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01.
medRxiv (Medicine) 2026-06-24

Utility of genetic screening for the prediction of severe arrhythmic outcomes in mitral valve prolapse

Background: Cardiomyopathy and channelopathy (CC) gene variants have been linked to sudden cardiac arrest (SCA) or death (SCD) in small, selected pedigree or post-mortem studies of arrhythmic mitral valve prolapse (MVP). However, the utility of clinical whole exome sequencing (WES) panels as a risk stratification tool in unselected MVP samples is unknown. Objectives: The goal of the study was to test the utility of clinical WES panels with CC variant screening for arrhythmic risk stratification in MVP. Methods: We performed research based WES in 203 consecutive MVPs without other arrhythmic substrate. Variants were filtered for rare (

02.
medRxiv (Medicine) 2026-06-15

Bidirectional associations between cannabis use, oddball performance, and P3 event-related potential

Importance: Cannabis use remains prevalent in youth despite concerns regarding its potential impact on cognitive function. Unraveling whether the association between cannabis use and cognition is partially due to preexisting differences or primarily related to use is vital to understanding underlying mechanisms. Objective: To estimate the longitudinal association between cannabis initiation and cognitive trajectories, indexed by task performance and P3 event-related potential (ERP), and to estimate whether baseline cognition is associated with cannabis initiation. Design: Data were analyzed from the ongoing longitudinal Collaborative Study on the Genetics of Alcoholism (COGA) cohort, which was followed up approximately every 2-5 years from 2004 to 2025. Setting: 6 sites across the United States. Participants: Adolescent and young adult offspring of past COGA participants and control families who reported on their cannabis use and who had Visual Oddball (VOP) performance and P3 ERP data (N=4814; 52.4% female, 68.4% white) were grouped based on the timing of cognitive data collection relative to cannabis initiation into Pre-onset (n=2,449; [&ge;]1 assessment) and Post-onset (n=998; [&ge;]3 assessments) subsamples. Main Outcomes and Measures: VOP measures include performance accuracy (%), reaction times (ms), and P3 amplitude (V) and latency (ms) during target trials. Cannabis measures included lifetime use of cannabis (i.e., ever used) and age at first use. Results: High P3 amplitude, and prolonged P3 latency and reaction time were associated with a reduced hazard of cannabis initiation (All Hazards Ratio, [H.R.s]< 0.91, p's

03.
arXiv (quant-ph) 2026-06-25

Rapid and robust laser-frequency auto-locking using Bayesian-optimization and discrete-wavelet-transformation algorithms

arXiv:2606.25267v1 Announce Type: new Abstract: Rapid and robust laser-frequency auto-locking is essential for the field deployment of quantum communications, quantum computing, and precision-measurement technologies; however, achieving this remains a considerable challenge. Here, we propose and demonstrate an auto-locking scheme employing Bayesian optimization and discrete biorthogonal wavelet transformation. First, the reference is rapidly sought by making intelligent use of historical observations, eliminating the inherent blindness of the traditional parameter-scanning method. Second, the frequency reference is robustly identified by pinpointing transition signals with the discrete biorthogonal wavelet transformation and analyzing their immutable frequency differences and relative magnitudes, which are determined by the inherent atomic structure and remain resistant to environmental disturbances. This proposed approach achieves a fivefold acceleration in reference searching compared to conventional scanning methods in the case where the laser frequency drifts far away from the reference. Crucially, it achieves an identification accuracy of more than 99.5 %, even under severe 50 % laser-intensity fluctuations, $9.95^\circ$ photodiode misalignment, and $18^\circ$C Rb cell temperature elevation. Finally, locking the laser frequency to the identified reference with a lead zirconate titanate-current double-servo loop narrows the linewidth to 20 kHz. We believe that this rapid, robust, and high-performance auto-locking technique will be pivotal towards the deployment of the next generation of practical quantum technologies in demanding field environments.

04.
arXiv (CS.AI) 2026-06-16

Sensor-Conditioned Representation Learning via Scene-Relevant Observation Quotients

arXiv:2606.16210v1 Announce Type: new Abstract: Learned representations in intelligent sensing systems are often evaluated by reconstruction fidelity or downstream prediction accuracy, but these criteria do not specify which latent distinctions are justified by the sensing process. In sensor-conditioned environments, nuisance factors can change measurements without changing the scene, while distinct scenes may be indistinguishable under limited sensing capability. This paper formulates sensor-conditioned representation correctness as preserving sensing-supported scene distinctions while suppressing nuisance-induced and sensor-unsupported variation. We introduce the scene-relevant observation quotient, a representation target induced by sensing-supported distinguishability after nuisance canonicalization, and develop Observation-Quotient Tucker-Structured Autoencoding (OQ-TSAE), a scene-nuisance factorized framework with diagnostics for false distinction, false merge, nuisance sensitivity, and latent ordering consistency. Experiments on a controlled benchmark show that quotient-consistent supervision improves representation-correctness diagnostics over reconstruction-oriented, metric-learning, and contrastive-learning baselines. Sensitivity, perturbation, and ablation studies show the importance of quotient-aligned supervision, reliable quotient relations, and quotient geometry. Complementary real-radar experiments show that a reconstruction-only OQ-TSAE variant retains competitive downstream utility, robustness under observation degradation, and low seed-to-seed variability. These results suggest that sensor-conditioned representations should be evaluated not only by predictive utility, but also by whether their latent geometry preserves sensing-justified scene distinctions.

05.
arXiv (CS.AI) 2026-06-15

Adversarial Concept Search: Predicting Compositional Errors From Feature Geometry

arXiv:2606.13934v1 Announce Type: new Abstract: Humans cannot always intuit what scenarios are most challenging to LLMs. Hoping to capture challenging edge cases, developers either design problems to be difficult for humans or curate extensive benchmarks. What if we could instead anticipate which scenarios a model will fail on? In this paper, we use an LLM's representational geometry to predict which concept combinations it will fail on. We attribute this compositional failure to interference between salient features. In tasks that require systematic composition - toy programmatic settings, multihop reasoning, multilingual factual recall - we find that when a pair of concepts is encoded near-orthogonally, the model reliably composes them. When their linear encodings are close, producing interference, the model fails to compose them. Our method reliably anticipates failure modes across different compositional tasks, without evaluating specific inputs. These results lay the groundwork to use representational geometry to identify high-risk examples, construct targeted stress tests, and provide a scalable foundation for active learning in real-world deployment.

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

Price of metric universality in vector quantization is at most 0.11 bit

arXiv:2602.05790v2 Announce Type: replace-cross Abstract: Fast computation of a matrix product $W^\top X$ is a workhorse of modern LLMs. To make their deployment more efficient, a popular approach is that of using a low-precision approximation $\widehat W$ in place of true $W$ (``weight-only quantization''). Information theory demonstrates that an optimal algorithm for reducing precision of $W$ depends on the (second order) statistics of $X$ and requires a careful alignment of vector quantization codebook with PCA directions of $X$ (a process known as ``waterfilling allocation''). Dependence of the codebook on statistics of $X$, however, is highly impractical. This paper proves that there exist a universal codebook that is simultaneously near-optimal for all possible statistics of $X$, in the sense of being at least as good as an $X$-adapted waterfilling codebook with rate reduced by 0.11 bit per dimension in the case when $W$ is Gaussian. Such universal codebook would be an ideal candidate for the low-precision storage format, a topic of active modern research, but alas the existence proof is non-constructive. Equivalently, our result shows existence of a net in $\mathbb{R}^n$ that is a nearly-optimal covering of a sphere simultaneously with respect to all Hilbert norms.

07.
arXiv (math.PR) 2026-06-16

Asymptotic behavior of some strongly critical decomposable 3-type Galton–Watson processes with immigration

arXiv:2406.09852v2 Announce Type: replace Abstract: We study the asymptotic behavior of a critical decomposable 3-type Galton-Watson process with immigration when its offspring mean matrix is triangular with diagonal entries 1. It is proved that, under second or fourth order moment assumptions on the offspring and immigration distributions, a sequence of appropriately scaled random step processes formed from such a Galton-Watson process converges weakly. The limit process can be described using independent squared Bessel processes $({\mathcal X}_{t,1})_{t\geq0}$, $({\mathcal X}_{t,2})_{t\geq0}$, and $({\mathcal X}_{t,3})_{t\geq0}$, the linear combinations of the integral processes of $({\mathcal X}_{t,1})_{t\geq0}$ and $({\mathcal X}_{t,2})_{t\geq0}$, and possibly the 2-fold iterated integral process of $({\mathcal X}_{t,1})_{t\geq0}$. The presence of the 2-fold iterated integral process in the limit distribution is a new phenomenon in the description of asymptotic behavior of critical multi-type Galton-Watson processes with immigration. Our results complete and extend some results of Foster and Ney (1978) for some strongly critical decomposable 3-type Galton-Watson processes with immigration.

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

SPADE: Split-and-Delay Embeddings for Autoregressive High-Granularity Calorimeter Simulation

arXiv:2606.11304v1 Announce Type: cross Abstract: We introduce SPADE (SPlit And Delay Embeddings), an autoregressive transformer for sequences whose tokens carry multiple features. Rather than embedding these features jointly, SPADE embeds them independently. Delaying each feature stream relative to the previous one allows intra-token correlations to be learned by the standard self-attention mechanism. Applied to point-cloud calorimeter shower generation in the highly granular ILD detector, SPADE is competitive with the state of the art AllShowers model on photon showers, and substantially outperforms its VQ-VAE-based predecessor OmniJet-$\alpha_C$. The mechanism is applicable to any generative task with multi-feature tokens, enabling LLM-style pretraining workflows for higher-dimensional data.

09.
arXiv (CS.LG) 2026-06-16

Diffusion Models for Adaptive Sequential Data Generation

arXiv:2606.06007v2 Announce Type: replace Abstract: Generating realistic synthetic sequential data is critical in real-world applications across operations research, finance, healthcare, energy systems, and scientific computing, where time-indexed observations are used for prediction, simulation, risk assessment, and data-driven decision-making. While diffusion models have achieved remarkable success in generating static data, their direct extensions to sequential settings often fail to capture temporal dependence and information structure. Designing diffusion models that can simulate sequential data in an adapted manner, and hence without anticipation of future information, therefore remains an open challenge. In this work, we propose a sequential forward-backward diffusion framework for adapted time series generation. Our approach progressively injects and removes noise along the sequence, conditioning on the previously generated history to ensure adaptiveness. A novel score-matching objective is introduced for efficient parallel training. We derive rigorous statistical guarantees under a generic framework, then establish score approximation, score estimation, and distribution estimation results with ReLU networks serving as a concrete instance. Empirically, we validate our method on synthetic data, including ARMA models and Gaussian processes, and demonstrate its effectiveness in constructing mean-variance optimal portfolios.

10.
arXiv (CS.LG) 2026-06-24

Machine Learning and Deep Learning for Exoplanet Detection and Atmospheric Characterization with JWST and the Upcoming Ariel Mission

arXiv:2606.23766v1 Announce Type: cross Abstract: The detection and atmospheric characterization of exoplanets have entered a new data-intensive era driven by the James Webb Space Telescope and the upcoming Ariel mission. Modern surveys produce millions of light curves and high-resolution spectra that overwhelm traditional pipelines, motivating the rapid integration of Machine Learning and Deep Learning methods into the exoplanet workflow. This review synthesizes the latest progress in applying ML/DL techniques to exoplanet detection (transit identification, candidate vetting, false-positive rejection) and atmospheric characterization (retrieval, detrending, cross-correlation, surrogate modelling) in the context of JWST and Ariel. We start with classical algorithms such as Random Forests and Convolutional Neural Networks, move through Transformers and Recurrent architectures, then survey modern simulation-based inference using Neural Posterior Estimation and Flow Matching Posterior Estimation with normalizing or continuous normalizing flows. We discuss benchmark efforts, including the Ariel Machine Learning Data Challenges (2019 to 2025) hosted with NeurIPS, and key JWST case studies such as the WASP-39b Early Release Science programme. Results indicate that DL approaches consistently match or exceed traditional pipelines in both speed and accuracy, while ML-driven retrievals reduce inference time from CPU-hours to seconds and can accelerate nested-sampling retrievals by factors of 3-8 without compromising Bayesian evidence. We identify outstanding challenges interpretability, calibration of uncertainties under noisy data, hybrid modelling, and the generalization of models across instruments and planet populations and outline a research roadmap spanning the JWST era and beyond into Ariel's launch in 2029.

11.
arXiv (quant-ph) 2026-06-24

Exact log-depth preparation of highly entangled matrix product states

arXiv:2606.24475v1 Announce Type: new Abstract: Preparing matrix product states (MPS) on a quantum device is a key subroutine in many quantum algorithms. The most competitive methods, based on the renormalisation group, prepare translationally invariant MPS of size $L$ and bond dimension $\chi$, up to an error $\varepsilon$, in circuit depth $\tilde O(\chi^{4}\log(L/\varepsilon))$ or $\tilde O(\chi^{6}\log\log(L/\varepsilon))$. We improve multiple aspects of these methods. First, using block-encoded correction maps, whose post-selection succeeds with constant probability, we render the preparation exact without sacrificing the scaling in $L$. Second, through a generalisation of oblivious amplitude amplification to isometries, we reduce the bond-dimension dependence, improving the depth to $\tilde O(\chi^{2}\log L + \chi^{4})$ or $\tilde O(\chi^{2}\log\log L + \chi^{4})$, and even to $\tilde O(\chi^{3}\log L)$ for incoherent preparations. Finally, we extend the framework to non-translationally invariant MPS and prove logarithmic-depth exact preparation for independent and identically distributed random tensor sequences. Confirmed by numerical studies, these results constitute, to the best of our knowledge, the most efficient exact MPS preparation protocols in the relevant parameter regimes.

13.
arXiv (CS.LG) 2026-06-19

Constrained hybrid modelling to predict microbial dynamics and organic matter turnover in soil systems

arXiv:2606.20329v1 Announce Type: new Abstract: Soil microorganisms control organic matter cycling and largely determine how soil systems can cope with and mitigate climate change and environmental threats. Representing microbial dynamics in process-based soil models is therefore critical to predict carbon cycling in soils, albeit highly challenging to inform from data. One promising approach to improve their parametrisation is the integration of genomic data, yet modelling the complex and unknown relationship between genomes and the processes the microbes are driving is an unsolved problem. In this work, we present the first hybrid modeling framework for deriving biokinetic parameter values of a process-based soil organic matter turnover model from metagenome-inferred functional traits based on DNA sequencing data. Our model predicts biokinetic parameters of the process-based model from genomic trait data with a neural network and integrates constraints from ecological theory and literature to ensure realistic behavior, even of non-observed state variables. We evaluate our method on synthetic genomic trait datasets of varying complexity and on real data, showing that our approach improves performance over multiple baselines and learns the dynamics of unmeasurable components of the process-based model effectively, even for small training datasets.

14.
arXiv (CS.LG) 2026-06-25

TurboMPC: Fast, Scalable, and Differentiable Model Predictive Control on the GPU

arXiv:2606.24039v1 Announce Type: cross Abstract: Robotics increasingly relies on GPUs for parallel simulation, large-scale learning, and neural-network inference. For model predictive control (MPC) to scale with this paradigm, solvers must run efficiently on this hardware while remaining fast, differentiable, and compatible with expressive MPC formulations used in robotics. We present TurboMPC, a differentiable MPC solver that runs entirely on the GPU and supports state and control inequality constraints, implicit integrators, cross-time-coupled costs, and slack variables. TurboMPC combines sequential quadratic programming (SQP), an alternating direction method of multipliers (ADMM) inner solver, implicit differentiation, and a co-designed JAX-CUDA implementation for efficiency and ease of use. In simulation, we validate TurboMPC on constrained planning, humanoid imitation learning, and reinforcement learning with neural-network cost function tasks, achieving up to $15\times$ and $58\times$ speedups over state-of-the-art CPU and GPU differentiable solvers, respectively. We deploy TurboMPC on a full-scale car for minimum-time racing and find that batched, GPU-accelerated tuning of MPC parameters via Bayesian optimization yields significantly faster driving than a hand-tuned baseline. TurboMPC also scales to planning horizons of over $8000$ knot points while maintaining control of the vehicle. We open-source TurboMPC at: https://github.com/ToyotaResearchInstitute/turbompc

16.
arXiv (math.PR) 2026-06-16

Higher-order spectral perturbation expansions II: Kernel matrices and manifold learning

arXiv:2606.16373v1 Announce Type: cross Abstract: We study spectral concentration bounds for kernel matrices as approximation of the corresponding kernel integral operator. Results are established under weak assumptions on the data setting and the reproducing kernel relying only on a Mercer condition and a local Weyl law. This allows us to deal with key features of kernel matrices, such as large multiplicities, large effective dimension, and heavy-tailed distributions. Our results apply to infinite dimensional principal component analysis, manifold learning, and Bayesian nonparametric statistics. We illustrate this via two prototypical examples: The heat kernel on the sphere and a wavelet prior from Bayesian nonparametrics.

17.
arXiv (CS.CL) 2026-06-17

FeedEval: Pedagogically Aligned Evaluation of LLM-Generated Essay Feedback

Going beyond the prediction of numerical scores, recent research in automated essay scoring has increasingly emphasized the generation of high-quality feedback that provides justification and actionable guidance. To mitigate the high cost of expert annotation, prior work has commonly relied on LLM-generated feedback to train essay assessment models. However, such feedback is often incorporated without explicit quality validation, resulting in the propagation of noise in downstream applications. To address this limitation, we propose FeedEval, an LLM-based framework for evaluating LLM-generated essay feedback along three pedagogically grounded dimensions: specificity, helpfulness, and validity. FeedEval employs dimension-specialized LLM evaluators trained on datasets curated in this study to assess multiple feedback candidates and select high-quality feedback for downstream use. Experiments on the ASAP++ benchmark show that FeedEval closely aligns with human expert judgments and that essay scoring models trained with FeedEval-filtered high-quality feedback achieve superior scoring performance. Furthermore, revision experiments using small LLMs show that the high-quality feedback identified by FeedEval leads to more effective essay revisions. We release our code and curated datasets at: https://github.com/BBeeChu/FeedEval.git.

18.
arXiv (CS.CV) 2026-06-16

Latent Space Reinforcement Learning for Inverse Material Estimation in Food Fracture Simulation

Realistic visual simulation of food manipulation requires accurate material parameters, yet these are difficult to measure directly and vary across the heterogeneous regions of a single food item. We address the inverse problem of estimating material parameters from a target description of fracture behavior in a non-differentiable continuum damage mechanics simulator. Using orange peeling as a test case, we train a neural surrogate on 2,000 forward simulations and compare Covariance Matrix Adaptation Evolution Strategy (CMA-ES, a gradient-free evolutionary optimizer) with Proximal Policy Optimization (PPO, a reinforcement learning algorithm) across the original 9-dimensional parameter space and two learned 4-dimensional latent representations. Since different oranges have different material properties, a practical inverse system must handle arbitrary targets without retraining. We train a goal-conditioned PPO policy that learns a general inverse mapping: given any target description of peeling behavior, the policy produces a material parameter estimate in a single forward pass (8 surrogate evaluations, approximately 10ms). Operating in a normalizing flow latent space with a shared surrogate evaluator, the goal-conditioned policy achieves 0.642 actual recovery when validated through the simulator, outperforming the original parameter space by 23%. A warm-start extension that initializes CMA-ES refinement from the policy's output further improves recovery to 0.828 with 540 evaluations. These findings provide a practical framework for inverse food physics and lay groundwork for vision-driven material identification from video observations of food manipulation.

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

Less is More: Improving LLM Reasoning with Minimal Test-Time Intervention

Recent progress in large language models (LLMs) has focused on test-time scaling to improve reasoning via increased inference computation, but often at the cost of efficiency. We revisit test-time behavior and uncover a simple yet underexplored phenomenon: reasoning uncertainty is highly localized-only a small subset of high-entropy tokens dominantly affects output correctness. Motivated by this, we propose Minimal Test-Time Intervention (MTI), a training-free framework that enhances reasoning accuracy and stability with minimal overhead. MTI includes: (i) Selective CFG intervention, applying classifier-free guidance only at uncertain positions; and (ii) Lightweight negative-prompt guidance, reusing the main model's KV cache to approximate unconditional decoding efficiently. MTI yields consistent gains across general, coding, and STEM tasks-e.g., +9.28% average improvement on six benchmarks for DeepSeek-R1-7B and +11.25% on AIME2024 using Ling-mini-2.0-while remaining highly efficient.

20.
arXiv (quant-ph) 2026-06-25

Simulating Universal Quantum Gate Sets on Photonic OAM Qubits: Single-Qubit and Multi-Qubit Operations via Spatial Light Modulator Phase Holography

arXiv:2606.26088v1 Announce Type: new Abstract: Spatial light modulators (SLMs) have emerged as reconfigurable platforms for photonic quantum information processing, offering software-defined control over the orbital angular momentum (OAM) of light encoded in Laguerre-Gaussian (LG) beams. This paper presents a comprehensive simulation and hardware-grounded fidelity analysis of quantum gate operations implemented on the HOLOEYE LC 2012 transmissive SLM. A realistic three-channel noise model comprising 8-bit quantisation noise, twisted-nematic (TN) electronic and thermal noise, and phase-wrap clipping error is obtained from the manufacturer's datasheet without free-parameter fitting, yielding a total noise of $\sigma_{total} = 92.4mrad$. The complete universal single-qubit gate set $\{X, Y, Z, S, T, H\}$ and two-qubit entangling gates $\{CNOT, CZ, SWAP\}$ are simulated on a $512 \times 512$ computational grid. Results show that predicted gate fidelity are in the range of $F = 0.9914–0.9936$, with fork grating gates limited primarily by TN noise and phase gates achieving higher fidelity owing to zero phase-wrap clipping error. In addition, Bell state preparation via the H-CNOT circuit achieves $F(\Phi^+) = 0.9914$ after two SLM interactions. We benchmark our obtained results against six published experimental studies spanning the 78%–99.6% fidelity range. Finally, a wavelength-dependent analysis identifies 450–532 nm operation as the optimal regime for this device.

21.
arXiv (quant-ph) 2026-06-25

Benchmarking Dark Matter Search using a Parity-Check Protocol with Machine-Learning Optimized Pulses

arXiv:2606.25795v1 Announce Type: new Abstract: We report on an improved microwave detection protocol for dark matter candidates such as the axion and the dark photon. We employ a superconducting transmon qubit dispersively coupled to a double-cavity system, enabling quantum non-demolition measurements of the photon occupation in a relatively short-lived storage cavity. To reduce the experimental cycle time and enhance sensitivity for axion and dark-photon searches, we operate this detector in a regime of increased qubit-cavity coupling, resulting in Stark shifts of 4.6 MHz. In this regime, conventional control pulses suffer from strong frequency-detuning sensitivity and photon-number-dependent errors. We address this limitation by implementing frequency-detuning-robust $\pi/2$ pulses (obtained by machine-learning optimization) that preserve high-fidelity qubit control over a bandwidth of approximately 20 MHz. We experimentally validate this protocol and demonstrate single-photon detection performance comparable to previous implementations, despite significantly reduced qubit coherence times and storage-cavity lifetimes. Using parity-based measurement sequences combined with a Hidden Markov Model (HMM) analysis, we achieve background rates on the order of $\mathcal{O}(20)$ Hz. In the absence of a magnetic field, we derive exclusion limits on the dark photon model for dark matter, reaching a sensitivity to the kinetic mixing angle of $\epsilon_{95\%} \sim 1\times10^{-14}$ at 5.051 GHz. These results establish machine-learning robust control as a key enabler for faster, more scalable microwave quantum sensors for dark-matter searches.

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

U$^2$Mamba: A Two-level Nested U-structure Mamba for Salient Object Detection

Mamba-based models have emerged as a promising alternative for salient object detection (SOD), offering significant advantages in modeling long sequences. However, existing models often fail to explore contextual information and the depth of the entire architecture. This paper introduces U$^2$Mamba, a powerful and innovative U-structured network for salient object detection. We propose multiscale Mamba U-blocks (MMUBs) that enhance the model depth to improve local feature extraction capabilities. Our newly developed nested U-structure, incorporating MMUBs, enables the network to integrate various receptive fields from shallow and deep layers, thereby collecting richer contextual information and longer-range data without being constrained by resolution. Instead of using the traditional deep supervision scheme and top-level supervised training, we propose a hierarchical training supervision method where the loss is computed at each level during the training process. Extensive experiments demonstrate that U$^2$Mamba achieves highly competitive performance against state-of-the-art methods. The source code is available at \url{https://github.com/JL021/U2Mamba}.

23.
medRxiv (Medicine) 2026-06-16

Validating an Early Pregnancy HbA1c as the Screening Test for Gestational Diabetes Mellitus: Findings from PRISMA Pakistan Cohort

Background: Early identification of gestational diabetes mellitus (GDM) is critical to improving maternal and neonatal outcomes, particularly in resource-constrained settings where universal oral glucose tolerance testing (OGTT) is burdensome. We assessed whether early-pregnancy HbA1c alone or combined with common risk factors can predict GDM and reduce the burden of OGTT requirements in a peri-urban cohort in Karachi, Pakistan. Methods: We conducted a secondary analysis of the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) Pakistan cohort. Women enrolled before 20 weeks' gestation with available early-pregnancy HbA1c and a 2-hour 75g OGTT at 24 to 28 weeks were included. We externally validated GDM prediction models originally developed in the STRiDE-India cohort. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). We assessed four models: HbA1c alone (Model 1a); age, BMI, and family history of diabetes mellitus (FH DM) (Model 1b); HbA1c combined with age, BMI, and FH DM (Model 2); and an extended model, i.e., Model 2 combined with socioeconomic status, gestational age, parity, systolic and diastolic blood pressure (Model 3). A dual-threshold approach was applied to assess rule-in and rule-out performance. Results: Among 2,489 women, GDM incidence was 7.5% (n=186). Models with a broader set of predictors demonstrated higher AUC values, with Model 2 achieving an AUC of 0.61 (95% CI: 0.57, 0.66). Including additional factors (Model 3) did not further improve predictive ability (AUC: 0.62; 95% CI: 0.58, 0.66). In addition, at predefined thresholds, Model 2 achieved sensitivity of 73.7% (rule-out) and specificity of 83.5% (rule-in), with the potential to reduce OGTT requirements (58.5%). Conclusions: Early-pregnancy risk stratification using HbA1c combined with simple clinical predictors offers a pragmatic approach to streamline GDM screening among high-risk pregnant women. A dual-threshold strategy using Model 2 could reduce reliance on universal OGTT while prioritizing high-risk women for confirmatory testing.

25.
arXiv (quant-ph) 2026-06-24

Altermagnet-Superconductor Heterostructure: a Scalable Platform for Braiding of Majorana Modes

arXiv:2506.08095v2 Announce Type: replace-cross Abstract: Topological quantum computation, featuring qubits built out of anyonic excitations known as Majorana zero modes (MZMs), have long presented an exciting pathway towards scalable quantum computation. Recently, the advent of altermagnetic materials has presented a new pathway towards localized MZMs on the boundary of two-dimensional materials, consisting of an altermagnetic film, subject to a superconducting proximity effect from a superconducting substrate. In this work, we demonstrate the possibility for an altermagnet-superconductor heterostructure, to not only harbor MZMs, but also freely manipulate their position along the topological boundary of the material, via rotation of the Néel vector. Using this mechanism, on a square platform, we utilize a time-dependent method to simulate the Z-gate via braiding, and then extend this to a larger H-junction, where we implement the $\sqrt{X}$ and $\sqrt{Z}$ gate on a single-qubit system. Further, this structure is eminently scalable to many-qubit systems, thus providing the essential ingredients towards universal quantum computation.