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01.
arXiv (CS.LG) 2026-06-19

Optimal Deterministic Multicalibration and Omniprediction

arXiv:2606.20557v1 Announce Type: new Abstract: A model is multicalibrated on a collection of group weights $G$ if it is calibrated – i.e. unbiased even conditional on its prediction – not just overall, but also after reweighting contexts by each $g \in G$. It is a useful property for many downstream applications and is a basic desideratum of trustworthy machine learning. Before this work, all predictors known to attain the minimax-optimal $\widetilde O(\varepsilon^{-3})$ sample complexity rate for $\varepsilon$-multicalibration were randomized, while deterministic predictors were known only with substantially worse sample complexity. Whether randomization is necessary for optimal sample complexity in multicalibration was explicitly asked by [CLNR26] and implicitly in several prior works. We resolve this open problem by giving a minimax-optimal multicalibration algorithm that outputs a deterministic predictor. We then generalize the algorithm to produce optimal deterministic predictors that satisfy outcome indistinguishability (OI) with respect to finite or finitely covered collections of tests. As an application, this also gives deterministic omnipredictors and panpredictors with optimal sample complexity, resolving open problems posed by [OKK25] and [BHHLZ25].

02.
medRxiv (Medicine) 2026-06-15

Routine use of oral iron for people with heart failure and iron deficiency in primary care; retrospective cohort study

Aims: Iron deficiency is common among people with heart failure and associated with morbidity and mortality. While intravenous iron improves clinical outcomes, oral iron continues to be prescribed in routine practice despite limited evidence of benefit. Methods: We completed a retrospective primary care cohort study (2016 to 2021) to investigate the proportion of people with an incident diagnosis of heart failure who had iron deficiency identified (defined as ferritin

03.
arXiv (CS.CV) 2026-06-16

Focus, Align, and Sustain: Counteracting Gradient Dilution in Incremental Object Detection

Adapting Detection Transformers to Incremental Object Detection (IOD) poses a systemic challenge, as set-based optimization is inherently destabilized by sequential learning. In this work, we identify Gradient Dilution as the root cause of performance degradation, wherein optimization signals required to preserve old knowledge are progressively weakened. This phenomenon manifests as a cascading erosion of preservation gradients in magnitude, direction, and support coverage, driven by three tightly coupled factors: Signal Dispersion, where foreground gradients are overwhelmed by background noise; Assignment Drift, where stochastic query-target matching induces inconsistent gradient trajectories; and Support Attrition, where gradients from retained samples insufficiently cover the old-class feature space, weakening decision boundaries under interference from new classes. To counteract this, we propose FAS, a unified framework that Focuses, Aligns, and Sustains gradient flow throughout incremental learning. Specifically, we introduce prior-injected queries to focus discriminative signals by filtering background interference at the source. We further propose deterministic anchor distillation to align query-target assignments and enforce semantic consistency across stages under unstable matching. Finally, we devise manifold-support replay to sustain distributional support of old classes, counteracting representational erosion induced by continual updates. Extensive experiments show that FAS restores robust optimization dynamics and outperforms state-of-the-art methods, achieving over 5.0 AP improvement in the challenging 40+10x4 incremental setting.

04.
arXiv (CS.CL) 2026-06-15

Persona-Pruner: Sculpting Lightweight Models for Role-Playing

Language Models (LMs) have shown remarkable potential as role-playing chatbots, delivering consistent, stylized interactions when given a specification of a character or user persona. However, applying these capabilities to real-world applications (e.g., ecosystems with numerous NPCs interacting simultaneously) exposes a critical inefficiency due to the excessive computational cost. In this paper, we question the necessity of dedicating a full, generalist model to a single persona, hypothesizing that a specific character identity relies on only a fraction of the model's total capacity. We observe that naively pruning LMs often severely degrades the role-playing performance for a specific persona; it does not distinguish between redundant knowledge and essential character traits. We propose Persona-Pruner, a framework that sculpts a lightweight role-playing model by isolating persona-specific sub-networks from a single description. Our experiments consistently show that Persona-Pruner preserves role-playing performance substantially more effectively than existing state-of-the-art LLM pruning techniques, reducing the performance drop from the dense model by up to 93.8% over the strongest baseline on RoleBench in LLM-as-a-judge score, while still maintaining general LLM capabilities. Code is available at https://github.com/jsu-kim/Persona-Pruner.

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

Bring My Cup! Personalizing Vision-Language-Action Models with Visual Attentive Prompting

arXiv:2512.20014v3 Announce Type: replace-cross Abstract: While Vision-Language-Action (VLA) models generalize well to generic instructions, they struggle with personalized commands such as "bring my cup," where the robot must act on one specific instance among visually similar objects. We study this setting of manipulating personal objects, in which a VLA must identify and control a user-specific object unseen during training using only a few reference images. To address this challenge, we propose Visual Attentive Prompting (VAP), a simple-yet-effective training-free perceptual adapter that equips frozen VLAs with top-down selective attention. VAP treats the reference images as a non-parametric visual memory, grounds the personal object in the scene through open-vocabulary detection and embedding-based matching, and then injects this grounding as a visual prompt by highlighting the object and rewriting the instruction. We construct two simulation benchmarks, Personalized-SIMPLER and Personalized-VLABench, and a real-world tabletop benchmark to evaluate personalized manipulation across multiple robots and tasks. Experiments show that VAP consistently outperforms generic policies and token-learning baselines in both success rate and correct-object manipulation, helping to bridge the gap between semantic understanding and instance-level control.

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

Clifford disentanglers for entanglement reduction in molecular electronic structure simulations

arXiv:2606.12056v1 Announce Type: new Abstract: Entanglement is a key bottleneck limiting the efficiency of tensor-network and quantum simulations of molecular electronic structures. Here, we systematically assess and extend Clifford disentanglers as a structure-preserving approach to entanglement reduction: they can modify the entanglement structure of qubit wavefunctions while retaining the Pauli-string form of qubit Hamiltonians. To enable a practical search over Clifford transformations, we classify Clifford operators by their action on the Schmidt spectrum across a bipartition, reducing the two- and four-qubit search spaces to 20 and 91392 representatives, respectively. Embedded in an iterative Clifford-augmented matrix product state framework, these transformations reduce the energy errors at fixed bond dimension for the molecular test cases studied and mitigate the dependence on orbital orderings and fermion-to-qubit mappings. We further show that Clifford disentanglers can also benefit quantum simulations such as the shallow-circuit variational quantum eigensolver calculations. Together, these results establish Clifford disentanglers as a useful structure-preserving entanglement-engineering tool for tensor-network and quantum simulations of molecular electronic structure, while also clarifying their correlation dependence and motivating future developments.

07.
arXiv (CS.CL) 2026-06-19

When Does Streaming Tool Use Help? Characterizing Tool-Intent Stabilization in Streaming Retrieval-Augmented Generation

Streaming Retrieval-Augmented Generation (Streaming RAG) reduces user-perceived latency by issuing tool queries in parallel with ongoing user input, before the utterance is complete. Reported gains are aggregate, yet the mechanism's benefit is fundamentally query-intrinsic: speculation can only help when the correct tool query becomes determinable before the user stops speaking or typing. We isolate and measure this property – tool-intent stabilization, the point in the input stream at which a speculative query's retrieval converges to the answer-bearing result. On the CRAG benchmark (1371 validation questions) we (i) measure the distribution of stabilization, (ii) derive a model-agnostic bound H on the portion of tool latency that can be hidden behind the user's remaining input, as a function of tool latency L and input cadence {\delta}, (iii) validate against a working streaming pipeline that realized savings meet or exceed this bound, and (iv) identify which query properties predict early versus late stabilization. The study requires no model training and runs on commodity CPU hardware. We find that at a realistic operating point (L=600ms, {\delta}=3w/s, {\theta}=0.8), 73.9% of queries across the full benchmark admit substantial latency hiding – a blended figure that mixes sufficiency stabilization on the 21.3% of questions where gold evidence is verbatim-present and BM25-retrievable (95.2% streamable on this favorable slice) with a grounding-free top-1-settling fallback on the remainder. On the favorable slice, {\phi}_suf is bracketed to [0.26, 0.281] by exact and relaxed grounding – both early. Question type produces a significant but coarse early/late split (Kruskal-Wallis p=0.017, epsilon^2=0.04), directly informing when a learned speculative trigger is worth its cost.

08.
arXiv (CS.AI) 2026-06-11

Runtime Enforcement of Hybrid System Properties

arXiv:2606.12022v1 Announce Type: cross Abstract: Runtime enforcement has emerged as a promising approach for ensuring the safety of autonomous and cyber-physical systems operating in uncertain and dynamic environments. Unlike traditional runtime verification, runtime enforcement actively intervenes during execution to prevent property violations by modifying unsafe system behaviors. Existing enforcement frameworks primarily focus on untimed or discrete-time specifications and are often limited to delaying or suppressing events, making them inadequate for reactive systems exhibiting complex continuous dynamics. In this paper, we propose a runtime enforcement framework where safety requirements are modeled using Hybrid Automata (HA). The framework combines discrete-event editing with continuous-time monitoring to support enforcement actions such as suppression, delay, and insertion of events at arbitrary time instants. Upon observing environmental inputs, the automaton is initialized, and runtime reachability analysis is used to synthesize safe corrective actions. We formally define the enforcement problem for safety hybrid automata, establish enforceability conditions, and present an online enforcement algorithm for reactive systems. A detailed case study on an Adaptive Cruise Control (ACC) system demonstrates the effectiveness of the proposed approach in maintaining safety properties under unsafe controller behaviors. Experimental results show that the framework introduces minimal computational overhead while ensuring continuous compliance with safety requirements in real time.

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

DOG-DPO:Dynamic Optimization in Geometry for Safety Alignment

arXiv:2606.07678v2 Announce Type: replace-cross Abstract: Safety alignment for large language models relies on preference data, but current pipelines often train on large, redundant datasets. Existing data selection methods typically score each preference pair independently, collapsing directional preference information into scalar quality or diversity scores. This sample-centric view is especially limiting in multi-dataset settings, where shared safety directions coexist with dataset-specific residual risks. We propose DOG-DPO, a training-free data selection framework that treats preference pairs as structured geometric signals. DOG-DPO first represents each preference pair as a direction in model representation space. It then decomposes multi-dataset preference geometry into a global anchor subspace and dataset-specific residual subspaces. Finally, it selects subsets by maximizing diversity-based coverage, encouraging broad, non-redundant coverage of alignment directions before DPO training. Across six safety benchmarks and two model backbones, DOG-DPO achieves a strong utility-robustness trade-off using only 11% of the preference pairs. It recovers most of the safety gains of full-data training while remaining entirely teacher-free, training-free, and substantially faster than representative selection baselines.

10.
arXiv (CS.CV) 2026-06-17

Human-in-the-Loop Atlas-Based 3D Asset Segmentation for Interactive Content Workflows

Segmenting 3D assets into meaningful regions remains challenging, especially when segmentation criteria are application-dependent and require user control. We present a human-in-the-loop pipeline for generating a segmented 2D parameterized atlas from a 3D model for interactive media, game, and XR content workflows. Our method first selects a compact set of rendered views using a greedy set cover strategy over sampled surface points, and then supports interactive segmentation of these views with SAM~2 and Label Studio. The resulting masks are back-projected onto the model's UV parameterization to produce a unified segmented atlas that supports downstream production tasks such as segment-wise material assignment, style transfer, and semantic labeling. We assess the pipeline through a demonstration-based technical evaluation on eight cultural heritage objects. The results show that the approach can generate usable segmented atlases across diverse geometries while revealing recurring sources of manual correction, particularly fine structures, cavities, and weak appearance boundaries.

11.
arXiv (math.PR) 2026-06-15

Secondary terms for first moments of Selmer groups of twists of elliptic curves over global function fields

作者:

arXiv:2606.14274v1 Announce Type: cross Abstract: Let $E$ be a non-isotrivial elliptic curve over a global function field $\mathbb{F}_q(t)$ of characteristic coprime to $2$ and $3$. Under some explicit conditions, we determine the secondary terms for the first moments of prime Selmer groups of cyclic prime twist families of $E$ over $\mathbb{F}_q(t)$.

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

Two-Phase Bilevel Search for the Moving-Target Traveling Salesman Problem with Moving Obstacles

arXiv:2606.18730v1 Announce Type: cross Abstract: The Moving-Target Traveling Salesman Problem (MT-TSP) seeks a minimum cost trajectory for an agent that departs from a static depot, visits a set of moving targets, each within one of their assigned time windows, and returns to the depot. In this article, we study the Moving-Target Traveling Salesman Problem with Moving Obstacles (MT-TSP-MO), a generalization of the MT-TSP where the agent trajectory must avoid moving obstacles. We present a Mixed-Integer Conic Programming (MICP) formulation that can be solved using off-the-shelf solvers, as well as a fast and scalable Two-Phase Bilevel Search (TPBS) algorithm that computes high-quality feasible solutions for the problem. We evaluate our approaches against an existing baseline algorithm on a broad range of problem instances with up to 40 targets and 40 obstacles. The results demonstrate that both the proposed methods significantly outperform the baseline with respect to success rates, solution costs, and computation time.

13.
arXiv (CS.CL) 2026-06-12

Why Sampling Is Not Choosing: Intentionality, Agency, and Moral Responsibility in Large Language Models

Recent advances in large language models (LLMs) have prompted claims that such systems exhibit agency or qualify as moral agents. This paper argues that these attributions are misguided. We maintain that moral responsibility requires commitment-bearing agency grounded in intrinsic intentionality and self-attributed action, and that such agency constitutes the form of free will relevant to responsibility. Although LLMs generate coherent and normatively evaluable outputs, their operation is fully characterized by probabilistic input-output mappings learned from data. Their apparent intentionality is derived rather than intrinsic, and their outputs are neither owned as commitments nor guided by reasons. Variability introduced by stochastic sampling does not amount to choice or authorship. We address objections from the intentional stance, functionalism, compatibilism, and the presence of moral reasoning in model outputs, arguing that none suffice to establish genuine agency.

14.
arXiv (CS.CV) 2026-06-18

SCR-Guided Difficulty-Aware Optimization for Infrared Small Target Detection

Infrared small target detection remains challenging due to severe background clutter, low contrast, and weak spatial responses where geometric overlap alone is insufficient to characterize detection quality. In this work, we propose REEM (Reweighted Explicit-visibility Enhanced Modulation), a lightweight SCR-guided difficulty-aware optimization framework that incorporates Signal-to-Clutter Ratio (SCR) as a physically meaningful visibility prior during training. Instead of modifying the network architecture or directly optimizing SCR, REEM computes a ground-truth local SCR from the input image and applies a differentiable modulation to the soft-IoU learning signal, emphasizing low-visibility targets while preserving stable optimization and identical inference behavior. REEM is integrated into a U-Net-based MSHNet without introducing additional parameters, architectural modifications, or inference-time overhead. Extensive experiments demonstrate consistent improvements over the baseline, achieving higher IoU and detection probability (Pd) together with substantially reduced false alarms (FA), particularly under challenging low-visibility conditions. These results suggest that SCR-guided difficulty-aware optimization provides an effective and physically grounded complement to conventional overlap-based objectives for infrared small target detection. The code is available at https://github. com/yall-in-one/Reemm.

15.
arXiv (quant-ph) 2026-06-17

A matching decomposition algorithm for simulating quantum walk Hamiltonians

arXiv:2601.11418v3 Announce Type: replace Abstract: In this work, we present a new algorithm for generating quantum circuits that efficiently implement continuous time quantum walks on arbitrary simple sparse graphs. The algorithm, called matching decomposition, works by decomposing a continuous-time quantum walk Hamiltonian into a collection of exactly implementable Hamiltonians corresponding to matchings in the underlying graph followed by a novel graph compression algorithm that merges edges in the graph. We develop a greedy matching heuristic and a compression-aware matching heuristic, both of which can be used in the quantum circuit algorithm. Lastly, we convert the walks to a circuit and Trotterize over these components. The dynamics of the walker on each edge in the matching can be implemented in the circuit model as sequences of CX and CRx gates. We do not use Pauli decomposition when implementing walks along each matching. Furthermore, we compare greedy (compression-aware) matching decomposition to a standard Pauli-based simulation pipeline and find that greedy (compression-aware) matching decomposition consistently yields substantial resource reductions, requiring up to 43$\%$ (70\%) fewer controlled gates and up to 54$\%$ (75\%) shallower circuits than Pauli decomposition across multiple graph families. Finally, we also present examples and theoretical results for when matching decomposition can exactly simulate a continuous-time quantum walk on a graph.

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

Scaling Human and G2P Supervision for Robust Phonetic Transcription

Expert phonetic annotation is costly, especially for non-standard dialects and atypical speech. A common alternative is using Grapheme-to-Phoneme (G2P) models to auto-generate phonetic labels from text transcripts at scale. We study how automatic phonetic transcription performance scales with human and G2P supervision in English. Using a curated 80-hour benchmark spanning native, non-native and post-stroke speech, we identify a supervision quality threshold: G2P supervision helps only when fewer than 20-30 hours of human annotation are available. Beyond this threshold, it provides no significant benefit and can reduce cross-dialect robustness. What is effective after this threshold is ASR pretraining which we use to achieve a 2.3x reduction in weighted phone feature error rate over prior systems, with strong gains on non-native and aphasic speech. These results suggest that quantity-driven G2P scaling may yield diminishing returns for robust generalization.

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

Can LLM Coding Agents Reason About Time Series?

Large language models (LLMs) are increasingly being used for automated decision-making systems in finance, healthcare, or environmental monitoring. Time series data are ubiquitous in these fields, yet hard to process automatically. Can time series be analyzed by LLM agents? We examine three approaches: providing the agent with raw numerical data, using the LLM as a coding agent, or a combination of both. In the coding agent setup, the model iteratively queries the data using Python code. Using two time series understanding benchmarks, we show that agents with code access can outperform models processing raw data by up to 10%. However, even the best performing agent still answers about 22-34% of the questions incorrectly. To get insights into models' strategies and reasoning gaps, we analyze the model outputs with a strong LLM judge. Our analysis reveals that coding agents can select appropriate statistical tests, but often miss important nuances. Meanwhile, models with access to raw data can reach the right conclusions using back-of-the-envelope calculations.

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

MoDiCoL: A Modular Diagnostic Continual Learning Dataset for Robust Speech Recognition

Modern Automatic Speech Recognition (ASR) systems have made remarkable progress on standard benchmarks, yet performance gaps have emerged under real-world distribution shifts, caused by recording conditions, accents, speech impairments, and noise. Existing datasets and benchmarks typically isolate these factors, which overlooks their co-occurrence in real-world applications. In this paper, we argue that model robustness can be treated as a dynamic capability that continually develops, and we introduce MoDiCoL, a Modular Diagnostic Continual Learning dataset designed for controlled analysis of linguistic content, speaker characteristics, and acoustic environments. Furthermore, we propose a real-world-inspired continual learning curriculum to simulate incremental updates and study how robustness is acquired, transferred, and forgotten. We evaluate three continual learning strategies and provide detailed insights into robustness under evolving conditions.

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

An In-depth Study of LLM Contributions to the Bin Packing Problem

arXiv:2510.27353v2 Announce Type: replace Abstract: Recent studies have suggested that Large Language Models (LLMs) could provide interesting ideas contributing to mathematical discovery. This claim was motivated by reports that LLM-based genetic algorithms produced heuristics offering new insights into the online bin packing problem under uniform and Weibull distributions. In this work, we reassess this claim through a detailed analysis of the heuristics produced by LLMs, examining both their behavior and interpretability. Despite being human-readable, these heuristics remain largely opaque even to domain experts. Building on this analysis, we propose a new class of algorithms tailored to these specific bin packing instances. The derived algorithms are significantly simpler, more efficient, more interpretable, and more generalizable, suggesting that the considered instances are themselves relatively simple. We then discuss the limitations of the claim regarding LLMs' contribution to this problem, which appears to rest on the mistaken assumption that the instances had previously been studied. Our findings instead emphasize the need for rigorous validation and contextualization when assessing the scientific value of LLM-generated outputs.

20.
Nature Medicine 2026-06-12

The Hong Kong Genome Project is a flagship initiative for precision medicine in Chinese populations

作者: 未知作者

The Hong Kong Genome Project established a genome sequencing database that provides improved diagnoses for patients and more efficient, population-tailored carrier status screening. Actionable pharmacogenomic variants were identified in almost all participants, informing drug prescriptions. This work establishes a genomic resource and a transferable model for equitable precision medicine in underrepresented populations worldwide.

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

PoQ-Judge: A Multi-Architecture Evaluation Framework for Cost-Aware Proof-of-Quality in Decentralized LLM Inference

Decentralized LLM inference networks need lightweight, reference-free quality evaluation for Proof of Quality (PoQ). We present PoQ-Judge, a framework that trains dedicated judge models to score query-output pairs without ground-truth references. We study three architectures across the quality-cost tradeoff: a TextCNN judge, a MiniLM cross-encoder, and a DeBERTa judge. Using two-stage training on UltraFeedback plus GPT-labeled in-domain data, the best model reaches 0.747 Pearson correlation with the ground-truth proxy on a held-out test set, outperforming reference-based evaluators from prior work. As a reference-free component in composite scoring, it achieves 0.645 Pearson correlation, matching the best single reference-based evaluator while removing the need for reference answers. We also show that online calibration identifies semantic quality as the dominant dimension and that cascade evaluation reduces cost by 72.7 percent with only modest quality loss. Results are much stronger on QA than summarization, pointing to proxy quality as the main remaining limitation.

22.
arXiv (CS.AI) 2026-06-19

AutoPass: Evidence-Guided LLM Agents for Compiler Performance Tuning

arXiv:2606.20373v1 Announce Type: cross Abstract: Large Language Models (LLMs) show promise for code compilation tasks, but applying them to runtime performance tuning is difficult due to complex microarchitectural effects and noisy runtime measurements. We present AutoPass, a multi-agent framework for compiler performance tuning that uses compiler and runtime evidence to guide LLM-generated optimization decisions. Rather than treating the compiler as a black box like prior auto-tuning schemes, AutoPass opens up the compiler to the LLM, enabling it to query compiler-internal optimization states and analyze the intermediate representation to orchestrate compiler options. The search process iteratively refines optimization configurations using measured runtime feedback to diagnose regressions and guide latency-improving edits. AutoPass operates in an inference-only, training-free setting and requires no offline training or task-specific fine-tuning, making it readily applicable to new benchmarks and platforms. We implement AutoPass on the LLVM compiler and evaluate it on server-grade x86-64 and embedded ARM64 systems. AutoPass outperforms expert-tuned heuristics and classical autotuning methods, achieving geometric-mean speedups of 1.043x and 1.117x over LLVM -O3 on x86-64 and ARM64, respectively.

23.
bioRxiv (Bioinfo) 2026-06-21

Antibody-Antigen Affinity Prediction with Chain-Aware Protein Language Modeling

Motivation: Antibody-antigen affinity determines which antibodies advance in therapeutic discovery, repertoire analysis and affinity maturation, but experimental measurements are sparse relative to the scale of sequence libraries. Structure-based predictors can exploit interface geometry when reliable complexes are available, yet early discovery often requires ranking many heavy-light chain pairs against antigens for which no complex structure exists. Existing sequence-based models are scalable, but frequently compress heavy and light chains into a single antibody representation or concatenate antibody and antigen features obscuring the chain-specific and epitope-specific signals that drive binding. Results: We present AbAffinity, a sequence-only chain-aware three-stream architecture that maintains heavy chain, light chain and antigen as distinct streams. It integrates frozen ESM-2 embeddings with heavy-chain CDR-focused pooling, heavy-light self-attention, adaptive fusion gating and gated cross-attention, training only a compact interaction module. On the SAAINT-DB benchmark, AbAffinity achieves strong predictive performance under ten-fold cross-validation and maintains robust accuracy on novel antigens. It consistently outperforms recent sequence-based models across external benchmarks including SAbDab, AB-Bind and SKEMPI 2.0. Ablation studies highlight the contributions of chain-specific representations, CDR-focused pooling and the gated interaction pathway. Integrated Gradients attributions recover known paratope and epitope residues at structurally validated interfaces. AbAffinity provides a lightweight, explainable sequence-first framework for antibody triage and prioritisation when structural information is limited or unavailable.

24.
medRxiv (Medicine) 2026-06-11

Neighborhood socioeconomic status associated with post-stroke cognitive impairment: a retrospective cohort study

Background: Late complications after stroke (LCAS), including cognitive symptoms, impact quality of life and recovery. It is not known if neighborhood-level measures of socioeconomic status (SES) influence LCAS. This study assessed associations between SES measures, including neighborhood income inequality (Gini) and area deprivation index (ADI), and cognitive symptoms after acute ischemic stroke (AIS) in a hospital leveraging active surveillance of LCAS. Methods: This retrospective cohort study included 512 patients hospitalized with AIS at Tufts Medical Center with subsequent follow-up (between zero and three months or between three and twelve months) in the Stroke Clinic from 1/1/2018 - 12/31/2022. Using ZIP code data, patients were characterized as low Gini (low inequality) and high ADI (high deprivation) (Gini = 5) by state medians. These variables were combined, indicating patients who were living in both a low Gini and high ADI neighborhood to evaluate the effects of living in a homogeneously deprived area. There were 206 and 281 patients in the low Gini and high ADI groups respectively. 140 patients lived in a low Gini and high ADI neighborhood. The multivariable logistic analysis assessed the likelihood of cognitive symptoms, adjusting for age, race, ethnicity, sex, NIH Stroke Scale (NIHSS), thrombolysis, active LCAS surveillance, poverty, and ADI-Gini combination. Results: There were no associations between high ADI (OR: 1.03, 95% CI: 0.67 ? 1.57) or low Gini (OR: 1.74, 95% CI: 0.98 ? 3.07) alone and cognitive symptoms after AIS. However, the combined variable demonstrated increased likelihood of cognitive symptoms in the high ADI-low Gini group (OR: 1.82, 95% CI: 1.08 ? 3.06). Conclusions: This study suggests that individuals living in homogeneously deprived neighborhoods report higher likelihood of cognitive symptoms after AIS. Further studies with increased power are needed to investigate the underlying causes of these disparities and to develop interventions to reduce these complications.

25.
medRxiv (Medicine) 2026-06-16

Sleep regularity outweighs sleep duration as a predictor of disease

Sleep regularity, the consistency of sleep-wake timing from one day to the next, is more strongly associated with longevity than adequate sleep duration. Whether this relationship persists across common diseases is unknown. We compared sleep regularity vs. sleep duration as risk factors for 199 diseases and disorders, using ten million hours of objective sleep-wake data (N=60,998, age[mean{+/-}SD]=62.8{+/-}7.8, 55% female). Multivariable-adjusted risks of incident diseases/disorders for regular/irregular and short/adequate sleepers were compared across 9.5 years of follow-up. Irregular sleep predicted risks for 131 diseases/disorders, more than double the number predicted by short sleep duration (63). Irregular sleep was a superior predictor than short sleep duration for 90 diseases/disorders, including circulatory, metabolic, digestive, renal, infectious, neurological, and musculoskeletal conditions, and mental disorders, whereas short sleep duration was the superior predictor for only 9 diseases/disorders. For models where short sleep duration explained disease risks, 83% were improved by adding sleep regularity. Sleep regularity was a stronger predictor of diseases/disorders than sleep duration in this cohort and should be considered an essential dimension of sleep health.