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01.
arXiv (CS.CL) 2026-06-15

DLawBench: Evaluating LLMs Through Multi-Turn Legal Consultation

Lawyer-client consultation is a critical starting point for legal services. Effective legal assistance hinges on eliciting sufficient and truthful information from clients in order to devise strategies that best protect their interests. This task requires Large Language Models (LLMs) not only to perform robust legal reasoning, but also to strategically elicit material facts through multi-turn interactions and effectively guide clients with diverse personalities. Yet existing legal benchmarks overlook this interactive capability. To fill this gap, we introduce DLawBench, a diagnostic benchmark for real-world legal consultation. Drawing on realistic client behavior, we characterize lawyer-client interactions into four types: Cooperative, Dependent, Withdrawn, and Adversarial. Using dialogues grounded in real cases, DLawBench evaluates whether LLMs can effectively conduct legal consultation under realistic conditions. DLawBench comprises 461 cases from Chinese and U.S. law, 5,532 paired fact entries, 3,411 inquiry rubrics, and 3,348 issue-resolution rubrics, and evaluates 26 representative LLMs. Systematic experiments show substantial headroom: the best-performing model, GPT-5.5, achieves only 0.562 on consultation-grounded legal reasoning. More importantly, DLawBench exposes both sycophancy in legal consultation and a paradox: models perform worse when clients need guidance most.

02.
arXiv (CS.LG) 2026-06-18

Generative models for decision-making under distributional shift

arXiv:2604.04342v2 Announce Type: replace Abstract: Many data-driven decision problems are formulated using a nominal distribution estimated from historical data, while performance is ultimately determined by a deployment distribution that may be shifted, context-dependent, partially observed, or stress-induced. This tutorial presents modern generative models, particularly flow- and score-based methods, as mathematical tools for constructing decision-relevant distributions. From an operations research perspective, their primary value lies not in unconstrained sample synthesis but in representing and transforming distributions through transport maps, velocity fields, score fields, and guided stochastic dynamics. We present a unified framework based on pushforward maps, continuity, Fokker-Planck equations, Wasserstein geometry, and optimization in probability space. Within this framework, generative models can be used to learn nominal uncertainty, construct stressed or least-favorable distributions for robustness, and produce conditional or posterior distributions under side information and partial observation. We also highlight representative theoretical guarantees, including forward-reverse convergence for iterative flow models, first-order minimax analysis in transport-map space, and error-transfer bounds for posterior sampling with generative priors. The tutorial provides a principled introduction to using generative models for scenario generation, robust decision-making, uncertainty quantification, and related problems under distributional shift.

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

Approximate Structured Diffusion for Sequence Labelling

Sequence labelling, a core task of Natural Language Processing (NLP), consists in assigning each token of an input sentence a label. From a Machine Learning point of view, sequence labelling is often cast as a Linear-Chain Conditional Random Field (CRF) parametrised by a neural network. While this approach gives good empirical results, CRFs assume a finite decision span (eg label bigrams) which can limit their expressivity and hurt performance when long-range dependencies are required. We show we can leverage diffusion to train a CRF conditioned on an entire label sequence, with the caveat that the condition is on a noisy version of labels. We show experimentally that this method, in conjunction with approximate CRF inference, improves label accuracy with a 16.5% error reduction for POS-tagging.

04.
arXiv (quant-ph) 2026-06-12

Simple analytical flux-tuned iSWAP pulses for leakage suppression

arXiv:2606.13052v1 Announce Type: new Abstract: Fast, high-fidelity two-qubit gates are a key requirement for fault-tolerant quantum computation. Tunable coupler architectures provide a flexible approach for implementing entangling gates through flux control with large on-off ratios, but fast flux modulation can induce diabatic transitions and population leakage to non-computational states, limiting gate performance. Here we present an analytical flux control method enabling derivative removal by adiabatic gate ($\Phi$-DRAG) for suppressing leakage in flux tunable two-qubit gates. We show that $\Phi$-DRAG differs fundamentally from conventional microwave implementations and derive modified flux modulation protocols that suppress leakage below $10^{-4}$ for fast entangling gates. The method remains effective across a range of asymmetry between qubit anharmonicities and different circuit parameters, enabling high-fidelity two-qubit gates within the fifteen nanosecond range.

05.
arXiv (quant-ph) 2026-06-17

Tripartite entanglement of remote atomic qubits

arXiv:2606.17173v1 Announce Type: new Abstract: Distributed entanglement across multi-node quantum networks is essential for a wide range of quantum technologies, including modular quantum computers, distributed sensing and metrology, and multi-party secure communication protocols. Such large-scale quantum networks will require photonic interconnects to generate and sustain entangled states across localized nodes. Previously, three-node distributed Greenberger-Horne-Zeilinger (GHZ) states have been generated between solid-state qubits and atomic ensembles, but not yet in the platform of individual atomic qubits, which can be replicated, detected, and individually controlled with high fidelity. Here we report the first fully-distributed GHZ state of qubits across a three-node quantum network of single atomic memories, using photonic interconnects. We achieve a bounded fidelity of $0.841(17) \leq \mathcal{F} \leq 0.881(17)$ at an entanglement generation rate of 0.095(5)/sec and measure a clear violation of Mermin's inequality while closing the detection loophole for the first time in a fully-distributed multipartite entangled state.

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

Denoising Score Matching with Random Features: Insights on Diffusion Models from Precise Learning Curves

arXiv:2502.00336v3 Announce Type: replace Abstract: We theoretically investigate the phenomena of generalization and memorization in diffusion models. Empirical studies suggest that these phenomena are influenced by model complexity and the size of the training dataset. In our experiments, we further observe that the number of noise samples per data sample ($m$) used during Denoising Score Matching (DSM) plays a significant and non-trivial role. We capture these behaviors and shed insights into their mechanisms by deriving asymptotically precise expressions for test and train errors of DSM under a simple theoretical setting. The score function is parameterized by random features neural networks, with the target distribution being $d$-dimensional Gaussian. We operate in a regime where the dimension $d$, number of data samples $n$, and number of features $p$ tend to infinity while keeping the ratios $\psi_n=\frac{n}{d}$ and $\psi_p=\frac{p}{d}$ fixed. By characterizing the test and train errors, we identify regimes of generalization and memorization as a function of $\psi_n,\psi_p$, and $m$. Our theoretical findings are consistent with the empirical observations.

07.
medRxiv (Medicine) 2026-06-24

Screen-Free Haptic Breathwork with HRV-Adaptive Control, Pilot Outcomes and System Design

Vayu is a mobile breathwork system comprising an iOS companion app and Apple Watch application that delivers slow, resonant breathing using screen-free haptic cues, HRV-adaptive pacing, and reflective journaling grounded in Patanjali's five states of mind. The watchOS component provides tactile phase guidance and real-time biometric sensing (heart rate, HRV), while the iOS interface supports analytics and personalized recommendations. In a 4-6-week naturalistic pilot involving 199 adults (ages 22-65) across Canada, the United States, and India, participants engaged in daily 5-10-minute sessions guided by on-wrist haptics. Average adherence was 4.1 +/- 2.3 sessions per week, with 71% of active users maintaining at least 3 sessions per week. By week four, perceived stress (PSS-10) decreased by 2.5 points, resting heart rate declined by 7.4 bpm, and HRV increased by a median of 28.6% relative to baseline, accompanied by mood improvements. No adverse events were reported. HRV metrics are derived from Apple Watch PPG-based proxies and interpreted as relative trends. These findings suggest Vayu is effective and well-tolerated, demonstrating strong engagement and early efficacy signals.

08.
arXiv (CS.CV) 2026-06-15

Compressing Image Style Training into a Single Model Forward

Diffusion-based style transfer must balance inference efficiency with stylization fidelity. Adapter-based methods are efficient, but they inject style as an external condition and can either weaken reference-specific appearance or copy reference semantics into the generated image. Optimization-based personalization methods such as LoRA internalize style more effectively, but require a separate training process for every new style. We introduce i2L (image-to-LoRA), a framework that amortizes style LoRA training into a single forward pass. Given one or more reference images, i2L predicts LoRA weights for a text-to-image model, enabling immediate style instantiation without per-style optimization. The architecture combines an image encoder, learnable LoRA queries, and compressed decoding heads that generate adapted matrices. Training on semantically diverse style pairs encourages the predictor to preserve appearance cues while suppressing reference-content copying. Experiments on Z-Image, FLUX.2, and Hidream-O1 show that i2L improves style fidelity, prompt alignment, and perceptual quality over existing baselines. Because i2L produces explicit LoRA weights, it also supports asymmetric classifier-free guidance, multi-reference style fusion, and composition with controllable-generation modules.

09.
arXiv (CS.CV) 2026-06-18

AMALIA-VL: A Native European Portuguese Open-Source Vision and Language Model

Large Vision and Language Models (LVLMs) have advanced rapidly, yet European Portuguese (pt-PT) remains systematically underserved by existing open-source multimodal models, which either conflate it with Brazilian Portuguese or severely under-represent it in their training data mixes. We introduce AMALIA-VL, the first open-source instruction-tuned LVLM built natively for pt-PT, pairing a high-resolution vision encoder with dynamic image tiling and a fully open pt-PT-optimized language model via a learned connector. We contribute with a purposefully designed three-stage training process - vision-language alignment, general visual instruction tuning, and preference optimization - together with a pt-PT-centric multimodal data mix combining curated and translated public datasets with novel datasets that address the near-total absence of European Portuguese multimodal resources. Our evaluation shows that AMALIA-VL establishes a strong baseline for open-source pt-PT LVLMs.We will release model weights, training data, and construction pipelines along with machine-translated pt-PT evaluation benchmarks to help democratize pt-PT LVLM development.

10.
medRxiv (Medicine) 2026-06-15

ECHOCARDIOGRAPHY ABNORMALITIES IN PREECLAMPSIA WITH SEVERE FEATURES.

Purpose To determine the frequency of echocardiographic abnormalities in women with preeclampsia with severe features. To describe the spectrum and types of echocardiographic abnormalities associated with preeclampsia with severe features. Method This is a Prospective observational study conducted in Vani Vilas hospital attached to Bangalore Medical College and Research Institute, Bangalore from January 2023 to December 2025. 560 pregnant women diagnosed with severe preeclampsia(SPE) were included in the study. Chronic hypertension without superimposed preeclampsia, underlying cardiac diseases and previous history of peripartum cardiomyopathy were excluded from the study. Transthoracic echocardiography-TTE (2D ECHO) was done to evaluate cardiac structure and function. Echocardiographic abnormalities identified during the study were documented and analysed using descriptive statistical methods. Results Abnormalities in ECHO was noted in 23.03%. A unique finding was the documentation of elevated pulmonary artery systolic pressures (PASP) suggestive of Pulmonary Hypertension (PH) (PASP >35 mm HG) among 20.25% of the participants. It was also the commonest abnormality on ECHO. Mild PH was the commonest (15.71%), moderate PH was seen in 3.92% and severe PH in 0.71% of cases. Next most frequent abnormality was moderate to severe valvular regurgitation (10%), followed by left ventricular hypertrophy (5.53%). Diastolic dysfunction (DD) was seen in 3.92%, systolic dysfunction(SD) in 3.57%, chamber dilatation in 3.57% and LV global hypokinesia in 3.03% cases of SPE Conclusion Preeclampsia with severe features (SPE) is associated with 23.03% abnormalities on echocardiography. SPE is associated with systolic dysfunction, diastolic dysfunction, chamber dilatation, valvular regurgitation, left ventricular hypertrophy and pulmonary hypertension.

11.
arXiv (CS.CV) 2026-06-16

HiRo: A Compact Four-Directional Hierarchical Reservoir Token-Mixer for Efficient Image Classification

Recent image classification models must balance local feature modeling, cross-window interaction, and parameter efficiency. Many high-performing architectures rely on fully trainable token-mixers, which improve representation learning but increase parameter count, optimization complexity and computational cost. We propose a parameter-efficient image classification model called HiRo that integrates shifted-window partitioning with multi-directional hierarchical reservoir computing. Images are divided into non-overlapping patches (treated as tokens), linearly projected, normalized, and enriched with 2D sinusoidal positional encodings, then processed within local windows. Inside each window, tokens are scanned in four directions and passed through a two-stage slice-and-mix reservoir module. In the first stage, directional sequences are split into contiguous slices, each processed by its own fixed reservoir with a trainable closed-loop readout. The resulting slice outputs are summarized using the start, end, and mean representations, and then mixed by a second-stage fixed reservoir for each direction. The mixed slice representations are expanded back to the token level and fused with the first-stage outputs, after which the four directional outputs are realigned and averaged. Consecutive blocks alternate between regular and shifted windows to enable cross-window interaction, followed by layer normalization, a residual feed-forward network, and global pooling for classification. This design combines regular and shifted window partitioning with hierarchical multi-directional reservoirs to make an efficient local-to-cross-window token-mixing framework for image classification. Despite using under 1M trainable parameters and significantly lower memory and time than transformer-style baselines, HiRo also achieves 99.46%, 85.57%, and 59.10% accuracy on MNIST, CIFAR-10, and CIFAR-100, respectively.

12.
arXiv (CS.AI) 2026-06-19

Global Ease of Living Index: a machine learning framework for longitudinal analysis of major economies

arXiv:2502.06866v3 Announce Type: replace-cross Abstract: The drastic changes in the global economy, geopolitical conditions, and disruptions such as the COVID-19 pandemic have impacted the cost of living and quality of life. It is essential to comprehend the long-term implications of the cost of living and quality of life in major economies. A transparent and comprehensive living index must include multiple dimensions of living conditions. In this study, we present an approach to quantifying the quality of life through the Global Ease of Living Index that combines various socio-economic and infrastructural factors into a single composite score. Our index utilises economic indicators that define living standards, which could help in targeted interventions to improve specific areas. We present a machine learning framework to address missing data for certain economic indicators in specific countries. We then curate and update the data and use a dimensionality reduction approach (Principal Component Analysis and Factor Analysis) to create the Ease of Living Index for major economies since 1970. Our work significantly adds to the literature by offering a practical tool for policymakers to identify areas needing improvement, such as healthcare systems, employment opportunities, and public safety. Our approach with open data and code can be easily reproduced and applied to various contexts, providing transparency and accessibility for ongoing research and policy development in quality-of-life assessment.

13.
arXiv (quant-ph) 2026-06-25

Collective rotational cat states of molecules in microwave cavities

arXiv:2606.25815v1 Announce Type: new Abstract: We show theoretically that an ensemble of polar molecules coupled to a microwave cavity supports hybrid rotational-photonic cat states. The cavity couples to a symmetric rotor in the bright manifold of $N$ molecules with $\sqrt{N}$-enhancement. In the dispersive limit of the collective strong coupling regime, virtual multilevel transitions induce an effective Kerr nonlinearity, as confirmed by Wigner tomography and a Schrieffer-Wolff analysis, leading to parity-locked cat structure in the cavity sectors. Collective molecular rotations thus provide a new route to hybrid light-matter cat states.

14.
arXiv (CS.LG) 2026-06-24

A Fast and Effective Method for Euclidean Anticlustering: The Assignment-Based-Anticlustering Algorithm

arXiv:2601.06351v2 Announce Type: replace Abstract: Anticlustering is an NP-hard combinatorial optimization problem that consists of partitioning a set of objects into equal-sized groups called anticlusters such that the objects in the same anticluster are as dissimilar as possible and thereby representative of the entire set of objects. Here we study the case where the dissimilarity metric is the squared Euclidean distance between the respective feature vectors. Applications of Euclidean anticlustering include social studies, cross-validation, creating mini-batches for stochastic gradient descent, and finding balanced K-cut partitions. In particular, machine-learning applications such as mini-batch generation involve million-scale datasets and very large values of K, making scalable anticlustering algorithms essential. We propose a new algorithm, the Assignment-Based Anticlustering (ABA) algorithm, that scales to instances with millions of objects and hundreds of thousands of anticlusters within seconds to minutes, which is far beyond what existing anticlustering methods can manage. We demonstrate here, via an extensive computational study, that our algorithm outperforms existing anticlustering methods in both solution quality and running time. This is so also for anticlustering with categories. For the related problem of balanced K-cut partitioning, our algorithm is superior to the well-known METIS method. The code of our algorithm is available on GitHub.

15.
arXiv (CS.AI) 2026-06-12

PI-Hunter: Automated Red-Teaming for Exposing and Localizing Prompt Injections

arXiv:2606.12737v1 Announce Type: cross Abstract: Large Language Models (LLMs) are rapidly evolving into agentic systems that interact with external tools and environments, introducing new security risks such as indirect prompt injection attacks through untrusted external sources. Existing defenses mainly focus on blocking malicious content at inference time, and current red-teaming methods primarily optimize attack success. As a result, developers have limited visibility into how latent prompt injections emerge and propagate through agents. We propose PI-Hunter, an automated agentic auditing framework for proactive vulnerability exposure in LLM agents. PI-Hunter constructs realistic source-aware test cases and iteratively evolves them through feedback-driven exploration to induce agents to retrieve and reveal latent malicious instructions embedded within external environments. Extensive experiments across multiple benchmarks, agent architectures, attacks, and defenses demonstrate that PI-Hunter substantially improves vulnerability exposure and attack-surface coverage over strong automated red-teaming baselines, while remaining effective under existing prompt injection defenses.

16.
arXiv (CS.AI) 2026-06-11

RoVE: Rotary Value Embeddings Attention for Relative Position-dependent Value Pathways

arXiv:2606.11275v1 Announce Type: cross Abstract: Rotary Position Embeddings (RoPE) make attention scores position-relative but leave the value pathway position-blind: the message sent by a value token is the same regardless of its distance from the query. We propose RoVE, a parameter-free modification that makes values position-sensitive by rotating them simultaneously with keys, and show that it turns RoPE attention into attentive convolution. This new perspective unifies several independent formulations of the same operation across computer vision, robotics, and modern LLM architectures. Trained 124M and 354M GPT-2 models show consistent empirical gains over RoPE on few-shot in-context learning, out-of-distribution perplexity, and long-context retrieval, with the clearest improvements on tasks that require long-range aggregation.

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

Majorana bound states in a hybrid Kitaev ladder with long-range pairing

arXiv:2606.19963v1 Announce Type: new Abstract: We investigate an inter-leg coupled hybrid Kitaev ladder composed of two parallel superconducting chains with distinct pairing interactions. The upper chain of the ladder hosts conventional $p$-wave pairing, while the lower chain exhibits long-range pairing that decays algebraically with distance. We demonstrate that the mutual influence of long-range pairing exponent, chemical potential, and inter-leg coupling strength gives rise to a rich topological phase diagram characterized by multiple Majorana zero modes and massive Dirac modes. In particular, we show that the inter-leg coupling renormalizes the effective energy scales, leading to a systematic shift of the topological phase boundaries and enabling controlled tuning of the Majorana modes. Furthermore, we identify a transition from a two Majorana zero mode phase to a phase encapsulating four Majorana zero modes, as the long-range pairing exponent is varied. This transition is accompanied by a crossover regime in which Majorana zero modes coexist with massive Dirac modes, reflecting hybridization between edge and bulk excitations. This ladder thus provides a minimal and attractive platform for realizing the impact of a long-range pairing on topological phases. Our results highlight the potential of long-range hybrid systems for engineering tunable topological states relevant for quantum information applications.

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

Structuring and Tokenizing Distributed User Interest Context for Generative Recommendation

arXiv:2606.20554v1 Announce Type: cross Abstract: Generative recommendation is an emerging paradigm that has shown promise in industrial recommendation systems, aiming to predict users' next interactions from their historical behaviors. At the core of generative recommendation lies item tokenization, which bridges item semantics and recommendation models. However, existing methods often struggle to effectively organize and inject complex user-behavioral and item-semantic contexts into recommendation models simultaneously. On the one hand, existing graph-based integration methods, such as graph serialization and graph neural networks, either suffer from scalability issues or exploit only local graph information. On the other hand, existing semantic tokenization methods typically rely on heuristics and lack explicit supervision signals, which may lead to inaccurate or suboptimal semantic representations. To address these limitations in user interest context modeling, we propose G2Rec, a scalable framework that unifies holistic graph-based user co-engagement modeling with semantic tokenization for industrial-scale generative recommendation. Overall, G2Rec enables recommendation models to capture holistic and semantically grounded user interest prototypes without requiring ground-truth user interests, thereby providing more comprehensive and accurate modeling of user behavior contexts in industrial sequential recommendation. Online deployment across product surfaces and extensive experiments on public datasets demonstrate the superiority of G2Rec over existing methods.

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

Hardy-type self-testing and exposedness of tripartite GHZ correlations

arXiv:2512.16242v2 Announce Type: replace Abstract: Nonlocality can be witnessed either through Bell-inequality violations or through logical contradictions such as Hardy's paradox. In the bipartite two input two outcome scenario, these two routes have distinct geometric behavior: CHSH-maximal correlations are exposed points of the quantum set, whereas known Hardy-type self-testing correlations on the no-signaling boundary are non-exposed. Here we show that this bipartite intuition fails in the tripartite two input two outcome scenario. We study the tripartite instance of a multipartite Hardy-type paradox and prove that the correlation attaining the maximal Hardy success probability self-tests the Greenberger–Horne–Zeilinger state and the associated measurements. Although this correlation lies on the no-signaling boundary, we show that it is an extremal and exposed point of the quantum correlation set. Moreover, it coincides with the correlation attaining the maximal violation of the Mermin inequality. Thus, in the tripartite GHZ scenario, the logical-paradox and Bell-inequality routes to nonlocality select the same exposed quantum boundary point. We also establish a robust version of the self-test, showing that small deviations from the ideal Hardy constraints imply quantitative closeness to the target state and measurements. Our results reveal a qualitative geometric difference between bipartite and tripartite Hardy-type nonlocality and suggest a broader investigation of exposedness for multipartite Hardy correlations in the multiparty setting.

20.
arXiv (CS.CV) 2026-06-18

Physics-IQ Verified

Video generative models ( VGMs) have become a new frontier that can be used not just for video generation but for a multitude of downstream tasks, including world modeling. To advance these tasks, a good video model must understand the physical reality of the world. Evaluating this understanding is an emerging field and has led to the Physics-IQ benchmark, which quantifies this explicitly by comparing model-generated videos to real-world videos of physical experiments. In this work, we present a systematic audit of the Physics-IQ benchmark, expose shortcomings and propose three solutions that sharpen how we can measure physical understanding of VGMs. Specifically, we improve prompt and ground-truth quality to reduce the influence of confounding factors and further introduce a sample-level scoring system that weights each sample and metric equally. Our resulting benchmark, Physics-IQ Verified, refines 57.6\% of all samples and improves over 34.8\% of prompts. In a comparison study using six image-to-video generative models, we observe moderate but meaningful ranking changes (Kendall's $\tau = 0.46$). We hope Physics-IQ Verified advances the community by providing a more reliable signal toward physically accurate VGMs. The code for the benchmark can be accessed at https://github.com/google-deepmind/physics-iq-benchmark

21.
medRxiv (Medicine) 2026-06-16

Enteral docosahexaenoic and arachidonic acid supplementation and retinopathy of prematurity: a re-analysis of randomized controlled trials in preterm infants

Background. A recent meta-analysis by Dang et al. [1] concluded that enteral supplementation with docosahexaenoic acid (DHA), with or without arachidonic acid (ARA) did not significantly affect retinopathy of prematurity (ROP) outcomes in preterm infants. Of four eligible trials that supplemented both DHA and ARA, only two contributed to each ROP outcome analyzed, and severe ROP was not assessed. Methods. We replicated the eligibility criteria and search strategy of Dang et al., restricted to trials that supplemented both DHA and ARA, and reanalyzed three ROP endpoints (any ROP, ROP requiring treatment, and severe ROP [stage 3 and/or treated]) using complete outcome records from all eligible trials. Crude risk ratios (RR) were pooled by Mantel-Haenszel fixed-effect meta-analysis. Gestational age-adjusted odds ratios (adjOR) were pooled on the log scale by inverse-variance random-effects meta-analysis with restricted maximum likelihood (REML) estimation of between-study variance and Hartung-Knapp confidence intervals. Results. Five trials were included; one trial was identified in our replicated search but was excluded by Dang et al. without a stated rationale. The pooled estimate for any ROP was consistent with Dang et al. (RR 0.87 [95% CI 0.71-1.08]; adjOR 0.70 [0.46-1.08]). For ROP requiring treatment, the crude RR suggested a lower risk but did not reach statistical significance (RR 0.60 [0.35-1.04]), whereas the gestational age-adjusted estimate indicated lower odds (adjOR 0.47 [0.23-0.94]). For severe ROP, DHA+ARA supplementation produced a significant protective effect in both unadjusted and adjusted models (RR 0.56 [0.36-0.86]; adjOR 0.42 [0.19-0.96]). Conclusions. When all eligible trials contribute to each endpoint and severe ROP is included as an outcome, enteral DHA+ARA supplementation reduces severe ROP and is associated with lower odds of ROP requiring treatment after adjustment for gestational age. These findings differ from the conclusions of Dang et al. and support reconsideration of DHA+ARA supplementation as a strategy to reduce sight-threatening ROP in preterm infants.

22.
medRxiv (Medicine) 2026-06-22

Regional Service-System Conditions Associated with Facility-Linked Home-Based Specialist Care in Japan: A Claims-Based Ecological Study of Home Dialysis

Background Complex chronic care is increasingly delivered in patients' homes while remaining linked to specialist facilities for training, monitoring, and backup care. Home dialysis provides a useful case because peritoneal dialysis (PD) and home hemodialysis (HHD) share a home-facility delivery structure but differ in technical and operational requirements. This study examined regional service-system conditions associated with the presence and scale of PD and HHD in Japan. Methods This ecological study used publicly available claims, administrative, census, and geospatial data harmonized to 334 Secondary Medical Areas. Regional indicators were organized into four domains: dialysis service delivery, implementation support for home-based care, hospital backup capacity, and living and sociodemographic context. Diffusion was examined using claims-based indicators of regional presence and post-presence scale, analyzed separately for PD and HHD with Firth penalized logistic regression and zero-truncated negative binomial regression, respectively. Results PD was observed in 271 regions and HHD in 109. Patterns of associated regional conditions differed by modality and stage. PD was associated mainly with existing dialysis-service organization, whereas HHD was associated with broader regional supports, including home-care delivery, living infrastructure, transition support, and hospital-system indicators. Conditions associated with presence differed from those associated with scale. Cross-modality associations suggested that shared regional factors may shape the distribution of both modalities. Conclusions Regional conditions for home dialysis diffusion in Japan differed by modality and stage. PD was linked mainly to existing dialysis-service organization, whereas HHD was linked to multi-domain regional support for technically demanding home treatment. Under standardized reimbursement, local service-system capacity may remain important for modality- and stage-specific diffusion of home dialysis.

23.
medRxiv (Medicine) 2026-06-16

Daily Healthy Eating Index (HEI-2020) scoring reveals diet quality patterns masked by aggregation

The Healthy Eating Index (HEI-2020) is conventionally computed by aggregating intake across days before scoring. Digital food logging enables an alternative: scoring each day and averaging daily scores. These methods are not equivalent. The HEI's density-based structure and component caps cause aggregation to inflate adequacy scores when intake is irregular. Using Food & You data, we show daily HEI correlates more strongly with microbiome diversity, and recommend co-reporting both metrics.

24.
arXiv (math.PR) 2026-06-17

Killed resolvents and measure-valued stopping gains for reflected optimal stopping with max-type rewards

arXiv:2606.17517v1 Announce Type: new Abstract: We study an infinite-horizon optimal stopping problem for a normally reflected two-dimensional diffusion in the positive quadrant with nonsmooth max-type reward \(G(x_1,x_2)=x_1\vee \alpha x_2\). The paper develops a conditional measure-theoretic framework for the associated reflected obstacle problem. The main innovation is to show that the stopping gain \(\Gamma=c+rG-\mathcal LG\) is a signed measure, not a function: the kink of \(G\) generates an explicit negative surface measure on \(\Delta=\{x_1=\alpha x_2\}\). We then prove that the correct potential representation uses the resolvent of the reflected diffusion killed on first entry into the stopping set, rather than the unrestricted reflected resolvent. Under explicit monotonicity, regularity, and measure-superharmonicity assumptions, we derive an epigraph representation, a continuation-side boundary-trace condition, and a candidate verification theorem. The framework clarifies hidden regularity and uniqueness assumptions in multidimensional nonsmooth optimal stopping.

25.
Nature (Science) 2026-06-24

Immunological mechanisms of mRNA vaccines for infectious diseases

Nucleoside-modified mRNA–lipid-nanoparticle (mRNA–LNP) vaccines confer a high level of protection against severe COVID-19 and, since their first authorization for human use in 2020, have saved millions of lives. The efficacy of this vaccine platform relies on the induction of powerful and coordinated innate and adaptive immune responses. A deep understanding of the mechanisms of action by which mRNA–LNP vaccines drive protective immunity is crucial for advancing the development of next-generation mRNA vaccines with improved immunogenicity and tolerability. A flurry of recent studies has shed light on aspects of this vaccine modality’s modus operandi. Nonetheless, key gaps in knowledge remain, including understanding how LNPs are sensed by the immune system and exert their adjuvant activity, identifying the specific signals and cellular pathways critical for eliciting protective immune responses and determining whether it is feasible to uncouple vaccine immunogenicity and reactogenicity. Here we review the known and unknown features of the immunological mechanisms of mRNA–LNP vaccines for infectious diseases. Furthermore, we discuss how the components of this vaccine platform can be modified to fine-tune immune responses against challenging pathogens for which effective vaccines do not exist or need improvement. A Review of the immunological mechanisms of mRNA–lipid-nanoparticle vaccines for infectious diseases discusses how the components of this vaccine platform can be modified to fine-tune immune responses against challenging pathogens.