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01.
arXiv (quant-ph) 2026-06-25

Closed Quantum Boltzmann Bridges: Coherent Revivals, Hidden Microstates, and the Emergence of Classical Two-Time Entropy Conditioning

arXiv:2606.25260v1 Announce Type: new Abstract: The classical Boltzmann Bridge describes entropy histories conditioned on both an initial low-entropy macrostate and a later macrostate. Unlike the usual past-only formulation of the thermodynamic arrow, this two-time conditioning can produce entropy profiles that rise above the final entropy and then decrease toward the imposed endpoint. In this work, we formulate closed quantum analogues of the Boltzmann Bridge using macro-subspace projectors, unitary time evolution, and Boltzmann entropy defined by the dimension of coarse-grained macroscopic sectors. We first study a minimal coherent chamber-qubit model, in which each particle has only a two-state chamber degree of freedom. Although this model is the most direct quantization of the classical two-box system, its bridge entropy profile is dominated by coherent oscillations and revivals rather than classical relaxation. We then introduce a hidden-microstate bridge, in which each chamber sector contains unresolved internal degrees of freedom while the full dynamics remain unitary. Numerical experiments show that increasing the internal Hilbert-space dimension suppresses sample-dependent revival behavior and produces bridge entropy profiles whose sign structure and coarse-grained shape increasingly agree with the classical Boltzmann Bridge. We further use a Random Forest classifier to explore the parameter regime separating revival-dominated quantum behavior from classical-like coarse-grained bridge behavior. These results suggest that classical two-time-conditioned entropy behavior is not recovered by quantizing the chamber variable alone, but can emerge statistically from closed quantum.

02.
arXiv (quant-ph) 2026-06-15

Sensitivity of polaron-molecule observables to MDR/GUP-like ultraviolet deformations at low energies via quantum computing

arXiv:2606.14479v1 Announce Type: new Abstract: We show that impurity many-body observables can display enhanced sensitivity to ultraviolet deformations of generalized-uncertainty-principle and modified-dispersion-relation type at accessible energy scales. Using a deformed polaron-molecule Hamiltonian constructed to preserve the infrared sector, we quantify the impact of such deformations on spectral and Ramsey observables and implement the corresponding dynamics in a controlled quantum computing setting. We identify regimes near the polaron-molecule crossover where small ultraviolet deformations are strongly amplified, leading to experimentally resolvable changes in quasiparticle properties and spectral response. Our results establish a concrete sensitivity-based route to low-energy quantum-gravity phenomenology in a well-defined many-body platform and delimit the validity of the effective description. Furthermore, we report experimental validation on the QRed superconducting quantum processor (BSC-CNS).

03.
arXiv (CS.AI) 2026-06-24

Sensing Intelligence as a Trainable Metamaterial Property

arXiv:2605.23967v2 Announce Type: replace-cross Abstract: In biological systems, sensing is not performed by the brain alone: the body deforms, vibrates, and filters external stimuli before they are transduced into neural signals. In engineered systems, this processing burden is placed largely on electronics and computation, while the mechanical body is usually designed only for strength and stability. Here, we present sensing intelligence as a trainable property of the body. We show that the geometry of a metamaterial can be optimized to reshape external stimuli into internal signals that are easier for a neural network to interpret. Rather than hand-designing this physical preprocessing, we let the neural network train its own body for sensing by backpropagating the sensing loss to the body's design parameters through differentiable simulation. Across numerical and experimental sensing scenarios, the optimized body improves sensing accuracy by up to fivefold or reduces the number of required electronic sensors by nearly an order of magnitude.

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

See-and-Reach: Precise Vision-Language Navigation for UAVs within the Field of View

arXiv:2606.20045v1 Announce Type: cross Abstract: UAV Vision-Language Navigation (UAV-VLN) is typically formulated as a holistic search-and-reach problem, where long-range target discovery and final target approach are optimized and evaluated jointly. This formulation makes it difficult to assess a critical capability of aerial embodied agents, namely whether a UAV can accurately ground a visible target and translate vision-language evidence into precise 3D motion once the target enters its field of view. To address this limitation, we introduce UAV-VLN-FOV, a target-visible navigation task that isolates the see-and-reach stage and enables a more diagnostic evaluation of terminal reaching ability. We further propose 3DG-VLN, a vision-language waypoint prediction framework guided by dynamic 3D direction cues to enhance fine-grained visual grounding and spatial direction alignment for precise target reaching. Specifically, 3DG-VLN adaptively processes high-resolution front-view and downward-view observations to preserve fine-grained visual and geometric details for target grounding. It also updates the target-relative direction online during closed-loop navigation, allowing the agent to maintain spatial alignment with the target and reduce accumulated direction drift. To support this task, we construct a dedicated high-resolution benchmark which contains 2,717 trajectories with target-oriented high-level instructions, high-resolution front-view and downward-view egocentric observations, and continuous 3D waypoint annotations. Experiments show that 3DG-VLN outperforms competitive UAV-VLN baselines, achieving a 13.82\% improvement in success rate. Real-world trials further demonstrate the potential of 3DG-VLN for practical see-and-reach navigation. The source code and benchmark are available at https://github.com/xuefanfu/3DG-VLN.

05.
medRxiv (Medicine) 2026-06-11

What level of expertise is necessary to generate ACLS training test questions: pre-med students vs. artificial intelligence?

Abstract Introduction In-hospital cardiac arrest carries high mortality despite standardized ACLS training. Educators face increasing time constraints in developing assessment tools for ACLS training. Two possible solutions to this problem are using pre-medical students or using artificial intelligence to generate test questions. This study compared the quality of pre-medical student-generated ACLS test questions vs. AI-generated ACLS test questions, testing the hypothesis that AI-generated questions are non-inferior to student-generated questions. Methods Ten pre-medical students created ACLS questions following predefined criteria, while an AI model (Northwell's Artificial Intelligence Hub) generated comparable questions. A blinded ACLS-certified physician evaluated questions on the qualities of Alignment, Clarity, Cognitive Level, and Question Design using a standardized rubric (Likert scale: 1 = poor quality, 5 = excellent). Student's T-test and Chi-square analysis were used to compare the quality of questions on different rubric domains within each arm (student vs. AI) and within one domain (eg, question Clarity) between arms. The Student's T test was used when 2 comparator groups were compared (eg, Clarity of student-generated vs. AI-generated questions) within one arm. The ANOVA test was used when comparing more than 2 comparator groups (eg, Alignment vs. Clarity vs. Cognitive Level) within one arm. Statistical significance was set as a priority at p

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

Cross-Attention Multimodal Learning for Predicting Response to Neoadjuvant Imatinib in Gastrointestinal Stromal Tumors: A Multicenter Retrospective Study

Background: Response to neoadjuvant imatinib in gastrointestinal stromal tumors (GISTs) is highly variable and cannot be reliably predicted using current clinical or molecular markers. This study developed and evaluated an explainable multimodal deep learning framework integrating computed tomography (CT) imaging and clinical variables to predict treatment response. Methods: Patients from four tertiary centers were retrospectively included between 2000-2023 in independent pretraining (n=935) and prediction (n=213) cohorts. A cross-attention framework integrating clinical variables and tumor-centered CT imaging was developed to predict response to neoadjuvant imatinib. Two training strategies were evaluated: (1) self-supervised pretraining with low-rank adaptation and (2) training from scratch. Hyperparameters were optimized using SMAC3. Performance was assessed through internal cross-validation and external testing. Ablation analyses and attention-based explanations were used to quantify modality contributions. Results: Among 213 patients (54.5% responders), responders had larger tumors (112 vs. 89 mm, P=0.026), higher mitotic index (3 vs. 0, P

07.
arXiv (CS.CL) 2026-06-18

Trust Region On-Policy Distillation

On-Policy Distillation (OPD) is a fundamental technique for efficient post-training of large language models (LLMs), with broad applications in agent learning, multi-task enhancement, and model compression. However, OPD training becomes unstable when the teacher and student distributions differ substantially, as teacher supervision on student-generated tokens may yield unreliable policy gradients and even cause optimization failure. This work addresses reliable on-policy token-level supervision through credit assignment strategies, and proposes Trust Region On-Policy Distillation, TrOPD. It features the following characteristics: 1) Trust-Region On-Policy Learning: TrOPD performs OPD only in regions where the teacher provides reliable supervision, mitigating the optimization difficulty of the K1 reverse-KL estimator under distribution mismatch. 2) Outlier Estimation: For outlier regions, we explore gradient clipping, masking, and forward-KL estimation to reduce the adverse effects of unreliable supervision. 3) Off-Policy Guidance: The student continues generation from teacher prefixes and uses forward KL to imitate off-policy guidance, encouraging on-policy exploration toward reliable regions. Experiments show that TrOPD consistently outperforms SoTA OPD baselines, including OPD, EOPD, and REOPOLD, across mathematical reasoning, code generation, and general-domain benchmarks.

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

Federated Foundation Language Model Post-Training Should Focus on Open-Source Models

arXiv:2505.23593v4 Announce Type: replace Abstract: Post-training of foundation language models has emerged as a promising research domain in federated learning (FL) with the goal to enable privacy-preserving model improvements and adaptations to user's downstream tasks. Recent advances in this area adopt centralized post-training approaches that build upon black-box foundation language models where there is no access to model weights and architecture details. Although the use of black-box models has been successful in centralized post-training, their blind replication in FL raises several concerns. Our opinion is that using black-box models in FL contradicts the core principles of federation such as data privacy and autonomy. In this paper, we critically analyze the usage of black-box models in federated post-training, and provide a detailed account of various aspects of openness and their implications for FL.

09.
arXiv (CS.CL) 2026-06-24

From Task-Guided Conversational Graphs to Goal-Oriented Dialogue Runtimes

Graph and multi-agent orchestration frameworks make production large language model (LLM) workflows practical, but they do not by themselves solve conversational continuity when users maintain several interdependent objectives. This conceptual systems paper focuses on the high-complexity end of that design space, where goals can be suspended, resumed, revised, and invalidated by actions in other goals. We introduce the Goal-Oriented Dialogue Runtime (GODR), a framework-neutral design pattern that treats goals, task frames, lifecycle state, invalidation rules, and resumption contracts as first-class runtime objects while delegating bounded execution to graph runtimes, agents, tools, or application programming interfaces (APIs). GODR is not proposed as a replacement for workflow graphs in simple guided processes; it is intended for complex, multi-domain, interruptible conversations where objective continuity cannot be recovered reliably from agent identity, chat history, or execution-graph position alone. The paper formalizes the problem, proposes runtime objects and architecture-selection criteria, and frames evaluation as an agenda for future empirical validation rather than as a measured performance claim.

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

Mask Proposal Voting Based on Geodesic Framework for Robust Image Segmentation

Despite great advances, finding accurate segmentation remains a challenging task, especially in scenarios with cluttered backgrounds, complex intensity variations and topology appearance. Minimal path models have exhibited their strong ability in addressing image segmentation tasks. However, the performance of minimal paths-based segmentation approaches is heavily influenced by model initialization, hence limiting their application scope in practice. In this work, we propose a novel mask proposal voting framework that overcomes the major drawback of classical approaches, allowing robust segmentation even in complicated scenarios. Firstly, we introduce an efficient method for constructing adaptive domain cuts as a constraint for initializing the region-based min-cut evolution, by which diverse and reliable mask proposal candidates can be generated, substantially increasing the possibility of accurately covering the objective region by these proposals. Secondly, we propose a new mask voting scheme to build a voting score map encoding the final segmentation information. In contrast to classical path voting methods, our model allows incorporating priors to assign different importance to each individual mask. As a consequence, the proposed segmentation model is capable of accurately delineating object boundaries under complex scenarios, and is insensitive to initialization. Experiments demonstrate that our method consistently outperforms state-of-the-art minimal path-based approaches in both accuracy and robustness.

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

Crystalline Spectral Form Factors

arXiv:2512.11054v3 Announce Type: replace Abstract: We investigate crystalline-like behavior of the spectral form factor in unitary quantum systems with extremely strong eigenvalue repulsion. Using a low-temperature Coulomb gas as a model of repulsive eigenvalues, we derive the Debye-Waller factor suppressing periodic oscillations of the spectral form factor and estimate the order of its singularities at multiples of the Heisenberg time. We also reproduce this crystalline-like behavior using perturbed permutation circuits and random matrix ensembles associated with Lax matrices. Our results lay a foundation for future studies of quantum systems that exhibit intermediate level statistics between standard random matrix ensembles and permutation circuits.

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

Feasibility-driven QAOA with penalty scheduling

arXiv:2606.25117v1 Announce Type: new Abstract: Most available quantum algorithms address constrained optimization problems by treating constraints as soft penalty terms within a QUBO formulation. This approach requires careful adjustment of the penalty coefficients, which scales poorly with the number of constraints and lacks a proper strategy to balance feasibility and solution quality. In this work, we introduce two extensions of standard linear-ramp QAOA (lr-QAOA) tailored to problems with multiple heterogeneous constraints. We first construct $\Lambda$-lr-QAOA, in which each penalty term is assigned its own linear-ramp schedule, promoting penalty weights from external hyperparameters to internal variational parameters of QAOA, similarly to the objective and mixer parameters. By optimizing all schedules jointly in a single run, this approach eliminates nested penalty tuning and scales more efficiently to multiple constraints. The optimization is guided by a feasibility-driven loss function that pushes the quantum state towards high-quality feasible solutions. As a further refinement, we introduce piecewise-ramp QAOA, in which the linear ramps are replaced by two-segment piecewise schedules, enhancing the expressiveness of the Ansatz at the cost of a small parameter overhead independent of the circuit depth. We benchmark both methods on Earth-observation satellite mission planning tasks formulated as budget-constrained Maximum Weight Independent Set problems. Numerical results show that piecewise-ramp QAOA consistently outperforms lr-QAOA and $\Lambda$-lr-QAOA across circuit depths and system sizes. Furthermore, both $\Lambda$-lr-QAOA and piecewise-ramp QAOA exhibit a high feasibility rate, which is crucial in industrial applications. Our analysis highlights an intrinsic feasibility-optimality trade-off, which we address by introducing a filtered variant of the loss providing a single hyperparameter to tune this balance.

13.
arXiv (CS.AI) 2026-06-16

MemPO: Self-Memory Policy Optimization for Long-Horizon Agents

arXiv:2603.00680v4 Announce Type: replace Abstract: Long-horizon agents face the challenge of growing context size during interaction with environment, which degrades the performance and stability. Existing methods typically introduce the external memory module and look up the relevant information from the stored memory, which prevents the model itself from proactively managing its memory content and aligning with the agent's overarching task objectives. To address these limitations, we propose the self-memory policy optimization algorithm (MemPO), which enables the agent (policy model) to autonomously summarize and manage their memory during interaction with environment. By improving the credit assignment mechanism based on memory effectiveness, the policy model can selectively retain crucial information, significantly reducing token consumption while preserving task performance. Extensive experiments and analyses confirm that MemPO achieves absolute F1 score gains of 25.98 over the base model and 7.1 over the previous SOTA baseline, while reducing token usage by 67.58% and 73.12%. The code is released at https://github.com/TheNewBeeKing/MemPO.

14.
arXiv (CS.CV) 2026-06-11

PIGEON: VLM-Driven Object Navigation via Points of Interest Selection

Object navigation in unseen indoor environments requires agents to perform semantic search under partial observability. Vision-language models (VLMs) provide strong semantic-spatial priors for this task, but how to interface them with robot navigation remains challenging: dense VLM inference is expensive, while abstracting environments into symbolic memories often separates high-level reasoning from the raw visual evidence that supports it. We propose we propose PIGEON (Point of Interest Guided Exploration for Object Navigation), a VLM-driven framework that formulates object navigation as raw-observation-grounded sparse decision problem. PIGEON introduces Points of Interest (PoIs) as sparse visual decision units that couple geometrically executable waypoints with raw egocentric observations. Rather than using VLMs as dense controllers or restricting them to frontier ranking, PIGEON enables VLMs to select among task-critical PoIs, including exploration frontiers, suspected target objects, traversable stairs, and floor-level summaries, while low-level planners execute continuous motion between them. This PoI interface further makes high-level navigation decisions verifiable, allowing us to develop an RLVR pipeline that improves local VLMs without manual Chain-of-Thought annotations. Extensive experiments on Habitat ObjectNav benchmarks show that PIGEON achieves state-of-the-art zero-shot performance, scales consistently with foundation model capacity, and transfers to Active Embodied Question Answering with only prompt modifications. Real-world deployments on physical robots further demonstrate its robustness and efficiency.

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

Code-Augur: Agentic Vulnerability Detection via Specification Inference

arXiv:2606.18619v1 Announce Type: cross Abstract: The advent of agentic vulnerability detection is already becoming a watershed moment for software security. Audits conducted entirely by autonomous LLM agents are uncovering critical vulnerabilities in fundamental software underpinning digital society. Many of these vulnerabilities remained masked for years, surfacing only now with AI agents. Yet the reasoning behind these discoveries remains alarmingly opaque and unvalidated. What assumptions did the agent make about a function's inputs when it deemed that function to be secure? Failures in reasoning and incorrect assumptions can lead to missed vulnerabilities and reduce trust in agentic analysis. We propose a security-specification-first paradigm that (1) exposes the agent's tacit assumptions explicitly as security specifications and (2) continuously refines those specifications via runtime falsification. We realize our approach in Code-Augur, a novel harness for agentic vulnerability detection. Given a codebase, Code-Augur analyzes each component of the system for vulnerable code. When it deems a component to be secure, it commits the local invariants behind that judgment as in-source assertions. In parallel, Code-Augur leverages a guided fuzzer to attempt to falsify those assumptions. When the fuzzer triggers an assertion, this either reveals a genuine vulnerability or a flawed specification to refine. In both cases, this process grounds the agent's understanding, aligning its view of code intent with how the code actually behaves. On real-world subjects, Code-Augur effectively leverages security specifications to detect more vulnerabilities than other state-of-the-art agents. Additionally, Code-Augur found 22 new vulnerabilities in key open-source projects. Compared to curated specialized models like Claude Mythos, Code-Augur offers effective agentic vulnerability detection built on widely available LLMs like Sonnet and DeepSeek.

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

ST-DiffEye: Diffusion-based Continuous Gaze Generation via Joint Scanpath-Trajectory Modeling

We study the problem of human gaze modeling, which aims to generate the gaze patterns a viewer produces while observing a visual stimulus. Gaze is primarily captured through two modalities: continuous eye-tracking trajectories, which describe fine-grained motion dynamics, and discrete scanpaths, which describe high-level fixation structure. Because gaze varies substantially across viewers and trials, we treat this variability as a defining property rather than noise and model gaze as a stochastic generative process. Existing generative gaze models supervise on only one of these two representations in isolation. We hypothesize that trajectories and scanpaths describe gaze at complementary scales and are jointly informative during training, and test this hypothesis through ST-DiffEye, a joint trajectory-scanpath diffusion framework that couples both modalities by concatenating them as an additional raw input channel, requiring no architectural overhead beyond an input and output channel expansion. We further introduce a principled evaluation framework based on the Continuous Ranked Probability Score (CRPS), which generalizes any existing sequence similarity metric into a proper scoring rule that jointly assesses the accuracy and diversity of generated gaze. Experiments on task-driven visual search, covering both target-present and target-absent scenarios, and on free-viewing benchmarks demonstrate state-of-the-art performance. These results, along with detailed ablations, confirm the benefit of joint modeling and the value of distribution-aware evaluation in capturing the intrinsic variability of human gaze. Project webpage: https://st-diffeye.github.io/

17.
arXiv (quant-ph) 2026-06-11

Experimental straintronics in nanotube quantum dots

arXiv:2606.12180v1 Announce Type: cross Abstract: Single-wall carbon nanotubes (SWCNTs) are narrow ribbons of graphene with atomically precise edges and a single quantum transport channel, at experimentally-relevant dopings. This makes them ideal systems to harness quantum transport straintronics (QTS), i.e. using mechanical strain to control accurately quantum transport. We present QTS data from three single-wall carbon nanotube quantum dot (SWCNT-QD) transistors over a broad range of in-situ tunable and reversible uniaxial strain ($\Delta\varepsilon_mech\approx$ 0 to 3 %). We first present the nanofabrication of the suspended SWCNT transistors whose channel lengths are $\approx$ 30 nm. The channels are strained by moving gold clamps holding firmly the nanotubes. We present detailed charge transport data, $dI/dV_{B} - V_{B} - V_{G}$ and $dI/dV_{B} - V_{B} - \Delta\varepsilon_mech$, showing a large mechanical-gating effect of the SWCNT-QDs. The precise reversibility of the data, and their agreement with QTS theory, confirms that the tubes are strained elastically. We demonstrate that the mechanical control of the QD doping is not due to capacitive-gating effects, but to quantitatively predictable bandstructure changes including a strain-tunable bandgap. This precise mechanical control of the doping and bandgap of SWCNT-QDs could find applications in qubits, condensed matter physics, and homojunction molecular transistors.

18.
arXiv (quant-ph) 2026-06-19

Resolving problems with the continuum limit in coherent-state path integrals

arXiv:2602.02466v2 Announce Type: replace Abstract: The paper solves the problem of continuum limit in bosonic thermal coherent-state path integrals. For this purpose, exact discrete versions of the path integral are constructed for three different orderings of the Hamiltonian: normal, anti-normal and symmetric (Weyl order). Subsequently, their different continuum versions are checked on the harmonic oscillator, to choose the symmetric ordering as a possibly correct choice for all polynomial Hamiltonians. Spotted mathematical subtleties in the simple case serve as a clue to the general solution. Finally, a general justification for the symmetric order is provided by deriving the continuum path integral starting from the exact discrete case using a renormalization procedure in the imaginary time frequency domain. While the role of Weyl order has already been found, the paper provides the missing proof of its suitability for every polynomial Hamiltonian and simplifies the previously established construction by referring only to creation and annihilation operators (without position and momentum operators).

19.
arXiv (CS.LG) 2026-06-17

Learning in Matching Games with Bandit Feedback

arXiv:2506.03802v2 Announce Type: replace Abstract: We introduce a learning problem in a generalized two-sided matching market, where agents select actions to interact with their match. Specifically, we consider a setting in which matched agents engage in zero-sum games with initially unknown payoff matrices, and we investigate whether a centralized procedure can learn an equilibrium from bandit feedback. We adopt the solution concept of a matching equilibrium, where a matching \( \mathfrak{m} \) and a set of agent strategies \( X \) form an equilibrium if no agent has an incentive to deviate from \( (\mathfrak{m}, X) \). To quantify deviations of a candidate solution \( (\mathfrak{m}, X) \) from the equilibrium \( (\mathfrak{m}^\star, X^\star) \), we introduce the notion of matching instability, which serves as a regret measure for the learning problem. We propose a UCB-based algorithm in which agents form preferences and select actions according to optimistic estimates of the payoffs. Our analysis establishes a sublinear, instance-independent regret upper bound, further supported by empirical evidence.

20.
arXiv (CS.CL) 2026-06-25

Narrative Feature or Structured Feature? A Study of Large Language Models to Identify Cancer Patients at Risk of Heart Failure

Cancer treatments are known to introduce cardiotoxicity, negatively impacting outcomes and survivorship. Identifying cancer patients at risk of heart failure (HF) is critical to improving cancer treatment outcomes and safety. This study examined machine learning (ML) models to identify cancer patients at risk of HF using electronic health records (EHRs), including traditional ML, Time-Aware long short-term memory (T-LSTM), and large language models (LLMs) using novel narrative features derived from the structured medical codes. We identified a cancer cohort of 12,806 patients from the University of Florida Health, diagnosed with lung, breast, and colorectal cancers, among which 1,602 individuals developed HF after cancer. The LLM, GatorTron-3.9B, achieved the best F1 scores, outperforming the traditional support vector machines by 39%, the T-LSTM deep learning model by 7%, and a widely used transformer model, BERT, by 5.6%. The analysis shows that the proposed narrative features remarkably increased feature density and improved performance.

21.
medRxiv (Medicine) 2026-06-12

Metastatic Patterns and Treatment Characteristics of Triple-Negative Breast Cancer in Nigeria: A Retrospective Cohort Study

Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype characterized by the absence of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression. It is associated with limited targeted treatment options, early relapse, and a high propensity for visceral metastasis. Data describing metastatic patterns and treatment characteristics of TNBC in Nigeria remain limited. Methods: This retrospective descriptive cohort study included 869 patients with TNBC managed at the Medserve-LUTH Cancer Center, Lagos University Teaching Hospital, Nigeria between June 2019 and June 2024. Demographic, clinicopathologic, metastatic, and treatment-related data were extracted from electronic medical records. Descriptive statistics were used to summarize patient characteristics, metastatic patterns, and treatment profiles. Associations between metastatic disease and selected clinicopathologic and treatment variables were explored using Pearsons chi-square test. Complete-case analysis was applied throughout. Results: The mean age at presentation was 52.09 {+/-} 12.26 years. Most patients were married (79.1%), postmenopausal (64.3%), and of Yoruba ethnicity (56.8%). Advanced disease predominated, with Stage III and Stage IV disease accounting for 42.9% and 35.6% of cases, respectively. Invasive ductal carcinoma was the most common histologic subtype (77.0%), while Grade II tumours constituted 51.3% of graded cases. Surgery was performed in 73.1% of patients, predominantly mastectomy (70.9% of surgical procedures). Chemotherapy was administered to 83.2% of patients, most commonly anthracycline-based regimens (41.8%), while radiotherapy was delivered to 63.5% of patients, with hypofractionated schedules of 42-43 Gy in 15-16 fractions accounting for 47.2% of radiotherapy courses. Metastatic disease was documented in 32.9% of evaluable patients. Lung metastasis was the most frequent site (62.5%), followed by bone (46.3%), regional lymph node invasion (38.5%), liver (23.0%), and brain (22.6%). Tumour grade and histologic subtype were not significantly associated with metastatic disease, whereas radiotherapy exposure demonstrated a significant association with metastatic status ({chi}{superscript 2} = 10.35, p = 0.001). Conclusion: TNBC in this Nigerian cohort was characterized by advanced-stage presentation, invasive ductal predominance, extensive use of multimodality treatment, and substantial visceral metastatic burden. Lung metastasis was the most common metastatic site. These findings provide contemporary real-world data on TNBC in Nigeria and highlight the continuing need for earlier diagnosis, timely referral, and sustained investment in comprehensive cancer care services.

22.
PLOS Medicine 2026-05-08

Climate change and non-communicable diseases: An invisible syndemic

by Gokul Parameswaran, Sadeer Al-Kindi, Sanjay Rajagopalan Climate change accelerates non-communicable diseases (NCDs) through cascading environmental disruptions and is attributed to driving increased NCD-related mortality. Yet this syndemic remains invisible and underfunded. We detail why addressing the climate-NCD intersection is critical for improving health. In this Perspective, Sanjay Rajagopalan and colleagues discusses how climate change accelerates non-communicable diseases (NCDs) and exacerbates NCD-related mortality, and calls for greater visibility and funding to address this syndemic and improve human health.

23.
medRxiv (Medicine) 2026-06-18

Effectiveness and Safety of Bempedoic Acid Across Clinically Relevant Subgroups: Insights from the CLEAR Taiwan Study

Background Despite available lipid-lowering therapies (LLT), many patients fail to achieve low-density lipoprotein cholesterol (LDL-C) targets. This gap persists across clinically relevant subgroups. Bempedoic acid has demonstrated effective LDL-C lowering with a favorable safety profile in the CLEAR Taiwan study; however, its effects across subgroups in Asian populations remains limited. Methods The phase IV CLEAR Taiwan study (NCT06925100) enrolled patients with inadequately controlled hypercholesterolemia who received bempedoic acid for 12 weeks in addition to background LLT. This analysis evaluated changes in lipid parameters, high-sensitivity C-reactive protein (hsCRP), and safety outcomes in clinically relevant subgroups, including cardiovascular risk, diabetes, age, statin tolerance, and sex. Results A total of 180 patients were included. Bempedoic acid achieved significant LDL-C reductions in all subgroups. Numerically greater LDL-C reductions were observed in primary prevention, statin-intolerant, younger (< 65 years), and female patients, while comparable reductions were observed across diabetes status. Reductions in non-high-density lipoprotein cholesterol, total cholesterol, and apolipoprotein B were consistent with LDL-C findings. Significant decreases in hsCRP were observed in all subgroups, with numerically greater reductions in patients aged < 65 years and those without diabetes. Bempedoic acid was well tolerated, with a low incidence of adverse events and no new safety signals identified. Changes in liver enzymes, renal function, and uric acid were minimal within subgroups. Conclusion Subgroup analyses from the CLEAR Taiwan study demonstrate consistent efficacy and safety of bempedoic acid across clinically relevant subgroups and support its use as a flexible option to address residual gaps in lipid management.

25.
arXiv (CS.AI) 2026-06-16

Posterior Twins: Distributional Behavioral Simulation for Enterprise Decisions

作者:

arXiv:2606.16415v1 Announce Type: new Abstract: Enterprise behavioral simulation requires more than producing a plausible response. Many decisions depend on the shape of a population under a proposed action: which segments accept, defect, hesitate, or move into risk-sensitive states. This paper introduces Posterior Twins, a memory-grounded digital-twin approach that represents likely behavior as an updated distribution under a specific decision context. We evaluate a family of Twinning Labs behavioral-model operating points on a 226-example held-out behavioral-response benchmark and report both modal accuracy and Wasserstein-1 distance. The results show that modal accuracy and distributional fidelity identify different operating regimes. TL-Twin Alpha achieves the lowest observed Wasserstein-1 distance in the reported result set ($W_1 = 1.16$), while TL-Twin Delta and TL-Twin Gamma provide balanced operating points near the modal-accuracy frontier. The paper frames these results as a systems result: governed memory, behavioral model routing, scenario orchestration, distributional aggregation, and auditability are necessary for turning simulated behavior into reusable enterprise decision evidence.