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01.
arXiv (CS.AI) 2026-06-19

ORAgentBench: Can LLM Agents Solve Challenging Operations Research Tasks End to End?

arXiv:2606.19787v1 Announce Type: new Abstract: Large language models are increasingly deployed as autonomous agents for multi-step tasks in executable environments, yet their ability to perform realistic operations research (OR) work remains unclear. Existing OR evaluations often decouple modeling from solving, rely on pre-formalized or text-only instances, and rarely test the full workflow from operational artifacts to validated decisions. In this work, we introduce ORAgentBench, an execution-grounded benchmark for evaluating autonomous agents on challenging end-to-end operations research tasks. It contains 107 human-reviewed tasks across diverse operational scenarios, each packaged in an isolated environment with a natural-language brief, multi-file data, configuration artifacts, and a required submission schema. Agents must write and run solution code, and their submissions are evaluated by hidden validators for schema validity, hard-constraint feasibility, and normalized objective quality. Experiments with fourteen frontier agent-model configurations show that current agents remain far from reliable OR practice. The best agent passes only 35.51% of all tasks and 20.59% of hard tasks, and many feasible submissions still fall below the required quality threshold. Failure analysis further shows that errors are dominated by strategic weaknesses, including missed operational rules, brittle formulations, weak feasible-solution construction, and insufficient solution improvement. OR-specific procedural skills increase hard-task feasibility, but do not reliably improve solution quality or pass rate. These results suggest that progress in OR agents requires moving beyond plausible optimization code toward dependable, high-quality operational decision-making.

02.
arXiv (CS.CL) 2026-06-11

BioDivergence: A Benchmark and Evaluation Framework for Hidden Contextual Contradictions in Biomedical Abstracts

Biomedical findings often seem to conflict across studies, but many of these differences are context-dependent rather than true contradictions. Variations in cohort, geography, assay protocol, disease subtype, and clinical setting can make both claims locally valid. Existing NLI and scientific claim-verification benchmarks reduce such cases to entailment, contradiction, or neutral, failing to capture the contextual structure behind divergence. To address this, we introduce BioDivergence, an evaluation framework with a six-class conflict taxonomy, a 13-axis divergence ontology, and four structured outputs per claim pair: conflict type, divergence axes, dominant confounder, and reconciliation explanation. We release BioDivergence-Silver-v1.0, an article-disjoint silver benchmark of 11,865 claim pairs across five biomedical domains, alongside a legacy deduplicated variant for comparison. Results show notable ranking differences between the two variants, with the fine-tuned reference model dropping about 12 points under the article-disjoint setting, while Mistral-7B-Instruct-v0.3 achieves 0.5523 accuracy and 0.3894 contextual-F1 on the 842-example primary test set. BioDivergence offers a more faithful way to distinguish contextual divergence from direct contradiction and to separate article-level memorization from genuine task learning.

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

Training-Free Adversarial Robustness in Computational MRI

Deep learning (DL) methods have become the state-of-the-art for reconstructing sub-sampled magnetic resonance imaging (MRI) data. However, studies have shown that these methods are susceptible to small adversarial input perturbations, resulting in major distortions in the output images. Various strategies have been proposed to reduce the effects of these attacks, but they require retraining. In this work, we propose a novel approach for mitigating adversarial attacks on MRI reconstruction models without any retraining. Based on the idea of cyclic measurement consistency, we devise a novel mitigation objective that is minimized in a small ball around the attack input. Results show that our method substantially reduces the impact of adversarial perturbations across different datasets, attack types/strengths and PD-DL networks, and qualitatively and quantitatively outperforms conventional mitigation methods. We also introduce a practically relevant scenario for small adversarial perturbations that models impulse noise in raw data, which relates to herringbone artifacts, and show the applicability of our approach in this setting. Finally, we show our mitigation approach remains effective in two realistic extension scenarios: a blind setup, where the attack strength or algorithm is not known to the user; and an adaptive attack setup, where the attacker has full knowledge of the defense strategy.

04.
arXiv (CS.LG) 2026-06-17

The Implicit Bias of Steepest Descent with Mini-batch Stochastic Gradient

arXiv:2602.11557v2 Announce Type: replace Abstract: A variety of widely used optimization methods like SignSGD and Muon can be interpreted as instances of steepest descent under different norm-induced geometries. In this work, we study the implicit bias of mini-batch stochastic steepest descent in multi-class classification, characterizing how batch size, momentum, and variance reduction shape the limiting max-margin behavior and convergence rates under general entry-wise and Schatten-$p$ norms. We show that, without momentum, worst-case convergence and successful classification can only be guaranteed with full-batch gradient. In contrast, momentum enables small-batch convergence to an approximate max-margin solution through a batch-momentum trade-off, though it slows convergence. This approach provides fully explicit, dimension-free rates that improve upon prior results. Moreover, we prove that variance reduction can recover the exact full-batch implicit bias for any batch size, albeit at a slower convergence rate. Finally, we further investigate the batch-size-one steepest descent without momentum, and reveal its convergence to a fundamentally different bias via a concrete data example, which reveals a key limitation of purely stochastic updates. Overall, our unified analysis clarifies when stochastic optimization aligns with full-batch behavior, and paves the way for perform deeper explorations of the training behavior of stochastic gradient steepest descent algorithms.

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

Light Forcing: Accelerating Autoregressive Video Diffusion via Sparse Attention

Advanced autoregressive (AR) video generation models have improved visual fidelity and interactivity, but the quadratic complexity of attention remains a primary bottleneck for efficient deployment. While existing sparse attention solutions have shown promise on bidirectional models, we identify that applying these solutions to AR models leads to considerable performance degradation for two reasons: isolated consideration of chunk generation and insufficient utilization of past informative context. Motivated by these observations, we propose \textsc{Light Forcing}, the first sparse attention solution tailored for AR video generation models. It incorporates a Chunk-Aware Growth mechanism to quantitatively estimate the contribution of each chunk, which determines their sparsity allocation. This progressive sparsity increase strategy enables the current chunk to inherit prior knowledge in earlier chunks during generation. Additionally, we introduce a Hierarchical Sparse Attention to capture informative historical and local context in a coarse-to-fine manner. Such two-level mask selection strategy (i.e., frame and block level) can adaptively handle diverse attention patterns. Extensive experiments demonstrate that our method outperforms existing sparse attention in quality (e.g., 84.5 on VBench) and efficiency (e.g., $1.2{\sim}1.3\times$ end-to-end speedup). Combined with other efficient solutions, \textsc{Light Forcing} further achieves a $2.0{\sim}3.0\times$ end-to-end speedup across diverse GPUs (e.g., 27.4\,FPS on RTX 5090 and 33.9\,FPS on H100). Code is released via this \href{https://github.com/chengtao-lv/LightForcing}{link}.

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

Blind Dexterous Grasping via Real2Sim2Real Tactile Policy Learning

arXiv:2606.11767v1 Announce Type: cross Abstract: Blind grasping with a dexterous hand is a crucial manipulation capability. Nevertheless, learning such tactile-only policies for real robots remains challenging due to the tactile sim-to-real gap and the limited expressiveness of sparse tactile signals. To bridge this gap, we propose a framework for tactile-only blind grasping that is deployable on a physical multi-fingered robotic hand. Our approach combines three key components. First, we introduce a Real2Sim tactile calibration pipeline that constructs a contact-calibrated digital-twin simulator capable of reproducing real tactile signals. Second, we improve the expressiveness of sparse tactile observations using a layout-aware tactile encoder, which incorporates sensor-geometry priors through self-supervised pretraining. Third, to improve generalization to unseen objects, we train object-specific reinforcement-learning experts in the calibrated simulator and aggregate their successful grasp trajectories into a tactile-conditioned Diffusion Policy. We evaluate our method on a physical LEAP Hand equipped with distributed tactile sensing across 10 seen and 10 unseen objects. The deployed policy achieves a 27\% real-world grasp success rate across all 20 objects, without real-world grasping demonstrations or visual input. Simulation ablations show that layout-aware tactile pretraining improves grasping performance, while sensing-level evaluations confirm that Real2Sim calibration increases the consistency of tactile contact events between simulation and hardware. Together, these results suggest that contact-event calibration, geometry-aware tactile representation learning, and diffusion-based policy aggregation provide an effective path toward tactile-only blind grasping on real dexterous robotic hands. Project page:Dex-Blind-Grasp.github.io.

07.
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.

08.
arXiv (CS.AI) 2026-06-19

BIM-Edit: Benchmarking Large Language Models for IFC-Based Building Information Modeling

arXiv:2606.20146v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly applied to computer-aided design (CAD) to generate design artifacts from textual instructions. In engineering practice, this requires more than creating new geometry, models must also understand existing scenes, edit them correctly, and preserve semantics and relations. However, many CAD benchmarks focus on creating new models rather than editing existing ones, and mostly evaluate geometric correctness. We introduce BIM-Edit, a benchmark for evaluating LLMs on natural-language editing of Building Information Models (BIM) represented in the Industry Foundation Classes (IFC) format. BIM provides a challenging testbed because building models encode geometry together with semantic and relational structure. BIM-Edit contains 324 editing tasks spanning 11 realistic building models and 36 synthetic scenes. Tasks are expressed using three instruction categories - direct, spatial, and topological - covering both explicit and scene-grounded edits. We evaluate outputs along three dimensions: geometric accuracy, semantic validity, and topological consistency. Across evaluated LLMs, the best-performing model achieves only 49.5% average score across the three metrics, and no model fully solves more than 3.4% of tasks. These results demonstrate a substantial gap between current LLM capabilities and the requirements of structured engineering design workflows.

09.
arXiv (math.PR) 2026-06-11

A Hybrid LSMC-PDE Method for Bermudan Option Pricing under the Gatheral Double Mean-Reverting Model

arXiv:2606.11237v1 Announce Type: cross Abstract: We study Bermudan option pricing under the Gatheral Double Mean-Reverting (GDMR) stochastic volatility model. The model features a variance process together with a stochastic long-run mean variance process and allows Constant Elasticity of Variance (CEV)-type exponents in the diffusion coefficients. This model is attractive since it provides a flexible specification for volatility dynamics. However, the pricing of early-exercise derivatives under the GDMR model remains largely unexplored in the literature. To address this challenge, we adapt a Hybrid Least-Squares Monte Carlo-Partial Differential Equation (LSMC-PDE) framework to the GDMR model and provide a detailed model-specific implementation. Conditioning on simulated variance paths, the pricing problem reduces to a one-dimensional problem in the asset price, which is solved by a Fourier-based approach, while the remaining dependence on the variance variables is approximated by least-squares regression. Our numerical experiments demonstrate that the Hybrid LSMC-PDE approach yields accurate pricing estimates and often lower pricing errors than plain LSMC, particularly for low and moderate numbers of simulation paths, showing the benefit of using the model structure in early-exercise option pricing.

10.
bioRxiv (Bioinfo) 2026-06-20

Seed variation impacts clustering stability in Single-Cell RNA-Seq and can be mitigated by StAbility-BasEd-Reassignment (SABER)

Single-cell RNA-seq clustering is commonly treated as reproducible once a random seed is fixed, yet the choice of seed itself may alter cell assignments and downstream interpretation. We systematically quantified seed-induced clustering variability by running Louvain and Leiden clustering across 100 seeds in Seurat and Scanpy on 28 single-cell RNA-seq datasets from the Human Cell Atlas and IMMUcan. Using Element-Centric Consistency, we found that seed choice affected a substantial fraction of cells, with Scanpy showing more unstable assignments than Seurat on average, 40.46% versus 26.78% unstable cells, respectively. This increased stability came at a marked computational cost: Seurat required approximately 19-fold higher median memory than Scanpy. Seed-dependent clustering variability also propagated to cell-type annotation, particularly among transcriptionally related populations including macrophage/monocyte, endothelial/epithelial and T/NK cell states. To mitigate this instability, we developed StAbility-BasEd Reassignment (SABER), a Scanpy-based framework that identifies seed-sensitive cells across repeated clusterings and reassigns them to stable cluster cores using cosine similarity. SABER improved clustering quality while preserving annotation concordance and reduced median memory usage 3.5-fold compared with Seurat-Louvain. Our results identify seed choice as an underappreciated source of variability in single-cell analysis and provide a scalable strategy to improve clustering robustness.

11.
arXiv (CS.CV) 2026-06-25

Chorus II: Cross-Request Sparsity Reuse for Efficient Image-to-Video Generation

Serving diffusion models for image-to-video generation is computationally expensive, posing significant challenges for large-scale deployment. Real I2V workloads often contain similar requests, such as repeated effect templates, related subjects, and recurring shot layouts. Existing cross-request acceleration methods mainly exploit this redundancy through feature reuse. We observe that similar I2V requests also share highly consistent sparse attention patterns, enabling historical sparse masks to serve as request-conditioned priors with almost no online mask-prediction overhead. We propose a cross-request reuse framework centered on sparsity reuse, with feature reuse as an optional extension safeguarded by a lightweight guidance enhancement. Our sparsity reuse is implemented as shared sparse mask reuse, which reuses high-quality sparse masks from similar historical requests to avoid per-request online mask prediction. Optional feature reuse applies downsampled computation to highly redundant spatiotemporal regions, mitigating boundary artifacts while preserving efficiency gains. Guidance enhancement reinforces image/text conditioning after reuse, mitigating semantic drift and condition-adherence issues. Experiments show that default sparsity reuse configuration preserves generation quality with a 2.16$\times$ speedup.

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

A Penalty Approach for Differentiation Through Black-Box Quadratic Programming Solvers

arXiv:2602.14154v3 Announce Type: replace Abstract: Differentiating through the solution of a quadratic program (QP) is a central problem in differentiable optimization. Most existing approaches differentiate through the Karush–Kuhn–Tucker (KKT) system, but their computational cost and numerical robustness can degrade at scale. To address these limitations, we propose dXPP, a penalty-based differentiation framework that decouples QP solving from differentiation. In the solving step (forward pass), dXPP is solver-agnostic and can leverage any black-box QP solver. In the differentiation step (backward pass), we map the solution to a smooth approximate penalty problem and implicitly differentiate through it, requiring only the solution of a much smaller linear system in the primal variables. This approach bypasses the difficulties inherent in explicit KKT differentiation and significantly improves computational efficiency and robustness. We evaluate dXPP on various tasks, including randomly generated QPs, large-scale sparse projection problems, and a real-world multi-period portfolio optimization task. Empirical results demonstrate that dXPP is competitive with KKT-based differentiation methods and achieves substantial speedups on large-scale problems. Our implementation is open source and available at https://github.com/mmmmmmlinghu/dXPP.

13.
arXiv (quant-ph) 2026-06-24

Connecting Quantum Tomography and Quantum Retrodiction

arXiv:2606.23777v1 Announce Type: new Abstract: Quantum tomography and quantum retrodiction are traditionally viewed as separate inference tasks: tomography reconstructs quantum states from measurement data, whereas retrodiction infers past quantum states from observed outcomes. We show that the two are manifestations of the same underlying principle. We prove that the Petz recovery map associated with a measurement channel is precisely the gradient update of the log-likelihood used in maximum-likelihood tomography. Consequently, repeated applications of the Petz map monotonically increase the likelihood. Extending beyond measurement channels, we derive a noncommutative generalization of the Petz map from the gradient of a generalized likelihood for arbitrary quantum channels. The resulting iterative procedure maximizes the likelihood and provides a general framework for quantum tomography, establishing a direct bridge between retrodiction, recovery maps, and statistical inference.

14.
arXiv (CS.CV) 2026-06-19

CUPID: Reconstructing UV Texture Maps for Interpretable Person-of-Interest Deepfake Detection

Deepfakes targeting a high-profile individual, known as Person-of-Interest (POI), are a threat to modern democracies and societies. Current POI deepfake detection methods still struggle to combine robustness to post-processing, efficiency and interpretability, focal aspects of modern deepfake detectors. In this paper we propose CUPID, a POI video deepfake detector that combines UV texture maps, a facial appearance representation derived from 3D face reconstructions, with the representation learning capabilities of the Masked Autoencoder (MAE). Our method does not require any deepfake videos in its training phase. Moreover, it does not even require to include a specific POI in the training set: the combination of UV texture maps extracted from real video frames and the MAE context-guided reconstruction yields a latent space that captures rich and discriminative facial features also for identities unseen during training. In the testing phase, the embeddings extracted from a query video depicting the POI can be matched against pristine reference videos to assess the video authenticity. Furthermore, operating in the UV space naturally provides an additional layer of interpretability. Specifically, we can extract decoded residual maps that highlight which facial regions of a test video deviate most from the identity representation of the corresponding POI. Experiments on four deepfake datasets show that CUPID outperforms current state of the art on most datasets and achieves the best overall robustness against strong downscaling and compression, providing also substantially faster inference. Our experimental code will be released at https://github.com/polimi-ispl/CUPID.

15.
arXiv (quant-ph) 2026-06-11

Super-Heisenberg Non-Equilibrium Quantum Sensing with Waveguide-Coupled Emitters

arXiv:2606.11975v1 Announce Type: new Abstract: We explore an array of quantum emitters as non-equilibrium probes, coupled to a one-dimensional photonic waveguide, aiming to estimate its properties such as wave number which encodes the waveguide frequency and dispersive characteristics. By considering transient dynamics following initial excitation, we show that the quantum Fisher information (QFI) can be significantly enhanced through careful emitter positioning. For two-emitter probes, optimal spacing stabilizes populations and coherences in the single-excitation subspace, suppressing super radiant decay and extending both the magnitude and longevity of QFI. Randomized emitter configurations also reveal that vanishing waveguide-mediated cross decay maximizes both achievable sensitivity and the temporal duration over which information about the parameter remains accessible. Extending to multipartite probes, we demonstrate that the maximum QFI and its temporal integral scale with system size, exceeding the Heisenberg limit for all positioning strategies. Our results highlight the potential of waveguide-coupled emitter arrays as versatile quantum sensors, where collective radiative dynamics can be harnessed to achieve tunable, long-lived, and enhanced precision.

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

A Perception vs. Distortion Perspective on Score-Based Generative Channel Estimation

arXiv:2606.16815v1 Announce Type: cross Abstract: Driven by their remarkable success in computer vision and inverse problem solving, score-based models are increasingly applied to wireless communications, where they show promise across a range of physical-layer tasks. However, despite this growing interest, the current literature often lacks a rigorous analysis of when score-matching offers a tangible advantage over traditional discriminative learning. This paper aims to address this gap through the use-case of channel estimation, a fundamental inverse problem in wireless systems. We present a theoretically grounded interpretation of score-based channel estimation through the lens of the perception-distortion tradeoff, identifying the conditions where score matching excels as well as its key limitations. In particular, by modeling downstream wireless tasks (e.g., capacity maximization) as functionals of the channel estimation process, we quantify the excess risk incurred by standard distortion-minimization approaches. Extensive numerical results show that under high predictive uncertainty, the large excess risk gap can be offset by score-based estimation, enabling near Bayesian-optimal precoding via the learned posterior, whereas in the low predictive uncertainty regime, discriminative distortion-minimization approaches are preferable due to lower complexity and more efficient use of model capacity.

17.
arXiv (quant-ph) 2026-06-15

Nonadiabatic Self-Healing of Trotter Errors in Digitized Counterdiabatic Dynamics

arXiv:2512.22636v2 Announce Type: replace Abstract: Trotter errors in digitized quantum dynamics arise from approximating time-ordered evolution under noncommuting Hamiltonian terms with a product formula. In the adiabatic regime, such errors are known to exhibit long-time self-healing [Phys. Rev. Lett. 131, 060602 (2023)], where discretization effects are effectively suppressed. Here we show that self-healing persists at finite evolution times once nonadiabatic errors induced by finite-speed ramps are compensated. Using counterdiabatic driving to cancel diabatic transitions and isolate discretization effects, we study both noninteracting and interacting spin models and characterize the finite-time scaling with the Trotter steps and the total evolution time. In the instantaneous eigenbasis of the driven Hamiltonian, the leading digital error maps to an effective harmonic perturbation whose dominant Fourier component yields an analytic upper bound on the finite-time Trotter error and reveals the phase-cancellation mechanism underlying self-healing. Our results establish finite-time self-healing as a generic feature of digitized counterdiabatic protocols, clarify its mechanism beyond the long-time adiabatic limit, and provide practical guidance for high-fidelity state preparation on gate-based quantum processors.

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

Efficient Hallucination Detection for LLMs Using Uncertainty-Aware Attention Heads

While large language models (LLMs) have become highly capable, they remain prone to factual inaccuracies, commonly referred to as "hallucinations." Uncertainty quantification (UQ) offers a promising way to mitigate this issue, but most existing methods are computationally intensive and/or require supervision. In this work, we propose Recurrent Attention-based Uncertainty Quantification (RAUQ), an unsupervised and efficient framework for identifying hallucinations. The method leverages an observation about transformer attention behavior: when incorrect information is generated, certain "uncertainty-aware" attention heads tend to reduce their focus on preceding tokens. RAUQ automatically detects these attention heads and combines their activation patterns with token-level confidence measures in a recurrent scheme, producing a sequence-level uncertainty estimate in just a single forward pass. Through experiments on twelve datasets spanning question answering, summarization, and translation across nine different LLMs, we show that RAUQ consistently outperforms state-of-the-art UQ baselines. Importantly, it incurs minimal overhead, requiring less than 1\% additional computation. Since it requires neither labeled data nor extensive parameter tuning, RAUQ serves as a lightweight, plug-and-play solution for real-time hallucination detection in white-box LLMs.

19.
arXiv (CS.AI) 2026-06-16

ARB4WM: An Adversarial Robustness Benchmark for World Models in Continuous Control

arXiv:2606.16605v1 Announce Type: new Abstract: World models are widely used in robotic and agentic engineering control systems due to their ability to learn latent dynamics for planning and decision-making. As these systems are increasingly deployed in safety-critical settings, understanding their robustness under adversarial conditions has become essential. However, existing evaluations lack a unified benchmark for testing adversarial threats across the policy, value, and latent-dynamics levels of world-model agents. To fill this gap, we present ARB4WM, a unified evaluation framework for pre-deployment robustness and risk assessment of world-model agents under visual perturbations. ARB4WM defines five white-box loss objectives across these three levels and studies their effects when combined with single-step or multi-step perturbation strategies and temporal attack modes, including full-frame, half-sequence, and sparse-frame exposure. Specifically, we evaluate four Dreamer-style agents across 20 tasks from MetaWorld and the DeepMind Control Suite under different loss objectives, perturbation strategies, and temporal attack modes. Results show that attacks targeting value estimation, latent representations, and RSSM dynamics can be as damaging as direct policy disruption, and that early or frequent perturbations are especially harmful, while input-level defenses provide limited recovery under adaptive attacks. These findings suggest that safety, risk, and reliability assessment for world models should cover multiple component-oriented attack objectives and temporal exposure protocols rather than relying solely on action-space robustness. Source code is available at https://github.com/zaoanguai/ARB4WM.

20.
medRxiv (Medicine) 2026-06-18

Early-life Urban Environment, Nutrition, and Pubertal Timing in Southern Europe: An Exposome Analysis

Background: Urban environmental and lifestyle factors during early life may influence pubertal timing, but the combined effects of multiple environmental exposures within an exposome analytical framework remain poorly understood. Objective: To examine the association between early-life urban environmental exposures and pubertal timing, and to explore whether these exposures interact with early-life nutritional factors, namely breastfeeding duration and childhood diet quality. Methods: Data from two European population-based birth cohorts were analysed: Generation XXI (G21, Portugal; n=5263; 51.5% girls) and INfancia y Medio Ambiente (INMA, Spain; n=1019; 50.1% girls). Urban environmental exposures including indicators of air pollution, traffic, built environment, and natural spaces were estimated at 4 early-life stages at both cohorts: pregnancy (INMA only), birth, 1 year, and 4-5 years of age. Pubertal development timing was assessed using Tanner staging and/or the Pubertal Development Scale (PDS), and age at menarche was self-reported. Exposome-Wide Association Study (ExWAS) models and unsupervised clustering followed by ordinal logistic regression models were used to examine single- and multi-exposure associations, respectively. Regression models were fitted adjusting for relevant child characteristics, maternal factors, and household socioeconomic conditions, and corrected for multiple testing. Results: Individuals living in more unfavourable urban environments characterised by higher building density, air pollution, and lower access to natural spaces showed earlier pubertal timing according to multiple outcomes, across multiple early-life exposure periods, and in both cohorts. In the G21 cohort, these environmental profiles were associated with earlier age at menarche, particularly for exposures at 1-1.5 and 4-5 years (e.g., 1-1.5y: {beta}=-0.172, FDR-adjusted p-value=0.041), while in the INMA cohort, boys exposed to more unfavourable environmental profiles showed more advanced pubertal development, also particularly for exposures at 1-1.5 and 4-5 years of age (e.g., 1-1.5y; {beta}=0.572, FDR-adjusted p-value=0.008). Among environmental domains, air pollution and traffic were the factors most consistently associated with pubertal timing. Regarding early-life nutritional factors, longer duration of exclusive breastfeeding was associated with a lower Tanner stage among girls in G21. No significant interactions between breastfeeding duration and environmental exposure clusters were observed. Conclusion: Early-life urban environmental exposures, particularly air pollution and traffic, may influence pubertal timing. Exclusive breastfeeding may have a protective role against earlier pubertal development. These findings highlight the importance of improving urban environmental conditions and promoting breastfeeding to support healthy developmental trajectories.

21.
medRxiv (Medicine) 2026-06-15

ICD-10 Code Ambiguity Obscures Treatment-Eligible Adults with Spinal Muscular Atrophy: A Single-Center Chart Review and Patient Outreach Study

Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.

22.
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.

23.
arXiv (CS.LG) 2026-06-16

HAPI-EP: Towards Hybrid, Adaptive, and Predictive Digital Twins of Cardiac Electrophysiology

arXiv:2606.15637v1 Announce Type: new Abstract: A digital twin (DT) of a patient-specific heart offers significant potential in personalized medicine. However, its rapid and dynamic adaptation to an individual's live data and its predictive capability after adaptation remains central challenges. We examine this challenge from its two building blocks: DT formulation where mechanistic and data-driven models show competing merits and limitations, and DT optimization strategies that are largely driven by a reconstruction objective leading to un-identifiable models. We address both bottlenecks via HAPI – an AI framework for building hybrid, adaptive, and predictive DTs with three key enablers. First, HAPI constructs a physics-integrated gray-box model in which an interpretable mechanistic backbone is augmented by a neural component that models its residual to the observed data. Second, rather than attempting to pre-encode all possible variations in a static hybrid model, HAPI enables rapid on-the-fly adaptation of the hybrid model to few-shot live data, achieved by feedforward meta-learners realizing amortized inference of both mechanistic and neural parameters of the hybrid model trained with predictive objectives. Finally, we show that this adaptivity corresponds to the construction of a conditional generative model (i.e., the hybrid DT) that endows it with theoretical identifiability and thus strong performance in predictive scenarios. We demonstrate the proof-of-concept of HAPI in cardiac electrophysiology using a hybrid monodomain model with mechanistic reaction kinetics and neural graph diffusion. Across synthetic and real-data studies, we show that HAPI's mechanistic-neural hybridization and predictive adaptation are critical for obtaining identifiable DTs with strong predictive and out-of-distribution capabilities.

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

Naturalness Predicts but Does Not Cause Transferability in Image Encodings of Real-World Streams

A common practice converts a one-dimensional signal into an image so that a vision backbone pretrained on natural photographs can be reused for recognition, yet the encoded image is rarely examined. We ask how the visual naturalness of an encoded image relates to its transfer accuracy under a frozen backbone. We build WorldStream, a corpus of 299 heterogeneous current-value series from key-free public APIs (weather, air quality, earthquakes, gold and oil, equities, crypto, foreign exchange, web activity and space weather), with a nine-way source-recognition task over 3143 temporally split windows. Across seven encodings and six frozen backbones, the Frechet distance of an encoding to natural images (FID) predicts its accuracy: Spearman $\rho=-0.72$. Two controlled interventions show this is not causal in the spectrum. Our invertible encoder has a single adjustable part, a spectral exponent $\beta$ (power $\propto |f|^{-\beta}$); varying $\beta$ moves the image toward or away from the natural-image manifold at fixed content. FID is lowest near the natural value $\beta \approx 2$, but frozen accuracy stays flat and far below the structured baselines (19.2% vs. 73.0%), and FID and accuracy are only weakly related over the sweep (Pearson $-0.32$). A second intervention, phase scrambling, holds the power spectrum exactly fixed while removing local structure; now FID and accuracy fall together (Pearson $-0.89$). The cross-encoding correlation is thus mediated by local structure, not spectral naturalness: FID predicts accuracy because Inception reads the same structure the backbones do. Full fine-tuning does not close the gap (27% vs. 67%), so the deficit is structural. The encoder is exactly invertible, recovering the signal from the 8-bit image at 72.9 dB, so the image doubles as a lossless record of the data.

25.
medRxiv (Medicine) 2026-06-22

Characteristics and Outcomes of Gene-Elusive Dilated Cardiomyopathy

Background and Aims Genetic testing in dilated cardiomyopathy (DCM) guides risk stratification and family screening. Likely pathogenic or pathogenic (LP/P) variants are identified in approximately one-third of patients, leaving many without a genetic diagnosis. Cohort studies suggest that "gene-elusive" patients have a lower risk of adverse events. This study aims to better characterise this group and identify factors associated with adverse outcomes. Methods Consecutive and unrelated DCM patients undergoing genetic testing and returning no LP/P variants were retrospectively recruited and compared to two control cohorts of DCM patients carrying LP/P variants in LMNA and TTN for a primary composite endpoint of end-stage heart failure (ESHF) or malignant ventricular arrhythmia (MVA). Results Among patients without prior MVA, the composite endpoint occurred in 36/423 (8.5%) gene-elusive, 14/39 (35.9%) LMNA and 11/100 (11%) TTN cardiomyopathy patients (log-rank p