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

ThousandWorlds: A benchmark for climate emulation of potentially habitable exoplanets

arXiv:2606.18338v1 Announce Type: new Abstract: The search for life beyond Earth will depend on detecting faint signatures in the atmospheres of potentially habitable exoplanets. Interpreting those signatures requires understanding the host planet's climate: the same molecule may signal life on one planet and abiotic chemistry on another. Global climate models (GCMs) provide this understanding, but individual runs can require up to millions of core-hours and substantial domain expert time. Machine-learning emulators could remove this bottleneck, but progress has been limited by the absence of a curated, multi-model exoclimate dataset. We introduce ThousandWorlds, an ML-ready benchmark for exoclimate emulation and for the broader regime of low-data, multi-simulator, parameter-to-field regression. The dataset contains approximately 1800 simulations from five GCMs, mapping eight planet parameters to 3D atmospheric fields including temperature, humidity, winds, clouds, and radiation. Three nested subsets define progressively harder challenges: single-simulator regression, multi-simulator regression with complete observations, and multi-simulator regression with structured missingness. We propose two evaluation protocols: one for ranking methods, and one that measures performance relative to the disagreement between GCMs themselves. We evaluate seven baselines spanning simple methods, deep learning, and Gaussian processes. GP-based methods perform best, suggesting that ThousandWorlds exposes a regime where off-the-shelf deep learning does not yet succeed. Data: https://doi.org/10.57967/hf/8695. Code: https://github.com/edstevenson/ThousandWorlds.

02.
arXiv (CS.AI) 2026-06-11

Quantized Stochastic Primal-Dual Methods for Distributed Optimization under Relaxed Global Geometry

arXiv:2606.11339v1 Announce Type: cross Abstract: We study distributed optimization with stochastic gradients and finite-bit communication modeled by random (unbiased) quantization. We propose q-PDGD, a quantized stochastic primal-dual method, and analyze it under relaxed global geometry. Under restricted secant inequality (RSI), a constant step-size yields linear contraction to an explicit neighborhood determined by gradient noise, quantization distortion, and network connectivity, while a diminishing step-size achieves O(1/k) convergence without shared-minimizer assumptions. Under Polyak-Lojasiewicz (PL) inequality, we obtain linear-to-neighborhood convergence in the same stochastic quantized setting. Our results match the best-known centralized stochastic rates in oracle complexity, and are supported by experiments demonstrating the predicted tradeoffs between quantization level, step-size choice, and graph structure.

03.
arXiv (CS.AI) 2026-06-18

Benchmarking Action Spaces in Reinforcement Learning for Vision-based Robotic Manipulation

arXiv:2606.18594v1 Announce Type: cross Abstract: In real-world reinforcement learning (RL), the choice of action space can play a key role in shaping motion smoothness, safety, and overall task performance. In this study, we evaluate pose increment, pose velocity, joint position increment, and joint velocity across two vision-based manipulation tasks: object picking and pushing. We train policies in simulation and deploy them to the real world using sim-to-real transfer. We find that action-space representation indeed significantly affects sim-to-real performance. In particular, we find that the joint velocity action space is best for the vision-based picking and pushing tasks in terms of smoothness and final task performance. We also provide practical guidance for RL practitioners in choosing action spaces for both simulation and real-world experiments.

04.
arXiv (CS.CL) 2026-06-12

LLMs Can Better Capture Human Judgments–With the Right Prompts

Are large language models (LLMs) bad at capturing human judgment? Two commonly stated limitations are that LLMs fail to capture full distributions of responses, and that their judgments are unstable across wording variations. We demonstrate simple prompting strategies that mitigate these limitations. Across two datasets–a U.S.-representative set of 144 moral scenarios and 38 moral beliefs from the International Social Survey Programme's Family and Changing Gender Roles module covering 32 countries–we show how simple elicitation techniques help improve AI-human alignment. First, prompting models to report standard deviations and response proportions recovers the full range of human responses better than common strategies. Second, ensuring scenarios are clear to human participants–as reflected in human confusion ratings–boosts model alignment, and LLMs can track human confusion ratings. At the same time, we find that LLMs' estimates of their own error are poorly calibrated, though they can predict human variability relatively well. These results suggest that asking better questions to LLMs can yield better answers.

05.
medRxiv (Medicine) 2026-06-15

Long-read sequencing enables high-accuracy mitochondrial heteroplasmy detection in Parkinson's disease

Background: Low-frequency heteroplasmic mitochondrial DNA (mtDNA) variants are associated with aging and neurological diseases, including Parkinson's disease (PD). Targeted deep mtDNA sequencing using PacBio HiFi long reads has the potential to resolve heteroplasmy across the full mitochondrial genome with high accuracy. Methods: To validate Vega PacBio sequencing for detecting mtDNA heteroplasmy, we analyzed four predefined mixtures of two mtDNA haplotypes. We generated a single long-range PCR amplicon covering the entire mitochondrial genome. These amplicons were mixed at predefined ratios (minor mixture haplotype component: 5%, 2%, 1%, and 0.1%). Variant calling was performed using Mutserve2, and accuracy was assessed by calculating the F1 score from comparisons between expected and detected variants. Full-length mtDNA PacBio sequencing was applied to investigate heteroplasmy across fibroblast passages derived from five LRRK2 p.Gly2019Ser variant carriers (n=3 affected with PD and n=2 unaffected carriers). Changes in mtDNA heteroplasmy level and variant load were assessed longitudinally using a linear mixed model. Results: The single-amplicon approach enabled full-length haplotype resolution without amplification bias associated with overlapping PCR strategies. The F1 score of the predefined mixtures was 1.0 for heteroplasmy levels between 5% and 1% and remained high (0.91) at 0.1%. We detected n=10/62 variants discordant with the Illumina reference at the 0.1% mixture, but sensitivity remained very high at 1.00 in that mixture. Detected minor variants closely matched expected heteroplasmy levels, with average variant levels of 0.057 (5%), 0.022 (2%), 0.011 (1%), and 0.001 (0.1%). Across twelve fibroblast passages, we observed fewer mtDNA heteroplasmic variants ({beta}=-3.2, p=0.026). Increased heteroplasmic variant load over time was also associated with older age ({beta}=1.50, p=0.001) and PD affection status ({beta}=5.0, p=1.0 x 10-4) in LRRK2 variant carriers. Notably, we observed distinct patterns of heteroplasmic variants that either increased or decreased in heteroplasmy level across passages. Conclusion: PacBio HiFi sequencing, combined with a single-amplicon strategy, enables accurate full-length mtDNA heteroplasmy detection and longitudinal analysis, providing a valuable tool for studying mitochondrial variation and dynamics in disease.

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

Neural FOXP2 – Language Specific Neuron Steering for Targeted Language Improvement in LLMs

LLMs are multilingual by training, yet their lingua franca is often English, reflecting English language dominance in pretraining. Other languages remain in parametric memory but are systematically suppressed. We argue that language defaultness is governed by a sparse, low-rank control circuit, language neurons, that can be mechanistically isolated and safely steered. We introduce Neural FOXP2, that makes a chosen language (Hindi or Spanish) primary in a model by steering language-specific neurons. Neural FOXP2 proceeds in three stages: (i) Localize: We train per-layer SAEs so each activation decomposes into a small set of active feature components. For every feature, we quantify English vs. Hindi/Spanish selectivity overall logit-mass lift toward the target-language token set. Tracing the top-ranked features back to their strongest contributing units yields a compact language-neuron set. (ii) Steering directions: We localize controllable language-shift geometry via a spectral low-rank analysis. For each layer, we build English to target activation-difference matrices and perform layerwise SVD to extract the dominant singular directions governing language change. The eigengap and effective-rank spectra identify a compact steering subspace and an empirically chosen intervention window (where these directions are strongest and most stable). (iii) Steer: We apply a signed, sparse activation shift targeted to the language neurons. Concretely, within low to mid layers we add a positive steering along the target-language dominant directions and a compensating negative shift toward the null space for the English neurons, yielding controllable target-language defaultness.

07.
medRxiv (Medicine) 2026-06-15

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

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

08.
arXiv (quant-ph) 2026-06-16

Benchmarking Quantum Computers via Protocols, Comparing IBM's Heron vs IBM's Eagle

arXiv:2603.04377v3 Announce Type: replace Abstract: As quantum computing hardware rapidly advances, objectively evaluating the capabilities and error rates of new processors remains a critical challenge for the field. A clear and realistic understanding of current quantum performance is essential for guiding research priorities and driving meaningful progress. In this work, we apply and extend a protocol-based benchmarking methodology (Meirom, Mor, Weinstein Arxiv 2505.12441) that utilizes well-defined \underline{quantumness} thresholds. By evaluating performance at protocol level rather than the gate level, this approach provides a transparent and intuitive assessment of whether specific quantum processors, or isolated sub-chips within them, can demonstrate a practical quantum advantage. To illustrate the utility of this method, we compare two generations of IBM quantum computers: the older Eagle architecture and the newer Heron architecture. Our findings reveal the genuine operational strengths and limitations of these devices, demonstrating substantial performance improvements in the newer Heron generation. This work was made possible by IBM Quantum policies that enable independent and objective assessment of its quantum computers and sub-chips. We strongly encourage other companies to emulate the independent qubit availability and the fair pricing that allow researchers to perform such assessments.

09.
medRxiv (Medicine) 2026-06-15

Iron deficiency testing among people with incident heart failure in primary care

Background: Given around 50% of people with heart failure have a degree of iron deficiency, guidelines recommend screening. It is uncertain to what extent this is done in primary care and whether testing is equitable. Aim: To report the proportion of people with incident heart failure who undergo a ferritin test within 12 months. Design and setting: Retrospective primary care cohort study using Clinical Practice Research Datalink Aurum data, between 2016 and 2021. Methods: We report the proportion of adults with an incident diagnosis of heart failure who received a ferritin test within 12 months. Multivariable logistic regression was used to examine the odds of testing based on key demographic covariates and co-morbidities. Results: Among 105,749 individuals with an incident diagnosis of heart failure (mean age 71.6 years, SD 14.3), only 35,688 (33.7%) received a ferritin test within the subsequent year. Increasing age (odds ratio 1.25 per 10-year increase, 95% CI: 1.24-1.27), female sex (male sex OR 0.86, 0.84-0.89) and Asian ethnicity (OR 1.70, 1.59-1.80) were all associated with increased odds of testing as were diagnoses of coeliac disease (OR 1.86, 1.58-2.21), type 1 diabetes (OR 1.82, 1.51-2.19) and cirrhosis (OR 1.64, 1.43-1.87). There was geographic variation in testing, even in adjusted analyses. Conclusion: In a large primary care dataset, two thirds of people with incident heart failure did not receive a ferritin test for iron deficiency within a year of diagnosis demonstrating a gap in current practice and an opportunity for improvements in service delivery.

10.
medRxiv (Medicine) 2026-06-11

Ferritin across long-term conditions in England: cross-sectional primary care study

Background Iron deficiency (ID) is a readily treatable condition once identified. Ferritin is the primary diagnostic marker, but cut-offs vary and inflammation complicates interpretation in patients with long-term conditions (LTCs). Aim To describe ferritin distribution and the prevalence of threshold-defined low ferritin in adults with and without LTCs in primary care. Design and setting Cross-sectional observational study using routinely collected electronic health records from a national primary care database in England (1st January 2015 to 31st December 2021). Method Adults with >1 ferritin test in Clinical Practice Research Datalink (CPRD) Aurum were included. LTCs were identified using validated primary-care code lists. Outcomes included ferritin distribution and threshold-defined ID prevalence using World Health Organization (WHO) (

11.
arXiv (CS.AI) 2026-06-16

An Attention Mechanism for Robust Multimodal Integration in a Global Workspace Architecture

arXiv:2602.08597v3 Announce Type: replace Abstract: Robust multimodal systems must remain effective when some modalities are noisy, degraded, or unreliable. Existing multimodal fusion methods often learn modality selection jointly with representation learning, making it difficult to determine whether robustness comes from the selector itself or from full end-to-end co-adaptation. Motivated by Global Workspace Theory (GWT), we study this question using a lightweight top-down modality selector operating on top of a frozen multimodal global workspace. We evaluate our method on two multimodal datasets of increasing complexity: Simple Shapes and MM-IMDb 1.0, under structured modality corruptions. The selector improves robustness while using far fewer trainable parameters than end-to-end attention baselines, and the learned selection strategy transfers better across downstream tasks, corruption regimes, and even to a previously unseen modality. Beyond explicit corruption settings, on the MM-IMDb 1.0 benchmark, we show that the same mechanism improves the global workspace over its no-attention counterpart and yields decent benchmark performance.

12.
arXiv (CS.AI) 2026-06-24

Impatient Bandits: Optimizing for the Long-Term Without Delay

arXiv:2501.07761v2 Announce Type: replace-cross Abstract: Increasingly, recommender systems are tasked with improving users' long-term satisfaction. In this context, we study a content exploration task, which we formalize as a bandit problem with delayed rewards. There is an apparent trade-off in choosing the learning signal: waiting for the full reward to become available might take several weeks, slowing the rate of learning, whereas using short-term proxy rewards reflects the actual long-term goal only imperfectly. First, we develop a predictive model of delayed rewards that incorporates all information obtained to date. Rewards as well as shorter-term surrogate outcomes are combined through a Bayesian filter to obtain a probabilistic belief. Second, we devise a bandit algorithm that quickly learns to identify content aligned with long-term success using this new predictive model. We prove a regret bound for our algorithm that depends on the Value of Progressive Feedback, an information-theoretic metric that captures the quality of short-term leading indicators that are observed prior to the long-term reward. We apply our approach to a podcast recommendation problem, where we seek to recommend shows that users engage with repeatedly over two months. We empirically validate that our approach significantly outperforms methods that optimize for short-term proxies or rely solely on delayed rewards, as demonstrated by an A/B test in a recommendation system that serves hundreds of millions of users.

13.
arXiv (CS.CV) 2026-06-17

Vision-language models for chest radiography do not always need the image

Medical vision-language models report strong chest radiograph accuracy, and this is increasingly read as evidence that they use the image. That inference is unsafe: a model exploiting finding-name priors scores like one that reads the scan, and no standard benchmark separates them. We introduce a causal audit that intervenes on the image, occluding the relevant region, occluding an irrelevant one, and swapping in another patient's same-label scan, and combines three behavioral metrics to test whether a correct answer depends on the image. Across nine systems, a text-only model with no image access reaches within 5.7 accuracy points of the best multimodal one, and a 119-billion-parameter multimodal model is statistically indistinguishable from a 7-billion text-only baseline. The audit splits the cohort into three models that ignore the image, one that is unstable, and five that use it selectively, for a subset of findings; the categories hold across a second dataset, resolution, and prompt phrasing. Against board-certified radiologists, a text-only model is statistically indistinguishable from a radiologist's accuracy while grounding at zero, whereas the image-using models ground at radiologist-comparable rates. Reported confidence flags ungrounded answers only when a model uses the image. Grounding audits, not accuracy, should gate clinical deployment.

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

Agents' Last Exam

Recent AI systems have achieved strong results on a wide range of benchmarks, yet these gains have not translated into economically meaningful deployment across many professional domains. We argue that this gap is largely an evaluation problem: widely used benchmarks lack sustained performance measurement on real and economically valuable workflows. This paper introduces Agents' Last Exam (ALE), a benchmark designed to evaluate AI agents on long horizon, economically valuable, real world tasks with verifiable outcomes. Developed in collaboration with 250+ industry experts, ALE covers non-physical industries defined with reference to O*NET / SOC 2018 (the U.S. federal occupational taxonomy). It is organized around a task taxonomy with 55 sub fields grouped into 13 industry clusters covering 1K+ tasks. Current results show that the hardest tier remains far from saturated: across mainstream harness and backbone configurations, the average full pass rate is below 1%. ALE is designed as a living benchmark: its task pool grows continuously as new workflows and industries are onboarded. More broadly, ALE is intended not merely as another leaderboard, but as an instrument for closing the gap between benchmark success and GDP relevant impact.

15.
arXiv (CS.AI) 2026-06-19

Beyond Static Leaderboards: Predictive Validity for the Evaluation of LLM Agents

arXiv:2606.19704v1 Announce Type: new Abstract: Agent benchmarks are growing fast, but no single benchmark touches more than four or five of the dimensions that deployment exposes. This paper aggregates the largest coordinated deep-dive of one MCP-based industrial-agent benchmark to date: fourteen parallel implementation studies covering new asset classes (including a multi-modal visual extension), alternative orchestrations, retrieval strategies, reasoning modes, infrastructure optimizations, and evaluation-methodology probes. Consolidating those studies with seven prior agent benchmarks, we argue that aggregate-score leaderboards systematically underspecify deployed-agent evaluation. Rankings derived from aggregate scores do not transfer to out-of-distribution settings; recent public-to-hidden competition retrospectives provide direct empirical evidence of this rank instability. We propose ranking configurations by predictive validity, the correlation between in-sample and out-of-sample rank, rather than in-sample mean, and report a twelve-tier measurement apparatus that exposes the deployment-relevant dimensions HELM and its agent-era successors collapse. The position is operationalized through three falsifiable out-of-distribution criteria with explicit thresholds; existing evidence partly supports it but is too thin to confirm. We close with a pre-registered pilot design and a field-level vision for what the next generation of agentic benchmarks should report.

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

QIAS 2026: Overview of the Shared Task on Islamic Inheritance Reasoning

This paper presents a comprehensive overview of the QIAS 2026 shared task, organized as part of the OSACT7 Workshop and co-located with LREC 2026. The shared task was designed to evaluate the ability of large language models to perform complex reasoning in the religious and legal domain of Islamic inheritance. Unlike conventional question-answering benchmarks, QIAS 2026 focuses on end-to-end reasoning from natural language cases, requiring systems to perform the full inheritance calculation process, from identifying the eligible heirs to assigning the correct share to each beneficiary. To support this evaluation, the task was based on the MAWARITH benchmark, a dataset of $12{,}500$ Arabic inheritance cases annotated with intermediate reasoning steps and final answers. System submissions were evaluated using MIR-E, a multi-step metric that measures performance across the main stages of inheritance reasoning. A total of $16$ teams participated in the shared task, investigating a range of approaches, including prompting-based methods, retrieval-augmented generation, and fine-tuning strategies. The results show that Islamic inheritance remains a highly challenging benchmark for current language models, especially in stages that require precise legal interpretation and structured numerical reasoning. This overview summarizes the task design, dataset, evaluation framework, participating systems, and main results.

17.
medRxiv (Medicine) 2026-06-22

Use of the Pharmacy First service in England in the first 12 months: geographic variation and health system context

Objectives: The Pharmacy First (PF) service was introduced across England from 31 January 2024 to expand the clinical role of community pharmacies and improve access to primary care. This paper describes use of PF in its first 12 months, in terms of uptake, access routes, consultation outcomes, geographic variations, service costs and antimicrobial supply. Methods: A descriptive analysis of all PF consultations submitted for payment to NHS Business Services Authority in England between 31 January 2024 and 31 January 2025. Pharmacy-level consultation data were linked to national data on population, location and pharmacy characteristics. PF use was examined using population-standardised consultation rates and consultations per pharmacy. Results: During the first year of implementation, 2,205,731 PF consultations were recorded as delivered across 11,349 pharmacies, with payment of GBP123 million to pharmacies. Uptake increased steadily over time. Most consultations were for acute sore throat (33%) and uncomplicated urinary tract infection (27%), with corresponding antibiotics, phenoxymethylpenicillin and nitrofurantoin being the most supplied. Most people self-referred (74%) into the service, with 95% of consultations managed without onward referral. Substantial geographic variation was observed. Northern regions had higher use based on the eligible population. The South East and Midlands had higher activity per pharmacy. London showed a distinct pattern, with higher self-referral into the service, lower medication supply and higher referral to other healthcare services. Higher consultation volume was weakly associated with pharmacy characteristics, including opening hours, pharmacy type and retail setting, and local context, in terms of socio-economic and geographic factors. Conclusions: PF had immediate uptake and is operating primarily as a direct-access model for common acute conditions. Findings suggest that PF is contributing to improved access to care and may shift demand away from general practice. However, the service uptake appears to be shaped by geographic location, proximity to other healthcare services and pharmacy characteristics.

18.
arXiv (quant-ph) 2026-06-11

A saturation-absorption rubidium magnetometer with multilevel optical Bloch-equation modeling for intermediate-to-high fields

arXiv:2601.09115v2 Announce Type: replace Abstract: We present SASHMAG (Saturated Absorption Spectroscopy High-field MAGnetometer), an atomic sensor designed for precision magnetic-field measurements in the intermediate-to-high field regime ($>0.2\,T$) using Rubidium-87 ($^{87}Rb$). The sensor operates in the hyperfine Paschen-Back regime, where the hyperfine and Zeeman interactions decouple, and utilizes counter-propagating pump-probe configuration in Faraday geometry to resolve isolated, Doppler-free Zeeman transitions. To interpret the resulting spectra in this strongly field-dependent regime, we developed a comprehensive multilevel optical Bloch-equation model solved explicitly in the uncoupled $\ket{m_I, m_J}$ basis, capturing state mixing and nonlinear saturation dynamics. This model reproduces measured spectra at sub-Doppler resolution and is consistent with analytical expectations for power broadening and thermal Doppler scaling. Magnetic field estimation is performed using a physics-constrained optimization routine that infers the magnetic field by minimizing the residual between experimentally extracted line centers and calculated transition frequencies from the field-dependent Hamiltonian. We demonstrate magnetic field retrieval from $0.2\,T$ to $0.4\,T$ with a precision of $\pm 0.0017 \,T$). Furthermore, the validated simulation establishes a foundation for generating synthetic training datasets, paving the way for autonomous, Machine Learning-enhanced magnetometry in applications ranging from MRI to fusion reactors.

19.
arXiv (CS.AI) 2026-06-15

Securing the Future of IoMT in the Post-Quantum Era: An Edge-Native Federated Learning Approach

arXiv:2606.14515v1 Announce Type: cross Abstract: Internet of Medical Things (IoMT) devices operate under strict resource constraints while handling highly sensitive health data, making security and privacy critical concerns. Federated learning (FL) further complicates this landscape, as model updates exchanged during training may unintentionally expose private medical information. Emerging quantum computing capabilities threaten the long-term viability of conventional lightweight cryptographic mechanisms, motivating the integration of Post-Quantum Cryptography (PQC) into IoMT systems. This article discusses key enabling technologies for quantum-resilient IoMT, including post-quantum key establishment, lightweight encryption, and edge-native orchestration. We propose a scalable Kubernetes-based framework that integrates PQC into FL-enabled IoMT environments and validate it on a Raspberry Pi testbed. Results demonstrate that distributed cryptographic processing significantly reduces latency compared to sequential designs while maintaining feasible resource overhead. The primary contribution of this work lies in the design and validation of a secure orchestration and communication framework for FL-enabled IoMT systems. We conclude by outlining future directions toward energy-aware architectures, intelligent security optimization, and resilient next-generation Intelligent Internet of Medical Things (IIoMT) ecosystems.

20.
arXiv (CS.CL) 2026-06-17

Translating the Untranslatable: An Operationalizable Ontology for Untranslatability

Untranslatability, cases where meaning cannot be directly preserved across languages, is well-studied in linguistics but underexplored in NLP. As machine translation (MT) systems improve on standard benchmarks, their limitations increasingly concentrate in such cases, where translation cannot be reduced to one-to-one equivalence. We introduce a structured ontology of untranslatability along with a taxonomy of compensation strategies, which are specific techniques to convey meaning under these untranslatable circumstances. We operationalize this framework into a multilingual dataset of untranslatable sentences paired with strategy-based translations, enabling controlled analysis of translation behavior. Initial human preference studies suggest that translation quality depends on the strategy used, with consistent preferences for outputs that include explanatory context, known as the Annotation compensation strategy. Our framework and dataset provide a foundation for studying and modeling strategy-informed machine translation.

21.
medRxiv (Medicine) 2026-06-22

Reform of the intermediate level of the health system in the Democratic Republic of the Congo: Adaptations and limits in the stabilization of the personnel of the Provincial Health Division: A cohort study.

Background: Human resources are one of the pillars of health systems. Since the World Health Organization's report on human resources issues, several countries have integrated this component into the various reforms aimed at strengthening their health systems. This study aims to explore the effects of reforming the intermediate level of a health system operating in a fragile state context. Methodology Our study was conducted in the Democratic Republic of Congo (DRC). It was a cohort study of the staff of the 14 Provincial Health Divisions (PHD) out of the 26 existing in the DRC. We established a database of the staff of these 14 PHD from 2016, just after the implementation of the intermediate level reform and the allocation of this staff by the Ministry of Health. We did a recall in 2021, in each of these PHD to survey this staff through a structured questionnaire and supplemented by the files of the agents available in each PHD. Sociodemographic, economic and academic variables were collected and analyzed. Data were entered into an Excel 2016 database and processed with SPSS software version 25. The chi-square test was used for comparison of proportions with a statistical significance level of p < 0.05. Risk ratios ratios (RR) and their 95% confidence intervals were calculated as measures of association. The error threshold was set at 5%. Results A total of 657 agents with an average age of 45.2 years had been identified in 2016 at the start of the survey and in 2021, 118 or 18% of them were no longer part of the PHD agents. Among the causes of absence noted: 48% of agents placed on leave, 16% promoted to other functions within the health system, 16% desertion and dismissal and 11% cases of death. 19.8% of absentees are executives, 19.5% men against 10.3% women; 22.3% of absentees in unstable provinces against 16.6% in stable ones. The factors associated with the absence of agents in the PHD remain the reaching of retirement age [RR (95% CI) = 5.5 (1.2-24.9) ]and male agents [RR (95% CI) = 3.2 (1.3-7.9)]. Among the agents who remained, 92% kept their initial position, 6% were subject to an internal permutation accompanied by a promotion. The factors associated with the stability of human resources at the level of the Provincial Health Division are: female gender, manager with experience or seniority > 5 years, Age > 35 years, Stable province, Presence of a partner bonus. Conclusion Even in a crisis and fragile context, health system reform is possible. It is possible to organize staff recruitment through a selection process independent of the political authorities of the Ministry of Health and supported by the technical services of the Ministry and partners . Experience and the presence of a financial bonus are motivating factors for staff stability. The involvement of Technical and Financial Support Partners in the recruitment process helped the Ministry of Health to minimize political influence in the recruitment of middle-level executives.

22.
medRxiv (Medicine) 2026-06-23

Timing of S. aureus-related mortality in a large randomized clinical trial: Implications for future study design

Background: Longer follow-up periods in clinical trials for S. aureus bacteremia (SAB) may capture unrelated deaths, adding random noise that risks biasing trial results towards the null. Objective: To evaluate the timing and infection-relatedness of deaths within a large SAB clinical trial platform. Design: Blinded duplicate adjudication of trial deaths using a modified 7-point Likert-Scale. A third reviewer settled disagreements. Setting: 37 Canadian hospitals participating in the S. aureus Network Adaptive Platform (SNAP) Trial. Participants: 1515 adult patients recruited to SNAP between February 2022 and May 2026. Measurements: Timing and relatedness of 90-day deaths categorized as at least possibly SAB-related not likely to be SAB-related. Optimal follow-up cut-off was determined using Youden's index and graphically. Results: 247 deaths occurred; 97 (39.3%) were adjudicated as at least possibly SAB-related and 150 (60.7%) as not likely related. For probably/definitely related deaths, interrater agreement was 85.0% (Gwet's AC 0.73, substantial); for at least possibly related, it was 77.3% (Gwet's AC 0.55, moderate). Median survival was significantly shorter for SAB-related deaths (12 vs. 30.5 days; difference: 19 days earlier, 95% CI: 12-26, p

23.
arXiv (CS.CL) 2026-06-17

Adaptive Activation Steering for Efficient LLM Reasoning via Closed-Loop PID Control

Reasoning LLMs trained with long chain-of-thought often overthink: they spend tokens on redundant reflection and transitions that inflate cost without improving accuracy. Static activation steering (e.g.\ SEAL) suppresses such content with a fixed vector, but applies the same strength regardless of how redundant the current chunk actually is. We describe PID-steering, a training-free, decoding-time method that modulates the steering strength with a PID controller driven by a lightweight chunk-level redundancy classifier. On a subset of GSM8K with DeepSeek-R1-Distill-Qwen-1.5B, the method improves accuracy from 85.7\% to 89.6\% (+3.9 pp) while cutting average output length from 1026 to 790 tokens ($-$23\%). We report it as a small-scale proof of concept rather than a benchmark result.

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

State-Grounded Multi-Agent Synthetic Data Generation for Tool-Augmented LLMs

Training tool-augmented LLM agents requires large corpora of multi-turn, tool-grounded conversational data that is expensive to annotate, privacy-constrained in production settings, and largely absent from public datasets. We present StateGen, a synthetic data generation platform that produces scored, reasoning-trace-rich training conversations by orchestrating a four-role LLM loop: a persona-conditioned user simulator, an agent under test, a state-grounded tool simulator, and a multi-axis LLM judge. The key architectural contribution is an authoritative state manager that maintains a structured world-state object across turns, enforcing a backend-is-truth invariant that eliminates the dominant class of tool-call hallucinations by construction. StateGen extends naturally to hierarchical multi-agent settings by declaring sub-agents as tools, all sharing a single state object. We report results on 64,698 evaluated conversations across three production corpora: tool-call hallucination scores reach 9.66/10, the system supports persona-driven variation via a 23-dimensional trait vector, and a cleanly separated train and golden evaluation set split confirms the data is not memorization bait (per-criterion gap analysis). Comparison with eight external systems shows that no single publicly available platform combines multi-turn generation, state-grounded tool simulation, hierarchical multi-agent support, and built-in judge scoring.

25.
arXiv (CS.CV) 2026-06-15

NEST3D: A High-Resolution Multimodal Dataset of Sociable Weaver Tree Nests

Sociable weaver nests function as complex ecological structures offering thermoregulatory microhabitats and sustaining diverse species; however, datasets used in prior studies lack fine-grained 3D structural detail. Producing usable and accurate 3D weaver nest data is challenging due to their irregular geometry and integration with complex host vegetation. We bridge this gap with an open-access, 1.4 TB multimodal drone dataset of 104 nest-bearing trees, comprising 27,945 RGB images, 111,780 multispectral images, approximately 781 million 3D points, and expert-annotated semantic segmentation labels. We benchmark semantic segmentation using KPConv, RandLA-Net, and Point Transformer V3, with PT-v3 achieving an mIoU of 86.35% on the test set. While the results demonstrate strong performance for transformer-based and point-wise methods, they also highlight architecture-dependent challenges, particularly for convolution-based approaches such as KPConv. By uniquely combining spectral, spatial, and structural information, the presented dataset advances 3D reconstruction, segmentation, and classification algorithms, enabling ecological applications from nest volume estimation to species conservation, and serves as a demanding benchmark that exposes architecture-dependent performance under extreme class imbalance.