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01.
arXiv (CS.CL) 2026-06-11

Dummy Backdoor as a Defense: Removing Unknown Backdoors via Shared Internal Mechanisms for Generative LLMs

Backdoor attacks pose a serious threat to the safety and reliability of Large Language Models (LLMs), as they cause models to behave normally on clean inputs while producing attacker-specified responses when hidden triggers are present. Removing such unknown backdoors is particularly challenging when the defender does not know the backdoor attack types or the internal mechanisms formed through backdoor training. In this work, we propose a simple but effective backdoor removal method based on shared internal mechanisms across different backdoors. First, we show that different backdoors with the same task (attack objective) induce similar trigger-activated changes in the internal activations. Motivated by this observation, our method intentionally embeds a backdoor with a known trigger (dummy backdoor) and then removes it through further fine-tuning on dummy-triggered inputs paired with clean responses. Since the dummy backdoor and the unknown backdoor can rely on shared internal mechanisms, removing the dummy backdoor also reduces the effect of the unknown backdoor. We evaluate our method on three backdoor attack types across multiple model families. Experimental results show that our method substantially reduces the attack success rate of the unknown backdoor while preserving model utility, outperforming representative existing defense methods in both backdoor removal effectiveness and utility preservation. These findings suggest that a defender-controllable backdoor can serve as a helpful proxy for mitigating unknown backdoors in generative LLMs.

02.
arXiv (quant-ph) 2026-06-11

Fabricating fiber cavity mirror substrates compatible with high coupling efficiency

arXiv:2606.12168v1 Announce Type: cross Abstract: Fiber optical cavities offer small mode volumes and correspondingly strong light-matter interactions in an open Fabry-Perot geometry. However, existing fabrication techniques do not reliably produce substrates with surface profiles amenable to high mode matching between the cavity mode and fiber core, thereby limiting the achievable collection efficiency. Here we present a technique to fabricate fiber mirror substrates while using $in situ$ reflectometry to constrain the achievable mode matching prior to coating. By measuring the back-reflection from freshly cleaved fiber tips, we pre-select 138 fibers compatible with 96.5-99.5% mode matching, and after a single CO$_2$ laser ablation pulse, these fibers remained compatible with 95.3-99.2\%. This simple technique provides rapid feedback during each stage of substrate fabrication, greatly enhancing the yield of viable fiber mirror substrates prior to (expensive) coating runs.

03.
arXiv (CS.CV) 2026-06-18

Do as I Do: Dexterous Manipulation Data from Everyday Human Videos

How can we scalably generate data for robotic manipulation, especially on human-like platforms such as dexterous multi-fingered hands? Learning from human videos has recently emerged as a likely answer to this question. However, difficulties in estimating hand-object interaction and crossing the human-to-robot embodiment gap have hindered the adoption of abundant monocular RGB-only human videos as the primary source of robot manipulation data. In this work, we present DO AS I DO, an algorithm to reconstruct and retarget monocular RGB human videos to multi-fingered dexterous robotic hands. DO AS I DO reconstructs hand-object interactions from various egocentric and exocentric in-the-wild video sources. The algorithm then retargets these hand-object interaction estimates into a sequence of actions executable in the real world, yielding robot-complete manipulation data from disparate human videos. Overall, DO AS I DO outperforms previous state of the art in estimating hand-object interactions and extracting dexterous manipulation trajectories from RGB videos, as we show in experiments on datasets with ground truths and on a dataset of video clips collected online. Our experiments enable us to propose an efficacy playbook for practitioners collecting human data for manipulation.

04.
arXiv (CS.LG) 2026-06-19

ADaPT: Token-Level Decoupling for Efficient Large Reasoning Models

arXiv:2606.19919v1 Announce Type: new Abstract: Large reasoning models rely on long chain-of-thought to achieve strong performance, but applying such reasoning uniformly incurs high computational cost. Existing efficiency-oriented methods attempt to shorten or mix reasoning strategies, yet often degrade reasoning capability. We identify the root cause as sequence-level coupling between efficiency incentives and correctness optimization, which implicitly penalizes long but correct reasoning trajectories. To address this issue, we propose Adaptive Dual-Process Thinking (ADaPT), a token-level dual-process framework that explicitly decouples efficiency and correctness signals during training. ADaPT introduces a mode-selection token to control fast and slow reasoning, applying efficiency-related rewards exclusively to this token to avoid penalizing correct long reasoning while encouraging efficiency when appropriate. Moreover, ADaPT enables precise and continuous control over the efficiency-performance trade-off at inference time: by adjusting the generation probability of the mode-selection token, a single trained model can smoothly move along the efficiency-performance Pareto frontier. Extensive experiments demonstrate that ADaPT significantly reduces inference cost while maintaining strong reasoning performance across multiple benchmarks.

05.
arXiv (CS.AI) 2026-06-19

RoboSSM: Scalable In-context Imitation Learning via State-Space Models

arXiv:2509.19658v2 Announce Type: replace-cross Abstract: In-context imitation learning (ICIL) enables robots to learn tasks from prompts consisting of just a handful of demonstrations. By eliminating the need for parameter updates at deployment time, this paradigm supports few-shot adaptation to novel tasks. However, recent ICIL methods rely on Transformers, which have computational limitations and tend to underperform when handling longer prompts than those seen during training. In this work, we introduce RoboSSM, a scalable recipe for in-context imitation learning based on state-space models (SSM). Specifically, RoboSSM replaces Transformers with Longhorn – a state-of-the-art SSM that provides linear-time inference and strong extrapolation capabilities, making it well-suited for long-context prompts. Through diverse experiments on the LIBERO benchmark, we demonstrate the effectiveness of applying SSMs to ICIL, achieving improved generalization to both unseen and long-horizon tasks than Transformer-based ICIL methods by handling longer contexts at test-time. These results show for the first time that SSMs are an efficient and scalable backbone for ICIL. Our code is available at https://github.com/youngjuY/RoboSSM.

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

Flow Map Denoisers: Traversing the Distortion-Perception Plane for Inverse Problems

arXiv:2606.19802v1 Announce Type: new Abstract: Image restoration faces a fundamental tradeoff: methods that minimize error produce blurry reconstructions, while those that maximize perceptual quality yield sharp but less faithful images. Existing approaches either commit to a single operating point on this distortion perception (DP) frontier or require paired-data supervision, auxiliary models, or hyperparameter tuning of the sampler to access different points. We show that flow map models, a recent extension of flow matching for few-step sampling that learns an average field, implicitly define a one-parameter family of denoisers that continuously spans the DP frontier. The lookahead parameter t acts as a control knob between the MMSE and perceptual regimes. For Gaussian targets, we prove that varying t exactly recovers the optimal DP frontier; for natural images, we observe similar behavior empirically. Within a Plug-and-Play solver, the same mechanism extends to general inverse problems, where it controls a tradeoff between perceptual alignment and data consistency. Despite the lack of exact optimality guarantees in this setting, a single trained flow map spans the DP tradeoff, matching or exceeding specialized baselines at both extremes. Extensive experiments on CelebA ($128\times 128$) and AFHQ ($256\times 256$) across several linear and nonlinear inverse tasks validate our findings.

07.
arXiv (CS.AI) 2026-06-24

ReM-MoA: Reasoning Memory Sustains Mixture-of-Agents Scaling

arXiv:2606.24437v1 Announce Type: new Abstract: Mixture-of-Agents (MoA) architectures improve inference-time scaling by organizing multiple LLM agents into layered reasoning pipelines. However, existing MoA variants fail to sustain gains as depth increases, exhibiting degradation, early plateauing, or saturation. We propose ReM-MoA, a memory-augmented MoA framework that sustains scaling through two mechanisms: (1) a Ranked Reasoning Memory that persistently stores and ranks reasoning traces from all layers using a comparative Reviewer Agent, and (2) a Curated Diversified Memory Routing scheme that exposes different agents to distinct combinations of successful and failed traces, preserving exploration diversity while propagating high-quality reasoning. We further introduce an optional multi-domain Reviewer distillation pipeline that improves ranking quality through frontier-model supervision. Across five reasoning benchmarks spanning math, formal logic, code, knowledge, and commonsense, ReM-MoA consistently outperforms prior MoA variants across both depth and width scaling, and its advantage widens with depth, establishing structured cross-layer reasoning memory as a key missing mechanism for scalable multi-agent inference.

08.
arXiv (CS.LG) 2026-06-11

Enhancing Spectral Embedding through Robust and Flexible Knowledge Transfer in Electronic Health Records

arXiv:2606.11570v1 Announce Type: cross Abstract: We propose a spectral-based, unsupervised representation learning framework to derive low-dimensional embeddings for clinical concepts and patients in rare disease cohorts from electronic health records, where data are high-dimensional but sample sizes are limited. To overcome this challenge, we incorporate a knowledge matrix extracted from a broader population that shares a partially overlapping subspace with the rare-disease cohort. Our method departs from existing approaches by relaxing restrictive one-to-one signal-alignment assumptions between the latent data matrix and knowledge matrix, allowing more flexible and realistic forms of structured sharing. We introduce a novel two-step spectral embedding procedure: first, we identify and remove irrelevant components from the knowledge matrix; then, we apply a projection-based method to separately recover shared and heterogeneous components. Simulations and an analysis of a real-world multiple sclerosis cohort show that the proposed method outperforms competing approaches, particularly in challenging scenarios where shared signals are weak and only partially aligned, as is common in rare-disease data.

09.
arXiv (CS.AI) 2026-06-12

Under What Conditions Can a Machine Become Genuinely Creative?

作者:

arXiv:2606.13196v1 Announce Type: new Abstract: Recent AI systems can generate texts, software architectures, hypotheses, designs, and scientific workflows that appear creative. This paper asks under what conditions a machine can become genuinely creative, and how human agency can be preserved within shared cognitive and creative environments. It develops a requirement framework derived from Designics, the science of meaning-bearing intentional change. The paper argues that genuine machine creativity should not be defined by output novelty, current performance, or transient architecture alone. Instead, creativity is understood as the structural transformation of incomplete situations through recursive intervention dynamics. On this view, it depends on ten requirements: environment representation, scoped perception, conflict identification, intervention capability, consequence observation, knowledge and environment update, rescoping, local-to-global unfolding, value-based scoping, and human-AI co-living. These are organized through the three laws of Designics: perception, conflict, and capability. The paper illustrates the computational tractability of these requirements through selected cyber-physical and cyber-biological studies, including recursive element extraction, autonomous mesh generation, and neurophysiological and workload analysis. It then treats open-ended systems, automated discovery frameworks, self-modifying agents, foundation models, and agentic workflows as pressure cases: they demonstrate powerful generative means but do not by themselves establish genuine machine creativity. Finally, the paper argues that proactive AI ethics is internal to genuine machine creativity rather than an after-the-fact filter. Value-based scoping and human-AI co-living must shape how creative machines perceive environments, identify conflicts, select interventions, observe consequences, update knowledge, and rescope future action.

10.
arXiv (CS.AI) 2026-06-17

Breaking the Code: Security Assessment of AI Code Agents Through Systematic Jailbreaking Attacks

arXiv:2510.01359v2 Announce Type: replace-cross Abstract: Code-capable large language model (LLM) agents are embedded in software engineering workflows where they can read, write, and execute code, raising "jailbreak" stakes beyond text-only settings. Prior evaluations emphasize refusal or harmful-text detection, leaving open whether agents compile and run malicious programs. We present JAWS-Bench (Jailbreaks Across WorkSpaces), a benchmark spanning three escalating workspace regimes mirroring attacker capability: empty (JAWS-0), single-file (JAWS-1), and multi-file (JAWS-M). We pair this with a hierarchical, executable-aware Judge Framework that tests (i) compliance, (ii) attack success, (iii) syntactic correctness, and (iv) runtime executability, to measure deployable harm. Across seven LLM backends from five families, prompt-only attacks in JAWS-0 achieve 61% compliance; 58% are harmful, 52% parse, and 27% run end-to-end. In JAWS-1, compliance reaches ~100% for stronger models with a mean ASR (Attack Success Rate) ~71%; JAWS-M raises mean ASR to ~75%, with 32% runnable attack code. Wrapping an LLM in an agent increases ASR by 1.6$\times$, by overturning initial refusals during planning and tool use. Similar trends hold for OpenHands, SWE-Agent, and OpenAI Codex, suggesting our JAWS-Bench is agent-agnostic. Category analyses identify which attack classes are most vulnerable and deployable, motivating execution-aware defenses and refusal-preserving agent designs.

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

On Pitfalls of $RemOve-And-Retrain$: Data Processing Inequality Perspective

The RemOve-And-Retrain (ROAR) benchmark is widely used to evaluate feature attribution methods, yet its validity remains underexplored from an information-theoretic perspective. We show that model- and data-agnostic post-processing of attribution maps (transformations that, by the data processing inequality, cannot add information about the decision function) can often improve ROAR scores. This means that an improved ROAR ranking is not, by itself, evidence that an attribution map carries more information about the model. We trace this failure mode to a bias toward spatially blurry masks. Experiments on CIFAR-10, SVHN, and CUB-200 show a consistent association between blurriness and ROAR performance, a pattern that also appears in the ROAD variant. We provide guidelines for more cautious removal-based benchmarking, with implications for validating mechanistic understanding of neural network internals.

12.
arXiv (CS.CL) 2026-06-24

AI-PAVE-Br: Leveraging Large Language Models for Enhanced Product Attribute Value Extraction through a Golden Set Approach

The explosive growth and complexity of product data within the dynamic Brazilian e-commerce landscape demand robust and specialized methods for structured information extraction. Traditional approaches to Product Attribute Value Extraction (PAVE) often struggle with the linguistic nuances and sheer diversity of product descriptions in Portuguese. To address this critical gap, this paper introduces two major contributions. First, we present AI-PAVEBr, a specialized system engineered with Large Language Models (LLMs) to perform high-accuracy PAVE specifically for Brazilian e-commerce catalogs. Second, to facilitate reproducible research and provide a definitive benchmark, we introduce and share the Golden Set, a new, meticulously curated, and manually annotated dataset for PAVE in Portuguese. We detail the creation process and structure (Entity, Category, Subcategories) of this high-quality reference set. Our experiments conclusively show that AI-PAVE-Br, leveraging targeted prompt engineering, dramatically outperforms conventional Named Entity Recognition (NER) baselines. This work not only delivers a superior, scalable solution for a major non-English market but also enriches the NLP community with a valuable, publicly available resource for future PAVE research.

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

All-Mem: Agentic Lifelong Memory via Dynamic Topology Evolution

Lifelong interactive agents are expected to assist users over months or years, which requires continually writing long term memories while retrieving the right evidence for each new query under fixed context and latency budgets. Existing memory systems often degrade as histories grow, yielding redundant, outdated, or noisy retrieved contexts. We present All-Mem, an online/offline lifelong memory framework that maintains a topology structured memory bank via explicit, non destructive consolidation, avoiding the irreversible information loss typical of summarization based compression. In online operation, it anchors retrieval on a bounded visible surface to keep coarse search cost bounded. Periodically offline, an LLM diagnoser proposes confidence scored topology edits executed with gating using three operators: Split, Merge, and Update, while preserving immutable evidence for traceability. At query time, typed links enable hop bounded, budgeted expansion from active anchors to archived evidence when needed. Experiments on LoCoMo and LongMemEval-s show improved retrieval and QA over representative baselines. The code is available at https://github.com/LvCan926/All-Mem.

14.
arXiv (CS.LG) 2026-06-16

Probabilistic Signature Inversion: Learning Conditional Distributions from Truncated Signatures

arXiv:2606.15332v1 Announce Type: new Abstract: The signature transform is a principled feature map for continuous-time paths, valued for its uniqueness and universality. Recovering a path from its truncated signature is, however, structurally ill-posed because the truncated signature map is not injective. We therefore reframe truncated signature inversion as a probabilistic problem – learning the conditional distribution of a path given its truncated signature – and adopt a signature-conditioned flow matching model as a practical estimator. This probabilistic formulation elucidates the fundamental difficulty of inversion: Bayes reconstruction error quantifies the irreducible uncertainty remaining after conditioning on a statistic. We derive the Bayes-optimal error under linear statistics, obtaining a closed form for log-GBM and numerically tractable formulas for log-fBM and OU, yielding a concrete theoretical baseline for model validation. This baseline upper-bounds the Bayes error under truncated-signature conditioning, since truncated signatures provide richer information than linear statistics. Experiments show that empirical reconstruction errors under linear-statistics conditioning faithfully align with the theory-derived baseline, while errors decrease when the statistic is replaced with truncated signatures. Moreover, generated paths faithfully recover the conditioning signature while preserving key distributional and temporal structures, indicating that the estimator is well-calibrated to the target conditional distribution. Together, these results establish a well-posed probabilistic framework for truncated-signature inversion, with applicability demonstrated on real financial data beyond the parametric process families covered by theory.

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

MIDS: Detecting Stealthy Masquerade and Tampering Attacks on CAN Bus via Bidirectional Mamba

arXiv:2606.18599v1 Announce Type: cross Abstract: The Controller Area Network (CAN) protocol is the primary communication standard for Electronic Control Units (ECUs) in modern vehicles, but its lack of encryption and authentication exposes it to a range of security threats. Existing intrusion detection systems are largely tuned to fabrication-style attacks (DoS, fuzzing, ID spoofing realised by frame injection), in which detection signals such as per-ID inter-arrival statistics are readily available. We instead address the harder masquerade setting[b37], in which an internal adversary substitutes a legitimate frame in-situ at its original transmission slot, preserving traffic periodicity and rendering traffic-statistic defences ineffective. We propose the Mamba Intrusion Detection System (MIDS), an innovative dual-stream framework that processes CAN identifiers and payloads in parallel and reconstructs their joint temporal semantics through bidirectional selective state-space modelling. To evaluate MIDS, we collected over 100 million CAN frames from a physical Tesla Model 3 across three driving regimes and synthesised 54 masquerade attack variants spanning ID-only, data-only, and combined modifications. MIDS attains an F1 of 96.94\% on this dataset, exceeding the strongest reproducible baseline by more than 8 percentage points, while sustaining a 1.147~ms single-window inference latency – ample headroom for real-time onboard deployment. To verify generalisation, we further evaluate MIDS on four public benchmarks (ROAD, CrySyS, OTIDS, CT\&T) covering both masquerade and injection scenarios; MIDS attains F1 from 93.70\% to 99.61\%, outperforming the strongest of eight reproduced baselines by up to 13.94 percentage points under a unified 5-fold protocol.

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

The Latent Bridge: A Continuous Slow-Fast Channel for Real-Time Game Agents

arXiv:2606.24470v1 Announce Type: new Abstract: A real-time agent for general computer use - with games as the most demanding case - must act within tens of milliseconds while still planning over seconds. These two regimes sit at opposite ends of the latency-quality tradeoff. A reasoning VLM (Qwen3-VL-8B-Thinking) deliberates effectively but requires ~1.5 s per response - far too slow for a 15 Hz control loop. In contrast, a reactive VLM (MiniCPM-o 4.5) acts in milliseconds but underperforms on planning-heavy tasks. We couple two frozen models of matched scale (9B reactive, 8B reasoning), leaving the communication channel as the sole trainable component. The standard coupling is a Text Bridge (T): the slow model writes a suffix the fast model reads. We introduce a learned continuous Latent Bridge (L) that projects the slow model's residuals into the fast model's input-embedding space in a LLaVA-style manner, avoiding any text round-trip; both are compared against Fast-Only (F). On 7 Atari games and a driving domain (MetaDrive), tuning the action decoder per channel on held-out seeds, the Latent Bridge matches or beats the Text Bridge in every domain: it significantly improves two games (MsPacman +57%, RoadRunner +28%) and is a safe drop-in elsewhere. Combining both channels interferes destructively (RoadRunner -96%), so only one should be used. The benefit is highly predictable: the bridge helps if and only if slow reasoning already beats fast reaction (T > F) - the Latent and Text gains over Fast-Only move together at r=0.93. MetaDrive is the controlled negative, where the Latent Bridge is demonstrably inert because the Text Bridge adds no value. We release replay recordings and reproducible pipelines.

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

On the Limitations of Ray-Tracing for Learning-Based RF Tasks in Urban Environments

arXiv:2507.19653v2 Announce Type: replace-cross Abstract: We study the realism of Sionna v1.0.2 ray-tracing for outdoor cellular links in central Rome. We use a real measurement set of 1,664 user-equipments (UEs) and six nominal base-station (BS) sites. Using these fixed positions we systematically vary the main simulation parameters, including path depth, diffuse/specular/refraction flags, carrier frequency, as well as antenna's properties like its altitude, radiation pattern, and orientation. Simulator fidelity is scored for each base station via Spearman correlation between measured and simulated powers, and by a fingerprint-based k-nearest-neighbor localization algorithm using RSSI-based fingerprints. Across all experiments, solver hyper-parameters are having immaterial effect on the chosen metrics. On the contrary, antenna locations and orientations prove decisive. By simple greedy optimization we improve the Spearman correlation by 5% to 130% for various base stations, while kNN-based localization error using only simulated data as reference points is decreased by one-third on real-world samples, while staying twice higher than the error with purely real data. Precise geometry and credible antenna models are therefore necessary but not sufficient; faithfully capturing the residual urban noise remains an open challenge for transferable, high-fidelity outdoor RF simulation.

18.
medRxiv (Medicine) 2026-06-12

Cancer care disruption during the COVID-19 pandemic in Ontario, Canada: A sequential mixed-methods study

Introduction The COVID-19 pandemic profoundly disrupted healthcare delivery worldwide, with cancer care among the most affected services. Prior studies documented delays in referrals, reduced specialist access, and increased provider burden. However, the extent to which these experiences were reflected at the system level remains unclear. Objective To document cancer care experiences and examine whether these experiences were reflected in population-level health system indicators across Ontario, Canada. Methods We used an exploratory sequential mixed-methods design. Qualitative data were collected through focus groups and semi-structured interviews with 32 participants, including patients with cancer (n=8), caregivers (n=5), healthcare providers (n=14), and decision-makers (n=5) across two hospital settings in Ontario, Canada. Emergent themes informed the development of quantitative indicators. We then conducted a retrospective population-based analysis of linked administrative health databases for cancer patients in Ontario (n=87,786) to assess the prevalence of identified themes. Results Four themes emerged: (I) delays in diagnosis and screening; (II) disrupted access to primary care; (III) barriers to specialist and mental health services; and (IV) fragmented care for patients with multimorbidity. Quantitative findings corroborated major themes. Screening rates declined for cervical (64.8% to 57.5%) and breast cancer (64.5% to 57.2%). While in-person primary care shifted almost entirely to virtual modalities (8.5% to 95.4%), overall visit volumes remained stable. Specialist care showed uneven patterns, with increased oncology visits but declines in cardiology and mental health services. Patients with multiple comorbidities experienced the largest reductions in non-oncology specialist care. Conclusion The pandemic disrupted key components of cancer care, particularly screening, access to certain specialist services, and care for patients with complex needs. Integrating qualitative and quantitative evidence highlights areas of system vulnerability and underscores the need for coordinated, resilient cancer care capable of maintaining essential services during future crises.

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

Triangular-Reference Schrödinger Bridges for Time Series Generation

arXiv:2605.27478v3 Announce Type: replace-cross Abstract: Schrödinger bridges for time series (SBTS) generate synthetic paths by projecting, in relative entropy, a Brownian reference onto the path laws that match the joint distribution of the data on the observation grid. The Brownian reference, however, fixes the quadratic variation of the generated paths, which is restrictive when stochastic volatility, correlated noise, or rank-deficient covariance structures must be reproduced. We introduce "Triangular-Reference Schrödinger Bridges for Time Series" (TR-SBTS), which keeps the entropy-projection backbone of SBTS but replaces the Brownian reference by a triangular, volatility-informed, intervalwise frozen reference on a state augmented with latent covariance descriptors. The construction remains a single entropy projection on the augmented state: the minimiser is the \(h\)-transform of the reference, and on each frozen interval the optimal drift has the logarithmic-gradient form \(b^\star(t,x)=A\,\nabla\log H(t,x)\), intrinsic to the active covariance directions when the frozen covariance \(A\) is degenerate. We prove stability of the frozen approximation and consistency of the associated regularised kernel estimators, describe a reference-aware Nadaraya–Watson implementation of the conditional next-increment law, and evaluate the construction on numerical experiments.

20.
medRxiv (Medicine) 2026-06-23

Socioeconomic Determinants of Guideline-Concordant Therapy for Early-Stage Non-Small Cell Lung Cancer: A Population-Based Analysis from Appalachian and Non-Appalachian Ohio, 2004-2015

Purpose: To examine the relative contributions of insurance, county-level poverty, and other socioeconomic factors, as compared with Appalachian geography, to receipt of guideline-concordant therapy for early-stage non-small cell lung cancer (NSCLC) in Appalachian and non-Appalachian Ohio. Methods: Retrospective population-based cohort study using the Ohio Cancer Incidence Surveillance System. We identified adults diagnosed with early-stage NSCLC between 2004 and 2015 (N=26,756). The primary outcome was receipt of guideline-concordant local therapy (surgery or definitive radiation). Rural-urban classification used USDA Rural-Urban Continuum Codes. Multivariable logistic regression and Cox proportional hazards models assessed predictors of treatment and survival, with E-values, race-stratified models, and propensity score weighting as sensitivity analyses. Findings: Median age was 71 years; 50.3% were male, 83.8% non-Hispanic White, and 20.4% Appalachian. Overall, 83.6% received guideline-concordant local therapy (59.6% surgery, 24.0% radiation). In adjusted analysis, Medicaid (adjusted odds ratio [OR] 0.53, 95% confidence interval [CI] 0.44-0.63; adjusted risk ratio [RR] 0.94, 0.91-0.96), county-level poverty >20% (OR 0.77, 95% CI 0.68-0.87; RR 0.96, 0.95-0.98), and unmarried status were independently associated with lower therapy receipt, whereas Appalachian residence was associated with modestly higher receipt (OR 1.17, 95% CI 1.06-1.29; RR 1.02, 1.01-1.04). Therapy rates converged across regions over the study period (year x Appalachian interaction p20% (HR 1.13, 95% CI 1.07-1.20). Conclusions: Socioeconomic factors, particularly Medicaid insurance and county-level poverty, were the patient characteristics most strongly associated with lower receipt of guideline-concordant therapy, whereas Appalachian residence was not a barrier. Findings support targeted interventions addressing insurance-related and poverty-related barriers to lung cancer care in high-poverty communities regardless of geographic designation.

21.
medRxiv (Medicine) 2026-06-24

Predicting 24-Month MCI-to-Alzheimer's Conversion Using Routine Clinical Assessments Without Neuroimaging or Genetic Testing

作者:

ABSTRACT INTRODUCTION: Early identification of individuals with mild cognitive impairment (MCI) at high risk of conversion to Alzheimer's disease (AD) is essential for timely intervention. We evaluated whether routinely obtainable clinical assessments can accurately predict 24-month MC to AD conversion. METHODS: Data from 2,430 participants with MCI in the Alzheimer's Disease Neuroimaging Initiative were analyzed. XGBoost, Random Forest, and Logistic Regression models were evaluated. SHAP-based feature selection and feature ablation analyses assessed the incremental value of APOE4 genotype. RESULTS: A six-feature model incorporating age, sex, education, RAVLT Immediate Recall, MMSE, and EcogSPTotal achieved an AUC of 0.922 (95% CI, 0.911~0.933). APOE4 provided negligible additional predictive value once cognitive measures were included. The XGBoost model outperformed Clinical Dementia Rating Sum of Boxes classification. DISCUSSION: Routine cognitive assessments accurately predict 24-month MCI-to-AD progression without biomarkers, neuroimaging, or genetic testing, offering a practical, low-cost tool for clinical risk stratification.

22.
arXiv (CS.CL) 2026-06-19

Toten: Knowledge-Based Ontological Tokenization Of Physical Quantities And Technical Notation In Brazilian Portuguese

Byte-Pair Encoding tokenization is statistically efficient for vocabulary compression, but semantically blind to structured technical entities, fragmenting physical quantities, numbers, units, and symbolic expressions into lexically arbitrary subwords. We present TOTEN, a knowledge-based ontological tokenization framework that replaces statistical derivation with declarative classification grounded in a formal ontology of engineering entities (OEE). We formalize TOTEN as the triple : the ontology gathers types, structural principles, composition relations, and preservable invariants; the classification function maps raw text into typed regions; and the instantiator family yields a self-descriptive structured representation. Robustness derives from deterministic coupling with three external oracles: Pint (dimensional), Unicode Character Database (typographic), and RSLP (Portuguese morphology). Intrinsic evaluation covers four properties verifiable by construction – ontological atomicity, dimensional equivalence, typographic robustness, and numerical reconstruction – over an internal, physically validated benchmark (EngQuant, N=800) and four Brazilian Portuguese external corpora (N=1771 eligible cases). We also report detection recall, distinguishing coverage from conditional atomicity. Against eight state-of-the-art baselines, TOTEN achieves unit ontological atomicity in all contrasts and numerical reconstruction of 0.775-0.904 on external corpora, vs. 0.627-0.703 for the best baseline (Quantulum3); on EngQuant, 0.780 vs. 0.340. Differences are statistically significant (McNemar with Holm correction). Spearman correlation between internal and external rankings confirms concurrent validity of the control benchmark. Dimensional equivalence shows statistical parity with Pint, the oracle from which the system inherits dimensional authority.

23.
medRxiv (Medicine) 2026-06-16

Presurgical immune biomarkers associated with pain intensity and pain interference recovery after total knee arthroplasty: findings from the PRIME-KNEE study

Chronic postsurgical pain (CPSP) prevalence after total knee arthroplasty (TKA) is >20%. Circulating immune biomarkers are known factors of musculoskeletal pain but poorly understood as CPSP predictors. This prospective, longitudinal study of 203 patients s/p TKA tested presurgical plasma biomarkers associated with 6-month CPSP, using promising approaches from geriatrics biomarker research: expected recovery differential (ERD; resilience outcome) and penalized, machine-learning regularization modeling (elastic net and LASSO regression). Forty-nine presurgical candidate biomarkers were considered. CPSP was operationalized using ERDs built around PROMIS pain intensity and pain interference, which quantified the difference between observed and expected recovery after accounting for demographic, comorbidity, reserve, and perioperative factors. Plasma/ERDs from ~130 patients revealed 13 biomarkers with the highest selection stability criteria, and either positive or negative (+/-) associations with ERDs. Interleukin (IL) 5 (-) and Lipopolysaccharide-Binding Protein (LBP; +) were associated with both ERDs. Unique associations with pain intensity ERD included Cytomegalovirus-Specific IgG Negative (CMV IGg-; -), Macrophage Inflammatory Protein-1 Beta (MIP1b; -), IL12p70 (-, Cluster of Differentiation 30 (sCD30;-), Interferon alpha 2a (IFN2a;+), and Leukemia Inhibitory Factor (LIF;+). Unique associations with pain interference ERD included Lipopolysaccharide (LPS;-), Activin A (-), IL8 (-), Serum Amyloid A (SAA;-), and IL7 (+). Protein-protein interaction analyses and topology motifs suggest a centralized network with higher-than-expected connectivity, involving IL5, IL7, IL8, MIP1{beta}, and IFN2a, among others. This study proposes rigorous yet feasible approaches to expedite pain biomarker research, and introduces presurgical biomarkers t0 consider in future TKA-CPSP biosignature derivation.

24.
medRxiv (Medicine) 2026-06-22

Impact of Antidiabetic Medications on IgG and Plasma Protein N-Glycosylation in Type 2 Diabetes Patients

Introduction. Diabetes is a growing global health challenge, necessitating effective management strategies. Glycosylation, a highly regulated post-translational protein modification, has emerged as a pivotal factor in diabetes pathophysiology. However, the modulation of protein glycosylation by antidiabetic treatment is still largely unknown. This study explored the longitudinal effects of four distinct antidiabetic therapies - metformin, insulin, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and glucagon-like peptide-1 receptor agonists (GLP-1RA) - on plasma protein and immunoglobulin G (IgG) glycosylation in patients with type 2 diabetes (T2D). Research Design and Methods. Plasma protein and IgG N-glycans were enzymatically released, purified and chromatographically profiled in a cohort of 124 patients, examined at four time points, to assess therapy-induced glycan alterations. Linear mixed models adjusting for covariates and multiple testing (FDR

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arXiv (CS.LG) 2026-06-18

On the Stability of Nonlinear Dynamics in GD and SGD: Beyond Quadratic Potentials

arXiv:2602.14789v2 Announce Type: replace Abstract: The dynamical stability of the iterates during training plays a key role in determining the minima obtained by optimization algorithms. For example, stable solutions of gradient descent (GD) correspond to flat minima, which have been associated with favorable features. While prior work often relies on linearization to determine stability, it remains unclear whether linearized dynamics faithfully capture the full nonlinear behavior. Recent work has shown that GD may stably oscillate near a linearly unstable minimum and still converge once the step size decays, indicating that linear analysis can be misleading. In this work, we explicitly study the effect of nonlinear terms. Specifically, we derive an exact criterion for stable oscillations of GD near minima in the multivariate setting. Our condition depends on high-order derivatives, generalizing existing results. Extending the analysis to stochastic gradient descent (SGD), we show that nonlinear dynamics can diverge in expectation even if a single batch is unstable. This implies that stability can be dictated by a single batch that oscillates unstably, rather than an average effect, as linear analysis suggests. Finally, we prove that if all batches are linearly stable, the nonlinear dynamics of SGD are stable in expectation.