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01.
arXiv (quant-ph) 2026-06-17

When Renormalisation Remembers: UV/IR Mixing as an Entanglement Bridge

Authors:

arXiv:2606.17147v1 Announce Type: cross Abstract: Renormalisation is traditionally understood to be a Wilsonian memoryless process in which ultraviolet (UV) degrees of freedom gradually decouple, leaving an autonomous infrared (IR) description. However this need not be the case: in UV/IR mixed theories correlations between widely separated scales can persist. In this work I recast UV/IR mixing as a Hilbert-space phenomenon, realised as correlations across renormalisation scales. This formulation is implemented using the Born-Reciprocal Tensor Network (BRTN), a new configuration of tensor network that is globally symmetric under phase-space reciprocity. On this network I prepare the vacuum and reproduce the expected radiative corrections. The resulting renormalisation geometry exhibits memory, with a bridge linking reciprocal representations of IR physics, whose cross-bridge entanglement provides a precise criterion for the viability of an effective description. I analyse when this criterion is met, and show that there is a large-volume limit, with the fundamental scale held fixed, in which the obstruction to a local description scales away: Wilsonian behaviour is restored and renormalisation forgets. The BRTN therefore provides a concrete and calculable platform for UV/IR mixing.

02.
arXiv (CS.CL) 2026-06-16

CODA-BENCH: Can Code Agents Handle Data-Intensive Tasks?

Advanced agents are increasingly demonstrating the potential to operate as autonomous engineers, creating a growing demand for evaluation benchmarks that capture the complexity of real-world development. Such environments typically involve both complex code and large-scale data (i.e., file system). However, existing benchmarks usually evaluate code-centric or data-centric capabilities in isolation, leaving a clear gap with real development scenarios. In this paper, we bridge this gap by introducing CODA-BENCH, the first benchmark to jointly evaluate code and data intelligence in a data-intensive environment. We construct a data-intensive Linux sandbox based on the Kaggle ecosystem (containing hundreds of datasets), where agents must actively explore complex file hierarchies to identify relevant resources and generate code for data-driven analytical tasks. CODA-BENCH comprises 1,009 tasks spanning 31 communities, with each task environment containing an average of 980 files, simulating realistic data scale and noise. Evaluations of advanced agents reveal that even top-performing systems struggle to effectively integrate data discovery with code execution, achieving a success rate of only 61.1%. These results highlight a substantial gap in current agentic capabilities for data-intensive tasks and point to promising directions for future research.

03.
medRxiv (Medicine) 2026-06-22

Use of the Pharmacy First service in England in the first 12 months: geographic variation and health system context

Objectives: The Pharmacy First (PF) service was introduced across England from 31 January 2024 to expand the clinical role of community pharmacies and improve access to primary care. This paper describes use of PF in its first 12 months, in terms of uptake, access routes, consultation outcomes, geographic variations, service costs and antimicrobial supply. Methods: A descriptive analysis of all PF consultations submitted for payment to NHS Business Services Authority in England between 31 January 2024 and 31 January 2025. Pharmacy-level consultation data were linked to national data on population, location and pharmacy characteristics. PF use was examined using population-standardised consultation rates and consultations per pharmacy. Results: During the first year of implementation, 2,205,731 PF consultations were recorded as delivered across 11,349 pharmacies, with payment of GBP123 million to pharmacies. Uptake increased steadily over time. Most consultations were for acute sore throat (33%) and uncomplicated urinary tract infection (27%), with corresponding antibiotics, phenoxymethylpenicillin and nitrofurantoin being the most supplied. Most people self-referred (74%) into the service, with 95% of consultations managed without onward referral. Substantial geographic variation was observed. Northern regions had higher use based on the eligible population. The South East and Midlands had higher activity per pharmacy. London showed a distinct pattern, with higher self-referral into the service, lower medication supply and higher referral to other healthcare services. Higher consultation volume was weakly associated with pharmacy characteristics, including opening hours, pharmacy type and retail setting, and local context, in terms of socio-economic and geographic factors. Conclusions: PF had immediate uptake and is operating primarily as a direct-access model for common acute conditions. Findings suggest that PF is contributing to improved access to care and may shift demand away from general practice. However, the service uptake appears to be shaped by geographic location, proximity to other healthcare services and pharmacy characteristics.

04.
arXiv (CS.CV) 2026-06-17

Attention Sinks in Diffusion Transformers: A Causal Analysis

Attention sinks – tokens that receive disproportionate attention mass – are assumed to be functionally important in autoregressive language models, but their role in diffusion transformers remains unclear. We present a causal analysis in text-to-image diffusion, dynamically identifying dominant attention recipients per timestep and suppressing them via paired, training-free interventions on the score and value paths. Across 553 GenEval prompts on Stable Diffusion~3 (with SDXL corroboration), removing these sinks does not degrade text-image alignment (CLIP-T) or preference proxies (ImageReward, HPS-v2) at $k{=}1$; only under stronger interventions ($k\!\geq\!10$) does HPS-v2 exhibit a metric-dependent boundary, while CLIP-T remains robust throughout. The perceptual shifts induced by suppression are nonetheless sink-specific – $\sim\!6\times$ larger than equal-budget random masking – revealing an empirical dissociation between trajectory-level perturbation and semantic alignment in diffusion transformers. \footnote{Code available at https://github.com/wfz666/ICML26-attention-sink.}

05.
arXiv (CS.AI) 2026-06-12

PolyFlow: Safe and Efficient Polytope-Constrained Flow Matching with Constraint Embedding and Projection-free Update

arXiv:2606.13400v1 Announce Type: cross Abstract: While flow-based generative models have demonstrated strong performance across a wide range of domains, deploying them in safety-critical physical systems remains challenging due to strict constraint requirements. Existing approaches typically enforce safety through post-hoc corrections, which incur substantial computational overhead and may distort the learned distribution. We propose PolyFlow, a polytope-constrained flow matching framework that embeds constraints directly into the model and flow dynamics. PolyFlow introduces a discrete-time flow formulation and a projection-free architecture, which eliminate the discretization error and guarantee strict satisfaction of arbitrary polyhedral constraints, without the need for expensive iterative solvers. Experimental results show that PolyFlow achieves zero constraint violation while maintaining high distributional fidelity across a range of planning and control tasks. Compared to state-of-the-art constrained generation baselines, PolyFlow significantly reduces inference latency and demonstrates a favorable trade-off between safety, efficiency, and generative quality. Code is available on https://github.com/MJianM/PolyFlow.

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

Hierarchical mutual distillation for multi-view fusion: Learning from all possible view combinations

Multi-view learning often struggles to effectively leverage images captured from diverse angles and locations. Learning methods for unstructured multi-view images remain largely underexplored. We propose a novel Hierarchical Mutual Distillation for Multi-View Fusion (HMDMV) method, which can handle both structured and unstructured multi-view scenarios. It makes predictions utilizing all possible view combinations: single view, partial multi-view, and full multi-view. The method generates predictions for each view combination and then applies hierarchical mutual distillation to enhance inter-view consistency. An uncertainty-based weighting mechanism further refines the fusion process by adjusting the influence of each view combination according to its prediction confidence, reducing the impact of low-confidence views. Extensive experiments on large-scale structured and unstructured datasets demonstrate that HMDMV consistently achieves state-of-the-art classification accuracy. Another unique advantage of HMDMV is that it provides improved flexibility in inference, allowing for more or fewer view counts in inference than those used in training without additional processing. We also provide a light version with reduced training cost by designing an efficient strategy that randomly samples subsets of view combinations during each training iteration. These results highlight HMDMV's robustness in real-world settings where view availability is variable or incomplete. The code is available at https://github.com/labhai/HMDMV.

07.
arXiv (CS.CV) 2026-06-17

Structure-Aware Text Recognition for Ancient Greek Critical Editions

Recent advances in visual language models (VLMs) have transformed end-to-end document understanding. However, their ability to interpret the complex layout semantics of historical scholarly texts remains limited. This paper investigates structure-aware text recognition for Ancient Greek critical editions, which have dense reference hierarchies and extensive marginal annotations. We introduce two novel resources: (i) a large-scale synthetic corpus of 185,000 page images generated from TEI/XML sources with controlled typographic and layout variation, and (ii) a curated benchmark of real scanned editions spanning more than a century of editorial and typographic practices. Using these datasets, we evaluate three state-of-the-art VLMs under both zero-shot and fine-tuning regimes. Our experiments reveal substantial limitations in current VLM architectures when confronted with highly structured historical documents. In zero-shot settings, most models significantly underperform compared to established off-the-shelf software. Nevertheless, the Qwen3VL-8B model achieves state-of-the-art performance, reaching a median Character Error Rate of 1.0\% on real scans. These results highlight both the current shortcomings and the future potential of VLMs for structure-aware recognition of complex scholarly documents.

08.
arXiv (quant-ph) 2026-06-19

Scalable quantum circuit knitting using a weak-coupling approximation

arXiv:2606.19035v2 Announce Type: replace Abstract: We present a method for performing distributed quantum computing with controlled approximations. Exact distributed quantum computing requires exponential classical information to reconstruct the quantum process. However, we show how the classical cost is reduced to polynomial if the quantum procedure can be partitioned between a qubit that is weakly coupled the other qubits. We demonstrate our method for a layered circuit based on the circuits used for the quantum approximate optimization algorithm.

09.
arXiv (CS.LG) 2026-06-18

RouteJudge: An Open Platform for Reproducible and Preference-Aware LLM Routing

arXiv:2606.18774v1 Announce Type: new Abstract: We present RouteJudge, an online pairwise preference evaluation framework for LLM routing systems, with a public platform available at https://routejudge.cn. Different from model-level response evaluation, RouteJudge focuses on router-level decision quality. For each user query, multiple routing strategies independently recommend candidate models under the same model pool and budget constraints. The selected model responses are then presented to users through anonymous pairwise comparisons, and the resulting user preferences are attributed back to the routing strategies behind the compared responses. Each evaluation record stores the query, routing decisions, model responses, preference labels, cost, latency, and task metadata, enabling preference-aware, cost-aware, and task-conditioned analysis of LLM routers. To support the continuous expansion of routing methods in RouteJudge, we further release ORBIT (Optimal Routing and Budgeted Inference Toolbox), a modular and extensible toolbox that standardizes the end-to-end workflow of LLM routing. ORBIT provides unified interfaces for benchmark loading, query representation, router implementation, budget-aware evaluation, and method comparison, allowing researchers to develop and evaluate routing algorithms under consistent protocols. It also serves as the submission and integration layer for RouteJudge: researchers can implement routing methods within ORBIT, validate them on existing routing benchmarks, and submit compatible routers for online preference-based evaluation. The code of ORBIT is available at https://github.com/AIGNLAI/LAMDA-ORBIT.

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

Gradual Fine-Tuning for Flow Matching Models

arXiv:2601.22495v2 Announce Type: replace Abstract: Fine-tuning flow matching models is a central challenge in settings with limited data, evolving distributions, or computational constraints. While recent work has produced significant advances, particularly in the area of reward-based fine-tuning, current methods fail to demonstrate both theoretical correctness as well as strong empirical results in terms of stability, efficiency, and diversity preservation. In this work, we propose Gradual Fine-Tuning (GFT), a simple yet principled annealing-based framework for fine-tuning flow generative models when only samples from the target distribution are available. For stochastic flows, GFT defines a temperature-controlled sequence of intermediate objectives that smoothly interpolate between the pretrained and target drifts, provably approaching the true target as the temperature approaches zero. We analytically demonstrate that sample generation after GFT can be made substantially more efficient with the use of arbitrary (e.g., optimal transport) couplings, as well as by utilizing few-step inference methods. Empirically, GFT significantly improves convergence stability, while maintaining or improving generation quality, training speed, and generation diversity compared to other fine-tuning methods. Our results position GFT as a simple yet theoretically grounded and practically effective alternative for scalable adaptation of flow matching models under distribution shift.

11.
arXiv (CS.CL) 2026-06-18

VISUALSKILL: Multimodal Skills for Computer-Use Agents

Computer-use agents (CUAs) approach human-level performance on standardised benchmarks but still struggle on long-horizon tasks and unseen software. Existing skill libraries address this with reusable skills, but represent the skill artifact as text only, despite the visual nature of GUI interaction. We propose VISUALSKILL: a hierarchical multimodal skill, tailored to each target application and organised as a central index over per-topic files, which the agent consumes through a load_topic MCP tool that fetches the relevant topic's text and figures on demand. We construct each skill with a two-stage pipeline that combines authored documentation with live-application UI exploration. On two CUA benchmarks, CUA-World and OSExpert-Eval, a Claude Code CLI agent backed by Claude Opus 4.6 reaches an average score of 0.456 with VISUALSKILL, a +15.3 point absolute lift over the no-skill baseline (0.303). Against a matched text-only skill that is generated from the same source content and differs from VISUALSKILL only in modality, VISUALSKILL yields a further +8.3 point absolute gain over the matched text-only skill (0.373 vs. 0.456), providing direct evidence that retaining visual figures in the skill artifact, rather than verbalizing them away, helps the agent both identify UI elements and verify workflow state after each action. Our code is available at https://github.com/XMHZZ2018/VisualSkills.

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

Mining Architectural Quality Under Agentic AI Adoption: A Causal Study of Java Repositories

arXiv:2606.13298v1 Announce Type: cross Abstract: AI coding tools are now used by a majority of developers, and agentic use of these tools has popularized the practice colloquially called "vibe coding". Yet causal evidence on their effect on software architecture is scarce. Prior causal work has measured code-level outcomes (complexity, static analysis warnings); whether such degradation propagates to architecture-level outcomes remains unknown. We mine 151 open-source Java repositories, 74 with detectable agentic AI adoption (identified via configuration files and Co-Authored-By commit trailers) and 77 propensity-matched controls, across a 13-month per-repository window yielding 1,811 monthly Arcan snapshots. We estimate the causal effect of adoption on architectural smell density (ASD) with a staggered difference-in-differences design and the Borusyak imputation estimator, applying a causal design recently used for code-level metrics to the architecture level. Total smell counts are essentially unchanged (+1.1%, p = 0.82) while lines of code grow +12.8% (p = 0.003); the resulting 6.7% ASD decline (p = 0.004) is therefore a denominator effect rather than an architectural improvement. Per-type estimates and robustness checks (wild cluster bootstrap, Lee bounds, stale-observation sensitivity) corroborate the pattern; pre-trends are flat (Wald p = 0.90), consistent with parallel trends. Density-normalized outcomes can mislead when treatment affects system size: raw counts and explicit decomposition are required for causal mining studies of AI tool adoption. The complete replication package, including the curated 151-repository monthly panel, is publicly available.

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

Efficient Online 3D Multi-Camera Multi-Object Tracking and Pose Estimation

This paper proposes a fast and online method for jointly performing 3D multi-object tracking and pose estimation using multiple monocular cameras. Our algorithm requires only 2D bounding box and pose detections, eliminating the need for costly 3D training data or computationally expensive deep learning models. Our solution is an efficient implementation of a Bayes-optimal multi-object tracking filter, enhancing computational efficiency while maintaining accuracy. We demonstrate that our algorithm is significantly faster than state-of-the-art methods without compromising accuracy, using only publicly available pre-trained 2D detection models. We also illustrate the robust performance of our algorithm in scenarios where multiple cameras are intermittently disconnected or reconnected during operation.

14.
Nature (Science) 2026-06-17

Emergent decadal predictability in Antarctic contribution to sea-level rise

Despite large uncertainties associated with future mass loss from the Antarctic Ice Sheet, ice-sheet models show that the rate of sea-level rise from Antarctic ice loss in 2025 is strongly predictive of the rate for the next several decades, regardless of emission pathway or model complexity. This finding is robust across all models that were considered in the Intergovernmental Panel on Climate Change Sixth Assessment Report global mean sea-level projections, including the low-likelihood, high-impact scenarios of sea-level rise. Given this strong near-term decadal predictability, ice-sheet models that can accurately reproduce present-day ice-mass loss provide a reliable basis for near-term sea-level planning and adaptation through to mid-century. The predictability breaks down by the end of the twenty-first century as feedbacks, such as those related to marine ice-sheet retreat, begin to emerge, leading to accelerating ice loss. Drawing on these results, we identify key feedback mechanisms that can account for the transition between near-term decadal predictability and the longer-term, feedback-driven evolution, and suggest priorities for ice-sheet model development aimed at resolving long-term sea-level rise uncertainty. Although Antarctic ice loss projections diverge widely by 2100, this Perspective shows that present-day rates robustly predict mid-century sea level rise, providing a firm basis for near-term planning, while highlighting priorities for model development aimed at resolving longer-term sea level rise uncertainty.

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

MA-SBI: Misspecification-Aware Simulation-Based Inference via Side-Channel Guidance

arXiv:2606.16923v1 Announce Type: new Abstract: Simulation-based inference (SBI) of latent parameters is often hindered by simulator misspecification, the mismatch between simulated and real-world observations caused by inherent modeling simplifications. RoPE, the recent state-of-the-art for robust SBI, addresses this through optimal transport between learned representations of real and simulated observations, but requires ground-truth parameter calibration pairs that are typically unavailable in the very settings where SBI is needed. What practitioners do have is unstructured side-information such as regime labels, instruction text, and policy bulletins. We propose Misspecification-Aware Simulation-Based Inference (MA-SBI), a calibration-free framework that turns this side-channel into a posterior correction. A learned corrector maps side-channel text to an observation-space shift applied before any pre-trained amortized posterior, requiring no retraining and no parameter ground-truth. Our main theorem bounds achievable bias reduction by the mutual information between misspecification and side-channel, with a non-vacuous constant that extends to all sub-Gaussian noise via Donsker-Varadhan. On hide-the-calibration benchmarks, MA-SBI with text alone matches the oracle posterior across 10 seeds and two backbones (TOST equivalence), while RoPE given more data does not. The two approaches are complementary: where misspecification is structural and recoverable from parameter pairs, RoPE dominates, as the theory predicts. A stochastic variant improves posterior-predictive log-likelihood on real COVID and OxCGRT epidemiological data, and correctly leaves the posterior unchanged on a well-specified cognitive-science corpus.

16.
arXiv (CS.CV) 2026-06-18

Technical Report for ICRA 2026 GOOSE 2D Fine-Grained Semantic Segmentation Challenge: Leveraging DINOv3 for Robust Outdoor Scene Understanding in Field Robotics

The GOOSE 2D Fine-Grained Semantic Segmentation Challenge at the ICRA 2026 Workshop on Field Robotics evaluates dense semantic segmentation of off-road imagery over a fine-grained taxonomy of 64 classes and 11 evaluated non-void coarse categories. We present the first-place solution to this challenge. Our solution comprises two complementary improvements: (a) a network-level design that combines a self-supervised DINOv3 ViT-L/16 backbone, a ViT-Adapter, and a Mask2Former mask-classification decoder, together with a coarse-category auxiliary loss on the global [CLS] token; and (b) an inference-time aggregation strategy based on multi-scale and horizontal-flip test-time augmentation and an ensemble of the top three checkpoints selected using Codabench scores. Our method achieves an official composite score of 76.57%, consisting of 69.32% fine-class mIoU and 83.81% category-level mIoU, and ranks first on the final phase leaderboard: www.codabench.org/competitions/14257/#/results-tab.

17.
Nature (Science) 2026-06-17

Towards Conversational AI for Disease Management

While large language models (LLMs) have shown promise in diagnostic dialogue1, their capabilities for effective management reasoning—including disease progression, therapeutic response, and safe medication prescription—remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE)1−3 through a new LLM-based agentic system optimized for multi-visit clinical management and dialogue. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini’s long-context capabilities4, combining in-context retrieval with structured reasoning to align its output with up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialists and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. Though AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE’s strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

19.
arXiv (quant-ph) 2026-06-15

All about quantum error correction: distillation, mitigation, self-correction and beyond

Authors:

arXiv:2606.14034v1 Announce Type: new Abstract: In this work, it is shown that many quantum error-manipulating techniques, such as distillation, error mitigation, and dynamical decoupling, are special cases of the most general framework for quantum error correction. This unifying perspective is achieved by extending quantum error correction to include state-adaptive and channel-adaptive settings, as well as multi-stage coding scenarios. Based on this insight, a model of self-correcting quantum memory is also proposed. This work clarifies the relationship among these techniques and illustrates, through explicit constructions, how the unified perspective can guide the design of reliable quantum information systems.

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

Uncertainty-Aware Hybrid Retrieval for Long-Document RAG

Retrieval augmented generation (RAG) depends critically on the quality and granularity of retrieved evidence. Large retrieval units preserve context but often introduce irrelevant content, which can dilute answer bearing evidence and worsen long context utilization. Fine-grained units are more compact, but they may be difficult to retrieve reliably because short chunks can lack semantic, lexical, or bridging cues needed to match the query. We propose Uncertainty-aware Multi-Granularity RAG (UMG-RAG), a training-free hybrid retrieval framework that treats chunk granularity as query-specific reliability estimation. Instead of training a new retriever or modifying the generator, UMG-RAG uses existing dense and sparse retrievers as complementary experts across multiple chunk granularities. For each query, it converts each expert-granularity score list into an evidence distribution, estimates reliability from distribution entropy, and fuses candidates according to query-specific semantic, lexical, and granularity confidence. We further introduce UMGP-RAG, a parent promotion variant that uses fine-grained hits to locate relevant evidence while returning broader non-redundant parent chunks for local coherence. Experiments on question answering benchmarks show that uncertainty-aware fusion and parent promotion improve generation quality while maintaining a lightweight, plug-and-play retrieval pipeline.

21.
arXiv (CS.AI) 2026-06-11

Precomputing Multi-Agent Path Replanning Using Temporal Flexibility

arXiv:2601.04884v3 Announce Type: replace Abstract: Executing a multi-agent plan can be challenging when an agent is delayed, because this typically creates conflicts with other agents. So, we need to quickly find a new safe plan. Replanning only the delayed agent often does not yield an efficient plan, and sometimes cannot even yield a feasible one. On the other hand, replanning other agents may lead to a cascade of changes and delays, and it is computationally expensive. We show how to efficiently replan a single delayed agent by tracking and using the temporal flexibility of other agents while avoiding cascading delays. This flexibility is the maximum delay that the agent can take without changing the order with agents other than the initially delayed agent, or further delaying other agents. Our algorithm, FlexSIPP, precomputes all possible plans for the delayed agent and returns the changes to the other agents within the given scenario. We demonstrate our method in a real-world case study of replanning trains in the densely-used Dutch railway network and in the MovingAI MAPF benchmark set. Our experiments show that FlexSIPP provides effective solutions relevant to real-world adjustments, and within a reasonable timeframe.

22.
arXiv (quant-ph) 2026-06-19

Subsystem Quantum Error Correction for Noisy Quantum Metrology

arXiv:2606.19628v1 Announce Type: new Abstract: Quantum error correction has been successfully applied to enhance the precision of parameter estimation in the presence of noise. Nonetheless, existing methods require a number of noiseless, controllable ancillae and lack efficient encoding and decoding procedures. In this Letter, we demonstrate that subsystem error correction provides a new direction that can substantially simplify the metrological protocol. We derive general conditions under which subsystem stabilizer codes achieve the Heisenberg limit and show that, for broad classes of noise, this can be realized by syndrome-free protocols using at most a single ancilla qubit. Furthermore, we extend this framework to dynamical error correction and show that Floquet codes can protect time-dependent metrological signals in reaching the Heisenberg limit.

23.
medRxiv (Medicine) 2026-06-16

Physiological Aging of the Respiratory System (PARS): from development to application

Background: Aging has a critical role in lung changes and the outcome of lung disease. Several lung aging equations have been proposed to measure deviation from physiological aging of the respiratory system. In this study, we aimed to develop a single measure of accelerated lung aging and show its application as a measure of lung aging. Method: We used a pre-bronchodilator pulmonary function test (PFT) from NHANES adult participants recruited from 2007 to 2011. We applied Klemera-Dubal Method (KDM) to four PFT measurements, FEV1, FVC, FEF25-75, and PEF, to calculate a measure of lung biological aging. Physiological Aging of the Respiratory System (PARS) was calculated from the residual method vs. chronological age. We tested the construct validity of PARS by measuring its association with risk factors of lung health. The prognostic validity was measured using a survival analysis. Sampling weights were applied to all analyses. Results: In 14,123 adult participants, the mean (SD) of accelerated lung age (PARS) was 0 (8.2) years. Participants with a history of asthma and emphysema had 4- and 10-year higher PARS. Cigarette smoking, lower socioeconomic status, black race, higher serum cadmium, and lower serum selenium and magnesium were associated with higher PARS. During 116 months of follow-up, PARS was associated with a higher mortality (HR = 1.06, 95%CI: 1.05-1.07 per year). Females with higher PARS had a higher risk of death (P for interaction < 0.001). Results were consistent across different subgroups and sensitivity analyses. Conclusion: PARS is a noninvasive lung aging marker and can be applied as a single measure of lung accelerated aging in the adult population. Its strong construct and predictive validity support its future application among different populations with and without lung disease.

24.
medRxiv (Medicine) 2026-06-12

Effect of tenofovir on the outcomes of COVID-19 in persons with chronic hepatitis B: a nationwide cohort study in Sweden.

Background: Patients with chronic hepatitis B (CHB) may have an increased risk of severe COVID-19. Tenofovir has been hypothesized to confer protection against severe disease, but evidence is inconclusive. We evaluated the risk of severe COVID-19 among CHB patients treated with tenofovir compared with other nucleos(t)ide analogues (NAs). Methods and findings: In this nationwide, registry-based cohort study, we included all adults with CHB and laboratory-confirmed COVID-19 in Sweden between February 2020 and July 2022. Data from national health and socioeconomic registers were linked using unique personal identification numbers (PINs). Patients with HIV, hepatitis C, or hepatitis D coinfection were excluded. Exposure was defined as tenofovir versus other NA therapy. The primary outcome was severe COVID-19, defined as hospitalization >2 days or death within 30 days of diagnosis. Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI), controlling for age, sex, comorbidities, vaccination, socioeconomic status, and region of birth. Among 5,877 CHB patients with COVID-19, 672 were receiving NA therapy (437 tenofovir, 235 other NAs). Severe COVID-19 occurred in 8.0% of tenofovir-treated patients and 14.5% of those receiving other NAs (unadjusted OR 0.52; 95% CI, 0.31-0.85). After adjustment, the association was attenuated and no longer significant (aOR 0.72; 95% CI, 0.39-1.31). Older age, comorbidities, and unvaccinated status were strongly associated with severe disease. Conclusions: The apparent protective effect of tenofovir against severe COVID-19 in unadjusted analyses was largely explained by confounding factors. The risk of severe disease was primarily driven by age, comorbidities, and vaccination status. Prevention of severe COVID-19 in patients with CHB should instead focus on vaccination and management of comorbidities.

25.
Nature (Science) 2026-06-17

A distant brown dwarf coplanar to a warm Jupiter and a hot super-Earth

In transiting planetary systems, in which planetary sizes are accurately determined from transit observations, the presence of transit-timing variations1 (TTVs), especially when combined with radial velocity (RV) data, provides powerful constraints on masses and orbital eccentricities. Together, these measurements offer crucial insights into system architecture, formation mechanisms and dynamical evolution. We present long-term RV and transit/TTV monitoring of the relatively young star (age approximately 1 Gyr) TOI-201, revealing an exceptional multi-planet system composed of a hot super-Earth (SE) size planet transiting every 5.8 days, a warm Jupiter (WJ) on a 53-day orbit and an eccentric (e = 0.62) low-mass brown dwarf (BD) on an approximately 8-year orbit, with an estimated mass MBD of about 16 Jupiter masses. The BD is the longest-period transiting substellar object ever characterized by means of RVs and the only one known to be coplanar with inner planets. The architecture of this system suggests that the SE was formed isolated and in the innermost region of the gaseous disk. On the other hand, the orbital configuration of the outer companions suggests a nearly in situ formation of both objects, with the WJ forming in a dense inner disk. Alternatively, the BD might have formed farther out and migrated inward, while increasing its eccentricity owing to interactions with the disk. Analysis of long-term radial velocity data and transit time variations, induced by a super-Earth, a warm Jupiter and a brown dwarf in a coplanar orbit around the relatively young star TOI201.