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01.
arXiv (CS.LG) 2026-06-15

Federated Learning for Feature Generalization with Convex Constraints

arXiv:2606.14416v1 Announce Type: new Abstract: Federated learning (FL) often struggles with generalization due to heterogeneous client data. Local models are prone to overfitting their local data distributions, and even transferable features can be distorted during aggregation. To address these challenges, we propose FedCONST, an approach that adaptively modulates update magnitudes based on the parameter strength of the global model. This prevents over-emphasizing well-learned parameters while reinforcing underdeveloped ones. Specifically, FedCONST employs linear convex constraints to ensure training stability and preserve locally learned generalization capabilities during aggregation. A Gradient Signal to Noise Ratio (GSNR) analysis further validates the effectiveness of FedCONST in enhancing feature transferability and robustness. As a result, FedCONST effectively aligns local and global objectives, mitigating overfitting and promoting stronger generalization across diverse FL environments, achieving state-of-the-art performance.

02.
arXiv (CS.CL) 2026-06-12

MDForge: Agentic Molecular Dynamics Pipeline Design under Sparse Simulator Feedback

Molecular dynamics (MD) is the canonical in-silico method for atomistic molecular science, simulating molecular behavior from first-principle physics. Designing an MD pipeline for a new system requires substantial expert knowledge: running it on even one molecule is expensive, ruling out trial-and-error. We automate this expert pipeline-design process with an LLM agent. Unlike existing MD agents that orchestrate a predefined tool set, we treat pipeline design as open-ended code generation in which the agent's behavior is reshaped online by verbal reward. Specifically, we build MDForge, an LLM agent whose in-context update rule densifies the sparse reward via a multi-agent debate among physics experts. On three SAMPL host-guest binding free-energy benchmarks, MDForge automatically designs MD pipelines competitive with human experts. Deployed on a library of unseen candidate guests, its CB[7] pipeline discovers a novel binder that wet-lab competition NMR confirms is a high-affinity, picomolar CB[7] binder. Our data and code are available at https://github.com/Zehong-Wang/MDForge.

03.
arXiv (CS.CV) 2026-06-15

Towards Physically Realizable Adversarial Attenuation Patch against SAR Object Detection

Deep neural networks have demonstrated excellent performance in SAR target detection tasks but remain susceptible to adversarial attacks. Existing SAR-specific attack methods can effectively deceive detectors; however, they often introduce noticeable perturbations and are largely confined to digital domain, neglecting physical implementation constrains for attacking SAR systems. In this paper, a novel Adversarial Attenuation Patch (AAP) method is proposed that employs energy-constrained optimization strategy coupled with an attenuation-based deployment framework to achieve a seamless balance between attack effectiveness and stealthiness. More importantly, AAP exhibits strong potential for physical realization by aligning with signal-level electronic jamming mechanisms. Experimental results show that AAP effectively degrades detection performance while preserving high imperceptibility, and shows favorable transferability across different models. This study provides a physical grounded perspective for adversarial attacks on SAR target detection systems and facilitates the design of more covert and practically deployable attack strategies. The source code is made available at https://github.com/boremycin/SAAP.

04.
arXiv (CS.AI) 2026-06-18

What Must Generalist Agents Remember?

arXiv:2606.18746v1 Announce Type: new Abstract: This paper develops a formal account of what generalist agents must store in memory in order to act near-optimally across multiple environments and goals. It shows that when two domains share an observational bottleneck but require incompatible optimal actions, any uniformly near-optimal policy must induce distinct memory distributions at that bottleneck. The result yields a separation theorem: sufficiently successful agents cannot rely only on current state observations, but must preserve domain-relevant information in memory. The paper further shows that if an agent's memory contains enough information to estimate values for related goals, then that memory can be used to approximately reconstruct the agent's local transition dynamics. Together, these results characterize memory as the substrate that supports domain disambiguation, transition-model reconstruction, and planning for generalist agents.

05.
arXiv (math.PR) 2026-06-12

Interference Queueing Networks: A Replica Mean-Field Approach in the Symmetric Setting

arXiv:2606.13264v1 Announce Type: new Abstract: We propose a model for evaluating the performance of wireless communication networks beyond the ubiquitous full-buffer assumption, under which every transmitter is always active. The network is represented by N interacting queues arranged on a torus, with homogeneous arrival rate and service rates depending on the activity of neighboring interferers. More precisely, each queue is associated with a transmitter-receiver pair, and its service rate is given by the Shannon capacity, which depends on the corresponding Signal-to-Interference-plus-Noise Ratio (SINR). Since interfering transmitters only emit when their queue is non-empty, the SINR and hence the service rate improves when neighboring queues are empty. We derive the stability region of the system, together with approximations of its stationary distribution and its exponential rate of convergence to stationarity. These approximations are obtained via a replica mean-field limit, for which we establish propagation of chaos and long-time behavior results.

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

Insulin4RL: Real-Time Insulin Management in the Intensive Care Unit for Offline Reinforcement Learning

arXiv:2606.19481v1 Announce Type: new Abstract: Offline reinforcement learning (ORL) offers the potential to improve the quality of clinical decision-making using historical electronic health record (EHR) data. Current training and evaluative practices in this field rely heavily on EHR datasets that have been temporally discretised into fixed, regular time intervals. Discretisation creates fictional representations of complex clinical scenarios and compromises the generalisability of retrospective model evaluations. In this paper, we introduce Insulin4RL, a healthcare ORL dataset featuring naturally irregular inputs and actions from real clinical trajectories. Derived from MIMIC-IV, Insulin4RL comprises over 375,000 labelled decisions across 12,209 patients requiring insulin infusion titration in the Intensive Care Unit. The dataset can thus be used for research into ORL model performance under realistic clinical sampling assumptions. We provide a description of the dataset's structure and characteristics, baseline performance metrics using model-free offline reinforcement learning, and a standardised evaluation protocol using fitted Q-evaluation. We conclude with suggested areas for future research that could be addressed using this resource.

07.
arXiv (CS.CV) 2026-06-16

An Extensive Benchmark for Single-round and Multi-round Instruction-based Image Editing

In recent years, there have been notable advancements in the area of instruction-based image editing (IIE), which focuses on the automatic alteration of input images using a model. Nevertheless, assessing the effectiveness of these editing models poses a considerable challenge due to the intricate nature of instructions and the wide variety of edits. To tackle this problem, one urgent task in this domain is the development of a robust evaluation framework that can precisely gauge the quality of editing outcomes and offer valuable benchmarks to guide future improvements. To address this challenge, we present a comprehensive evaluation benchmark named I2EBench2.0, designed for single-round and multi-round assessment of IIE models. I2EBench2.0 has four key features: 1) Evaluation Across Single and Multi-rounds: I2EBench2.0 simultaneously evaluates both single-round and multi-round instruction-based edits, assessing the precision and consistency of the edits. 2) Extensive Evaluation Criteria: I2EBench2.0 encompasses a broad range of criteria, evaluating both high-level and low-level aspects of each IIE model. Specifically, it incorporates 16 dimensions for single-round evaluations and 7 for multi-round evaluations. 3) Alignment with Human Judgment: To ensure our benchmark aligns with human evaluation, we conducted a comprehensive user study for each criterion. 4) Research-driven Insights: By analyzing the strengths and weaknesses of current IIE models across all 16 single-round and 7 multi-round dimensions, we provide critical insights aimed at directing future research in this area. We tested eight recently developed IIE models using I2EBench2.0 and derived academic insights through meticulous comparison and analysis. The related code, dataset, and images generated by all IIE models are available on GitHub: https://github.com/cocoshe/I2EBench.

08.
arXiv (CS.CL) 2026-06-12

Multi-Turn Reasoning When Context Arrives in Pieces: Scalable Sharding and Memory-Augmented RL

When a user reveals task-critical information across several conversation turns, LLM accuracy drops by up to 65% despite full context availability. We show that this Lost in Conversation degradation can be substantially mitigated by training models to maintain a compact rolling memory instead of attending to a growing history. To make such training scalable, we introduce a low-cost sharding pipeline that converts single-turn QA datasets into multi-turn fragmented-information episodes, eliminating the need for hours of manual annotation. Training only on sharded GSM8K, our memory-augmented policy significantly improves multi-turn accuracy and generalises zero-shot to harder math and out-of-domain long-context QA. Moreover, memory-trained models outperform full-history baselines even when given the full history at test time, suggesting that learning to compress induces more robust incremental reasoning than full-context exposure alone.

09.
arXiv (quant-ph) 2026-06-16

Enhancing Quantum Machine Learning with Anyons

arXiv:2606.16090v1 Announce Type: new Abstract: The power of quantum computing and quantum machine learning relies on harnessing uniquely quantum phenomena as computational resources. While superposition, coherence and entanglement have been central to this effort, the role of particle exchange statistics remains largely unexplored. Here, we introduce a quantum kernel framework that unifies bosonic, fermionic, and anyonic (fractional) exchange statistics within a single learning paradigm. We study this family of kernels from three perspectives. At the representation level, Haar-averaged effective-dimension analysis shows that fractional exchange phases access feature-space directions inaccessible to the purely symmetric or antisymmetric limits. At the level of kernel geometry, the corresponding Gram matrices show greater separation from the distinguishable-particle baseline and reduced label-dependent model complexity. Finally, on learning benchmarks, anyonic kernels consistently outperform their bosonic and fermionic counterparts, with stronger target alignment and more favorable class geometry. Together, these findings show that exchange statistics reshape the structure and geometry of quantum feature space, leading to enhanced learning performance. Our work identifies particle exchange statistics as an overlooked computational ingredient for quantum machine learning and provides the first systematic comparison of quantum learning models across exchange phases.

10.
arXiv (CS.AI) 2026-06-17

DRFLOW: A Deep Research Benchmark for Personalized Workflow Prediction

arXiv:2606.18191v1 Announce Type: new Abstract: Deep research (DR) systems are increasingly used for complex information-seeking tasks, but existing works mainly focus on generating reports and summaries. In contrast, many enterprise tasks instead require an agent to identify concrete workflows which is a sequence of action-steps. For example, rather than summarizing budgeting policies, an agent should be able to determine the steps needed to answer a question such as: "How do I request new headcount given a fixed budget?". Therefore, we introduce DRFLOW, a benchmark for evaluating personalized workflows predicted by agents from heterogeneous sources. Each task requires the agent to identify relevant evidence from scattered sources, then use that evidence to predict the correct action-step sequence for the user's task. DRFLOW contains 100 tasks across five domains, with 1,246 reference workflow steps grounded in more than 3,900 sources. We define seven diagnostic metrics covering factual grounding, step recovery, structural ordering, condition resolution, and personalization. We further present DRFLOW-Agent (DRFA), a workflow-oriented reference agent to predict personalized workflow. We show that although DRFA improves over strong baseline agents (upto 10.02% average F1 score), there is substantial room for improvement remains across these workflow metrics, indicating that predicting complete and correct personalized workflows remains a challenging frontier for deep research.

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

SierpinskiCam: Camera-Controlled Video Retaking with Sierpinski Triangle Pattern Cues

Generating novel renderings of a scene along user-defined camera trajectories from a single monocular video, dubbed video retaking, is a compelling but difficult problem in content creation and visual effects. Existing geometry-guided approaches reconstruct a 4D representation from the source video and render it along the target trajectory to condition video diffusion models. However, this guidance degrades as the target camera departs from the source trajectory, leaving newly revealed regions sparse or entirely missing. We propose SierpinskiCam, which addresses this limitation by augmenting geometry-based guidance with Sierpinski dome texture cues that contains rich trackable features even under large viewpoint changes. We further introduce a reference video conditioning mechanism that appends source-video tokens to the target-token sequence and separates the two streams with negative RoPE indices, enabling appearance grounding without architectural modification or per-video adaptation. Extensive experiments show that SierpinskiCam achieves significant gains in camera controllability, geometric consistency, and video quality across diverse and challenging retaking scenarios. Project page: https://hyelinnam.github.io/SierpinskiCam/.

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

Sphere Packings in Higher Dimension (after Boaz Klartag)

arXiv:2606.13313v1 Announce Type: cross Abstract: Let $\delta_n^L$ be the maximal density of a lattice sphere packing in the $n$-dimensional Euclidean space. We explain how Boaz Klartag proved the inequality $\delta_n^L \geq c n^2 2^{-n}$ where $c>0$ is a universal constant. In higher dimension, even for non-lattice sphere packings, this new lower bound is a substantial improvement. Klartag's proof uses the probabilistic method in two different ways. The first, very standard, relies on the statistical properties of a uniformly chosen random lattice. The second, completely new, studies the stochastic evolution of an ellipsoid constrained to contain non nonzero lattice points in the interior.

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

Learning the generating functional for variance reduction in lattice QCD

arXiv:2606.15986v1 Announce Type: cross Abstract: The generating functional in quantum field theory provides the natural framework for constructing correlation functions as derivatives with respect to source operators. We present a methodology that leverages machine-learned normalizing flows to reduce the variance of arbitrary $N$-point correlation functions of bosonic operators in lattice gauge field theory calculations by encoding a representation of the generating functional. We show that it is possible to systematically approach noiseless estimators of correlation functions in this framework. We demonstrate this methodology with applications to calculations of glueball correlation functions and Wilson loops in Quantum Chromodynamics and Yang-Mills theory. The results show up to three orders of magnitude variance reduction.

14.
arXiv (quant-ph) 2026-06-16

Scalable generation of heralded single photons via active feed-forward switching of a fiber delay line

arXiv:2606.16741v1 Announce Type: new Abstract: Quasi-deterministic single-photon generation is a key requirement for many photonic quantum technologies. Photon sources based on spontaneous parametric down-conversion (SPDC) are widely used for producing high-quality photons; however, the probabilistic nature of the process limits the generation of synchronized multi-photon states. Here, we demonstrate temporal synchronization of multiple photon-generation events using a free-space-fiber hybrid delay line with feed-forward control, enabling fast and efficient switching and scalable operation. Narrow-band, telecom-wavelength photons compatible for fiber transmission are heralded from a monolithic cavity SPDC source and synchronized across 20 time bins. This yields a sixfold enhancement in synchronized rates and enables multi-photon synchronization, with only a marginal increase of higher-order photon-number contributions.

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

The Metric Picks the Winner: Evaluation Choice Flips Model Rankings for Drug-Response Prediction in Unseen Chemistry

arXiv:2606.12639v1 Announce Type: new Abstract: Predicting how a cell's transcriptome responds to a drug it has never seen is a core, hard problem in computational cell biology: recent benchmarks show complex models often fail to beat trivial baselines once test compounds are held out by chemistry. We study one cell line and assay, THP-1 cells profiled by DRUG-seq, scored by the active-compound weighted MSE(wMSE) of the VCPI prediction contest. We propose a staged approach: dumb baselines (untreated control and mean training-compound response) that the field keeps failing to beat; non-parametric retrieval (a Tanimoto-weighted average of a held-out compound's nearest training compounds); and a fusion stage combining a frozen chemistry embedding with retrieval-support features to predict the residual over the mean, with an uncertainty head and gene programs. On the released VCPI THP-1 drug-seq data (14,026 training compounds), under a Bemis-Murcko scaffold split, the model ranking inverts depending on the metric. Under an inverse-variance per-gene proxy, a regularized linear regression on Morgan fingerprints appears to win over the deep models, retrieval, and ChemBERTa – the textbook "simple baselines win" result. But under the contest's true active-set metric (per-(gene, compound) Mejia weights, validated against the official scorer; mean baseline 0.535 vs the organizers' 0.507 reference), that reverses: the deep models win, our fusion decoder significantly beats the linear fingerprint baseline (-0.012 wMSE, paired bootstrap p < 10^-4), and the proxy's winner becomes the worst chemistry-aware predictor. Picking the metric picks the winner – to our knowledge the first demonstration on real held-out drug chemistry of the metric-calibration effect established largely on genetic perturbation. We release a reproducible pipeline wired to the official scorer that emits a valid submission over the real 1064 x 12,995 grid.

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

Physics-Informed Attention Mechanism and Generalization Capability of Deep Learning-Based Grain Growth Evolution Prediction

arXiv:2606.17235v1 Announce Type: cross Abstract: Machine Learning (ML) models for grain growth prediction are typically trained on idealized synthetic data, yet practical applications require generalization to conditions outside the training distribution. This study evaluated the Out-Of-Distribution (OOD) generalization capability of the trained model from our previous study across three test cases, including experimental microstructures, microstructures characterized by a bimodal grain size distribution, and abnormal grain growth. To further probe whether physics-informed architectural design could improve robustness under these different conditions, a boundary-masked attention mechanism was proposed specifically for grain growth, constraining attention to grain boundary pixels. Both the baseline and the proposed physics-informed attention model were evaluated without retraining or fine-tuning on the OOD data. Both models successfully generalized to all three test cases, yet the boundary-masked attention mechanism provided substantial improvements, with the most notable gains for microstructures characterized by a bimodal grain size distribution, where Structural Similarity Index Measure (SSIM) improved from \num{0.6221} to \num{0.7609} and mean grain size ($\overline{R}$) error decreased from \operatorname{SI}{8.75}{\percent} to \operatorname{SI}{3.57}{\percent}. The attention heatmap analysis revealed that the boundary-masked attention model learned to concentrate attention on large grain boundaries in a manner consistent with curvature-driven grain growth physics, emerging from training without being explicitly encoded into the architecture. These results indicate that models trained on synthetic data can generalize to diverse OOD conditions without retraining, and that physics-informed attention may improve accuracy when the boundary morphology matches the training domain.

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

SCOPE-FL: A Strategy-proof Chain-based Optimal pareto efficient Federated Learning System

arXiv:2606.18384v1 Announce Type: new Abstract: Hierarchical Federated Learning (HFL) enables scalable collaborative model training across distributed devices while preserving data privacy. However, existing HFL client selection mechanisms suffer from a fundamental strategic inefficiency. By prioritizing stability over Pareto efficiency (PE), they produce suboptimal resource allocations, and without strategy proofness (SP), participants are incentivized to misrepresent their true preferences, both failures degrading system overall welfare in the Pareto sense in practice. To address it, we propose SCOPE-FL (Strategy-proof Chain-based Optimal pareto efficient Federated Learning), a synchronous HFL framework that formulates client selection as a two-sided school choice problem solved through the Top Trading Cycle (TTC) algorithm that simultaneously guarantees PE and SP. For reward distribution, SCOPE-FL employs a scalable Shapley value approximation based on One-Round Reconstruction (OR), ensuring compensation proportional to each client's contribution. The entire mechanism executes via blockchain smart contracts, providing the tamper-proof environment required for the SP guarantees to hold in practice. A comprehensive evaluation on MNIST, Fashion-MNIST, and CIFAR-10 demonstrates that SCOPE-FL outperforms state-of-the-art approaches, including DA, IAS, and other methods across model accuracy, convergence rate, and reward efficiency, while achieving communication latency comparable to DA and blockchain overhead significantly lower than DA at scale.

18.
arXiv (CS.LG) 2026-06-12

Adaptive generative moment matching networks for improved learning of dependence structures

arXiv:2508.21531v2 Announce Type: replace-cross Abstract: An adaptive bandwidth selection procedure for the mixture kernel in the maximum mean discrepancy (MMD) for fitting generative moment matching networks (GMMNs) is introduced, and improved learning of copula random number generators is demonstrated. Based on the relative error of the training loss, the number of kernels is increased during training; additionally, the relative error of the validation loss is used as an early stopping criterion. While training time remains similar, adaptively training GMMNs (AGMMNs) significantly increases training performance, which is shown based on validation MMD trajectories, samples and validation MMD values. Superiority of AGMMNs over GMMNs and parametric copula models is also demonstrated in terms of three applications. First, convergence rates of estimators based on quasi-random versus pseudo-random samples from copulas are investigated in dimensions as large as 100 for the first time. Second, replicated validation MMDs, as well as Monte Carlo and quasi-Monte Carlo applications demonstrate the improved training of AGMMNs for a copula model implied by the 50 constituents of the S&P 500 index after deGARCHing. Last, both the latter dataset and 50 constituents of the FTSE 100 are used to demonstrate that the improved training of AGMMNs indeed translates to an improved model prediction.

19.
arXiv (CS.CV) 2026-06-15

FoleyGenEx: Unified Video-to-Audio Generation with Multi-Modal Control, Temporal Alignment, and Semantic Precision

We present FoleyGenEx, a unified video-to-audio (VTA) framework integrating multi-modal control, frame-level temporal alignment, and fine-grained semantics, enabling synchronized, versatile audio synthesis for diverse tasks. Existing VTA methods either have multi-modal control but weak temporal alignment or strong alignment but lack reference audio conditioning and semantic precision. FoleyGenEx fills this gap via three core innovations: a conditional injection mechanism for audio-controlled VTA and Foley extension, a multi-modal dynamic masking strategy preserving training synchronization, and an adverb-based data augmentation algorithm leveraging signal processing and large language models to enhance textual supervision with nuanced semantics. Experiments on AudioCaps, VGGSound, and Greatest Hits demonstrate its competitive controllable VTA performance against existing methods. Demo samples are available at https://foleygenex.github.io/FoleyGenEx.

20.
arXiv (CS.LG) 2026-06-15

How Task Structure Limits Multi-Agent Success: An Information-Theoretic Analysis

arXiv:2606.13733v1 Announce Type: cross Abstract: Multi-agent systems (MAS) were expected to overcome the limitation of single-agent systems (SAS) through collaboration. However, under typicality conditions on the task's constraint graph and bounded inter-agent communication, we prove that the success probability of a MAS is closely tied to the connectivity of task constraints, where each agent has limited information-processing capacity. Specifically, the success probability decays exponentially with an information bottleneck that emerges from partitioning the task's constraint graph among agents. We define this quantity as the minimum cut cost $C_{\min}$ of the potential constraint graph of each task. This information-theoretic bound applies to both open systems with external feedback and closed systems without. We validate our theory on both synthetic experiments and real-world empirical data from SWE-bench submissions. From our framework, effective MAS design should incorporate task-inherent constraints alongside engineering optimization, and when $\Cmin$ is high, practitioners should restructure tasks rather than simply scaling agents or communication.

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

Provable quantum speedups for computing persistence in topological data analysis

arXiv:2410.21258v2 Announce Type: replace-cross Abstract: Topological data analysis (TDA) aims to extract noise-robust features from a data set by examining the number and persistence of holes in its topology. We provide an efficient quantum algorithm for a computational problem closely related to a core task in TDA – determining whether a given hole persists across different length scales. Further, we prove the problem itself is $\mathsf{BQP}_1$-hard, implying that a classical solution is extremely unlikely; this stands in contrast to all previous quantum approaches to TDA, where the problems were also intractable for quantum computers, or where a rigorous proof of classical hardness still remains open. This result implies an {exponential} quantum speedup for this problem under standard complexity-theoretic assumptions. Our approach relies on encoding the persistence of a hole in a variant of the guided sparse Hamiltonian problem, where the guiding state is constructed from a harmonic representative of the hole.

22.
arXiv (math.PR) 2026-06-16

Mean-field BSDEs with non-Lipschitz coefficients and double mean reflections

arXiv:2510.11228v2 Announce Type: replace Abstract: The present paper is devoted to the study of mean-field backward stochastic differential equations (MFBSDEs) with double mean reflections whose generators are not Lipschitz continuous. With the help of the Skorokhod problem and some a priori estimates for MFBSDEs, we establish the existence and uniqueness results for doubly mean reflected MFBSDEs.

23.
arXiv (CS.CV) 2026-06-16

Uncertainty Quality of VGGT: An Analysis on the DTU Benchmark Dataset

Visual Geometry Grounded Transformer (VGGT) has already attracted a great deal of attention in a short period of time, not least due to the Best Paper Award at CVPR-2025. Similar to DUSt3R and MASt3R, VGGT aims to bring about a paradigm shift by replacing established methods like bundle adjustment and feature matching with a simple, unified, feed-forward neural network that predicts camera poses, depth maps, and dense 3D structure directly from multiple images of a scene in a few seconds. A key aspect is its ability to process an arbitrary number of views consistently in a single forward pass without any post-processing or iterative optimization. For photogrammetry, this opens new possibilities for real-time, scalable, and accessible 3D reconstruction. In this context, not only high reconstruction accuracy but also high-quality uncertainty estimates are crucial, as they foster trust and enable robust quality assurance. This paper therefore investigates the quality of VGGT's uncertainty predictions. The analysis identifies an effective confidence threshold for filtering VGGT's raw output and demonstrates that enhancing uncertainty quality holds strong potential for improving the accuracy of its 3D reconstructions.

24.
medRxiv (Medicine) 2026-06-22

Leishmaniasis on YouTube: a critical appraisal of the quality, reliability, and transparency of educational content

Background: Leishmaniasis is a neglected tropical disease of significant global public health importance, for which accurate information is essential to support prevention and early care-seeking, particularly in endemic, resource-limited settings. YouTube is a widely used source of health information, but the quality and reliability of leishmaniasis-related content have not been evaluated. We aimed to assess the quality, reliability, and transparency of English-language YouTube videos on leishmaniasis. Methods: We conducted a cross-sectional analysis of YouTube videos retrieved via the YouTube Data API on 15 June 2026 using the terms "leishmaniasis," "cutaneous leishmaniasis," and "visceral leishmaniasis." After applying eligibility criteria and screening the 150 most-viewed eligible videos, 48 videos were included. Two reviewers independently assessed each video using the modified DISCERN (mDISCERN) tool, the Global Quality Score (GQS), and the JAMA benchmark criteria, with disagreements resolved by consensus. Inter-rater agreement was assessed using the intraclass correlation coefficient (ICC), and associations were examined using Spearman's rank correlation. Results: Of 402 videos retrieved, 48 met the inclusion criteria. The median GQS was 3.00 (IQR 2.00-4.00) and median mDISCERN was 3.00 (IQR 2.38-4.50), indicating moderate quality and reliability, while the median JAMA score was 2.00 (IQR 1.00-2.00), reflecting limited transparency; no video met all four JAMA criteria. The overwhelming majority of videos (47/48, 97.9%) were of professional or institutional origin. Inter-rater agreement was good to excellent (ICC 0.883 for GQS, 0.896 for mDISCERN, 1.000 for JAMA). The instruments were strongly inter-correlated (mDISCERN-GQS rho = 0.841, p < 0.001). Quality scores did not correlate positively with views, likes, or video duration; comments correlated weakly and negatively with mDISCERN (rho = -0.337, p = 0.031) and JAMA (rho = -0.381, p = 0.014). Conclusions: YouTube videos on leishmaniasis are of moderate quality and reliability but limited transparency, and are produced almost exclusively by professional sources. Video popularity, length, and age were not indicators of quality. There is a need for experts and institutions to produce clearly authored, well-sourced, and transparent educational content on this neglected tropical disease.

25.
medRxiv (Medicine) 2026-06-15

Sociodemographic Disparities in Tafamidis Initiation and Clinical Outcomes in ATTR-CM Across the United States

BACKGROUND Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease. Sociodemographic factors may influence time to treatment initiation and resulting clinical outcomes, yet these relationships are poorly characterized. OBJECTIVE Assess the effects of sex and race on tafamidis initiation and subsequent outcomes and their interaction with factors such as ATTR-CM type and social deprivation measures. METHODS A retrospective cohort analysis was conducted using the US Komodo Healthcare Map (01/2016-06/2024) among patients with amyloidosis, identified by ICD-10-CM diagnosis codes. Cumulative incidence of treatment initiation and survival probabilities for cardiovascular-related hospitalization (CVH) or death were estimated by Kaplan-Meier, stratified by sex and race. Cox proportional hazards models were fitted for both endpoints to estimate hazard ratios, adjusting for demographics and clinical characteristics. RESULTS Of 11,311 patients identified, White and Black patients (n=9,223) were included in subsequent analyses. Within 12 months of diagnosis, White women had the lowest cumulative incidence of tafamidis initiation (11.4%), followed by Black women (22.0%), Black men (26.7%), and White men (31.0%). Event-free survival at 12 months was lowest in Black women (42.9%), followed by Black men (46.8%), White women (48.6%), and White men (54.4%). Median (95% CI) time to CVH or death was shortest for Black women (8.0 months [6.8-10.0]) followed by Black men (9.9 months [8.8-12.0]), White women (11.0 months [9.6-13.0]), and White men (15.0 months [14.0-16.0]). CONCLUSIONS In this large, real-world cohort of US patients with ATTR-CM, sex and race contributed to disparities in tafamidis initiation and survival, underscoring compounded disparities in both access and outcomes.