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01.
arXiv (CS.LG) 2026-06-25

Don't Go Breaking My LLM: The Impact of Pruning Attention Layers on Explanation Faithfulness and Confidence Calibration

arXiv:2606.24970v1 Announce Type: new Abstract: Pruning Large Language Models (LLMs) reduces memory and inference costs by removing parts of the network, producing smaller models that retain most of their accuracy. As attention layers are the most resource-intensive parts of LLMs, pruning them is a promising compression strategy. Prior work shows that up to 33% of attention layers can be pruned with minimal accuracy loss. Nevertheless, the impact of attention pruning on model interpretability, specifically faithfulness and confidence calibration, remains unstudied. To address this gap, we study how pruning attention layers affects explanation faithfulness and confidence calibration across five LLMs and eight datasets. While the pruned models often maintain high accuracy, we find that their faithfulness and calibration often degrade. Notably, faithfulness and calibration can fluctuate significantly, even when accuracy remains stable, highlighting a misalignment between model confidence, interpretability, and accuracy. Our findings suggest that layer pruning can affect LLMs' interpretability and reliability in ways not captured by accuracy and efficiency measures alone. We recommend including explainability and calibration metrics when evaluating pruned models.

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

Explainable deep learning improves human mental models of self-driving cars

arXiv:2411.18714v3 Announce Type: replace-cross Abstract: Self-driving cars increasingly rely on deep neural networks to achieve human-like driving. The opacity of such black-box planners makes it challenging to accurately anticipate when they will fail, with potentially catastrophic consequences. While research into interpreting these systems has surged, most of it is confined to simulations or toy setups due to the difficulty of real-world deployment, leaving the practical utility of such techniques unknown. Here, we introduce the Concept-Wrapper Network (CW-Net), a method for faithfully explaining the behavior of machine-learning-based planners that causally grounds their reasoning in human-interpretable concepts without sacrificing performance. We deploy CW-Net on a real self-driving car and show that the resulting explanations improve the human driver's mental model of the vehicle, allowing them to better predict its behavior, particularly in surprising situations. This demonstrates that explainable deep learning integrated into self-driving cars can be both understandable and useful in a realistic deployment setting. We anticipate our method could be applied to other safety-critical systems, such as autonomous drones and robotic surgeons, as well as to other architectures, such as end-to-end learning systems and vision-language-action models. Overall, our study establishes a deployment-validated pathway to interpretability for autonomous agents, which could help make them more transparent and safe.

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

Rescaling MLM-Head for Neural Sparse Retrieval

arXiv:2606.18811v1 Announce Type: cross Abstract: Learned sparse retrieval (LSR) models such as SPLADE have traditionally used BERT-style masked language models as backbone encoders. A natural expectation is that replacing BERT with stronger pretrained encoders should improve retrieval effectiveness. However, we find that under standard SPLADE training recipes, backbones with large MLM-head L2 norms can suffer performance degradation and even training collapse under standard SPLADE training recipes. We identify this failure as a scale mismatch in the MLM head: SPLADE directly uses MLM-head outputs to construct sparse lexical representations, and query-document relevance is computed by an unnormalized dot product over these representations. As a result, an inflated MLM-head scale can amplify sparse activations, distort matching scores, and destabilize contrastive training under common training settings. To address this issue, we introduce a simple initialization-time correction that rescales the MLM-head projection by a constant factor before SPLADE training. This zero-cost adjustment improves training stability without modifying the model architecture or training objective. Across both in-domain and out-of-domain retrieval benchmarks, this simple correction substantially improves large-norm backbones such as ModernBERT and Ettin, turning unstable training runs into competitive sparse retrievers. In several settings, the corrected models further match or surpass the classic BERT-SPLADE baseline. These findings suggest that the bottleneck in adapting pretrained encoders to LSR is not encoder capacity alone, but the calibration of the MLM-head scale used to construct sparse lexical representations.

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

Echo2ECG: Enhancing ECG Representations with Cardiac Morphology from Multi-View Echos

arXiv:2603.08505v2 Announce Type: replace-cross Abstract: Electrocardiography (ECG) is a low-cost, widely used modality for diagnosing electrical abnormalities like atrial fibrillation by capturing the heart's electrical activity. However, it cannot directly measure cardiac morphological phenotypes, such as left ventricular ejection fraction (LVEF), which typically require echocardiography (Echo). Predicting these phenotypes from ECG would enable early, accessible health screening. Existing self-supervised methods suffer from a representational mismatch by aligning ECGs to single-view Echos, which only capture local, spatially restricted anatomical snapshots. To address this, we propose Echo2ECG, a multimodal self-supervised learning framework that enriches ECG representations with the heart's morphological structure captured in multi-view Echos. We evaluate Echo2ECG as an ECG feature extractor on two clinically relevant tasks that fundamentally require morphological information: (1) classification of structural cardiac phenotypes across three datasets, and (2) retrieval of Echo studies with similar morphological characteristics using ECG queries. Our extracted ECG representations consistently outperform those of state-of-the-art unimodal and multimodal baselines across both tasks, despite being 18x smaller than the largest baseline. These results demonstrate that Echo2ECG is a robust, powerful ECG feature extractor. Our code is accessible at https://github.com/michelleespranita/Echo2ECG.

05.
arXiv (CS.LG) 2026-06-16

Taming Curvature: Architecture Warm-Up for Stable Transformer Training

arXiv:2606.16768v1 Announce Type: new Abstract: Training billion-parameter Transformers is often brittle, with transient loss spikes and divergence that waste compute. Even though the recently developed Edge of Stability (EoS) theory provides a powerful tool to understand and control the stability of optimization methods via the (preconditioned) curvature, these curvature-controlling methods are not popular in large-scale Transformer training due to the complexity of curvature estimation. To this end, we first introduce a fast online estimator of the largest (preconditioned) Hessian eigenvalue (i.e., curvature) based on a warm-started variant for power iteration with Hessian-vector products. We show theoretically, and verify empirically, that the proposed method makes per-iteration curvature tracking feasible at billion parameter scale while being more accurate. Using this tool, we find that training instabilities coincide with surges in preconditioned curvature and that curvature grows with depth. Motivated by these observations, we propose architecture warm-up: progressively growing network depth to carefully control the preconditioned Hessian and stabilize training. Experiments on large Transformers validate that our approach enables efficient curvature tracking and reduces instabilities compared to existing state-of-the-art stabilization techniques without slowing down convergence.

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

DemoDiffusion: One-Shot Human Imitation using pre-trained Diffusion Policy

arXiv:2506.20668v3 Announce Type: replace-cross Abstract: We propose DemoDiffusion, a simple method for enabling robots to perform manipulation tasks by imitating a single human demonstration, without requiring task-specific training or paired human-robot data. Our approach is based on two insights. First, the hand motion in a human demonstration provides a useful prior for the robot's end-effector trajectory, which we can convert into a rough open-loop robot motion trajectory via kinematic retargeting. Second, while this retargeted motion captures the overall structure of the task, it may not align well with plausible robot actions in-context. To address this, we leverage a pre-trained generalist diffusion policy to modify the trajectory, ensuring it both follows the human motion and remains within the distribution of plausible robot actions. Unlike approaches based on online reinforcement learning or paired human-robot data, our method enables robust adaptation to new tasks and scenes with minimal effort. In real-world experiments across 8 diverse manipulation tasks, DemoDiffusion achieves 83.8\% average success rate, compared to 13.8\% for the pre-trained policy and 52.5\% for kinematic retargeting, succeeding even on tasks where the pre-trained generalist policy fails entirely. Project page: https://demodiffusion.github.io/

07.
arXiv (CS.AI) 2026-06-11

An XAI View on Explainable ASP: Methods, Systems, and Perspectives

arXiv:2601.14764v2 Announce Type: replace Abstract: Answer Set Programming (ASP) is a popular declarative reasoning and problem solving approach in symbolic AI. Its rule-based formalism makes it inherently attractive for explainable and interpretive reasoning, which is gaining importance with the surge of Explainable AI (XAI). A number of explanation approaches and tools for ASP have been developed, which often tackle specific explanatory settings and may not cover all scenarios that ASP users encounter. In this survey, we provide, guided by an XAI perspective, an overview of types of ASP explanations in connection with user questions for explanation, and describe their coverage by current theory and tools. Furthermore, we pinpoint gaps in existing ASP explanations approaches and identify research directions for future work.

08.
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.

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

InterleaveThinker: Reinforcing Agentic Interleaved Generation

Recent image generators have demonstrated impressive photorealism and instruction-following capabilities in single-image generation and editing. However, constrained by their architectures, they cannot achieve interleaved generation (text-image sequence), which has crucial applications in visual narratives, guidance, and embodied manipulation. Even the latest open-source Unified Multimodal Models (UMMs) exhibit limited performance in this regard. In this paper, we introduce InterleaveThinker, the first multi-agent pipeline designed to endow any existing image generator with interleaved generation capabilities. Specifically, we employ a planner agent to organize the image-text input sequence, instructing the image generator on the required execution at each step. Subsequently, we introduce a critic agent to evaluate the generator's outputs, identify samples that deviate from the planned instructions, and refine the instructions for regeneration. To implement this pipeline, we construct the Interleave-Planner-SFT-80k and Interleave-Critic-SFT-112k to perform a format cold-start. Then we develop Interleave-Critic-RL-13k to reinforce the step-wise instruction correction capability within a generation trajectory using GRPO. Since a single interleaved generation trajectory may involve over 25 generator calls, optimizing the entire trajectory is computationally impractical. Therefore, we propose accuracy reward and step-wise reward, allowing single-step RL to effectively guide the entire generation trajectory. The results show that InterleaveThinker improves performance across various image generators. On interleaved generation benchmarks, it achieves performance comparable to Nano Banana and GPT-5. Surprisingly, it also significantly enhances the base model on reasoning-based benchmarks; for example, on 4-step FLUX.2-klein, we observe substantial gains on WISE and RISE.

10.
arXiv (CS.CV) 2026-06-17

ThinkJEPA: Empowering Latent World Models with Large Vision-Language Reasoning Model

Recent progress in latent world models (e.g., V-JEPA2) has shown promising capability in forecasting future world states from video observations. Nevertheless, dense prediction from a short observation window limits temporal context and can bias predictors toward local, low-level extrapolation, making it difficult to capture long-horizon semantics and reducing downstream utility. Vision–language models (VLMs), in contrast, provide strong semantic grounding and general knowledge by reasoning over uniformly sampled frames, but they are not ideal as standalone dense predictors due to compute-driven sparse sampling, a language-output bottleneck that compresses fine-grained interaction states into text-oriented representations, and a data-regime mismatch when adapting to small action-conditioned datasets. We propose a VLM-guided JEPA-style latent world modeling framework that combines dense-frame dynamics modeling with long-horizon semantic guidance via a dual-temporal pathway: a dense JEPA branch for fine-grained motion and interaction cues, and a uniformly sampled VLM thinker branch with a larger temporal stride for knowledge-rich guidance. To transfer the VLM's progressive reasoning signals effectively, we introduce a hierarchical pyramid representation extraction module that aggregates multi-layer VLM representations into guidance features compatible with latent prediction. Experiments on hand-manipulation trajectory prediction show that our method outperforms both a strong VLM-only baseline and a JEPA-predictor baseline, and yields more robust long-horizon rollout behavior.

11.
arXiv (CS.CL) 2026-06-17

A Framework for Evaluating Agentic Skills at Scale

Agent skills – structured, reusable knowledge artifacts that augment LLM agent capabilities – have been rapidly adopted in industry, yet their cross-domain impact and use across commercial and open-source models remain under-studied, and no reusable methodology exists for evaluating an individual skill. In this work, we present an evaluation framework that lets a skill author construct realistic tasks to rigorously assess the aspects of a skill that matter most to them, and that estimates skill utility by solving those tasks. Further, we apply our evaluation approach at scale to 500 real-world skills, generating 1,000 tasks derived from the skills' content, along with instruction-following and goal-completion scoring rubrics. Using these metrics, we evaluate how 19 agent-model configurations, both proprietary and open-source, perform on the tasks. Our results show that models vary widely in how closely they adhere to the instructions encoded in skills, leading to substantial differences in their performance gains. Furthermore, we show that access to a skill significantly changes model behavior compared to the no-skill setup, providing an essential mechanism for encoding opinionated workflows into LLM agents. We release our evaluation dataset to support future work on agent skills.

12.
medRxiv (Medicine) 2026-06-12

High coverage, persistent gaps: quality of Antenatal Care and its determinants in Zambia based on the 2024 Demographic and Health Survey.

Abstract Background Evaluating antenatal care (ANC) quality is critical to reducing maternal and neonatal mortality. In Zambia, despite high basic ANC attendance, comprehensive national evidence on the clinical content and quality of services remains limited. This study assessed the coverage of WHO-recommended ANC interventions and identified factors associated with care quality using the latest national data. Methods A cross-sectional analysis was conducted using data from the 2024 Zambia Demographic and Health Survey. The final analytic sample comprised 4,829 women aged 15-49 with a live birth in the preceding 5 years. A composite index of 15 selected, equally weighted WHO-recommended components evaluated clinical assessment, counseling/screening, preventive interventions, and utilization. Survey-weighted Poisson regression estimated adjusted incidence rate ratios (aIRRs) for the count of ANC components received. Results The mean ANC quality score was 12.5 out of 15 (95% CI: 12.4-12.6), and 78.5% (95% CI: 77.0-80.0) of women achieved adequate ANC ([≥] 12/15 components). While individual clinical and counseling coverage generally exceeded 90%, only 47.2% (95% CI: 45.3-49.0) of women initiated care during the first trimester, and just 4.8% (95% CI: 4.1-5.6) achieved [≥] 8 ANC contacts. Maternal education was the strongest and most stable predictor of quality across all models. Compared to no education, higher education was associated with an 8.0% higher expected quality score (aIRR = 1.080, 95% CI: 1.051-1.110). Lower ANC quality was significantly associated with unwanted pregnancies (aIRR = 0.970, 95% CI: 0.956-0.993) and with residence in Western (aIRR = 0.923, 95% CI: 0.897-0.951) and North Western (aIRR = 0.966, 95% CI: 0.937-0.996) provinces. Absence of distance barriers and residence in Eastern, Luapula, and Copperbelt provinces were associated with higher quality scores. Conclusion While average ANC component coverage in Zambia is high, critical gaps persist in early initiation and total contact frequency. Care adequacy is strongly influenced by maternal education, relationship status, pregnancy intention, and regional inequities. These findings underscore the need for interventions targeted at uneducated women, preventing unintended pregnancies, and underserved regions such as Western and North Western Provinces. Keywords: Antenatal care quality, ANC content, Zambia, maternal education.

13.
medRxiv (Medicine) 2026-06-22

The circulating blood proteome of childhood acute leukemia

The circulating blood proteome provides a systemic readout of disease biology and holds promise for advancing diagnostics and disease monitoring in pediatric leukemia. Here, we profiled 3072 proteins in diagnostic serum from 54 children with acute lymphoblastic leukemia (ALL), 21 with acute myeloid leukemia (AML), and 12 healthy controls using the Olink Proximity Extension Assay. We observed profound alterations in circulating protein levels in leukemia patients compared with controls and identified immunophenotype-specific proteins, including SIGLEC15 in B-cell precursor ALL (BCP-ALL), NOTCH1 in T-ALL, and CEBPA in AML, all which remained high even in patients with low (

14.
arXiv (CS.LG) 2026-06-25

Generating Input Distributions for Explaining Portfolio Optimization Pipelines

arXiv:2606.25808v1 Announce Type: cross Abstract: We propose a predict-optimize-explain framework that uses gradient-based sample generation to interpret various portfolio models by identifying macroeconomic conditions that induce specified portfolio outcomes. Unlike traditional feature-importance methods, this approach directly probes decision pipelines (predictive models coupled with portfolio optimization) by constructing economically meaningful what-if questions. We focus on four such questions: under what macroeconomic conditions a predict-then-optimize pipeline closes or reverses its return gap with a predict-and-optimize pipeline; what conditions lead a pipeline to diversify rather than concentrate its allocation; when a pipeline trained on calm markets overtakes one trained through crises; and what conditions would let a pipeline match a benchmark return. These examples illustrate how our framework uncovers key behavioral differences between various decision pipelines. Beyond these cases, the proposed framework is flexible and can support a wide range of probing questions tailored to specific portfolio objectives. Our findings highlight the value of integrating prediction, optimization, and explanation to produce more robust and transparent portfolio strategies.

15.
arXiv (CS.CV) 2026-06-18

Transformer Geometry Observatory TGO-I: Spectral Geometry Observatory

Despite the widespread adoption of Vision Transformers (ViTs) and their success across numerous computer vision applications, the fundamental understanding of their dimensional and representational geometry remains relatively underexplored. To address this gap, we introduce Transformer Geometry Observatory (TGO), a systematic framework of experiments and analysis pipelines designed to investigate the representational geometry and dynamics of Vision Transformers. TGO-I, the first installment of the framework, focuses on the spectral geometry of ViT representations. Using a ViT-Small/16 model trained on ImageNet-100, we analyze Effective Rank, Stable Rank, Participation Ratio, Spectral Entropy, Spectral Flatness, Spectral Anisotropy, covariance structure, eigenspectra, and singular value spectra throughout training. Our results reveal a consistent increase in dimensional utilization, accompanied by decreasing anisotropy, increasing spectral entropy, increasing participation ratio, and progressively flatter eigenspectra. Contrary to the common intuition that training should concentrate information into a small number of dominant directions, we observe a progressive redistribution of variance across representational dimensions. This phenomenon is particularly pronounced in the final CLS token representation, which exhibits the highest effective dimensionality and lowest anisotropy within the network.

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

Pantheon360: Taming Digital Twin Generation via 3D-Aware 360{\deg} Video Diffusion

Generating complete digital twins from videos requires precise camera control, global scene coverage, and strict spatial-temporal consistency constraints that remain challenging for perspective video generators due to their limited field of view (FoV). Their narrow FoV forces long or multi-view trajectories, amplifying cross-view inconsistency and temporal drift. We argue that 360{\deg} video generation offers a natural solution: panoramic coverage simplifies trajectory design and provides a strong global context for maintaining coherence. We introduce Pantheon360: Taming Digital Twin Generation via 3D-Aware 360{\deg} Video Diffusion, a controllable 360{\deg} video generation framework that synthesizes high-fidelity videos from sparse 360{\deg} inputs. The key idea is an explicit 3D Cache, reconstructed from the input, which serves as a geometric scaffold for any user-defined camera path. This allows the diffusion model to focus on photorealistic texture refinement while the 3D Cache enforces global geometric consistency. Experiments show that Pantheon360 achieves superior visual quality and unmatched geometric coherence, enabling reliable and flexible 360{\deg} scene generation for downstream simulation and digital-twin applications.

17.
arXiv (CS.LG) 2026-06-24

Constrained Variable Projection for Structured Problems

arXiv:2606.23939v1 Announce Type: cross Abstract: Variable projection is a classical technique for separable nonlinear least-squares problems, in which variables that enter linearly are eliminated exactly, yielding a reduced nonlinear problem. By expressing this framework as a particular instance of a broader class of bilevel optimization problems, we develop a constrained variable-projection framework for data-science models, where the remaining variables are subject to convex constraints and the eliminated variables arise from a lower-level least-squares problem. In particular, by interpreting variable projection as a collapsed bilevel optimization problem, we derive exact reduced-gradient formulas compatible with automatic differentiation and propose a conditional-gradient algorithm for the resulting constrained reduced problem. We establish convergence guarantees under standard smoothness and compactness assumptions, and discuss extensions to structured lower-level variables. Numerical experiments on sparse autoencoding, dictionary learning, blind deconvolution, and few-shot learning suggest that the method can improve wall-clock efficiency and data efficiency relative to natural joint-optimization baselines.

18.
medRxiv (Medicine) 2026-06-15

Association of Genetic Liability to Psychiatric Disorders with Peripheral Metabolic Dysregulation

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

19.
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

20.
medRxiv (Medicine) 2026-06-22

Evidence-guided AI regularization for suicidal ideation prediction in pediatric bipolar disorder

Background: Suicide prediction models in psychiatry often rely on purely data-driven feature selection, which can produce unstable and clinically opaque predictor sets in modest-sized samples. We developed Evidence-Based AI LASSO (EBAL), an evidence-guided regularization framework that incorporates curated clinical evidence into feature-specific penalty factors for interpretable prediction. Methods: Baseline data from 136 youth with confirmed bipolar spectrum disorder in the Greater Houston Area Bipolar Registry were analyzed using 20 candidate clinical predictors. Forty higher-level evidence documents on suicidality and related predictor domains were curated through a structured evidence synthesis workflow and indexed as an auditable evidence corpus. An open-weight large language model assigned feature-specific penalty factors using a prespecified scoring rubric, and these penalties were used to fit a weighted LASSO model. EBAL was compared with a standard evidence-agnostic LASSO using nested leave-one-out cross-validation. Results: For suicidal ideation, EBAL achieved an AUROC of 0.768, balanced accuracy of 0.757, sensitivity of 0.758, and specificity of 0.757. The standard LASSO achieved an AUROC of 0.760 and balanced accuracy of 0.715. EBAL improved balanced accuracy (+0.042, p=0.010) and Matthews correlation coefficient (+0.079, p=0.010), while retaining fewer stable predictors than standard LASSO (11/20 vs 18/20). The strongest positive predictors were current depressed mood, duration of mood disorder illness, and comorbid generalized anxiety disorder. For suicidal behavior, both models performed near chance and retained all candidate predictors. Limitations: The study was cross-sectional, single-site, and modest in sample size, with no external validation cohort. Conclusions: EBAL produced a sparser and more clinically coherent model for suicidal ideation in pediatric bipolar disorder, but did not improve prediction of suicidal behavior. These findings support evidence-guided regularization as a transparent strategy for aligning psychiatric prediction models with prior clinical knowledge while preserving interpretability.

21.
medRxiv (Medicine) 2026-06-22

Vaccine introductions in the WHO African Region, 2023-26: a country-level ecological analysis by Gavi eligibility and conflict-affected status

Background. The Immunization Agenda 2030 (IA2030) tracks new and underused vaccine introduction as an access metric, and its mid-term review calls for stronger country ownership, prioritisation, data use and tailored support in conflict-affected and resource-constrained settings; however, national launch status does not measure recurrent financing, implementation, safety or equity. We examined how recent vaccine-introduction activity was distributed across the WHO African Region. Methods. We conducted a descriptive country-level ecological analysis of all 47 Member States from January 2023 to June 2026. The country was the unit of analysis and contributed one cumulative, unweighted count of nationally endorsed vaccine-introduction and programme-change events. Counts were linked to Gavi eligibility, World Bank FY26 conflict-affected status, broader fragile and conflict-affected situation status in sensitivity analysis, and concurrent system-performance indicators, and modelled with Poisson regression using HC1 robust standard errors. Two Expanded Programme on Immunization (EPI) manager survey waves were summarised at country level. Reporting followed STROBE and RECORD. Results. Seventy-two events were recorded across 38 of 47 Member States: 48 new-antigen introductions, 20 dose or schedule expansions and four combination-vaccine introductions; malaria vaccines accounted for 21. Gavi-eligible conflict-affected countries averaged 2.50 events per country versus 1.27 in both comparison groups. Gavi-eligible conflict-affected status was associated with a higher count (incidence rate ratio [IRR] 1.97, 95% confidence interval [CI] 1.38-2.81; p

22.
medRxiv (Medicine) 2026-06-24

Uncovering the fitness of endemically circulating Zika virus strains

Zika virus (ZIKV) is an arbovirus that usually causes few symptoms and has circulated endemically in Asia for decades. However, a large outbreak in South America in 2015 uncovered the serious risk of congenital Zika syndrome in infants born from ZIKV infected mothers. It is unknown whether a lineage with distinct pre-existing fitness advantage emerged from Asia to cause the South American outbreak, and whether there is ongoing evolution that can result in future globally fit strains. Here we used 107 sequences from a single setting (Thailand) collected over an 18 year period (2006-2023). We used novel analytical tools to identify distinct lineages that have circulated in the population and estimated their relative epidemiological fitness. We found there have been six lineages circulating sequentially in the country, with regular emergence and replacement of lineages showing higher fitness than their predecessors. We identified 15 lineage-defining amino acid changes, including four well-documented fitness-enhancing mutations, and two UTR substitutions. The lineage that emerged in South America was evolutionarily linked to the highest-fitness lineage in Thailand, carrying seven of our lineage-defining substitutions acquired during endemic circulation there, and subsequently accumulating four additional changes. After the global pandemic, endemic ZIKV in Thailand continued to evolve, with newly emerged lineages showing novel mutations and increased fitness. Our findings have key implications for the monitoring of ZIKV and can help identify the pathway to increased transmissibility of this globally important pathogen.

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

Memory-Efficient Meta-Reinforcement Learning for Adaptive Safety-Critical Control in Adversarial Spacecraft Proximity Operations

arXiv:2606.17414v1 Announce Type: new Abstract: Autonomous spacecraft rendezvous and proximity operations (RPO) require controllers that guarantee safety under thrust constraints while minimizing fuel expenditure. Input-constrained control barrier functions (ICCBFs) provide a control method for nonlinear systems with actuation constraints that construct a forward-invariant safe set. Previous work has shown that learning class-$\mathcal{K}$ functions defining the ICCBF recursion via meta reinforcement learning (meta-RL) yields a robust, non-greedy approach to safety-critical control in RPO. This paper extends that framework further by investigating the performance of three recurrent network architectures (Long Short Term Memory (LSTM), Gated Recurrent Unit (GRU), Selective State Space Model (Mamba)) and two training algorithms (Proximal Policy Optimization (PPO) and Soft Actor Critic (SAC)) to identify the best setup for tuning ICCBF class-K functions via meta-RL. In addition to cooperative test cases, performance is evaluated in the presence of adversarial behavior where the target spacecraft behaves in a way that worsens the safety of the chaser spacecraft. Results indicate that state space models such as Mamba when used with PPO achieve superior task completion, safety, and fuel-savings compared to other architectures, across all cooperative and uncooperative scenarios tested.

24.
arXiv (CS.CV) 2026-06-17

Complex Layout Classification in the Wild: A Low-Resource Approach with Layout-Preserving Augmentations

Many digitized corpora suffer from low resources because annotations may be scarce, page scans are noisy and of poor resolution, or layouts are structurally complex in ways that negatively affect the quality of automatic transcription. Developing robust classification models for low-resource languages is inhibited by the lack of large-scale annotated data and by the frequent semantic complexity of page layouts. To this end, we have curated a complex-layout dataset, manually classified into eight distinct layout types based on their separator regions. To overcome data scarcity, we propose a novel training strategy in the form of a CNN-based classifier that employs strong, domain-aware augmentations to improve generalization. We utilize narrow anisotropic Gaussian masking to suppress incidental textual details while preserving essential separations, compelling the model to learn global geometric arrangements. Additionally, we implement reflection-induced label transformations to enrich the training distribution while maintaining label consistency across asymmetric categories. The results demonstrate that layout-specific augmentations can substantially improve page-level layout classification under severe annotation scarcity.

25.
arXiv (CS.CL) 2026-06-25

How Large Language Models Source Brand Reputation Across Languages and Markets

When a large language model (LLM) answers a question about a company, it grounds the answer in retrieved web sources, and those sources decide what the model says. Most analysis of AI brand visibility looks at the answer text. This study looks one step earlier, at the citations. We merge three Rankfor.AI datasets covering 128 brands across 12 home markets and 13 languages, and analyse 167,551 URL-grounded citations (189,974 total attribution rows). We classify each citation by domain and source type and measure where AI gets its brand information, by language and by market. Four patterns hold. First, AI grounds brand answers overwhelmingly in third-party sources: 85.7% of citations point to sites the brand does not own, against 14.3% owned. Second, the source base is concentrated and long-tailed: 80% of citations come from about 18% of domains, fitting a Zipf law (alpha = 0.86, R^2 = 0.983). Third, one reference site dominates almost everywhere: Wikipedia is the most-cited domain in 11 of 12 languages, the exception being Lithuanian, where the business daily vz.lt edges it (4.38%). Fourth, the source mix is market-specific at the margin: for 46 Polish national brands the most-cited domain is YouTube, and four HR and careers portals supply 637 citations against 297 for Polish Wikipedia, about twice as many.