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

Mental-R1: Aligning LLM Reasoning for Mental Health Assessment

arXiv:2606.13176v1 Announce Type: new Abstract: Mental health problems such as anxiety, depression, and suicide remain urgent global challenges, where timely and accurate assessment is critical for effective intervention. Recently, large language models have been explored for mental health assessment. However, existing general-purpose post-training methods do not align with the cognitive processes of human assessment, which may lead to unreliable reasoning outcomes. To bridge this gap, we propose Cognitive Relative Policy Optimization (CRPO), a reinforcement learning framework tailored for the mental health domain. CRPO extends group relative policy optimization by integrating stage-dependent uncertainty modeling into the policy optimization process. Specifically, we introduce a stage-wise entropy regularization mechanism that encourages broad exploration in early reasoning phases and progressively enforces confident decision-making in later stages, mimicking the human cognitive shift from uncertainty to certainty. In addition, inspired by cognitive appraisal theory, we formalize cognitive reasoning stages, thereby guiding theory-grounded interpretable inference. Experiments on 8 mental health datasets show that CRPO achieves an average improvement of 10.4 percentage points in weighted F1-score over the best reinforcement learning baseline. Furthermore, the CRPO-trained model Mental-R1 demonstrates clear advantages compared with existing large language models on reasoning-intensive cases, suggesting that CRPO enhances reasoning capabilities for mental health assessment.

02.
arXiv (CS.AI) 2026-06-11

SVoT: State-aware Visualization-of-Thought for Spatial Reasoning via Reinforcement Learning

arXiv:2606.11770v1 Announce Type: new Abstract: Spatial reasoning remains a challenge for Multimodal Large Language Models (MLLMs), as it requires reliable multi-hop inference over both intermediate states and state transitions. Current studies often leave intermediate states unverified and treat state transitions as implicit processes, which limits reliability in multi-hop spatial reasoning. To address this, we propose State-aware Visualization-of-Thought (SVoT), a reinforcement learning framework that generates interleaved, verifiable intermediate states and visualizations. SVoT integrates transition reasoning chains into the generation processes, enabling the model to verify action preconditions and effects through interleaved textual and visual reasoning. We train SVoT via Group Relative Policy Optimization (GRPO), instantiating verification through reward design and evaluating the efficacy of different fine-grained rewards. As existing benchmarks reduce state transitions to single-variable updates, substantially simplifying the problems, we establish five domains by extending classical environments and introducing two novel domains, Pacman and Gather, that require multi-object interactions and numerical reasoning. These domains support systematic evaluation of multi-hop spatial reasoning with quantitative verification of generated intermediate states and transition reasoning. SVoT with transition-aware supervision achieves state-of-the-art performance across the introduced domains, yielding up to a 65% absolute accuracy gain on out-of-distribution test sets.

03.
arXiv (CS.LG) 2026-06-12

To GAN or Not To GAN: Segmentation Analysis on Mars DEM

arXiv:2606.13252v1 Announce Type: new Abstract: To better understand Martian Surface, which is needed to enable Rovers navigate Mars with ease, it is necessary to be able to determine the location of mounds. Detecting and studying these morphologies can also help us find evidence of extraterrestrial life, in this case, more specifically, water or signs of life conducive environments. Detection of mounds was done by manually mapping morphological parameters onto Digital Elevation Models. This paper solves the problem by automatically detecting and or predicting mounds on Mars using Neural Network based Semantic Segmentation methodologies. This is done by using supervised semantic segmentation model and generative adversarial approach. A comparison of the approaches shows that adding extra artificially generated data did not improve the result.

04.
arXiv (CS.CL) 2026-06-12

One Token to Fool LLM-as-a-Judge

Large language models (LLMs) are increasingly trusted as automated judges, assisting evaluation and providing reward signals for training other models, particularly in reference-based settings like Reinforcement Learning with Verifiable Rewards (RLVR). However, we uncover a critical vulnerability even in this reference-based paradigm: generative reward models are systematically susceptible to reward hacking. We find that superficial inputs, which we term ''master keys'' such as non-word symbols (e.g., '':'' or ''.'') or generic reasoning openers (e.g., ''Thought process:'' or ''Let's solve this problem step by step.''), can consistently elicit false positive rewards without any substantive reasoning. Our systematic evaluation demonstrates this is a widespread failure affecting a diverse range of models, including leading proprietary systems such as GPT-o1 and Claude-4. These results challenge the assumed robustness of LLM judges and pose a significant threat to their reliability. To address this, we propose a simple yet effective data augmentation strategy using truncated model outputs as adversarial negative examples. The resulting Master Reward Models (Master-RMs) demonstrate state-of-the-art robustness against these ''master key'' attacks while maintaining high performance in standard evaluation settings. We supplement these findings with a comprehensive analysis of the vulnerability across model scales, prompt variations, and common inference-time strategies, offering insights to guide future research on robust LLM evaluation. We release our robust, general-domain reward models and the synthetic training data at https://huggingface.co/sarosavo/Master-RM and https://huggingface.co/datasets/sarosavo/Master-RM.

05.
medRxiv (Medicine) 2026-06-15

Reaching out-of-school girls with HPV vaccination: A qualitative evaluation in six low- and middle-income countries using the RE-AIM framework

Background Infection with human papillomavirus (HPV), the primary cause of cervical cancer, disproportionately affects women in low- and middle-income countries (LMICs). While school-based vaccination of adolescent girls against HPV is highly effective, this strategy systematically excludes out-of-school (OOS) girls. Using the RE-AIM framework, we explored strategies to reach OOS girls with HPV vaccination across six African and Asian LMICs. Methods We conducted semi-structured key informant interviews with 32 vaccination program stakeholders from Cambodia, Cameroon, Kenya, Malawi, Mozambique, and Uganda between May and September 2024. Interviews explored countries implementation successes, challenges, and strategies to reach OOS girls with HPV vaccination and sustainability considerations. Data were analyzed using a hybrid team-based thematic analysis approach guided by the RE-AIM framework. Results Community outreach-based strategies, typically integrated into routine immunization outreach, were identified as the most effective approach to reach OOS girls with HPV vaccination. Targeted strategies, such as locating outreach clinics in community venues frequented by OOS girls (e.g., churches, markets) enhanced implementation. Perceived effectiveness of these strategies varied across participants, and formal assessment of effectiveness was constrained by the absence of disaggregated vaccination coverage data by school enrollment status. Some subpopulations of OOS girls (i.e., girls in nomadic or migrant communities, urban OOS girls) were not readily reached through standard outreach approaches, prompting implementation of adapted and tailored strategies for these subpopulations. Costs associated with conducting outreach in harder-to-reach areas were major barriers to reaching OOS girls, presenting challenges to the sustainability and cost-effectiveness of these approaches. Conclusions Routine community outreach platforms were widely perceived as most effective for reaching OOS girls. Strengthening disaggregated monitoring systems, adapting outreach for harder-to-reach subpopulations of OOS girls, and financing delivery models for tailored outreach strategies will be critical to improving equitable HPV vaccine coverage among OOS girls.

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

ReAge3D: Re-Aging 3D Faces with View Consistency

We present a novel framework for realistic and controllable 3D face re-aging which produces highly detailed, identity-preserving results. Existing 3D editing methods, while effective for coarse semantic changes, are not well suited for re-aging, as even small inconsistencies across re-aged 2D views can lead to over-smoothing of subtle but perceptually important age-related details. To address this challenge, we first introduce a 2D diffusion-based re-aging model, DiffReaging, trained on synthetically generated image pairs. We further propose a center-out editing propagation strategy that leverages this re-aging model to reconstruct multi-view-consistent re-aged images. Specifically, starting from a re-aged frontal pivot view, we reconstruct the remaining views through warping and our proposed Masked-DiffReaging process. By injecting existing content at every step of the diffusion process, Masked-DiffReaging ensures that the reconstructed regions remain coherent with existing pixels. The resulting consistent set of re-aged views supervises the optimization of the re-aged 3D representation. Our method outperforms existing 3D editing techniques both visually and quantitatively, enabling smooth, fine-grained control over age transformations in 3D face models.

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

Plan, Don't Pose: Long Composite Motion Generation with Text-Aligned BFM

arXiv:2605.29906v2 Announce Type: replace Abstract: Text-to-motion (T2M) generation has broad applications in character animation, virtual avatars, and human-robot interaction. Existing methods typically generate pose trajectories or motion tokens directly from language, forcing a single model to handle semantic interpretation, long-horizon structure, and low-level physical realization. This coupling makes them costly and often unreliable for long, compositional, or semantically dense prompts. We propose Text2BFM, the first framework that aligns natural language with pretrained Behavioral Foundation Models (BFMs) for T2M generation without relying on heavy end-to-end motion generators. Text2BFM operates in the latent policy space of a frozen BFM, using it as an executable motion prior. A text-aligned variational behavioral bottleneck compresses BFM policy-latent sequences into compact motion representations that are compatible with language and preserve long-horizon behavioral structure. Generation is performed in this compact behavioral manifold with a lightweight conditional generator, and the resulting latent encoded behaviors are decoded into policy latents that drive the pretrained frozen BFM. By decoupling semantic planning from motion execution, Text2BFM achieves efficient, robust T2M generation and strong performance on long, compositional textual descriptions.

08.
arXiv (quant-ph) 2026-06-15

On-site interactions in quantum thermal machines: efficiency, rectification and entanglement beyond local and global master equations

arXiv:2606.14593v1 Announce Type: new Abstract: Advances in experimental techniques have opened new routes for harnessing non-equilibrium dynamics in mesoscopic quantum systems. In this context, we study the impact of on-site interactions on the transport properties of a continuous quantum thermal machine composed of two coupled oscillators connected to two thermal reservoirs. In the weak system-reservoir coupling regime, where a long-standing debate concerns which reduced description should be preferred, we first show that the Redfield master equation (RME) provides an accurate and unifying framework that interpolates between two well-known limits: the local and global master equations. By relying on the Hierarchy of Pure States (HOPS), a numerically exact stochastic method, we then explore the full parameter space and show that interactions can be leveraged to tune the efficiency of the thermal machine at high temperatures (while leaving it essentially unchanged at low temperatures), induce non-reciprocal transport under asymmetric reservoir couplings, and generate steady-state entanglement within the junction. We derive expressions for system-bath correlators, such as heat and particle currents, consistently across different frameworks. Our work features on-site interactions to enhance the versatility of quantum thermodynamic junctions and clarifies the role of non-Markovianity and non-linearities in quantum transport.

09.
arXiv (CS.CV) 2026-06-16

Text-Vision Co-Instructed Image Editing

Existing image editing methods can be generally categorized into textual instruction-based and visual prompt-based ones. Textual instructions are semantically expressive, but are limited by the coarse granularity of spatial control of the editing results. In contrast, visual prompts such as drag and point can provide precise spatial guidance, but are limited by the inherent ambiguity in semantic intent. To unify the strength of textual and visual prompts, we present Text-Vision Co-Instructed Image Editing, which jointly models textual instructions as semantic intent and sparse visual instructions as spatial guidance, aiming to achieve precise and intent-faithful image manipulation. To this end, we first construct a textual-visual instruction paired dataset with more than 23K samples derived from dynamic videos, enabling aligned supervision for cross-modal instruction. We then propose TV-Edit, a Textual-Visual instruction unified Editing framework to contextualize drag or point-based visual instructions with image-text semantics and lift them into semantic-aware control representations for pretrained editing backbones. By integrating semantic intent and spatial constraints, TV-Edit leads to more precise spatial control, less instruction ambiguity, and stronger structural consistency than text-only or drag-based alternatives. Finally, we establish TV-Edit-Bench, a deliberately designed benchmark to evaluate semantic faithfulness, spatial alignment, and visual consistency with ground-truth references and controlled textual-visual variations for reliable assessment. Our experiments across multiple editing backbones demonstrate that TV-Edit consistently yields more precise and intent-faithful edits, significantly outperforming state-of-the-art instruction-based and drag-based baselines.

10.
arXiv (math.PR) 2026-06-12

Interference Queueing Networks: A Replica Mean-Field Approach in the Symmetric Setting

arXiv:2606.13264v1 Announce Type: new Abstract: We propose a model for evaluating the performance of wireless communication networks beyond the ubiquitous full-buffer assumption, under which every transmitter is always active. The network is represented by N interacting queues arranged on a torus, with homogeneous arrival rate and service rates depending on the activity of neighboring interferers. More precisely, each queue is associated with a transmitter-receiver pair, and its service rate is given by the Shannon capacity, which depends on the corresponding Signal-to-Interference-plus-Noise Ratio (SINR). Since interfering transmitters only emit when their queue is non-empty, the SINR and hence the service rate improves when neighboring queues are empty. We derive the stability region of the system, together with approximations of its stationary distribution and its exponential rate of convergence to stationarity. These approximations are obtained via a replica mean-field limit, for which we establish propagation of chaos and long-time behavior results.

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

Airport Terminal Passenger Queue Forecasting for Departure Gates and Security Checkpoints

arXiv:2606.07622v2 Announce Type: replace Abstract: Accurate passenger queue forecasting in airport terminals is essential for efficient departure operations, as it enables proactive congestion management. However, time-varying passenger demand and heterogeneous facility usage across multiple departure facilities make forecasting challenging. In this work, we propose a passenger queue forecasting framework that learns historical passenger flow patterns from operational data. The proposed model employs a Transformer-based architecture to capture temporal dependencies and inter-facility correlations using past queue length and waiting time at departure gates and security checkpoints, together with passenger throughput at check-in islands. The learned representations are mapped to two facility-specific prediction heads to predict queue length and waiting time at departure gates and security checkpoints. Experimental results demonstrate accurate forecasts up to two hours ahead. The proposed approach offers practical real-time decision support for proactive queue management and staff reallocation in airport terminal operations.

13.
bioRxiv (Bioinfo) 2026-06-11

Tumour evolution as ground truth for cancer whole-genome sequencing

Cancer genomes are shaped by evolutionary processes that couple mutagenesis, clonal selection, chromosomal instability, spatial growth and treatment response into structured genomic patterns, yet current benchmarking strategies largely ignore this evolutionary dependency. Here, we present SCOUT, a large-scale synthetic whole-genome sequencing resource of over 200 samples, designed for systematic benchmarking of tumour genomic analysis and evolutionary inference under controlled evolutionary ground truth. Unlike conventional task-specific simulations, SCOUT models tumour evolution as a latent generative process that simultaneously shapes mutations, copy-number alterations, variant allele frequencies, mutational signatures and clonal architectures. SCOUT recapitulates key features of solid and haematological malignancies, including driver mutations, chromosomal instability, intratumour heterogeneity, spatial sampling and treatment-associated evolutionary dynamics in tumour and matched-normal longitudinal and multi-region sequencing designs. Using SCOUT, we benchmarked widely used methods for somatic variant detection, copy-number analysis, mutational signature inference and tumour evolutionary reconstruction. Across analytical tasks, performance deteriorated in low-purity, highly subclonal and structurally complex tumours, while spatial sampling bias and hypermutation generated spurious evolutionary signals that confounded tumour interpretation across multiple inference layers. Evolutionary simulations further distinguished lineage-restricted genetic bottlenecks from multi-lineage resistance dynamics associated with tumour plasticity. Tumour purity consistently exerted a stronger effect on inference accuracy than sequencing depth. Together, our results establish evolutionary ground truth as a prerequisite for reproducible benchmarking and biologically interpretable analysis of cancer whole-genome sequencing data.

14.
medRxiv (Medicine) 2026-06-19

A soluble bi-specific fusion protein for the improved expansion of human CD8+ CAR-T cells

The success of Chimeric Antigen Receptor (CAR) T cell therapy is heavily dependent on the quality of the final cellular product. Current expansion protocols often rely on reagents that require removal from cell culture media, posing logistical challenges in manufacturing, and can also lead to terminal differentiation. Here, we evaluate the use of a soluble, bead-free T cell activator, T cell expansion protein (T-CEP), as a streamlined alternative for generating potent CAR-T cells. Human T cells were activated with T-CEP or known T cell activators (Dynabeads and TransAct) and transduced with either CD19 or interleukin-13 (IL-13) mutein (tetravariant-13; TV-13)-based CAR lentiviral vectors. Our results demonstrate that T-CEP supports robust CAR-T cell expansion and achieves transduction efficiencies comparable to commercial reagents for both types of CAR-T cells. Notably, T-CEP significantly favored the expansion of CD8+ T cells, yielding an enhanced CD27+ phenotype and a lower CD4:CD8 ratio compared to TransAct. Cytotoxicity assays confirmed that T-CEP-expanded CAR-T cells possess cytolytic function equivalent to commercial reagents for both CARs, while exhibiting lower levels of inflammatory cytokine secretion. In summary, T-CEP represents a competitive alternative to existing expansion agents, as it does not require its removal during CAR-T manufacturing and generates a CD8+ dominant, less-differentiated phenotype without compromising efficacy.

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

Authorship Attribution in Multilingual Machine-Generated Texts

As Large Language Models (LLMs) have reached human-like fluency and coherence, distinguishing machine-generated text (MGT) from human-written content becomes increasingly difficult. While early efforts in MGT detection have focused on binary classification, the growing landscape and diversity of LLMs require a more fine-grained yet challenging authorship attribution (AA), i.e., being able to identify the precise generator (LLM or human) behind a text. However, AA remains nowadays confined to a monolingual setting, with English being the most investigated one, overlooking the multilingual nature and usage of modern LLMs. In this work, we introduce the problem of Multilingual Authorship Attribution, which involves attributing texts to human or multiple LLM generators across diverse languages. Focusing on 18 languages – covering multiple families and writing scripts – and 8 generators (7 LLMs and the human-authored class), we investigate the multilingual suitability of monolingual AA methods in terms of their cross-lingual transferability, and the impact of generators on attribution performance. Our results reveal that while certain monolingual AA methods can be adapted to multilingual settings, significant limitations and challenges remain, particularly in transferring across diverse language families, underscoring the complexity of multilingual AA and the need for more robust approaches to better match real-world scenarios.

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

NeuMesh++: Towards Versatile and Efficient Volumetric Editing with Disentangled Neural Mesh-based Implicit Field

Recently neural implicit rendering techniques have evolved rapidly and demonstrated significant advantages in novel view synthesis and 3D scene reconstruction. However, existing neural rendering methods for editing purposes offer limited functionalities, e.g., rigid transformation and category-specific editing. In this paper, we present a novel mesh-based representation by encoding the neural radiance field with disentangled geometry, texture, and semantic codes on mesh vertices, which empowers a set of efficient and comprehensive editing functionalities, including mesh-guided geometry editing, designated texture editing with texture swapping, filling and painting operations, and semantic-guided editing. To this end, we develop several techniques including a novel local space parameterization to enhance rendering quality and training stability, a learnable modification color on vertex to improve the fidelity of texture editing, a spatial-aware optimization strategy to realize precise texture editing, and a semantic-aided region selection to ease the laborious annotation of implicit field editing. Extensive experiments and editing examples on both real and synthetic datasets demonstrate the superiority of our method on representation quality and editing ability. Project page: https://zju3dv.github.io/neumeshplusplus/

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

MeshPad: Interactive Sketch-Conditioned Artist-Reminiscent Mesh Generation and Editing

We introduce MeshPad, a generative approach that creates 3D meshes from sketch inputs. Building on recent advances in artist-reminiscent triangle mesh generation, our approach addresses the need for interactive mesh creation. To this end, we focus on enabling consistent edits by decomposing editing into 'deletion' of regions of a mesh, followed by 'addition' of new mesh geometry. Both operations are invoked by simple user edits of a sketch image, facilitating an iterative content creation process and enabling the construction of complex 3D meshes. Our approach is based on a triangle sequence-based mesh representation, exploiting a large Transformer model for mesh triangle addition and deletion. In order to perform edits interactively, we introduce a vertex-aligned speculative prediction strategy on top of our additive mesh generator. This speculator predicts multiple output tokens corresponding to a vertex, thus significantly reducing the computational cost of inference and accelerating the editing process, making it possible to execute each editing step in only a few seconds. Comprehensive experiments demonstrate that MeshPad outperforms state-of-the-art sketch-conditioned mesh generation methods, achieving more than 22% mesh quality improvement in Chamfer distance, and being preferred by 90% of participants in perceptual evaluations.

18.
arXiv (quant-ph) 2026-06-12

Coarse-grained quantum thermodynamics: Observation-dependent quantities, observation-independent laws

arXiv:2507.15918v2 Announce Type: replace Abstract: In both classical and quantum thermodynamics, physical quantities are typically assigned objective values defined independently of our observations. We then refer to the 'work performed by a gas', or the 'entropy of the gas', regardless of how they are evaluated. Here, we question this conception in the context of quantum thermodynamics, estimating how the definition of pivotal thermodynamic quantities is affected by experimental instruments of limited precision. We find that the coarse-grained thermodynamic quantities frequently lead to different conclusions from those drawn in fine-grained scenarios. For instance, the irreversibility of a process, or its work payoff, can significantly vary with the instrument precision. We show nonetheless that coarse-grained thermodynamic quantities satisfy the same relations (i.e., the second law inequality, the relation between dissipation and distinguishability of a process from its time-reverse, and the quantum work fluctuation theorems) as their fine-grained counterparts. These results highlight the observation-independence of relations linking thermodynamic quantities which are themselves observation-dependent.

20.
arXiv (math.PR) 2026-06-15

Real-order moments, tail representations, and logarithmic means

arXiv:2606.14019v1 Announce Type: cross Abstract: This paper develops a unified framework for the study of real-order moments of arbitrary random variables. General integral representations are established in terms of cumulative distribution functions and survival functions, covering continuous, discrete, and mixed distributions supported on the whole real line. These formulas extend the classical tail-integral identities for nonnegative random variables and provide a common treatment of positive, fractional, and negative moments. For discrete distributions, explicit series representations are derived in terms of cumulative probabilities, yielding simple criteria for the existence of moments. Applications are presented for the zeta and Skellam distributions, illustrating how tail behavior determines moment finiteness and how moments can be represented geometrically through cumulative distribution functions. In addition, a representation for logarithmic moments is obtained, linking logarithmic means, Laplace transforms, and the classical Frullani identity. The results provide a unified perspective on moment representations and establish useful connections between tail probabilities, distribution functions, Laplace transforms, and moment existence.

21.
arXiv (CS.CV) 2026-06-17

MODE-RAG: Manifold Outlier Diagnosis and Energy-based Retrieval-Augmented Generation Evaluation

While Multimodal Retrieval-Augmented Generation (M-RAG) enhances Large Vision-Language Models, it remains highly susceptible to cross-modal hallucinations, causal fabrications, and sycophancy. Furthermore, existing mitigation pipelines often face an intervention paradox: static rules tend to unnecessarily disrupt accurate generations, whereas leaving the multi-modal reasoning completely unguided allows existing mismatches to cascade into severe logical fabrications. To quantify and mitigate these hallucinations, we propose a Multi-Agent system, MODE-RAG, driven by Variational Free Energy (VFE) and internal attention states to dynamically gate interventions. High-risk queries are routed to five stage-specific agents, integrating Monte Carlo Tree Search (MCTS) for rigorous causal derivation and logit perturbations to penalize sycophancy. Dedicated Correction and Overseer agents ensure formatting stability and perform post-hoc factual verification. To objectively evaluate our approach, we introduce ModeVent, a challenging subset derived from the MultiVent dataset. Extensive experiments indicate that our system effectively reduces hallucination rates and logical fabrication, significantly improving the robustness of M-RAG systems.

22.
medRxiv (Medicine) 2026-06-19

Rumination as a cognitive vulnerability factor in perinatal bereavement: evidence from the CARING study

Purpose. Perinatal loss is associated with a high risk of persistent psychological distress, including prolonged grief, depression, anxiety, and post-traumatic stress symptoms. Cognitive processes such as rumination may play a crucial role in maintaining and amplifying distress following loss, yet their specific contribution in perinatal bereavement remains underexplored. Methods. The CARING (Cognitive Analysis and Rumination INvestigation in perinatal Grief) study employed a cross-sectional design involving 298 parents who experienced perinatal loss within the previous five years. Participants completed an anonymous online survey including measures of depressive rumination (Ruminative Response Scale, RRS), angry rumination (Anger Rumination Scale, ARS), perinatal grief (Perinatal Grief Scale, PGS), general psychopathology (SCL-90), and post-traumatic stress symptoms (NSESSS). Non-parametric analyses were conducted to examine associations between rumination patterns and psychological outcomes. Results. Higher levels of rumination were significantly associated with greater perinatal grief, depressive and anxiety symptoms, and post-traumatic stress. Depressive rumination showed consistently stronger associations with all outcomes compared to angry rumination. Participants presenting both depressive and angry rumination exhibited the highest levels of grief intensity, psychological distress, and PTSD symptoms, suggesting a graded relationship between rumination patterns and severity of distress. Rumination levels were not significantly associated with gestational age at loss or with having received psychological support. Conclusions. Rumination, particularly in its depressive form, appears to function as a transdiagnostic cognitive vulnerability factor in perinatal bereavement. These findings highlight rumination as a potential target for early screening and tailored psychological interventions aimed at reducing long-term distress following perinatal loss.

23.
medRxiv (Medicine) 2026-06-15

Pulmonary extracellular vesicles drive alveolar macrophage dysfunction via microRNA transfer in Acute Respiratory Distress Syndrome

Background: Alveolar macrophage (AM) dysfunction contributes to Acute Respiratory Distress Syndrome (ARDS) pathogenesis. We investigated the role of extracellular vesicles (EVs) in mediating this dysfunction. Methods: Pulmonary EVs were isolated from broncho-alveolar lavage and non-directed bronchial lavage samples of ventilated sepsis patients with and without ARDS, and post-operative control patients via ultracentrifugation. AMs were isolated from lung tissue resections of lobectomy patients. AMs were treated with pooled EVs for 24 hours prior to functional, metabolic and autophagy profiling. EV cargo was profiled via small RNA transcriptomics and proteomics. Mechanistic role of EV microRNAs was assessed via mimic / antagomir transfection. Results: Pulmonary EVs from sepsis patients with ARDS impaired AM efferocytosis, and control EVs had no effect. ARDS EV treatment enhanced AM mitochondrial-linked respiration, but not glycolysis. ARDS EV treatment impaired LC3B-II and LAMP1 expression, indicating dysregulated AM autophagy-lysosomal machinery. Proteomics revealed downregulation of innate immune pathways in ARDS EVs. Transcriptomics revealed enrichment of 24 microRNAs in ARDS EVs; miR-652-3p was the most enriched, validated by RT-qPCR. EV miR-652-3p was associated with 90-day mortality (9.20 vs 0.59 RQ, p=0.0295) and inversely correlated with oxygenation (PaO2/FiO2). AM transfection with miR-652-3p mimic induced similar dysregulation of function and autophagy as ARDS EVs. Transfection of ARDS EVs with antagomirs to miR-652-3p prior to AM treatment partially rescued efferocytosis and autophagy. Conclusions: Targeting EV miR-652-3p may restore alveolar macrophage function and reduce excessive inflammation, thus offering a novel therapeutic strategy for patients with ARDS.

24.
Nature (Science) 2026-06-08

Targeting Cancer-Specific Mutations with RNA-Triggered Chromatin Shredding

Authors:

Genetic mutations that drive cancer often occur in tumor suppressor proteins, including the p53 transcription factor which is altered in ~40-50% of cases1,2. However, current therapies fail to target most such mutations because the mutant proteins typically lack defined drug-binding pockets, and restoring the endogenous function has proven challenging. Here, we programmed CRISPR-Cas12a2, an RNA-guided nuclease with trans-nucleolytic cleavage activities3,4, to selectively kill cancer cells by targeting cancer-specific transcripts. This approach limits cell growth by inducing trans shredding of chromatin, triggering DNA damage responses and cell death. Unlike existing methods, RNA-guided Cas12a2 senses cellular RNA signatures, enabling precise targeting of undruggable mutations. Transcript-activated chromatin shredding provides a new approach to precision disease treatments for undruggable targets.

25.
medRxiv (Medicine) 2026-06-16

A Poisson Process Life Expectancy framework for optimising patient lifetime during chemotherapy

Cancer therapy balances between two competing objectives - treatment efficacy against the tumour and the risk of treatment related severe adverse events, including patient death. Most existing optimal control theory (OCT) formulations rely on optimising heuristic cost functionals that lack direct clinical interpretability. In clinical practice treatment efficacy and patient tolerability are primarily assessed through survival metrics and adverse event rates. Here we introduce the Continuous Lifetime Payoff (CLP), a novel OCT objective functional that directly links treatment decisions to patient survival. It explicitly incorporates tumour dynamics, tumour eradication, and patient mortality from tumour progression, drug-related toxicity and age. We fit age-related mortality from life tables and infer parameters from simulated survival data. The CLP provides a clinically grounded framework for optimising chemotherapy regimens.