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Letter to the Editor
Academic Intelligence · Curated Daily
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Letter to the Editor
arXiv:2606.09744v3 Announce Type: replace Abstract: We study feed-forward ReLU networks with fixed readout and quadratic loss. The aim is to rewrite gradient descent not primarily as a dynamics in weight space, but as a collective dynamics closed in terms of fields defined on the training-set space. For a single hidden layer, the weight variables can be eliminated from the activation dynamics, yielding a closed equation for the residuals governed by a collective kernel that factorizes into an input-geometric matrix and a dynamical co-activation matrix. For deeper networks, the residual dynamics retains a clean layer-wise kernel structure. However, from depth three onward, closure requires a hierarchy of weight-induced Gram operators that mediate information transport across layers. Moreover, the conjugate-field dynamics is governed by operators satisfying a backward pullback recursion, of which the weight-induced Gram operators are the first nontrivial instances.
arXiv:2605.30456v2 Announce Type: replace Abstract: Many learning tasks in science and engineering are characterized by sparse datasets, which limits the effectiveness of purely data-driven approaches. At the same time, these problems are often accompanied by rich domain knowledge derived from physical laws, operational requirements, and expert heuristics. Such knowledge is frequently expressed as rules involving logical propositions and linear inequalities. Existing neuro-symbolic methods typically enforce these rules approximately through soft penalties, assume input-independent rules when designing specialized architectures, or rely on non-differentiable post-processing at inference time to achieve hard constraint satisfaction. While recent advances in differentiable optimization layers enable end-to-end feasibility enforcement within neural networks, extending these approaches to logical or mixed-integer rules remains challenging due to inherent nonconvexity. In this work, we propose a unified end-to-end framework for enforcing hard, input-dependent mixed integer linear constraints within neural networks. Our approach represents rules as disjunctive constraints and applies hierarchical convex relaxations to obtain convex hull formulations. These relaxations yield tractable linear constraints that can be embedded as differentiable optimization layers while enabling exact rule satisfaction. We demonstrate the effectiveness of the proposed framework on real-world datasets, achieving perfect rule satisfaction and strong predictive performance.
arXiv:2411.08653v2 Announce Type: replace-cross Abstract: We present a unified theoretical framework for kernel-based measures of dependence on product spaces. Building on the ideas underlying distance covariance, distance multivariance, and the Hilbert-Schmidt Independence Criterion (HSIC), we define a new family of kernels on an $n$-fold Cartesian product, termed positive definite independent of order $k$ (PDI$_{k}$ kernels). These kernels extend the concepts of positive definite and conditionally negative definite kernels to higher orders and provide the foundation for generalized independence and interaction tests, such as the generalized Lancaster interaction of order $k$ ($\Lambda_{k}^{n}$), and the Streitberg interaction ($\Sigma$). Our analysis focuses on the continuous setting, where we prove a Kernel Mean Embedding Theorem for PDI$_{k}$ kernels and establish the corresponding integrability restrictions. Based on these results, we characterize how the Kronecker products of PDI kernels behave.
arXiv:2512.25065v2 Announce Type: replace-cross Abstract: Systems resource management tasks rely primarily on hand-designed heuristics. However, growing hardware heterogeneity and workload diversity require heuristics specialized to particular deployment instances, making manual design expensive and difficult to scale. In this paper, we explore how to synthesize systems heuristics using LLMs. The main challenge is ensuring that generated heuristics execute safely, integrate correctly with the surrounding system, and still achieve strong performance. We propose Vulcan, a framework that identifies LLM-friendly interfaces that isolate core decision logic from the rest of the implementation. With Vulcan, LLM-generated code is restricted to simple stateless decision functions, while trusted runtime abstractions provide rich derived statistics for meaningful policy exploration without system-integration bugs. To ensure execution safety, LLMs synthesize heuristics in a restricted language, Anvil, that guarantees important properties by construction. We evaluate Vulcan across three well-studied domains and demonstrate up to 4.9x higher savings for spot-VM scheduling, up to 2x lower miss ratios for cache eviction, and up to 10% higher application performance for tiered-memory systems, while ensuring execution safety throughout.
Time-series anomaly detection (TSAD) is critical in domains such as industrial monitoring, healthcare, and cybersecurity, but it remains challenging due to rare and heterogeneous anomalies and the scarcity of labelled data. This scarcity makes unsupervised approaches predominant, yet existing methods often rely on reconstruction or forecasting, which struggle with complex data, or on embedding-based approaches that require domain-specific anomaly synthesis and fixed distance metrics. We propose ASTER, a framework that generates pseudo-anomalies directly in the latent space, avoiding handcrafted anomaly injections and the need for domain expertise. A latent-space decoder produces tailored pseudo-anomalies to train a Transformer-based anomaly classifier, while a pre-trained LLM enriches the temporal and contextual representations of this space. Experiments on three benchmark datasets show that ASTER achieves state-of-the-art performance and sets a new standard for LLM-based TSAD.
arXiv:2606.09500v3 Announce Type: replace Abstract: As autonomous research agents and AI co-scientist systems push large language models (LLMs) from drafting toward end-to-end manuscript production, the bottleneck shifts from generation to verification. Fluent LLM output can hide fabricated citations, numbers that drift from source tables, and unmet reporting-guideline items; existing tools generate without verifying, and self-critique inherits the blind spots that produce confident fabrication. We describe an architecture pairing generation with verification, resting on three principles: decompose the workflow into self-contained skills, gate every stage transition with halt-on-failure, and resolve each integrity question with the cheapest sufficient mechanism, a deterministic, re-executable check where one suffices and a prose-level probe only where interpretation is unavoidable. This determinism-where-possible split, organized as an integrity-gate taxonomy, is the core contribution. It is realized as MedSci Skills, an open-source toolkit of 43 skills with a 21-detector deterministic tier, evaluated on three public-dataset pipelines (STARD, PRISMA, STROBE) and a seeded-defect ablation. Across the three pipelines every content-hash manifest verified clean and the gates surfaced real defects; on 27 identical injected defects the deterministic gates detected all 27 with no false positives on the matched clean fixtures, whereas a single-prompt LLM reviewer detected 11, its misses in code, bibliography, and style defects the prose hides. Determinism-where-possible verification yields an auditable, re-executable trail that exposes the evidence a human needs to check an LLM-assisted manuscript: feasibility and reproducibility evidence, not a claim of human-competitive quality, which a separate blinded study addresses. MedSci Skills is MIT-licensed and archived (v3.8.0).
Cinematic video depicts multiple subjects acting or interacting at specific moments, captured with deliberate camera movement, and stitched together by shot transitions. Together, these elements demand a level of fine-grained control beyond current text-to-video models. Existing work addresses each axis in isolation: multi-subject personalization, temporal control, multi-shot synthesis, or camera control; no prior framework jointly integrates all four. We present CineOrchestra, a unified video diffusion model that controls subjects, events, cameras, and shot transitions simultaneously. Our key insight is that these heterogeneous cinematic elements share a fundamental structure: each is an entity acting over a specific temporal interval, which can therefore all be expressed through one shared structure of entity-centric conditioning primitives, augmented with reference images for visual entities. This formulation reduces the architectural challenge to a single positional encoding problem, which we solve with two parameter-free coordinated rotary embeddings: (a) an interval-sampled temporal RoPE that yields consistent attention behavior across events of dramatically varying duration, and (b) a 2D entity-temporal cross-attention RoPE that disambiguates per-entity conditions and routes each to its corresponding spatiotemporal region. On two new benchmarks, CineOrchestra outperforms six per-axis specialists on dense caption following and shot-transition timing, with consistent gains in a pairwise user study and component ablations.
arXiv:2606.16276v1 Announce Type: new Abstract: As large language models (LLMs) are increasingly deployed in real-world applications, alignment is no longer governed by a single universal notion of safety or helpfulness, but instead by provider- or application-specific model specifications. These specifications are typically long, structured, and frequently updated, yet existing alignment pipelines lack a systematic mechanism to operationalize them as training signals. In this paper, we propose specification-grounded alignment, a new alignment paradigm that treats provider-authored model specifications as the primary alignment target rather than abstract principles or static benchmarks. To instantiate this paradigm, we introduce SpecAlign, a framework that synthesizes alignment data directly from specification documents. SpecAlign combines structured rule annotation, controllable specification instantiation, and multi-agent adversarial data synthesis to generate fine-grained, boundary-aware preference pairs that capture both compliant behaviors and meaningful specification violations. Experiments across multiple model specifications and backbone models demonstrate that training with SpecAlign consistently improves rule compliance while preserving general capabilities and avoiding over-conservative behavior. These results suggest that grounding alignment in explicit model specifications enables rapid, precise, and scalable adaptation of LLM behavior to evolving policy requirements.
Personalized presentation generation requires more than conditioning on a current prompt or template: agents must preserve stable user preferences across tasks, retain newly introduced preferences and constraints during multi-turn revision, and carry out local edits reliably. We propose MemSlides, a hierarchical memory framework for personalized presentation agents that separates long-term memory from working memory and further divides long-term memory into user profile memory and tool memory. User profile memory stores intent-conditioned profiles for round-0 personalization, working memory carries active preferences and session constraints across revision rounds, and tool memory stores reusable execution experience for reliable localized editing. MemSlides pairs this memory design with scoped slide-local revision, so targeted updates act on the smallest affected region instead of repeatedly regenerating the full deck. In controlled experiments, user profile memory improves persona-alignment judgments on a multi-persona, multi-intent profile bank, tool-memory injection improves closed-loop modify behavior in diagnostic matched-pair settings, and qualitative cases illustrate working memory's ability to carryover preferences. Taken together, these results suggest that effective personalization in presentation authoring depends on separating persistent user profiles, session-level working memory, and reusable execution experience across generation and localized revision.
arXiv:2605.29483v2 Announce Type: replace Abstract: Wearable devices enable continuous monitoring of physiological signals such as ECG and PPG, but existing mHealth systems are largely limited to task-specific prediction pipelines or reactive question answering over static summaries. They lack the ability to support temporal reasoning, persistent physiological context, and proactive monitoring over long-term signal streams. We propose VitalAgent, a tool-augmented agentic framework for ECG/PPG-based mHealth that supports both reactive question answering and proactive monitoring. VitalAgent is built on a longitudinal physiological memory and a tool-augmented reasoning interface that enables dynamic computation over raw signals. We further introduce VitalBench, a longitudinal physiological monitoring benchmark dataset comprising 1,862 QA pairs for reactive question answering and 90.2 hours of continuous ECG/PPG recordings for proactive monitoring, covering cardiac, physical activity, and stress-related tasks. Experiments demonstrate that VitalAgent achieves over 25% improvement over prompt-based and ReAct baselines in reactive evaluation and supports proactive alert monitoring over long-term physiological signals, highlighting the importance of dynamic tool use and long-term physiological monitoring.
Forecasting human life outcomes is important to gain insights into how individuals attain long and healthy lives. Conventional statistical approaches yield limited accuracy, potentially due to discarding the sequential structure of the life course. Modern methods such as transformer architectures require large scale training data that most longitudinal panel studies lack. Here we introduce LifeSentence, a model for life-course reasoning that bridges large language models with longitudinal panel data. By representing each life event as a structured natural-language record and instruction-tuning a pretrained 24-billion-parameter language model across an 18-task evaluation taxonomy spanning prediction, robustness and reasoning, LifeSentence supplements panel data with distributional knowledge already encoded during pretraining. Trained on approximately 65,000 individuals from the German Socio-Economic Panel - roughly 45 times fewer than prior transformer-based approaches - LifeSentence outperforms classical and deep learning baselines across all task families, achieving a threefold improvement in joint event-and-timing prediction from best baselines and 91.2% Kendall's tau when reconstructing chronological order from timestamp-stripped event sets. Without explicit supervision, the model recovers documented patterns of social stratification, including the education premium, the gender wage gap and the motherhood penalty, from discrete event sequences alone. A natural-language interface further enables qualitatively new research queries, such as connecting an early-life history to a specified late-life endpoint, establishing LifeSentence as both a predictive tool and a probe for counterfactual exploration of human biographies.
arXiv:2606.12997v1 Announce Type: new Abstract: Two dominant approaches have emerged for generating probabilistic forecasts of physical systems: generative models, such as diffusion or flow matching; and ensembles of deterministic models with stochasticity injected, trained using the continuous ranked probability score (CRPS) loss. While both approaches have demonstrated strong predictive accuracy, the reliability of their uncertainties has not been systematically assessed. We address this gap by developing a framework to evaluate both approaches across diverse 2D spatiotemporal physical systems, under matched model size and computational budget. We assess the reliability of probabilistic emulation by inspecting the empirical coverage of predictive intervals, while also considering accuracy and computational efficiency metrics. CRPS-trained ensembles typically achieve more reliable uncertainties on both single-step prediction and autoregressive rollouts, demonstrating better coverage than the standard alternative of training generative models in a latent space. Moreover, the CRPS approach offers significantly faster inference. When generative models are trained in ambient rather than a compressed latent space, which is often infeasible for high-dimensional problems, they exhibit comparable coverage to CRPS-trained ensembles, though with substantially larger inference latency. In contrast, when CRPS-trained ensembles are trained in latent space they do not show a marked degradation in coverage with respect to ambient space. Both generative models and CRPS-trained ensembles demonstrate good predictive accuracy. To facilitate future research and application, we release AutoCast, a modular framework implementing both generative models and CRPS-trained ensembles, alongside AutoSim, a flexible dataset generation package for rapid prototyping.
Existing benchmarks for Vision-Language Models (VLMs) primarily evaluate spatio-temporal understanding on simple single-action videos, closed attribute sets and restricted entity types, failing to capture the freeform, multi-action interactions between diverse entities which characterize real-world video understanding. Furthermore, the lack of a systematic framework for analyzing model failures across complementary spatio-temporal axes hinders comprehensive evaluation. To address these gaps, we introduce VISTA, a Video Interaction Spatio-Temporal Analysis benchmark designed for open-set, multi-entity and multi-action spatio-temporal understanding in VLMs. VISTA decomposes videos into interpretable entities, their associated actions, and relational dynamics, enabling multi-axis diagnostics and unified assessment of relational, spatial, and temporal understanding. Our benchmark integrates multiple datasets into a single interaction-aware taxonomy and comprises ~12K curated video-query pairs spanning diverse scenes and complexities. We systematically evaluate 11 state-of-the-art VLMs on VISTA, and break down aggregate performance across our taxonomy to reveal shortcomings and pronounced spatio-temporal biases obscured by traditional metrics. By providing detailed, taxonomy-driven diagnostics on a challenging dataset, VISTA offers a nuanced framework to guide advances in model design, pretraining strategies, and evaluation protocols. Overall, VISTA is the first, large-scale, interaction-aware diagnostic benchmark for spatio-temporal understanding in VLMs.
arXiv:2509.05664v2 Announce Type: replace-cross Abstract: Using a recently derived integral in terms of elementary functions, we derive new asymptotic expansions of the normal inverse Gaussian cumulative distribution function. One of the asymptotic representations is in terms of the normal Gaussian distribution or complementary error function.
arXiv:2606.12280v1 Announce Type: new Abstract: Post-training quantization lets large text-to-image diffusion transformers run on consumer GPUs, yet the hardware-specific trade-offs are seldom measured directly. We quantize Ideogram 4.0 - a 9.3B flow-matching diffusion transformer (DiT), shipped as two separate-weight copies of a single-stream 34-layer backbone for classifier-free guidance and conditioned by a Qwen3-VL-8B encoder - for Ampere RTX 3090 GPUs, which lack FP8 tensor cores. Our INT8 W8A8 recipe (per-channel weights, per-token dynamic activations, SmoothQuant, and mixed-precision protection of a small high-fragility layer set) holds the FP8 quality ceiling: on a 200-prompt benchmark the paired same-seed bootstrap CI for INT8-FP8 includes zero on both Pick and CLIP, while INT8 improves on NF4 by $+1.9$ CLIP (95% CI $[+1.21,+2.64]$, excluding zero). A per-category OCR analysis, to our knowledge unreported for this model class, confirms text legibility is preserved, and an ablation isolates protection of the FFN down-projections as the dominant quality lever. Our GGUF Q4_K quantization beats NF4 at equal on-disk size and is the Pareto winner on the quality-memory frontier, with paired confidence intervals excluding zero (Q8_0 is quality neutral). Finally, we characterize where 8-bit quantization helps and where it does not: INT8's weights match FP8's footprint rather than shrink it, so a speed gain on Ampere awaits a fused INT8 kernel.
We study six production image-to-image AI systems (gpt-image-1, Gemini 2.5 Flash Image, Flux Kontext, SDXL img2img, SD3 img2img, and Qwen Image Edit) under a content-adaptive sub-JND adversarial perturbation pipeline, scoring all outputs by frozen DINOv2 ViT-B/14 token distances against clean references. Across a 3,588-call corpus spanning COCO photographs, CelebA-HQ portraits, and AI-generated inputs, the six systems partition into two image-invariant behavioral bands on a 2D (patch_mean, ssim_clean) plane: edit-trained models (Flux Kontext, Qwen Edit, Gemini) cluster in a tight band, while T2I-base models adapted at sampling time (SDXL, SD3, gpt-image-1) cluster in a drift band.
arXiv:2603.12006v2 Announce Type: replace-cross Abstract: We consider the identity of the abelian sandpile group of finite approximation graphs of the Sierpinski gasket, and we show that the second-order term in the scaling limit converges to the path distance to the nearest corner on the Sierpinski gasket. The proof relies on a decomposition of the identity of the sandpile group into the sum of a constant function and the Laplacian of the graph distance on the approximating graphs.
arXiv:2606.18236v1 Announce Type: new Abstract: In learning theory, the sign rank of a binary concept class captures the smallest dimension in which it can be represented by points and halfspaces. Despite tremendous interest, lower bounds on sign rank are notoriously difficult to come by. Two recent approaches to the problem establish lower bounds on sign rank by measures that are easier to analyze: the $\mathbb{Z}_2$-index and the list replicability number. We order these measures, showing that the $\mathbb{Z}_2$-index is upper-bounded by a linear function of the list replicability number. As a main consequence, we obtain a strong separation between sign rank and $\mathbb{Z}_2$-index, thereby resolving a question of Frick, Hosseini, and Vasileuski. This motivates a thorough study of list replicability, the stronger of the two lower-bounding measures. We establish upper bounds on the list replicability number by two combinatorial measures: height and minimum star number. We also prove a fundamental composition result, showing that the product of two concept classes has list replicability number bounded by the sum of the list replicability numbers of the two classes.
Recent progress has shown promise in distilling multi-step video diffusion models into efficient few-step students. Among them, Distribution Matching Distillation (DMD) and its successor DMD2 achieved strong generation quality and fast convergence. However, due to the nature of the reverse Kullback–Leibler (KL) objective, these methods exhibit two persistent failure modes: a substantial drop in sample diversity, and visibly over-saturated outputs that deviate from real-video appearance. In this work, we propose Data-Forcing Distillation (DFD), a simple post-training framework that restores diversity and fidelity in DMD with only a single-line of code change. At its core is the teacher score discrepancy to guide the student toward the real-data distribution, pulling it to missing modes (mitigating mode collapse) and away from problematic modes absent in real data (avoiding over-saturation). We provide an in-depth theoretical analysis of our framework and validate our approach on text-to-video, image-to-video, and autoregressive video generation. With only 100–300 steps of finetuning, DFD effectively restores diversity and fidelity on both Wan2.1-1.3B and Cosmos-Predict2.5-2B model, resolving the over-saturation artifacts with significantly better video dynamics and appearance, and even outperforms the teacher model.
arXiv:2606.20387v1 Announce Type: new Abstract: We investigate how interaction geometry shapes the low-energy phases of sparse tunable long-range quantum models. We focus on a class of graphs whose degree grows logarithmically with system size, and show how symmetry and frustration in graph connectivity can drive, suppress, and reshape ground-state phase transitions. The central examples are power-of-$p$ graphs, where even and odd values of $p$ exhibit qualitatively distinct behaviour: even-$p$ graphs inherit the rich phase structure of the power-of-two model, while odd-$p$ graphs are governed by geometric frustration. Fibonacci graphs provide a contrasting case, lacking the discrete self-similarity of the power-of-$p$ family but exhibiting a direct geometric mapping between the short- and long-range limits. Across our models, we find that phase structure and criticality are governed by the same effective-geometry principle, unifying our framework for experimentally motivated long-range quantum systems.
arXiv:2606.12845v1 Announce Type: cross Abstract: This study explores privacy-preserving machine learning (PPML) techniques using the PySyft platform to enable collaborative prediction of student retention between institutions. We developed a remote data science (RDS) framework with a semi-air-gapped architecture consisting of high-side and low-side servers, allowing researchers from three universities to build predictive models on sensitive student data without direct data access. Using historical data from a small private university (N=720), we evaluated three synthetic data generation approaches and validated the framework through inter-institutional collaboration. The results demonstrate consistent classification performance across institutions (Macro F1: 0.690–0.695) while maintaining strict Family Educational Rights and Privacy Act (FERPA) compliance. We also propose Data-Type-Aware Templates, a novel synthetic data method that prioritizes privacy over distributional fidelity. Our findings confirm that RDS-based PPML is technically feasible for educational settings and offers a practical alternative to federated learning for small-scale inter-institutional collaborations. The code is available at https://github.com/jtfields/NAIRR240195-Privacy-Preserving-Machine-Learning.
Cellular heterogeneity is a major confounder in bulk DNA methylation data for epigenome-wide association studies. Existing reference-based DNAm deconvolution methods often ignore hierarchies among related cell types and may generalize poorly across datasets due to limited variability in reference profiles. We developed HOMED (Hierarchically Optimized Methylation Deconvolution), a framework that integrates cell-lineage hierarchies, single-cell RNA sequencing-guided deconvolution, and paired bulk RNA-seq/DNAm data for CpG signature optimization. Across simulated and real peripheral blood mononuclear cell, lung, and placental datasets, HOMED consistently yielded the highest PCCs and lowest RMSEs, outperforming existing scRNA-seq-guided DNAm deconvolution methods, improving accuracy, resolution, and cross-tissue generalizability.
arXiv:2606.12211v1 Announce Type: cross Abstract: A central principle in quantum machine learning is that an ansatz should be expressive enough to represent the quantum data of interest. Yet, the expressibility is statistically meaningful only insofar as it can be learned from finitely many copies of an unknown quantum state. In this work, we develop an information-theoretic Occam theory for quantum data generated by finite-size quantum circuits. For the class $S_{n,G}$ of $n$-qubit pure states preparable with at most $G$ two-qubit gates, a metric-entropy argument gives the realizable sample law $\widetilde{\Theta}(G/\epsilon^2)$ in the circuit-limited regime. For an arbitrary source $\hat{\rho}$, we introduce the best $G$-gate approximation error $d_G(\hat{\rho})$ and the approximate circuit complexity $C_\eta(\hat{\rho})$. We prove an agnostic quantum Occam theorem: with $M$ copies, one can learn up to the best $G$-gate approximation error plus a statistical penalty $\widetilde{O}(\sqrt{G/M})$. We then remove the need to know $G$ in advance through an adaptive model-selection theorem whose oracle inequality selects the circuit complexity justified by the data. Matching lower bounds yield a sample-supported expressibility law: at trace-distance accuracy $\epsilon$, $M$ samples can support only $G_supported \simeq M\epsilon^2$ gates, up to logarithmic factors and tomography saturation at $2^n$. Thus, the circuit complexity becomes an adaptive statistical resource rather than a static promise. Our framework turns bounded circuit complexity into a model-selection principle for quantum machine learning.
Abstract Background Non-cardiac chest pain (NCCP) is commonly regarded as a low-risk condition. However, long-term mortality, cause-specific death, and high-risk subgroup characteristics remain poorly defined. Methods In this multicentre registry-linked cohort study, we linked the Chest Pain Center Registry from 101 hospitals in Hunan, China, with the Mortality and Cause of Death Registry. Adults diagnosed with NCCP from Jan 1, 2017, to Dec 31, 2021, were included. We assessed 3-year all-cause, cardiovascular, and non-cardiovascular mortality using Cox, restricted cubic spline, and Fine-Gray models. Findings Among 160,245 patients, 4674 deaths occurred within 3 years (2.9%). Mortality increased sharply after 60.5 years. Age [≥] 60.5 years (adjusted hazard ratio [aHR] 7.49 [95% CI 6.89-8.14]), rural residence (time-varying aHR 1.46 [1.35-1.57] in year 1 and 1.66 [1.46-1.89] in years 1-3), and male sex (aHR 1.47 [1.38-1.57]) independently predicted death. Three-year mortality ranged from 0.3% in younger urban women to 8.4% in older rural men. Cardiovascular diseases accounted for 56.4% of deaths among older patients, whereas other non-cardiovascular causes (22.8%) and malignancy (20.8%) were the largest categories among younger decedents. Interpretation NCCP is not uniformly benign. Age, rural residence, and sex identify patients who could benefit from risk-stratified follow-up, with cardiovascular prevention prioritised for older rural men and broader non-cardiovascular assessment considered for younger patients.