Paper Plaza - AcademicHub

01.

PLOS Medicine 2026-05-20 DOI: HASH:5b47d66d09bc5b131ec3f326f79cad8f

Prescribed hormonal contraceptive use trends in the Estonian Biobank: A longitudinal observational study

Authors:

by Jelisaveta Džigurski, Märt Möls, Kristi Läll, Hannah Currant, Mall Eltermaa, Estonian Biobank Research Team , Reedik Mägi, Lili Milani, Triin Laisk Background Hormonal contraceptives (HCs) are widely used and have well-documented population-level statistics. Previous studies with short follow-ups have focussed on individual HC use and side effects. However, the same aspects over longer periods, HC formulation switching, and the impact of genetic factors on HC side effects remain understudied due to the limited availability of suitable datasets. We investigated whether the Estonian Biobank (EstBB) is suitable for studying genetic risk for HC side effects. Methods and findings This is a longitudinal descriptive study combining prescribed HC purchase data collected from 2004 to 2022 with genetic and health data from 73,071 female EstBB HC users aged 15–55 at the time of purchase. HC usage was defined by the Anatomical Therapeutic Chemical (ATC) codes G02B, G03A, and G03HB01. Methods included calculating age-stratified annual user prevalence, inferring usage periods from purchases, assessing formulation switching, identifying the International Classification of Diseases, Tenth Revision (ICD-10)-based side effect-related diagnoses and thromboembolism risk factors, and assessing carrier status for Factor V Leiden (FVL, rs6025) and prothrombin G20210A (PTM, rs1799963) genetic variants as proof-of-concept. Over 19 years, 20 HC formulations with five administration routes (oral pills, transdermal patches, vaginal rings, subdermal implants, intrauterine devices) were used. In the EstBB, combined HCs were the most commonly used among users aged 15–29, while progestin-only HC use increased with age and over time, comparable to the Estonian population. Overall, 64.2% (n = 46,920) of users switched formulations at least once, with 17.7% (n = 12,929) being rapid switchers. Side effect-related diagnoses were observed in 23.1% (n = 2,982) of rapid switchers, with excessive/irregular menstrual bleeding being the most common. Genetic analysis revealed that 5.3% (n = 3,886) of users carried at least one variant previously associated with increased thrombosis risk (3.5% (n = 2,556) carried FVL only, 1.8% (n = 1,276) PTM only, and 0.07% (n = 54) both). Carriers of thrombosis-associated variants had a significantly higher percentage of thrombosis (6.5%) than non-carriers (4.2%; OR = 1.61, 95% CI [1.40, 1.84], p

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02.

arXiv (CS.LG) 2026-06-19 DOI: arXiv:2606.20172

Predicting gestational age at birth in the context of preterm birth from multi-modal fetal MRI

Authors:

Diego Fajardo-Rojas ↗Megan Hall ↗Daniel Cromb ↗Mary A. Rutherford ↗Lisa Story ↗Emma C. Robinson ↗Jana Hutter ↗

arXiv:2606.20172v1 Announce Type: new Abstract: Preterm birth is associated with significant mortality and a risk for lifelong morbidity. The complex multifactorial aetiology hampers accurate prediction and thus optimal care. A pipeline consisting of bespoke machine learning methods for data imputation, feature selection, and regression models to predict gestational age (GA) at birth was developed and evaluated from comprehensive multi-modal morphological and functional fetal MRI data from 333 control cases and 93 preterm birth cases. The GA at birth predictions were classified into term and preterm categories and their accuracy, sensitivity, and specificity were reported. An ablation study was performed to further validate the design of the pipeline. Performance was evaluated using stratified 10-fold cross-validation. The pipeline achieves an R2 score of 0.13 and a mean absolute error of 2.74 weeks. It also achieves a 0.77 accuracy, 0.59 sensitivity, and 0.82 specificity across folds. The predominant features selected by the pipeline include cervical length and statistics derived from placental T2* values. The confluence of fast, motion-robust and multi-modal fetal MRI techniques and machine learning prediction allowed the prediction of the gestation at birth. This information is essential for any pregnancy. To the best of our knowledge, preterm birth had only been addressed as a classification problem in the literature. Therefore, this work provides a proof of concept. Future work will increase the cohort size to allow for finer stratification within the preterm birth cohort. Our code is available at https://github.com/dfajardorojas/ml-for-preterm-birth-.

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03.

arXiv (math.PR) 2026-06-18 DOI: arXiv:2401.13648

The FBSDE approach to sine-Gordon up to $6\pi$

Authors:

Massimiliano Gubinelli ↗Sarah-Jean Meyer ↗

arXiv:2401.13648v3 Announce Type: replace-cross Abstract: We develop a stochastic analysis of the sine-Gordon Euclidean quantum field $(\cos (\beta \varphi))_2$ on the full space up to the second threshold, i.e. for $\beta^2 < 6 \pi$. The basis of our method is a forward-backward stochastic differential equation (FBSDE) for a decomposition $(X_t)_{t \geqslant 0}$ of the interacting Euclidean field $X_{\infty}$ along a scale parameter $t \geqslant 0$. This FBSDE describes the optimiser of the stochastic control representation of the Euclidean QFT introduced by Barashkov and one of the authors. We show that the FBSDE provides a description of the interacting field without cut-offs and that it can be used effectively to study the sine-Gordon measure to obtain results about large deviations, integrability, decay of correlations for local observables, singularity with respect to the free field, Osterwalder-Schrader axioms and other properties.

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04.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2606.14960

Leveraging Physiological Signals to Predict Exam Outcomes with Machine Learning

Authors:

Lala Yamazaki ↗Ramchandra Rimal ↗

arXiv:2606.14960v1 Announce Type: new Abstract: This study investigates the application of machine learning models to predict exam outcomes using physiological data collected during examination sessions. Physiological stress indicators, including electrodermal activity, heart rate, and skin temperature, were analyzed to uncover their association with academic performance. A variety of machine learning approaches were employed, ranging from standard models like logistic regression, random forest, and support vector machines to more advanced architectures, including transformers, long short-term memory (LSTM), and gated recurrent unit (GRU) models. This diversity aimed to capture the complex interactions within the data effectively. A key focus was assessing the adaptability of transformers in processing numerical data and evaluating their performance in this novel context. Standard performance metrics, such as accuracy, precision, recall, and F1-score, were used to compare model efficacy. The experimental results demonstrate that while deep learning models generally excel at capturing complex relationships in physiological data, simpler models like random forests can sometimes achieve superior performance while offering computational efficiency and interpretability. Furthermore, transformers demonstrated notable versatility, showcasing performances comparable to those of the LSTM and GRU models. This research underscores the importance of experimenting with a broad class of models that align with the objectives of the problem at hand, balancing precision, efficiency, and interpretability. By elucidating the relationships between physiological signals and academic performance, this study contributes to understanding stressors affecting students' mental health. It further promotes leveraging physiological data to enhance student well-being and academic outcomes.

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05.

arXiv (CS.AI) 2026-06-19 DOI: arXiv:2606.20142

RACL: Reasoning-Agent Control Layers for Continuous Metaheuristic Learning

Authors:

Ant\'on Asla Manz\'arraga ↗

arXiv:2606.20142v1 Announce Type: new Abstract: This paper introduces RACL, a Reasoning-Agent Control Layer for metaheuristics. RACL places a reasoning agent above an existing optimizer. The agent does not replace the optimizer and does not modify business constraints. Instead, it controls the optimizer's internal search behavior by observing operational memory, reasoning over past behavior, formulating bounded hypotheses, testing interventions, evaluating outcomes, applying guardrails, consolidating useful policies and explaining its decisions. The experiment uses vehicle routing as a testbed, but the contribution is not a new routing solver, a particular ALNS configuration or a specific set of routing rules. The contribution is the RACL method: a way for a reasoning agent to discover, validate, consolidate and explain algorithmic control rules for a metaheuristic. In the current experimental setting, RACL improves or ties the Operational Memory Policy in 21 of 21 feasible cases and improves or ties a non-reasoning Stagnation-Triggered Policy in 18 of 21 feasible cases, with an average RACL vs STP cost delta of -0.641%. In the Sevilla-9/10 runtime sample, RACL improves average cost by -8.337% versus Fixed and -1.605% versus STP without showing material computational overhead. During the proof-of-concept, Codex was used as an in-the-loop reasoning agent observing executions, interpreting logs and proposing live bounded interventions. The policy proxy was later used only to make quantitative evaluation reproducible.

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06.

arXiv (CS.LG) 2026-06-24 DOI: arXiv:2604.03345

Hardware-Oriented Inference Complexity of Kolmogorov-Arnold Networks

Authors:

Bilal Khalid ↗Pedro Freire ↗Sergei K. Turitsyn ↗Jaroslaw E. Prilepsky ↗

arXiv:2604.03345v2 Announce Type: replace Abstract: Kolmogorov-Arnold Networks (KANs) have recently emerged as a powerful architecture for various machine learning applications. However, their unique structure raises significant concerns regarding their computational overhead. Existing studies primarily evaluate KAN complexity in terms of Floating-Point Operations (FLOPs) required for GPU-based training and inference. However, in many latency-sensitive and power-constrained deployment scenarios, such as neural network-driven non-linearity mitigation in optical communications or channel state estimation in wireless communications, training is performed offline and dedicated hardware accelerators are preferred over GPUs for inference. Recent hardware implementation studies report KAN complexity using platform-specific resource consumption metrics, such as Look-Up Tables, Flip-Flops, and Block RAMs. However, these metrics require a full hardware design and synthesis stage that limits their utility for early-stage architectural decisions and cross-platform comparisons. To address this, we derive generalized, platform-independent formulae for evaluating the hardware inference complexity of KANs in terms of Real Multiplications (RM), Bit Operations (BOP), and Number of Additions and Bit-Shifts (NABS). We extend our analysis across multiple KAN variants, including B-spline, Gaussian Radial Basis Function (GRBF), Chebyshev, and Fourier KANs. The proposed metrics can be computed directly from the network structure and enable a fair and straightforward inference complexity comparison between KAN and other neural network architectures.

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07.

arXiv (CS.CV) 2026-06-12 DOI: arXiv:2606.12595

Emerging Flexible Designs for Geospatial Multimodal Foundation Models

Authors:

Philipe Dias ↗Waqwoya Abebe ↗Abhishek Potnis ↗Aristeidis Tsaris ↗Dan Lu ↗Xiao Wang ↗Dalton Lunga ↗

Foundation models are rapidly transforming Earth observation by enabling scalable pretraining across diverse unlabeled geospatial modalities. However, their architectural diversity ranging from encoder-only to encoder-decoder and masked autoencoding paradigms makes it challenging to assess performance trade offs in a consistent manner. In this work, we present an apples-to-apples comparison of leading FM architectures designed for geospatial multimodal reasoning, with a particular focus on flexibility across varied spectral band configurations. We standardize pretraining using identical self supervised learning objectives and training datasets, and evaluate all models under consistent parameterization on the GEOBench benchmark across classification and segmentation tasks. Our results offer new insights into the design trade-offs between model flexibility, modality alignment, and downstream task performance. By highlighting architectural strengths and limitations under controlled conditions, this study provides practical guidance for building next generation geospatial foundation models capable of robust multimodal reasoning.

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08.

arXiv (CS.AI) 2026-06-11 DOI: arXiv:2606.11635

Are LLMs Bad at Moral Reasoning?

Authors:

Menghang Zhu ↗Seth Lazar ↗

arXiv:2606.11635v1 Announce Type: cross Abstract: For highly capable AI systems to operate safely in dynamic, open-ended environments, they must be able to identify, understand, and respond to moral reasons for action, and constrain their behaviour accordingly. A growing body of research aims to evaluate this capacity – moral competence – in today's most capable AI systems, recently reaching broadly pessimistic conclusions. One of the most ambitious such papers collects gold-standard human-authored rubrics for evaluating moral reasoning in 1,000 cases, and benchmarks frontier AI models against those rubrics, with underwhelming results. In this paper, we argue that the MoReBench dataset can be redeployed to give a much more optimistic picture of LLMs' moral reasoning (an essential part of moral competence). We show that if, instead of scoring LLMs' responses to these cases against these rubrics, we instead give the LLMs the same task given to humans – to generate scoring rubrics for the moral analysis of particular cases – the rubrics they generate are both better calibrated to the human rubrics than their open-ended responses, and, where they differ, plausibly reflect nothing more than the vast dimensionality of most moral problems, as well as highlighting some human departures from the "rubric for creating rubrics". Taking these points into consideration, the MoReBench dataset suggests that LLMs are significantly more capable at moral reasoning than was previously believed.

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09.

arXiv (CS.CV) 2026-06-17 DOI: arXiv:2606.17362

DriveJudge: Rethinking Autonomous Driving Evaluation with Vision-Language Models

Authors:

Xinglong Sun ↗Kevin Xie ↗Jenny Schmalfuss ↗Despoina Paschalidou ↗Xiuming Zhang ↗Sanja Fidler ↗Kashyap Chitta ↗Jose M. Alvarez ↗

Autonomous driving has shifted towards end-to-end policy learning, where reliable, interpretable policy evaluation is a fundamental challenge as driving quality is highly context-dependent. Commonly used rule-based driving metrics like EPDMS are interpretable but lack context-awareness, while recent VLMbased evaluations are context-aware but limited by ambiguous VLM outputs and weak physical grounding. To evaluate driving in a manner that is both interpretable and context-aware, we introduce DriveJudge. DriveJudge is a driving evaluation agent that combines rule-grounded evaluation with Vision-Language Model (VLM) reasoning and selectively invokes physically-grounded deterministic rule functions after interpreting the environmental context. To train and evaluate DriveJudge, we curate a large-scale dataset of 33,577 challenging driving samples with human annotations on whether the driving behavior is reasonable in the given scenario. With this dataset, we address the underexplored problem of driving metric evaluation, and introduce two human-aligned benchmark tasks: Driving Quality Classification and Trajectory Preference Selection. DriveJudge outperforms EPDMS for driving quality classification by 21.23 AUC, and the recent VLM-based DriveCritic for trajectory preference selection by 6.5%, setting a new standard for interpretable and precise driving evaluation.

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10.

arXiv (CS.AI) 2026-06-15 DOI: arXiv:2602.05670

HyperPotter: Spell the Charm of High-Order Interactions in Audio Deepfake Detection

Authors:

Qing Wen ↗Haohao Li ↗Zhongjie Ba ↗Peng Cheng ↗Miao He ↗Li Lu ↗Kui Ren ↗

arXiv:2602.05670v2 Announce Type: replace-cross Abstract: Advances in AIGC technologies have enabled the synthesis of highly realistic audio deepfakes capable of deceiving human auditory perception. Although numerous audio deepfake detection (ADD) methods have been developed, most rely on local temporal/spectral features or pairwise relations, overlooking high-order interactions (HOIs). HOIs capture discriminative patterns that emerge from multiple feature components beyond their individual contributions. We propose HyperPotter, a hypergraph-based framework designed to capture high-order relations associated with synergistic patterns through clustering-based hyperedges with class-aware prototype initialization. Extensive experiments on 13 test sets show that HyperPotter improves over the baseline on 11 sets, yielding an average relative EER reduction of 12.68\% across all test sets and 22.15\% on the improved sets. These results demonstrate strong cross-scenario generalization, while also revealing robustness limits under severe codec or channel distortion.

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11.

arXiv (CS.CV) 2026-06-16 DOI: arXiv:2606.14958

MVEB: Massive Video Embedding Benchmark

Authors:

We introduce the Massive Video Embedding Benchmark (MVEB), a 23-task benchmark for video embeddings spanning classification, zero-shot classification, clustering, pair classification, retrieval, and video-centric question answering. We evaluate 33 models and find that no single model dominates: MLLM-based embeddings lead on classification, clustering, pair classification, and QA; multimodal binding leads on retrieval and zero-shot classification; generative MLLMs without contrastive adaptation collapse on cross-modal tasks. Paired video-only vs. audio+video evaluations show that audio's contribution depends on dataset annotation provenance: audio helps when labels were produced from both modalities and hurts when they were produced from visuals alone, a six-point gap consistent across model families. MVEB is derived from MVEB+, a 184-task pool, and is designed to maintain task diversity while reducing evaluation cost. It integrates into the MTEB ecosystem for unified evaluation across text, image, audio, and video. We release MVEB and all 184 tasks along with code and a leaderboard at https://github.com/embeddings-benchmark/mteb.

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12.

arXiv (CS.CV) 2026-06-16 DOI: arXiv:2601.08010

CASHEW: Stabilizing Multimodal Reasoning via Iterative Trajectory Aggregation

Authors:

Chaoyu Li ↗Deeparghya Dutta Barua ↗Fei Tao ↗Pooyan Fazli ↗

Vision-language models achieve strong performance across a wide range of multimodal understanding and reasoning tasks, yet their multi-step reasoning remains unstable. Repeated sampling over the same input often produces divergent reasoning trajectories and inconsistent final predictions. To address this, we introduce two complementary approaches inspired by test-time scaling: (1) CASHEW, an inference-time framework that stabilizes reasoning by iteratively aggregating multiple candidate trajectories into higher-quality reasoning traces, with explicit visual verification filtering hallucinated steps and grounding reasoning in visual evidence, and (2) CASHEW-RL, a learned variant that internalizes this aggregation behavior within a single model. CASHEW-RL is trained using Group Sequence Policy Optimization (GSPO) with a composite reward that encourages correct answers grounded in minimal yet sufficient visual evidence, while adaptively allocating reasoning effort based on task difficulty. This training objective enables robust self-aggregation at inference. Extensive experiments on 13 image understanding, video understanding, and video reasoning benchmarks show significant performance improvements, including gains of up to +26.2 percentage points on ScienceQA and +9.1 percentage points on EgoSchema.

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13.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2507.20424

Communication-Efficient Distributed Training for Collaborative Flat Optima Recovery in Deep Learning

Authors:

Tolga Dimlioglu ↗Anna Choromanska ↗

arXiv:2507.20424v3 Announce Type: replace Abstract: We study centralized distributed data parallel training of deep neural networks (DNNs), aiming to improve the trade-off between communication efficiency and model performance of the local gradient methods. To this end, we revisit the flat-minima hypothesis, which suggests that models with better generalization tend to lie in flatter regions of the loss landscape. We introduce a simple, yet effective, sharpness measure, Inverse Mean Valley, and demonstrate its strong correlation with the generalization gap of DNNs. We incorporate an efficient relaxation of this measure into the distributed training objective as a lightweight regularizer that encourages workers to collaboratively seek wide minima. The regularizer exerts a pushing force that counteracts the consensus step pulling the workers together, giving rise to the Distributed Pull-Push Force (DPPF) algorithm. Empirically, we show that DPPF outperforms other communication-efficient approaches and achieves better generalization performance than local gradient methods and synchronous gradient averaging, while maintaining communication efficiency. In addition, our loss landscape visualizations confirm the ability of DPPF to locate flatter minima. On the theoretical side, we show that DPPF guides workers to span flat valleys, with the final valley width governed by the interplay between push and pull strengths, and that its pull-push dynamics is self-stabilizing. We further provide generalization guarantees linked to the valley width and prove convergence in the non-convex setting.

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14.

arXiv (CS.LG) 2026-06-15 DOI: arXiv:2606.14648

Which Directions Matter? Sparse Design for Affine Robust Optimization

Authors:

Pedro Chumpitaz-Flores ↗My Duong ↗Juan S. Borrero ↗Kaixun Hua ↗

arXiv:2606.14648v1 Announce Type: new Abstract: Robust machine learning and optimization rely on the uncertainty model choice. We investigate which uncertainty directions a model must cover when defined by a finite dictionary and a budget constraint. Selecting a subset forms an atomic uncertainty set with a closed form support function, yielding tractable robust programs for affine objectives. We propose a data driven selection rule based on a coverage objective over evaluation directions, including gradients, adversarial perturbations, or shifts observed on held out data. We prove this objective is monotone and submodular, supporting a greedy method with a $(1-1/e)$ approximation guarantee and a matching hardness barrier. We also provide a certificate bounding the loss from the selected subset and a radius calibration rule with out of sample control.

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15.

arXiv (CS.AI) 2026-06-17 DOI: arXiv:2606.17073

Extracting Semantics: LLM-Guided Automatic Population of Robot Ontology from URDF

Authors:

Bastien Dussard ↗Guillaume Sarthou ↗

arXiv:2606.17073v1 Announce Type: cross Abstract: While commonsense knowledge may suffice for virtual agents, embodied robots interacting with humans require grounded and semantically rich representations of both their environment and their own physical embodiment. In cognitive robotics, ontologies are effective for integrating such heterogeneous knowledge to enable explainable reasoning, even during continuous knowledge updates. Yet, their manual construction remains a bottleneck. We present a preliminary approach for the automatic generation of robot semantic abstractions by transforming Unified Robot Description Format (URDF) models into populated ontologies. Although URDF files provide structural and kinematic descriptions, their identifiers often require commonsense interpretation to recover meaningful semantics, a task at which Large Language Models (LLMs) excel. Our pipeline leverages LLMs to infer semantic relationships by prompting them with concepts from an existing ontology, ensuring the final classification remains aligned with the formal model. To improve reliability, the pipeline combines majority voting across multiple LLM queries along with syntactic and schema-level validation to ensure that generated outputs conform to the expected representation format and ontology constraints. We evaluate the approach on multiple robot descriptions and discuss the generated abstractions. Initial results indicate that the proposed method can effectively bridge the gap between low-level robot descriptions and the structured, grounded knowledge representations required for human-robot interaction.

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16.

arXiv (CS.AI) 2026-06-18 DOI: arXiv:2606.18634

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

Authors:

Zecheng Yin ↗Benedict Jun Ma ↗

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

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17.

arXiv (CS.CL) 2026-06-11 DOI: arXiv:2606.12003

Agreement in Representation Space for Open-Ended Self-Consistency

Authors:

Paula Ontalvilla ↗Gorka Azkune ↗Aitor Ormazabal ↗

Self-consistency improves LLM reasoning by sampling multiple outputs and selecting the most consistent answer, but existing formulations largely rely on exact matching and therefore remain limited to tasks with categorical outputs. In this work, we study self-consistency in open-ended generation tasks such as code synthesis and text summarization. We hypothesize that consistency can be understood as a geometric property of the generation space, where semantically compatible generations concentrate in similar regions of representation space. To study this hypothesis, we introduce Embedding-Based Agreement (EBA), a simple training-free operationalization that estimates agreement by clustering sampled generations in embedding space. Through experiments on mathematical reasoning, code generation, and summarization, we show that agreement in representation space provides a robust and scalable signal of self-consistency for open-ended tasks. In particular, EBA consistently outperforms random selection and exhibits more stable scaling behavior than recent selection approaches based on LLM evaluation or uncertainty estimation. We further show that these agreement signals remain stable across model families and embedding spaces, even with native hidden representations. Finally, our analysis shows that the geometric location occupied by sampled generations is strongly correlated with generation quality: generations concentrated near central regions of representation space tend to correspond to more reliable outputs, whereas peripheral generations are substantially less accurate. Overall, our findings support viewing self-consistency as a property of the geometric organization of sampled generations rather than exact symbolic overlap.

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18.

medRxiv (Medicine) 2026-06-16 DOI: HASH:57f5c75d29d8f40beb20ce338ce748df

Comparative Effectiveness and Safety of Prophylactic Vasopressors for Preventing Post-induction Hypotension in the Elderly: A Systematic Review and Network Meta-analysis

Authors:

Zhang ↗Wang ↗Duan ↗C. L ↗Di ↗Y. R ↗

Background: Post-induction hypotension is a predictable haemodynamic hazard in older adults undergoing general anaesthesia. Prevention remains divided among volume optimisation, anaesthetic dose reduction, rescue treatment after hypotension occurs and proactive vasoactive support. Methods: We searched PubMed, Embase, Web of Science, CENTRAL, CNKI, Wanfang and VIP from inception to 30 March 2026. Eligible studies were randomised trials of prophylactic vasoactive drugs given before, during or immediately after induction in older adults. The primary outcome was post-induction hypotension. Secondary outcomes were post-induction mean arterial pressure (MAP), systolic arterial pressure (SBP), heart rate (HR) and reported haemodynamic adverse events. Random-effects network meta-analysis was used, and confidence in network estimates was assessed using CINeMA principles. Results: Thirty-one trials including 2,821 participants were included in the revised network. Compared with placebo/control, all active agents favoured lower post-induction hypotension. The most favourable point estimates were observed for phenylephrine (odds ratio [OR] 0.17, 95% confidence interval [CI] 0.01 to 2.16) and metaraminol (OR 0.19, 95% CI 0.02 to 1.53), although both were imprecise. More precise reductions were observed for methoxamine (OR 0.23, 95% CI 0.13 to 0.43), norepinephrine (OR 0.25, 95% CI 0.13 to 0.47) and ephedrine (OR 0.34, 95% CI 0.19 to 0.63). Phenylephrine ranked highest for MAP support, norepinephrine ranked highest for SBP support, and ephedrine ranked highest for HR preservation. Global inconsistency was detected for SBP but not for hypotension incidence, MAP or HR, supporting cautious profile-based interpretation. Conclusions: Prophylactic vasopressor choice during induction should be guided by haemodynamic phenotype rather than ranking alone. In the revised network, active prophylaxis consistently favoured lower hypotension, but sparse nodes produced uncertainty. Norepinephrine retained a comparatively balanced profile when vasodilatory post-induction hypotension is anticipated, phenylephrine and related alpha-agonists provided stronger pressure support when HR and cardiac-output reserve are preserved, and ephedrine was most relevant when chronotropic support is desired. Keywords: general anaesthesia; induction; hypotension; norepinephrine; phenylephrine; ephedrine; network meta-analysis; older adults.

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19.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2606.15690

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

Authors:

Filippo Zacchei ↗Ana Larra\~naga ↗Attilio Frangi ↗Andrea Manzoni ↗Steven L. Brunton ↗

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.

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20.

arXiv (CS.AI) 2026-06-11 DOI: arXiv:2602.05746

Learning to Inject: Automated Prompt Injection via Reinforcement Learning

Authors:

Xin Chen ↗Jie Zhang ↗Florian Tram\`er ↗

arXiv:2602.05746v2 Announce Type: replace-cross Abstract: Prompt injection is a critical vulnerability in LLM agents, yet the strongest methods still rely on human red-teamers and hand-crafted prompts. Adapting automated jailbreak optimizers does not close this gap: jailbreaks shape models toward generic compliance, while prompt injection requires emitting specific tool calls with correct parameters. The success signal is binary, and randomly sampled suffixes almost never trigger it, so standard optimizers have no gradient to follow. We present AutoInject, a black-box reinforcement learning (RL) framework that learns adversarial suffixes for prompt injection. A learned comparison-based reward scores each candidate against the best suffix seen so far, turning the binary signal into a dense reward suitable for RL optimization. The framework supports both online query-based attacks and offline-trained transferable suffixes that need no utility access at deployment, and incorporates a utility objective when task-completion feedback is available. On AgentDojo, AutoInject outperforms template attacks, GCG, TAP, and adaptive attack across production models, with statistically significant improvements under McNemar's test with p

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21.

arXiv (CS.CV) 2026-06-17 DOI: arXiv:2606.17540

TaFD: Threat-Aware Frequency Decoupling for Adversarial Robustness against Heterogeneous Attacks

Authors:

Mengda Xie ↗Yiling He ↗Meie Fang ↗

Multi-threat robustness remains a fundamental challenge in deep learning. Although joint adversarial training (JAT) is widely adopted, it suffers from negative transfer under heterogeneous threats, particularly between $\ell_p$-bounded and semantic attacks. Through first-order gradient analysis, we formalize this as gradient incompatibility and theoretically establish the necessity of decoupled optimization. We further reveal that these conflicting threats exhibit separable spectral characteristics in the frequency domain. Motivated by this observation, we propose Threat-aware Frequency Decoupling (TaFD), a two-stage defense framework that reformulates JAT as a frequency-domain divide-and-conquer paradigm. TaFD first discovers latent threat domains via unsupervised clustering of attack spectral prototypes and trains a lightweight classifier for inference-time threat domain identification. Conditioned on the prediction, TaFD employs a Frequency-Conditional Convolution that learns threat-domain-specific spectral masks and routes each sample to the corresponding expert, enforcing structural parameter separation and alleviating optimization conflicts. We validate TaFD on three representative image-classification benchmarks (CIFAR-10, CIFAR-100, and Tiny-ImageNet) and on two representative architectures (the convolutional ResNet and the hybrid-transformer MobileViT). Extensive results demonstrate that TaFD achieves more balanced robustness against heterogeneous attacks than existing JAT and frequency-domain baselines, improving average robust accuracy by approximately 11\% over the strongest baseline while maintaining leading clean accuracy.

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22.

medRxiv (Medicine) 2026-06-22 DOI: HASH:4a65a4d531f20dd3c5de1793f22ab221

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.

Authors:

Mushagalusa ↗C. R ↗Mayeri ↗D. G ↗Gaylord ↗A. N ↗Chimanuka ↗C. M ↗Mwene-Batu ↗P. L ↗Albert ↗M. T ↗…

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.

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23.

arXiv (quant-ph) 2026-06-12 DOI: arXiv:2606.12781

Quantum Network Routing based on Surface Code Error Correction

Authors:

Tianjie Hu ↗Jindi Wu ↗Qun Li ↗

arXiv:2606.12781v1 Announce Type: new Abstract: Quantum networks encounter unavoidable channel noises and erasure errors, presenting a huge obstacle in designing protocols that attain both high reliability and efficiency. Typically, quantum networks fall into two categories: those utilize quantum entanglements for quantum teleportation, and those directly transfer the actual quantum messages. In this paper, we present SurfNet, a quantum network that inherits the main advantages from both categories. It employs surface codes as logical qubits for encoding messages, and utilizes two parallel communication channels to fault-tolerantly transfer each surface code in a modular manner. Our approach of using surface codes can timely correct both operational and photon loss errors within the network, and the integration of the two channels within the network can greatly improve network throughput. For the implementation of SurfNet, we propose a novel network architecture, designed to better integrate surface codes into quantum networks. We also propose a novel error correction decoder, designed to fully utilize the modular characteristic of surface codes within our network. Simulation results demonstrate that SurfNet with its decoder significantly enhances the communication fidelity within quantum networks.

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24.

medRxiv (Medicine) 2026-06-10 DOI: HASH:22b69db888d8ce50e43123b7b3317f6b

Documented clinical genetic testing among carriers of hereditary breast and ovarian cancer variants: Ancestry and socioeconomic disparities in the All of Us research program

Authors:

Yerukala Sathipati ↗Scott ↗

Importance: Hereditary breast and ovarian cancer (HBOC) variant carriers benefit from risk-reducing interventions, but only if identified. The extent to which carriers are clinically recognized, and whether recognition is equitable across diverse populations, is poorly characterized in a single large U.S. cohort. Objective: To estimate P/LP HBOC carrier prevalence across genetic ancestry groups, quantify documented clinical genetic testing among carriers, and evaluate ancestry and socioeconomic disparities in testing. Design, Setting, and Participants: Cross-sectional analysis of the All of Us Research Program Controlled Tier (Curated Data Repository v8/C2024Q3R9), comprising participants with short-read whole genome sequencing and linked electronic health record (EHR) and survey data. Carriers were ascertained from research genomic data independent of clinical testing. Exposures: Genetically inferred ancestry (African [AFR], Admixed American [AMR], East Asian [EAS], European [EUR], Middle Eastern [MID], South Asian [SAS]); self-reported household income and educational attainment. Main Outcomes and Measures: (1) Carrier prevalence with Wilson 95% CIs; (2) documented clinical genetic testing (procedure codes) among carriers; (3) adjusted odds of documented testing among women, by ancestry, before and after socioeconomic adjustment, using multivariable logistic regression. Results: Among 414,830 participants, P/LP HBOC carrier prevalence was 1.42% (95% CI, 1.38-1.45) overall and similar across ancestry groups (AFR 1.24%, AMR 1.32%, EAS 1.19%, EUR 1.52%, MID 1.68%, SAS 1.33%; overlapping CIs). Among 250,071 women in the testing analysis, documented clinical genetic testing was rare: only 74 of 5,878 carriers overall (1.3%) and 59 of 3,572 European-ancestry carriers (1.7%) had a documented test, with counts below reportable thresholds in all other ancestry groups. African-ancestry women had lower adjusted odds of documented testing than European-ancestry women (Model 1 adjusted odds ratio [aOR], 0.32; 95% CI, 0.27-0.39), an association that attenuated but persisted after adjustment for income and education (Model 2 aOR, 0.48; 95% CI, 0.40-0.58; P < 0.001); Admixed American women also had reduced adjusted odds (aOR, 0.71; 95% CI, 0.61-0.84). Lower income and lower education were independently and dose-dependently associated with lower testing odds (income

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25.

arXiv (CS.AI) 2026-06-16 DOI: arXiv:2606.15835

Wasserstein Convergence of ODE-Based Samplers in Decentralized Diffusion Model via Velocity Field Decomposition

Authors:

Chencheng Tang ↗Xuanyu Xue ↗Fangyikang Wang ↗Chao Zhang ↗Hubery Yin ↗

arXiv:2606.15835v1 Announce Type: cross Abstract: Diffusion models have achieved impressive empirical success in generative tasks, and their convergence theory is now relatively well understood. Motivated by privacy and scalability, recent decentralized diffusion architectures replace a single global velocity field with multiple local experts and a routing mechanism, yielding a sampling dynamics with stochastic expert switching that falls outside standard diffusion convergence analyses. In this work, We study a decentralized diffusion framework with stochastic velocity fields and ODE-based sampling. We establish a convergence guarantee in Wasserstein-2 distance, showing that the distribution of the $N$-step discretization converges to the analytical solution at rate $\mathcal{O}(N^{-1/2}+\varepsilon)$ in $W_2$, where $\varepsilon$ captures the neural approximation errors. To our knowledge, this is the first $W_2$ convergence result for decentralized diffusion models with an ODE-based sampling scheme.

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