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01.
Nature (Science) 2026-06-10

Improved quantum processor logical error rates via correction and detection

作者:

Performing quantum algorithms for critical problems in physics and chemistry requires substantially lower error rates than the physical error rates of present quantum computers. Achieving such low logical error rates requires quantum error correction1,2 and physical error rates below a critical threshold value3–8. We experimentally demonstrate on a trapped-ion quantum charge-coupled device (QCCD)9,10 improvements in logical error rates ranging from 11× to 800× compared with several physical circuit baselines, including quantum computation on multiple qubits. Our results hinge on two quantum error correction code constructions optimized for an ion-trap processor: a 12-qubit code encoding two qubits inspired by Knill11 and a 16-qubit tesseract colour code encoding four qubits12,13. These constructions are combined with a scalable method of error detection and post-selection to achieve reduced logical error rates. Our results show that state-of-the-art quantum devices are already able to make use of fault tolerance and error correction to strongly suppress errors in non-trivial quantum circuit computations. Experimental demonstration of quantum error-correcting codes combined with error detection and post-selection applied to a trapped-ion quantum processor shows improvements in logical error rates ranging from 11× to 800× compared with several physical circuit baselines.

02.
arXiv (CS.LG) 2026-06-19

Approximate Next Policy Sampling: Replacing Conservative Target Policy Updates in Deep RL

arXiv:2605.05481v2 Announce Type: replace Abstract: We revisit a classic "chicken-and-egg" problem in reinforcement learning: to safely improve a policy, the value function must be accurate on the state-visitation distribution of the updated policy. That distribution over states is unknown and cannot be sampled for the purposes of training the value function. Conservative updates solve this problem, but at the cost of shrinking the policy update. This paper explores an alternative solution, Approximate Next Policy Sampling (ANPS), which addresses the problem by modifying the training distribution rather than constraining the policy update. ANPS is satisfied if the distribution of the training data approximates that of the next policy. To demonstrate the feasibility and efficacy of ANPS, we introduce Stable Value Approximate Policy Iteration (SV-API). SV-API modifies the standard approximate policy iteration loop to hold the target policy fixed while an iteratively updated behavioral policy gathers relevant experience. It only commits to a new policy once a convergence criterion has been met. If certain stability criteria are met, the update is guaranteed to be safe; otherwise, it remains no less safe than standard approximate policy iteration. Applying SV-API to PPO yields Stable Value PPO (SV-PPO), which matches or improves performance on high-dimensional discrete (Atari) and continuous control benchmarks while executing substantially larger target policy updates. These results demonstrate the viability of ANPS as a new solution to this classic challenge in RL.

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

WaveDINO: Learning-Based Atmospheric Correction of Unwrapped InSAR Interferograms Validated by GNSS: Results at Laguna del Maule and Campi Flegrei Volcanoes

Interferometric Synthetic Aperture Radar (InSAR) enables effective monitoring of volcanic deformation; however, the observed signals are often corrupted by atmospheric phase delays, seasonal surface changes, and decorrelation effects. Existing atmospheric correction methods, such as numerical weather model-based methods, can reduce these effects but do not consistently remove atmospheric artefacts and may introduce residual biases. To address these limitations, we propose a novel learning-based method for denoising unwrapped InSAR interferograms, using a hybrid training strategy that combines physically motivated synthetic deformation with real atmospheric noise. Specifically, we introduce WaveDINO, a wavelet-based multi-scale denoising framework conditioned on frozen DINOv3 foundation-model features and terrain information. Training uses synthetic magma-source deformation superimposed on short-term interferograms to expose the network to realistic atmospheric statistics while retaining known ground truth. Performance is evaluated on both controlled synthetic data and long-term real interferograms from Laguna del Maule (Chile) and Campi Flegrei (Italy), with independent GNSS measurements used for validation. WaveDINO consistently outperforms competing models, improving agreement with GNSS measurements, and reducing mean GNSS misfit by approximately 3% and 19% at two sites, respectively, while surpassing weather-model-based corrections.

05.
arXiv (CS.AI) 2026-06-19

Formal Verification of Learned Multi-Agent Communication Policies via Decision Tree Distillation

arXiv:2606.19632v1 Announce Type: cross Abstract: Multi-agent reinforcement learning (MARL) enables agents to develop coordination strategies through emergent communication, but neural policies lack the formal safety guarantees required for safety-critical robotic deployment in drone swarms and autonomous vehicle fleets. We present the first end-to-end framework for safety verification of learned multi-agent communication policies through policy abstraction: neural policies are distilled into interpretable decision trees, then formally verified, with empirical validation confirming that verified safety properties transfer to original networks. Our four-stage pipeline consists of domain-specific feature extraction from agent observations, decision tree distillation achieving 97.9% +/- 1.2% fidelity to neural policies, automated translation to PRISM probabilistic model checker specifications with complete feature-to-state-variable correspondence, and compositional verification of Probabilistic Computation Tree Logic (PCTL) properties via pairwise decomposition with union-bound aggregation and empirical neighbor modeling. Evaluating Vector-Quantized Variational Information Bottleneck (VQ-VIB) policies for multi-drone coordination with 5-7 agents, we verify 18 temporal logic properties across safety, liveness, and cooperation, achieving 88.9% property satisfaction with all five safety thresholds satisfied (0.3% collision probability vs. 1% threshold). Monte Carlo validation of original neural policies confirms that verified safety properties transfer with

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

EMS: Multi-Agent Voting via Efficient Majority-then-Stopping

arXiv:2604.02863v2 Announce Type: replace Abstract: Majority voting is the standard for aggregating multi-agent responses into a final decision. However, traditional methods typically require all agents to complete their reasoning before aggregation begins, leading to significant computational overhead, as many responses become redundant once a majority consensus is achieved. In this work, we formulate efficient multi-agent voting as a reliability-aware agent scheduling problem and propose Efficient Majority-then-Stopping (EMS) to improve reasoning efficiency. EMS first estimates a Task-Conditioned Reliability Ordering (TCRO) for each agent by retrieving its historical consensus evidence on semantically similar queries, and then invoking agents in descending reliability order. Next, Adaptive Incremental Voting (AIV) terminates the process once the current leading answer cannot be overturned by any possible votes from the remaining agents, and returns this answer. Finally, Reliability History Updating (RHU) updates only the invoked agents according to their consensus with the final decision. Extensive evaluations across five benchmarks show that EMS preserves the accuracy of Majority Voting while reducing the average number of invoked agents by 35% and token consumption by 44%, respectively. The code is available at https://github.com/fuyu66/EMS.

07.
arXiv (CS.CL) 2026-06-11

Context-Driven Incremental Compression for Multi-Turn Dialogue Generation

Modern conversational agents condition on an ever-growing dialogue history at each turn, incurring redundant attention and encoding costs that grow with conversation length. Naive truncation or summarization degrades fidelity, while existing context compressors lack cross-turn memory sharing or revision, causing information loss and compounding errors in long dialogues. We revisit the context compression under conversational dynamics and empirically present its fragility. To improve both efficiency and robustness, we introduce Context-Driven Incremental Compression (C-DIC), which treats a conversation as interleaved contextual threads and stores revisable per-thread compression states in a single, compact dialogue memory. At each turn, a lightweight retrieve, revise, and write-back loop shares information across turns and updates stale memories, stabilizing long-horizon behavior. In addition, we adapt truncated backpropagation-through-time (TBPTT) to our multi-turn setting, learning cross-turn dependencies without full-history backpropagation. Extensive experiments on long-form dialogue benchmarks demonstrate superior performance and efficiency of C-DIC; notably, C-DIC shows stable inference latency and perplexity over hundreds of dialogue turns, supporting a scalable path to high-quality dialogue modeling.

08.
arXiv (CS.AI) 2026-06-16

SkillsBench: Benchmarking How Well Agent Skills Work Across Diverse Tasks

arXiv:2602.12670v4 Announce Type: replace Abstract: Agent Skills are structured packages of procedural knowledge that augment large language model (LLM) agents at inference time. Despite rapid adoption, there is no standard way to measure whether they actually help. We present SkillsBench, a benchmark whose current inventory contains 87 tasks across 8 domains paired with curated Skills and deterministic verifiers. Our latest aggregate evaluation runs the 87-task benchmark under matched no-Skills and curated-Skills conditions for 18 model-harness configurations. Curated Skills raise the average pass rate from 33.9% to 50.5% (+16.6 percentage points; 25.5% normalized gain), with configuration-level gains ranging from +4.1 to +25.7 pp. Focused Skills with at most three modules outperform larger or exhaustive bundles, and smaller models with Skills can match larger models without them. SkillsBench establishes paired evaluation as the foundation for rigorous measurement of Skill efficacy on agentic, expertise-heavy work.

09.
arXiv (CS.LG) 2026-06-11

SEDULity: A Proof-of-Learning Framework for Distributed and Secure Blockchains with Efficient Useful Work

arXiv:2512.13666v2 Announce Type: replace-cross Abstract: The security and decentralization of Proof-of-Work (PoW) have been well-tested in existing blockchain systems. However, its tremendous energy waste has raised concerns about sustainability. Proof-of-Useful-Work (PoUW) aims to redirect the meaningless computation to meaningful tasks such as solving machine learning (ML) problems, giving rise to the branch of Proof-of-Learning (PoL). While previous studies have proposed various PoLs, they all, to some degree, suffer from security, decentralization, or efficiency issues. In this paper, we propose a PoL framework that trains ML models efficiently while maintaining blockchain security in a fully distributed manner. We name the framework SEDULity, which stands for a Secure, Efficient, Distributed, and Useful Learning-based blockchain system. Specifically, we encode the template block into the training process and design a useful function that is difficult to solve but relatively easy to verify, as a substitute for the PoW puzzle. We show that our framework is distributed, secure, and efficiently trains ML models. We further demonstrate that the proposed PoL framework can be extended to other types of useful work and design an incentive mechanism to incentivize task verification. We show theoretically that a rational miner is incentivized to train fully honestly with well-designed system parameters. Finally, we present simulation results to demonstrate the performance of our framework and validate our analysis.

10.
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.

12.
arXiv (quant-ph) 2026-06-16

Grid-state deformation in a no-jump non-Hermitian bosonic dimer

arXiv:2606.17036v1 Announce Type: new Abstract: We study the no-jump evolution of ideal grid states in a lossy bosonic dimer with differential decay. The effective non-Hermitian quadratic dynamics induces a complex symplectic flow in phase space that deforms both the primitive lattice vectors and the origin seed. The average decay rate controls common attenuation, while coherent hopping and differential decay control the reduced dimer deformation. The reduced sector contains elliptic, parabolic, and hyperbolic regimes with imaginary spectra, an exceptional point, and real spectra, producing oscillatory, linear, and exponential lattice deformations. Although projected lattice areas can change, the deformation comes from a determinant-one complex symplectic flow on the full four-dimensional phase space. For a Gaussian regularization of the origin seed, we derive the associated complex width matrix and identify the positivity conditions that preserve Gaussian form. For an initial two-mode qunaught product state, the lossless limit recovers the standard beam-splitter generation of a square GKP$+$ Bell pair, while the no-jump dynamics produces its non-Hermitian deformation with a postselection cost set by the no-jump probability.

13.
arXiv (quant-ph) 2026-06-12

Statistical Mechanics and Symmetries of Non-Abelian Anyon Proliferation: From Deformation to Decoherence

arXiv:2606.12527v1 Announce Type: new Abstract: Topological quantum computation relies on braiding non-Abelian anyons, but requires the underlying topological order to survive imperfect state preparation and environmental noise. We show that the instability of topological order to wavefunction deformations and to decoherence, with the latter probed by syndrome distributions, are generically captured by stat-mech models whose symmetries naturally expose the corrupting anyonic excitations. As an example, we combine this framework with Monte-Carlo simulations to resolve the stability of $D_4$ topological order under deformations and quantum channels that proliferate multiple non-Abelian anyon species that individually are unable to condense. We show that beyond a finite threshold, proliferation of two non-Abelian anyon species parasitically condenses a shared Abelian-anyon fusion outcome, destroying the topological order. Our symmetry-based approach sharply differentiates the resulting trivial phase from that obtained by condensing all Abelian charges; in other words, the trivial phase "remembers" which anyons condensed. This framework provides a first step into identifying the relevant symmetry for optimal decoders, conditioned on syndrome measurements, of non-Abelian topological order.

14.
arXiv (CS.LG) 2026-06-11

Mitigating Disparate Impact of Differentially Private Learning through Bounded Adaptive Clipping

arXiv:2506.01396v2 Announce Type: replace Abstract: Differential privacy (DP) has become an essential framework for privacy-preserving machine learning. Existing DP learning methods, however, often have disparate impacts on model predictions, e.g., for minority groups. Gradient clipping, which is often used in DP learning, can suppress larger gradients from challenging samples. We show that this problem is amplified by adaptive clipping, which will often shrink the clipping bound to tiny values to match a well-fitting majority, while significantly reducing the accuracy for others. We propose bounded adaptive clipping, which introduces a tunable lower bound to prevent excessive gradient suppression. Our method improves worst-class accuracy by over 10 percentage points on Skewed and Fashion MNIST compared to unbounded adaptive clipping, 7 points compared to Automatic clipping, and 5 points compared to constant clipping. The code is available at https://github.com/TrustworthyMLHelsinki/adaptive-clipping-fairness.

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

Structuring The Future: Diffusion LLM Speculative Decoding via Calibrated Draft Graphs

Diffusion LLMs (dLLMs) have recently emerged as a powerful alternative to autoregressive LLMs (AR-LLMs) with the potential to operate at significantly higher token-generation rates. To unlock this potential, we present Spiffy, a speculative decoding algorithm to accelerate dLLM inference while provably preserving the model's output distribution. This work addresses the unique challenges involved in applying ideas from speculative decoding of AR-LLMs to dLLMs. Spiffy performs auto-speculation to eliminate the overheads of an independent draft model, structuring draft states in the form of a novel directed draft graph to take advantage of the bidirectional, blockwise nature of dLLM generation. These draft graphs are calibrated offline to maximize acceptance rates and are dynamically pruned during inference for improved computational efficiency. We present a detailed formulation of Spiffy and demonstrate its ability to accelerate LLaDA, Dream, and SDAR models in combination with KV caching and threshold-based dynamic unmasking leading to up to $8.6\times$ reduction in model inferences and $6.3\times$ acceleration in token rate.

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

Questioning the Coverage-Length Metric in Conformal Prediction: When Shorter Intervals Are Not Better

arXiv:2601.21455v2 Announce Type: replace-cross Abstract: Conformal prediction(CP) has become a cornerstone of distribution-free uncertainty quantification, conventionally evaluated by its coverage and interval length. This work critically examines the sufficiency of these standard metrics. We demonstrate that the interval length might be deceptively improved through a counter-intuitive approach termed Prejudicial Trick(PT), while the coverage remains valid. Specifically, for any given test sample, PT probabilistically returns an interval, which is either null or constructed using an adjusted confidence level, thereby preserving marginal coverage. While PT potentially yields a deceptively lower interval length, it introduces practical vulnerabilities: the same input can yield completely different prediction intervals across repeated runs of the algorithm. We formally derive the conditions under which PT achieves these misleading improvements and provide extensive empirical evidence across various regression and classification tasks. Furthermore, we introduce a new metric interval stability which helps detect whether a new CP method implicitly improves the length based on such PT-like techniques. Code is available at https://github.com/benben-cd/PT-Conformal-Prediction.

17.
arXiv (CS.CL) 2026-06-12

SkillCAT: Contrastive Assessment and Topology-Aware Skill Self-Evolution for LLM Agents

Skill self-evolution methods for LLM agents aim to turn execution trajectories into reusable skill documents, but current pipelines typically learn from one trajectory per task, merge candidate skill patches before checking them, and load the full skill corpus before inference. We propose SkillCAT, a training-free framework that separates this process into three stages. Contrastive Causal Extraction (CCE) samples multiple trajectories for each task and compares same-task success/failure pairs to identify evidence that explains outcome differences. Assessment-Augmented Evolution (AAE) replays each candidate patch on source-task clones and keeps only patches that improve or preserve task outcomes before hierarchical skill patch merging. Topology-Aware Task Execution (TTE) compiles the evolved skills into a routable sub-skill topology, so inference loads only the capability nodes relevant to the task. We evaluate SkillCAT on common agent benchmarks, including SpreadsheetBench, WikiTableQuestions, and DocVQA, and further test cross-model and out-of-distribution generalization. Across these settings, SkillCAT raises the average score over baselines by up to 40.40%, demonstrating reliable skill evolution without model training.

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

A High-Resolution Landscape Dataset for Concept-Based XAI With Application to Species Distribution Models

arXiv:2604.13240v2 Announce Type: replace-cross Abstract: Mapping the spatial distribution of species is essential for conservation policy and invasive species management. Species distribution models (SDMs) are the primary tools for this task, serving two purposes: achieving robust predictive performance while providing ecological insights into the driving factors of distribution. However, the increasing complexity of deep learning SDMs has made extracting these insights more challenging. To reconcile these objectives, we propose the first implementation of concept-based Explainable AI (XAI) for SDMs. We leverage the Robust TCAV (Testing with Concept Activation Vectors) methodology to quantify the influence of landscape concepts on model predictions. To enable this, we provide a new open-access landscape concept dataset derived from high-resolution multispectral and LiDAR drone imagery. It includes 653 patches across 15 distinct landscape concepts and 1,450 random reference patches, designed to suit a wide range of species. We demonstrate this approach through a case study of two aquatic insects, Plecoptera and Trichoptera, using two Convolutional Neural Networks and one Vision Transformer. Results show that concept-based XAI helps validate SDMs against expert knowledge while uncovering novel associations that generate new ecological hypotheses. Robust TCAV also provides landscape-level information, useful for policy-making and land management. Code and datasets are publicly available.

20.
arXiv (CS.AI) 2026-06-16

On-Policy Distillation with Curriculum Turn-level Guidance for Multi-turn Agents

arXiv:2606.15912v1 Announce Type: cross Abstract: Multi-turn agents that plan, invoke tools, and interact with environments offer a promising paradigm for solving complex tasks, yet their capabilities typically rely on very large models whose inference cost is prohibitive in practice.On-Policy Distillation (OPD) is a natural recipe for transferring such capabilities to smaller students, but we find that it suffers a characteristic failure mode in this setting: small student errors compound across turns and push the trajectory out of the teacher's familiar state distribution, so the teacher's supervision becomes least reliable precisely where the student needs it most.We propose Guided On-Policy Distillation (Guided-OPD), a simple yet effective algorithm that mixes teacher- and student-generated turns within each rollout and schedules the teacher's intervention probability along a curriculum that decays to zero.Strong guidance keeps early trajectories close to the teacher distribution and is then gradually withdrawn to recover the purely on-policy regime used at inference.On ALFWorld, ScienceWorld, and WebShop, distilling Qwen3 students from a Qwen3-30B-A3B teacher, Guided-OPD improves Score by 21.1\% and Success Rate by 25.5\% over vanilla OPD on average, with larger gains on smaller students.

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

Intelligent Skin Cancer Detection Using a Multispectral Metasurface and a Hybrid

Skin cancer is among the most prevalent malignancies worldwiAdbe satnradcitts early detection is essential for improving patient survival and reducing treatment costs Conventional dermoscopic and visual imaging techniques are primarily limited to the visible spectrum and often fail to capture subtle spectral signatures associated with early stage malignancies This study proposes an innovative framework that integrates a multispectral metasurface for imaging with a hybrid deep learning architecture based on Convolutional Neural Networks and Vision Transformers The designed metasurface enables noninvasive acquisition of rich spectral information highly sensitive to tissue alterations while the hybrid CNN ViT model simultaneously extracts local and global features to robustly classify skin lesions Simulation-based evaluations demonstrate that the proposed method achieves approximately 98 accuracy 95 percentages sensitivity and 99 perentage specificity surpassing conventional RGB-based and single-architecture approaches Qualitative analyses using attention maps reveal that the model focuses on clinically relevant lesion regions improving interpretability Overall the results indicate that combining metasurface based multispectral imaging with hybrid deep learning can introduce a new generation of diagnostic tools in dermatology and pave the way for portable fast and highly accurate clinical systems

22.
arXiv (CS.CV) 2026-06-15

One Layer's Trash is Another Layer's Treasure: Adaptive Layer-wise Visual Token Selection in LVLMs

Large Vision-Language Models (LVLMs) have achieved remarkable success across diverse multimodal tasks, yet their practical deployment remains constrained by the computational burden arising from lengthy visual tokens. While visual token pruning has emerged as a promising solution, existing methods suffer from a fundamental limitation: once tokens are pruned at a specific layer, they become inaccessible to all subsequent layers, leading to premature information loss that can compromise model performance. Through empirical studies, we observe that different layers exhibit distinct visual region focus, indicating a varying optimal token subset across layers. Motivated by this insight, we propose Adaptive Layer-wise Visual Token Selection (ALVTS), a novel framework that breaks away from the conventional static token pruning paradigm. ALVTS incorporates a lightweight token selector to identify and route important tokens for further processing, while allowing less important tokens to skip the layer, thus minimizing computational redundancy. These two streams of tokens are seamlessly reintegrated before being fed into subsequent layers, facilitating adaptive compression across the entire model. Grounded in our importance consistency constrained low-rank approximation, the proposed token selection module closely emulates the full attention mechanism, effectively capturing its essential patterns without requiring model retraining. Extensive experiments on LLaVA-1.5, LLaVA-NeXT, and Qwen2.5-VL validate the effectiveness of our method. With an 89% token compression ratio, ALVTS retains 96.7% of the original model's accuracy, achieving a superior efficiency-accuracy trade-off for LVLM inference.

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

Pretraining A Large Language Model using Distributed GPUs: A Memory-Efficient Decentralized Paradigm

Pretraining large language models (LLMs) typically requires centralized clusters with thousands of high-memory GPUs (e.g., H100/A100). Recent decentralized training methods reduce communication overhead by employing federated optimization; however, they still need to train the entire model on each node, remaining constrained by GPU memory limitations. In this work, we propose SParse Expert Synchronization (SPES), a memory-efficient decentralized framework for pretraining mixture-of-experts (MoE) LLMs. SPES trains only a subset of experts per node, substantially lowering the memory footprint. Each node updates its local experts and periodically synchronizes with other nodes, eliminating full-parameter transmission while ensuring efficient knowledge sharing. To mitigate limited per-expert data utilization under sparse expert updates, we introduce an expert-merging warm-up strategy, where experts exchange knowledge early in training, to rapidly establish foundational capabilities. With SPES, we train a 2B-parameter MoE LLM using 16 standalone 48GB GPUs over internet connections, which achieves competitive performance with centrally trained LLMs under similar computational budgets. We further demonstrate scalability by training a 7B model from scratch and a 9B model upcycled from a dense checkpoint, both of which match prior centralized baselines. Our code is available at https://github.com/zjr2000/SPES.

24.
medRxiv (Medicine) 2026-06-22

Association of Digoxin Use at Norwood Discharge with Fontan Completion: A Study from the Pediatric Heart Network Public Dataset

Background: Digoxin use after the Norwood procedure has been associated with improved interstage survival in hypoplastic left heart syndrome and related conditions. Whether this benefit translates into improved longer-term outcomes through staged palliation remains unknown. We aimed to determine the association of digoxin use at Norwood discharge with transplant-free survival and Fontan completion. Methods: We conducted a retrospective cohort study using the Pediatric Heart Network (PHN) Single Ventricle Reconstruction trial public dataset, including 549 infants enrolled at 15 North American centers between 2005 and 2008. Competing risk analysis was used to evaluate Fontan completion and Cox regression to assess death or transplantation within 6 years after the Norwood procedure. Mixed-effects models compared pre-Fontan hemodynamic and echocardiographic right ventricular indices between patients treated with and without digoxin after accounting for center clustering and adjustment for sex, shunt type, heart failure medications at Norwood discharge, and census block poverty level. Results: The 6-year cumulative incidence of Fontan completion was higher among patients discharged on digoxin than among those not receiving digoxin (82% vs 71%; p = 0.013). Competing-risk analysis accounting for death and transplant demonstrated a greater likelihood of Fontan completion among digoxin users (aHR 1.31; 95%CI 1.09-1.58; p = 0.005), without significant difference in the hazard of death or transplant (aHR 0.78; 95%CI 0.53-1.15; p = 0.208). No significant differences in pre-Fontan hemodynamic or echocardiographic indices were observed between groups. Initiation of digoxin post Stage II procedure was not associated with improved survival or likelihood to complete Fontan. Conclusion: Digoxin use at the time of Norwood discharge was associated with a 30% greater likelihood of Fontan completion by 6 years, without accompanying improvement in transplant-free survival. These findings extend prior observations of improved interstage outcomes associated with digoxin use and suggest that treatment may facilitate progression through staged palliation.

25.
Nature (Science) 2026-06-18

Daily briefing: The brain builds a sentence neuron by neuron

作者:

Researchers have tracked the electrical activity of individual brain cells during conversation in real time. Plus, the history of GPS and a cross-species transplant that could reveal clues about the origin of animals. Researchers have tracked the electrical activity of individual brain cells during conversation in real time. Plus, the history of GPS and a cross-species transplant that could reveal clues about the origin of animals.