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01.
arXiv (CS.LG) 2026-06-18

PACT: Preserving Anchored Cores in Task-vectors for Model Merging

arXiv:2606.18627v1 Announce Type: new Abstract: Model merging has emerged as a training-free alternative to multi-task learning, aiming to combine multiple task-specific fine-tuned models into a single multi-task model. Most existing model merging approaches follow the Task Arithmetic paradigm, which decomposes fine-tuned weights into pre-trained parameters and task vectors, and performs merging exclusively in the task-vector space. The effectiveness of this paradigm implicitly relies on the assumption that task-specific knowledge is encoded solely within task vectors. We argue that this assumption generally does not hold due to the intrinsic task preferences of pre-trained models. Specifically, we identify Load-Bearing Wall (LBW) dimensions, namely some task-critical knowledge that remains embedded in the pre-trained weights rather than being fully transferred into task vectors. We characterize LBW dimensions from both scalar-weight and subspace perspectives, thereby covering the major paradigms of existing model merging methods. Our analysis reveals that, by ignoring LBW dimensions, task-vector-based approaches fail to fully resolve task conflicts and may inadvertently damage task-specific knowledge encoded in the pre-trained model, leading to degradation. To address this issue, we propose PACT, which preserves the anchored task-specific cores (i.e., LBW dimensions) within task vectors by aligning their orthogonal complements with the subspace of the pre-trained weights. These aligned subspace components are then removed from the task vectors before applying existing model merging algorithms. Furthermore, we develop an efficient variant based on randomized SVD to improve scalability. PACT can be seamlessly integrated with existing methods. Extensive experiments across multiple benchmarks demonstrate that PACT consistently enhances mainstream model merging approaches and establishes new state-of-the-art performance.

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

Domain Generalizable Adaptation of 3D Vision-Language Models via Regularized Fine-Tuning

Domain adaptation remains a central challenge in 3D vision, especially for multimodal foundation models that align 3D point clouds with visual and textual data. While these models demonstrate strong general capabilities, adapting them to downstream domains with limited data often leads to overfitting and catastrophic forgetting. To address this, we introduce ReFine3D, a regularized fine-tuning framework designed for domain-generalizable tuning of 3D large multimodal models (LMMs). ReFine3D combines selective layer tuning with two targeted regularization strategies: multi-view consistency across augmented point clouds and text diversity through synonym-based prompts generated by large language models. Additionally, we incorporate point-rendered vision supervision and a test-time augmentation mechanism with confidence-based aggregation to further enhance robustness. Extensive experiments across different 3D domain generalization benchmarks show that ReFine3D improves base-to-novel class generalization by 1.36%, cross-dataset transfer by 2.43%, robustness to corruption by 1.80%, and few-shot accuracy by up to 3.11%, outperforming prior state-of-the-art methods with minimal added computational overhead.

03.
arXiv (CS.AI) 2026-06-12

EWAM: An Enhanced World Action Model for Closed-Loop Online Adaptation in Embodied Intelligence

arXiv:2606.12690v1 Announce Type: cross Abstract: In this paper, we propose the Enhanced World Action Model (EWAM), a closed-loop online adaptation architecture built upon a pretrained and fully frozen Cosmos3 backbone network. Evaluated entirely under a zero-shot task protocol, EWAM is centrally focused on reducing the amount of additional deployment data required to adapt to new task layouts. Notably, no extra task-specific demonstration sets were introduced in any of the evaluations, and no fine-tuning was performed on the backbone network. Its performance gains stem entirely from an inference-time co-reasoning mechanism composed of four inserted lightweight neural layers: the Neural Experience Memory Layer located in the intermediate layers of the Diffusion Transformer (DiT) provides task-relevant execution context; the Neural Anomaly Detection Layer after the state prediction head monitors the divergence between predicted and actual states in real time; the Neural Policy Routing Layer dynamically selects direct execution, conservative replanning, or rollback recovery based on the anomaly severity; and the Neural Action Correction Layer refines the generated action chunks using execution diagnostics. Unlike naive feature fusion, the memory, anomaly detection, and correction modules are deeply integrated into the Cosmos3 forward path in a differentiable manner, with only the final routing decision being a discrete supervised one.

04.
arXiv (CS.CL) 2026-06-19

Your Mouse and Eyes Secretly Leak Your Preference: LLM Alignment using Implicit Feedback from Users

To align a Large Language Model (LLM), most existing methods collect explicit human feedback and train a reward model to predict the human preference based on the response text. These existing methods have two key limitations. First, the users rarely provide explicit feedback for LLM responses, which makes the high-quality preference annotation expensive to collect. Second, the methods do not leverage implicit human feedback, which has proven vital to the economic moats of Internet giants. To quantify the value of implicit feedback, we build a new dataset called IFLLM, which collects 1336 multi-turn questions from the 59 Mechanical Turk workers, their mouse trajectories, and eye gazing points to the LLMs' responses from their webcams. IFLLM shows that the users have very diverse types of gazing behavior and mouse trajectories. Our reward model based on the implicit user feedback boosts the accuracy of the text-based reward model from 55% to 64% and nearly triples the relative response quality improvements after applying the DPO to eight LLMs, demonstrating the value of implicit feedback in the wild. Our data collection website, dataset, and codes can be found at https://github.com/themehulpatwari/llm-implicit-feedback/.

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

SDS-LoRA: Overcoming Anisotropic Gradient Scaling in Low-Rank Adaptation

arXiv:2606.16454v1 Announce Type: cross Abstract: Low-Rank Adaptation (LoRA) enables efficient adaptation of large pre-trained models to downstream tasks by parameterizing weight updates with low-rank matrices. In this paper, we investigate the limitations of the LoRA parameterization from a geometric perspective. Specifically, we show that when a full fine-tuning gradient is backpropagated to the low-rank matrices, it undergoes anisotropic scaling driven by their singular values. We argue that this phenomenon is undesirable because it distorts the full fine-tuning gradient by skewing it toward dominant singular directions while suppressing others. Our analyses demonstrate that anisotropic gradient scaling reduces the effective rank of the low-rank matrices' gradients and results in suboptimal alignment between the full fine-tuning gradient and its low-rank approximation in LoRA, thereby exacerbating the gap to full fine-tuning. To address these limitations, we propose a new low-rank parameterization, SDS-LoRA, which structurally decouples singular values from the backward pass. Our method ensures that the full fine-tuning gradient backpropagates only through the orthonormal bases of the low-rank matrices' subspaces, independent of their scales. Convergence analysis demonstrates that while LoRA's convergence rate degrades with the condition number of the low-rank matrices, SDS-LoRA remains independent of it. Experimental results across natural language and vision benchmarks show that SDS-LoRA improves loss convergence and reduces the gap to full fine-tuning, significantly enhancing adaptation performance.

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

An XAI View on Explainable ASP: Methods, Systems, and Perspectives

arXiv:2601.14764v2 Announce Type: replace Abstract: Answer Set Programming (ASP) is a popular declarative reasoning and problem solving approach in symbolic AI. Its rule-based formalism makes it inherently attractive for explainable and interpretive reasoning, which is gaining importance with the surge of Explainable AI (XAI). A number of explanation approaches and tools for ASP have been developed, which often tackle specific explanatory settings and may not cover all scenarios that ASP users encounter. In this survey, we provide, guided by an XAI perspective, an overview of types of ASP explanations in connection with user questions for explanation, and describe their coverage by current theory and tools. Furthermore, we pinpoint gaps in existing ASP explanations approaches and identify research directions for future work.

07.
arXiv (quant-ph) 2026-06-12

Coulomb crystallization of xenon highly charged ions in a laser-cooled Ca+ matrix

arXiv:2512.12266v2 Announce Type: replace-cross Abstract: We report on the sympathetic cooling and Coulomb crystallization of xenon highly charged ions (HCIs) with laser-cooled Ca$^+$ ions. The HCIs are produced in a compact electron beam ion trap, then charge selected, decelerated, and finally injected into a cryogenic linear Paul trap. There, they are captured into $^{40}$Ca$^+$ Coulomb crystals, and co-crystallized within them, causing dark voids in their fluorescence images. Fine control over the number of trapped ions and HCIs allows us to realize mixed-species crystals with arbitrary ordering patterns. By investigating Xe$^{q+}$–Ca$^+$ strings, we confirm the HCI charge states, measure their lifetime and characterize the mixed-species motional modes. Our system effectively combines the established quantum control toolbox for Ca$^+$ with the rich set of atomic properties of Xe highly charged ions, providing a resourceful platform for optical frequency metrology, searches for signatures of new physics, and quantum information science.

08.
arXiv (math.PR) 2026-06-17

Periodicity, type $II_1$ factors and free Poisson laws in interacting Fock spaces

arXiv:2606.18162v1 Announce Type: cross Abstract: We show that the von Neumann algebra generated by position operators in a 2-periodic interacting Fock space is a type $II_1$ factor. On the probabilistic side, we prove that the squared position operators have a Marchenko-Pastur distribution with respect to the vacuum state, yielding a natural realization of free Poisson laws within this framework.

09.
arXiv (quant-ph) 2026-06-11

Compressed minimum-purity time evolution for late-time quantum dynamics

arXiv:2606.11392v1 Announce Type: cross Abstract: Unitary time evolution of initially simple quantum many-body states rapidly generates entanglement and complex correlations, which limits direct numerical simulations. The late-time dynamics of physical observables, however, typically exhibits an effective simplicity in the form of hydrodynamics or kinetic theory. This leads to the question whether microscopic equations of motion can remain accurate and tractable up to long time scales by discarding irrelevant information in a controlled manner. Here, we introduce compressed minimum-purity time evolution (CoMPuTE) as an approach to keep track of a consistent set of reduced local density matrices, closing the hierarchical equations of motion using a minimum-purity principle. In benchmark applications we demonstrate (i) accurate description of energy diffusion in the one-dimensional mixed-field Ising model, (ii) the applicability to genuinely out-of-equilibrium Floquet dynamics starting from a pure state, and (iii) the limitations of the local reduced density matrix approximation when describing transport in the XXZ chain at $\Delta=1$ that is governed by increasingly non-local integrals of motion. The CoMPuTE method enhances computational efficiency in comparison to the closely related local-information time evolution algorithm, opening a possible route towards an extension to systems in higher spatial dimensions.

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

Surprise-Guided MergeSort: Budget-Efficient Human-in-the-Loop Ranking via Adaptive Comparison Scheduling

arXiv:2606.15623v1 Announce Type: cross Abstract: Pairwise comparison is the gold standard for subjective ranking tasks; however, exhaustive annotation requires a massive number of human comparisons ($O(n^2)$). While sorting-based methods have reduced this burden to $O(n\log n)$, they still require expensive human judgment for every single comparison. To further improve annotation efficiency, we propose leveraging a Vision-Language Model (VLM) not as an annotator replacement, but as a question prioritizer to identify which comparisons genuinely require human judgment. The proposed Surprise-Guided MergeSort (SGS) framework achieves this through three integrated components: (1) a bottom-up MergeSort scheduler that structures comparisons and exploits transitivity, (2) a composite Surprise Scorer – combining position-bias-cancelled VLM confidence, Elo gap, and vote entropy – to quantify comparison ambiguity, and (3) an adaptive budget allocator that routes high-surprise pairs to humans while automating low-surprise pairs via transitivity inference. Validation was conducted on six diverse benchmarks spanning text similarity (STS-B, BIOSSES, SICKR-STS) and image quality assessment (KonIQ-10k, TID2013, LIVE Challenge). SGS effectively identified and skipped up to 535 non-informative comparisons per session. Consequently, it achieved Kendall's $\tau{\times}100$ improvements of $+6$ to $+12$ over Active Elo under the same total budget. These results demonstrate that combining VLM-guided surprise metrics with algorithmic sorting provides a generally consistent accuracy-efficiency trade-off across diverse domains.

11.
arXiv (CS.AI) 2026-06-12

Mapping AI Programs in the U.S: A Status Report from Early 2026 and an Analysis of AI Majors and Minors

arXiv:2606.12428v1 Announce Type: cross Abstract: We present a report on the status of undergraduate Artificial Intelligence (AI) programs in the United States in Spring 2026. In so doing, we 1) describe our scraping and mapping tools, which dynamically update to track the state of AI education in the U.S., and 2) create a historic record at a time of great upheaval. The tool we developed, available at https://cicmap.ai, detects, scrapes, and displays data from more than 350 undergraduate AI programs–majors, minors, concentrations, and certificates–at 4-year universities. Our tool searched over 560 institutions to locate these programs, a sample that represents 86\% of all undergraduate Computer Science (CS) graduates in the U.S. This tool allows prospective students, guidance counselors, administrators, and faculty to easily access AI program requirements and is designed to continually update as new programs emerge. To the best of our knowledge, this survey represents the most comprehensive snapshot of the state of AI programs in the U.S. to date. With this work we offer three important contributions: 1) a record of AI programs in the U.S. at a time of great upheaval; 2) a tool to explore AI programs and their requirements; and 3) an analysis of the courses required for 66 AI majors and 87 AI minors. Our analysis of majors and minors shows great variability in the size and the requirements of these degrees, but we note two takeaways. First, not all majors require a general AI course, but if they don't, they do require a Machine Learning (ML) course. Second, while more than a third of majors require an Ethics in AI course, just under a quarter of AI minors do.

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

FAPO: Fully Autonomous Prompt Optimization of Multi-Step LLM Pipelines

arXiv:2606.19605v1 Announce Type: cross Abstract: Multi-step LLM pipelines fail through interactions among retrieval, reasoning, and formatting steps, so prompt-only optimization can miss bottlenecks in the chain. We present FAPO (Fully Autonomous Prompt Optimization), a framework that lets Claude Code optimize an LLM pipeline inside a standardized codebase. FAPO evaluates a pipeline, inspects intermediate steps, diagnoses failures, proposes scoped changes, and validates variants repeatedly to optimize against a score function. It first tries prompt edits and, only when prompt optimization appears insufficient, changes chain structure within the permitted scope when attribution identifies a structural bottleneck. Across six benchmarks and three task models, FAPO beats the baseline GEPA in 15 of 18 model-benchmark comparisons. In 11 model-benchmark comparisons, FAPO wins with non-overlapping mean $\pm$ trial-standard-deviation ranges, and the mean FAPO-GEPA gain is +14.1 pp. In the six HoVer and IFBench comparisons where prompt-first search escalated to structural changes, FAPO wins all six with a mean gain of +33.8 pp. FAPO also improves performance on security tasks: on CTIBench-RCM, a security CVE-to-CWE task, prompt-only FAPO lifts test accuracy by +4.0 pp on GPT-5, +7.1 pp on Foundation-Sec-8B-Instruct, and +2.0 pp on Foundation-Sec-8B-Reasoning. These results position FAPO as a state-of-the-art pipeline optimization technique for both general-purpose and security-focused tasks.

13.
medRxiv (Medicine) 2026-06-12

Does the method matter? Evaluating the effectiveness, efficiency and ease of hearing-aid gain self-adjustment

In conventional hearing-aid personalisation, clinicians cannot hear what their patients hear, and patients cannot often reliably detect or describe what they hear. Self-adjustment avoids this issue but requires user controls that adjust hearing-aid signal processing parameters to be effective, efficient and easy. In this study, we explored (a) the roles of interface complexity and stimulus type in the self-adjustment of hearing-aid gain, and (b) how well individuals can adjust one sound to match another to assess the same interfaces and stimuli. Adult hearing-aid users with mild to moderate symmetrical sensorineural hearing loss repeatedly adjusted the gain (a) to their preference from individual prescription (n = 41) and (b) to match their previous preferences from a random starting point (n = 32) using three interfaces representing different bass/mid/treble configurations and three stimuli (music, speech and speech-in-noise). The large interindividual variability in self-adjusted gains clustered into three patterns of deviation from initial prescription: increased relative bass, overall gain reduction, and close to initial prescription. There were no substantial effects of interface nor stimulus on self-adjustment reliability (median {sigma} = 2.8 dB), whereas absolute sound-matching error increased with increasing interface complexity and centre frequency. Neither individual matching accuracy nor questionnaire responses predicted either self-adjusted gains or reliability. Overall, these results show that many - but not all - hearing-aid users can adjust gains with reasonable reliability, and while it can be difficult to predict the behaviour from the individual, the individual applies a similar self-adjustment behaviour across different interfaces and stimuli.

14.
arXiv (math.PR) 2026-06-12

Branching-selection particle systems and inverse first passage problems

作者:

arXiv:2606.13487v1 Announce Type: new Abstract: A generalised inverse first passage problem asks whether, given a probability measure $p$ on $[0,\infty]$, one can find a boundary $b:[0,\infty]\to \mathbb{R}$ such that the stopping time:\[\tau:=\inf\left\{t:\Lambda\int_0^t \omega(W_s-b(s))ds \geq U\right\}\] has distribution $p$, where $U\sim Exp(1)$, $\Lambda\in(0,\infty)$ and $\omega$ is a monotonic decreasing function. We construct a branching-selection particle system whose hydrodynamic limit is governed by a free boundary problem and connect this to the generalised inverse first passage problem. In the $N$-particle system, particles move as independent Brownian motions, branch at a prescribed rate, and are removed at a rate proportional to their location relative to a position $b^N(t)$ which is a function of the empirical distribution. We identify the limit of $b^N$ as the solution of the inverse first passage problem.

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

DeFAb: A Verifiable Benchmark for Defeasible Abduction in Foundation Models

arXiv:2606.18557v1 Announce Type: new Abstract: A rule-based logic solver resolves every instance in our benchmark in under 50 microseconds with 100% accuracy; the best frontier language model reaches 65% at best and drops to 23.5% under rendering-robust evaluation (worst case over four surface renderings). We introduce DeFAb (Defeasible Abduction Benchmark), a dataset and generation pipeline that converts four decades of publicly funded knowledge bases into formally grounded instances for defeasible abduction: constructing hypotheses that explain anomalies by overriding defaults while preserving unrelated expectations. Because every hypothesis must pass polynomial-time checks for valid derivation, conservativity, and minimality, DeFAb makes logical rigor the instrument for measuring creativity and theoretical reasoning, scoring the disciplined construction of theory revisions rather than fluent but theory-destroying prose. The pipeline pairs taxonomic hierarchies (OpenCyc, YAGO, Wikidata) with behavioral property graphs (ConceptNet, UMLS) to produce 372,648+ instances across 33.75M materialized rules from 18 sources, in three levels with polynomial-time verifiable gold standards. Four frontier models do not reliably internalize defeasible reasoning: rendering-robust Level 2 accuracy is 7.8-23.5%; chain-of-thought variance (~36 pp) exceeds any inter-model gap; and a matched contamination control isolates a +19.4 pp Level 3 gap. We further release DeFAb-Hard (a 235-instance Level 3 difficulty variant; best model 53.3% vs 100% symbolic) and CONJURE (a kernel-verified transformative-creativity variant of 560 Lean 4/Mathlib instances whose gold answers are definitions the proof kernel did not previously contain, judge-free verifier; a pilot finds zero novel concepts). The same verifier doubles as an exact reward for preference optimization (DPO, RLVR/GRPO). Released under MIT at https://huggingface.co/datasets/PatrickAllenCooper/DeFAb.

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

Hua-Chen New Theory of Economic Optimization

arXiv:2504.19134v4 Announce Type: replace-cross Abstract: Between 1957-1985, Chinese mathematician Loo-Keng Hua pioneered economic optimization theory through three key contributions: establishing economic stability's fundamental theorem, proving the uniqueness of equilibrium solutions in economic systems, and developing a consumption-integrated model 50 days before his death. Since 1988, Mu-Fa Chen has been working on Hua's theory. He introduced stochastics, namely Markov chains, to economic optimization theory. He updated and developed Hua's model and came up with a new model (Chen's model) which has become the starting point of a new economic optimization theory. Chen's theory can be applied to economic stability test, bankruptcy prediction, product ranking and classification, economic prediction and adjustment, economic structure optimization. Chen's theory can also provide efficient algorithms that are programmable and intelligent. {Stochastics} is the cornerstone of Chen's theory. There is no overlap between Chen's theory, and the existing mathematical economy theory and the economics developments that were awarded Nobel Prizes in Economics between 1969 and 2024. The distinguished features of Chen's theory from the existing theories are quantitative, calculable, predictable, optimizable, programmable and can be intelligent. This survey provides a theoretical overview of the newly published monograph [5rw24]. Specifically, the invariant of the economic structure matrix, also known as the Chen's invariant, was first published in this survey.

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

DeceptionX: Explainable Deception Detection with Multimodal Large Language Models

Deception detection is a critical and highly challenging task within affective computing and behavioral analysis. Existing deep learning methods typically treat this task as a straightforward classification problem; however, this black-box approach lacks interpretability and fails to capture the complex logical deduction processes utilized by human experts when identifying lies. While Multimodal Large Language Models (MLLMs) have shown potential, applying them effectively requires a bridge between low-level audiovisual cues and high-level logical reasoning. In this paper, we propose DeceptionX, a novel MLLM framework that shifts the paradigm of deception detection from black-box classification to an interpretable Observe-Think-Summarize reasoning process. To address the scarcity of high-quality reasoning data, we first constructed DeceptChain, a high-quality dataset developed through a human-in-the-loop process. This dataset synthesizes fine-grained visual and auditory evidence (such as micro-expressions and vocal tremors) into structured chain-of-thought reasoning data. Furthermore, we propose a three-stage training pipeline and a Discrepancy-Aware Redundancy Elimination~(DARE) strategy for DeceptionX to further enhance the model's generalization capabilities. Extensive experiments demonstrate that DeceptionX not only outperforms existing MLLM baselines and state-of-the-art methods on standard real-world benchmarks but also provides transparent, expert-level reasoning paths, bridging the critical gap between accuracy and interpretability in multimodal deception detection.

18.
arXiv (math.PR) 2026-06-16

The existence of invariant sublinear expectations for $G$-SDEs

arXiv:2606.15203v1 Announce Type: new Abstract: In this paper, we study the existence of invariant sublinear expectations of Markovian semigroups on sublinear expectation spaces. To achieve this, we establish a complete metric space of sublinear expectations, on which we extend Harris' method to the nonlinear setting on the convergence of sublinear semigroups. We then explore two cases of $G-$diffusions by studying the Lyapunov function and the local Doeblin condition. One is the $G-$Brownian motion on the unit circle which is the case studied in Feng and Zhao [Zhaonon], but with the new method. Another is the multidimensional $G-$SDEs on the whole space $\mathbb{R}^d$. We establish, for the first time in the literature, the existence of the invariant sublinear expectation for $G-$SDEs under the non-degenerate and weakly dissipative assumption. For this, we prove that for a class of $G-$SDEs, the $G-$expectation can be represented as the supremum of the semigroup of a family of SDEs, of which the regularity is obtained by considering the Bismut-Elworthy-Li formula and the Denis-Hu-Peng representation for the distribution of $G-$Brownian motions.

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

SP$^3$: Spherical Priors for Plug-and-Play Restoration

In this paper, we introduce SP$^3$, a novel Plug-and-Play algorithm that accelerates maximum a posteriori image restoration by replacing denoisers with Spherical Encoders (SE) as generative priors. SP$^3$ approximates the intractable proximal prior step by utilizing the SE tightly structured latent space as a robust projection onto the natural image manifold. Alternating this projection with a closed-form data-consistency step, via Half-Quadratic Splitting, achieves stable convergence without requiring gradient computation during inference. This unique formulation unlocks "anytime" restoration capabilities, producing sharp, plausible images from the first iteration. Evaluations across a variety of image restoration tasks demonstrate that SP$^3$ achieves perceptual quality comparable to state-of-the-art zero-shot diffusion and flow methods while being $3$-$630\times$ faster.

20.
arXiv (CS.CV) 2026-06-16

RGFVR: Reference-Guided Face Video Restoration with Flow Matching

Face video restoration from degraded observations is challenging, as it requires simultaneously recovering visual fidelity, temporal consistency, and subject identity. Existing approaches are often either reference-free, which can lead to identity loss when person-specific facial details are lost, or subject-specific, which limits generalization to unseen identities. We propose a subject-agnostic, reference-guided framework for identity-preserving face video restoration. Our method introduces bimodal perceptual-descriptive identity conditioning into a pretrained flow-based text-to-video generator and employs a two-stage training strategy to strengthen identity guidance during restoration. Experiments show that our approach improves restoration fidelity, temporal consistency, and identity preservation, achieving superior performance under challenging video degradations, including downsampling, blur, noise, and compression artifacts. The code is available under: https://github.com/batuhanntosun/RG-FVR.

21.
medRxiv (Medicine) 2026-06-12

Heterogeneity of Treatment Effect of Aspirin and Clinically Significant Bleeding in Older Adults

Aim: The global population of older adults is growing, and older age is linked to higher bleeding risk. Although guidelines discourage aspirin for primary prevention in healthy older adults due to bleeding harms outweighing benefits, many continue taking it without a clear indication. It remains unclear whether all older adults face uniform aspirin-related bleeding risk or if certain subgroups are more vulnerable. Methods: We analyzed data from 19,114 ASPREE trial participants to develop machine learning models using 116 baseline variables. Random forest (RF) and random survival forest (RSF) models predicted 5-year bleeding risk, and participants were stratified into low, intermediate, and high-risk groups based on the 20th and 80th percentiles of predicted risk. We assessed heterogeneity of treatment effect (HTE) by testing treatment-by-risk group interactions on the relative scale using Fine-Gray models, and on the absolute scale using observed 5-year cumulative incidence rates. Results: Over a median follow-up of 4.7 years, 626 major bleeding events occurred. The RF model had moderate discrimination (AUC = 0.65, 95% CI: 0.63-0.67) and good calibration (Brier = 0.032, 95% CI: 0.029-0.034). Statistically significant HTE was observed on the relative scale, with the greatest relative increase in bleeding risk seen in the low-risk group (subdistribution hazard ratio = 2.26, 95% CI: 1.27-4.01). On the absolute scale, low-risk participants experienced higher bleeding with aspirin (absolute risk difference (ARD) = 1.17%, 95% CI: 0.37-1.95), but heterogeneity in ARDs was not statistically significant (Cochran's Q p > 0.45). Similar findings were observed when using the RSF model. Conclusion: Participants at lowest baseline bleeding risk experienced the greatest relative increase in bleeding risk with aspirin therapy. We found statistically significant heterogeneity in treatment effects on the relative but not absolute scale. These findings support an individualized, risk-based approach to aspirin therapy decision-making in older adults.

22.
arXiv (CS.CV) 2026-06-12

Cascade Classification of Dermoscopic Images of Skin Neoplasms with Controllable Sensitivity and External Clinical Validation

Purpose. To compare deep learning architectures and classification schemes for dermoscopic images of skin neoplasms and assess their generalization on transfer from open international datasets to independent clinical datasets of Russian practice. Methods. Four architectures (ViT-B/16, Swin-S, ConvNeXt-S, EfficientNetV2-S) were compared in three schemes: binary (malignant/benign), single-stage four-class (benign, MEL, SCC, BCC), and a two-stage cascade (binary triage, then three-class differentiation MEL/SCC/BCC). All models used ImageNet-pretrained weights and a single augmentation protocol on aggregated open ISIC Archive data, and were evaluated on an internal held-out sample and two clinical datasets (Melanoscope AI mobile system; Sechenov University). Results. Internally the binary stage attains ROC-AUC 0.952-0.966; on Sechenov University it drops to 0.797-0.893, sensitivity to 0.53-0.67, and ECE rises from 0.02 to 0.27-0.39 with underestimation of malignancy, quantifying a generalization gap in ranking and calibration. Paired tests confirm one inter-architecture result on clinical data: the deficit of ViT-B/16 at the binary stage (p

23.
PLOS Medicine 2026-05-20

Prescribed hormonal contraceptive use trends in the Estonian Biobank: A longitudinal observational study

by Jelisaveta Džigurski, Märt Möls, Kristi Läll, Hannah Currant, Mall Eltermaa, Estonian Biobank Research Team , Reedik Mägi, Lili Milani, Triin Laisk Background Hormonal contraceptives (HCs) are widely used and have well-documented population-level statistics. Previous studies with short follow-ups have focussed on individual HC use and side effects. However, the same aspects over longer periods, HC formulation switching, and the impact of genetic factors on HC side effects remain understudied due to the limited availability of suitable datasets. We investigated whether the Estonian Biobank (EstBB) is suitable for studying genetic risk for HC side effects. Methods and findings This is a longitudinal descriptive study combining prescribed HC purchase data collected from 2004 to 2022 with genetic and health data from 73,071 female EstBB HC users aged 15–55 at the time of purchase. HC usage was defined by the Anatomical Therapeutic Chemical (ATC) codes G02B, G03A, and G03HB01. Methods included calculating age-stratified annual user prevalence, inferring usage periods from purchases, assessing formulation switching, identifying the International Classification of Diseases, Tenth Revision (ICD-10)-based side effect-related diagnoses and thromboembolism risk factors, and assessing carrier status for Factor V Leiden (FVL, rs6025) and prothrombin G20210A (PTM, rs1799963) genetic variants as proof-of-concept. Over 19 years, 20 HC formulations with five administration routes (oral pills, transdermal patches, vaginal rings, subdermal implants, intrauterine devices) were used. In the EstBB, combined HCs were the most commonly used among users aged 15–29, while progestin-only HC use increased with age and over time, comparable to the Estonian population. Overall, 64.2% (n = 46,920) of users switched formulations at least once, with 17.7% (n = 12,929) being rapid switchers. Side effect-related diagnoses were observed in 23.1% (n = 2,982) of rapid switchers, with excessive/irregular menstrual bleeding being the most common. Genetic analysis revealed that 5.3% (n = 3,886) of users carried at least one variant previously associated with increased thrombosis risk (3.5% (n = 2,556) carried FVL only, 1.8% (n = 1,276) PTM only, and 0.07% (n = 54) both). Carriers of thrombosis-associated variants had a significantly higher percentage of thrombosis (6.5%) than non-carriers (4.2%; OR = 1.61, 95% CI [1.40, 1.84], p 

24.
medRxiv (Medicine) 2026-06-22

Paired plasma and EV-enriched plasma proteomics reveal nonredundant sepsis-associated host-response signatures in critical illness

Background: Plasma proteomics may identify host-response signatures in sepsis, but it is unclear whether extracellular vesicle (EV)-enriched plasma provides distinct or redundant information compared with plasma. We compared paired plasma and EV-enriched plasma proteomes in critically ill patients with sepsis and critically ill non-sepsis controls (CINS). Methods: In this prospective observational study, paired plasma and EV-enriched plasma samples were analyzed from 56 critically ill adults, including 40 patients with sepsis and 16 CINS patients. Protein abundance was quantified using liquid chromatography-tandem mass spectrometry. Analyses compared proteomic depth, protein overlap, global concordance between compartments, and differential protein abundance between CINS and sepsis. Exploratory Gene Ontology enrichment was performed as a supplementary analysis. Results: EV-enriched plasma expanded proteomic detection, identifying 2,476 filtered proteins compared with 506 in plasma. Only 386 proteins were detected in both compartments, while 2,090 were unique to EV-enriched plasma and 120 were unique to plasma. Among shared proteins, plasma and EV-enriched plasma showed modest global concordance across critically ill patients (Spearman coeff = 0.322, p = 9.19 x 10^-11), with similar findings in sepsis alone. Differential abundance analysis identified 11 sepsis-associated proteins in plasma and 22 in EV-enriched plasma. Only SAA1, SAA2, and IGFBP6 were significant in both compartments. Exploratory pathway analysis supported acute-phase and inflammatory enrichment in plasma sepsis-associated proteins, while EV-enriched signals were directionally plausible but did not meet prespecified FDR thresholds. Conclusion: Plasma and EV-enriched plasma proteomics capture related but nonredundant sepsis-associated host-response information in critically ill patients.

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Nature Medicine 2026-06-08

Effects of SGLT2 inhibition on incident heart failure in carriers of cardiomyopathy-associated genetic variants

Although the beneficial effects of sodium–glucose cotransporter 2 (SGLT2) inhibition in heart failure (HF) have been well established, it is unknown whether SGLT2 inhibition confers benefit in carriers of rare variants in cardiomyopathy-associated genes. Here we evaluated whole-exome sequencing data from the randomized DECLARE-TIMI 58 trial, in which adults with type 2 diabetes and increased cardiovascular risk were randomized to dapagliflozin or placebo treatment. Pathogenic or likely pathogenic variants (P/LP) in high-confidence cardiomyopathy genes were identified, and treatment effects on hospitalization for HF (HHF) were compared between carriers of such variants and noncarriers. Among 12,685 patients for whom sequence data were obtained, 121 carried a cardiomyopathy variant (76 dilated cardiomyopathy, 25 hypertrophic cardiomyopathy and 25 arrhythmogenic cardiomyopathy). Over a median follow-up of 4.2 years, dapagliflozin lowered the risk of HHF more strongly in carriers (hazard ratio 0.18, 95% confidence interval 0.04–0.86) than in noncarriers (hazard ratio 0.70, 95% confidence interval 0.57–0.86; P interaction 0.03). Absolute risk reduction was 13.0% in carriers and 1.0% in noncarriers (P interaction 0.03). Most carriers (82%) had no prior HF, and in carriers without prior HF, treatment with dapagliflozin reduced the absolute risk of HHF by 12.8%, compared with a reduction of 0.6% in noncarriers (P interaction 0.01). The findings from this cohort of older and high-risk patients raise the possibility that SGLT2 inhibitor treatment should be started early to prevent HF in individuals who carry P/LP cardiomyopathy variants. These results need to be confirmed in a prospective, dedicated trial of preventive HF treatments in carriers of P/LP cardiomyopathy-associated variants. In a whole-exome sequencing analysis, the beneficial effects of the SGLT2 inhibitor dapagliflozin in reducing the risk of future heart failure hospitalization in individuals with type 2 diabetes were markedly greater in individuals who carried a cardiomyopathy-associated genetic variant compared with noncarriers, suggesting a personalized preventative therapy based on genetic information.