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01.
PLOS Medicine 2026-05-08

Climate change and non-communicable diseases: An invisible syndemic

Authors:
Gokul Parameswaran↗

by Gokul Parameswaran, Sadeer Al-Kindi, Sanjay Rajagopalan Climate change accelerates non-communicable diseases (NCDs) through cascading environmental disruptions and is attributed to driving increased NCD-related mortality. Yet this syndemic remains invisible and underfunded. We detail why addressing the climate-NCD intersection is critical for improving health. In this Perspective, Sanjay Rajagopalan and colleagues discusses how climate change accelerates non-communicable diseases (NCDs) and exacerbates NCD-related mortality, and calls for greater visibility and funding to address this syndemic and improve human health.

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02.
arXiv (CS.LG) 2026-06-15

A Complexity Measure for Active Learning in Multi-group Mean Estimation

Authors:
Abdellah Aznag↗Rachel Cummings↗Adam N. Elmachtoub↗

arXiv:2606.14690v1 Announce Type: new Abstract: We study a max-risk objective for active learning in a multi-group mean estimation $d$-armed bandits: a learner adaptively allocates a budget of $T$ samples across $d$ groups to minimize the worst-case uncertainty index $\max_{k\in[d]}\sigma_k^2/n_k$, where $\sigma_k$ is the standard deviation of the distribution of arm $d$, and $n_k$ is the number of times arm $d$ is sampled. We develop a local minimax framework and prove the first general lower bound for this objective, valid for any finite-variance hypothesis class. The bound separates difficulty into three orthogonal factors: a budget term, a heteroscedasticity index measuring how unevenly the uncertainty is spread across arms, and a model-dependent complexity measure, the Variance Local Curvature ($\mathrm{VLC}$), which captures how much information a local change of variance creates inside the hypothesis class. For smooth classes, the $\mathrm{VLC}$ is a reparametrization of a variance–Fisher information, with closed-form values for common families. Benchmarking against the strongest available upper bound shows near-optimality up to logarithmic factors in broad regimes, and pinpoints a systematic gap in highly heterogeneous instances. Our proof introduces two key ingredients: a loss-induced $\ell_1$ geometry on the decision space, and a representation-based instance generator that reduces hard-instance construction to an explicit random matrix calculation.

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

On the Oracle Complexity of Interpolation-Based Gradient Descent

Authors:
Dongmin Lee↗William Lu↗Anuran Makur↗

arXiv:2606.19878v1 Announce Type: new Abstract: Recent work on first-order optimizers for empirical risk minimization (ERM) has suggested that smoothness of ERM loss functions in the training data, rather than in the optimization parameters, can be leveraged to improve the oracle complexity of gradient descent (GD) methods. In this paper, we propose an inexact gradient method, piecewise polynomial interpolation-based gradient descent (PPI-GD), which approximates the full gradient in each iteration by querying the first-order oracle at equidistant points in the data domain to construct polynomial interpolants of the resulting gradient samples over appropriately sized patches of the data domain. We analyze the oracle complexity of PPI-GD for strongly convex and non-convex loss functions when the data space dimension is bounded by a polylogarithmic function of the number of training samples, and find it to outperform several GD variants in key regimes when the loss function is sufficiently smooth. Furthermore, our analysis extends several techniques from the error analysis of bicubic spline interpolants to the setting of $d$-variate tensor product polynomial interpolants which may be of independent interest in interpolation analysis.

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04.
arXiv (CS.AI) 2026-06-17

Comprehensive pKa Data Augmentation from Limited Real Data through an Engineered Models-Quantum Framework

Authors:
Wang Rui↗Liu Dinghao↗

arXiv:2606.17077v1 Announce Type: cross Abstract: Proton dissociation constants (pKa) are critical for functional molecule discovery and molecular modeling. Building on iBonD, the largest experimental pKa database established, we and other researchers have developed several methods including machine-learning-based empirical prediction and high-accuracy energy calculations. Despite this foundation, the rapid augmentation of high-quality pKa data remains fundamentally constrained. As part of this work, we performed large-scale regression-based pKa prediction on unlabeled molecular datasets using a collection of extensively optimized machine-learning models. The results indicate that, since the feature distributions of unlabeled molecular datasets, the pKa data distribution approximates normality, with extreme scarcity of tail-region samples. Although such augmentation is highly valuable for improving overall data availability and predictive modeling, it remains insufficient for efficiently discovering molecules with broad-spectrum pKa properties. To address this, we explore the targeted generation of molecules with sparse pKa properties from the vast chemical space. Given that traditional continuous latent space VAE-RNN methods for molecular generation suffer from insufficient stability and fail to demonstrate clear advantages in complementing sparse data, we design and implement a quantum-assisted sparse-pKa molecular generation. Feasibility is validated on a simulated quantum annealer, and superior extreme-value sampling is further achieved on physical coherent Ising machines (CIMs). (to be continued)

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

Federated Medical Image Segmentation under Real-World Label Noise: A Benchmark Suite for Noisy Label Learning Method Selection

Authors:
Markus Bujotzek↗Dimitrios Bounias↗Stefan Denner↗Ralf Floca↗Maximilian Fischer↗Peter Neher↗Klaus Maier-Hein↗

While federated learning (FL) enables collaborative medical image segmentation without centralizing sensitive data, real-world deployment is frequently complicated by cross-site label imperfections such as contour disagreement, missing or additional structures, and confused labels. Federated noisy label learning (FNLL) aims to mitigate these effects, yet remains underused in practice as existing evidence is largely based on synthetic noise, simplified settings, and limited real-world noisy evaluation. We address this gap by introducing a benchmark suite that combines diverse real-world noisy datasets, deployment-relevant client-noise scenarios, and label-noise-targeted evaluation to support systematic FNLL assessment and informed method selection. The suite combines curated real-world noisy medical image segmentation datasets from diverse sources with a comprehensive federated segmentation framework including various client-noise scenarios and noise-targeted evaluation. The presented suite provides a realistic and discriminative basis for FNLL evaluation in medical image segmentation and establishes a reusable foundation for fair benchmarking, dataset-specific label-noise characterization, and future method development under realistic federated settings. Code is available at https://github.com/MIC-DKFZ/FedSegNoiseBench.

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

Minimal surfaces, Knots, and Neural Networks

Authors:
Tancredi Schettini Gherardini↗Marco Usula↗

arXiv:2605.26234v2 Announce Type: replace-cross Abstract: A recent conjecture by Joel Fine posits a relationship between the coefficients of the HOMFLY polynomial of a knot $K$ in the 3-sphere $S^3$, and the signed count of minimal surfaces in hyperbolic 4-space $\mathrm{H}^4$ meeting the sphere at infinity at $K$, with prescribed genus and self-intersection number. In this paper, we develop a novel machine learning framework based on Physics-Informed Neural Networks (PINNs) to solve the minimal surface equation in hyperbolic space. We utilise this framework to test Fine's Conjecture by constructing near-minimal surfaces bounding various families of knots in $S^3$. Furthermore, we develop an algorithmic method to find self-intersections and compute their sign. For every knot analysed, the computationally discovered minimal surfaces and their self-intersection numbers perfectly align with the predictions of Fine's Conjecture, providing empirical evidence for it.

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07.
arXiv (quant-ph) 2026-06-15

Spin mixing induced dynamics of spinor solitons in $F=1$ Bose Einstein condensates

Authors:
T. Panagos↗A. Romero-Ros↗G. C. Katsimiga↗P. Schmelcher↗P. G. Kevrekidis↗

arXiv:2606.14231v1 Announce Type: cross Abstract: We explore soliton interactions in a homogeneous spinor $F=1$ Bose Einstein Condensate (BEC) in the presence of a magnetic field, focusing on dark bright dark and bright dark bright configurations. We investigate how these interactions depend on the phase differences among bright solitons and their influence during the dynamics. Our findings align with prior non spinor results, i.e., repulsion among in phase bright solitons and attraction among out of phase pairs in self repulsive atomic BECs. The potential bright soliton attraction, added to the short range repulsion of dark dark soliton interactions, can lead to bound states. However, we find that these bound states break in the presence of spinor interactions due to the particle exchange dynamics between the hyperfine states of the components. Additonally, we develop an effective classical model to describe the soliton dynamics, using a Lagrangian approach. The accuracy of the model is tested by comparing it against numerical simulations. Our results suggest that the proposed model captures the essential features of soliton behavior in the presence of spin interactions, and provides congruent soliton trajectories and interspecies particle exchange dynamics in most of the cases.

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08.
medRxiv (Medicine) 2026-06-22

Association of Digoxin Use at Norwood Discharge with Fontan Completion: A Study from the Pediatric Heart Network Public Dataset

Authors:
Aljiffry↗Jergel↗Xiang↗Oster↗M. E↗Kochilas↗L. K↗

Background: Digoxin use after the Norwood procedure has been associated with improved interstage survival in hypoplastic left heart syndrome and related conditions. Whether this benefit translates into improved longer-term outcomes through staged palliation remains unknown. We aimed to determine the association of digoxin use at Norwood discharge with transplant-free survival and Fontan completion. Methods: We conducted a retrospective cohort study using the Pediatric Heart Network (PHN) Single Ventricle Reconstruction trial public dataset, including 549 infants enrolled at 15 North American centers between 2005 and 2008. Competing risk analysis was used to evaluate Fontan completion and Cox regression to assess death or transplantation within 6 years after the Norwood procedure. Mixed-effects models compared pre-Fontan hemodynamic and echocardiographic right ventricular indices between patients treated with and without digoxin after accounting for center clustering and adjustment for sex, shunt type, heart failure medications at Norwood discharge, and census block poverty level. Results: The 6-year cumulative incidence of Fontan completion was higher among patients discharged on digoxin than among those not receiving digoxin (82% vs 71%; p = 0.013). Competing-risk analysis accounting for death and transplant demonstrated a greater likelihood of Fontan completion among digoxin users (aHR 1.31; 95%CI 1.09-1.58; p = 0.005), without significant difference in the hazard of death or transplant (aHR 0.78; 95%CI 0.53-1.15; p = 0.208). No significant differences in pre-Fontan hemodynamic or echocardiographic indices were observed between groups. Initiation of digoxin post Stage II procedure was not associated with improved survival or likelihood to complete Fontan. Conclusion: Digoxin use at the time of Norwood discharge was associated with a 30% greater likelihood of Fontan completion by 6 years, without accompanying improvement in transplant-free survival. These findings extend prior observations of improved interstage outcomes associated with digoxin use and suggest that treatment may facilitate progression through staged palliation.

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09.
arXiv (CS.LG) 2026-06-17

Eigen-Spike Emergence and Quadratic Equivalents for Conjugate Kernels on Nonlinearly Separable Data

Authors:
Collin Cranston↗Zhichao Wang↗Todd Kemp↗Michael W. Mahoney↗

arXiv:2605.29669v2 Announce Type: replace-cross Abstract: Recent work in random matrix theory (RMT) has developed the notion of deterministic equivalents: typically linear surrogate models that approximate the spectral behavior of large nonlinear random matrices, such as nonlinear feature maps in neural networks (NNs). Such equivalents make theoretical predictions tractable by reducing a complex model to a simpler one with properties that fall under the umbrella of classical RMT tools. However, this leaves open the question of whether this idealized linear equivalence remains meaningful for classification of high-dimensional nonlinearly separable data. Motivated by this, we consider the conjugate kernel (CK), which is the nonlinear feature map of a one-layer feedforward NN, under a canonical nonlinearly separable dataset for the XOR problem; and we use the study of informative outlier eigenvalues in the CK and whether their corresponding eigenvectors asymptotically align with XOR labels as a proxy for nonlinear learnability. We develop a robust quadratic equivalent of the CK matrix that enables a precise analysis of emergent informative spikes, as one modifies various knobs common in ML practice: sample complexity, signal-to-noise ratio (SNR), nonlinear activation choice, and pretrained features. We identify regimes in which these knobs move the CK beyond the linear equivalent and produce BBP-type transitions to label-aligned outlier eigenspaces. Our analysis helps bring deterministic-equivalence tools from RMT to bear on problems of practical relevance in ML.

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10.
arXiv (CS.AI) 2026-06-16

Greed Is Learned: Visible Incentives as Reward-Hacking Triggers

Authors:
Tong Che↗Rui Wu↗

arXiv:2606.16914v1 Announce Type: new Abstract: Deployed agents increasingly act with their reward proxy in view, such as a balance, score, or KPI dashboard. We show that reinforcement learning can make a policy addicted to such a visible self-benefit channel. It chases the displayed payoff across held-out domains, sacrifices the true task to do so, and follows the channel wherever we rewrite it, while policies that never saw the channel stay honest. We call this reward-channel addiction and study it in MoneyWorld, a synthetic sandbox. The addiction can flip a model's safety alignment: trained only on innocuous money tasks with no safety content, the model abandons the safe action it otherwise always takes whenever a dashboard pays for an unsafe one, and reverts to safe once the channel is hidden. This learned bribe replicates across model scales and families. Blindly optimizing super-capable, next-generation AI on KPIs or P\&L can be dangerous for alignment. Greed is learned when following such a channel pays.

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

Theoretical Grounding of Out-Of-Distribution Detection With Reinforcement Learning Optimizer

Authors:
Salimeh Sekeh↗Xin Zhang↗

Out-of-distribution (OOD) detection in dynamic open-world environments requires a model to continually adapt to evolving data distributions while generalizing to covariate-shifted inputs and rejecting semantic-shifted OOD examples. Most existing OOD detection methods optimize only the current-step objective and do not explicitly account for how post-deployment environment changes affect future OOD behavior. In this paper, we establish a theoretical grounding for dynamic OOD detection using a reinforcement learning (RL)-guided optimizer that explicitly favors updates that reduce the semantic OOD false positive rate over time. We develop a novel augmented optimizer that uses an RL-guided correction term on top of standard gradient descent (GD) and show its improvement over both future-domain generalization and semantic-OOD rejection. We analyze temporal error decomposition in terms of model-change and environment-change generalization errors and develop a new theoretical framework for comparing the generalization errors under both GD and RL-guided optimizers.

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

Mask, Sample, Revise: A Revisable CTMC Inference Stack for Guided Discrete Flow Matching Text-to-Speech

Authors:
Alef Iury Siqueira Ferreira↗Lucas Rafael Stefanel Gris↗Luiz Fernando de Ara\'ujo Vidal↗Frederico Santos de Oliveira↗Christopher Dane Shulby↗Anderson da Silva Soares↗Arlindo Rodrigues Galv\~ao Filho↗

arXiv:2606.13989v1 Announce Type: cross Abstract: Recent alignment-free non-autoregressive (NAR) text-to-speech (TTS) models formulate synthesis as a conditional infilling task, bypassing explicit duration predictors and external aligners. When speech is represented with neural codec tokens, the infilling problem becomes discrete, making Discrete Flow Matching (DFM), a Continuous-Time Markov Chain (CTMC) framework for discrete generation, a natural fit. However, inference-time control for stable low-step conditional infilling remains underexplored. We propose Mask, Sample, Revise, an inference-time CTMC stack for alignment-free DFM-TTS. The stack combines predictor-free guidance to strengthen text conditioning, prompt-matched conditional coupling to align the probability path with the acoustic prompt, and SC-ReMask, a schedule-constrained remasking mechanism that introduces token-to-mask transitions so early de-masking decisions can be revised. These components require no post-hoc fine-tuning and operate in a single tau-leaping sampler. Controlled ablations show that this stack improves intelligibility and robustness in the low-NFE prompted setting, outperforming unguided and guidance-only samplers with substantially more steps.

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13.
arXiv (CS.CV) 2026-06-16

3D Classification of Paramagnetic Rim Lesions in Multiple Sclerosis via Asymmetric QSM-FLAIR Modeling

Authors:
Veronica Pignedoli↗Giacomo Boffa↗Nicoletta Noceti↗Matilde Inglese↗Francesca Odone↗Matteo Moro↗

Paramagnetic rim lesions (Rim$^+$) identified on susceptibility-sensitive MRI have recently emerged as a specific biomarker of chronic active inflammation in Multiple Sclerosis (MS) and are associated with long-term disability progression. However, susceptibility imaging and expert interpretation remain limited to specialized centers, visual assessment is time-consuming and variable, and the low prevalence of Rim$^+$ lesions poses severe class imbalance challenges for automated analysis. We propose a 3D multimodal deep learning framework for lesion-level Rim$^+$/Rim$^-$ classification from Quantitative Susceptibility Mapping (QSM) and FLAIR MRI. The architecture explicitly models modality asymmetry by treating QSM as the primary susceptibility-driven signal and conditioning it with FLAIR-derived structural context. To improve robustness under limited data, we employ self-supervised multimodal pretraining followed by supervised fine-tuning with contrastive regularization. The method was evaluated on a clinically acquired cohort of 88 people with MS with expert lesion annotations as reference standard. Results highlight improved performance compared to prior architectures, supporting the effectiveness of asymmetric multimodal modeling for automated chronic active lesion identification.

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14.
arXiv (CS.CV) 2026-06-11

ReMoT: Reinforcement Learning with Motion Contrast Triplets

Authors:
Cong Wan↗Zeyu Guo↗Jiangyang Li↗SongLin Dong↗Yifan Bai↗Lin Peng↗Zhiheng Ma↗Yihong Gong↗

We present ReMoT, a unified training paradigm to systematically address the fundamental shortcomings of VLMs in spatio-temporal consistency – a critical failure point in navigation, robotics, and autonomous driving. ReMoT integrates two core components: (1) A rule-based automatic framework that generates ReMoT-16K, a large-scale (16.5K triplets) motion-contrast dataset derived from video meta-annotations, surpassing costly manual or model-based generation. (2) Group Relative Policy Optimization, which we empirically validate yields optimal performance and data efficiency for learning this contrastive reasoning, far exceeding standard Supervised Fine-Tuning. We also construct the first benchmark for fine-grained motion contrast triplets to measure a VLM's discrimination of subtle motion attributes (e.g., opposing directions). The resulting model achieves state-of-the-art performance on our new benchmark and multiple standard VLM benchmarks, culminating in a remarkable 25.1% performance leap on spatio-temporal reasoning tasks.

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15.
arXiv (quant-ph) 2026-06-16

Gaussian superpositions for bosonic encodings

Authors:
Federico Centrone↗Juan Pablo Paz↗Augusto Roncaglia↗

arXiv:2603.15258v2 Announce Type: replace Abstract: Non-Gaussian bosonic states are ubiquitous in interacting light–matter systems, many-body platforms, and relativistic quantum field settings, but their quantitative characterization is hindered by the infinite-dimensional Hilbert space and by the poor scalability of Fock-space truncation methods. We introduce an exact finite-manifold encoding for states supported on a finite span of Gaussian branches, enabling the use of standard finite-dimensional quantum-information tools directly on an effective density matrix whose entries are determined by Gaussian overlaps. As demonstrations, we obtain closed-form and numerically stable evaluations of entropies and relative-entropy non-Gaussianity, and derive an analytic expression for the bipartite entanglement negativity of arbitrary multimode two-branch Gaussian superpositions, including a minimal which-branch dephasing model. Our framework provides a practical bridge between experimentally accessible continuous-variable resources (e.g., cat-like and measurement-conditioned states) and discrete-variable information measures, with immediate applications to benchmarking non-Gaussian resources in several quantum technology platforms.

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16.
arXiv (quant-ph) 2026-06-11

Linear Combination of Hamiltonian Simulation with Commutator Scaling

Authors:
Junaid Aftab↗Dong An↗Konstantina Trivisa↗

arXiv:2606.11475v1 Announce Type: new Abstract: The Linear Combination of Hamiltonian Simulation (LCHS) framework simulates dissipative linear dynamics by representing time evolution as an integral over unitary operators, which is discretized by quadrature and implemented via Hamiltonian simulation. While existing analyses achieve near-optimal scaling in time and precision using norm-based quantities of the dissipative generator, we show that implementing the Hamiltonian simulation steps with Multi-Product Formulas (MPFs) yields commutator-sensitive error and complexity bounds. We demonstrate that the quadrature rule affects not only discretization error but also commutator structure and query complexity. This dependence is quantified through post-quadrature analysis for abstract MPF error profiles and for general time-independent and local Hamiltonians using known commutator-sensitive MPF error estimates. We compare uniform trapezoidal and free-scale sinh–sinh quadrature, showing improved quadrature-cardinality scaling for the latter, and illustrate the framework with applications to fractional diffusion, advection–diffusion, and open quantum systems.

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

A Tool for the Synthesis of Adaptive Probabilistic Processors Based on the Ising Model

Authors:
Jonathan Juracy Carneiro da Silva↗Leonardo R. Gobatto↗Jose Rodrigo Azambuja↗

arXiv:2606.19533v1 Announce Type: cross Abstract: This work presents a tool for the synthesis and simulation of probabilistic architectures for solving combinatorial optimization problems by mapping them to the Ising model. The proposed approach automatically constructs the Ising Hamiltonian and determines the number of probabilistic elements (p-bits) based on problem characteristics such as size and topology. Furthermore, the tool introduces an adaptive strategy for selecting the most suitable update algorithm among Gibbs Sampling, Simulated Annealing (SA), Simulated Quantum Annealing (SQA), and cluster-based methods. Experimental results using benchmark problems demonstrate improved convergence behavior and flexibility compared to fixed approaches. The proposed framework enables systematic evaluation of probabilistic computing strategies and supports the development of future hardware implementations based on MTJs and p-bits.

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18.
arXiv (CS.AI) 2026-06-17

Brick-DICL: Dynamic In-Context Learning for Automated Brick Schema Classification

Authors:
Yiyue Qian↗Shinan Zhang↗Huan Song↗Negin Sokhandan↗Hannah Marlowe↗Diego Socolinsky↗

arXiv:2606.17637v1 Announce Type: new Abstract: Building Management Systems (BMS) are essential for optimizing energy efficiency and operational performance in modern buildings. However, the lack of standardization across BMS points from different manufacturers creates significant barriers to integration and data utilization. While the Brick schema offers a standardized ontology for building systems, mapping BMS points to appropriate Brick classes presents three critical challenges: (i) the extensive number of Brick classes (936 in the latest version), (ii) limited domain-specific knowledge in large language models (LLMs), and (iii) substantial manual effort required for verification. To address these challenges, we propose Brick-DICL, a two-stage dynamic in-context learning framework for automated Brick schema classification. Brick-DICL consists of two primary components: metadata-RAG, which retrieves relevant examples to enhance LLMs' domain knowledge, and class-RAG, which narrows down potential Brick classes to address the large classification space. Additionally, we implement a multi-LLM filtering mechanism that compares predictions across multiple models, flagging low-confidence classifications for human review. As a result: (i) General: Brick-DICL is applicable to any building management system regardless of manufacturer or metadata format; (ii) Novel and Powerful: as the first dynamic in-context learning approach for Brick schema classification, Brick-DICL achieves significant classification accuracy improvements on building datasets, outperforming existing methods; (iii) Efficient: our multi-LLM filtering strategy reduces manual verification effort, enabling rapid digital building onboarding. Extensive experiments demonstrate Brick-DICL's effectiveness across diverse building datasets, accelerating the path toward standardized, interoperable building management systems.

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

Adaptive Multi-Resolution Procedural Knowledge Compression for Large Language Models

Authors:
Changyue Wang↗Weihang Su↗Qingyao Ai↗Yichen Tang↗Runzhong Qiao↗Xuancheng Li↗Min Zhang↗Yiqun Liu↗

Large language models (LLMs) are widely used to tackle complex tasks with autonomous workflows. Recently, reusable natural language skills have emerged as a popular paradigm to inject procedural knowledge into LLM applications. Since popular skills are often invoked repeatedly, placing their full text in every context significantly increases prefill cost and latency. While text compression techniques have the potential to solve this problem, most existing methods are designed to compress factual knowledge in documents instead of procedural knowledge, making them insufficient for skill compression. In this paper, we argue that an effective skill compression method should: 1) preserve logical dependencies among workflows and tool protocols, 2) enable lightweight, offline compression for frequently updated community skills, and 3) be adaptable to varying complexities across skills. To address this, we present SKIM (SKIll coMpression), an adaptive multi-resolution soft token compression framework for procedural skills. Depending on the complexity of each skill, SKIM creates different numbers of soft tokens that not only improve the efficiency of LLM inference, but also preserve the effectiveness of skill usage. Experiments indicate that SKIM compresses skills to 30 to 60 percent of their original token length while preserving task performance better than existing compression methods.We have released our code at https://github.com/bebr2/SKIM .

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20.
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

Authors:
Nalwanga↗Clements↗Musiime↗Mulenga↗Mujuru↗H. A↗Sidat↗Buck↗W. C↗Madhi↗Bielicki↗J. A↗…

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.

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21.
arXiv (CS.CV) 2026-06-19

TimeProVe: Propose, then Verify for Efficient Long Video Temporal Reasoning in Activities of Daily Living

Authors:
Arkaprava Sinha↗Dominick Reilly↗Siddharth Krishnan↗Hieu Le↗Srijan Das↗

Long Video Question Answering (LVQA) requires identifying sparse, query-relevant evidence within hours-long untrimmed videos. Existing approaches either process videos densely with large vision-language models (VLMs), incurring prohibitive computational cost, or rely on sparse caption-based reasoning, which often misses temporally localized and motion-centric evidence. We introduce TimeProVe, a cost-efficient hybrid framework for temporally grounded reasoning in long videos. TimeProVe first employs lightweight modules to generate action-grounded answer–evidence hypotheses and subsequently invokes an expensive VLM only for targeted verification. The core of our framework lies in the Action-based Candidate Evidence (ACE) module, which converts temporally localized actions into query-conditioned candidate answers and supporting evidence windows through lightweight LLM reasoning. We further introduce OpenTSUBench (OTB), an open-ended benchmark designed to evaluate temporally grounded reasoning in real-world Activities of Daily Living (ADL) scenarios. Experiments show that TimeProVe outperforms the strongest baseline on OTB by 7.3%, while reducing VLM calls by 75% and inference cost by 93%. Furthermore, without explicit temporal grounding training, TimeProVe achieves competitive performance on Charades-STA, and reaches state-of-the-art results when enhanced with grounding VLMs.

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22.
medRxiv (Medicine) 2026-06-11

Association between depressive symptoms and physical function among participants with heart disease in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study.

Authors:
Fasokun↗M. E↗Safford↗M. M↗Khodneva↗Colantonio↗L. D↗Goyal↗Alanaeme↗C. J↗Hanif↗A. A. M↗…

Background: Depression and heart disease frequently co-occur in the aging population and are associated with functional decline and poor health outcomes. Understanding how depressive symptoms relate to different aspects of physical function among adults with heart disease may help identify high-risk subgroups. Objective: To examine the association of depressive symptoms with self-reported and observed physical function measures among participants with heart disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and assess whether associations differ by sex and race?sex groups. Methods: We conducted a cross-sectional analysis using data from REGARDS study second in-home visit (2013?2016). Depressive symptoms were measured with the 10-item Center for Epidemiologic Studies Depression scale (CES D 10), considering scores ?10 as clinically significant. Physical function measures were instrumental activities of daily living (IADL), activities of daily living (ADL), chair stand time (5 repetitions), and gait speed. Linear regression models estimated associations of depressive symptoms with function, adjusting for sociodemographic, health behavior, antidepressant medications, body mass index, and social support. Effect modification by sex and race?sex group was evaluated. Results: Among 3,055 participants, 11.7% had CES D 10 ?10. Compared to CES-D-10 scores

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

CineDance: Towards Next-Generation Multi-Shot Long-Form Cinematic Audio-Video Generation

Authors:
Yuheng Chen↗Teng Hu↗Yuji Wang↗Qingdong He↗Zhucun Xue↗Qianyu Zhou↗Jason Li↗Lizhuang Ma↗Jiangning Zhang↗Dacheng Tao↗

The fidelity and structural diversity of training datasets fundamentally determine the capabilities of video generation models. While commercial systems showremarkableabilitytogeneratecinematicnarratives, the progress of open-source models remains limited by the scarcity of high-quality training data. To bridge this gap, we introduce CineDance-1M, a large-scale, open research Text-to-Audio-Video (T2AV) dataset designed specifically for multi-shot, long-form joint audio-video generation. Averaging 92.8 seconds and 24.2 continuous shots per video, it provides configurable, structured annotations for both audio and video modalities. This exceptional quality is achieved through a rigorous three-stage curation pipeline: i) diverse sourcing and comprehensive cleansing, ii) film-theory-inspired narrative parsing, and iii) hierarchical dual-modal captioning. For a comprehensive assessment, we propose CineBench, featuring a diverse prompt suite and a six-dimensional, human-aligned metric system tailored for complex narrative audio-video evaluation. Furthermore, we adapt LTX-2.3 into CineDance, which demonstrates exceptional single-modality quality alongside precise audio-video alignment and robust subject and environment consistency, effectively validating our curation strategy and the high quality of CineDance-1M. We anticipate that this work will serve as a solid foundation for accelerating future research in multi-shot, long-form joint audio-video generation. Our project page is available at https://aliothchen.github.io/projects/CineDance/.

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24.
medRxiv (Medicine) 2026-06-22

Substantia Nigra and Subthalamic Nucleus Deep Brain Stimulation Exert Opposing Effects on Novelty Recognition in Parkinson's Disease

Authors:
Li↗Jiang↗Liu↗Yang↗Yao↗Zhang↗Xie↗Hollunder↗Strange↗Meng↗Wang↗Shi↗…

Episodic memory plays a critical role in supporting adaptive behavior; however, whether it can be causally regulated in humans via deep subcortical stimulation remains unclear. In the present study, we investigated the differential effects of substantia nigra (SN) and subthalamic nucleus (STN) stimulation on episodic memory, as well as the underlying mechanisms of its associated brain networks, using a recognition memory task combined with concurrent functional magnetic resonance imaging in patients with Parkinson's disease. SN-DBS increased recognition sensitivity and reduced false alarms at both frequencies, whereas 10 Hz STN-DBS reduced sensitivity and increased false alarms. Functional connectivity analyses in the absence of DBS stimulation identified a false recognition-related network linking nigral, pallidal, subthalamic, medial temporal, frontal, and occipital regions. SN-DBS-related false alarm reduction tracked modulation of this circuit and was marked by its baseline vulnerability state. These behavioral effects mapped onto target-dependent parieto-occipital and SN-visual retrieval pathways, supporting a model in which DBS bidirectionally regulates recognition memory through target- and frequency-dependent subcortical-cortical circuits.

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

SproutRAG: Attention-Guided Tree Search with Progressive Embeddings for Long-Document RAG

Authors:
Amirhossein Abaskohi↗Issam H. Laradji↗Peter West↗Giuseppe Carenini↗

Retrieval-augmented generation (RAG) systems must balance retrieval granularity with contextual coherence, a challenge that existing methods address through LLM-guided chunking, single-level context expansion, or hierarchical summarization. These approaches variously depend on costly LLM calls during indexing or retrieval, limit context aggregation to a single granularity level, or introduce information loss through summarization. We present SproutRAG, an attention-guided hierarchical RAG framework that addresses this trade-off by organizing sentence-level chunks into progressively larger but semantically coherent units, using learned inter-sentence attention to construct a binary chunking tree. Unlike prior approaches that rely on external LLMs, fixed context expansion, or lossy summarization, SproutRAG learns which attention heads and layers best capture semantic document structure, enabling multi-granularity retrieval without additional LLM calls or compressed summaries. At retrieval time, SproutRAG uses hierarchical beam search to retrieve candidates at multiple granularities, capturing multi-sentence relevance beyond flat retrieval. The framework is trained end-to-end with a joint objective that improves both embeddings and tree structure. Experiments across four benchmarks spanning scientific, legal, and open-domain settings demonstrate that SproutRAG improves information efficiency (IE) by 6.1% on average over the strongest baseline. Code is available on https://github.com/AmirAbaskohi/SproutRAG.

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