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01.
arXiv (CS.LG) 2026-06-18

Provable quantum speedups for computing persistence in topological data analysis

arXiv:2410.21258v2 Announce Type: replace-cross Abstract: Topological data analysis (TDA) aims to extract noise-robust features from a data set by examining the number and persistence of holes in its topology. We provide an efficient quantum algorithm for a computational problem closely related to a core task in TDA – determining whether a given hole persists across different length scales. Further, we prove the problem itself is $\mathsf{BQP}_1$-hard, implying that a classical solution is extremely unlikely; this stands in contrast to all previous quantum approaches to TDA, where the problems were also intractable for quantum computers, or where a rigorous proof of classical hardness still remains open. This result implies an {exponential} quantum speedup for this problem under standard complexity-theoretic assumptions. Our approach relies on encoding the persistence of a hole in a variant of the guided sparse Hamiltonian problem, where the guiding state is constructed from a harmonic representative of the hole.

02.
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.

03.
arXiv (CS.AI) 2026-06-16

Beyond Case Law: Evaluating Structure-Aware Retrieval and Safety in Statute-Centric Legal QA

arXiv:2604.06173v2 Announce Type: replace-cross Abstract: Legal QA benchmarks have predominantly focused on case law, overlooking the unique challenges of statute-centric regulatory reasoning. In statutory domains, relevant evidence is distributed across hierarchically linked documents, creating a statutory retrieval gap where conventional retrievers fail and models often hallucinate under incomplete context. We introduce SearchFireSafety, a structure- and safety-aware benchmark for statute-centric legal QA. Instantiated on fire-safety regulations as a representative case, the benchmark evaluates whether models can retrieve hierarchically fragmented evidence and safely abstain when statutory context is insufficient. SearchFireSafety adopts a dual-source evaluation framework combining real-world questions that require citation-aware retrieval and synthetic partial-context scenarios that stress-test hallucination and refusal behavior. Experiments across multiple large language models show that graph-guided retrieval substantially improves performance, but also reveal a critical safety trade-off: domain-adapted models are more likely to hallucinate when key statutory evidence is missing. Our findings highlight the need for benchmarks that jointly evaluate hierarchical retrieval and model safety in statute-centric regulatory settings.

04.
arXiv (quant-ph) 2026-06-11

Robust Mixed-State Cluster States and Spurious Topological Entanglement Negativity

arXiv:2504.16165v2 Announce Type: replace Abstract: We investigate 1D and 2D cluster states under local decoherence to assess the robustness of their mixed-state subsystem symmetry-protected topological (SSPT) order. By exactly computing fidelity correlators via dimensional reduction of effective statistical mechanics models, we pinpoint the critical error rate for strong-to-weak spontaneous breaking of strong subsystem symmetry. Without resorting to the replica trick, we demonstrate that mixed-state SSPT order remains remarkably robust up to the maximal decoherence rate when noise respects strong subsystem symmetry. Furthermore, we propose that the mixed-state SSPT order can be detected by a constant correction to the area-law scaling of entanglement negativity, termed spurious topological entanglement negativity. This also highlights that topological entanglement negativity, a widely used diagnostic for mixed-state topological order, is generally not invariant under finite-depth quantum channels.

05.
arXiv (CS.LG) 2026-06-18

AGDN: Learning to Solve Traveling Salesman Problem with Anisotropic Graph Diffusion Network

arXiv:2606.19185v1 Announce Type: new Abstract: The Traveling Salesman Problem (TSP) is a cornerstone of combinatorial optimization and arises in many practical scenarios. Although graph-based learning approaches have been explored for TSP, the question of how to exploit graph structure more effectively remains open. We present the Anisotropic Graph Diffusion Network (AGDN), a new Graph Neural Network framework designed to solve TSP. Our method tackles two central difficulties: (1) the lack of informative topological prior in fully connected TSP graphs, and (2) losing connected nodes in the optimal solution after the commonly used graph sparsification techniques. To overcome these issues, we construct a MixScore transition matrix that merges node similarity with pairwise distance, and we develop an anisotropic graph diffusion strategy that supports efficient information exchange across multiple hops. Comprehensive experiments spanning diverse instance sizes and node distributions show that AGDN consistently outperforms existing methods while keeping computation time competitive. Furthermore, AGDN generalizes well to problem sizes and distributions beyond those seen during training. The implementation is publicly available at: https://github.com/LabRAI/AGDN.

07.
medRxiv (Medicine) 2026-06-22

REPRODUCIBILITY OF 7T MRI MEASUREMENTS OF THE SUSCEPTIBILITY AND VOLUME OF HIPPOCAMPAL SUBFIELDS

PURPOSE: The UK7T travelling head dataset was used to characterise the reproducibility of 7T measurements of the susceptibility of the hippocampal subfields, focusing on the Cornu Ammonis (CA1, CA2 and CA3), dentate gyrus (DG), subiculum (SUB), tail of the hippocampus (TAIL) and entorhinal cortex (ERC). METHODS: Susceptibility maps were created from whole-brain 3D single-echo GRE data (TE=20 ms; 0.7 mm isotropic resolution) using Multi-Scale Dipole Inversion. Automatic Segmentation of Hippocampal Subfields (ASHS) was applied to high resolution T1- and T2-weighted images for segmentation. The mean magnetic susceptibility and volume of hippocampal subfields was evaluated in 50 data sets, comprising 5 repeat acquisitions on 10 healthy participants (age 32 + or -6 years; 3 female). RESULTS: Averaging over subjects, susceptibility values spanned an 18ppb range over the hippocampus (ranging from -13.3ppb in DG to 4.7ppb in ERC). Susceptibility values in the larger hippocampal subfields showed a consistent pattern of variation across subjects, being generally more positive in ERC and SUB than in CA1 and more positive in CA1 than in DG and TAIL. The standard deviation of subfield susceptibilities over subjects ranged from 8.2ppb in the TAIL to 1.7ppb in CA1, and the average standard deviation across repeated measurements, which ranges from 1.7 to 4 ppb, was less than half of the inter-participant standard deviation in all subfields. Susceptibility values in the smaller subfields (CA2 and CA3) were more variable, but ICC(2,k) values for all subfields were >0.82. CONCLUSION: The reported data characterises the variation and reproducibility of hippocampal subfield susceptibility measurements at 7T.

08.
arXiv (quant-ph) 2026-06-19

Unleashing Emergent Fermions with Rydberg Atom Simulators

arXiv:2606.19444v1 Announce Type: cross Abstract: Rydberg atom simulators, in both analog and digital modes, have attracted significant recent interest due to their versatile geometric reconfigurability. In this work, leveraging this feature, we propose two complementary approaches, one for each mode, to characterize emergent fermions in critical quantum many-body systems. In the analog mode, we assemble the Rydberg atoms in a "developable" (namely, preserving local couplings) Möbius band geometry to realize antiperiodic boundary conditions, where fermionic states reside. Spectroscopic measurement in this sector then reveals universal energy ratios of the bosonic and fermionic states. In the digital mode, we carry out a fermionic version of Kibble-Zurek ramping with a quantum circuit, directly addressing the fermionic scaling form. Reconfigurability allows an exponential speed-up of this task, with an $O(\log L\log\log L)$ circuit-depth overhead. Our work establishes the Rydberg atom simulator as a uniquely powerful platform to attack the notoriously difficult issue of experimentally probing emergent fermions that are nonlocally defined in a bosonic system.

09.
arXiv (CS.AI) 2026-06-19

Denoising Implicit Feedback for Cold-start Recommendation

arXiv:2606.19658v1 Announce Type: new Abstract: Implicit feedback is widely used in recommender systems due to its accessibility and generality, yet it usually presents noisy samples (e.g., clickbait, position bias). Meanwhile, recommenders inevitably face the item cold-start problem due to the continuous influx of new items. We identify that cold items are more prone to noisy samples due to the aforementioned factors, and researchers often overlook the significance of denoising implicit feedback for cold items. Previous denoising studies usually identify noisy samples based on heuristic patterns, such as higher loss values, and mitigate noise through sample selection or re-weighting. However, these methods have limited adaptability and are ineffective in cold-start scenarios. To achieve denoising implicit feedback for cold-start recommendation, we propose a model-agnostic denoising method called DIF. First, user preferences for content remain stable, which allows us to infer pseudo-labels indicating whether a user is interested in a cold item through content-similar warm items. Furthermore, to improve pseudo-label accuracy, we model the confidence of pseudo-labels based on the content similarity between the cold item and warm items, and then aggregate multiple pseudo-labels for each sample. Finally, we explicitly estimate the uncertainty of the noisy sample label by considering its relative entropy and the cold-start status of the item, which adaptively guides the role of pseudo-labels to correct the noisy labels at the sample level. DIF's superiority is supported by both theoretical justification and extensive experiments on real-world datasets. The method has been deployed on a billion-user scale short video application Kuaishou and has significantly improved various commercial metrics within cold-start scenarios.

11.
medRxiv (Medicine) 2026-06-11

Plasma protein prioritisation in rheumatoid arthritis reveals druggable targets and shared biology with cardiovascular diseases

Abstract Background Rheumatoid arthritis (RA) is an autoimmune inflammatory disease with complex and incompletely understood molecular mechanisms. Understanding circulating proteins associated with RA may improve understanding of disease biology and clarify its pathological links with cardiometabolic comorbidities. Methods A proteome-wide two-sample Mendelian randomisation (MR) drug target analysis was conducted using plasma proteins measured in 54,219 participants from the UK Biobank Pharma Proteomics Project as exposures and RA and cardiometabolic diseases as the outcomes. Summary statistics for RA included 53,663 cases and 1,070,200 controls. Colocalisation analysis was performed to confirm shared single causal variants and prioritise RA proteins supported by both MR and colocalisation. The prioritised proteins were then evaluated in the Accelerating Medicines Partnership RA Phase II synovial single-cell dataset for cell-type expression patterns. Druggability was then assessed followed by analysis of genetic overlap between RA-associated proteins and cardiometabolic diseases. Results 37 plasma proteins had a causal effect on RA risk, supported by combined evidence from MR and conditional colocalisation. In synovial tissue, TPPP3, RARRES2, AKAP12, and GGT5 were predominantly expressed in stromal and endothelial cell clusters. Druggability assessment identified IFNGR2, IL6R, CD40, and FCGR2B as Tier 1 targets. However, several biologically relevant proteins, including RARRES2, AKAP12, TPPP3, and SNX2, had limited available druggability data. Genetic overlap analysis demonstrated shared protein signals between RA and cardiovascular diseases, including overlap of RARRES2 and TPPP3 with coronary artery disease (CAD) and FCGR2B with atrial fibrillation (AF). To approximate the therapeutic effect of target inhibition, the direction of effect estimates for proteins showing overlap between RA-CAD and RA-AF was reversed. Conclusion This study identified circulating proteins involved in RA pathogenesis and reveals shared mechanisms between RA and cardiovascular diseases. While some proteins showed clear translational potential targets, several prioritised proteins had limited available druggability information and could not be confidently classified. Addressing these gaps may help identify new targets relevant to RA management. Future work should also use phenome-wide MR studies to evaluate potential on-target adverse effects of protein inhibition across RA-CAD and RA-AF.

12.
arXiv (CS.CV) 2026-06-16

Disentangling Hallucinations: Orthogonal Semantic Projection for Robust Interpretability

As Vision-Language Models are increasingly deployed in safety-critical applications, the trustworthiness of their explanations becomes crucial. Explainable AI (XAI) methods for Vision-Language Models often suffer from semantic hallucination, where attribution maps highlight prominent image regions even when prompted with incorrect text descriptions (e.g., highlighting a dog when prompted ``cat''). Although this problem is widespread, a formal mathematical analysis of XAI methods and CLIP embeddings is largely missing in the literature. We demonstrate that this phenomenon is not specific to a single architecture but is a fundamental consequence of Linear Semantic Leakage in high-dimensional embedding spaces. We propose a unified theoretical framework, Linear Semantic Attribution (LSA), which generalizes across discriminative methods. We introduce OSP, a geometric intervention that utilizes the residual property of OMP to disentangle unique semantic signals from shared concepts. We prove theoretically and demonstrate empirically that OSP minimizes hallucination by orthogonalizing the query vector against distractor concepts, rendering the attribution model blind to shared features while preserving fidelity for correct prompts. Our code is available at: https://github.com/emirhanbilgic/Orthogonal-Semantic-Projection

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

VANDERER: Map-Free Exploration using Future-Aware and Visual-Curiosity-Guided Diffusion Policy

Mobile agents require efficient exploration strategies to map unseen environments and autonomously plan tasks. Traditional methods rely on generating occupancy maps and optimizing the sequence in which unexplored regions are visited. However, in sensor-constrained settings, such as those limited to monocular cameras, generating accurate occupancy maps is challenging. To address this, we propose VANDERER, an exploration framework that leverages a Visual Curiosity Module (VCM) to guide pre-trained diffusion policies using only monocular image data. This curiosity module predicts the outcomes of proposed actions via a navigation world model and evaluates them through a curiosity cost. The cost then guides the diffusion process toward generating actions that maximize exploration. Evaluated across diverse simulated environments, VANDERER consistently outperforms established baselines, exploring an average of 13.4% more area than NoMaD. Our results reveal a direct correlation between visual and geometric curiosity in outdoor environments, demonstrating that VANDERER can effectively leverage this relationship for efficient exploration using sensor-constrained agents.

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

Planning with Unified Multimodal Models

With the powerful reasoning capabilities of large language models (LLMs) and vision-language models (VLMs), many recent works have explored using them for decision-making. However, most of these approaches rely solely on language-based reasoning, which limits their ability to reason and make informed decisions. Recently, a promising new direction has emerged with unified multimodal models (UMMs), which support both multimodal inputs and outputs. We believe such models have greater potential for decision-making by enabling reasoning through generated visual content. To this end, we propose Uni-Plan, a planning framework built on UMMs. Within this framework, a single model simultaneously serves as the policy, dynamics model, and value function. In addition, to avoid hallucinations in dynamics predictions, we present a novel approach self-discriminated filtering, where the generative model serves as a self-discriminator to filter out invalid dynamics predictions. Experiments on embodied decision-making tasks show that Uni-Plan substantially improves success rates compared to VLM-based methods, while also showing strong data scalability, requiring no expert demonstrations and achieving better performance under the same training-data size. This work lays a foundation for future research in reasoning and decision-making with UMMs.

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

Auditing Discriminatory Patterns in Mortgage Lending Through Association Rules and Fair Binning

arXiv:2606.12435v1 Announce Type: cross Abstract: Mortgage lending in the United States exhibits persistent racial and gender disparities. We investigate whether standard data preprocessing steps, specifically attribute binning, amplify these disparities in downstream pattern mining. Using 103,481 cleaned mortgage applications from the HMDA 2023 dataset (Chicago metropolitan area), we build a three-stage pipeline: (1) a PySpark data cleaning and binning pipeline that implements both standard equal-frequency binning and the epsilon-biased fair binning algorithm from Asudeh et al. [1], (2) FP-Growth association rule mining that compares denial patterns under both binning regimes, and (3) K-Means clustering with a per-cluster disparate impact audit. Our standard binning shows 9.63% racial bias in income discretization, consistent with the 8-10% reported in prior work. Fair binning with seven race groups is infeasible at epsilon=0.03 and only succeeds at epsilon=0.08 with a Price of Fairness of 29.4%. FP-Growth reveals that high debt-to-income ratio is the dominant denial predictor (67.2% confidence, 2.81 lift), while racial bias does not appear as explicit high-support rules. However, K-Means clustering followed by a disparate impact audit flags 10 out of 45 cluster-group pairs, showing that Black applicants face significantly higher denial rates than White applicants even among financially similar groups.

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

When Cognitive Graphs Meet LLMs: BDEI Cognitive Pathways for Panic Emotional Arousal Prediction

Predicting individual panic emotional arousal timing before manifestation is essential for proactive emergency intervention. Existing methods incorporate cognitive elements but none explicitly model the emotional arousal process, making them ill-suited for emotional arousal timing prediction. We argue that grounding prediction in appraisal emotion theory is necessary because it explicitly models this process, but three problems must be solved. (1) Appraisal theory posits that emotion arises from simultaneous evaluation across multiple threat dimensions, yet no prior work fuses these inputs into risk perception. (2) Existing cognitive models lack an Emotion node, decoupling threat appraisal from emotional arousal and forcing emotions to be inferred indirectly from behaviors. (3) Given their generalizable cognitive reasoning, current approaches adopt LLMs as the primary decision-maker, yet overlook the fragility and hallucination-proneness of their outputs. To address these issues, we introduce PanicCognitivePath (PCP), a framework that addresses all three. A Psychological Safety Distance (PSD) model, grounded in psychological distance theory, maps four-domain signals into a unified risk metric as the entry condition for subsequent cognitive reasoning. An explicit Emotion node grounded in appraisal emotion theory is introduced into BDI, forming a Belief-Desire-Emotion-Intention (BDEI) pathway. Agents whose risk metric exceeds the PSD threshold enter this pathway, coupling threat appraisal directly to emotional arousal. The BDEI pathway governs all state transitions while the LLM is confined to parameter estimation for the Belief-to-Desire transition, confining hallucinations to a single step and preventing error propagation. Experiments on Hurricane Sandy show PCP improves arousal timing accuracy by 10.68% over baselines, reduces peak count error to 7.07%.

17.
arXiv (CS.CV) 2026-06-19

Evaluation of Image Matching for Art Skills Assessment

While some individuals possess a natural talent for drawing, mastering this skill requires dedicated training and practice. Determining one's skill in the art of drawing requires proper comprehensive assessment. In this paper, we propose a method to measure drawing skill by by matching the hand-drawn image with the original template. Existing techniques often involve complex processes. However, advancements in computer vision allow us to train computers to perform these comparisons at a human-like level, thereby resolving the tedious and overwhelming traditional process. Using computer vision applications, determining image similarity involves identifying the level of similarities in an image with a reference image. We have implemented and analyzed the SIFT feature and Siamese network to measure image similarity. Our results indicate that it is feasible to assess art skill levels. Through feature analysis, we found that SIFT-based key point matching provides a more effective means of detecting drawing skills.

18.
arXiv (CS.CV) 2026-06-16

Variational Test-time Optimization for Diffusion Synchronization

Collaborative generation, which coordinates multiple diffusion trajectories to extend the capabilities of pretrained priors, has emerged as a powerful paradigm for extending the applicability of diffusion models. Among existing approaches, diffusion synchronization provides a scenario-agnostic solution by introducing general guidance mechanisms. However, current synchronization approaches rely heavily on heuristics and still require task-specific tailoring, which limits their generalizability and performance. In this work, we mathematically derive a synchronization framework based on optimal control, providing a principled explanation of diffusion synchronization. During sampling, we optimize control variables to guide multiple trajectories toward coherent solutions while remaining close to the underlying diffusion prior. Our method operates entirely at test-time without additional training, thereby enabling broad applicability across diverse generation scenarios when combined with strong pretrained priors. We demonstrate consistent improvements over baselines on three representative collaborative generation tasks, covering a wide range of modalities and applications. Beyond performance gains, our work establishes a novel foundation for collaborative generation, opening a principled path toward extending pretrained generative models to new collaborative generation settings.

19.
arXiv (math.PR) 2026-06-11

Instability of a nonlinear oscillator with small friction and small additive noise

arXiv:2606.11389v1 Announce Type: new Abstract: Let $\lambda = \lambda(\beta,\sigma,a,b)$ denote the top Lyapunov exponent for the linearization along trajectories of the noisy damped non-linear oscillator $\ddot{x}+\beta \dot{x} + ax+bx^3 = \sigma \dot{W}_t$, where $a$, $b$ and $\beta$ are all positive and $\sigma \neq 0$. In 2004 Arnold, Imkeller and Sri Namachchivaya stated without proof that $\lambda(\varepsilon^2 \beta,\varepsilon \sigma,a,b) \sim \overline{\lambda} \varepsilon^{2/3}$ as $\varepsilon \to 0$ with $\overline{\lambda} > 0$. This paper contains a proof of this assertion.

20.
arXiv (quant-ph) 2026-06-17

Many-body spectral transitions through the lens of the variable-range SYK2 model

arXiv:2412.14280v2 Announce Type: replace-cross Abstract: The Sachdev-Ye-Kitaev (SYK) model is a cornerstone in the study of quantum chaos and holographic quantum matter. Real-world implementations, however, deviate from the idealized all-to-all connectivity, raising questions about the robustness of its chaotic properties. In this work, we investigate a quadratic SYK model with distance-dependent interactions governed by a power-law decay. By analytically and numerically studying the spectral form factor (SFF), we uncover how transitions present in the single-particle limit carry over to the many-body system. Non-trivial cancellations in the one-loop contributions lead to a robustness of the SFF under a considerable reduction of the interaction range. Further suppression leads to a breakdown of perturbation theory around the infinite-range path-integral saddle and the appearance of new spectral regimes, marked by a higher dip and the emergence of a secondary plateau. Our results highlight the interplay between single-particle criticality and many-body dynamics, offering new insights into the quantum chaos-to-localization transition and its reflection in spectral statistics.

21.
arXiv (CS.LG) 2026-06-19

Capturing Intransitive Dominance in Tennis Forecasting: A Graph Neural Network Approach

arXiv:2510.20454v2 Announce Type: replace Abstract: Intransitive player dominance, where player A beats B, B beats C, but C beats A, is common in competitive tennis. Yet, there are few known attempts to incorporate it within forecasting methods. We address this problem with a graph neural network approach that explicitly models these intransitive relationships through temporal directed graphs, with players as nodes and their historical match outcomes as directed edges. Our model (65.7% accuracy, 0.214 Brier score) forecasts competitively with established rating systems such as Weighted Elo. Although it does not improve on the baseline in unconditional accuracy, a forecast-encompassing test shows that it carries complementary information. A combined forecast significantly outperforms Weighted Elo, and there is some indication that the gain grows more strongly on the intransitive matchups our model targets. A graph-based representation of player interactions thus captures a forecasting signal that transitive rating systems discard, even between players who share no common opponents.

22.
arXiv (CS.AI) 2026-06-15

Applicability Condition Extraction for Therapeutic Drug-Disease Relations

arXiv:2606.14031v1 Announce Type: new Abstract: Identifying conditions that a certain drug takes therapeutic effect on a target disease is crucial for clinical decision-making support. However, most existing biomedical information extraction methods have focused on identifying only relations between drugs and diseases, while largely overlooking the context-specific conditions where such relations can apply. To address this problem, we introduce the task of applicability condition extraction for therapeutic drug–disease relations from biomedical research literature. We create the first dataset that has manually annotated triples of drugs, diseases, and applicability conditions on biomedical paper abstracts with 1,119 drug-disease pairs. Using this dataset, we systematically evaluate the performance of a range of existing methods. In addition, we propose a new method that enhances LoRA to consider relations between drugs and diseases. Our method consistently outperforms strong baselines across different evaluation settings. The source code and dataset of this paper can be obtained from: https://github.com/guantingluo98/Drug-ACE

23.
medRxiv (Medicine) 2026-06-22

Knowledge, Attitudes, and Practices Regarding Maternal Nutrition Counselling Among Frontline Health Workers in Udupi, Karnataka, India: A Sequential Explanatory Mixed-Methods Study

Background Indias maternal nutrition profile is undergoing a dual-direction shift, with persistent undernutrition coexisting alongside rising overweight and micronutrient deficiencies. Despite national efforts through Integrated Child Development Services (ICDS) and the National Health Mission (NHM), maternal dietary diversity remains suboptimal in India. Frontline health workers (FLWs) play a central role in delivering nutrition counselling; however, gaps remain between knowledge and its translation into practice, highlighting the need to strengthen training, applied competencies, and health system support within primary care settings. Objective To assess knowledge, attitudes, and practices (KAP) regarding maternal nutrition counselling among FLWs and to explore contextual factors influencing counselling delivery. Methods A sequential explanatory mixed-methods study was conducted in Udupi, Karnataka, India. In phase one, 46 FLWs- Accredited Social Health Activists (ASHA), Community Health Officers (CHO), and Primary Health Care Officers (PHCO) completed a validated Knowledge, Attitudes, and Practices (KAP) questionnaire. Data were analysed using descriptive statistics, Kruskal-Wallis test, Spearman correlation, and exploratory multiple linear regression. In phase two, one focus group discussion with 21 participants was conducted and analysed using reflexive thematic analysis. Results FLWs demonstrated moderate KAP scores (37.50 {+/-} 5.09), with lower scores observed in dietary diversity knowledge and counselling practices. CHOs and PHCOs had significantly higher knowledge (p < 0.001) and practice scores (p = 0.002) compared to ASHAs, while attitudes were similar across cadres. Knowledge was positively associated with practice ({rho} = 0.389, p = 0.008). Exploratory regression indicated that cadre and knowledge were associated with practice, while attitude was not statistically significant. Qualitative findings suggested that counselling was largely protocol-based and constrained by workload, limited counselling tools, economic barriers, and cultural food practices. Conclusion Despite positive attitudes towards maternal nutrition counselling, frontline health workers demonstrated gaps in knowledge and counselling practices. Mixed-methods findings suggest that counselling delivery is shaped by both provider competencies and health-system constraints, highlighting the need for implementation-focused strategies to strengthen maternal nutrition counselling in routine antenatal care.

24.
medRxiv (Medicine) 2026-06-22

Sex-specific multimorbidity clusters and all-cause mortality in relatively healthy older adults: findings from the ASPREE cohort

Background: Multimorbidity is common in older adults, but sex differences in chronic condition clustering remain unclear. This study explored multimorbidity clusters and their associations with all-cause mortality among community-dwelling adults aged 70 years and over. Methods: This was a secondary analysis of data from 16,095 Australian ASPREE participants aged at least 70 years without prior dementia or cardiovascular disease. Fifteen baseline chronic conditions were grouped using latent class analysis (LCA). Observed-to-expected (O/E) ratios characterised conditions over-represented within clusters, and Cox proportional hazards models assessed associations with all-cause mortality. Results: Among 16,095 participants (mean age 74 years), 88.3% had multimorbidity at baseline; 4,217 deaths occurred over a median follow-up of 10.85 years. Five clusters were identified overall: hypertension and dyslipidemia (52.1%), gout and metabolic (14.4%), depressive symptoms, osteoporosis and frailty (10.0%), anaemia and kidney disease (10.2%), and hypotension, thyroid disorder and past cancer (13.3%). Sex-stratified analyses revealed three clusters in males and four in females. The frailty, depressive symptoms and osteoporosis cluster was associated with higher mortality in both sexes (aHR 1.56 [95% CI 1.40-1.73] in males; 1.68 [1.49-1.89] in females). Higher mortality was also observed for the metabolic, gout and kidney disease cluster in males (aHR 1.63 [1.47-1.81]) and the gout, anaemia and kidney disease cluster in females (aHR 1.96 [1.74-2.21]). Conclusions: Distinct multimorbidity clusters differed by sex and were associated with increased all-cause mortality. These findings may support risk stratification, targeted screening, and more person-centred management of older adults with multimorbidity.

25.
arXiv (quant-ph) 2026-06-15

Dealing with locality in QAOA

arXiv:2606.14447v1 Announce Type: new Abstract: Shallow-depth QAOA on sparse, high-diameter MaxCut instances faces a locality bottleneck: at depth \(p\), local observables can depend only on a bounded neighborhood of the circuit interaction graph. We propose a transport-augmented QAOA that keeps the MaxCut cost Hamiltonian unchanged but enriches the mixer with optimized, unweighted shortcut couplings (scheduled \(XX+YY\)) to collapse the effective interaction-graph diameter. Using exact finite-depth support recursions, we relate optimal shortcut placement to bounded-diameter graph augmentation, and show in benchmarks that (unlike ma-QAOA) performance becomes effectively size-invariant once the diameter is reduced. For bipartite families (base diameter 4), reducing the interaction path to \(d=1\) raises the ensemble-averaged approximation ratio from 0.7378 (ma-QAOA) to 0.9767 at \(p=1\) (\(\sigma=0.0251\), nine system sizes); on random trees (base diameter 10), at \(p=2\) it improves from 0.9226 to 0.9997 (\(\sigma=0.0001\)).