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

Interpreting Neural Combinatorial Optimization via Evolving Programmatic Bottlenecks

arXiv:2606.19741v1 Announce Type: new Abstract: Neural Combinatorial Optimization (NCO) achieves strong performance, yet its black-box nature remains a key roadblock to deployment and scientific diagnosis. Standard interpretability tools, such as Concept Bottleneck Models (CBMs), are ill-equipped for NCO, whose decisions are dynamic, state-dependent, and lack proper concept vocabulary definition. To close this gap, we introduce Evolving Programmatic Bottlenecks (EPB), to our knowledge, the first framework for interpreting NCO policies by distilling black-box NCO models into human-readable program portfolios. EPB employs an LLM to autonomously evolve a bank of programs, where each program's per-step action distribution serves as the bottleneck. EPB works through an iterative framework: Block I fixes program bank capacity and introduces a hybrid textual-numerical gradient descent scheme that couples numerical gradients for student router updates and textual gradients for LLM-based program revision; Block II dynamically adapts bank capacity via fault-targeted expansion and redundancy pruning. Extensive experiments demonstrate EPB's effectiveness and broad applicability, where the distilled program portfolios largely match original performance. EPB also reveals that NCO behavior shifts across optimization stages and can be approximated as a composition of classic heuristic variants. Our work advances interpretable NCO and establishes EPB as a promising tool for interpreting sequential decision-making models.

02.
arXiv (CS.CL) 2026-06-17

A Red-Team Study of Anthropic Fable 5 & Opus 4.8 Models

Authors:

We evaluate the adversarial robustness of two frontier large language models (LLMs) developed by Anthropic, Fable 5 and Opus 4.8, against four families of automated jailbreak attack across 7 826 harmful intents spanning a ten-category harm taxonomy. Using the HackAgent red-teaming framework, hundreds of thousands of adversarial attempts were generated and every apparent success was independently re-adjudicated by a panel of three judge models (majority vote). Both models resist the majority of attacks, but the residual surface is larger than aggregate framing suggests: it is dominated by adaptive iterative attacks, while static obfuscation is near-fully neutralised. The strongest adaptive search (tree-of-attacks) breaks Opus 4.8 on 11.5% of intents overall, whereas Fable 5 stays in the single digits (6.1% worst-case). Aggregate rates therefore should not be read as reassurance. Even in these hardened configurations, the two models produced 1 620 (Opus 4.8) and 702 (Fable 5) panel-confirmed harmful completions spanning every harm category, located automatically, cheaply, and within the first one or two refinement steps by an attacker model with no human expert in the loop. The reasonable conclusion is that even the best, most-tested frontier models remain reliably breakable under sustained automated pressure.

03.
arXiv (CS.LG) 2026-06-15

Federated Learning for Feature Generalization with Convex Constraints

arXiv:2606.14416v1 Announce Type: new Abstract: Federated learning (FL) often struggles with generalization due to heterogeneous client data. Local models are prone to overfitting their local data distributions, and even transferable features can be distorted during aggregation. To address these challenges, we propose FedCONST, an approach that adaptively modulates update magnitudes based on the parameter strength of the global model. This prevents over-emphasizing well-learned parameters while reinforcing underdeveloped ones. Specifically, FedCONST employs linear convex constraints to ensure training stability and preserve locally learned generalization capabilities during aggregation. A Gradient Signal to Noise Ratio (GSNR) analysis further validates the effectiveness of FedCONST in enhancing feature transferability and robustness. As a result, FedCONST effectively aligns local and global objectives, mitigating overfitting and promoting stronger generalization across diverse FL environments, achieving state-of-the-art performance.

04.
arXiv (CS.AI) 2026-06-17

From Noise to Order: Learning to Rank via Denoising Diffusion

arXiv:2602.11453v3 Announce Type: replace-cross Abstract: Learning-to-rank (LTR) methods have traditionally been limited to discriminative machine learning approaches that model the probability of the document being relevant to the query given some feature representation of the query-document pair. We propose an alternative denoising diffusion-based generative approach to LTR that instead models the full joint distribution over features and relevance labels. While in discriminative LTR, an over-parameterized ranking model may find different ways to fit the training data, we posit that candidate solutions that can explain the full data distribution under the generative setting maybe better at estimating relevance. Thus, we propose DiffusionRank that extends TabDiff, an existing diffusion model for tabular datasets, to create generative alternatives to classical discriminative pointwise and pairwise LTR objectives. Our work demonstrates improvements from DiffusionRank over discriminative counterparts on four standard LTR datasets and points to a rich space for future exploration to leverage ongoing advancements in deep generative models for LTR. Our code is publicly available at https://github.com/sadjadeb/DiffusionRank.

05.
arXiv (quant-ph) 2026-06-15

Stab-QRAM: A Clifford-Only Quantum Oracle for Affine Boolean Data

arXiv:2509.26494v3 Announce Type: replace Abstract: Oracle-based quantum algorithms require coherent evaluation of classical functions on superposed inputs, and in fault-tolerant architectures this cost is dominated by non-Clifford gates: generic lookup constructions incur $T$-counts that grow with the data size. Here we show that affine Boolean functions $f(\mathbf{x})=A\mathbf{x}+\mathbf{b}$ over $\mathbb{F}_2$ – the algebraic core of parity checks, linear feedback shift registers, and cipher linear layers – are exactly the functions admitting computational-basis-preserving Clifford oracles, and we develop this correspondence into Stab-QRAM, a compiler mapping a specification $(A,\mathbf{b})$ to an ancilla-free circuit of CNOT and $X$ gates with zero $T$-count. Via K\"{o}nig's edge-coloring theorem, the compiled schedule provably attains the minimum depth for its gate set. Case studies spanning Simon-type oracles, block-encodings of $X$-type coset operators, and syndrome extraction for CSS codes show one compiler serving the algorithm, primitive, and error-correction layers of the quantum stack.

06.
PLOS Computational Biology 2026-06-01

A statistical framework for comparing epidemic forests

Authors:

by Cyril Geismar, Peter J. White, Anne Cori, Thibaut Jombart Inferring who infected whom in an outbreak is essential for characterising transmission dynamics and guiding public health interventions. However, this task is challenging due to limited surveillance data and the complexity of immunological and social interactions. Instead of a single definitive transmission tree, epidemiologists often consider multiple plausible trees forming epidemic forests. Various inference methods and assumptions can yield different epidemic forests, yet no formal test exists to assess whether these differences are statistically significant. We propose such a framework using a chi-square test and permutational multivariate analysis of variance (PERMANOVA). We assessed each method’s ability to distinguish simulated epidemic forests generated under different offspring distributions. While both methods achieved perfect specificity for forests with 100+ trees, PERMANOVA consistently outperformed the chi-square test in sensitivity across all epidemic and forest sizes. Implemented in the R package mixtree, we provide the first statistical framework to robustly compare epidemic forests.

08.
arXiv (CS.LG) 2026-06-17

Blind Recovery of Latent Domains via Unsupervised Symmetry Discovery

arXiv:2606.17782v1 Announce Type: new Abstract: Primary motivation in blind inverse problems is to recover signals of interest from corrupted observations without knowing the obfuscating mechanism. Blind deconvolution is a prominent approach when the corruption is convolutional, but it is not applicable when general linear transformations obfuscate the domain structure. In this work, we propose an unsupervised framework for recovering latent domains and signals by discovering symmetries of the data distribution. Our framework models observations as linear measurements of signals sampled from a latent random field, and optimizes a shallow group-convolutional network by imposing stationarity and locality regularization at the model output. The model learns a latent symmetry action and an appropriate filter, thereby mapping unstructured observations to a symmetry-based representation that reveals latent signals. Experiments on stochastic processes, Ising models, shuffled and bit-scrambled images, and neural recordings show that the method recovers latent domains and signals from unstructured observations, suggesting symmetry discovery as a new direction for unsupervised structure learning and blind inverse problems.

09.
arXiv (CS.CV) 2026-06-18

When Cars Have Stereotypes: Auditing Demographic Bias in Objects from Text-to-Image Models

While prior research on text-to-image generation has predominantly focused on biases in human depictions, demographic bias in generated objects remains relatively underexplored. We introduce SODA (Stereotyped Object Diagnostic Audit), a novel framework for systematically measuring these biases through automated attribute discovery and three standardized metrics: Base vs. Demographic Divergence (BDS), Cross-Demographic Disparity (CDS), and Visual Attribute Concentration (VAC). Applying SODA to 8,000 images across five state-of-the-art models and eight object categories (e.g., cars), we find that "neutral" prompts produce outputs most visually similar to middle-aged and White people, suggesting these groups are implicitly over-represented in model defaults. Furthermore, demographic cues trigger highly skewed stereotypical outputs: 26.6% of object-model-demographic combinations produce results where all 20 generated images share the exact same attribute value (e.g., rose gold laptops for women). Finally, prompt-level debiasing reduces inter-group disparity but paradoxically collapses within-group diversity, replacing one stereotype with another. SODA offers a practical pipeline for making these implicit associations measurable, serving as a step toward more responsible AI development.

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

REFLEX: Reflective Evolution from LLM Experience

Authors:

Large multimodal language models (LLMs) have emerged as powerful tools for guiding evolutionary search toward interpretable programmatic policies. However, existing frameworks rely on a monolithic model call to simultaneously interpret visual behavioral evidence and synthesize corrective code. This diagnosis-repair entanglement creates an opaque feedback loop, obscuring the rationale behind mutations and preventing the retention of algorithmic insights across independent runs. To achieve auditable and efficient policy search, we argue that visual diagnosis must be structurally decoupled from code generation. We present REFLEX, a train-free evolutionary framework that operationalizes this decoupling. In REFLEX, a vision-enabled Critic first distills task-specific behavioral evidence into structured, auditable diagnoses. Subsequently, a text-optimized Actor synthesizes child policies using these diagnoses alongside a persistent, self-evolving Skill Memory of reusable code snippets. This architecture not only provides transparent mutation traces but also enables cross-run programmatic knowledge transfer. Extensive evaluations across control benchmarks (Lunar Lander, Acrobot, Pendulum) and a 36-dimensional antenna array synthesis task demonstrate exceptional sample efficiency. Notably, REFLEX solves Acrobot and Pendulum in under 10 LLM calls and reaches a best Normalized Weighted Score of 1.092 on Lunar Lander, achieving highly competitive final performance while significantly accelerating the early-stage discovery of transparent policies.

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

On the Redundancy of Timestep Embeddings in Diffusion Models

arXiv:2606.20416v1 Announce Type: new Abstract: Diffusion models rely heavily on explicit timestep embeddings to modulate the denoising process across various noise scales. In this work, we challenge the necessity of these temporal signals by analyzing their impact on U-Net and Diffusion Transformer architectures. Beyond empirical evidence, we provide a theoretical framework demonstrating that, under certain conditions, the global minimizer of the diffusion training objective can be achieved without explicit timestep conditioning. Our findings reveal a surprising robustness when timestep embeddings are completely removed. Extensive ablation studies on the CelebA and CIFAR-10 datasets show that these time-agnostic models can maintain high structural fidelity and even surpass their conditioned counterparts in competitive metrics, including FID, precision, and recall. Our analysis suggests these architectures can implicitly infer noise scales from the corrupted input under specific assumptions, rendering explicit temporal conditioning redundant. This study challenges long-standing temporal conditioning paradigms and paves the way for more efficient and structurally focused generative architectures.

12.
arXiv (CS.CV) 2026-06-19

Gaussian Process Prior Variational Autoencoder for Endoscopic Videos

Endoscopic video analysis is essential for gastrointestinal diagnosis and computer-assisted interventions, but video sequences are routinely degraded by specular reflections, motion artifacts, and missing frames. These transient corruptions can distract clinicians, reduce image interpretability, and disrupt downstream tasks such as 3D reconstruction and navigation. Effective restoration therefore requires methods that exploit temporal continuity rather than treating frames in isolation. We introduce a Gaussian Process Prior Variational Autoencoder (GPVAE) framework for endoscopic video restoration that replaces the standard factorized latent prior with a temporal Gaussian process prior, enabling interpolation of missing frames with uncertainty-aware reconstruction. The framework combines endoscopy-specific encoders, including a convolutional EndoVAE backbone and pretrained Vision Transformer encoders from GastroNet-5M, with two scalable GP approximations: Hierarchical Prior Approximation (HPA) and Sparse Precision Approximation (SPA). Specular reflections are handled using a DUCKNet-based masking pipeline that excludes corrupted pixels from the reconstruction objective. On the C3VDv2 colonoscopy dataset, the best GPVAE variants reduced image reconstruction RMSE by 21.9\% on average, and by up to 26.1\%, relative to matched VAE baselines. Downstream trajectory RMSE was reduced by 12.7\% on average across classical visual odometry and a pretrained PoseNet, at an average increase of 27.3\% in training time per epoch. Finally, the GP posterior provides per-frame uncertainty estimates that reflect temporal support and offer a confidence signal for restored frames.

13.
arXiv (CS.CL) 2026-06-16

MedSynth: Realistic, Synthetic Medical Dialogue-Note Pairs

Physicians spend significant time documenting clinical encounters, a burden that contributes to professional burnout. To address this, robust automation tools for medical documentation are crucial. We introduce MedSynth – a novel dataset of synthetic medical dialogues and notes designed to advance the Dialogue-to-Note (Dial-2-Note) and Note-to-Dialogue (Note-2-Dial) tasks. Informed by an extensive analysis of disease distributions, this dataset includes over 10,000 dialogue-note pairs covering over 2000 ICD-10 codes. We demonstrate that our dataset markedly enhances the performance of models in generating medical notes from dialogues, and dialogues from medical notes. The dataset provides a valuable resource in a field where open-access, privacy-compliant, and diverse training data are scarce. Code is available at https://github.com/ahmadrezarm/MedSynth/tree/main and the dataset is available at https://huggingface.co/datasets/Ahmad0067/MedSynth.

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

DuoBench: A Reproducible Benchmark for Bimanual Manipulation in Simulation and the Real World

arXiv:2606.11901v1 Announce Type: cross Abstract: Bimanual robot systems substantially expand manipulation capabilities, but coordinating two arms introduces additional control complexity and failure modes that are not well captured by existing benchmarks. We introduce DuoBench, an extensible benchmarking framework for bimanual manipulation policies on the FR3 Duo platform. DuoBench comprises eleven tasks spanning four coordination categories, implemented in simulation and partially reproduced in the real world through reproducible task recipes with 3D-printable assets. In addition, we propose a stage-based evaluation scheme that supports fine-grained semantic failure analysis beyond binary success and provide human-teleoperated datasets for all benchmark tasks. We benchmark several dual-arm imitation-learning and vision-language-action policies in simulation and on real hardware. Our results show that current policies remain challenged by bimanual manipulation, particularly in early interaction stages, parallel arm execution, and transfer between simulation and real-world settings. DuoBench provides a reproducible testbed for diagnosing these failure modes and studying future methods for dual-arm policy learning. Code, datasets, and videos are available at https://duobench.github.io/

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

GAE: Unleashing Physical Potential of VLM with Generalizable Action Expert

Vision-language models demonstrate strong reasoning and planning abilities, yet grounding these predictions into precise robot actions remains a central challenge. Existing Vision-Language-Action methods typically entangle reasoning and action generation, leading to limited generalization. We propose Generalizable Action Expert (GAE), a task-agnostic model that converts sparse geometric plans into dense robot actions. Our approach introduces a sparse geometric interface: the VLM predicts sparse 3D waypoints representing high-level intention, while GAE maps these waypoints together with real-time point cloud observations to continuous action trajectories. GAE is pretrained on a large-scale pointcloud-trajectory dataset comprising 150k trajectories from both simulation and real-world robots. To further improve efficiency and generalization, we introduce an Action Pre-training, Pointcloud Fine-tuning (APPF) scheme that decouples learning action dynamics from geometry grounding. After pretraining, GAE is frozen and reused across downstream tasks, requiring only lightweight fine-tuning of the VLM to produce the sparse interface. Experiments show that our method achieves strong performance and generalization across diverse visual domains, camera viewpoints, and natural language instructions.

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

AI4SLT: Empirical Processes in Lean 4 for Formal Statistical Learning Theory

We present the first comprehensive Lean 4 formalization of statistical learning theory (SLT) grounded in empirical process theory. Our en-to-end formal infrastructure implement the missing contents in latest Lean library, including a complete development of Gaussian Lipschitz concentration, Dudley's entropy integral theorem for sub-Gaussian processes, and an application to least-squares (sparse) regression with a sharp rate. The project was carried out using a human-AI collaborative workflow, in which humans design proof strategies and AI agents execute tactical proof construction, leading to the human-verified Lean 4 toolbox for SLT. Beyond implementation, the formalization process exposes and resolves implicit assumptions and missing details in standard SLT textbooks, enforcing a granular, line-by-line understanding of the theory. This work establishes a reusable formal foundation and opens the door for future developments in machine learning theory. The code is provided in https://github.com/YuanheZ/lean-stat-learning-theory.

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

Realistic noise synthesis reduces bias and improves tissue microstructure estimation with supervised machine learning

arXiv:2606.02044v2 Announce Type: replace Abstract: Diffusion MRI enables non-invasive probing of tissue microstructure, but accurate parameter estimation is challenged by noise-related effects. In supervised machine learning frameworks trained on simulated data, discrepancies between the noise characteristics of simulated and acquired signals introduce a form of covariate shift, whereby the input signal distribution differs between training and inference. We investigated the impact of this mismatch on microstructure parameter estimation and propose a realistic noise synthesis (RNS) framework to mitigate it. RNS incorporates both the Rician expectation and the effective post-processing noise variance into simulated training signals. The Rician expectation was modelled using a noise standard deviation estimated with MPPCA, while the effective standard deviation was derived from spherical harmonic residuals of preprocessed data. The method was evaluated using the cylinder-zeppelin and the SANDI models on simulated datasets across multiple SNR levels and on in vivo diffusion data with repeated acquisitions. Sensitivity to noise misestimation was also assessed. Ignoring magnitude-induced noise effects during training produced systematic, SNR-dependent parameter bias, particularly at low SNR. Incorporating the Rician expectation substantially reduced bias to the level of noise-aware nonlinear least-squares fitting. Modelling the effective standard deviation further improved precision. Performance was largely independent of regression architecture but sensitive to accurate noise estimation. These findings demonstrate that realistic noise modelling in simulated training data mitigates signal-domain covariate shift and is essential for unbiased supervised microstructure estimation, particularly in low-SNR regimes associated with high b-values or high spatial resolution.

18.
arXiv (CS.AI) 2026-06-11

An Ethical eValuation Agent (EeVA): Results of a Proof-of-Concept Test on a Prototype Agentic-like Workflow to Assist Ethical Deliberations

arXiv:2606.11218v1 Announce Type: cross Abstract: Ethical deliberation is often misunderstood as a search for single right or wrong answers, creating difficulties for non-ethically trained personnel who must address ethically laden challenges. We developed EeVA, an agentic-like LLM-based workflow designed to support comparative ethical reflection rather than deliver definitive ethical answers. EeVA was programmed in n8n using three interconnected workflows: starter, worker, and emitter. It evaluated uploaded use cases against 10 ethical frameworks through evaluator and synthesis prompts. Proof-of-concept testing used three published cases from urban mobility, peer-to-peer energy trading, and social-service resource allocation. Across all cases, EeVA produced consistently structured framework-specific evaluations and integrated syntheses. Outputs differentiated between frameworks, identified convergences and divergences, recommended modifications to increase alignment, and highlighted persistent ethical tensions. Syntheses were readable for non-specialists and shifted attention away from simplistic answers toward design conditions, safeguards, and areas where full cross-framework agreement was unlikely. The findings suggest that LLMs can be organised into usable workflows that preserve ethical plurality while helping bridge the communicative gap between ethicists and non-ethically trained personnel. EeVA's value lies not in replacing ethicists or resolving moral disagreement, but in scaffolding structured ethical deliberation. EeVA offers a promising proof of concept for supporting ethical reflection where access to ethics expertise is limited. Further work is needed on reproducibility, human evaluation, user testing, and efficiency before it can be considered a mature tool.

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

SCAN: Enhance Time Series Anomaly Detection via Multi-Scale Neighborhood-Centered Clustering

arXiv:2606.19255v1 Announce Type: new Abstract: Time series anomaly detection plays a crucial role in a wide range of real-world applications. Reconstruction-based methods have become the mainstream paradigm, but they suffer from over-generalization and under-generalization problems, which are challenging to balance. To address this, we introduce multi-scale clustering to enhance reconstruction-based methods. At the representation level, we integrate the cluster center representations of normal patterns to constrain the model to target representative normal patterns for reconstruction, preventing dominance of powerful capacity and representation capability. At the anomaly criterion level, we derive anomaly confidence score based on cluster membership probability and combine it with reconstruction error, providing dual criteria for detection. Furthermore, the effectiveness of the cluster center representations and anomaly confidence score depends on the clustering performance. Accordingly, we extract neighborhood-centered representations for multi-view clustering to improve clustering performance. Extensive experiments on multiple real-world datasets from diverse application domains demonstrate the state-of-the-art performance of SCAN.

20.
arXiv (CS.CL) 2026-06-16

Can LLM Agents Infer World Models? Evidence from Agentic Automata Learning

We propose agentic automata learning to evaluate the extent to which tool-calling LLM agents can uncover hidden environments through interaction. In our setup, an agent should uncover a hidden deterministic finite automaton (DFA) by interacting with an oracle through (1) membership queries ("Does this string belong to the target language?") and (2) equivalence queries ("Is this the target DFA?"). This yields a scalable testbed with controlled task complexity, measurable interaction efficiency, and strong baselines (classic automata-learning algorithms). Evaluating state-of-the-art LLMs, we find that performance drops sharply as DFA size increases. Reasoning models are markedly stronger than non-reasoning models, yet trajectory analyses reveal recurring failures in query planning, evidence integration, and hypothesis construction. Overall, our results show that current LLM agents can sometimes perform non-trivial interactive discovery, but remain far less robust and efficient than classic algorithms for the task.

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

Encode Errors: Representational Retrieval of In-Context Demonstrations for Multilingual Grammatical Error Correction

Grammatical Error Correction (GEC) involves detecting and correcting the wrong usage of grammar. While large language models (LLMs) with in-context learning (ICL) capabilities have shown significant progress on various natural language processing (NLP) tasks, their few-shot performance on GEC remains suboptimal. This is mainly due to the challenge of retrieving suitable in-context demonstrations that capture error patterns instead of semantic similarity. In this paper, we demonstrate that LLMs can inherently capture information related to grammatical errors through their internal states. From these states, we extract the Grammatical Error Representation (GER), an informative and semantically neutral encoding of grammatical errors. Our novel GER-based retrieval method significantly boosts performance in ICL settings on multilingual GEC datasets, improving the precision of correction. For high-resource languages, our results on 8B-sized open-source models match those of closed-source models such as Deepseek2.5 and GPT-4o-mini. For low-resource languages, our $F_{0.5}$ scores surpass the baseline by up to a factor of 1.20. This method provides a more precise and resource-efficient solution for multilingual GEC, offering a promising direction for interpretable GEC research.

22.
arXiv (quant-ph) 2026-06-19

Attosecond Path Qubits in High-Harmonic Generation: Classical Dephasing and Trace-Out Decoherence

arXiv:2606.20372v1 Announce Type: cross Abstract: High-harmonic generation (HHG) is governed by interference between electron trajectories. We propose that the dominant short and long trajectories define an experimentally addressable two-level subsystem: an attosecond path qubit (APQ). We formulate a trajectory-resolved density matrix to identify two distinct coherence-loss mechanisms: classical dephasing from ensemble averaging and quantum decoherence arising from the trace-out of unobserved degrees of freedom. By investigating shot-to-shot fluctuations and unresolved transverse momentum, we demonstrate that while dephasing suppresses coherence through averaging, the ``trace-out'' channel produces mixed states even for fixed driving parameters. We explore how these mechanisms modify APQ purity and show that mode selection and conditioning provide operational routes to isolate them. These results establish a reduced-state framework for diagnosing coherence loss in HHG and for engineering trajectory-based quantum states in attosecond interferometry.

23.
medRxiv (Medicine) 2026-06-16

Upper airway disease in primary ciliary dyskinesia: Clinical management and factors influencing decision-making, a multicentre analysis

Background Upper airway disease is common in primary ciliary dyskinesia (PCD), but management evidence is limited. We aimed to describe management practices and identify factors influencing management decisions. Methods Using data from the Ear-Nose-Throat (ENT) Prospective International Cohort of patients with PCD (EPIC-PCD) and an ENT-specialist survey across participating centres, we described management practices recorded at routine follow-up. We assessed clinical factors associated with practices via mixed-effects logistic regression models. In a subgroup of patients, we assessed factors associated with initiation or discontinuation of practices. Results We included 579 patients: median age 15 years, 46% female. Nasal rinsing (54%) and nasal corticosteroids (22%) were most frequently prescribed. Among 466 patients with available data, 47 had grommets (10%) and 42 hearing aids (9%). Nasal corticosteroids and rinsing were more frequently prescribed in patients with polyps (odds ratio [OR] 3.74, 95% confidence interval [CI] 1.80-7.76; OR 3.39, 95% CI 1.37-8.37) or turbinate hypertrophy (OR 1.89, 95% CI 1.03-3.47; OR 2.89, 95% CI 1.55-5.38), and upper airway nebulisation in patients with frequent nasal symptoms (OR 2.86, 95% CI 1.11-7.39). Management practices differed between centres, as seen also by the specialists survey responses. In 177 patients with multiple visits, initiation of nasal rinsing was associated with frequent nasal symptoms (OR 3.18, 95% CI 1.24-8.18) and turbinate hypertrophy (OR 3.21, 95% CI 1.20-8.59). Conclusion Upper airway disease management in PCD varies and is partly guided by symptom burden and clinical findings. This variation across centres highlights the need for care standardisation and PCD-specific management guidelines.

24.
Nature (Science) 2026-06-10

A first-in-class pulsatile FXR agonist for bile-acid-related liver diseases

Authors:

Nuclear receptors are central regulators of metabolism1, yet therapeutic strategies that enforce continuous receptor activation frequently lead to reduced efficacy and unacceptable toxicity. Here we report a first-principles drug design strategy that aligns pharmacokinetics with physiological signalling cycles. We developed linafexor, a potent non-bile-acid agonist of the farnesoid X receptor (FXR)2; it is engineered for rapid systemic clearance, which enables pulsatile receptor activation that mirrors endogenous bile acid dynamics3–5. Linafexor has robust efficacy across multiple preclinical models of metabolic dysfunction-associated steatohepatitis6, liver fibrosis7, primary biliary cholangitis and primary sclerosing cholangitis8,9. Transcriptomic analyses reveal that, unlike long-acting FXR agonists10,11, linafexor preserves cyclic FXR signalling, avoids receptor downregulation and prevents broad transcriptional dysregulation. Direct manipulation of delivery patterns demonstrates that sustained FXR activation—independent of compound identity—induces severe toxicity, establishing activation duration as a determinant of therapeutic index. In phase 1 clinical studies (ClinicalTrials.gov; NCT05082779), linafexor administered once daily produces transient FXR pathway engagement, marked by (1) induction of FGF1912–14, a key endocrine mediator of bile acid feedback regulation; and (2) suppression of C415, an intermediate reflecting hepatic bile acid synthesis, with no treatment-related adverse events. Together, these findings identify pulsatile FXR activation as a mechanistically grounded and clinically translatable strategy, and establish linafexor as a first-in-class therapeutic for bile acid–related liver diseases. Linafexor is a rapidly cleared FXR agonist designed to mimic natural bile acid signalling, achieving transient receptor activation with strong efficacy and reduced toxicity in preclinical and early clinical studies.

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

How Should World Models Be Evaluated? A Decision-Making-Centric Position

arXiv:2606.15032v1 Announce Type: new Abstract: World models have rapidly become one of the central abstractions in modern AI. Yet the term now refers to several different objects: action-conditioned environment models, latent imagination models, future-video predictors, interactive neural simulators, latent predictive representations, and synthetic-data engines. Evaluation has broadened with the term. Recent papers measure video realism, perceptual similarity, instruction following, physical plausibility, policy ranking, executability, planning success, and downstream policy improvement. The result is not only metric diversity but also a recurring problem of claim/evidence mismatch: papers frequently make a stronger claim about what their model is useful for than their evaluation can actually establish. This paper surveys the recent literature and argues that the central question is use-dependent. When a model is presented as a world model for embodied decision-making, a more decisive issue is not whether it generates visually compelling videos, but whether it supports reliable counterfactual reasoning, policy evaluation, planning, and policy optimization under intervention, policy-induced distribution shift, and long-horizon rollout. We organize the literature using an L0–L7 ladder that ranges from visual plausibility to policy optimization utility. In our interpretation, L0–L3 are most naturally read as diagnostics of generated artifacts, L4 is often the first genuinely interventional test, and L5–L7 provide the most direct evidence of decision usefulness. Based on this diagnosis, we propose a decision-making-centric evaluation framework and a benchmark protocol that foreground counterfactual action fidelity, closed-loop rollout validity, reward/value prediction, policy-ranking agreement, optimization lift, model exploitability, and uncertainty calibration.