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01.
arXiv (CS.LG) 2026-06-16

TriAdReview: Triangular Adversarial Review Architecture for Multi-Model Technical Document Generation

arXiv:2606.15074v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly used for technical document generation, yet single-model outputs often suffer from over-engineering, security blind spots, and incomplete coverage. We propose TriAdReview, a triangular adversarial review architecture that employs two independent reviewer models (engineering and boundary perspectives) and a triangular judging mechanism to iteratively improve a generator model's output. We evaluate TriAdReview across five benchmark tasks - architecture design, code generation, proposal review, security audit, and requirements analysis - using three configurations: single model (baseline), dual model (single review), and triple model (full system). Results across 75 experiments (n=5 per cell) show that the triple model configuration achieves a 10.1% overall improvement over the single model baseline (26.2 vs. 23.8 out of 50; p

02.
arXiv (CS.AI) 2026-06-18

Vibe Coding Ate My Homework: An evaluation of AI approaches to greenfield software engineering and programming

arXiv:2606.18293v1 Announce Type: cross Abstract: Thanks to rapid developments in generative AI, we are in the midst of a paradigm shift that may change how we interact with computers forever. We have observed a growth in the use of natural language prompts to build applications and coding infrastructures without underlying knowledge of the field, and this practice has been dubbed `vibe coding.' It arguably represents what the field of programming has been building towards since the beginning, with every higher level of abstraction that is conceived. Vibe coding promises to be the endpoint for the meta of high-level programming as far as method of input is concerned: eliminating a human's use of code syntax entirely in favour of programming in their mother tongue. This paper aims to evaluate the viability of vibe coding for greenfield software engineering tasks, as well as analyse the benchmarks that have been used to measure its software engineering prowess. To this end, we have developed an evaluation suite for analysing an LLM's proficiency in carrying out simple, isolated greenfield programming tasks in Python to provide scoped insight on the matter.

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

Vocabulary Dropout for Curriculum Diversity in LLM Co-Evolution

Co-evolutionary self-play, where one language model generates problems and another solves them, promises autonomous curriculum learning without human supervision. In practice, the proposer quickly converges to a narrow distribution of problems that satisfy the reward function. This diversity collapse renders the curriculum uninformative for the solver, stalling the co-evolutionary loop. We introduce vocabulary dropout, a random mask applied to the proposer's output logits during both policy training and curriculum generation, as a lightweight mechanism to sustain diversity. The mask is hard and non-stationary, preventing the proposer from locking into fixed token sequences. Training Qwen3-4B and Qwen3-8B on mathematical reasoning via R-Zero, we find that vocabulary dropout sustains proposer diversity across lexical, semantic, and functional metrics throughout training. It also yields solver improvements averaging +4.4 points at 8B, with the largest gains on competition-level benchmarks. Our findings suggest that explicit action-space constraints, analogous to the structural role that game rules play in classical self-play, can help sustain productive co-evolution in language. Vocabulary dropout is one simple instantiation of this principle.

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

Control-Plane Placement Shapes Forgetting: An Architectural Study of Agent Memory Across Thirteen System Configurations

Authors:

Where an LLM sits in an agent memory pipeline – between the recall plane that retrieves stored facts (extensively benchmarked) and the control plane that mutates them via supersede, release, purge (largely untested) – shapes which forgetting failure modes the system recovers. Comparing thirteen system configurations on a 385-case adversarial surface, we observe three placement regimes with partly complementary coverage: deterministic primitives suffice for lexical/temporal categories but fail canonicalization (5% on identifier-obfuscation, 0% on cross-lingual); inscribe-time LLM recovers canonicalization (100%) but cannot help intent-aware deletion (0% on prefix-collision and compound-fact); a mutation-time hook recovers intent-aware deletion (78-85%) and brightens nearly all categories simultaneously (91.7-93.2% overall, $0.17 per 385-case run, 2.3s/case mutation latency vs. 64-191ms/case deterministic, recall path unchanged). We expose the trade-off via ForgetEval, a 1000-case templated suite plus a 385-case adversarial layer (132 hand-crafted + 253 LLM-drafted oracle-validated) scored by deterministic substring match, paired with a six-method Adapter Protocol with honest N/A scoring that lets heterogeneous memory stores enter in 130 lines. Admission is corroborated by 10-annotator IAA (Fleiss' kappa = 0.958) and a 77-case external-authored subset (four blind contributors) that replicates the canonicalization asymmetry and amplifies the joint-placement lift (+27.8 pt). Production failures are predominantly forgetting failures rather than recall failures, yet existing benchmarks measure only recall. ForgetEval and all adapters are released under MIT.

05.
arXiv (CS.CL) 2026-06-18

Trust Region On-Policy Distillation

On-Policy Distillation (OPD) is a fundamental technique for efficient post-training of large language models (LLMs), with broad applications in agent learning, multi-task enhancement, and model compression. However, OPD training becomes unstable when the teacher and student distributions differ substantially, as teacher supervision on student-generated tokens may yield unreliable policy gradients and even cause optimization failure. This work addresses reliable on-policy token-level supervision through credit assignment strategies, and proposes Trust Region On-Policy Distillation, TrOPD. It features the following characteristics: 1) Trust-Region On-Policy Learning: TrOPD performs OPD only in regions where the teacher provides reliable supervision, mitigating the optimization difficulty of the K1 reverse-KL estimator under distribution mismatch. 2) Outlier Estimation: For outlier regions, we explore gradient clipping, masking, and forward-KL estimation to reduce the adverse effects of unreliable supervision. 3) Off-Policy Guidance: The student continues generation from teacher prefixes and uses forward KL to imitate off-policy guidance, encouraging on-policy exploration toward reliable regions. Experiments show that TrOPD consistently outperforms SoTA OPD baselines, including OPD, EOPD, and REOPOLD, across mathematical reasoning, code generation, and general-domain benchmarks.

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

Rethinking Text-to-Image as Semantic-Aware Data Augmentation for Indoor Scene Recognition

In the realm of computer vision, indoor image recognition presents challenges due to the intricate interplay of lighting conditions, occlusions, and diverse object arrangements within confined spaces. To address the lacks of training indoor images, we introduce a novel approach leveraging Stable Diffusion (SD) for the generation of synthetic images, which serve as a powerful data augmentation tool. The utilization of SD offers a principled framework for synthesizing diverse and realistic indoor scenes, thereby enriching the training data pool for robust indoor image recognition models. Experimental findings on the MIT Indoor Scene dataset reveal the potential of our proposed approach in enhancing the training of deep models when authentic data is limited. Furthermore, to prevent the misuse of SD synthetic images, we introduce a counter measure based on DIffusion Reconstruction Error (DIRE). The powerful DIRE presentation enables training robust classifiers only using lightweight deep models. Experiments show that our approach can perfectly recognize SD generated images with the accuracy of 100% using MobilenetV3.

07.
arXiv (CS.CV) 2026-06-18

SuperCarver: Texture-Consistent 3D Geometry Super-Resolution for High-Fidelity Surface Detail Generation

Conventional production workflow of high-precision mesh assets necessitates a cumbersome and laborious process of manual sculpting by specialized 3D artists/modelers. The recent years have witnessed remarkable advances in AI-empowered 3D content creation for generating plausible structures and intricate appearances from images or text prompts. However, synthesizing realistic surface details still poses great challenges, and enhancing the geometry fidelity of existing lower-quality 3D meshes (instead of image/text-to-3D generation) remains an open problem. In this paper, we introduce SuperCarver, a 3D geometry super-resolution pipeline for supplementing texture-consistent surface details onto a given coarse mesh. We start by rendering the original textured mesh into the image domain from multiple viewpoints. To achieve detail boosting, we construct a deterministic prior-guided normal diffusion model, which is fine-tuned on a carefully curated dataset of paired detail-lacking and detail-rich normal map renderings. To update mesh surfaces from potentially imperfect normal map predictions, we design a noise-resistant inverse rendering scheme through deformable distance field. Experiments demonstrate that our SuperCarver is capable of generating realistic and expressive surface details depicted by the actual texture appearance, making it a powerful tool to both upgrade historical low-quality 3D assets and reduce the workload of sculpting high-poly meshes.

08.
arXiv (CS.LG) 2026-06-15

EqCollide: Equivariant and Collision-Aware Deformable Objects Neural Simulator

arXiv:2506.05797v2 Announce Type: replace Abstract: Simulating collisions of deformable objects is a fundamental yet challenging task due to the complexity of modeling solid mechanics and multi-body interactions. Existing data-driven methods often suffer from lack of equivariance to physical symmetries, inadequate handling of collisions, and limited scalability. Here we introduce \name, the first end-to-end equivariant neural fields simulator for deformable objects and their collisions. We propose an equivariant encoder to map object geometry and velocity into latent control points. A subsequent equivariant Graph Neural Network-based Neural Ordinary Differential Equation models the interactions among control points via collision-aware message passing. To reconstruct velocity fields, we query a neural field conditioned on control point features, enabling continuous and resolution-independent motion predictions. Experimental results on 2D and 3D scenarios show that \name achieves accurate, stable, and scalable simulations across diverse object configurations. It achieves $24.34\%$ to $57.62\%$ lower rollout MSE, even compared with the best-performing baseline model. Furthermore, \name could generalize to more colliding objects and extended temporal horizons, and stay robust to input transformed with group action. Code is available at: https://github.com/AI4Science-WestlakeU/EqCollide

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

Uncertainty Is Not a Safety Net for Clinical VQA, but Can It Anticipate Model Failure?

Safe deployment of clinical vision-language models (VLMs) requires reliable uncertainty estimation (UE): a signal indicating when predictions should be trusted or escalated to a clinician. We test whether current UE methods actually deliver this signal. Benchmarking 8 methods across 12 VLMs on clinical visual question-answering (VQA), we find that UE quality is not an intrinsic property of the UE method: it tracks model accuracy, degrading precisely where the model performance is weakest, and therefore where reliability is most needed. When we stress-test models by hiding the correct option among the multiple-choice answers (NOTA perturbations), accuracy collapses while uncertainty barely changes, leaving models systematically miscalibrated. Yet, we find that uncertainty on the unperturbed input reliably anticipates which predictions will collapse under NOTA, indicating that UE in current VLMs carries diagnostic information about model fragility. Our results position UE as a diagnostic tool for identifying fragile predictions and motivate perturbation-based evaluation as a path toward safe clinical deployment.

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

Multi-agent Framework for Time-Sensitive Complementary Collaboration in Minecraft

arXiv:2606.15684v1 Announce Type: new Abstract: We present TickingCollabBench, a Minecraft-based multi-agent benchmark for a novel class of time-sensitive complementary collaboration tasks. Our benchmark reflects four core characteristics of real-world collaboration: agent heterogeneity, mandatory collaboration, dynamic environments, and strict real-time constraints with failure risks. To enable this, we develop the TickingCollab framework, which supports the generation of diverse dynamic environments and abstracts Minecraft's primitive APIs to enable declarative YAML task specifications for composing these events. Building on this, we design a feasibility-aware automated benchmark generation pipeline, where an LLM drafts structurally diverse task configurations and feasibility verifier filters out invalid ones using approximate constraints. Evaluations demonstrate that lang latency and inherent difficulty of coordinating under partial observability and agent heterogeneity cause LLMs to frequently fail under dynamic environments and fall significantly short of a global-knowledge oracle.

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

Minimalist Genetic Programming

arXiv:2606.10237v2 Announce Type: replace Abstract: Genetic programming (GP) is based on two important insights. First, that any learning task can fundamentally be posed as a program induction problem, where the goal is to construct a symbolic hierarchical model that is expressed as a syntax tree. Second, to pose this task as a search problem, and use evolution to locate the desired model. Since it was proposed, GP has produced notable results in a wide range of tasks and problem domains. This work presents an alternative view by modifying the second core insight of GP, posing the problem as a syntactic derivation task instead. In particular, this paper presents Minimalist Genetic Programming (MGP), an algorithm that like GP is biologically inspired, but instead of evolution it takes inspiration from the Minimalist Program to human language, in which syntax is understood as an optimal solution to the problem of linking two other mental systems. In minimalism, the core computational process is a binary set formation operator called $MERGE$, than can be used to incrementally construct complex syntactic structures using a simple Markovian process. MGP is able to discover the core building blocks of the symbolic expressions, and to incrementally combined them using $MERGE$. The proposed system is benchmarked on symbolic regression tasks that are known to be difficult to solve with standard GP systems because of the propensity for bloat. Results show that when a proper lexicon of atomic syntactic objects are chosen, MGP is able to consistently produce the exact ground truth model on a set of symbolic regression tasks where standard GP struggles to do the same. The insights provided by minimalism are shown to be relevant to the problem of program induction, and should be explored further based on the potential exhibited by MGP in this work.

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

Contrastive Geometric Learning Unlocks Unified Structure- and Ligand-Based Drug Design

arXiv:2601.09693v3 Announce Type: replace Abstract: Structure-based and ligand-based computational drug design have traditionally relied on disjoint data sources and modeling assumptions, limiting their joint use at scale. In this work, we introduce Contrastive Geometric Learning for Unified Computational Drug Design (ConGLUDe), a single contrastive geometric model that unifies structure- and ligand-based training. ConGLUDe couples a geometric protein encoder that produces whole-protein representations and implicit embeddings of predicted binding sites with a fast ligand encoder, removing the need for predefined pockets. By aligning ligands with both global protein representations and multiple candidate binding sites through contrastive learning, ConGLUDe supports ligand-conditioned pocket prediction in addition to virtual screening and target fishing, while being trained jointly on protein-ligand complexes and large-scale bioactivity data. Across diverse benchmarks, ConGLUDe achieves competitive zero-shot virtual screening performance, substantially outperforms existing methods on a challenging target fishing task, and demonstrates state-of-the-art ligand-conditioned pocket selection. These results highlight the advantages of unified structure-ligand training and position ConGLUDe as a step toward general-purpose foundation models for drug discovery.

13.
arXiv (CS.AI) 2026-06-19

Spatial-Aware Reduction Framework: Towards Efficient and Faithful Visual State Space Models

arXiv:2606.19932v1 Announce Type: cross Abstract: Mamba demonstrates strong efficiency in modeling long visual sequences. However, when token reduction is applied to structurally enhanced Mamba variants, these models exhibit a severe performance collapse. We attribute this degradation to the spatially agnostic nature of existing reduction methods, which violate the two-dimensional structural premise required by the selective scanning mechanism. In this work, we propose STORM, a spatial-aware token reduction framework designed to maintain structural integrity throughout the compression process. STORM reformulates reduction into a structured operation on spatial units, enforcing localized constraints to maintain both grid topology and neighborhood coherence. As a plug-and-play module, STORM equips existing reduction pipelines with explicit spatial awareness without any training. Empirical results demonstrate that STORM achieves state-of-the-art pruning accuracy across diverse vision Mamba backbones under training-free settings. Notably, STORM delivers a substantial accuracy recovery on VMamba, outperforming prior methods by up to 63.3\% in top-1 accuracy. Meanwhile, STORM incurs only a 1.0\% accuracy drop on PlainMamba, achieving performance comparable to ViT.

14.
arXiv (CS.CL) 2026-06-16

A Self Consistency Based Reranking for Narrative Question Answering

Narrative question answering (NQA) is a challenging task in natural language processing that requires models to understand long textual contexts, capture relationships across events, and generate coherent responses. Despite recent advances in pretrained language models, most existing approaches rely on a single decoding output during inference, making them sensitive to generation variability and often resulting in incomplete or inconsistent answers .To address this limitation, we propose a self-ensemble Self-Consistency-Based reranking framework for narrative question answering. The proposed method generates multiple candidate answers for each story-question pair and selects the final answer based on semantic agreement among the generated responses. This allows the model to explore diverse answer formulations while improving robustness through consensus-based selection without requiring modifications to the underlying architecture .The framework combines pretrained and fine-tuned language generation with multi-answer inference and similarity-based reranking. We evaluate the proposed approach on the NarrativeQA dataset using multiple models, including FLAN-T5 (Base and Small) and Pegasus-Large, under both baseline and fine-tuned settings .Experimental results demonstrate that the proposed method consistently improves performance across all models. In particular, FLAN-T5-Base achieves the best overall performance, improving from 82.32% to 86.66% (+4.34%) when combined with self-ensemble inference. Additionally, the largest improvement is observed with Pegasus-Large, which increases from 72.50% to 87.07% (+14.57%), highlighting the effectiveness of the proposed strategy.

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

Policy-driven Conformal Prediction for Trustworthy QoT Estimation

arXiv:2606.12501v1 Announce Type: new Abstract: We propose Conformal QoT, a policy-driven framework that combines statistically guaranteed QoT estimation with operational decision policies, enabling reliable lightpath-feasibility predictions under domain shift and improving accuracy from 92\% to 99.6\% on open datasets.

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

The Information-Theoretic Benefit of Shared Representations under Orthogonality Constraints

arXiv:2606.16028v1 Announce Type: new Abstract: Modern deep learning architectures are increasingly multi-task and multi-modal, using a pretrained foundation model combined with task-specific, fine-tuned models. Empirically, exploiting similarity across different problems, instead of solving them individually, can significantly improve overall performance. While the generalization and sample complexity properties of multitask learning have been widely studied, the parametric complexity of joint approximation in comparison to separate approximation remains less well understood. The question is particularly relevant in modern deep learning, where models are increasingly required to satisfy structural constraints such as equivariance, conservation laws, or orthogonality. We prove lower and upper bounds on the description-length for separate and joint approximation classes, respectively, in uniform norm. We build a class of orthogonal functions by composing a shared hard feature, realized by a Rademacher-Haar wavelet series, with Sawtooth-Walsh readouts to enforce orthogonality of output coordinates. The dyadic tree structure of the Rademacher-Haar wavelet concentrates the approximation hardness in the common feature component, while the readouts act as task-specific heads. Using an information-theoretic framework, we obtain a sharp gap between the optimal approximation rates achievable by joint and separate coding. Finally, we realize this separation in a neural network model using Heaviside activations via reduction to triangle-wave approximation. Our results show that even under an orthogonality constraint joint approximation requires strictly fewer bits in compositional architectures, provided the tasks share a latent hard feature. This provides theoretical insight into the description-length-efficiency of compositional multi-output architectures and clarifies how neural networks can retain expressivity under geometric constraints.

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

QK-Normed MLA: QK normalization without full key caching

Query-key (QK) normalization stabilizes attention by controlling the scale of queries and keys before the dot product, but is not immediately compatible with Multi-head Latent Attention (MLA). MLA achieves efficient decoding by caching low-dimensional latent states instead of full keys, whereas post-projection QK RMSNorm appears to require the fully projected key for every cached token. We show this apparent incompatibility is an implementation artifact, not an architectural constraint. RMSNorm decomposes into a static affine weight and a dynamic scalar RMS statistic. The static key-side weight can be absorbed into the MLA query-side projection; the dynamic key statistic reduces to one inverse-RMS scalar per token and KV group. The resulting formulation is exactly equivalent to explicit post-projection QK RMSNorm in exact arithmetic and preserves MLA's latent decode path. In our 400M runs trained for up to 100B tokens, QK-Normed MLA achieves lower training loss and better downstream accuracy than QK clipping, while H800 decode benchmarks show less than 2% latency overhead up to 256k context. These results make QK normalization a practical stabilization option for MLA models without requiring full-key caching.

18.
arXiv (quant-ph) 2026-06-19

Extracting the physical content of Liouvillian eigenmodes: Semiclassical quantization

arXiv:2606.20271v1 Announce Type: new Abstract: Unlike in closed quantum systems where individual energy eigenstates are understood as physical excitations, open quantum systems have distinct right and left eigenstates of the Liouvillian that decay with time and are difficult to interpret. Here we introduce a physically motivated quasiprobability measure combining the two types of eigenstates that interprets a Liouville eigenmode as a set of coherences. This coherence measure is intimately connected to the return probability and allows one to visualize the modes as quasiprobability distributions in a "doubled" phase space. Using this measure we show that, remarkably, an oscillator retains its quantized "orbits" in phase space for a large class of linear and nonlinear damping, thus providing a formulation of semiclassical quantization for open systems. The orbits have measurable dynamical signatures and are broadened in the presence of a thermal bath, similar to energy levels. For quadratic systems, our results yield an extension of the concept of invariant tori, which play a central role in Hamiltonian systems.

19.
arXiv (CS.AI) 2026-06-16

LLM-WikiRace Benchmark: How Far Can LLMs Plan over Real-World Knowledge Graphs?

arXiv:2602.16902v5 Announce Type: replace Abstract: We introduce LLM-Wikirace, a benchmark for evaluating planning, reasoning, and world knowledge in large language models (LLMs). In LLM-Wikirace, models must efficiently navigate Wikipedia hyperlinks step by step to reach a target page from a given source, requiring look-ahead planning and the ability to reason about how concepts are connected in the real world. We evaluate a broad set of open- and closed-source models, including Gemini-3, GPT-5, and Claude Opus 4.5, which achieve the strongest results on the easy level of the task and demonstrate superhuman performance. Despite this, performance drops sharply on hard difficulty: the best-performing model, Gemini-3, succeeds in only 23\% of hard games, highlighting substantial remaining challenges for frontier models. Our analysis shows that world knowledge is a necessary ingredient for success, but only up to a point, beyond this threshold, planning and long-horizon reasoning capabilities become the dominant factors. Trajectory-level analysis further reveals that even the strongest models struggle to replan after failure, frequently entering loops rather than recovering. LLM-Wikirace is a simple benchmark that reveals clear limitations in current reasoning systems, offering an open arena where planning-capable LLMs still have much to prove. Our code and leaderboard available at https:/llmwikirace.github.io.

21.
Nature Medicine 2026-06-08

Apitegromab for lean mass preservation during tirzepatide-induced weight loss: a randomized, double-blind, placebo-controlled phase 2 trial

Loss of lean mass in proportion to total weight loss is observed with incretin mimetic therapies such as tirzepatide and has the potential to adversely affect health and function. Apitegromab is an investigational, fully human monoclonal antibody that selectively inhibits myostatin activation and is, thereby, capable of increasing muscle mass. In the randomized, double-blind, placebo-controlled phase 2 EMBRAZE study, adults with overweight or obesity (n = 102) were randomized 1:1 to receive tirzepatide plus apitegromab (10 mg kg−1) or tirzepatide plus placebo. At week 24, apitegromab resulted in a least square mean (80% confidence interval (CI)) of 1.9 (1.2−2.7) kg less lean mass loss than placebo (P = 0.001), despite similar total body weight loss between groups, representing a 54.9% retention of lean mass relative to placebo. In participants receiving apitegromab, trough concentrations of apitegromab and total latent myostatin, a pharmacodynamic marker, both increased over time and reached a plateau after approximately 16 weeks. Incidence of adverse events (AEs) (% (95% CI)) was generally similar across apitegromab-treated participants and placebo-treated participants, with 39 of 51 (76% (63−86%)) and 36 of 51 (71% (57−81%)) participants experiencing an AE, respectively. Serious adverse events (SAEs) were balanced and experienced by one of 51 (2% (0−10%)) participants in each arm. In summary, this proof-of-concept study demonstrated that selective targeting of myostatin by apitegromab was well tolerated and effective in preserving lean mass when combined with tirzepatide. ClinicalTrials.gov identifier: NCT06445075 . In the phase 2 EMBRAZE study, participants receiving tirzepatide and apitegromab lost less lean mass compared to participants receiving tirzepatide and placebo.

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

WildIFEval: Instruction Following in the Wild

Recent LLMs have shown remarkable success in following user instructions, yet handling instructions with multiple constraints remains a significant challenge. In this work, we introduce WildIFEval - a large-scale dataset of 7K real user instructions with diverse, multi-constraint conditions. Unlike prior datasets, our collection spans a broad lexical and topical spectrum of constraints, extracted from natural user instructions. We categorize these constraints into eight high-level classes to capture their distribution and dynamics in real-world scenarios. Leveraging WildIFEval, we conduct extensive experiments to benchmark the instruction-following capabilities of leading LLMs. WildIFEval clearly differentiates between small and large models, and demonstrates that all models have a large room for improvement on such tasks. We analyze the effects of the number and type of constraints on performance, revealing interesting patterns of model constraint-following behavior. We release our dataset to promote further research on instruction-following under complex, realistic conditions.

23.
medRxiv (Medicine) 2026-06-22

Cumulative Metabolic Exposure to Hyperglycemia and Risk of Cardiovascular and Limb Events in Peripheral Artery Disease

Background: Although diabetes is a potent risk factor for the development of peripheral artery disease (PAD), the effect of cumulative metabolic exposure to hyperglycemia on risk of cardiovascular or limb events in patients with PAD remains unclear. Methods: The Peripheral Artery Disease: Long-term Survival (PEARLS) is a longitudinal registry of Veterans with newly diagnosed PAD identified using a natural language processing approach. Included patients had ankle brachial index [≤]0.9 or toe brachial index [≤]0.7, and no history of lower extremity revascularization or major amputation. Among patients with diabetes in this cohort, we assessed cumulative exposure to hyperglycema based on a 24-month rolling average of hemoglobin (Hgb) A1c values, categorized as [≤]7%, >7% to [≤]8%, and >8%. Multivariable Cox regression models evaluated the association between categories of HgbA1c, modeled as a time-varying exposure, and risk of cardiovascular (CV: myocardial infarction or stroke) and limb (chronic limb threatening ischemia [CLTI] or major amputation) events. Results: Among 45,109 patients with new diagnosis of PAD and pre-existing diabetes, the mean HgbA1c at baseline was 7.5%, with nearly one-third (30.4%) having HgbA1c >8%. The mean age was 70.4 years, 19.8% were Black and 4% were Hispanic. Patients with baseline HgbA1c >8% were younger and compared to those with HgbA1c [≤]7%, more likely to have coronary disease, kidney disease, and obesity. Over a median follow up of 4.2 years, 8,306 (18.4%) patients experienced a CV event, and 8,199 (18.2%) experienced a limb event. The adjusted association between HgbA1c and hazard of CV events was 12% higher in patients exposed to HgbA1c >7% to [≤]8% (HR 1.12; 95%CI: 1.05-1.18) and 38% higher in those exposed to HgbA1c >8% (HR 1.38; 95%CI: 1.30-1.46), compared to HgbA1c 7% to [≤]8% (HR 1.20; 95%CI: 1.13-1.28) and HgbA1c >8% (HR 1.60; 95%CI: 1.51-1.70), respectively when compared to HgbA1c [≤]7%. These findings were consistent in subgroups based on age and severity of PAD. Conclusions: Among diabetic patients with PAD, cumulatiave metabolic exposure to hyperglycemia is associated with a markedly increased risk of clinical events, especially limb events.

24.
medRxiv (Medicine) 2026-06-22

Integration of lung tissue proteomics and genome-wide association data to identify lung cancer susceptibility proteins and potential drug targets

Background: Proteins directly impact disease development and act as drug targets. Therefore, we integrated genomic and lung tissue proteomics data to identify lung cancer susceptibility proteins, elucidating genetic mechanisms and candidate drug targets. Method: We profiled the proteome and genome in non-neoplastic lung tissue from 200 lung cancer patients. Using this data, we constructed genetic models to predict abundance across the proteome in lung tissue. We applied these models to genome-wide association study (GWAS) data from 55,174 lung cancer cases and 1,294,174 controls to evaluate their associations with the risk of lung cancer, overall and by major histological subtypes. Bayesian colocalization and Mendelian randomization (MR) analyses were used to prioritize putative causal proteins, which were cross-referenced with three main drug-protein databases to identify potential therapeutic targets. Results: We identified 29 proteins associated with lung cancer risk at a false discovery rate < 5%, including 25 for overall lung cancer, two (AQP3 and IL18) specifically for adenocarcinoma, and another two (HMGN2 and HLA-DMB) for squamous cell carcinoma. Of them, genes encoding 17 proteins reside at least 2Mb away from any known GWAS risk loci, including 14 for overall lung cancer (HYI, GPX1, GMPPB, DSP, HDDC2, MTCH2, SUOX, JMJD7, PDIA3, IL16, IQGAP1, SULT1A2, ARHGAP27, and TYMP) and three for subtypes (AQP3, IL18, and HMGN2). Among the 12 proteins located within the known risk loci, EPHX2, CLDN18, PSMD5, and CYP2S1 proteins showed an association independent of the proximal GWAS-identified lead variant. Colocalization and/or MR analysis suggested 11 potential causal proteins. Five of these candidate causal proteins (DSP, CLDN18, IQGAP1, IL18 and TYMP) are targeted by nine drugs already approved by the FDA or in phase III trials. Conclusion: Our study identified novel lung cancer susceptibility proteins and potential drug targets, offering valuable insights into lung cancer biology and future translational utilities.

25.
arXiv (CS.CV) 2026-06-12

Bridging Modal Isolation in Interleaved Thinking: Supervising Modality Transitions via Stepwise Reinforcement

Interleaved thinking, where a unified multimodal model alternates between textual reasoning and visual generation, has shown promise on spatial and physical tasks. However, in complex long-chain scenarios, we identify a fundamental failure mode: generated images diverge from the textual context while subsequent text ignores the visual evidence, causing the two modalities to alternate without genuinely informing each other. We term this Modal Isolation and attribute it to compounding information loss at modality boundaries. We decompose each reasoning cycle into atomic operations and define modality transition loss, quantifying cross-modal hallucination (text-to-image) and visual utilization deficit (image-to-text) at each boundary. We propose MoTiF (Modality Tiransition Fidelity), a two-stage training framework that directly optimizes these transitions: Reflective SFT trains the model to detect and recover from erroneous visual outputs; Flow-GRPO improves image generation fidelity via reinforcement learning. All training signals in MoTiF derive from transition-level fidelity rather than end-task accuracy. Across four visual puzzle benchmarks, this transition-level supervision substantially improves both cross-modal coherence and final task accuracy. The results demonstrate that effective interleaved reasoning requires explicit structural supervision at modality boundaries, not merely scaling or end-task optimization.