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01.
arXiv (CS.AI) 2026-06-12

Learning What to Remember: Observability-Safe Memory Retention via Constrained Optimization for Long-Horizon Language Agents

arXiv:2606.10616v2 Announce Type: replace Abstract: Long-horizon language agents accumulate observations, reasoning traces, and retrieved facts that exceed their finite context windows, making memory retention a fundamental resource-allocation problem. Existing memory systems improve management through heuristic scoring, retrieval optimization, or learned compression, but largely treat retention as a local decision problem and do not explicitly model its long-term consequences under realistic observability constraints. To fill this gap, we formulate memory retention as a constrained stochastic optimization problem with explicit budget feasibility, evidence utility, and delayed costs including miss penalties, reacquisition delays, and stale-information risk. We then propose OSL-MR (Observability-Safe Learning for Memory Retention), a novel framework that enforces a strict separation between online-observable features and offline-available supervision (OAS). OSL-MR combines an evidence learner trained from realized evidence supervision with a Mixed-Score heuristic that serves both as a deployable online-safe baseline and as a structured inductive prior for learning. The resulting policy learns query-conditioned evidence value directly from interaction data while remaining deployable under the same observability constraints. Experiments on LOCOMO and LongMemEval show that OSL-MR consistently outperforms recency-based methods, Generative Agents-style scoring, and other heuristic baselines, particularly under tight memory budgets. The Mixed-Score prior further improves precision while preserving recall, and sensitivity analysis demonstrates robustness across a wide range of cost configurations.

02.
arXiv (quant-ph) 2026-06-12

Symmetry and Topology of Monitored Quantum Dynamics

arXiv:2412.06133v4 Announce Type: replace-cross Abstract: The interplay between unitary dynamics and quantum measurements induces diverse phenomena in open quantum systems with no counterparts in closed quantum systems at equilibrium. Here, we generally classify Kraus operators and their effective non-Hermitian dynamical generators, thereby establishing the tenfold classification for symmetry and topology of monitored free fermions. Our classification elucidates the role of topology in measurement-induced phase transitions and identifies potential topological terms in the corresponding nonlinear sigma models. Furthermore, we establish the bulk-boundary correspondence in monitored quantum dynamics: nontrivial topology in spacetime manifests itself as topologically nontrivial steady states and gapless boundary states in Lyapunov spectra, such as Lyapunov zero modes and chiral edge modes, leading to the topologically protected slowdown of dynamical purification.

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

Structural Preservation and the Logical Expressiveness of Graph Neural Networks

arXiv:2606.17882v1 Announce Type: new Abstract: Bridges between graph neural networks (GNNs) and logical formalisms have been established by fixing architectural choices, such as the types of aggregation, combination, and activation functions. These choices define restricted classes of GNNs for which tight correspondences with logical formalisms can be obtained, by showing that logical formulae can be translated into equivalent GNNs and, conversely, that GNNs can be translated into equivalent formulae. In this paper we take a semantic perspective by establishing the logical expressiveness of classes of GNN classifiers that are preserved under structural properties: embeddings (extensions), injective homomorphisms, and homomorphisms. We show that, for each such property, there exists a fragment of graded modal logic characterising the class of GNNs. In particular, preservation under embeddings, injective homomorphisms, and homomorphisms corresponds to existential graded modal logic, its existential-positive fragment, and existential-positive modal logic, respectively. These results characterise the expressiveness of broad classes of GNNs independently of specific architectural choices, but we also show that each of these classes admits a GNN architecture of the same expressiveness. Technically, our approach uses a new well-quasi-order result for trees of bounded height, yielding finite representations of unravelling-invariant classes.

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

EmbodiTTA: Resource-Efficient Test-Time Adaptation for Embodied Visual Systems

Continual Test-time adaptation (CTTA) continuously adapts the deployed model on every incoming batch of data. While achieving optimal accuracy, existing CTTA approaches present poor real-world applicability on resource-constrained edge devices, due to the substantial memory overhead and energy consumption. In this work, we first introduce a novel paradigm – on-demand TTA – which triggers adaptation only when a significant domain shift is detected. Then, we present OD-TTA, an on-demand TTA framework for accurate and efficient adaptation on edge devices. OD-TTA comprises three innovative techniques: 1) a lightweight domain shift detection mechanism to activate TTA only when it is needed, drastically reducing the overall computation overhead, 2) a source domain selection module that chooses an appropriate source model for adaptation, ensuring high and robust accuracy, 3) a decoupled Batch Normalization (BN) update scheme to enable memory-efficient adaptation with small batch sizes. Extensive experiments show that OD-TTA achieves comparable and even better performance while reducing the energy and computation overhead remarkably, making TTA a practical reality.

05.
arXiv (quant-ph) 2026-06-15

Quantum Horizon: An evaluation of quantum computing as a threat to Bitcoin and Ethereum

arXiv:2606.14484v1 Announce Type: new Abstract: Quantum computing poses a real, broad-based, but bounded and substantially mitigable threat to Bitcoin and Ethereum. We separate the two quantum algorithms that public discussion routinely conflates: Shor's algorithm breaks the elliptic-curve signatures (ECDSA over secp256k1, BLS over BLS12-381) that authorize spending, whereas Grover's algorithm does not meaningfully threaten proof-of-work mining, which is protected by a merely quadratic speedup, fault-tolerant per-operation costs, a square-root parallelization wall, and difficulty adjustment. Folding hardware scaling, the falling resource requirement, a fault-tolerance readiness lag, and expert surveys into a single Monte-Carlo forecast yields a wide, bimodal arrival distribution for a cryptographically relevant quantum computer: about a one-in-six chance by 2035, near 30% by 2040, and about 60% by 2050. Exposure is concentrated and mostly migratable: of Bitcoin's roughly six million quantum-exposed coins only about 2.3 million are irreducibly at risk, while 50 to 65% of Ether sits at key-revealed accounts that can adopt post-quantum signatures. A timely migration beats even an optimistic 2035 machine, so the binding constraint is governance, not technology. A survey of the top twenty cryptocurrencies finds none fully post-quantum. Reproducible models accompany every quantitative claim.

06.
medRxiv (Medicine) 2026-06-23

Respiratory support with Continuous Positive Airway Pressure in preterm neonates: an analysis of coverage and quality of care in 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania implementing with the NEST360 Alliance

Background: Prematurity is the leading cause of child deaths worldwide, with the highest neonatal mortality in sub Saharan Africa. Respiratory distress syndrome (RDS) is the leading mortality pathway in preterm neonates, but continuous positive airway pressure (CPAP) has high impact. This analysis reports CPAP coverage and quality of care for preterm neonates admitted to 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania. Methods: Analyses used individually linked neonatal inpatient data and cross-sectional health systems data. All admitted neonates were eligible for inclusion (January 2021 through December 2024). Service readiness for CPAP delivery and mean CPAP coverage were described for CPAP eligible newborns (weighing 1500g). Quality of care cascades were constructed to illustrate key indicators. Survival among CPAP eligible neonates was analysed using regression models, stratified by clinical severity scores. Results: 375,255 newborn admissions were analysed in 66 neonatal units. Functional CPAP availability varied with median 16% of days (IQR: 4 to 47%) classified as high demand (>1.5 eligible newborns per CPAP). Of 64,761 CPAP eligible neonates, 22,006 (34%, 95% CI 33 to 34%) received CPAP. All countries showed improvement in CPAP coverage, with Tanzanian hospitals recording 63% increase in mean coverage (p-value=0.001) over time. Quality of care cascades showed treatment was initiated 1 day for 42% (95% CI 41 to 43%) of eligible neonates receiving CPAP. Only 10% of neonates

07.
arXiv (CS.LG) 2026-06-12

Foundations of Practical Quantum Advantage in Quantum-Informed Machine Learning for Predicting Chaos

arXiv:2606.13422v1 Announce Type: cross Abstract: We develop theoretical foundations for a practical quantum-advantage mechanism in quantum-informed machine learning for chaotic dynamical systems. A family of k-indexed higher-order quantum statistical priors (Q-Priors) hosts the k-point marginal of the invariant measure on n_q = kq qubits, extending the single-site construction of prior work. We prove a two-stage advantage. In the representation stage, superposition and entanglement compactly store non-factorisable spatial correlations of the invariant measure on n_q qubits. In the extraction stage, joint Bell measurements on two copies estimate any post hoc Pauli functional with a copy-pair count independent of n_q, whereas any adaptive single-copy protocol for the corresponding full-Pauli read-out requires Omega(2^(n_q)) copies; this is a provable quantum-classical separation in copy-measurement complexity. The two-copy read-out is realised in simulation and on IQM superconducting processors. Two case studies instantiate the mechanism in workflows of independent scientific value: a turbulent channel-flow study in which the two-copy read-out yields a named non-diagonal correlator of the invariant measure (the velocity-direction coherence), and a medium-range weather forecasting workflow on the European Centre for Medium-Range Weather Forecasts ERA5 reanalysis in which the diagonal k

08.
arXiv (CS.CL) 2026-06-15

Independent-Component-Based Encoding Models of Brain Activity During Story Comprehension

Encoding models provide a powerful framework for linking continuous stimulus features to neural activity; however, traditional voxelwise approaches are limited by measurement noise, inter-subject variability, and redundancy arising from spatially correlated voxels encoding overlapping neural signals. Here, we propose an independent component (IC)-based encoding framework that dissociates stimulus-driven and noise-driven signals in fMRI data. We decompose continuous fMRI data from naturalistic story listening into ICs using one subset of the data, and train encoding models on independent data to predict IC time series from large language model representations of linguistic input. Across subjects, a subset of ICs exhibited consistently high predictivity. These ICs were spatially and temporally consistent across subjects and included cognitive networks known to respond during story listening (auditory and language). Auditory component time series were strongly correlated with acoustic stimulus features, highlighting the interpretability of identified component time series. Components identified as noise or motion-related artifacts by ICA-AROMA showed uniformly poor predictive performance, confirming that highly predicted components reflect genuine stimulus-related neural signals rather than confounds. Overall, IC-based encoding models enable analyses at the level of functional networks, accommodating the variability in network locations across individuals and providing interpretable results that are easy to compare across subjects. Code provided at: https://github.com/kamyahari/IC-Encoding-Models.git

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

TacCoRL: Integrating Tactile Feedback into VLA via Simulation

arXiv:2606.11743v1 Announce Type: cross Abstract: Vision-language-action (VLA) models provide strong visual, language, and action priors for robot manipulation, but visual observations alone often miss the local contact state required for contact-rich tasks. We present TacCoRL, a scalable framework that injects Tactile feedback into VLA policies and improves them through sim-real Co-training and simulation-based reinforcement learning (RL), without requiring large-scale tactile pretraining or extensive real-world contact exploration. The key idea is not only adding touch as an input, but learning how contact readings should modulate action responses in near-failure states that are rare in demonstrations and risky to collect on hardware. We use a real-aligned simulator as a closed-loop training environment for contact interaction. Mixed simulated and real trajectories first warm-start tactile-conditioned actions in the pretrained policy. Reinforcement learning with verifiable task rewards then optimizes the policy using simulated contact rollouts. It reinforces tactile-conditioned actions that lead to task completion, while a supervised objective on real trajectories keeps the refined policy anchored to deployment visual, tactile, and action distributions. The resulting policy transfers directly to the real robot without privileged simulation state or online real-world RL. Across four bimanual contact-rich tasks, the final visuo-tactile policy achieves an average success rate of 72.5%, compared to baseline of 50.0%. Result videos and more details are available at https://tac-corl.github.io/

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

Beyond Weights and Gradients: A Taxonomy of Federated Learning Messages

arXiv:2606.16891v1 Announce Type: cross Abstract: Federated Learning is rapidly evolving beyond the exchange of traditional model weights and gradients, yet existing definitions fail to capture the full scope of modern payloads like synthetic data and federated analytics. This paper addresses the gap by proposing a formal mathematical definition of a federated message that accounts for both utility and privacy. We introduce a taxonomy that organizes these exchanges into three categories: model structures, statistical summaries, and data-conditioned representations. By evaluating these groups based on computational demands, communication costs, and privacy risks, we provide a clearer understanding of the trade-offs involved in decentralized training. Our review of 202 recent publications highlights a significant shift since 2021 toward diverse messaging paradigms, signaling a move away from standard deep learning updates toward more specialized information sharing. This framework provides a structured path for future research to optimize federated systems for varying hardware and security requirements.

11.
arXiv (CS.AI) 2026-06-16

Cognitive Debt: AI as Intellectual Leverage and the Dynamics of Systemic Fragility

Authors:

arXiv:2606.15078v1 Announce Type: new Abstract: We develop a formal theory of cognitive debt: the stock of unverified reasoning obligations that accumulates when individuals use AI as a substitute rather than a complement for first-principles cognition. The model features two state variables per agent, cognitive capital and cognitive debt, and a multiplicative production technology in which cognitive capital functions as collateral that determines the return to AI adoption. We establish six propositions. Rational agents incur positive cognitive debt because the costs are deferred, partially external, and masked by short-run productivity gains. Tranquil periods lower subjective risk assessments, raise AI substitution intensity, and compound leverage, generating a cognitive Minsky moment in which subjective risk falls while true systemic fragility rises. Expected crisis losses are convex in aggregate leverage. Post-crisis, output-target pressure can produce a false-correction loop in which agents patch AI failures with more AI. The decentralised equilibrium over-adopts substitutive AI relative to the social optimum because of systemic risk, cognitive public goods, and arms-race externalities. In a two-type heterogeneous-agent economy, high-cognitive-capital agents adopt AI more intensively and may eventually erode their unaided cognitive capital below that of initially lower-skilled agents.

12.
arXiv (CS.AI) 2026-06-16

Probing Low Frame Rate Degradation in Neural Audio Codecs

arXiv:2606.16969v1 Announce Type: cross Abstract: Low frame rates in neural audio codecs are attractive for autoregressive speech synthesis, where the generation cost scales linearly with the sequence length. Recent work has demonstrated that codecs can operate at 12.5 Hz and below, but the mechanisms underlying low frame rate degradation remain insufficiently understood. We investigate these mechanisms through a controlled frame rate ablation. We reproduce a quality cliff at 6.25 Hz reported in previous works and evaluate candidate explanations: phonemic collisions and codebook saturation, neither of which shows evidence of a fundamental barrier. The cliff is instead caused by suboptimal training configuration: fixed clip duration during training yields too few tokens at low frame rates, starving the decoder of inter-token context. Once corrected, WER degrades smoothly with phonemic load down to 3.1 Hz and 1.6 Hz, suggesting the inference-time efficiency gains of low frame rate codecs are more accessible than previously assumed.

13.
arXiv (CS.LG) 2026-06-18

Stochastic Adaptive Gradient Descent Without Descent

arXiv:2509.14969v2 Announce Type: replace Abstract: We introduce a new adaptive step-size strategy for convex optimization with stochastic gradient that exploits the local geometry of the objective function only by means of a first-order stochastic oracle and without any hyper-parameter tuning. The method comes from a theoretically-grounded adaptation of the Adaptive Gradient Descent Without Descent method to the stochastic setting. We prove the convergence of stochastic gradient descent with our step-size under various assumptions, and we show that it empirically competes against tuned baselines.

14.
arXiv (CS.CL) 2026-06-16

Are Online Skill and Memory Modules Always Worth Their Tokens? A Budget-Constrained Study of Web Agents

Online web agents often augment a base actor with memory, workflow, or skill modules. These modules can improve performance, but they also consume test-time tokens, a cost rarely reported alongside the actor's inference cost. We study online augmentation, where this overhead is paid on every task, and re-evaluate its benefits under a fixed total inference budget. We compare AWM, ASI, and ReasoningBank with a token-matched vanilla baseline that uses the same budget for additional actor steps. Across three WebArena domains and three models, Gemini 3 Flash, GPT-5.4-mini, and Qwen 3.6-27B, the vanilla baseline matches or surpasses all three augmentation methods in aggregate success rate while often using fewer total tokens. We observe a similar trend on WorkArena-L1 with Qwen 3.6-27B, indicating that the effect extends to enterprise knowledge-work tasks. Our results suggest that skills and workflow memory can be useful in specific domains, but their apparent gains often vanish against a budget-matched actor. We further show that run-to-run variance materially affects outcomes and should be reported as a core evaluation criterion for online web agents.

15.
medRxiv (Medicine) 2026-06-12

Order-Based Bayesian Network Modeling of Early Detection and Post-Diagnosis Control for Cardiovascular Disease Risk in Type 2 Diabetes

Patients diagnosed with type 2 diabetes (T2D) are at increased risk of developing cardiovascular disease (CVD), the leading cause of morbidity and mortality in this population. Early detection and glycemic control within the first year after diagnosis reduce CVD risk. However, gaps remain in how to operationalize early detection of T2D using Electronic Health Record (EHR) data and quantify its relationship with subsequent CVD risk using longitudinal observations. We developed a probabilistic graph model to analyze the interdependencies between early detection of T2D, post-diagnosis glycemic control, and CVD occurrence. Using a temporally structured Bayesian Network (BN) learned from EHR data of 9,450 primary care patients between 2017 and 2023, we quantified probabilistic dependencies between demographics, diagnostic delay surrogates, glycemic control, and post-diagnosis CVD occurrence. Percentile based thresholds defined risk groups, where individuals with predicted probabilities in the bottom decile ([≤] 10th percentile) were classified as low risk, and those in the top decile ([≥] 90th percentile) as high risk. Results demonstrated heterogeneity in predicted risks across glycemic and cardiovascular outcomes. Predicted probability of developing CVD within the first year after T2D diagnosis ranged from a mean of 5.2% in the low-risk group to 28.9% in the high-risk group, while predicted probabilities of mean Hemoglobin A1c (HbA1c) [≥] 8% during the first year post-diagnosis ranged from 1.6% in low-risk to 55.1% in high-risk group. Patients with HbA1c at diagnosis [≥] 8% had higher predicted probabilities of first-year post-diagnosis mean HbA1c [≥] 8% (53.3% vs. 1.9%) and high HbA1c coefficient of variation (18.7% vs. 3.1%) compared with those with HbA1c [≤] 6.5%. Incorporating early clinical outcomes refined later risk predictions, with long-term CVD risk reaching 33.5% among high-risk individuals. The proposed model achieved predictive performance comparable to conventional machine learning approaches while providing interpretable relationships for risk stratification in primary care populations.

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

Plug-and-Adapt: Multimodal Coreference Resolution at First Sight with a Pretrained Alignment Model

Visual information helps resolve ambiguity in coreference resolution, leading to notable performance gains. However, existing Multi-modal Coreference Resolution (MCR) methods require training with (partially) annotated data from the target dataset before they can be applied, preventing their direct usability and raising concerns about generalization. While Vision-Language Large Models (VLLMs) with billions of parameters offer promising zero-shot capabilities, they remain largely inaccessible. Their massive size limits deployability, and many are only accessible through paid APIs. In this paper, we propose a plug-and-adapt method that strategically adapts a carefully pre-trained alignment model for immediate use in MCR tasks, designed to eliminate the need for training on scarce benchmark datasets or relying on resource-intensive VLLMs. Specifically, we first pre-train a fine-grained alignment model between textual and visual contextual information using vision-language alignment datasets. We then repurpose the alignment model to MCR through similarity aggregation by fusing visual and categorical cues with evidence theory, thereby enhancing effectiveness. Experiments on the Coreference Image Narratives (CIN) benchmark dataset demonstrate the effectiveness of our method, achieving a 5.31\% and 2.12\% improvement in CoNLL F1 over SOTA dedicated methods and popular VLLMs, respectively. We further evaluate our method on a masked CIN dataset for robustness testing and on a specially constructed VCR-MCR dataset for generalization assessment, with results confirming both capabilities.

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

HEPTv2: End-to-End Efficient Point Transformer for Charged Particle Reconstruction

arXiv:2606.20437v1 Announce Type: cross Abstract: Charged-particle tracking – reconstructing trajectories from sparse detector measurements – is a fundamental high-energy-physics inference problem and a canonical example of learning under extreme combinatorial ambiguity. At the High-Luminosity Large Hadron Collider (HL-LHC), tracking must remain accurate and efficient despite unprecedented collision densities. Graph neural networks perform strongly, but incur substantial costs from graph construction and processing, while transformer-based approaches rely on auxiliary stages that prevent end-to-end optimization. To address this, we present HEPTv2, an end-to-end point-transformer architecture that reconstructs tracks from detector hits in one trainable pipeline. HEPTv2 combines a locality-aware point encoder with a track decoder that predicts complete trajectories without graph-building, clustering, or filtering. The encoder uses locality-sensitive hashing in detector coordinate space to preserve tracking-relevant geometry while enabling efficient local attention. The decoder resolves ambiguities through sectorized decoding and direct hit-to-track prediction under joint encoder-decoder supervision, allowing the full pipeline to be optimized end-to-end. On TrackML, HEPTv2 achieves 98.6% double-majority tracking efficiency at a 0.8% fake rate, while requiring only $\sim$15~ms inference time and 0.4~GB peak memory per event on a NVIDIA A100 GPU. Latency and memory scale approximately linearly for events with up to $5\times10^5$ hits. HEPTv2 establishes a new state of the art in the accuracy-latency trade-off, improving efficiency by 4.5% over the strongest prior transformer and by 1.1–2.2% over optimized graph-based pipelines, while reducing latency by factors of 7 and 38–52, respectively. These results show end-to-end transformers can deliver the accuracy and efficiency required for real-time particle reconstruction at the HL-LHC.

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

Anomaly Detection via Mean Shift Density Enhancement

arXiv:2602.03293v2 Announce Type: replace Abstract: Unsupervised anomaly detection stands as an important problem in machine learning. Existing unsupervised anomaly detection algorithms rarely perform well across different anomaly types, often excelling only under specific structural assumptions. This lack of robustness also becomes particularly evident under noisy settings. We propose Mean Shift Density Enhancement (MSDE), a fully unsupervised framework that detects anomalies through their geometric response to density-driven manifold evolution. MSDE is designed as a general purpose anomaly detection framework, based on the principle that normal samples, being well supported by local density, remain stable under iterative density enhancement, whereas anomalous samples undergo large cumulative displacements as they are attracted toward nearby density modes. To operationalize this idea, MSDE employs a weighted mean-shift procedure with adaptive, sample-specific density weights derived from a manifold learning-based fuzzy neighborhood graph. We evaluate MSDE on an anomaly detection benchmark comprising 46 real-world tabular datasets, four realistic anomaly generation mechanisms, and six noise levels. Compared to 13 established unsupervised baselines, MSDE achieves consistently strong, balanced and robust performance for several standard classification metrics, at several noise levels and on average over several types of anomalies. These results demonstrate that displacement-based scoring provides a robust alternative to the existing state-of-the-art for unsupervised anomaly detection.

20.
medRxiv (Medicine) 2026-06-18

The relationship between serotonin transporter occupancy and extracellular serotonin concentration is hyperbolic, not linear: implications for safely tapering antidepressants

Background: Hyperbolic tapering is an increasingly recognized approach for discontinuing serotonin reuptake inhibitor (SRI) antidepressants that involves non-linear dose reductions with equal stepwise reductions in serotonin transporter (SERT) occupancy to mitigate withdrawal symptoms. Its theoretical basis is the hyperbolic relationship between SRI dose and SERT occupancy reported in radioligand imaging studies. Hyperbolic tapering implicitly assumes that changes in SERT occupancy approximate changes in biologic effect and withdrawal risk. Because SERT occupancy plateaus across the therapeutic dose range of SRIs, this framework predicts relatively small biologic effects and withdrawal risk within this range. However, SERT occupancy influences serotonergic activity only indirectly via its effects on extracellular serotonin concentrations, and the relationship between these two variables is poorly characterized. Methods: We developed a two-pathway clearance model derived from mass-action kinetics to evaluate the steady-state relationship between SERT occupancy and extracellular serotonin concentrations under chronic SRI treatment. Results: Our analysis indicates that serotonin concentrations increase hyperbolically as transporter occupancy increases, suggesting that biologically meaningful differences in serotonergic signaling persist across the therapeutic dose range of SRIs despite plateauing occupancy. Conclusions: Our model predicts a hyperbolic relationship between SERT occupancy and extracellular serotonin concentrations, suggesting that changes in occupancy may not map proportionally onto serotonergic effect. These findings provide a potential mechanistic explanation for dose-dependent clinical effects of SRIs despite plateauing transporter occupancy and generate testable hypotheses regarding antidepressant tapering strategies. Empirical validation is warranted.

21.
Nature Medicine 2026-06-15

Adaptive deep brain stimulation for dynamic gait control in Parkinson’s disease: a randomized feasibility trial

A randomized crossover study of five patients with Parkinson’s disease (PD) demonstrates that gait-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared with continuous stimulation. Gait dysfunction in PD is a major source of disability and is often insufficiently treated by continuous deep brain stimulation (cDBS). Although adaptive DBS (aDBS) has shown efficacy for other motor symptoms using β-based, state-driven neural signals, gait is a dynamic, cyclical behavior that may require temporally precise modulation. Here we evaluated a behavior-contingent aDBS approach that synchronizes stimulation to gait phase. We reported a single-center, blinded, randomized, crossover study evaluating the feasibility of identifying patient-specific biomarkers to drive aDBS. The primary outcome was feasibility of successful identification of gait-phase biomarkers to implement aDBS. Five participants with PD undergoing pallidal DBS and subdural electrode paddle implantation were enrolled. We successfully identified personalized gait-phase biomarkers from cortical or pallidal field potentials in all five patients and embedded them into a bidirectional neurostimulator. During acute in-clinic testing, aDBS improved step variability and step symmetry versus cDBS. Three participants subsequently completed a double-blinded, multi-day crossover phase. In this setting, aDBS maintained general motor symptom control, reduced falls and yielded patient-specific gait improvements. No adverse events occurred and aDBS was well tolerated. These findings establish the feasibility of biomarker-driven, movement-synchronized neuromodulation and support the development of a larger randomized trial to determine clinical efficacy. ClinicalTrial.gov registration: NCT04675398 . A randomized crossover study shows that gait-phase-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared to continuous stimulation in Parkinson’s disease.

22.
medRxiv (Medicine) 2026-06-12

Cancer care disruption during the COVID-19 pandemic in Ontario, Canada: A sequential mixed-methods study

Introduction The COVID-19 pandemic profoundly disrupted healthcare delivery worldwide, with cancer care among the most affected services. Prior studies documented delays in referrals, reduced specialist access, and increased provider burden. However, the extent to which these experiences were reflected at the system level remains unclear. Objective To document cancer care experiences and examine whether these experiences were reflected in population-level health system indicators across Ontario, Canada. Methods We used an exploratory sequential mixed-methods design. Qualitative data were collected through focus groups and semi-structured interviews with 32 participants, including patients with cancer (n=8), caregivers (n=5), healthcare providers (n=14), and decision-makers (n=5) across two hospital settings in Ontario, Canada. Emergent themes informed the development of quantitative indicators. We then conducted a retrospective population-based analysis of linked administrative health databases for cancer patients in Ontario (n=87,786) to assess the prevalence of identified themes. Results Four themes emerged: (I) delays in diagnosis and screening; (II) disrupted access to primary care; (III) barriers to specialist and mental health services; and (IV) fragmented care for patients with multimorbidity. Quantitative findings corroborated major themes. Screening rates declined for cervical (64.8% to 57.5%) and breast cancer (64.5% to 57.2%). While in-person primary care shifted almost entirely to virtual modalities (8.5% to 95.4%), overall visit volumes remained stable. Specialist care showed uneven patterns, with increased oncology visits but declines in cardiology and mental health services. Patients with multiple comorbidities experienced the largest reductions in non-oncology specialist care. Conclusion The pandemic disrupted key components of cancer care, particularly screening, access to certain specialist services, and care for patients with complex needs. Integrating qualitative and quantitative evidence highlights areas of system vulnerability and underscores the need for coordinated, resilient cancer care capable of maintaining essential services during future crises.

23.
arXiv (CS.AI) 2026-06-15

The Insurability Frontier of AI Risk: Mapping Threats to Affirmative Coverage, Silent Exposures, and Exclusions

arXiv:2605.18784v2 Announce Type: replace-cross Abstract: The rapid diffusion of agentic AI has created a new coverage problem for commercial insurance: some AI-mediated losses are now affirmatively insured, some create silent-AI exposure under legacy cyber, technology errors-and-omissions (E&O), directors-and-officers (D&O), employment practices liability (EPLI), crime, and media policies, and others are being actively excluded. This paper maps that emerging boundary by coding 55 AI threat classes against 26 insurance products, endorsements, and exclusion regimes using public carrier materials and OWASP/MITRE threat catalogs. We identify a four-tier insurability frontier: affirmatively insured perils, silent-AI exposures, actively excluded perils, and perils outside conventional private insurance structures. Our coding measures publicly claimed positioning rather than executed contract wording; the headline statistics describe what carriers publicly state about coverage, not what would be paid in any specific claim. Three patterns emerge. First, affirmative AI coverage is beginning to differentiate by primary risk emphasis: public materials often position Munich Re around model performance and drift, Armilla and parts of the Lloyd's market around hallucination and broader AI liability, Tokio Marine Kiln and CFC around IP and technology E&O concerns, Apollo ibott around emerging autonomous system liability, and Coalition around deepfake and AI-enabled cyber response. Second, legacy lines retain silent-AI exposure where AI is an instrumentality rather than the legal cause of loss. Third, foundation model concentration is the clearest genuinely novel insurability frontier because upstream model failure can correlate losses across many cedents at once; the relevant market design question is which insurability constraint each candidate structure relaxes, not merely which systemic risk template exists.

24.
arXiv (quant-ph) 2026-06-19

Resolving problems with the continuum limit in coherent-state path integrals

arXiv:2602.02466v2 Announce Type: replace Abstract: The paper solves the problem of continuum limit in bosonic thermal coherent-state path integrals. For this purpose, exact discrete versions of the path integral are constructed for three different orderings of the Hamiltonian: normal, anti-normal and symmetric (Weyl order). Subsequently, their different continuum versions are checked on the harmonic oscillator, to choose the symmetric ordering as a possibly correct choice for all polynomial Hamiltonians. Spotted mathematical subtleties in the simple case serve as a clue to the general solution. Finally, a general justification for the symmetric order is provided by deriving the continuum path integral starting from the exact discrete case using a renormalization procedure in the imaginary time frequency domain. While the role of Weyl order has already been found, the paper provides the missing proof of its suitability for every polynomial Hamiltonian and simplifies the previously established construction by referring only to creation and annihilation operators (without position and momentum operators).

25.
medRxiv (Medicine) 2026-06-17

Nickel and Dimed: How a Common Earth Element is Short-Changing Our Health

Nickel has been studied for a long time as an environmental contaminant but less so in its connection to population health. It does not announce itself as loudly as its transition metal brethren like mercury and cadmium, but its chemical properties permit it to be deleterious as a low-dose, chronic exposure, particularly among those with immune systems sensitized to it. There is a growing evidence base and vocabulary to discuss nickel's affect on health. However, in the U.S., there are not recent, reliable estimates of the share of the population with a nickel allergy, let alone how much nickel Americans are exposed to through their diet. This paper seeks to close this evidence gap by creating a new dataset of dietary nickel and other heavy metal exposure and assessing how high levels of dietary nickel exposure shape local demand for health care services. We use soil data from the U.S. Geological Survey and data on agricultural product transport from FoodFlows.org to create a county-level dietary nickel exposure index. We then use a large electronic health record database and double machine learning to estimate how demand for primary care services varies across levels of dietary nickel exposure. We find that counties with high nickel exposure experience an increase in the share of primary care office visits for symptoms highly suggestive of nickel poisoning. This result survives multiple hypothesis test corrections and placebo tests. Our research suggests that nickel has harmful effects on individual health whose exposure can be measured at a population level, and is shaping primary care across the U.S.