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01.
medRxiv (Medicine) 2026-06-17

Sao Tome and Principe on the verge of eliminating lymphatic filariasis as a public health problem: evidence from IDA impact assessment surveys

Background Accelerated efforts to eliminate lymphatic filariasis (LF) as a public health problem have been supported by the introduction of the triple-drug regimen of ivermectin, diethylcarbamazine and albendazole (IDA) in endemic settings. In Sao Tome and Principe, nationwide mass drug administration (MDA) with diethylcarbamazine and albendazole was implemented in 2018, followed by IDA in 2019 and 2020. This study assesses progress towards elimination using post-MDA impact assessment surveys conducted after cessation of treatment. Methods Cross-sectional surveys were conducted among adults aged 20 years and older in 2022 and again between December 2024 and January 2025. Circulating filarial antigen (CFA) was detected using the filarial test strip (FTS). Individuals who tested positive were examined for microfilaremia using nocturnal calibrated thick blood smear microscopy. Additionally, programme data on MDA coverage and morbidity were obtained from national surveillance records. Results Three rounds of nationwide MDA achieved high epidemiological coverage (86.4% in 2018, 74.2% in 2019 and 80.0% in 2020). The impact assessment surveys conducted in 2022 evaluated 14 132 adults, with 21 individuals (0.15%) testing positive for CFA, while the follow-up survey conducted between December 2024 and January 2025 assessed 14 653 adults and detected seven positive cases (0.05%). No microfilariae were detected among the 28 antigen-positive individuals examined using nocturnal calibrated thick blood smears. National morbidity records documented 190 cases of lymphoedema and nine cases of hydrocoele. Conclusions Infection indicators remain well below WHO decision thresholds, suggesting that LF transmission is unlikely to be sustained. Sao Tome and Principe appears to be close to eliminating LF as a public health problem. However, strengthening morbidity management services will be essential to support the preparation of the national elimination dossier.

02.
arXiv (CS.LG) 2026-06-11

Learning Patterns and Abstractions from Perceptual Sequences

Authors:

arXiv:2503.10973v2 Announce Type: replace Abstract: Cognition swiftly breaks high-dimensional sensory streams into familiar parts and uncovers their relations. Why do structures emerge, and how do they enable learning, generalization, and prediction? What computational principles underlie this core aspect of perception and intelligence? A sensory stream, simplified, is a one-dimensional sequence. In learning such sequences, we naturally segment them into parts – a process known as chunking. In the first project, I investigated factors influencing chunking in a serial reaction time task and showed that humans adapt to underlying chunks while balancing speed and accuracy. Building on this, I developed models that learn chunks and parse sequences chunk by chunk. Normatively, I proposed chunking as a rational strategy for discovering recurring patterns and nested hierarchies, enabling efficient sequence factorization. Learned chunks serve as reusable primitives for transfer, composition, and mental simulation – letting the model compose the new from the known. I demonstrated this model's ability to learn hierarchies in single and multi-dimensional sequences and highlighted its utility for unsupervised pattern discovery. The second part moves from concrete to abstract sequences. I taxonomized abstract motifs and examined their role in sequence memory. Behavioral evidence suggests that humans exploit pattern redundancies for compression and transfer. I proposed a non-parametric hierarchical variable model that learns both chunks and abstract variables, uncovering invariant symbolic patterns. I showed its similarity to human learning and compared it to large language models. Taken together, this thesis suggests that chunking and abstraction as simple computational principles enable structured knowledge acquisition in hierarchically organized sequences, from simple to complex, concrete to abstract.

03.
arXiv (CS.CL) 2026-06-11

Organize then Retrieve: Hierarchical Memory Navigation for Efficient Agents

Large language model (LLM) agents struggle with long-horizon tasks due to their inherent statelessness, requiring all task-relevant information to be encoded in growing input contexts. The resulting degraded reasoning quality, increased inference cost, and higher latency necessitate efficient working memory mechanisms. However, existing approaches either rely on lossy compression or similarity-based retrieval, which often fail to capture temporal structure and causal dependencies required for multi-step agentic tasks. In this work, we present HORMA, a Hierarchical Organize-and-Retrieve Memory Agent that organizes experience into a file-system-like hierarchical structure, where summarized entities are linked to the corresponding raw trajectories, enabling efficient access without losing detailed information. HORMA decomposes working memory into two stages: structured memory construction and navigation-based retrieval. The construction module iteratively refines how experiences are structured by distinguishing between failures caused by missing information and those caused by misleading or overloaded context. The navigation module retrieves task-relevant context by traversing the hierarchy using a lightweight agent trained with reinforcement learning to select minimal yet sufficient context, thereby reducing latency along the critical execution path. Across ALFWorld, LoCoMo, and LongMemEval, HORMA improves task performance under constrained context budgets while requiring at most 22.17% of the baseline token usage in long conversation tasks. Compared to existing methods, it consistently achieves better efficiency-performance trade-offs and generalizes effectively to unseen tasks.

04.
arXiv (quant-ph) 2026-06-17

Canonical regularization of the stationary Coulomb problem and an Aufbau-like spectral ordering

arXiv:2606.17359v1 Announce Type: new Abstract: The stationary hydrogen atom has Coulomb degeneracy across orbital levels, whereas the Aufbau/Madelung ordering is an empirical, many-electron rule established in atomic physics. We examine the hydrogen atom through a regularized de Broglie–Bohm representation, in which stationary amplitude current constraints generate separable Sturm–Liouville branches. In this formulation, the radial, orbital, and magnetic sectors acquire canonical Langer-like inverse square corrections. The modified boundary value problems allow analytical solutions and produce a hydrogen-like spectrum with regularized radial and angular indices. Consequently, radial Coulomb quantization acquires an orbital dependent shift, lifting the Coulomb degeneracy and producing a spectral ordering that follows the Aufbau/Madelung sequence. On this basis, we construct the ordering of the regularized de Broglie–Bohm states and show that the spectral structure retains the standard degenerate Rydberg sequence in the l=0 sector. The separated amplitudes are represented by generalized special function branches, including the associated Laguerre, Legendre, and Bessel functions with non-integral parameters arising from regularized separation. Therefore, the treatment is intended as an analytical examination of spectral ordering in a regularized one center Coulomb problem rather than as a replacement for the many electron atomic structure theory. Keywords: de Broglie–Bohm representation; Coulomb spectrum; canonical regularization; Langer correction; Sturm–Liouville equations; Aufbau principle; Madelung ordering; associated Legendre functions; associated Laguerre functions; Bessel functions.

05.
arXiv (CS.CV) 2026-06-17

Attention Sinks in Diffusion Transformers: A Causal Analysis

Attention sinks – tokens that receive disproportionate attention mass – are assumed to be functionally important in autoregressive language models, but their role in diffusion transformers remains unclear. We present a causal analysis in text-to-image diffusion, dynamically identifying dominant attention recipients per timestep and suppressing them via paired, training-free interventions on the score and value paths. Across 553 GenEval prompts on Stable Diffusion~3 (with SDXL corroboration), removing these sinks does not degrade text-image alignment (CLIP-T) or preference proxies (ImageReward, HPS-v2) at $k{=}1$; only under stronger interventions ($k\!\geq\!10$) does HPS-v2 exhibit a metric-dependent boundary, while CLIP-T remains robust throughout. The perceptual shifts induced by suppression are nonetheless sink-specific – $\sim\!6\times$ larger than equal-budget random masking – revealing an empirical dissociation between trajectory-level perturbation and semantic alignment in diffusion transformers. \footnote{Code available at https://github.com/wfz666/ICML26-attention-sink.}

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

Explainable deep learning improves human mental models of self-driving cars

arXiv:2411.18714v3 Announce Type: replace-cross Abstract: Self-driving cars increasingly rely on deep neural networks to achieve human-like driving. The opacity of such black-box planners makes it challenging to accurately anticipate when they will fail, with potentially catastrophic consequences. While research into interpreting these systems has surged, most of it is confined to simulations or toy setups due to the difficulty of real-world deployment, leaving the practical utility of such techniques unknown. Here, we introduce the Concept-Wrapper Network (CW-Net), a method for faithfully explaining the behavior of machine-learning-based planners that causally grounds their reasoning in human-interpretable concepts without sacrificing performance. We deploy CW-Net on a real self-driving car and show that the resulting explanations improve the human driver's mental model of the vehicle, allowing them to better predict its behavior, particularly in surprising situations. This demonstrates that explainable deep learning integrated into self-driving cars can be both understandable and useful in a realistic deployment setting. We anticipate our method could be applied to other safety-critical systems, such as autonomous drones and robotic surgeons, as well as to other architectures, such as end-to-end learning systems and vision-language-action models. Overall, our study establishes a deployment-validated pathway to interpretability for autonomous agents, which could help make them more transparent and safe.

07.
arXiv (CS.LG) 2026-06-16

Stochastic Schrödinger Diffusion Models for Pure-State Ensemble Generation

arXiv:2605.03573v3 Announce Type: replace-cross Abstract: Quantum machine learning increasingly relies on pure-state representations, motivating generative models that sample directly in quantum representation space rather than perturbing classical inputs and re-encoding. We introduce Stochastic Schrödinger Diffusion Models (SSDMs), a score-based generative framework that defines diffusion, scores, and reverse-time sampling intrinsically on the complex projective manifold $\mathbb{CP}^{d-1}$ under the Fubini–Study metric. SSDMs combine a Riemannian Ornstein–Uhlenbeck forward diffusion with a stochastic Schrödinger realization, and learn reverse-time dynamics driven by the Riemannian score. Our central technical contribution is a local-time learning objective that exploits the local Euclidean OU limit of intrinsic manifold diffusions in Fubini-Study normal coordinates to obtain an analytic teacher score, bypassing the intractable transition densities that limit existing Riemannian score-based models. Across synthetic, physics-inspired (TFIM, XXZ), and quantum feature-state benchmarks up to $14$ qubits, SSDMs match target pure-state ensembles by orders of magnitude on MMD and observable statistics over both ambient Euclidean and matched Riemannian score-based baselines, and improve representation-level diagnostics for downstream quantum kernel methods.

08.
arXiv (CS.AI) 2026-06-17

LLMCodec: Adapting Video Codecs for Efficient Weight Compression of Large Language Models

arXiv:2606.05861v2 Announce Type: replace-cross Abstract: The rapid development of large language models(LLMs) has led to remarkable advances in natural language processing. However, the increasing scale of these models introduces substantial challenges in terms of storage, transmission, and deployment. Though great efforts have been devoted to model compression and quantization, existing methods often rely on fine-tuning or calibration data, which exhibit limited generalization across different tensor types. In this paper, we argue that video codecs offer a promising solution for LLM compression, due to their inherent compatibility with matrix structured data, configurable compression strategies, and the availability of highly optimized, off-the-shelf implementations. Therefore, we present LLMCodec, a video codec-based LLM compression method that integrates affine quantization with the recent VVC/H.266 video codec. Beyond VVC, we further compare a range of video codecs and encoding profiles to evaluate their impact on compression performance. Experiments on different models demonstrate the robustness and generality of LLMCodec. Notably, on LLaMA-3-8B at 2-bit precision, LLMCodec reduces perplexity by over 1.5x and improves downstream task accuracy by 21% compared with the existing method.

09.
medRxiv (Medicine) 2026-06-15

Association of Genetic Liability to Psychiatric Disorders with Peripheral Metabolic Dysregulation

Importance: Individuals with psychiatric disorders face elevated cardiometabolic risk which is linked to increased mortality. The extent to which this reflects shared pathogenesis or the downstream effects of illness and treatment remains poorly understood. Objective: To characterize the direct pleiotropic effects of psychiatric genetic liability on circulating metabolites and aggregate cardiometabolic risk, independent of psychiatric diagnosis and psychotropic medication use. Design: Cohort study. Setting: Mass General Brigham Biobank (MGBB). Participants: MGBB participants with metabolomic profiling, genomic data, and linked electronic health records. Exposures: Genetic liability to nine psychiatric disorders quantified using polygenic risk scores (PRS): attention deficit/hyperactivity disorder (ADHD), anorexia nervosa (ANO), anxiety disorder (ANX), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), PTSD, schizophrenia (SCZ), and substance use disorder (SUD). Main Outcomes and Measures: 249 circulating metabolites and four metabolomic risk scores (MRS) for type 2 diabetes, myocardial infarction, ischemic stroke, and vascular dementia. PRS-metabolite associations were estimated using nested models adjusting for lifetime psychiatric diagnosis and psychotropic medication use. Results: Across 25,290 participants, we identified 604 significant PRS-metabolite associations (Bonferroni p< 1.36 x 10-4), of which 89% persisted after adjustment for lifetime diagnosis and medication use, suggesting that the direct genetic effects on metabolism are largely independent of illness or treatment. PRS for MDD, PTSD, and ADHD showed the most extensive dysregulation, with a transdiagnostic pattern of elevated lipids and systemic inflammation, specifically triglycerides ({beta} = 0.04 to 0.05, all p< 4.4 x10-13) and glycoprotein acetyls ({beta} = 0.05, all p< 2.2 x10-16). Notably, PRS for SCZ and BD showed minimal metabolite dysregulation despite having the strongest association with their target diagnoses. PRS for MDD, PTSD, ADHD, and SUD were associated with increased MRS across cardiometabolic conditions ({beta} = 0.03 to 0.08, all p< 2.1 x10-4). Sensitivity analyses controlling for BMI or excluding participants without any psychiatric history (N: 21,305 and 11,150, respectively) showed a similar pattern. Conclusions and Relevance: Psychiatric genetic liability is associated with systemic metabolic dysregulation independent of illness onset or treatment, supporting a partially pleiotropic basis for psychiatric-cardiometabolic comorbidity.

10.
arXiv (CS.CL) 2026-06-16

Evaluating LLM Personalization via Semantic Constraint Verification

Current evaluation paradigms for Large Language Model (LLM) personalization rely heavily on brittle surface-matching metrics or computationally expensive LLM-as-a-judge protocols, both of which lack interpretability. To address these limitations, we introduce Natural Language Inference Constraint Verification (NLICV), a scalable, semantically invariant framework that maps sentence meanings to truth-condition sets to verify personalization constraints via a Natural Language Inference (NLI) model. Moving beyond binary scoring, NLICV categorizes LLM behaviors into four distinct modes: personalization, generalization, sycophancy, and failure. Extensive experiments demonstrate that NLICV aligns closely with human annotations while drastically reducing the latency and token costs associated with LLM judges (up to 2100 inference speedup). Finally, through an ablation-based procedure, NLICV pinpoints the exact sentences driving the constraint verification, yielding faithful, understandable evidence for its evaluations.

11.
Science (Express) 2026-05-07

TranscriptFormer: A generative cell atlas across 1.5 billion years of evolution | Science

Authors: Unknown Author

Single-cell transcriptomics is revolutionizing our understanding of cellular diversity, yet comparing transcriptional programs across the tree of life remains challenging. We developed TranscriptFormer, a family of generative foundation models trained on up to 112 million cells spanning 1.53 billion years of evolution across 12 species. We demonstrate state-of-the-art performance on cell type classification, even for species separated over 685 million years of evolution, and zero-shot disease state identification in human cells. Developmental trajectories, phylogenetic relationships and cellular hierarchies emerge naturally in TranscriptFormer’s representations without any explicit training on these annotations. This work establishes a powerful framework for quantitative single-cell analysis and comparative cellular biology, thus demonstrating that universal principles of cellular organization can be learned and predicted across the tree of life.

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

Integrating Reasoning and Generalization in Text-to-SQL via Self-Enhanced Fine-Tuning

arXiv:2606.15598v1 Announce Type: new Abstract: Text-to-SQL aims to translate natural language questions into executable SQL queries over structured databases, enabling non-expert users to access data intuitively. While recent advances in large language models (LLMs) have shown promise in this task, existing LLM-based approaches often struggle to strike a balance between strong reasoning capabilities and robust generalization. To address these limitations, we propose CoTE-SQL to enhance the LLM-based text-to-SQL generation with three key innovations: (i) self-enhanced reasoning traces distilled from LLMs without human annotation, (ii) structured chain-of-thought (CoT) prompting with modular decomposition and examples retrieval, and (iii) error-aware revision based on SQL execution feedback. Extensive experiments on the Spider and Bird benchmarks demonstrate that CoTE-SQL achieves new state-of-the-art performance among methods built on open-source LLMs with comparable model sizes on Bird (53.39% EX / 59.02 VES) and strong results on Spider (79.60% EX / 77.19 VES), with especially significant gains on complex queries. Results highlight the effectiveness of combining self-enhancement, structured reasoning, and execution-time feedback within an LLM-based framework for text-to-SQL design.

13.
arXiv (CS.CL) 2026-06-18

Are LLMs Ready to Assist Physicians? PhysAssistBench for Interactive Doctor-Patient-EHR Assistance

The most plausible near-term role of medical LLMs is to assist rather than replace physicians, yet current evaluations often test isolated capabilities: clinical knowledge, EHR system interaction, or patient communication. Physician assistance instead requires coordinating these capabilities within the same interaction, where physicians issue underspecified requests, patients describe symptoms ambiguously, and EHR systems demand precise tool use. We introduce PhysAssistBench, a benchmark for interactive doctor-patient-EHR assistance. Built from real MIMIC-IV cases, PhysAssistBench uses a scalable pipeline to construct agentic patients: interactive, record-grounded agents that turn static EHR records into multi-turn clinical scenarios while preserving clinical factuality. PhysAssistBench provides a curated bilingual evaluation set of 1,296 manually reviewed and physician-validated turns. Experiments with leading LLMs show that current models remain unreliable in this setting, which exposes a key bottleneck for clinical LLMs: reliable assistance requires coordination across knowledge, communication, and systems, not isolated gains in any of them.

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

PragReST: Self-Reinforcing Counterfactual Reasoning for Pragmatic Language Understanding

Natural language understanding often depends on meanings that are implied rather than explicitly stated, requiring pragmatic reasoning. Despite strong performance on math and logical reasoning, large language models (LLMs) still struggle with making pragmatic inferences, often choosing literal interpretations. To improve LLM pragmatic reasoning, we introduce PragReST, a self-supervised framework that constructs pragmatic QA data, generates counterfactual reasoning traces, and trains models to internalize them through supervised fine-tuning and reinforcement learning, without human-labeled training data or distillation from a stronger teacher. Across four pragmatic benchmarks (PragMega, Ludwig, MetoQA, and AltPrag), PragReST improves over backbone models, task-specific pragmatic tuning baselines, and non-counterfactual variants of the same pipeline. On accuracy-based benchmarks, PragReST improves over the instruct backbone by 5.37 and 5.50% (absolute) for Qwen3-8B and Qwen3-14B, respectively. Our error analysis and ablations underscore the importance of counterfactual reasoning: PragReST primarily reduces errors caused by failures to contrast observed utterances with plausible alternatives, and removing counterfactual reasoning substantially reduces performance. Moreover, our training preserves out-of-domain performance on general-knowledge and mathematical reasoning benchmarks.

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

HAPI-EP: Towards Hybrid, Adaptive, and Predictive Digital Twins of Cardiac Electrophysiology

arXiv:2606.15637v1 Announce Type: new Abstract: A digital twin (DT) of a patient-specific heart offers significant potential in personalized medicine. However, its rapid and dynamic adaptation to an individual's live data and its predictive capability after adaptation remains central challenges. We examine this challenge from its two building blocks: DT formulation where mechanistic and data-driven models show competing merits and limitations, and DT optimization strategies that are largely driven by a reconstruction objective leading to un-identifiable models. We address both bottlenecks via HAPI – an AI framework for building hybrid, adaptive, and predictive DTs with three key enablers. First, HAPI constructs a physics-integrated gray-box model in which an interpretable mechanistic backbone is augmented by a neural component that models its residual to the observed data. Second, rather than attempting to pre-encode all possible variations in a static hybrid model, HAPI enables rapid on-the-fly adaptation of the hybrid model to few-shot live data, achieved by feedforward meta-learners realizing amortized inference of both mechanistic and neural parameters of the hybrid model trained with predictive objectives. Finally, we show that this adaptivity corresponds to the construction of a conditional generative model (i.e., the hybrid DT) that endows it with theoretical identifiability and thus strong performance in predictive scenarios. We demonstrate the proof-of-concept of HAPI in cardiac electrophysiology using a hybrid monodomain model with mechanistic reaction kinetics and neural graph diffusion. Across synthetic and real-data studies, we show that HAPI's mechanistic-neural hybridization and predictive adaptation are critical for obtaining identifiable DTs with strong predictive and out-of-distribution capabilities.

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

Evaluation Sovereignty in Metadata-Driven Classification: A Multi-Track Framework for Weakly Supervised Information Systems

arXiv:2606.13436v1 Announce Type: new Abstract: Evaluation in machine learning is typically treated as a neutral measurement process. However, in operational information systems, evaluation outcomes are often conditioned by the processes used to generate labels. This paper does not seek to improve classification performance. Instead, it examines the validity of performance measurement under differing label-authority regimes. This issue is particularly relevant in large-scale metadata-driven systems, where labels are often incomplete, inconsistent, or weakly supervised. We introduce evaluation sovereignty, defined as the degree to which performance metrics are independent of label authority and supervision regime, and propose a multi-track evaluation framework that systematically varies training and evaluation label sources. Using hierarchical multi-label classification on large-scale scientific metadata, we demonstrate that models exhibiting strong performance under operational ("silver") evaluation degrade substantially under independent ("gold") evaluation, particularly for fine-grained classification. For example, Micro-F1 decreases from approximately 0.54 to 0.03. Notably, ranking-based metrics remain above baseline, revealing a divergence between latent model signal and classification validity. These findings suggest that commonly reported performance metrics may reflect alignment with labeling processes rather than true predictive capability. We therefore reconceptualize evaluation validity as a system-level property shaped by label governance and provide a practical methodology for auditing intelligent systems operating under weak supervision.

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

The BD-LSC Dataset: Facilitating the Benchmarking of Models for Lexical Semantic Change Detection in Slang and Standard Usage

Automatic semantic change detection aims to identify how word meanings shift over time, offering insights into both linguistic and societal change. Despite recent progress in computational lexical semantic change (LSC), existing benchmarks and methods struggle to capture bi-directional semantic change, particularly cases where words simultaneously gain and lose senses. This problem is especially challenging for words that have both slang and standard meanings. To address these gaps, we introduce two complementary benchmark datasets. The Bi-Directional Lexical Semantic Change (BD-LSC) dataset captures sense gain, sense loss, and stability across three time periods, enabling the study of complex semantic trajectories. The SlangTrack Word Sense Disambiguation (ST-WSD) dataset provides fine-grained, instance-level sense annotations for words combining slang and standard usages, supporting systematic benchmarking of WSD and semantic change detection models. Using these benchmarks, we systematically evaluate models across different methodological families: unsupervised clustering using contextualised embeddings, supervised machine learning, transformer-based models, and state-of-the-art large language models. Among the evaluated systems, the few-shot GPT-4o model achieved the strongest aggregate performance on Exact Sense Match (ESM) and multi-label accuracy; however, Macro-F1 scores near 0.5 across all systems show that rare slang senses remain difficult, which we identify as the central open challenge.

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

Beyond Static Endpoints: Tool Programs as an Interface for Flexible Agentic Web Services

arXiv:2606.19992v1 Announce Type: cross Abstract: In the agentic web era, LLM-based agents increasingly invoke web services as tools, yet most interfaces remain static endpoints that poorly express long-horizon workflows with loops, conditionals, joins, and retries. We present ToolPro, which represents an agent's tool intent as an executable tool program that compactly encodes multi-step service interactions with explicit effect types. ToolPro combines constraint-guided program construction, effect-aware replay for exactly-once state-modifying calls, and a profile-driven policy that decides when program execution outperforms stepwise calling. We instantiate ToolPro over MCP-style services with WebAssembly sandboxing and evaluate it on diverse workflows of real-world applications. ToolPro reduces end-to-end latency by up to 53.4\% and client-side traffic by up to 96.1\%, with larger gains under higher network latency and workflow complexity.

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

Frozen Foundation-Model Embeddings Discard Small-Lesion Signal in Chest Radiography: Implications for Pre-Deployment Evaluation

Frozen vision-transformer (ViT) foundation-model embeddings increasingly serve as the substrate for downstream chest-radiography (CXR) pipelines, yet where small-scale, low-contrast signal is retained or lost in the frozen forward pass has not been systematically quantified across architectures, pretraining domains, and objectives. We probed five frozen ViTs (RAD-DINO, DINOv2-B/14, DINOv3 ViT-7B, BiomedCLIP, MedSigLIP) and a frozen DINO-pretrained ResNet-50 architectural control across three large CXR cohorts (NIH-CXR14, MIMIC-CXR, Emory-CXR; aggregate pool n=492,724) and ChestX-Det10 (n=3,543; 1,462 small-lesion bounding boxes across Calcification, Nodule, Mass). Each model was evaluated with a small-scale-perturbation panel and a region-aware bounding-box-stratified probe on real lesions, comparing three pooling modes from the same forward pass: classification token (CLS), patch-mean (mean over all final-layer patch tokens), and bounding-box-restricted patch-local. On the perturbation panel, CLS embeddings sat at the chance floor (area under the ROC curve [AUC] 0.500-0.524); patch-mean was indistinguishable from CLS on iso-blur and reticular-fine cells but rose with CLS on larger directional-blur footprints, while disease AUC on globally decided tasks ranged 0.642-0.913. Patch-local probes recovered AUC ~1.0 from the same forward pass (per-model mean improvement +0.412 to +0.488); the ResNet-50 control reproduced the chance floor. On ChestX-Det10, image-level CLS classification showed within-class small-versus-large stratum gaps up to +0.243 AUC; bounding-box-level patch-local pooling on the same forward pass recovered AUC >= 0.899 on every (model x class) cell. Frozen ViT embeddings silently suppress small-scale signal at the global-aggregation step; the signal is recoverable from patch tokens conditional on a region of interest.

20.
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 (

21.
arXiv (CS.CV) 2026-06-12

Dual-State Slot Attention: Decoupling Appearance and Identity for Video Object-Centric Learning

Unsupervised video object-centric learning aims to decompose dynamic scenes into persistent, object-level representations without supervision. However, existing slot-based methods struggle to maintain stable object identity in challenging settings such as rapid motion and partial occlusion. First, they typically encode both the per-frame appearance of an object and its identity across frames in a single slot vector, creating an objective conflict that leads to slot swapping: reconstruction requires sensitivity to transient visual changes, whereas temporal consistency requires invariance to them. Second, the token renormalization used in Slot Attention can amplify weakly attending slots, allowing them to absorb tokens from other objects and destabilize slot-to-object correspondence. We propose Dual-State Slot Attention (DSSA), a fully self-supervised framework that addresses these limitations by separating appearance from identity and by reducing spurious updates from weakly matching slots. DSSA decomposes each slot into a local state for per-frame appearance and an identity state for temporally stable object information, thereby aligning reconstruction and temporal consistency with separate representations. The identity state is updated through a learned recurrent transition that acts as a temporal filter on the local state, while competition-modulated aggregation (CMA) down-weights updates from weakly matching slots and prevents them from absorbing tokens from other objects. Experiments on MOVi-C, MOVi-D, and YouTube-VIS demonstrate that DSSA consistently improves segmentation quality and temporal consistency over prior methods, while also yielding stronger downstream object recognition and video dynamics prediction. Code and models will be made publicly available upon acceptance.

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

Hybrid Classical-Quantum (HCQ) Alzheimer's Classification via Supervised $\beta$-VAE and Quantum Kernels

This paper presents a two-stage Hybrid Classical-Quantum (HCQ) pipeline for binary Alzheimer's disease (AD) classification from 3D T1-weighted structural MRI volumes, where the classical and quantum components are designed to complement each other rather than operate independently. A supervised 3D $\beta$-variational autoencoder (VAE) is trained end-to-end under voxel-wise reconstruction, KL-divergence, and focal classification losses that compress each 3D MRI volume (resized from 152 x 184 x 152 to 96 x 96 x 96) into a 64-dimensional latent code. Partial Least Squares (PLS) regression selects the six components in the latent code that best separate Alzheimer's Disease (AD) from cognitively normal (CN) subjects and rescales them into rotation angles, which are encoded onto a six-qubit register using the ZZ quantum feature map to give us the respective quantum states. The input to a precomputed-kernel Support Vector Machine (SVM) is an N x N Gram matrix (N = 308), created by calculating the overlap between every pair of quantum states. The novelty of this work lies in the fact that the quantum kernel operates directly on disease-aware features that are learned end-to-end by a supervised autoencoder, rather than on pre-extracted inputs. On 308 ADNI-1 subjects, consisting of 137 AD and 171 CN subjects, the baseline achieved 67.2% accuracy and 0.759 AUC, while the stability-enhanced variant reached 72.1% accuracy and 0.799 AUC with cross-fold variance halved. 3D Grad-CAM further helped validate our model's focus on brain regions linked to Alzheimer's. The HCQ pipeline could serve as a general-purpose framework for diagnostic classification across biomedical imaging domains that present similar challenges for classical approaches.

23.
arXiv (quant-ph) 2026-06-11

Emergent mirror symmetry in the optimization of the central-spin quantum battery

arXiv:2606.11557v1 Announce Type: new Abstract: Quantum batteries provide a useful setting for exploring nonequilibrium many-body effects in energy storage. Here we investigate the optimization of a quantum battery based on the central-spin model. We identify two complementary structural indicators associated with the effective charging dynamics: one yields an upper bound on the average charging power, while the other characterizes the buildup of stored energy. We show that these two indicators are jointly optimized at a distinguished initial charger excitation number, which selects a particular Dicke sector of the model. At this common optimal point, the effective charging Hamiltonian becomes exactly mirror symmetric, suggesting mirror symmetry as a useful structural indicator for optimizing quantum batteries. We further show that the corresponding optimal dynamics can be closely approximated by product initial states, in particular by spin coherent states whose excitation-number distribution is centered at the symmetry-selected point. Our results establish a direct connection between charging performance, optimal-state structure, and emergent symmetry in the central-spin quantum battery, and suggest symmetry as a useful organizing principle for efficient charging in interacting many-body quantum systems.

24.
arXiv (CS.CL) 2026-06-19

Med-R2: Perception and Reflection-driven Complex Reasoning for Medical Report Generation

Automated medical report generation (MRG) is increasingly used to reduce the burden of manual reporting and for decision support. Large vision-language models (LVLMs) hold great promise for automated MRG due to their fine-grained image-text alignment and advanced text-generation capabilities. Currently, state-of-the-art MRGs primarily focus on adapting pre-trained LVLMs with direct supervised fine-tuning (SFT), a fine-tuning strategy with medical image-report pairs. However, several factors limit the performance of these LVLMs. Firstly, direct SFT enables LVLMs to generate medical reports directly without an intermediate thinking process of pathological feature perception and diagnostic reasoning. This causes a potential failure to perceive pathological features and thus leads to misdiagnosis. Secondly, direct SFT lacks the incorporation of radiology-specific knowledge guidance, causing LVLMs to misinterpret perceived pathological features and make incorrect diagnoses. To address these gaps, we propose a novel fine-tuning strategy named Med-R2. We introduce a perception-driven long reasoning process that precedes report generation and incorporates radiology-specific knowledge as guidance. Additionally, to alleviate potential perceptual errors in complex reasoning, a reflection mechanism is introduced to refine the perception of pathological features and the generated report. Our experiments demonstrate that Med-R2 effectively enhances the capability of pathological features perception and diagnosis accuracy for MRG via fine-tuned LVLMs.

25.
medRxiv (Medicine) 2026-06-16

The biological clock of multimorbidity: temporal dynamics of disease co-occurrence in primary care

Multimorbidity is the dominant clinical reality of primary care, yet the temporal dynamics governing when and how persistent comorbidity associations emerge remain poorly characterised. Most large-scale comorbidity studies adopt a single observation window after an index diagnosis, implicitly assuming that associations detectable at one year are equally detectable at five. Using 11 years of electronic health records from 5,821,197 individuals in Catalan primary care, we applied a matched cohort design across nine complementary follow-up windows, five cumulative (0-1 to 0-5 years) and four conditional (1-2 to 4-5 years), to 1,315 index diseases, identifying 144,030 significant directed comorbidity associations in the five-year network. We found that 60.1% of these associations required at least three years of follow-up and were undetectable in shorter-window analyses, demonstrating that observation window length is a primary determinant of which comorbidities can be observed. To organise this temporal heterogeneity, we introduce the biological clock of multimorbidity: a two-dimensional framework that positions ICD-10 disease categories according to their rates of cumulative signal attenuation and the persistence of conditional risk. This framework identifies four reproducible temporal patterns (episodic, chronic stable, chronic progressive, and transient-persistent) that are robust under bootstrap resampling, leave-one-disease-out sensitivity analysis, and alternative clustering approaches. The biological clock is systematically modulated by sex, with Blood/Immune and Musculoskeletal disorders showing the largest sex differences in temporal dynamics. Network analysis identified 19 disease "initiators" that generate broad downstream comorbidity burdens and 21 "sinks" representing convergent endpoints of multiple disease trajectories. Comparison with hospital-based Danish data from 6,909,676 individuals showed that shared associations were 2.7-fold enriched over chance expectation (hypergeometric test, p