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01.
arXiv (CS.AI) 2026-06-12

Iterating Toward Better Search: A Two-Agent Simulation Framework for Evaluating Agentic Search Architectures in E-Commerce

arXiv:2606.12924v1 Announce Type: new Abstract: We present a modular two-agent simulation framework for evaluating conversational shopping assistant architectures. An independent buyer agent, configured with personas, missions, and patience levels, is paired with an interchangeable responder that integrates with a real e-commerce search API. Holding the buyer constant across experiments enables controlled comparison of responder designs on identical scenarios. Using 2011 conversations across 14 persona buckets, we establish four empirical findings. First, rolling-window memory outperforms intent-extraction memory on all quality metrics while being 35% faster per query. Second, illustrating rapid evidence-driven iteration, a systematic failure analysis of a responder version enables targeted fixes that reduce failure and near-failure rates by 62% across the full dataset. Third, swapping the responder LLM backbone from Gemini~2.5 to Llama~3.3~70B costs 0.16–0.45 points despite identical architecture. Finally, we document systematic philosophical disagreement between frontier LLM judges: Gemini rewards process correctness while Claude demands concrete outcomes, despite using the same evaluation prompt.

02.
arXiv (math.PR) 2026-06-16

Transposition Approach to Optimal Control of McKean-Vlasov SPDEs

arXiv:2603.06245v2 Announce Type: replace Abstract: In this paper, we investigate an optimal control problem for McKean-Vlasov stochastic partial differential equations, in which the coefficients depend on the law of the state process. For systems with nonconvex control sets, we establish a Pontryagin-type stochastic maximum principle that provides necessary optimality conditions for admissible controls. The analysis is based on the classical spike variation method together with the introduction of an adjoint backward stochastic partial differential equation involving Lions derivatives with respect to probability measures. Our results extend the stochastic maximum principle for McKean-Vlasov controlled stochastic differential equations to the infinite-dimensional SPDE setting.

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

Prior-guided Fusion of Multimodal Features for Change Detection from Optical-SAR Images

Multimodal change detection (MMCD) identifies changed areas in multimodal remote sensing data, demonstrating significant application value in land use monitoring and urban sustainable development. However, literature MMCD approaches exhibit limitations in both cross-modal interaction and exploiting modality-specific characteristics. This leads to insufficient modeling of fine-grained change information, thus hindering the precise detection of semantic changes. To address these problems, we propose STSF-Net, a framework designed for MMCD between optical and SAR images. STSF-Net jointly models modality-specific and spatio-temporal common features to enhance change representations. Specifically, modality-specific features are exploited to capture genuine semantic change signals, while spatio-temporal common features are embedded to suppress pseudo-changes caused by differences in imaging mechanisms. Furthermore, we introduce an optical and SAR feature fusion strategy that adaptively adjusts multimodal feature importance based on semantic priors obtained from visual foundation models. Finally, we introduce the novel Delta-SN6 dataset, the first openly-accessible multiclass MMCD benchmark consisting of very-high-resolution fully polarimetric SAR and optical images. Experimental results on Delta-SN6, BRIGHT, and Wuhan datasets demonstrate that our method outperforms the state-of-the-art by 3.21%, 0.87%, and 1.32% in mIoU, respectively.

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

Towards More General Control of Diffusion Models Using Jeffrey Guidance

A key strength of diffusion models lies in their flexibility, since their outputs can be controlled at sampling time through guidance. However, beyond simple cases such as conditional sampling, the target distribution is often left implicit, defined only through a sampling rule or a heuristic energy function. To address this, we propose Jeffrey guidance, a principled framework that extends diffusion-model control to applications beyond what standard guidance can express. It leverages Jeffrey's rule of conditioning to update marginal distributions towards a prescribed target, preserving the conditional structure and minimally perturbing the joint distribution. We first demonstrate Jeffrey guidance by targeting a prescribed embedding distribution. With Inception embeddings as the target, this leads to substantial reductions in FID on both CIFAR-10 and FFHQ. We further apply Jeffrey guidance to fairness on CelebA-HQ, updating an unconditional diffusion model to enforce independence between attributes.

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

Symmetry-Induced Relaxation Comb and Strong Quantum Mpemba Effect in Long-Range XXZ Spin Chains

arXiv:2605.20930v3 Announce Type: replace Abstract: Understanding how symmetry constrains dissipative relaxation in open quantum many-body systems remains a central challenge in nonequilibrium physics. Here we uncover a symmetry-filtered Liouvillian mechanism for fast relaxation in a long-range XXZ spin chain subject to dephasing noise. At the isotropic point, the Hamiltonian has global \(SU(2)\) symmetry, whereas the full Liouvillian retains only the \(U(1)\) symmetry associated with total magnetization. This interplay selects a family of spatially uniform \(U(1)\)-neutral eigenoperators with exact eigenvalues \(\lambda=-2q\). Highly symmetric initial states have spectral weight only on this family, so higher-order components decay rapidly and the \(\lambda=-2\) mode governs the long-time dynamics, producing universal \(D(t)\sim e^{-2t}\) relaxation independent of system size and interaction range. Breaking the Hamiltonian symmetry restores overlap with slow Liouvillian modes and strongly suppresses relaxation. This symmetry-filtered accessibility gives rise to a strong quantum Mpemba effect, where a state farther from the steady state relaxes faster than closer thermal states. Our results establish symmetry-filtered Liouvillian mode accessibility as a route to controlling nonequilibrium relaxation in open quantum systems.

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

The Critical Role of Model Selection in Causal Inference: A Comparative Analysis of Classification Models within the InferBERT Framework for Pharmacovigilance

Distinguishing causal adverse drug events (ADEs) from spurious correlations remains a central challenge in pharmacovigilance. The InferBERT framework integrates transformer models with Do-calculus, but its success hinges on the underlying classification model. This study evaluates the impact of model choice in InferBERT, assessing whether simpler models suffice, if domain-specific pre-training helps, whether scaling to LLMs improves causal detection, and the effect of post-hoc calibration. We performed a comparative study on two benchmarks: Analgesics-induced Acute Liver Failure (AILF) and Tramadol-related Mortalities (TRAM). Four models were evaluated-XGBoost (baseline), ALBERT (original InferBERT), BioBERT (biomedical transformer), and Med-LLaMA (medical LLM)-using 5-fold cross-validation repeated over 20 runs. We measured accuracy, Expected Calibration Error (ECE) pre- and post-isotonic regression, and Jaccard concordance of causal terms with PRR, ROR, and EBGM; significance was tested with paired t-tests. BioBERT achieved the highest accuracy on both datasets, while Med-LLaMA underperformed despite its size and parameter-efficient fine-tuning. Domain-specific pre-training was decisive. Calibration improved ECE but had mixed effects on accuracy and causal discovery. BioBERT's superiority also yielded the strongest concordance with traditional pharmacovigilance signals. These results show that domain-specific pre-training provides a clear advantage over simpler baselines and larger LLMs. Investing in manageable, domain-aware models is more effective for computational pharmacovigilance than simply scaling model size.

07.
arXiv (CS.AI) 2026-06-11

Mathematical perspective on genetic algorithms with optimization guided operators

arXiv:2606.12279v1 Announce Type: cross Abstract: Recent work in ML applies genetic algorithms at inference time to iteratively improve solutions to optimization problems. The basic mutation and recombination operators involved are qualitatively different from those studied classically. Mutations are no longer random; an ML algorithm mutates a solution with the goal of improving an objective. Similarly, recombination is not based on random collages of parent solutions. Instead, it is an ML optimization-based operator whose goal is to synthesize improved solutions from its inputs. Thus, these mutation and recombination operators are more likely to improve the objective, but their computational cost is much higher. We introduce a general model of genetic algorithms and formulating optimization in this model as a query-complexity problem, using the language of reinforcement learning. We then study specialized models. We show that some optimization problems require generation, mutation, and recombination to be solved. We then obtain qualitatively tight algorithms for a family of problems within this framework that captures the nontrivial role of diversity in the solution pool, a key feature of practical ML genetic algorithms.

08.
bioRxiv (Bioinfo) 2026-06-14

Somatic variant detection in normal tissues from single-cell sequencing data

A crucial advantage of single-cell sequencing (SCS) is its ability to identify somatic variants in individual cells, enabling phylogenetic analysis of cellular populations within bulk tissues. While identifying somatic variants in tumor tissues via SCS has become a common practice, doing so in normal tissues remains challenging due to the rarity of somatic variants in normal cells. To evaluate the feasibility of somatic variant calling from widely available single-nucleus RNA-seq (snRNA-seq) and single-nucleus ATAC-seq (snATAC-seq) data, we profiled a Cell-line mix of six HapMap samples prepared by the SMaHT consortium using 10x Genomics 5' snRNA-seq (12k cells with 36k mean reads per cell) and snATAC-seq (11k cells with 14k median high-quality fragments per cell) for variant calling. PacBio long-read whole genome sequencing (WGS) data (109x) generated from individual cell lines were used as ground truth. Two computational tools, Monopogen and SComatic, were used for somatic variant calling from the SCS data. Monopogen achieved single nucleotide variant (SNV) detection accuracies of 93.30% in the snRNA-seq and 99.64% in the snATAC-seq data, both of which outperformed SComatic (74.35% and 94.29%, respectively). Monopogen also consistently detected somatic SNVs at cellular fractions as low as 0.5% (2.54% in snRNA and 0.81% in snATAC) in individual samples. Notably, snATAC-seq exhibited higher genomic coverage breadth and larger number of variants detected than snRNA-seq. While the SCS data have lower overall genome coverage than that of the bulk WGS, the single-cell level variant resolution allows Monopogen to assign variants to their cells of origin with over 80% accuracy in both RNA and ATAC modalities, thereby facilitating studies of clonal evolution and cell-type-specific mutagenesis. Other benchmarking methods were also evaluated (DeepVariant, Cellsnp-lite and Mutect2) for comparison. In conclusion, our study demonstrated the feasibility of performing reliable single-cell somatic mutation calling in a cell-line mixture and discussed the strengths and limitations of current computational methods when applied to normal tissues.

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

A Minimal Model of Bounded Trade-Off Screening in Multi-Attribute Choice

arXiv:2606.13201v1 Announce Type: new Abstract: Human decision-making often involves choosing between multi-attribute alternatives, yet classical models assume fully compensatory utility aggregation despite evidence that people reject options with poor performance on critical attributes. We propose a bounded trade-off reasoning framework in which decisions are governed by a screening process that evaluates the balance between gains and losses across attributes. The model introduces a trade-off tolerance parameter that controls acceptable imbalance and can vary across contexts. Through simulation, we show that this mechanism produces preference patterns that differ from standard utility-based models and captures context-dependent variation in trade-off behavior. These results establish bounded trade-off screening as a plausible computational mechanism for multi-attribute choice and generate testable predictions for future behavioral studies.

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

A Formal Framework for Declarative Agentic AI in Business Process Analysis

arXiv:2606.15291v1 Announce Type: new Abstract: Agentic AI opens new opportunities for automating Business Process (BP), enabling autonomous decision-making and dynamic adaptation. However, realising this potential requires BP entities and their interactions to be defined with formal precision. This paper presents a formal framework for Agentic BP analysis through the AGO methodology. AGO captures the modelling perspective in terms of who is acting (Agents), why it is carried out (Goals), and what the relevant entities are (Objects). Grounded in set theory and mathematical logic, we formally define the AGO entity types and their interactions, organising all definitions into a BP Knowledge Base (BPKB). The resulting BPKB supports structured querying, incremental updates, and automatic generation of BP workflows, while ensuring soundness and completeness of the derived paths.

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

A Quantitative Analysis of Multimodal Biomarkers in Alzheimer's Disease

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

13.
arXiv (CS.CV) 2026-06-18

Forged Calamity: Benchmark for Cross-Domain Synthetic Disaster Detection in the Age of Diffusion

The rapid advancement of text-to-image diffusion models has enabled the creation of highly photorealistic synthetic images that closely resemble real photographs, making it increasingly difficult to distinguish authentic content from AI-generated fabrications. This poses challenges for cybersecurity, digital forensics, and disaster response, where fake imagery of floods, fires, or earthquakes can spread misinformation or disrupt emergency operations. To address this, we introduce Forged Calamity, a benchmark dataset for synthetic disaster detection containing 30,000 images, including 6,000 real and 24,000 synthetic samples generated by four diffusion models. Comprehensive experiments across fine-tuned and zero-shot settings reveal consistent weaknesses in current forensic approaches. Fine-tuned detectors perform well in-distribution but lose up to 50\% accuracy on unseen generators or disaster types, showing overfitting to model-specific artifacts. Zero-shot generalized detectors also struggle to maintain stable accuracy, with only limited resilience in a few representation-robust models. These findings highlight persistent generalization gaps and the urgent need for domain- and model-agnostic detection methods to ensure visual authenticity in the diffusion era.

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

Additivity and chain rules for quantum entropies via multi-index Schatten norms

arXiv:2502.01611v3 Announce Type: replace Abstract: The primary entropic measures for quantum states are additive under the tensor product. In the analysis of quantum information processing tasks, the minimum entropy of a set of states, e.g., the minimum output entropy of a channel, often plays a crucial role. A fundamental question in quantum information and cryptography is whether the minimum output entropy remains additive under the tensor product of channels. Here, we establish a general additivity statement for the optimized sandwiched Rényi entropy of quantum channels. For that, we generalize the results of [Devetak, Junge, King, Ruskai, CMP 2006] to multi-index Schatten norms. As an application, we strengthen the additivity statement of [Van Himbeeck and Brown, 2025] thus allowing the analysis of time-adaptive quantum cryptographic protocols. In addition, we establish chain rules for Rényi conditional entropies that are similar to the ones used for the generalized entropy accumulation theorem of [Metger, Fawzi, Sutter, Renner, CMP 2024].

15.
arXiv (CS.AI) 2026-06-19

ROSE: Benchmarking the Perception-to-Action Gap in Multimodal Models

arXiv:2606.19965v1 Announce Type: cross Abstract: Multimodal large language models (MLLMs) are increasingly expected to act on visual information, yet the same scene may require different actions under different task contexts. How reliably can a model turn the same visual evidence into the action required by the current context? To answer this question, we introduce \textsc{ROSE} (Reference-conditioned Oddity and Symbolic Execution), a controlled benchmark that holds the visual scene fixed while varying region constraints and required symbolic outputs. Through coupled counting and coordinate-action tasks, \textsc{ROSE} tests whether models can infer an implicit majority reference and act on the resulting fine-grained visual evidence under changing contexts. Across nine recent MLLMs, performance drops by as much as 44.5 percentage points from counting-oriented tasks to region-conditioned action, despite 98.8\% human performance. The gap persists on paired scenes and regions for which the same model returns the correct count, while global-click and matched local controls show that coordinate grounding explains only part of the loss, revealing a distinct, model-dependent bottleneck in turning shared visual evidence into context-specific actions.

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

Adiabatic preparation of a fractional quantum Hall fluid by coherently pumping atoms from a Bose-Einstein condensate

arXiv:2606.15951v1 Announce Type: cross Abstract: We propose a protocol to adiabatically prepare a many-particle fractional quantum Hall fluid of bosonic ultracold atoms exploiting a time-dependent coherent coupling of a strongly interacting atomic state with a large dilute Bose-Einstein condensate. Starting from an empty cloud, atoms with well-defined angular momentum are coherently pumped into the fluid by Raman beams with a Laguerre-Gauss profile. Compared to number-conserving schemes which rely on finite-size-induced topological gaps, we identify an adiabatic path in the Fock space which avoids crossing topological phase transitions and thus maintains a sizable adiabatic gap open at all times. The efficiency of our preparation protocol is numerically assessed for typical experimental parameters up to particle numbers that largely exceed the experimental state-of-the-art. The crucial advantage of including an anharmonic confinement is finally highlighted.

17.
arXiv (CS.AI) 2026-06-15

DIFF-ERO: A Conformance-Aware Loss for Deep Learning in Process Mining

arXiv:2606.14283v1 Announce Type: cross Abstract: Deep learning has driven many recent advances in process analytics, especially for predictive and prescriptive monitoring. However, standard objectives such as cross-entropy optimize local next-step likelihoods and only implicitly capture control-flow structure. As a result, models can achieve high token-level accuracy while permitting imprecise global behaviour. We introduce DIFF-ERO, a conformance-aware loss function for deep learning models on process data. DIFF-ERO is a differentiable formulation of entropy-based stochastic conformance that incorporates control-flow information during training. Our approach constructs batch-level stochastic transition matrices with soft edge memberships, allowing structural precision and recall signals to directly inform backpropagation. The loss is model-agnostic and can be applied whenever the final representation parametrizes stochastic transitions. We instantiate DIFF-ERO in transformer encoder-decoder pipelines for next-activity prediction and use it jointly with cross-entropy to analyse its theoretical components with respect to convergence. Across benchmarks comparing other loss functions and targets, DIFF-ERO shows improved predictive performance where structure matters most while maintaining parity elsewhere. At the same time, the learned stochastic automaton converges towards the structural ground truth, indicating that the network internalizes process model structure.

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

LLM-as-Judge in Education: A Curriculum-Grounded Marking Pipeline

arXiv:2606.17507v1 Announce Type: new Abstract: Generative AI and large language models (LLMs) are increasingly applied to question generation and automated assessment. However, deploying LLMs in preparation for high-stakes exams requires more than prompt engineering; it demands software pipelines that systematically ground model outputs in authorised curriculum artefacts and marking guidelines issued by education authorities. This paper presents a curriculum-grounded, configurable LLM-as-Judge pipeline for question-level marking, co-developed with an industrial partner, to support exam preparation for university admission. The pipeline identifies the relevant topics, subtopics, and cognitive demand of a question, and assembles verifiable and authorised context to support LLM judgement. Curriculum intent is operationalised through concrete syllabus artefacts, including prescribed verbs and outcomes, performance band descriptors, glossary definitions, and marking-guideline principles. A staged LLM workflow is employed to first generate question-specific rubrics, capturing structured expectations of performance, and then derive and evaluate marking criteria used to allocate marks to student responses. This design improves consistency, transparency, and alignment with official marking practices. Preliminary evaluation shows that the proposed LLM-as-Judge pipeline delivers marking outcomes comparable to human tutors, while yielding justifications that are more traceable to authorised curriculum artefacts and marking standards. The pipeline has also been integrated into an online study platform, where early deployment data provide initial insights into operational usage and manual overrides.

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

Sensory Restoration via Brain-Computer Interfaces: A Unified 2 x 2 Framework and Convergence Roadmap

arXiv:2606.15091v1 Announce Type: cross Abstract: Millions of individuals worldwide suffer from sensory and communication deficits caused by neurodegenerative diseases, stroke, or trauma. Brain-computer interfaces (BCIs) offer a promising avenue for sensory and motor restoration. However, the scientific literature remains highly fragmented between invasive neuroprosthetics and non-invasive electrophysiological decoders, with a lack of consistent terminology and comparison metrics. This chapter proposes a unified 2 x 2 framework categorizing BCIs along two axes: degree of invasiveness (invasive vs. non-invasive) and signal direction (afferent sensory-IN vs. efferent sensory-OUT). We define and distinguish the paradigms of restoration, substitution, and augmentation. Furthermore, we outline a structural roadmap for the convergence of these modalities over near-, medium-, and long-term horizons, focusing on physical limits and the integrative role of machine learning foundation models.

20.
arXiv (math.PR) 2026-06-11

The Statistical Compass

arXiv:2606.11282v1 Announce Type: cross Abstract: This monograph develops probability and stochastic-process ideas as a translation language for statistics: from designed observations and data objects to targets, stability statements, inference, and use. The chapters move from motivating examples and randomization through probability measures, kernels, likelihoods, data objects, weak convergence, empirical fields, functional data, M- and Z-estimation, testing, local approximations, event-time processes, and prediction. Historical and biomedical examples are used to keep abstract objects tied to records, mechanisms, and decisions. The aim is to give readers a common grammar for classical probability, modern data structures, and statistical practice.

21.
arXiv (CS.AI) 2026-06-18

Improving Human-Robot Teamwork in Urban Search and Rescue Through Episodic Memory of Prior Collaboration

arXiv:2606.18836v1 Announce Type: cross Abstract: Effective human-robot teamwork requires robots to adapt to partners, situations, and task dynamics from the start of an interaction. In the MATRX Urban Search and Rescue (USAR) environment, people can externalize collaboration patterns (CPs) they discover during teamwork through a chat and reflection interface. We study whether a robot can use such prior team experience to become a better teammate in future interactions. To this end, we represent historical CPs as knowledge-graph episodic memories and use graph representation learning with a node-classification objective to identify a representative and effective memory for reuse. We then initialize the robot with this memory before a new collaboration episode begins. Across 20 participants and 160 round-level observations, initializing the robot with a single automatically selected prior CP increases rescue success from 25.7% to 41.3% and reduces average task time by 283 seconds. The strongest gains appear at the beginning of interaction, suggesting that reusable episodic memory can help robots enter collaboration with more effective task knowledge and support smoother early teamwork.

22.
arXiv (math.PR) 2026-06-11

Percolation phase transition on planar spin systems

arXiv:2105.13314v2 Announce Type: replace Abstract: In this article we study the continuity and sharpness of the phase transition for percolation models defined on top of planar spin systems. The two examples that we treat in detail concern the Glauber dynamics for the Ising model and a Dynamic Bootstrap process. For both of these models we prove that their phase transition is continuous and sharp, providing also quantitative estimates on the two point connectivity. The techniques that we develop in this work can be applied to a variety of different percolation models based on spin-flip dynamics. We also discuss some of the problems that can be tackled in a similar fashion.

23.
arXiv (CS.AI) 2026-06-18

Scaling Learning-based AEB with Massive Unlabeled Data

arXiv:2606.18864v1 Announce Type: cross Abstract: This paper studies how to scale learning-based automatic emergency braking (AEB) with massive unlabeled fleet data under production constraints. Our approach is based on meta-feedback semi-supervised learning (MF-SSL), where a teacher generates pseudo labels for unlabeled driving data and is updated using a small labeled anchor set as safety-critical feedback. In production, anchor ambiguity and labeled-unlabeled mismatch can amplify systematic pseudo-label errors, leading to spurious triggers. We propose a stabilized MF-SSL framework with (i) Noise-Aware Decoupling, which removes ambiguity-prone anchors from the teacher's supervised update path, and (ii) kinematics-gated pseudo-labeling with a teacher conflict penalty to suppress mismatch-induced risk hallucinations on unlabeled data while maintaining broad coverage. Extensive experiments show consistent gains as unlabeled data scale from 1M to 1B windows, improving safety while keeping comfort stable. The 1B-trained student model is deployed to hundreds of thousands of vehicles and validated over \$10^9$ km of driving, achieving a positive-to-false activation ratio exceeding 100:1 and a 35% improvement in accident-free driving mileage over a production rule-only baseline.

24.
medRxiv (Medicine) 2026-06-18

Plasma proteomics reveals clinical and mechanistic heterogeneity among individuals who develop coronary artery disease

BACKGROUND: Individuals who develop coronary artery disease (CAD) are clinically and mechanistically heterogeneous, and understanding this variation is crucial for precise risk stratification and tailored interventions. However, the molecular mechanisms that connect these two kinds of heterogeneity remain unclear, limiting progress toward biologically grounded risk stratification and targeted interventions. Here, we investigated the heterogeneity of individuals who develop CAD by leveraging plasma proteomic signatures, placed individuals along continuous metabolic gradients and revealed the molecular programs underlying these patterns, thereby linking mechanistic variation to clinical heterogeneity. METHODS AND RESULTS: From 42,803 UK Biobank participants, including 3,713 individuals who developed CAD within 10 years (incident CAD), we first identified a 320-protein panel from 2,923 baseline proteins that improved prediction of incident CAD beyond clinical risk scores. Using reverse graph embedding, we reduced the proteomic data to two dimensions and mapped each incident case onto the resulting two-dimensional latent proteomic space. These proteomic dimensions show significant associations with cardiometabolic and kidney-related clinical markers. The patterns were replicated in the EPIC-Norfolk study. Phenome-wide Cox regression analyses further linked these proteomic dimensions to 10-year incidence rates for various diseases, including type 2 diabetes, obesity, and chronic kidney disease (CKD). Furthermore, adding the proteomic dimensions to clinical variable-based Cox regression model improved prediction of 10-year incidence of CKD and other diseases, demonstrating the value of proteomic dimensions beyond conventional clinical risk factors. Moreover, individuals with prevalent CAD (diagnosed before proteomic sampling) exhibited high, metabolically adverse dimension values, indicating that these axes capture cumulative metabolic burden. Pathway enrichment analyses implicated altered extracellular matrix organization and immune programs among the proteins contributing to the proteomic dimensions. CONCLUSIONS: Our findings demonstrate that plasma proteomic signatures can dissect the heterogeneity of individuals who develop CAD in continuous phenotypic gradients, improve prediction of CAD and comorbidities, and map underlying biological mechanisms.

25.
medRxiv (Medicine) 2026-06-15

Filum Terminale Diameter on Routine Pediatric MRI: A Large-Cohort Clinical Reference in 3,406 Children and the Age-Dependent Meaning of the 2-mm Thickened-Filum Threshold

Background. A filum diameter >2 mm is the conventional MRI threshold for a thickened filum, but it derives from small, mostly adult series showing no age dependence; whether one cutoff suits all of childhood is untested. Objective. To build an age-specific filum-diameter reference on routine pediatric MRI and test, adjusting for image resolution, whether the 2-mm threshold is age-stationary. Materials and methods. In this retrospective study an nnU-Net tracer measured the maximal filum diameter on consecutive lumbosacral MRI; versus manual tracing it showed negligible bias but moderate single-measure agreement. After excluding report-confirmed fatty filum, lipoma, or tethered cord, the proportion >2 mm was analysed within one acquisition protocol and by logistic regression adjusting for voxel size and slice thickness. Results. Of 7,245 examinations, 3,869 (53%) were traceable; untraced ones were younger (median 0.75 vs 2.0 years). The presumed-normal cohort had median diameter 1.48 mm. At matched resolution, 2 mm marked the 94th percentile in infants (5.6% exceeded it) but the 83rd by 3-6 years (17.4%); the age effect persisted after adjusting for voxel size and slice thickness (3-6 years vs infants, adjusted OR 4.7; P < .001). Conclusion. Filum diameter clusters near 1.5 mm, and the fixed 2-mm cutoff flags ~5% of infants but ~17% of preschoolers. Caliber should be judged against an age-specific clinical reference, not one fixed cutoff; a thick filum is not itself a diagnosis of tethered cord.