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01.
arXiv (CS.AI) 2026-06-11

What Limits Does Quantization Place on Dense Top-$k$ Retrieval? A Theoretical Study

arXiv:2606.11780v1 Announce Type: cross Abstract: We establish conditions for embedding a corpus of $N$ documents as $d$-dimensional vectors such that every $k$-subset $S \subseteq [N]$ is realizable as a result of top-$k$ retrieval by some query vector. Recent work shows that $d = O(k)$ suffices for such embeddings to exist in $\mathbb{R}^d$, independently of $N$. We theoretically prove that this corpus-independent bound is specific to infinite precision. With $B$ bits per coordinate, perfect top-$k$ retrieval requires $Bd = \Omega(k \ln N)$; thus, at any fixed precision, the dimension must grow at least logarithmically with $N$. Specializing to a $\ell_2$-normalized $B$-bit uniform scalar quantization model, we also identify a threshold on the precision $B^{*} = O(\ln \ln N)$ below which no dimension suffices, together with two further regimes that bound the feasible $(B, d)$ pairs. Our result implies that in practical vector databases and dense retrieval systems where quantization is standard, the embedding dimension and possibly the precision must grow with the corpus size.

02.
arXiv (quant-ph) 2026-06-12

Global Control with the Tavis-Cummings Interaction

arXiv:2606.12906v1 Announce Type: new Abstract: We study the controllability of a system of qubits under global control, where control pulses act identically on all qubits. Specifically, we consider a collection of qubits identically coupled to a single bosonic mode, or harmonic oscillator, via the Jaynes-Cummings interaction. This collective coupling, known as the Tavis-Cummings (TC) interaction, has been realized in several quantum computing platforms, including superconducting and atomic qubit systems. Although the qubits do not interact directly with one another, they can become entangled through their common coupling to the bosonic mode. We characterize the group of unitaries that can be implemented on the joint Hilbert space of the qubits and bosonic mode using the TC interaction together with a global $z$ field $J_z$, corresponding to identical z rotations on all qubits. We show that for n>2 qubits the set of realizable unitaries is restricted by an "accidental" symmetry of the TC Hamiltonian, distinct from its "standard" U(1) and permutational symmetries. On the other hand, we find that the Hamiltonian $J_z^2$ breaks this accidental symmetry and, together with the TC interaction and $J_z$, achieves semi-universality: it allows the implementation of arbitrary unitaries that respect permutational and U(1) symmetry, up to certain constraints on the center of the group. In a companion paper, we further analyze this remarkable accidental symmetry and show that it can be understood through Schwinger's bosonic model of angular momentum.

03.
arXiv (quant-ph) 2026-06-17

Projected logical ensembles in surface codes via the random-matrix theory of quantum dots

arXiv:2606.17140v1 Announce Type: new Abstract: Measurements underpin active quantum error correction (QEC) and have been recognized as a source of novel measurement-induced many-body phenomena. Here, we study the statistical properties of post-measurement logical states arising in QEC on topological codes subject to deterministic transversal unitary gates. Upon syndrome extraction followed by maximum-likelihood decoding, a Born-weighted ensemble arises which we dub the "projected logical ensemble" (PLE). Focusing on surface codes subject to uniform single-qubit Pauli-$X$ rotations, we characterize the measurement-induced randomness of the PLE. To this end, we show that for a code with a single logical qubit, the PLE is isomorphic to an ensemble of scattering matrices describing mesoscopic quantum dots obtained from a 2D Majorana network model with suitable boundary conditions. We uncover regimes where these quantum dots are chaotic such that their scattering matrices are well-described by random matrix theory. In these regimes, the PLE approaches a universal ensemble that is maximally random up to symmetry and decoder-induced constraints. The symmetry constraints, set by stabilizer and logical operator weights, realize Altland-Zirnbauer classes D or DIII, which we both illustrate. Our results establish a fundamental connection between emergent universality concepts in mesoscopic physics, quantum many-body systems, and QEC.

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

Shift-and-Sum Quantization for Visual Autoregressive Models

Post-training quantization (PTQ) enables efficient deployment of deep networks using a small set of data. Its application to visual autoregressive models (VAR), however, remains relatively unexplored. We identify two key challenges for applying PTQ to VAR: (i) large reconstruction errors in attention-value products, especially at coarse scales where high attention scores occur more frequently; and (ii) a discrepancy between the sampling frequencies of codebook entries and their predicted probabilities due to limited calibration data. To address these challenges, we propose a PTQ framework tailored for VAR. First, we introduce a shift-and-sum quantization method that reduces reconstruction errors by aggregating quantized results from symmetrically shifted duplicates of value tokens. Second, we present a resampling strategy for calibration data that aligns sampling frequencies of codebook entries with their predicted probabilities. Experiments on class-conditional image generation, inpainting, outpainting, and class-conditional editing show consistent improvements across VAR architectures, establishing a new state of the art in PTQ for VAR.

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

DADP: Domain Adaptive Diffusion Policy

arXiv:2602.04037v3 Announce Type: replace Abstract: Learning domain adaptive policies that can generalize to unseen transition dynamics, remains a fundamental challenge in learning-based control. Substantial progress has been made through domain representation learning to capture domain-specific information, thus enabling domain-aware decision making. We analyze the process of learning domain representations through dynamical prediction and find that selecting contexts adjacent to the current step causes the learned representations to entangle static domain information with varying dynamical properties. Such mixture can confuse the conditioned policy, thereby constraining zero-shot adaptation. To tackle the challenge, we propose DADP (Domain Adaptive Diffusion Policy), which achieves robust adaptation through unsupervised disentanglement and domain-aware diffusion injection. First, we introduce Lagged Context Dynamical Prediction, a strategy that conditions future state estimation on a historical offset context; by increasing this temporal gap, we unsupervisedly disentangle static domain representations by filtering out transient properties. Second, we integrate the learned domain representations directly into the generative process by biasing the prior distribution and reformulating the diffusion target. Extensive experiments on challenging benchmarks across locomotion and manipulation demonstrate the superior performance, and the generalizability of DADP over prior methods. More visualization results are available on the https://outsider86.github.io/DomainAdaptiveDiffusionPolicy/.

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

MEAL: A Benchmark for Continual Multi-Agent Reinforcement Learning

arXiv:2506.14990v3 Announce Type: replace Abstract: Benchmarks play a central role in reinforcement learning (RL) research, yet their computational constraints often shape what is studied. Despite the motivation of lifelong learning, most continual RL papers consider only 3-10 sequential tasks, as CPU-bound environments make longer sequences impractical. Meanwhile, continual learning in cooperative multi-agent settings remains largely unexplored. To address these gaps, we introduce MEAL (Multi-agent Environments for Adaptive Learning), the first benchmark for continual multi-agent RL. By leveraging JAX and GPU acceleration, MEAL enables training on sequences of 100 tasks in a few hours on a single GPU. We find that long task sequences reveal failure modes that do not appear at smaller scales.

08.
medRxiv (Medicine) 2026-06-22

Brain-gut axis imaging, motion correction with 11C-carfentanil total-body PET

Background: Mu-opioid receptors (MORs) are expressed throughout the body including in the brain and gastrointestinal (GI) tract. Total-body PET imaging of the brain and GI tract offers a promising approach for cross-sectional in vivo evaluation of the MOR brain-GI axis. However, intestinal motility and bladder filling introduce motion throughout the GI tract over the scan window. Here we establish analysis methodology to account for motion for dynamic imaging of the brain-GI axis, to further characterize peripheral MORs throughout the body and provide a framework for semi-automatic total-body PET modeling. Methods: 4 subjects underwent 90-min dynamic [11C]-carfentanil (cfn) total-body PET acquisitions at baseline, after intravenous naloxone (central antagonist) administration, and after orally administered loperamide (peripheral agonist and P-glycoprotein substrate). Thalamic MOR availability was measured using the Logan reference tissue model. Using CT-based segmentation, the GI tract was subdivided into anatomical segments, in addition to other peripheral organs (e.g., liver, psoas muscle). Frame-by-frame semi-automatic motion correction was performed with three distinct reference frames (11-14 min post-injection, p.i., 35-40 min p.i., and 85-90 min p.i.). The performance of these three were compared to manual correction. Compartment modeling and Logan graphical analysis were performed to estimate relevant kinetic parameters (K1, VT, VTLogan). Results: Across the 4 subjects and regions, kinetic parameter estimates were highly correlated (r>0.7) for K1, VT and VT Logan when comparing semi-automatic (reference frame at 35-40 min p.i.) and manual correction. With semi-automatic motion correction, graphical-based estimation of VTLogan in the gastrointestinal tract was significantly decreased with loperamide relative to baseline (p

09.
arXiv (quant-ph) 2026-06-17

Einstein-Podolsky-Rosen correlations between mechanical oscillators revealed through SU(1,1) interferometry

arXiv:2606.18202v1 Announce Type: new Abstract: Quantum correlations are essential for achieving quantum advantage in computing, communication and sensing. Moreover, their observation challenges and constrains our fundamental understanding of nature. Mechanical oscillators in the quantum regime provide an appealing platform for preparing and investigating quantum correlations at macroscopic scales. Despite substantial progress, however, continuous-variable quantum correlations stronger than entanglement have not yet been observed in this macroscopic regime. Here, we report the experimental observation of continuous-variable Einstein-Podolsky-Rosen correlations between two spatially-separated mechanical oscillators with an effective mass of $\sim 16 \,\mu g$ each. This is achieved by coupling them to a superconducting qubit which allows for engineering a two-mode squeezing interaction when parametrically driven. Crucially, we show that this interaction can be used to witness quantum correlations through the realization of a mechanical SU(1,1) interferometer. Our results expand the toolbox of operations in circuit quantum acoustodynamics and demonstrate that quantum correlations stronger than entanglement can also be observed in macroscopic systems, thereby shedding light on the boundary between quantum and classical regimes.

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

The Accountability Paradox: How Platform API Restrictions Undermine AI Transparency Mandates

arXiv:2505.11577v5 Announce Type: replace-cross Abstract: Recent application programming interface (API) restrictions on major social media platforms challenge compliance with the EU Digital Services Act [20], which mandates data access for algorithmic transparency. We develop a structured audit framework to assess the growing misalignment between regulatory requirements and platform implementations. Our comparative analysis of X/Twitter, Reddit, TikTok, and Meta identifies critical ``audit blind-spots'' where platform content moderation and algorithmic amplification remain inaccessible to independent verification. Our findings reveal an ``accountability paradox'': as platforms increasingly rely on AI systems, they simultaneously restrict the capacity for independent oversight. We propose targeted policy interventions aligned with the AI Risk Management Framework of the National Institute of Standards and Technology [80], emphasizing federated access models and enhanced regulatory enforcement.

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

Proactive Conversational Assistant for a Procedural Manual Task based on Audio and IMU

Real-time conversational assistants for procedural manual tasks often depend on video input, which can be computationally expensive and compromise user privacy. For the first time, we propose a real-time conversational assistant that provides comprehensive guidance for procedural manual tasks using only lightweight privacy-preserving modalities such as audio and IMU inputs from a user's wearable device to understand the context. Using a furniture assembly task and a cooking task, we show how this assistant proactively communicates step-by-step instructions to a user performing a procedural task, and answers user questions. We illustrate the data generation method and the system design to achieve such an assistant. On observing that an off-the-shelf language model is a talkative assistant but is not always able to answer questions correctly, we demonstrate how finetuning the model improves its ability to limit unnecessary dialogues with a 50% increase in the precision, while also improving its ability to answer questions correctly, measured by a 150% increase in the recall of answers. We further describe how such an assistant is implemented on an edge device with no dependence on the cloud.

12.
Nature (Science) 2026-06-09

Good recycling starts at home — and benefits the world

Authors: Unknown Author

New research supports the value of household-level waste separation. But policies must also carefully consider consumer behaviours to maximize the quality of material collected. New research supports the value of household-level waste separation. But policies must also carefully consider consumer behaviours to maximize the quality of material collected.

13.
arXiv (CS.CV) 2026-06-19

Abstraction in Style: Beyond Texture and Color

Artistic styles often embed abstraction beyond surface appearance, involving deliberate reinterpretation of structure rather than mere changes in texture or color. Conventional style transfer methods typically preserve the input geometry and therefore struggle to capture this deeper abstraction behavior, especially for illustrative and nonphotorealistic styles. In this work, we introduce Abstraction in Style (AiS), a generative framework that separates structural abstraction from visual stylization. Given a target image and a small set of style exemplars, AiS first derives an intermediate abstraction proxy that reinterprets the target's structure in accordance with the abstraction logic exhibited by the style. The proxy captures semantic structure while relaxing geometric fidelity, enabling subsequent stylization to operate on an abstracted representation rather than the original image. In a second stage, the abstraction proxy is rendered to produce the final stylized output, preserving visual coherence with the reference style. Both stages are implemented using a shared image space analogy, enabling transformations to be learned from visual exemplars without explicit geometric supervision. By decoupling abstraction from appearance and treating abstraction as an explicit, transferable process, AiS supports a wider range of stylistic transformations, improves controllability, and enables more expressive stylization.

14.
arXiv (quant-ph) 2026-06-11

Energy-Modulated Time-Asymmetric Spontaneous Collapse: Forward-Backward Dynamics from Stochastic Ito Reversal and Bright Solitons

arXiv:2606.06452v3 Announce Type: replace Abstract: We present a rigorous theoretical framework for symmetry breaking and quantum irreversibility arising from stochastic Ito field reversal within a cubic-quintic nonlinear Schrodinger equation (CQ-NLSE) formalism. Starting from three physically motivated considerations, forward and backward nonlinear stochastic differential equations are derived via the Ito calculus. Kinematic time-reversal is shown to be fundamentally incompatible with the Ito stochastic structure, yielding the universal asymmetry-coupling parameter of 2/3. An energy-driven collapse operator proportional to the product of noise strength, local probability density, and excitation energy squared is introduced, amplifying the collapse in high-density, high-excitation regions. Exactly bright soliton solutions are obtained for a quasi-one-dimensional BEC of attractive Li-7 atoms, with forward and backward amplitude ratio of 1.870. Heat map analysis of the parameter planes reveals that the forward collapse operator grows monotonically in time while the backward counterpart decays, achieving a ratio approximately 1030, sharply distinguishing this framework from conventional symmetric collapse models.

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

Sensorimotor World Models: Perception for Action via Inverse Dynamics

arXiv:2606.20104v1 Announce Type: cross Abstract: Perception for action suggests that representations of the world should be shaped not by visual fidelity alone, but by their relevance for actions. At the same time, latent JEPA-style world models advocate learning compact predictive states from high-dimensional observations to facilitate the prediction of future states, but end-to-end training of these models is nontrivial because representations may collapse if our only goal is to construct a latent state that is easy to predict. We introduce a sensorimotor world model (SMWM): a latent world model trained end-to-end with inverse dynamics regularization. This single regularizer addresses both issues: it prevents representation collapse and induces action-aligned representations. By forcing latent states to preserve information about the action underlying a transition, it biases the model toward the controllable degrees of freedom of the environment while discarding uncontrollable distractors. This yields stable latent world models trained from offline, reward-free trajectories, without frozen encoders, exponential moving averages, or complex latent regularizers. Empirically, SMWM learns compact, interpretable latent spaces and enables competitive planning performance across simple 2D and 3D control tasks.

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

Statistical Learning from Attribution Sets

arXiv:2602.06276v2 Announce Type: replace Abstract: We address the problem of training conversion prediction models in advertising domains under privacy constraints, where direct links between ad clicks and conversions are unavailable. Motivated by privacy-preserving browser APIs and the deprecation of third-party cookies, we study a setting where the learner observes a sequence of clicks and a sequence of conversions, but can only link a conversion to a set of candidate clicks (an attribution set) rather than a unique source. We formalize this as learning from attribution sets generated by an oblivious adversary equipped with a prior distribution over the candidates. Despite the lack of explicit labels, we construct an unbiased estimator of the population loss from these coarse signals via a novel approach. Leveraging this estimator, we show that Empirical Risk Minimization achieves generalization guarantees that scale with the informativeness of the prior and is also robust against estimation errors in the prior, despite complex dependencies among attribution sets. Simple empirical evaluations on standard datasets suggest our unbiased approach significantly outperforms common industry heuristics, particularly in regimes where attribution sets are large or overlapping.

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

TetriServe: Efficiently Serving Mixed DiT Workloads

arXiv:2510.01565v4 Announce Type: replace Abstract: Diffusion Transformer (DiT) models excel at generating high-quality images through iterative denoising steps, but serving them under strict Service Level Objectives (SLOs) is challenging due to their high computational cost, particularly at larger resolutions. Existing serving systems use fixed-degree sequence parallelism, which is inefficient for heterogeneous workloads with mixed resolutions and deadlines, leading to poor GPU utilization and low SLO attainment. In this paper, we propose step-level sequence parallelism to dynamically adjust the degree of parallelism of individual requests according to their deadlines. We present TetriServe, a DiT serving system that implements this strategy for highly efficient image generation. Specifically, TetriServe introduces a novel round-based scheduling mechanism that improves SLO attainment by (1) discretizing time into fixed rounds to make deadline-aware scheduling tractable, (2) adapting parallelism at the step level and minimizing GPU hour consumption, and (3) jointly packing requests to minimize late completions. Extensive evaluation on state-of-the-art DiT models shows that TetriServe achieves up to 32% higher SLO attainment compared to existing solutions without degrading image quality.

18.
arXiv (CS.AI) 2026-06-12

HarnessBridge: Learnable Bidirectional Controller for LLM Agent Harness

arXiv:2606.12882v1 Announce Type: new Abstract: Large language models are increasingly deployed as agents for long-horizon tasks, yet their performance is shaped not only by model capability and environment design, but also by the harness that mediates agent–environment interaction. Existing harnesses are largely manually engineered, making them difficult to scale as trajectories grow longer and interactions become more complex. In this work, we ask whether harness can be generated by a learnable plug-in module that can be trained in an end-to-end fashion. We introduce HarnessBridge, a lightweight learnable harness controller that parameterizes the agent–environment interface as a bidirectional projection. HarnessBridge learns two bidirectional projections: observation projection, which distills raw trajectories into compact, decision-relevant states, and action projection, which converts proposed actions into executable transitions or trajectory-grounded rejections. We train HarnessBridge on a harness supervision dataset via unified instruction tuning. On Terminal-Bench~2.0 and SWE-bench Verified, HarnessBridge matches or surpasses strong specialized harnesses while substantially reducing token usage and trajectory length, and generalizes from smaller generators to larger commercial models.

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

Towards Verifiable Agentic Data Science: Solving Irregular TSQA Via Tool-Grounded Reasoning

arXiv:2606.15107v1 Announce Type: new Abstract: Time series data in real-world deployments is overwhelmingly irregular. Observations are asynchronous, missing values are informative rather than random, and sampling frequencies vary across sensors and operational windows. However, existing Time Series Question Answering (TSQA) benchmarks mostly assume regularly sampled inputs, leaving a fundamental gap in understanding how large language models (LLMs) and AI agents perform under irregular conditions. To bridge this gap, we introduce IRTS-ToolBench, a benchmark of 1,700 questions spanning 10 task types across 13 domains. IRTS-ToolBench is designed to be used independently by any researcher working on LLM-based irregular time series analysis, providing standardized inputs and a reproducible evaluation protocol. Code can be found in https://github.com/SanhornC/IRTS-ToolBench.

20.
arXiv (CS.CL) 2026-06-19

Benchmarking Agentic Review Systems

A new class of agentic review systems are emerging as a remedy to the pressure placed on peer review systems by AI-assisted research, but it is unclear how they should be evaluated. We evaluate two open-source systems (OpenAIReview and coarse), one proprietary system (Reviewer3), and a zero-shot baseline, across six LLMs spanning frontier and efficient models. First, we study whether AI reviews on ICLR/NeurIPS papers track with papers' quality as approximated by external signals such as citations and acceptance decisions. Every system performs above chance in pairwise accuracy, and the best is OpenAIReview + GPT-5.5 at 83.0%. Second, to test whether systems can catch errors with known ground truth, we construct a perturbation benchmark that injects four categories of errors into papers across eight arXiv subject classes and measure detection recall. The strongest configuration (OpenAIReview + GPT-5.5) catches 71.6% of injected errors, leaving substantial room for improvement. The union of detections across six models reaches 83.3% recall, suggesting different models detect different errors and better harness design can potentially increase performance. Beyond these benchmarks, we study a public deployment of OpenAIReview with real users. Votes on its comments skew positive at 1.44 to 1, and the most common complaints are about false positives and minor nitpicks. Together, by evaluating full review systems backed by state-of-the-art models on real research papers, we show that while AI reviews still have room for improvement, they can already track human quality judgments well, catch important errors, and earn positive feedback from real users.

21.
Nature (Science) 2026-06-17

Towards Conversational AI for Disease Management

While large language models (LLMs) have shown promise in diagnostic dialogue1, their capabilities for effective management reasoning—including disease progression, therapeutic response, and safe medication prescription—remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE)1−3 through a new LLM-based agentic system optimized for multi-visit clinical management and dialogue. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini’s long-context capabilities4, combining in-context retrieval with structured reasoning to align its output with up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialists and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. Though AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE’s strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

22.
arXiv (CS.AI) 2026-06-16

TS-Memory: Plug-and-Play Memory for Time Series Foundation Models

arXiv:2602.11550v2 Announce Type: replace-cross Abstract: Time Series Foundation Models (TSFMs) achieve strong zero-shot forecasting through large-scale pre-training, but adapting them to downstream domains under distribution shift remains challenging. Existing solutions face a trade-off: Parametric Adaptation can cause catastrophic forgetting and requires costly multi-domain maintenance, while Non-Parametric Retrieval improves forecasts but incurs high inference latency due to datastore search. We propose Parametric Memory Distillation and implement it as TS-Memory, a lightweight memory adapter that augments frozen TSFMs. TS-Memory is trained in two stages. First, we construct an offline, retrieval-leakage-safe kNN teacher that synthesizes confidence-aware quantile targets from retrieved futures. Second, we distill this retrieval-induced distributional correction into a lightweight memory adapter via confidence-gated supervision. During inference, TS-Memory fuses memory and backbone predictions with constant-time overhead, enabling retrieval-free deployment. Experiments across diverse TSFMs and benchmarks demonstrate consistent improvements in both point and probabilistic forecasting over representative adaptation methods, with efficiency comparable to the frozen backbone. Code: https://github.com/sisuolv/TS-Memory.

23.
arXiv (quant-ph) 2026-06-17

Approximately Decoding the Colour Code

Authors:

arXiv:2606.18035v1 Announce Type: new Abstract: Recently we showed that minimum weight decoding in the (6.6.6 planar) colour code is NP-hard. However, it remained an open question as to whether it was possible to approximate the minimum weight decoding arbitrarily closely in polynomial time. In this paper we prove that it is possible: for any $\varepsilon>0$ there is an polynomial time algorithm that, given a syndrome, can find an error-set generating that syndrome whose weight is at most $1+\varepsilon$ times the weight of the minimum weight decoding. As a consequence we see that, for any $\varepsilon>0$, there is a polynomial time algorithm that can correct all errors of weight up to $(1-\varepsilon)d/2$ in the distance $d$ colour code (so almost up to the theoretical $d/2$ limit). The polynomial we give is impractically large, but it does open the door for sensible polynomial time algorithms that approximate minimum weight decoding and, in particular, shows that approximate decoding is not NP-hard.

24.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

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

Metis: A Generalizable and Efficient World-Action Model for Autonomous Driving and Urban Navigation

World action models~(WAMs) have shown great promise for autonomous driving and urban navigation. Built upon Vision-Language-Action models or video generation models, existing approaches suffer key limitations: (1) High inference latency due to future observation prediction at test time, and (2) tightly coupled video and action modeling leading to representational mismatch and degraded generalization. To address both issues, we propose Metis, an end-to-end WAM framework that decouples video generation and action prediction. Specifically, Metis employs a Mixture-of-Transformers architecture with dedicated experts for video generation and action prediction, preserving the intrinsic distributional properties of each task. To enhance efficiency, we introduce an asymmetric attention mask that enables joint training of both experts while allowing the action model to bypass explicit video generation during inference. This design ensures training-inference consistency and significantly reduces computational costs without compromising planning performance. Extensive experiments demonstrate state-of-the-art performance on the NAVSIM navhard and navtest benchmarks and the CityWalker navigation benchmark, validating both the generalizability and efficiency across diverse tasks. Real-robot deployments further confirm the practical feasibility of our approach.