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

Deep Residual Injection for Full-Spectrum Forensic Signal Perception in Multimodal Large Language Models

Multimodal large language models (MLLMs) have been increasingly adopted in forensics for their robust semantic understanding. As AI-generated images become realistic, semantic-level inconsistencies alone are often insufficient for reliable detection. This motivates a critical question: whether MLLMs can achieve full-spectrum forensic signal perception, i.e., capturing low-level generator artifacts without sacrificing pre-trained semantic knowledge. We further perform a layer-wise analysis of forensic signal perception in MLLMs, showing that semantic information is primarily formed in the early-to-middle layers, whereas direct fine-tuning for artifact learning disrupts these semantic representations. Based on this insight, we propose Deep Visual Residual MLLM (Deep-VRM) to preserve early semantic processing while injecting artifact-specific visual signals as a residual path into an intermediate layer, where they are fused with semantic token representations and propagated through subsequent trainable layers. This enables later layers to jointly model semantic reasoning and signal-level forensic cues, and surprisingly, the model learns to adaptively leverage different levels of forensic signals depending on the input, achieving robust and generalizable detection performance. Extensive experiments show that our method achieves state-of-the-art across most benchmarks. The code and data are available at https://github.com/KQL11/Deep-VRM.

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

Raw-Curve Quantum Fingerprints: A Mahalanobis Authentication Framework with Drift Early Warning and Adversarial Detection

arXiv:2606.11644v1 Announce Type: new Abstract: Quantum cloud platforms are poised to deliver powerful computing capabilities, but users have no direct means to verify which physical device executes their workload. This lack of transparency enables hardware substitution attacks, where a malicious adversary could redirect a job to a substituted or inferior processor. We present a general authentication framework that addresses this problem by constructing multi-dimensional quantum fingerprints from raw measurement data. Without any curve fitting, we directly concatenate the raw statistics of complementary experiments into a high-dimensional feature vector that preserves subtle device-specific information. A Mahalanobis nearest-neighbor classifier achieves 100\% benign authentication accuracy on three superconducting processors over a three-week chronological split. The classifier naturally yields an authentication confidence $C_{\mathrm{claimed}}$ which reveals device-specific safety margins and motivates per-device alert thresholds. We assess the framework's robustness under two distinct scenarios. Under additive isotropic Gaussian noise, $C_{\mathrm{claimed}}$ decays predictably at a rate explained by inverse covariance traces, enabling an early warning mechanism. Against white-box adversarial perturbations, the same confidence threshold detects $L_2$ targeted attacks with near-perfect success and reveals device-dependent empirical thresholds for $L_\infty$ attacks, while untargeted and sparse attacks are ineffective. The proposed framework thus unifies fingerprint extraction, drift-resilient authentication, proactive health monitoring, and adversarial defense, offering a practical step toward trustworthy quantum cloud computing.

03.
Nature Medicine 2026-06-22

<b>PROTEUS trial heralds perioperative therapy for prostate cancer</b>

Perioperative androgen-deprivation therapy plus apalutamide could represent a new treatment option for patients with high-risk, localized prostate cancer. Perioperative androgen-deprivation therapy plus apalutamide could represent a new treatment option for patients with high-risk, localized prostate cancer.

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

ReNikud: Audio-Supervised Hebrew Grapheme-to-Phoneme Conversion

Grapheme-to-phoneme (G2P) conversion for Modern Hebrew is needed for applications like text-to-speech (TTS), but is challenging due to the language's abjad writing system, which leaves vowels largely unwritten, creating substantial ambiguity. Standard approaches first predict vowel diacritics (nikud) to produce International Phonetic Alphabet (IPA) transcriptions, but this is limited: vocalization data is scarce and laborious to produce, it does not specify features such as lexical stress, and it reflects formal grammatical rules rather than everyday spoken pronunciation. Direct sequence-to-sequence IPA prediction, meanwhile, struggles on limited data and fails to exploit the character-level alignment characteristic of abjads. Our method, ReNikud, overcomes these limitations with two key insights: (1) Weak audio supervision via a phoneme-based automatic speech recognition (ASR) pseudo-labeling pipeline on thousands of hours of unlabeled Hebrew audio, yielding phonemic transcriptions that reflect natural spoken norms without manual annotation. (2) A pseudo-vocalization architecture that predicts IPA phonemes at each character position, enforcing character-level alignment as an inductive bias. Results on existing Hebrew G2P benchmarks and the new targeted MILIM benchmark for spoken Hebrew show that ReNikud surpasses previous state-of-the-art methods. We will release our code and trained models to support further work on Hebrew TTS and speech technologies.

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

Power Term Polynomial Algebra for Boolean Logic

arXiv:2603.13854v2 Announce Type: replace-cross Abstract: We introduce power term polynomial algebra, a representation language for Boolean formulae designed to bridge conjunctive normal form (CNF) and algebraic normal form (ANF). The language is motivated by the tiling mismatch between these representations: direct CNFANF conversion may cause exponential blowup unless formulas are decomposed into smaller fragments, typically through auxiliary variables and side constraints. In contrast, our framework addresses this mismatch within the representation itself, compactly encoding structured families of monomials while representing CNF clauses directly, thereby avoiding auxiliary variables and constraints at the abstraction level. We formalize the language through power terms and power term polynomials, define their semantics, and show that they admit algebraic operations corresponding to Boolean polynomial addition and multiplication. We prove several key properties of the language: disjunctive clauses admit compact canonical representations; power terms support local shortening and expansion rewrite rules; and products of atomic terms can be systematically rewritten within the language. Together, these results yield a symbolic calculus that enables direct manipulation of formulas without expanding them into ordinary ANF. The resulting framework provides a new intermediate representation and rewriting calculus that bridges clause-based and algebraic reasoning and suggests new directions for structure-aware CNFANF conversion and hybrid reasoning methods.

08.
Nature (Science) 2026-06-17

Reimagining machine vision with optical computing

作者: 未知作者

A general-purpose artificial-intelligence vision system for use in image-sensing devices has been developed by embedding fundamentals of core computer-vision operations into a light-manipulating planar material called an optical metasurface. A prototype enables accurate, real-time perception and processing across diverse tasks, suggesting that this could be a solution for rapid, low-energy, on-device vision intelligence. A specialized ‘metasurface’ can preprocess incoming scene information on image-generating devices.

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

Individual Control Barrier Functions-Guided Diffusion Model for Safe Offline Multi-Agent Reinforcement Learning

arXiv:2606.12640v1 Announce Type: new Abstract: Offline reinforcement learning allows control policies to be learned directly from data without online interaction, making it suitable for safety-critical tasks. Recent studies have applied diffusion models to offline reinforcement learning to leverage their strong capacity for modeling complex data distributions. However, existing approaches primarily focus on single-agent settings, leaving the safety challenges in multi-agent environments largely unexplored. In this work, we propose a safe offline multi-agent reinforcement learning algorithm that embeds neural individual control barrier functions into the diffusion model to enhance safety during trajectory generation, with control policies recovered through inverse dynamics. We evaluate our algorithm across diverse benchmarks, demonstrating substantial safety improvements while maintaining competitive rewards.

10.
arXiv (CS.CV) 2026-06-16

BadWorld: Adversarial Attacks on World Models

Visual world models (VWMs) synthesize interactive, action-conditioned rollouts from a single context image. However, it remains an open question how robust these models are to adversarial perturbations. Standard adversarial attacks fail to assess this vulnerability because attackers lack ground-truth future videos and cannot predict subsequent user controls. We introduce BadWorld, a label-free adversarial framework tailored for autoregressive VWMs that systematically overcomes both constraints. First, to bypass the need for future supervision, we propose a self-supervised velocity attack that directly disrupts the early denoising dynamics of the model. Second, to ensure the attack generalizes across unpredictable user actions, we formulate a trajectory-adaptive bi-level optimization that actively mines hard control sequences to forge control-agnostic perturbations. Evaluated on representative VWMs with continuous and discrete controls, BadWorld exposes severe structural fragility. Visually indistinguishable adversarial images reliably trigger catastrophic degradation in future rollouts, leading to incomplete denoising, structural collapse, and control inconsistency. These findings reveal critical risks for deploying VWMs in safety-critical systems while highlighting a practical mechanism for privacy protection.

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

Weakly Supervised Segmentation as Semantic-Based Regularization

Weakly supervised semantic segmentation (WSSS) trains dense pixel-level segmentation models from partial or coarse annotations such as bounding boxes, scribbles, or image-level tags. While recent work leverages foundation models such as the Segment Anything Model (SAM) to generate pseudo-labels, these approaches typically depend on heuristic prompt choices and offer limited ways to incorporate prior knowledge or heterogeneous labels. We address this gap by taking a neurosymbolic perspective: integrating differentiable fuzzy logic with deep segmentation models. Weak annotations and domain-specific priors are unified as continuous logical constraints that fine-tune SAM under weak supervision. The refined foundation model then produces improved pseudo-labels, from which we train a second-stage prompt-free segmentation model. Experiments on Pascal VOC 2012 and the REFUGE2 optic disc/cup segmentation dataset show that our logic-guided fine-tuning yields higher-quality pseudo-labels, leading to state-of-the-art segmentation accuracy that often exceeds densely supervised baselines.

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

Semantic Reasoning in Medicine: The Role of Knowledge Graphs Across Five Key Domains

arXiv:2606.15155v1 Announce Type: new Abstract: Knowledge graphs (KGs) have emerged as a promising solution for integrating and reasoning over complex biomedical and clinical data in healthcare. By representing structured relationships among entities such as diseases, drugs, symptoms, and patient records, KGs provide a semantic backbone for decision-making, prediction, recommendation, and personalized care. Recent advances have demonstrated their utility across diverse medical applications–including clinical decision support systems, disease and treatment outcome prediction, health recommender systems, precision medicine, and medical question answering–where KGs often enhance interpretability, semantic coherence, and patient-specific reasoning. In parallel, a growing body of work focuses on medical KG generation itself, proposing frameworks that construct graphs from EHRs, clinical narratives, biomedical literature, and web resources using ontologies, semantic web technologies, deep-learning-based information extraction, and hybrid neuro-symbolic pipelines. Despite this progress, significant challenges remain, including limited and fragmented knowledge coverage, difficulties in aligning heterogeneous data sources, the fragility of current reasoning and representation-learning methods on dense multi-relational graphs, and unresolved issues related to privacy, bias, and accountability. This survey reviews and categorizes current research on KGs in medicine along both application-oriented and methodology-oriented dimensions, discusses their benefits and technical foundations, and outlines key limitations and open research directions. By analyzing trends, architectures, and evaluation practices, this work aims to guide future developments in KG-driven medical AI systems and support their safe and effective integration into healthcare environments.

13.
arXiv (CS.AI) 2026-06-17

Catastrophic Forgetting is Low-Rank: A Function-Space Theory for Continual Adaptation

arXiv:2606.18024v1 Announce Type: cross Abstract: Catastrophic forgetting in continual adaptation is usually studied through parameter drift, replay, or distillation, but these views do not identify which output-space directions are vulnerable. We give a function-space account in the NTK regime: new-task training induces old-task prediction drift through the cross-task kernel, yielding a closed-form predictor for the forgetting vector before any new-task gradient step. In frozen-backbone linear-head PEFT-CL, where the model is linear in the trainable parameters, the predictor is exact up to numerical precision; for nonlinear adapters/full fine-tuning, it is a local NTK approximation. The same expression reveals that forgetting concentrates in a small number of old-task NTK eigenmodes and under frozen linear heads gives a Kronecker scaling rule for the vulnerable rank. These results clarify the relation to prior NTK-overlap theory, explain why parameter-space regularizers can miss output-space interference, and motivate a targeted spectral regularizer.

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

Geometry-Preserving in 3D Gaussian Splatting for LiDAR-Camera Extrinsic Calibration

Accurate LiDAR-camera calibration is essential for robust multi-modal perception. Targetless approaches avoid manual setup but remain limited by the scarcity of discriminative cross-modal features. Recent methods address this by reconstructing the scene within a differentiable model, enabling extrinsic optimization through dense photometric supervision. Among these, 3D Gaussian Splatting (3DGS) has been widely adopted as a geometric proxy that bridges LiDAR and camera within a single differentiable framework. However, since 3DGS was originally designed for novel view synthesis, existing methods tend to prioritize rendering quality, causing the proxy geometry to drift from the true LiDAR structure. We propose a framework that preserves the metric geometry of the Gaussian proxy by aggregating multi-view LiDAR observations for dense depth supervision and blocking photometric gradients from updating the Gaussian spatial parameters. We validate our method on public driving datasets, where it consistently outperforms existing targetless methods in calibration accuracy.

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

Machine Learning for Biomedical Raman Spectroscopy: From Spectral Acquisition to Clinical Translation

arXiv:2606.14169v1 Announce Type: new Abstract: Raman spectroscopy provides label-free, chemically specific characterization of biological systems and has become an important tool for cancer diagnosis, molecular subtyping, microbiological identification, and intraoperative decision support. Biomedical Raman spectra are, however, high-dimensional, noisy, and affected by fluorescence background, acquisition variability, and biological heterogeneity, making robust computational analysis essential. This review examines the role of machine learning across the biomedical Raman spectroscopy pipeline, from preprocessing and signal correction to unsupervised structure discovery, supervised diagnosis and molecular stratification, representation and transfer learning, explainability, biomarker discovery, and multimodal integration with imaging, pathology, and molecular profiling. Emphasis is placed on the use of machine learning not only for diagnostic classification, but also for biologically interpretable and clinically actionable analysis. We also discuss the main barriers to clinical translation, including limited dataset sizes, inter-instrument variability, inconsistent preprocessing, insufficient external validation, reproducibility concerns, and limited sharing of software, data, and metadata. We argue that progress will require methodological advances together with standardization, robust validation, explainability, and deployment-ready analytical frameworks. By integrating methodological, biomedical, and translational perspectives, this review outlines key directions for developing reliable and clinically deployable Raman-AI systems.

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

TerraBench: Can Agents Reason Over Heterogeneous Earth-System Data?

arXiv:2606.13148v1 Announce Type: new Abstract: Climate and environmental decision-making increasingly requires reasoning across heterogeneous inputs, including gridded physical data, satellite imagery, geospatial context, and simulator outputs. Weather and climate foundation models can forecast well, but do not reason interactively in language, while large language models (LLMs) reason in language but cannot operate directly on high-dimensional Earth-system data. As a result, real scientific workflows in Earth-science remain underserved. We introduce TerraBench, a benchmark for grounded Earth-science reasoning, built on TerraAgent, a ReAct-style executable framework that interleaves reasoning, tool calls, and observations to couple LLM planning with scientific tools for environmental retrieval, geospatial processing, simulation, and artifact-backed computation. TerraBench unifies analysis of Earth observation imagery, gridded data, GIS reasoning and simulation in a single executable interface, whereas prior benchmarks isolate these capabilities into narrow individual tasks. It is also the first in this space to pair process-level tool-use metrics with tolerance-aware numeric scoring. The benchmark comprises 403 extensive agentic tasks across three tracks (Fundamentals, Simulator-Grounded, and Document-Grounded Verification) and eight application domains with 24,500 verified execution steps. These results indicate that reliable Earth-science agents must go beyond tool access to coordinate heterogeneous workflows, parameterize tools precisely, and preserve artifact provenance.

17.
medRxiv (Medicine) 2026-06-23

Multivariate Echocardiographic Phenotyping of Hypertensive Heart Failure Using Unsupervised Machine Learning: A Pilot Study

Background Heart failure in hypertensive patients is heterogeneous and poorly captured by traditional left ventricular ejection fraction (LVEF) based classification. Multivariate echocardiographic data combined with unsupervised machine learning may provide a more precise phenotypic characterization. This pilot study evaluated the feasibility of unsupervised clustering of routine transthoracic echocardiographic data to identify phenotypic subgroups of hypertensive heart failure. Methods This retrospective pilot study analyzed transthoracic echocardiography reports from hypertensive patients with clinical heart failure. After data cleaning and exclusion of incomplete records, 102 patients with 11 echocardiographic variables were included. Variables describing left ventricular geometry, systolic function, and diastolic performance were standardized and subjected to K-means clustering. Optimal cluster number was determined using the elbow method and silhouette analysis. Cluster characteristics were assessed using descriptive statistics and Kruskal Wallis testing. Concordance with LVEF based heart failure categories was evaluated. Results Three distinct echocardiographic phenotypes were identified. Cluster 0 (n = 50) demonstrated preserved LVEF with concentric remodeling, consistent with heart failure with preserved ejection fraction (HFpEF) phenotype. Cluster 1 (n = 37) showed marked ventricular dilation and reduced systolic function, consistent with heart failure with reduced ejection fraction (HFrEF). Cluster 2 (n = 15) exhibited concentric hypertrophy with intermediate LVEF, consistent with heart failure with mildly reduced ejection fraction (HFmrEF) like phenotype. All echocardiographic variables differed significantly across clusters (p < 0.001). While Cluster 0 showed strong concordance with HFpEF (96%), Clusters 1 and 2 demonstrated substantial overlap across LVEF categories, indicating partial discordance between structural phenotypes and LVEF based classification. Conclusion Application of unsupervised machine learning to routine echocardiographic data identifies distinct heart failure phenotypes in hypertensive patients. These phenotypes demonstrate significant structural heterogeneity beyond LVEF based classification, supporting the utility of data-driven approaches for refined cardiac phenotyping. This pilot study provides a foundation for larger prospective studies.

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

Right or Wrong, Models Comply: Directional Blindness in LLM Moral Judgment

As language models take integrated roles across many domains, the response of LLMs to user pushback becomes a critical alignment property. Yet many existing evaluations treat compliance as unidirectional, measuring whether models resist pressure but not whether they resist it selectively. We introduce Compliance Asymmetry (A = BCR/HCR), a bidirectional diagnostic that compares beneficial output change under helpful nudges with harmful change under misleading nudges. Across 9 models and 972,000 nudge-condition responses, we find that this selectivity differs in factual and moral judgments: models follow helpful nudges more than harmful ones on factual questions (A = 1.58), but follow both directions at nearly identical rates on moral questions (A = 1.04). This phenomenon persists across model families, capability levels, and nudging types. Interestingly, we also find that chain-of-thought prompting amplifies helpful and harmful compliance together, while identity-based prompting suppresses both by nearly identical margins. These results identify direction-blind moral compliance as a distinct failure mode in current LLMs and suggest that alignment should target directionally calibrated updating rather than lower compliance alone.

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

Is Code Better Than Language for Algorithmic Reasoning

arXiv:2606.15589v1 Announce Type: cross Abstract: For tool-augmented language models, comparing natural-language reasoning with code-execution pipelines is difficult because the comparison changes both the intermediate representation and the execution mechanism. We separate these factors with an intermediate intervention: the model expresses its reasoning as executable code, and the language model simulates that code in context to produce an answer. On a 40-task verifiable algorithmic benchmark, deterministic code execution outperforms natural-language reasoning by +31.6pp. We observe that the intermediate intervention is not meaningfully different from natural-language reasoning (+0.15pp). These results suggest that, in our evaluated setting, changing the intermediate representation alone does not explain the tool-use advantage, providing evidence for the performance gains requiring reliable external execution. We formalize this intuition with a simple statistical decision-theoretic model that characterizes when execution dominates end-to-end risk in our disentangled trace-generation/execution regime. We validate our theory using a reconstruction intervention that leverages a proxy language model to infer natural-language reasoning traces from code representations, recovering performance comparable to the original natural-language reasoning pipeline. All experiments are at https://github.com/TerryTong-Git/ToolProj.

20.
arXiv (quant-ph) 2026-06-11

Quantum ergodicity and semiclassical measures: mathematical results

arXiv:2606.12098v1 Announce Type: new Abstract: In this chapter we review some results describing the high-frequency eigenmodes of the Laplacian on compact manifolds, or Euclidean domains, for which the geodesic flow is chaotic. We focus on the macroscopic distribution of these eigenmodes, which is described by the concept of semiclassical measure. The main result on the question is the Quantum Ergodicity theorem, originally due to Schnirelman. We provide the detailed proof of this theorem, including the adjustments necessary to treat the case of manifolds with boundary. We also discuss the Quantum Unique Ergodicity conjecture, and some progress towards this conjecture for strongly chaotic (Anosov) systems. In particular, we describe the constraints on admissible semiclassical measures, in terms of their Kolmogorov-Sinai entropy, as well as more recent delocalization results.

21.
arXiv (CS.AI) 2026-06-24

Low-power analogue neural networks with trainable nonlinear connections for continuous control

arXiv:2606.23742v1 Announce Type: cross Abstract: Physical neural networks promise low-power machine learning by computing directly with analogue device physics, but most architectures force nonlinear device responses to act as scalar weights. Inspired by Kolmogorov-Arnold networks, we place trainable nonlinear functions on the connections, making each physical connection a learnable computational element. Realising these functions as analogue band-pass filters on field-programmable analogue arrays, we find that the benefit is task-dependent and follows from the smoothness of the physical basis: the networks represent smooth, continuously valued targets, including robotic kinematics, continuous control, and photovoltaic maximum-power-point tracking, with far fewer nodes and connections than multilayer perceptrons, but offer no parameter-efficiency advantage on classification-like decision boundaries. Trained networks transfer to hardware across approximately 35,000 connections with quantified fidelity, and a dedicated CMOS implementation is projected to operate at approximately 30 microwatts. A memristive realisation reproduces the same behaviour in simulation, indicating that the advantage comes from placing trainable nonlinearity on connections, rather than from a particular device.

22.
bioRxiv (Bioinfo) 2026-06-18

A Two-Stage Interpretable Framework for Predicting Plant-Derived Small RNA Targets on Human 3'UTRs

作者:

Can plant-derived small RNAs target human mRNA 3'UTRs via complementary base pairing and produce experimentally detectable regulatory effects? This question concerns not only the fundamental feasibility of cross-kingdom RNA regulation but also the technological pathway for screening plant-derived active small nucleic acids. Existing miRNA target prediction tools are predominantly designed for endogenous miRNA-mRNA systems, exhibiting notable limitations when applied to cross-species small RNA inputs and small-sample wet-lab experimental adaptation. In this study, we developed a two-layer prediction framework, MetaLulu-AI. The first layer builds upon publicly available human miRNA-mRNA 3'UTR interaction data, utilizing XGBoost to learn foundational binding rules on human 3'UTRs based on 41 interpretable computational features, including seed region pairing types, local context sequence composition, site positioning, and RNA secondary structures. The second layer is tailored to the experimental system of plant-derived small RNAs and human target genes. It introduces 40 experimental samples using significant changes in endogenous protein expression as the regulatory standard (determined by Western blot or ELISA 48 hours post-transfection of small RNAs via Lipo3000). Using 52-dimensional computational features and the optimal transcript scores from the first layer as inputs, this layer employs TabPFN for experimental label adaptation. The first-layer dataset consists of 38,752 training samples, 5,536 validation samples, and 11,073 testing samples (totaling 55,361), with a positive-to-negative sample ratio of approximately 1:5.4. On the randomly split test set, the model achieved an AUC of 0.9686, a recall of 0.8523, a precision of 0.8080, and an accuracy of 0.9452 (at a decision threshold of 0.4797). Group-based splitting revealed that the model maintains high discriminative power for unseen genes (AUC = 0.9541), though its generalization ability for completely unseen miRNAs decreases (AUC = 0.7390). For the 40 experimental samples in the second layer, the TabPFN model achieved an average AUC of 0.7406 {+/-} 0.092 across ten repeated 70/30 random splits, outperforming the baseline of directly using the first-layer scores (0.3563 {+/-} 0.149); the average AUC in a 5-fold cross-validation was 0.770 {+/-} 0.177. SHAP analysis demonstrated a clear divergence in the discriminative basis of the two models: the first layer relies more heavily on the thermodynamics of the small RNA itself and the quality of canonical seed sites, whereas the second layer focuses more on the local UTR environment and statistical site features. Although the current second-layer results are constrained by sample size and gene coverage, this framework serves as a preliminary observation of the adaptation mechanism for cross-kingdom regulation experiments, and motivating future large-scale validation. Under stricter leave-one-gene-out and leave-one-small-RNA-out evaluation, the adapter exceeded the first-layer score baseline but only matched the majority-class baseline, underscoring that entity-level generalization is not yet established.

23.
medRxiv (Medicine) 2026-06-22

A Controlled Human Malaria Infection model for relapsing Plasmodium vivax

Background Plasmodium vivax malaria relapses are a major source of morbidity and onward transmission of infection. The underlying mechanisms are poorly understood and current therapies sub-optimal. We examined the safety and feasibility of a controlled human malaria infection (CHMI) model for relapsing P. vivax. Methods We conducted an open-label, proof-of-concept, CHMI study of relapsing P. vivax. Healthy, malaria-naive, Duffy-positive adults aged 18-45 years with extensive CYP2D6 metaboliser phenotype and normal blood glucose-6-phosphate dehydrogenase (G6PD) levels were recruited in Oxford, UK. Mosquito-bite CHMI was performed in Nijmegen, The Netherlands, using Anopheles stephensi mosquitoes infected with PvW1, a clonal isolate of P. vivax from Thailand. All follow-up visits were conducted in Oxford, UK. Primary P. vivax infections (qPCR > 500 genome copies/mL) were treated with artemether-lumefantrine (80mg/480mg at 8, 24, 36, 48 and 60 hours). From Day 28 following CHMI, participants attended a fortnightly clinic for clinical review and qPCR blood sampling, with additional assessments performed for any reported symptoms. P. vivax relapse infections (qPCR > 500 genome copies/mL) were treated with artemether-lumefantrine as per primary infection. Definitive anti-malarial treatment with atovaquone-proguanil (1000mg/400mg once daily for three days) and primaquine (0{middle dot}5 mg/kg/day for 14 days) was administered six months following CHMI, regardless of parasitaemia or symptoms. The primary objective was to assess the safety, feasibility and frequency of relapsing P. vivax after CHMI. Remote follow-up (5 years) is ongoing. The study is registered with ISRCTN registry (ISRCTN48625883). Findings 20 participants were screened for eligibility from 21 January 2025. Five participants (median age 22 years) underwent CHMI (five infected mosquitoes per participant) on 15 April 2025. All participants developed primary P. vivax infection and experienced at least one relapse infection. Two participants experienced a second relapse. Overall incidence rate was 3{middle dot}6 relapse infections per person-year. Solicited adverse events were mild or moderate and there were no serious adverse events. Definitive anti-malarial treatment was administered to all participants. One participant experienced primaquine-induced methaemoglobinaemia, resolving with early discontinuation of treatment (total dose 5{middle dot}3 mg/kg). To date, more than six months after primaquine treatment, no further relapses have been recorded. Interpretation CHMI of relapsing P. vivax is safe and feasible, allowing exploration of the mechanisms underlying relapse infections and providing a platform for future anti-relapse efficacy studies. Funding European Union Horizon Europe programme and UK Research and Innovation (UKRI) via OptiVivax consortium; UK National Institute for Health and Care Research Biomedical Research Centre: Oxford; and UK Medical Research Council.

24.
medRxiv (Medicine) 2026-06-15

Neural Correlates of Human Food Memory link to Microbial, Homeostatic, and Hedonic Signals: Evidence from a Prebiotic Randomized Clinical Trial

Background Homeostatic and hedonic brain circuits regulate eating behavior but also shape how food memories are encoded and retrieved. Objective We examined neural correlates during food memory encoding and retrieval during functional MRI before and after a 14-day prebiotic intervention in a preregistered, double-blind crossover trial (NCT03829189). Design 55 healthy adults with overweight (19 females, age 28{+/-}6.5, BMI 25-30 kg/m2) underwent 3 Tesla task-based functional MRI before and after dietary intervention of prebiotic (30g inulin/day) or equicaloric placebo for 14 days. Peripheral metabolic, short-chain fatty acids (SCFA), and microbial markers using 16S rRNA analysis were assessed in fasting blood and feces. Results Food memory was enhanced by assigned reward value and engaged brain activity in hedonic regions, including the nucleus accumbens, orbitofrontal cortex, caudate, cingulate, dorsomedial prefrontal cortex, and ventral tegmental area, as well as homeostatic and memory-related such as the hypothalamus and the hippocampus. Higher neural activations during food encoding were related to higher Actinobacteriota abundance, fecal SCFA acetate, and creatinine levels, and lower ghrelin levels. Activations in reward-related and homeostatic brain areas partially correlated with insulin, glucagon-like peptide-1, leptin, and thyroid-stimulating hormone levels. Neural activations related to food memory decreased after prebiotic intervention. The prebiotic supplementation induced decrease of hippocampal activity during food encoding related to changes in gut microbiota Firmicutes abundance. Conclusions This study indicates that neuronal food-related memory processes depend on homeostatic and hedonic brain signals modulated by the gut-brain axis. Our findings raise implications for the treatment of obesity and substance use disorder.

25.
PLOS Computational Biology 2026-06-22

Towards modeling phage therapy

by Rob J. de Boer, Robert Schooley, Alan S. Perelson Patients infected with life-threatening multi-drug resistant (MDR) bacteria have been treated with cocktails of bacteriophages. This is a complicated form of personalized medicine as the phages given to a patient have to be selected beforehand on the basis of their lytic capacity of the infecting bacteria. Because bacteria rapidly become resistant, the evolution of resistance to a diverse cocktail of phages is a complicated dynamical process, during which competing bacterial strains replace one another by accumulating several resistance mechanisms, each of which may involve a fitness cost. As a consequence, it is typically not known why a particular phage therapy succeeded or failed, and how one can optimize the composition of the cocktails to maximize the rate of success. To improve upon this, we extend an existing in vivo-calibrated mouse model into a novel mathematical model for the human situation, and include multiple phages infecting multiple bacterial strains, differing in their resistance to each of the phages. We adjust several parameter estimates of the bacterial model to the human situation, and use the model to describe a successful case of phage therapy involving several cocktails, each containing several phages. In the model, treatment success crucially depended on pretreatment resistance levels, and on the diversity and the timing of the cocktails. Once an appropriate cocktail is found, it is less important to further optimize the infection rates of the phages. Resistant bacterial strains expand rapidly when sensitive strains decline, and the higher the infectivity of the phages, the faster resistant strains expand. Because resistance evolves rapidly, it is best to provide a diverse set of phages right from the start of therapy, i.e., to hit hard and early, and create a high genetic barrier to bacterial resistance.