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01.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

03.
arXiv (CS.CL) 2026-06-12

ChiKhaPo: A Large-Scale Multilingual Benchmark for Evaluating Lexical Comprehension and Generation in Large Language Models

Existing benchmarks for large language models (LLMs) are largely restricted to high- or mid-resource languages, and often evaluate performance on higher-order tasks in reasoning and generation. However, plenty of evidence points to the fact that LLMs lack basic linguistic competence in the vast majority of the world's 3800+ written languages. We introduce ChiKhaPo, consisting of 8 subtasks of varying difficulty designed to evaluate the lexical comprehension and generation abilities of generative models. ChiKhaPo draws on existing lexicons, monolingual data, and bitext, and provides coverage for 2700+ languages for 2 subtasks, surpassing any existing benchmark in terms of language coverage. We further show that 6 SOTA models struggle on our benchmark, and discuss the factors contributing to performance scores, including language family, language resourcedness, task, and comprehension versus generation directions. With ChiKhaPo, we hope to enable and encourage the massively multilingual benchmarking of LLMs.

04.
arXiv (CS.AI) 2026-06-18

DeFAb: A Verifiable Benchmark for Defeasible Abduction in Foundation Models

arXiv:2606.18557v1 Announce Type: new Abstract: A rule-based logic solver resolves every instance in our benchmark in under 50 microseconds with 100% accuracy; the best frontier language model reaches 65% at best and drops to 23.5% under rendering-robust evaluation (worst case over four surface renderings). We introduce DeFAb (Defeasible Abduction Benchmark), a dataset and generation pipeline that converts four decades of publicly funded knowledge bases into formally grounded instances for defeasible abduction: constructing hypotheses that explain anomalies by overriding defaults while preserving unrelated expectations. Because every hypothesis must pass polynomial-time checks for valid derivation, conservativity, and minimality, DeFAb makes logical rigor the instrument for measuring creativity and theoretical reasoning, scoring the disciplined construction of theory revisions rather than fluent but theory-destroying prose. The pipeline pairs taxonomic hierarchies (OpenCyc, YAGO, Wikidata) with behavioral property graphs (ConceptNet, UMLS) to produce 372,648+ instances across 33.75M materialized rules from 18 sources, in three levels with polynomial-time verifiable gold standards. Four frontier models do not reliably internalize defeasible reasoning: rendering-robust Level 2 accuracy is 7.8-23.5%; chain-of-thought variance (~36 pp) exceeds any inter-model gap; and a matched contamination control isolates a +19.4 pp Level 3 gap. We further release DeFAb-Hard (a 235-instance Level 3 difficulty variant; best model 53.3% vs 100% symbolic) and CONJURE (a kernel-verified transformative-creativity variant of 560 Lean 4/Mathlib instances whose gold answers are definitions the proof kernel did not previously contain, judge-free verifier; a pilot finds zero novel concepts). The same verifier doubles as an exact reward for preference optimization (DPO, RLVR/GRPO). Released under MIT at https://huggingface.co/datasets/PatrickAllenCooper/DeFAb.

05.
arXiv (CS.AI) 2026-06-11

When Researchers Say Mental Model/Theory of Mind of AI, What Are They Really Talking About?

arXiv:2510.02660v2 Announce Type: replace-cross Abstract: When researchers claim AI systems possess ToM or mental models, they are fundamentally discussing behavioral predictions and bias corrections rather than genuine mental states. This position paper argues that the current discourse conflates sophisticated pattern matching with authentic cognition, missing a crucial distinction between simulation and experience. While recent studies show LLMs achieving human-level performance on ToM laboratory tasks, these results are based only on behavioral mimicry. More importantly, the entire testing paradigm may be flawed in applying individual human cognitive tests to AI systems, but assessing human cognition directly in the moment of human-AI interaction. I suggest shifting focus toward mutual ToM frameworks that acknowledge the simultaneous contributions of human cognition and AI algorithms, emphasizing the interaction dynamics, instead of testing AI in isolation.

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

From Awareness to Action: Understanding and Overcoming the Research-Practice Gap in Algorithmic Fairness for Public Health

arXiv:2606.11214v1 Announce Type: cross Abstract: Algorithmic fairness is essential for responsible ML-driven public health research, yet its practical implementation remains limited. To investigate this awareness-action gap, we conducted a sequential mixed-methods study comprising expert interviews, an online survey, and systematic mapping. The expert interviews informed the design of the survey, which in turn revealed fragmented definitions of fairness, limited training and guidance, reliance on external sources, and rare use of formal assessment, mitigation, or monitoring. These findings were subsequently mapped onto three established research-practice gap lenses: the Knowledge-Practice Gap, the Knowledge-to-Action Cycle, and the Knowing-Doing Gap, each offering complementary perspectives. Building on this synthesis, we introduce the Fairness-to-Action framework, which integrates methodological, organizational, and systemic dimensions to identify where translation of algorithmic fairness knowledge stalls. Our analysis shows that fairness remains weakly institutionalized, translation mechanisms are externally driven, and system-level priorities continue to emphasize accuracy over fairness. These insights suggest critical leverage points for advancing safe, fair, and ethical ML-driven public health research practice.

07.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

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

Learner-based Concept Drift Detection: Analysis and Evaluation

arXiv:2606.20216v1 Announce Type: cross Abstract: Machine learning algorithms deployed for evolving streaming environments must handle the non-stationary data distributions, commonly referred to as concept drift. The presence of concept drift poses a major challenge for many real-world applications because it can severely degrade their predictive performance, hindering their ability to support robust decision-making. Consequently, the timely and efficient detection of drift events is critical for sustaining high accuracy over time. This study examines theoretically the concept drift characteristics and numerous drift detection algorithms across several categories. Furthermore, we evaluate their performance on both synthetic and real-world datasets exhibiting diverse streaming scenarios and drift characteristics, such as abrupt and gradual changes. This study aims to enhance understanding of the complex notion of concept drift characteristics and behavior of drift detectors, along with their applicability to diverse contexts.

09.
medRxiv (Medicine) 2026-06-22

Characteristics and Outcomes of Gene-Elusive Dilated Cardiomyopathy

Background and Aims Genetic testing in dilated cardiomyopathy (DCM) guides risk stratification and family screening. Likely pathogenic or pathogenic (LP/P) variants are identified in approximately one-third of patients, leaving many without a genetic diagnosis. Cohort studies suggest that "gene-elusive" patients have a lower risk of adverse events. This study aims to better characterise this group and identify factors associated with adverse outcomes. Methods Consecutive and unrelated DCM patients undergoing genetic testing and returning no LP/P variants were retrospectively recruited and compared to two control cohorts of DCM patients carrying LP/P variants in LMNA and TTN for a primary composite endpoint of end-stage heart failure (ESHF) or malignant ventricular arrhythmia (MVA). Results Among patients without prior MVA, the composite endpoint occurred in 36/423 (8.5%) gene-elusive, 14/39 (35.9%) LMNA and 11/100 (11%) TTN cardiomyopathy patients (log-rank p

10.
arXiv (CS.CL) 2026-06-11

System Report for CCL25-Eval Task 5: New Dataset and LoRA-Fine-Tuned Qwen2.5

作者:

Recently, large language models (LLMs) have achieved promising progress in the fields of classical Chinese translation and the generation of classical poetry. However, domain-specific research on precise translation and affective-semantic understanding of classical poetry remains limited. The main challenge is that most studies treat the poetic appreciation task as a general-domain problem, neglecting the distinctive features of poetic appreciation, while high-quality and domain-specific datasets are extremely limited. To address this limitation, we decompose the task into three subtasks: term interpretation, semantic interpretation, and emotional inference. Based on multiple open-source datasets, we perform data cleansing and alignment to construct the Classical Chinese Poetry Instruction Pair Dataset (CCPoetry-49K), which comprises 49,404 high-quality instruction-response pairs explicitly optimized for this domain. We then propose a domain-specialized LLM, called PoetryQwen, by applying Low-Rank Adaptation (LoRA) to fine-tune the Qwen2.5-14B model. Experimental results on the CCL25-Eval Task 5 benchmark demonstrate that PoetryQwen achieves a score of 0.757, representing a 9.7% improvement over the Qwen2.5-14B-Instruct baseline (0.690). These findings clearly indicate that PoetryQwen significantly enhances performance in precise translation and emotional understanding of classical poetry. We present new dataset and methodological considerations intended to support the domain-specific optimization of LLMs.

11.
arXiv (CS.CL) 2026-06-15

Characterizing Cultural Localization in AI-Generated Stories

The global use of artificial intelligence has increased interest in assessing the ability to generate culturally localized content, including stories. Cultural localization in stories often occurs through either templated localization – the use of cultural markers (e.g., names, locations) in a generic narrative – or holistic localization – the variation of plots, values, and themes, in addition to cultural markers. We propose a method to measure the degree to which content was generated through templated localization. Specifically, we identify the lexical tokens that distinguish stories across nationalities and measure the similarity of the narratives that remain after removing them. In stories generated by five models on 125 topics for 193 nationalities, our method is able to detect that only a small subset (9-17%) of the vocabulary accounts for the variation across nationalities and that the narratives that remain after removing them contain repeated multi-word sequences, suggesting the presence of a shared culturally-agnostic narrative template. Finally, we characterize the cultural markers for their stereotypicality and offensiveness, finding that markers from 19 countries, mostly located in the Global South, are on average offensive.

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

Observation of Non-Gaussian Magnon Dynamics in a Two-Dimensional Long-Range XY Model

arXiv:2606.13499v1 Announce Type: new Abstract: Non-Gaussian evolution of high-order spin correlations characterizes important properties of quantum many-body systems. In practice, decoherence, statistical fluctuation and miscalibration of experimental parameters all hinder the witness of non-Gaussian dynamics. Here we demonstrate the crossover between Gaussian and non-Gaussian dynamics on a two-dimensional XY model with long-range and spatially structured interaction using a trapped ion quantum simulator. We prepare different initial densities of magnon excitations and verify the dynamics of single-spin observables for the engineered Hamiltonian. Then we compare the high-order spin correlations with the mean-field solution and the Holstein-Primakoff approximation, and demonstrate the non-Gaussian behavior in a way independent of the calibration errors. Our work provides a verifiable path from classically simulatable dynamics to regimes where quantum advantage may emerge.

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

VCG: A Multimodal Retrieval Framework for E-Commerce Video Feeds under Extreme Cold-Start Conditions

arXiv:2606.19627v1 Announce Type: cross Abstract: The digital commerce landscape is shifting from static, search-driven catalogs to dynamic, immersive video feeds. This transition introduces an ``extreme cold-start'' problem: unlike traditional items, new short-form videos lack the dense interaction history required for collaborative filtering. Furthermore, immersive feeds introduce strong position and duration biases that distort standard engagement signals. In this paper, we demonstrate the Video Candidate Generation (VCG) system, a scalable multimodal retrieval engine designed to solve these challenges in a large-scale e-commerce environment. By leveraging a domain-adapted vision-language model (based on CLIP), we map users and videos into a shared semantic space, enabling zero-shot retrieval based on visual content rather than behavioral history. We detail the system's architecture and present a rigorous evaluation comparing generative (LLM) vs. discriminative (CLIP) embeddings. Our results show that while generative models excel at attribute prediction, they suffer from embedding space collapse in retrieval tasks. Online A/B testing demonstrates that VCG effectively mitigates engagement biases, yielding a 50\% uplift in deep video completion. To showcase the system's capabilities, we present an interactive demonstration featuring three bi-directional retrieval scenarios: Product-to-Video, Video-to-Product, and Zero-Shot Semantic Search.

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

Risk-Aware LLM Agents for Geospatial Data Retrieval: Design and Preliminary Adversarial Evaluation

We present an LLM-driven framework for retrieving remote sensing data from cloud-based geospatial catalogues using natural language queries. The system converts user intent into structured API calls, enabling efficient access to satellite imagery and environmental datasets. The architecture integrates three agents: Guardrail for safety and policy enforcement, General-QA for intent interpretation, and Recommender-Analyst for schema-aware API call generation. This coordinated design ensures reliable, semantically aligned interaction with external data services. The modular framework is portable across platforms through API schema substitution and supports applications in environmental monitoring, disaster response, and climate analysis. It establishes a scalable interface between user intent and geospatial infrastructure, enabling streamlined and automated Earth observation workflows. Preliminary experiments under adversarial multi-turn settings show that prompt-level safety instructions improve robustness, although rare high-impact failures persist in API manipulation scenarios and highlight the need for adaptive, system-level defenses that balance safety, usability, and cost efficiency, which motivates the use of our intercept-level Guardrail agent.

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

A novel Framework for Open-Vocabulary Multi-Object Recognition using CLIP

To address the limitations of existing open-vocabulary object recognition methods, including high system complexity, substantial training costs, and limited generalization capability, this paper proposes a novel Open-Vocabulary Object Recognition (OVOR) framework based on a streamlined two-stage strategy: object segmentation followed by recognition. The proposed framework eliminates the need for complex retraining procedures and labor-intensive annotation. After extracting object regions, object-level image embeddings and category-level text embeddings are generated using CLIP, enabling recognition over arbitrary vocabularies. To reduce dependence on CLIP and enhance encoding flexibility, we further introduce a CNN/MLP-based approach that extracts convolutional neural network (CNN) feature maps and employs a multilayer perceptron (MLP) to align visual features with text embeddings. The resulting embeddings are then concatenated for cross-modal matching. Finally, object recognition is performed through similarity matching between image and text embeddings. Experiments on COCO, Pascal VOC, and ADE20K demonstrate that CLIP-based image encoding achieves the highest average AP, outperforming current state-of-the-art methods. Meanwhile, the results reveal the potential of CLIP-independent image encoding as a promising alternative for OVOR.

16.
arXiv (math.PR) 2026-06-18

Rigidity of infinite exchangeable sequences with Gaussian marginals

arXiv:2606.18654v1 Announce Type: new Abstract: We study infinite exchangeable sequences with Gaussian one-dimensional marginals. We formulate the conjecture that joint Gaussianity of a single pair of coordinates forces the entire sequence to be a Gaussian process. Although this conjecture remains open, we prove that joint Gaussianity of the first four coordinates is sufficient. We also establish the corresponding two-point criterion under the additional assumption that the directing measure is almost surely infinitely divisible.

17.
arXiv (quant-ph) 2026-06-19

Recursive perturbation approach to time-convolutionless master equations: Explicit construction of generalized Lindblad generators for arbitrary open systems

arXiv:2506.04095v2 Announce Type: replace Abstract: We develop a recursive perturbative expansion for the time-convolutionless (TCL) generator of an open quantum system in a generalized Lindblad form. This formulation provides a systematic approach to derive the generator at arbitrary order while preserving a Lindblad-like structure, without imposing assumptions on the system or environment beyond an initially uncorrelated state. The generator is written, at all orders, in a canonical form, which also corresponds to the minimal dissipation condition, which uniquely specifies the decomposition of the generator into Hamiltonian and dissipative contributions. To validate the method and show its effectiveness in addressing non-Markovian dynamics and strong-coupling effects, we compute the generator explicitly up to fourth order.

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

MMD-SLAM: Structure-Enhanced Multi-Meta Gaussian Distribution-Guided Visual SLAM

3D Gaussian Splatting (3DGS) has significantly boosted novel view synthesis and high-fidelity scene reconstruction, expanding the potential of 3DGS-based Visual Simultaneous Localization and Mapping (SLAM) methods. However, most existing systems fail to fully exploit the underlying structural information, which limits rendering quality and often leads to inconsistent maps. To address these limitations, we propose MMD-SLAM, a structure-enhanced Visual SLAM framework that leverages the Atlanta World (AW) assumption to guide a Multi-Meta Gaussian representation for photorealistic mapping. First, we introduce a point-line fusion strategy for pose optimization, where 3D line segments are incorporated to improve tracking robustness and provide additional constraints for mapping. Second, we design a Multi-Meta Gaussian representation with dominant directions, explicitly encoding structural priors from the AW hypothesis. Finally, we propose a Gaussian evolution strategy that adapts to scene geometry and incorporates structural cues into global optimization. Extensive experiments demonstrate that these innovations enable MMD-SLAM to achieve state-of-the-art performance in both tracking accuracy and mapping quality. e.g., our method achieves a 48.56% reduction in ATE RMSE on ScanNet and a 5.71% improvement in PSNR on Replica, compared with MonoGS.

19.
arXiv (math.PR) 2026-06-17

Convergence Analysis of the Random Bisection Method

arXiv:2603.20483v2 Announce Type: replace-cross Abstract: We propose a generalized version of the bisection method where the cutting point between the two subintervals is chosen at random following an arbitrary distribution. We compute expected convergence rates with respect to any arbitrary a priori distribution for the position of the root in the initial interval and proved that it depends only on the the expectation $\mathbb{E}[c(1-c)]$ of the cut $c$. We also provide a generalization of the method for $K$ random cuts and study its convergence properties. Most probabilistic derivations are kept fairly simple for the ease of understanding of a larger audience. Our theoretical results are then validated numerically using statistical simulation.

20.
arXiv (math.PR) 2026-06-16

Joint convergence in Wiener chaos via transport hierarchy and Malliavin covariances

arXiv:2606.14812v1 Announce Type: new Abstract: We study the joint convergence in distribution of a sequence $X_N = I_p(f_N)$ of multiple Wiener–Itô integrals of order $p\geq 2$ that converges to a Gaussian limit $Z\sim N(0,\sigma^2)$, together with another sequence $Y_N = I_q(g_N)$ converging in law. The central finding is that the joint convergence of $(X_N, Y_N)$ is completely governed by the asymptotic behavior of the iterated Malliavin covariances $Y_{r+1,N} = \langle DX_N, DY_{r,N}\rangle_H$, $r\geq 0$: joint convergence holds as soon as these covariances converge jointly with $Y_N$, and the structure of the limiting distribution is then explicitly determined by their limits. Moreover, the convergence of the Malliavin covariances is necessary for joint convergence, as shown by a counterexample. When $q

21.
arXiv (CS.CV) 2026-06-11

UI2Code^N: UI-to-Code Generation as Interactive Visual Optimization

UI-to-code aims to translate UI screenshots into executable front-end code. Despite progress with vision-language models (VLMs), most existing methods formulate UI-to-code as a single-pass generation, which mismatches real-world UI development that is inherently iterative and feedback-driven. We reformulate UI-to-code as an interactive visual optimization problem, where code generation is embedded in a closed-loop process of execution, visual inspection, and iterative refinement driven by rendered visual feedback. To address the non-differentiability of visual objectives and the noise of absolute visual evaluators, we propose Relative Visual Policy Optimization (RVPO), a preference-based reinforcement learning method that optimizes relative visual rankings among rendered candidates under execution feedback. We instantiate this paradigm in UI2Code^N, an open-source 9B model trained via continual pre-training, supervised fine-tuning, and reinforcement learning. Experiments demonstrate state-of-the-art performance on UI drafting, UI polishing, and UI editing benchmarks, even outperforming larger models, with performance consistently improving through iterative visual optimization. Our code and models are available at https://github.com/zai-org/UI2Code_N.

22.
arXiv (CS.LG) 2026-06-18

Anomaly Detection for Sparse and Irregular Multivariate Time Series with Latent SDEs

arXiv:2606.18898v1 Announce Type: new Abstract: Multivariate time series anomaly detection (MTSAD) is critical for a wide range of application areas, such as industrial monitoring, cybersecurity, or healthcare. Real-world data is often sparse, irregularly sampled or partially observed, yet existing methods assume uniformly sampled time series. We propose a generative approach based on Latent SDEs that projects the observed time series on a continuous-time stochastic dynamical system, directly being able to handle missing observations and irregular sampling, while also naturally capturing possible cyclic behavior that many real-world use cases inherently possess. Experiments on six anomaly benchmark datasets show that our proposed method ranks first among state-of-the-art baselines. We further demonstrate that our method remains robust under severe data sparsity, while performance significantly degrades for the tested baseline methods. These results highlight latent SDEs as a natural inductive bias for anomaly detection in multivariate time series, especially in presence of real-world irregularities.

23.
arXiv (quant-ph) 2026-06-11

Dynamically Optimal Unraveling Schemes for Simulating Lindblad Equations

arXiv:2509.19887v2 Announce Type: replace Abstract: Stochastic unraveling schemes are powerful computational tools for simulating Lindblad equations, offering significant reductions in memory requirements. However, this advantage is accompanied by increased stochastic uncertainty, and the question of optimal unraveling remains open. In this work, we investigate unraveling schemes driven by Brownian motion or Poisson processes and present a comprehensive parametric characterization of these approaches. For the case of a single Lindblad operator and one noise term, this parametric family provides a complete description for unraveling scheme with pathwise norm-preservation. We further analytically derive dynamically optimal quantum state diffusion (DO-QSD) and dynamically optimal quantum jump process (DO-QJP) that minimize the growth rate of the variance of an observable locally in time. Compared to jump process ansatz, DO-QSD offers two notable advantages: firstly, the variance for DO-QSD can be rigorously shown not to exceed that of any jump-process ansatz locally in time; secondly, it has very simple expressions. Numerical results demonstrate that the proposed DO-QSD scheme may achieve substantial reductions in the variance of observables and the resulting simulation error.

24.
arXiv (CS.LG) 2026-06-17

Reward hacking in physical reinforcement learning revealed by turbulent drag reduction

arXiv:2606.06227v2 Announce Type: replace-cross Abstract: A reinforcement-learning agent maximises its reward, which can diverge from the outcome its designer intended. In physical control the reward rarely closes that gap, and drag reduction in wall turbulence makes it concrete. A mass-conservation projection couples agents' outputs and erases the per-agent credit the policy gradient needs; a memoryless policy cannot resolve the slow near-wall cycle it acts on; and a pressure-gradient reward pays for nominal drag reduction by pumping power through the wall. Two degenerate controllers achieve large drag reductions while total dissipation rises, so the reported figure can mask a more wasteful flow. We trace each fault to its cause and fix it: a differentiable projection that restores credit, a recurrent policy with a widened sensing stencil, and a reward scored on the true wall power. The corrected controller acts on the flow within a closed energy budget, earning a conservative $17\%$ under honest accounting.

25.
PLOS Medicine 2026-05-21

Semaglutide-associated risk of nonarteritic anterior ischemic optic neuropathy in patients with type 2 diabetes: A systematic review and meta-analysis of observational studies

by Jędrzej Chrzanowski, Magdalena Walicka, Jacek Burzyński, Małgorzata Zaraś, Arkadiusz Michalak, Wojciech Fendler Background Semaglutide, a glucagon-like peptide-1 receptor agonist, is widely used for the management of type 2 diabetes (T2DM). Recent case reports have raised concerns about a potential association between semaglutide use and the development of nonarteritic anterior ischemic optic neuropathy (NAION), a rare but vision-threatening condition. We aimed to evaluate whether semaglutide use is associated with an increased risk of NAION in patients with T2DM. Methods and findings We conducted a systematic review and meta-analysis of observational studies comparing patients with T2DM aged ≥12 years treated with semaglutide to those receiving other glucose-lowering therapies. We searched PubMed, Scopus, and Web of Science databases from January 2023 to November 2025. Two reviewers independently extracted data on study design, population characteristics, and outcomes. Risk of bias was assessed using the Newcastle–Ottawa Scale, and ROBINS-I v.2. Certainty of the evidence was graded according to the GRADE framework. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using fixed-effects models; sensitivity analyses included crude and subgroup HRs, and overlapping study replacement. Leave-one-out analysis was conducted to assess small-study effects and publication bias. Results were contextualized within other meta-analyses, systematic reviews, consensus statements, and regulatory communications on the topic.Five eligible observational studies met the inclusion criteria, and 7 additional studies were included in the sensitivity analysis. Semaglutide use was associated with a significantly increased hazard of NAION compared with nonsemaglutide glucose-lowering regimens (HR 2.17, 95% CI [1.73, 2.74]; p