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01.
PLOS Medicine 2026-05-06

Pathways of emergency care for severely ill children in Nigerian and Ugandan hospitals: A process mapping study

Authors:

by Rami Subhi, Abiodun Sogbesan, Dan Muramuzi, Mikael Burhin, Ayobami A. Bakare, Adegoke G. Falade, Freddy E. Kitutu, Freddie Ssengooba, Carina King, Sumit Kane, Belinda Dawson-McClaren, Hamish R. Graham, the MOXY-Implementation Research Collaboration Background Child mortality remains high in countries with weak emergency care systems. Facility organisation for paediatric emergency care is heterogeneous and under-described. We examined how hospitals in Uganda and Nigeria are organised to deliver emergency care for neonates and children. Methods and findings We conducted a qualitative, multi-method study in 26 purposively selected secondary and tertiary facilities in Uganda and Nigeria from October 2023 to December 2024. Embedded researchers documented patient pathways, resources for care, and care processes for severely ill children (

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

Environment-Grounded Automated Prompt Optimization for LLM Game Agents

LLM agents in interactive environments are highly sensitive to their prompts, yet prompt engineering remains a manual, task-specific process. We introduce an automated prompt optimization framework for LLM agents that decomposes the observation-to-action pipeline into a goal-conditioned descriptor agent and an action selection agent, and iteratively refines each module's prompt through an LLM-driven evolutionary loop guided by environment returns. We propose a behavior analyzer to attribute episode outcomes to specific prompt components, and a mutator to propose targeted revisions to the prompt, before validating them through environment rollouts. We evaluate on all five BabyAI tasks in the BALROG benchmark, comparing our pipeline against BALROG's RobustCoTAgent under both plain and guided prompt initializations. Optimization improves performance consistently across tasks and conditions, without requiring updates to the model weights. On PutNext, a multi-step coordination task where the RobustCoTAgent achieves 0% success, our framework reaches up to 72.5% success rate using the same underlying LLM with optimized prompts. These results suggest that a multi-agent framework, combined with automatic prompt optimization, enhances LLMs without the need for fine-tuning or extensive human supervision.

03.
arXiv (CS.CL) 2026-06-18

Continual Adaptation for Pacific Indigenous Speech Recognition

Speech foundation models struggle with low-resource Pacific Indigenous languages because of severe data scarcity. Furthermore, full fine-tuning risks catastrophic forgetting. To address this gap, we present an empirical study adapting models to real-world Pacific datasets. We investigate the impact of data volume, adaptation strategies, and representational drift on speech foundation models for various Pacific languages. Additionally, we analyze a continual learning framework for sequential language acquisition. Empirical results across three distinct Pacific Indigenous languages demonstrate that adapting to these linguistically distant languages induces severe internal representational drift. Consequently, these models face a strict plasticity and stability dilemma. While LoRA adapts well initially, it suffers from catastrophic forgetting during sequential learning. Ultimately, this study highlights the urgent need for robust adaptation strategies tailored to underrepresented languages.

04.
arXiv (CS.CV) 2026-06-18

Visual-OPSD: Cross-Modal On-Policy Self-Distillation for Efficient Unified Multimodal Reasoning

Unified multimodal models (UMMs) interleave generated ''visual thoughts'' (VTs) with text reasoning to improve spatial tasks. This incurs roughly an order-of-magnitude inference cost from multi-step diffusion. We find this cost yields limited direct benefit. On ThinkMorph, removing or noising VTs barely changes accuracy across nine benchmarks. Once rendered, attention concentrates on the VT regardless of content. Yet a KL diagnostic shows that conditioning on a privileged VT trace shifts the model's completion distribution. This suggests the generation pathway encodes useful reasoning beyond the rendered pixels. Motivated by this gap, we propose Visual On-Policy Self-Distillation(Visual-OPSD). Teacher and student share identical weights but differ in context: the teacher sees privileged VTs while the student sees only the question. Token-level JSD distillation on on-policy student trajectories transfers the teacher's reasoning to a text-only student. Across nine benchmarks, Visual-OPSD improves over its generative teacher by $+3.40$pp with $14.3\times$ speedup (10.0s vs. 142.8s per sample) and outperforms same-scale VLMs by $+63.83$pp on VSP. A Gaussian-noise control ($+0.40$pp vs. $+10.28$pp for real VTs) and $58.4\%$ closure of the KL gap confirm that gains come from the semantic content of the generation pathway.

05.
medRxiv (Medicine) 2026-06-22

Panel-level multilocus methylation quantification in native cell-free DNA by PCR-compatible sequential enzymatic processing

DNA methylation is informative for liquid biopsy, but low template abundance, distributed methylation signals and workflow complexity limit implementation. Here we present Delta-HLD, a PCR-compatible methylation assay platform that quantifies methylation directly in native DNA through sequential hybridization, ligation and methylation-sensitive digestion. The assay co-reports methylation-dependent signals from multiple loci through a shared amplification architecture, generating a single panel-level PCR readout. We established the chemistry, optimized panel size and composition through model-guided experiments, and implemented the assay as a triplex qPCR workflow with per-sample internal process controls. Plasma proof-of-concept analyses showed discriminatory signal in CRC and proof-of-concept transferability to hepatocellular carcinoma. Additional platelet-retaining experiments identified a strategy to increase recovery of analyzable circulating templates while reducing genomic DNA recognition. Delta-HLD provides a compact PCR-compatible framework for low-input methylation analysis without base conversion.

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

deFOREST: Fusing Optical and Radar satellite data for Enhanced Sensing of Tree-loss

arXiv:2510.14092v2 Announce Type: replace-cross Abstract: In this paper we develop a deforestation detection pipeline that incorporates optical and Synthetic Aperture Radar (SAR) data. A crucial component of the pipeline is the construction of anomaly maps of the optical data, which is done using the residual space of a discrete Karhunen-Lo\'{e}ve (KL) expansion. Anomalies are quantified using a concentration bound on the distribution of the residual components for the nominal state of the forest. This bound does not require prior knowledge on the distribution of the data. This is in contrast to statistical parametric methods that assume knowledge of the data distribution, an impractical assumption that is especially infeasible for high dimensional data such as ours. Once the optical anomaly maps are computed they are combined with SAR data, and the state of the forest is classified by using a Hidden Markov Model (HMM). We test our approach with Sentinel-1 (SAR) and Sentinel-2 (Optical) data on a $92\,km \times 92\,km$ region in the Amazon forest. The results show that both the hybrid optical-radar and optical only methods achieve high accuracy that is superior to the recent state-of-the-art hybrid method. Moreover, the hybrid method is significantly more robust in the case of sparse optical data that are common in highly cloudy regions.

07.
arXiv (CS.CV) 2026-06-18

Test-Time Adaptation in Optical Coherence Tomography Using Trajectory-Aligned Time-Independent Flow

Optical coherence tomography (OCT) is essential in ophthalmology, but inconsistent image quality especially in low-cost devices hinders automated analysis. To address this, we introduce a flow-matching-based test-time adaptation method that generates high-quality surrogate images from noisy inputs. Typically, domain gaps between test and training data cause pixel distribution mismatches during the denoising process. We overcome this by matching the test image's histogram to synthetic reference trajectories, successfully aligning the input with expected distributions. Additionally, we remove the network's time conditioning to account for slight deviations in real-world noise distributions. Our approach achieves state-of-the-art performance in segmenting critical biomarkers for two stages of Age-related Macular Degeneration (AMD). Code is available: https://github.com/Veit21/tta-flow.

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

Is Your Trajectory Displacement Safe in Long-tail?

arXiv:2606.16313v1 Announce Type: cross Abstract: Long-tail scenarios remain a major bottleneck for autonomous driving evaluation, even as datasets grow by orders of magnitude. Existing evaluation pipelines are rarely human-aligned, safety-aware, verifiable, and explainable at the same time: closed-loop metrics often saturate among strong planners, while unstructured human ratings can be noisy without a carefully designed protocol. We formulate planning evaluation as additional-threat detection: given a planner trajectory and an expert reference, does the planner's displacement introduce new unsafe driving behavior? We propose FluidTest, an evaluation pipeline with three components: a pairwise WebUI protocol for reliable human annotation; a taxonomy of 32 semantic threats with evidence-grounded decision graphs; and a three-agent verification system with reflection for precision and auditability. Experiments on the WOD-E2E dataset show that FluidTest produces consistent labels among trained annotators and identifies additional threats in 65% of Poutine trajectories and 51% of RAP trajectories. These results show that state-of-the-art planners can still exhibit substantial safety-relevant failures despite high Rater Feedback Scores (RFS) and low Average Displacement Error (ADE). Additional details, guidance, and code are available at https://fluidtest.web.app.

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

Efficient Time Series Clustering from Multiscale Reservoir Dynamics with Granular-Ball Anchoring Graph Optimization

arXiv:2606.12077v1 Announce Type: new Abstract: Time-series clustering remains challenging due to the inherent trade-off between clustering effectiveness and computational efficiency. Similarity-based methods often suffer from quadratic complexity caused by pairwise distance computations, while deep learning-based approaches typically rely on costly iterative training and a large number of trainable parameters. In this paper, we propose MSRGC-Net, an efficient time-series clustering framework that integrates multiscale reservoir computing, granular-ball-based anchoring graph construction, and consensus learning. MSRGC-Net adopts a training-free reservoir computing paradigm to extract multiscale temporal representations from raw time series without backpropagation, significantly reducing computational overhead. To capture the intrinsic structure of the resulting representations, granular-ball computing is employed to adaptively model data distributions via density-consistent regions, yielding compact and robust anchor graph representations. Furthermore, a consensus-based anchoring graph optimization strategy is introduced to effectively align multiscale reservoir representations and integrate complementary information across temporal scales. Extensive experiments on widely used univariate and multivariate benchmark datasets demonstrate that MSRGC-Net consistently outperforms state-of-the-art methods in clustering performance while maintaining superior computational efficiency.

10.
arXiv (CS.LG) 2026-06-17

Learn from Your Mistakes: Self-Correcting Masked Diffusion Models

arXiv:2602.11590v3 Announce Type: replace Abstract: Masked diffusion models (MDMs) have emerged as a promising alternative to autoregressive models, enabling parallel token generation while achieving competitive performance. Despite these advantages, MDMs face a fundamental limitation: once tokens are unmasked, they remain fixed, leading to error accumulation and ultimately degrading sample quality. We address this by proposing a framework that trains a model to perform both unmasking and correction. By reusing outputs from the MDM denoising network as inputs for corrector training, we train a model to recover from potential mistakes. During generation we apply additional corrective refinement steps between unmasking ones in order to change decoded tokens and improve outputs. We name our training and sampling method Progressive Self-Correction (ProSeCo) for its unique ability to iteratively refine an entire sequence, including already generated tokens. We conduct extensive experimental validation across multiple conditional and unconditional tasks, demonstrating that \method~yields better quality-efficiency trade-offs (up to ~4x faster sampling) and enables inference-time compute scaling to further increase sample quality beyond standard MDMs (up to ~1.2x improvement on benchmarks).

11.
medRxiv (Medicine) 2026-06-17

Preserved Medial Temporal Lobe Flexibility Predicts Memory Generalization Only in the Context of Good Sleep Quality among Older African Americans

Objectives: Poor sleep quality is a risk factor for Alzheimer's disease (AD). Older African Americans experience disproportionately high rates of sleep disturbance and AD. Medial temporal lobe (MTL) flexibility reflects dynamic neural reorganization and may be a marker of generalization performance. This study examined whether sleep quality moderates the association between MTL flexibility and memory generalization. Methods: Fifty older African Americans (MeanAge=69.7{+/-}6.21 years; 80% women) underwent rs-fMRI to quantify MTL flexibility, Rutgers Acquired Equivalence Task for memory generalization, and Pittsburgh Sleep Quality Index for sleep quality. Results: Greater MTL flexibility was associated with better generalization (r=0.367, p=.017). Good sleepers showed higher MTL flexibility (F(1,44)=8.11, p2=.156, p=.007) and superior generalization (F(1,46)= 12.33, p2=.211, p=.001). Sleep quality significantly moderated the MTL flexibility and generalization relationship ({beta}=-1.519, p=.012). Conclusions: Preserved MTL flexibility may confer generalization only in good sleepers, suggesting that sleep disturbance may disrupt the MTL neural resilience among older African Americans.

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

Exact Federated Continual Unlearning for Ridge Heads on Frozen Foundation Models

arXiv:2603.12977v3 Announce Type: replace Abstract: Foundation models are commonly deployed as frozen feature extractors with a small trainable head to adapt to private, user-generated data in federated settings. The ``right to be forgotten'' requires removing the influence of specific samples or users from the trained model on demand. Existing federated unlearning methods target general deep models and rely on approximate reconstruction or selective retraining, making exactness costly or elusive. We study this problem in a practically relevant but under-explored regime: a frozen foundation model with a ridge-regression head. The exact optimum depends on the data only through two additive sufficient statistics, which we turn into a communication protocol supporting an arbitrary stream of add and delete requests via fixed-size messages. The server maintains a head that is, in exact arithmetic, pointwise identical to centralized retraining after every request. We provide deterministic retrain-equivalence guarantees, order and partition invariance, two server-side variants, and a Bayesian certificate of zero KL divergence. Experiments on four benchmarks confirm the guarantees: both variants match centralized ridge retraining to within $10^{-9}$ relative Frobenius error and complete each request at orders-of-magnitude lower cost than federated retraining baselines.

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

FAPO: Fully Autonomous Prompt Optimization of Multi-Step LLM Pipelines

arXiv:2606.19605v1 Announce Type: cross Abstract: Multi-step LLM pipelines fail through interactions among retrieval, reasoning, and formatting steps, so prompt-only optimization can miss bottlenecks in the chain. We present FAPO (Fully Autonomous Prompt Optimization), a framework that lets Claude Code optimize an LLM pipeline inside a standardized codebase. FAPO evaluates a pipeline, inspects intermediate steps, diagnoses failures, proposes scoped changes, and validates variants repeatedly to optimize against a score function. It first tries prompt edits and, only when prompt optimization appears insufficient, changes chain structure within the permitted scope when attribution identifies a structural bottleneck. Across six benchmarks and three task models, FAPO beats the baseline GEPA in 15 of 18 model-benchmark comparisons. In 11 model-benchmark comparisons, FAPO wins with non-overlapping mean $\pm$ trial-standard-deviation ranges, and the mean FAPO-GEPA gain is +14.1 pp. In the six HoVer and IFBench comparisons where prompt-first search escalated to structural changes, FAPO wins all six with a mean gain of +33.8 pp. FAPO also improves performance on security tasks: on CTIBench-RCM, a security CVE-to-CWE task, prompt-only FAPO lifts test accuracy by +4.0 pp on GPT-5, +7.1 pp on Foundation-Sec-8B-Instruct, and +2.0 pp on Foundation-Sec-8B-Reasoning. These results position FAPO as a state-of-the-art pipeline optimization technique for both general-purpose and security-focused tasks.

14.
arXiv (CS.AI) 2026-06-18

Veriphi: Attack-Guided Neural Network Verification with Dataset-Dependent Training Methods

arXiv:2606.18454v1 Announce Type: cross Abstract: We present Veriphi, a GPU-accelerated neural network verification system that combines fast adversarial attacks with formal bound certification using alpha,beta-CROWN methods. Through systematic experiments on MNIST and CIFAR-10 using three training methodologies (standard, adversarial, certified), we demonstrate that training method effectiveness is fundamentally dataset-dependent. Interval Bound Propagation (IBP) achieves 78% certified accuracy on simple MNIST (784 dimensions) but provides negligible certification performance on the more complex CIFAR-10 dataset, where PGD adversarial training dominates with 94% certification at small perturbations. We achieve 5x verification speedup through attack-guided falsification and scale our approach to production-size models (105.8M parameters) for real-world aerospace logistics optimization. Our results challenge the assumption that certified training universally outperforms adversarial training, showing context matters critically for verification strategy selection.

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

From Passive Generation to Investigation: A Proactive Scientific Peer Review Agent

Large language models (LLMs) have shown promise in automating scientific peer review. However, existing approaches often struggle to generate in-depth reviews supported by concrete evidence. We argue that a key limitation is the lack of flexibility to proactively investigate suspicious parts of a paper based on accumulated evidence, as human reviewers do. In this paper, we explore how to enable an LLM-based review agent to perform such proactive investigation. We find that this can be naturally formulated as a Markov Decision Process (MDP), and propose ProReviewer, a scientific peer review agent that proactively reviews a paper guided by a maintained, structured review log. The structured review log serves as a workspace for the agent to track evidence and intermediate findings collected during review. Experiments show that ProReviewer with an 8B backbone, trained by supervised fine-tuning and optimized by reinforcement learning, achieves the highest average score across five quality dimensions, outperforming prompt-based methods with much larger frontier LLMs by up to 39% and the strongest fine-tuned baseline by 16% relatively. It also attains the highest win rates against baselines in human evaluation.

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

GitOfThoughts: Version-Controlled Reasoning and Agent Memory You Can Replay, Diff, and Merge

Large language model (LLM) reasoning is ephemeral: chains of thought vanish with the context window, pruned search branches leave no record, and memory buffers cannot be diffed, merged, or audited. Every other complex software process (code, infrastructure, data, experiments) is version-controlled; reasoning is not. We introduce GitOfThoughts, which stores an agent's reasoning tree as a git repository: every scored thought is a commit, scores are notes, outcomes are tags, and retrieval is "git log" over the agent's own history. This makes reasoning replayable, auditable, and mergeable across agents at near-zero engineering cost. We then ask the harder question: does memory, in any substrate, actually improve accuracy? Across five substrates (none, markdown, vector, graph, git), two benchmarks, two model scales, and pre-registered replications, the answer for novel problems is no. No memory format reliably helps, and a promising early result collapsed under its own pre-registered replication. Memory pays only above what we call the copyability threshold: when the retrieved case is a near-duplicate of the current problem (similarity >~ 0.8), accuracy jumps sharply; below it, nothing. The gain is answer retrieval, not method transfer: a 4.5x larger model doubles the near-duplicate payoff yet still cannot extract a transferable method from a worked example. The only general lever we find is test-time sampling. The case for git-as-substrate is therefore auditability, provenance, and mergeability at accuracy parity. We document a retracted result and a refuted hypothesis to model the evaluation standard we hold ourselves to.

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

From Memorization to Creation: Evaluating the Cognitive Depth of LLM-Generated Educational Questions

arXiv:2606.18257v1 Announce Type: cross Abstract: While LLMs show promise in automating educational content creation, their ability to generate questions that stimulate higher-order thinking remains understudied. This work evaluates six widely-used LLMs through a Bloom's Taxonomy lens, focusing on their capacity to transcend rote memorization and achieve cognitive leaps. Using a hybrid human–AI evaluation protocol, we generate and analyze 20{,}700 questions across computer science, K–12 math, and social-science domains. Key contributions include: (1) a fine-grained prompting strategy that reduces question repetitiveness by 24.45\% for Qwen2.5-7B-Instruct, and increases the proportion of higher-order cognitive level outputs by 11.53\% for InternLM3-8B-Instruct; (2) quantitative metrics for cognitive shift intensity (CogShift) and category drift, revealing InternLM3's superior performance in multi-level transitions; (3) an interpretability analysis revealing metric-level correlations that enhance the transparency of Chain-of-Thought prompting. Our findings highlight the importance of cognitive-aware prompt design and provide benchmarks for deploying LLMs in personalized learning systems.

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

An Attention Mechanism for Robust Multimodal Integration in a Global Workspace Architecture

arXiv:2602.08597v3 Announce Type: replace Abstract: Robust multimodal systems must remain effective when some modalities are noisy, degraded, or unreliable. Existing multimodal fusion methods often learn modality selection jointly with representation learning, making it difficult to determine whether robustness comes from the selector itself or from full end-to-end co-adaptation. Motivated by Global Workspace Theory (GWT), we study this question using a lightweight top-down modality selector operating on top of a frozen multimodal global workspace. We evaluate our method on two multimodal datasets of increasing complexity: Simple Shapes and MM-IMDb 1.0, under structured modality corruptions. The selector improves robustness while using far fewer trainable parameters than end-to-end attention baselines, and the learned selection strategy transfers better across downstream tasks, corruption regimes, and even to a previously unseen modality. Beyond explicit corruption settings, on the MM-IMDb 1.0 benchmark, we show that the same mechanism improves the global workspace over its no-attention counterpart and yields decent benchmark performance.

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

A Machine Learning Framework for Real-Time Personalized Ergonomic Pose Analysis

This paper introduces a new methodology for real-time prediction of ergonomic and non-ergonomic human poses using volumetric video data in three dimensions. Although the methodology was designed for ergonomic assessments, it can be adapted to other applications requiring real-time analysis of human posture. One aspect that makes this system stand out is its ability to analyze 3D point clouds during the assessment, enabling computation from multiple angles. This overcomes a critical limitation of cameras which provide often a fixed viewpoint, thereby restricting the data available for a thorough postural evaluation, especially when occlusions occur. The system continuously and automatically performs pose inference using the chosen perspective on the real-time streaming data; however, only the poses manually selected and labeled by the user are used to train the personalized deep learning classifier. The methodology has been refined through a case study in which RGB-D cameras captured subjects performing load-lifting tasks, enabling real-time skeletal labeling. The model was trained on this data and, following the training phase, performs inference on new streaming data in real time. This research offers a scalable and pragmatic approach for real-time ergonomic evaluation by combining state-of-the-art 3D data technologies and traditional 2D pose estimation algorithms. It addresses the increasing need for safety and health monitoring in workplace environments, marking a notable contribution to the domain.

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

FrozenDrive: Zero-Shot Text-Guided Driving Scene Generation and Data Augmentation with Parameter-Free Frozen Diffusion Model

Synthetic data for autonomous driving is surging, powered by diffusion models that promise scalable scene generation. Yet key obstacles remain, as enforcing multi-view and temporal consistency often relies on backbone fine-tuning or added layers, which erodes pre-trained knowledge and weakens text alignment. Models also stay close to the training distribution, struggling under adverse weather and unseen configurations, and fidelity favors frequent over rare classes. We address these gaps with FrozenDrive, a controllable generative framework that preserves a pretrained diffusion models knowledge while achieving strong consistency. FrozenDrive conditions on rich driving-stack signals and text prompts, and introduces knowledge-preserving spatio-temporal attention to impose cross-view alignment and temporal coherence in a single pass within a parameter-free frozen diffusion backbone. An additional object-focused constraint improves per-object fidelity for rare categories. Without any weather- or scene-specific fine-tuning, our model synthesizes globally coherent multi-view driving scenes from text, particularly under adverse and rare conditions, and surpasses prior baselines. On nuScenes, FrozenDrive augmented data significantly improves AD models performance, especially at night and in rain, demonstrating stronger robustness when trained with our scenario-targeted data.

21.
arXiv (CS.LG) 2026-06-18

Stochastic Thermodynamics and SDE-based Generative Models

Authors:

arXiv:2606.18290v1 Announce Type: cross Abstract: SDE-based generative models, including diffusion models and the Schrödinger bridge, have found broad applications in signal processing tasks such as speech enhancement, image restoration, and time-series generation. This note presents a modeling framework for such models within the context of stochastic thermodynamics. The main results of this note are trajectory-level definitions of work, heat, and entropy production, along with a generalized Jarzynski identity and a second-law-like inequality. The proposed framework extends the original Jarzynski setup to accommodate time-dependent bath temperature and nonconservative driving forces. This thermodynamic perspective may deepen our understanding of diffusion models and the Schrödinger bridge from a nonequilibrium statistical mechanics viewpoint.

22.
medRxiv (Medicine) 2026-06-10

Optimisation of steatotic liver disease screening algorithm for resource-poor settings using machine learning

Background The European Association for the Study of the Liver (ESAL) - Steatotic Liver Disease (SLD) screening algorithm involves two steps; initial screening with FIB-4 followed by referral for vibration-controlled transient elastography (VCTE) in patients likely to have significant fibrosis (SF). However, VCTE is not widely available in resource-limited settings. Aim To optimise the EASL SLD screening algorithm for resource-poor settings using machine learning (ML). Methods We analysed data from 964 adults aged [≥]35 years who underwent VCTE at a tertiary referral centre in Sri Lanka between November 2024 and 2025. Multiple ML models using different methods and variable combinations were trained on 80% of the dataset and tested on the remaining 20%. Best models were selected based on performance and externally validated using data from 430 patients who underwent VCTE before November 2024. Model performance was compared with the FIB-4 using confusion matrices. Results A Random Forest model incorporating age, AST, ALT, and platelet count separately, rather than using FIB-4, outperformed. The all-variable ML model showed the best predictive performance for SF, with accuracy of 77.2%, recall of 0.762, precision of 0.778, and AUC-ROC of 0.818. The variables used in the model, in descending order of feature importance, were AST, platelet count, BMI, ALT, age, diabetes mellitus, hypertension, dyslipidaemia, sex, family history, hypothyroidism, diabetes complication and smoking. External validation demonstrated 75.1% accuracy and an AUC of 0.779. When used as the first step of the SLD screening algorithm, the all-variable ML model identified 37 (17.1%) additional true positives and reduced false-negative diagnoses by 50% compared with FIB-4. Conclusions ML-based models were more effective than the FIB-4 score as the first-line screening tool for VCTE referral, substantially improving the identification of patients with significant fibrosis in this South Asian cohort.

23.
arXiv (quant-ph) 2026-06-15

Dealing with locality in QAOA

arXiv:2606.14447v1 Announce Type: new Abstract: Shallow-depth QAOA on sparse, high-diameter MaxCut instances faces a locality bottleneck: at depth \(p\), local observables can depend only on a bounded neighborhood of the circuit interaction graph. We propose a transport-augmented QAOA that keeps the MaxCut cost Hamiltonian unchanged but enriches the mixer with optimized, unweighted shortcut couplings (scheduled \(XX+YY\)) to collapse the effective interaction-graph diameter. Using exact finite-depth support recursions, we relate optimal shortcut placement to bounded-diameter graph augmentation, and show in benchmarks that (unlike ma-QAOA) performance becomes effectively size-invariant once the diameter is reduced. For bipartite families (base diameter 4), reducing the interaction path to \(d=1\) raises the ensemble-averaged approximation ratio from 0.7378 (ma-QAOA) to 0.9767 at \(p=1\) (\(\sigma=0.0251\), nine system sizes); on random trees (base diameter 10), at \(p=2\) it improves from 0.9226 to 0.9997 (\(\sigma=0.0001\)).

24.
medRxiv (Medicine) 2026-06-12

High coverage, persistent gaps: quality of Antenatal Care and its determinants in Zambia based on the 2024 Demographic and Health Survey.

Abstract Background Evaluating antenatal care (ANC) quality is critical to reducing maternal and neonatal mortality. In Zambia, despite high basic ANC attendance, comprehensive national evidence on the clinical content and quality of services remains limited. This study assessed the coverage of WHO-recommended ANC interventions and identified factors associated with care quality using the latest national data. Methods A cross-sectional analysis was conducted using data from the 2024 Zambia Demographic and Health Survey. The final analytic sample comprised 4,829 women aged 15-49 with a live birth in the preceding 5 years. A composite index of 15 selected, equally weighted WHO-recommended components evaluated clinical assessment, counseling/screening, preventive interventions, and utilization. Survey-weighted Poisson regression estimated adjusted incidence rate ratios (aIRRs) for the count of ANC components received. Results The mean ANC quality score was 12.5 out of 15 (95% CI: 12.4-12.6), and 78.5% (95% CI: 77.0-80.0) of women achieved adequate ANC ([≥] 12/15 components). While individual clinical and counseling coverage generally exceeded 90%, only 47.2% (95% CI: 45.3-49.0) of women initiated care during the first trimester, and just 4.8% (95% CI: 4.1-5.6) achieved [≥] 8 ANC contacts. Maternal education was the strongest and most stable predictor of quality across all models. Compared to no education, higher education was associated with an 8.0% higher expected quality score (aIRR = 1.080, 95% CI: 1.051-1.110). Lower ANC quality was significantly associated with unwanted pregnancies (aIRR = 0.970, 95% CI: 0.956-0.993) and with residence in Western (aIRR = 0.923, 95% CI: 0.897-0.951) and North Western (aIRR = 0.966, 95% CI: 0.937-0.996) provinces. Absence of distance barriers and residence in Eastern, Luapula, and Copperbelt provinces were associated with higher quality scores. Conclusion While average ANC component coverage in Zambia is high, critical gaps persist in early initiation and total contact frequency. Care adequacy is strongly influenced by maternal education, relationship status, pregnancy intention, and regional inequities. These findings underscore the need for interventions targeted at uneducated women, preventing unintended pregnancies, and underserved regions such as Western and North Western Provinces. Keywords: Antenatal care quality, ANC content, Zambia, maternal education.

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

Equity with Efficiency: An Empirical Study of Tokenizers for Multilingual Large Language Models

Multilingual large language models (LLMs) depend on subword tokenization to bridge discrete text and continuous neural representation. State-of-the-art multilingual LLMs often use Byte-level Byte-Pair Encoding (BPE) tokenizers that structurally favor high-resource languages and Latin scripts. For speakers of underrepresented languages, particularly those across Southeast Asia, this bias inflates inference costs and widens cross-lingual capability gaps. We present the first systematic comparison of equitable tokenizers on a unified benchmark spanning 11 Southeast Asian languages. Beyond tokenizer-level analysis of compression efficiency and cross-lingual equity, we assess downstream task performance through controlled 1.5B-parameter language model training using the same training data. Our results show that Parity-aware BPE lies on the Pareto frontier of the efficiency-equity trade-off, achieving strong compression parity at competitive cost. Morphology-Driven Byte Encoding delivers the best semantic reasoning performance through morphologically richer representations, albeit at a higher computational expense. Byte Latent Transformer underperforms on downstream tasks, possibly because its architectural assumptions misalign with the constraints of limited low-resource training data. Together, our findings demonstrate that cross-lingual fairness and tokenization efficiency are not fundamentally at odds, and offer practical guidance for designing equitable multilingual models.