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

SPI: Query-Depth-Adaptive Indexing for Streaming RAG in Vector Databases

Vector databases (VecDBs) are increasingly deployed in retrieval-augmented generation (RAG) pipelines where query processing and document ingestion occur concurrently. The index layer needs to provide low-latency search while incorporating new vectors without frequent global rebuilding. Existing VecDB pipelines typically operate within a uniform representation regime, despite substantial variation in the semantic granularity required across queries. This motivates an index design that supports incremental updates while adapting retrieval depth to query distribution and complexity. We propose Semantic Pyramid Indexing (SPI), a VecDB-layer indexing framework that organizes embeddings into $L$ semantically aligned resolution levels and selects retrieval depth per query via a lightweight uncertainty-aware controller. SPI supports progressive coarse-to-fine ANN search, level-wise streaming insertion without global rebuilds, and distributed execution through LSH partitioning with asynchronous gRPC coordination. Unlike hierarchical ANN structures with fixed traversal rules (e.g., SPANN), SPI adapts resolution at query time while remaining compatible with FAISS and Qdrant backends. On MS MARCO and Natural Questions, SPI achieves competitive Recall@10 with lower latency under the same dense encoder family, yielding a 1.4–2.3$\times$ average retrieval latency reduction under fixed Recall@10 targets relative to comparable approximate-ANN baselines. A prototype scaling study up to 8 nodes shows $6.2\times$ throughput scaling (${\approx}73\%$ efficiency); the 16-node configuration is included for completeness but shows diminishing efficiency. We provide a top-$K$ stability guarantee: queries with sufficient retrieval margin return an identical top-$K$ set at a shallower level. Code and configurations are available at https://github.com/FastLM/SPI_VecDB.

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

Mind the Gap: Diagnosing Constraint Discovery Failures in Text-in-Image Editing

作者:

A key challenge in multimodal reasoning is determining which visual dependencies become relevant under a specific task, rather than merely recognizing visible content. We study this through edit-induced constraint discovery in text-in-image editing, a controlled diagnostic setting where a local text change can activate secondary consistency constraints: given a valid editing instruction and an image, can a model identify the secondary regions that must also change? Across 461 diagnostic cases, four MLLMs, and 19 constraint subtypes, models recover only 46% case-level macro recall under unguided prompting versus 94% when constraints are explicitly provided, suggesting that a substantial portion of the failure arises when models must decide which unstated dependencies to surface. Oracle-field decomposition shows that case-specific causal explanations are the most effective partial guidance (0.782 recall), above region names (0.610) or type labels (0.646), suggesting that edit-specific causal cues account for much of the oracle gain. A downstream experiment further shows that higher self-discovery recall does not necessarily improve task performance: unverified self-discovery introduces false positives that offset recall gains, motivating precision-aware constraint elicitation.

03.
medRxiv (Medicine) 2026-06-18

Chest X-Ray as a critical screening tool for Household Contacts of TB: Lessons from Three Years of Programmatic Data in India

Introduction: Household contacts (HHCs) of pulmonary TB patients remain at high risk for TB infection and disease progression, yet many remain asymptomatic and are missed by symptom-screening pathways. While India expanded its TB preventative guidelines to include all HHCs in 2021, chest X-ray (CXR) screening continues to be used selectively, representing a missed opportunity in early case detection. Methods: The analysis uses programmatic data from Project JEET 2.0 (Joint Effort for Elimination of Tuberculosis), implemented by the William J. Clinton Foundation in India, between October 2021 and March 2024. Eligible HHCs (>=5 years) were offered CXR screening as part of TB preventive therapy (TPT) evaluation. Descriptive and multivariable analyses examined predictors of CXR uptake and TB yield. A two-stage logistic regression model estimated potential TB yield under universal CXR coverage. Model performance was evaluated using the area under the curve (AUC), and bootstrap simulations generated counterfactual estimates of missed TB cases. Results: Among 1,034,621 HHCs, 1.02% individuals were found positive for TB, which includes 7,786 HHCs who were on TB treatment already, while an additional 2,812 were identified during pre-TPT evaluation. Among eligible HHCs (n = 1,026,835), 70% were screened with CXR, of which 2.4% had suggestive TB findings. Of these, 79% went for further TB assessment. Symptomatic HHCs were more likely to be CXR screened (84% vs 69%) and assessed for TB, yet two-thirds of all detected TB cases were asymptomatic. It is estimated that universal CXR coverage and TB testing for suggestive cases can increase TB detection by at least 87%. Conclusion: The study provides a scalable approach to expand CXR coverage through public-private partnerships, enabling early TB detection among HHCs, especially among asymptomatic contacts. Future implementations will benefit from integrating AI-enabled reading, along with systematic follow up for those with suggestive findings.

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

Searching for Synergy in Shared Workspace Human-AI Collaboration

arXiv:2606.18413v1 Announce Type: new Abstract: Automated AI agents are increasingly capable, yet many scientific and professional tasks require human judgment and contextual expertise. We study shared-workspace human-AI teams, where AI agents and human collaborators must coordinate responsibilities before submitting a final answer. Using the Collaborative Gym environment with DiscoveryBench tasks, we examine when adding simulated human collaborators improves performance and when process loss turns additional collaborators into coordination overhead. Across 1,482 sessions, adding relevant collaborators can lower performance when teams lack structure to coordinate their contributions. We then evaluate scaffolding that combines shared group memory with simulated human-in-the-loop (HITL) gates, where selected actions require approval from a designated simulated participant. This scaffolding yields higher mean performance, most clearly in three-person teams, with clearer responsibility signals and stronger routing of expertise to team actions. Overall, how human-AI teams coordinate and integrate expertise matters as much as the capability available to them.

05.
arXiv (quant-ph) 2026-06-12

Quantum-Driven Neuromorphic Computing for Million-Qubit-Scale Workloads

arXiv:2606.12968v1 Announce Type: new Abstract: We introduce Apollo, a 10000 node p-qubit neuromorphic processor fabricated in 16 nm mixed signal CMOS and operating fully at room temperature with a typical analog core power envelope of about 0.5 W. Its fundamental element, the p-qubit, is a bistable stochastic unit whose continuous time state fluctuations are driven by integrated quantum entropy units that inject true quantum derived randomness. This enables ultrafast stochastic transitions at low energy while preserving a classical state representation. Apollo combines these p-qubits with a high degree Hyperion 256 interconnect topology, allowing efficient embedding of dense Ising and QUBO problems with substantially reduced minor embedding overhead compared with sparse annealing platforms. We show that, through the Suzuki Trotter correspondence, the equilibrium statistics and annealing dynamics of the p-qubit network reproduce key properties of transverse field quantum annealing without cryogenic cooling, long lived coherence, or microwave control. Beyond device level validation, Apollo is evaluated on a three dimensional spin glass benchmark previously used to study quantum advantage in superconducting annealers. Across 300 disorder realizations, Apollo reaches substantially lower ground state energies than reported cryogenic quantum annealing hardware, while remaining distinct from classical simulated annealing and simulated quantum annealing. A 350 nm release candidate device experimentally validates the core p-qubit dynamics, thermodynamic sampling correctness, and continuous time annealing behavior. These results establish Apollo as a room temperature, industrially scalable platform for quantum driven energy based optimization, probabilistic inference, generative modeling, and hybrid classical quantum workflows.

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

The Erdős-Hajnal High-Girth Subgraph Conjecture Holds in the Polynomial Chromatic-Sparsity Regime

作者:

arXiv:2606.17901v1 Announce Type: cross Abstract: For a graph $G$ put $h_r(G)=\max{\chi(H):H\subseteq G,\operatorname{girth}(H)\ge r}.$ Erdős and Hajnal asked whether $h_r(G)\to\infty$ as $\chi(G)\to\infty$, for every fixed $r\ge4$. We prove this in every fixed polynomial edge-density regime: for all $r\ge4$, $k\ge2$, $P,C>0$, there is $M=M_{r,k}(P,C)$ such that $\chi(G)\ge M,\ e(G)\le C\chi(G)^P\Longrightarrow h_r(G)\ge k.$ Quantitatively, after replacing $P$ by $P\vee2$ and $C$ by $C\vee2$, $M_{r,k}(P,C)\le \exp!\left(O_{r,k}\bigl((P+2+\log(C\vee2))^2\bigr)\right),$ and consequently the same conclusion holds throughout the quasi-polynomial range $e(G)\le \exp\bigl(C_0(\log\chi(G))^a\bigr),\ 1 < a < 3/2,$ for all sufficiently large $\chi(G)$. In each fixed polynomial-density regime we also obtain $f_{P,C}(k,r)\le k^{O_{r,P,C}(1)}.$ The proof combines a chromatic-defect random extraction lemma, compact and near-quadratic sparse-core bases, and a peeling/thinning bootstrap increasing the admissible edge exponent by $1/(r-1)$. We also prove structural saturation results for possible counterexamples, including Moore-strength exact-cycle packings and quadratic saturation in projected colour-pair space. Finally, writing $h_r^{\mathrm f}(G)=\max{\chi_{\mathrm f}(H):H\subseteq G,\operatorname{girth}(H)\ge r},$ we develop a fractional random-extraction framework based on Mohar-Wu preservation. We prove sufficient cheap-cycle-killing criteria and verify them for several structured families, including clique-organised families, line graphs of incidence graphs of equal-order generalized quadrangles and generalized hexagons, and the Bohman-Keevash tracking-time triangle-free-process graph. We also isolate a density-free obstruction that any proof using this fractional surgery route must overcome.

07.
arXiv (CS.AI) 2026-06-19

AAPA: Adversarially Anchored Preference Alignment for Post-Training of Large Language Models

arXiv:2509.25148v2 Announce Type: replace Abstract: Post-training alignment of large language models often combines supervised fine-tuning (SFT) on expert demonstrations with reinforcement learning (RL) from preference or verifiable feedback. SFT provides a useful behavioral anchor but can overfit to static demonstrations, whereas RL encourages exploration but may drift from expert behavior or exploit imperfect rewards. We propose AAPA (Adversarially Anchored Preference Alignment), a plug-in framework that augments existing post-training objectives with a sentence-level adversarial anchoring signal. AAPA compares policy rollouts with offline, pre-collected expert responses using a fixed lightweight discriminator, and therefore requires neither online teacher inference nor discriminator co-training during policy optimization. The same anchoring term can be added to SFT, GRPO, and CHORD while preserving their original training pipelines. Experiments on instruction-following benchmarks show that AAPA consistently improves the corresponding base objectives across model scales. In particular, the staged AAPA configuration improves over a strong GRPO baseline by 5.77\% on \texttt{Qwen3-0.6B} and 3.75\% on \texttt{Qwen3-4B}. Further analyses on response length, log-probability distributions, and discriminator variants suggest that adversarial anchoring provides a stable semantic grounding signal for preference optimization. Code is available at \url{https://github.com/IsFaqq/AAPA}.

08.
medRxiv (Medicine) 2026-06-15

Non-invasive intracranial pressure waveform reconstruction with deep learning

Purpose: Continuous intracranial pressure (ICP) monitoring requires invasive instrumentation, reaching only a narrow subset of critically ill patients. We tested whether deep learning models trained on routinely acquired extracranial signals can reconstruct continuous ICP waveforms at clinically relevant accuracy in an independent external cohort. Methods: In adults admitted to the ICU at a single quaternary health system, five deep learning architectures were trained on high-frequency arterial blood pressure (ABP), photoplethysmography (PPG), and electrocardiography (ECG) waveforms, using invasive (intraparenchymal) ICP as ground truth. Two fusion strategies (early and late) and three training objectives (waveform-morphology, baseline robust regression, and weighted robust regression) were evaluated. Models were externally validated on the held-out MIMIC-III Waveform Database. Performance was assessed by mean absolute error (MAE) and waveform similarity by Pearson correlation (r). Results: We analyzed data from 158 critically ill adults (~5,322 hours) across two quaternary health systems (Johns Hopkins Hospital, Baltimore; Beth Israel Deaconess Medical Center, Boston). Validation MAE ranged from 4.276 mmHg [95% CI 4.269, 4.283] (gated recurrent, late fusion) to 4.946 mmHg [95% CI 4.938, 4.956] (attention-based, early fusion), with Pearson r ranging from 0.599 [95% CI 0.599, 0.600] to 0.722 [95% CI 0.722, 0.723]. The multiscale encoder-decoder model demonstrated the most favorable MAE-correlation tradeoff. Conclusion: This is the first demonstration that continuous ICP waveform reconstruction from bedside signals generalizes across institutions at clinically relevant accuracy, establishing a foundation for non-invasive ICP monitoring and motivating validation across broader populations and ICP ranges.

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

PI-Hunter: Automated Red-Teaming for Exposing and Localizing Prompt Injections

arXiv:2606.12737v1 Announce Type: cross Abstract: Large Language Models (LLMs) are rapidly evolving into agentic systems that interact with external tools and environments, introducing new security risks such as indirect prompt injection attacks through untrusted external sources. Existing defenses mainly focus on blocking malicious content at inference time, and current red-teaming methods primarily optimize attack success. As a result, developers have limited visibility into how latent prompt injections emerge and propagate through agents. We propose PI-Hunter, an automated agentic auditing framework for proactive vulnerability exposure in LLM agents. PI-Hunter constructs realistic source-aware test cases and iteratively evolves them through feedback-driven exploration to induce agents to retrieve and reveal latent malicious instructions embedded within external environments. Extensive experiments across multiple benchmarks, agent architectures, attacks, and defenses demonstrate that PI-Hunter substantially improves vulnerability exposure and attack-surface coverage over strong automated red-teaming baselines, while remaining effective under existing prompt injection defenses.

10.
arXiv (CS.CL) 2026-06-15

Learning to Hear Hesitation: Continual Learning for Disfluency-Aware ASR

Despite advances in large-scale Automatic Speech Recognition (ASR), disfluent speech remains challenging, as state-of-the-art systems are often optimized to omit disfluencies, leading to information loss and hallucinations. Prior work has focused on verbatim transcription and the integration of disfluency markers, but adapting models on limited datasets can lead to catastrophic forgetting of general-domain knowledge. We address this gap by leveraging continual learning (CL) with explicit disfluency tokens. We first introduce these tokens into a pretrained ASR model to establish stable token mechanisms, and then continue training on additional datasets with varying disfluency distributions. Through a detailed analysis of model dynamics during training, we identify a trade-off between marker learning and ASR performance, and a consistent cross-attention head mechanism shared across CL methods.

11.
arXiv (math.PR) 2026-06-17

Killed resolvents and measure-valued stopping gains for reflected optimal stopping with max-type rewards

arXiv:2606.17517v1 Announce Type: new Abstract: We study an infinite-horizon optimal stopping problem for a normally reflected two-dimensional diffusion in the positive quadrant with nonsmooth max-type reward \(G(x_1,x_2)=x_1\vee \alpha x_2\). The paper develops a conditional measure-theoretic framework for the associated reflected obstacle problem. The main innovation is to show that the stopping gain \(\Gamma=c+rG-\mathcal LG\) is a signed measure, not a function: the kink of \(G\) generates an explicit negative surface measure on \(\Delta=\{x_1=\alpha x_2\}\). We then prove that the correct potential representation uses the resolvent of the reflected diffusion killed on first entry into the stopping set, rather than the unrestricted reflected resolvent. Under explicit monotonicity, regularity, and measure-superharmonicity assumptions, we derive an epigraph representation, a continuation-side boundary-trace condition, and a candidate verification theorem. The framework clarifies hidden regularity and uniqueness assumptions in multidimensional nonsmooth optimal stopping.

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

Augmentation techniques for video surveillance in the visible and thermal spectral range

In intelligent video surveillance, cameras record image sequences during day and night. Commonly, this demands different sensors. To achieve a better performance it is not unusual to combine them. We focus on the case that a long-wave infrared camera records continuously and in addition to this, another camera records in the visible spectral range during daytime and an intelligent algorithm supervises the picked up imagery. More accurate, our task is multispectral CNN-based object detection. At first glance, images originating from the visible spectral range differ between thermal infrared ones in the presence of color and distinct texture information on the one hand and in not containing information about thermal radiation that emits from objects on the other hand. Although color can provide valuable information for classification tasks, effects such as varying illumination and specialties of different sensors still represent significant problems. Anyway, obtaining sufficient and practical thermal infrared datasets for training a deep neural network poses still a challenge. That is the reason why training with the help of data from the visible spectral range could be advantageous, particularly if the data, which has to be evaluated contains both visible and infrared data. However, there is no clear evidence of how strongly variations in thermal radiation, shape, or color information influence classification accuracy. To gain deeper insight into how Convolutional Neural Networks make decisions and what they learn from different sensor input data, we investigate the suitability and robustness of different augmentation techniques...

13.
medRxiv (Medicine) 2026-06-15

Association of Genetic Liability to Psychiatric Disorders with Peripheral Metabolic Dysregulation

Importance: Individuals with psychiatric disorders face elevated cardiometabolic risk which is linked to increased mortality. The extent to which this reflects shared pathogenesis or the downstream effects of illness and treatment remains poorly understood. Objective: To characterize the direct pleiotropic effects of psychiatric genetic liability on circulating metabolites and aggregate cardiometabolic risk, independent of psychiatric diagnosis and psychotropic medication use. Design: Cohort study. Setting: Mass General Brigham Biobank (MGBB). Participants: MGBB participants with metabolomic profiling, genomic data, and linked electronic health records. Exposures: Genetic liability to nine psychiatric disorders quantified using polygenic risk scores (PRS): attention deficit/hyperactivity disorder (ADHD), anorexia nervosa (ANO), anxiety disorder (ANX), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), PTSD, schizophrenia (SCZ), and substance use disorder (SUD). Main Outcomes and Measures: 249 circulating metabolites and four metabolomic risk scores (MRS) for type 2 diabetes, myocardial infarction, ischemic stroke, and vascular dementia. PRS-metabolite associations were estimated using nested models adjusting for lifetime psychiatric diagnosis and psychotropic medication use. Results: Across 25,290 participants, we identified 604 significant PRS-metabolite associations (Bonferroni p< 1.36 x 10-4), of which 89% persisted after adjustment for lifetime diagnosis and medication use, suggesting that the direct genetic effects on metabolism are largely independent of illness or treatment. PRS for MDD, PTSD, and ADHD showed the most extensive dysregulation, with a transdiagnostic pattern of elevated lipids and systemic inflammation, specifically triglycerides ({beta} = 0.04 to 0.05, all p< 4.4 x10-13) and glycoprotein acetyls ({beta} = 0.05, all p< 2.2 x10-16). Notably, PRS for SCZ and BD showed minimal metabolite dysregulation despite having the strongest association with their target diagnoses. PRS for MDD, PTSD, ADHD, and SUD were associated with increased MRS across cardiometabolic conditions ({beta} = 0.03 to 0.08, all p< 2.1 x10-4). Sensitivity analyses controlling for BMI or excluding participants without any psychiatric history (N: 21,305 and 11,150, respectively) showed a similar pattern. Conclusions and Relevance: Psychiatric genetic liability is associated with systemic metabolic dysregulation independent of illness onset or treatment, supporting a partially pleiotropic basis for psychiatric-cardiometabolic comorbidity.

14.
arXiv (CS.CL) 2026-06-17

From Trainee to Trainer: LLM-Designed Training Environment for RL with Multi-Agent Reasoning

Reinforcement learning pipelines for Large Language Model (LLM) training often rely on manually redesigned environments between stages, requiring practitioners to heuristically infer which configuration will best improve the current policy. To automate this process, we propose the LLM-as-Environment-Engineer framework in which the current policy model analyzes failure trajectories together with contextual information and proposes modifications to the next-stage training environment configuration. We also introduce MAPF-FrozenLake, a controllable testbed whose generator exposes multi-dimensional environment configurations, making it suitable for studying and benchmarking environment redesign. On this testbed, we condition the environment engineer on structured summaries of policy behavior, failure cases, and environment statistics, from which it produces the configuration for the next training stage. With Qwen3-4B as the backbone, our framework achieves the strongest aggregate performance on our benchmarks, outperforming larger proprietary LLMs (e.g., GPT, Gemini) and fixed-environment training baselines. We further analyze which forms of context are most effective, finding that successful environment updates rely on failure evidence and preserve configurations that already work. Interestingly, the current RL checkpoint serves as a better environment engineer than the original base model, suggesting that policy learning improves the model's ability to diagnose its remaining weaknesses.

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

Stability of a Generalized Debiased Lasso with Applications to Resampling-Based Variable Selection

作者:

arXiv:2405.03063v3 Announce Type: replace-cross Abstract: We propose a generalized debiased Lasso estimator based on a stability principle. When a single column of the design matrix is perturbed, the estimator admits a simple update formula that can be computed from the original solution. Under sub-Gaussian designs with well-conditioned covariance, this approximation is asymptotically accurate for all but a vanishing fraction of coordinates in the proportional growth regime. The proof relies on concentration and anti-concentration arguments to control error terms and sign changes. In contrast, establishing comparable distributional limits (e.g., Gaussianity) under similar assumptions remains open. As an application, we show that the approximation significantly reduces the computational cost of resampling-based variable selection procedures, including the conditional randomization test and a local knockoff filter.

16.
bioRxiv (Bioinfo) 2026-06-08

HydraMPP: A lightweight library for distributed massive parallel processing in Python - threading at scale.

We now exist in the era of massive datasets from genomics, large language models, and all the known knowledge of humanity right at our fingertips. Much of this data is becoming more accessible; however, processing such data remains an ongoing issue across systems including high performance computing (HPC) infrastructures. Massively parallel computing (MPP) has solved this using a divide and conquer approach by splitting workloads across independent nodes (i.e., central processing units (CPU) allowing for higher scaling of data). The main engine for this in python is Ray; however, it has many issues including a large code space, security issues, debugging opacity, and memory management issues. Here, we present HydraMPP, a lightweight, ease of use and utilization, with high auditability, and with SLURM ergonomics.

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

Object Tokens as a Bridge Between Segmentation and Visual Question Answering in Robotic Surgery

Visual Question Answering (VQA) in robotic surgery, referred to as surgical VQA, requires high-level understanding of complex surgical scenes and the integration of visual perception with language reasoning, with the potential to support surgical training and intraoperative decision-making. Recent Vision-Language Models (VLMs) have shown promising performance through parameter-efficient fine-tuning; however, most existing approaches rely on coarse visual grounding, typically limited to bounding boxes, which fails to capture the fine-grained spatial structure of surgical objects. In this work, we propose a unified framework that jointly performs pixel-level segmentation and visual question answering within a single framework. Our approach integrates a VLM with a Segment Anything Model (SAM)-based decoder and represents scene elements as object tokens generated by the VLM. These object tokens guide answer prediction and are further projected to the SAM-based decoder to produce segmentation masks. By optimizing the object token embeddings through both segmentation and question answering objectives, the model learns spatially grounded representations that enhance visual reasoning while providing explicit pixel-level grounding. We evaluate the proposed method on the private RAMIE (Robot-Assisted Minimally Invasive Esophagectomy) dataset and the public EndoVis18 dataset, where it consistently outperforms baseline methods for surgical VQA. These results demonstrate that incorporating context-aware object tokens into vision-language models improves fine-grained surgical scene understanding.

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

Unlocking air traffic flow prediction through microscopic aircraft-state modeling

arXiv:2605.10083v2 Announce Type: replace Abstract: Short-term air traffic flow prediction in terminal airspace is essential for proactive air traffic management. Existing approaches predominantly model traffic flow as aggregated time series. However, traffic dynamics are governed by aircraft states and their interactions in continuous airspace. Such aggregation obscures fine-grained information, including aircraft kinematics, boundary interactions, and control intent. Here we present AeroSense, a state-to-flow modeling paradigm that predicts future traffic flow directly from instantaneous airspace situations represented as dynamic sets of aircraft states derived from ADS-B trajectories. By establishing an end-to-end mapping from microscopic aircraft states to future regional traffic flow, AeroSense preserves aircraft-level dynamics while naturally accommodating varying traffic density without relying on historical look-back windows. Experiments on a large-scale real-world dataset show that AeroSense exhibits admirable predictive accuracy and robustness over aggregation-based forecasting approaches, particularly during high-density traffic periods. These findings suggest that aircraft-state situation modeling provides a promising alternative to conventional time-series forecasting in air traffic flow management.

19.
medRxiv (Medicine) 2026-06-10

Frozen elephant trunk repair in heritable thoracic aortic disease: Impact of genetic aortopathy on long-term outcomes - A multicenter analysis

Aims This multicenter study aims to compare outcomes of total aortic arch replacement (TAR) using the frozen elephant trunk (FET) technique in patients with and without heritable thoracic aortic disease (HTAD) and to assess whether HTAD influences postprocedural adverse aortic events (AAEs). Methods From 06/2007 to 05/2024, aortic databases from 13 European centers were screened for HTAD patients undergoing TAR with FET. All consecutive dissection and aneurysm non-HTAD patients from the four core centers served as comparator. The primary outcome was AAE, a composite of diameter progression, distal stent graft induced new entry (dSINE), malperfusion, rupture and pseudoaneurysm at 5 years after FET implantation. Results Of 2739 FET patients, 196 (7.2%) were diagnosed with HTAD. The control group consisted of 867 non-HTAD FET patients. Marfan syndrome was the most common condition (72%), followed by Loeys-Dietz syndrome (11%), vascular Ehlers-Danlos syndrome (5.6%) and Turner syndrome (2.0%). Seventeen (8.8%) patients were diagnosed with ns-HTAD. At 5 years 46 (24%) AAEs occurred in the HTAD group, 169 (20%) in the non-HTAD group (p=0.2). Diameter progression was the most common event (10% vs. 12%; p=0.6), followed by dSINE (5.8% vs. 4.5%; p=0.5), malperfusion (4.2% vs. 3.3%; p=0.5), rupture (2.1% vs. 0.7%; p=0.09) and pseudoaneurysm (0.5% vs. 0.2%; p=0.5). Conclusions The FET technique appears safe and effective for acute and chronic aortic disease in HTAD patients, with outcomes comparable to non-HTAD cases and no increase in graft-related complications, challenging traditional concerns about stent graft use in genetically mediated aortic disease.

20.
bioRxiv (Bioinfo) 2026-06-08

DipSkmer: Reference-free population genomics with diploid genome skims

Ecologists and conservation biologists rely on genetic diversity as a key essential biodiversity variable (EBV) used to track population health and dynamics, and utilize the population parameter {theta} (estimated by the average pairwise genomic distance) as a key metric of diversity. While whole-genome-sequencing (wgs) is increasingly affordable, it will be considerable time before the full diversity of life is represented by high-quality assembled genomes; even then, constant monitoring will still require repeated sampling of populations. In contrast, genome skimming (low-coverage, short-read wgs) is highly cost-effective but challenging to analyze because the coverage is too low for assembly and reliable error correction. Mature methods, such as Mash, exist for estimating pairwise genomic distances based on the Jaccard similarity of k-mer sets computed using sketching techniques. Some, such as Skmer, additionally model the impacts of low coverage. These methods have been successfully applied to assembly-free species identification and phylogenetics; however, their use in population genetics has been limited. This is because these methods implicitly treat genomes as haploid and heterozygosity confounds true estimates of genomic distance for diploid organisms. In this paper, we address this problem through a number of technical advances. First, we use coalescent theory to mathematically derive how the Jaccard index between two diploid samples changes with the scaled population size parameter ({theta}). Next, we derive an estimator that computes {theta} from the Jaccard index, in addition to several auxiliary variables, which we also estimate from the genome skims. The resulting method, DipSkmer, enables more accurate estimates of coverage, sequencing error, and pairwise nucleotide distance for diploid samples. Analyses of both simulated and empirical datasets show that for diploids and low distances (e.g.,

21.
medRxiv (Medicine) 2026-06-12

A Machine Learning Pipeline for Scalable Annotation of Patient-Ventilator Dyssynchrony from Bedside Ventilator Data

Objective: Patient-ventilator dyssynchrony (PVD) is a common and clinically consequential problem in critically ill patients receiving invasive mechanical ventilation. Yet automated identification of PVD subtypes at scale remains an unmet clinical need, owing to the lack of large annotated bedside waveform datasets. Methods: We developed and validated a semi-supervised algorithm for automated annotation of PVD. In two medical ICUs at a tertiary academic center, bedside devices continuously collected airway flow and pressure waveforms from the ventilators. We developed a software interface with an information retrieval system that grouped similar breaths for expert human review, yielding 1,542,296 labeled breaths across eight categories: 2 labels for breath delivery mode, 5 labels for PVD subtypes, and 1 label denoting a normal breath. Two pulmonary physicians with expertise in ventilator training and education provided the expert reference labels. We trained an initial classification model on a model-derivation set of 771,148 breaths (divided into training and validation) and evaluated it on a hold-out test set of 771,149 breaths A semi-supervised approach was utilized to extend labeling to an additional 12,965,000 unlabeled breaths. Results: The supervised model performed well across all labels, with Macro-F1 scores between 0.96 and 1.00. Semi-supervised learning across 12 rounds expanded the training set from 771,148 to 8,563,995 breaths without significant performance degradation. Conclusion: We developed a practical and scalable system for automated PVD annotation that performed well across all subtypes. This work provides a reproducible foundation for automated PVD labeling to support the development of machine-learning-based clinical decision support systems for identifying patient-level asynchrony.

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

Asymptotic analysis of the finite predictor for fractional Gaussian noise

arXiv:2504.01562v2 Announce Type: replace-cross Abstract: This paper proposes a new approach to the asymptotic analysis of the finite predictor for stationary sequences. Our method yields the exact asymptotics of both the relative prediction error and the partial correlation coefficients. The underlying assumptions are analytic in nature, making the approach applicable to processes with long-range dependence. The ARMA-type process driven by fractional Gaussian noise (fGn), which had previously remained elusive, is used as a case study.

23.
arXiv (CS.CV) 2026-06-12

Learning Visually Interpretable Oscillator Networks for Soft Continuum Robots from Video

Learning soft continuum robot (SCR) dynamics from video offers flexibility but existing methods lack interpretability or rely on prior assumptions. Model-based approaches require prior knowledge and manual design. We bridge this gap by introducing: (1) The Attention Broadcast Decoder (ABCD), a plug-and-play module for autoencoder-based latent dynamics learning that generates pixel-accurate attention maps localizing each latent dimension's contribution while filtering static backgrounds, enabling visual interpretability via spatially grounded latents and on-image overlays. (2) Visual Oscillator Networks (VONs), a 2D latent oscillator network coupled to ABCD attention maps for on-image visualization of learned masses, coupling stiffness, and forces, thereby enabling mechanical interpretability. We validate our approach on single- and double-segment SCRs, demonstrating that ABCD-based models significantly improve multi-step prediction accuracy with 5.8x error reduction for Koopman operators and 3.5x for oscillator networks on a two-segment robot. VONs autonomously discover a chain structure of oscillators. This fully data-driven approach yields compact, mechanically interpretable models with potential relevance for future control applications.

24.
arXiv (CS.CL) 2026-06-16

Compositional Reasoning Depth Predicts Clinical AI Failure: Empirical Evidence Consistent with Transformer Compositionality Limits in Electronic Health Record Question Answering

作者:

Aggregate accuracy benchmarks conceal a systematic structure in how large language models fail at electronic health record (EHR) question answering: questions requiring more inferential steps produce disproportionately more errors. Motivated by theoretical results on transformer compositionality limits, we introduce a pre-specified hop-count taxonomy – the number of distinct reasoning steps required to answer a clinical question from an EHR – as a principled predictor of model failure. We annotate 313 clinician-generated MedAlign EHR question-answer pairs across four hop levels and evaluate 301 questions in a within-model ablation (claude-sonnet-4-6, zero-shot vs. extended thinking) and cross-architecture replications (gpt-4o and gpt-5.4-2026-03-05, zero-shot). All three models, spanning two providers and two OpenAI generations (GPT-4 and GPT-5), show monotone accuracy decline with hop count: Claude Sonnet zero-shot falls from 30.6% (hop=1) to 17.6% (hop=4) (Cochran-Armitage z=-2.30, p=0.011; OR per hop 0.72, 95% CI [0.56,0.92], p=0.008); GPT-4o replicates this (37.8% to 14.7%; OR 0.58 [0.45,0.75], p

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arXiv (CS.CL) 2026-06-12

Attention Expansion: Enhancing Keyphrase Extraction from Long Documents with Attention-Augmented Contextualized Embeddings

Pre-trained language models (PLMs) have achieved strong performance in keyphrase extraction (KPE), largely due to their ability to generate rich contextualized representations. However, long-document KPE remains challenging because salient keyphrase evidence may be scattered across distant document sections that cannot be jointly captured within the limited context window of most PLMs. Although long-context large language models (LLMs) can process broader textual contexts, their computational cost limits their practicality for efficient and high-throughput KPE. To overcome this limitation, we propose an attention expansion mechanism that augments PLM token representations with information from surrounding out-of-context chunks using pre-trained word embeddings. The proposed mechanism expands the effective contextual scope of PLM-based KPE models without requiring full-document attention or expensive LLM-based inference. We evaluate our approach across five PLM backbones, including general-purpose, scientific, task-specific, and long-context encoders, using two training regimes and five benchmark corpora from scientific and news domains. Experimental results demonstrate that attention expansion consistently enhances KPE performance across all evaluation settings, outperforming state-of-the-art models and yielding notable improvements in F1 score. The improvements extend to domain-specific, task-specialized, and native long-context models, showing that the proposed mechanism provides complementary information rather than merely compensating for limited input length. These results establish attention expansion as an efficient and effective strategy for long-document KPE.