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01.
arXiv (quant-ph) 2026-06-12

Approximate quantum error correction theory of non-isometric codes

作者:
Yixu Wang↗Yijia Xu↗Zi-Wen Liu↗

arXiv:2606.13559v1 Announce Type: new Abstract: Non-isometric encoding arises in various important contexts in quantum error correction, most notably in the finite-energy, non-ideal codewords inevitable in experimental realizations of continuous-variable codes, and holographic quantum gravity. In this work, we present a general and systematic theory of non-isometric quantum error-correcting codes. In particular, we employ the approximate quantum error correction framework to quantitatively study the fundamental limitations imposed by non-isometric encodings on the accuracy of quantum error correction and implementation of logical operations. We apply our theory to analyze GKP and tiger codes under energy constraints, and discuss the implications to holography.

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

Provable Recovery of Locally Important Signed Features and Interactions from Random Forest

作者:
Kata Vuk↗Nicolas Alexander Ihlo↗Merle Behr↗

arXiv:2512.11081v2 Announce Type: replace-cross Abstract: Feature and Interaction Importance (FII) methods are essential in supervised learning for assessing the relevance of input variables and their interactions in complex prediction models. In many domains, such as personalized medicine, local interpretations for individual predictions are often required, rather than global scores summarizing overall feature importance. Random Forests (RFs) are widely used in these settings, and existing interpretability methods typically exploit tree structures and split statistics to provide model-specific insights. However, theoretical understanding of local FII methods for RF remains limited, making it unclear how to interpret high importance scores for individual predictions. We propose a novel, local, model-specific FII method that identifies frequent co-occurrences of features along decision paths, combining global patterns with those observed on paths specific to a given test point. We prove that our method consistently recovers the true local signal features and their interactions under a Locally Spike Sparse (LSS) model and also identifies whether large or small feature values drive a prediction. We illustrate the usefulness of our method and theoretical results through simulation studies and a real-world data example.

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

Physics-Driven Zero-Shot MRI Reconstruction with Non-local Image Priors

作者:
Lingtong Zhang↗Wenlei Li↗Mu He↗Li Xiao↗Yang Ji↗

Zero-Shot Self-Supervised Learning (ZS-SSL) has emerged as a promising paradigm for accelerated Magnetic Resonance Imaging (MRI) reconstruction, eliminating the reliance on fully-sampled external datasets. However, learning solely from a single under-sampled scan suffers from supervision scarcity and optimization instability, often leading to overfitting or artifacts. To address these challenges, we propose a robust physics-driven ZS-SSL framework that synergizes physical consistency with image-domain non-local priors. Our method introduces three core innovations: (1) a Coil Sensitivity Map (CSM)-Guided Dynamic Repository, which stabilizes the training trajectory by filtering physically inconsistent artifacts based on coil sensitivity constraints; (2) a SPIRiT-based regularization, which enforces k-space self-consistency via a learned correlation kernel and stochastic masking; (3) a Non-Local Self-Similarity (NSS) Pixel Bank, which leverages the high-fidelity reference established by the former modules to explicitly mine non-local anatomical similarities, thereby augmenting supervision in the image domain. Extensive experiments on the FastMRI dataset demonstrate that our approach achieves state-of-the-art performance, particularly under high acceleration factors, effectively bridging the gap between zero-shot learning and supervised methods. The code is available at https://github.com/Zolento/NS-SSL.

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

Who Should Lead Decoding Now? Tracking Reliable Trajectories for Ensembling Masked Diffusion Language Models

作者:
Heecheol Yun↗Joonhyung Park↗Joowon Kim↗Eunho Yang↗

Masked Diffusion Language Models (MDLMs) have emerged as a distinct paradigm for sequence generation. As MDLMs become diverse in capabilities and knowledge coverage, an important question is how to combine their knowledge. Toward this, we first investigate the unique decoding dynamics of MDLMs. We find that successful generations exhibit stable confidence dynamics over answer-relevant positions, while unreliable trajectories can often be corrected by injecting promising intermediate states from other models. Guided by this observation, we propose $TIE$ ($T$rajectory-based $I$terative $E$nsembling), a knowledge fusion framework in which MDLMs iteratively identify reliable decoding trajectories and relay them across models. TIE tracks confidence dynamics over answer-relevant positions to determine which model currently follows a more reliable trajectory and selectively transfers partially denoised sequences across models. As the model on the more promising trajectory often changes across denoising steps, TIE allows different models to contribute complementary strengths at different stages of generation. Strong performance across diverse reasoning tasks, along with our analyses, suggests that TIE offers a practical approach to the underexplored problem of MDLM ensembling.

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05.
medRxiv (Medicine) 2026-06-17

Cardio Heart Connect: Protocol for a Randomized Trial of a Commercially Available mHealth Fitness Intervention for Cardiac Rehabilitation After Transcatheter Aortic Valve Replacement

作者:
Rosen↗Butala↗N. M↗Kramer↗D. B↗Helmkamp↗L. J↗Gama↗Goldberg↗Marzec↗Peterson↗P. N↗…

Background: Despite ample evidence of the benefits of cardiac rehabilitation (CR), few transcatheter aortic valve replacement (TAVR) patients participate. Commercially available mobile health offers an opportunity to deliver activity-promotion content to populations that are challenged to participate in CR. This study aims to test the efficacy of clinically controlled, commercially available fitness programming for improving physical activity and cardiovascular health outcomes designed to be initiated while patients are on waitlists for traditional CR. Methods: The Cardio Heart Connect study is a hybrid type I effectiveness-implementation trial aiming to enroll N=200 patients who have been placed on a cardiac rehab waitlist following a TAVR procedure from the University of Colorado Hospital Heart and Vascular Center. Participants will be randomized 1:1 to the Cardio Heart Connect intervention with commercially available fitness or attention control, designed to control for technology access. At baseline, post-intervention (8 weeks), and follow-up (12 months), we will assess the primary outcome of participants? daily steps as measured by smartwatch accelerometer and secondary outcomes of interest including functional capacity (Duke Activity Status Index; VO2max), quality of life (Kansas City Cardiomyopathy Questionnaire), and cardiovascular health status (Life Essential 8). In addition, we will use mixed methodologies to evaluate the implementation of intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Conclusions: Commercially available fitness programs have the potential to provide more accessible opportunities for patients recovering from TAVR to engage in physical activity and may be preferred due to their customizability, convenience, and ease of scheduling. Overall, this study will provide insight into the use of commercial mHealth to promote activity following TAVR.

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06.
arXiv (CS.LG) 2026-06-15

Operator Calculus for Population-Based Optimization: A Mean-Field Convergence Theory

作者:
Pekka Malo↗Lauri Viitasaari↗Patrik Nummi↗Antti Suominen↗Ankur Sinha↗Olli Tahvonen↗

arXiv:2606.14289v1 Announce Type: cross Abstract: Population-based and distributional optimization methods, from evolution strategies and consensus-based optimization to covariance-matrix adaptation and stochastic gradient methods viewed as distributional dynamics, are widely used for nonconvex or black-box problems, yet their convergence analyses remain fragmented across algorithm-specific techniques. We introduce an operator calculus in which a broad class of such methods, after choosing an appropriate state space and, where necessary, augmenting the state by memory or strategy variables, is described as a composition of three elementary operators (mutation, selection, and recombination) acting on probability measures. Under explicit stability and regularity conditions, the composite operator admits a pre-generator whose continuous-time limit is a transport-reaction-jump (TRJ) PDE that preserves the operator splitting. On this foundation we establish a modular Lyapunov principle. If a state-space Lyapunov function both dissipates under the full generator and controls the relevant search-space gauges, then the state-space Lyapunov functional and the induced search errors decay exponentially. The additive generator structure allows dissipation estimates to be assembled operator by operator, providing a toolkit for certifying convergence of composite mean-field algorithms.

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07.
arXiv (CS.CL) 2026-06-16

GePBench: Evaluating Fundamental Geometric Perception for Multimodal Large Language Models

作者:
Shangyu Xing↗Changhao Xiang↗Yuteng Han↗Yifan Yue↗Zhen Wu↗Xinyu Liu↗Zhangtai Wu↗Fei Zhao↗Xinyu Dai↗

Geometric shapes play important roles in both physical world and human cognition. While multimodal large language models (MLLMs) have made significant advancements in visual understanding, their abilities to recognize geometric shapes and their spatial relationships, which we term geometric perception, are not explicitly and systematically explored. To address this gap, we introduce GePBench, a novel benchmark specifically designed to assess the geometric perception capabilities of MLLMs. Our extensive evaluations reveal that even the current state-of-the-art MLLMs exhibit significant deficiencies in geometric perception tasks. Furthermore, we show that models trained with GePBench data demonstrate considerable improvements on a wide range of downstream tasks, highlighting the critical role of geometric perception in enabling advanced multimodal applications. Our code and datasets are available at \href{https://github.com/Changhao-Xiang/GePBench}{https://github.com/Changhao-Xiang/GePBench}.

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08.
medRxiv (Medicine) 2026-06-18

Multicluster measles outbreak with a substantial proportion of modified cases in Tokyo, Japan, January-May 2026

作者:
Nishikawa↗Kurita↗Sugawara↗Matsuda↗Morikawa↗Imokawa↗Iwamura↗Suzuki↗Kodaira↗Kikuchi↗Takahashi↗Nishizuka↗…

Tokyo experienced a measles outbreak (260 cases) in early 2026 despite elimination status. Adults aged 20-39 years were most affected, and 38% of cases were modified measles, increasing with prior vaccination. Although incidence rose until April, the effective reproduction number; R(t) fell below 1, consistent with outbreak control. Multiple clusters were identified, but many cases lacked epidemiological links, suggesting that modified measles is less likely to be considered in differential diagnosis. Intensive contact tracing and surveillance contributed to limiting transmission.

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09.
arXiv (CS.CV) 2026-06-12

Revisiting Vehicle Color Recognition in Long-Tailed Surveillance Scenarios

作者:
Vin\'icius Orr\'u↗Bruno H. Foggiatto↗Gabriel E. Lima↗David Menotti↗Rayson Laroca↗

Vehicle color recognition is an important cue for vehicle identification in surveillance systems, especially when license plates are illegible due to low resolution, occlusion, motion blur, or poor illumination. However, real-world vehicle color distributions are highly imbalanced, making overall accuracy insufficient to assess performance on rare but operationally relevant colors. This paper presents a comprehensive study of vehicle color recognition under severe class imbalance using UFPR-VeSV, a challenging real-world surveillance dataset. We investigate synthetic minority-class augmentation through two off-the-shelf generative strategies: text-conditioned image generation with RunDiffusion/JuggernautXL and image-conditioned color editing with Gemini 2.0 Flash. The curated synthetic data are combined with modern visual representations, loss reweighting, learning-rate scheduling, color-safe augmentation, foreground-aware preprocessing, and ensemble fusion. The bestperforming approach achieves 94.6% micro accuracy and 79.7% macro accuracy, improving macro accuracy by 8.2 percentage points over recent literature. A manual error analysis further shows that many remaining failures are visually ambiguous even for human annotators, highlighting the practical limits of color-based vehicle identification in unconstrained surveillance imagery. The generated images and source code are publicly available at https://github.com/viniciusorru/vcr-synthetic

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

Let Them Steal: Trapping Large Language Model Extraction Attacks with Knowledge Honeypot

作者:
Yuyang Dai↗Yushun Dong↗

arXiv:2606.15810v1 Announce Type: cross Abstract: Large language models deployed as commercial APIs are vulnerable to model extraction attacks, while existing defenses either act too late or degrade utility for legitimate users. We propose Knowledge Trap, a defense that redirects extraction attacks toward low-transferability knowledge through a Honeypot Knowledge Graph (HKG) and breadcrumb-guided exploration. Instead of blocking queries or perturbing outputs, Knowledge Trap consumes the attacker's limited query budget on knowledge with negligible downstream utility while preserving benign-user performance. Experiments in medical and financial domains show that Knowledge Trap reduces surrogate Agreement by 6.2\% on average without degrading legitimate-user accuracy, outperforming existing defenses that impose measurable user impact. These results suggest that defending knowledge-space traversal is a practical direction for mitigating LLM extraction attacks.

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11.
arXiv (CS.CL) 2026-06-12

KCSAT-ML: Probing Reasoning Models with Nationwide-Cohort Human Difficulty

作者:
Sanghee Park↗Geewook Kim↗Kee-Eung Kim↗

Math reasoning benchmarks have proliferated, yet most lack a per-item difficulty signal grounded in actual human performance. We introduce KCSAT-ML, a decade (2014-2025) of Korean College Scholastic Ability Test (KCSAT; Suneung) mathematics: 664 problems with a 339-item core set carrying official per-item error rates from nationwide cohorts of hundreds of thousands of examinees. We pair the benchmark with Difficulty-aligned Reasoning Gain (DRG): a score-orthogonal metric that asks whether a model's mistakes concentrate on the items humans found hard, or on items humans found easy. Together they expose, across a wide range of VLMs (and LLMs via OCR), three patterns: (i) low-budget accuracy collapses on the high-human-error tail at every model size; (ii) test-time scaling (TTS) raises token use roughly linearly with cohort error rate, while accuracy gains follow a non-monotonic curve; (iii) within a single family, TTS flips between anti-scaling on the hardest items and overthinking on easier ones – two faces of the same alignment failure. On DRG, models with near-identical accuracy can sit at near-opposite values: one model gets wrong what humans also find hard, while another solves the hardest items yet fails on items humans find easy – a contrast that aggregate accuracy hides. Our code and dataset builder will be open-sourced at https://github.com/naver-ai/KCSAT-ML.

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

Imitating What Works: Simulation-Filtered Modular Policy Learning from Human Videos

作者:
Albert J. Zhai↗Kuo-Hao Zeng↗Jiasen Lu↗Ali Farhadi↗Shenlong Wang↗Wei-Chiu Ma↗

The ability to learn manipulation skills by watching videos of humans has the potential to unlock a new source of highly scalable data for robot learning. Here, we tackle prehensile manipulation, in which tasks involve grasping an object before performing various post-grasp motions. Human videos offer strong signals for learning the post-grasp motions, but they are less useful for learning the prerequisite grasping behaviors, especially for robots without human-like hands. A promising way forward is to use a modular policy design, leveraging a dedicated grasp generator to produce stable grasps. However, arbitrary stable grasps are often not task-compatible, hindering the robot's ability to perform the desired downstream motion. To address this challenge, we present Perceive-Simulate-Imitate (PSI), a framework for training a modular manipulation policy using human video motion data processed by paired grasp-trajectory filtering in simulation. This simulation step extends the trajectory data with grasp suitability labels, which allows for supervised learning of task-oriented grasping capabilities. We show through real-world experiments that our framework can be used to learn precise manipulation skills efficiently without any robot data, resulting in significantly more robust performance than using a grasp generator naively.

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13.
PLOS Medicine 2026-06-09

Molecular Tumor Boards clinical impact on patient care and structural features: A systematic review and meta-analysis

作者:
Luigi Russo↗

by Luigi Russo, Erika Giacobini, Nicolò Lentini, Tommaso Osti, Maud Kamal, Stefania Boccia, Roberta Pastorino Background Molecular Tumor Boards (MTBs) bring together multidisciplinary experts to translate genomic data into clinical decisions in oncology, however, their overall clinical impact remains unclear. The aim of this systematic review is to assess the clinical impact of MTB-recommended therapies on patients with cancer outcomes. Methods and findings In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and CENTRAL up to July 2025. We included studies of any design, both single-arm studies and studies with a comparator group, that reported the clinical impact of MTBs in patients who received MTB-guided therapy. Meta-analyses were performed separately by study design, using hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), relative risks (RRs) for objective response rate (ORR) and disease control rate (DCR), and pooled proportions for PFS ratio ≥1.3. All meta-analyses were conducted using random-effects models based on the inverse variance method. We evaluated the risk of bias using the RoB 2.0 for RCTs and ROBINS-I for non-randomized studies.From 6,846 records, 78 studies (9,195 patients; 4,569 treated per MTB recommendations) were included. MTB-guided therapies were associated with reduced risk of death (HR 0.87; 95% CI [0.76, 1.01]; p = 0.069; I2 = 0.0% in RCTs; 0.62 in retrospective studies) and disease progression (HR 0.73; 95% CI [0.64, 0.84]; p 

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

Hierarchical Probabilistic Conformal Prediction for Distributed Energy Resources Adoption

作者:
Wenbin Zhou↗Shixiang Zhu↗

arXiv:2411.12193v4 Announce Type: replace-cross Abstract: The rapid growth of distributed energy resources (DERs) presents both opportunities and operational challenges for electric grid management. Accurately predicting DER adoption is critical for proactive infrastructure planning, but the inherent uncertainty and spatial disparity of DER growth complicate traditional forecasting approaches. Moreover, the hierarchical structure of distribution grids demands that predictions satisfy statistical guarantees at both the circuit and substation levels, a non-trivial requirement for reliable decision-making. In this paper, we propose a novel uncertainty quantification framework for DER adoption predictions that ensures validity across hierarchical grid structures. Leveraging a multivariate Hawkes process to model DER adoption dynamics and a tailored split conformal prediction algorithm, we introduce a new nonconformity score that preserves statistical guarantees under aggregation while maintaining prediction efficiency. We establish theoretical validity under mild conditions and demonstrate through empirical evaluation on customer-level solar panel installation data from Indianapolis, Indiana that our method consistently outperforms existing baselines in both predictive accuracy and uncertainty calibration.

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15.
arXiv (CS.CV) 2026-06-16

Active Reference Acquisition in Few-Shot Font Generation

作者:
Shinnosuke Matsuo↗

Few-shot font generation aims to synthesize the remaining glyphs of a font given one or a few reference glyphs while preserving stylistic consistency, thereby supporting font designers in efficiently completing a typeface. Existing methods primarily focus on improving generation quality given a fixed reference set. However, when the current reference glyphs are insufficient to represent the target style, few-shot font generation may fail to produce satisfactory results. In practical scenarios, additional reference glyphs can often be obtained from the designer when necessary. Accordingly, we propose a new framework, Active Reference Acquisition in Few-Shot Font Generation, in which the model sequentially decides which character to acquire next as an additional reference. Furthermore, we propose a reference part-coverage-based acquisition function to efficiently query the designer. Motivated by the observation that font styles are well characterized by local structural parts, we represent each glyph using a histogram of local features and select query characters that maximize the expected part coverage of the reference set. By prioritizing characters that contain parts not yet covered by the current references, the proposed method progressively expands the diversity of visual parts in the reference set. As a result, generation quality is improved with fewer queries. Experiments on the Google Fonts dataset demonstrate that the proposed method achieves higher generation quality than random querying and reference-agnostic baselines. The code is available at https://github.com/matsuo-shinnosuke/ActiveRef-FontGen.

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

Beyond Dark Knowledge: Mixup-Based Distillation for Reliable Predictions

作者:
Jos\'e Medina↗Paul Honeine↗Abdelaziz Bensrhair↗Amnir Hadachi↗

Knowledge Distillation (KD) and mixup have proven effective at inducing smoothness in class boundaries; KD captures inherent class relationships in probability distributions, and mixup enforces them through convex combinations of inputs. Their interaction, however, remains poorly understood, particularly when mixup is applied only during student training. In this setting, the teacher is queried on inputs drawn from a vicinal distribution it never saw during training, a controlled mismatch whose effect on knowledge transfer has not been characterised. We show that this mismatch causes the teacher's supervisory signal to be dominated by distributional confusion rather than inter-class structure. Despite it, the student does not merely imitate the teacher: it independently acquires greater linearity in the vicinal region, a structural property that the teacher lacks, and goes beyond dark-knowledge transfer. KD with mixup consistently improves student accuracy and reduces overconfidence by an order of magnitude relative to the baseline, across CIFAR and ImageNet with varying-capacity teachers. Crucially, calibration propagates from teacher to student independently of accuracy transfer, and temperature scaling governs a measurable accuracy-calibration trade-off that becomes more pronounced under vicinal training. These results reframe mixup distillation not as a degraded version of standard KD, but as a richer transfer channel that simultaneously shapes discriminative performance, uncertainty estimation, and representational geometry.

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

Epistemic Uncertainty Is Not the Reducible Kind

作者:
Robin Young↗

arXiv:2606.12646v1 Announce Type: cross Abstract: The standard taxonomy of predictive uncertainty defines epistemic uncertainty as the part removable by collecting more data, while the standard measure identifies it with a mutual-information term. We prove the definition and the measure are extensionally inconsistent. On an explicit construction, the measure assigns all uncertainty to the epistemic class, yet no quantity of training data reduces it. Reducibility is instead a property of the pair (uncertainty, acquisition class), and the dichotomy resolves into three parts: aleatoric, sample-reducible epistemic, and mechanism-reducible epistemic uncertainty. An exact identity for the value of an observation shows that in-distribution data never reduces mechanism-irreducible uncertainty and generically increases it. Ensemble disagreement, the deployed epistemic estimate, tracks the training procedure rather than the epistemic term. It collapses to zero beneath a positive truth under consistent training, and equals hyperparameter-scaled initialization noise under interpolation. A finite-sample falsification test and seed-swept experiments confirm the theory.

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18.
arXiv (CS.CV) 2026-06-17

A Quantitative Analysis of Multimodal Biomarkers in Alzheimer's Disease

作者:
Antonio Scardace↗Daniele Rav\`i↗

Despite increasing adoption of multimodal approaches in Alzheimer's Disease (AD) research – aimed at integrating molecular, structural, clinical, and genetic biomarkers to enhance disease characterization – the relationships among these modalities remain poorly understood. A systematic analysis of their dynamic interaction is essential for improving disease modeling, identifying redundant assessments, and reducing patient burden and acquisition costs. In this paper, we present a quantitative analysis of multimodal AD biomarkers by integrating tau-PET, structural MRI, cognitive scores (MMSE and CDR), and APOE4 data from 789 subjects drawn from the ADNI dataset. In our analyses, we (A) quantify cross-modal mutual information and explained variance to assess redundancy and predictive dependencies; (B) examine associations between tau topologies and structural atrophy across brain regions to select informative ROIs; (C) perform a statistical decomposition of the tau-cognition association into atrophy-related and atrophy-independent components; (D) and identify a dominant neurodegenerative trajectory that aligns with cognitive decline. This study provides a systematic characterization of cross-modal relationships, improving the interpretability and selection of biomarkers in AD. Code is publicly available at: https://github.com/antonioscardace/Multimodal-AD.

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

Adaptive Distance-Aware Trunk Deep Operator Learning for Long-Span Roadway Bridges

作者:
Bilal Ahmed↗Diab W. Abueidda↗Waleed El-Sekelly↗Tarek Abdoun↗Mostafa E. Mobasher↗

arXiv:2606.20015v1 Announce Type: new Abstract: Long-span roadway bridges exhibit highly localized structural responses under vehicular loading, making repeated FE analysis computationally expensive for applications such as influence surface generation and structural digital twins. Existing SciML approaches struggle to accurately capture these localized responses. To address this challenge, this study proposes an adaptive-trunk DeepONet for localized structural response prediction in large-scale bridge systems. The framework dynamically constructs a load-dependent learning domain using a KNN strategy, allowing the network to focus on structural influence zones. The trunk network is further enhanced using distance-aware features that encode the geometric relationship between the load and structural nodes. A physics-based full-field reconstruction is incorporated through a stiffness-informed Schur complement formulation, enabling predictions at adaptive nodes to be extended to the entire structural domain. To enable scalable training, response data are generated using a reduced-order equivalent shell model that preserves the dominant global behavior while significantly reducing computational cost. The proposed framework is validated on both a benchmark bridge model and the real-world Mussafah Bridge. Results show that the method achieves FEM-level accuracy with relative errors below 5%, while reducing the total response evaluation time (including full-field reconstruction) by approximately 60x; excluding the post-processing reconstruction step, the AD-DeepONet inference is up to four orders of magnitude faster than FEM. In addition, the framework enables rapid generation of full-field responses, influence lines, and influence surfaces under arbitrary vehicular loading configurations, demonstrating strong potential for large-scale bridge analysis and digital twin applications.

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20.
medRxiv (Medicine) 2026-06-15

ICD-10 Code Ambiguity Obscures Treatment-Eligible Adults with Spinal Muscular Atrophy: A Single-Center Chart Review and Patient Outreach Study

作者:
Holly↗Bean↗Beshay↗Edwards↗Streicher↗N. S↗

Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.

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21.
Nature Medicine 2026-06-15

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

作者:
Kenneth H. Louie↗

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

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22.
arXiv (quant-ph) 2026-06-11

Classical representation of the dynamics of quantum spin chains

作者:
Tony Jin↗

arXiv:2502.10502v3 Announce Type: replace-cross Abstract: Since the advent of quantum mechanics, classical probability interpretations have faced significant challenges. A notable issue arises with the emergence of negative probabilities when attempting to define the joint probability of non-commutative observables. In this work, we propose a resolution to this dilemma for quantum spin chains, by introducing an exact representation of their dynamics in terms of classical continuous-time Markov chains (CTMCs). These CTMCs effectively model the creation, annihilation, and propagation of pairs of classical particles and antiparticles. The quantum dynamics then emerges by averaging over various realizations of this classical process.

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

Exploding and vanishing gradients in deep neural networks: the effect of residual connections

作者:
Vivek S Borkar↗

arXiv:2606.17013v1 Announce Type: cross Abstract: The well known phenomenon of exploding and vanishing gradients in deep neural networks is analyzed using multiplicative ergodic theory. The effect of adding a residual connection is explained in this context. Specifically, a characterization of Liapunov exponents due to Furstenberg and Kifer is exploited in order to make a precise statement about the Liapunov spectrum and the effect of residual connections on it.

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

Implementing Hamiltonian Renormalization Group Flow on Quantum Computers with VAPOR

作者:
Federica Fragomeno↗Jorden Roberts↗Saeed Rastgoo↗Klaus Liegener↗

arXiv:2606.11306v1 Announce Type: cross Abstract: While Hamiltonian Lattice Gauge Theory is gaining traction, today's limited numerical capacity leaves simulations affected by discretization errors. This motivates the implementation of renormalization group (RG) techniques to find discretization-error-free operators. To this end, we introduce VAPOR, a variational quantum algorithm that decomposes operators into Pauli strings, identifies RG flow orbits, and determines fixed points of a naively discretized operator. We illustrate this using a toy model of a kinematic operator in a symmetry-restricted SU(2) Yang-Mills theory.

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25.
arXiv (CS.LG) 2026-06-11

Impact of Connectivity on Laplacian Representations in Reinforcement Learning

作者:
Tommaso Giorgi↗Pierriccardo Olivieri↗Keyue Jiang↗Laura Toni↗Matteo Papini↗

arXiv:2603.08558v3 Announce Type: replace Abstract: Learning compact state representations in Markov Decision Processes (MDPs) has proven crucial for addressing the curse of dimensionality in large-scale reinforcement learning (RL) problems. Existing principled approaches leverage structural priors on the MDP by constructing state representations as linear combinations of the state-graph Laplacian eigenvectors. When the transition graph is unknown or the state space is prohibitively large, the graph spectral features can be estimated directly via sample trajectories. In this work, we prove an upper bound on the approximation error of linear value function approximation under the learned spectral features. We show how this error scales with the algebraic connectivity of the state-graph, grounding the approximation quality in the topological structure of the MDP. We further bound the error introduced by the eigenvector estimation itself, leading to an end-to-end error decomposition across the representation learning pipeline. Additionally, our expression of the Laplacian operator for the RL setting, although equivalent to existing ones, prevents some common misunderstandings, of which we show some examples from the literature. Our results hold for general (non-uniform) policies without any assumptions on the symmetry of the induced transition kernel. We validate our theoretical findings with numerical simulations on gridworld environments.

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