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01.
arXiv (CS.AI) 2026-06-15

HarnessX: A Composable, Adaptive, and Evolvable Agent Harness Foundry

arXiv:2606.14249v1 Announce Type: new Abstract: AI agent performance depends critically on the runtime harness, comprising the prompts, tools, memory, and control flow that mediate how a model observes, reasons, and acts. Yet today's harnesses remain largely hand-crafted and static: each new model or task still demands bespoke scaffolding, and the rich traces produced during execution are rarely distilled back into systematic improvement. We introduce HarnessX, a foundry for composable, adaptive, and evolvable agent harnesses. HarnessX assembles typed harness primitives via a substitution algebra, adapts them through AEGIS, a trace-driven multi-agent evolution engine grounded in an operational mirror between symbolic adaptation and reinforcement learning, and closes the harness-model loop by turning trajectories into both harness updates and model training signal. Across five benchmarks (ALFWorld, GAIA, WebShop, tau^3-Bench, and SWE-bench Verified), HarnessX yields an average gain of +14.5% (up to +44.0%), with gains largest where baselines are lowest. These results suggest that agent progress need not come from model scaling alone: composing and evolving runtime interfaces from execution feedback is an actionable and complementary lever. The complete codebase will be open-sourced in a future release.

02.
arXiv (quant-ph) 2026-06-24

An Analysis of Speculative Window Decoders for Quantum Error Correction

arXiv:2606.24048v1 Announce Type: new Abstract: Fault-tolerant quantum computing is essential for realizing the substantial computational speedups that quantum computing can bring, but it requires real-time error decoding with high performance. Speculative window decoding improves performance by reducing the time spent waiting for dependencies from prior decoding windows. However, speculative decoders have only been evaluated under the regime of superconducting qubits with fast gate speeds, surface codes, and matching decoders. Since different quantum technologies can have slower gate speeds, we evaluate the performance of speculative decoding under slow gate speeds. We also examine its sensitivity to speculation accuracy, decoder latency, processor count, and workload parallelism, which can vary across different quantum error correction codes, decoders, and hardware platforms. This work presents design principles for identifying when speculative decoding yields the greatest performance improvements. It also reveals the conditions under which non-speculative decoders outperform speculative decoders.

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

Towards a future space-based, highly scalable AI infrastructure system design

arXiv:2511.19468v2 Announce Type: replace-cross Abstract: If AI is a foundational general-purpose technology, we should anticipate that demand for AI compute – and energy – will continue to grow. The Sun is by far the largest energy source in our solar system, and thus it warrants consideration how future AI infrastructure could most efficiently tap into that power. This work explores a scalable compute system for machine learning in space, using fleets of satellites equipped with solar arrays, inter-satellite links using free-space optics, and Google tensor processing unit (TPU) accelerator chips. To facilitate high-bandwidth, low-latency inter-satellite communication, the satellites would be flown in close proximity. We illustrate the basic approach to formation flight via an 81-satellite cluster of 1 km radius, and describe an approach for using high-precision ML-based models to control large-scale constellations. Trillium TPUs are radiation tested. They survive a total ionizing dose equivalent to a 5 year mission life without permanent failures, and are characterized for bit-flip errors. Launch costs are a critical part of overall system cost; a learning curve analysis suggests launch to low-Earth orbit (LEO) may reach $\lesssim$\$200/kg by the mid-2030s.

04.
arXiv (CS.AI) 2026-06-16

DOG-DPO:Dynamic Optimization in Geometry for Safety Alignment

arXiv:2606.07678v2 Announce Type: replace-cross Abstract: Safety alignment for large language models relies on preference data, but current pipelines often train on large, redundant datasets. Existing data selection methods typically score each preference pair independently, collapsing directional preference information into scalar quality or diversity scores. This sample-centric view is especially limiting in multi-dataset settings, where shared safety directions coexist with dataset-specific residual risks. We propose DOG-DPO, a training-free data selection framework that treats preference pairs as structured geometric signals. DOG-DPO first represents each preference pair as a direction in model representation space. It then decomposes multi-dataset preference geometry into a global anchor subspace and dataset-specific residual subspaces. Finally, it selects subsets by maximizing diversity-based coverage, encouraging broad, non-redundant coverage of alignment directions before DPO training. Across six safety benchmarks and two model backbones, DOG-DPO achieves a strong utility-robustness trade-off using only 11% of the preference pairs. It recovers most of the safety gains of full-data training while remaining entirely teacher-free, training-free, and substantially faster than representative selection baselines.

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

The Shrinking Lifespan of LLMs in Science

arXiv:2604.07530v2 Announce Type: replace-cross Abstract: Scaling laws describe how language model capabilities grow with compute and data, but say nothing about how long a model matters once released. We introduce time-to-peak and lifespan as measures of model obsolescence and use them to characterize the scientific adoption trajectories of 62 LLMs across more than 108k citing papers (2019-2025), separating active adoption from background citation to recover per-model trajectories that citation counts cannot resolve. We find that a model's longevity is shaped more by when it was released than by its characteristics: release year predicts time-to-peak and lifespan more strongly than architecture, openness, or scale. LLM adoption follows an inverted-U curve (rising after release, peaking, and then declining), but this pattern is rapidly compressing. Each successive release year is associated with a 27% shorter time-to-peak and a 23% shorter lifespan ($p < 0.001$), robust to minimum-age thresholds and controls for model size. These adoption-side dynamics are invisible to scaling laws and suggest that specialization on any single model may be a depreciating investment, with costs falling on reproducibility and migration.

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

PathRouter: Aligning Rewards with Retrieval Quality in Agentic Graph Retrieval-Augmented Generation

Agentic GraphRAG trains language-model agents to iteratively retrieve and reason over graph-structured evidence, enabling more accurate and context-aware decision-making by efficiently navigating complex information networks. However, outcome-only reinforcement learning suffers from answer-path reward aliasing, where correct answers may come from shortcuts rather than useful evidence paths. It also exhibits search-update ambiguity, as scalar trajectory-level feedback does not indicate which retrieval actions to adjust. To mitigate these shortcomings, we present PathRouter, a path-aware training framework for agentic GraphRAG. PathRouter jointly evaluates each trajectory along answer correctness and evidence-path overlap, yielding four trajectory categories with differentiated GRPO advantage scaling that suppresses shortcut reinforcement while preserving evidence-seeking behavior. For evidence-poor trajectories, a frozen gold-evidence teacher provides token-level KL guidance on reasoning and search-query tokens, excluding answer tokens to avoid direct response imitation. Experiments on six QA benchmarks across three model sizes show that PathRouter consistently improves answer F1 and evidence-path overlap, achieving average F1 gains of 3.1 on 3B and 4.9 on 7B models compared to a strong baseline.

07.
medRxiv (Medicine) 2026-06-15

Multi-domain AD risk burden and plasma biomarkers in cognitively unimpaired adults

Introduction: Alzheimer's disease (AD) pathology accumulates decades before symptom onset, yet how the cumulative effect of genetic, familial, and modifiable lifestyle risk burden jointly affects plasma biomarker levels and trajectories in cognitively unimpaired older adults remains unknown. Methods: We analyzed data from 261 participants in the PREVENT-AD cohort. A composite risk score integrating APOE e4 status, polygenic score, family history, and modifiable/lifestyle risk was examined against six plasma biomarkers using linear regression and linear mixed-effects models. Results: APOE e4 was the strongest predictor of plasma biomarker levels. Higher composite risk burden was associated with elevated ptau181, ptau217, ptau217/Ab42, and GFAP levels, and lower Ab42/40 levels. A higher risk burden was predictive of accelerated ptau181 accumulation. Discussion: Cumulative AD risk burden is broadly associated with plasma biomarker levels and specifically predicts accelerated ptau181 accumulation in cognitively unimpaired older adults, supporting structured composite risk profiling as a framework for AD risk stratification.

08.
arXiv (CS.AI) 2026-06-16

Limited Marginal Benefit of Reasoning-Heavy LLM Deployment in ESG Narrative Scoring: A 4-Model Consensus Study on Japanese Listed Firms

arXiv:2606.13693v1 Announce Type: cross Abstract: Automated scoring of ESG narrative disclosures with large language models (LLMs) is gaining traction, yet whether reasoning-heavy frontier models add value commensurate with their cost remains empirically unsettled. We evaluate this question on a corpus of ten Japanese listed firms across three rubric axes – quantitative targets, progress-tracking infrastructure, and external-standard alignment – using a four-model consensus design that combines a reasoning-on frontier model with three reasoning-off contemporaries. Across 120 firm x axis x model scores, the pooled mean absolute deviation between the reasoning-on model and each reasoning-off counterpart is 0.38 on a 5-point scale; only 2% of pairwise comparisons reach a two-point deviation, and none exceeds two points. Per-firm cost accounting shows the reasoning-on arm alone costs roughly 5.6x as much as the three-provider reasoning-off ensemble, for outcomes that differ only within small margins. We conclude that in span-based ESG narrative scoring, reasoning-heavy deployment does not materially improve outcomes relative to reasoning-off consensus, while substantially increasing operational cost. We discuss implications for cost-effective ESG auto-scoring pipelines and LLM deployment governance in applied accountability settings. An earlier version of this work is available on SSRN (Abstract ID 6683303).

09.
arXiv (CS.CV) 2026-06-15

OmniVideo-100K: A Dataset for Audio-Visual Reasoning through Structured Scripts and Evidence Chains

Current automated pipelines for audio-visual Question Answering (QA) generally adopt a ``video-caption-QA'' paradigm. However, these methods typically segment videos into short clips and generate separate descriptions for audio and visual modalities. This decoupled processing severs inherent associations between sounds and their visual sources, while independent clip processing often causes inconsistent descriptions of the same entity across segments. Furthermore, coupling long-text comprehension and QA synthesis into a single step often restricts models to localized events, yielding questions lacking long-term temporal connections and deep cross-modal reasoning. To address these issues, we propose an automated data engine featuring two mechanisms: (1) Entity-Anchored Video Scripting transforms videos into structured scripts, comprising summaries, main entity lists, and segment-wise audio-visual descriptions. The entity list serves as a global prior to ensure cross-segment referential consistency and reconstruct audio-visual associations. (2) Clue-Guided QA Generation prompts models to first mine cross-segment, multimodal clues from the script, and subsequently generate QA pairs based on these high-value clues. Leveraging this pipeline, we construct the instruction-tuning dataset OmniVideo-100K and a human-verified test set, OmniVideo-Test. Fine-tuning VITA-1.5, Qwen2.5-Omni-7B and Qwen3-Omni-30B on OmniVideo-100K yields performance gains of up to 20.59% on OmniVideo-Test, demonstrating strong generalization (up to 12.64% improvements) across established benchmarks like Daily-Omni and JointAVBench.

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

SPATIA: Multimodal Generation and Prediction of Spatial Cell Phenotypes

Understanding how cellular morphology, gene expression, and spatial context jointly shape tissue function is a central challenge in biology. Image-based spatial transcriptomics technologies now provide high-resolution measurements of cell images and gene expression profiles, but existing methods typically analyze these modalities in isolation or at limited resolution. We address the problem by introducing SPATIA, a multi-level generative and predictive model that learns unified, spatially aware representations by fusing morphology, gene expression, and spatial context from the cell to the tissue level. SPATIA also incorporates a spatially conditioned generative framework with confidence-aware OT reweighting and morphology-profile alignment for modeling target-state morphology distributions. Specifically, we propose a confidence-aware flow matching objective that reweights weak optimal-transport pairs based on uncertainty. We further apply morphology-profile alignment to encourage biologically meaningful image generation, enabling the modeling of microenvironment-dependent phenotypic transitions. We assembled a multi-scale dataset consisting of 25.9 million cell-gene pairs across 17 tissues. We benchmark SPATIA against 18 models across 12 tasks, spanning categories such as phenotype generation, annotation, clustering, gene imputation, and cross-modal prediction. SPATIA achieves improved performance over state-of-the-art models, improving generative fidelity by 8% and predictive accuracy by up to 3%.

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

Kuramoto Attention: Synchronizing Self-Attention on the Torus

Authors:

We introduce Kuramoto attention, a self-attention layer in which each hidden coordinate is an angle. The layer scores tokens by gated cosine similarity, attends over previous phase states, and updates each token by the tangent component of the attention-weighted circular mean. Because the values are the raw phase states, this update is exactly the Kuramoto coupling term $\sum_u A_{t,u}\sin(\theta_u-\theta_t)$, with the attention matrix acting as an adaptive, content-dependent coupling kernel. Equivalently, the gated score is a learned metric on the torus that selects which tokens couple, and the update pulls each token toward the circular mean of the tokens it selects, tightening their phase agreement. The same two ingredients, an invariant similarity score and an on-manifold mean, define such a layer on any compact group; the torus is the abelian case, where both are closed-form. The softmax weights solve an entropy-regularized phase-retrieval problem, and rotary position enters as a position-dependent phase drift in the score. On enwiki8 character-level language modeling, the layer trains as a functional language model whose bits-per-character stays close to a strong matched RoPE+SwiGLU transformer: within $0.02$ BPC at one million parameters ($1.637\pm0.010$ versus $1.616\pm0.004$) and level on the median at five million ($1.448$ versus $1.452$ over five seeds) with the transformer ahead on the mean ($1.468$ versus $1.456$). These experiments establish that the constrained geometric structure is a viable language model at this scale; the structure itself, and its synchronization reading, is the contribution. Ablations isolate the load-bearing components, and the result gives a compact bridge between self-attention and phase synchronization.

13.
arXiv (CS.LG) 2026-06-15

Multi-Variable Stellar Parameter Estimation Using Residual Multitask Neural Networks

arXiv:2606.13868v1 Announce Type: cross Abstract: We present an end-to-end pipeline for estimating stellar parameters from Sloan Digital Sky Survey Data Release 12 spectra using a fully connected multitask neural network with residual blocks, whose hyperparameters are tuned via Bayesian optimization. The preprocessing pipeline includes per-spectrum standardization, RobustScaler normalization of the target variables – effective temperature $T_{\mathrm{eff}}$, metallicity $[\mathrm{Fe/H}]$, and surface gravity $\log g$ – and data augmentation via Gaussian noise injection. On a held-out test set, the model achieved Mean Absolute Errors (MAE) of $59.76~\mathrm{K}$ for $T_{\mathrm{eff}}$, $0.103~\mathrm{dex}$ for $[\mathrm{Fe/H}]$, and $0.130~\mathrm{dex}$ for $\log g$. Normalized against the full-scale range of each parameter, these results represent range-normalized errors between $1\%$ and $3\%$, achieved with a highly efficient model complexity of approximately 540,000 trainable parameters. These results demonstrate that a compact residual multitask architecture, combined with principled signal preprocessing, provides a parameter-efficient solution for nonlinear parameter estimation in large-scale spectral datasets. In particular, the proposed model achieves competitive performance with substantially lower complexity than deeper neural network baselines.

14.
arXiv (CS.CV) 2026-06-18

Test-Time Adaptation in Optical Coherence Tomography Using Trajectory-Aligned Time-Independent Flow

Optical coherence tomography (OCT) is essential in ophthalmology, but inconsistent image quality especially in low-cost devices hinders automated analysis. To address this, we introduce a flow-matching-based test-time adaptation method that generates high-quality surrogate images from noisy inputs. Typically, domain gaps between test and training data cause pixel distribution mismatches during the denoising process. We overcome this by matching the test image's histogram to synthetic reference trajectories, successfully aligning the input with expected distributions. Additionally, we remove the network's time conditioning to account for slight deviations in real-world noise distributions. Our approach achieves state-of-the-art performance in segmenting critical biomarkers for two stages of Age-related Macular Degeneration (AMD). Code is available: https://github.com/Veit21/tta-flow.

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

UniMM: A Unified Mixture Model Framework for Multi-Agent Simulation

arXiv:2501.17015v2 Announce Type: replace Abstract: Simulation plays a crucial role in assessing autonomous driving systems, where the generation of realistic multi-agent behaviors is a key aspect. In multi-agent simulation, the primary challenges include behavioral multimodality and closed-loop distributional shifts. In this study, we formulate a unified mixture model (UniMM) framework for generating multimodal agent behaviors, which can cover the mainstream methods including regression-based mixture models and discrete NTP models. Furthermore, we introduce a closed-loop sample generation approach tailored for mixture models to mitigate distributional shifts. Within the UniMM framework, we recognize critical configurations from both the model and data perspectives. We conduct a systematic examination of various model configurations, and comprehensively characterize their effects. Moreover, our investigation into the data configuration highlights the pivotal role of closed-loop samples in achieving realistic simulations. To extend the benefits of closed-loop samples across a broader range of mixture models, we further introduce a temporal disentanglement-and-alignment mechanism to address the shortcut learning and off-policy learning issues. Leveraging insights from our exploration, the distinct variants proposed within the UniMM framework, including discrete, anchor-free, and anchor-based models, all achieve state-of-the-art performance on the WOSAC benchmark.

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

A Synthetic Reliability-Aware PINN Benchmark for Offshore Wind Turbine Support-Structure Monitoring with Bayesian Inverse Identification

Reliable structural health monitoring (SHM) of offshore wind turbine (OWT) support structures requires fast state estimation from sparse measurements. Repeated high fidelity finite element or aeroelastic analyses are difficult to use directly in online monitoring loops, while purely data-driven surrogates can require large training sets. This paper presents Digi Turbine, a synthetic reliability-aware Physics Informed Neural Network (PINN) benchmark for OWT monopile support structure monitoring. The workflow embeds a simplified Euler Bernoulli beam equation with Winkler soil foundation in the training objective, couples it with Bayesian-prior-informed inverse identification, and adds First Order Reliability Method (FORM) screening. All validation uses synthetic configurations with analytical or finite-difference ground truth motivated by the NREL 5MW reference turbine context.

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

Semantic Segmentation of Node and Edge Diagrams for Assistive Technology

In this paper, we present a novel set of related models for semantic segmentation of node-link diagrams. These diagrams are frequently used to represent mathematical graphs, relationships between concepts, and flowcharts. Such diagrams are difficult to access non-visually; while some assistive interfaces have been designed for node-link diagrams, they rely upon a machine-readable representation of the diagram, whereas such diagrams will generally be made available as bitmap images. Our compact deep learning models show excellent quantitative and qualitative performance on a large synthetic dataset of node-link diagrams, reaching per-pixel accuracy over 93\%.

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

TechRAG: Evidence-Gated Multimodal Agentic RAG for Technical Literature Reasoning

arXiv:2606.01613v2 Announce Type: replace-cross Abstract: This paper presents an agentic multimodal retrieval-augmented generation (RAG) framework for domain-specific literature reasoning, instantiated on a curated corpus of several thousand papers in intelligent tires, vehicle dynamics, vehicle control, sensing, estimation, and machine learning. Unlike conventional single-pass RAG systems, the proposed architecture uses an autonomous, evidence-gated pipeline that classifies query intent, generates separate text and visual query rewrites, performs hybrid text retrieval with FAISS and BM25 followed by cross-encoder reranking, expands evidence through graph-guided chunk traversal over a Neo4j knowledge graph, and retrieves visual document evidence using ColSmol late-interaction embeddings with MUVERA fixed-dimensional encoding, approximate nearest-neighbor search, and MaxSim reranking. The framework scores evidence sufficiency using a 100-point rubric with hybrid rule-based/LLM review, retries retrieval through drift-guarded reformulation, searches external academic databases through optimize–search–vet loops, merges and deduplicates multimodal evidence, verifies citation integrity, and generates cited answers through Planner, Researcher, Writer, and Critic agents with self-correcting revision. Key contributions include: (i) a scalable multimodal retrieval architecture combining text, graph, and visual evidence over 40,000 document pages; (ii) an interpretable evidence sufficiency and retry mechanism; (iii) a multi-agent generation pipeline with evidence mapping and critic-driven revision; (iv) a domain knowledge graph with LLM-based entity extraction, OpenAlex author validation, and intra-corpus citation resolution; and (v) a route-dependent external search architecture for targeted literature expansion. The result is a practical, evidence-gated, multimodal agentic RAG architecture for technical reasoning over specialized research corpora.

19.
arXiv (CS.CL) 2026-06-24

Cross-Lingual Exploration for Parametric Knowledge

Parametric knowledge in Large Language Models is not equally accessible across languages. As a result, standard inference techniques often struggle to surface localized facts, leading to failures in cross-lingual knowledge transfer and consistency. In this work, we investigate techniques for accessing hidden factual knowledge by exploring cross-lingual prompting strategies. We identify four inherent dimensions of cross-lingual exploration that directly govern parametric knowledge retrieval and evaluate them on multilingual factual benchmarks covering 17 typologically diverse languages. Our results demonstrate that cross-lingual exploration significantly improves knowledge transfer and factual recall, representing a more efficient compute Pareto frontier than native-language scaling. Furthermore, we observe corresponding improvements in cross-lingual consistency, exceeding what can be explained by accuracy gains alone. Overall, our work establishes multilingual prompt exploration as a highly effective inference-time strategy for unlocking latent parametric knowledge.

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

A Biased Nonnegative Block Term Tensor Decomposition Model for Dynamic QoS Prediction

arXiv:2605.04813v2 Announce Type: replace Abstract: With the rapid development of cloud computing and Web services, Quality of Service (QoS) has become a key criterion for service selection and recommendation. Tensor latent feature analysis provides an effective way to model multidimensional QoS data, and most existing QoS prediction methods are mainly based on Canonical Polyadic (CP) decomposition or Tucker decomposition. However, constrained by their inherent structural properties, these methods cannot accurately capture the complex and dynamic dependencies in user-service interactions, which limits their prediction performance. To address this issue, this paper proposes a dynamic QoS prediction framework based on the Biased Nonnegative Block Term Tensor Decomposition Model, termed BNBT. Specifically, the proposed framework is developed from three aspects: (1) block term tensor decomposition is employed to enhance the representation capability of latent feature learning; (2) linear bias terms are incorporated to further improve prediction accuracy; and (3) a tensor-oriented single-element-dependent nonnegative multiplicative update algorithm, called SLF-NMUT, is designed for efficient parameter estimation. Extensive experiments on real-world QoS datasets demonstrate that the proposed BNBT framework consistently outperforms several state-of-the-art QoS prediction methods in terms of prediction accuracy.

21.
arXiv (CS.AI) 2026-06-16

EEG-FM-Bench: A Comprehensive Benchmark for the Systematic Evaluation and Diagnostic Analyses of EEG Foundation Models

arXiv:2508.17742v3 Announce Type: replace-cross Abstract: Electroencephalography foundation models (EEG-FMs) have advanced brain signal analysis, but the lack of standardized evaluation benchmarks impedes model comparison and scientific progress. Current evaluations rely on inconsistent protocols that render cross-model comparisons unreliable, while a lack of diagnostic analyses obscures the internal mechanisms driving transfer efficiency and scaling behaviors. To address this, we introduce EEG-FM-Bench, a unified system for the standardized evaluation of EEG-FMs. The benchmark integrates 14 datasets across 10 paradigms and incorporates diverse experimental settings, including multiple fine-tuning strategies, task organizations, and classifier configurations, supported by tools for gradient and representation analysis. Our experiments and analysis reveal several critical insights: (1) multi-task learning often acts as a useful regularizer that mitigates overfitting in data-scarce EEG contexts, although negative transfer can arise under specific task paradigms; (2) pre-training efficiency is currently limited by gradient conflicts between reconstruction objectives and downstream tasks; (3) under released checkpoints and a matched downstream protocol, model or data scale alone does not fully explain transfer performance, while objective alignment, adaptation compatibility, and EEG-specific design appear to be important factors. This benchmark enables fair comparison and reproducible analysis, providing a step toward fairer comparison and more interpretable analysis of EEG-FMs. Code is available at https://github.com/xw1216/EEG-FM-Bench.

22.
medRxiv (Medicine) 2026-06-17

Accounting for Human Movement to Improve Exposure-Health Models

Background. Current exposure-health models rely on averaged, residential-based environmental exposures, failing to account for human movement. This aggregation can lead to exposure misclassification and biased exposure-response estimates, potentially distorting our understanding of the true health effects of environmental conditions. We developed exposure disaggregation regression models that explicitly account for human movement when linking environmental exposures to health outcomes. Methods. By weighting pixel-level exposures according to distance from home as a simple proxy for human movement, our model linked disaggregated environmental exposures to individual-level health outcomes. Weights were either fixed a priori or derived from a latent distance-decay power parameter learned from the data. We additionally evaluated model performance under a nonlinear exposure-response relationship. Model performance was assessed across multiple sample sizes (N = 1,114; 50,000; and 100,000). A simulation study examined parameter recovery using bias, empirical standard error (EmpSE), and credible interval coverage. As a case study, Demographic and Health Surveys (DHS) data from Albania were used to link acute respiratory infection (ARI) outcomes among children under five to pixel-level NDVI within a 3 km buffer around DHS cluster centroids, and the proposed models were applied to these data. Results. Across all models (fixed-weight, learned-weight, and restricted cubic spline models), parameter recovery improved with increasing sample size. At N = 1,114, estimates were biased and imprecise, with incorrect effect direction for exposure-response parameters (e.g., learned-weight {beta}1 bias = - 0.79; EmpSE = 2.61; coverage = 0.88). In contrast, the models accurately recovered parameters at larger sample sizes, including the latent distance-decay parameter (bias = - 0.02; EmpSE = 0.15; coverage = 0.95 at N = 100,000), demonstrating their ability to reliably learn movement-based exposure weights when sufficient data were available. Conclusion. Instead of relying on arbitrarily-sized buffers, this statistical framework provides a novel method for studying environmental exposure-health relationships whilst accounting for human movement. With sufficiently large sample sizes, it can accurately estimate the influence of disaggregated environmental exposures on individual-level health and help address exposure misclassification arising from residential-only metrics. This methodological framework remains scalable, interpretable, and adaptable to other exposures and outcomes, offering a foundation for future work that integrates richer mobility-informed exposure-health research.

23.
medRxiv (Medicine) 2026-06-15

Reaching out-of-school girls with HPV vaccination: A qualitative evaluation in six low- and middle-income countries using the RE-AIM framework

Background Infection with human papillomavirus (HPV), the primary cause of cervical cancer, disproportionately affects women in low- and middle-income countries (LMICs). While school-based vaccination of adolescent girls against HPV is highly effective, this strategy systematically excludes out-of-school (OOS) girls. Using the RE-AIM framework, we explored strategies to reach OOS girls with HPV vaccination across six African and Asian LMICs. Methods We conducted semi-structured key informant interviews with 32 vaccination program stakeholders from Cambodia, Cameroon, Kenya, Malawi, Mozambique, and Uganda between May and September 2024. Interviews explored countries implementation successes, challenges, and strategies to reach OOS girls with HPV vaccination and sustainability considerations. Data were analyzed using a hybrid team-based thematic analysis approach guided by the RE-AIM framework. Results Community outreach-based strategies, typically integrated into routine immunization outreach, were identified as the most effective approach to reach OOS girls with HPV vaccination. Targeted strategies, such as locating outreach clinics in community venues frequented by OOS girls (e.g., churches, markets) enhanced implementation. Perceived effectiveness of these strategies varied across participants, and formal assessment of effectiveness was constrained by the absence of disaggregated vaccination coverage data by school enrollment status. Some subpopulations of OOS girls (i.e., girls in nomadic or migrant communities, urban OOS girls) were not readily reached through standard outreach approaches, prompting implementation of adapted and tailored strategies for these subpopulations. Costs associated with conducting outreach in harder-to-reach areas were major barriers to reaching OOS girls, presenting challenges to the sustainability and cost-effectiveness of these approaches. Conclusions Routine community outreach platforms were widely perceived as most effective for reaching OOS girls. Strengthening disaggregated monitoring systems, adapting outreach for harder-to-reach subpopulations of OOS girls, and financing delivery models for tailored outreach strategies will be critical to improving equitable HPV vaccine coverage among OOS girls.

24.
bioRxiv (Bioinfo) 2026-06-18

Trajectory inference of epithelial-centered neighborhood profiles reconstructs a pseudo-temporal continuum in idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is characterized by complex lung architecture and spatially heterogeneous remodeling, which have hindered integrated analysis of cell-intrinsic activity and intercellular communication during disease progression. Here we profiled six IPF lung specimens comprising more than 630,000 cells using the Xenium 5k panel and developed an epithelial-centered neighborhood profiling framework based on the local cellular composition around each epithelial cell. This approach captured fibrosis-associated variation in epithelial niches without requiring predefined histological regions. Pseudo-temporal continuum inference of these profiles reconstructed a continuous axis that reflected the spatial progression of fibrotic remodeling from relatively preserved alveolar regions to fibrotic and airway-like remodeled regions. Within this spatial dataset, we mapped coordinated changes in epithelial states, local microenvironments, epithelial intracellular pathway activities, and directional interactions with neighboring cell types along the same axis. Our findings provide a spatial framework that generates testable hypotheses for progressive epithelial niche remodeling in IPF.

25.
Nature Medicine 2026-06-17

General-purpose chatbots outperform clinical AI tools on physicians’ real-world questions

Authors: Unknown Author

Specialized clinical AI tools are entering medical practice with little independent testing. In a head-to-head evaluation across two public benchmarks and real questions from physicians, three general-purpose frontier large language models outperformed two leading clinical AI tools, which performed no better than Google search AI overview.