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01.
arXiv (math.PR) 2026-06-16

Layerwise Terminal Discrepancy in Chen's Reverse-Heat Coupling on the Boolean Cube

arXiv:2606.04573v2 Announce Type: replace-cross Abstract: Recently, Chen [Chen2026] proved that Talagrand's Boolean convolution conjecture holds up to the dimension-free factor \((\log\log\eta)^{3/2}\), namely for every fixed \(\tau>0\), \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{(\log\log\eta)^{3/2}}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \] We revisit the terminal testing-discrepancy step in Chen's perturbed reverse-heat coupling. Chen estimates this discrepancy globally in terms of the remaining gap to the terminal level. We keep the same coupling and the same reverse-heat formulations, but localize the terminal discrepancy on each remaining-gap layer before summing the layers. This changes the fixed-time anti-concentration cost from order \((\log L)^{3/2}/\sqrt L\) to order \((\log L)/\sqrt L\), where \(L=\log\eta\). Consequently, we obtain a \((\log\log\eta)^{1/2}\) improvement as \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{\log\log\eta}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \]

02.
arXiv (CS.CL) 2026-06-16

Metacognitive Myopia in Large Language Models

Large Language Models (LLMs) exhibit potentially harmful biases that reinforce culturally embedded stereotypes, influence moral judgments, or amplify positive evaluations of majority groups. We propose metacognitive myopia as a cognitive-ecological framework accounting for a conglomerate of established and emerging LLM biases. Our theoretical framework posits that biased samples in the information environment cause five symptoms of metacognitive myopia in LLMs: integration of invalid embeddings, susceptibility to redundant information, neglect of base rates in conditional computation, decision rules based on frequency, and inappropriate higher-order statistical inference for nested data structures. Moreover, it posits that the two main components of metacognition, monitoring and control, could account for these five symptoms. Accordingly, we further outline how monitoring and control could be approximated technically, for instance, through hidden parallel reasoning histories that allow interactive LLMs to evaluate risks of myopic inference before generating overt responses. Our theoretical framework provides a novel perspective on flawed human-machine interactions and agentic AI and raises significant ethical concerns regarding the implementation of LLMs in organizational structures and high-stakes decisions.

03.
arXiv (quant-ph) 2026-06-11

Entanglement preservation and Clauser-Horne nonlocality in electromagnetically induced transparency quantum memories

arXiv:2507.15453v4 Announce Type: replace Abstract: Entanglement preservation in noisy quantum memories represents a central challenge in quantum information science. While experiments have shown that electromagnetically induced transparency (EIT) memories can store entangled photons, a quantitative theoretical analysis of whether nonlocal quantum correlations can survive storage loss induced by ground-state decoherence remains limited. Here we combine the dark-state polariton formalism with a reduced density-operator treatment to derive an EIT-specific effective pure-loss description for the retrieved photonic state in the ground-state-decoherence-limited regime. The analysis reveals that decoherence transforms an initially pure Bell state into a mixed state with a vacuum component and predicts a protocol-dependent storage-efficiency benchmark of 89.7% for violating the chosen unconditional Clauser-Horne (CH) inequality. Above this benchmark, the retrieved photonic state violates the CH inequality without post-selection, whereas below it, this unconditional CH violation is no longer obtained. This framework provides a quantitative theoretical description of entanglement retention, retrieved photonic density operators, and protocol-dependent Bell-test benchmarks in EIT quantum memories.

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

Image Quality Assessment of Identity Cards Using Measures from Open Face Image Quality

This paper addresses the challenge of assessing image quality in ID cards in remote verification systems by applying capture-related quality measures from the Open Face Image Quality (OFIQ) standard to ID card images. Our preprocessing pipeline includes corner detection, perspective normalization, and comprehensive foreground masking to ensure accurate and unbiased quality measure computation. We evaluate the effectiveness of these measures by analyzing their correlation with the performance of three presentation attack detection (PAD) algorithms across four diverse ID card datasets, where two datasets contain bona fide, i.e. pristine, images and two contain printed mock ID cards. Our results suggest that quality assessment based on some OFIQ measures can significantly improve PAD performance.

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

Distilling Drifting Transformers with Representation Autoencoders

arXiv:2606.15553v1 Announce Type: cross Abstract: Representation Autoencoders (RAEs) have improved diffusion and flow models by semantically richer latent space owing to the strongly label-wise clustered DINO features in the pretrained encoders. Yet in the distillation stage, the severe anisotropy and large curvatures caused by the rich semantic representations would hinder the convergence and performance, making the trajectory-based distillation unstable. In this work, we argue that the RAE latent space is compatible with distillation via the newly proposed Drifting Models. We first quantitatively study the curvatures and isotropy statistics across different autoencoders, and theoretically reveal that Drifting Model itself is highly likely to fail on extremely scattered spaces like reconstruction-based VAEs. These motivate us to apply the drifting paradigm directly to representation autoencoders. Our proposed method, Drift-RAE, distills pretrained flow models in RAE latent spaces using Drifting, together with insightful modifications that improve training stability by thereotically aligning drifting fields with other frameworks. Regarding the experimental evidences, we achieve 1.77 FID on ImageNet 256 dataset using only 10k distillation steps, surpassing state-of-the-art RAE distillation methods and appearing comparative with the original Drifting Model without requiring an auxiliary MAE feature extractor. The code will be made publicly available.

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

Space Is Intelligence: Neural Semigroup Superposition for Riemannian Metric Generation

Authors:

arXiv:2606.18828v1 Announce Type: cross Abstract: Traditional approaches place intelligence in the agent, whether as a learned policy or a search procedure. We instead place intelligence in the space itself: a scene induces a Riemannian metric on the configuration manifold, and action reduces to following the geodesics of that metric rather than invoking a separate planner or collision checker. A single Encoder-Router network realizes this idea through three complementary parameter groups – frame parameters that orient the generators, modulation parameters that govern their spatial propagation, and basic coefficients that determine their strength. These groups combine through a shared semigroup-superposition mechanism to produce a single Riemannian metric field, yielding a compact architecture whose geometry scales naturally with scene complexity. Trained on a single two-obstacle scene, the model demonstrates robust zero-shot generalization across unseen obstacle configurations, with orders-of-magnitude separation between collision-free and obstacle-penetrating path costs.

09.
arXiv (CS.CL) 2026-06-17

PseudoBench: Measuring How Agentic Auto-Research Fuels Pseudoscience

As Large Language Model based agents enter autonomous scientific research, their ability to resist pseudoscience becomes increasingly important. Otherwise, such systems may rapidly generate plausible yet misleading studies that contaminate academic literature and erode trust in science. We present PseudoBench, an adversarial benchmark for evaluating whether agentic auto-research systems can identify and resist pseudoscientific narratives. PseudoBench contains 200 curated pseudoscientific claim-evidence pairs across five domains and evaluates agents through an end-to-end research pipeline from experiments to writing. Testing seven state-of-the-art agents, we find that current systems readily produce persuasive reports that align with pseudoscientific premises with near-zero refusal rates and the highest resistance of only 27.4%. Stronger agents risk packaging pseudoscience in more sophisticated scientific language, increasing its apparent credibility. These findings reveal an alarming capacity to fuel pseudoscience, calling for scientific alignment before widespread deployment.

10.
arXiv (quant-ph) 2026-06-17

Einstein-Podolsky-Rosen correlations between mechanical oscillators revealed through SU(1,1) interferometry

arXiv:2606.18202v1 Announce Type: new Abstract: Quantum correlations are essential for achieving quantum advantage in computing, communication and sensing. Moreover, their observation challenges and constrains our fundamental understanding of nature. Mechanical oscillators in the quantum regime provide an appealing platform for preparing and investigating quantum correlations at macroscopic scales. Despite substantial progress, however, continuous-variable quantum correlations stronger than entanglement have not yet been observed in this macroscopic regime. Here, we report the experimental observation of continuous-variable Einstein-Podolsky-Rosen correlations between two spatially-separated mechanical oscillators with an effective mass of $\sim 16 \,\mu g$ each. This is achieved by coupling them to a superconducting qubit which allows for engineering a two-mode squeezing interaction when parametrically driven. Crucially, we show that this interaction can be used to witness quantum correlations through the realization of a mechanical SU(1,1) interferometer. Our results expand the toolbox of operations in circuit quantum acoustodynamics and demonstrate that quantum correlations stronger than entanglement can also be observed in macroscopic systems, thereby shedding light on the boundary between quantum and classical regimes.

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

Bounded Context Management for Tabular Foundation Models on Stream Learning

arXiv:2606.18677v1 Announce Type: cross Abstract: Tabular stream learning requires predictions on sequentially arriving examples under distribution shift. While standard methods adapt by updating model states, tabular foundation models (TFMs) make predictions conditioned on a labeled context in an in-context manner, making them a natural alternative for stream learning. This shifts the challenge from how to update the model to how to manage the context. We propose a future information view that yields three practical requirements for context management: preserve recent examples, retain uncertain examples, and remove redundant examples. We instantiate these requirements as CURE (Context management via Uncertainty-aware admission and Redundancy aware Eviction), a context-managing policy with entropy-gated admission and redundancy-aware eviction. Across seven streams, CURE shows up to 27.0% relative improvement over classical stream learners, remains robust across multiple TFM backbones, and ranks first among other policy variants. Code and datasets are available at https://github.com/morcellinus/CURE-ICML-FMSD.

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

Asynchronous Decentralized Federated Learning over Lossy Wireless Links via Reception- and Age-Aware Aggregation

arXiv:2606.10774v2 Announce Type: replace Abstract: Decentralized Federated Learning(DFL) enables collaborative model training across wireless edge nodes, including IoT deployments, autonomous vehicles, UAV swarms, and satellite constellations. Operating over lossy wireless links under constraints, these systems cannot rely on retransmissions, so model parameters must be accepted as partial chunks, leading to two key failure modes, which are selection bias, where poor-quality links are systematically under-represented in gossip aggregation, and update staleness, where asynchronous nodes contribute outdated models. We prove that classical gossip aggregation introduces irreducible selection bias proportional to the link-loss rate. We propose DFL-AA (Decentralized Federated Learning with Adaptive AoI-weighted Aggregation), which corrects selection bias using Inverse Probability Weighting (IPW) with online channel estimation and mitigates staleness via Age-of-Information (AoI) decay without requiring a global clock. We prove that DFL-AA removes link-quality distortion in expectation and consistently outperforms state-of-the-art baselines across varying loss rates and heterogeneous channel conditions on fixed directed topologies.

13.
arXiv (quant-ph) 2026-06-12

Quantum Stochastic Inflation

arXiv:2606.12636v1 Announce Type: cross Abstract: We formulate stochastic inflation in an open quantum system framework. The field coarse-grained in a patch of fixed physical size, and the total momentum of that patch, form a canonical pair and act on a one-mode Fock space which we identify as the "bulk". At each time step, new comoving modes join the coarse-grained patch and the bulk has to be redefined. This redefinition produces an entangled mode that is traced over, yielding a non-unitary evolution equation for the bulk's density matrix. For a free test field in de Sitter, one obtains GKLS dynamics, generated by an effective Hamiltonian and a single non-Hermitian Lindblad operator, hence diffusion and Hubble friction originate from the same quantum channel. The Wigner-Weyl transform of the GKLS equation leads to a Fokker-Planck equation for the Wigner function, which matches the one that applies to the classical phase-space distribution of stochastic inflation. We also provide several schemes under which one can unravel the GKLS dynamics into stochastic Schrodinger equations when continuous measurements of the decoupled mode are performed, making contact with Langevin formulations of stochastic inflation. In the light-field regime, an additional overdamped reduction can be performed by integrating out the momentum variable in the Wigner distribution, leading to Starobinsky's slow-roll Fokker-Planck equation. In that regime, the purity of the patch is strongly suppressed. In contrast, for heavy fields, field diffusion is suppressed and the coarse-grained patch remains close to a pure underdamped oscillator, which prevents a classical stochastic treatment.

14.
arXiv (CS.CV) 2026-06-12

Language-Guided Abstraction for Visual Reasoning

The Abstraction and Reasoning Corpus (ARC) is viewed as a critical avenue to Artificial General Intelligence (AGI), as it enables models to learn abstract transformation rules from few-shot examples and then generalize to new tasks. However, prevalent ARC methodology is either pure language or vision-only (i.e., VARC). The former depends heavily on LLMs, consuming billions of parameters. The latter often struggles to capture high-level semantics, leading to overfitting on pixel-level patterns. To bridge this gap, we propose L-VARC, a novel framework that enhances visual reasoning via a language-guided Learning Using Privileged Information (LUPI) branch. Specifically, we design a Semantic Compression Module by feeding a unified, task-agnostic prompt into DeepSeek-V3. In this way, the raw LARC (a crowd-sourced language description dataset) can be substantially refined and structured, fitting with the context length constraint of standard text encoders (e.g., CLIP). Moreover, we design a Cross-Attention Projector to align visual features with semantic embeddings, aiming to guide the training of the ARC model. Notably, the LUPI branch is taken in the training process and will be discarded during inference, thereby yielding a lightweight model with a mere 18 million parameters. Extensive experiments demonstrate that our L-VARC effectively leverages linguistic priors to boost visual reasoning and outperforms state-of-the-art. Ablation studies further confirm the contribution of the two new designs towards the L-VARC framework. The code is available at https://github.com/GZHU-DVL/L-VARC.

15.
arXiv (math.PR) 2026-06-16

Cluster sizes in subcritical soft Boolean models

arXiv:2404.13730v2 Announce Type: replace Abstract: We consider the soft Boolean model, a model that interpolates between the Boolean model and long-range percolation, where vertices are given via a stationary Poisson point process. Each vertex carries an independent Pareto-distributed radius and each pair of vertices is assigned another independent Pareto weight with a potentially different tail exponent. Two vertices are now connected if they are within distance of the larger radius multiplied by the edge weight. We determine the tail behaviour of the Euclidean diameter and the number of points of a typical maximally connected component in a subcritical percolation phase. For this, we present a sharp criterion in terms of the tail exponents of the edge-weight and radius distributions that distinguish a regime where the tail behaviour is controlled only by the edge exponent from a regime in which both exponents are relevant. Our proofs rely on fine path-counting arguments identifying the precise order of decay of the probability that far-away vertices are connected.

16.
medRxiv (Medicine) 2026-06-15

Routine use of oral iron for people with heart failure and iron deficiency in primary care; retrospective cohort study

Aims: Iron deficiency is common among people with heart failure and associated with morbidity and mortality. While intravenous iron improves clinical outcomes, oral iron continues to be prescribed in routine practice despite limited evidence of benefit. Methods: We completed a retrospective primary care cohort study (2016 to 2021) to investigate the proportion of people with an incident diagnosis of heart failure who had iron deficiency identified (defined as ferritin

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

Personal Care Utility: Health as Everyday Infrastructure

Healthcare is essential, expert, and episodic by design - built around the roughly one hour per year a person spends with a clinician. The 8,759 hours outside clinical settings, where eating, sleeping, movement, medication, and stress actually shape long-term health, have no comparable infrastructure. The bottleneck for personalized health is not raw data or reasoning capability; it is the absence of that infrastructure layer. This paper introduces the Personal Care Utility (PCU): a layered, event-driven architecture proposed as the missing utility for everyday health, in the way that payments, networks, and power are utilities for their domains. PCU organizes continuous personal signals into semantically meaningful life events through a Personicle, estimates dynamic health state against personal baselines, reasons about cause and context, and routes guidance through an orchestrator that separates clinical decision logic, behavioral strategy selection, and natural-language expression. This separation lets large language models support reasoning and communication while keeping safety-critical clinical decisions grounded in validated evidence. We instantiate PCU for Type 2 Diabetes - turning CGM, meal, activity, medication, sleep, stress, and clinical data into glycemic events, individualized state estimates, causal explanations, and knowledge-grounded interventions. A day-in-the-life scenario shows the same infrastructure producing real-time nudges, weekly summaries, medication check-ins, silence, or deterministic safety alerts depending on context and risk. We close with how PCU generalizes to other chronic conditions and the governance questions any always-on personal health utility must address. The result is a blueprint that treats personalization not as a final messaging layer, but as an architectural property of everyday health guidance.

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

AutoPass: Evidence-Guided LLM Agents for Compiler Performance Tuning

arXiv:2606.20373v1 Announce Type: cross Abstract: Large Language Models (LLMs) show promise for code compilation tasks, but applying them to runtime performance tuning is difficult due to complex microarchitectural effects and noisy runtime measurements. We present AutoPass, a multi-agent framework for compiler performance tuning that uses compiler and runtime evidence to guide LLM-generated optimization decisions. Rather than treating the compiler as a black box like prior auto-tuning schemes, AutoPass opens up the compiler to the LLM, enabling it to query compiler-internal optimization states and analyze the intermediate representation to orchestrate compiler options. The search process iteratively refines optimization configurations using measured runtime feedback to diagnose regressions and guide latency-improving edits. AutoPass operates in an inference-only, training-free setting and requires no offline training or task-specific fine-tuning, making it readily applicable to new benchmarks and platforms. We implement AutoPass on the LLVM compiler and evaluate it on server-grade x86-64 and embedded ARM64 systems. AutoPass outperforms expert-tuned heuristics and classical autotuning methods, achieving geometric-mean speedups of 1.043x and 1.117x over LLVM -O3 on x86-64 and ARM64, respectively.

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

TimeRouter: Efficient and Adaptive Routing of Time-Series Foundation Models

arXiv:2606.11625v1 Announce Type: new Abstract: Time-series foundation models (TSFMs) are increasingly explored as predictive experts within emerging agentic time-series systems. However, TSFMs exhibit heterogeneous inductive biases, and no single model consistently dominates across forecasting regimes, making expert selection a critical challenge. Existing systems often delegate this decision to LLM-based controllers, incurring substantial inference overhead. We present TimeRouter, an efficient routing framework that leverages empirical complementarity across a pool of pretrained TSFMs through lightweight discriminative routing, selective gating, and ensemble fallback. Concretely, TimeRouter combines a learned routing head, a selective gate, and an ensemble fallback, enabling adaptive expert selection without invoking an LLM at inference time. TimeRouter achieves state-of-the-art performance on the GIFT-EVAL leaderboard, with an LB MASE of 0.6765. Beyond benchmark performance, our ablation studies provide empirical insights into TSFM routing design, highlighting the importance of pool composition and selective gating. Taken together, these results position TimeRouter as a modular and lightweight routing layer for future agentic time-series systems built upon foundation-model pools. Our code is available at https://github.com/UConn-DSIS/TimeRouter.

20.
arXiv (CS.CV) 2026-06-15

$\mu_0$: A Scalable 3D Interaction-Trace World Model

World models that capture how actions induce physical change enable scalable robot learning without reliance on embodiment-specific action labels. Pixel-space video models provide broad visual priors but expend model capacity on dense appearance reconstruction, while direct action models require embodiment-specific labels that hinder scalability. We present $\mu_0$, a scalable world model based on 3D traces. Rather than predicting dense pixels or directly modeling actions, $\mu_0$ forecasts smooth 3D trajectories for salient interaction points such as objects, tools, hands, and contact regions, yielding a compact, embodiment-agnostic motion interface. To enable training from diverse video sources, our TraceExtract system automatically extracts 3D supervision by selecting keypoints, constructing globally aligned traces, and associating motion segments with hierarchical language captions. This TraceExtract supervision pretrains $\mu_0$ by combining a pretrained vision-language backbone with a modular trace expert, which represents each query via B-spline control points and predicts future traces. Experiments show that $\mu_0$ outperforms baselines in both 2D and 3D trace prediction, including trace prediction models and tokenized VLM methods. Because $\mu_0$ is frozen and reusable, it can be paired with action experts for downstream robot embodiments. Despite action-free pretraining, the resulting trace-conditioned policies achieve performance competitive with VLA models pretrained with action supervision, such as $\pi_0$. These results establish 3D traces as a scalable and transferable representation for cross-embodiment manipulation.

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

InstantForget: Update-Free Backdoor Unlearning with Inference-Time Feature Reset

Authors:

arXiv:2606.15730v1 Announce Type: cross Abstract: Backdoor unlearning aims to remove a malicious trigger behavior from a deployed model while preserving clean utility. We study the update-free inference-time setting, where model parameters remain frozen. First, we audit a common projection assumption under oracle paired clean and triggered features. Projection succeeds mainly on BadNets and leaves WaNet, Blended, and SIG at 0.683, 0.888, and 0.941 ASR on CIFAR-10 ResNet-18. This failure is not explained by spectral compactness, spatial locality, or subspace misalignment. It is predicted by a logit-triplet gap involving the target margin, target-logit drop, and non-target logit rise. We then introduce InstantForget, a clean-calibrated gated reset that flags anomalous features with a Mahalanobis score and moves only flagged features toward a neutral non-target representation. With one fixed operating point selected on held-out triggered validation, InstantForget reduces average ASR to 0.071 across four non-adaptive CIFAR-10 triggers without triggered samples or parameter updates at deployment. It also reaches 0.981 detection AUROC and transfers to six of eight tested backbones. Reported failures under WaNet, ModelNet10 point blend, two backbone geometries, and adaptive feature-compactness attacks define the method's scope.

22.
arXiv (CS.CV) 2026-06-17

Visuals Lie, Consistency Speaks: Disentangling Spatial Attention from Reliability in Vision-Language Models

Multimodal Foundation Models are increasingly used as reasoning agents, making reliability, knowing when a model may hallucinate, critical. A common intuition, which we call the Attention-Confidence Assumption, holds that reliability follows from "structural" visual perception: tight attention on relevant regions should signal a trustworthy answer, while scattered attention signals confusion. We challenge this through the VLM Reliability Probe (VRP), a systematic cross-family study of reliability signals in contemporary Vision-Language Models (VLMs). We introduce structural-attention metrics, cluster counts (C_k) and spatial entropy (H_s), to quantify the visual encoder's gaze, and track its evolution (Delta H_s) across layers. This reveals a "Symbolic Detachment": models often "Early Lock" visual features only to diffuse attention later, severing early perception from final generation. Contrary to the grounding hypothesis, we find a "Cluster Failure": spatial attention has near-zero correlation (R approx 0.001) with accuracy. Instead, reliability is a phenomenon of generation dynamics and internal-state distributions. Self-Consistency, the agreement rate across sampled reasoning paths, is the dominant predictor of truth (R = 0.429). Scaling causal interventions exposes a sharp architectural divergence: LLaVA locks its prediction in a fragile late-stage bottleneck, whereas PaliGemma and Qwen2-VL distribute reliability globally, staying resilient even when ~50% or more of their most predictive layer is destroyed. For current VLMs, reliability signals are detached from visual grounding maps and are best inferred from generation-time dynamics and hidden-state probes.

23.
arXiv (CS.AI) 2026-06-11

FreeBridge: Variational Schrödinger Bridges for Cellular Transition Dynamics

arXiv:2606.11286v1 Announce Type: cross Abstract: High-content imaging assays quantify cellular responses to chemical and genetic perturbations, yet continuous trajectories of individual cells are unobservable because cells are chemically fixed at acquisition. Perturbation modeling therefore reduces to inferring stochastic transport between control and treated populations observed only as separate marginals. While recent generative models achieve strong end-point alignment, boundary consistency does not determine intermediate evolution: multiple stochastic processes may connect identical marginals while traversing regions unsupported by observed single-cell morphologies. We introduce FreeBridge, a Schrödinger Bridge formulation for single-cell transition modeling under endpoint-only supervision. FreeBridge defines atomic states as instance-segmented single-cell representations, establishing a fixed cellular manifold, and learns stochastic transport constrained within this geometry via empirical latent support regularization. Across BBBC021, RxRx1, and JUMP, FreeBridge maintains competitive or improved endpoint fidelity and mechanism-of-action retention under a unified evaluation protocol; on BBBC021, it further reduces intermediate support violations. These findings highlight the importance of geometric grounding for biologically interpretable perturbation dynamics. Project page: https://y-research-sbu.github.io/FreeBridge/.

24.
medRxiv (Medicine) 2026-06-17

Long-term mortality and cause-specific death after non-cardiac chest pain: a multicentre cohort study of 160,245 patients in China

Abstract Background Non-cardiac chest pain (NCCP) is commonly regarded as a low-risk condition. However, long-term mortality, cause-specific death, and high-risk subgroup characteristics remain poorly defined. Methods In this multicentre registry-linked cohort study, we linked the Chest Pain Center Registry from 101 hospitals in Hunan, China, with the Mortality and Cause of Death Registry. Adults diagnosed with NCCP from Jan 1, 2017, to Dec 31, 2021, were included. We assessed 3-year all-cause, cardiovascular, and non-cardiovascular mortality using Cox, restricted cubic spline, and Fine-Gray models. Findings Among 160,245 patients, 4674 deaths occurred within 3 years (2.9%). Mortality increased sharply after 60.5 years. Age [≥] 60.5 years (adjusted hazard ratio [aHR] 7.49 [95% CI 6.89-8.14]), rural residence (time-varying aHR 1.46 [1.35-1.57] in year 1 and 1.66 [1.46-1.89] in years 1-3), and male sex (aHR 1.47 [1.38-1.57]) independently predicted death. Three-year mortality ranged from 0.3% in younger urban women to 8.4% in older rural men. Cardiovascular diseases accounted for 56.4% of deaths among older patients, whereas other non-cardiovascular causes (22.8%) and malignancy (20.8%) were the largest categories among younger decedents. Interpretation NCCP is not uniformly benign. Age, rural residence, and sex identify patients who could benefit from risk-stratified follow-up, with cardiovascular prevention prioritised for older rural men and broader non-cardiovascular assessment considered for younger patients.

25.
medRxiv (Medicine) 2026-06-22

Longitudinal multi-omics characterization of the malignant evolution in multirelapsing glioblastoma

Linking glioblastoma (GBM) evolution to clinical progression is challenged by multiple factors, including tumor location for repeated sample collection, and short patient survival. In a single individual, we collected and analysed samples from 11 operations distributed across 31 months of multi-relapsing and multifocal GBM, including terminal leptomeningeal progression. All samples shared genomic ancestry of the retinoblastoma protein 1 (RB1) and neurofibromin 1 (NF1) mutations while advanced progression and extracranial metastases featured mutations of tuberous sclerosis complex 2 (TSC2), PBRM1, CD22 and Fanconi anemia supplementation group I (FANCI), correlated with clinical resistance to immunotherapies and DNA-damaging agents. Single-cell analytics revealed distinct yet reversible shifts in response to the precision medicine arsenal. GBM parenchymal dissemination and extracranial progression were associated with strengthening of neuron-like cell phenotypes. Our multidimensional study describes GBM evolution over a rarely reported time scale, and provides a valuable resource linking genetic, molecular, cellular and clinical progressions.