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SAMA: Semantic Anchor-aligned Augmentation for Unified Low-Resource Multimodal Information Extraction
Multimodal Information Extraction (MIE)-covering tasks such as Multimodal Named Entity Recognition (MNER), Relation Extraction (MRE), and Event Extraction (MEE)-is essential for understanding multimedia content but remains constrained by severe data scarcity. Although data augmentation is a promising remedy, existing approaches are impeded by coarse cross-modal alignment and fragmented, task-specific designs that fail to exploit shared semantic knowledge. To overcome these limitations, we introduce Semantic Anchor-aligned Multimodal Augmentation (SAMA), a unified framework for generating high-fidelity, task-aware synthetic data. SAMA constructs structured semantic anchors from ground-truth labels to guide a Collaborative Multi-Experts Multimodal Large Language Model (CME-MLLM), which integrates a Universal Adapter for shared semantics with Task-Specific Adapters to produce diverse yet constraint-compliant textual samples. For image synthesis, SAMA employs an Anchor-Preserving Diffusion mechanism that uses anchor-weighted prompts and latent conditioning to maintain critical semantic anchors while diversifying visual contexts. To eliminate the need for manual verification, SAMA further introduces a Dual-Constraint Filtering module that selects synthetic samples based on both cross-modal consistency and anchor fidelity. Extensive experiments across benchmark datasets for MNER, MRE, and MEE demonstrate that SAMA consistently outperforms state-of-the-art augmentation baselines under both fully supervised and low-resource settings, underscoring its versatility, robustness, and effectiveness.
Unlocking LLM Code Correction with Iterative Feedback Loops
arXiv:2606.17514v1 Announce Type: cross Abstract: Large Language Models have shown remarkable capabilities in code generation. However, most existing evaluations focus only on single-attempt accuracy and overlook the iterative refinement process that is central to real-world programming. This study presents a systematic investigation of LLMs' ability to rectify their own code through execution feedback. Using real-world programming problems across four models and two major programming languages, this study evaluates performance using iterative refinement framework where LLMs receive compiler error messages and testcase feedback after each attempt. This study introduces metrics to evaluate code failures, analyze rectification patterns, and compare the effectiveness of reasoning and non-reasoning models, offering actionable insights into both the understanding and practical application of feedback loops in LLM-driven code generation systems. Results show that reasoning models consistently improve over iterations, substantially outperforming non-reasoning models in leveraging feedback, while syntactic and runtime errors are far more tractable than logical or algorithmic failures.
The Challenges of Balancing AI Compliance and Technological Innovations in Critical Sectors: A Systematic Literature Review
arXiv:2606.12423v1 Announce Type: cross Abstract: The rapid integration of artificial intelligence (AI) into critical infrastructure including healthcare, finance, energy, and defense, offers transformative benefits but also conflicts with evolving regulatory and governance frameworks. This paper presents a systematic literature review (SLR) to examine the challenges of balancing AI compliance and technological innovation across critical infrastructure sectors. The review follows established SLR guidelines to extract and synthesize insights from peer-reviewed articles, report, and institutional sources published between 2020-2025. The study identifies three interrelated challenges: fragmented regulations, excessive compliance burdens for smaller to medium enterprises (SMEs), and misaligned governance models. To address these challenges, the study highlights practical governance strategies, including risk-tiered regulation, compliance by design, and explainable AI, to support scalable and trustworthy AI deployment in critical sectors. Key contributions include a concise mapping of core AI-governance challenges and a conceptual diagram illustrating their overlap, as well as actionable strategies for policymakers and practitioner to harmonize oversight with innovation.
A Practical Evaluation Method for Long-Form Simultaneous Speech-to-Speech Translation
Simultaneous speech-to-speech translation (SimulS2ST) enables real-time cross-lingual communication, but existing evaluation has focused largely on short or pre-segmented speech rather than long-form, continuous input. Prior approaches are difficult to reproduce and make assumptions that do not hold for end-to-end systems. We present a practical evaluation method for long-form SimulS2ST. Given source speech, pre-segmented source transcripts, and reference translations, we run automatic speech recognition (ASR) and forced alignment on the generated target speech to recover token-level timestamps, then apply a sentence-embedding-based aligner to match the target text to its corresponding source sentences. This enables sentence-level computation of latency and quality metrics, including YAAL and xCOMET, which are then aggregated into final system-level scores. Experiments on representative SimulS2ST systems show that the method is effective in practice and reveal that current systems suffer from substantial latency accumulation on long speech.
Conformal Recovery-Deadline Certificates for Runtime Assurance of Adapting Controllers
arXiv:2606.25371v1 Announce Type: cross Abstract: Runtime assurance (RTA) protects a safety-critical system by switching from an advanced controller to a verified safe controller when a monitored condition is violated. The standard latching rule, which trips on the first breach of the safe set and then coasts, is correct for a diverging controller but pathological for a capable online-adapting one. Such a controller is unsafe by design during a bounded recovery transient. It must excite the plant to identify the fault before it can correct it, so a latching shield trips on that transient and suppresses a controller that would have recovered. We introduce the conformal recovery-deadline certificate, a split-conformal, distribution-free, finite-sample upper bound on the adapting controller's recovery time that licenses delayed fallback with a coverage guarantee, backstopped by a verified monitor at a hard critical limit. The certified deadline discriminates capable from incapable controllers, keeping the recoverer autonomous while catching the diverger. The construction separates autonomy, governed by statistical coverage, from safety, governed by the verified backstop, as an instance of reliability-asymmetric design. We prove marginal coverage, a weighted extension that restores coverage under a known fault-distribution shift, and group-conditional Mondrian coverage. We demonstrate all three on two unrelated Simplex testbeds: a 6-DOF spacecraft attitude controller and a torque-controlled inverted pendulum. Both show the same suppression pathology and the same cure, making the certificate a domain-general mechanism rather than a single-system trick.
Lost at the End: Primacy Bias in Multimodal Retrieval-Augmented Question Answering
Knowledge-based visual question answering (KB-VQA) lets vision-language systems answer questions that exceed their parametric knowledge by conditioning a reader on passages retrieved from a Wikipedia-scale knowledge base. In pure-text long-context LLMs, retrieved-context use follows the U-shaped "lost-in-the-middle" effect of Liu et al. (2024): information at the start and end of context is used, the middle is lost. Whether this transfers to deployed multimodal KB-VQA is open. To close this gap, we design the first controlled probe of reader-side position dependence in multimodal KB-VQA: a gold-position protocol in which only the gold passage's prompt slot varies within question. We run it on three open-source 7B/8B VLM readers and two KB-VQA benchmarks at k up to 20. The shape flips from U to primacy: gold-at-first beats gold-at-last by 16 to 26 points on every reader-by-benchmark cell, an effect we call "Lost at the End". Three targeted ablations narrow the cause: a text-only control shows the multimodal setting amplifies an already-present text-mode primacy 2.2 to 4.5 times, and image-position and distractor-shuffle ablations together pin the locus to prompt slot 0 of the instruction-tuned reader. On a frozen reader, three retrieval-side fixes (MMR, oracle reranking, rank-based reordering) all leave the gap intact (no separable improvement). Our findings indicate that recall@k is the wrong metric for deployed KB-VQA and that closing the gap requires reader-side intervention; we release our protocol as a controlled instrument for evaluating such interventions.
Isotopic evidence for a cold and distant origin of 3I/ATLAS
Interstellar objects provide the only directly observable samples of icy planetesimals formed around other stars, and can therefore provide insight into the diversity of physical and chemical conditions occurring during exoplanet formation1−3. Here we report isotopic measurements of the interstellar comet 3I/ATLAS, which reveal an elemental composition unlike any Solar System body. The water in 3I/ATLAS is enriched in deuterium, at a level of D/H = (0.98 ± 0.06)%, which is more than an order of magnitude higher than in known comets, while its range of 12C/13C ratios (141–191 for CO2 and 123–172 for CO) exceeds typical values found in the Solar System, as well as nearby interstellar clouds and protoplanetary disks. Such extreme isotopic signatures indicate formation at temperatures ≲ 30 K in a relatively metal-poor environment. When interpreted with respect to models for Galactic chemical evolution, the carbon isotopic composition implies that 3I/ATLAS may have accreted as long ago as 12 billion years, following a period of intense, early star formation. 3I/ATLAS thus represents a preserved fragment of an ancient planetary system.
Quantum iterative approach to the Traveling Salesman Problem
arXiv:2606.11843v1 Announce Type: new Abstract: The Traveling Salesman Problem (TSP) is a classical NP-hard problem in combinatorial optimization, where determining the shortest route among a set of cities becomes computationally prohibitive as the problem size increases. This work explores quantum computing as an alternative approach to address this complexity. Unlike existing methods that primarily rely on quantum annealing, we propose a quantum iterative framework integrating Quantum Phase Estimation (QPE) and Grover's search algorithm. Route costs are encoded as quantum phases, enabling QPE to efficiently evaluate them, while Amplitude Amplification, implemented via the Grover-Long algorithm, iteratively refines the solution space toward the optimal route. A proof-of-concept case study on a small-scale TSP instance demonstrates the feasibility of this approach and its potential for scaling to larger optimization problems. Furthermore, under an expectation-based analysis, the algorithm exhibits an expected computational complexity of $O(\frac{m^2\log_2(m)\log_2(1/\epsilon)}{\sqrt{\epsilon}})$ which depends on the error tolerance parameter $\epsilon$. This estimation omits the initialization term, which we expect future refinements to render subdominant to Phase Estimation.
Dual-Domain Equivariant Generative Adversarial Network for Multimodal CT-PET Synthesis
We present a Dual-Domain Equivariant Generative Adversarial Network (DDE-GAN) for multimodal CT-PET image synthesis. Traditional GAN-based approaches often operate solely in the spatial domain and ignore geometric consistency, resulting in limited structural fidelity. DDE-GAN addresses these challenges by jointly learning from both spatial and frequency (Fourier) domains, capturing complementary anatomical and spectral information. Furthermore, rotational equivariance embedded in the physics of the CT and PET measurements are integrated into the loss of both the generator and discriminator to ensure consistent responses under rotations, improving anatomical accuracy. A hierarchical dual-domain training strategy enforces intra- and inter-domain consistency through multi-stage loss functions. Evaluated on the HECKTOR 2022 CT-PET dataset, DDE-GAN achieves superior synthesis quality over baseline models for CT-PET image synthesis. The results demonstrate that combining dual-domain learning with geometric equivariance substantially enhances multimodal image synthesis accuracy and robustness, enabling practical applications in PET completion and data augmentation.
SorryDB: Can AI Provers Complete Real-World Lean Theorems?
arXiv:2603.02668v2 Announce Type: replace Abstract: We present SorryDB, a dynamically-updating benchmark of open Lean tasks drawn from 78 real world formalization projects on GitHub. Unlike existing static benchmarks, often composed of competition problems, hillclimbing the SorryDB benchmark will yield tools that are aligned to the community needs, more usable by mathematicians, and more capable of understanding complex dependencies. Moreover, by providing a continuously updated stream of tasks, SorryDB mitigates test-set contamination and offers a robust metric for an agent's ability to contribute to novel formal mathematics projects. We evaluate a collection of approaches, including generalist large language models, agentic approaches, and specialized symbolic provers, over a selected snapshot of 1000 tasks from SorryDB. We show that current approaches are complementary: even though an agentic approach based on Gemini Flash is the most performant, it is not strictly better than other off-the-shelf large-language models, specialized provers, or even a curated list of Lean tactics.
Beyond Fully Random Masking: Attention-Guided Denoising and Optimization for Diffusion Language Models
Diffusion large language models (dLLMs) offer an efficient alternative to autoregressive models through parallel decoding, yet existing post-training methods largely rely on random masking strategies that overlook intrinsic token dependencies. In this work, we present an empirical analysis of attention in dLLMs and show that tokens attending more strongly to unmasked context exhibit greater generation stability and play a critical role in reasoning. Motivated by these findings, we propose AGDO, an attention-guided denoising and optimization framework that aligns both training and optimization with attention-derived dependencies. AGDO determines the denoising order based on attention structure and emphasizes attention-critical tokens during supervised fine-tuning and reinforcement learning. Experiments on mathematical and coding benchmarks demonstrate that AGDO consistently improves reasoning performance, outperforming state-of-the-art post-training methods for dLLMs.
Publisher Correction: Oral small molecule GLP-1 receptor agonist aleniglipron in people with overweight or obesity: a randomized, double-blind, placebo-controlled phase 2b trial
该条目无摘要(多为勘误、社论或新闻类内容,出版方未提供摘要)
Enhancing Spectral Embedding through Robust and Flexible Knowledge Transfer in Electronic Health Records
arXiv:2606.11570v1 Announce Type: cross Abstract: We propose a spectral-based, unsupervised representation learning framework to derive low-dimensional embeddings for clinical concepts and patients in rare disease cohorts from electronic health records, where data are high-dimensional but sample sizes are limited. To overcome this challenge, we incorporate a knowledge matrix extracted from a broader population that shares a partially overlapping subspace with the rare-disease cohort. Our method departs from existing approaches by relaxing restrictive one-to-one signal-alignment assumptions between the latent data matrix and knowledge matrix, allowing more flexible and realistic forms of structured sharing. We introduce a novel two-step spectral embedding procedure: first, we identify and remove irrelevant components from the knowledge matrix; then, we apply a projection-based method to separately recover shared and heterogeneous components. Simulations and an analysis of a real-world multiple sclerosis cohort show that the proposed method outperforms competing approaches, particularly in challenging scenarios where shared signals are weak and only partially aligned, as is common in rare-disease data.
Judging to Improve: A De-biased VLM-as-3D-Judge Protocol for Single-Image 3D Generation
arXiv:2606.20364v1 Announce Type: new Abstract: A companion study established a de-biased, cross-model VLM-as-3D-judge that reliably ranks single-image-to-3D mesh quality where cheap geometry and CLIP proxies fall short. This paper asks: can that judge's preferences specialize a strong open generator, TRELLIS, on one asset class (furniture), cheaply and without human labels? Taking the judge from ranking to optimization is where the work lives. Pushing a VLM judge into the training and evaluation loop exposes failure modes ranking never triggered, so our contribution is an optimization-grade hardening of the judge: a training judge (Qwen2.5-VL-7B) held distinct from an evaluation judge (InternVL3-8B) to break circularity; position-bias correction; and fixes for three failure modes (image overload, geometry-hiding splat renders, and reference-free judging that rewards clean-but-wrong outputs), with calibration evidence (clear-gap win-rate 0.83-1.0; base-vs-base ~0.5). Using this protocol as an independent evaluator, and working only from public models and data with lightweight parameter-efficient adaptation, we find our methods match the strong base rather than exceed it. Independent base samples carry essentially no learnable preference (0.94 order-flip rate), so signal must be engineered by quality-contrastive construction. Across six adaptation methods, two input regimes, and a severity sweep, the most targeted - conditioner repair under severe degradation - reaches parity (0.50) with the base, while no method clears the >=65% win-rate target. The result is mechanistic: clean inputs saturate the judge, flow-DIT fine-tuning washes out through the sampler, and conditioning repair is the locus that moves geometry. Win-rates are directional at n=8 objects. Matching a strong public-data base with cheap adaptation is itself informative: exceeding it needs more than lightweight PEFT on public data, and the judge protocol is reusable.
Agent-based models for the evolution of morphological alternation patterns
Why is the past of English "go" the apparently unrelated "went"? Such alternations are frequent in languages. They neither aid communication nor learnability, yet they can be persistent, surviving over centuries or millennia. We present a multi-agent simulation of the emergence of morphological stem and inflection alternations. Alternate forms arise by phonological changes or, as with "go/went", from lexical alternatives associated with a subset of the population. When an agent 'hears' another agent use a novel form for a slot in the paradigm of a word (say, the past tense of go), they will with some probability adopt that form, possibly spreading its use to other slots in the paradigm that shared the same original form. Thus alternative forms can spread through the population and become entrenched as stem or inflectional marker alternants. Unlike many previous computational studies, our system allows for naturalistic lexical forms, realistic phonological rules, lexicons with hundreds or thousands of entries, and agent populations in the tens or hundreds. It supports several network topologies, diffusion patterns and agent adoption policies. One issue with such simulations is evaluation: how realistic is the resulting morphology compared to those of real languages? We introduce the AI Historical Linguist, a novel Large Language Model-driven system that models a debate between two historical linguists. We use this to compare a set of real language morphologies, disguised morphologies, and experimentally evolved morphologies. The results suggest that among the factors that favor more plausible morphologies are scale-free social networks and random Bernoulli adoption of forms. We also present three case studies modeling attested historical changes, allowing us to test what might have happened if history had been different. All code and data are released.
T2MM: An LLM Supported Architecture For Inquiry-Based Modeling
Model Construction is a foundational practice in science learning that relies on visualization and interactivity. Large Language Models, increasingly augmented with multimodal capabilities, have been integrated in education contexts to support learning. However, these tools lack visual interactivity that is required by some learning contexts. We introduce Text to Multimodal Model (T2MM), a robust, dynamic LLM supported architecture that assists in model construction within the open inquiry ecology-based modeling software Virtual Experimental Research Assistant (VERA). T2MM accounts for the current context of the learner's model and creates interactive models, rather than static images, enabling the model to remain responsive to manual adjustment. To measure technical feasibility, we evaluate T2MM through a custom procedurally generated dataset of natural language learner modeling requests and target models within the VERA system. T2MM outperforms a baseline model generation architecture implemented through LLM-supported full code generation, common in the literature, across all measured success metrics. Our contribution not only outlines LLM integration into a inquiry-based learning modeling tool, but also describes a possible architecture through which more interactive multimodal LLM tools can be created.
Surrogate Benchmarks for Model Merging Optimization
arXiv:2509.02555v2 Announce Type: replace-cross Abstract: Model merging techniques aim to integrate the abilities of multiple models into a single model. Most model merging techniques have hyperparameters, and their setting affects the performance of the merged model. Because several existing works show that tuning hyperparameters in model merging can enhance the merging outcome, developing hyperparameter optimization algorithms for model merging is a promising direction. However, its optimization process is computationally expensive, particularly in merging LLMs. In this work, we develop surrogate benchmarks for optimization of the merging hyperparameters to realize algorithm development and performance comparison at low cost. We define two search spaces and collect data samples to construct surrogate models to predict the performance of a merged model from a hyperparameter. We demonstrate that our benchmarks can predict the performance of merged models well and simulate optimization algorithm behaviors.
On the Adversarial Robustness of Multimodal LLM Judges
Multimodal Large Language Models (MLLMs) are increasingly used as automated judges, e.g., for image quality and safety assessment. However, their adversarial robustness remains largely unexplored, threatening the fairness and reliability of automated judging. To bridge this gap, we introduce RobustMLLMJudge, the first general framework for evaluating the adversarial robustness of general-purpose MLLMs when functioning as judges. It covers diverse attacks against popular judge approaches across quality and safety evaluation scenarios. Using RobustMLLMJudge, we reveal that i) different MLLM judges are highly vulnerable to score-inflating adversarial attacks; and ii) although effective, these attack methods face a critical challenge due to unique constraints in the evaluation protocols of MLLM judges. We further propose MGSIA, namely Manifold-Guided Semantic Induction Attack, a novel method that bypasses these constraints to enable more effective and transferable attacks on MLLM judges. The core idea of MGSIA is to combine affirmative semantic induction with high-score manifold alignment: it maximizes the probability that judges yield affirmative responses (e.g., "Yes") to binary semantic queries, while regularizing adversarial representations toward high-score centers estimated from proxy protocols. Together, these objectives yield transferable score-inflating perturbations. Extensive experiments demonstrate the superiority and generalizability of MGSIA in deceiving advanced MLLM judges under different evaluation scenarios, highlighting the need for robust MLLM judges. Code and data will be made available at https://github.com/mala-lab/RobustMLLMJudge.
Resource-Efficient Variational Quantum Classifier
arXiv:2511.09204v3 Announce Type: replace-cross Abstract: We introduce the unambiguous quantum classifier based on Hamming distance measurements combined with classical post-processing. The proposed approach improves classification performance through a more effective use of ansatz expressivity, while requiring significantly fewer circuit evaluations. Moreover, the method demonstrates enhanced robustness to noise, which is crucial for near-term quantum devices. We evaluate the proposed method on a breast cancer classification dataset. The unambiguous classifier achieves an average accuracy of 90%, corresponding to an improvement of 6.9 percentage points over the baseline, while requiring eight times fewer circuit executions per prediction. In the presence of noise, the improvement is reduced to approximately 3.1 percentage points, with the same reduction in execution cost. We substantiate our experimental results with theoretical evidence supporting the practical performance of the approach.
Can I Buy Your KV Cache?
arXiv:2606.13361v1 Announce Type: new Abstract: Right now, across the world, AI agents are repeating the same absurd act: to read one document, they each recompute it from scratch. Every agent re-runs prefill, the most compute-intensive step a large model takes, over identical text, only to rebuild a key-value (KV) cache identical to the one the agent before it just built. The same answer, computed a million times. We make a proposal that is almost offensively simple: compute it once. Let a publisher precompute a document's KV cache, and let every other agent buy the right to load it and skip prefill. It works, and it is token-exact: loading a precomputed KV and continuing matches prefilling from scratch (24/24 greedy tokens, and at the logits level), with no accuracy cost. On Qwen3-4B, reuse is 9-50x cheaper in compute than prefill, and the gap widens with length (prefill's attention scales with L^2), so a single reuse already pays it back. Then the part that matters: where the KV lives. Shipping it fails, because KV is nearly incompressible, so per-load egress costs more than the prefill it saves. Hosting it provider-side, exactly as production prompt-caching works, removes egress entirely. The size of the prize is set by our measured compute saving: serving one hot 3774-token document to 80M agents costs ~$1.5M to re-prefill but only ~$0.03M of reuse compute (49.7x less). The 0.1x cache-read tariff APIs charge passes a 10x discount to users while sitting inside this measured envelope, so the 10x is a floor that the measured ~50x compute saving clears, and the gap to the physical ~50x is provider margin: millions of dollars per popular document. We frame the resulting agent-native prefill CDN and leave lossless KV compression and a cross-party payment layer as the open problems.
GRASP: Gradient-Aligned Sequential Parameter Transfer for Memory-Efficient Multi-Source Learning
arXiv:2606.14900v1 Announce Type: new Abstract: Multi-source transfer learning faces a fundamental scalability bottleneck: existing approaches require either loading all K source models into memory simultaneously during parameter fusion, requiring O(K) memory, or deploying all models at inference time, making production deployment infeasible. We propose GRASP (Gradient-Aligned Sequential Parameter Transfer), which achieves superior knowledge integration while maintaining O(1) memory consumption through three key innovations: (1) sequential processing that merges one source at a time into an evolving target model, (2) parameter-wise gradient alignment that selectively transfers only parameters whose optimization directions align with the target domain, avoiding negative transfer, and (3) iterative fine-tuning that adapts transferred knowledge before integrating the next source. Extensive experiments across three continual learning benchmarks (Yearbook, CLEAR-10, CLEAR-100) spanning 10 to 108-year temporal distribution shifts and four architectures (1.3M to 25.6M parameters) demonstrate that GRASP achieves 93.5% mean accuracy over all datasets and architectures compared to ensemble method's 71.7% accuracy while requiring only constant memory versus K models for standard multi-source fusion. Critically, GRASP's sequential previously merged models and scales to arbitrarily many sources without memory growth, making it uniquely suitable for resource-constrained deployment and continually evolving source domains.
Posterior Continuation with Noise-Conditioned Frequency Exposure for Diffusion Inverse Problems
Diffusion posterior sampling solves inverse problems by combining a pretrained diffusion prior with measurement-consistency guidance. However, full-band guidance can be unreliable at high noise levels, where clean estimates contain score-induced errors and high-frequency measurement directions are weakly identifiable. We argue that posterior guidance should expose measurement frequencies according to the instantaneous diffusion noise level. Based on this principle, we propose a posterior continuation framework that constructs a family of intermediate posteriors whose likelihood emphasizes currently reliable frequency bands and gradually returns to full-band consistency. We instantiate this framework with a stabilized sampler that combines a diffusion predictor, frequency-limited likelihood refinement, and a Haar-domain commitment rule that commits reliable coarse corrections while deferring weakly identifiable details. Across super-resolution, inpainting, and deblurring, our method achieves competitive-to-state-of-the-art restoration performance, including up to 5 dB PSNR improvement on motion deblurring over strong baselines in evaluations on FFHQ and ImageNet.
Explosion and non-explosion in pure birth Crump–Mode–Jagers branching processes
arXiv:2601.06850v2 Announce Type: replace Abstract: In this short note, we provide an explicit sufficient condition for non-explosion of Crump–Mode–Jagers branching processes with pure birth reproduction. It shows that the standard sufficient condition for explosion, namely the convergence of the series of reciprocals of the birth rates, is – at least for rate sequences without excessive oscillations – remarkably close to being necessary. At the same time, it is not necessary in full generality: we construct a counterexample which also yields a general preferential attachment tree without fitness with an infinite path and no vertices of infinite degree, thereby answering an open question previously raised in the literature.
Population-Scale, Genotype-First Characterization of Monogenic Diabetes in 374,973 Multi-Ancestry Individuals from the All of Us Research Program
OBJECTIVE To characterize the prevalence and penetrance of maturity-onset diabetes of the young (MODY) in a multi-ancestry population using a genotype-first design. RESEARCH DESIGN AND METHODS We analyzed whole-genome sequencing and clinical data from 374,973 unrelated All of Us participants (42.0% non-European ancestry). We identified pathogenic or likely pathogenic (P/LP) variants in 10 established MODY genes and assessed carrier prevalence, diabetes penetrance, and glycemic profiles. We evaluated age-dependent diabetes risk by comparing carriers with non-carriers stratified by type 2 diabetes polygenic risk score (T2D PRS). RESULTS We identified 370 carriers of P/LP MODY gene variants (0.099%; 1 in 1,013), with similar carrier prevalence among European- and African-ancestry participants (0.105% in both groups). Diabetes penetrance was incomplete (13.4% by age 40; 43.5% by age 60) and varied by etiology: highest for GCK (56.0% by age 60), intermediate for HNF genes (HNF1A/HNF1B/HNF4A; 45.4%), and lowest for non-GCK/HNF genes (ABCC8/INS/KCNJ11/NEUROD1/PDX1/RFX6; 29.0%). In multivariable Cox models using non-carriers in the middle 80% of the T2D PRS as the reference, non-GCK/HNF gene variant carriers had modestly increased diabetes risk (HR, 1.57), similar to non-carriers in the top 10% of T2D PRS (HR, 1.64). These associations were observed in both European- and non-European-ancestry individuals. HbA1c profiles differed by etiology, with stable mild hyperglycemia in GCK variant carriers and greater variability among HNF and non-GCK/HNF gene variant carriers. CONCLUSIONS MODY gene variants showed incomplete, etiology-dependent penetrance across ancestries. Carriers of P/LP variants in lower-penetrance genes had diabetes risk comparable to that of non-carriers with high polygenic susceptibility.