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01.
arXiv (quant-ph) 2026-06-11

Large Fluctuations in Open Quantum Systems

arXiv:2606.11822v1 Announce Type: new Abstract: We study statistics of atypical measurement outcomes in the steady states of driven open quantum systems. In equilibrium, the probability distribution over the phase space, as encoded in, e.g., the Wigner function, is analytic in the phase-space coordinates. We show that this property is generically lost in driven dissipative systems: their {\it large-deviation function} develops lines and surfaces across which its derivatives are discontinuous. As an illustrative example, we consider a parametrically driven Kerr oscillator coupled linearly and/or nonlinearly to a dissipative bath. Rare fluctuations in the amplitude and phase of the induced oscillations are governed by semiclassical instanton trajectories of the corresponding Keldysh-Lindblad action. We demonstrate that a given fluctuation can be realized through multiple distinct instanton trajectories. The competition between these trajectories leads to abrupt switching of the dominant instanton and, consequently, to non-analytic features in the large-deviation function.

02.
arXiv (CS.CL) 2026-06-24

Preferences of a Voice-First Nation: Large-Scale Pairwise Evaluation and Preference Analysis for TTS in Indian Languages

Crowdsourced pairwise evaluation has emerged as a scalable approach for assessing foundation models. However, applying it to Text to Speech(TTS) introduces high variance due to linguistic diversity and multidimensional nature of speech perception. We present a controlled multidimensional pairwise evaluation framework for multilingual TTS that combines linguistic control with perceptually grounded annotation. Using 5K+ native and code-mixed sentences across 10 Indic languages, we evaluate 7 state-of-the-art TTS systems and collect over 120K pairwise comparisons from over 1900 native raters. In addition to overall preference, raters provide judgments across 6 perceptual dimensions: intelligibility, expressiveness, voice quality, liveliness, noise, and hallucinations. Using Bradley-Terry modeling, we construct a multilingual leaderboard, interpret human preference using SHAP analysis and analyze leaderboard reliability alongside model strengths and trade-offs across perceptual dimensions.

03.
arXiv (CS.CV) 2026-06-16

SceneCraft: Interactive System for Image Editing via Scene Graph

Recent advances in generative AI have enabled natural language-driven image editing, yet existing systems often fail in complex scenes with multiple interacting objects because they rely heavily on users crafting precise text prompts. To address the absence of structured control, we propose SceneCraft, a novel interactive framework that bridges user intent and model execution by representing images as editable scene graphs. Instead of guessing text prompts through trial and error, users interact directly with a visual graph to perform complex spatial and relational operations. These graph modifications are automatically translated into precise, context-aware editing prompts, effectively eliminating linguistic ambiguity. To ensure robust and diverse results, structured prompts are dispatched to multiple state-of-the-art generative models. Evaluations across diverse editing scenarios show that SceneCraft provides a more intuitive control mechanism, significantly reducing the cognitive burden of manual prompt engineering while generating outputs that users consistently rate as higher in quality and fidelity.

04.
medRxiv (Medicine) 2026-06-17

Impact of the disposable vape ban in Great Britain: a representative interrupted time-series study 2022-2026

Objective: To examine changes in vaping and smoking trends following the announcement and implementation of the disposable vape ban in Great Britain. Design: Interrupted time-series analysis of representative monthly cross-sectional data from the Smoking Toolkit Study. Setting: Great Britain. Participants: 118,946 adults ([≥]16y), including 12,042 young adults (16-24y), surveyed between Jan-2022 and Feb-2026. Main outcome measures: Changes in trends in disposable vape use among vapers, and current vaping and smoking prevalence, using seasonally-adjusted generalised additive models with comparisons against a no-ban counterfactual in which pre-announcement trends continued unchanged. Results: The proportion of vapers mainly using disposable devices began to decline following the announcement of the ban in Jan-2024, with the fall accelerating after implementation in June-2025. By Feb-2026, 5.6% (95%CI 4.6-6.9) of adult vapers and 7.1% (5.1-10.1) of young adult vapers mainly used disposables, compared with 62.0% (53.6-71.8) and 63.6% (52.7-76.7), respectively, under a no-ban counterfactual. Increases in vaping prevalence slowed post-announcement and plateaued post-implementation; by Feb-2026, prevalence was lower than the no-ban counterfactual in adults (13.6% v 18.8%; difference -5.2 percentage points, 95%CI -7.1 to -3.3) and young adults (27.8% v 39.1%; -11.3, -18.6 to -4.1). Declines in smoking prevalence stalled among adults and reversed among young adults post-announcement, before shifting downward again post-implementation; by Feb-2026, smoking prevalence was similar to the no-ban counterfactual in adults (difference +0.9 percentage points, -0.5 to +2.2) but possibly higher in young adults (+3.3, -0.5 to +7.1). Conclusions: The disposable vape ban in Great Britain was associated with substantial changes after both announcement and implementation, including a marked reduction in disposable vape use and a slowing then plateauing of growth in overall vaping prevalence. However, declines in smoking also temporarily slowed–and among young adults, reversed–after the announcement, before downward trends resumed after implementation.

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

DRIVE: Distributional and Retrieval-Augmented Bidding with Value Evaluation

arXiv:2606.14192v1 Announce Type: new Abstract: Auto-bidding is a core component of real-time advertising systems, where decisions must optimize long-term performance under budget and cost constraints, while online exploration is prohibitively risky. Offline reinforcement learning and, more recently, Transformer-based sequence modeling have shown promise for learning bidding policies from logged data, but their unimodal and purely parametric formulations often collapse multiple effective bidding strategies into suboptimal averaged actions and perform unreliably under sparse or long-tail traffic. To mitigate these limitations, we propose DRIVE (Distributional and Retrieval-Augmented Bidding with Value Evaluation), a unified Transformer-based framework that decouples candidate action generation from decision making for offline auto-bidding. DRIVE combines distributional action modeling, retrieval-augmented candidate generation from high-quality historical decisions, and value-based evaluation to select the most promising bid at inference time. Extensive experiments on AuctionNet and additional offline reinforcement learning benchmarks demonstrate that DRIVE consistently improves bidding performance and generalizes well across multiple Transformer-based methods.

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

Principled RL for Flow Matching Emerges from the Chunk-level Policy Optimization

Recent Progress in post-training flow matching for text-to-image (T2I) generation with Group Relative Policy Optimization (GRPO) has demonstrated strong potential. However, it is hindered by a critical limitation: inaccurate advantage attribution. In this work, we argue that aggregating consecutive steps into a coherent 'chunk' and shifting the policy optimization paradigm from GRPO's step level to the chunk level can effectively mitigate the negative impact of this issue. Building on this insight, we propose Group Chunking Policy Optimization (GCPO), the first chunk-level reinforcement learning approach for post-training flow matching. Extensive experiments demonstrate that GCPO achieves superior performance on both standard T2I benchmarks and preference alignment, with up to 43% relative gains over GRPO, highlighting the promise of chunk-level policy optimization. The code is available on https://github.com/xingzhejun/GCPO.

07.
arXiv (CS.AI) 2026-06-25

Conformal Recovery-Deadline Certificates for Runtime Assurance of Adapting Controllers

arXiv:2606.25371v1 Announce Type: cross Abstract: Runtime assurance (RTA) protects a safety-critical system by switching from an advanced controller to a verified safe controller when a monitored condition is violated. The standard latching rule, which trips on the first breach of the safe set and then coasts, is correct for a diverging controller but pathological for a capable online-adapting one. Such a controller is unsafe by design during a bounded recovery transient. It must excite the plant to identify the fault before it can correct it, so a latching shield trips on that transient and suppresses a controller that would have recovered. We introduce the conformal recovery-deadline certificate, a split-conformal, distribution-free, finite-sample upper bound on the adapting controller's recovery time that licenses delayed fallback with a coverage guarantee, backstopped by a verified monitor at a hard critical limit. The certified deadline discriminates capable from incapable controllers, keeping the recoverer autonomous while catching the diverger. The construction separates autonomy, governed by statistical coverage, from safety, governed by the verified backstop, as an instance of reliability-asymmetric design. We prove marginal coverage, a weighted extension that restores coverage under a known fault-distribution shift, and group-conditional Mondrian coverage. We demonstrate all three on two unrelated Simplex testbeds: a 6-DOF spacecraft attitude controller and a torque-controlled inverted pendulum. Both show the same suppression pathology and the same cure, making the certificate a domain-general mechanism rather than a single-system trick.

08.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

09.
arXiv (math.PR) 2026-06-16

Collapsibility in Multiparametric Models of Random Simplicial Complexes

Authors:

arXiv:2606.15276v1 Announce Type: cross Abstract: We study collapsibility in the multiparametric models of random simplicial complexes, namely the lower and upper models. In the upper model, we improve upon a result of Farber and Nowik, and assert that the homology is a.a.s concentrated in a single dimension by proving that the complex collapses to that \di. In the lower model, we prove that the complex a.a.s collapses to the \di\ with maximal non-trivial cohomology. We then compare this threshold to the ones derived previously for the special cases of the clique complex (by Kahle) and the Linial-Meshulam model.

10.
arXiv (CS.CL) 2026-06-12

Unraveling Syntax: Language Modeling and the Substructure of Grammars

While language models achieve impressive results, their learning dynamics are far from understood. Many domains of interest – such as natural language syntax, coding languages, arithmetic – are captured by context-free grammars (CFGs). In this work, we extend prior work on neural language modeling of CFGs in a novel direction: how language modeling behaves with respect to CFG substructure, namely subgrammars. We define subgrammars, and prove a set of fundamental theorems connecting language modeling and subgrammars. We show that language modeling loss recurses linearly over its top-level subgrammars; applied recursively, the loss decomposes into losses for "irreducible" subgrammars. Under additional assumptions, and empirically, parametrized models learn subgrammars in parallel, unlike children who first master simple substructures. We find that subgrammar pretraining can improve final performance, but only for tiny models relative to the grammar, while alignment analyses show that pretraining consistently leads to internal representations that better reflect the grammar's substructure.

11.
arXiv (CS.LG) 2026-06-24

Activation Functions, Statistics and Learning of Higher-Order Interactions in Restricted Boltzmann Machines

arXiv:2605.19178v2 Announce Type: replace-cross Abstract: The great success of neural networks primarily arises from the presence of the large number of weight parameters combined with nonlinearities in the input-output relationship of single neurons. In this work, we study the relationship between the statistical properties of the weights and the nonlinearity of the hidden unit in Restricted Boltzmann Machines (RBMs) on the one side, and the distribution induced on binary visible units. We do this for four commonly used activation functions: Linear, Step, ReLU, and Exponential, and make qualitative predictions about the ability of these models to learn distributions with strong higher order interactions over the visible nodes. We show that in general, in an ensemble of RBMs with Gaussian weights, these distributions are rare and hard to learn, except when the hidden unit activation function is an Exponential.

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

AVIS: Adaptive Test-Time Scaling for Vision-Language Models

Modern Vision-Language Models (VLMs) benefit from chain-of-thought prompting and test-time scaling, but these gains often come with prohibitive inference cost due to large visual contexts and long decoding chains. We view this cost through two coupled axes: Visual Context Scaling (VCS), which controls how much visual evidence is passed to the language model, and Visual Reasoning Scaling (VRS), which controls how much inference-time reasoning search is performed. Existing methods typically optimize one axis at a time, leaving the joint allocation of compute across these axes underexplored. We introduce Adaptive Visual Inference Scaling (AVIS), a lightweight policy that adapts both VCS and VRS per query. AVIS realizes VCS through Key Diversity Visual (KDV) pruning, a training-free $O(N)$ key-based rule for removing redundant visual tokens before prefilling, and realizes VRS through adaptive self-consistency, using a learned difficulty predictor to select the number of reasoning rollouts. AVIS is deployment-friendly and compatible with shared-prefill inference, where all rollouts reuse a single prefilling pass and KV cache. Across diverse image and video reasoning benchmarks, AVIS improves the accuracy–compute trade-off relative to VCS-only and VRS-only baselines, and remains effective on top of RL post-trained VLMs while keeping compute and latency low.

13.
arXiv (CS.AI) 2026-06-12

Fusion Learning from Dynamic Functional Connectivity: Combining the Amplitude and Phase of fMRI Signals to Identify Brain Disorders

arXiv:2603.24603v2 Announce Type: replace-cross Abstract: Dynamic functional connectivity (dFC) derived from resting-state functional magnetic resonance imaging (fMRI) has been extensively utilized in brain science research. The sliding window correlation (SWC) method is a widely used approach for constructing dFC by computing correlation coefficients between amplitude time series of signals from pairs of brain regions. In this study, we propose an integrated approach that incorporates both amplitude and phase information of fMRI signals to improve the detection of brain disorders. Specifically, we introduce a multi-scale fusion learning framework, namely MSFL, which leverages two complementary dFC features derived from SWC and phase synchronization (PS). Here, SWC captures amplitude correlations, while PS measures phase coherence within dFC. We evaluated the efficacy of MSFL in classifying autism spectrum disorder and major depressive disorder using two publicly available datasets: ABIDE I and REST-meta-MDD, respectively. The results indicate that MSFL significantly outperforms existing comparative models. Moreover, we performed model explanation analysis using the SHAP framework, which showed that both types of dFC features from SWC and PS contribute to detecting brain disorders.

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

Amnesia: A Stealthy Replay Attack on Continual Learning Dreams

Continual learning (CL) models often use experience replay to reduce catastrophic forgetting, but their robustness to replay sampling interference remains underexplored. Existing CL attacks alter inputs or training pipelines (poisoning/backdoors) and rarely include explicit auditable constraints, limiting realism. Here, auditability means a monitor can verify compliance from sampler-visible telemetry - e.g., logged replay index/label statistics - by checking that the realized replay class histogram stays close to a nominal baseline and that replay rate is unchanged per batch and/or over a rolling window. We study a limited-privilege insider who controls only replay index selection, not pixels, labels, or model parameters, while staying within auditable limits such as queue priorities. We introduce Amnesia, a replay composition attack that maximizes degradation under two budgets: a visibility budget delta bounding the TV/KL divergence from a nominal class histogram p0, and a mass budget f fixing the replay rate. Amnesia has two steps: (i) compute lightweight class utilities, such as EMA loss or confidence, to tilt p0 toward harmful classes; and (ii) project the tilt back into the delta-ball using efficient KL (exponential tilt) or TV (balanced mass redistribution) optimizers. A windowed scheduler enforces rolling audits. Across challenging CL benchmarks and strong replay baselines, Amnesia consistently lowers final accuracy (ACC) and worsens backward transfer (-BWT). The KL variant delivers high impact while remaining largely undetected under multiple audit schemes, including per-batch and rolling-window checks. The TV variant is more damaging but easier to detect, especially under tight per-class constraints. These results expose index-only replay control as a practical, auditable threat surface in CL systems and establish a principled impact-visibility trade-off.

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

Neural Machine Translation for Low-Resource Tangkhul–English

We present a study on low-resource machine translation for the Tangkhul-English (nmf-en) language pair. Tangkhul is a severely under-resourced Tibeto-Burman language spoken primarily in Manipur, India, with virtually no prior natural language processing infrastructure. We describe two systems: (1) a primary system based on ByT5-large fine-tuned on 38,336 Tangkhul-English parallel sentence pairs, and (2) a contrastive system based on mT5-small fine-tuned on the same corpus. Our primary ByT5-large system achieves a corpus BLEU score of 39.97, chrF++ of 58.07, BERTScore F1 of 0.8104, and COMET (wmt22-comet-da) of 0.7302 on a held-out test set of 3,856 sentences. We further discuss the orthographic challenges specific to Tangkhul's Latin-script diacritics, the domain bias of our training corpus (which comprises biblical text, stories, and conversational data), and avenues for future improvement through data diversification and domain adaptation.

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

CRAFTIIF: Cross-Resolution Analytic Four-Type Interpretable Isolation Forest for Multivariate Time Series Anomaly Detection

Authors:

arXiv:2606.13486v1 Announce Type: cross Abstract: Anomaly detection in multivariate time series is challenged by four structurally distinct anomaly types – point (isolated spikes), distributional (level shifts), temporal (rhythm changes), and collective (inter-sensor correlation breakdowns) – each requiring different feature representations. Most unsupervised methods target only one or two types and provide limited interpretability. We present CRAFTIIF (Cross-Resolution Analytic Four-Type Interpretable Isolation Forest), a fully unsupervised framework targeting all four types without dataset-specific tuning. CRAFTIIF generates K=500 random analytic wavelet feature draws across four families (Morlet, DOG, Haar, Coiflet), each targeting a specific anomaly type, feeding five structured Isolation Forests – one per type plus a meta-IF for compound anomalies. An adaptive Otsu/MAD threshold calibrates detection automatically across anomaly rates from 0.1% to 69.2%. Because each IF is trained exclusively on type-specific features, branch firing provides direct anomaly-type attribution by construction, without post-hoc explanation. Evaluated on all 19 datasets of the mTSBench benchmark (Zhou et al., TMLR 2026), CRAFTIIF achieves mean F1=0.228 (all 19 datasets) and F1=0.322 (13 detectable datasets), ranking first among all 25 evaluated methods on VUS-PR (0.463 vs. previous best 0.329, +40.7%). A diagnostic framework – oracle F1, detectability limits, and branch separation ratios – identifies 6 of 19 datasets as fundamentally undetectable by any unsupervised method. Ablation over 11 conditions confirms adaptive thresholding (+38% F1), four-branch structure (+20%), and meta-IF (+23%) are each essential. Code: https://github.com/smitswil/craftiif

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

PAWS: Preference Learning with Advantage-Weighted Segments

arXiv:2606.11982v1 Announce Type: new Abstract: Preference-based reinforcement learning (PbRL) learns policies from human trajectory-level comparisons, avoiding explicit reward design and expert demonstrations. Existing methods typically train utility functions on trajectory or segment-level preferences while relying on per-step utility estimates during policy optimization. This training and inference mismatch induces a distribution shift that severely degrades temporal credit assignment and limits policy learning. We analyze this issue and propose PAWS, a segment-based preference learning method that performs policy updates directly using segment-level advantage functions. By aligning utility training with policy optimization, PAWS preserves trajectory-level preference information and avoids unreliable per-step learning signals. Experiments on simulated robotic manipulation and locomotion tasks demonstrate that PAWS consistently outperforms existing PbRL approaches, highlighting the importance of distribution-consistent preference learning.

18.
arXiv (CS.AI) 2026-06-16

Embedded Arena: Iterative Optimization via Hardware Feedback

arXiv:2606.16190v1 Announce Type: cross Abstract: Embedded devices from wildlife monitoring stations to clinical wearables require local AI inference due to latency, communication, or privacy constraints. Optimizing models for heterogeneous microcontrollers (MCUs) requires simultaneously satisfying hard physical constraints on memory, power, and temperature while preserving accuracy, a multidimensional optimization that is today performed manually by experts. We ask whether an LLM agent can autonomously navigate this complex, multi-turn pipeline guided by real hardware feedback, and introduce a hardware-in-the-loop agent arena in which the agent iteratively refines both model and firmware – compiling, flashing, and measuring on real hardware – to enable closed-loop optimization. Frontier models, including Claude Opus 4.7 and Gemini 3.1 Pro, fail entirely without hardware feedback (0% deployment success), whereas our hardware-in-the-loop formulation achieves the first successful deployment within three iterations and can surpass human expert results within seven. This agentic co-optimization achieves 250x compression for vision models with

19.
arXiv (CS.CV) 2026-06-12

Cross-Modal Masked Compositional Concept Modeling for Enhancing Visio-Linguistic Compositionality

Contrastively trained vision-language models like CLIP, have made remarkable progress in learning joint image-text representations, but still face challenges in compositional understanding. They often exhibit a "bag-of-words" behavior–struggling to capture the object relations, attribute-object bindings, and word order dependencies. This limitation arises not only from the reliance on global, single-vector representations for optimization, but also from the insufficient exploitation and modeling of the rich compositional information inherently present in paired image text data. In this work, we propose MACCO (MAsked Compositional Concept MOdeling), a framework that masks compositional concepts in one modality and reconstructs them conditioned on the full contextual information from the other, enabling the model to capture and align cross-modal compositional structures more effectively. To facilitate this process, we introduce two auxiliary objectives that jointly align and regularize masked features both inter-modally and intra-modally. Extensive experiments on five compositional benchmarks, along with in-depth analyses, demonstrate that our approach not only significantly enhances compositionality in VLMs but also improves their ability to capture syntactic structure and linguistic information. Additionally, the improved compositionality also benefits text-to-image generation and multimodal large language model. Code is available at https://github.com/hiker-lw/MACCO.

20.
arXiv (CS.LG) 2026-06-12

Interpretable Factor Decomposition for Decision Intelligence in Large-Scale Financial Markets: Evidence from China's A-Share Market

arXiv:2606.12843v1 Announce Type: new Abstract: We present an interpretable machine learning pipeline to decompose Cross-Sectional Equity Return Predictability into auditable factor contribution. We apply an XGBoost model with TreeSHAP attribution and conduct stress testing on 3632 Chinese A-share stocks from 2009 until 2019. Using 60-month, rolling windows over 55 months of out-of-sample data, XGBoost obtains a mean AUC of 0.547 and +2.38%/month (Newey-West t = 5.94; Annualized Sharpe 2.23) long-short spread for the top vs bottom quintiles. This alpha is persistent after adjusting for the Carhart four-factor model (+2.31%/month; t = 7.48). SHAP Decomposition indicates that behavioral signals (turnover and momentum) account for 58.2% of predictive attribution compared to 10.7% for valuation ratios, on average, across 55 industry groups. Ablation analysis serves to cross-validate this ranking and provides evidence that SHAP and ablation diverge in a manner that highlights feature substitutability structure that is largely invisible to either method used in isolation.

21.
arXiv (math.PR) 2026-06-11

On the Wasserstein distance between a hyperuniform point process and its mean

arXiv:2404.09549v3 Announce Type: replace Abstract: We study the existence of bounds on the expected $p$-Wasserstein distance between a random measure and its mean under the assumption that the $p$-th centered moments of the counting statistics are controlled uniformly in space. The average Wasserstein transport cost is shown to be bounded from above and from below by some multiples of the number of points. $D$-dimensional versions of those results are also obtained. As a corollary, we prove that for any value of $p\geq 1$ the Ginibre point process can be seen as a perturbed lattice with identically distributed perturbations with a finite $p$-th moment.

22.
medRxiv (Medicine) 2026-06-17

Performance of five risk stratification tools for paediatric pneumonia against WHO scores using data from the PediCAP trial in sub-Saharan Africa

Background Risk stratification tools for childhood pneumonia have been proposed to improve identification of children at highest risk of death, particularly in low-resource settings. However, their added value over the WHO Integrated Management of Childhood Illness (IMCI) criteria and danger signs remains uncertain. Methods We conducted a secondary analysis of a multi-country randomised controlled trial of children without HIV hospitalised with pneumonia in Mozambique, South Africa, Uganda, Zambia, and Zimbabwe. We evaluated the performance of five published risk scores alongside WHO IMCI severity classification and danger signs. Discrimination for (1) in-hospital mortality, (2) 28-day mortality, and (3) 28-day readmission or death was assessed using area under the receiver operating characteristic curve (AUC). Comparative performance and clinical utility were examined. Results Of the 1010 participants, 18 (1.8%) died in hospital, 22 (2.2%) died in hospital or in the 7 days post-discharge, and 63 (6.2%) died or were readmitted by day 28. Univariate case-fatality rates were highest for variables associated with malnutrition, convulsions, and hypoxaemia. All risk scores demonstrated moderate discrimination for in-hospital and in-hospital+7-day mortality (AUC range approximately 0.75-0.84), with no meaningful differences between models, and performed similarly to the WHO danger signs and IMCI severity classification. In contrast, all approaches performed poorly in predicting 28-day readmission or death (AUC approximately 0.54-0.58). No risk score consistently outperformed simple clinical criteria. Conclusions In this multi-country dataset, we found no evidence that published paediatric pneumonia risk scores meaningfully outperform WHO IMCI-based clinical assessment for predicting mortality. The relatively small number of mortality events limits precision, and modest differences cannot be excluded. These findings suggest that, in low-resource settings, strengthening implementation of existing WHO clinical criteria may be more effective than adopting more complex prediction tools.

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

Improving Pre-trained Adult Glioma Segmentation Models Using only Post-processing Techniques

Gliomas are the most common malignant brain tumors in adults and are among the most lethal. Despite aggressive treatment, the median survival rate is less than 15 months. Accurate multiparametric MRI (mpMRI) tumor segmentation is critical for surgical planning, radiotherapy, and disease monitoring. While deep learning models have improved the accuracy of automated segmentation, large-scale pre-trained models generalize poorly and often underperform, producing systematic errors such as false positives, label swaps, and slice discontinuities in slices. These limitations are further compounded by unequal access to GPU resources and the growing environmental cost of large-scale model training. In this work, we propose adaptive post-processing techniques to refine the quality of glioma segmentations produced by large-scale pretrained models developed for various types of tumors. We demonstrated the techniques in multiple BraTS 2025 segmentation challenge tasks, with the ranking metric improving by 14.9 % for the sub-Saharan Africa challenge and 0.9% for the adult glioma challenge. This approach promotes a shift in brain tumor segmentation research from increasingly complex model architectures to efficient, clinically aligned post-processing strategies that are precise, computationally fair, and sustainable.

24.
medRxiv (Medicine) 2026-06-24

Pre-activity glycemic prediction prioritizes post-meal movement

Post-meal activity can attenuate glucose excursions; however, the exact magnitude of this effect remains unquantified, and guidance is rarely personalized to the meal occasion. We linked Human Phenotype Project diet logs, continuous glucose monitoring and wearable step counts to test whether glycemic risk estimated before activity occurs can prioritize post-meal movement. An activity-blind PPGR model trained on 391,214 PPGR-valid meals from 9,561 participants generated pre-activity meal scores. Among 55,949 step-linked meals from 1,627 adults without diabetes, higher 0-120-min post-meal steps were associated with lower within-participant PPGR (-53.0 mg/dL*min per 1 s.d. higher log steps; 95% CI, -64.2 to -41.7), with larger adjusted PPGR iAUC contrasts at 1,501-2,500 observed steps (-154.4 mg/dL*min versus 0-50 steps). Associations were stronger among participants with higher glycemic-adiposity burden and after meals with higher predicted PPGR. A held-out pre-activity step-response ranking concentrated larger inverse step-PPGR associations (-79.1 top versus -15.0 mg/dL*min bottom quintile), providing a testable strategy for prediction-guided, post-meal movement prompts.

25.
arXiv (CS.AI) 2026-06-16

MBABench: Evaluating LLM Agents on End-to-End Spreadsheet Tasks in Finance

arXiv:2605.22664v3 Announce Type: replace Abstract: LLM agents are increasingly expected to carry out end-to-end workflows, producing complete artifacts from high-level user instructions. To meet enterprise needs, frontier AI labs have developed agents that can construct entire spreadsheets from scratch. This is especially relevant in finance, where core workflows such as financial modeling, forecasting, and scenario analysis are commonly conducted through spreadsheets. Yet, existing spreadsheet benchmarks do not measure this advanced capability, focusing instead on question-answering or single-formula edits. To address this gap, we provide one of the first evaluations of agents on end-to-end spreadsheet tasks, focusing on economically critical financial workflows such as modeling and scenario analysis. Since deliverables therein are routinely reviewed and revised by multiple stakeholders, judging their quality necessarily involves high-level criteria such as readability or ease of modification. To reflect the multidimensional nature of solution quality, we develop an evaluation taxonomy comprising three dimensions: Accuracy, Formula, and Format, each comprising fine-grained criteria that reflect professional standards. The Claude family leads the benchmark and produces the most professional-looking outputs in our qualitative review, but even the strongest agents frequently fall short of professional finance standards and degrade sharply as the difficulty increases beyond a few chained calculations. This suggests that current agents are not yet able to reliably produce professional-quality spreadsheets at the level of complexity real-world workflows demand.