShoppingBench: A Real-World Intent-Grounded Shopping Benchmark for LLM-based Agents

Existing benchmarks in e-commerce primarily focus on basic user intents, such as finding or purchasing products. However, real-world users often pursue more complex goals, such as applying vouchers, managing budgets, and finding multi-products seller. To bridge this gap, we propose ShoppingBench, a novel end-to-end shopping benchmark designed to encompass increasingly challenging levels of grounded intent. Specifically, we propose a scalable framework to simulate user instructions based on various intents derived from sampled real-world products. To facilitate consistent and reliable evaluations, we provide a large-scale shopping sandbox that serves as an interactive simulated environment, incorporating over 2.5 million real-world products. Experimental results demonstrate that even state-of-the-art language agents (such as GPT-4.1) achieve absolute success rates under 50% on our benchmark tasks, highlighting the significant challenges posed by our ShoppingBench. In addition, we propose a trajectory distillation strategy and leverage supervised fine-tuning, along with reinforcement learning on synthetic trajectories, to distill the capabilities of a large language agent into a smaller one. As a result, our trained agent achieves competitive performance compared to GPT-4.1.

19.
arXiv (quant-ph) 2026-06-16

Experimental quantum state learning with pairs of photons

arXiv:2606.16932v1 Announce Type: new Abstract: Tomography allows one to estimate the density matrix describing the state an ensemble of quantum systems are prepared in (for example, polarization tomography determines the polarization state of a beam of identically prepared photons). In general, it is not possible to uniquely decompose the density matrix into its pure state components. Agarwal et al. proposed a protocol which, for a mixture composed of any two pure states of a qubit (with arbitrary probabilities), allows an observer to infer not only the density matrix but the identity of those specific pure states and their weights - the additional requirement being that the qubits arrive in pairs, where both qubits in each pair are in the same state. We experimentally demonstrate this learning-from-pairs concept using photons in the polarization degree of freedom. We use tomography to measure a sequence of single photons and make use of their time-of-arrival information to 'pair up' the photons after the measurement. From here we are able to infer the photons' polarization states and their respective probabilities, and we demonstrate this for various different choices of polarization states and ratios. Finally, we investigate our ability to discriminate between two equal mixtures of distinct pairs of orthogonal polarization states. We find that on the order of approx. 10e4 photons is typically enough to achieve tomography fidelities of approximately 0.9999. This is sufficient to discriminate between two different preparations of the same mixed state, differing by angles of less than 5 degrees between the pure states used in the two preparations.

20.
arXiv (CS.AI) 2026-06-16

Trust-Region Diffusion Policies for Massively Parallel On-Policy RL

arXiv:2606.15260v1 Announce Type: cross Abstract: Reinforcement learning with massively parallel simulations has become a standard framework for developing robust, deployable policies; however, most existing approaches still rely on simple Gaussian policy parameterizations. Diffusion models provide a more expressive policy class and have shown strong performance on challenging control problems, yet most diffusion-based RL methods are designed for offline or off-policy training. In this work, we ask whether diffusion policies can be trained effectively in the massively parallel, on-policy regime. To this end, we introduce Trust-region Diffusion Policies (TruDi), which enables diffusion policies for on-policy RL with massively parallel simulations. This setting is particularly challenging because the data distribution changes quickly across updates, making stable training with complex policies difficult. TruDi addresses this by integrating a trust-region optimization rule to enforce a KL-divergence constraint over the entire diffusion trajectory. Empirically, we evaluate TruDi on a diverse set of 4 massively parallel RL benchmarks comprising a total of 73 tasks. Across these tasks, TruDi consistently outperforms or is on-par with strong baselines on standard tasks and achieves clear gains on more challenging humanoid control tasks, establishing a strong new baseline for massively parallel on-policy RL.

21.
arXiv (CS.AI) 2026-06-11

The Standard Interpretable Model: A general theory of interpretable machine learning to deductively design interpretable methods using Lagrangian mechanics

arXiv:2606.12289v1 Announce Type: cross Abstract: As Artificial Intelligence models grow in complexity, interpretability has become an indispensable tool for understanding, debugging, and controlling their computations. However, interpretability lacks general theories to deductively design interpretable methods. This gap between theories and methods results in a fragmented literature and inconsistent evaluation protocols. To fill this gap, we introduce the Standard Interpretable Model (SIM), a general theory grounded in Lagrangian mechanics that enables the deductive design of interpretable methods. Specifically, the SIM summarises, in a set of premises, what interpretability is for a target user. From these premises, the SIM systematically derives interpretability symmetries and corresponding constraints, which shape the landscape of a Lagrangian whose minima correspond to optimal interpretable models. To reach the minima, one can either update the parameter values of an opaque model to make it more interpretable or compile constraints into an interpretable architecture. We empirically show that the SIM identifies and solves limitations of existing methods (including traditional, concept-based, and mechanistic interpretability), highlights underexplored research directions, and informs the design of core programming interfaces. Beyond being a research method, the deductive nature of the SIM offers pedagogical grounding for interpretability curricula and may shift the scientific community's perspective of a discipline that has long been fragmented.

22.
arXiv (CS.AI) 2026-06-24

Can Aggregate Invariants Accelerate Continuous Subgraph Matching? Limits, Laws, and a Dynamic Spectral Index

arXiv:2606.24421v1 Announce Type: new Abstract: Spectral filtering recently delivered substantial pruning for static subgraph matching: Laplacian interlacing rejects candidates whose neighborhoods cannot host the query. We study whether such aggregate structural tests can accelerate continuous subgraph matching (CSM) over dynamic graphs, and answer in three parts. First, lazily maintained spectral bounds are infeasible exactly where spectral pruning has value: we characterize the tightest safe rule over a formalized perturbation relaxation and show that even it loses essentially all pruning power within four touching updates. Second, exact maintenance is affordable when selective: pruning utility and recomputation cost are anti-correlated across vertices – hubs provably never prune – so recomputing small-neighborhood spectra on touch sustains exact local spectra at microseconds per update, complete by construction. Third, integrated into a decoupled CSM benchmark against an identical-minus-spectra control, the tests remove up to $51\%$ of candidates or safely skip up to $47\%$ of update enumerations, yet enumeration intermediates remain unchanged – beyond the gates' skipped first-level bindings, typically zero – across two engines, four real graphs, two stream types, and $77$ solved queries; a constructed radius-stratified workload confirms the instrument detects the exception when one exists ($-99.9\%$ intermediates, $748\times$ faster). Aggregate tests accelerate what scales with candidate sets – construction, list scans – never adjacency-guided exploration. We distill an intermediate-invariance methodology for evaluating CSM filters and release a reusable dynamic local-spectra index.

23.
medRxiv (Medicine) 2026-06-16

Prevalence and Correlates of Ideal Cardiovascular Health among Ugandan Adolescents: A Cross-Sectional Study

Introduction: Cardiovascular disease (CVD) risk factors often emerge during adolescence and track into adulthood, yet data on cardiovascular health (CVH) in sub-Saharan Africa remain limited. We assessed the prevalence and correlates of ideal CVH among Ugandan adolescents. Methods: We analysed baseline data of adolescents enrolled in a cluster-randomised controlled trial being conducted in urban (Kampala) and rural (Jinja) districts of Uganda. In this study, Ideal CVH was defined as meeting "ideal" status of 5-7 of the American Heart Association's Life's Simple 7 metrics. Random-effects logistic regression was used to identify factors associated with ideal CVH, accounting for village-level clustering. Results: We recruited 1316 participants with a mean age of 13.2 years, of whom 58.1% were female. Overall, the prevalence of ideal CVH was 66.8% (95% CI: 64.2% - 69.3%). The prevalence was higher in Jinja (74.4%, 95%CI: 70.9% - 77.7%) than Kampala (59.6%, 95%CI: 55.8%-63.2%) and the difference was evident (p

24.
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.

25.
arXiv (CS.AI) 2026-06-24

No Certificate, No Categorical Speech Act: A Brouwerian Assertibility Constraint for Public Reason

arXiv:2603.03971v3 Announce Type: replace-cross Abstract: Generative AI can convert uncertainty into authoritative-seeming verdicts, intensifying the hypersuasive force of automated speech and displacing the justificatory work on which democratic epistemic agency depends. As a corrective, I propose a Brouwer-inspired assertibility constraint for responsible AI: in high-stakes domains, systems may assert or deny claims only if they can provide a publicly inspectable and contestable certificate of entitlement; otherwise they must return Undetermined. This constraint yields a three-status interface semantics (Asserted, Denied, Undetermined) in which statuses mark entitlement to categorical speech rather than truth values of the underlying world-claim. The semantics cleanly separates internal entitlement from public standing while connecting them via the certificate as a boundary object. It also produces a time-indexed entitlement profile that is stable under numerical refinement yet revisable as the public record changes. I operationalize the constraint through decision-layer gating of threshold and argmax decisions, using internal witnesses (e.g., sound bounds or separation margins where available, and contestable surrogates otherwise) and an output contract with reason-coded abstentions. A design lemma shows that any total, certificate-sound binary interface yields witnessed decidability of the deployed predicate on its declared scope, so Undetermined is not a tunable reject option but a mandatory status whenever no adequate forcing witness is available. By making outputs answerable to challengeable warrants rather than confidence alone, the paper aims to preserve epistemic agency against the persuasive pull of automated speech in public justification.