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

Stitching and dimensionality effects on large artificially generated volume datasets

Generating large images via deep learning requires patching input data to accommodate hardware memory limitations, then assembling output patches, a process that can introduce stitching artifacts when neighboring patches do not align at borders. While these artifacts are known to affect segmentation tasks, their impact on generative models for style-transfer remains poorly understood. We investigated three stitching approaches and two patch dimensionalities (2D vs 3D) using cycleGAN models trained on cryo-electron microscopy datasets. We evaluated both perceptual quality and performance on downstream mitochondria segmentation. Our key findings reveal that: (1) FID scores fail to detect subtle stitching artifacts that significantly impact downstream segmentation performance, (2) 3D models with artifact-free stitching marginally outperform 2D models on downstream tasks, though the improvement barely justifies the computational cost, and (3) 2D models train more stably due to larger batch sizes. Additionally, we demonstrate that ensembling predictions from three orthogonal directions can improve low-quality volumes but provides no benefit for high-quality outputs. These results demonstrate that maximizing generative model performance on large scientific datasets requires careful consideration and mitigation of stitching artifacts, and that perceptual metrics alone are insufficient for evaluating domain adaptation quality in biomedical imaging.

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

ProGRank: Probe-Gradient Reranking to Defend Dense-Retriever RAG from Corpus Poisoning

arXiv:2603.22934v3 Announce Type: replace Abstract: Retrieval-Augmented Generation (RAG) improves large language model applications by grounding generation in retrieved evidence, but also introduces corpus poisoning as a new attack surface. In this setting, an adversary injects or edits passages so that they enter the Top-$K$ results for target queries and influence downstream generation. Existing defences often rely on content filtering, auxiliary models, or generator-side reasoning, which complicates deployment. We propose ProGRank, a post hoc, training-free retriever-side defence for dense-retriever RAG. ProGRank stress-tests each query–passage pair under mild randomized perturbations, extracts probe gradients from a small fixed parameter subset, and derives two instability signals: representational consistency and dispersion risk. It then combines these signals with a score gate for reranking. ProGRank preserves the original passage content, requires no retraining, and supports a surrogate-based variant when the deployed retriever is unavailable. Experiments across datasets, retrievers, attacks, and retrieval-stage and end-to-end settings show that ProGRank improves robustness and maintains a favorable robustness–utility trade-off, including under adaptive evasive attacks.

03.
arXiv (CS.CL) 2026-06-19

Large Language Models Hack Rewards, and Society

Reinforcement learning (RL) has become a dominant post-training paradigm, enabling large language models (LLMs) to learn from rewards. We observe that societal regulations are structurally similar to reward functions. They define measurable outcomes, thresholds, and exceptions, while often leaving institutional intent only partially specified. We hypothesise that the RL training process may exploit these gaps and therefore ask whether models' well-known tendency to hack reward functions during RL can scale into a more consequential failure mode named societal hacking: discovering loopholes in the rules society runs on. To study this phenomenon, we introduce SocioHack, a sandbox of 72 societal environments, and find that within these environments, reward hacking naturally emerges and leads to regulatory loophole discovery. Models learn to hack the social rules and generate strategies that remain technically compliant while defeating regulatory intent, and current LLM safeguards provide only limited mitigation. Therefore, collecting in-the-wild feedback for model training requires greater caution, and we need a next-generation post-training paradigm for safely iterating LLMs in real society.=

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

Context Compression Is Not One Thing: Readable Symbolic Re-expression vs. Coherent Summary at Matched Budget

We study context compression for multi-hop question answering with small language models. We propose Telegraph English, a readable symbolic format that rewrites retrieved passages into structured entity-relation statements, preserving reasoning evidence at lower token cost. In controlled experiments on MuSiQue, TwoWiki, and HotpotQA, Telegraph English outperforms three matched-budget compression baselines (character-level deletion, truncation, and random sub-sampling) on every dataset, with gains of 13 to 20 F1 percentage point. It also outperforms a coherent prose summary produced by the same encoder on the hardest dataset. A pre-registered depth-interaction hypothesis is null: the advantage does not grow with reasoning depth within datasets. We interpret these results as evidence that readable symbolic re-expression preserves entity content more densely than either natural language or coherent summarization at matched token budget.

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

Federated Medical Image Segmentation under Real-World Label Noise: A Benchmark Suite for Noisy Label Learning Method Selection

While federated learning (FL) enables collaborative medical image segmentation without centralizing sensitive data, real-world deployment is frequently complicated by cross-site label imperfections such as contour disagreement, missing or additional structures, and confused labels. Federated noisy label learning (FNLL) aims to mitigate these effects, yet remains underused in practice as existing evidence is largely based on synthetic noise, simplified settings, and limited real-world noisy evaluation. We address this gap by introducing a benchmark suite that combines diverse real-world noisy datasets, deployment-relevant client-noise scenarios, and label-noise-targeted evaluation to support systematic FNLL assessment and informed method selection. The suite combines curated real-world noisy medical image segmentation datasets from diverse sources with a comprehensive federated segmentation framework including various client-noise scenarios and noise-targeted evaluation. The presented suite provides a realistic and discriminative basis for FNLL evaluation in medical image segmentation and establishes a reusable foundation for fair benchmarking, dataset-specific label-noise characterization, and future method development under realistic federated settings. Code is available at https://github.com/MIC-DKFZ/FedSegNoiseBench.

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

Delving into Latent Spectral Biasing of Video VAEs for Superior Diffusability

Latent diffusion models pair VAEs with diffusion backbones, and the structure of VAE latents strongly influences the difficulty of diffusion training. However, existing video VAEs typically focus on reconstruction fidelity, overlooking latent structure. We present a statistical analysis of video VAE latent spaces and identify two spectral properties essential for diffusion training: a spatio-temporal frequency spectrum biased toward low frequencies, and a channel-wise eigenspectrum dominated by a few modes. To induce these properties, we propose two lightweight, backbone-agnostic regularizers: Local Correlation Regularization and Latent Masked Reconstruction. Experiments show that our Spectral-Structured VAE (SSVAE) achieves a $3\times$ speedup in text-to-video generation convergence and a 10\% gain in video reward, outperforming strong open-source VAEs. The code is available at https://github.com/zai-org/SSVAE.

07.
arXiv (CS.CL) 2026-06-17

MemSlides: A Hierarchical Memory Driven Agent Framework for Personalized Slide Generation with Multi-turn Local Revision

Personalized presentation generation requires more than conditioning on a current prompt or template: agents must preserve stable user preferences across tasks, retain newly introduced preferences and constraints during multi-turn revision, and carry out local edits reliably. We propose MemSlides, a hierarchical memory framework for personalized presentation agents that separates long-term memory from working memory and further divides long-term memory into user profile memory and tool memory. User profile memory stores intent-conditioned profiles for round-0 personalization, working memory carries active preferences and session constraints across revision rounds, and tool memory stores reusable execution experience for reliable localized editing. MemSlides pairs this memory design with scoped slide-local revision, so targeted updates act on the smallest affected region instead of repeatedly regenerating the full deck. In controlled experiments, user profile memory improves persona-alignment judgments on a multi-persona, multi-intent profile bank, tool-memory injection improves closed-loop modify behavior in diagnostic matched-pair settings, and qualitative cases illustrate working memory's ability to carryover preferences. Taken together, these results suggest that effective personalization in presentation authoring depends on separating persistent user profiles, session-level working memory, and reusable execution experience across generation and localized revision.

08.
arXiv (CS.CL) 2026-06-16

Building Customer Support AI Agents at 100M-User Scale: An Evaluation-Driven Framework

The rapid rise in LLM capabilities has made AI agents increasingly viable across a broad range of tasks. Among the most promising applications is building production-ready customer-facing agents, a challenge that demands coordinated excellence in evaluation methodology, context engineering, training, and online measurement. Yet these critical pillars are typically developed in isolation, creating blind spots that only surface after deployment. In this paper, we present a unified framework that bridges offline development with online impact for customer support AI agents at Nubank, a company with 100M+ users. Our approach integrates several key components: (1) structured context engineering tailored to customer support agents, (2) systematic human-in-the-loop prompt iteration, (3) rigorous LLM judge evaluation with measured inter-rater agreement and GEPA optimization for consistency, and (4) ideation-to-production validation. A central insight is that evaluation-pipeline quality directly determines iteration velocity. We present results from five production deployments spanning distinct domains: card delivery, debt management, credit-limit support, card management, and product explanation. These deployments deliver consistent customer-satisfaction gains while substantially accelerating iteration. In our card-delivery deployment, large-scale A/B testing yields a 37 percentage-point improvement in AI transactional Net Promoter Score and a 29 percentage-point gain in self-service rate over prior agent variants, alongside a strong correlation between offline simulation metrics and online outcomes, demonstrating that eval-driven development reliably predicts production impact. On most use cases, AI satisfaction reaches within a few percentage points of expert human agents.

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

Artemis: Anatomy-Resolved inTervention for Eliminating Multimodal NeuroImage confounderS

arXiv:2606.18287v1 Announce Type: new Abstract: Multimodal neuroimaging, integrating functional connectivity from fMRI and structural connectivity from DTI, enables non-invasive analysis of brain networks using graph neural networks. However, demographic factors such as age and sex systematically confound the relationship between brain connectivity and clinical outcomes, causing GNNs to exploit spurious shortcuts rather than learning causally invariant representations. While recent causal GNN methods introduce causality at the graph-modeling level, their causal mechanisms remain domain-agnostic without accounting for the real-world confounders inherent in clinical neuroimaging data. Moreover, brain networks are constructed from atlas-based parcellations where each region exhibits distinct sensitivity to demographic factors, necessitating region-aware adjustment. We propose Artemis, a region-level causal framework that bridges this gap with causal intervention at each brain region independently by learning region-specific confounder representations with lightweight parameters. Our adjustment comprehensively utilized the multimodal functional and structural features for graph reasoning as a plug-in module compatible with arbitrary GNN backbones. Experiments on three benchmarks, ADNI for disease diagnosis, OASIS for dementia staging, and HCP for sex classification, demonstrate consistent improvements over representative GNN-based baselines. Multiple supporting experiments further demonstrate statistical significance and neuroscientific interpretability.

10.
arXiv (CS.CV) 2026-06-25

PRISM: Feed-Forward Single-Image 3D Reconstruction via Geometric Warp-Residual Modeling

Reconstructing 3D scenes from a single image is a fundamental challenge in computer vision, with broad applications in virtual reality, robotics, and content creation. Recent methods achieve outstanding performance by leveraging camera-controlled video diffusion models, but rely on iterative diffusion sampling, which greatly limits their practical deployment. We observe that geometric forward warping alone can cover the majority of a target view directly from the input image, with only a compact residual left for the encoder to correct. Motivated by this observation, we propose PRISM, a feed-forward framework that decomposes multi-view latent prediction into a parameter-free geometric prior and a learned residual correction, with no diffusion sampling required at inference. To enable generalization from purely synthetic training data, we devise a two-stage training strategy combining latents supervised distillation for geometric generalization and perceptual fine-tuning for appearance quality optimization. Extensive experiments on three benchmarks demonstrate that PRISM achieves competitive reconstruction quality compared with diffusion-based methods, while reducing inference time dramatically to only 36 seconds per scene.

11.
Nature (Science) 2026-06-18

Daily briefing: The brain builds a sentence neuron by neuron

作者:

Researchers have tracked the electrical activity of individual brain cells during conversation in real time. Plus, the history of GPS and a cross-species transplant that could reveal clues about the origin of animals. Researchers have tracked the electrical activity of individual brain cells during conversation in real time. Plus, the history of GPS and a cross-species transplant that could reveal clues about the origin of animals.

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

From Detection to Recovery: Operational Analysis on LLM Pre-training with 504 GPUs

arXiv:2605.09370v5 Announce Type: replace-cross Abstract: Large-scale AI training is fundamentally a distributed systems problem, where hardware failures are routine operating conditions rather than rare exceptions, yet public operational evidence from production training clusters remains limited. This report presents an empirical analysis of a 63-node NVIDIA B200 production cluster (504 GPUs), using 55 days of Prometheus time-series data and 73 days of operational logs covering 224 multi-node training sessions. The environment is cross-organizational: five parties (SKT, Upstage, Lablup, NVIDIA Korea, VAST Data) share a unified monitoring pipeline. This enabled joint diagnosis of a 60-node-scale storage I/O bottleneck absent in 2-4-node tests, a production-scale phenomenon no single team could isolate alone. We perform three quantitative analyses yielding four findings. First, over 751 Prometheus metrics and 10 XID-identified GPU failures, no single metric is consistently dominant across failure types, motivating multi-signal detection. Second, 523 checkpoint events trace the save/load path from GPU VRAM to the NFS server: restart loading reaches 21.5% of maximum read bandwidth (700 GB/s) and save bursts 16.0% of maximum write bandwidth (250 GB/s), with NFS/RPC queueing and transport-layer backlog rising together. Third, across 224 sessions over 73 days, node exclusions concentrate so the top 3 of 63 nodes account for over 50%. Fourth, auto-retry chain analysis shows a 33.3% success rate over 12 chains (73 attempts), 2.7x the 12.5% manual rate, with a median retry interval of 11 minutes (IQR 10-11). All analyses are grounded in production infrastructure providing session-level workload management, GPU-centric scheduling, and unified observability.

13.
medRxiv (Medicine) 2026-06-24

Rare protein-coding variation and the genetic architecture of height in >1.4 million individuals

Highly heritable, polygenic, and easily measured, adult height has long been the model trait in human genetics. While the landscape of height-associated common genetic variation has been studied extensively, rare variation remains relatively unexplored. Using rare protein-altering variants in a discovery set of 826,066 exomes, we identify 207 height-associated genes - 98% of which replicate in an additional 624,567 individuals. The rarest and most deleterious class of variation, singleton (frequency

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

SAC$^2$-Net: Semantic Anchoring and Complementary-Consensus Fusion for Multimodal Micro-Expression Recognition

Micro-expression recognition (MER) is challenging due to subtle facial movements, limited data, and the ambiguous relationship between Action Units (AUs) and emotion categories. Optical flow and motion magnification have been widely used to describe subtle facial dynamics from different perspectives: the former captures local motion displacement, while the latter amplifies weak appearance changes. In this work, we observe that these two modalities often exhibit asymmetric failure patterns: one modality may become noisy, distorted, or uninformative, while the other still preserves discriminative AU-related evidence. This phenomenon reveals their complementarity, but also raises two key challenges for fusion: cross-modal heterogeneity and spatially varying modality reliability. Motivated by this observation, we propose SAC$^2$-Net, a Semantic Anchoring and Complementary-Consensus Network for multimodal MER, which first aligns visual modalities with semantic anchors and then performs reliability-aware fusion. To reduce cross-modal heterogeneity before fusion, we introduce Semantic Anchoring Soft Alignment (SASA), which converts activated AUs into textual prompts and uses them as stable semantic anchors to align motion-magnified and optical-flow representations. Unlike hard contrastive learning, SASA constructs hierarchical AU-aware soft labels to preserve semantic proximity among samples with overlapping or anatomically related AU patterns. Based on the aligned representations, Complementary-Consensus Fusion (CCF) first repairs unreliable local evidence through complementary exchange and then enforces a shared spatial focus through consensus refinement. Extensive experiments on five MER benchmarks show that SAC$^2$-Net achieves state-of-the-art or highly competitive performance across coarse-grained, fine-grained, large-scale, and cross-dataset evaluation settings.

15.
arXiv (quant-ph) 2026-06-19

General circuit mapping algorithm for neutral atom quantum computers

arXiv:2606.20503v1 Announce Type: new Abstract: Neutral atom quantum computers (NAQC) are emerging as a promising, scalable quantum computing platform because of their long qubit coherence, flexible qubit arrangement, and multiqubit gate capabilities. However, circuit execution often requires physically moving qubits, making compilation a critical optimization challenge. We propose a circuit independent mathematical framework built on graph-theoretic combinatorial optimization that determines the minimal number of required qubit transfers. This model captures spatial constraints specific to NAQC platforms with zone-limited gate operations and multi-qubit gates. From this framework, we encode the qubit mapping problem as a nonlinear integer program and solve it using a genetic algorithm, enabling trade-offs between minimizing the total traveled distance and the number of parallel transfer operations. Compared to the state-of-the-art scalable compiler for zoned architectures, our approach consistently finds fewer transfers. Depending on the optimization focus, our method produces shorter traveled distances or fewer parallel transfer operations. This work provides both theoretical guaranties and a practical tool for efficient, architecture-aware quantum circuit compilation. As a result, practitioners can generate hardware-aware mappings that reduce movement-induced errors and better exploit atom transfer parallelism, directly improving execution efficiency on NAQC devices.

16.
arXiv (CS.CV) 2026-06-17

Reinforcing Dual-Path Reasoning in Spatial Vision Language Models

Spatial VLMs have made substantial progress in geometric perception, yet complex spatial reasoning requiring multi-step inference over depth, distance, and scene relations remains challenging. Moreover, different spatial queries call for fundamentally different strategies: some are best addressed through purely linguistic, step-by-step deduction, while others require explicit 3D grounding before quantitative inference. We present Dual-Path Spatial Reasoning via Reinforcement Learning for Spatial VLMs (SR-REAL), a unified framework that equips a spatial VLM with two complementary reasoning paths: Language-Only Reasoning (LOR), which performs step-by-step linguistic deduction, and Detect-Then-Reason (DTR), which detects 3D geometric cues (e.g., centers or bounding boxes) via region tokens before explicit geometric inference. SR-REAL begins with a cold-start supervised fine-tuning stage that constructs LOR and DTR chain-of-thought supervision and exposes a region-to-3D interface, followed by RL that optimizes the policy model with accuracy and format rewards; for DTR, a discrete center-based detection reward further refines geometric alignment. Across diverse spatial benchmarks, SR-REAL significantly outperforms spatial VLM baselines: (i) a single RL-trained model supports both reasoning paths, with DTR excelling in region-aware tasks through precise 3D localization and LOR enhancing general spatial reasoning; (ii) jointly training both paths fosters mutual reinforcement; (iii) high-quality, blended cold-start data is crucial for stable RL optimization; and (iv) the model generalizes across datasets and domains without per-task tuning, demonstrating positive transfer between LOR and DTR.

17.
arXiv (CS.CL) 2026-06-11

Layer-Isolated Evaluation: Gating the Deterministic Scaffold of a Production LLM Agent with a No-LLM, Regression-Locked Test Harness

End-to-end task-success is the dominant way to evaluate LLM agents, but one aggregate number tells you that an agent regressed, not where. We present layer-isolated evaluation: a deployed ordering agent is decomposed into a fixed taxonomy of layers (ontology, intent, routing, decomposition, escalation, safety, memory, and cross-cutting envelope/defense), each exercised by its own assertion slice in a deterministic, no-LLM "pure" mode. The pure suite (238 cases across 23 slices; 225 run in 2.39 s, ~10 ms/case) runs in CI on every change against a locked per-slice baseline. We validate by controlled regression injection, degrading one layer at a time across seven non-safety layers. The effect we did not design in is masking: the aggregate pass-rate barely moves (-1.7 to -5.9 pp for six local regressions), while the matching slice craters (-25 to -91 pp). A layer's slice reacting to its own fault is partly by construction; the measured results are (i) the aggregate masking and (ii) that damage stays off the other slices: the injected layer's slice is the single worst-hit in 5 of 7 cases and top-3 in 7 of 7 (mean rank 1.29 of 19). Localization replicates on a second, structurally different tenant (Starbucks SG): all seven matching slices crater, so it is not a single-catalog artifact. We position it as a concrete, deterministic instantiation of the component-level evaluation EDDOps prescribes but leaves unimplemented, with CheckList as ancestor and as the deterministic mirror image of whole-workflow stochastic mutation testing. Our contributions: (a) a fully decomposed, sub-second, no-LLM per-layer harness for a production agent, (b) a coverage-honesty test-adequacy criterion that refuses to score an unexercised layer, and (c) the regression-injection demonstration that per-slice baseline-locked gates localize regressions an aggregate metric masks.

19.
arXiv (CS.CL) 2026-06-11

PoQ-Judge: A Multi-Architecture Evaluation Framework for Cost-Aware Proof-of-Quality in Decentralized LLM Inference

Decentralized LLM inference networks need lightweight, reference-free quality evaluation for Proof of Quality (PoQ). We present PoQ-Judge, a framework that trains dedicated judge models to score query-output pairs without ground-truth references. We study three architectures across the quality-cost tradeoff: a TextCNN judge, a MiniLM cross-encoder, and a DeBERTa judge. Using two-stage training on UltraFeedback plus GPT-labeled in-domain data, the best model reaches 0.747 Pearson correlation with the ground-truth proxy on a held-out test set, outperforming reference-based evaluators from prior work. As a reference-free component in composite scoring, it achieves 0.645 Pearson correlation, matching the best single reference-based evaluator while removing the need for reference answers. We also show that online calibration identifies semantic quality as the dominant dimension and that cascade evaluation reduces cost by 72.7 percent with only modest quality loss. Results are much stronger on QA than summarization, pointing to proxy quality as the main remaining limitation.

20.
arXiv (CS.CL) 2026-06-11

Adaptive Multi-Resolution Procedural Knowledge Compression for Large Language Models

Large language models (LLMs) are widely used to tackle complex tasks with autonomous workflows. Recently, reusable natural language skills have emerged as a popular paradigm to inject procedural knowledge into LLM applications. Since popular skills are often invoked repeatedly, placing their full text in every context significantly increases prefill cost and latency. While text compression techniques have the potential to solve this problem, most existing methods are designed to compress factual knowledge in documents instead of procedural knowledge, making them insufficient for skill compression. In this paper, we argue that an effective skill compression method should: 1) preserve logical dependencies among workflows and tool protocols, 2) enable lightweight, offline compression for frequently updated community skills, and 3) be adaptable to varying complexities across skills. To address this, we present SKIM (SKIll coMpression), an adaptive multi-resolution soft token compression framework for procedural skills. Depending on the complexity of each skill, SKIM creates different numbers of soft tokens that not only improve the efficiency of LLM inference, but also preserve the effectiveness of skill usage. Experiments indicate that SKIM compresses skills to 30 to 60 percent of their original token length while preserving task performance better than existing compression methods.We have released our code at https://github.com/bebr2/SKIM .

21.
arXiv (CS.LG) 2026-06-18

Data-driven sparse identification of governing PDEs via knockoff filters and multi-criteria trade-offs

arXiv:2605.26631v2 Announce Type: replace-cross Abstract: We propose KO-PDE-IDENT, a data-driven framework for identifying parsimonious partial differential equations (PDEs) with false discovery rate (FDR) control. PDE discovery from noisy observations is often hindered by extreme multicollinearity among candidate terms, which causes typical sparse-regression methods to select spurious terms. To address this problem, KO-PDE-IDENT initially mines a support set of potential candidate terms via model-X knockoff filters with finite-sample FDR control, then refines and ranks the surviving PDE alternatives. The framework integrates three components. First, knockoff feature statistics are constructed by coupling $\ell_{0}$-constrained adaptive best-subset selection with SHapley Additive exPlanations (SHAP), yielding an effective and computationally efficient difference statistic. Second, a recursive feature elimination (RFE) procedure removes terms whose marginal contributions are dispensable and assesses statistical necessity through knockoff-perturbed hypothesis testing. Third, the final model selection is formulated as a multi-criteria decision-making (MCDM) problem, where the optimal governing equation is the alternative that best balances a wide range of criteria such as predictive accuracy, model complexity and coefficient uncertainty. We evaluate KO-PDE-IDENT on five canonical PDEs under severe noise corruption. Empirical results show that our framework can exactly recover the true PDE structure, eliminating false discoveries while retaining all true underlying terms, with low coefficient estimation error.

22.
arXiv (CS.LG) 2026-06-25

Asymptotic Learning Curves for Diffusion Models with Random Features Score and Manifold Data

arXiv:2603.22962v3 Announce Type: replace Abstract: We study the theoretical behavior of denoising score matching–the learning task associated to diffusion models–when the data distribution is supported on a low-dimensional manifold and the score is parameterized using a random feature neural network. We derive asymptotically exact expressions for the test, train, and score errors in the high-dimensional limit. Our analysis reveals that, for linear manifolds the sample complexity required to learn the score function scales linearly with the intrinsic dimension of the manifold, rather than with the ambient dimension. Perhaps surprisingly, the benefits of low-dimensional structure starts to diminish once we have a non-linear manifold. These results indicate that diffusion models can benefit from structured data; however, the dependence on the specific type of structure is subtle and intricate.

23.
medRxiv (Medicine) 2026-06-15

International Consensus Guideline on Management of Genitourinary Adverse Events Associated with Prostate Cancer Radiotherapy

Purpose/Objective: Genitourinary (GU) adverse events (AEs) are common during and after pelvic radiation therapy (RT) for prostate cancer and can substantially impact quality of life. We convened an international committee to establish consensus in the prevention, mitigation, and management of radiation-related acute and late GU AEs, as there are no relevant evidence-based consensus guidelines to inform treating providers. Materials/Methods: A systematic evidence review focused on mitigation and management of radiation-related acute and late GU AEs was performed in PubMed, Embase and Cochrane. The following topics were addressed: management of acute GU AEs in the intact and post-operative settings; RT techniques; bladder outlet obstruction procedures; and indications for urology referral or hyperbaric oxygen therapy (HBO). Evidence-based consensus recommendations were developed using a Delphi process. We highlight the current state of evidence and evidence gaps worthy of future study. Results: Consensus was reached for 31 key questions. For management of lower urinary tract symptoms (LUTS), most evidence comes from trials in patients without cancer and not undergoing RT. A consensus algorithm for medical management of acute GU AEs was developed with the following highlights: (a) alpha blockers as 1st-line for obstructive symptoms in the intact setting, (b) anti-spasmodics as 1st -line for irritative symptoms in the intact setting, and (c) anti-spasmodics as 1st -line in the post-operative setting. The consensus algorithm provides an ordered list of medications to offer if 1st -line options afford inadequate relief. For RT fractionation, randomized clinical trial (RCT) data are available. 40% of panelists rarely or never use standard fractionation over moderate hypofractionation for patients with baseline LUTS, but most consider moderate hypofractionation over SBRT for AUA IPSS > 15. For patients with severe obstructive LUTS (most commonly AUA IPSS >20), the panel recommends a prophylactic bladder outlet obstruction procedure and, if obstructive symptoms improve, consideration of moderate hypofractionation or SBRT, based on retrospective data. There is one RCT supporting use of HBO for late radiation cystitis. Conclusions: The consensus guideline synthesizes available evidence and expert opinion across key clinical decision points to provide practical guidance in the prevention, mitigation, and management of radiation-related acute and late GU AEs in prostate cancer RT. Envisioned as a living document with periodic updates, this guideline serves as a resource for practicing radiation oncologists by outlining expert-derived consensus recommendations of evidence-based care in areas where high-quality data is limited.

24.
Nature (Science) 2026-06-17

Lethal plague outbreaks in Lake Baikal hunter-gatherers 5,500 years ago

Plague is among the most devastating diseases in human history1. However, early strains of the plague-causing bacterium Yersinia pestis lacked virulence factors that are required for the bubonic form until around 3,800 years ago2,3. Consequently, the morbidity and mortality of early plague strains remain unclear. Here we describe early plague strains that are associated with two phases of outbreaks among mid-Holocene hunter-gatherers near Lake Baikal in southeast Siberia, beginning from about 5,500 years ago. These outbreaks occur across four hunter-gatherer cemeteries, with a 39% detection rate for plague infection. By reconstructing kinship pedigrees, we show that small familial groups were affected, consistent with human-to-human spread of disease, and that the first outbreak occurred within a single generation. The infections appear to have resulted in acute mortality, especially among children (aged 8 to 11 years). We further note functional differences, including in the ypm superantigen locus, which is also present in present day Yersinia pseudotuberculosis. The new strains diverge ancestrally to known Y. pestis and constrain the timing of its emergence, indicating that this happened before approximately 5,700 years ago. These findings show that plague outbreaks happened earlier than previously thought and were indeed lethal. We contend that the occurrence of outbreaks among mid-Holocene hunter-gatherer communities well outside the sphere of Late Neolithic Europe challenges the notion that higher population densities and lifestyle changes during the Neolithic agricultural transition were prerequisites for plague epidemics. Analyses of ancient DNA from hunter-gatherers near Lake Baikal in southeast Siberia around 5,500 years ago indicate that highly virulent Yersinia pestis emerged earlier than previously estimated, far from the next known cases of infection in Late Neolithic Europe.

25.
arXiv (quant-ph) 2026-06-12

Steady-State Noise Signatures of Lindbladian Exceptional Points

arXiv:2606.13377v1 Announce Type: new Abstract: Exceptional points (EPs) are non-Hermitian degeneracies at which two or more eigenvalues and their corresponding eigenvectors coalesce. In open quantum systems, exceptional points can arise in the Lindbladian governing the dissipative dynamics. Their signatures have so far been mainly identified in finite-time observables, such as transient currents, while steady-state average currents generally provide no direct evidence of the underlying exceptional-point structure. In this work, we demonstrate that signatures of Lindbladian EPs can nevertheless be accessed in the steady-state regime through current noise. We derive general expressions for current correlation functions within a Lindblad master-equation framework and show, in particular, how exceptional points affect their behaviour as a function of the time delay. We illustrate these results with the paradigmatic example of two interacting qubits coupled to two reservoirs, where the steady-state noise clearly distinguishes overdamped, underdamped, and critical regimes. Our results establish current correlation functions as a steady-state probe of Lindbladian EPs in open quantum systems.