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

Robust Regularized Policy Iteration under Transition Uncertainty

arXiv:2603.09344v3 Announce Type: replace Abstract: Offline reinforcement learning (RL) enables data-efficient and safe policy learning without online exploration, but its performance often degrades under distribution shift. The learned policy may visit out-of-distribution state-action pairs where value estimates and learned dynamics are unreliable. To address policy-induced extrapolation and transition uncertainty in a unified framework, we formulate offline RL as robust policy optimization, treating the transition kernel as a decision variable within an uncertainty set and optimizing the policy against the worst-case dynamics. We propose Robust Regularized Policy Iteration (RRPI), which replaces the intractable max-min bilevel objective with a tractable KL-regularized surrogate and derives an efficient policy iteration procedure based on a robust regularized Bellman operator. We provide theoretical guarantees by showing that the proposed operator is a $\gamma$-contraction and that iteratively updating the surrogate yields monotonic improvement of the original robust objective with convergence. Experiments on D4RL benchmarks demonstrate that RRPI achieves strong average performance, outperforming recent baselines including percentile-based methods on the majority of environments while remaining competitive on the rest. Moreover, RRPI exhibits robust performance by aligning lower $Q$-values with high epistemic uncertainty, which prevents the policy from executing unreliable out-of-distribution actions.

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

Geometry-Aware Superpixel Graph Transformer with Metadata for Skin Lesion Classification

Automated skin cancer classification from dermoscopic images remains challenging due to heterogeneous lesion structure, strong intra-class variability, and subtle visual differences between benign and malignant cases. Existing CNN/ViT pipelines typically rely on global or patch-level features and often combine patient metadata via late fusion, which limits spatially grounded multimodal reasoning. We present a novel region-based graph learning framework that explicitly models lesions as graphs of spatially coherent superpixel regions represented as frozen CNN features. To capture fine-grained lesion arrangements, we encode inter-regional geometry as edge attributes and introduce a dedicated metadata context node connected to all regions, providing structured integration of demographic/clinical variables within the same relational space. Node representations are updated using our edge-aware graph transformer followed by attention-driven propagation, and a final graph-level embedding for benign-malignant classification. Experiments on four public benchmarks demonstrate that explicit region-level relational modeling and graph-native multimodal fusion yield consistent gains over the state-of-the-art. Consequently, we establish a new graph-centric perspective in which CNN features are modeled as relational nodes and improved through contextual integration, yielding more expressive and robust classifications.

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

Formalizing and Mitigating Structural Distortion in LLM Attention for Zero-Shot Graph Reasoning

arXiv:2606.15633v1 Announce Type: new Abstract: Large Language Models (LLMs) have shown promise for reasoning over Text-Attributed Graphs (TAGs). However, applying LLMs to graphs requires linearizing their structure into sequences, introducing distortion rooted in the graph bandwidth problem. While this distortion has been shown to degrade performance, it is often attributed to prompt design or model scale, leaving the underlying mechanism unclear. In this work, we show how rotary positional embeddings turn graph linearization into bandwidth-dependent attention decay, suppressing attention between graph-adjacent nodes that are forced far apart in the serialized sequence. This shifts the focus of LLM-based graph reasoning from prompt engineering and scaling toward correcting attention misalignment. Motivated by this analysis, we propose Graph-aligned Language Attention (GaLA), a lightweight, inference-time modification for LLMs. GaLA biases attention toward graph-adjacent nodes while preserving the LLM's sequential inductive biases. Across TAG benchmarks, GaLA improves performance with negligible overhead, demonstrating that distortion is a correctable bottleneck in LLM-based graph reasoning.

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

Forced Deferral: Manipulating Routing Decisions in Multimodal LLM Cascades

arXiv:2606.15308v1 Announce Type: new Abstract: While multimodal large language models (MLLMs) have shown strong visual reasoning abilities, serving a large model for every query is computationally expensive. MLLM cascades mitigate this cost by first querying a weak but cheaper model and deferring to a strong model when the weak model's output is unconfident. However, since the weak model's confidence directly controls compute allocation, these systems expose a new attack surface: an adversary can manipulate confidence so that their queries are consistently deferred to the strong model. Motivated by this vulnerability, we introduce the Forced Deferral Attack (FDA), an adversarial image attack that lowers the weak model's confidence and causes cascades to route queries to the strong model. FDA learns a universal border trigger by optimizing a temperature-flattened objective. This objective pushes the weak model's token distribution on triggered inputs toward less concentrated targets constructed from its clean responses. Across datasets, model families, and deferral metrics, FDA consistently increases strong-model routing while outperforming image-perturbation and prompt-injection baselines. These results show that MLLM cascades are vulnerable to attacks that manipulate compute allocation, forcing unintended strong-model usage without directly targeting answer correctness.

07.
arXiv (CS.AI) 2026-06-15

Learning Urban Access Costs from Origin-Destination Flows via Inverse Optimal Transport

arXiv:2606.14157v1 Announce Type: cross Abstract: Cities deliver basic services through mixed public-private facility networks, including schools, clinics, transit providers, and subsidized service points. In these systems, planners often observe where households go, but not the latent cost function through which they trade off factors such as distance, price, and institutional access. We study this urban problem through school choice in the Philippines, where the country's largest national education subsidy is intended to redirect learners from congested public schools to participating private schools. Treating school-to-school enrollment flows as an entropic optimal transport plan, we recover latent choice costs using two complementary inverse optimal transport models: an interpretable distance-banded model with a subsidy term, and a neural cost model trained through a differentiable Sinkhorn forward pass. Applied to 283{,}016 learner trips across 23{,}820 observed flows in the most populated region, the framework estimates a subsidy-equivalent distance, $\lambda^{(k)}$, interpreted as the kilometers of perceived travel cost offset by the subsidy. The case demonstrates how administrative origin-destination data can be transformed into interpretable planning metrics for accessibility-aware subsidy design, facility siting, and urban service allocation.

08.
arXiv (quant-ph) 2026-06-17

Time-spectral control of accidental coincidences in daylight entanglement-based free-space QKD

arXiv:2606.17365v1 Announce Type: new Abstract: Daylight entanglement-based free-space quantum key distribution (QKD) is limited by accidental coincidences from receiver-admitted background light. We develop and experimentally validate a receiver-level framework linking receiver bandwidth, accepted temporal width, and background-noise density to Bob singles, sifted-key rate, error rate, and quantum bit error rate (QBER) in telecom-wavelength BBM92 QKD. Indoor sweeps show that useful sifted counts saturate near the source-matched bandwidth, whereas broader bandwidth or higher background mainly increases accidental contamination. Increasing the accepted temporal width leaves Bob singles nearly unchanged but directly raises QBER by enlarging the random-overlap probability. A two-dimensional design map shows that the temporal-window margin contracts rapidly with increasing background-to-signal ratio, while the bandwidth margin remains comparatively broad near source-matched filtering. A 10 m rooftop daylight experiment demonstrates operation in the predicted low-accidental regime, yielding a mean sifted-key rate of 2,811 cps and a mean QBER of 4.43%.

09.
arXiv (CS.CV) 2026-06-17

4DSloMo: 4D Reconstruction for High Speed Scene with Asynchronous Capture

Reconstructing fast-dynamic scenes from multi-view videos is crucial for high-speed motion analysis and realistic 4D reconstruction. However, the majority of 4D capture systems are limited to frame rates below 30 FPS (frames per second), and a direct 4D reconstruction of high-speed motion from low FPS input may lead to undesirable results. In this work, we propose a high-speed 4D capturing system only using low FPS cameras, through novel capturing and processing modules. On the capturing side, we propose an asynchronous capture scheme that increases the effective frame rate by staggering the start times of cameras. By grouping cameras and leveraging a base frame rate of 25 FPS, our method achieves an equivalent frame rate of 100-200 FPS without requiring specialized high-speed cameras. On processing side, we also propose a novel generative model to fix artifacts caused by 4D sparse-view reconstruction, as asynchrony reduces the number of viewpoints at each timestamp. Specifically, we propose to train a video-diffusion-based artifact-fix model for sparse 4D reconstruction, which refines missing details, maintains temporal consistency, and improves overall reconstruction quality. Experimental results demonstrate that our method significantly enhances high-speed 4D reconstruction compared to synchronous capture.

10.
arXiv (CS.AI) 2026-06-18

Optimizing Lithium Production Decisions under Geological, Demand, and Pricing Uncertainties: A POMDP Framework for Multi-Objective Decision Making

arXiv:2606.18598v1 Announce Type: new Abstract: Decision making in lithium production is challenging, whether from an investor's perspective or a strategic production standpoint. Determining which mines to open and when to open them involves not only geological and price uncertainties, but also complexities around the choice of extraction method, from direct lithium extraction to hard rock mining. Prior work explored models of this problem and different methods to optimize mining decisions; these models did not account for uncertainty in pricing, uncertainty in demand, or different mining technologies to extract lithium. Incorporating different pricing models and extraction technology into these models enables more robust strategies for determining not only when and where to open a mine, but also which method of production to pursue. We frame the problem as a partially observable Markov decision process (POMDP) and solve using belief state planning methods to get optimal decision making. In our study, we show that POMDP solvers outperform human inspired heuristics by dynamically adapting to shifting lithium price regimes (static, linear, exponential, and stochastic) through belief state planning and explicit uncertainty management. By optimally sequencing exploration, production, and technology choice, the framework achieves higher demand fulfillment and more balanced economic environmental outcomes over the projects lifetime in all different pricing and deposit scenarios.

11.
arXiv (quant-ph) 2026-06-19

Optimizing resource allocation for accuracy in noisy variational quantum algorithms

arXiv:2606.20153v1 Announce Type: new Abstract: For quantum algorithms to achieve their full potential, we need methodologies to optimize them, such as reaching a given output accuracy with minimal resource costs. Here, we develop such a methodology for a class of Noisy Intermediate-Scale Quantum (NISQ) algorithms. We leverage simulations of a Variational Quantum Eigensolver (VQE) to propose a phenomenological model of such algorithms that captures the complex relationship between algorithmic accuracy, algorithmic resource costs, and the noise that exists in realistic quantum hardware. For this, we take the algorithmic resource cost to be the total number of quantum gate-operations in the algorithm; minimizing this cost typically makes the algorithm faster and more energy-efficient. We consider the subtle trade-off between quantum circuit size (small circuits are too imprecise, but large ones are too noisy), and the number of iterations of that quantum circuit for the full algorithm to sufficiently converge. Using a noise-metric-resource methodology, we identify the sweet spot (of circuit size versus iterations) that minimizes the algorithmic resource costs for a desired algorithm accuracy. It also gives the circuit size that maximizes algorithm accuracy for a fixed resource cost. Our methodology provides a practical guideline for near-term deployment of variational algorithms on realistic noisy hardware, including hardware that uses error mitigation.

12.
arXiv (CS.CV) 2026-06-15

Boundary-Centric Clip-Budgeted Active Learning for Temporal Action Segmentation

Temporal action segmentation (TAS) in untrimmed videos requires dense temporal supervision. However, most of the annotation cost is spent identifying action transitions where segmentation errors concentrate and small temporal shifts can disproportionately degrade segment-level metrics. We introduce B-ACT, a clip-budgeted active learning framework that explicitly allocates supervision to these error-prone boundary regions. B-ACT operates in a hierarchical two-stage loop: (i) it ranks and queries unlabeled videos using predictive uncertainty, and (ii) within each selected video, it detects candidate transitions from the current model predictions and selects the top-$K$ boundaries via a novel boundary score. The boundary score fuses neighborhood uncertainty, class ambiguity, and temporal prediction dynamics to reveal the underlying importance of each frame. Importantly, our annotation protocol requests labels only at the boundary frames while still training on boundary-centered clips to exploit temporal context through the model's receptive field. Extensive experiments on GTEA, 50Salads, and Breakfast demonstrate that boundary-centric supervision delivers strong label efficiency and consistently surpasses representative TAS active learning baselines and prior state of the art under sparse budgets. Gains are largest on datasets where performance is highly sensitive to boundary placement, as measured by edit and overlap-based F1 metrics.

13.
arXiv (CS.CL) 2026-06-15

Harsher on Male? Evaluating LLMs on Gender-Asymmetric Moral Framing Across Diverse Conflict Scenarios

Existing studies on gender bias in LLMs have largely focused on stereotypes, occupational associations, or explicit harmful outputs. In this work, we ask whether LLMs apply consistent response standards to the same negative behavior under matched male-actor and female-actor conditions. We introduce GAMA-Bench, a gender-mirrored benchmark of 1,298 scenarios covering intimate relationship and public social conflicts. It constructs gender-neutral misconduct templates through controlled grids and cross-model review, then compiles them into paired first-person prompts with matched actor-gender and role-reference variations. We further design a structured response-framing protocol to measure how models allocate punishment, empathy, escalation, instruction, and blame. Experiments on 10 representative LLMs reveal a consistent male-disadvantaging asymmetry: male actors receive more punitive, escalatory, and blame-centered framing, whereas female actors receive more therapeutic and empathy-oriented framing for the same misconduct. Further analyses show that this pattern persists across model families, scenario tracks, model scale, and explicit thinking-style reasoning. The official code is available at https://github.com/xufeiqiong/GAMA-Bench.

14.
arXiv (CS.CL) 2026-06-16

A Large-Scale Multi-Dimensional Empirical Study of LLMs for Conversation Summarization

Despite the significant advancement of LLMs in conversation summarization, their evaluation remains limited by insufficient scenarios, input lengths, and sample sizes. Furthermore, existing benchmarks often omit frontier reasoning systems and efficient small models, or lack fine-grained, multi-dimensional assessments. To bridge these gaps, we propose OmniCSEval, a unified benchmark comprising 1,800 diverse conversations across six real-world scenarios, featuring context lengths ranging from 128 to 32k tokens. For fine-grained evaluation, we employ a bidirectional fact-checking framework that integrates key fact matching to assess completeness and conciseness, alongside summary fact verification to evaluate faithfulness. To ensure reliable assessment, we establish a human-LLM collaborative pipeline for key fact extraction and a multi-LLM consensus verifier for summary fact decomposition. Leveraging this framework, we evaluate 28 LLMs across four distinct categories grouped by reasoning capability and model scale. Our extensive empirical study reveals critical insights regarding the cross-scenario challenges current LLMs continue to face, the impacts of reasoning and scale, and the efficiency and adaptability of reasoning models. We also provide guidance for system selection in real-world deployments.

15.
arXiv (CS.AI) 2026-06-16

Reward Hacking in Language Model Agents: Revisiting AI Safety Gridworlds

arXiv:2606.15385v1 Announce Type: new Abstract: Reward hacking, where AI systems exploit misspecified objectives to achieve high reward without satisfying intended goals, remains a central challenge in AI safety. Yet most known instances have been discovered post hoc in frontier systems where controlled study is impractical. We adapt the AI Safety Gridworlds framework into a text-based evaluation suite that reformulates classic reinforcement learning safety tasks for language-based agents. Across frontier and mid-scale models, we find that specification gaming emerges zero-shot: models systematically achieve high observed reward while underperforming on hidden safety objectives, and even apparently safe behaviors can reflect misunderstanding rather than principled safety. Reinforcement learning does not correct these failures: direct reward optimization widens the gap between observed and hidden reward, as the model's initial competence causes it to lock into locally rewarding strategies before discovering safer alternatives. This pattern persists across model scales (1.5B–14B) and is not resolved by finer credit assignment, exploration prompts, or entropy regularization. Our results show that reward hacking arises naturally when optimizing proxy objectives with capable language model agents and resists standard mitigations, suggesting that proxy-reward failures in agentic settings may require approaches beyond standard exploration and credit-assignment fixes. To facilitate reproducibility, the code for this work is available at \href{https://github.com/asparius/verl-agent-safety}{our public repository}.

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

Qwen-RobotWorld Technical Report: Unifying Embodied World Modeling through Language-Conditioned Video Generation

We introduce Qwen-RobotWorld, a language-conditioned video world model for embodied intelligence. With natural language as a unified action interface, it predicts physically grounded future visual trajectories from current observations across robotic manipulation, autonomous driving, indoor navigation, and human-to-robot transfer. This unified formulation provides three promising application directions: synthetic data generation for policy training augmentation, scalable virtual environments for policy evaluation, and language-guided planning signals for downstream robot control. This is achieved through a three-part design: a) Double-Stream MMDiT with MLLM Action Encoding, where a 60-layer double-stream diffusion transformer couples frozen Qwen2.5-VL semantics with video-VAE latents through layer-wise joint attention; b) Embodied World Knowledge (EWK), an 8.6M video-text corpus (200M+ frames) with action-language mapping over 20+ embodiments and 500+ action categories; and c) General+Expert Progressive Curriculum, a two-stage training strategy that first learns general visual priors and then injects embodied specialization under a shared language interface. Extensive results show strong competitiveness: ranks 1st overall on EWMBench and DreamGen Bench, outperforms all open-source models on WorldModelBench and PBench. Additional zero-shot analyses on RoboTwin-IF benchmark further support robust generalization and multi-view consistency.

17.
medRxiv (Medicine) 2026-06-18

Distinct Neuronal, Proliferative, and Secretory Pathways are Perturbed in Cancer Survivors with Depressive Symptoms

Introduction Depression is highly prevalent among cancer survivors and may be biologically distinct, although clinical studies investigating these mechanisms remain limited. Thus, the aims of this study were to (1) identify perturbed biological pathways associated with depressive symptom severity in cancer survivors, and (2) investigate whether these pathways are common or distinct to those perturbed in an age-matched non-cancer cohort. Methods We analyzed cross-sectional self-reported and transcriptomic data from the Multi-Ethnic Study of Atherosclerosis (PHD #39341). Cancer survivors and an age-matched non-cancer cohort (target ratio 1:2) were identified. The 20-item Center for Epidemiologic Studies Depression Scale (CES-D) was used to split participants into low (CES-D

18.
arXiv (CS.AI) 2026-06-17

FacProcessTwin: An LLM-Based System for Process Twin Development

arXiv:2606.17666v1 Announce Type: cross Abstract: Process twins provide real-time representations of entire production processes. By capturing how process steps interact, rather than monitoring a single machine in isolation as an asset-based digital twin does, they have the potential to drive efficiency gains across the whole process. However, developing a process twin is costly. It requires accurately modelling the entire production process: its process steps, the equipment and product-specific settings each step uses, and its process variations. The resulting model must then be bound to live operational data. We present FacProcessTwin, a system that leverages a large language model (LLM) to reduce this development time, building a process twin from a plant's process documentation and natural-language input from an operator. FacProcessTwin generates this complete process model and then automatically binds its process steps to live operational data. The generated model and its data bindings are rendered as an interactive process diagram through which manufacturing personnel can monitor and correct the system's autonomous decisions, such as resolving uncertainty at safety-critical binding steps. We evaluate FacProcessTwin through a real-world case study of an Australian food manufacturer, covering 16 production process flows that span chilled, frozen, and aseptic shelf-stable product categories and include process variations within the same product. The results show that FacProcessTwin generates these process models accurately (a mean F1 of 95.2% against ground truth) and builds each twin in roughly a sixth of the manual time. Its human-in-the-loop governance then keeps the safety-critical bindings correct: at ambiguous tags where a single-pass baseline silently mis-binds 75.0% of the time, FacProcessTwin defers to the operator and mis-binds none.

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

NeRD: Neuro-Symbolic Rule Distillation for Efficient Ontology-Grounded Chain-of-Thought in Medical Image Diagnosis

Interpretability is essential for trustworthy medical image diagnosis. However, existing concept-driven interpretable methods have key limitations: Concept Bottleneck Models (CBMs) require scoring all predefined concepts at inference time and for manual intervention, imposing a substantial burden on clinicians, while rationale-based generative approaches often select concepts by class discriminability, which can drift from diagnostic ontologies. To address these issues, we propose Neuro-Symbolic Rule Distillation (NeRD), a framework that produces efficient, ontology-grounded reasoning chains that are sufficient yet non-redundant, without manually crafting diagnostic rules. Experiments on two skin datasets demonstrate strong diagnostic performance and interpretability, and blinded expert evaluation confirms the clinical plausibility of NeRD rationales. Our method further enables a first expert-in-the-loop study for Multimodal Chain-of-Thought-based diagnosis, achieving efficient and effective concept-level intervention.

20.
arXiv (CS.AI) 2026-06-12

Prefill Awareness in Large Language Models

arXiv:2606.12747v1 Announce Type: new Abstract: Safety-relevant studies of language models, including alignment and jailbreaking evaluations and AI control protocols, often rely on prefilling model outputs. If AI models can recognize and act on the fact their prior assistant messages have been inserted or edited, the effectiveness and validity of these methods could be compromised. We investigate whether frontier language models can distinguish between tampered and untampered assistant-side context, a capability we call prefill awareness. To do so, we construct a binary preference benchmark across three prefill mechanisms, filtering for cases where models show consistent stances. We find that frontier models show substantial prefill awareness: Claude Opus 4.5 detects prefills opposing its preferences in 9-35% of cases with a 0% false positive rate when prompted; additionally, models often revert towards baseline behavior without explicitly reporting that the prefill was foreign. Controlled ablations later also show that detection and resistance rely on different cues, where stylistic mismatch mainly affects whether models flag a prefill as foreign, while preference mismatch mainly affects whether they revert toward their baseline answer. We also examine more realistic agentic settings such as misalignment-continuation evaluations and SWE-bench trajectories, where frontier models sometimes disavow prefilled assistant turns in ways that depend strongly on dataset, task success, and hidden formatting artifacts. Our results indicate that prefill awareness is already a substantial confound for some prefill-based methods. We recommend that model developers track this capability in frontier systems.

21.
arXiv (CS.AI) 2026-06-17

Prefill/Decode-Aware Evaluation of LLM Inference on Emerging AI Accelerators

arXiv:2606.17104v1 Announce Type: cross Abstract: As large language models (LLMs) are increasingly deployed in latency- and cost-sensitive settings, inference efficiency has become a central systems challenge. While GPUs dominate current deployments, a growing number of AI accelerators claim advantages for LLM inference, yet it remains unclear under which conditions such accelerators outperform GPUs in practice. Recent inference systems decompose execution into Prefill and Decode phases, which exhibit distinct computational characteristics and latency metrics, commonly captured by time to first token (TTFT) and time per output token (TPOT). This paper presents a phase-aware evaluation of LLM inference performance across GPUs and emerging AI accelerators using a common model, Llama2-7B. By separately measuring Prefill and Decode performance, we reveal that accelerator advantages differ by phase and metric. Our results show that GPUs consistently excel in the compute-intensive Prefill phase, while GroqRack achieves significantly lower TPOT during Decode (batching not currently supported). However, GPUs regain an advantage in Decode throughput as batch size increases. These findings demonstrate that each platform exhibits distinct phase-dependent strengths. We further analyze heterogeneous Prefill/Decode disaggregation across different accelerator platforms, identifying performance gains and the workload and network conditions under which such gains are realized.

22.
arXiv (CS.LG) 2026-06-18

Starter-Iterator Neural Operator: A Unified Architecture for High-Fidelity Forward and Inverse PDE Problems

arXiv:2606.18305v1 Announce Type: cross Abstract: Operator learning is an emerging interdisciplinary field that integrates machine learning with scientific computing. By mapping infinite-dimensional function spaces, this approach provides an efficient surrogate modeling framework for high-dimensional partial differential equations (PDEs). Compared to traditional numerical solvers, it achieves a superior trade-off between computational complexity and approximation accuracy, demonstrating significant advantages in many-query tasks such as real-time prediction and parameter sweeps. Given the stringent accuracy requirements of both forward simulation and inverse inference, as well as the precision bottlenecks of existing operator learning methods in handling complex boundaries or long-term evolution, we propose the Starter-Iterator Neural Operator (SINO). Our framework reinterprets the initialization strategies and iterative formats of traditional iterative methods through neural networks, establishing an efficient approach for spectral-spatiotemporal collaborative modeling. Specifically, the frequency-domain initialization module captures globally stable low-frequency features, while the time-domain learning module focuses on optimizing local solution residuals, thereby effectively overcoming the inherent limitations of conventional single-domain modeling approaches. Extensive experiments on typical dynamical systems such as the Navier-Stokes equations and acoustic wave equations, as well as practical applications including super-resolution imaging and weather forecasting, demonstrate that SINO achieves outstanding performance in numerical accuracy, generalization capability, and robustness.

23.
medRxiv (Medicine) 2026-06-17

Proteomics Uncovers Cryptic JPH2 Loss in Paediatric Dilated Cardiomyopathy

Despite recent advances in next-generation sequencing, genetic diagnostic rates for dilated cardiomyopathy (DCM) remain low. Among paediatric DCM, causes are often heritable, with a greater frequency of de novo, recessive and syndromic causes of disease. Novel diagnostic methods are therefore required to solve monogenic cases. To assess the value of proteomics as a diagnostic tool for paediatric DCM, we obtained left ventricle myocardial samples from paediatric patients undergoing heart transplantation at the Royal Children's Hospital, Melbourne. We performed genome sequencing and proteomics and leveraged this multi-omics dataset to uncover the molecular cause of disease in a gene elusive proband. The proband carried a heterozygous JPH2 frameshift variant identified on clinical exome sequencing. However, proteomic analysis showed a pronounced downregulation of JPH2, suggestive of biallelic loss-of-function. Closer inspection of the genomic data revealed a large inversion (~8.34 Mb) with a breakpoint falling within intron 5 of JPH2 that displaces the 3'UTR from the coding transcript. The two variants were confirmed to be in trans using long read DNA sequencing, consistent with a diagnosis of JPH2 autosomal recessive DCM. Finally, we applied RNA sequencing with total RNA library preparation to show that transcripts containing a 3'UTR were reduced to ~10% relative to controls. As a proof-of-principle, we present the first reported use of proteomics from explanted cardiac tissue to provide a genetic diagnosis. Our methodology has broad relevance to patients with genetically unsolved Mendelian diseases, who might undergo organ transplantation as part of clinical management.

24.
bioRxiv (Bioinfo) 2026-06-10

Promera: a unified model for biomolecular structure prediction, filtering, and design

Generative models have become staple tools for modeling and designing biomolecular structures. However, although these tools have improved in structural prediction accuracy, their ability to filter designed binders—an essential use case—remains insufficient; whereas design methods have focused more on unconstrained binder generation rather than capabilities enabled by controllable design. We introduce Promera, a unified generative model that combines all-atom structure prediction with improved filtering and controllable design. We find that Promera's confidence metrics are more accurate for filtering binders from non-binders for both miniproteins and nanobodies, while its co-folding performance surpasses popular open-source models (OpenFold3-p2, Boltz-2) on therapeutically relevant categories. As a design model, Promera generates binders by predicting masked protein sequences with optional epitope, paratope, and template constraints. Remarkably, our nanobody designs match the in silico success rates from backprop-based techniques (mBER) when evaluated under co-folding confidence filters. We further provide two in silico demonstrations of the the versatile capabilities of our design method: epitope targeting of the Andes hantavirus glycoprotein with VHHs and active state stabilization of the beta-2 andrenergic GPCR. We conclude by proposing a scaling law for co-folding models, suggesting a path for further performance improvement.

25.
medRxiv (Medicine) 2026-06-11

A Global Health Quality Improvement Project: Enhancing Cervical Cancer Awareness and screening in Nigeria

Background Cervical cancer remains a significant global public health challenge, ranking as the fourth most common cancer among women worldwide. According to The World Health Organization (WHO) 604,000 women were diagnosed with cervical cancer globally in 2020, with over 342,000 deaths amongst this group [1]. Despite its high mortality, cervical cancer is largely preventable through early detection and vaccination against human papillomavirus (HPV), which causes nearly all cases of cervical cancer [1,2] In Nigeria, it is the second most common cancer among women in Nigeria and a leading cause of cancer-related deaths, with low screening rates exacerbating late diagnoses and poor outcomes [1]. Despite global commitments to elimination with Pap smear screening and HPV vaccination, less than 10% of women in Nigeria have undergone screening due to misconceptions, stigma, and limited awareness. Educational interventions may improve awareness and promote screening behaviors. This global health quality improvement (QI) project aimed to enhance cervical cancer awareness and increase Pap smear uptake at the Central Bank of Nigeria (CBN) Clinic in Abuja, Nigeria. Methods In November 2024, we conducted a health education intervention at the Central Bank of Nigeria (CBN) through a structured educational session for male and female CBN staff members. The session focused on cervical cancer prevention, risk factors, and screening guidelines. Additionally, cervical cancer awareness was raised via email, social media, and electronic bulletin board. Participants completed pre and post-interventions surveys assessing cervical cancer knowledge across 10 key items and demographic characteristics. Pap smear uptake was assessed using the CBN clinic records for three months before and after the intervention. Institutional approval was obtained from CBN and external institutional review board approval was not required. Results 188 participants attended the health education session with 124 survey responses (70 pre-event, 54 post-event). Participants were mostly women aged 30-39. Post-intervention, eight of ten survey questions showed improved knowledge, with five demonstrating statistically significant gains: understanding Pap smear frequency (p