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

The Unreasonable Effectiveness of Discrete-Time Gaussian Process Mixtures for Robot Policy Learning

arXiv:2505.03296v2 Announce Type: replace-cross Abstract: We present Mixture of Discrete-time Gaussian Processes (MiDiGap), a novel approach for flexible policy representation and imitation learning in robot manipulation. MiDiGap enables learning from as few as five demonstrations using only camera observations and generalizes across a wide range of challenging tasks. It excels at long-horizon behaviors such as making coffee, highly constrained motions such as opening doors, dynamic actions such as scooping with a spatula, and multimodal tasks such as hanging a mug. MiDiGap learns these tasks on a CPU in less than a minute and scales linearly to large datasets. We also develop a rich suite of tools for inference-time steering using evidence such as collision signals and robot kinematic constraints. This steering enables novel generalization capabilities, including obstacle avoidance and cross-embodiment policy transfer. MiDiGap achieves state-of-the-art performance on diverse few-shot manipulation benchmarks. On constrained RLBench tasks, it improves policy success by 76 percentage points and reduces trajectory cost by 67%. On multimodal tasks, it improves policy success by 48 percentage points and increases sample efficiency by a factor of 20. In cross-embodiment transfer, it more than doubles policy success. We make the code publicly available at https://midigap.cs.uni-freiburg.de.

02.
arXiv (math.PR) 2026-06-12

Scaling limit of additive functionals for reversible non-gradient exclusion process: critical cases

arXiv:2606.13442v1 Announce Type: new Abstract: For the reversible speed-change exclusion process $(\eta_t)_{t \geq 0}$ in $\mathbb{Z}^d$, we study the scaling limit of additive functionals ${\Gamma_t(f) = \int_0^t f(\eta_s)\, \mathrm{d} s}$. Concerning the local centered function $f$, the previous work [Commun. Math. Phys. 104, 1-19, 1986] by Kipnis and Varadhan and [Comm. Pure Appl. Math., 66: 649-677, 2013] by Gon{ç}alves and Jara respectively covered the cases $d \geq 3$ and $d=1$. The present paper completes the missing part $d=2$, and also develops the theory for functions with higher degree. The novelty is a quantitative homogenization of the resolvent, which allows to overcome the obstacle of correlation function in non-gradient models.

03.
medRxiv (Medicine) 2026-06-17

Nickel and Dimed: How a Common Earth Element is Short-Changing Our Health

Nickel has been studied for a long time as an environmental contaminant but less so in its connection to population health. It does not announce itself as loudly as its transition metal brethren like mercury and cadmium, but its chemical properties permit it to be deleterious as a low-dose, chronic exposure, particularly among those with immune systems sensitized to it. There is a growing evidence base and vocabulary to discuss nickel's affect on health. However, in the U.S., there are not recent, reliable estimates of the share of the population with a nickel allergy, let alone how much nickel Americans are exposed to through their diet. This paper seeks to close this evidence gap by creating a new dataset of dietary nickel and other heavy metal exposure and assessing how high levels of dietary nickel exposure shape local demand for health care services. We use soil data from the U.S. Geological Survey and data on agricultural product transport from FoodFlows.org to create a county-level dietary nickel exposure index. We then use a large electronic health record database and double machine learning to estimate how demand for primary care services varies across levels of dietary nickel exposure. We find that counties with high nickel exposure experience an increase in the share of primary care office visits for symptoms highly suggestive of nickel poisoning. This result survives multiple hypothesis test corrections and placebo tests. Our research suggests that nickel has harmful effects on individual health whose exposure can be measured at a population level, and is shaping primary care across the U.S.

04.
medRxiv (Medicine) 2026-06-23

THE SILENT STRUGGLE: EXPLORING THE EFFECTS OF COMMUNICATION BREAKDOWNS IN HEALTHCARE DELIVERY IN THE NORTHERN REGION OF GHANA

Abstract Effective health communication is central to patient-centred care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing Semi-Structured interviews with purposively sampled twenty patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted Content Analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinderer patient openness and the quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact on treatment and assistive practice, specifically in culturally diverse environment and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers. Abstract Effective health communication is central to patient-centered care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing semi-structured interviews with twenty purposively sampled patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted content analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinder patient openness and quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact treatment and assistive practice, specifically in culturally diverse environments and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers.

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

FraudSMSWalker: Benchmarking Agentic Large Language Models for SMS-to-Webpage Fraud Detection

SMS fraud is increasingly cross-channel: a message directs the user to a webpage, and the final risk depends on how the SMS claim aligns with the page content and requested user action. However, existing evaluations either focus on message-only smishing classification or expose URL and domain cues that allow models to rely on reputation shortcuts. To address this gap, we introduce FraudSMSWalker, a controlled benchmark for URL-masked SMS-to-webpage fraud judgment. FraudSMSWalker contains 699 bilingual chains, including 332 fraudulent and 367 benign cases, across ten service scenarios. The model-visible input consists of the SMS context and sanitized webpage evidence, while raw URLs, hosts, domains, IPs, redirects, and reputation metadata are withheld. The benchmark further includes hard benign cases whose pages contain login, payment, verification, or account-management elements that are plausible under the service context but also appear in scam flows. We evaluate nine web agents under masked browser-agent protocols and conduct URL-visibility ablations. The results show that current agents can detect suspicious cues, but struggle to preserve benign recall and often produce positive predictions that are weakly supported by the observed evidence. These findings position FraudSMSWalker as a benchmark for measuring whether web agents can make fraud judgments that remain both accurate and evidence-grounded when direct reputation shortcuts are suppressed. The associated code and dataset are accessible at the \href{https://anonymous.4open.science/w/FraudMessageWalker-Bench}{anonymous link}.

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

Learn-to-learn on Arbitrary Textual Conditioning: A Hypernetwork-Driven Meta-Gated LLM

Conventional LLMs may suffer from corpus heterogeneity and subtle condition changes. While finetuning can create the catastrophe forgetting issue, application of meta-learning on LLMs is also limited due to its complexity and scalability. In this paper, we activate the meta-signal of $\beta$ within the SwiGLU blocks, resulting in a meta-gating mechanism that adaptively adjusts the nonlinearity of FFN. A hypernetwork is employed which dynamically produces $\beta$ on textual conditions, providing meta-controllability on LLMs. By testing on different condition types such as task, domain, persona, and style, our method outperforms finetuning and meta-learning baselines, and can generalize reasonably on unseen tasks, condition types, or instructions. Our code can be found in https://github.com/AaronJi/MeGan.

07.
arXiv (quant-ph) 2026-06-17

Robust Spin Splitting and Strain-Controlled Optical Response in Monolayer CrC2N4 for Valleytronic and Optoelectronic Applications

arXiv:2606.17329v1 Announce Type: cross Abstract: Monolayer CrC2N4 recently emerged as a promising two-dimensional semiconductor, yet its spin-orbit-coupled (SOC) physics and strain-tunable optical response remained largely unexplored. Here, we investigated the electronic, valley, charge-transfer, and optical properties of pristine and biaxially strained monolayer CrC2N4 using first-principles calculations. The monolayer exhibited a direct band gap at the K/K' valleys. SOC produced valley contrasting out-of-plane spin polarization, yielding a moderate valence band spin splitting of 51.9 meV and a small conduction band spin splitting of 1.7 meV. Orbital-resolved analysis showed that the edge states were mainly governed by Cr-d and N-p hybridization, while Bader analysis indicated polar-covalent bonding through charge transfer toward N atoms. Biaxial strain in the range of -4% to +4% tuned the band gap from 1.987 to 1.421 eV and drove an indirect-to-direct gap transition near -1% strain. Tensile strain enhanced the Berry curvature and red-shifted the optical response toward the visible-near-infrared region. These results suggested monolayer CrC2N4 as a promising platform for strain-engineered valleytronic and optoelectronic device applications.

08.
arXiv (CS.LG) 2026-06-19

Improved Stochastic Optimization of LogSumExp

arXiv:2509.24894v4 Announce Type: replace-cross Abstract: The LogSumExp function, dual to the Kullback-Leibler (KL) divergence, plays a central role in many important optimization problems, including entropy-regularized optimal transport (OT) and distributionally robust optimization (DRO). In practice, when the number of exponential terms inside the logarithm is large or infinite, optimization becomes challenging since computing the gradient requires differentiating every term. We propose a novel convexity- and smoothness-preserving approximation to LogSumExp that can be efficiently optimized using stochastic gradient methods. This approximation is rooted in a sound modification of the KL divergence in the dual, resulting in a new $f$-divergence called the Safe KL divergence. Our experiments and theoretical analysis of the LogSumExp-based stochastic optimization, arising in DRO and continuous OT, demonstrate the advantages of our approach over existing baselines.

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

YTClickbait21K: Human-Annotated Multimodal Dataset for YouTube Clickbait Detection Across Diverse Channels and Content Categories

Clickbait content on video-sharing platforms poses a significant challenge to information reliability, yet progress in automated detection has been constrained by the lack of large-scale, high-quality multimodal datasets. We present YTClickbait21K, a human-annotated YouTube clickbait dataset comprising 21,238 videos collected from 40 channels across 29 countries, covering diverse content categories such as news, entertainment, education, and gaming. Each sample includes structured metadata (title, description, engagement statistics) along with associated thumbnail images, enabling comprehensive multimodal analysis. To ensure annotation quality, every video was independently labeled by three annotators using a standardized decision framework that incorporates textual, visual, and cross-modal consistency cues, with final labels determined through majority voting. The dataset exhibits substantial inter-annotator agreement (k=0.65), confirming reliable labeling despite the inherent subjectivity of clickbait detection. By combining scale, annotation rigor, and multimodal richness, this dataset provides a robust benchmark for developing and evaluating machine learning models, facilitating research in cross-modal semantic understanding, and advancing automated content moderation systems.

10.
arXiv (CS.CL) 2026-06-18

GraphPO: Graph-based Policy Optimization for Reasoning Models

Reinforcement Learning with Verifiable Rewards (RLVR) has become a standard paradigm for enhancing the capability of large reasoning models. RLVR typically samples responses independently and optimizes the policy using from final answers. This paradigm has two limitations. First, independently responses often contain similar intermediate reasoning steps, causing redundant exploration and wasted computation. Second, sparse final-answer rewards make it hard to identify useful steps. Tree-based methods partly address this problem by sharing prefixes and comparing branches from the same prefix to provide fine-grained signals. However, tree branches are still expanded independently. When different branches reach similar reasoning states, they cannot share information and repeat similar exploration. Moreover, tree-based methods ignore such dispersion and only perform local comparisons within separate branches, which can lead to higher variance in advantage estimation. To address this challenge, we propose GraphPO (Graph-based Policy Optimization), a novel RL framework that represents rollouts as a directed acyclic graph, with reasoning steps as edges and semantic states summarized from the reasoning paths as nodes. GraphPO merges semantically equivalent reasoning paths into equivalence classes, allowing them to share suffixes and reallocating budget away from redundant expansions to diverse exploration. Furthermore, we assign efficiency advantages to incoming edges and correctness advantages to outgoing edges, thereby improving inference efficiency while deriving process supervision from outcome. Theory shows that GraphPO reduces advantage-estimation variance and enhances reasoning efficiency. Experiments on three LLMs across reasoning and agentic search benchmarks show that GraphPO consistently outperforms chain- and tree-based baselines with the same token budgets or response budgets.

11.
arXiv (CS.LG) 2026-06-17

Can Vision Foundation Models Navigate? Zero-Shot Real-World Evaluation and Lessons Learned

arXiv:2603.25937v2 Announce Type: replace-cross Abstract: Visual Navigation Models (VNMs) promise generalizable, robot navigation by learning from large-scale visual demonstrations. Despite growing real-world deployment, existing evaluations rely almost exclusively on success rate, whether the robot reaches its goal, which conceals trajectory quality, collision behavior, and robustness to environmental change. We present a real-world evaluation of five state-of-the-art VNMs (GNM, ViNT, NoMaD, NaviBridger, and CrossFormer) across two robot platforms and five environments spanning indoor and outdoor settings. Beyond success rate, we combine path-based metrics with vision-based goal-recognition scores and assess robustness through controlled image perturbations (motion blur, sunflare). Our analysis uncovers three systematic limitations: (a) even architecturally sophisticated diffusion and transformer-based models exhibit frequent collisions, indicating limited geometric understanding; (b) models fail to discriminate between different locations that are perceptually similar, however some semantics differences are present, causing goal prediction errors in repetitive environments; and (c) performance degrades under distribution shift. We will publicly release our evaluation codebase and dataset to facilitate reproducible benchmarking of VNMs.

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

Surrogate-Assisted Framework for SI-Compliant Interconnect Design Optimization Using the Earth Mover's Distance

arXiv:2606.15234v1 Announce Type: cross Abstract: This work presents a deterministic, machine-assisted framework for SI-compliant PCB design based on the Earth Mover's Distance (EMD). In contrast to conventional surrogate-based optimization methods that rely on iterative black-box search procedures, the proposed approach follows an interpretable, sequential evaluation strategy. Neural surrogate models are first used to efficiently predict waveform describing features from topology-dependent design parameters. A decision tree then acts as a physically motivated quality gate that identifies SI-compliant waveforms according to predefined SI criteria. Within the resulting valid solution space, the Earth Mover's Distance is employed as a similarity metric to rank candidate designs according to their proximity to an ideal reference signal. This enables not only the deterministic identification of admissible parameter regions but also a transparent prioritization of physically superior solutions without inverse modeling or stochastic search procedures. The methodology is demonstrated using a large-scale set of simulated DDR3 fly-by waveforms. By combining surrogate prediction, interpretable classification, and EMD-based waveform evaluation, the framework provides an explainable and computationally efficient alternative to conventional optimization strategies for supporting PCB development with AI-based methods.

13.
arXiv (CS.CL) 2026-06-12

Reward Modeling for Multi-Agent Orchestration

Multi-Agent Systems (MAS) built on Large Language Models (LLMs) require effective orchestration to coordinate specialized agents, yet training such orchestrators is hindered by limited supervision and high computational cost. We propose Orchestration Reward Modeling (OrchRM), a self-supervised framework for evaluating orchestration quality without human annotations. OrchRM leverages intermediate artifacts from multi-agent executions to construct win-lose pairs for Bradley-Terry reward model training. Unlike existing MAS test-time scaling and orchestrator training frameworks that rely on costly sub-agent rollouts, OrchRM operates directly at the orchestration level, enabling efficient and high-performing reward-guided orchestrator training and MAS test-time scaling. OrchRM improves training efficiency by up to 10x in token usage while improving MAS test-time scaling performance by up to 8% in accuracy. These gains consistently transfer across multiple domains, including mathematical reasoning, web-based question answering, and multi-hop reasoning, demonstrating orchestration-level reward modeling as a scalable direction for robust multi-agent orchestration. Code will be available at https://github.com/Wang-ML-Lab/OrchRM.

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

A Spatio-Temporal Expert Prefetching Framework for Efficient MoE-based LLM Inference

arXiv:2606.15453v1 Announce Type: cross Abstract: Mixture-of-Experts (MoE) based large language models (LLMs), such as Qwen and DeepSeek, have recently emerged as an effective approach to improving model capacity without proportionally increasing computational cost. By replacing the conventional feed-forward network in dense LLMs with a set of experts and activating only a subset of them for each input token, MoE models significantly increase the total number of parameters while keeping the per-token computation relatively manageable. However, this dynamic and irregular expert activation pattern also introduces substantial expert loading overhead during inference, since the required experts must be fetched on demand according to token-dependent routing results. As a result, expert loading latency becomes a major source of performance and energy inefficiency. To this end, we first perform a comprehensive analysis of expert selection behavior in various MoE-based LLMs and applications, including language understanding and code generation. Our analysis reveals that, within each application domain, expert requests exhibit strong correlation across both adjacent MoE layers and consecutive decoding tokens, making future expert activations predictable. Based on this insight, we propose ST-MoE, a spatio-temporal expert prefetching framework that proactively stages experts ahead of use to overlap expert loading with ongoing computation. ST-MoE combines a lightweight runtime prediction mechanism that preserves the original routing behavior with a reconfigurable hardware design that efficiently supports dynamic expert prefetching. The combined effect of the prediction mechanism with the supporting hardware significantly improves MoE inference performance and energy efficiency while preserving model inference accuracy.

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

Secure Coding Drift in LLM-Assisted Post-Quantum Cryptography Development: A Gamified Fix

arXiv:2606.19474v1 Announce Type: cross Abstract: The transition to Post Quantum Cryptography (PQC) introduces considerable implementation complexity, requiring strict adherence to constant-time execution, side channel resistance, and precise parametrisation. Simultaneously, large language models (LLMs) are heavily embedded in software development workflows, including cryptographic engineering. While LLMs improve productivity, evidence shows that they frequently generate insecure or suboptimal code, particularly in security critical domains. This paper introduces Secure Coding Drift in PQC, a novel socio technical vulnerability model capturing the gradual degradation of secure coding practices due to sustained reliance on LLM-generated code. Unlike prior work that focuses on static vulnerabilities, we conceptualise security risk as a longitudinal behavioural phenomenon rising from human AI interaction. To mitigate this, we propose a gamified, LLM augmented secure coding framework that embeds adversarial evaluation, behavioural feedback, and security scoring into development workflows. Our approach reframes LLMs from passive assistants into active security co-pilots, contributing toward safer PQC implementation in AI mediated environments.

16.
arXiv (quant-ph) 2026-06-16

Conditions for Unitarity in Timeless Quantum Theory

arXiv:2504.01579v3 Announce Type: replace Abstract: Quantum timeless approaches solve the problem of time by recovering the usual unitary evolution of quantum theory relative to a clock in a stationary quantum Universe. For some Hamiltonians of the Universe, such as those including an interaction term with the clock, the dynamics is substantially altered and can be non-unitary. This work derives necessary and sufficient conditions for the relative dynamics to be unitary and finds the general form of the unitary evolution operator. A physical interpretation of these conditions is given in terms of the clock's rate. Unitary dynamics is associated with rates that are constant in time and independent of the clock's internal structure.

17.
arXiv (math.PR) 2026-06-15

The 1/4-phenomenon of placement probabilities of tilings in the Aztec diamond

arXiv:2512.08377v2 Announce Type: replace-cross Abstract: We consider domino tilings of the Aztec diamond. Using the Domino Shuffling algorithm introduced by Elkies, Kuperberg, Larsen, and Propp in arXiv:math/9201305, we are able to generate domino tilings uniformly at random. In this paper, we investigate the probability of finding a domino at a specific position in such a random tiling. We prove that this placement probability is always equal to $1/4$ plus a rational function, whose shape depends on the location of the domino, multiplied by a position-independent factor that involves only the size of the diamond. This result leads to significantly more compact explicit counting formulas compared to previous findings. As a direct application, we derive explicit counting formulas for the domino tilings of Aztec diamonds with $2\times 2$-square holes at arbitrary positions.

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

Prediction of Alzheimer's Disease Risk Factors from Retinal Images via Deep Learning: Development and Validation of Biologically Relevant Morphological Associations in the UK Biobank

The systemic, metabolic, lifestyle factors have established associations with Alzheimer's Disease (AD) through epidemiologic and AD-specific biomarker studies. Whether colored fundus photography (CFP) contains retinal structural signatures corresponding to these AD-related risk domains remains unclear. To determine whether deep learning (DL) models can predict 12 AD-related risk factors from CFP and to characterize the retinal structures underlying these predictions, thereby assessing whether CFP reflects pathways to AD vulnerability. Using 62,876 CFPs from 44,501 unique participants from the UK Biobank, DL models were trained to predict 12 factors linked to AD incidence: 6 categorical (sex, smoking, sleeplessness, economic status, alcohol use, depression) and 6 continuous (age, age at completing education, BMI, systolic, diastolic blood pressure, HbA1c). Model performance, model saliency, and saliency-derived scores (CAM-Score) were evaluated and compared to retinal morphometry. The scores were also compared between incident-AD cases (average 8.55 years before onset) and matched controls. Performance of DL ranged from AUROC= 0.5654-0.9480 for categorical and R2=-0.0291-0.7620 for continuous factors, outperforming most of the morphometry-machine learning models. Saliency-based score consistently highlighted biologically meaningful regions, particularly the optic nerve head and retinal vasculature. It also aligned with present morphometric variations. Several saliency-based scores differed significantly between incident AD and matched controls, suggesting potential overlap between retinal correlates of risk factors and preclinical AD-associated changes. CFP encodes retinal signatures linked to AD risk factors. Although not diagnostic, DL-derived retinal representations may uncover biologically meaningful risk-related structural changes mirroring the potential AD vulnerability.

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

Causal Emotion Recognition in Conversation: Context Saturation and Discourse-Marker Evidence

We address two persistent gaps in Emotion Recognition in Conversation: which modeling choices materially affect performance, and how recognition findings connect to interpretable discourse-level patterns. We study both through a systematic investigation on IEMOCAP with cross-dataset validation on MELD. For recognition, we run controlled ablations with 10 random seeds and paired significance tests with multiple-comparisons correction, yielding three findings. First, conversational context is the dominant factor, but performance saturates quickly: roughly 90% of the gain is captured within the most recent 10-30 preceding turns, depending on the label set. Second, hierarchical sentence representations help most in utterance-only settings and show a clear advantage on MELD, but their benefit disappears once turn-level context is available, suggesting that conversational history subsumes much of the intra-utterance structure. Third, integrating an external affective lexicon does not improve results, consistent with pretrained encoders already capturing most of the affective signal needed for ERC. Under a strictly causal setting, our simple models achieve strong performance (82.69% 4-way; 67.07% 6-way weighted F1), showing that competitive accuracy is achievable without future turns. For linguistic analysis, we examine 5,286 discourse-marker occurrences and find a reliable association between emotion and marker position (p < .0001). Sad utterances show reduced left-periphery marker usage (21.9%) relative to other emotions (28-32%), consistent with accounts linking left-periphery markers to active discourse management. This aligns with our recognition results, where Sad benefits most from conversational context (+22 percentage points), suggesting sadness may be more context-dependent than emotions with stronger local pragmatic cues.

20.
PLOS Medicine 2026-06-12

Comparison of count-based and clustering definitions of multimorbidity and their association with prevalence of multimorbidity, health profiles, and mortality: A cohort study of UK Biobank participants

by Gabriella C. Silva, Aurore Fayosse, Louis Jacob, Séverine Sabia, Archana Singh-Manoux, Benjamin Landré Background Multimorbidity, the presence of several chronic conditions, is linked to higher mortality and healthcare use and thus poses a major challenge for aging populations. While most studies rely on simple counts of conditions, clustering approaches have been proposed to describe patterns of co-occurring diseases. We aimed to evaluate the extent to which these methodological choices influence prevalence and association with health profiles and mortality. Methods and findings Using UK Biobank baseline data (n = 474,397), collected between 2006 and 2010, we compared six count-based definitions of multimorbidity based on different condition lists (extended, most prevalent, or body systems) and thresholds (≥2 versus ≥3 conditions). We also applied a clustering analysis to characterize subtypes of multimorbidity among participants with at least two chronic conditions. We compared prevalence and associations with concurrent health outcomes (polypharmacy, self-rated health, frailty, falls, surgery, chronic pain), blood-based measures (C-reactive protein, Cystatin-C, HDL, LDL Cholesterol, IGF-1), and 3- and 10-year mortality risks. Analyses were undertaken separately in men and women using multivariable regression models adjusted for sociodemographic characteristics and body mass index. Multimorbidity prevalence ranged from 1.0% (cluster-based) to 35.3% (count-based). Count-based definitions using lists with more conditions yielded higher prevalence. Higher thresholds identified more severe health profiles on all measured health outcomes, blood-based measures, but not higher mortality risks. Associations with blood-based measures were more pronounced using clustering, with the highest differences from the standard definition distributed across clusters. Odds ratios for 3-year mortality ranged from 1.44 [1.26; 1.64] to 4.60 [3.73; 5.62] for men and 1.35 [1.07; 1.69] to 3.83 [2.78; 5.14] for women. For 10-year mortality, they ranged from 1.42 [1.34; 1.50] to 3.86 [3.46; 4.30] in men and 1.29 [1.21; 1.39] to 3.33 [2.93; 3.77] for women, with clustering identifying groups with low prevalence and high mortality risks. Findings should be interpreted in light of the selected nature of the UK Biobank cohort and the cross-sectional assessment of several health indicators. Conclusion Operational definitions of multimorbidity substantially influence prevalence estimates, while associations with mortality appear more robust across count-based approaches. Clustering analyses provide complementary insights into heterogeneity within multimorbid populations. Future translational studies are warranted to determine how multimorbidity definitions can be optimized to ultimately improve clinical management and health outcomes in practice.

21.
medRxiv (Medicine) 2026-06-22

National trends and operational drivers of vaccine wastage in Uganda, 2020-2025: a descriptive analysis of four tracer antigens

Background Vaccine wastage reduces immunisation efficiency, increases costs, and complicates supply forecasting. Uganda routinely monitors vaccine use, but national evidence comparing observed wastage with World Health Organization (WHO) and Uganda-specific planning thresholds has been limited. We described national and sub-national trends for four tracer antigens to inform supply-chain planning and forecasting. Methods We conducted a retrospective descriptive analysis of routinely reported immunisation data from Ugandas District Health Information Software 2, 2020-2025. We analysed Bacille Calmette-Guerin (BCG), measles-rubella (MR), oral polio vaccine (OPV), and diphtheria-tetanus-pertussis-containing vaccine (DPT). Vaccine wastage was calculated as the proportion of issued doses not administered. Annual wastage rates were summarised using medians, and temporal trends were assessed using the Mann-Kendall test. Observed wastage was compared with WHO thresholds: BCG[&le;]50%, MR[&le;]25%, OPV[&le;]10%, DPT[&le;]15%, and Ugandas planning thresholds: BCG[&le;]70%, MR[&le;]40%, OPV[&le;]15%, DPT[&le;]10%. Effective Vaccine Management reports were reviewed to summarise reported reasons for wastage. Results During 2020-2025, median national wastage was 40.6% for BCG, 25.9% for MR, 10.0% for OPV, and 9.2% for DPT. OPV wastage declined from 12.8% in 2020 to 8.0% in 2025, with a significant downward trend ({tau}b=-1.00; p=0.008). OPV and DPT wastage remained largely within their respective Uganda in-country thresholds ([&le;]15% and [&le;]10%) for most of the study period, while BCG generally remained below the WHO threshold ([&le;]50%) and MR frequently exceeded the WHO threshold ([&le;]25%) but remained within Uganda's planning threshold ([&le;]40%) in most years. The proportion of districts exceeding both WHO and Uganda thresholds declined for OPV from 36.3% to 5.5% (p=0.024) and for DPT from 22.6% to 1.4% (p=0.013). Wastage was consistently higher in lower-level (Health Centre II and III) facilities, compared to hospitals. Among 50 service delivery points, reported reasons included low session attendance (66%), multi-dose vial policy non-compliance (28%), and vaccine expiry (12%). Conclusion Uganda achieved reductions in OPV wastage and district-level improvements in DPT wastage, while BCG and MR remained more variable and frequently had higher wastage. Strengthening adherence to the multi-dose vial policy and improving session planning at lower-level facilities could strengthen vaccine utilisation and forecasting.

22.
medRxiv (Medicine) 2026-06-22

Substantia Nigra and Subthalamic Nucleus Deep Brain Stimulation Exert Opposing Effects on Novelty Recognition in Parkinson's Disease

Episodic memory plays a critical role in supporting adaptive behavior; however, whether it can be causally regulated in humans via deep subcortical stimulation remains unclear. In the present study, we investigated the differential effects of substantia nigra (SN) and subthalamic nucleus (STN) stimulation on episodic memory, as well as the underlying mechanisms of its associated brain networks, using a recognition memory task combined with concurrent functional magnetic resonance imaging in patients with Parkinson's disease. SN-DBS increased recognition sensitivity and reduced false alarms at both frequencies, whereas 10 Hz STN-DBS reduced sensitivity and increased false alarms. Functional connectivity analyses in the absence of DBS stimulation identified a false recognition-related network linking nigral, pallidal, subthalamic, medial temporal, frontal, and occipital regions. SN-DBS-related false alarm reduction tracked modulation of this circuit and was marked by its baseline vulnerability state. These behavioral effects mapped onto target-dependent parieto-occipital and SN-visual retrieval pathways, supporting a model in which DBS bidirectionally regulates recognition memory through target- and frequency-dependent subcortical-cortical circuits.

23.
arXiv (CS.LG) 2026-06-11

Density estimation for Hellinger via minimum-distance estimators: mixtures of Gaussians, log-concave, and more

arXiv:2606.11469v1 Announce Type: cross Abstract: We study the task of density estimation, where we hope to accurately estimate a probability density from $n$ samples. A textbook method for density estimation in total variation distance is the minimum-distance estimator approach, where we conclude both the algorithm and the analysis merely from bounding the VC dimension of a particular concept class (the so-called Yatracos class). While this technique has originally yielded sharp guarantees primarily for total variation distance, in this work we extend the minimum-distance estimator approach for learning within Hellinger distance. Our main observation is that we may produce an analogous recipe for Hellinger (where we only require bounding the VC dimension of a related concept class) by drawing connections to recent results yielding reverse data processing inequalities. This recipe is flexible enough to accommodate fast algorithms originally designed for total variation distance; by modifying the approach of Acharya et al. (2017) we conclude the first near-linear time algorithm for learning classes including univariate mixtures of log-concave densities and mixtures of Gaussians (with arbitrary variances), with near-optimal sample complexity.

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

From Tokens to Regions: CUDA-Sensitive Instruction Tuning for GPU Kernel Generation

arXiv:2606.16231v1 Announce Type: cross Abstract: High-performance CUDA kernels are essential for scalable AI systems, while Large Language Models (LLMs) still struggle to generate correct kernels due to strict and implicit execution constraints. Existing LLM-based approaches either rely on costly agentic or reinforcement-learning (RL) pipelines, or adopt supervised fine-tuning (SFT) objectives that fail to explicitly model CUDA sensitivity, namely code tokens or regions tightly coupled with execution constraints. In this work, we investigate CUDA sensitivity from the perspective of token confidence patterns, showing that CUDA sensitivity appears at both token and region levels, where most CUDA-sensitive tokens are predicted with high confidence, while a smaller low-confidence subset forms regions corresponding to execution-critical structures. These findings suggest that effective CUDA kernel generation should both leverage high-confidence CUDA-sensitive tokens and preserve low-confidence CUDA-sensitive regions. Building on these insights, we propose \underline{CUDA-\underline{Se}nsitive Instruction \underline{T}uning (CuSeT)}, a low-cost post-training method within a simple SFT framework. CuSeT follows the principle of ``from tokens to regions'' by combining adaptive token-level masking with region-aware sample reweighting. Experiments show that CuSeT consistently improves functional correctness across multiple model families and scales, outperforming standard SFT and advanced SFT variants, while achieving competitive performance against frontier CUDA kernel generation models with substantially lower inference cost.

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arXiv (CS.AI) 2026-06-16

Metric Match: A Subset Selection Approach to Evaluating LLM Judge Reliability

arXiv:2606.15029v1 Announce Type: new Abstract: LLM judges are used to reduce the need for costly human labor in evaluating open-ended text generation. However, the reliability of these judges depends critically on their alignment with human raters – a property that itself depends on costly human annotations. In this work, we develop a method (Metric Match) for estimating correlation-based reliability metrics of LLM judges from limited annotations. Metric Match selects a subset of samples for human annotation such that the subset matches the population reliability metric with respect to acquired synthetic labels. We empirically show that Metric Match achieves a win-rate of 0.838 against random subset selection across four different correlation metrics and 15 datasets, with an 18.7% decrease in average estimation error and reduces annotation needs by 32.5%. We provide a cost model and highlight a medical case study where our method saves $1,041.67 compared to random selection for expert annotation. Further, we shift our task from reliability estimation to reliability classification of whether a given judge is above a deployment threshold, outperforming random selection with Metric Match. All project code is publicly available, and we additionally provide an installable package for ease of use.