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01.
medRxiv (Medicine) 2026-06-17

Frequency-dependent cognitive effects of Deep Brain Stimulation in Parkinson's Disease: A Systematic Review and Meta-Analysis

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) improves levodopa-induced motor complications and cardinal motor symptoms of Parkinson's disease (PD), but stimulation frequency may differentially shape outcomes. This is evident for axial and gait symptoms, which may respond differently to lower-frequency stimulation. Whether frequency-dependent effects extend to cognition remains unclear. Objective: To investigate the cognitive effects of DBS at distinct frequencies in PD. Methods: We conducted a systematic review and meta-analysis (PROSPERO - CRD42024618253). PubMed, Web of Science, and EMBASE were searched for studies assessing cognitive outcomes under different stimulation frequencies. Eight cognitive domains were defined: verbal fluency, cognitive flexibility, executive control, working memory, attention, processing speed, episodic memory, and time processing. Multilevel random-effects meta-analyses were performed, with effect sizes expressed as Hedges' g. Results: Forty-three studies met the inclusion criteria, the majority (n = 31) involving STN-DBS. Twenty-one STN-DBS studies, including 355 patients, were included in the meta-analysis. Compared with HFS ([≥] 130 Hz), lower frequencies (4-80 Hz) were associated with better verbal fluency (g = 0.27) and cognitive flexibility (g = 0.38), with consistent effects across sensitivity and leave-one-out analyses. Accuracy-based executive control measures also favored lower-frequency stimulation. OFF-stimulation comparisons showed a concordant pattern. Evidence for other targets (PPN and NBM) was limited. Conclusions: Lower-frequency STN-DBS was associated with modest benefits in specific cognitive domains compared with HFS. These findings highlight the need for future research to determine how frequency interacts with stimulation location and symptom-specific networks to shape cognitive and cognitive-motor outcomes in PD.

02.
arXiv (CS.CL) 2026-06-19

CombEval: A Framework for Evaluating Combinatorial Counting in Large Language Models

We present CombEval, a dynamic benchmark for evaluating combinatorial counting in large language models. CombEval represents each problem as a typed Cofola specification over entities, combinatorial objects, object dependencies, and constraints, enabling controlled generation of natural-language counting problems with exact solver-verified answers. Unlike static collections, CombEval supports systematic variation of object type, entity scale, constraint count, and reasoning depth. We evaluate 11 LLMs under direct and code-augmented settings and find that models remain brittle on ordered objects, indistinguishable elements, relatively positional constraints, and nested object dependencies. Error analysis further identifies failures in constraint interpretation and counting principles. CombEval provides a diagnostic testbed for studying when and why LLMs fail at combinatorial reasoning. The code and generated benchmark suites are publicly available at \url{https://github.com/YuxuZhou-CN/combination-problem-generation}.

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

Redirecting the Flow: Image Customization through Attention Distribution Shift

Subject-driven image customization aims to generate images that not only follow textual instructions but also preserve the identity of a given reference subject. Existing approaches, including test-time fine-tuning, encoder-based methods, and token competition in shared attention spaces, suffer from limited efficiency, misalignment between extracted reference features and the generative process, and interference from irrelevant information. To address these limitations, we formulate the customization task as a distribution shift induced by incorporating reference images into text-to-image generation, and derive a Conditional Attention Distribution Shift formulation grounded in maximum entropy theory. Building on this formulation, we propose CustomShift, a dual-branch architecture based on Stable Diffusion 3. The Reference-Alignment Branch leverages self-attention between reference images and subject names to achieve layer-wise alignment with latent representations, while the Cross-Guidance Branch integrates textual and reference cues to guide generation. Experiments on the DreamBooth and Custom101 benchmarks demonstrate that our method consistently outperforms state-of-the-art approaches, achieving a better balance between semantic fidelity and subject consistency.

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

Self-Distillation Zero: Self-Revision Turns Binary Rewards into Dense Supervision

Current post-training methods in verifiable settings fall into two categories. Reinforcement learning (RLVR) relies on binary rewards, which are broadly applicable and powerful, but provide only sparse supervision during training. Distillation provides dense token-level supervision, typically obtained from an external teacher or using high-quality demonstrations. Collecting such supervision can be costly or unavailable. We propose Self-Distillation Zero (SD-Zero), a method that is substantially more training sample-efficient than RL and does not require an external teacher or high-quality demonstrations. SD-Zero trains a single model to play two roles: a Generator, which produces an initial response, and a Reviser, which conditions on that response and its binary reward to produce an improved response. We then perform on-policy self-distillation to distill the reviser into the generator, using the reviser's token distributions conditioned on the generator's response and its reward as supervision. In effect, SD-Zero trains the model to transform binary rewards into dense token-level self-supervision. On math and code reasoning benchmarks with Qwen3-4B-Instruct and Olmo-3-7B-Instruct, SD-Zero improves performance by at least 10% over the base models and outperforms strong baselines, including Rejection Fine-Tuning (RFT), GRPO, and Self-Distillation Fine-Tuning (SDFT), under the same question set and training sample budget. Extensive ablation studies show two novel characteristics of our proposed algorithm: (a) token-level self-localization, where the reviser can identify the key tokens that need to be revised in the generator's response based on reward, and (b) iterative self-evolution, where the improving ability to revise answers can be distilled back into generation performance with regular teacher synchronization. Code: https://github.com/princeton-pli/Self-Distillation-Zero.

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

When the Past Matters: FlashBack Memory for Precipitation Nowcasting

Accurate precipitation nowcasting is crucial for disaster mitigation and socio-economic planning, yet existing methods often struggle with false alarms, missed events, and long range dependency modeling at high spatiotemporal resolution. To address these challenges, we propose FlashBack Memory (FB), a module that dynamically retrieves key historical states and integrates them via an adaptive fusion gate, enhancing the spatiotemporal representation capability of recurrent-based models. We incorporate FB into PredRNN, PredRNNpp, MIM, MotionRNN, and PredRNN-V2, and evaluate on CIKM2017, Shanghai2020, and SEVIR datasets. Experimental results demonstrate that FB significantly improves MSE, MAE, SSIM, and CSI metrics, particularly for high-intensity rainfall and long-sequence predictions, while reducing false alarms and missed events and enhancing temporal consistency and spatial localization. The proposed method provides a general and efficient memory enhancement mechanism, improving the overall performance of recurrent-based precipitation nowcasting models.

06.
medRxiv (Medicine) 2026-06-15

Bidirectional associations between cannabis use, oddball performance, and P3 event-related potential

Importance: Cannabis use remains prevalent in youth despite concerns regarding its potential impact on cognitive function. Unraveling whether the association between cannabis use and cognition is partially due to preexisting differences or primarily related to use is vital to understanding underlying mechanisms. Objective: To estimate the longitudinal association between cannabis initiation and cognitive trajectories, indexed by task performance and P3 event-related potential (ERP), and to estimate whether baseline cognition is associated with cannabis initiation. Design: Data were analyzed from the ongoing longitudinal Collaborative Study on the Genetics of Alcoholism (COGA) cohort, which was followed up approximately every 2-5 years from 2004 to 2025. Setting: 6 sites across the United States. Participants: Adolescent and young adult offspring of past COGA participants and control families who reported on their cannabis use and who had Visual Oddball (VOP) performance and P3 ERP data (N=4814; 52.4% female, 68.4% white) were grouped based on the timing of cognitive data collection relative to cannabis initiation into Pre-onset (n=2,449; [&ge;]1 assessment) and Post-onset (n=998; [&ge;]3 assessments) subsamples. Main Outcomes and Measures: VOP measures include performance accuracy (%), reaction times (ms), and P3 amplitude (V) and latency (ms) during target trials. Cannabis measures included lifetime use of cannabis (i.e., ever used) and age at first use. Results: High P3 amplitude, and prolonged P3 latency and reaction time were associated with a reduced hazard of cannabis initiation (All Hazards Ratio, [H.R.s]< 0.91, p's

07.
bioRxiv (Bioinfo) 2026-06-20

RNAStabFormer: Region-Aware Multi-Task Hybrid Learning for RNA Stability Prediction from Pulse-Chase Transcriptomics

Authors:

RNA stability is a central layer of post-transcriptional gene regulation, yet large-scale stability labels derived from pulse-chase transcriptomics depend strongly on quantification region, time-window definition, and replicate quality control. We present RNAStabFormer, a controlled learning framework for predicting human RNA stability proxies from transcript sequence. Its core model, RAMHT, combines region-specific nucleotide Transformer encoders for CDS, and sequence, a CDS codon stream, engineered sequence-grammar features, gated fusion, and four task-specific regression heads. We construct four strict consensus labels from ENCODE BrU-seq/BruChase-seq data by crossing gene-sense and exon-sense quantification with late-chase 6 h/2 h and total-chase 6 h/0 h retention ratios, and evaluate all models on fixed repeated-random and chromosome-holdout splits. Across chromosome holdouts, XGBoost remains the strongest standalone model, with median Pearson correlations of 0.504, 0.544, 0.546, and 0.778 on the four labels. RAMHT is competitive with raw-sequence deep models but does not universally exceed engineered-feature baselines. A strict nested RAMHT–XGBoost blend nevertheless improves gene total-chase prediction by 0.017 mean Pearson and exon late-chase prediction by 0.004 mean Pearson over XGBoost. Region and mechanism analyses show that CDS, local k-mer composition, and codon-sensitive signals dominate predictive information. RNAStabFormer therefore provides both a multi-task neural model and a leakage-controlled evaluation protocol for RNA stability prediction from pulse-chase data.

08.
arXiv (CS.AI) 2026-06-12

Proprioceptive-visual correspondence enables self-other distinction in humanoid robots

arXiv:2606.13222v1 Announce Type: cross Abstract: Distinguishing self from others is a prerequisite for social intelligence, yet humanoid robots that increasingly share workspaces with humans still lack this ability. Here we show that a humanoid robot can learn self-other distinction from proprioceptive-visual correspondence, without any identity labels or kinematic models. Once established, this distinction bootstraps a predictive self-model that maps joint configurations to three-dimensional body occupancy, capturing how the robot's body changes with action. In multi-agent scenes involving humans or morphologically identical robots, the system reliably identifies itself, learns a 3D self-model, and supports downstream tasks including target reaching, collision-aware motion planning, and human-to-robot motion retargeting. Together, these results outline a route toward bodily self-representation in robots that act and coordinate alongside others in shared physical environments. Project page: https://euron-zc.github.io/humanoid-self-model/.

09.
arXiv (CS.CV) 2026-06-16

HSQ-VLM: A Novel Spatially-Constrained Quadrant Segmentation VLM Model for Explainability in Diabetic Retinopathy

Authors:

Diabetic Retinopathy (DR) is an aggressive retinal disease and a leading cause of global blindness, yet its clinical management is currently hindered by the black-box nature of diagnostic AI. While deep learning models achieve high classification accuracy, there is a critical lack of explainability methods capable of detailing the exact anatomical landmarks and lesion distributions that lead to a clinical decision for DR. Therefore, we propose HSQ-VLM, a novel quadrant segmentation pipeline on fundus images that utilizes a Landmark-Anchored Cartesian Cross-Attention mechanism to unify visual feature extraction with structured clinical reasoning. Unlike traditional methods that rely on arbitrary image partitioning, our pipeline implements 4-quadrant Topological Latent Partitioning (TLP) to dynamically align retinal features with a fovea-centered coordinate system. This allows the Vision-Language Model to generate natural language reports that quantify pathology with anatomical precision. On a dataset of 3,500 high-resolution fundus images, this innovative methodology achieved a lesion detection sensitivity of 99.6% for hemorrhages and 96.4% for microaneurysms, while demonstrating a significant reduction in boundary-ambiguity errors compared to standard segmentation baselines.

10.
arXiv (CS.AI) 2026-06-11

AutoMine Solution for AV2 2026 Scenario Mining Challenge

arXiv:2606.11874v1 Announce Type: new Abstract: With the development of autonomous driving systems, mining high-value, safety-critical, and planning-relevant scenarios from large-scale driving logs has become essential for data-driven evaluation. In this paper, we propose AutoMine, a robust self-refining scenario mining method based on LLMs and VLMs. AutoMine uses semantics-preserving prompt augmentation to reduce LLM prompt sensitivity, combines robust trajectory atomic functions with VLM-based functions to handle perception noise and open-world visual cues, and refines generated code through execution feedback from real logs. In the Argoverse 2 Scenario Mining Competition at CVPR 2026, AutoMine achieves a HOTA-Temporal score of 36.38 and a Timestamp BA score of 77.21.

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

Schützen: Evaluating LLM Safety in Bulgarian and German Contexts

Large language models are increasingly deployed across professional domains, bringing hard-to-predict risks, including the generation of harmful or disrespectful content. Although substantial progress has been made in developing safety evaluation datasets, existing resources remain overwhelmingly English- and Chinese-centric. This limitation is particularly pronounced when evaluating languages that operate within shared sociocultural, legal, and ethical contexts. To address this gap, we introduce Sch\"{u}tzen: a German–Bulgarian safety dataset designed to assess model answerability under risk, covering both a low-resource language (Bulgarian) and a high-resource language (German). Experiments with multilingual and language-specific LLMs reveal pronounced cross-language differences in safety behavior, highlighting the necessity of tailored, region-specific evaluation resources to support the responsible deployment of LLMs in Germany and Bulgaria. Datasets and code are available at https://github.com/xnlp-lab/Schutzen. Warning: this paper contains examples that may be offensive, harmful, or biased.

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

From Benchmarks to Skills: Low-Rank Factors for LLM Evaluation

Current evaluations of large language models (LLMs) rely heavily on a growing collection of benchmarks and on aggregate benchmark scores, yet it remains unclear what this comparison actually captures, and what these scores reveal about models' underlying capabilities. Here, we propose a new paradigm for LLM evaluation, by asking whether benchmark performance reflects many independent abilities, or rather relies on a small number of shared dimensions. To answer this, we apply Factor Analysis (FA) to a massive performance matrix of LLMs versus benchmarks \((60\times44)\) revealing an intrinsically low-rank structure of that matrix. That is, a small number of latent factors captures most of the structure in the full task space. This low-rank geometry reveals substantial redundancy across existing tasks and explains why many benchmarks appear to be measuring overlapping abilities. We further show that these latent factors correspond to coherent, skill-like, dimensions of LLM behavior. Leveraging this latent skill-space, we deliver three practical tools for LLM evaluation and downstream users: (i)~identifying redundant tasks, (ii)~profiling new models using a small subset of tasks, and (iii)~selecting models aligned with desired skill profiles. Our method provides a solid alternative to the de-facto standard of a single aggregate score, and establishes an interpretable and practical framework for understanding and benchmarking LLM core capabilities.

13.
medRxiv (Medicine) 2026-06-16

Infections and suicide and self-harm: a population-based matched cohort study

Background Infections have been associated with adverse mental health outcomes, including suicide, but evidence beyond severe or central nervous system infections is limited. We investigated associations between a range of acute infections and subsequent suicide/self-harm outcomes. Methods We conducted six infection-specific matched cohort studies using English primary care records from the Clinical Practice Research Datalink Aurum (2007-2024), linked to hospital admissions and mortality data. Adults ([&ge;]18 years) with a primary care record of infection (gastroenteritis, lower respiratory tract [LRTI], skin/soft-tissue [SSTI], urinary tract [UTI], sepsis, meningitis/encephalitis [positive control]) were matched (age, sex, practice, calendar period) to up to five comparators without infection. We estimated hazard ratios (HRs) for suicide/self-harm outcomes using Cox regression, stratified by matched set and implicitly adjusting for matching factors, with additional adjustment for deprivation, lifestyle factors, and comorbidities. We examined whether associations varied over time, by infection severity, antimicrobial treatment, sex, and prior mental health conditions. Findings Cohorts ranged from 18,192 individuals with meningitis/encephalitis (matched to 90,915 without) to 398,099 with SSTI (matched to 1,743,747). After adjustment, individuals with infection had a higher hazard of suicide/self-harm outcomes than comparators across all cohorts: sepsis (HR 1.79, 95% CI 1.65-1.93), gastroenteritis (1.62, 1.55-1.70), meningitis/encephalitis (1.56, 1.32-1.84), UTI (1.41, 1.33-1.50), SSTI (1.37, 1.31-1.43), and LRTI (1.37, 1.31-1.44). Risk was highest in the year post-infection, attenuating over time, and was higher among severe infections and those without prior mental health conditions. Interpretation Common acute infections recorded in primary care are associated with increased risk of suicide and self-harm, particularly following severe infections and in the year post-infection. Findings support suicide risk monitoring following acute infection, particularly among individuals without prior mental health conditions, and highlight infection prevention as a potentially modifiable strategy in vulnerable populations. Funding Wellcome and La Caixa. Copyright This work is licensed under a Creative Commons Attribution (CC BY) licence.

14.
arXiv (CS.LG) 2026-06-19

Sparsity, Superposition, and Forgetting: A Mechanistic Study of Representation Retention in Continual Learning

arXiv:2606.20431v1 Announce Type: new Abstract: Continual learning (CL) systems often forget previously acquired knowledge, yet the mechanisms driving forgetting remain hard to isolate in practice because real datasets entangle many factors. We present a controlled, toy-world framework that makes these mechanisms observable and testable. Using a synthetic generator-separator pipeline, we define ground-truth latent features, build tasks with tunable sparsity and overlap, and introduce measurable quantities for representation strength and superposition (directional overlap among features). We then study retention dynamics-the temporal change of representation strength by fitting sparse dynamical relations (via SINDy) between retention, superposition, and exposure history. A complementary task-level analysis based on effective rank characterizes how representational capacity is allocated across tasks. Our controlled experiments yield three takeaways. (1) Superposition tends to increase over time with transient dips at task boundaries, suggesting boundary-specific interference rather than steady drift. (2) Higher feature sparsity induces more superposition yet does not inevitably cause forgetting; when representations remain strong, forgetting can be reduced despite overlap. (3) Task-level effective rank grows with sparsity, indicating broader capacity usage under sparse regimes. Together, these results nuance the common intuition that more superposition leads to more forgetting by showing that overlap interacts with representation strength and capacity allocation. Our toy analysis provides falsifiable hypotheses and diagnostic tools for CL.

15.
arXiv (CS.CL) 2026-06-12

ProPlay: Procedural World Models for Self-Evolving LLM Agents

Self-evolving agents are expected to improve through interaction without external supervision, but this remains difficult in partially observable environments where agents must explore actively, learn from limited feedback, and decide when to trust prior experience. Existing LLM-agent methods often rely on memory or planning modules, yet they rarely close the loop between them to continually refine an internal understanding of environment dynamics. We introduce ProPlay, a procedural world model that supports procedure-level preplay, where agents can rehearse future procedural paths using the learned world knowledge. Rather than representing experience as isolated rules or low-level action constraints, ProPlay abstracts successful trajectories into procedures and organizes them in a procedure graph that captures causal transitions among task stages. Each transition is associated with a reliability record embedding to estimate its task-specific contribution from past outcomes. Before each episode, ProPlay simulates future procedural trajectories over known graph structures as structured soft guidance; after execution, it refines the graph using environment feedback. Experiments on public benchmarks show that ProPlay consistently improves environment understanding and self-evolution capability over strong baselines. Our code has been released in https://github.com/antman9914/proplay.

16.
arXiv (quant-ph) 2026-06-17

Microwave-free vector magnetometry and crystal orientation determination with Nitrogen-Vacancy centers using Bayesian inference

arXiv:2512.13835v2 Announce Type: replace Abstract: Nitrogen-vacancy (NV) centers in diamond provide a solid-state platform for quantum sensing. While optically detected magnetic resonance techniques offer high sensitivity, their reliance on microwaves introduces heating and stray electromagnetic fields that can perturb nearby samples. Optical approaches based on cross-relaxation between differently oriented NV centers remove this constraint but have so far required stringent alignment of the external field with crystallographic axes, restricting their practicality. Here we introduce a general framework for microwave-free vector magnetometry at near-zero field that leverages Bayesian inference to extract both the magnetic field vector and the NV orientation directly from photoluminescence maps. An analytical model of cross-relaxation resonances enables efficient inference under arbitrary field and orientation configurations, while naturally incorporating the discrete degeneracies of the NV symmetry. We experimentally demonstrate robust orientation determination and vector-field reconstruction, establishing a general route toward compact and alignment-free NV magnetometers for practical sensing applications.

17.
arXiv (CS.LG) 2026-06-16

Analytic Torsion and Spectral Gap Capture Persistent-Laplacian Performance

arXiv:2606.16990v1 Announce Type: new Abstract: While persistent Laplacians (PL) offer a richer geometric representation of data than persistent homology, utilizing their full eigenspectrum for learning tasks is often hampered by high dimensionality and the ``varying length'' problem across different filtration scales. We propose a compact spectral representation that distills the persistent Laplacian into three mathematically grounded invariants: Betti numbers, the spectral gap, and analytic torsion. Across benchmark datasets including MNIST, QM-3D, and SKEMPI WT, we demonstrate that this reduced feature space captures the essential predictive signal of the full spectrum, and in some cases outperforms it, while significantly reducing computational overhead and preventing the noise introduced by higher-frequency eigenvalues. Our results suggest that these invariants provide a principled, fixed-length interface between spectral geometry and topological learning.

18.
medRxiv (Medicine) 2026-06-15

Routine use of oral iron for people with heart failure and iron deficiency in primary care; retrospective cohort study

Aims: Iron deficiency is common among people with heart failure and associated with morbidity and mortality. While intravenous iron improves clinical outcomes, oral iron continues to be prescribed in routine practice despite limited evidence of benefit. Methods: We completed a retrospective primary care cohort study (2016 to 2021) to investigate the proportion of people with an incident diagnosis of heart failure who had iron deficiency identified (defined as ferritin

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

Will AI Agents Free Us From Meaningless Work? A Human-Centered Analysis

arXiv:2606.12430v1 Announce Type: cross Abstract: Some claim that AI agents will free workers from the boring parts of their jobs, yet little is known about how workers themselves identify which tasks should be automated. Prior research focuses on occupations, overlooking that workers experience varying levels of meaning across tasks within the same role. We address this gap with a task-level analysis grounded in Graeber's theory of bullshit jobs. Using ratings from 202 workers on 171 workplace tasks, we (1) validate a five-item scale of perceived bullshitness, (2) show that perceived bullshitness strongly predicts desire for AI delegation, and (3) find that such tasks are also seen as requiring less human oversight. Together, these findings suggest that tasks perceived as bullshit are natural candidates for AI delegation, aligning worker preferences with perceived feasibility.

20.
arXiv (quant-ph) 2026-06-16

Scalable generation of heralded single photons via active feed-forward switching of a fiber delay line

arXiv:2606.16741v1 Announce Type: new Abstract: Quasi-deterministic single-photon generation is a key requirement for many photonic quantum technologies. Photon sources based on spontaneous parametric down-conversion (SPDC) are widely used for producing high-quality photons; however, the probabilistic nature of the process limits the generation of synchronized multi-photon states. Here, we demonstrate temporal synchronization of multiple photon-generation events using a free-space-fiber hybrid delay line with feed-forward control, enabling fast and efficient switching and scalable operation. Narrow-band, telecom-wavelength photons compatible for fiber transmission are heralded from a monolithic cavity SPDC source and synchronized across 20 time bins. This yields a sixfold enhancement in synchronized rates and enables multi-photon synchronization, with only a marginal increase of higher-order photon-number contributions.

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

Double-Helix Vision (DH-V2): A Geometry-Based Visual Sampler for Bandwidth-Constrained Perception

Authors:

We present Double-Helix Vision (DH), a geometry-based visual sampler that compresses 2D images into compact 1D signals using paired golden-ratio-inspired spiral trajectories. Rather than processing every pixel uniformly, DH employs two phase-shifted helices (Alpha and Beta, offset by 180 degrees) to sample the image with biologically-inspired foveation: high density at the center, sparse coverage at the periphery. At 4K resolution, DH achieves a 1,433x compression ratio (99.93% reduction) while preserving the geometric structure of the scene. The full perception pipeline – including spatial mapping, temporal collision detection, and intra-frame structural disparity estimation – runs in 0.52 ms at 1080p on CPU-only hardware, with no neural network dependencies. On CIFAR-10 at extreme sampling budgets (K=128 points per helix), DH achieves a +6.03% accuracy gain over uniform random sampling. A JSON-serializable Robotics API is provided, delivering sub-millisecond spatial perception reports in 2.7 KB packets. Code and benchmarks are available under the MIT License.

22.
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.

23.
arXiv (CS.LG) 2026-06-16

Functional Gradient Descent with Adaptive Representations

arXiv:2606.16926v1 Announce Type: cross Abstract: Functional optimization problems are typically solved by optimizing the parameters of a fixed representation, such as a neural network, resulting in highly nonconvex losses that complicate both training and theoretical analysis. An interesting alternative is functional gradient descent (FGD), that is, gradient descent directly in function space, which benefits from strong convergence results and admits a clean theory. However, FGD is difficult to implement in practice because functional gradients are infinite-dimensional, and thus cannot be fully computed nor stored in memory. Existing implementations therefore rely on fixed approximations, which introduce approximation error. We propose a new, theoretically-grounded FGD algorithm that adapts the representation of the functional gradients over the course of optimization. By explicitly incorporating this approximation into the analysis, we establish convergence to a stationary point (for smooth losses) and to a global minimizer (under smoothness + a Polyak-Lojasiewicz-type condition) regardless of our approximations. To the best of our knowledge, this is the first implementable FGD method with such guarantees in a general setting. We demonstrate the effectiveness of our method on regression, numerical solution of PDEs, and modern computer vision. Across settings, our method consistently outperforms both FGD with fixed approximations and neural network baselines in efficiency and accuracy.

24.
medRxiv (Medicine) 2026-06-18

Age as a moderator of a brief alcohol intervention among injury patients in Northern Tanzania

Background: Alcohol use is a leading modifiable risk factor for injury in sub-Saharan Africa. In Tanzania, young people ([&le;]24 years) experience greater alcohol-related harm despite drinking less frequently than adults. Punguza Pombe kwa Afya Yako (PPKAY) is a culturally adapted, brief intervention for injury patients in Tanzania. This study examined whether age moderates its effectiveness. Methods: We conducted an exploratory secondary analysis of baseline and 3-month data from the PPKAY randomized trial among injury patients aged [&ge;]18 years at Kilimanjaro Christian Medical Centre, Tanzania. Eligible participants reporting alcohol use before injury, AUDIT [&ge;]8, or positive breathalyzer were randomized to usual care or PPKAY with SMS boosters. The primary outcome was binge drinking days. Count outcomes were analyzed using negative binomial regression with robust SEs and continuous outcomes using mixed-effects models. Effect modification was assessed using a three-way interaction (Time x intervention x Age). Results: Among 543 participants (mean age 36.8 years; 16.2% aged 18–24), age moderated the intervention effect for drinking days (IRR = 0.27, 95% CI 0.07 – 0.98; p = 0.046) and drinks consumed (IRR = 0.17, 95% CI 0.04 – 0.77; p = 0.021). The intervention reduced 4 drinking days (95% CI -7.1 to -0.8) and 27.5 drinks (95% CI -42.8 to -12.2) among young people, while adults showed reductions in both arms, without intervention-specific effect. Conclusion: The effects of ED-based brief alcohol interventions are not uniform, varying across both age groups and alcohol-related outcomes. We found a greater responsiveness in drinking frequency and quantity reported among young people.

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

Learn-to-learn on Arbitrary Textual Conditioning: A Hypernetwork-Driven Meta-Gated LLM

Conventional LLMs may suffer from corpus heterogeneity and subtle condition changes. While finetuning can create the catastrophe forgetting issue, application of meta-learning on LLMs is also limited due to its complexity and scalability. In this paper, we activate the meta-signal of $\beta$ within the SwiGLU blocks, resulting in a meta-gating mechanism that adaptively adjusts the nonlinearity of FFN. A hypernetwork is employed which dynamically produces $\beta$ on textual conditions, providing meta-controllability on LLMs. By testing on different condition types such as task, domain, persona, and style, our method outperforms finetuning and meta-learning baselines, and can generalize reasonably on unseen tasks, condition types, or instructions. Our code can be found in https://github.com/AaronJi/MeGan.