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01.
arXiv (CS.CL) 2026-06-19

What sentiment analysis can't see: Measuring whether customers were helped, and what went wrong, across 70,000 support conversations

Most companies read their customer support data at scale using sentiment analysis, which measures how customers sound rather than whether they were satisfied with the result. We tested a richer alternative on 70,450 support conversations from a leading online fundraising platform: alongside tone, we used GPT-5.4 to estimate each customer's satisfaction and to flag whether they reported a concrete problem, then validated all three readings against the 1-to-5 ratings customers left on the conversations they rated. The satisfaction estimate tracked those ratings far better than sentiment did, correlating at 0.47 against 0.36 and flagging unhappy customers with far fewer false alarms. The structured read also sees what sentiment cannot: tone and satisfaction disagree in 44% of conversations, a single "Neutral" label hides everything from quietly satisfied customers to ones who quietly gave up, and the largest group of all is "tolerated friction," customers who are satisfied but still reporting a fixable problem, a standing issue that no sentiment-based dashboard can surface. The broader finding is that LLM-based annotation can capture far more than the tonality of a customer's language, offering strong potential for new business metrics grounded instead in the customer's state (whether they were satisfied) and the cause of their problem extracted directly from the raw textual data of interactions and feedback.

02.
arXiv (CS.AI) 2026-06-16

WorkflowPerturb: Calibrated Stress Tests for Evaluating Multi-Agent Workflow Metrics

arXiv:2602.17990v2 Announce Type: replace Abstract: Multi-agent LLM systems that generate structured workflows from natural-language requests are now deployed in production across cloud automation, DevOps, and enterprise process orchestration. Operating such systems exposes a recurring change-management problem. Routine updates, such as re-running the same input, swapping the underlying LLM, or refactoring an agent's prompt or orchestration code, frequently produce workflows that differ substantially from previously validated references. Engineers are then left without a principled way to decide whether a change is safe to ship. Automatic workflow evaluation is the natural tool for answering this question. In practice, however, metric scores are poorly calibrated, and a numeric change rarely communicates the severity of the underlying degradation. We introduce WorkflowPerturb, a controlled benchmark for studying workflow evaluation metrics by applying realistic, graded perturbations to golden workflows. WorkflowPerturb contains 4,973 golden workflows and 44,757 perturbed variants across three perturbation types (Missing Steps, Compressed Steps, and Description Changes), each applied at severity levels of 10%, 30%, and 50%. We benchmark multiple metric families and analyze their sensitivity and calibration using expected score trajectories and residuals. Our results characterize systematic differences across metric families and support severity-aware interpretation of workflow evaluation scores in change-management settings. Our dataset will be released upon acceptance.

03.
medRxiv (Medicine) 2026-06-16

Enteral docosahexaenoic and arachidonic acid supplementation and retinopathy of prematurity: a re-analysis of randomized controlled trials in preterm infants

Background. A recent meta-analysis by Dang et al. [1] concluded that enteral supplementation with docosahexaenoic acid (DHA), with or without arachidonic acid (ARA) did not significantly affect retinopathy of prematurity (ROP) outcomes in preterm infants. Of four eligible trials that supplemented both DHA and ARA, only two contributed to each ROP outcome analyzed, and severe ROP was not assessed. Methods. We replicated the eligibility criteria and search strategy of Dang et al., restricted to trials that supplemented both DHA and ARA, and reanalyzed three ROP endpoints (any ROP, ROP requiring treatment, and severe ROP [stage 3 and/or treated]) using complete outcome records from all eligible trials. Crude risk ratios (RR) were pooled by Mantel-Haenszel fixed-effect meta-analysis. Gestational age-adjusted odds ratios (adjOR) were pooled on the log scale by inverse-variance random-effects meta-analysis with restricted maximum likelihood (REML) estimation of between-study variance and Hartung-Knapp confidence intervals. Results. Five trials were included; one trial was identified in our replicated search but was excluded by Dang et al. without a stated rationale. The pooled estimate for any ROP was consistent with Dang et al. (RR 0.87 [95% CI 0.71-1.08]; adjOR 0.70 [0.46-1.08]). For ROP requiring treatment, the crude RR suggested a lower risk but did not reach statistical significance (RR 0.60 [0.35-1.04]), whereas the gestational age-adjusted estimate indicated lower odds (adjOR 0.47 [0.23-0.94]). For severe ROP, DHA+ARA supplementation produced a significant protective effect in both unadjusted and adjusted models (RR 0.56 [0.36-0.86]; adjOR 0.42 [0.19-0.96]). Conclusions. When all eligible trials contribute to each endpoint and severe ROP is included as an outcome, enteral DHA+ARA supplementation reduces severe ROP and is associated with lower odds of ROP requiring treatment after adjustment for gestational age. These findings differ from the conclusions of Dang et al. and support reconsideration of DHA+ARA supplementation as a strategy to reduce sight-threatening ROP in preterm infants.

04.
medRxiv (Medicine) 2026-06-15

VarEx: A Large Language Model Pipeline for Automated Extraction of Exposures, Outcomes, and Covariates from Epidemiologic Studies

Objective: Observational studies are essential for investigating risk factors for Alzheimer's disease and related dementias (ADRD), but inconsistent reporting and selection of covariates can contribute to residual confounding, omitted-variable bias, and reduced reproducibility. We developed and evaluated VAREX (Variable Extraction), a large language model (LLM)-based information extraction framework designed to automatically identify exposures, outcomes, and covariates from epidemiologic studies and populate structured evidence repositories. Materials and Methods: VAREX combines retrieval-augmented generation, biomedical language-model embeddings, semantic chunking, cross-encoder reranking, and prompt-engineered LLM workflows to extract epidemiologic variables from full-text biomedical articles. The framework was evaluated using a reference-standard corpus of observational studies examining blood pressure variability (BPV) and Alzheimer's disease-related dementias (ADRD), together with external validation datasets involving other exposure-outcome relationships. Extracted variables were compared with independently curated human reference standards using semantic matching and one-to-one assignment procedures. Covariates were additionally classified into ten epidemiologically relevant semantic categories. Results: In the primary BPV[->]ADRD corpus (10 studies), VAREX achieved a precision of 0.91, recall of 0.84, and F1-score of 0.87 for variable extraction. Covariate classification accuracy was 0.90, yielding a strict extraction-and-classification F1-score of 0.78. External validation datasets demonstrated comparable performance across diverse epidemiologic domains, with extraction F1-scores ranging from 0.73 to 0.85. Category-level performance was strongest for health behaviors (F1=0.96), sociodemographic variables (F1=0.90), and medication exposures (F1=0.89). Compared with published estimates of manual systematic-review effort, VAREX reduced processing time from approximately 61 minutes to 9 minutes per article, representing an 85.7% reduction in review time. Discussion: These findings demonstrate that LLM-based information extraction can accurately identify and classify epidemiologic variables across heterogeneous observational-study designs. Automated extraction enables scalable construction of structured repositories of exposures, outcomes, and covariates while substantially reducing the labor required for evidence synthesis and systematic reviews. Conclusion: VAREX provides an effective framework for automated extraction and classification of epidemiologic variables from the biomedical literature. By supporting large-scale evidence synthesis and structured knowledge resource development, VAREX may facilitate more rigorous observational research, improved confounder identification, and enhanced reproducibility in epidemiology.

05.
arXiv (quant-ph) 2026-06-15

The Magic Barrier before Thermalization

arXiv:2510.11681v2 Announce Type: replace Abstract: We investigate the time dependence of anti-flatness in the entanglement spectrum, a measure for non-stabilizerness and lower bound for non-local quantum magic resource, on a subsystem of a linear SU(2) plaquette chain during thermalization. Tracing the time evolution of a large number of initial states, we find that the anti-flatness exhibits a barrier-like maximum during the time period when the entanglement entropy of the subsystem grows rapidly from the initial value to the microcanonical entropy. The location of the peak is strongly correlated with the time when the entanglement exhibits the strongest growth. This behavior is found for generic highly excited initial computational basis states and persists for coupling constants across the ergodic regime, revealing a universal structure of the entanglement spectrum during thermalization. We conclude that quantitative simulations of thermalization for nonabelian gauge theories require quantum computing. We speculate that this property generalizes to other quantum chaotic systems, a conjecture supported by analogous behavior observed in real-time simulations of the mixed-field Ising model.

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

Phonikud: Overcoming Phonetic Underspecification for Hebrew Text-To-Speech

Text-to-speech (TTS) for Modern Hebrew is challenged by the language's orthographic complexity, with existing solutions ignoring underspecified phonetic features such as stress. We present a framework for more phonetically accurate Hebrew TTS with four contributions: (1) Phonikud, an open-source Hebrew grapheme-to-phoneme (G2P) system that outputs fully-specified International Phonetic Alphabet (IPA) transcriptions, designed by augmenting a base diacritizer. (2) The ILSpeech corpus of paired Hebrew audio, text, and expert IPA annotations. (3) A benchmark for the previously unmeasured task of Hebrew G2P conversion. (4) Hebrew audio-to-IPA models capturing previously disregarded phonetic details for automatic TTS evaluation. Our results show that Phonikud more accurately predicts Hebrew phonemes than prior methods, and that small, local TTS models with phonetic input from Phonikud approach large proprietary systems. We release our code, data, and models at https://phonikud.github.io.

07.
arXiv (CS.LG) 2026-06-15

Optimal Hidden-Target Learning for Online Inventory Optimization on General Convex Sets

arXiv:2606.14679v1 Announce Type: new Abstract: Online inventory optimization (OIO) is online convex optimization with physical memory: inventory carryover makes the feasible action set depend on the past. A natural principle, used in stochastic inventory learning and recently in OIO under a single linear capacity constraint, is to maintain a hidden target chosen by an online learner and implement its projection onto the currently feasible order-up-to set. We prove that this simple principle is optimal for OIO on arbitrary bounded convex capacity sets. With online gradient descent as the base learner, the method improves the best known regret guarantee for OIO on general convex sets from inverse to inverse-square-root dependence on the common-demand probability, and we prove a matching lower bound. The same principle gives the first polylogarithmic regret guarantee for strongly convex losses and the first dynamic regret guarantee adapting to Euclidean path variation on general convex capacity sets. The analysis introduces a norm alignment principle: the right state variable is the distance from the hidden target to the feasible set, measured in the same norm as the projection. Under norm alignment, this distance evolves pathwise as a scalar queue, with target movement as arrival and common demand as service. This reduction to one-dimensional queue control resolves the state dependence and extends the guarantees to general convex capacity sets, beyond the reach of prior productwise approaches. Experiments on synthetic and real-world inventory data corroborate the theory.

08.
medRxiv (Medicine) 2026-06-17

Investigating shared genetic overlap of immune-mediated inflammatory diseases and cardiometabolic diseases

Abstract Background: Immune-mediated inflammatory diseases (IMIDs) are associated with increased risk of cardiometabolic diseases. Investigating genetic overlap among these conditions can provide insights into their clinical management. Methods: Genetic correlation was assessed using linkage disequilibrium score regression (LDSC). Then, a meta-analysis was conducted using Association Analysis Based on SubSETs (ASSET) to pinpoint independent single nucleotide polymorphisms (SNPs) shared across the diseases. Each independent SNP was then used to define a genomic window (+/-500KB) for colocalisation analysis and Local Analysis of [co]Variant Association (LAVA) to offer multiple layers of regional pleiotropic evidence. Over-representation analysis was then run to identify enriched biological pathways, which then were used for drug target analysis. Results: The LDSC analysis showed a significant global genetic correlation for rheumatoid arthritis (RA) and cardiometabolic diseases including hypertension, coronary artery disease (CAD), heart failure (HF), stroke, atrial fibrillation (AF), and type two diabetes mellitus (T2DM) ranging from rg = 0.09 to 0.24. ASSET meta-analysis identified 164 independent SNPs shared across RA and the cardiometabolic diseases with P < 5 x 10- in the overall one-sided meta-analysis P-value, FDR < 0.05 in both individual GWASs, and TRUE phenotype matrix. Colocalisation analysis revealed multiple loci with strong evidence (Posterior probabilities [&ge;] 80) of single causal SNPs between the trait pairs. LAVA analysis was then used as an additional layer of confirmation for the findings generated by ASSET and colocalisation and thus several loci were highlighted. Over-representation analysis showed significant enriched immune-related pathways across RA-hypertension, RA-CAD, RA-AF, and RA-T2DM trait pairs. Drug target analysis highlighted several drugs which could be further tested for their effectiveness in RA and its common comorbidities. Conclusion: The findings revealed a shared genetic architecture and key immune-related biological pathways underlying RA and its associated cardiometabolic comorbidities. The identified genes and drugs provide opportunities for further therapeutic assessment which could improve clinical management strategies.

09.
arXiv (CS.AI) 2026-06-24

Fix Initial Programs and Iteratively Refine Repair Instructions Toward Non-Elimination Multi-Turn Program Correction

arXiv:2604.23989v2 Announce Type: replace-cross Abstract: Recent work on large language models (LLMs) has emphasized the importance of scaling inference compute. From this perspective, the state-of-the-art method Scattered Forest Search (SFS) has been proposed, employing Monte Carlo Tree Search with carefully crafted initial seeds and textual optimization for multi-turn program correction. However, its complexity makes it unclear what factors contribute to improvements in inference performance. To address this problem, we analyze SFS and propose a simpler method, \textsc{Iterative Refinement of Repair Instructions} (IRRI), which fixes initial programs and iteratively refines repair instructions. Because of the simplicity of IRRI, we theoretically establish the non-elimination of IRRI using Oracle-Guided Inductive Synthesis (OGIS). Experiments on several program generation benchmarks suggest that IRRI achieves inference performance comparable to state-of-the-art methods. These results indicate that, even without complex search structures, refining initial programs with high-quality repair instructions alone can effectively improve inference performance.

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

Revisiting Outage for Edge Inference Systems

arXiv:2504.03686v3 Announce Type: replace-cross Abstract: One of the key missions of sixth-generation (6G) mobile networks is to deploy large-scale artificial intelligence (AI) models at the network edge to provide remote-inference services for edge devices. The resultant platform, known as edge inference, will support a wide range of Internet-of-Things applications, such as autonomous driving, industrial automation, and augmented reality. Given the mission-critical and time-sensitive nature of these tasks, it is essential to design edge inference systems that are both reliable and capable of meeting stringent end-to-end (E2E) latency constraints. Existing studies, which primarily focus on communication reliability as characterized by channel outage probability, may fail to guarantee E2E performance, specifically in terms of E2E inference accuracy and latency. To address this limitation, we propose a theoretical framework that introduces and mathematically characterizes the inference outage (InfOut) probability, which quantifies the likelihood that the E2E inference accuracy falls below a target threshold. Under an E2E latency constraint, this framework establishes a fundamental tradeoff between communication overhead (i.e., uploading more sensor observations) and inference reliability as quantified by the InfOut probability. To find a tractable way to optimize this tradeoff, we derive accurate surrogate functions for InfOut probability by applying a Gaussian approximation to the distribution of the received discriminant gain. Experimental results demonstrate the superiority of the proposed design over conventional communication-centric approaches in terms of E2E inference reliability.

11.
arXiv (math.PR) 2026-06-16

Layerwise Terminal Discrepancy in Chen's Reverse-Heat Coupling on the Boolean Cube

arXiv:2606.04573v2 Announce Type: replace-cross Abstract: Recently, Chen [Chen2026] proved that Talagrand's Boolean convolution conjecture holds up to the dimension-free factor \((\log\log\eta)^{3/2}\), namely for every fixed \(\tau>0\), \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{(\log\log\eta)^{3/2}}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \] We revisit the terminal testing-discrepancy step in Chen's perturbed reverse-heat coupling. Chen estimates this discrepancy globally in terms of the remaining gap to the terminal level. We keep the same coupling and the same reverse-heat formulations, but localize the terminal discrepancy on each remaining-gap layer before summing the layers. This changes the fixed-time anti-concentration cost from order \((\log L)^{3/2}/\sqrt L\) to order \((\log L)/\sqrt L\), where \(L=\log\eta\). Consequently, we obtain a \((\log\log\eta)^{1/2}\) improvement as \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{\log\log\eta}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \]

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

A fully GPU-based workflow for building physics emulators of hypersonic flows

arXiv:2606.13742v1 Announce Type: cross Abstract: The ability to resolve complex physical phenomena with high fidelity and at low computational cost is central to addressing key challenges in modern engineering. A prime example lies in hypersonic flows, where the precise prediction of the full flowfield topology, in particular with respect to shock wave location and intensity, is critical. Yet supersonic and hypersonic flows continue to be a stumbling block for traditional reduced-order models and neural emulators that struggle to capture steep gradients in flow states with physical consistency in applications of industrial relevance. To that end, we introduce a fully GPU based workflow that integrates accelerated data generation with the training of neural emulators augmented by uncertainty quantification and physics-aware refinement. Our workflow is enabled by a differentiable high-fidelity solver (JAX-Fluids) which we employ for rapid dataset creation and residual-based improvement of the neural emulator to enhance physical consistency. Building on this framework, we first present a suite of model architectures and analyze their scaling behavior to expose their strengths and shortcomings. We then show that residual-based refinement enables training on cases where only mesh and input parameters are available, substantially reducing residuals and improving physical consistency. Together, differentiable simulation and residual-based refinement yield physics emulators that remain reliable beyond their training distribution, a key requirement for deploying surrogates in real-world engineering design loops.

13.
medRxiv (Medicine) 2026-06-10

Development of a Novel Blood-Based Assay for Brain-Derived Tau and Its Validation in Traumatic Brain Injury

Brain-derived tau (BD-tau) is an emerging blood-based biomarker for neurodegeneration, yet there are currently limited well validated BD-tau assays available for research and clinical use. To enhance access to this vital biomarker for neurological disorders including traumatic brain injury (TBI), we developed a novel blood-based immunoassay for BD-tau on the ultra-sensitive Quanterix HD-X platform using Single Molecule Array technology. Analytical validation assessed dilution linearity, specificity, precision, detection limits, and spike recovery, each recording robust metrics in agreement with international expert recommendations. The assay demonstrated robust validation metrics, achieving between-run stability of 95% when analyzing aliquots from six independent plasma and serum samples across five analytical runs. It also showed strong dilution linearity when diluted four-fold and achieved over 90% recovery when spiked with cerebrospinal fluid. Next, we evaluated the clinical utility of the assay in cohorts of individuals with traumatic brain injury (TBI), where strong performances were recorded whether using the 2-step or 3-step assay formats ({rho}= 0.94; p < 0.0001). Furthermore, plasma BD-tau distinguished samples from TBI patients based on time from injury and severity (AUC=0.93). Plasma BD-tau differentiated between favorable and unfavorable functional outcomes in the acute-severe group. Our findings underscore the significant potential of the BD-tau assay as a biomarker for TBI in the severe phase.

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

ORAgentBench: Can LLM Agents Solve Challenging Operations Research Tasks End to End?

arXiv:2606.19787v1 Announce Type: new Abstract: Large language models are increasingly deployed as autonomous agents for multi-step tasks in executable environments, yet their ability to perform realistic operations research (OR) work remains unclear. Existing OR evaluations often decouple modeling from solving, rely on pre-formalized or text-only instances, and rarely test the full workflow from operational artifacts to validated decisions. In this work, we introduce ORAgentBench, an execution-grounded benchmark for evaluating autonomous agents on challenging end-to-end operations research tasks. It contains 107 human-reviewed tasks across diverse operational scenarios, each packaged in an isolated environment with a natural-language brief, multi-file data, configuration artifacts, and a required submission schema. Agents must write and run solution code, and their submissions are evaluated by hidden validators for schema validity, hard-constraint feasibility, and normalized objective quality. Experiments with fourteen frontier agent-model configurations show that current agents remain far from reliable OR practice. The best agent passes only 35.51% of all tasks and 20.59% of hard tasks, and many feasible submissions still fall below the required quality threshold. Failure analysis further shows that errors are dominated by strategic weaknesses, including missed operational rules, brittle formulations, weak feasible-solution construction, and insufficient solution improvement. OR-specific procedural skills increase hard-task feasibility, but do not reliably improve solution quality or pass rate. These results suggest that progress in OR agents requires moving beyond plausible optimization code toward dependable, high-quality operational decision-making.

15.
arXiv (CS.CL) 2026-06-16

SkillsVote: Lifecycle Governance of Agent Skills from Collection, Recommendation to Evolution

Long-horizon LLM agents generate traces that could become reusable experience, but raw trajectories are noisy, local, and hard to govern. Agent Skills offer a structured artifact for combining procedural guidance, executable resources, and applicability boundaries. Yet open skill ecosystems contain redundant, uneven, environment-sensitive artifacts, and indiscriminate updates can pollute future context. We present SkillsVote, a lifecycle-governance framework for Agent Skills across collection, recommendation, attribution, and evolution. SkillsVote profiles a million-scale open source corpus for environment requirements, quality, and verifiability, and synthesizes tasks for verifiable skills. Before execution, it performs agentic library search over structured skill folders to expose instructional context. After execution, it decomposes trajectories into skill-linked subtasks, attributes outcomes to skill-guided execution, agent exploration, environment, and result signals, and admits only successful reusable discoveries to evidence-gated updates. Experiments on Terminal-Bench 2.0 and SWE-Bench Pro show that SkillsVote improves agent performance on challenging agentic coding benchmarks. The gains arise from two complementary pathways: online evolution over task streams at test time and offline transfer via frozen libraries built from either historical trajectories or curated open source skills.

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

Quantifying Consistency in LLM Logical Reasoning via Structural Uncertainty

arXiv:2606.17312v1 Announce Type: new Abstract: Large language models can arrive at the same answer through reasoning paths that are unstable, contradictory, or difficult to rank consistently – a failure mode especially prevalent in multi-step deductive reasoning. Existing methods assess reliability primarily through output dispersion – measuring how much sampled answers differ – but this discards a complementary signal: whether the model can consistently rank competing reasoning candidates. We propose structural uncertainty, a consistency-aware framework derived from the stability of self-preference-induced rankings over sampled reasoning solutions. Given a query, we generate multiple candidate solutions and ask the model to judge pairwise preferences among its own outputs. We aggregate self-preferences into ranking distributions via Bradley-Terry modeling with PageRank, and decompose the signal into two entropy-based components: across-trial ranking instability and within-trial candidate ambiguity. Across five LLMs and eight benchmarks, structural signals provide information complementary to answer dispersion: on logical and mathematical reasoning tasks, the combination improves identification of unreliable instances, while on factual retrieval the structural signal collapses toward uniformity, diagnosing a regime boundary where reasoning-level consistency evaluation is uninformative. The two components relate differently to accuracy: within-trial ambiguity correlates positively with correctness – consistent with settings where multiple plausible solution paths remain competitive – while across-trial instability correlates negatively, signaling unreliable reasoning. Structural uncertainty is best understood not as a universal confidence estimator, but as a regime-sensitive evaluator of logical reasoning consistency.

17.
medRxiv (Medicine) 2026-06-11

Advancing Clinical Implementation of Cardiovascular Polygenic Risk Scores Through Patient-Level Robustness Assessment

Background and Aims: Polygenic risk scores (PRSs) for atherosclerotic cardiovascular disease (ASCVD) can perform equivalently at the population level yet disagree for individual patients. We examined whether such intra-individual variability reflects genuinely complementary risk information or mainly statistical and methodological uncertainty, and whether it affects clinical classification once PRSs are integrated into SCORE2-OP. Methods: In 4,137 ASCVD-free participants of the CoLaus|PsyCoLaus cohort (478 incident events over a median 14.4 years), we identified 16 ASCVD-PRSs with practically equivalent population-level performance using Bayesian equivalence testing. We quantified intra-individual variability (standard deviation, coefficient of variation, intraclass correlation, Cohen's kappa, extreme discordance), tested whether discordance exceeded chance, decomposed scores into shared and unique genetic components, and assessed variability after integration into SCORE2-OP, benchmarked against perturbation of systolic blood pressure. Results: For a typical individual, risk estimates varied by 18 percentile points across PRSs. Discordance matched chance expectations under a shared-signal model, with no distinct phenotypic profile among discordant individuals, and predictive power resided overwhelmingly in the shared genetic component. Variability tracked PRS size and weighting rather than distinct variants. After integration into SCORE2-OP, 75.6% of participants were placed in different categories by at least one model and 54.6% as both low and high risk; instability was concentrated near guideline thresholds and far exceeded that from blood-pressure measurement error. Conclusions: Equivalent population-level performance is not sufficient to treat PRSs as interchangeable at the individual level, and methodological standardisation and pragmatic clinical trials remain necessary to determine whether PRS integration improves long-term cardiovascular outcomes.

18.
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.

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

Edit Knowledge, Not Just Facts via Multi-Step Reasoning over Background Stories

arXiv:2602.02028v2 Announce Type: replace Abstract: Enabling artificial intelligence systems, particularly large language models, to update knowledge and flexibly apply it during reasoning remains a central challenge. Existing knowledge editing approaches emphasize atomic facts, improving factual recall but often failing to integrate updated information into a coherent framework usable across contexts. In this work, we argue that knowledge update is fundamentally a reasoning problem rather than a memorization problem. Consequently, a model should be trained in situations where the new information is instrumental to solving a task, combined with pre-existing knowledge, and exercised through multi-step reasoning. Based on this insight, we propose a training strategy based on three principles. First, new knowledge is introduced as a coherent background story that contextualizes novel facts and explains their relation to existing knowledge. Second, models are trained using self-generated multi-hop questions that require multi-step reasoning involving the new information. Third, training is done using knowledge distillation, forcing a student model to internalize the teacher's reasoning behavior without access to the novel information. Experiments show that models trained with this strategy effectively leverage newly acquired knowledge during reasoning and achieve remarkable performance on challenging questions that require combining multiple new facts.

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

NeRD: Neuro-Symbolic Rule Distillation for Efficient Ontology-Grounded Chain-of-Thought in Medical Image Diagnosis

Interpretability is essential for trustworthy medical image diagnosis. However, existing concept-driven interpretable methods have key limitations: Concept Bottleneck Models (CBMs) require scoring all predefined concepts at inference time and for manual intervention, imposing a substantial burden on clinicians, while rationale-based generative approaches often select concepts by class discriminability, which can drift from diagnostic ontologies. To address these issues, we propose Neuro-Symbolic Rule Distillation (NeRD), a framework that produces efficient, ontology-grounded reasoning chains that are sufficient yet non-redundant, without manually crafting diagnostic rules. Experiments on two skin datasets demonstrate strong diagnostic performance and interpretability, and blinded expert evaluation confirms the clinical plausibility of NeRD rationales. Our method further enables a first expert-in-the-loop study for Multimodal Chain-of-Thought-based diagnosis, achieving efficient and effective concept-level intervention.

21.
arXiv (CS.LG) 2026-06-17

Broadcast Product: Redefining Shape-aligned Element-wise Multiplication and Beyond

arXiv:2409.17502v2 Announce Type: replace Abstract: Broadcast operations are widely used in scientific computing libraries, yet their mathematical formulation is often implicit and inconsistently represented in machine learning literature. This problem frequently leads to invalid equations when element-wise products are written despite mismatched tensor shapes. In this paper, we formalize such operations by introducing the broadcast product $\boxdot$, which explicitly extends the Hadamard product through shape-aligned element duplication. We provide a rigorous definition of the broadcast product, analyze its algebraic properties, and show how it can be expressed using standard linear algebra. Building on this framework, we formulate least-squares problems and sketch a proof-of-concept broadcast decomposition. As a preliminary illustration, we show that the formalism enables a new family of decompositions with distinct structural properties from conventional tensor decompositions. This work establishes a mathematical foundation for broadcast-aware tensor operations, connecting practical implementations with rigorous tensor analysis.

22.
arXiv (CS.LG) 2026-06-12

Mirror Descent on Riemannian Manifolds

arXiv:2603.17527v2 Announce Type: replace-cross Abstract: Mirror Descent (MD) is a scalable first-order method widely used in large-scale optimization, with applications in image processing, policy optimization, and neural network training. This paper generalizes MD to optimization on Riemannian manifolds. In particular, we develop a Riemannian Mirror Descent (RMD) framework via reparameterization and further propose a stochastic variant of RMD. We also establish non-asymptotic convergence guarantees for both RMD and stochastic RMD. As an application to the Stiefel manifold, our RMD framework reduces to the Curvilinear Gradient Descent (CGD) method proposed in [26]. Moreover, when specializing the stochastic RMD framework to the Stiefel setting, we obtain a stochastic extension of CGD, which effectively addresses large-scale manifold optimization problems.

23.
Nature (Science) 2026-06-17

Spatial distribution of the proteome in the human body and in cancers

Authors:

A detailed, spatially resolved quantitative map of the human proteome is essential for a deeper understanding of human biology and disease1–4. Here we present a comprehensive human proteomic landscape, generated by profiling more than 13,000 proteins across 2,856 samples using data-independent acquisition mass spectrometry. The dataset spans 58 major tissue types, 251 specific tissue subtypes and 25 distinct carcinomas. This resource enables the depiction of spatially resolved proteome trajectories across tissue types and physiological states, including fetal, tumour, adjacent non-tumour and healthy adult tissue, thereby providing insight into both developmental processes and oncogenic progression. Furthermore, quantitative proteomics comparisons across diverse tissue types and states facilitate the indication of organ-specific toxicity, the identification of repurposable anticancer drug candidates and the prioritization of therapeutic targets for cancers. This study establishes a quantitative resource for navigating the proteome in the human body and in common cancers. A spatially resolved map of the human proteome across a variety of healthy tissues and cancers provides wide-ranging insights in developmental biology and oncology, and could aid the identification of therapeutic targets and development of treatments for cancer.

24.
arXiv (CS.LG) 2026-06-18

TS-Fault: Benchmarking Time Series Forecasters Against Structural Faults

arXiv:2606.18539v1 Announce Type: new Abstract: Time series forecasting (TSF) underpins consequential decisions in energy, transportation, finance, and healthcare, yet TSF models are almost universally ranked by a single number (e.g., average error) on clean held-out data, under the implicit assumption that it predicts deployed reliability. However, real faults are not i.i.d noise but structured events with temporal shape, broken cross-variable dependencies, regime change coupled with missingness, and causal propagation across a sensing pipeline. Treating TSF robustness as a data-quality problem, we present TS-Fault, a benchmark that evaluates forecasting models under explicit, parameterized fault scenarios with controllable semantic difficulty. TS-Fault organizes recurring failures into four modes along two orthogonal axes (observation- vs mechanism-level; univariate vs multivariate) and injects each fault into the most prediction-critical window via a unified importance score. This design enables robustness to be tested against the structures models actually rely on, rather than reduced to generic noise sensitivity. We evaluate 21 models across 6 datasets, 4 modes, and 5 difficulty levels under a paired clean/corrupt protocol. The results reveal three findings that contradict common leaderboard intuition: (i) clean-data accuracy anti-correlates with robustness; (ii) clean rankings are preserved under observation-level faults but reshuffled under mechanism-level faults; and (iii) all catastrophic failures occur under mechanism-level faults, with foundation models achieving the highest clean-data accuracy yet exhibiting the greatest fragility. The code is publicly available at https://github.com/Ray-zyy/TS-Fault.

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arXiv (CS.AI) 2026-06-12

Transformer Field Theory: A Response-Theoretic Approach to Mechanistic Interpretability

arXiv:2605.25225v2 Announce Type: replace-cross Abstract: Mechanistic interpretability often studies Transformer behavior by intervening on internal activations through activation patching, causal tracing, path patching, and steering directions. This paper develops Transformer Field Theory: a response-theoretic framework in which the residual stream of a fixed forward pass is treated as a Transformer field over layer depth and token position. In this formulation, patching becomes a localized source insertion into the Transformer field, first-order sensitivity fields predict patch effects, Green functions describe downstream propagation, and patch selection is posed as an adjoint inverse problem. Empirically, we test the theory's forward response objects in GPT-2-style autoregressive Transformers. Localized Transformer-field interventions exhibit a bounded local linear regime; first-order sensitivities predict patch effects across layer-token sites; localized sources generate structured anisotropic Transformer-field propagation; high-sensitivity sites and sliced Green operators provide reduced response descriptions; and prompt-induced Transformer-field displacements partially transfer answer behavior. These results establish sensitivities, Transformer-field responses, and sliced Green operators as practical objects for organizing patching experiments, while providing the forward mathematical basis for patch-site inference and cross-scale response transfer.