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01.
bioRxiv (Bioinfo) 2026-06-10

Promera: a unified model for biomolecular structure prediction, filtering, and design

Generative models have become staple tools for modeling and designing biomolecular structures. However, although these tools have improved in structural prediction accuracy, their ability to filter designed binders—an essential use case—remains insufficient; whereas design methods have focused more on unconstrained binder generation rather than capabilities enabled by controllable design. We introduce Promera, a unified generative model that combines all-atom structure prediction with improved filtering and controllable design. We find that Promera's confidence metrics are more accurate for filtering binders from non-binders for both miniproteins and nanobodies, while its co-folding performance surpasses popular open-source models (OpenFold3-p2, Boltz-2) on therapeutically relevant categories. As a design model, Promera generates binders by predicting masked protein sequences with optional epitope, paratope, and template constraints. Remarkably, our nanobody designs match the in silico success rates from backprop-based techniques (mBER) when evaluated under co-folding confidence filters. We further provide two in silico demonstrations of the the versatile capabilities of our design method: epitope targeting of the Andes hantavirus glycoprotein with VHHs and active state stabilization of the beta-2 andrenergic GPCR. We conclude by proposing a scaling law for co-folding models, suggesting a path for further performance improvement.

02.
arXiv (CS.AI) 2026-06-25

Securing Time Integrity in Energy IoT Against Clock Drift and Y2K38 Failures

arXiv:2601.23147v2 Announce Type: replace-cross Abstract: The integrity of time in distributed Internet of Things (IoT) devices is crucial for reliable operation in energy cyber-physical systems, such as smart grids and microgrids. However, IoT systems are vulnerable to clock drift, time-synchronization manipulation, and timestamp discontinuities, such as the Year 2038 (Y2K38) Unix overflow, all of which disrupt temporal ordering. Conventional anomaly-detection models, which assume reliable timestamps, fail to capture temporal inconsistencies. This paper introduces STGAT (Spatio-Temporal Graph Attention Network), a framework that models both temporal distortion and inter-device consistency in energy IoT systems. STGAT combines drift-aware temporal embeddings and temporal self-attention to capture corrupted time evolution at individual devices, and uses graph attention to model spatial propagation of timing errors. A curvature-regularized latent representation geometrically separates normal clock evolution from anomalies caused by drift, synchronization offsets, and overflow events. Experimental results on energy IoT telemetry with controlled timing perturbations show that STGAT achieves 95.7% accuracy, outperforming recurrent, transformer, and graph-based baselines with significant improvements (d > 1.8, p < 0.001). Additionally, STGAT reduces detection delay by 26%, achieving a 2.3-time-step delay while maintaining stable performance under overflow, drift, and physical inconsistencies.

03.
arXiv (CS.CV) 2026-06-19

DeepForestVisionV2: Ecology-Driven Taxonomy Expansion for Camera-Trap Monitoring in African Tropical Forests

Camera-trap monitoring in African tropical forests increasingly extends beyond closed-canopy interiors to riverbanks, clearings, and park edges. Among available open tools for African forest camera-trap classification, DeepForestVision is the only one providing a matched offline workflow for both photographs and videos, and previous work showed that it outperformed other available baselines on a comparable benchmark. However, it was designed for closed-canopy, ground-level forest interiors and uses a 35-class prediction space that becomes too coarse when deployments encounter arboreal primates, birds, semi-aquatic taxa, or human-associated confounders such as livestock. We present DeepForestVisionV2, an ecology-driven expansion from 35 to 64 prediction classes (61 animal classes plus human, vehicle, and blank) designed to address three recurrent deployment gradients: vertical stratification, scene openness, and anthropogenic interfaces. DeepForestVisionV2 retains the same offline workflow and is trained on 1,535,010 photographs and 243,354 videos from multi-country African tropical-forest projects. Evaluation combines a cross-country cropped-photo validation set, used to assess robustness across sites and camera-trap settings, with three held-out Uganda video benchmarks spanning the targeted gradients. On the validation set, DeepForestVisionV2 reaches 0.86 accuracy, 0.82 macro-F1, and 0.81 balanced accuracy. On the deployment benchmarks, it preserves or improves baseline accuracy despite its harder classification task, while increasing the number of identified taxa from 22 to 29 in forest-interior videos and from 4 to 9 at riverbanks. In the park-edge use case, it raises accuracy from 0.62 to 0.86 and reduces false alarms from 11 to 0. These results show that DeepForestVisionV2 materially improves field utility while preserving robustness across sites, habitats, and camera-trap settings.

04.
arXiv (CS.LG) 2026-06-15

Testing For Distribution Shifts with Conditional Conformal Test Martingales

arXiv:2602.13848v2 Announce Type: replace Abstract: We propose a sequential test for detecting arbitrary distribution shifts that allows conformal test martingales (CTMs) to work under a fixed, reference-conditional setting. Existing CTM detectors construct test martingales by continually growing a reference set with each incoming sample, using it to assess how atypical the new sample is relative to past observations. While this design yields anytime-valid type-I error control, it suffers from test-time contamination: after a change, post-shift observations enter the reference set and dilute the evidence for distribution shift, increasing detection delay and reducing power. In contrast, our method avoids contamination by design by comparing each new sample to a fixed null reference dataset. Our main technical contribution is a robust martingale construction that remains valid conditional on the null reference data, achieved by explicitly accounting for the estimation error in the reference distribution induced by the finite reference set. This yields anytime-valid type-I error control together with guarantees of asymptotic power one and bounded expected detection delay. Empirically, our method detects shifts faster than standard CTMs, providing a powerful and reliable distribution-shift detector.

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

Lesion-DDPM: Lesion-Enhanced 3D Diffusion for MS MRI Synthesis

3D FLAIR MRI is widely recommended as one of the standard MRI sequences for brain imaging in multiple sclerosis (MS), but publicly available MS datasets remain relatively small and vary across scanners, acquisition protocols, and lesion patterns. This scarcity and variability hinder the development of robust neuroimaging machine learning models and are particularly challenging for generative models that aim to synthesize images while preserving small, sparse lesions. We propose Lesion-DDPM, a 3D conditional diffusion framework for lesion-aware FLAIR synthesis that incorporates multi-level anatomical mask injection together with a lesion-weighted reconstruction loss to emphasize lesion voxels while maintaining global brain structure. Using a curated subset of the MSLesSeg dataset, we compare Lesion-DDPM with representative state-of-the-art GAN- and diffusion-based models, assessing both image-generation metrics and downstream 3D U-Net segmentation. In our experiments, Lesion-DDPM achieved the lowest lesion-region reconstruction error among all methods. In a downstream 3D U-Net lesion segmentation task, a model trained only on Lesion-DDPM-generated scans and evaluated on real MRIs reached a Dice score of 0.616 compared with 0.569 for the best competing synthetic dataset. When Lesion-DDPM images were added to the real training set, the Dice score further increased to 0.685.

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

SICI: A Semantic-Pragmatic Complexity Index Reveals Regime Shifts in LLM Stance Detection

Prompt-based LLMs are increasingly used for stance detection, but harder examples are not always repaired by clearer instructions, reasoning prompts, retrieval, or debate. We introduce SICI (Stance Inference Complexity Index), a seven-dimensional diagnostic measure of the semantic-pragmatic burden imposed by a target–text pair. Across SemEval-2016 and VAST, SICI predicts LLM accuracy better than surface proxies and shows substantial cross-scorer reliability ($\alpha=0.771$). More importantly, LLM errors change regime as SICI increases: low-complexity examples invite over-attribution, especially Against predictions; intermediate examples form an unstable boundary; and high-complexity examples rapidly concentrate on None. This phase-transition-like structure persists across GPT-3.5, GPT-4o-mini, DeepSeek-V3, and GPT-4o, although stronger models move the boundaries. A 15-method intervention study further shows that prompting, retrieval, and debate often shift models along the attribution–abstention axis rather than removing the high-complexity bottleneck.

07.
arXiv (quant-ph) 2026-06-17

A Quantum Approach to Stochastic Optimization in Insurance Underwriting

arXiv:2605.01169v2 Announce Type: replace Abstract: The presence of stochastic elements in combinatorial optimization problems makes them particularly challenging, as such problems quickly become intractable for classical computers even at relatively small sizes. In this work, we propose a novel quantum-classical hybrid scheme for solving a class of stochastic optimization problems known as chance-constrained knapsack problems, in which item weights follow probability distributions and constraints may be violated within a specified risk tolerance. Our method employs knapsack-specific QAOA-based circuits to generate samples which, when combined with a new self-consistent classical recovery scheme introduced in this work, produce high-quality solutions. Experiments carried out on IBM Heron processors, using circuits with depths up to 177 and comprising 3443 gates acting on as many as 150 qubits, yield solutions that indicate performance comparable to classical optimization schemes. The proposed quantum-classical scheme paves the way to tackling such problems, with the potential to outperform approaches that rely solely on classical computation.

08.
arXiv (CS.AI) 2026-06-17

Handling Feature Heterogeneity with Learnable Graph Patches

arXiv:2606.17667v1 Announce Type: cross Abstract: In recent years, the rapid development of foundation models and graph pre-training technologies has spurred increasing interest in constructing a universal pre-trained graph model or Graph Foundation Model (GFM). However, a significant challenge is that existing models are unable to address feature heterogeneity in graph data without textual information, which hinders the transferability of graph models across different datasets. To bridge this gap, we propose the concept of learnable graph patches, which we regard as the smallest semantic units of any graph data. We decompose the graph into learnable graph patches by unfolding the node features and constructing corresponding patch structures separately. We then design a framework that mines transferable information from graph data across domains. Specifically, after extracting graph patches, we propose a patch encoder to extract knowledge from each unit and a patch aggregator to learn how the units are combined into a whole. Due to its domain-agnostic nature, the model can be applied to downstream data across different domains. Furthermore, we analyze the connection between our method and existing graph models, as well as the transferability of the node embeddings it generates. Empirically, our method not only achieves the capability to use multi-domain graphs for pre-training, but also shows enhanced performance across various downstream datasets and tasks. Moreover, we observe consistent improvement in downstream performance as the volume of pre-training data increases.

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

NIM4-ASR: Towards Efficient, Robust, and Customizable Real-Time LLM-Based ASR

Integrating large language models (LLMs) into automatic speech recognition (ASR) has become a mainstream paradigm in recent years. Although existing LLM-based ASR models demonstrate impressive performance on public benchmarks, their training remains predominantly data-driven, leaving key practical challenges insufficiently addressed – particularly limited downward scalability in resource-constrained deployments and hallucinations under acoustically challenging conditions. To address these issues, we present NIM4-ASR, a production-oriented LLM-based ASR framework optimized for both efficiency and robustness. Grounded in a principled delineation of functional roles between the encoder and the LLM, we redesign the multi-stage training paradigm to align each module with its intended capability boundary. Specifically, we reformulate the pre-training architecture and objective to mitigate the modality gap and improve parameter efficiency; introduce an iterative asynchronous SFT stage to preserve acoustic fidelity and constrain representation drift; and design an ASR-specialized reinforcement learning stage to further enhance recognition quality and robustness. We additionally incorporate a suite of production-oriented optimizations, including robustness under noisy and silent conditions, real-time streaming inference, and hotword customization via retrieval-augmented generation (RAG). Experiments show that NIM4-ASR achieves state-of-the-art performance on multiple public benchmarks with merely 2.3B parameters, while substantially outperforming larger-scale competitors on internal benchmarks – particularly in entity-intensive real-world scenarios. NIM4-ASR further supports million-scale hotword customization via RAG with sub-millisecond retrieval latency, enabling efficient adaptation to emerging entities and personalized user requirements.

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

C2FL: Clustered Continual Federated Learning under Spatial and Temporal Drift

arXiv:2606.18003v1 Announce Type: cross Abstract: Collective Adaptive Systems (CAS) increasingly rely on machine learning to let each node learn from locally sensed data, aligning its behavior with the surrounding environment. Scaling this intelligence, however, raises fundamental challenges: sensed data is often privacy-sensitive, preventing centralized collection; nodes are mobile, traversing regions where nearby nodes perceive similar phenomena while distant ones observe radically different conditions, creating natural spatial clusters; and these distributions evolve over time due to mobility, introducing temporal drift that makes local models progressively stale. These dynamics arise across domains - vehicular sensing, drone-based monitoring, smartphone crowdsensing - yet the interplay of privacy, spatial heterogeneity, and temporal drift severely undermines conventional learning strategies. Therefore, we propose C2FL, a fully distributed Federated Learning (FL) approach where nodes self-organize into learning groups through spatial clustering, reflecting the geographic structure of the environment. To counteract temporal drift, each node combines experience replay with a dwell-time-aware adaptive averaging step, progressively incorporating the regional consensus as it remains longer within the same area, while preserving previously acquired knowledge under evolving distributions. We evaluate our approach on synthetic experiments that systematically reproduce spatial and temporal shifts, showing that standard federated strategies degrade significantly under these conditions and that our method restores robust collective adaptation.

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

Learning in Matching Games with Bandit Feedback

arXiv:2506.03802v2 Announce Type: replace Abstract: We introduce a learning problem in a generalized two-sided matching market, where agents select actions to interact with their match. Specifically, we consider a setting in which matched agents engage in zero-sum games with initially unknown payoff matrices, and we investigate whether a centralized procedure can learn an equilibrium from bandit feedback. We adopt the solution concept of a matching equilibrium, where a matching \( \mathfrak{m} \) and a set of agent strategies \( X \) form an equilibrium if no agent has an incentive to deviate from \( (\mathfrak{m}, X) \). To quantify deviations of a candidate solution \( (\mathfrak{m}, X) \) from the equilibrium \( (\mathfrak{m}^\star, X^\star) \), we introduce the notion of matching instability, which serves as a regret measure for the learning problem. We propose a UCB-based algorithm in which agents form preferences and select actions according to optimistic estimates of the payoffs. Our analysis establishes a sublinear, instance-independent regret upper bound, further supported by empirical evidence.

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

PVminerLLM2: Improving Structured Extraction of Patient Voice via Preference Optimization

Motivation: Patient-generated text contains critical information on patients' lived experiences, social context, and care engagement, but remains largely unstructured, limiting its use in patient-centered outcomes research. Prior work introduced the PV-Miner benchmark and PVMinerLLM models for structured extraction. However, supervised fine-tuning (SFT) alone struggles with rare, fine-grained, and unevenly distributed errors, particularly in token-critical structured outputs. Results: We present PVminerLLM2, an improved set of LLMs for structured patient voice extraction that applies preference optimization to address token-critical errors beyond the reach of supervised fine-tuning. Our method introduces (i) a preference objective with token-level gated stabilization term that prevents degradation of absolute token likelihood under preference optimization, and (ii) confusion-aware preference pair construction to better capture low-separation distinctions. We further incorporate token-importance weighting and inverse-frequency reweighing to address token imbalance and class skew. Across multiple model sizes, PVMinerLLM2 consistently outperforms strong baselines, achieving gains of up to 4.43% (Code), 3.50% (Sub-code), and 1.55% (Span), and outperforms baseline LLM trained with existing preference optimization methods. Availability and Implementation: The supplementary material, code, evaluation scripts, and trained models for PVminerLLM2 are publicly available at: https://github.com/Data-Mining-Lab-Yale/PVminerLLM2

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

MSAVBench: Towards Comprehensive and Reliable Evaluation of Multi-Shot Audio-Video Generation

Video generation is rapidly evolving from single-shot synthesis to complex multi-shot audio-video (MSAV) narratives to meet real-world demands. However, evaluating such frontier models remains a fundamental challenge. Existing benchmarks are limited in scope and data diversity, and rely on rigid evaluation pipelines, preventing systematic and reliable assessment of modern MSAV models. To bridge these gaps, we introduce MSAVBench, the first comprehensive benchmark and adaptive hybrid evaluation framework for multi-shot audio-video generation. Our benchmark spans four key dimensions, video, audio, shot, and reference, covering diverse task settings, varying shot counts of up to 15, and challenging non-realistic scenarios. Our evaluation framework improves robustness through an adaptive self-correction mechanism for shot segmentation, instance-wise rubrics for subjective metrics, and tool-grounded evidence extraction for complex judgments. Furthermore, MSAVBench achieves high alignment with human judgments, reaching a Spearman rank correlation of 91.5%. Our systematic evaluation of 19 state-of-the-art closed- and open-source models shows that current systems still struggle with director-level control and fine-grained audio-visual synchronization, while modular or agentic generation pipelines offer a promising path toward narrowing the gap between open- and closed-source models. The benchmark data and evaluation code are publicly available at https://github.com/ali-vilab/MSAVBench.

15.
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.

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

PolyFlow: Safe and Efficient Polytope-Constrained Flow Matching with Constraint Embedding and Projection-free Update

arXiv:2606.13400v1 Announce Type: cross Abstract: While flow-based generative models have demonstrated strong performance across a wide range of domains, deploying them in safety-critical physical systems remains challenging due to strict constraint requirements. Existing approaches typically enforce safety through post-hoc corrections, which incur substantial computational overhead and may distort the learned distribution. We propose PolyFlow, a polytope-constrained flow matching framework that embeds constraints directly into the model and flow dynamics. PolyFlow introduces a discrete-time flow formulation and a projection-free architecture, which eliminate the discretization error and guarantee strict satisfaction of arbitrary polyhedral constraints, without the need for expensive iterative solvers. Experimental results show that PolyFlow achieves zero constraint violation while maintaining high distributional fidelity across a range of planning and control tasks. Compared to state-of-the-art constrained generation baselines, PolyFlow significantly reduces inference latency and demonstrates a favorable trade-off between safety, efficiency, and generative quality. Code is available on https://github.com/MJianM/PolyFlow.

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

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

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

18.
arXiv (CS.CV) 2026-06-25

Cage-based Texture Transfer with Geometric Filtering

Real-time texture transfer expands the creative horizon for interactive applications, enabling seamless detail projection in scenarios that range from digital character cosmetics to procedural automotive texturing. Yet, its practical application is governed by inherent trade-offs between processing speed and suppression of artifacts. Low-latency transfer methods frequently fail to suppress artifacts, and robust alternatives rely on large-scale models that are costly in training and memory. Our proposed method bridges the gap between efficiency and robustness by using a cage-based geometric filtering method to identify Non-Cosmetic Zones (NCZs) for artifact suppression. While other models are resource-intensive and require multiple days of training on manually annotated datasets, we are able to successfully suppress artifacts and achieve immediate deployment on consumer-grade hardware. Our framework achieved highly efficient runtimes of ~70ms on mobile devices for a ~4.8k triangle mesh.

19.
arXiv (CS.LG) 2026-06-11

Understanding Sample Efficiency in Predictive Coding

arXiv:2605.11911v2 Announce Type: replace Abstract: Predictive Coding (PC) is an influential account of cortical learning. Much of recent work has focused on comparing PC to Backpropagation (BP) to find whether PC offers any advantages. Small scale experiments show that PC enables learning that is more sample efficient and effective in many contexts, though a thorough theoretical understanding of the phenomena remains elusive. To address this, we quantify the efficiency of learning in BP and PC through a metric called ``target alignment'', which measures how closely the change in the output of the network is aligned to the output prediction error. We then derive and empirically validate analytical expressions for target alignment in Deep Linear Networks. We show that learning in PC is more efficient than BP, which is especially pronounced in deep, narrow and pre-trained networks. We also derive exact conditions for guaranteed optimal target alignment in PC and validate our findings through experiments. We study full training trajectories of linear and non-linear models, and find the predicted benefits of PC persist in practice even when some assumptions are violated. Overall, this work provides a mechanistic understanding of the higher learning efficiency observed for PC over BP in previous works, and can guide how PC should be parametrised to learn most effectively.

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

Multi-Fidelity SINDy: Sparse Discovery of Nonlinear Dynamical Systems with Fidelity-Weighted Measurements

arXiv:2606.15690v1 Announce Type: new Abstract: Data from simulations and experiments are rarely noise-free and often exhibit heterogeneous levels of fidelity. Measurement uncertainty may vary across repeated observations, sensing devices, or even within a single experiment. This work addresses the problem of discovering nonlinear dynamical systems from such inhomogeneous data. We extend the Sparse Identification of Nonlinear Dynamical Systems (SINDy) framework to account for variable noise levels by combining Ensemble SINDy and Weak SINDy within a weighted regression formulation derived from generalized least squares. A statistical justification for the weighting strategy is also provided. The methodology is validated on several benchmark systems, including ordinary and partial differential equations. In addition, we show the benefit of multi-fidelity integration for forecasting the dynamics of a double pendulum system. The results confirm that the proposed approach mitigates the adverse effects of heteroscedastic noise and that repeated, low-cost, low-quality measurements can improve model recovery, in some cases matching or outperforming reconstructions obtained using only high-fidelity data.

21.
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[&le;]50%, MR[&le;]25%, OPV[&le;]10%, DPT[&le;]15%, and Ugandas planning thresholds: BCG[&le;]70%, MR[&le;]40%, OPV[&le;]15%, DPT[&le;]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 ([&le;]15% and [&le;]10%) for most of the study period, while BCG generally remained below the WHO threshold ([&le;]50%) and MR frequently exceeded the WHO threshold ([&le;]25%) but remained within Uganda's planning threshold ([&le;]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.

22.
arXiv (CS.CV) 2026-06-18

Bridging Single Distortion Artifacts and Mmultifactorial Clinical Quality: Few-shot Biparametric MRI Quality Assessment via Distortion-trained Prototypical Networks

Clinical prostate multi-parametric MRI relies heavily on high-quality diffusion-weighted imaging (DWI), yet reading DWI is frequently compromised by geometric distortion, often caused by rectal air. Assessing quality via the PI-QUAL scoring system is an emerging clinical standard, but it is subjective, time-consuming and suffers from a class imbalance where low-quality cases are diverse and relatively scarce. Using the PRIME clinical trial as an example, there are $6\%$ images with PI-QUAL scores lower than 4, $87\%$ of DWI issues are due to distortion. Many of the other clinical quality issues are under-represented. To address this common dual-scarcity of annotated clinical data, we propose a few-shot biparametric prototypical network for automated image quality assessment (IQA). Our framework utilizes a dual-branch 3D ResNet to fuse T2-weighted and DWI features, providing anatomical context to distinguish true morphology from distortion. To handle real-world heterogeneity, we introduce feature-wise linear modulation (FiLM) and a gradient reversal layer (GRL) to align feature distributions conditioned on varying b-values while suppressing acquisition-related biases. We demonstrate that a model meta-trained solely on comparatively objective, readily obtainable distortion labels can effectively adapt to predicting complex, multi-factorial clinical quality scores such as PI-QUAL using only five representative samples. Experimental results on two datasets show that our method significantly outperforms few-shot learning baselines for this challenging IQA task, offering a practically feasible and data-efficient solution for standardizing prostate MRI quality control in clinical workflows.

23.
arXiv (CS.CL) 2026-06-12

The Illusion of Multi-Agent Advantage

Prevailing wisdom posits that Multi-Agent Systems (MAS) are superior to Single-Agent Systems (SAS), citing advantages like context protection, parallel processing and distributed decision-making. However, empirical support for this claim relies primarily on comparisons with SAS baselines using benchmarks that prioritize isolated reasoning tasks, which do not adequately assess these advantages. Focusing on automatically generated MAS that are designed for enhanced generalizability over manually-designed counterparts, we perform a rigorous, systematic evaluation against SAS, specifically Chain-of-Thought with Self-Consistency (CoT-SC). Across traditional reasoning datasets and tasks with interactive multi-step workflows (e.g., BrowseComp-Plus), we demonstrate that automatic MAS consistently underperform CoT-SC despite being up to 10x more expensive. To isolate these failures from limitations inherent to task structure, we introduce a diagnostic synthetic dataset tailored for MAS featuring explicit task decomposition, context separation and parallelization potential. We show that expert-architected MAS consistently outperforms automatically generated architectures in both raw performance and cost-efficiency on this dataset, demonstrating that existing evaluation frameworks mask critical architectural gaps and inefficiencies of complex MAS by failing to account for the marginal utility of increased computational cost. Critically, systematic deconstruction of the generated MAS architectures reveals that current automated design paradigms produce architectural bloat that prioritizes superficial complexity which does not translate into functional utility, exposing a fundamental misalignment with multi-agent principles.

24.
arXiv (CS.CL) 2026-06-18

Are LLMs Ready to Assist Physicians? PhysAssistBench for Interactive Doctor-Patient-EHR Assistance

The most plausible near-term role of medical LLMs is to assist rather than replace physicians, yet current evaluations often test isolated capabilities: clinical knowledge, EHR system interaction, or patient communication. Physician assistance instead requires coordinating these capabilities within the same interaction, where physicians issue underspecified requests, patients describe symptoms ambiguously, and EHR systems demand precise tool use. We introduce PhysAssistBench, a benchmark for interactive doctor-patient-EHR assistance. Built from real MIMIC-IV cases, PhysAssistBench uses a scalable pipeline to construct agentic patients: interactive, record-grounded agents that turn static EHR records into multi-turn clinical scenarios while preserving clinical factuality. PhysAssistBench provides a curated bilingual evaluation set of 1,296 manually reviewed and physician-validated turns. Experiments with leading LLMs show that current models remain unreliable in this setting, which exposes a key bottleneck for clinical LLMs: reliable assistance requires coordination across knowledge, communication, and systems, not isolated gains in any of them.

25.
arXiv (CS.LG) 2026-06-18

Strategic Feature Selection

arXiv:2606.18867v1 Announce Type: new Abstract: When algorithmic predictors inform resource allocation in high-stakes domains such as healthcare, these predictors must account for strategic manipulation of input features. The typical solution is to redesign the predictor itself to explicitly account for strategic interactions. In practice, however, decision makers are often constrained to adjusting coarser levers within existing prediction pipelines. For example, healthcare organizations often select which features to exclude based on perceived manipulability, while using standard regularization procedures to shrink the coefficients of retained features. In this work, we initiate a formal study of strategic classification through feature selection and its interaction with ridge regularization. Our main finding is that excluding individual features based on their manipulability alone is generally suboptimal. We provide a fine-grained characterization of the performance of a feature subset under optimal regularization, yielding new insights for policy design. Motivated by this characterization, we develop a practical algorithm for jointly choosing the feature set and the level of ridge regularization. Through a real-world case study on a healthcare payments benchmark, we illustrate how our algorithm can guide the design of coarse policy levers in practice. Our results provide a principled, practical framework for mitigating the effects of strategic behavior in algorithmic decision-making systems.