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01.
arXiv (CS.CV) 2026-06-19

Geometry-Preserving in 3D Gaussian Splatting for LiDAR-Camera Extrinsic Calibration

Accurate LiDAR-camera calibration is essential for robust multi-modal perception. Targetless approaches avoid manual setup but remain limited by the scarcity of discriminative cross-modal features. Recent methods address this by reconstructing the scene within a differentiable model, enabling extrinsic optimization through dense photometric supervision. Among these, 3D Gaussian Splatting (3DGS) has been widely adopted as a geometric proxy that bridges LiDAR and camera within a single differentiable framework. However, since 3DGS was originally designed for novel view synthesis, existing methods tend to prioritize rendering quality, causing the proxy geometry to drift from the true LiDAR structure. We propose a framework that preserves the metric geometry of the Gaussian proxy by aggregating multi-view LiDAR observations for dense depth supervision and blocking photometric gradients from updating the Gaussian spatial parameters. We validate our method on public driving datasets, where it consistently outperforms existing targetless methods in calibration accuracy.

02.
arXiv (CS.LG) 2026-06-18

P$^2$CE: Model-Agnostic Plausible Pareto-Optimal Counterfactual Explanations

arXiv:2606.18418v1 Announce Type: new Abstract: The increasing use of machine learning algorithms in social applications has raised concerns about fairness and transparency, leading to the development of counterfactual explanations. These explanations supports individuals to understand and potentially alter unfavorable decisions in areas such as loan applications, job selections, and more, by providing actionable changes to input features that would lead to a desired outcome. Existing methods often struggle to balance feasibility, plausibility, and computational efficiency. To address this, we introduce P$^2$CE, an algorithm for generating plausible Pareto-optimal counterfactual explanations, offering users a diverse set of optimal trade-offs between different notions of feasibility. P$^2$CE employs an auxiliary isolation forest outlier detector to ensure that explanations are in accordance with the data distribution and leverages SHAP values to obtain optimal results with short computing times, regardless of the underlying model. Our algorithm was empirically evaluated on three datasets, demonstrating superior performance in terms of both solution quality and computational efficiency compared to related techniques.

03.
arXiv (quant-ph) 2026-06-16

Against probability: A quantum state is more than a list of probability distributions

arXiv:2601.18872v2 Announce Type: replace Abstract: The state of a quantum system can be represented by listing the outcome probabilities for a tomographically complete set of measurements. Such representations appear throughout physics, for example, in quantum field theory via correlation functions and in quantum foundations within generalized probabilistic frameworks. In this paper, we show a no-go result: To enable useful statements, the probability representation must be topologically robust$\unicode{x2014}$preserving the notion of closeness between states. Yet, a topologically robust probability representation cannot simultaneously retain other essential structure, such as the subsystem structure.

04.
arXiv (CS.AI) 2026-06-17

When Life Gives You BC, Make Q-functions: Extracting Q-values from Behavior Cloning for On-Robot Reinforcement Learning

arXiv:2605.05172v2 Announce Type: replace-cross Abstract: Behavior Cloning (BC) has emerged as a highly effective paradigm for robot learning. However, BC lacks a self-guided mechanism for online improvement after demonstrations have been collected. Existing offline-to-online learning methods often cause policies to replace previously learned good actions due to a distribution mismatch between offline data and online learning. In this work, we propose Q2RL, Q-Estimation and Q-Gating from BC for Reinforcement Learning, an algorithm for efficient offline-to-online learning. Our method consists of two parts: (1) Q-Estimation extracts a Q-function from a BC policy using a few interaction steps with the environment, followed by online RL with (2) Q-Gating, which switches between BC and RL policy actions based on their respective Q-values to collect samples for RL policy training. Across manipulation tasks from D4RL and robomimic benchmarks, Q2RL outperforms SOTA offline-to-online learning baselines on success rate and time to convergence. Q2RL is efficient enough to be applied in an on-robot RL setting, learning robust policies for contact-rich and high precision manipulation tasks such as pipe assembly and kitting, in 1-2 hours of online interaction, achieving success rates of up to 100% and up to 3.75x improvement against the original BC policy. Code and video are available at https://pages.rai-inst.com/q2rl_website/

06.
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.

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

EffiNav: Fusing Depth and Vision-Language for Efficient Object Goal Navigation

arXiv:2606.18634v1 Announce Type: cross Abstract: To locate a target object while exploring the unknown environment is a fundamental capability for autonomous agents, with applications ranging from search-and-rescue to field robots. A simplified version of such task is Object Goal Navigation (ObjNav). In ObjNav, successful arrival at the target object provides a basic measure of performance; however, the efficiency of the navigation trajectory is equally important, as it indicates how intelligently the agent explores and how much time remains for subsequent tasks. In unknown environments, the key to efficient navigation lies in deciding where to explore next. While many prior works aim to address this core challenge and achieved promising performance in certain settings, recent training-based models and non-training frameworks still suffer from generalization and efficiency issues respectively, which in the worst cases can lead to excessive exploration of already-visited areas or redundant back-and-forth motion. We evaluate EffiNav on two widely used simulation benchmarks Habitat Matterport 3D (HM3D) and Open-Vocabulary Object goal Navigation (OVON), and further validate its effectiveness on physical robots in real-world settings. We conduct failure analysis on massive simulation episodes. With minimal modification, we also extend EffiNav to a memory-augmented ObjNav task on the GOAT-BENCH dataset, demonstrating its adaptability beyond standard ObjNav settings. Across two standard metrics–Success Rate (SR) and Success weighted by Path Length (SPL), EffiNav matches or outperforms recent baselines, reflecting its efficiency, robustness, and practical applicability. Recognizing the different emphases of the two datasets, the performances reveals this framework is more balanced and generalizable for efficient ObjNav.

08.
arXiv (CS.AI) 2026-06-16

WorkflowPerturb: Calibrated Stress Tests for Evaluating Multi-Agent Workflow Metrics

arXiv:2602.17990v2 Announce Type: replace Abstract: Multi-agent LLM systems that generate structured workflows from natural-language requests are now deployed in production across cloud automation, DevOps, and enterprise process orchestration. Operating such systems exposes a recurring change-management problem. Routine updates, such as re-running the same input, swapping the underlying LLM, or refactoring an agent's prompt or orchestration code, frequently produce workflows that differ substantially from previously validated references. Engineers are then left without a principled way to decide whether a change is safe to ship. Automatic workflow evaluation is the natural tool for answering this question. In practice, however, metric scores are poorly calibrated, and a numeric change rarely communicates the severity of the underlying degradation. We introduce WorkflowPerturb, a controlled benchmark for studying workflow evaluation metrics by applying realistic, graded perturbations to golden workflows. WorkflowPerturb contains 4,973 golden workflows and 44,757 perturbed variants across three perturbation types (Missing Steps, Compressed Steps, and Description Changes), each applied at severity levels of 10%, 30%, and 50%. We benchmark multiple metric families and analyze their sensitivity and calibration using expected score trajectories and residuals. Our results characterize systematic differences across metric families and support severity-aware interpretation of workflow evaluation scores in change-management settings. Our dataset will be released upon acceptance.

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

CloudCons: A Comprehensive End-to-End Benchmark for Cloud Resource Consolidation

arXiv:2606.13513v1 Announce Type: new Abstract: Driven by conservative over-provisioning to guarantee service reliability, resource utilization in cloud data centers remains at low levels. To mitigate this, the forecast-then-optimize paradigm has emerged to optimize consolidation by anticipating future demands. While emerging time series foundation models promise to enhance this paradigm through zero-shot generalization, existing benchmarks focus solely on prediction error metrics. The actual decision utility of these advanced models remains unverified, rendering their practical value for downstream tasks uncertain. To bridge this gap, we propose CloudCons, a comprehensive end-to-end benchmark designed to evaluate forecasting models within the specific context of cloud resource consolidation. We build high-quality datasets that cover diverse workloads from Huawei Cloud, Microsoft Azure, and Google Borg, capturing distinct service characteristics ranging from synchronized diurnal rhythms to stochastic, pulse-like bursts and high-frequency noise. We conduct an extensive evaluation of statistical, deep learning, and foundation models. Our experiments reveal a pivotal finding: while foundation models demonstrate superior zero-shot forecasting accuracy, this advantage does not inherently translate into better decision utility. Of practical significance, we systematically analyze how the selection of predictive quantiles acts as a critical lever. We provide actionable guidelines for calibrating these selections to balance the trade-off between resource efficiency and service reliability, offering vital insights for real-world deployment decisions.

10.
arXiv (math.PR) 2026-06-16

Sharp connectivity bounds for the vacant set of random interlacements

arXiv:2504.02777v2 Announce Type: replace Abstract: We consider percolation of the vacant set of random interlacements at intensity $u$ in dimensions three and higher, and derive lower bounds on the truncated two-point function for all values of $u>0$. These bounds are sharp up to principal exponential order for all $u$ in dimension three and all $u \neq u_\ast$ in higher dimensions, where $u_*$ refers to the critical parameter of the model, and they match the upper bounds derived in the article arXiv:2503.14497. In dimension three, our results further imply that the truncated two-point function grows at large distances $x$ at a rate that depends on $x$ only through its Euclidean norm, which offers a glimpse of the expected (Euclidean) invariance of the scaling limit at criticality. The rate function is atypical, it incurs a logarithmic correction and comes with an explicit pre-factor that converges to $0$ as the parameter $u$ approaches the critical point $u_*$ from either side. A particular challenge stems from the combined effects of lack of monotonicity due to the truncation in the super-critical phase, and the precise (rotationally invariant) controls we seek, that measure the effects of a certain "harmonic humpback" function. Among others, their derivation relies on rather fine estimates for hitting probabilities of the random walk in arbitrary direction $e$, which witness this invariance at the discrete level, and preclude straightforward applications of projection arguments.

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

WorkBench Revisited: Workplace Agents Two Years On

作者:

The best agent on WorkBench in March 2024, GPT-4, completed 43% of tasks and took an unintended harmful action, such as emailing the wrong person, on 26% of them. We re-visit the benchmark in June 2026 and find that the best agent to date, Claude Opus 4.8, completes 89% and takes an unintended harmful action on 2.5%. Aside from this considerable progress in frontier agent performance, three things stand out. First, capability and safety go together on WorkBench rather than trade off, so the models that finish the most tasks also do the least unintended damage. Second, while several classes of error have been totally eliminated, frontier models still make some basic mistakes that occasionally result in irreversible harm, such as sending an email to the wrong person. Third, the rise of open-weight models has drastically lowered costs for a performance level that was previously only accessible to proprietary models, while frontier costs have stayed relatively stable. We release an updated version of the benchmark with data and code quality improvements, new model scores, and analysis of agent progress on WorkBench since 2024.

12.
arXiv (CS.LG) 2026-06-11

AsFT: Anchoring Safety During LLM Fine-Tuning Within Narrow Safety Basin

arXiv:2506.08473v4 Announce Type: replace Abstract: Fine-tuning large language models (LLMs) improves performance but introduces critical safety vulnerabilities: even minimal harmful data can severely compromise safety measures. We observe that perturbations orthogonal to the alignment direction - defined by weight differences between aligned (safe) and unaligned models - rapidly compromise model safety. In contrast, updates along the alignment direction largely preserve it, revealing the parameter space as a "narrow safety basin". To address this, we propose AsFT (Anchoring Safety in Fine-Tuning) to maintain safety by explicitly constraining update directions during fine-tuning. By penalizing updates orthogonal to the alignment direction, AsFT effectively constrains the model within the "narrow safety basin," thus preserving its inherent safety. Extensive experiments on multiple datasets and models show that AsFT reduces harmful behaviors by up to 7.60%, improves task performance by 3.44%, and consistently outperforms existing methods across multiple tasks.

14.
arXiv (quant-ph) 2026-06-16

Black Hole–Entropy Container or Creator

arXiv:2603.18374v3 Announce Type: replace-cross Abstract: Do black holes possess entropy or do they create it? The dominant assumption is that they possess entropy, and a they evaporate that entropy is emitted and decreases. In this paper I use a model of a linear amplifier, in which I argue that the amplifier has not entropy and yet it emits entropy in the process of it operation. This model is closely related to behaviour of black holes, resulting in answer the question of that title that black holes do not have entropy, but nevertheless them create and emit entropy with the total entropy emitted being the same as the usual expression proportional to the square of the mass of the black hole.

15.
arXiv (CS.CL) 2026-06-16

DYNA : Dynamic Episodic Memory Networks for Augmenting Large Language Models with Temporal Knowledge Graphs in Continuous Learning

Large Language Models (LLMs) struggle to incorporate new knowledge without forgetting or costly retraining. We propose DYNA, a lightweight framework that augments a frozen LLM with a temporal knowledge graph where events are nodes and temporal relations are directed, timestamped edges. The graph serves as an external, updatable memory. At query time, DYNA retrieves relevant nodes via random walks and centrality measures, then augments the LLM's response. Evaluated on three temporal recall tasks, DYNA reduces catastrophic forgetting by ~7% compared to fine-tuning and improves temporal ordering by ~5% over standard RAG. Higher graph clustering coefficients correlate with better retrieval, showing that graph structure matters. Contributions: (1) episodic memory as temporal KG, (2) retraining-free LLM augmentation, (3) graph properties as predictors of retrieval performance.

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

Eigen-Spike Emergence and Quadratic Equivalents for Conjugate Kernels on Nonlinearly Separable Data

arXiv:2605.29669v2 Announce Type: replace-cross Abstract: Recent work in random matrix theory (RMT) has developed the notion of deterministic equivalents: typically linear surrogate models that approximate the spectral behavior of large nonlinear random matrices, such as nonlinear feature maps in neural networks (NNs). Such equivalents make theoretical predictions tractable by reducing a complex model to a simpler one with properties that fall under the umbrella of classical RMT tools. However, this leaves open the question of whether this idealized linear equivalence remains meaningful for classification of high-dimensional nonlinearly separable data. Motivated by this, we consider the conjugate kernel (CK), which is the nonlinear feature map of a one-layer feedforward NN, under a canonical nonlinearly separable dataset for the XOR problem; and we use the study of informative outlier eigenvalues in the CK and whether their corresponding eigenvectors asymptotically align with XOR labels as a proxy for nonlinear learnability. We develop a robust quadratic equivalent of the CK matrix that enables a precise analysis of emergent informative spikes, as one modifies various knobs common in ML practice: sample complexity, signal-to-noise ratio (SNR), nonlinear activation choice, and pretrained features. We identify regimes in which these knobs move the CK beyond the linear equivalent and produce BBP-type transitions to label-aligned outlier eigenspaces. Our analysis helps bring deterministic-equivalence tools from RMT to bear on problems of practical relevance in ML.

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

CoMNeT: A MedNeXt-CorrDiff Framework for Volumetric Brain Tumor Segmentation

Accurate brain tumor segmentation from multiparametric magnetic resonance imaging (MRI) is critical for treatment planning, response assessment, and quantitative neuro-oncology research. However, automated segmentation remains a difficult task in computer vision because of variation in tumor appearance and MRI protocols across patient scans. Moreover, clinically important regions such as enhancing tumor (ET) and tumor core (TC) are often small relative to the full brain volume, furthering increasing the difficulty of achieving high voxel-level precision. In this paper, we show that combining a modern 3D convolutional segmentation model with corrective diffusion-based refinement and ensembling improves volumetric glioma segmentation on the UTSW-Glioma dataset. We propose CoMNeT, a MedNeXt-CorrDiff framework that uses four MRI modalities as input and predicts ET, TC, and whole tumor (WT) regions for automated brain tumor segmentation. MedNeXt is used as the primary segmentation model with Global Response Normalization for feature learning, while CorrDiff is trained as a postprocessing residual refinement method to correct errors in the probability maps before final thresholding. Using five-fold cross-validation, CoMNeT achieved the highest Dice score for most tumor regions, with ET, TC, WT, and average Dice scores of 0.7543 +/- 0.0261, 0.6806 +/- 0.0166, 0.9049 +/- 0.0128, and 0.7798 +/- 0.0184, respectively. CoMNeT outperformed two selected baseline models: SegResNet (0.7555 +/- 0.0190 average Dice) and standalone MedNeXt (0.7697 +/- 0.0154 average Dice). Our findings support the use of corrective diffusion and fold-level probability ensembling as practical additions to existing state-of-the-art 3D convolutional models for automated glioma segmentation.

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

XPR: An Extensible Cross-Platform Point-Based Differentiable Renderer

Point-based differentiable rendering underpins modern 3D reconstruction, novel-view synthesis, and learning-based graphics pipelines, but developing new rendering methods often requires extensive low-level implementation, hardware-specific kernels, and manually written backward passes. This limits rapid prototyping, reproducibility, exploration, and deployment, especially across diverse hardware platforms. This paper presents XPR, an extensible cross-platform framework for point-based differentiable rendering. XPR introduces a high-level programming interface that separates method-specific logic from the shared rendering pipeline, allowing users to implement new methods in a few lines of code. Its pipeline decomposes rendering into modular, statically shaped parallel operations that can be lowered by a cross-platform compiler to GPUs, TPUs, CPUs, and other ML accelerators. We demonstrate implementations of 3DGS, 3DGUT, and LinPrim, with only a few 100s lines of Python code, each of which can be compiled to a range of hardware platforms with the XLA compiler. These results show that XPR enables fast experimentation and portable execution for emerging point-based differentiable rendering systems.

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

Petrov-Galerkin Variational Physics-Informed Neural Network Framework for Two-Dimensional Singularly Perturbed Problems

arXiv:2606.16510v1 Announce Type: cross Abstract: This study proposes a Petrov-Galerkin based Variational Physics-Informed Neural Network (VPINN) for efficiently solving two-dimensional singularly perturbed problems (SPPs) with one and two small perturbation parameters. The approach employs neural networks to construct the trial solution space, while tensor-product hat functions are adopted as test functions to enforce the variational form. To accurately resolve of sharp boundary layers, the variational form is implemented using a Petrov-Galerkin formulation. Dirichlet boundary conditions are imposed directly, while the source terms are computed using automatic differentiation. Computational experiments on standard two-dimensional problems demonstrate that the proposed method achieves high accuracy in both the maximum and L_2 norms. These results confirm the efficiency and robustness of the Petrov-Galerkin VPINN approach in accurately capturing the multiscale features of two-dimensional SPPs.

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

Recovering Stranded Discrimination in Knowledge Tracing: Per-Item Bias Correction via Empirical-Bayes Shrinkage

arXiv:2606.14123v1 Announce Type: cross Abstract: Deployed knowledge-tracing models are typically frozen after training, yet systematic per-item logit bias arises, from limited per-item expressivity in backbone architectures and from post-deployment shifts in item properties, degrading prediction quality. Global post-hoc calibrators such as Platt scaling, temperature scaling, and isotonic regression improve probability estimates but leave discriminative ability, as measured by AUC, unchanged. This AUC invariance is a structural consequence of monotone score-only transforms; recovering the stranded discrimination requires conditioning on item identity. We propose SLC (State-space Logit Correction), which converts binary observations to Gaussian pseudo-observations via Laplace/IRLS, applies empirical-Bayes shrinkage through a Kalman smoother, and fits an offset-Platt link. The state-space formulation also yields a detectability bound that characterizes the Bernoulli information floor, explaining why temporal tracking provides no benefit at current data densities. Across four datasets, five backbones, and three seeds, SLC improves AUC on all four datasets and NLL on three, with the advantage concentrating on sparse items. Cross-domain controls suggest that the same phenomenon can arise beyond education when the deployed backbone leaves entity-level bias.

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

Detecting Hidden ML Training With Zero-Overhead Telemetry

arXiv:2606.19262v1 Announce Type: new Abstract: Hardware-enabled monitoring of GPU workloads underpins many proposals for AI compute governance, but if developers can defeat monitoring mechanisms, such schemes are unworkable. We evaluate the adversarial robustness of GPU workload classification using only zero-overhead, privacy-preserving NVML telemetry: content-agnostic signals that observe physical effects of computation without accessing model weights, training data, or hyperparameters. Across 5 rounds of monitor-evader iteration, we evaluate 20 evasion strategy families on 9 GPU models spanning 4 architecture generations. We develop a classifier that achieves 98.2% binary accuracy at identifying training workloads across the whole corpus, and 43-87% accuracy against the most challenging unexpected workloads even when they are adversarially disguised.

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

Where Black-box Drug-Target Interaction Prediction Models Look: Cross-Method Explainability

arXiv:2606.14245v1 Announce Type: new Abstract: Drug-target interaction (DTI) and affinity (DTA) predictors increasingly achieve strong benchmark scores, yet their internal use of sequence, fingerprint, and graph features often remains opaque. We present an interpretability audit of BridgeDPI architecture on three different datasets including Gao, Human, and C.elegans. This study combines gradient-based attributions – integrated gradients, saliency, layer-wise relevance propagation, SmoothGrad, and SmoothGrad-IG – with feature-wise occlusion ablation and strict intersection consensus across methods to reduce single-explainer bias. We summarize sensitivity and signed effects at raw inputs, at the bridge similarity scaffold, and through the graph convolution, including edge-level sensitivities and targeted edge removals. The results show that explainability is most informative when treated as model criticism: it reveals modality dominance, padding and special-token artifacts, dataset-dependent cooperative versus suppressive effects across layers, and chemistry-consistent fragment and composition motifs where methods agree. These analyses do not substitute for structural or experimental ground truth, yet they can provide testable hypotheses for downstream validation in computational drug discovery pipelines. More broadly, applying modern XAI to contemporary DTI/DTA models is still an early pass over the rich structure implicit in trained weights and data – yet even this first layer of scrutiny already helps researchers relate predictions to drug- and target-side representations and to prioritize external validation.

23.
arXiv (math.PR) 2026-06-11

Feynman–Kac formula for the heat equation with a one-center point interaction in $d=3$

arXiv:2606.11677v1 Announce Type: new Abstract: We study Schrödinger operators with a one-center point interaction, formally defined by \begin{align*} -\Delta_\alpha=-\Delta+\alpha\,\delta_0(\cdot), \end{align*} for $\alpha\in\mathbb{R}$, and the associated heat equation \begin{align} \partial_t u=\tfrac{1}{2}\Delta_{\alpha} u,\quad u(0,x)=u_0(x)\in C_c^{\infty}(\mathbb{R}^3\setminus\{0\}).\label{eq:HEapp} \end{align} Here $\Delta$ denotes the Laplacian (self-adjoint on $L^2(\mathbb{R}^3)$) and $\delta_x$ the Dirac measure at $x$. The operator $-\Delta_\alpha$ can be realized either as a self-adjoint extension of $-\Delta|_{C_0^{\infty}(\mathbb{R}^3\setminus\{0\})}$ in $L^2(\mathbb{R}^3)$, or as the norm-resolvent limit of $-\Delta+\lambda_\varepsilon V(\cdot/\varepsilon)$ for suitable $\lambda_\varepsilon$ and $V:\mathbb{R}^3\to\mathbb{R}$. In this paper we construct, for each $t>0$ and $x\in\mathbb{R}^3\setminus\{0\}$, a probability law on path space and a normalizing function $G_t^\alpha(x)$ giving the following probabilistic representation of the solution to the associated equation: \begin{align*} u(t,x)=G_t^\alpha(x)\,\mathbb{E}\bigl[u_0\bigl(W^{t,x}(t)\bigr)\bigr], \end{align*} where $\{W^{t,x}(s):0\le s\le t\}$ is a continuous process depending on $(t,x,\alpha)$. The result provides a Feynman–Kac type formula for the heat equation with a one-point interaction in three dimensions.

24.
medRxiv (Medicine) 2026-06-15

Beyond the Apnea-Hypopnea Index: Physiological and Demographic Predictors of Excessive Daytime Sleepiness in Obstructive Sleep Apnea

Excessive daytime sleepiness (EDS) is a common but inconsistently predicted symptom of obstructive sleep apnea (OSA). OSA is typically diagnosed with polysomnography (PSG), and the current standard for severity assessment is the apnea-hypopnea index (AHI). AHI has many limitations, including its inability to explain physiological mechanisms or reflect variability in patient symptoms, such as EDS. This retrospective study aims to find physiological and demographic parameters that better predict EDS in patients with OSA and to evaluate whether these parameters outperform AHI using PSG data from the Mount Sinai Integrative Sleep Center. Clinical variables used to predict EDS included arousal index (AI), average oxygen desaturation during sleep, average heart rate during sleep, and AHI, along with demographic variables including age, sex, and BMI. Hypothesis tests, logistic regression models, and decision tree classifier models were performed on the data to discriminate sleepy from nonsleepy patients as determined by an Epworth Sleepiness Scale (ESS) score [≥] 10. AI and oxygen desaturation were found to be the most predictive physiological variables, and sex and BMI were found to be the most predictive demographic variables. The final decision tree model with these four variables outperformed the AHI in predicting EDS. These findings suggest that daytime sleepiness in OSA can be better explained by measures of apnea burden, oxygenation impairment, and patient demographics than by AHI alone, although these remain only modestly predictive. Future studies should focus on investigating more comprehensive physiological markers, multi-night sleep data, and more objective assessments of sleepiness.

25.
medRxiv (Medicine) 2026-06-10

Impact of Early Treatment on Symptom Improvement and Procedural Events among Men with BPH and Bothersome Lower Urinary Tract Symptoms: A Contemporary Analysis of the American Urological Association Quality (AQUA) Registry

PURPOSE: As the armamentarium of BPH therapies continues to expand, it remains imperative to maximize patient satisfaction and minimize decisional regret. We sought to determine the impact of time from BPH diagnosis to index treatment on symptom improvement and subsequent procedural events. MATERIALS AND METHODS: We queried the American Urological Association Quality Registry for men [&ge;] 40 years old with BPH, available IPSS data, and no receipt of prior BPH treatment. Index treatment included medication, surgery, or minimally invasive surgical therapy (MIST). Outcomes included IPSS over 3 years of follow-up, change in percentage of mild lower urinary tract symptoms (LUTS) by 3 months, and time to procedural event. Patients were stratified by time from index diagnosis to treatment by 3 years. Outcomes were compared across time-to-treatment cohorts with appropriate statistical tests with p < 0.05 as significant. RESULTS: 43,919 patients met criteria with 19,642 pursuing treatments. Patients pursued treatment at comparably lower baseline IPSS compared to prior prospective series. Patients undergoing surgery and MIST had significantly higher baseline IPSS, while medical comorbidities were significantly more common among men initiating pharmacotherapy. Early surgery and MIST were associated with significant improvement in IPSS within 6-12 months and an increase in mild LUTS by 3 months. All forms of early treatment were associated with delayed time to procedural events, including catheterization and fulguration. CONCLUSIONS: Early procedural intervention for BPH is associated with early symptom improvement and delayed time to procedural events among real-world, contemporary practice.