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01.
bioRxiv (Bioinfo) 2026-06-19

FeatureMSEA: Metabolic Feature-based Metabolite Set Enrichment Analysis

Authors:
Liu↗Wang↗Huan↗Shen↗

Liquid chromatography-mass spectrometry (LC-MS) untargeted metabolomics detects thousands of metabolic features, but converting these chemical signals into metabolite set-level biological knowledge remains challenging. This is because most features lack unambiguous metabolite identities. Conventional metabolite set enrichment analysis (MSEA) generally requires identified metabolites and metabolite-level ranked inputs, leaving much of the untargeted feature space unused. Here, we present FeatureMSEA, a feature rank-based framework for metabolite set enrichment directly from metabolic features with ambiguous annotations. FeatureMSEA integrates multi-evidence feature-to-metabolite annotation, feature rank-based enrichment scoring, permutation-based inference, and iterative leading-edge-guided annotation refinement, with an optional LLM-assisted module for post-enrichment interpretation. In null comparisons of randomly split healthy samples, FeatureMSEA detected no significant metabolite sets, whereas metabolite-set spike-in simulations showed recovery of implanted signals. In a cerebrospinal fluid metabolomics study of Huntington's disease, FeatureMSEA identified dysregulated metabolite sets related to amino acid metabolism, mitochondrial energy metabolism, and neuroactive signaling. MS/MS-based annotation analysis further showed that FeatureMSEA refinement reduced annotation ambiguity and prioritized chemically consistent candidate metabolites. In summary, FeatureMSEA provides a general framework for extracting metabolite set-level biological insights from LC-MS untargeted metabolomics in which confident metabolite identification remains incomplete.

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02.
medRxiv (Medicine) 2026-06-16

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

Authors:
Naz↗Yazdani↗Hoodbhoy↗Ghebremihael-Weldeselassie↗Mazhar↗Hotwani↗Jehan↗Nisar↗M. I↗Iqbal↗

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

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03.
medRxiv (Medicine) 2026-06-22

Evidence-guided AI regularization for suicidal ideation prediction in pediatric bipolar disorder

Authors:
Jabbar Abdl Sattar Hamoudi↗Wu↗M.-J↗Sanches↗Zunta-Soares↗G. B↗Soutullo↗C. A↗Soares↗J. C↗Mwangi↗

Background: Suicide prediction models in psychiatry often rely on purely data-driven feature selection, which can produce unstable and clinically opaque predictor sets in modest-sized samples. We developed Evidence-Based AI LASSO (EBAL), an evidence-guided regularization framework that incorporates curated clinical evidence into feature-specific penalty factors for interpretable prediction. Methods: Baseline data from 136 youth with confirmed bipolar spectrum disorder in the Greater Houston Area Bipolar Registry were analyzed using 20 candidate clinical predictors. Forty higher-level evidence documents on suicidality and related predictor domains were curated through a structured evidence synthesis workflow and indexed as an auditable evidence corpus. An open-weight large language model assigned feature-specific penalty factors using a prespecified scoring rubric, and these penalties were used to fit a weighted LASSO model. EBAL was compared with a standard evidence-agnostic LASSO using nested leave-one-out cross-validation. Results: For suicidal ideation, EBAL achieved an AUROC of 0.768, balanced accuracy of 0.757, sensitivity of 0.758, and specificity of 0.757. The standard LASSO achieved an AUROC of 0.760 and balanced accuracy of 0.715. EBAL improved balanced accuracy (+0.042, p=0.010) and Matthews correlation coefficient (+0.079, p=0.010), while retaining fewer stable predictors than standard LASSO (11/20 vs 18/20). The strongest positive predictors were current depressed mood, duration of mood disorder illness, and comorbid generalized anxiety disorder. For suicidal behavior, both models performed near chance and retained all candidate predictors. Limitations: The study was cross-sectional, single-site, and modest in sample size, with no external validation cohort. Conclusions: EBAL produced a sparser and more clinically coherent model for suicidal ideation in pediatric bipolar disorder, but did not improve prediction of suicidal behavior. These findings support evidence-guided regularization as a transparent strategy for aligning psychiatric prediction models with prior clinical knowledge while preserving interpretability.

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

Towards End-to-End Automation of AI Research

Authors:
Yutaro Yamada↗Robert Tjarko Lange↗Cong Lu↗Chris Lu↗Shengran Hu↗Jakob Foerster↗David Ha↗Jeff Clune↗

arXiv:2606.15497v1 Announce Type: new Abstract: The automation of science is a long-standing ambition in the field of AI. While the community has made significant progress in automating individual components of the scientific process, a system that autonomously navigates the entire research lifecycle – from conception to publication – has remained out of reach. Here, we present the strongest demonstration to date toward automating the entire process end-to-end. We present The AI Scientist, which creates research ideas, writes code, runs experiments, plots and analyzes data, writes the entire scientific manuscript and performs its own peer review. Its ideas, execution, and presentation are of sufficient quality to produce a manuscript generated by an AI system that passes the first round of peer review at a major machine learning conference workshop. The workshop has an acceptance rate of 70 percent. Our system leverages modern foundation models within a complex agentic system. We evaluate The AI Scientist in two settings: a focused mode using human-provided code templates as an initial scaffold to conduct research on a specific topic, and a template-free, open-ended mode that leverages agentic search for wider scientific exploration. Both settings produce diverse ideas and automatically test, report on, and evaluate them. This achievement demonstrates AI's growing capacity for scientific contribution and signifies a potential paradigm shift in how research is conducted. As with any impactful new technology, there could be significant risks, including taxing overwhelmed review systems and adding noise to scientific literature. However, if developed responsibly, such autonomous systems could greatly accelerate scientific discovery.

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05.
arXiv (CS.CV) 2026-06-17

Contrastive Action-Image Pre-training for Visuomotor Control

Authors:
Yuvan Sharma↗Dantong Niu↗Anirudh Pai↗Zekai Wang↗Zhuoyang Liu↗Baifeng Shi↗Stefano Saravalle↗Boning Shao↗Ruijie Zheng↗Jing Wang↗Konstantinos Kallidromitis↗Yusuke Kato↗…

Existing vision encoders for robotics face a fundamental bottleneck: robotic datasets lack the scale necessary for large-scale pre-training. Prior work circumvents this data scarcity by turning to internet-scale image and language data or egocentric human video. While these models show promise, neither paradigm learns from paired vision and action data, which downstream visuomotor control policies require. However, robot trajectories, the most direct source of this paired signal, are not available at pre-training scale, motivating us to extract action signals from abundant human video instead. To this end, we introduce CAIP (Contrastive Action-Image Pre-training), a vision encoder that treats human hand poses from large-scale egocentric video as a proxy for end-effector actions. By extracting 3D hand keypoints, a representation that aligns naturally with downstream robot action spaces, CAIP learns a unified action-image representation through a contrastive objective. Leveraging 32,041 hours of egocentric human video and only 88 hours of robotic manipulation data, CAIP outperforms state-of-the-art vision encoders including DINOv2, SigLIP, MVP, and R3M. Evaluated on a challenging real-world dexterous manipulation setup using Dexmate Vega and Sharpa Wave hands, CAIP yields performance gains of more than 30% on tasks involving folding, pouring, and fine-grained manipulation. Our results show that our method of contrastive action-centric pre-training yields a scalable path to achieving robust visual representations better suited for physical interaction.

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06.
medRxiv (Medicine) 2026-06-22

Clinical-grade Cuffless Blood Pressure Monitoring via Deep-tissue Diffuse Speckle Pulsatile Flowmetry

Authors:
Choo↗T. W. J↗Yap↗A. A. M↗Kawaja↗Chao↗V. T. T↗Ng↗C. J↗Olivo↗Bi↗

Blood pressure (BP) is a vital sign which is measured to diagnose and manage hypertension. However, current methods to measure BP use inflatable cuffs which cause discomfort and limit the frequency at which measurements can be made, or intra-arterial catheters which are invasive and pose infection risks. Here, we propose and evaluate the use of Diffuse Speckle Pulsatile Flowmetry (DSPF) as a cuffless BP measurement method to address these limitations. DSPF is a laser speckle-based technique which simultaneously records blood flow rate and blood volume (i.e. photoplethysmography or PPG) signals from relatively deep vascular tissue. Using information from these signals, we studied DSPFs effectiveness in measuring systolic BP (SBP) and diastolic BP (DBP) through an outpatient study in which 133 patients were recruited, and in measuring beat-to-beat BP waveforms through an inpatient study in which two patients were recruited. In the outpatient study, the DSPF method was able to achieve mean absolute errors (MAEs) of 4.17 mmHg and 2.42 mmHg for SBP and DBP respectively compared to conventional cuff-based methods. It was also able to fulfil the requirements of the AAMI/ESH/ISO 81060-2:2018 standard for BP measurement devices and attain an "A" grade according to the British Hypertension Society grading scheme. For the inpatient study, it produced BP waveforms which had MAEs of 2.35 mmHg and 3.06 mmHg compared to arterial-line measurements for the two patients, respectively. Compared to PPG which has been studied more extensively as a cuffless BP measurement method, we found through ablation studies that DSPF was able to reach significantly lower MAEs and hence better accuracies. DSPF augments the performance of PPG-only methods by leveraging additional information from the blood flow rate signal, and we therefore find it to be a superior cuffless BP measurement method which can potentially be used in outpatient, inpatient, and remote settings.

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07.
arXiv (CS.AI) 2026-06-24

Context-Aware Prediction of Student Quiz Performance with Multimodal Textbook Features

Authors:
Samin Khan↗

arXiv:2606.24770v1 Announce Type: cross Abstract: Educational platforms often predict student performance from prior interactions, but the assessment content itself also varies in linguistic and visual complexity. This paper studies whether lightweight content features extracted from CourseKata chapter-review questions improve prediction of end-of-chapter quiz scores beyond a student's average prior exercise performance. The study combines 2023 CourseKata student response data with chapter-level text features from review-question wording and image features from textbook visuals. Across 4,742 student-chapter observations from 562 class-student IDs, adding content features improves student-grouped five-fold quiz prediction performance by 9.1% relative to a prior-performance baseline. In leave-chapter-out validation, text features reduce prediction error relative to the baseline, while image-containing models have higher error. This paper suggests that a context-aware model adds useful signal about the text and visual features of questions to better predict student quiz performance compared with using past student performance alone.

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08.
medRxiv (Medicine) 2026-06-15

Filum Terminale Diameter on Routine Pediatric MRI: A Large-Cohort Clinical Reference in 3,406 Children and the Age-Dependent Meaning of the 2-mm Thickened-Filum Threshold

Authors:
Tang↗Dong↗Chen↗Yang↗Huang↗Yu↗Zhu↗Shen↗

Background. A filum diameter >2 mm is the conventional MRI threshold for a thickened filum, but it derives from small, mostly adult series showing no age dependence; whether one cutoff suits all of childhood is untested. Objective. To build an age-specific filum-diameter reference on routine pediatric MRI and test, adjusting for image resolution, whether the 2-mm threshold is age-stationary. Materials and methods. In this retrospective study an nnU-Net tracer measured the maximal filum diameter on consecutive lumbosacral MRI; versus manual tracing it showed negligible bias but moderate single-measure agreement. After excluding report-confirmed fatty filum, lipoma, or tethered cord, the proportion >2 mm was analysed within one acquisition protocol and by logistic regression adjusting for voxel size and slice thickness. Results. Of 7,245 examinations, 3,869 (53%) were traceable; untraced ones were younger (median 0.75 vs 2.0 years). The presumed-normal cohort had median diameter 1.48 mm. At matched resolution, 2 mm marked the 94th percentile in infants (5.6% exceeded it) but the 83rd by 3-6 years (17.4%); the age effect persisted after adjusting for voxel size and slice thickness (3-6 years vs infants, adjusted OR 4.7; P < .001). Conclusion. Filum diameter clusters near 1.5 mm, and the fixed 2-mm cutoff flags ~5% of infants but ~17% of preschoolers. Caliber should be judged against an age-specific clinical reference, not one fixed cutoff; a thick filum is not itself a diagnosis of tethered cord.

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

StarOR: Synergizing Tree Search and Test-Time Reinforcement Learning for Optimization Modeling

Authors:
Jiajun Li↗Yu Ding↗Shisi Guan↗Ran Hou↗Wanyuan Wang↗

arXiv:2606.15197v1 Announce Type: cross Abstract: Optimization modeling is inherently hierarchical, requiring a precise sequence of symbolic commitments. Traditional learning-based automated optimization modeling methods improve modeling policies through large-scale annotated or curated training data, but are costly to adapt to new problem distributions. Meanwhile, one-shot generation remains brittle in hierarchical modeling, where early symbolic errors can propagate into invalid formulations. Test-time scaling offers a promising alternative by enabling structural exploration with additional instance-level computation; however, existing search-based methods typically rely on a fixed policy, causing repeated rollouts to inherit similar modeling biases and providing limited credit assignment for intermediate decisions. To address these limitations, we propose StarOR, a synergistic search-and-adaptation framework that couples MCTS with Test-Time Reinforcement Learning for optimization modeling. StarOR decomposes the modeling process into four stages and updates a transient LoRA adapter via GRPO at each non-terminal node. By using MCTS-generated siblings as local comparison sets, StarOR transforms search-time exploration into instance-specific policy refinement. Moreover, an unsupervised multi-faceted reward system provides fine-grained feedback for intermediate formulation decisions without ground-truth labels. Experiments across five optimization benchmarks show that StarOR achieves state-of-the-art performance even with a 4B backbone, outperforming existing methods and the frontier LLMs.

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10.
arXiv (quant-ph) 2026-06-16

Hardy-type self-testing and exposedness of tripartite GHZ correlations

Authors:
Smritikana Patra↗Soumyajit Pal↗Ranendu Adhikary↗

arXiv:2512.16242v2 Announce Type: replace Abstract: Nonlocality can be witnessed either through Bell-inequality violations or through logical contradictions such as Hardy's paradox. In the bipartite two input two outcome scenario, these two routes have distinct geometric behavior: CHSH-maximal correlations are exposed points of the quantum set, whereas known Hardy-type self-testing correlations on the no-signaling boundary are non-exposed. Here we show that this bipartite intuition fails in the tripartite two input two outcome scenario. We study the tripartite instance of a multipartite Hardy-type paradox and prove that the correlation attaining the maximal Hardy success probability self-tests the Greenberger–Horne–Zeilinger state and the associated measurements. Although this correlation lies on the no-signaling boundary, we show that it is an extremal and exposed point of the quantum correlation set. Moreover, it coincides with the correlation attaining the maximal violation of the Mermin inequality. Thus, in the tripartite GHZ scenario, the logical-paradox and Bell-inequality routes to nonlocality select the same exposed quantum boundary point. We also establish a robust version of the self-test, showing that small deviations from the ideal Hardy constraints imply quantitative closeness to the target state and measurements. Our results reveal a qualitative geometric difference between bipartite and tripartite Hardy-type nonlocality and suggest a broader investigation of exposedness for multipartite Hardy correlations in the multiparty setting.

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11.
medRxiv (Medicine) 2026-06-16

Investigating naming error patterns after non-invasive brain stimulation and language treatment in persons with aphasia

Authors:
Sydnor↗M. J↗Johnson↗M. A↗Lammers↗Murter↗J. L↗Lindquist↗Sebastian↗

Abstract Background: Transcranial direct current stimulation (tDCS) paired with behavioral language therapy can improve naming in persons with aphasia (PWA), yet naming errors persist. Little is known about how naming error patterns change after non-invasive brain stimulation is combined with language treatment. Aims: To examine whether right cerebellar tDCS plus computerized aphasia therapy changes the types of naming errors in people with chronic aphasia across timepoints, and to determine whether effects differ by cerebellar tDCS polarity (anode vs. cathode). Methods and Procedures: In a randomized, double-blind, sham-controlled, within-subject crossover study, we retrospectively analyzed behavioral data from 24 individuals with post-stroke aphasia. Each participant completed two 15-session intervention periods (3-5 sessions/week) with active cerebellar tDCS + computerized aphasia therapy and sham + computerized aphasia therapy, separated by a two-month washout. General linear models (GLMs) assessed longitudinal changes in six error types (semantic, phonological real word, phonological nonword, no response, mixed, unrelated) on an untrained picture naming task (Philadelphia Naming Test; PNT) and a trained task (Naming 80; N80). Additional GLMs evaluated polarity effects with 2 (Group: anode vs. cathode) x 2 (Treatment) interactions, and treatment-order effects with 2 (Group: tDCS-first vs. sham-first) x 2 (Treatment) interactions. Outcomes and Results: Active cerebellar tDCS did not significantly change error types for trained items (N80). For untrained items (PNT), active tDCS reduced several error types relative to sham, with the clearest and most durable reduction in phonological nonword errors; more moderate reductions occurred for phonological real word and unrelated errors. Mixed errors showed a marginally opposite pattern, tending to increase after tDCS and decrease after sham. Polarity analyses indicated broadly similar effects across anodal and cathodal stimulation overall, but only the anode group showed a reliable treatment effect for phonological nonword errors on the PNT. Treatment-order analyses revealed no significant order effects. Conclusions: Our results indicate a shift in naming error types, particularly after tDCS treatment for the untrained naming task (PNT). These findings may help guide the course of treatment approaches of those with aphasia and what error naming pattern types may show changes post stroke when combining non-invasive brain stimulation and computerized aphasia therapy. Clinical Trial Registration: Cerebellar Transcranial Direct Current Stimulation and Aphasia Treatment [NCT02901574] Keywords: aphasia, naming errors, non-invasive brain stimulation, cerebellar tDCS, computerized aphasia treatment

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13.
arXiv (CS.CV) 2026-06-24

Bengal-HP_RU: A Dataset of Bengal People For Head Pose Estimation

Authors:
Md. Ahanaf Arif Khan↗Md. Tawhidur Rahman↗Sangeeta Biswas↗Md. Iqbal Aziz Khan↗Subrata Pramanik↗Sanjoy Kumar Chakravarty↗Bimal Kumar Pramanik↗

Existing head pose datasets predominantly feature subjects of Western or East Asian origin, leaving South Asian populations, particularly Bengali individuals, largely underrepresented. We introduce Bengal-HP_RU, the first publicly available head pose dataset centred on Bengali subjects, comprising 12,894 labelled head images annotated with continuous yaw, pitch, and roll values. Images were collected from Wikimedia Commons under free licences and processed through an automated pipeline followed by manual label correction. The dataset is partitioned by Wikimedia uploader identity to prevent data contamination, yielding 10,494 training and 2,400 test images across 296 unique uploaders. Bengal-HP_RU exhibits substantial diversity in subject age, gender, occlusion, illumination, and background, reflecting realistic in-the-wild conditions. The dataset is publicly available at https://doi.org/10.17632/xbw9kr37jb.2.

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14.
arXiv (CS.AI) 2026-06-24

ZONOS2 Technical Report

Authors:
Gabriel Clark↗Sofian Mejjoute↗Mohamed Osman↗George Close↗Beren Millidge↗

arXiv:2606.24320v1 Announce Type: cross Abstract: We present ZONOS2 8B, our latest TTS model, which achieves state-of-the-art naturalness, prosody, and voice cloning fidelity. We improve upon Zonos-v0.1 across scale, data, and training recipe. We scale the model from 1.6B to 8B total parameters (900M active) with a novel mixture-of-experts (MoE) backbone, improving inference latency and throughput. We expand our training corpus from 200K to over 6M hours using a new data processing pipeline, and we simplify our post-training and conditioning recipes to improve naturalness and voice cloning fidelity. We evaluate ZONOS2 8B on quality, speaker similarity, WER, and ZTTS1-Eval, our novel TTS benchmark, where it performs competitively with state-of-the-art systems while maintaining good streaming latency. We release our model weights and example inference code under an Apache 2.0 license on GitHub and Hugging Face.

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15.
arXiv (CS.AI) 2026-06-17

The Price of Anarchy in Disaggregated Inference

Authors:
Athos Georgiou↗

arXiv:2606.17081v1 Announce Type: cross Abstract: Disaggregated inference architectures physically separate prefill and decode phases onto distinct GPU pools, creating competing "agents" that share a fixed hardware budget. We provide, to our knowledge, the first formal game-theoretic analysis of this architecture, using NVIDIA Dynamo as a concrete case study. We model disaggregated serving as three coupled games: a two-player resource game between prefill and decode pools, a selfish caching game over the hierarchical KV cache, and a congestion game with positive externalities for request routing. We empirically validate the latter two; the P/D resource game is treated analytically (Section 9.2). We characterize how GPU saturation induces regime transitions that shift the game's payoff structure: below saturation, selfish behavior has bounded Price of Anarchy (PoA); at saturation, superlinear latency and cache externalities drive our empirical estimator PoA-hat (defined in Section 6.4) upward. Based on this analysis, we design an adaptive controller that detects saturation transitions in real time and adjusts routing parameters accordingly, shifting from cache-affinity exploitation to load-balanced congestion avoidance. We instantiate our framework on a 3-node NVIDIA B200 cluster running Dynamo with two models, Nemotron-4-340B (TP=8, full-node workers with cross-InfiniBand KV transfers) and Llama-3.1-70B (TP=4), and find the same three-regime PoA-hat structure with the same first post-knee grid point (C=128) on both models. Adaptive routing shifts each model to a better operating point. Our strongest result is on the 70B 1P/5D topology, where PoA-hat drops 3.1x (66.4 to 21.5) in the saturated phase at a 13% throughput cost. On the 70B 1P/2D, PoA-hat drops 2.2x and TTFT P99 drops 7.6x (see Section 8.5).

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16.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

Authors:
Erkison Ewomazino Odih↗

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

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17.
Nature Medicine 2026-06-10

Dual-target gene therapy in Parkinson’s disease: a multicenter phase 1 trial

Authors:
Mengyue Niu↗

Restoring striatal dopamine synthesis is a promising gene therapy strategy for Parkinson’s disease. Previous adeno-associated virus-mediated aromatic L-amino acid decarboxylase (AADC) monotherapies remain dependent on exogenous levodopa, whereas multigene delivery is constrained by strict adeno-associated virus packaging limits. A ‘dual approach’ targeting the two rate-limiting enzymes, tyrosine hydroxylase (TH) and AADC, offers the potential for autonomous dopamine synthesis. We report the 12-month primary safety and tolerability outcomes of a multicenter, open-label, dose-escalation, phase 1 trial evaluating BBM-P002, a new adeno-associated virus vector—AAVT42—codelivering constitutively active TH and AADC. Ten participants with moderate-to-advanced Parkinson’s disease were enrolled and received bilateral intraputaminal infusions across doses of 4.0 × 1011 vg (Cohort 1; n = 1), 6.0 × 1011 vg (Cohort 2; n = 2), 1.0 × 1012 vg (Cohort 3; n = 2) and 1.2 × 1012 vg (Cohort 4; n = 5). The trial achieved its primary outcome, as BBM-P002 demonstrated a favorable safety and tolerability profile within 12 months post-treatment. No dose-limiting toxicities or drug-related serious adverse events occurred. A total of 23 adverse events were reported, all judged unrelated to BBM-P002 and primarily mild and transient. Systemic toxicity and clinically meaningful immunogenicity were absent. In conclusion, intraputaminal delivery of BBM-P002 was safe and well tolerated in this phase 1 trial, supporting continued clinical development. ClinicalTrials.gov registration: NCT05822739 . Phase 1 results reveal that BBM-P002, a dual-target gene therapy co-delivering TH and DDC, is safe and well tolerated in Parkinson’s disease, with 12-month motor improvements signaling therapeutic potential.

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18.
arXiv (CS.CV) 2026-06-19

Exploring Multi-Modal Large Language Models and Two-Stage Fine-Tuning for Fashion Image Retrieval

Authors:
Nguyen Cao Hoang↗Hoang Bui Le↗Nam Vo Hoang↗Trung-Nghia Le↗

Composed image retrieval retrieves a target image using a composed query of a reference image and a modified text description. In the fashion domain, this task requires understanding subtle attribute variations such as color, pattern, and texture. However, existing approaches face limitations due to scarce annotated data and simplistic negative sampling. We propose a novel framework that integrates a multi-modal large language model (LLaVA) to generate attribute-aware triplets and introduces a two-stage fine-tuning strategy to enhance contrastive learning. We leverage pretrained vision-language models, such as CLIP-ViT/B32, to generate and concatenate sentence-level prompts with the relative caption and to scale the number of negatives using static representations. Experimental results demonstrate enhanced compositional reasoning and improved fine-grained retrieval behavior, underscoring the feasibility and potential of the proposed framework for fashion retrieval.

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19.
arXiv (quant-ph) 2026-06-12

Driven-dissipative entanglement of distant giant atoms

Authors:
Aziza Almanakly↗Ariadna Soro↗Alejandro Vivas-Via\~na↗Beatriz Yankelevich↗Caspar Groiseau↗David Pahl↗Junyoung An↗Gabriel Cutter↗Michael E. Gingras↗Bethany M. Niedzielski↗Hannah Stickler↗Ren\'ee DeP\'encier Pi\~nero↗…

arXiv:2606.13375v1 Announce Type: new Abstract: Quantum interconnects distribute entanglement via controlled light-matter interactions for quantum computing and sensing applications. Many entanglement generation schemes use coherent, reversible interactions that require precisely calibrated pulses to execute. In contrast, driven-dissipative protocols use a continuous-wave drive in the presence of correlated dissipation to stabilize entanglement in protected (dark) states. However, the same dissipation that generates the entanglement also limits its utility once the stabilization protocol ends. Here, we engineer a superconducting system of two giant artificial atoms coupled sequentially to a waveguide, with tunable individual and correlated dissipation enabled by interference between coupling points. Continuously driving the atoms through the waveguide exploits correlated dissipation to generate remote entanglement. We then tune the qubit frequencies in situ to suppress individual dissipation and thereby preserve the entanglement, achieving a Bell-state fidelity F = 0.89 +/- 0.02. This demonstration indicates that the driven dissipation of giant atoms is a viable approach for distributing entanglement across quantum networks.

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20.
arXiv (CS.AI) 2026-06-17

KANLib – An Modular, Extensible and Fast Kolmogorov-Arnold Network Implementation

Authors:
Julian Hoever↗Gregor Schiele↗

arXiv:2606.17927v1 Announce Type: cross Abstract: Kolmogorov-Arnold Networks (KANs) have recently emerged as a promising alternative to traditional multilayer perceptrons by replacing linear weights with learnable univariate functions. Despite their theoretical advantages in interpretability and expressiveness, practical research of KANs remains difficult due to high computational costs and inconsistent feature support across existing frameworks. This paper introduces KANLib, a modular, extensible, and computationally efficient framework for developing and evaluating KAN architectures. KANLib unifies core concepts from existing implementations, including PyKAN, EfficientKAN, and FastKAN, within a consistent software architecture that emphasizes flexibility, feature parity, and high performance. The framework supports two basis function types, adaptive grid rescaling, grid extension, and fine-grained architectural customization while maintaining compatibility with standard PyTorch workflows. Experimental evaluation on the California Housing benchmark demonstrates that KANLib reproduces the predictive behavior of established reference KAN implementations while achieving competitive computational efficiency. Furthermore, the framework enables the exploration of architectural variations beyond standard KAN formulations with only minor impacts on predictive performance. Overall, KANLib provides a robust foundation for future research on scalable and extensible KAN architectures.

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21.
arXiv (quant-ph) 2026-06-12

Block algebra for morphing circuits

Authors:
Rui Chao↗

arXiv:2606.12724v1 Announce Type: new Abstract: Morphing circuits are a new paradigm for quantum error correction that relaxes hardware requirements. We present four constructions for CNOT-based CSS morphing circuits with explicit qubit connectivity degrees. All four constructions are specified in block algebra notation, with entries in algebras generated by permutation matrices. The first three are obtained by rewriting existing surface- and color-code morphing circuits; the fourth is a new three-round construction modeled on the 6.6.6 color code. The surface-code construction recovers the morphing circuit of Ref. [ST25] for two-block group algebra codes. Numerical search then instantiates these permutation matrices using regular representations of finite groups. [ST25] M. H. Shaw and B. M. Terhal, Phys. Rev. Lett. 134(9), 090602 (2025).

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23.
arXiv (CS.CV) 2026-06-11

Frozen Foundation-Model Embeddings Discard Small-Lesion Signal in Chest Radiography: Implications for Pre-Deployment Evaluation

Authors:
Raajitha Muthyala↗Zhenan Yin↗Alekhya Jilla↗Frank Li↗Theo Dapamede↗Bardia Khosravi↗Mohammadreza Chavoshi↗Judy Gichoya↗Saptarshi Purkayastha↗

Frozen vision-transformer (ViT) foundation-model embeddings increasingly serve as the substrate for downstream chest-radiography (CXR) pipelines, yet where small-scale, low-contrast signal is retained or lost in the frozen forward pass has not been systematically quantified across architectures, pretraining domains, and objectives. We probed five frozen ViTs (RAD-DINO, DINOv2-B/14, DINOv3 ViT-7B, BiomedCLIP, MedSigLIP) and a frozen DINO-pretrained ResNet-50 architectural control across three large CXR cohorts (NIH-CXR14, MIMIC-CXR, Emory-CXR; aggregate pool n=492,724) and ChestX-Det10 (n=3,543; 1,462 small-lesion bounding boxes across Calcification, Nodule, Mass). Each model was evaluated with a small-scale-perturbation panel and a region-aware bounding-box-stratified probe on real lesions, comparing three pooling modes from the same forward pass: classification token (CLS), patch-mean (mean over all final-layer patch tokens), and bounding-box-restricted patch-local. On the perturbation panel, CLS embeddings sat at the chance floor (area under the ROC curve [AUC] 0.500-0.524); patch-mean was indistinguishable from CLS on iso-blur and reticular-fine cells but rose with CLS on larger directional-blur footprints, while disease AUC on globally decided tasks ranged 0.642-0.913. Patch-local probes recovered AUC ~1.0 from the same forward pass (per-model mean improvement +0.412 to +0.488); the ResNet-50 control reproduced the chance floor. On ChestX-Det10, image-level CLS classification showed within-class small-versus-large stratum gaps up to +0.243 AUC; bounding-box-level patch-local pooling on the same forward pass recovered AUC >= 0.899 on every (model x class) cell. Frozen ViT embeddings silently suppress small-scale signal at the global-aggregation step; the signal is recoverable from patch tokens conditional on a region of interest.

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24.
arXiv (CS.CV) 2026-06-12

OR-Action: Multi-Role Video Understanding with Fine-Grained Actions

Authors:
Felix Tristram↗Ege \"Ozsoy↗Christian Benz↗Marcel Walch↗Ghazal Ghazaei↗Nassir Navab↗

Fine-grained understanding of operating room (OR) activity could enable workflow-aware assistance, yet remains difficult due to clutter, occlusions, and limited sensing. The prevailing approach to model this environment is scene graphs as an interpretable representation of OR interactions. Converting their frame-wise relational predictions into temporally extended, fine-grained actions however, is challenging without explicit temporal modeling. To enable a principled temporal evaluation of current OR understanding methods, we introduce the first action-centric benchmark built on a publicly available ego-exocentric OR dataset by defining a fine-grained, multi-role action taxonomy and generating dense action segments via distillation from ground-truth scene graph state changes. Experiments on this benchmark show that current scene graph prediction methods struggle to model temporal structure, even when adding explicit modeling through Graph Neural Networks. We therefore introduce a vision-only temporal model that outperforms graph-based methods significantly when using all available egocentric video as input. Building on this model we also introduce a novel multi- to single-view feature alignment strategy that improves single-view performance on multi-role action recognition, mitigating the need for extensive egocentric video capture. Benchmark and code will be released upon acceptance.

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

Exact log-depth preparation of highly entangled matrix product states

Authors:
Keisuke Murota↗Fr\'ed\'eric Sauvage↗Marco Ballarin↗Gabriel Matos↗Enrico Rinaldi↗

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

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