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01.
medRxiv (Medicine) 2026-06-16

Comparative Effectiveness and Safety of Prophylactic Vasopressors for Preventing Post-induction Hypotension in the Elderly: A Systematic Review and Network Meta-analysis

Background: Post-induction hypotension is a predictable haemodynamic hazard in older adults undergoing general anaesthesia. Prevention remains divided among volume optimisation, anaesthetic dose reduction, rescue treatment after hypotension occurs and proactive vasoactive support. Methods: We searched PubMed, Embase, Web of Science, CENTRAL, CNKI, Wanfang and VIP from inception to 30 March 2026. Eligible studies were randomised trials of prophylactic vasoactive drugs given before, during or immediately after induction in older adults. The primary outcome was post-induction hypotension. Secondary outcomes were post-induction mean arterial pressure (MAP), systolic arterial pressure (SBP), heart rate (HR) and reported haemodynamic adverse events. Random-effects network meta-analysis was used, and confidence in network estimates was assessed using CINeMA principles. Results: Thirty-one trials including 2,821 participants were included in the revised network. Compared with placebo/control, all active agents favoured lower post-induction hypotension. The most favourable point estimates were observed for phenylephrine (odds ratio [OR] 0.17, 95% confidence interval [CI] 0.01 to 2.16) and metaraminol (OR 0.19, 95% CI 0.02 to 1.53), although both were imprecise. More precise reductions were observed for methoxamine (OR 0.23, 95% CI 0.13 to 0.43), norepinephrine (OR 0.25, 95% CI 0.13 to 0.47) and ephedrine (OR 0.34, 95% CI 0.19 to 0.63). Phenylephrine ranked highest for MAP support, norepinephrine ranked highest for SBP support, and ephedrine ranked highest for HR preservation. Global inconsistency was detected for SBP but not for hypotension incidence, MAP or HR, supporting cautious profile-based interpretation. Conclusions: Prophylactic vasopressor choice during induction should be guided by haemodynamic phenotype rather than ranking alone. In the revised network, active prophylaxis consistently favoured lower hypotension, but sparse nodes produced uncertainty. Norepinephrine retained a comparatively balanced profile when vasodilatory post-induction hypotension is anticipated, phenylephrine and related alpha-agonists provided stronger pressure support when HR and cardiac-output reserve are preserved, and ephedrine was most relevant when chronotropic support is desired. Keywords: general anaesthesia; induction; hypotension; norepinephrine; phenylephrine; ephedrine; network meta-analysis; older adults.

02.
arXiv (CS.LG) 2026-06-15

Decoupled Latent Optimization of Diffusion Models for Full Waveform Inversion

arXiv:2606.14139v1 Announce Type: new Abstract: Full waveform inversion (FWI) recovers subsurface velocity from seismic recordings by solving a severely ill-posed, nonconvex PDE-constrained optimization. Classical regularizers stabilize the inversion but fail to reproduce realistic geological structures; recent diffusion-prior methods improve realism at the cost of a fragile trade-off between data fidelity and prior consistency. We propose Decoupled Latent Optimization (DLO), which relaxes the standard latent-optimization formulation into a quadratic-penalty objective over an auxiliary physical variable and a latent variable. The data-fidelity gradient acts in physical space, the diffusion sampler contributes only through a decoded prior sample, and the standard smoothed-velocity initialization of classical FWI is preserved. On the OpenFWI benchmark, DLO outperforms classical regularizers and existing diffusion-based methods under clean, noisy, and missing-trace acquisitions. The prior, trained on 70*70 OpenFWI models, transfers directly to the Marmousi and Overthrust benchmarks, where DLO recovers intricate fault structures and remains robust to initialization smoothing and measurement noise.

03.
arXiv (CS.CV) 2026-06-17

MambaCount: Efficient Text-guided Open-vocabulary Object Counting with Spatial Sparse State Space Duality Block

Text-guided Open-vocabulary Object Counting (TOOC) aims to estimate the number of objects described by text prompts, which is particularly challenging in dense scenes with large scale variations. Existing TOOC approaches predominantly rely on Transformers, whose quadratic complexity with respect to image resolution limits their scalability. Mamba offers a promising alternative due to its linear complexity. However, previous Mamba-based methods have two main limitations. On the one hand, the inherent causal formulation of Mamba constrains the bidirectional spatial dependency modeling required by non-causal vision tasks. On the other hand, existing Mamba-based vision models often overlook the unconstrained high entropy in the spatial token responses, which can weaken local details and high-frequency cues. To address these limitations, we propose MambaCount, an efficient framework built on the Spatial Sparse State Space Duality (S^4D) block. Specifically, we analyze and reconstruct the decay dynamics of hidden states in Mamba to alleviate the dependency constraints introduced by causal modeling. Moreover, we introduce a Spatial Token Selection (STS) sub-block to reduce the unconstrained high entropy in spatial token responses within Mamba. In addition, we design Multi-Granularity Prototypes (MGP) to identify object-like regions at different semantic levels, improving cross-modal alignment and interpretability. Extensive experiments on FSC-147 demonstrate that MambaCount achieves state-of-the-art performance among methods without secondary querying, obtaining a test MAE of 12.23, while retaining linear complexity.

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

Learned Image Compression for Vision-Language-Action Models

Vision-language-action (VLA) models increasingly rely on high-frequency multi-camera observations, making visual communication a major bottleneck for real-time robotic control in bandwidth-constrained or distributed deployment settings. Existing image and video codecs, however, are designed to preserve generic visual fidelity rather than the control performance of downstream VLA policies. In this work, we introduce SPARC (SPatially Adaptive Rate Control), a learned image compression framework tailored for VLA-driven robots. Our key observation is that the importance of visual information varies substantially across both camera views and spatial regions within an image. Based on this observation, SPARC employs a lightweight temporal mask selector that adaptively allocates bitrate over latent representations according to task relevance while leveraging temporal context. We further introduce a tilted rate loss that stabilizes training by reducing the tendency of entropy-based objectives to over-suppress rare yet task-critical visual patterns. Experiments on diverse robotic benchmarks, including RoboCasa365, VLABench, and LIBERO, show that SPARC consistently achieves stronger control performance than conventional image/video codecs and recent learned compression methods under the same bitrate budget. We additionally demonstrate real-world deployment benefits in remote-control settings, where our method substantially improves the bitrate-success tradeoff.

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

Large Language Models for Agentic NetOps and AIOps: Architectures, Evaluation, and Safety

arXiv:2605.12729v2 Announce Type: replace-cross Abstract: Large language models are increasingly being used to support network operations (NetOps) and artificial intelligence for IT operations (AIOps), including incident investigation, root-cause analysis, configuration synthesis, and limited self-healing. In both NetOps and AIOps, this shift is changing how tasks are managed. Agent-based operations work as workflows, from gathering evidence to taking action, following permissions, policies, and checks, and providing rollback options when necessary. This is crucial because operational decisions can have instant impacts. To make the argument concrete, we organise the relevant literature around the hierarchy of autonomy, tool scope, evidence traces, and assurance contracts. These contracts define what an agent may observe, propose, and execute. They also define the checks that must pass before any action is allowed. A consistent pattern appears across work on telemetry query recommendation, diagnosis, root-cause analysis, configuration synthesis, change planning, and limited self-healing. Operational reliability does not come chiefly from the model itself. It depends on the machinery around the model. We also argue that evaluation should go beyond static question answering. Agentic NetOps and AIOps systems require workflow-centred evaluation, including trace quality, bounded tool use, safe proposal generation, replay in sandboxed environments, and canary trials with rollback-aware scoring. Without these measures, a system may appear robust yet remain too fragile. Finally, we examine security, privacy, and governance risks that become acute when agents sit close to operational control surfaces. Taken together, the survey concludes that progress in intelligent NetOps and AIOps will depend on treating autonomy as a constrained operational control problem, whose outputs must be reliable, auditable, and securely deployable.

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

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

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

07.
arXiv (quant-ph) 2026-06-16

Suppressing Intrinsic Spin-Phonon Errors in Trapped-Ion Quantum Simulation

arXiv:2606.15518v1 Announce Type: new Abstract: Trapped-ion quantum simulators realize programmable spin models through phonon-mediated interactions. For Hamiltonians with noncommuting terms, however, the same phonon bus generates intrinsic spin-phonon errors that strongly distort the target dynamics. Because these errors are governed by the full time history of the spin-dependent phonon motion, they survive standard loop-closing control and limit simulation accuracy. Using a sequence of frame transformations, we isolate the residual error dynamics and show that this intrinsic error can be strongly suppressed while preserving programmable Ising couplings. Full spin-boson simulations of multi-ion chains demonstrate orders-of-magnitude lower error than both constant-drive and conventional loop-closing protocols. These results remove a central precision barrier in trapped-ion analog quantum simulation and enable accurate programmable simulation of noncommuting many-body Hamiltonians and dynamical protocols.

08.
arXiv (CS.AI) 2026-06-19

Wisdom of Committee: Diverse Distillation from Large Foundation Models and Domain Experts

arXiv:2402.14035v4 Announce Type: replace-cross Abstract: Knowledge distillation from foundation models to compact domain models is challenging due to substantial gaps in capacity, architecture, and modality. For example, in our experiments, distilling from a 76M-parameter language model to a 2M-parameter recommender closes less than 40% of the performance gap between the undistilled student and the teacher. We show that introducing domain-specific experts – which share the student's architectural characteristics – alongside the foundation model as a diverse teacher committee significantly improves transfer. However, standard multi-teacher methods fail to exploit this diversity: naively combining heterogeneous teachers can degrade performance below single-teacher distillation. To address this, we propose DiverseDistill, an interactive distillation framework that employs a learnable Question-Answer mechanism to generate teacher-conditioned queries and align heterogeneous teacher outputs into the student's representation space. Unlike methods requiring gradient-based co-optimization or architectural modification of teachers, DiverseDistill operates with frozen teachers using only forward-pass inference through their intermediate layers: no parameter updates, no co-training, and no architectural surgery. A dynamic teacher importance mechanism further reduces training cost by filtering low-relevance teachers per sample (e.g., ~30% fewer forward passes with no quality loss for recommendation tasks), while the entire Distillation Module is discarded after training, adding zero inference overhead. Evaluations on recommendation (38x compression) and vision (3.6x compression) tasks demonstrate that DiverseDistill recovers 73-114% of the teacher-student performance gap, consistently outperforming all single- and multi-teacher baselines.

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

Simple Domain Generalization Methods are Strong Baselines for Open Domain Generalization

In real-world applications, a machine learning model is required to handle an open-set recognition (OSR), where unknown classes appear during the inference, in addition to a domain shift, where the data distribution differs between the training and inference phases. Domain generalization (DG) aims to handle the domain shift situation where the target domain of the inference phase is inaccessible during the model training. Open domain generalization (ODG) considers DG and OSR. Domain-augmented meta-learning (DAML) is a method targeting ODG; however, it has a complicated learning process. By contrast, although various DG methods have been proposed, they have not been evaluated in ODG situations. In this study, we comprehensively evaluate the existing DG methods in ODG and show that the two simple DG methods, CORrelation ALignment (CORAL) and maximum mean discrepancy (MMD), are competitive with DAML in several cases. In addition, we propose simple extensions of CORAL and MMD by introducing the techniques used in DAML, such as ensemble learning and Dirichlet mixup data augmentation. The experimental evaluation demonstrates that the extended CORAL and MMD can perform comparably to DAML with lower computational costs. This suggests that the simple DG methods and their simple extensions are strong baselines for ODG.

10.
arXiv (CS.AI) 2026-06-16

An affordable hardware-aware neural architecture search for deploying convolutional neural networks on ultra-low-power computing platforms

arXiv:2606.16290v1 Announce Type: cross Abstract: Hardware-aware neural architecture search (HW-NAS) allows the integration of Convolutional Neural Networks (CNNs) in microcontrollers devices by automatically designing neural architectures that can fit prearranged hardware constraints. However, state-of-the-art HW-NAS target high-performance microcontrollers, whose power consumption does not meet sensing nodes requirements. This work presents a HW-NAS generating tiny CNNs that can run on ultra-low-power microcontrollers, featuring a lightweight search procedure enabling its execution even on embedded devices. Empirical results on three well-known benchmarks for tiny computer vision proved that the proposed HW-NAS was able to generate tiny CNNs while preserving state-of-the-art classification accuracy.

11.
arXiv (quant-ph) 2026-06-16

Quantum Illumination with Symmetry-Constrained Random Unitaries

arXiv:2606.15586v1 Announce Type: new Abstract: Quantum illumination provides a quantum advantage in detecting weakly reflecting objects embedded in a noisy environment, even when environmental noise destroys most of the initial entanglement. We investigate this advantage using Haar-random probe states constrained to symmetry-resolved subspaces. Employing tools from quantum channel discrimination and asymptotic hypothesis testing, we derive the discrimination exponents associated with Haar-random probe ensembles and identify the role of symmetry in determining their performance. We show that typical states drawn from fixed-charge sectors achieve the same asymptotic quantum-illumination advantage as maximally entangled probes. In particular, we show that the effective thermal-noise suppression and the corresponding Chernoff exponent are governed by the dimension of the accessible symmetry sector. Our results reveal that the operational resource underlying quantum illumination can be generalized from fine-tuned structure of a specific probe state to the existence of a large symmetry-protected correlation subspace. These findings establish a direct connection between quantum illumination, symmetry-resolved typicality, and quantum channel discrimination, and demonstrate that near-optimal quantum hypothesis testing resources can emerge naturally from generic many-body quantum states constrained by conservation laws.

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

Effects of sparsity and superposition on loss in simple autoencoders

arXiv:2606.18538v1 Announce Type: new Abstract: One of the major difficulties in the mechanistic interpretability of neural networks is the occurrence of polysemanticity, which suggests that each neuron is typically responsible for multiple different tasks, impeding a clean interpretation of their function. The seminal paper of Elhage et al. (2022) argues that this occurs due to superposition, a phenomenon where the neural network represents distinct features as non-orthogonal directions in a lower-dimensional space, a strategy that allows much greater compression of the data without sacrificing fidelity due to the feature sparsity of input vectors. Elhage et al. (2022) empirically validates these hypotheses in a rather natural and simple autoencoder with sparse inputs. The contribution of the present work is to analyze the mathematical basis for the occurrence and optimality of superposition, while rigorously corroborating some of their findings. In particular, we provide upper and lower bounds for the L2 reconstruction loss, tight in the very sparse regime, for power activation functions. A short list of interesting open problems are also included at the end.

13.
arXiv (CS.LG) 2026-06-19

Distributionally Robust Set Representation Learning Under Inference-Time Element Corruption

arXiv:2605.30089v2 Announce Type: replace Abstract: Standard Set Representation Learning methods typically excel on curated data but often overlook the challenge of inference-time element corruption. This refers to scenarios where deployed models encounter element-level degradations, such as outliers or missing components, that may distort set representation and degrade performance. We propose SW-DRSO, a distributionally robust optimization framework tailored for sets. Rather than minimizing loss solely on observed training data, SW-DRSO optimizes a tractable surrogate of the worst-case expected loss over a family of plausible inference-time variations. We introduce a barycentric adversary that approximates the intractable search over corrupted sets by a differentiable training-time optimization over simplex weights. Extensive experiments across four tasks demonstrate that SW-DRSO effectively enhances robustness against corruption while maintaining high overall performance.

14.
arXiv (math.PR) 2026-06-12

A mathematical study of the excess growth rate

arXiv:2510.25740v2 Announce Type: replace-cross Abstract: The excess growth rate, defined as the gap in Jensen's inequality for the logarithm, is a fundamental functional in portfolio theory. In this paper, we present a mathematical study motivated by information theory. We begin by establishing its properties and showing that it has rich connections with information theoretic concepts such as the Helmholtz free energy, L. Campbell's measure of average code length and large deviations. Our main results consist of three axiomatic characterization theorems of the excess growth rate, in terms of (i) the relative entropy, (ii) the gap in Jensen's inequality, and (iii) the logarithmic divergence that generalizes the Bregman divergence. Furthermore, we study maximization of the excess growth rate and compare it with the growth optimal portfolio. Our results not only provide theoretical justifications of the significance of the excess growth rate, but also establish new connections between information theory and quantitative finance.

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

CheXGenBench: A Unified Benchmark For Fidelity, Privacy and Utility of Synthetic Chest Radiographs

Structured benchmarks have advanced text-conditional image generation for real-world imagery, however, no such benchmark exists for synthetic radiograph generation. Despite being a highly active area of research, existing studies continue adopting inconsistent evaluation protocols and lack a unified assessment of the three most critical criteria: generative fidelity, privacy risk, and downstream utility. To address these limitations, we introduce CheXGenBench, the first unified evaluation framework for synthetic chest radiograph generation that simultaneously assesses fidelity, privacy risks, and downstream utility across frontier text-to-image (T2I) generative models. Our evaluation protocol, comprising over 20 quantitative metrics, covers 11 leading T2I architectures with plug-and-play integration for newer models. Through a rigorous and fair evaluation protocol, we establish comprehensive baseline state-of-the-art (SoTA) performances across all dimensions to guide future research. Furthermore, our results uncover several limitations of current generative models, which include first, even SoTA models struggle with long-tailed medical distributions; second, models pose high privacy risks regardless of fidelity quality; and third, while synthetic data already benefits downstream classification, it is of limited utility for downstream multimodal tasks. Drawing from these results, we propose concrete research directions to advance the field. The code is available at https://github.com/Raman1121/CheXGenBench

16.
Nature (Science) 2026-06-17

Mapping the neuronal building blocks of human language with language models

作者:

Humans can convey new and highly diverse information through language. This ability to form and combine words into elaborate phrases and sentences enables us to express inexhaustible meanings and is fundamental to human cognition1–5. However, understanding the microscopic cellular building blocks and cortical landscape that precisely underlie human language has remained a challenge. Here we used wide-scale single-neuronal recordings combined with natural language processing models to identify fine-grained linguistic representations across the human frontotemporal cortex during language production. We find that, whereas certain neurons represented the detailed grammatical relationships between words or their parts of speech, others tracked the sentences’ higher-order syntactic structure, their phrase transitions and sequence. Collectively, these neurons reliably captured the words’ syntactic and semantic properties but also dynamically incorporated their specific sentence contexts, therefore enabling them to encode information combinatorially and at highly granular levels of detail. We show how these cell populations were locally organized and how their microscale representations differed from that of their wider field potential patterns. We also show how these neurons were distributed broadly across the frontotemporal cortex, but how their ability to encode linguistic information was left-lateralized and varied between cortical regions. Together, these findings identify some of the most basic cellular building blocks by which linguistic information is encoded in humans and begin to define the cortical landscape of language at a combined micro (cellular), meso (local population) and macro (regional) scale. Wide-scale recordings reveal neurons in the human brain that encode fundamental components of language such as the grammatical relationships between words, their parts of speech and the higher-order syntactic structure of phrases and sentences.

17.
arXiv (CS.LG) 2026-06-19

A Hybrid GNN-FEM Framework for Phase-Field Fracture Simulation. Physics-Preserving Hybridization for Generalizable Surrogate Modeling

arXiv:2606.19378v1 Announce Type: new Abstract: Scientific machine learning (SciML) has emerged as a promising approach for accelerating simulations of complex physical systems, yet achieving physically consistent and generalizable predictions for nonlinear, history-dependent problems remains a central challenge. In this study, we propose a hybrid GNN–FEM framework for efficient and generalizable phase-field fracture modeling. While phase-field approaches provide a robust variational framework for simulating complex crack evolution, their high computational cost limits practical applications because they require solving coupled, nonlinear, and history-dependent systems within an incremental finite element procedure. To address this challenge, a graph neural network surrogate is integrated into the conventional staggered scheme, replacing the phase-field update at each load increment while retaining the FEM-based displacement solver to enforce mechanical equilibrium and boundary conditions. By preserving the incremental solution structure, the framework remains consistent with history-dependent fracture evolution without requiring the surrogate to approximate the full solution trajectory. This selective surrogate strategy emphasizes the identification of a physically meaningful and incrementally structured learning target, rather than relying on brute-force data generation to learn the full fracture process. The proposed framework achieves strong generalization across varying geometries, loading conditions, material properties, and discretizations through dimensionless feature design, a graph-based formulation on mesh-based domains, and a physics-informed loss derived from the governing phase-field equation. Numerical experiments demonstrate that the hybrid approach reduces computational cost while maintaining accuracy compared with conventional FEM, and exhibits robust predictive performance across diverse problem settings.

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

QSignAI: Quantum-Randomness-Seeded Identity Signatures at the Intersection of AI for Science and Science for AI

arXiv:2605.27729v2 Announce Type: cross Abstract: The 2024-2025 Nobel and Turing awards recognised AI and quantum science simultaneously. Yet no deployed system has brought these streams together for the public. This paper presents QSignAI, a production-deployed platform demonstrating a bidirectional AI-quantum relationship in a real-time event participation system. We address three questions: can quantum-randomness generation via a two-source extractor be embedded in an AI-driven social platform with acceptable latency; can an AI bot make quantum phenomena perceptually legible to general audiences; and does the combined system work in practice? A conversational bot routes each participant's first message through a quantum pipeline comprising a Toeplitz two-source extractor over independent single-qubit Hadamard measurements on SV1 and DM1 simulators, plus a 2-qubit Bell state, producing a unique quantum-randomness-seeded identity signature per participant. The first two questions are answered through system architecture and qualitative deployment evidence from live events; the third through successful production deployment. The current deployment uses cloud quantum simulators; physical QPU randomness is the near-term extension. Measurable benchmarks are identified as priority future work.

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

AgentFairBench: Do LLM Agents Discriminate When They Act?

arXiv:2606.16723v1 Announce Type: new Abstract: Large language model (LLM) agents increasingly take actions (screening applicants, recommending credit, triaging patients), yet fairness for LLMs is still measured by grading answers. We introduce AgentFairBench, a cheap, reproducible, multi-domain benchmark for demographic disparity in the actions of LLM agents. Grounded in a companion framework, the Bias Conduction Framework (BCF, restated here), it spans three regulator-anchored domains: hiring, lending, and medical triage. Synthetic, demographic-neutral profiles are evaluated in counterfactual matched sets that vary only a name-coded race x gender signal (in the Bertrand Mullainathan tradition), under four agent scaffolds of increasing agency (direct, chain-of-thought, multi-agent deliberation, tool-augmented). A NumPy-only harness computes counterfactual flip rate, mean absolute score difference (MASD), action-rate disparity, and tool-invocation disparity, with bootstrap confidence intervals, paired tests, and false-discovery-rate control, for single-digit dollars per model. A live leaderboard with a held-out private split and a contamination canary admits external models by submission. Our pilot (864 decisions plus a test-retest replication) carries a methodological lesson: comparing a six-group score spread against a two-run noise difference overstates disparity by ~ 2.4X through statistic arity alone. Against an arity matched noise floor and an omnibus group test, claude haiku 4 5 shows no demographic effect above sampling noise (0 of 120 pairwise and 0 of 9 omnibus contrasts survive correction); a planted-bias test confirms the instrument detects disparity when present. The contribution is a sound, sensitive, adoption-ready instrument, the arity matched null methodology, and open artifacts to scale it. Code, data, and harness are released under open licenses, with an anonymized review artifact.

20.
arXiv (CS.CV) 2026-06-18

Conditional Latent Diffusion Model with Fourier-based Motion Modelling for Virtual Population Synthesis

In-silico trials of medical devices require the generation of virtual populations of anatomies. In cardiovascular applications, virtual anatomy is typically represented as a 3D+t mesh sampled from a generative model. However, most existing mesh generators focus on static anatomy, while sequence models often lack explicit periodicity. To this end, we propose 4D F-MeshLDM, a conditional generative framework comprising a convolutional mesh VAE to encode meshes, a structural latent space that parameterises motion using a truncated Fourier series, and a diffusion prior that learns the latent distribution over Fourier coefficient tokens. By conditioning the diffusion process on clinical covariates via affine modulation, we enable controllable synthesis. Sampling tokens and performing inverse Fourier synthesis yield cycle-consistent latent trajectories, which can be decoded into 3D+t cardiac mesh sequences. Experiments on 5,000 UK Biobank subjects demonstrate that 4D F-MeshLDM outperforms state-of-the-art baselines in anatomical fidelity and achieves near-zero cycle closure error. Furthermore, the generated cohorts accurately preserve clinical functional indices, highlighting the potential of our framework for reliable in-silico cardiac trials.

21.
arXiv (quant-ph) 2026-06-17

A Quantum Approach to Stochastic Optimization in Insurance Underwriting

arXiv:2605.01169v2 Announce Type: replace Abstract: The presence of stochastic elements in combinatorial optimization problems makes them particularly challenging, as such problems quickly become intractable for classical computers even at relatively small sizes. In this work, we propose a novel quantum-classical hybrid scheme for solving a class of stochastic optimization problems known as chance-constrained knapsack problems, in which item weights follow probability distributions and constraints may be violated within a specified risk tolerance. Our method employs knapsack-specific QAOA-based circuits to generate samples which, when combined with a new self-consistent classical recovery scheme introduced in this work, produce high-quality solutions. Experiments carried out on IBM Heron processors, using circuits with depths up to 177 and comprising 3443 gates acting on as many as 150 qubits, yield solutions that indicate performance comparable to classical optimization schemes. The proposed quantum-classical scheme paves the way to tackling such problems, with the potential to outperform approaches that rely solely on classical computation.

22.
medRxiv (Medicine) 2026-06-18

Intra-arterial recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) thrombolysis for acute medium vessel occlusion (MeVO-TNK): Study rationale and design

Background The optimal management of acute ischemic stroke caused by medium vessel occlusion (MeVO) remains uncertain. Recent randomized trials have failed to demonstrate a clear benefit of endovascular therapy in this population, whereas intra-arterial thrombolysis (IAT) has emerged as a biologically plausible alternative. However, prospective evidence supporting IAT in MeVO is lacking, and the optimal dosing strategy for stand-alone IAT remains undefined. Aim To preliminarily evaluate the efficacy and safety of intra-arterial tenecteplase (IA-TNK) plus standard medical therapy (SMT) compared with SMT alone in patients with acute MeVO stroke, and to explore a stepwise IA-TNK dosing strategy. Design The MeVO-TNK trial is a multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE), exploratory phase II study. A total of 60 participants with imaging-confirmed MeVO will be randomized 1:1 to receive either IA-TNK plus SMT or SMT alone. Participants presenting beyond 6 hours from symptom onset must demonstrate salvageable penumbral tissue on advanced imaging. Those assigned to the intervention group will receive up to two intra-arterial boluses of tenecteplase (0.0625 mg/kg per bolus), with the second bolus administered based on angiographic assessment of reperfusion and safety. Outcomes The primary efficacy outcome is final infarct volume measured at 72{+/-}24 hours after randomization. Secondary efficacy outcomes include the proportions of patients achieving modified Rankin Scale (mRS) scores of 0-1, 0-2 and 0-3 at 90 days, a shift analysis of the mRS distribution at 90 days, early neurological deterioration, and National Institutes of Health Stroke Scale score at 7 days or discharge. The primary safety outcome is symptomatic intracranial hemorrhage within 24 hours. Conclusions This trial will provide preliminary evidence on the biological efficacy, reperfusion potential and safety of stand-alone IA-TNK for acute MeVO stroke, helping to address an important evidence gap and inform the design of future confirmatory studies.

23.
arXiv (CS.AI) 2026-06-19

CareTransition-Audit: A Benchmark to Audit Discharge Summaries for Efficient Care Transitions

arXiv:2604.05435v2 Announce Type: replace Abstract: Incomplete or inconsistent discharge documentation drives care fragmentation and avoidable readmissions. Despite its critical role in patient safety, auditing discharge summaries relies on manual review and does not scale. We propose an automated framework for auditing discharge summaries using large language models (LLMs). Our approach operationalizes the DISCHARGED framework into a checklist of 46 questions. Using 50 summaries from the MIMIC-IV database, with clinician ground-truth labels, we benchmark 11 LLMs. Model-assessed mean documentation completeness ranges from 54.9% to 74.2%, and the best-performing models achieve a Cohen's kappa values around 0.5 against clinician labels, indicating moderate agreement. All models struggle to identify ambiguous documentation (Unclear), highlighting a key gap in current automated auditing. This work provides a clinician-validated benchmark and zero-shot baselines for systematic quality improvement in clinical documentation.

24.
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.

25.
arXiv (CS.LG) 2026-06-18

On the Residual Scaling of Looped Transformers: Stability and Transferability

arXiv:2606.18524v1 Announce Type: new Abstract: Looped (weight-tied) Transformers apply a shared residual block $N$ times ($h \leftarrow h + \varepsilon\,f(h)$, same $f$ at each step), increasing effective depth without adding parameters. Prior depth-scaling analyses prescribe $\varepsilon = 1/\!\sqrt{L}$ for depth-$L$ residual networks. We show that this is insufficient for looped architectures: weight sharing makes residual updates correlated across iterations, requiring the stronger scaling $\varepsilon = 1/N$. For multi-layer blocks ($L$ unique layers looped $N$ times), we derive a factored parameterization $\varepsilon = \lambda/(N\!\sqrt{L})$ that separates the two sources of growth: $1/N$ controls the within-layer loop correlation, and $1/\!\sqrt{L}$ controls the across-layer variance. A key consequence is that the optimal learning rate depends only on the number of unique layers $L$, not on the loop count $N$, enabling direct hyperparameter transfer from small to large $N$ without retuning. Experiments on looped Transformers confirm that $1/N$ scaling improves trainability and yields better loss than $1/\!\sqrt{N}$ scaling across loop counts.