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01.
arXiv (CS.CL) 2026-06-17

SuCo: Sufficiency-guided Continuous Adaptive Reasoning

Despite remarkable performance on complex tasks, Large Reasoning Models (LRMs) often generate excessively long Chain-of-Thoughts (CoT), inflating computational costs even for simple queries. Existing efforts to mitigate this inefficiency typically rely on discrete reasoning modes or fixed budget tiers, lacking a principled criterion of when reasoning is sufficient. In this work, we introduce Minimal Sufficient CoT (MSC), defined as the shortest prefix of a CoT trajectory which is adequate for producing the correct answer. We empirically show that MSC not only reduces reasoning tokens, but also improves accuracy across difficulty levels. Building on MSC, we propose Sufficiency-guided Continuous Adaptive Reasoning (SuCo), a two-stage training framework for autonomous reasoning control along a continuous spectrum. In stage 1, MSC-Aligned Fine-Tuning (MFT) constructs MSC data using problem-adaptive sufficiency thresholds that naturally scale with question difficulty, then fine-tunes the model to internalize concise yet sufficient reasoning patterns. In stage 2, Sufficiency-Aware Policy Optimization (SAPO) further optimizes the model through reinforcement learning with dynamic complexity tracking and sufficiency-aware rewards that penalize both over- and under-thinking. Extensive experiments across mathematics, code, and science benchmarks show that SuCo consistently achieves improvements in both accuracy and reasoning efficiency.

02.
Nature (Science) 2026-06-24

Genetic diversity of late Neanderthals in northwestern Europe

Archaeological, osteological and genetic evidence suggests that Neanderthals lived in small groups1,2; however, less is known about whether these groups were part of isolated communities or belonged to larger, well-connected populations3. The dense concentration of broadly contemporaneous Neanderthal sites in the Meuse Basin, Belgium4, provides a rare opportunity to study regional populations at high resolution. Here we generated genetic data from 27 Neanderthals who lived less than approximately 52,500 years ago from ten archaeological sites in Belgium and France, including a high-coverage genome from a 45,000-year-old individual from Goyet, Belgium. We show that most of these individuals are more closely related to one another than to other contemporaneous late Neanderthals in Europe. Further, some of these individuals carry DNA from a Neanderthal lineage predating the split of late Neanderthals. Although these Neanderthals overlapped temporally with early modern humans in northwestern Europe from around 47,000 years ago, we find no evidence of recent gene flow from modern humans. They also do not show the genetic signatures of mating among close relatives found in Altai Neanderthals, suggesting that they lived in larger or better-connected groups. Moreover, genetic load did not accumulate over time, arguing against progressive genetic deterioration as a driver of Neanderthal extinction. Genetic sequencing of multiple late Neanderthals living less than 52,500 years ago provides an overview of genetic diversity and demonstrates that even low-coverage nuclear genome data can increase resolution of within-Neanderthal diversity.

03.
arXiv (CS.AI) 2026-06-18

Searching for Synergy in Shared Workspace Human-AI Collaboration

arXiv:2606.18413v1 Announce Type: new Abstract: Automated AI agents are increasingly capable, yet many scientific and professional tasks require human judgment and contextual expertise. We study shared-workspace human-AI teams, where AI agents and human collaborators must coordinate responsibilities before submitting a final answer. Using the Collaborative Gym environment with DiscoveryBench tasks, we examine when adding simulated human collaborators improves performance and when process loss turns additional collaborators into coordination overhead. Across 1,482 sessions, adding relevant collaborators can lower performance when teams lack structure to coordinate their contributions. We then evaluate scaffolding that combines shared group memory with simulated human-in-the-loop (HITL) gates, where selected actions require approval from a designated simulated participant. This scaffolding yields higher mean performance, most clearly in three-person teams, with clearer responsibility signals and stronger routing of expertise to team actions. Overall, how human-AI teams coordinate and integrate expertise matters as much as the capability available to them.

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

Net-Ev$^2$: A Generative Simulator for Network Event Evolution

arXiv:2606.12494v1 Announce Type: new Abstract: Reducing real-world trial and error has long been a central goal of decision making, and generative simulators advance this goal by modeling the evolution of future states. An even more challenging yet meaningful task is simulating how disturbance events (e.g., accidents) propagate their impacts across real-world networks. The existing approaches fall short of modeling both structured attributes and unstructured semantics of events, and capturing topological structures in simulating network event evolution. Therefore, we are motivated to propose Net-Ev$^2$ ($\underline{Net}$work $\underline{Ev}$ent $\underline{Ev}$olution), a novel generative simulator that jointly leverages event cues while preserving network topology in simulations. Specifically, the framework consists of two stages, namely structure-guided masked pre-training and topology-aware diffusion process, which is achieved by U-Net-like graph downsampling and upsampling during denoising. At inference time, Net-Ev$^2$ can generate simulations using natural-language event input only, with greater flexibility for practical usage. Furthermore, we introduce Net-Ev$^2$-6.5M, a multimodal benchmark of aligned event and network traffic data across four large-scale road networks, as well as a new topology-aware metric, namely JL-MMD, to evaluate topological fidelity in generated network dynamics. Extensive experiments demonstrate the state-of-the-art performance and strong generalization ability of Net-Ev$^2$. Code is made available at https://github.com/Guangyu4/Net-Ev-2.

05.
arXiv (quant-ph) 2026-06-16

Non-Hermitian Crystalline Braid Topology from Hermitian Projection: A Zero-Mode Resonance Mechanism

arXiv:2606.06626v2 Announce Type: replace-cross Abstract: Non-Hermitian topological phases are typically engineered through gain and loss, nonreciprocity, or interaction with an environment. Here we show that they can instead emerge purely by projecting a fully Hermitian, topologically trivial parent lattice onto an embedded subsystem. The mechanism is general: when a zero mode of the eliminated degrees of freedom couples to the retained subsystem, the embedding self-energy develops a pole, the zero-frequency description becomes singular, and topology is carried by the finite-frequency projected Green's function. We realize the mechanism exactly in a trivial nearest-neighbor square lattice with an embedded one-dimensional zig-zag brane. In the periodic transverse geometry, the parity of the eliminated complement selects the outcome: even sectors reduce to a regular Schur complement and yield conventional SSH-type descendants, whereas odd sectors host a sublattice-imbalance zero mode and follow the resonant route. There, the complex bands braid through isolated finite-frequency exceptional points (EPs), while a parity symmetry inherited from the embedding, together with $\mathrm{TRS}^{\dagger}$, induces conjugated pseudo-Hermiticity and quantizes the complex Berry phase. The stable bulk invariant of the nondegenerate phases is this quantized complex Berry phase; adjacent sectors are separated by parity-paired exceptional points whose half-integer vorticities encode the local exchange of complex-energy strands.The absence of the non-Hermitian skin effect ensures that the invariant is defined directly on the ordinary Brillouin zone. A topolectrical implementation of the projected response predicts momentum-resolved transmission minima at the exceptional-point transition frequencies together with a characteristic low-frequency resonant admittance, providing an experimentally testable signature of the mechanism.

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

CheXGenBench: A Unified Benchmark For Fidelity, Privacy and Utility of Synthetic Chest Radiographs

Structured benchmarks have advanced text-conditional image generation for real-world imagery, however, no such benchmark exists for synthetic radiograph generation. Despite being a highly active area of research, existing studies continue adopting inconsistent evaluation protocols and lack a unified assessment of the three most critical criteria: generative fidelity, privacy risk, and downstream utility. To address these limitations, we introduce CheXGenBench, the first unified evaluation framework for synthetic chest radiograph generation that simultaneously assesses fidelity, privacy risks, and downstream utility across frontier text-to-image (T2I) generative models. Our evaluation protocol, comprising over 20 quantitative metrics, covers 11 leading T2I architectures with plug-and-play integration for newer models. Through a rigorous and fair evaluation protocol, we establish comprehensive baseline state-of-the-art (SoTA) performances across all dimensions to guide future research. Furthermore, our results uncover several limitations of current generative models, which include first, even SoTA models struggle with long-tailed medical distributions; second, models pose high privacy risks regardless of fidelity quality; and third, while synthetic data already benefits downstream classification, it is of limited utility for downstream multimodal tasks. Drawing from these results, we propose concrete research directions to advance the field. The code is available at https://github.com/Raman1121/CheXGenBench

07.
arXiv (CS.CV) 2026-06-24

FlowDec: Temporal Conditional Flow Decorruptor for Robust Continuous Vision-Language Navigation

Vision-and-Language Navigation in Continuous Environments (VLN-CE) requires agents to follow natural-language instructions in unseen scenes. While Large Models (LMs) have advanced VLN-CE, their performance remains severely degraded by real-world visual corruptions, a critical yet underexplored domain constraint. We introduce Temporal Conditional Flow Decorruptor (FlowDec), a novel image restoration framework tailored for LM-based VLN-CE. FlowDec integrates a hybrid temporal conditioning strategy to align the generative flow path with historical context and employs action-centroid guided filtering to dynamically assess and integrate outputs. Extensive experiments demonstrate that FlowDec outperforms state-of-the-art decorruption methods in both navigation accuracy and generation latency. Our approach establishes a robust, efficient paradigm for resilient embodied navigation in unpredictable real-world conditions.

08.
arXiv (CS.CL) 2026-06-19

PsyScore: A Psychometrically-Aware Framework for Trait-Adaptive Essay Scoring and ZPD-Scaffolded Feedback

Effective Automated Essay Scoring (AES) are expected to support both reliable assessment and actionable instructional feedback. However, existing approaches often treat scoring and feedback as separate components: neural scoring models provide limited interpretability, while Large Language Model (LLM)-based feedback is typically insensitive to learners proficiency levels. To address this fragmentation, this work proposes PsyScore, a psychometrically-aware framework that integrates diagnostic assessment with instructional scaffolding through a shared latent ability representation. PsyScore comprises three key modules: a Trait-Adaptive Neural IRT Scorer that incorporates the Graded Partial Credit Model (GPCM) into a neural architecture, enabling the precise estimation of student ability while maintaining psychometric interpretability, a ZPD-Scaffolded Feedback Generator, which conditions multi-agent feedback strategies on the diagnosed ability parameter to adapt instructional focus across different proficiency levels, and a Multi-Perspective Feedback Evaluation Strategy that assesses feedback quality via pairwise preference judgements and student revision simulations. Experiments on the ASAP++ dataset demonstrate that PsyScore achieves competitive scoring performance while providing more pedagogically aligned feedback.

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

Preregistration for Experiments with AI Agents

arXiv:2606.11217v1 Announce Type: cross Abstract: The proliferation of large language models (LLMs) and autonomous AI agents has given rise to a rapidly growing methodological paradigm: "in silico" behavioral experiments. Originally conceived as a way to use AI agents as proxies for human participants in studies of cognition, decision-making, and social dynamics, this approach has taken on new significance – as AI agents increasingly negotiate, transact, and make consequential decisions on behalf of people and organizations, understanding their behavior has become a research priority in its own right. While these experiments with AI agents offer unprecedented advantages in terms of scalability, cost efficiency, and experimental control, they also inherit, and in some cases amplify, methodological vulnerabilities that have long plagued human subjects research. To address these issues, this paper argues that preregistration practices – central to improving the credibility of human subjects experiments – should now be extended to experiments with AI agents. We systematically catalog the researcher degrees of freedom that experiments with AI agents introduce – model selection, prompt wording, settings, and outcome-contingent redesign, for example – and show how the low cost of iteration and lack of reporting norms make these choices both easy to exploit and difficult to detect. We propose a preregistration template tailored to experiments with AI agents and call on conferences, journals, and funding agencies to make preregistration standard practice for this emerging research paradigm.

10.
arXiv (quant-ph) 2026-06-16

Exact Many-body Quantum Dynamics in One-Dimensional Baths via Collective Spins

arXiv:2505.00588v2 Announce Type: replace Abstract: Computing the exact dynamics of many-body quantum systems becomes intractable as system size grows. Here, we present a symmetry-based method that provides an exponential reduction in the complexity of a broad class of such problems $\unicode{x2014}$ qubits coupled to one-dimensional electromagnetic baths. We identify conditions under which partial permutational symmetry emerges and exploit it to group qubits into collective multi-level degrees of freedom, which we term ''superspins.'' These superspins obey a generalized angular momentum algebra, reducing the relevant Hilbert space dimension from exponential to polynomial. Using this framework, we efficiently compute many-body superradiant dynamics in large arrays of qubits coupled to waveguides and ring resonators, showing that $\unicode{x2014}$ unlike in conventional Dicke superradiance $\unicode{x2014}$ the total spin length is not conserved. At long times, dark states become populated. We identify configurations where these states exhibit metrologically useful entanglement. Our approach enables exact treatment of complex dissipative dynamics beyond the fully symmetric limit and provides a rigorous benchmark for approximate numerical methods.

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

CreativeBench: Benchmarking and Enhancing Machine Creativity via Self-Evolving Challenges

The saturation of high-quality pre-training data has shifted research focus toward evolutionary systems capable of continuously generating novel artifacts, leading to the success of AlphaEvolve. However, the progress of such systems is hindered by the lack of rigorous, quantitative evaluation. To tackle this challenge, we introduce CreativeBench, a benchmark for evaluating machine creativity in code generation, grounded in a classical cognitive framework. Comprising two subsets – CreativeBench-Combo and CreativeBench-Explore – the benchmark targets combinatorial and exploratory creativity through an automated pipeline utilizing reverse engineering and self-play. By leveraging executable code, CreativeBench objectively distinguishes creativity from hallucination via a unified metric defined as the product of quality and novelty. Our analysis of state-of-the-art models reveals distinct behaviors: (1) scaling significantly improves combinatorial creativity but yields diminishing returns for exploration; (2) larger models exhibit ``convergence-by-scaling,'' becoming more correct but less divergent; and (3) reasoning capabilities primarily benefit constrained exploration rather than combination. Finally, we propose EvoRePE, a plug-and-play inference-time steering strategy that internalizes evolutionary search patterns to consistently enhance machine creativity.

12.
bioRxiv (Bioinfo) 2026-06-19

Evaluation of analysis modes for RNA coexpression in single-cell and bulk tissue

Coexpression of transcripts presents the most common means of computational inference of transcription factor regulation, and is often combined with other data types to infer regulatory networks. With the growing popularity of single-cell approaches, there are questions about how best to extract coexpression information from the data. Recently we reported a simulation study that explored the differences among coexpression performed at different levels: across single cells (xCell, per cell type), across subjects from pseudobulked single-cell data (xSubject, per cell type), or across subjects using bulk tissue samples (xBulk). Here we test predictions made by those models using real data. We consider both preservation (consistency of coexpression findings across different levels of analysis of the same data) and replicability across independent studies, as well as biological interpretability. We find that preservation across levels is limited, indicating the choice of analysis level will affect outcomes. We show that xCell coexpression is more replicable across studies compared to xSubject. xBulk coexpression is dominated by patterns driven by variability in cellular composition and fails to capture much coexpression that is reliably detected at finer resolutions. While all modes of analysis exhibit some enrichment for known regulatory relationships, it was highest with the xCell mode. Finally, we present a case study of the effect of analysis modes on a schizophrenia-associated pattern, reinforcing the importance of analytic choices in the interpretation and replicability of coexpression analyses. Together with our modeling study, this work emphasizes the importance of understanding sources of expression covariation as they relate to the goals of the analysis, and recommend single-cell-based data with biological replicates should be the focus of attempts to infer dynamic regulatory interactions that are more likely to be replicable by others.

13.
bioRxiv (Bioinfo) 2026-06-19

Identification of Altered Potassium Channels for Drug Repurposing in Long COVID Patients

Long COVID (LC) is a complex condition characterized by persistent, chronic multisystem manifestations, with a significant proportion of patients exhibiting neurological symptoms. Human ion channels (HICs), particularly potassium channels, are abundantly expressed in the nervous system and linked to key metabolic processes, making them potential candidates for understanding LC pathophysiology and drug repurposing. Meta-analysis of RNA-Seq datasets from COVID-19 recovered and LC patients was performed to identify altered HICs in LC. Differential gene expression analysis, functional enrichment analysis, and weighted gene co-expression network analysis (WGCNA) were performed to uncover key genes, pathways, and co-expression modules consisting of HICs, lipid metabolism-, and immune signaling-related genes. Drug-gene interaction analysis was performed to identify approved drugs targeting potential HICs. A total of 715 dysregulated genes, including eighteen HICs were identified, among which seven were potassium channels. Three significant modules containing HICs, lipid metabolism-, and immune signaling-related genes were identified and found to be associated with antigen processing and presentation, complement and coagulation cascades, and cytokine-related pathways. Approved drugs targeting KCNA6, KCNJ10, KCNN3, and KCNH4 were identified. With further experimental validation, these dysregulated potassium channels, supported by their co-expression networks and pathway associations, may act as potential candidates for drug repurposing in LC patients.

14.
arXiv (quant-ph) 2026-06-11

Quantum Entanglement, Stratified Spaces, and Topological Matter: Towards Entanglement-Sensitive Langlands Data

arXiv:2601.13467v2 Announce Type: replace Abstract: Using the spinless Haldane model, we study the witness-filtered Berry curvature, quantum geometric tensor, and quantum Fisher information on the gapped strata of the parameter space and evaluate them through the Fukui-Hatsugai-Suzuki discretization. The filtered quantities isolate the part of the geometric response carried by sublattice coherence: they suppress contributions from regions where the occupied Bloch state is locally A/B-separable and emphasize regions where curvature and coherence coexist. We derive exact lattice identities, reconstruction formulas for the curvature-weighted coherence, and bounds relating the filtered quantum geometric tensor and quantum Fisher information to single-particle mode entanglement. Across the gap-closing stratum, the quantized response changes admit a natural description in terms of Hecke modifications. We elicit a corresponding Langlands viewpoint – not as a full correspondence, but as an organizational principle and as the mathematical shadow of these physical geometric constructions.

15.
arXiv (CS.LG) 2026-06-24

Prediction of Viscoelastic Droplet Impact Dynamics Using a Vision Transformer-Based Approach

arXiv:2606.23940v1 Announce Type: cross Abstract: Droplet impact on solid surfaces is a complex fluid dynamics problem with applications in spray cooling, inkjet printing, and pharmaceutical processing. Although numerical simulations are widely used to investigate these dynamics, their computational cost becomes significant when multiple parametric variations are considered. In this work, we investigate the use of a Video Vision Transformer (ViViT) architecture to predict the temporal evolution of viscoelastic droplets impacting solid surfaces using volume fraction fields obtained from the Volume of Fluid (VOF) method. In Newtonian fluids, impact dynamics are mainly characterized by the Reynolds number $Re$, representing the ratio of inertial to viscous forces, and the Weber number $We$, representing the ratio of inertial to surface tension forces. For viscoelastic fluids, additional parameters are required to account for elastic effects, namely the solvent viscosity ratio $\beta$ and the Weissenberg number $Wi$, increasing simulation complexity and cost. Instead of simulating the entire droplet dynamics, the proposed approach uses only the initial 10% to 20% of the simulation to predict the remaining evolution. Depending on the prediction configuration, this strategy reduces computational cost by approximately 80% to 90% compared to full numerical simulations. The ViViT produces physically consistent predictions across different parameters and prediction horizons, successfully capturing both spreading and bouncing regimes while preserving geometric features and structural similarity. Since volume fraction fields can also be extracted from experimental videos, the proposed framework could be extended to incorporate experimental data during training, potentially improving the physical fidelity of the predicted dynamics.

16.
arXiv (CS.CL) 2026-06-25

Membox: Weaving Topic Continuity into Long-Range Memory for LLM Agents

Long-term human-agent dialogues are organized by topic continuity: adjacent turns often develop the same goal, plan, problem, or event, while related activities may recur across distant sessions. Yet many LLM agent memory systems first decompose histories into isolated turns or fixed-size chunks, then compensate through enrichment, consolidation, or retrieval mechanisms still tied to semantic proximity or fragment-level records. This weakens temporal and causal organization and biases memory access toward semantic proximity rather than task- or topic-level continuity. We introduce Membox, a hierarchical memory architecture that instantiates topic continuity as an explicit organization layer for agent memory. Its Topic Loom incrementally organizes dialogue streams into boxes whose internal turns follow the same local topic, while its Trace Weaver links extracted events across boxes into macro-topic traces that recover recurring activities, goals, and factual developments across distant sessions. On LoCoMo, Topic-Loom-only retrieval improves over the best Mem0/A-MEM retrieval-depth setting by 13.00 F1 points (53.95 vs. 40.95), and trace-expanded retrieval further raises F1 to 55.28; with GPT-4o, trace-expanded retrieval reaches 59.71 F1. Additional DialSim results show the same gain from adding cross-box traces in multi-party dialogue. These results show that local topic-continuity organization and macro-topic trace expansion improve long-range memory beyond semantic retrieval over fragmented records.

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

MOLAR: Learning Multimodal Molecular Representations from Noisy Labels

arXiv:2606.18390v1 Announce Type: new Abstract: Motivation: Noisy labels are a common challenge in molecular property prediction because molecular annotations are often obtained from assays, curated databases, or weak annotation pipelines rather than directly observed clean biological states. Treating recorded labels as reliable supervision can cause models to memorize corrupted observations and learn misleading molecular evidence. In multimodal molecular representation learning, this issue can be amplified by graph-text fusion or alignment, which may propagate label-induced errors across modalities. Results: We propose MOLAR, a noise-aware framework for learning multimodal molecular representations from noisy labels. MOLAR separates latent clean-property inference from recorded-label observation: graph and text views contribute residual evidence to a clean-property distribution, and a categorical label-observation channel maps this distribution to recorded labels for training. This formulation derives posterior label reliability and modality-specific molecular evidence from the model. Experiments on naturally noisy molecular benchmarks and controlled label-flipping benchmarks show that MOLAR consistently outperforms representative baselines. Visualization analyses further show that MOLAR provides interpretable reliability and modality-evidence diagnostics.

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

VISTA: Video Interaction Spatio-Temporal Analysis Benchmark

Existing benchmarks for Vision-Language Models (VLMs) primarily evaluate spatio-temporal understanding on simple single-action videos, closed attribute sets and restricted entity types, failing to capture the freeform, multi-action interactions between diverse entities which characterize real-world video understanding. Furthermore, the lack of a systematic framework for analyzing model failures across complementary spatio-temporal axes hinders comprehensive evaluation. To address these gaps, we introduce VISTA, a Video Interaction Spatio-Temporal Analysis benchmark designed for open-set, multi-entity and multi-action spatio-temporal understanding in VLMs. VISTA decomposes videos into interpretable entities, their associated actions, and relational dynamics, enabling multi-axis diagnostics and unified assessment of relational, spatial, and temporal understanding. Our benchmark integrates multiple datasets into a single interaction-aware taxonomy and comprises ~12K curated video-query pairs spanning diverse scenes and complexities. We systematically evaluate 11 state-of-the-art VLMs on VISTA, and break down aggregate performance across our taxonomy to reveal shortcomings and pronounced spatio-temporal biases obscured by traditional metrics. By providing detailed, taxonomy-driven diagnostics on a challenging dataset, VISTA offers a nuanced framework to guide advances in model design, pretraining strategies, and evaluation protocols. Overall, VISTA is the first, large-scale, interaction-aware diagnostic benchmark for spatio-temporal understanding in VLMs.

19.
medRxiv (Medicine) 2026-06-23

Multivariate Echocardiographic Phenotyping of Hypertensive Heart Failure Using Unsupervised Machine Learning: A Pilot Study

Background Heart failure in hypertensive patients is heterogeneous and poorly captured by traditional left ventricular ejection fraction (LVEF) based classification. Multivariate echocardiographic data combined with unsupervised machine learning may provide a more precise phenotypic characterization. This pilot study evaluated the feasibility of unsupervised clustering of routine transthoracic echocardiographic data to identify phenotypic subgroups of hypertensive heart failure. Methods This retrospective pilot study analyzed transthoracic echocardiography reports from hypertensive patients with clinical heart failure. After data cleaning and exclusion of incomplete records, 102 patients with 11 echocardiographic variables were included. Variables describing left ventricular geometry, systolic function, and diastolic performance were standardized and subjected to K-means clustering. Optimal cluster number was determined using the elbow method and silhouette analysis. Cluster characteristics were assessed using descriptive statistics and Kruskal Wallis testing. Concordance with LVEF based heart failure categories was evaluated. Results Three distinct echocardiographic phenotypes were identified. Cluster 0 (n = 50) demonstrated preserved LVEF with concentric remodeling, consistent with heart failure with preserved ejection fraction (HFpEF) phenotype. Cluster 1 (n = 37) showed marked ventricular dilation and reduced systolic function, consistent with heart failure with reduced ejection fraction (HFrEF). Cluster 2 (n = 15) exhibited concentric hypertrophy with intermediate LVEF, consistent with heart failure with mildly reduced ejection fraction (HFmrEF) like phenotype. All echocardiographic variables differed significantly across clusters (p < 0.001). While Cluster 0 showed strong concordance with HFpEF (96%), Clusters 1 and 2 demonstrated substantial overlap across LVEF categories, indicating partial discordance between structural phenotypes and LVEF based classification. Conclusion Application of unsupervised machine learning to routine echocardiographic data identifies distinct heart failure phenotypes in hypertensive patients. These phenotypes demonstrate significant structural heterogeneity beyond LVEF based classification, supporting the utility of data-driven approaches for refined cardiac phenotyping. This pilot study provides a foundation for larger prospective studies.

20.
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.

21.
medRxiv (Medicine) 2026-06-16

Care Delivery Gap framework: a proof-of-concept patient-reported measure of guideline-referenced care-process omissions in sickle cell disease

Abstract Background:Sickle cell disease (SCD) is concentrated in sub-Saharan Africa, where delivery of guideline-referenced care remains challenging. Current evaluation approaches rely largely on access indicators and clinical outcomes, which do not directly measure care delivery. We developed the Care Delivery Gap (CDG) framework, a patient-reported approach for identifying care-process omissions, and conducted a proof-of-concept study to assess feasibility and explore variation across income strata. Methods: We conducted a cross-sectional framework-development study involving a proof-of-concept sample of 52 individuals with SCD or caregivers recruited through clinics and moderated SCD communities across Africa, North America, and Europe between June 2025 and March 2026. The CDG framework assessed patient-reported omissions in specialist involvement, follow-up continuity, cardiovascular screening, and biochemical surveillance. Analyses were descriptive. Results: Substantial multi-domain care-process omissions were identified despite high reported healthcare engagement. Across geographic income strata, cardiovascular screening was reported by 4/35 (11%) LMIC versus 16/17 (94%) HIC participants, and regular follow-up within the preceding 12 months by 14/35 (40%) versus 16/17 (94%), respectively. High CDG scores, representing 1 omissions across three or four domains, occurred in 20/35 (57%) LMIC compared with 1/17 (6%) HIC participants. Similar disparities were observed across specialist review and vitamin B12 surveillance domains. Conclusion: A structured patient-reported framework identified multi-domain omissions in guideline-referenced SCD care, including among individuals reporting healthcare access. The divergence between access indicators and reported care delivery suggests that service contact alone may not reflect care quality. The framework provides a feasible foundation for future process-level quality measurement in high-burden settings.

22.
arXiv (CS.LG) 2026-06-12

The Urysohn Machine: A Metric-Topological Model of Computation

作者:

arXiv:2508.14143v2 Announce Type: replace Abstract: We introduce the Urysohn Machine, an effective model of classification-oriented computation in which metric separation, frontier structure, and contraction are explicit parts of the computational state. Its basic object is a Urysohn Triple: a support region, a target partition, and a separating classifier stored in a reusable Metric Library. The topological foundation is a constructive Urysohn Realization theorem for finite simplicial settings. It builds separators from dyadic ladders of nested polyhedral regions and equips their frontiers with a chain-level calculus: frontiers are cycles, and shells between levels have boundaries given by differences of frontiers. This construction yields two related complexity measures: decision-boundary width, the geometric measure of a single classifier's boundary, and Urysohn width, the total frontier mass represented by a library or realization. We prove an Amortized Separation Theorem showing that approximating a boundary of width to accuracy requires a number of simple basis triples proportional to boundary width and inversely proportional to resolution, under explicit boundary-footprint assumptions. We also introduce a contrastive separation operator whose graph-cut functional consistently estimates decision-boundary width from sampled metric data, while its Laplacian spectrum certifies class-component structure and conductance. Finally, we analyze the dynamic Urysohn ladder and prove four guarantees: separability under quotient collapse, stability of committed frontiers, bounded capacity under contraction, and scalability with quotient distance. Together, these results give a metric-topological account of classification complexity, amortized inference, and compositional reuse that preserves classical computability while exposing geometric structure hidden by purely symbolic descriptions.

23.
arXiv (quant-ph) 2026-06-24

Linear optical Bell state measurement for rotation-symmetric cat codes

arXiv:2606.22832v2 Announce Type: replace Abstract: Rotation-symmetric cat (RS-cat) codes are a bosonic-code platform for quantum information processing, combining finite-energy realizability with robustness against photon loss through their discrete rotational symmetry. For applications in long-distance quantum communication and fusion-based quantum computation (FBQC), efficient Bell state measurement (BSM) is a key primitive. In this work, we consider a BSM protocol for RS-cat codes using only a half beam splitter (HBS) and photon-number-resolving detectors (PNRDs). By exploiting the characteristic photon-number structure induced by the discrete rotational symmetry of RS-cat codes, our protocol extracts both photon-number modulo and phase information for Bell-state discrimination. We show that, under ideal loss-free conditions, the proposed BSM protocol becomes deterministic for arbitrary symmetry order $N$ for sufficiently large amplitudes $\alpha$. We further numerically evaluate the success probability under photon loss and identify the loss regime in which higher-order RS-cat codes provide an advantage. Finally, we show that post-selection can enhance the success probability.

24.
medRxiv (Medicine) 2026-06-23

Antibodies against influenza A/H1N1pdm2009 and B/Victoria strains but not A/H3N2 are increased in recent onset type 1 narcolepsy versus matched controls

Study Objectives: Onsets of Narcolepsy type-1 (NT1) increased following A/H1N1 vaccination with PandemrixTM in Europe and with A/H1N1pdm2009 infections in China and other countries. To test if other strains could trigger narcolepsy, we measured strain-specific antibodies in patients with recent onset NT1 compared to controls. Methods: Antibodies against hemagglutinin (HA) and neuraminidase (NA) were tested in 62 patients with very recent onset (onset and blood collection following a single flu season, mean +/- SEM: 0.44 +/- 0.06 years since onset) and 100 controls matched by age, sex, season and year of collection (2000-2025). Results were next extended to 181 recent onset patients (mean +/- SEM: 1.00 +/- 0.05 years) versus 260 controls, matched by sex, season and year, but having a slightly higher mean age. HA inhibition (HAI) and NA inhibition (NAI) assays were conducted using flu strains known to circulate during the corresponding flu seasons. HAI results are shown as % positive (titers >= 40) and NAI results as geometric mean titers. Odds ratio (OR) and coefficient were used to compare antibody titers in NT1 versus controls. The contribution of each assay to prediction was finally quantified in the larger sample set using Shapley decomposition. Results: NT1 patients had increased anti-HA and anti-NA antibodies against A/H1N1pdm2009 (anti-HA OR = 3.86, anti-NA coefficient = 0.35) and B/Victoria (anti-HA OR =1.90, anti-NA coefficient = 0.22), but not A/H1N1pre2009, A/H3N2, or B/Yamagata, independent of HLA-DQB1*06:02 status, age, sex, and flu season. Correlations between anti-HA and anti-NA antibodies titers were weak to moderate but significant (r2=-0.10 to 0.34). Multivariable model outperformed age-only baseline (McFadden R2 = 0.19 vs. 0.03; AUC = 0.79 vs. 0.64; likelihood-ratio test X2 = 51, p