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01.
medRxiv (Medicine) 2026-06-17

Waning protection of long-acting RSV monoclonal antibodies in infants: a Bayesian analysis of clesrovimab and nirsevimab trial data

Authors:
Gong↗Flasche↗Hodgson↗

Clesrovimab and nirsevimab are long-acting monoclonal antibodies used to prevent respiratory syncytial virus (RSV) disease in infants, but waning protection in the first year of life is incompletely characterised. We applied a published Bayesian inference framework to clesrovimab and pooled nirsevimab trial data to estimate time-varying efficacy against medically attended RSV lower respiratory tract infection (LRTI) and RSV-associated hospitalisation, accounting for differences in placebo-arm event timing between trials. Estimated clesrovimab efficacy declined from 60.7% (95% CrI: 46.3-72.6) shortly after dosing to 38.3% (8.6-52.9) at six months against medically attended RSV LRTI, and from 87.1% (71.2-96.2) to 49.6% (10.4-70.7) against RSV-associated hospitalisation. For nirsevimab, corresponding estimates declined from 86.9% (75.4-95.0) to 53.8% (27.4-69.7) against LRTI, and from 77.5% (52.6-91.8) to 49.7% (15.7-68.3) against hospitalisation. After accounting for differences in RSV exposure timing and LRTI endpoint definitions between trials, we found no evidence of a difference in efficacy or waning between clesrovimab and nirsevimab.

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

Breaking the Filter Bubble: A Semantic Pareto-DQN Framework for Multi-Objective Recommendation

Authors:
Cl\'audio L\'ucio Do Val Lopes↗Lucca Machado da Silva↗Andr\'e de Oliveira Brand\~ao↗

arXiv:2606.24042v1 Announce Type: new Abstract: Recommender systems often induce filter bubbles and semantic homogenization by monolithically optimizing for immediate user engagement. Standard single-objective models, including traditional Deep Q-Networks, are ill-equipped to navigate the trade-offs between platform retention and critical societal values like information diversity and provider fairness. To address these limitations, we introduce a multi-objective reinforcement learning framework that formalizes recommendation as a semantic multi-objective Markov decision process. By integrating high-fidelity semantic embeddings with a Pareto-DQN agent, our architecture treats engagement, diversity, and fairness as distinct, non-aggregable reward signals, avoiding the pitfalls of static reward scalarization. Empirical evaluations on the MovieLens small dataset shows that our hypervolume based action selection disrupts the feedback loops responsible for semantic collapse. By sustaining high state-trajectory variance, the Pareto-DQN effectively maps the Pareto frontier, achieving gains in auxiliary societal objectives with only marginal impacts on engagement. This work provides a path toward intrinsically aligned, responsible recommender systems.

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

Transfer Learning for FHIR Questionnaire Terminology Binding

Authors:
Maxim Gorshkov↗

Electronic prior authorization workflows require FHIR Questionnaire items to carry LOINC codes, yet most items in the HL7 Da Vinci CDS-Library lack these bindings. We treat this as a retrieval problem: given a Questionnaire item's text, find the correct LOINC code in a pool of 97,314 active codes. We compare six methods (TF-IDF, frozen MiniLM, BioBERT, BioLORD, contrastively fine-tuned MiniLM, and a TF-IDF+GPT reranker) on a 54-item evaluation set spanning three query styles (natural question, medium, and terse). No single method wins on every metric. BioLORD, a frozen encoder pre-trained on biomedical ontology definitions, has the best top-rank accuracy (R@1 = 0.185, MRR = 0.246) despite seeing no task-specific data, while a contrastive fine-tune on raw LHC-Forms pairs takes R@5 (0.389) and R@10 (0.426). A distribution-shift ablation shows why the fine-tune in our main table is not the strongest one: adding GPT-generated paraphrases to the raw pairs drops R@5 from 0.389 to 0.296, so the augmented union underperforms raw-only training on every metric except R@1. Performance peaks at 5k training pairs. Error analysis on BioLORD's R@1 failures shows that wrong-specificity and ambiguous-text cases together account for 59% of errors.

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

EpiBench: Verifiable Evaluation of AI Agents on Epigenomics Analysis

Authors:
Harihara Muralidharan↗Reema Baskar↗Soo Hee Lee↗Tim Proctor↗Kenny Workman↗

arXiv:2606.13602v1 Announce Type: new Abstract: We introduce EpiBench, a verifiable benchmark for short-horizon epigenomics analysis. EpiBench evaluates whether agents can make well-defined analysis decisions from realistic workflow states and return deterministically gradable answers. The benchmark includes 106 evaluations across CUT\&Tag/CUT\&RUN, ATAC-seq, ChIP-seq, and DNA methylation workflows. Across 5,088 valid trajectories from 16 model-harness pairs, no system passed a majority of attempts: GPT-5.5 / Pi led at 45.0\% (143/318 attempts; 95\% confidence interval (CI), 36.3–53.7), followed by GPT-5.5 / OpenAI Codex at 39.9\% (127/318 attempts; 95\% CI, 31.6–48.3). Claude Opus 4.8 Max / Pi and GPT-5.4 / Pi each passed 39.0\% (124/318 attempts; 95\% CI, 30.2–47.8 and 31.0–47.0, respectively). Performance varies across assay types, and many failed runs still contain parts of the correct answer. Agents often found the right files and computed useful intermediate results, but failed when the task required deeper, assay-specific scientific judgment.

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05.
arXiv (CS.AI) 2026-06-18

Caring Without Feeling: Affective Dynamics as the Control Layer of Human-AI Agent Collaboration

Authors:
Junjie Xu↗Xingjiao Wu↗Zihao Zhang↗Yujia Xu↗Yuzhe Yang↗Jin Zhu↗Luwei Xiao↗Wen Wu↗Liang He↗

arXiv:2606.18259v1 Announce Type: cross Abstract: AI agents that plan, retain memory across sessions, invoke external tools and act with partial autonomy are transforming human–AI collaboration. Research on affective computing, simulated empathy in large language models, trust in automation and AI safety has illuminated important design principles, yet these literatures remain fragmented. No integrated account explains how affective cues operate within agentic collaboration – settings in which humans delegate, monitor and correct consequential tasks. This Review synthesises computational and interactional mechanisms of affective dynamics: the processes through which affective cues, emotion-like behaviour and perceived agent affect shape trust calibration, delegation decisions, error correction, dependence and governance. We trace how model-generated affective signals enter interaction loops that govern reliance, repair and oversight, and propose a framework that treats affect not as an internal property of AI but as a coordination layer through which humans and agents negotiate capability, uncertainty and responsibility. The framework provides a foundation for calibrated measurement, purposeful design and informed governance.

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

Towards Physically Realizable Adversarial Attenuation Patch against SAR Object Detection

Authors:
Yiming Zhang↗Weibo Qin↗Feng Wang↗

Deep neural networks have demonstrated excellent performance in SAR target detection tasks but remain susceptible to adversarial attacks. Existing SAR-specific attack methods can effectively deceive detectors; however, they often introduce noticeable perturbations and are largely confined to digital domain, neglecting physical implementation constrains for attacking SAR systems. In this paper, a novel Adversarial Attenuation Patch (AAP) method is proposed that employs energy-constrained optimization strategy coupled with an attenuation-based deployment framework to achieve a seamless balance between attack effectiveness and stealthiness. More importantly, AAP exhibits strong potential for physical realization by aligning with signal-level electronic jamming mechanisms. Experimental results show that AAP effectively degrades detection performance while preserving high imperceptibility, and shows favorable transferability across different models. This study provides a physical grounded perspective for adversarial attacks on SAR target detection systems and facilitates the design of more covert and practically deployable attack strategies. The source code is made available at https://github.com/boremycin/SAAP.

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07.
arXiv (CS.LG) 2026-06-17

Tensor-based second-order causal discovery

Authors:
Nathan Ouyang↗Kexin Wan↗Anna Seigal↗

arXiv:2606.18074v1 Announce Type: cross Abstract: Causal discovery seeks to uncover the causal dependencies among variables. For this purpose, we propose an algorithm called Tensor-based Second-order Causal Discovery (TSCD). Its input is a tensor obtained from the covariance matrices of observational and interventional data. Assuming the causal dependencies follow a linear structural equation model on a directed acyclic graph (DAG), TSCD outputs the DAG and the functions on its edges, requiring only that the noise variables are uncorrelated. We also implement a version of the approach for nonlinear models. Our focus on second-order statistics (via the covariance matrices) is motivated by their statistical and computational efficiency relative to higher-order moments, their identifiability relative to first-order statistics, and that they work regardless of whether the variables are Gaussian. We show that TSCD has identifiable causal order and parameters from a number of interventions that is logarithmic in the number of variables. Experiments show that TSCD is robust to noise, competitive with existing methods, and scales to hundreds of variables.

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08.
arXiv (CS.CV) 2026-06-24

Accelerating Multimodal Large Language Models with Prior-Corrected Token Reduction

Authors:
Zengjie Chen↗Yuxiang Cai↗Jingcai Guo↗Taotao Cai↗Jianwei Yin↗Zhi Chen↗

Visual token reduction has emerged as an effective strategy for accelerating Multimodal Large Language Models (MLLMs). Many existing methods prune tokens by ranking text-visual attention scores. However, we show that attention is often dominated by a model-induced prior: even without textual instruction, MLLMs tend to focus on certain task-agnostic regions. Consequently, the attention scores of instruction-conditioned tokens are suppressed, increasing the risk that these tokens are discarded during pruning. To address this issue, we propose Prior-Corrected Token Reduction (PriorTR), a training-free token reduction method that explicitly separates task-conditioned attention from the model-induced prior. PriorTR estimates the attention map of the prior, and contrasts it with the task-conditioned attention distribution to measure the additional usable information contributed by each visual token. Importantly, PriorTR computes both the model-induced prior and the task-conditioned posterior within a single forward pass by introducing a null token that serves as an instruction-agnostic probe in the attention block. This design avoids duplicated propagation. Extensive experiments across multiple multimodal benchmarks and MLLMs demonstrate that PriorTR consistently improves the trade-off between accuracy and efficiency over strong training-free baselines, particularly under aggressive token budgets.

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09.
arXiv (CS.CL) 2026-06-11

Steering the Noise: Turning Random Perturbations into Effective Descent for Memory-Efficient LLM Fine-Tuning

Authors:
Feihu Jin↗Shipeng Cen↗Ying Tan↗

Fine-tuning large language models (LLMs) achieves strong performance but is often limited by the memory overhead of backpropagation. Zeroth-order (ZO) optimization avoids this overhead by estimating gradients through forward passes alone, yet it typically converges slowly because random Gaussian perturbations yield high-variance gradient estimates in high-dimensional parameter spaces. In this paper, we propose a plug-and-play framework that turns random perturbations into more effective descent directions. The key idea is to draw a small pool of candidate perturbations, evaluate their loss values, and then select or combine those that are best aligned with the optimization objective. We develop two instantiations of this idea: MeZO-GV, which forms a guiding vector from the contrast between low-loss and high-loss perturbation groups, and MeZO-Greedy, which keeps the single best perturbation within a fixed evaluation budget. We theoretically show that both strategies yield a larger per-step reduction in the objective than standard ZO estimation, leading to improved convergence rates. Experiments on LLMs of different scales and architectures confirm that the proposed methods integrate naturally with existing ZO optimizers and consistently improve convergence speed and task accuracy. On OPT-13B, our approach outperforms all ZO baselines across 11 benchmarks and exceeds gradient-based methods on 9 of them, while retaining the memory efficiency of forward-only optimization.

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10.
arXiv (CS.AI) 2026-06-15

When Errors Become Narratives: A Longitudinal Taxonomy of Silent Failures in a Production LLM Agent Runtime

Authors:
Wei Wu↗

arXiv:2606.14589v1 Announce Type: cross Abstract: LLM agent systems increasingly run as long-lived autonomous runtimes: scheduling jobs, calling tools, maintaining memory, and pushing results to humans. We present a longitudinal study of silent failures in one such system: a personal-assistant agent runtime in continuous production since March 2026, with roughly 40 scheduled jobs, 8 LLM providers, a tool-governance proxy, and a knowledge-base memory plane, defended by 4,286 unit tests and 827 governance checks. Over eight weeks we documented 22 incidents with full root-cause postmortems, in which one meta-pattern – a failure whose error signal never reaches a human in actionable form – manifested at least 28 times. We derive a five-class, mechanism-oriented taxonomy: (A) environment and platform quirks, (B) design-assumption mismatches, (C) error swallowing and dilution, (D) chained hallucination and fabrication, (E) operational omission and forensic blind spots. Class D is unique to LLM systems and the most dangerous: the system does not merely fail to report an error – the LLM transforms it into fluent, plausible narrative delivered to the user. We term this fail-plausible: gray failure's differential observability escalated – the observer is not just blind, it is convincingly lied to by the failure itself. Three findings: about 70% of silent failures were caught by human user-view observation, not tests or audits; a retrospective audit of 15 incidents found 0% ex-ante prevention but 87% regression blocking – audits are regression engines, not prediction engines; incident latency (13 hours to 60 days) tracks failure mechanism, not code complexity – the longest-lived failures lived in the seams between components, where no test runs. We describe the resulting defense framework and distill design principles for agent systems whose failures are loud, attributable, and boring. All postmortems and artifacts are public.

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

TextHOI-3D: Text-to-3D Hand-Object Interaction via Discrete Multi-View Generation and Joint Mesh Optimization

Authors:
Zixiong Hao↗Zhencun Jiang↗

Text-conditioned 3D generation has progressed rapidly for images and isolated objects, but producing a hand-object mesh remains challenging: the output must preserve language semantics, cross-view consistency, object geometry, articulated hand shape, and physically plausible contact. We present TextHOI-3D, a staged framework that uses generated multi-view observations as an explicit interface between text-conditioned visual generation and geometry-aware hand-object recovery. TextHOI-3D learns a compact VQ token space for fixed-camera hand-object observations, predicts multi-view visual tokens from text with a CLIP-conditioned visual autoregressive model, and recovers a unified hand-object mesh through prior initialization, multi-view joint optimization, and anti-penetration refinement. The design separates semantic generation from geometric recovery while keeping both stages connected by a discrete multi-view representation. On HO3D-derived evaluations, the multi-view setting reduces object CD from 17.26 mm to 4.92 mm and penetration volume from 5.3721 cm^3 to 0.2193 cm^3 compared with a single-view counterpart, while improving hand errors and surface F-scores. These results support multi-view visual tokens as an effective intermediate representation for text-driven 3D hand-object mesh creation.

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

Calibrated Sampling-Free Uncertainty Estimation in Bayesian Deep Learning

Authors:
Tobias Jan Wieczorek↗Leon de Andrade↗Thomas M\"ollenhoff↗Marcus Rohrbach↗

arXiv:2606.16214v1 Announce Type: cross Abstract: Modern deep learning models remain notoriously prone to overconfidence, limiting their reliability in high-stakes applications. Bayesian methods aim to counter this by learning a distribution over model parameters, and recent advances now make this feasible for large-scale architectures at costs comparable to AdamW. However, a challenge remains at test time: predictions must be averaged across many forward passes with weights sampled from the posterior, which is prohibitively expensive. Variance propagation offers an efficient alternative, computing layer-wise analytical approximations of uncertainty in a single forward pass. While such techniques are effective for MLPs, their extension to modern architectures remains challenging, due to increased depth and diversity of layer types. To fill this gap, we propose Calibrated Variance Propagation (CVP), which introduces a new propagation method for normalization layers, combines it with recent techniques for handling activation functions, and absorbs residual error through a light calibration step. CVP yields comparably accurate uncertainty estimates to MC sampling across transformers and CNNs, at a fraction of the cost. Against prior variance propagation work, CVP improves coverage at $0.5\%$ risk from $8.2\%$ to $14.6\%$ with BEiT-3 on Visual Reasoning (NLVR2) and from $2.6\%$ to $10.8\%$ with ViLT on VQAv2, with gains extending to convolutional architectures.

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

MagpieTTS-LF: Inference-Time Long-Form Speech Generation Without Training on Long-Form data

Authors:
Subhankar Ghosh↗Jason Li↗Paarth Neekhara↗Shehzeen Hussain↗Ryan Langman↗Xuesong Yang↗Roy Fejgin↗

arXiv:2606.18485v1 Announce Type: cross Abstract: Neural Text-to-Speech (TTS) systems achieve remarkable quality on short utterances but long-form speech generation shows prosodic drift, speaker inconsistencies and sentence boundary artifacts. Existing approaches either compress sequences, increase context length or naively concatenate independently synthesized chunks. We present an inference-time approach called MagpieTTS-LF that enables MagpieTTS to produce coherent long-form speech without model retraining. Our method introduces three key innovations: (1) soft attention priors to guide monotonic alignment while preserving past and future context; (2) a stateful inference algorithm that maintains context across sentence chunks, ensuring prosodic continuity; (3) history-aware text encoding that uses past text for discourse-level prosodic planning. Experiments on long texts show significant improvements in long-range intelligibility, prosodic coherence, speaker consistency, and boundary naturalness compared to other baselines.

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14.
arXiv (CS.CV) 2026-06-16

Training-Free Adversarial Robustness in Computational MRI

Authors:
Mahdi Saberi↗Chi Zhang↗Mehmet Ak\c{c}akaya↗

Deep learning (DL) methods have become the state-of-the-art for reconstructing sub-sampled magnetic resonance imaging (MRI) data. However, studies have shown that these methods are susceptible to small adversarial input perturbations, resulting in major distortions in the output images. Various strategies have been proposed to reduce the effects of these attacks, but they require retraining. In this work, we propose a novel approach for mitigating adversarial attacks on MRI reconstruction models without any retraining. Based on the idea of cyclic measurement consistency, we devise a novel mitigation objective that is minimized in a small ball around the attack input. Results show that our method substantially reduces the impact of adversarial perturbations across different datasets, attack types/strengths and PD-DL networks, and qualitatively and quantitatively outperforms conventional mitigation methods. We also introduce a practically relevant scenario for small adversarial perturbations that models impulse noise in raw data, which relates to herringbone artifacts, and show the applicability of our approach in this setting. Finally, we show our mitigation approach remains effective in two realistic extension scenarios: a blind setup, where the attack strength or algorithm is not known to the user; and an adaptive attack setup, where the attacker has full knowledge of the defense strategy.

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15.
arXiv (CS.AI) 2026-06-17

Trust the Right Teacher: Quality-Aware Self-Distillation for GUI Grounding

Authors:
Jingyuan Huang↗Zuming Huang↗Yucheng Shi↗Tianze Yang↗Xiaoming Zhai↗Wei Chu↗Ninghao Liu↗

arXiv:2606.18101v1 Announce Type: new Abstract: Graphical user interface (GUI) grounding requires vision-language models (VLMs) to identify small target elements in high-resolution screenshots and predict precise screen coordinates. On-policy self-distillation (OPSD) is a promising post-training approach for this coordinate-sensitive task, since it provides dense token-level teacher signals beyond hard coordinate labels. However, naive OPSD is not well suited to GUI grounding: OPSD evaluates the teacher on student-generated prefixes, the quality of coordinate-token teacher signals can degrade when the prefix has already deviated from the target coordinate, leading to unreliable teacher signal. To mitigate this, We propose quality-aware self-distillation for VLM-based GUI grounding, which improves coordinate-token teacher-signal quality through soft correctness-aware gating and teacher-probability scaling. The soft correctness-aware gate checks whether the teacher's current coordinate-token prediction can still be completed into the ground-truth box under the student-generated prefix. If not, the corresponding teacher signal is down-weighted. Teacher-probability scaling then uses the teacher's confidence as a lightweight factor to further calibrate the strength of the gated supervision. A key empirical finding is that neither component alone improves overall performance, whereas combining them consistently improves performance. This suggests that the two mechanisms play complementary roles: correctness-aware gating suppresses unreliable coordinate-token supervision, while teacher-probability scaling calibrates the strength of the remaining signals. Experiments across six GUI grounding benchmarks show that our method consistently improves the base model and outperforms strong baselines.

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16.
arXiv (CS.AI) 2026-06-19

Science Earth: Towards A Planet-Scale Operating System for AI-Native Scientific Discovery

Authors:
Zhe Zhao↗Haibin Wen↗Yingcheng Wu↗Jiaming Ma↗Yifan Wen↗Jinglin Jian↗Jiacheng Ge↗Xiangru Tang↗Bo An↗Ming Yin↗Sanfeng Wu↗Mengdi Wang↗…

arXiv:2606.01316v2 Announce Type: replace Abstract: Scientific discovery demands intelligence, perseverance, and serendipity across vast search spaces. Today, top scientific capabilities remain siloed–one AI system for biological analysis, another for clinical reasoning, mathematical derivation, or materials simulation–and no pre-designed team can anticipate every skill a question will need. Science Earth is a planet-scale scientific runtime in which any capability–a simulation cluster, a wet-lab robot, a proof engine, a single-cell pipeline–can connect to any other, with collaboration structure emerging from the question itself. Its underlying EACN protocol lets capabilities discover one another, negotiate task ownership, and adjudicate across incompatible evidentiary standards without prior knowledge of who will meet whom. This shifts the organizing challenge from workflow design to open-ended connectivity. Two runs validate this under structurally distinct conditions. In a trans-Pacific higher-order Kuramoto synchronization study, agents identified and corrected a closure-ratio assumption in Ott-Antonsen analytic theory that fails outside the Lorentzian limit, within thirty minutes. In an eight-agent single-cell run on the 4.88M-cell Kang 2024 pan-cancer atlas, heterogeneous capabilities coupled over a 64.9-hour window with one structural external instruction, producing three new result layers and anchoring findings against an independent wet-lab study on an adjacent CCR8- TIGIT+ Treg subset. These cases are a first empirical reading, not a benchmark sweep. They show that when AI capabilities are truly connectable and coordination emerges from the problem, scientific reasoning becomes a distributed, self-correcting process–a step towards scaling AI-native discovery to the planet.

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

PANDA: An LLM-Enhanced Performance-Driven Analog Design Framework Bridging Design Intent and Layout Generation

Authors:
Haoyi Zhang↗Weijian Fan↗Xiaohan Gao↗Bingyang Liu↗Runsheng Wang↗Yibo Lin↗

arXiv:2606.15052v1 Announce Type: cross Abstract: Traditional design of analog circuits heavily relies on manual interventions across topology, sizing, and layout, with prior automation addressing stages in isolation. In this work, we propose PANDA, an LLM-enhanced framework that bridges high-level design intent to final layout by actively managing cross-stage dependencies through guided topology synthesis, substructure-aware sizing, and constraint-driven layout generation. This shifts automation from algorithm-centric execution to intent-centric co-design, reducing turnaround time from days or weeks to hours while improving design performance.

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

Scalable Circuit Learning for Interpreting Large Language Models

Authors:
Naiyu Yin↗Dennis Wei↗Tian Gao↗Amit Dhurandhar↗Karthikeyan Natesan Ramamurthy↗Yue Yu↗

arXiv:2606.16939v1 Announce Type: cross Abstract: A prominent research direction in mechanistic interpretability is learning sparse circuits over LLM components to reveal how they jointly produce model behavior. However, raw neurons are polysemantic, making learned circuits hard to interpret. Sparse autoencoder (SAE) features alleviate this, but their high dimensionality makes existing intervention-based circuit learning methods computationally prohibitive. We propose CircuitLasso, a scalable circuit-learning approach based on sparse linear regression. CircuitLasso recovers circuits whose structural accuracy matches that of state-of-the-art intervention-based methods on the benchmark data, at a fraction of the computational cost. For interpretability, CircuitLasso efficiently uncovers relationships among SAE features, showing how human-interpretable semantic features propagate through the model and influence its predictions. Finally, we validate the utility of our learned circuits by leveraging their insights to achieve comparable performance at substantially lower cost on a domain-generalization task.

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19.
medRxiv (Medicine) 2026-06-11

Wealth-Related Inequalities in Cesarean Section Utilization Among Facility-Based Births in Bangladesh: Evidence from Public and Private Healthcare Facilities

Authors:
Mahmud↗

Background Bangladesh has experienced a rapid increase in cesarean section (CS) utilization over the past two decades. While previous studies have documented socioeconomic disparities in CS use, evidence on how wealth-related inequalities differ between public and private healthcare facilities remains limited. This study assessed the magnitude and drivers of socioeconomic inequality in CS utilization among facility-based births in Bangladesh. Methods We analyzed data from 3,008 facility-based births reported in the 2022 Bangladesh Demographic and Health Survey (BDHS). Survey-weighted multivariable logistic regression was used to identify factors associated with CS utilization. Wealth-related inequality was assessed using concentration curves and the Erreygers-corrected concentration index (ECCI). Regression-based decomposition of the standard concentration index was performed to quantify the contribution of socioeconomic, demographic, and healthcare-related factors to observed inequalities overall and separately for public and private facilities. Results Overall, 71.2% of facility-based births were delivered by CS, with substantially higher prevalence in private facilities (84.2%) than in public facilities (35.9%). Women delivering in private facilities had markedly higher odds of CS than those delivering in public facilities (adjusted odds ratio [AOR]: 9.07; 95% confidence interval [CI]: 7.17-11.47). Significant pro-rich inequality was observed overall (ECCI: 0.154; 95% CI: 0.117-0.191), with inequality substantially greater in public facilities (ECCI: 0.189; 95% CI: 0.114-0.264) than in private facilities (ECCI: 0.049; 95% CI: 0.014-0.084). Decomposition analysis showed that household wealth was the dominant contributor to inequality, particularly the richest wealth quintile, accounting for 81.5% of overall inequality, 63.8% in public facilities, and 109.7% in private facilities. Conclusions Wealth-related inequalities in CS utilization remain substantial in Bangladesh despite widespread use of the procedure. Although pro-rich inequality exists across both sectors, inequality is considerably greater in public facilities and is driven by different mechanisms across facility types. Policies should simultaneously improve equitable access to medically necessary CS and reduce unnecessary procedures, particularly within the private sector.

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20.
medRxiv (Medicine) 2026-06-22

The Unsteady Return of Command-Following: Recovery and Instability of Bedside Motor Command-Following After Acute Brain Injury

Authors:
Gorenshtein↗Adiniaev↗Omar↗Barash↗Klang↗Daniel↗

Background/Objective: Following a verbal command marks the bedside transition from unresponsiveness to overt recovery of consciousness after acute brain injury. Its timing across phenotypes, stability once present, and dependence on sedation are uncharacterized at scale. Methods: Retrospective cohort of adults with acute brain injury, first intensive care unit stay, MIMIC-IV. Command-following was the Glasgow Coma Scale motor response "Obeys Commands." Among patients not following commands at admission, cumulative incidence was estimated with death or hospice and discharge without recovery as competing events. Instability was quantified as transient first recovery and threshold crossings; examinations were tagged for concurrent sedation. Principal findings were externally validated in the multicenter eICU Collaborative Research Database. Results: Of 13,900 brain-injured patients with three or more motor examinations, 5,498 (39.6%) were not following commands at admission. The cumulative incidence of first command-following was 43.5% by 24 hours and 65.0% by 14 days, ranging at 14 days from 36.9% in anoxic injury to 77.2% in ischemic stroke (anoxic versus ischemic stroke at 72 hours, difference 0.41; adjusted P = .002). Among 3,573 patients who recovered, the first recovery was transient in 22.2%, and 62.4% crossed the threshold repeatedly. Non-following was strongly associated with sedation, consistent with an arousal-dependent examination. In eICU, the 14-day incidence was 64.8%, and transient first recovery was 22.7%, closely matching the primary cohort. Conclusions: After acute brain injury, overt bedside command-following returns early but unsteadily, with phenotype-dependent timing, threshold fluctuation, and strong dependence on sedation. A single charted observation is an unreliable index of the underlying state.

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21.
arXiv (CS.CL) 2026-06-12

The Illusion of Multi-Agent Advantage

Authors:
Prathyusha Jwalapuram↗Hehai Lin↗Chuyuan Li↗Fangkai Jiao↗Sudong Wang↗Yifei Ming↗Zixuan Ke↗Chengwei Qin↗Giuseppe Carenini↗Shafiq Joty↗

Prevailing wisdom posits that Multi-Agent Systems (MAS) are superior to Single-Agent Systems (SAS), citing advantages like context protection, parallel processing and distributed decision-making. However, empirical support for this claim relies primarily on comparisons with SAS baselines using benchmarks that prioritize isolated reasoning tasks, which do not adequately assess these advantages. Focusing on automatically generated MAS that are designed for enhanced generalizability over manually-designed counterparts, we perform a rigorous, systematic evaluation against SAS, specifically Chain-of-Thought with Self-Consistency (CoT-SC). Across traditional reasoning datasets and tasks with interactive multi-step workflows (e.g., BrowseComp-Plus), we demonstrate that automatic MAS consistently underperform CoT-SC despite being up to 10x more expensive. To isolate these failures from limitations inherent to task structure, we introduce a diagnostic synthetic dataset tailored for MAS featuring explicit task decomposition, context separation and parallelization potential. We show that expert-architected MAS consistently outperforms automatically generated architectures in both raw performance and cost-efficiency on this dataset, demonstrating that existing evaluation frameworks mask critical architectural gaps and inefficiencies of complex MAS by failing to account for the marginal utility of increased computational cost. Critically, systematic deconstruction of the generated MAS architectures reveals that current automated design paradigms produce architectural bloat that prioritizes superficial complexity which does not translate into functional utility, exposing a fundamental misalignment with multi-agent principles.

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22.
arXiv (quant-ph) 2026-06-11

Scaling-optimal purification of noisy qubit unitary channels

Authors:
Ryotaro Niwa↗Satoshi Yoshida↗Koki Ono↗Takeru Utsumi↗Zhaoyi Li↗Yuxiang Yang↗Ryuji Takagi↗Mio Murao↗

arXiv:2606.12394v1 Announce Type: new Abstract: We consider the problem of purifying noisy qubit unitary channels. Given the ability to apply an unknown qubit unitary channel followed by depolarizing noise, we aim to construct a superchannel that purifies the noisy unitary back to the original unknown unitary. We first provide numerical evidence that sequential strategies can strictly outperform parallel strategies when the number of channel uses is finite, highlighting the fundamental distinction from state purification. We then provide a concrete $\mathrm{U}(2)$-covariant parallel protocol based on a novel entanglement-assisted quantum error-correcting code that suppresses the first-order noise strength as $O(1/n)$ with $n$ channel uses and show this scaling is asymptotically optimal in the low-noise regime, even when sequential strategies are allowed.

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23.
arXiv (CS.CV) 2026-06-24

Counting Trees from Satellite Imagery with Noisy Supervision

Authors:
Dimitri Gominski↗Maurice Mugabowindekwe↗Qiue Xu↗Xiaowei Tong↗Martin Brandt↗Hieu Le↗Rasmus Fensholt↗Dimitris Samaras↗Loic Landrieu↗

Counting individual trees is a fundamental task for environmental monitoring, yet remains largely unexplored with satellite imagery. At these resolutions, isolated trees may still be identifiable, but crown boundaries become ambiguous in dense forests, making the notion of an individual tree inherently ill-defined. Moreover, large-scale manual annotations of individual trees are prohibitively expensive. While scalable supervision can be derived from airborne LiDAR, the resulting annotations are noisy and difficult to exploit effectively. We address these challenges by formulating tree counting as a spatial density matching problem supervised through Unbalanced Optimal Transport. This formulation naturally accommodates both precise localization of isolate trees and robust density estimation in dense forests. We further introduce a self-correction mechanism that leverages transport residuals to progressively refine noisy supervision during training. We evaluate our approach on TinyTrees, a new benchmark spanning three continents and three satellite sensors, comprising over 215 million tree annotations (including 773K manually verified instances) across 23,000 sq.km. Our method consistently outperforms detection-based, regression-based, and transport-based distribution-matching baselines, demonstrating the effectiveness of unbalanced transport and reliability-aware supervision for large-scale tree counting from satellite imagery. Code, data and models are available at https://github.com/dgominski/treematch.

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24.
arXiv (CS.LG) 2026-06-12

Design Criteria for SGD Preconditioners: Local Conditioning, Noise Floors, and Basin Stability

Authors:
Mitchell Scott↗Tianshi Xu↗Ziyuan Tang↗Alexandra Pichette-Emmons↗Qiang Ye↗Yousef Saad↗Yuanzhe Xi↗

arXiv:2511.19716v2 Announce Type: replace-cross Abstract: Stochastic Gradient Descent (SGD) often slows in the late stage of training due to anisotropic curvature and gradient noise. We analyze preconditioned SGD in the geometry induced by a symmetric positive definite matrix $\mathbf{M}$, deriving bounds in which both the convergence rate and the stochastic noise floor are governed by $\mathbf{M}$-dependent quantities: the rate through an effective condition number in the $\mathbf{M}$-metric, and the floor through the product of that condition number and the preconditioned noise level. For nonconvex objectives, we establish a preconditioner-dependent basin-stability guarantee: when smoothness and basin size are measured in the $\mathbf{M}$-norm, the probability that the iterates remain in a well-behaved local region admits an explicit lower bound. This perspective is particularly relevant in Scientific Machine Learning (SciML), where achieving small training loss under stochastic updates is closely tied to physical fidelity, numerical stability, and constraint satisfaction. The framework applies to both diagonal/adaptive and curvature-aware preconditioners and yields a simple design principle: choose $\mathbf{M}$ to improve local conditioning while attenuating noise. Experiments on a quadratic diagnostic and three SciML benchmarks validate the predicted rate-floor behavior.

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

Deterministic Integrity Gates for LLM-Assisted Clinical Manuscript Preparation: An Auditable Biomedical Informatics Architecture

Authors:
Yoojin Nam↗Jinhoon Jeong↗Namkug Kim↗

arXiv:2606.09500v3 Announce Type: replace Abstract: As autonomous research agents and AI co-scientist systems push large language models (LLMs) from drafting toward end-to-end manuscript production, the bottleneck shifts from generation to verification. Fluent LLM output can hide fabricated citations, numbers that drift from source tables, and unmet reporting-guideline items; existing tools generate without verifying, and self-critique inherits the blind spots that produce confident fabrication. We describe an architecture pairing generation with verification, resting on three principles: decompose the workflow into self-contained skills, gate every stage transition with halt-on-failure, and resolve each integrity question with the cheapest sufficient mechanism, a deterministic, re-executable check where one suffices and a prose-level probe only where interpretation is unavoidable. This determinism-where-possible split, organized as an integrity-gate taxonomy, is the core contribution. It is realized as MedSci Skills, an open-source toolkit of 43 skills with a 21-detector deterministic tier, evaluated on three public-dataset pipelines (STARD, PRISMA, STROBE) and a seeded-defect ablation. Across the three pipelines every content-hash manifest verified clean and the gates surfaced real defects; on 27 identical injected defects the deterministic gates detected all 27 with no false positives on the matched clean fixtures, whereas a single-prompt LLM reviewer detected 11, its misses in code, bibliography, and style defects the prose hides. Determinism-where-possible verification yields an auditable, re-executable trail that exposes the evidence a human needs to check an LLM-assisted manuscript: feasibility and reproducibility evidence, not a claim of human-competitive quality, which a separate blinded study addresses. MedSci Skills is MIT-licensed and archived (v3.8.0).

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