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01.
arXiv (quant-ph) 2026-06-16

Experimental quantum state learning with pairs of photons

arXiv:2606.16932v1 Announce Type: new Abstract: Tomography allows one to estimate the density matrix describing the state an ensemble of quantum systems are prepared in (for example, polarization tomography determines the polarization state of a beam of identically prepared photons). In general, it is not possible to uniquely decompose the density matrix into its pure state components. Agarwal et al. proposed a protocol which, for a mixture composed of any two pure states of a qubit (with arbitrary probabilities), allows an observer to infer not only the density matrix but the identity of those specific pure states and their weights - the additional requirement being that the qubits arrive in pairs, where both qubits in each pair are in the same state. We experimentally demonstrate this learning-from-pairs concept using photons in the polarization degree of freedom. We use tomography to measure a sequence of single photons and make use of their time-of-arrival information to 'pair up' the photons after the measurement. From here we are able to infer the photons' polarization states and their respective probabilities, and we demonstrate this for various different choices of polarization states and ratios. Finally, we investigate our ability to discriminate between two equal mixtures of distinct pairs of orthogonal polarization states. We find that on the order of approx. 10e4 photons is typically enough to achieve tomography fidelities of approximately 0.9999. This is sufficient to discriminate between two different preparations of the same mixed state, differing by angles of less than 5 degrees between the pure states used in the two preparations.

02.
medRxiv (Medicine) 2026-06-23

Respiratory support with Continuous Positive Airway Pressure in preterm neonates: an analysis of coverage and quality of care in 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania implementing with the NEST360 Alliance

Background: Prematurity is the leading cause of child deaths worldwide, with the highest neonatal mortality in sub Saharan Africa. Respiratory distress syndrome (RDS) is the leading mortality pathway in preterm neonates, but continuous positive airway pressure (CPAP) has high impact. This analysis reports CPAP coverage and quality of care for preterm neonates admitted to 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania. Methods: Analyses used individually linked neonatal inpatient data and cross-sectional health systems data. All admitted neonates were eligible for inclusion (January 2021 through December 2024). Service readiness for CPAP delivery and mean CPAP coverage were described for CPAP eligible newborns (weighing 1500g). Quality of care cascades were constructed to illustrate key indicators. Survival among CPAP eligible neonates was analysed using regression models, stratified by clinical severity scores. Results: 375,255 newborn admissions were analysed in 66 neonatal units. Functional CPAP availability varied with median 16% of days (IQR: 4 to 47%) classified as high demand (>1.5 eligible newborns per CPAP). Of 64,761 CPAP eligible neonates, 22,006 (34%, 95% CI 33 to 34%) received CPAP. All countries showed improvement in CPAP coverage, with Tanzanian hospitals recording 63% increase in mean coverage (p-value=0.001) over time. Quality of care cascades showed treatment was initiated 1 day for 42% (95% CI 41 to 43%) of eligible neonates receiving CPAP. Only 10% of neonates

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

Versioned Late Materialization for Ultra-Long Sequence Training in Recommendation Systems at Scale

arXiv:2604.24806v2 Announce Type: replace-cross Abstract: Modern Deep Learning Recommendation Models (DLRMs) follow scaling laws with sequence length, driving the frontier toward ultra-long User Interaction History (UIH). However, the industry-standard "Fat Row" paradigm, which pre-materializes these sequences into every training example, creates a storage and I/O wall where data infrastructure usage exceeds GPU training capacity due to data redundancy that is amplified in multi-tenant environments where models with vastly different sequence length requirements share a union dataset. We present a versioned late materialization paradigm that eliminates this redundancy by storing UIH once in a normalized, immutable tier and reconstructing sequences just-in-time during training via lightweight versioned pointers. The system ensures Online-to-Offline (O2O) consistency through a bifurcated protocol that prevents future leakage across both streaming and batch training, while a read-optimized immutable storage layer provides multi-dimensional projection pushdown for heterogeneous model tenants. Disaggregated data preprocessing with pipelined I/O prefetching and data-affinity optimizations masks the latency of training-time sequence reconstruction, keeping training throughput compute-bound by GPUs. Deployed on production DLRMs, the system reduces training data infrastructure resource usage while enabling aggressive sequence length scaling that delivers significant model quality gains, serving as the foundational data infrastructure for modern recommendation model architectures, including HSTU and ULTRA-HSTU.

04.
arXiv (CS.CV) 2026-06-19

World Engine: Towards the Era of Post-Training for Autonomous Driving

Autonomous vehicles must operate safely in the real world, where errors can have severe consequences. Although modern end-to-end driving policies excel in routine scenarios, their reliability is limited by the scarcity of safety-critical ``long-tail'' events in real driving datasets. These rare interactions define the practical safety boundary of the learned policy, yet they are difficult to collect at scale in the real world. Here we show that this fundamental limitation can be addressed by post-training pre-trained driving models on synthesized high-stakes interactions. We introduce World Engine, a generative framework that reconstructs high-fidelity interactive environments from real-world logs and systematically extrapolates them into realistic safety-critical variations. This paradigm enables reinforcement-based post-training to align policies with safety constraints, circumventing the physical risks inherent in real-world exploration. On a public benchmark built on nuPlan, World Engine substantially reduces failures in rare safety-critical scenarios and yields significantly larger gains than scaling pre-training data alone. Furthermore, when deployed on a production-scale autonomous driving system, the resulting policy reduces simulated collisions and demonstrates measurable improvements in on-road testing, showing that post-training on synthesized, safety-critical interactions offers a scalable and effective pathway to safer autonomous driving. The full codebase suite, including training, is released to the public.

05.
arXiv (CS.CL) 2026-06-15

Fusing Stylometric and Embedding Systems to Estimate Authorship Likelihood Ratios in Japanese

The likelihood ratio framework is widely recognized as the logically and legally sound basis for evidential analysis across forensic sciences, and its importance is increasingly acknowledged in analyses of authorship in textual evidence. To date, however, its application has been confined to English-language texts. Meanwhile, authorship attribution has traditionally relied on a diverse array of stylometric features, even as the rise of pre-trained large language models enables new contextual-embedding approaches. Combining these diverse approaches through fusion promises enhanced performance, yet it has not been applied to integrate stylometric-feature systems with embedding-based systems within the likelihood ratio paradigm. This study is the first to apply likelihood ratio-based forensic text comparison to Japanese digital texts, using ~1,000-character excerpts from blogs, to 1) evaluate system performance and likelihood ratio magnitudes and 2) assess the impact of fusing stylometric-feature systems with embedding-based systems. The results demonstrate that the fused system maintains excellent calibration while 1) increasing consistent-with-fact likelihood ratio magnitudes; 2) decreasing contrary-to-fact likelihood ratio magnitudes and 3) improving overall discriminability. The best-performing fusion achieved a log-likelihood-ratio cost of 0.32484, illustrating both the feasibility of likelihood ratio framework for Japanese and the benefits of fusion across heterogeneous systems.

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

Bengal-HP_RU: A Dataset of Bengal People For Head Pose Estimation

Existing head pose datasets predominantly feature subjects of Western or East Asian origin, leaving South Asian populations, particularly Bengali individuals, largely underrepresented. We introduce Bengal-HP_RU, the first publicly available head pose dataset centred on Bengali subjects, comprising 12,894 labelled head images annotated with continuous yaw, pitch, and roll values. Images were collected from Wikimedia Commons under free licences and processed through an automated pipeline followed by manual label correction. The dataset is partitioned by Wikimedia uploader identity to prevent data contamination, yielding 10,494 training and 2,400 test images across 296 unique uploaders. Bengal-HP_RU exhibits substantial diversity in subject age, gender, occlusion, illumination, and background, reflecting realistic in-the-wild conditions. The dataset is publicly available at https://doi.org/10.17632/xbw9kr37jb.2.

07.
arXiv (CS.LG) 2026-06-16

CacheMuon: Using Temporal Preconditioning To Approximate Polar Factor

arXiv:2606.16371v1 Announce Type: new Abstract: Muon is an optimizer that computes updates using the polar factor of the momentum matrix and has shown strong empirical performance across a range of training settings. A key component of Muon is the Newton-Schulz iteration used to compute this polar factor. Although this avoids the cost of an exact singular value decomposition, it remains expensive in practice because it is applied at every optimization step. At the same time, the momentum matrix changes smoothly over training, suggesting strong temporal correlation in the corresponding polar factors. In this paper, we exploit this structure and propose CacheMuon, a temporal preconditioning method that reuses information from previous optimization steps to approximate the polar factor at the current step. This reduces redundant orthogonalization computation across iterations. We analyze CacheMuon as an inexact Muon update, with error controlled by fresh-solver error and cache staleness. Empirically, CacheMuon provides a controllable quality-efficiency frontier: conservative thresholds closely match fresh Muon on language-model and vision training while reducing orthogonalization FLOPs, whereas more aggressive thresholds yield larger arithmetic savings at the cost of modest validation-quality degradation.

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

Learning Sparse Latent Predictive Foundation Model for Multimodal Neuroimaging

Brain MRIs are routinely acquired as multiple complementary sequences with unique contrast weighting, including T1-weighed imaging (T1w) anatomic and fluid-sensitive T2-weighted (T2w) contrasts. However, methods for learning unified representations across the multitude of MRI contrast mechanisms at health-system scale are lacking. In this study, we introduce Neuro-JEPA, a sparse multimodal neuroimaging foundation model that combines a latent predictive objective with a Mixture-of-Experts architecture to encode brain MRI across core T1w, T2w, and fluid-suppressed FLAIR imaging (FLAIR). We further provide a systematic methodological study of architectural, masking, objective, and sparsity design choices beneficial for robust neuroimaging multimodal representation learning. Neuro-JEPA was pretrained on 1,551,862 scans from 428,647 studies after modality-specific preprocessing with data curation across three core structural brain MRI sequences. We evaluated the learned representations across clinical and research settings, including 25 tasks from three health systems: NYU Langone, NYU Long Island, and Massachusetts General Hospital, and 22 tasks from 12 public datasets, covering unimodal, multimodal and cross-domain evaluation configurations. Across these benchmarks, existing neuroimaging foundation models showed inconsistent gains over a simple convolutional neural network (CNN) baseline, whereas Neuro-JEPA achieved stronger and more consistent performance across all evaluated settings. These results establish a scalable methodological framework for multimodal neuroimaging representation learning and highlight the need for foundation model evaluation protocols that include simple baselines, clinically heterogeneous cohorts and controlled multimodal comparisons.

09.
arXiv (CS.CV) 2026-06-16

Propagating Structural Guidance: Synthesizing Fluorescein Angiography from Fundus Images and Sparse OCT Scans

Fundus fluorescein angiography (FFA) is critical for assessing retinal vascular abnormalities, but its acquisition is invasive and not always feasible. In contrast, color fundus photography (CFP) is non-invasive and widely accessible, which has motivated studies on CFP-to-FFA synthesis. However, prior works rely solely on CFP surface texture, fundamentally limiting the ability to reconstruct functional vascular information and subtle pathological changes. To address this, we propose a novel framework that synthesizes FFA from CFP with structural guidance provided by optical coherence tomography (OCT). We construct a multi-modal retinal imaging dataset with paired CFP, FFA, and OCT from 3,676 patient eyes–the first tri-modally aligned dataset in retinal imaging. To bridge the spatial gap between OCT and fundus modalities, we propose a Spatially Aligned Cross-Modal Fusion (SACMF) module that projects depth-resolved OCT features onto the fundus plane and injects them into the CFP encoder via adaptive layer normalization. Beyond feature fusion, we further introduce Token-wise Cross-Modality Alignment (TCMA), a token-level contrastive learning strategy that explicitly aligns CFP and FFA representations at corresponding spatial positions. Our method achieves superior synthesis performance compared to state-of-the-art methods. Moreover, extensive experiments demonstrate that the FFA images synthesized by our approach bring greater improvements in downstream disease diagnosis performance than existing methods, highlighting the clinical potential of our approach as a non-invasive decision-support tool in routine workflows. The code is available at https://github.com/while-plus/OCT-guide-FFA-Syn.

10.
arXiv (CS.AI) 2026-06-16

On-Policy Distillation with Curriculum Turn-level Guidance for Multi-turn Agents

arXiv:2606.15912v1 Announce Type: cross Abstract: Multi-turn agents that plan, invoke tools, and interact with environments offer a promising paradigm for solving complex tasks, yet their capabilities typically rely on very large models whose inference cost is prohibitive in practice.On-Policy Distillation (OPD) is a natural recipe for transferring such capabilities to smaller students, but we find that it suffers a characteristic failure mode in this setting: small student errors compound across turns and push the trajectory out of the teacher's familiar state distribution, so the teacher's supervision becomes least reliable precisely where the student needs it most.We propose Guided On-Policy Distillation (Guided-OPD), a simple yet effective algorithm that mixes teacher- and student-generated turns within each rollout and schedules the teacher's intervention probability along a curriculum that decays to zero.Strong guidance keeps early trajectories close to the teacher distribution and is then gradually withdrawn to recover the purely on-policy regime used at inference.On ALFWorld, ScienceWorld, and WebShop, distilling Qwen3 students from a Qwen3-30B-A3B teacher, Guided-OPD improves Score by 21.1\% and Success Rate by 25.5\% over vanilla OPD on average, with larger gains on smaller students.

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

AfriSUD: A Dependency Treebank Collection for Evaluating Models on African Languages

Despite their linguistic diversity and global significance, African languages remain underrepresented in research and resources to support NLP. We aim to bridge this gap by introducing AfriSUD, the first large-scale collection of syntactically annotated treebanks for nine diverse African languages spanning major language families and regions across Sub-Saharan Africa. Using the Surface-Syntactic Universal Dependencies (SUD) framework, our community-led effort provides high-quality, native-speaker verified data that capture typological key features such as agglutination and tone. We evaluate a range of models on AfriSUD for part-of-speech tagging and dependency parsing including non-transformer baselines, multilingual pretrained encoders, and LLMs. Our results reveal a significant syntax gap, where models still show clear limitations across the nine languages, suggesting that existing architectures may not fully capture the structural diversity of African-language syntax.

12.
arXiv (quant-ph) 2026-06-19

Applications of quantum annealing to magnetic dipole hyperfine structure constants: First results beyond energies for atoms

arXiv:2606.20166v1 Announce Type: new Abstract: We report the first results of the magnetic dipole hyperfine structure (HFS) constants of neutral $\mathrm{Li}$, Li-like $\mathrm{Be}$, neutral $\mathrm{Na}$, and Na-like $\mathrm{Mg}$ using a modified version of the Quantum Annealer Eigensolver (QAE) algorithm on D-Wave's quantum hardware. The results are benchmarked against relativistic configuration interaction with multiconfiguration Dirac Hartree-Fock (MCDHF) calculations using the General-purpose Relativistic Atomic Structure Package (GRASP), and simulated annealing. In our modified QAE, a zooming-and-sigma-annealing approach with a floating-point encoding scheme is adopted to estimate the ground-state eigenvalue and eigenvector of the relativistic Dirac-Coulomb Hamiltonian matrices ($H_{\mathrm{DC}}$) constructed from 11 or fewer configuration state functions (CSFs). For calculations with extended correlation orbital sets, we applied a CSF truncation scheme, retaining only CSFs (up to 12) that make significant contributions to the ground-state wavefunction. Our modified QAE precision is kept limited to three decimal places (up to 10 qubits). Hardware demonstrations on the D-Wave quantum processing unit (QPU) yielded results that were completely consistent with GRASP (at the chosen precision) in determining the magnetic dipole HFS constants, with accuracy varying across systems and $H_{\mathrm{DC}}$ matrix dimensions.

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

Unlocking Latent Dimensions: Exploring Representations of Large-Scale X-ray Scattering Data using Variational Autoencoders

arXiv:2606.14999v1 Announce Type: new Abstract: Scientific user facilities generate X-ray scattering data faster than traditional workflows can process them. We address this challenge across two settings, offline dataset exploration and live on-the-fly analysis. We train a domain-specific attention-based Convolutional Variational Autoencoder (C-VAE) on 1.5 million X-ray scattering images to learn low-dimensional representations capturing structural variation across diverse experimental conditions. The learned latent space reveals well-organized clusters and smooth trajectories reflecting experimental progression. It further supports controlled synthetic scattering image generation across diverse structural states. When deployed without retraining, the model organizes time-resolved film formation experiments at two synchrotron facilities into interpretable latent structures. Benchmarking against DINOv3 (ViT-7B), a general-purpose vision foundation model, demonstrates that domain-specific training yields more interpretable latent organization for scattering data. Both workflows are integrated within Latent Space Explorer, a component of the MLExchange platform, supporting interactive structural exploration across archived datasets and live experiments.

14.
arXiv (CS.CL) 2026-06-18

GraphPO: Graph-based Policy Optimization for Reasoning Models

Reinforcement Learning with Verifiable Rewards (RLVR) has become a standard paradigm for enhancing the capability of large reasoning models. RLVR typically samples responses independently and optimizes the policy using from final answers. This paradigm has two limitations. First, independently responses often contain similar intermediate reasoning steps, causing redundant exploration and wasted computation. Second, sparse final-answer rewards make it hard to identify useful steps. Tree-based methods partly address this problem by sharing prefixes and comparing branches from the same prefix to provide fine-grained signals. However, tree branches are still expanded independently. When different branches reach similar reasoning states, they cannot share information and repeat similar exploration. Moreover, tree-based methods ignore such dispersion and only perform local comparisons within separate branches, which can lead to higher variance in advantage estimation. To address this challenge, we propose GraphPO (Graph-based Policy Optimization), a novel RL framework that represents rollouts as a directed acyclic graph, with reasoning steps as edges and semantic states summarized from the reasoning paths as nodes. GraphPO merges semantically equivalent reasoning paths into equivalence classes, allowing them to share suffixes and reallocating budget away from redundant expansions to diverse exploration. Furthermore, we assign efficiency advantages to incoming edges and correctness advantages to outgoing edges, thereby improving inference efficiency while deriving process supervision from outcome. Theory shows that GraphPO reduces advantage-estimation variance and enhances reasoning efficiency. Experiments on three LLMs across reasoning and agentic search benchmarks show that GraphPO consistently outperforms chain- and tree-based baselines with the same token budgets or response budgets.

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

Retrieve, Don't Retrain: Extending Vision Language Action Models to New Tasks at Test Time

arXiv:2606.15631v1 Announce Type: cross Abstract: Extending a vision-language-action (VLA) policy to a new task typically requires task-specific teleoperated demonstrations and per-task fine-tuning, making adaptation costly in both data collection and compute. In this paper, we show that this target-side per-task adaptation cost can be replaced by retrieval. Our retrieval-augmented policy is trained once on paired demonstrations from the target embodiment (query) and a cheaper embodiment (pool, e.g., human-hand video), then frozen. New tasks are added at deployment by appending pool-side demonstrations to a retrieval pool. The frozen policy conditions on retrieved trajectories at every control step, so new tasks are absorbed by indexing data rather than updating parameters. Fine-tuning is needed only to take on a new, unseen embodiment, not for each new task. We show that retrieval improves policies beyond a specific backbone, including standard VLA policies, but its effect is especially pronounced in Cosmos Policy, a video-generation-based world-action model (WAM). In this setting, retrieval supplies coarse task progression, while the WAM's future-image objective provides an additional visual consistency signal that strengthens the retrieval-conditioned actions. On PushT, we study how retrieval provides a reusable high-level motion prior for cross-embodiment generalization to unseen goal angles, while on RoboTwin 2.0 our method outperforms cross-embodiment baselines on unseen tasks, and we additionally demonstrate the method on a real robot.

16.
medRxiv (Medicine) 2026-06-17

Cross-Device Adaptation of Mirai for Mammography-Based Breast Cancer Risk Prediction

Fine-tuning can adapt pretrained medical imaging models to new clinical datasets, but device-specific domain shifts may limit generalizability. We evaluated Mirai, a mammography-based deep learning model for breast cancer risk prediction, in a large screening cohort containing Hologic and General Electric (GE) full-field digital mammography systems, including GE Premium View (GE PV) and Tissue Equalization (GE TE) post-processing software. Native Mirai showed lower performance on TE images than on Hologic or PV images. Fine-tuning on TE images improved TE performance, particularly for short-term risk prediction, but substantially reduced performance on Hologic images, consistent with catastrophic forgetting. To mitigate this effect, we developed a device-invariant model using interleaved multi-device sampling and conditional adversarial training. This approach largely restored Hologic performance while maintaining improved TE performance, providing better robustness across heterogeneous imaging platforms. Comparison of cumulative and annual risk AUCs over a five-year time horizon further showed that performance gains were driven mainly by short- and intermediate-term predictions. These findings highlight both the value and dangers of device-specific fine-tuning and support balanced domain-adaptation strategies for deploying mammography-based risk models across diverse clinical imaging environments.

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

Implicit vs. Explicit Prompting Strategies for LVLMs in Referential Communication

Two recent studies (Jones et al. (2026); Zeng et al. (2026)) reach apparently contradictory conclusions about whether LVLMs can coordinate on efficient referring expressions. We control for task differences between the studies while directly comparing their prompting styles. We replicate the finding that models can coordinate efficient referring expressions when explicitly prompted to do so, suggesting that other task differences are not responsible for divergent results. However, we also find that the same models fail to infer the need for communicative efficiency from a more implicit prompt, highlighting critical differences between how humans and AI systems communicate.

19.
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.

20.
arXiv (CS.CV) 2026-06-16

MambaH-Fit: Rethinking Hyper-surface Fitting-based Point Cloud Normal Estimation via State Space Modelling

We present MambaH-Fit, a state space modelling framework tailored for hyper-surface fitting-based point cloud normal estimation. Existing normal estimation methods often fall short in modelling fine-grained geometric structures, thereby limiting the accuracy of the predicted normals. Recently, state space models (SSMs), particularly Mamba, have demonstrated strong modelling capability by capturing long-range dependencies with linear complexity and inspired adaptations to point cloud processing. However, existing Mamba-based approaches primarily focus on understanding global shape structures, leaving the modelling of local, fine-grained geometric details largely under-explored. To address the issues above, we first introduce an Attention-driven Hierarchical Feature Fusion (AHFF) scheme to adaptively fuse multi-scale point cloud patch features, significantly enhancing geometric context learning in local point cloud neighbourhoods. Building upon this, we further propose Patch-wise State Space Model (PSSM) that models point cloud patches as implicit hyper-surfaces via state dynamics, enabling effective fine-grained geometric understanding for normal prediction. Extensive experiments on benchmark datasets show that our method outperforms existing ones in terms of accuracy, robustness, and flexibility. Ablation studies further validate the contribution of the proposed components.

21.
arXiv (CS.AI) 2026-06-17

Know Thy Reasoner: Not All Language Models Explore Alike

arXiv:2604.10827v2 Announce Type: replace Abstract: Compute scaling for LLM reasoning trades off exploring solution approaches (breadth) against refining promising ones (depth), yet why a given trade-off works, and why it often fails to transfer across models, remains unclear. We argue that the optimal strategy depends on the model's diversity profile, the spread of probability mass across solution approaches, and that this must be characterized before any exploration strategy is adopted. We formalize this with a framework decomposing reasoning uncertainty, deriving when depth-based refinement outperforms parallel sampling, and validate it across three model families at both inference and training. Our central finding is that the diversity regime dictates the strategy: low-diversity aligned models benefit from depth-based refinement with lightweight intrinsic signals, whereas high-diversity base models are often harmed by it, and instead need breadth or stronger signals to compensate.

22.
medRxiv (Medicine) 2026-06-18

Digital self-efficacy as a potential intermediary between vision impairment and daily internet use among older adults: A cross-sectional analysis of HINTS 2024

Background: Older adults with vision impairment often experience barriers to using digital technology. The indirect associations between vision impairment and digital access and skills via digital self-efficacy and frustration among older adults remain largely unknown. Objective: This study aimed to 1) explore factors associated with digital access, skills, self-efficacy, and frustration among older adults with vision impairment; 2) examine associations between vision impairment and digital access, skills, self-efficacy, and frustration among older adults; and 3) examine whether digital self-efficacy and frustration may help explain associations between vision impairment and digital access and skills among older adults. Methods: This was a cross-sectional study using nationally representative data from the Health Information National Trends Survey (HINTS) 2024. Respondents aged 60 and older were included. Vision impairment was assessed using a self-reported item. Outcomes included self-reported digital access, skills, self-efficacy, and frustration. Survey-weighted multivariable logistic regression and generalized structural equation modeling were conducted, adjusting for age, sex, race/ethnicity, education, and the number of comorbidities. Results: Among 3,149 older adults (mean [SD] age, 70.7 [10.0] years; 45.6% female), 7.1% (n=223) reported vision impairment. Among older adults with vision impairment, 65.6% (95% CI, 53.5% to 75.9%) used the internet daily, and 79.5% (95% CI, 66.8% to 88.2%) used a smartphone in the past 12 months. In multivariable logistic regression analyses among older adults with vision impairment, older age was associated with lower odds of daily internet use (OR, 0.84; 95% CI, 0.79 to 0.90), smartphone use (OR, 0.85; 95% CI, 0.75 to 0.97), wearable device use (OR, 0.88; 95% CI, 0.79 to 0.97), and using the internet to send a message to a healthcare provider (OR, 0.87; 95% CI, 0.80 to 0.93). Older adults who self-identified as racial and ethnic minority groups (e.g., Black/African American, Hispanic) had lower odds of daily internet use (OR, 0.15; 95% CI, 0.05 to 0.50) and using the internet to send a message to a healthcare provider (OR, 0.17; 95% CI, 0.04 to 0.73) compared with Non-Hispanic White older adults. Vision impairment was associated with lower odds of daily internet use (OR, 0.60; 95% CI, 0.37 to 0.99) and digital self-efficacy (OR, 0.53; 95% CI, 0.32 to 0.86). Digital self-efficacy was associated with higher odds of daily internet use (OR, 2.95; 95% CI, 2.04 to 4.26). Generalized structural equation modeling identified an indirect association between vision impairment and daily internet use via digital self-efficacy (coefficient, -0.68; 95% CI, -1.24 to -0.12). Conclusions: Findings suggest that reduced digital self-efficacy may help explain the observed association between vision impairment and daily internet use among older adults. Interventions targeting digital self-efficacy, including accessible interface designs, personalized coaching, and peer support, may help bridge the digital divide among older adults with vision impairment.

23.
arXiv (CS.AI) 2026-06-19

Configurable Clinical Information Extraction with Agentic RAG: What Works, What Breaks, and Why

arXiv:2606.19602v1 Announce Type: new Abstract: Patient contexts span hundreds of heterogeneous documents and thousands of structured data points, yet the document-level metadata that AI systems need for retrieval and triage is absent or incomplete. Standard retrieval-augmented generation fails on this data, mishandling temporal reasoning, cross-document dependencies, and missing metadata. We deploy ACIE (Agentic Clinical Information Extraction) at University Medicine Essen: an on-premise agentic RAG pipeline that reasons over complete patient contexts and grounds every answer in source passages for clinician verification. We quantify the metadata gap, trace the architectural decisions it shaped, and evaluate extraction alongside an independent retrospective lymphoma registry study, in which nuclear-medicine physicians verify every extracted value against its cited sources. Across 7,326 judgments, clinicians accepted 96.5\% of extractions, with per-type acceptance ranging from 80\% to 99\%.

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

PERRY: Policy Evaluation with Confidence Intervals using Auxiliary Data

arXiv:2507.20068v2 Announce Type: replace Abstract: Off-policy evaluation (OPE) methods estimate the value of a new reinforcement learning (RL) policy prior to deployment. Recent advances have shown that leveraging auxiliary datasets, such as those synthesized by generative models, can improve the accuracy of OPE methods. Unfortunately, such auxiliary datasets may also be biased, and existing methods for using data augmentation within OPE lack principled uncertainty quantification. In high stakes domains like healthcare, reliable uncertainty estimates are important for ensuring safe and informed deployment of RL policies. In this work, we propose two methods to construct valid confidence intervals for OPE with data augmentation. The first provides a confidence interval over $V^{\pi}(s)$, the policy value conditioned on an initial state $s$. To do so we introduce a new conformal prediction method suitable for Markov Decision Processes (MDPs) with continuous state spaces, extending prior work to higher-dimensional settings. Second, we consider the more common task of estimating the average policy performance over all initial states, $V^{\pi}$; we introduce a method that draws on ideas from doubly robust estimation and prediction powered inference. Across simulators spanning inventory management, robotics, healthcare, and a real healthcare dataset from MIMIC-IV, we find that our methods can effectively leverage auxiliary data and consistently produce confidence intervals that cover the ground truth policy values, unlike previously proposed methods. Our work enables a future in which OPE can provide rigorous uncertainty estimates for high-stakes domains.

25.
medRxiv (Medicine) 2026-06-22

National trends and operational drivers of vaccine wastage in Uganda, 2020-2025: a descriptive analysis of four tracer antigens

Background Vaccine wastage reduces immunisation efficiency, increases costs, and complicates supply forecasting. Uganda routinely monitors vaccine use, but national evidence comparing observed wastage with World Health Organization (WHO) and Uganda-specific planning thresholds has been limited. We described national and sub-national trends for four tracer antigens to inform supply-chain planning and forecasting. Methods We conducted a retrospective descriptive analysis of routinely reported immunisation data from Ugandas District Health Information Software 2, 2020-2025. We analysed Bacille Calmette-Guerin (BCG), measles-rubella (MR), oral polio vaccine (OPV), and diphtheria-tetanus-pertussis-containing vaccine (DPT). Vaccine wastage was calculated as the proportion of issued doses not administered. Annual wastage rates were summarised using medians, and temporal trends were assessed using the Mann-Kendall test. Observed wastage was compared with WHO thresholds: BCG[≤]50%, MR[≤]25%, OPV[≤]10%, DPT[≤]15%, and Ugandas planning thresholds: BCG[≤]70%, MR[≤]40%, OPV[≤]15%, DPT[≤]10%. Effective Vaccine Management reports were reviewed to summarise reported reasons for wastage. Results During 2020-2025, median national wastage was 40.6% for BCG, 25.9% for MR, 10.0% for OPV, and 9.2% for DPT. OPV wastage declined from 12.8% in 2020 to 8.0% in 2025, with a significant downward trend ({tau}b=-1.00; p=0.008). OPV and DPT wastage remained largely within their respective Uganda in-country thresholds ([≤]15% and [≤]10%) for most of the study period, while BCG generally remained below the WHO threshold ([≤]50%) and MR frequently exceeded the WHO threshold ([≤]25%) but remained within Uganda's planning threshold ([≤]40%) in most years. The proportion of districts exceeding both WHO and Uganda thresholds declined for OPV from 36.3% to 5.5% (p=0.024) and for DPT from 22.6% to 1.4% (p=0.013). Wastage was consistently higher in lower-level (Health Centre II and III) facilities, compared to hospitals. Among 50 service delivery points, reported reasons included low session attendance (66%), multi-dose vial policy non-compliance (28%), and vaccine expiry (12%). Conclusion Uganda achieved reductions in OPV wastage and district-level improvements in DPT wastage, while BCG and MR remained more variable and frequently had higher wastage. Strengthening adherence to the multi-dose vial policy and improving session planning at lower-level facilities could strengthen vaccine utilisation and forecasting.