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01.
arXiv (CS.CV) 2026-06-16

Improved Knowledge Distillation for Land-Use Image Classification

In the present article, an improved Knowledge Distillation (KD) framework has been proposed for efficient compression of deep convolutional neural networks for land-use image classification task. Motivated by the need to achieve competitive classification accuracy while reducing computational complexity, a teacher-student learning paradigm is adopted in which a VGG16 network transfers knowledge to a lightweight MobileNetV2 model. The proposed framework integrates hard supervision from ground truth labels with a soft supervision strategy that combines Kullback-Leibler divergence and Cosine Similarity losses. Experiments conducted on three land-use datasets show that the proposed KD-based method yields improved performance, and achieves an accuracy of 99.04%, outperforming both baseline student training and single-loss distillation approaches, while retaining substantial model compression.

02.
arXiv (CS.CL) 2026-06-17

SuCo: Sufficiency-guided Continuous Adaptive Reasoning

Despite remarkable performance on complex tasks, Large Reasoning Models (LRMs) often generate excessively long Chain-of-Thoughts (CoT), inflating computational costs even for simple queries. Existing efforts to mitigate this inefficiency typically rely on discrete reasoning modes or fixed budget tiers, lacking a principled criterion of when reasoning is sufficient. In this work, we introduce Minimal Sufficient CoT (MSC), defined as the shortest prefix of a CoT trajectory which is adequate for producing the correct answer. We empirically show that MSC not only reduces reasoning tokens, but also improves accuracy across difficulty levels. Building on MSC, we propose Sufficiency-guided Continuous Adaptive Reasoning (SuCo), a two-stage training framework for autonomous reasoning control along a continuous spectrum. In stage 1, MSC-Aligned Fine-Tuning (MFT) constructs MSC data using problem-adaptive sufficiency thresholds that naturally scale with question difficulty, then fine-tunes the model to internalize concise yet sufficient reasoning patterns. In stage 2, Sufficiency-Aware Policy Optimization (SAPO) further optimizes the model through reinforcement learning with dynamic complexity tracking and sufficiency-aware rewards that penalize both over- and under-thinking. Extensive experiments across mathematics, code, and science benchmarks show that SuCo consistently achieves improvements in both accuracy and reasoning efficiency.

03.
medRxiv (Medicine) 2026-06-17

Sao Tome and Principe on the verge of eliminating lymphatic filariasis as a public health problem: evidence from IDA impact assessment surveys

Background Accelerated efforts to eliminate lymphatic filariasis (LF) as a public health problem have been supported by the introduction of the triple-drug regimen of ivermectin, diethylcarbamazine and albendazole (IDA) in endemic settings. In Sao Tome and Principe, nationwide mass drug administration (MDA) with diethylcarbamazine and albendazole was implemented in 2018, followed by IDA in 2019 and 2020. This study assesses progress towards elimination using post-MDA impact assessment surveys conducted after cessation of treatment. Methods Cross-sectional surveys were conducted among adults aged 20 years and older in 2022 and again between December 2024 and January 2025. Circulating filarial antigen (CFA) was detected using the filarial test strip (FTS). Individuals who tested positive were examined for microfilaremia using nocturnal calibrated thick blood smear microscopy. Additionally, programme data on MDA coverage and morbidity were obtained from national surveillance records. Results Three rounds of nationwide MDA achieved high epidemiological coverage (86.4% in 2018, 74.2% in 2019 and 80.0% in 2020). The impact assessment surveys conducted in 2022 evaluated 14 132 adults, with 21 individuals (0.15%) testing positive for CFA, while the follow-up survey conducted between December 2024 and January 2025 assessed 14 653 adults and detected seven positive cases (0.05%). No microfilariae were detected among the 28 antigen-positive individuals examined using nocturnal calibrated thick blood smears. National morbidity records documented 190 cases of lymphoedema and nine cases of hydrocoele. Conclusions Infection indicators remain well below WHO decision thresholds, suggesting that LF transmission is unlikely to be sustained. Sao Tome and Principe appears to be close to eliminating LF as a public health problem. However, strengthening morbidity management services will be essential to support the preparation of the national elimination dossier.

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

RepWAM: World Action Modeling with Representation Visual-Action Tokenizers

This work presents RepWAM, a representation-centric world action model (WAM) built on representation visual-action tokenizers. Existing WAMs typically inherit reconstruction-oriented video tokenizers from pretrained video generation models. Although these tokenizers preserve visual fidelity, pixel reconstruction alone provides limited guidance for learning instruction-following dynamics that connect future prediction with robot control. To address this, we explore a semantic visual-action latent space for representation-centric world action modeling. Specifically, we train a representation visual-action tokenizer that maps visual inputs into aligned visual and latent action tokens. We then pretrain our WAM to jointly model future visual states and the latent actions that connect them under language instructions, followed by adaptation to real robot trajectories for closed-loop manipulation. Experiments on real-world manipulation tasks and simulation benchmarks show that RepWAM delivers strong performance across diverse manipulation settings, while ablations highlight the value of semantic visual-action tokenization over reconstruction-oriented alternatives. These results establish representation visual-action tokenization as a promising foundation for world action models and a step toward generalist robot policies. Code and weights will be available at https://github.com/wdrink/RepWAM.

05.
arXiv (CS.CV) 2026-06-12

Analyzing and Improving Fine-grained Preference Optimization in Medical LVLMs

Large Vision-Language Models (LVLMs) have achieved strong performance across medical imaging tasks, yet they remain prone to factual inconsistencies, poor visual grounding, and misalignment with clinically meaningful feedback. Existing post-training alignment approaches, including Direct Preference Optimization (DPO) and its variants, face three critical limitations in the medical domain: (1) sequence-level reward signals treat clinically critical tokens identically to generic filler text; (2) reliance on static supervised fine-tuning references as preferred responses introduces an off-policy distribution shift, steering optimization toward stylistic artifacts over clinical correctness; and (3) alignment objectives lack explicit visual grounding constraints, leaving models insensitive to subtle yet diagnostically decisive pathological features. Our method leverages a bidirectional token-wise KL regularizer alongside a visual-contrastive grounding objective that pairs clean and lesion-corrupted images to penalize responses generated without adequate visual evidence. Together, these components form a fine-grained, on-policy alignment framework that constructs preference pairs by minimally editing model-generated outputs, correcting only clinically erroneous spans while preserving the original linguistic style. Extensive experiments across medical imaging tasks and clinical text generation benchmarks validate the effectiveness of our approach.

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

Topological Flow Matching

arXiv:2606.15897v1 Announce Type: cross Abstract: Flow matching is a powerful generative modeling framework, valued for its simplicity and strong empirical performance. However, its standard formulation treats signals on structured spaces, such as fMRI data on brain graphs, as points in Euclidean space, overlooking the rich topological features of their domains. To address this, we introduce topological flow matching, a topology-aware generalization of flow matching. We interpret flow matching as a framework for solving a degenerate Schrödinger bridge problem and inject topological information by augmenting the reference process with a Laplacian-derived drift. This principled modification captures the structure of the underlying domain while preserving the desirable properties of flow matching: a stable, simulation-free objective and deterministic sample paths. As a result, our framework serves as a drop-in replacement for standard flow matching. We demonstrate its effectiveness on diverse structured datasets, including brain fMRIs, ocean currents, seismic events, and traffic flows.

07.
arXiv (CS.AI) 2026-06-19

The Hidden Evolution of Disguised Visual Context inside the VLM

arXiv:2606.20077v1 Announce Type: cross Abstract: Visual tokens enter Large Language Models (LLMs) as raw, foreign signals. How they are transformed into meaningful representations and interact with the language space depends entirely on the integration architecture. Whether by treating visual tokens as in-context prompts within the input sequence or injecting them directly into the LLM's intermediate layers. A controlled comparison and understanding of how these architectural choices affect visual information and its internal transformation to integrate with the LLM remains underexplored. We provide a fair comparison by evaluating in-context and layer-wise injection VLM integration paradigms under identical training conditions across single image, multi-image, and video benchmarks. In doing so, we uncover a hidden evolution where visual tokens enter the LLM as disguised visual context, raw representations lacking linguistic structure, but are progressively reshaped depending on the integration paradigm, each capturing fundamentally different frequency characteristics of the visual signal. We show that this evolution inside the LLM determines what visual features the VLM can utilize effectively, how visual representations align with the language space, and ultimately how each paradigm performs across different tasks. We further demonstrate that attention allocation alone is insufficient, and that performance is driven by the quality of visual representations at each layer.

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

Quantization Robustness of Monotone Operator Equilibrium Networks

arXiv:2603.10562v2 Announce Type: replace-cross Abstract: Monotone operator equilibrium networks are implicit-layer models whose output is the unique equilibrium of a monotone operator, guaranteeing existence, uniqueness, and convergence. When deployed on low-precision hardware, weights are quantized, potentially destroying these guarantees. We analyze weight quantization as a spectral perturbation of the underlying monotone inclusion. Convergence of the quantized solver is guaranteed whenever the spectral-norm weight perturbation is smaller than the monotonicity margin; the displacement between quantized and full-precision equilibria is bounded in terms of the perturbation size and margin; and a condition number characterizing the ratio of the operator norm to the margin links quantization precision to forward error. MNIST experiments confirm a phase transition at the predicted threshold: three- and four-bit post-training quantization diverge, while five-bit and above converge. The backward-pass guarantee enables quantization-aware training, which recovers provable convergence at four bits.

09.
PLOS Medicine 2026-05-21

Semaglutide-associated risk of nonarteritic anterior ischemic optic neuropathy in patients with type 2 diabetes: A systematic review and meta-analysis of observational studies

by Jędrzej Chrzanowski, Magdalena Walicka, Jacek Burzyński, Małgorzata Zaraś, Arkadiusz Michalak, Wojciech Fendler Background Semaglutide, a glucagon-like peptide-1 receptor agonist, is widely used for the management of type 2 diabetes (T2DM). Recent case reports have raised concerns about a potential association between semaglutide use and the development of nonarteritic anterior ischemic optic neuropathy (NAION), a rare but vision-threatening condition. We aimed to evaluate whether semaglutide use is associated with an increased risk of NAION in patients with T2DM. Methods and findings We conducted a systematic review and meta-analysis of observational studies comparing patients with T2DM aged ≥12 years treated with semaglutide to those receiving other glucose-lowering therapies. We searched PubMed, Scopus, and Web of Science databases from January 2023 to November 2025. Two reviewers independently extracted data on study design, population characteristics, and outcomes. Risk of bias was assessed using the Newcastle–Ottawa Scale, and ROBINS-I v.2. Certainty of the evidence was graded according to the GRADE framework. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using fixed-effects models; sensitivity analyses included crude and subgroup HRs, and overlapping study replacement. Leave-one-out analysis was conducted to assess small-study effects and publication bias. Results were contextualized within other meta-analyses, systematic reviews, consensus statements, and regulatory communications on the topic.Five eligible observational studies met the inclusion criteria, and 7 additional studies were included in the sensitivity analysis. Semaglutide use was associated with a significantly increased hazard of NAION compared with nonsemaglutide glucose-lowering regimens (HR 2.17, 95% CI [1.73, 2.74]; p 

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

One Transit Is All You Need: Detecting Exoplanets Through Learned Stellar Behaviour with EXOVEIL

arXiv:2606.02778v3 Announce Type: replace-cross Abstract: I present EXOVEIL, a transit detection system that learns what a star's brightness should look like and flags when reality disagrees. Unlike existing systems that require phase-folded input, EXOVEIL operates on raw flux time series and can detect planets that transit only once.A Transformer world model, trained on 16,499 Kepler light curves with transit-masked self-supervised learning, predicts expected stellar flux. A matched-filter detector with variance weighting extracts transit signals from the prediction residuals. A learned classifier (XGBoost) separates planets from false positives, achieving AUC 0.938 on Kepler DR25. Applied to single-transit injection-recovery, EXOVEIL recovers 32% of transits at 1000 ppm depth a task where all classification-based systems score 0% by construction. A blind search of 3,737 Kepler stars yields 179 new transit-like signals not present in the DR25 TCE catalogue, including 46 monotransit candidates. Applied withoutretraining to 47 confirmed TESS planets in the PLATO LOPS2 field, EXOVEIL achieves 100% recovery, demonstrating zero-shot cross-mission transfer. At PLATO's 25-second cadence, detection reaches 100 ppm – approaching the Earth-analog regime. I provide the first application of conformal prediction to transit detection (95.9% empirical coverage) and release the system as pip install exoveil with pretrained weights and a candidate catalogue.

11.
arXiv (CS.LG) 2026-06-15

The Program Is Still There: A Conservation Law for Program Discovery

arXiv:2606.13799v1 Announce Type: cross Abstract: Finding the shortest program that generates a sequence is uncomputable, and for six decades that fact has been mistaken for a wall around finding any generating program. It is not a wall but a price, and this paper measures it. For every algorithm that learns about a candidate program only through its score, a class spanning Levin search, evolutionary methods, simulated annealing, and the cross-entropy method, we define the coupling width of a search problem and prove an unconditional worst-case lower bound, exponential in that width with base one less than the domain size. From it follows a conservation law: structural knowledge injected into a search trades one for one against the search it removes, and their sum can never fall below the length of the program sought. Levin's 1973 upper bound and the lower bound proved here are the two ends of one conserved quantity, closing on each other as the instruction set grows. The only escape is to read a candidate's structure rather than its score, and its price, which we prove for generic targets, is incompleteness. A deterministic engine built on this theory recovers a generating program, certified by compressing its data and predicting an unseen continuation, for 2,383 of 3,914 sequences across four independent populations, including 244 of the 256 elementary cellular automata, with measured discovery cost rising along program length more than an order of magnitude inside the score-oracle worst case.

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

Phase Transition for Stochastic Block Model with more than $\sqrt{n}$ Communities

arXiv:2509.15822v3 Announce Type: replace-cross Abstract: Predictions from statistical physics postulate that recovery of the communities in the Stochastic Block Model (SBM) with a fixed number $K$ of communities is possible in polynomial time above, and only above, the Kesten-Stigum (KS) threshold. This conjecture has given rise to a rich literature, proving that non-trivial community recovery is indeed possible in SBM above the KS threshold. Failure of low-degree polynomials (LDP) below the KS threshold was also proven, as long as $K\ll \sqrt{n}$, where $n$ is the number of nodes in the observed graph. When $K\geq \sqrt{n}$, Chin et al.(2025) recently proved that, in a sparse regime, community recovery in polynomial time is possible below the KS threshold by counting non-backtracking paths. This breakthrough led them to postulate a new threshold for the many-communities regime $K\geq \sqrt{n}$. In this work, we provide evidence supporting their conjecture:\\ 1- We prove that, for any graph density, LDP fail to recover communities below the threshold postulated by Chin et al.(2025) ;\\ 2- We prove that community recovery is possible in polynomial time above the postulated threshold, not only in the sparse regime considered in Chin et al.~(2025), but also in moderately sparse regimes, by counting occurrences of some specific motifs inspired by the LDP analysis.\\ In particular, counting self-avoiding paths of length $\log(n)$, which is closely related to spectral algorithms based on the Non-Backtracking operator, is optimal only in the sparse regime. More complex motifs based on the blow-up of a cycle must be considered in denser regimes.

13.
arXiv (CS.CL) 2026-06-18

BCL: Bayesian In-Context Learning Framework for Information Extraction

Existing information extraction (IE) tasks increasingly adopt in-context learning (ICL) with large language models. However, current approaches either show inconsistent performance across model scales or lack systematic optimization and generalizability. Building on this, we propose BCL (Bayesian In-Context Learning Framework for Information Extraction), the first optimization framework that uses particle filtering with Bayesian updates to systematically refine label representations across IE tasks. Through four steps initialization, observation, weight update, and resampling, BCL generalizes to both sequence labeling and relation classification paradigms. Extensive experiments demonstrate substantial and consistent improvements over existing approaches.

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

AAPA: Adversarially Anchored Preference Alignment for Post-Training of Large Language Models

arXiv:2509.25148v2 Announce Type: replace Abstract: Post-training alignment of large language models often combines supervised fine-tuning (SFT) on expert demonstrations with reinforcement learning (RL) from preference or verifiable feedback. SFT provides a useful behavioral anchor but can overfit to static demonstrations, whereas RL encourages exploration but may drift from expert behavior or exploit imperfect rewards. We propose AAPA (Adversarially Anchored Preference Alignment), a plug-in framework that augments existing post-training objectives with a sentence-level adversarial anchoring signal. AAPA compares policy rollouts with offline, pre-collected expert responses using a fixed lightweight discriminator, and therefore requires neither online teacher inference nor discriminator co-training during policy optimization. The same anchoring term can be added to SFT, GRPO, and CHORD while preserving their original training pipelines. Experiments on instruction-following benchmarks show that AAPA consistently improves the corresponding base objectives across model scales. In particular, the staged AAPA configuration improves over a strong GRPO baseline by 5.77\% on \texttt{Qwen3-0.6B} and 3.75\% on \texttt{Qwen3-4B}. Further analyses on response length, log-probability distributions, and discriminator variants suggest that adversarial anchoring provides a stable semantic grounding signal for preference optimization. Code is available at \url{https://github.com/IsFaqq/AAPA}.

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

Distill Once, Adapt Life-Long: Exploring Dataset Distillation for Continual Test-Time Adaptation

Continual Test-Time Adaptation (CTTA) aims to maintain model performance under evolving target domains by adapting online without labeled data. However, practical deployments often cannot retain the source dataset due to privacy or licensing constraints, and purely source-free CTTA methods tend to become unstable under long-term distribution shift, suffering from compounding self-training errors and catastrophic forgetting. We introduce DO-ALL (Distill Once, Adapt Life-Long), a plug-and-play framework that revisits source information in a compact and privacy-conscious form via Dataset Distillation (DD). Before deployment, DO-ALL performs DD to produce a small set of synthetic distilled anchors that summarize the source distribution. During adaptation, each target sample is matched with its most semantically aligned anchor, which provides a stable reference for various CTTA via source replay, representation alignment, and manifold-smoothing regularization. DO-ALL can be seamlessly integrated into existing CTTA algorithms, consistently improving long-term robustness across CIFAR100-C, ImageNet-C, and the CCC benchmark. This demonstrates the potential of leveraging DD to enable stable and continuous adaptation without retaining raw source data. The code is available at https://github.com/blue-531/DOALL.

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

Koshur Diacritizer: A Byte-Level Sequence-to-Sequence Model for Kashmiri Diacritic Restoration

Kashmiri, an Indo-Aryan language written in a modified Perso-Arabic script, frequently omits diacritic marks in digital text, creating ambiguity and challenging downstream NLP applications. We present Koshur Diacritizer, a ByT5-small byte-level sequence-to-sequence model for restoring diacritics in Kashmiri text. To support this task, we release a publicly available dataset of 23.7k aligned undiacritized diacritized Kashmiri sentence pairs. The proposed framework combines script-aware normalization, alignment validation, and skeleton-preserving inference to ensure reliable restoration while maintaining the original base-letter sequence. Experimental results on a held-out test set achieve a DERm of 0.2012 and a WER of 0.2159. Additionally, evaluation by a native Kashmiri linguistic expert yields a mean accuracy of 77.5%. The dataset, model, and source code are publicly released to provide a reproducible baseline for Kashmiri diacritic restoration and future low-resource language research.

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

Bayesian Magnetic Resonance Joint Image Reconstruction and Uncertainty Quantification using Sparsity Prior Models and Markov Chain Monte Carlo Sampling

We propose a novel framework for uncertainty quantification using compressed sensing magnetic resonance image reconstruction. The problem is formulated within a Bayesian framework as a linear inverse problem, with prior distributions assigned to the unknown model parameters. Specifically, the image to be reconstructed is assumed to be sparse in a given basis. We develop a general framework applicable to any basis and as examples, we test the sparsity of the image in its (1) spatial gradients using a total variation prior model, and in its (2) wavelet transform. A Markov chain Monte Carlo (MCMC) method, based on a split-and-augmented Gibbs sampler, is then employed to sample from the posterior distribution of the unknown parameters. The non-differentiable conditional distributions are efficiently sampled using a proximal MCMC method. The proposed algorithms are validated on both single-coil and multi-coil datasets using various k-space sub-sampling patterns and ratios. The results demonstrate the superior performance of each proposed approach in reconstructing images compared to its counterpart optimisation-based method. Moreover, our framework effectively quantifies uncertainty, showing a notable correlation between estimated uncertainty maps and error maps computed using ground truth and reconstructed images, compared with existing deep learning-based methods.

18.
arXiv (CS.CV) 2026-06-15

WAM4D: Fast 4D World Action Model via Spatial Register Tokens

World action models (WAMs) have recently shown promise in jointly modeling future observations and executable robot actions. However, most existing WAMs still operate in 2D video or latent spaces, where visually plausible rollouts miss the 3D spatial constraints and occluded contact geometry required for precise manipulation. While geometric foundation models offer strong priors for recovering dense 3D structure and motion from visual observations, forcing WAMs to predict the dense 4D representation introduces costly geometric decoding and slows down causal action generation. To address the trade-off, we present WAM4D, a fast 4D world action model that uses lightweight spatial register tokens as training-time future-depth readouts to transfer pretrained geometric priors into a causal video-action transformer, then removes the register branch for lightweight action inference. To prevent non-causal shortcuts, we further design causal mixture attention for the Mixture-of-Transformers (MoT) WAM backbone, defining modality-specific visibility among video, action, and geometry tokens. Comprehensive experiments on RoboTwin 2.0 and challenging real-world manipulation tasks show that WAM4D improves spatial consistency and achieves competitive action prediction while maintaining efficient inference.

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

LLM-MINE: Large Language Model based Alzheimer's Disease and Related Dementias Phenotypes Mining from Clinical Notes

arXiv:2603.13673v2 Announce Type: replace Abstract: Accurate extraction of Alzheimer's Disease and Related Dementias (ADRD) phenotypes from electronic health records (EHR) is critical for early-stage detection and disease staging. However, this information is usually embedded in unstructured textual data rather than tabular data, making it difficult to be extracted accurately. We therefore propose LLM-MINE, a Large Language Model-based phenotype mining framework for automatic extraction of ADRD phenotypes from clinical notes. Using two expert-defined phenotype lists, we evaluate the extracted phenotypes by examining their statistical significance across cohorts and their utility for unsupervised disease staging. Chi-square analyses confirm statistically significant phenotype differences across cohorts, with memory impairment being the strongest discriminator. Few-shot prompting with the combined phenotype lists achieves the best clustering performance (ARI=0.290, NMI=0.232), substantially outperforming biomedical NER and dictionary-based baselines. Our results demonstrate that LLM-based phenotype extraction is a promising tool for discovering clinically meaningful ADRD signals from unstructured notes.

20.
arXiv (CS.CL) 2026-06-18

ActMem: Bridging the Gap Between Memory Retrieval and Reasoning in LLM Agents

Memory management is essential for LLM agents in long-term interactions. Current memory frameworks typically treat agents as passive ``recorders'' and retrieve information without understanding its deeper implications. They may fail in scenarios requiring reasoning and complex decision-making. To bridge this critical gap, we propose a novel actionable memory framework called ActMem that integrates memory retrieval with active causal reasoning. ActMem transforms unstructured dialogue history into a structured causal and semantic graph. By leveraging counterfactual reasoning and commonsense completion, it enables agents to deduce implicit constraints and resolve potential conflicts between past states and current intentions. Furthermore, we introduce a comprehensive dataset ActMemEval to evaluate agent reasoning capabilities in logic-driven scenarios, moving beyond the fact-retrieval focus of existing memory benchmarks. Experiments demonstrate that ActMem significantly outperforms baselines in handling complex, memory-dependent tasks, paving the way for more consistent and reliable intelligent assistants.

21.
arXiv (math.PR) 2026-06-17

Convergence rate of Euler–Maruyama scheme to the invariant probability measure under total variation distance for the SDEs

arXiv:2505.04218v3 Announce Type: replace Abstract: This article shows the geometric decay rate of Euler-Maruyama scheme for one-dimensional stochastic differential equation towards its invariant probability measure under total variation distance. Firstly, the existence and uniqueness of invariant probability measure and the uniform geometric ergodicity of the chain are studied through introduction of non-atomic Markov chains. Secondly, the equivalent conditions for uniform geometric ergodicity of the chain are discovered, by constructing a split Markov chain based on the original Euler-Maruyama scheme.

22.
medRxiv (Medicine) 2026-06-22

Reform of the intermediate level of the health system in the Democratic Republic of the Congo: Adaptations and limits in the stabilization of the personnel of the Provincial Health Division: A cohort study.

Background: Human resources are one of the pillars of health systems. Since the World Health Organization's report on human resources issues, several countries have integrated this component into the various reforms aimed at strengthening their health systems. This study aims to explore the effects of reforming the intermediate level of a health system operating in a fragile state context. Methodology Our study was conducted in the Democratic Republic of Congo (DRC). It was a cohort study of the staff of the 14 Provincial Health Divisions (PHD) out of the 26 existing in the DRC. We established a database of the staff of these 14 PHD from 2016, just after the implementation of the intermediate level reform and the allocation of this staff by the Ministry of Health. We did a recall in 2021, in each of these PHD to survey this staff through a structured questionnaire and supplemented by the files of the agents available in each PHD. Sociodemographic, economic and academic variables were collected and analyzed. Data were entered into an Excel 2016 database and processed with SPSS software version 25. The chi-square test was used for comparison of proportions with a statistical significance level of p < 0.05. Risk ratios ratios (RR) and their 95% confidence intervals were calculated as measures of association. The error threshold was set at 5%. Results A total of 657 agents with an average age of 45.2 years had been identified in 2016 at the start of the survey and in 2021, 118 or 18% of them were no longer part of the PHD agents. Among the causes of absence noted: 48% of agents placed on leave, 16% promoted to other functions within the health system, 16% desertion and dismissal and 11% cases of death. 19.8% of absentees are executives, 19.5% men against 10.3% women; 22.3% of absentees in unstable provinces against 16.6% in stable ones. The factors associated with the absence of agents in the PHD remain the reaching of retirement age [RR (95% CI) = 5.5 (1.2-24.9) ]and male agents [RR (95% CI) = 3.2 (1.3-7.9)]. Among the agents who remained, 92% kept their initial position, 6% were subject to an internal permutation accompanied by a promotion. The factors associated with the stability of human resources at the level of the Provincial Health Division are: female gender, manager with experience or seniority > 5 years, Age > 35 years, Stable province, Presence of a partner bonus. Conclusion Even in a crisis and fragile context, health system reform is possible. It is possible to organize staff recruitment through a selection process independent of the political authorities of the Ministry of Health and supported by the technical services of the Ministry and partners . Experience and the presence of a financial bonus are motivating factors for staff stability. The involvement of Technical and Financial Support Partners in the recruitment process helped the Ministry of Health to minimize political influence in the recruitment of middle-level executives.

23.
arXiv (CS.AI) 2026-06-15

Beyond LoRA: Is Sparsity-Induced Adaptation Better?

arXiv:2606.13767v1 Announce Type: cross Abstract: Low-rank adaptation (LoRA) and its variants provide a memory- and compute-efficient alternative to full fine-tuning of pre-trained models. However, questions remain about the comparative generalizability of these approaches and how the structural restrictions on low-rank updates preserve effective adaptation performance. We present a historical framing, covering the past (full fine-tuning and original LoRA), the present (different variants of LoRA), and propose simpler, cheaper, parameter-efficient extensions by inducing sparsity within existing LoRA variants: Cheap LoRA (cLA), training a single low-rank factor with the other fixed (deterministically or, in its randomized variant, stochastically), and the chained circulant variant, ${c}^3$LA. We frame cLA as a structured instance of asymmetric LoRA, serving as a controlled column-subspace restriction of full fine-tuning. We derive information-theoretic generalization error bounds for these variants, marking one of the first endeavors in this area. Empirically, we evaluate 11 fine-tuning methods across 10 pre-trained models and 14 datasets, analyzing the fine-tuned models' performance and generalization using tools such as loss landscapes and spectral analysis. Despite the sensitivity of fine-tuned models to the pre-trained model, datasets, and other factors, our study suggests that restricting LoRA-based PEFT methods' adaptation to a sparse, structured column space remains competitive across tasks with their parameter-matched baselines while reducing up to 10% training time and peak GPU memory up to 15%, even with a naïve, non-optimized, sparse implementation. Our theoretical and empirical generalization measures provide a more consistent and principled approach to their cost-effective adaptation than commonly used analytical tools. Overview and code are available at: https://elicaden.github.io/Beyond_LoRA/.

24.
medRxiv (Medicine) 2026-06-18

Expert in Ultrasound Skills: Feasibility of an IMU-video platform to describe technical profiles during focused cardiac ultrasound. Pilot study

Background: Focused cardiac ultrasound (FoCUS) is operator dependent and requires coordinated probe manipulation, image interpretation and iterative visual feedback. Existing assessment approaches often emphasize final image quality or expert rating. We developed Expert in Ultrasound Skills (EXUS) , a platform that synchronizes transducer-mounted inertial measurement unit (IMU) data with ultrasound video, and evaluated its technical feasibility during FoCUS acquisition. Methods: This observational pilot study included 6 operators performing two repetitions of a four-view FoCUS protocol, yielding 12 analytical sessions and 48 planned acquisitions. Feasibility was defined by acquisition completion, video availability, start/stop events, fused IMU-video windows, temporal coverage, complete human label entries and IMU integrity. A 100-image Likert rating task was used to summarize pairwise inter-rater agreement for still-frame image quality assessment. Results: All 48 planned acquisitions were completed with video, start/stop events, fused windows and complete human label entries. Temporal coverage was at least 90% in 47/48 acquisitions. IMU integrity endpoints exceeded the 80% threshold: 43/48 acquisitions had no extreme IMU-derived artifact, 43/48 had no active-segment IMU restart and 44/48 had no complete motion flatline. Mean pairwise exact agreement for the Likert task was 38.9%, with mean quadratic-weighted Cohen's kappa of 0.564. Post hoc profiles varied across duration, visual quality, mechanical load and motor efficiency. Conclusions: EXUS was technically feasible for synchronized IMU-video capture during FoCUS. The pilot supports multimodal acquisition data as a way to describe technical profiles and generate formative feedback hypotheses, but the post hoc indices are not validated competency measures. Keywords: focused cardiac ultrasound; point-of-care ultrasound; inertial measurement unit; medical education; deliberate practice

25.
arXiv (CS.CV) 2026-06-12

Amnesia: A Stealthy Replay Attack on Continual Learning Dreams

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