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

Large Language Models Hack Rewards, and Society

Reinforcement learning (RL) has become a dominant post-training paradigm, enabling large language models (LLMs) to learn from rewards. We observe that societal regulations are structurally similar to reward functions. They define measurable outcomes, thresholds, and exceptions, while often leaving institutional intent only partially specified. We hypothesise that the RL training process may exploit these gaps and therefore ask whether models' well-known tendency to hack reward functions during RL can scale into a more consequential failure mode named societal hacking: discovering loopholes in the rules society runs on. To study this phenomenon, we introduce SocioHack, a sandbox of 72 societal environments, and find that within these environments, reward hacking naturally emerges and leads to regulatory loophole discovery. Models learn to hack the social rules and generate strategies that remain technically compliant while defeating regulatory intent, and current LLM safeguards provide only limited mitigation. Therefore, collecting in-the-wild feedback for model training requires greater caution, and we need a next-generation post-training paradigm for safely iterating LLMs in real society.=

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

Differential Privacy of Gaussian Process Posterior Sampling

arXiv:2606.17995v1 Announce Type: cross Abstract: We study the privacy of releasing posterior sample paths from a Gaussian process (GP) when the entire training set including covariates and responses is private. Unlike standard differential-privacy (DP) mechanisms that add external noise, posterior sampling is random by construction. We show that this intrinsic randomness yields DP guarantees by deriving explicit Rényi-DP bounds for GP posterior sample-path release. The bounds separate posterior-mean leakage from data-dependent posterior-covariance leakage showing that meaningful privacy depends sharply on effective ridge regularisation. We apply membership-inference attacks to show that empirical leakage follows the predicted dependence on regularisation, posterior variance and the number of released posterior sample-paths. Utility experiments on downstream posterior-sampling tasks identify noisy-observation regimes where privacy-compatible regularisation preserves useful decisions with modest utility loss. When stronger privacy is needed, the intrinsic guarantee can be sharpened by adding calibrated GP noise, providing an explicit additional privacy knob.

03.
arXiv (CS.CL) 2026-06-15

Benchmarking Web Agent Safety under E-commerce Deceptive Interfaces

As autonomous web agents are increasingly deployed to perform real-world tasks, ensuring their safety has become a critical concern. In this work, we study web agent behavior under realistic deceptive interfaces in the e-commerce domain. We introduce WebDecept, a lightweight and configurable plugin framework that enables controlled injection of deceptive interface patterns into existing web environments. Using WebDecept, we instantiate seven deceptive patterns commonly observed on the open web, including targeted advertisements, domain redirection, and shopping manipulation. By injecting these patterns into the frontend during task execution, we perform controlled evaluation of multiple multimodal web agents. Our results show that current web agents are highly susceptible to multiple classes of deceptive interfaces, and that prompt-based constraints are often insufficient to mitigate these failures. We further analyze how the design choices of deceptive patterns influence the success of such manipulations. These findings highlight safety challenges that should be addressed as web agents are scaled toward real-world deployment.

04.
arXiv (CS.AI) 2026-06-19

Which Pairs to Compare for LLM Post-Training?

arXiv:2606.19607v1 Announce Type: new Abstract: Preference-based post-training has become a central paradigm for aligning language models. A common data-collection strategy is to generate a small set of completions for each prompt and label the resulting comparison pairs. However, human preference labels are often much more expensive than generating additional completions, suggesting a different use of the same labeling budget: generate a larger pool of completions, but label only the most informative comparison pairs. This paper studies which pairs should be compared in preference-based post-training. We formulate comparison curation as a sampling-design problem and evaluate designs by the quality of the final policy under the preference-based post-training objective. We instantiate this framework for Direct Preference Optimization (DPO), analyzing how the choice of labeled pairs propagates through DPO training to downstream policy performance. Our main results provide matching upper and lower bounds on the post-training optimality gap of the DPO-trained policy. The bounds show that comparison selection affects downstream performance through a single design-dependent information matrix, which links label allocation to parameter estimation error and policy suboptimality. This yields an explicit optimization criterion for budgeted comparison curation and motivates practical sampling designs for selecting informative pairs from large generated completion pools. Experiments on synthetic settings and language-model post-training benchmarks show that the proposed designs consistently improve sample efficiency over common comparison-selection heuristics.

05.
arXiv (CS.AI) 2026-06-24

Evaluating the Interpretability of Sparse Autoencoders with Concept Annotations

arXiv:2606.24716v1 Announce Type: cross Abstract: Sparse autoencoders (SAEs) are increasingly used to extract interpretable concepts from vision and vision language models, yet existing evaluation methods largely rely on proxy metrics or qualitative inspection rather than measuring semantic correspondence. We present a human-grounded evaluation framework that quantifies alignment between SAE latents and human-annotated concepts, without requiring user studies, and validate this matching through targeted attribute perturbations. To enable this intervention-style evaluation in vision, we construct synCUB and synCOCO, synthetic benchmarks of paired images that differ in exactly one attribute. We introduce Fully-Binary Matching Pursuit (FBMP), a coalition-based matching procedure that supports many-to-one mappings between SAE latents and annotated concepts, and consistently outperforms one-to-one baselines. For functional validation, we propose a Targeted Attribute Perturbation Alignment Score (TAPAScore), which tests whether matched concepts respond selectively and in the expected direction under targeted image-level attribute perturbations. Under sanity checks, our matching and TAPAScore are the only evaluated metrics that reliably distinguish trained SAEs from untrained ones. Across SAEs trained on CLIP and DINOv2 embeddings, we find that increased overcompleteness can reduce perturbation alignment, indicating a reduction in interpretability. Our evaluation framework suggests that moderate dictionary sizes provide the best trade-off, yielding the most interpretable SAEs. Code and datasets are available at https://github.com/JonasKlotz/sae-concept-eval.

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

Noise-Aware Boundary-Enhanced Generative Learning for Ultrasound Speckle Reduction

Ultrasound is a non-invasive, real-time, and cost-effective imaging technique widely used in clinical diagnosis. However, its diagnostic efficacy is often compromised by inherent speckle noise that degrades image quality and obscures underlying anatomical structures. Existing speckle reduction methods tend to over-smooth tissue boundaries and generalize poorly to heterogeneous noise levels. To address these limitations, we propose a Noise-Aware Boundary-Enhanced Generative Learning (NBGL) framework for ultrasound speckle reduction, which simultaneously preserves annotated anatomical boundaries and adapts to varying noise levels. The NBGL framework consists of a speckle reduction branch and a boundary enhancement branch. The former leverages generative learning to suppress speckle noise, while the latter learns boundary-sensitive representations to preserve target anatomical structures. Furthermore, a noise-aware interaction weight generation (NIWG) module estimates the speckle noise level via 3D Laplacian filtering and a median absolute deviation estimator, and translates it into an adaptive interaction weight. This weight is incorporated into a weighted feature-wise linear modulation (wFiLM) module to adaptively modulate cross-branch feature coupling, thereby improving robustness to varying noise levels. Extensive evaluations on 141 3D transvaginal ultrasound volumes demonstrate that NBGL consistently outperforms state-of-the-art methods in speckle reduction and structural preservation across six noise levels, while maintaining consistency with annotated anatomical boundaries.

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

Pragmatic Inference for Moral Reasoning Acquisition: Generalization via Metapragmatic Links

While moral reasoning has emerged as a promising research direction for large language models (LLMs), achieving robust generalization remains a critical challenge. This challenge arises from the gap between what is said and what is morally implied. In this paper, we build on metapragmatic links and Moral Foundations Theory to close this gap. Specifically, we develop a pragmatic inference approach that enables LLMs, given a moral situation, to acquire the metapragmatic links between moral reasoning objectives and the social variables that influence them. We adapt this approach to three different moral reasoning tasks to demonstrate its adaptability and generalizability. Experimental results show that our approach significantly enhances LLMs' generalization in moral reasoning, paving the way for future research to leverage pragmatic inference across a wide range of moral reasoning tasks.

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

ActiveSAM: Image-Conditional Class Pruning for Fast and Accurate Open-Vocabulary Segmentation

Segment Anything Model 3 (SAM 3) provides a strong frozen backbone for concept-prompted segmentation, but applying it directly to open-vocabulary semantic segmentation (OVSS) is inefficient: full-resolution decoding is typically run over the entire dataset vocabulary, whereas each image contains only a small active subset of classes. We introduce ActiveSAM, a training-free, zero-shot inference framework that turns SAM 3 into an active-vocabulary segmenter. ActiveSAM first canonicalizes and expands class prompts, then estimates an image-conditioned active set from a low-resolution presence preview. Only the retained classes are decoded at full resolution, using bucketed prompt multiplexing with the frozen SAM 3 decoder. The preview stage uses only class-presence evidence and skips unnecessary segmentation-head computation, while the final stage applies margin-aware background calibration to suppress low-confidence pixels. ActiveSAM requires no target-dataset training, no weight updates, and no oracle class-presence labels. Across eight OVSS benchmarks, ActiveSAM improves the speed-accuracy tradeoff of training-free open-vocabulary semantic segmentation, outperforming the current state-of-the-art SegEarth-OV3 by approximately +1.4 mIoU on average while running up to 5.5x faster on large-vocabulary datasets. ActiveSAM also demonstrates the strongest robustness under image corruption that simulates real-world distribution shift, making it well-suited for deployment in noisy-input domains such as autonomous driving and embodied AI. Code is available at https://github.com/VILA-Lab/ActiveSAM.

09.
arXiv (CS.CV) 2026-06-16

Texture-Shape Bias Balancing for Robust Synthetic-to-Real Semantic Segmentation in Automotive NIR Imagery

Semantic segmentation is a fundamental component of visual perception in modern automotive systems, enabling pixel-level scene understanding. Near-Infrared imaging (NIR) offers stable detection under difficult illumination conditions, but the development of domain-specific semantic segmentation models remains challenging due to the lack of high-quality annotated data from real-world scenarios. Synthetic datasets offer a scalable alternative, but models trained on synthetic images often suffer performance degradation when transferred to real domains. We present the first systematic study on synthetic to real domain adaptation for semantic segmentation in NIR images in the automotive domain. We propose a generative augmentation framework that transforms synthetic images into realistic NIR-style variants via our introduced target style adaptation (TSA). TSA fine-tunes a latent diffusion model via low-rank adaptation on a small curated set of real NIR images and applies it to synthetic training data using structure-preserving multi-signal conditioning. To reduce texture bias and improve segmentation robustness, we further apply a Voronoi-based style diversification strategy (VSD) that modifies the original textures while preserving scene geometry. Experiments with multiple model architectures on NIR data from vehicle interiors and street scenes show that balancing inductive bias during training leads to noticeably more robust semantic segmentation and effectively reduces the domain gap in our real-world scenarios by up to 63.6% on exterior and 28.4% on interior data. The code is available at GitHub.

10.
arXiv (CS.LG) 2026-06-25

Extreme Meta-Classification for Large-Scale Zero-Shot Retrieval

arXiv:2606.25237v1 Announce Type: cross Abstract: We develop accurate and efficient solutions for large-scale retrieval tasks where novel (zero-shot) items can arrive continuously at a rapid pace. Conventional Siamese-style approaches embed both queries and items through a small encoder and retrieve the items lying closest to the query. While this approach allows efficient addition and retrieval of novel items, the small encoder lacks sufficient capacity for the necessary world knowledge in complex retrieval tasks. The extreme classification approaches have addressed this by learning a separate classifier for each item observed in the training set which significantly increases the representation capacity of the model. Such classifiers outperform Siamese approaches on observed items, but cannot be trained for novel items due to data and latency constraints. To bridge these gaps, this paper develops: (1) A new algorithmic framework, EMMETT, which efficiently synthesizes classifiers on-the-fly for novel items, by relying on the readily available classifiers for observed items; (2) A new algorithm, IRENE, which is a simple and effective instance of EMMETT that is specifically suited for large-scale deployments, and (3) A new theoretical framework for analyzing the generalization performance in large-scale zero-shot retrieval which guides our algorithm and training related design decisions. Comprehensive experiments are conducted on a wide range of retrieval tasks which demonstrate that IRENE improves the zero-shot retrieval accuracy by up to 15% points in Recall@10 when added on top of leading encoders. Additionally, on an online A/B test in a large-scale ad retrieval task in a major search engine, IRENE improved the ad click-through rate by 4.2%. Lastly, we validate our design choices through extensive ablative experiments. The source code for IRENE is available at https://aka.ms/irene.

11.
arXiv (CS.CV) 2026-06-25

Homomorphic Encryptions for Privacy Preserving Vision

Legal requirements might prevent organizations from sharing sensitive data like medical or financial details of consumers which prevents them from leveraging cloud based ML-as-a-service solutions provided by third party providers, which are quickly gaining popularity these days. In this project, we aim to perform inference tasks in Computer Vision in a privacy-preserving manner, i.e, by only looking at encrypted data. Recent advances in fully homomorphic encryption make this possible. A fully homomorphic encryption allows an arbitrary sequence of additive and multiplicative operations to be performed on encrypted data directly. Applying homomorphic encryptions to CNNs requires modifying the conventional CNN layers, so that they adhere to the encryption scheme. Our aim was to explore the best methods to create CNNs which can classify encrypted images directly. We used Microsoft SEAL for performing homomorphic encryption. The performance of these "encryption based CNNs" should be comparable with baseline accuracies of the same CNNs trained on unencrypted data, and the aim was to achieve as low of a hit on inference-time performance as possible. We successfully obtained minimal drop in classification accuracy for various datasets. We used MNIST as our baseline, which is popularly used in related research work and then explored more complex datasets like Kuzushiji MNIST, Fashion-MNIST and CIFAR-10 as a part of our contribution. Additionally, we also added support for more complex operations on top of TenSEAL, like processing colored images (multi-channel input), applying multiple convolutional layers and performing average pooling.

12.
arXiv (math.PR) 2026-06-17

Moment generating function of the tacnode process

Authors:

arXiv:2606.17771v1 Announce Type: cross Abstract: The tacnode process is a universal determinantal point process arising in non-intersecting particle systems and random tiling models. In this paper, we study the generating function for the counting functions of the tacnode process on a union of $m$ intervals, $m\in\mathbb{N}^{+}$. Our first result provides an integral representation for the $m$-point generating function in terms of the Hamiltonian governing a system of $8m+4$ coupled differential equations. Combined with several differential identities for this Hamiltonian, the representation yields the large gap asymptotics, up to and including the constant term. As further applications, we obtain asymptotic formulae for the expectations, variances, and covariances of the counting functions, and establish a central limit theorem for their joint fluctuations. These results extend the previously known $1$-point theory for the tacnode process to the multi-interval setting with multiple discontinuities.

13.
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.

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

Sharing quantum indistinguishability with multiple parties

arXiv:2512.15199v3 Announce Type: replace Abstract: Quantum indistinguishability of non-orthogonal quantum states is a valuable resource in quantum information applications such as cryptography and randomness generation. In this article, we present a sequential state-discrimination scheme that enables multiple parties to share quantum uncertainty, in terms of the max relative entropy, generated by a single party. Our scheme is based upon maximum-confidence measurements and takes advantages of weak measurements to allow a number of parties to perform state discrimination on a single quantum system. We review known sequential state discrimination and show how our scheme would work through a number of examples where ensembles may or may not contain symmetries. Our results will have a role to play in understanding the ultimate limits of sequential information extraction and guide the development of quantum resource sharing in sequential settings.

15.
medRxiv (Medicine) 2026-06-22

Referral pathways, ETAT triage acuity, and inpatient outcomes among children presenting to a national tertiary paediatric emergency unit in Ghana: a prospective cohort study

Emergency referral systems in sub-Saharan Africa are fragmented, and children reaching tertiary facilities through different referral pathways often arrive in advanced clinical states. Prospective data simultaneously characterising referral patterns, triage acuity at presentation, diagnostic case mix, and inpatient mortality at a national tertiary paediatric emergency unit are lacking from West Africa. This prospective cohort study enrolled 675 consecutively presenting children aged one month to 12 years at the Paediatric Emergency Unit of Korle Bu Teaching Hospital, Accra, Ghana, from February to December 2019. The primary outcome was all-cause inpatient mortality. Key variables collected included referral status and facility tier, Emergency Triage Assessment and Treatment (ETAT) triage category, ICD-10 diagnostic classification, Oyedeji socioeconomic classification, and time from symptom onset to PEU registration. Crude odds ratios were computed for all candidate predictors. Multivariable logistic regression was conducted using complete case analysis (n = 613). Of 675 children, 63.0% (n = 425) were referred from another health facility; referred children had higher ETAT emergency triage category rates than self-presenting children (32.7% vs 27.6%, p < 0.001). Overall inpatient mortality was 9.9% (67/675). Mortality varied by referral source: 16.7% among secondary/regional hospital referrals, 11.0% among lower-tier facility referrals (district, municipal, CHAG, polyclinic, private, health centre, and maternity home facilities combined, n = 356), 7.6% among self-presenting children, and 7.4% among tertiary referrals. Overall, 30.8% of children were classified as ETAT emergencies on arrival, with case fatility rate of 21.6%. The three most common diagnostic domains were respiratory conditions (17.2%), blood and haematological disorders (17.0%), and digestive presentations (16.4%). Inpatient mortality was highest in neoplastic disease (33.3%, n = 30) and circulatory presentations (31.0%, n = 29). In the primary multivariable analysis (n = 613, 51 events; events-per-variable ratio 4.2), no referral tier was independently associated with inpatient mortality after adjustment. Referral from secondary/regional hospitals showed a borderline non-significant association (adjusted odds ratio 3.09, 95% CI 0.96 to 9.90, p = 0.058). School going children (60-119 months) had higher odds of inpatient death than infants (adjusted odds ratio 5.56, 95% CI 1.16 to 26.53, p = 0.032), as did adolescents (adjusted odds ratio 10.01, 95% CI 2.15 to 46.69, p = 0.003). ETAT emergency category and lower socioeconomic status were not independently significant in this model. A pre-specified sensitivity analysis using the full analytic cohort (n = 674, events-per-variable ratio 6.7) with collapsed referral categories did not confirm any referral tier association; ETAT emergency category and lower SES were independently associated in the sensitivity model. All multivariable estimates should be regarded as exploratory. This prospective cohort provides simultaneous characterisation of referral patterns, ETAT triage acuity, diagnostic case mix, and inpatient mortality at a national tertiary paediatric emergency unit in West Africa. The referral-mortality gradient and high ETAT emergency category proportion document the severity of illness arriving through different referral pathways at this facility. The association between secondary/regional hospital referral and inpatient mortality is hypothesis-generating and requires replication in an adequately powered multicentre study before any service-level conclusions can be drawn.

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

Convergence to the Brownian CRT for critical branching Markov processe

arXiv:2601.05906v2 Announce Type: replace Abstract: We prove an invariance principle for a general class of continuous time critical branching processes with finite variance (non-local) branching mechanism. We show that the genealogical trees, viewed as random compact metric measure spaces, converge under rescaling to the Brownian continuum random tree in the Gromov-Hausdorff-weak topology, establishing a universal scaling limit for critical finite variance branching processes.

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

How Inference Compute Shapes Frontier LLM Evaluation

arXiv:2606.17930v1 Announce Type: new Abstract: AI evaluations are shifting toward harder tasks that benefit from longer trajectories involving tool use and iterative problem solving. As a result, performance is increasingly sensitive to the amount and allocation of compute available at test time ("inference compute"). Yet many evaluations still report performance at a single restrictive budget, meaning that low scores may reflect the evaluation setup rather than the model's underlying capability. To test this, we evaluate up to 12 frontier language models on seven challenging benchmarks spanning software engineering, mathematics, medicine, and cybersecurity. We use a controlled setup combining three simple inference-scaling interventions: larger token budgets, context compaction, and repeated submission attempts, guided either by the model itself or by minimal correctness feedback. We find three main results. First, larger token budgets substantially improve performance on benchmarks across multiple domains, including cybersecurity, FrontierMath, Humanity's Last Exam, and TerminalBench. Second, fixed-budget evaluations can increasingly understate frontier capability as models advance. Newer models reach higher performance at large budgets, where they unlock harder tasks and solve them more reliably. Third, benchmarks differ in which inference-scaling methods help most: repeated submission broadly improves performance, but the value of larger token budgets, external feedback, and parallel attempts varies by benchmark. Overall, our results show that benchmark scores are protocol-dependent. We therefore argue that evaluations should report capability as a function of inference-time compute, specify protocol choices explicitly, and compare model generations over a large shared compute range at matched budgets, especially in safety- or policy-relevant settings.

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

From Sorting Algorithms to Scalable Kernels: Bayesian Optimization in High-Dimensional Permutation Spaces

arXiv:2507.13263v4 Announce Type: replace-cross Abstract: Bayesian Optimization (BO) is a powerful tool for black-box optimization, but its application to high-dimensional permutation spaces is severely limited by the challenge of defining scalable representations. The current state-of-the-art BO approach for permutation spaces relies on an exhaustive $\Omega(n^2)$ pairwise comparison, inducing a dense representation that is impractical for large-scale permutations. To break this barrier, we introduce a novel framework for generating efficient permutation representations via kernel functions derived from sorting algorithms. Within this framework, the Mallows kernel can be viewed as a special instance derived from enumeration sort. Further, we introduce the Merge Kernel , which leverages the divide-and-conquer structure of merge sort to produce a compact, $\Theta(n\log n)$ to achieve the lowest possible complexity with no information loss and effectively capture permutation structure. Our central thesis is that the Merge Kernel performs competitively with the Mallows kernel in low-dimensional settings, but significantly outperforms it in both optimization performance and computational efficiency as the dimension $n$ grows. Extensive evaluations on various permutation optimization benchmarks confirm our hypothesis, demonstrating that the Merge Kernel provides a scalable and more effective solution for Bayesian optimization in high-dimensional permutation spaces, thereby unlocking the potential for tackling previously intractable problems such as large-scale feature ordering and combinatorial neural architecture search.

19.
arXiv (CS.AI) 2026-06-18

TRIDENT: Breaking the Hybrid-Safety-Physics Coupling for Provably Safe Multi-Agent Reinforcement Learning

arXiv:2606.18308v1 Announce Type: cross Abstract: Safe coordination in networked cyber-physical systems forces learning algorithms to simultaneously handle hybrid discrete-continuous actions, hard training-time safety constraints, and physics-governed dynamics. We show that these three features form a directed cycle of biases that defeats any naive composition of off-the-shelf modules, and formalize this as a three-way coupling lemma. We then introduce TRIDENT, the first MARL framework whose three components are co-designed to cancel each leak: a Richardson-Romberg gradient correction reducing Gumbel-Softmax bias from O(tau) to O(tau^2), a Lyapunov-constrained sequential trust-region update enforcing per-iterate feasibility, and a physics-informed residual critic that decomposes value rather than reward. We prove an O~(1/sqrt(K)) convergence rate to a constrained Nash equilibrium and an O(sqrt(K)) cumulative-violation bound. On multi-UAV mobile-edge computing, autonomous intersection management, and a hybrid SMAC variant, TRIDENT cuts training-time violations by 95.5% over MADDPG and 76.3% over MACPO, while improving reward by 13.5% over the strongest unconstrained baseline.

21.
medRxiv (Medicine) 2026-06-13

Projected population level impact and cost-effectiveness of clinic and community-based tuberculosis screening approaches

The South Africa National Department of Health have set ambitious targets to scale up TB testing, focusing primarily on clinic attendees. In the context of declining funding for TB care and prevention, the most cost-effective approaches for targeting testing should be identified. We developed a mathematical model of TB in South Africa, explicitly incorporating clinic attendance by sex and HIV/ART status. We simulated six screening approaches over 2026-2035 (individually and in combination): three clinic-based (symptom screening, intensified targeted universal TB testing [TUTT, symptom-agnostic sputum testing of clinic attendees in key risk groups], and intensified TUTT allowing saliva samples) and three targeted community-based (community radiographic screening, symptom screening, and universal Xpert Ultra testing), each implemented at a range of coverage levels. Model outputs were combined with a mechanistic cost function to estimate potential impact and cost-effectiveness from a societal perspective. The most cost-effective standalone approach was community radiographic screening at 10% annual population coverage, with an incremental cost-effectiveness ratio (ICER) of $421 per disability-adjusted life year (DALY) averted. 10/11 scenarios along the expansion path included community radiographic screening at progressively higher coverage, combined with a clinic-based approach. Combining complementary approaches to reach both groups at increased risk of TB (e.g. clinic-based screening) and groups with lower screening coverage (e.g. community-based screening) may increase cost-effectiveness of TB screening, compared to standalone approaches. When designing TB screening strategies, both population risk and existing screening coverage should be considered.

22.
arXiv (CS.CL) 2026-06-15

Reward-SQL: Boosting Text-to-SQL via Stepwise Execution-Aware Reasoning and Process-Supervised Rewards

Recent advances in large language models (LLMs) trained with reinforcement learning (RL) have improved Text-to-SQL performance. However, RL-based approaches still struggle with complex queries due to two key limitations: insufficient stepwise execution-aware reasoning grounded in database feedback, and the lack of process-level rewards for guiding reasoning optimization. To address these issues, we propose CoCTE, a divide-and-conquer and execution-aware reasoning framework that progressively composes SQL queries through intermediate view validation and structured Common Table Expressions (CTEs), improving both accuracy and interpretability. To realize a CoCTE reasoning process, we develop Reward-SQL, a unified approach with three stages: (1) model initialization, which equips LLMs with structured CoCTE reasoning capabilities; (2) process reward design, which delivers fine-grained, execution-aware supervision; and (3) process-supervised RL and inference, which integrates process rewards into training and guides the inference stage by process rewards. This paper addresses the core challenges in Reward-SQL and makes the following contributions. We introduce a process reward model (PRM) that combines execution-aware trajectory scoring with entropy-based step weighting, providing dense and interpretable supervision across reasoning steps. We integrate PRM into both RL training and inference stages, stabilizing optimization and improving trajectory exploration with process-level signals. Experiments show that Reward-SQL significantly outperforms baselines with comparable model sizes, and exhibits strong cross-domain generalization.

23.
arXiv (CS.AI) 2026-06-16

Hybrid NARX-LLM for Greenland Iceberg Discharge: Prompt-Driven Residual Correction

arXiv:2606.15288v1 Announce Type: cross Abstract: Greenland iceberg discharge exhibits complex nonlinear dynamics with limited observability, challenging traditional predictive models. We present a Hybrid NARX-LLM framework that combines a nonlinear autoregressive model with exogenous inputs (NARX) and a large language model (LLM) for residual correction. We further propose a Physics-Informed Prompt (PIP) method that transforms unstructured physical knowledge into structured prompts for zero-shot in-context reasoning. The primary objective is to explore the corrective potential of this framework for modeling Greenland iceberg discharge, rather than merely optimizing predictive accuracy. The NARX component captures intrinsic temporal dependencies, while the LLM, guided by PIP, encodes glacier dynamics and environmental drivers and perceives key trend patterns to correct systematic prediction errors. This integration allows the model to reason about unmodeled factors and produce interpretable residuals, enhancing overall predictive accuracy. Applied to Greenland iceberg discharge time series, our approach addresses extreme events that are difficult to predict due to rare variations and nonstationary trends, a limitation often overlooked by traditional methods. By fusing structured time-series modeling with knowledge-driven foundation AI, the framework offers a scalable and interpretable pathway to bridge data-limited climate forecasting with physics-informed LLM reasoning. The code is available.

24.
arXiv (CS.CL) 2026-06-16

StagePilot: Stage-Level Planning for Long-Horizon Dialogue Simulation in Cybergrooming

Cybergrooming is an evolving threat to youth, requiring proactive educational interventions. We address this by modeling dialogue progression as a structured planning problem over stage-wise interactions. We propose StagePilot, a dialogue framework that separates stage-level planning from response generation, in which the model selects the next stage under constrained transitions and generates responses conditioned on it, enabling coherent and realistic progression. Reinforcement learning is used to learn stage-level policies from offline data, optimizing for both emotional alignment and goal-consistent progression. Our empirical experiments show that StagePilot generates more structured, coherent dialogue trajectories and reduces conversational stagnation compared to baselines; notably, the IQL+AWAC variant reaches the final stage more often while maintaining over 70% positive or neutral responses, yielding a 43% relative improvement.

25.
medRxiv (Medicine) 2026-06-17

A multistate model of frailty progression after severe infections in adults >=65 years in England: a matched-cohort study

Background Evidence on frailty progression following severe infections is limited. We compared rates of transition to greater frailty or death between adults with and without severe infection in England. Methods We conducted a matched-cohort study among adults aged [&ge;]65 years (1,452,117: median age 76 years, 45% male) in Clinical Practice Research Datalink Aurum (2006-2019). Adults with severe infection (hospitalised primarily due to infection) were matched on calendar time to individuals without severe infection on age, sex, and primary care practice. The admission date was used as index date and same was assigned to matched unexposed adults. We measured frailty using Electronic Frailty Index, a proportion of 36 health deficits in validated categories (Fit 0-0.12, Mild >0.12-0.24, Moderate >0.24-0.36, Severe >0.36). In a time-varying Markov multistate model, we focused on forward transitions from baseline or intermediate frailty states to higher states or death. For each transition, we used Cox regression to estimate cause-specific transition hazard ratios (HR) with 95% confidence intervals (CIs), comparing adults with and without severe infection. We adjusted for baseline frailty score, age, sex, deprivation, harmful alcohol use, smoking, and primary care infection history 5 years before index date. We estimated state occupancy probabilities, and expected length of stay (ELOS) in each state at year five among adults with and without severe infection. We explored effect modification by infection type. Results Across all transitions, severe infection was associated with higher adjusted hazards of transitioning to worsening frailty or death, HR, 95% CI: (fit to: mild[1.56, 1.54-1.58], moderate[2.51, 1.79-3.51], death[4.57, 4.50-4.65]; mild to: moderate[1.52, 1.50-1.53], severe[1.90, 1.43-2.52], death[2.67, 2.64-2.70]; moderate to: severe[1.40, 1.38-1.42], death[1.87, 1.85-1.90]; severe to death[1.48, 1.46-1.50]). Transition hazard ratios were strongest for lower respiratory tract infections, followed by sepsis, urinary tract infections, meningitis/encephalitis, gastroenteritis, and skin and soft tissue infections. At five years, adults with severe infection had higher probabilities of transitioning to greater frailty or death across all transitions and lower ELOS in each frailty state than those without severe infection. Interpretation Severe infections may accelerate frailty deterioration in older age. Prevention through vaccination, early detection, and prompt management may help mitigate this decline.