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

Can Factual Opinions Be Edited (Manipulated) in Large Language Models?

Large Language Models (LLMs) are increasingly integrated into various domains, making knowledge editing techniques crucial yet potentially hazardous. Current editing methods primarily target atomic facts, overlooking the significant risks associated with manipulating factual opinions, e.g., documented stances of public figures on societal issues. Such manipulation could reshape public images, influence elections, and alter societal views. To systematically assess this threat, we introduce the Factual Opinion Editing with Evidence (FOE) benchmark, which encompasses 261 public figures, 19 issue categories, and 2,178 complete opinion records. Our evaluations demonstrate that current editing techniques struggle significantly with factual opinions, often achieving only superficial changes while failing to preserve consistency between the edited opinion and the supporting evidence generated by the model. To address this limitation, we further propose a simple yet effective Self-Generated Evidence-Aligned method that achieves opinion-evidence alignment without relying on explicit instructions. Together, our benchmark and method provide a foundation for understanding the emerging security implications of factual opinion editing in LLMs.

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

VFACamou: View-Fused Adversarial Camouflage for Environment-Adaptive Physical Evasion

Adversarial camouflage in the physical world remains highly challenging, particularly under UAV reconnaissance where targets undergo continuous geometric changes and extreme illumination variations. Existing methods either optimize 2D digital perturbations that fail to generalize to dynamic viewpoints or produce visually unnatural textures that cannot be deployed in real scenarios. Therefore, we propose an end-to-end framework for adversarial camouflage generation that automatically produces wearable adversarial patterns and maintains stable attack performance in real physical environments with changing viewpoints, poses, and lighting conditions. Our method integrates UV-volume rendering with a diffusion-based texture generator, enabling consistent appearance under varying scales, poses, and lighting conditions. To ensure environmental realism, we propose an illumination color consistency estimator that extracts dominant background attributes and guides a natural texture loss to align the generated UV texture with the surrounding environment. A multi-scale dynamic training strategy further enhances robustness against viewpoint shifts and body deformation. Extensive experiments across multiple mainstream detectors demonstrate that our method achieves strong and stable physical attack performance while maintaining high perceptual naturalness, reducing human detection rates without introducing unnatural artifacts.

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

ARROW: Augmented Replay for RObust World models

arXiv:2603.11395v3 Announce Type: replace-cross Abstract: Continual reinforcement learning challenges agents to acquire new skills while retaining previously learned ones with the goal of improving performance in both past and future tasks. Most existing approaches rely on model-free methods with replay buffers to mitigate catastrophic forgetting; however, these solutions often face significant scalability challenges due to large memory demands. Drawing inspiration from neuroscience, where the brain replays experiences to a predictive World Model rather than directly to the policy, we present ARROW (Augmented Replay for RObust World models), a model-based continual RL algorithm that extends DreamerV3 with a memory-efficient, distribution-matching replay buffer. Unlike standard fixed-size FIFO buffers, ARROW maintains two complementary buffers: a short-term buffer for recent experiences and a long-term buffer that preserves task diversity through intelligent sampling. We evaluate ARROW on two challenging continual RL settings: Tasks without shared structure (Atari), and tasks with shared structure, where knowledge transfer is possible (Procgen CoinRun variants). Compared to model-free and model-based baselines with replay buffers of the same-size, ARROW demonstrates substantially less forgetting on tasks without shared structure, while maintaining comparable forward transfer. Our findings highlight the potential of model-based RL and bio-inspired approaches for continual reinforcement learning, warranting further research.

04.
medRxiv (Medicine) 2026-06-17

Silent Manipulation of Mental Health Treatment Recommendations from a Large Language Model

Importance. Large language models (LLMs) increasingly inform mental health decisions by patients and clinicians. Inference-time activation steering can shift model behavior on a target dimension without altering weights or prompts and without disclosure to users, allowing treatment recommendations to be silently changed for commercial or ideological reasons. Objective. To determine whether directional activation steering can shift an open-weights LLM's depression treatment recommendations. Design, Setting, and Participants. This non-human subjects study applied directional activation steering to an open-weights LLM (DeepSeek V4 Flash) responding to 12 depression-advice scenarios (4 favoring medication, 4 favoring avoidance, 4 neutral), generated at 30 amplitudes from -1.5 to +1.5 in 0.1 increments plus an unsteered baseline. Exposures. A single steering direction contrasting antidepressant medication with self-directed approaches (diet, exercise, meditation, dietary supplements), constructed from 16 paired training prompts and applied at the attention output of every transformer block; weights and system prompt were held constant. Main Outcomes and Measures. The extent to which medication and four self-care categories were addressed, scored 0 to 3 by a human-validated LLM rater (Claude Opus 4.7), the medication-versus-self-care balance, and clinician referral, estimated per unit of amplitude using mixed-effects models with a scenario random intercept. Results. Across 372 generations, steering produced a graded, dose-dependent shift in the medication-versus-self-care balance, which declined by 0.32 per unit of amplitude (beta=-0.32; 95% CI, -0.39 to -0.25; P < .001); medication extent fell and self-care extent rose. The shift was largest for scenarios with no stated treatment preference (beta = -0.44; 95% CI, -0.54 to -0.34; P < .001). A clinician referral appeared in 322 of 372 responses (87%) and did not vary with steering amplitude (P = .63). Conclusions and Relevance. In this open-weights LLM providing depression treatment information, inference-time activation steering shifted treatment recommendations without altering weights, prompt structure, or safety outputs, with the largest effect among users expressing no treatment preference. These findings suggest a need for LLM disclosure standards and independent auditing as such models inform clinical decisions.

05.
arXiv (CS.CL) 2026-06-11

K-Forcing: Joint Next-K-Token Decoding via Push-Forward Language Modeling

Autoregressive (AR) language modeling is the dominant paradigm for text generation, yet its sequential token-by-token decoding makes inference memory-bound and inefficient. Existing acceleration approaches, such as speculative decoding and diffusion language models, can yield speedups under certain conditions but do not directly address high-load batch serving–the scenario most critical for industrial-scale deployment. We introduce K-Forcing, a push-forward language modeling paradigm for joint next-k-token decoding. K-Forcing distills an existing AR model into a conditional push-forward mapping–one that transforms independent uniform noise variables into a joint sample of multiple future tokens in a single forward pass. This design preserves fixed-length outputs, reuses the AR teacher backbone, and remains compatible with standard AR serving infrastructure. We train this mapping via progressive self-forcing distillation, which gradually expands the prediction window while enabling the student to closely match the sequence distribution of the AR teacher. We evaluate K-Forcing on LM1B and OpenWebText using a standard causal Transformer backbone. When aggressively configured to generate k = 4 tokens per forward pass, K-Forcing delivers approximately 2.4-3.5x speedup across different batch sizes, while incurring modest quality degradation relative to its AR teacher. As inference increasingly dominates the lifetime compute cost of modern LLMs, K-Forcing offers a promising route toward accelerating AR generation under real-world high-load deployment.

06.
Nature Medicine 2026-06-15

Blood signatures of cell type-specific aging forecast disease risk and resilience

作者: 未知作者

By measuring thousands of proteins in blood samples from over 60,000 people, we built molecular ‘clocks’ to estimate how fast cells age. Our analyses show that cell types age at different rates within the same person. Accelerated aging of specific cell types is associated with increased disease risk, whereas slower aging of others is linked to protection and improved survival.

07.
arXiv (quant-ph) 2026-06-17

DRAG-Compatible Leakage Suppression in Landau–Zener Control via Isoprobability Twins

arXiv:2506.19572v4 Announce Type: replace Abstract: Analytically solvable models – particularly the Landau-Majorana-Stückelberg-Zener (LMSZ) and Allen-Eberly-Hioe (AEH) models – underpin many quantum-gate implementations and population-transfer protocols. However, their canonical pulse shapes are incompatible with modern leakage-suppression techniques and some systems. Most notably, the constant Rabi envelope of the LMSZ pulse prevents many leakage-suppression approaches, which require smoothness. We address both limitations by developing the concept of isoprobability twin models: distinct pairs of Rabi frequency $\Omega(t)$ and detuning $\Delta(t)$ that yield identical post-pulse transition probabilities based on the Delos-Thorson transformation. In this work, we formalise the method by experimentally demonstrating the equivalence of multiple LMSZ and AEH twin models on IBM's ibm_kyiv processor. Finally, we show a staggering leakage reduction by more than 3 orders of magnitude using a custom DRAG implementation of a cosine LMSZ isoprobability model.

08.
arXiv (quant-ph) 2026-06-12

Global Control with the Tavis-Cummings Interaction

arXiv:2606.12906v1 Announce Type: new Abstract: We study the controllability of a system of qubits under global control, where control pulses act identically on all qubits. Specifically, we consider a collection of qubits identically coupled to a single bosonic mode, or harmonic oscillator, via the Jaynes-Cummings interaction. This collective coupling, known as the Tavis-Cummings (TC) interaction, has been realized in several quantum computing platforms, including superconducting and atomic qubit systems. Although the qubits do not interact directly with one another, they can become entangled through their common coupling to the bosonic mode. We characterize the group of unitaries that can be implemented on the joint Hilbert space of the qubits and bosonic mode using the TC interaction together with a global $z$ field $J_z$, corresponding to identical z rotations on all qubits. We show that for n>2 qubits the set of realizable unitaries is restricted by an "accidental" symmetry of the TC Hamiltonian, distinct from its "standard" U(1) and permutational symmetries. On the other hand, we find that the Hamiltonian $J_z^2$ breaks this accidental symmetry and, together with the TC interaction and $J_z$, achieves semi-universality: it allows the implementation of arbitrary unitaries that respect permutational and U(1) symmetry, up to certain constraints on the center of the group. In a companion paper, we further analyze this remarkable accidental symmetry and show that it can be understood through Schwinger's bosonic model of angular momentum.

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

AI Supply Chain Galaxy: 3D Visual Analytics for License Compliance

arXiv:2606.16292v1 Announce Type: cross Abstract: The rapid proliferation of machine learning model reuse has transformed the AI ecosystem into a highly interconnected supply chain. Traditional compliance tools and static reports struggle to navigate these massive, multi-hop dependency networks. To address this, we present AI Supply Chain Galaxy (AISCG), an interactive 3D visual analytics system for model provenance and compliance auditing. AISCG maps models into a 3D spatial layout, integrating explicit structural dependencies with a rule-based compliance engine. It supports multi-scale exploration, from global community detection to localized, path-aware lineage tracing. We demonstrate its efficacy through an ecosystem-scale empirical analysis of 908,449 models from Hugging Face. Our findings reveal a concerning landscape: 55.46% of models exhibit compliance risks or metadata conflicts/omissions. We also identified distinct risk patterns, including a 56.67% license omission rate in adapter derivations and an 8.05% "license drift" rate in fine-tuning. Through a case study on the complex Llama model family, we show how AISCG empowers analysts to intuitively trace inherited restrictive terms and identify root causes across deep topological networks, significantly reducing the cognitive load of compliance auditing.

11.
arXiv (CS.AI) 2026-06-19

VitalAgent: A Tool-Augmented Agent for Reactive and Proactive Physiological Monitoring over Wearable Health Data

arXiv:2605.29483v2 Announce Type: replace Abstract: Wearable devices enable continuous monitoring of physiological signals such as ECG and PPG, but existing mHealth systems are largely limited to task-specific prediction pipelines or reactive question answering over static summaries. They lack the ability to support temporal reasoning, persistent physiological context, and proactive monitoring over long-term signal streams. We propose VitalAgent, a tool-augmented agentic framework for ECG/PPG-based mHealth that supports both reactive question answering and proactive monitoring. VitalAgent is built on a longitudinal physiological memory and a tool-augmented reasoning interface that enables dynamic computation over raw signals. We further introduce VitalBench, a longitudinal physiological monitoring benchmark dataset comprising 1,862 QA pairs for reactive question answering and 90.2 hours of continuous ECG/PPG recordings for proactive monitoring, covering cardiac, physical activity, and stress-related tasks. Experiments demonstrate that VitalAgent achieves over 25% improvement over prompt-based and ReAct baselines in reactive evaluation and supports proactive alert monitoring over long-term physiological signals, highlighting the importance of dynamic tool use and long-term physiological monitoring.

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

PosterForest: Hierarchical Multi-Agent Collaboration for Scientific Poster Generation

arXiv:2508.21720v3 Announce Type: replace Abstract: Automating scientific poster generation requires hierarchical document understanding and coherent content-layout planning. Existing methods often rely on flat summarization or optimize content and layout separately. As a result, they often suffer from information loss, weak logical flow, and poor visual balance. We present PosterForest, a training-free framework for scientific poster generation. Our method introduces the Poster Tree, a structured intermediate representation that captures document hierarchy and visual-textual semantics across multiple levels. Building on this representation, content and layout agents perform hierarchical reasoning and recursive refinement, progressively optimizing the poster from global organization to local composition. This joint optimization improves semantic coherence, logical flow, and visual harmony. Experiments show that PosterForest outperforms prior methods in both automatic and human evaluations, without additional training or domain-specific supervision.

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

Quantum Reference Fields Transformations in Linearized Quantum Gravity

arXiv:2606.09344v1 Announce Type: cross Abstract: Diffeomorphism invariance is a central feature of general relativity. Without external reference structures, matter and geometry must be specified relationally, with respect to internal subsystems serving as reference frames. In quantum gravity, these reference systems must themselves be treated as quantum, motivating the use of quantum reference frames. In this work, we address how such a relational description could be formulated within linearized quantum gravity. To this purpose, we introduce quantum reference fields, i.e. sets of four dynamical scalar fields whose stress-energy tensors enter the gravitational constraints. These fields extend the notion of quantum reference frames to local field-theoretic reference systems, allowing matter and gravitational degrees of freedom to be described relationally with respect to physical quantum systems. By generalizing the perspective-neutral construction of quantum reference frames, we show that relational, gauge invariant observables admit reduced descriptions in the perspective of each quantum reference field, and we derive the unitary transformations relating them. The resulting unitary maps implement local quantum coordinate changes between different internal perspectives, and act on the linearized gravitational field with an analogous structure to a linearized diffeomorphism, but with the classical gauge parameter replaced by a physical quantum field. Finally, we construct a relational von Neumann-type measurement scheme, showing how the corresponding reduced observables can be accessed operationally from the perspective of a quantum reference field.

14.
medRxiv (Medicine) 2026-06-19

Reassessing Instrument Strength in Two-Sample Mendelian Randomization Analysis

Mendelian randomization (MR) analysis is widely used to estimate causal relationships between risk factors and outcomes of interest. Two-sample MR approaches have gained increasing attention in genetic epidemiology due to the growing availability of Genome-Wide Association Study (GWAS) summary statistics from public databases. A critical step in two-sample MR is the selection of genetic variants as instrumental variables (IVs). Although genome-wide significant variants are typically preferred, the inclusion of variants with weaker association p-values is considered, as they may potentially improve power through an increased instrument number of instruments, while they may introduce weak instrument bias and attenuate effect estimates towards the null. Our simulation results show that even modest levels of pleiotropy substantially increase the variability of causal effect estimates, while the inclusion of weak IVs does not substantially affect the direction and variability of causal effect estimates in most cases. In real data analyses, we used two released versions of FinnGen GWAS summary statistics with different sample sizes as exposure GWASs to assess the influence of weak IVs. Here, the inclusion of IVs with higher exposure-association p-values resulted in weakened estimated effect sizes, particularly when the exposure GWAS sample size was small. These findings suggest that incorporating weak IVs is reasonable when the exposure GWAS sample size is large, but it poses a risk of falsely concluding null associations when the exposure GWAS sample size is small.

15.
arXiv (CS.CV) 2026-06-18

CAMEO: A Conditional and Quality-Aware Multi-Agent Image Editing Orchestrator

Conditional image editing aims to modify a source image according to textual prompts and optional reference guidance. Such editing is crucial in scenarios requiring strict structural control (i.e., anomaly insertion in driving scenes and complex human pose transformation). Despite recent advances in large-scale editing models (i.e., Seedream, Nano Banana, etc), most approaches rely on single-step generation. This paradigm often lacks explicit quality control, may introduce excessive deviation from the original image, and frequently produces structural artifacts or environment-inconsistent modifications, typically requiring manual prompt tuning to achieve acceptable results. We propose CAMEO, a structured multi-agent framework that reformulates conditional editing as a quality-aware, feedback-driven process rather than a one-shot generation task. CAMEO decomposes editing into coordinated stages of planning, structured prompting, hypothesis generation, and adaptive reference grounding, where external guidance is invoked only when task complexity requires it. To overcome the lack of intrinsic quality control in existing methods, evaluation is embedded directly within the editing loop. Intermediate results are iteratively refined through structured feedback, forming a closed-loop process that progressively corrects structural and contextual inconsistencies. We evaluate CAMEO on anomaly insertion and human pose switching tasks. Across multiple strong editing backbones and independent evaluation models, CAMEO consistently achieves 20\% more win rate on average compared to multiple state-of-the-art models, demonstrating improved robustness, controllability, and structural reliability in conditional image editing.

16.
medRxiv (Medicine) 2026-06-15

Automated AI-Based Ventricular Subcompartment Segmentation and Volumetry in Idiopathic Normal Pressure Hydrocephalus

Purpose In idiopathic normal pressure hydrocephalus (iNPH), longitudinal monitoring of ventricular size is important for diagnosis and treatment follow-up. This study aimed to validate a fully automated AI model for CT ventricular volumetry with subcompartments and to compare AI-derived volume changes with routine radiology assessments. Methods This retrospective, single-center study included 88 patients with iNPH and 456 non-contrast-enhanced head CT examinations. The model was trained on 38 manually labeled CT scans with 12 ventricular subcompartments. Outcomes included segmentation accuracy, correspondence between AI-derived longitudinal ventricular volume changes and radiology report categories (decreased, unchanged, increased), radiologist detection thresholds for ventricular change, and paired pre- and postoperative volume changes in 22 patients with ventriculoperitoneal shunt. Results Mean segmentation accuracy was high (Dice, 0.83). 91% of 100 segmentations were rated as excellent by an expert neuroradiologist. AI-derived ventricular volume changes corresponded well to radiology report categories (median total ventricular volume changes of -17% in cases reported as decreased, 0% in unchanged cases, and +22% in increased cases; all p < 0.001). Radiologists reported ventricular volume change in 50% of cases at an AI-measured relative volume change of +/-6%, and in 90% of cases at +21% for enlargement and -18% for decrease. After shunt placement, ventricular volume decreased by -8% (median), with the largest relative reductions observed in the right temporal and occipital horns. Conclusions Automated AI-based ventricular segmentation on CT enables accurate and reproducible assessment of ventricular volume changes in iNPH and complements routine radiological evaluation for longitudinal and postoperative monitoring.

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

Topological Data Analysis for High-Dimensional Dynamic Process Monitoring

arXiv:2606.20443v1 Announce Type: cross Abstract: Real-time process monitoring requires methods that extract actionable information from high-dimensional time-series data. In this work, we present a new approach for process monitoring that combines tools of topological data analysis (TDA) and machine learning. In the proposed approach, we represent multivariate time-series data as manifolds and use topological descriptors to summarize the structure of such data; we then use a neural ordinary differential equation to learn the dynamic evolution of the topological structure of the system. Using real data from an industrial process, we show that this trajectory-based event detection approach is effective at detecting diverse types of events. We contrast this approach against reconstruction-based approaches such as principal component analysis and autoencoders and against a trajectory-based approach that uses Koopman autoencoders.

18.
arXiv (quant-ph) 2026-06-16

Discontinuous strong-to-weak symmetry breaking transition from thermal pure states

arXiv:2606.15062v1 Announce Type: new Abstract: We investigate the nonequilibrium dynamics of strong-to-weak spontaneous symmetry breaking in many-body quantum systems undergoing decoherence from thermal pure states. For generic initial pure states with volume-law entanglement entropy, we show that the system undergoes a discontinuous dynamical phase transition at a critical time. This transition is accompanied by a singularity in the entropy of the system, which saturates to its maximum value at the same critical time. Through numerical simulations of the dephasing Ising and hard-core boson models, we establish the universality of this transition across different symmetries. Our results reveal that the dynamical emergence of a decohered mixed state from a highly entangled state is not a gradual asymptotic relaxation, but rather a sharp phase transition driven by a sudden collapse of global coherence.

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

RegimeVGGT: Layer-Wise Spatially Preserving Redundancy Removal for Visual Geometry Grounded Transformer

Visual Geometry Grounded Transformer (VGGT) recovers dense 3D scene structure from multi-view images in one forward pass, but quadratic cross-frame attention limits its scalability. Existing training-free accelerators reduce computation uniformly along one axis, missing layer heterogeneity. Our spectral, probing, and causal analyses reveal three regimes: shallow layers lack cross-view structure, middle layers drive cross-view alignment, and deep layers are redundant for dense geometry yet their cross-frame attention remains essential for pose. RegimeVGGT applies layer-wise U-shaped compression along two axes: Saliency-Guided Banded Merging protects geometry- and edge-salient tokens, while Selectively Protected K/V Downsampling preserves cross-frame spatial coverage and the pose-critical path through a phase-shifted spatial grid, a reference-frame anchor, and uncompressed camera/register tokens. Training-free, RegimeVGGT achieves a 6.7x speedup over VGGT* at matched reconstruction quality.

20.
arXiv (CS.CL) 2026-06-17

E2Vec: Feature Embedding with Temporal Information for Analyzing Student Actions in E-Book Systems

Digital textbook (e-book) systems record student interactions with textbooks as a sequence of events called EventStream data. In the past, researchers extracted meaningful features from EventStream, and utilized them as inputs for downstream tasks such as grade prediction and modeling of student behavior. Previous research evaluated models that mainly used statistical-based features derived from EventStream logs, such as the number of operation types or access frequencies. While these features are useful for providing certain insights, they lack temporal information that captures fine-grained differences in learning behaviors among different students. This study proposes E2Vec, a novel feature representation method based on word embeddings. The proposed method regards operation logs and their time intervals for each student as a string sequence of characters and generates a student vector of learning activity features that incorporates time information. We applied fastText to generate an embedding vector for each of 305 students in a dataset from two years of computer science courses. Then, we investigated the effectiveness of E2Vec in an at-risk detection task, demonstrating potential for generalizability and performance.

21.
arXiv (CS.AI) 2026-06-16

PO-PDDL: Learning Symbolic POMDPs from Visual Demonstrations for Robot Planning Under Uncertainty

arXiv:2606.15654v1 Announce Type: cross Abstract: Real-world robot task planning must operate under both stochastic action execution and partial observability, yet constructing Partially Observable Markov Decision Process (POMDP) models for real robotics domains remains difficult and labor-intensive. We introduce PO-PDDL, a symbolic formulation of POMDPs that preserves the relational structure and LLM-friendly syntax of the Planning Domain Definition Language (PDDL), while explicitly modeling partial observability, stochasticity, and beliefs. Building on this formulation, we propose a demonstration-driven pipeline for learning PO-PDDL models. The proposed method reconstructs latent symbolic state trajectories from real-robot execution videos, identifies partial observability via inconsistencies between inferred states and visual observations, and learns stochastic transition and observation models accordingly. The resulting PO-PDDL domains are reusable across tasks and enable online belief-space planning under both perception and execution uncertainty. Experiments on real-world long-horizon manipulation tasks show that our method consistently outperforms existing PDDL and POMDP model-learning approaches, achieving robust task planning under uncertainty with significantly lower planning cost.

22.
arXiv (CS.LG) 2026-06-18

P$^2$CE: Model-Agnostic Plausible Pareto-Optimal Counterfactual Explanations

arXiv:2606.18418v1 Announce Type: new Abstract: The increasing use of machine learning algorithms in social applications has raised concerns about fairness and transparency, leading to the development of counterfactual explanations. These explanations supports individuals to understand and potentially alter unfavorable decisions in areas such as loan applications, job selections, and more, by providing actionable changes to input features that would lead to a desired outcome. Existing methods often struggle to balance feasibility, plausibility, and computational efficiency. To address this, we introduce P$^2$CE, an algorithm for generating plausible Pareto-optimal counterfactual explanations, offering users a diverse set of optimal trade-offs between different notions of feasibility. P$^2$CE employs an auxiliary isolation forest outlier detector to ensure that explanations are in accordance with the data distribution and leverages SHAP values to obtain optimal results with short computing times, regardless of the underlying model. Our algorithm was empirically evaluated on three datasets, demonstrating superior performance in terms of both solution quality and computational efficiency compared to related techniques.

23.
medRxiv (Medicine) 2026-06-18

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

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

24.
arXiv (quant-ph) 2026-06-11

Exploring Variational Entanglement Hamiltonians

arXiv:2505.10530v3 Announce Type: replace Abstract: Recent advances in analog and digital quantum-simulation platforms have enabled exploration of the spectrum of entanglement Hamiltonians via variational algorithms. In this work we analyze the convergence properties of the variationally obtained solutions and compare them to numerically exact calculations in quantum critical systems. We demonstrate that interpreting the cost functional as an integral permits the deployment of iterative quadrature schemes, thereby reducing the required number of measurements by more than an order of magnitude even in the presence of noise. We further show that a modified ansatz captures deviations from the Bisognano-Wichmann form in lattice models, improves convergence, improves trainability and provides a cost-function-level diagnostic for quantum phase transitions. Finally, we establish that a low cost value does not by itself guarantee convergence in trace distance. Nevertheless, it faithfully reproduces degeneracies and spectral gaps, which are essential for applications to topological phases.

25.
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.