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

Quantile of Means: A Bonus-Free Ensemble Method for Minimax Optimal Reinforcement Learning

arXiv:2606.20107v1 Announce Type: new Abstract: Optimal Reinforcement Learning (RL) algorithms typically rely on carefully constructed count-based uncertainty estimates to drive exploration. Although theoretically sound, such estimates are hard to compute in practical settings and therefore offer limited insight for designing exploration heuristics. Meanwhile, ensembling has emerged as a practical approach, but remains without theoretical justification. Building on a recent ensemble-based method for Multi-Armed Bandits, we propose a quantile-based ensemble method for finite-horizon Markov Decision Processes (MDPs). Our simple count-free approach achieves optimal variance-dependent regret bounds, providing theoretical grounding for ensemble-based exploration in RL.

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

MathVis-Fine: Aligning Visual Supervision with Necessity via Progressive Dependency-Guided Training for Multimodal Mathematical Reasoning

arXiv:2606.17888v1 Announce Type: new Abstract: Chain-of-Thought (CoT) reasoning has extended from purely linguistic domains to multimodal scenarios; however, existing approaches often treat visual inputs as homogeneous or auxiliary signals, failing to capture the intricate and sample-specific dependencies between text and images in mathematical problem-solving. This gives rise to two core issues: first, the supervisory signals for visual content are generalized and coarse-grained, lacking adaptation to the actual necessity of visual information in each sample; second, training feedback becomes inaccurate when visual rewards are uniformly applied without distinguishing the complementary relationships among inputs. These limitations hinder models from achieving precise multimodal reasoning. In this work, we propose a framework for modeling fine-grained visual dependencies in mathematical reasoning. We first construct the MathVis-Fine dataset, augmenting fine-grained visual annotations with visual dependency ratings. Building upon this dataset, we introduce a two-stage progressive visual enhancement training paradigm that balances answer correctness rewards and visual grounding rewards according to the intrinsic visual dependency level of each sample, thereby mitigating reward bias and improving supervision accuracy. Extensive experiments demonstrate that the MathVis-Fine framework effectively enhances visual perception progressively based on visual dependency, offering a more precise training framework for multimodal mathematical reasoning. We will release the dataset upon acceptance.

03.
arXiv (CS.CV) 2026-06-16

The Third Challenge on Image Denoising at NTIRE 2026: Methods and Results

This paper reports on the NTIRE 2026 Challenge on Image Denoising, specifically focusing on the high-noise regime ($\sigma = 50$). The competition investigates advanced neural architectures designed to restore high-fidelity details from images corrupted by additive white Gaussian noise (AWGN). Unlike constrained benchmarks, this track emphasizes peak quantitative performance, measured by Peak Signal-to-Noise Ratio (PSNR), without limitations on parameter count or computational overhead. By synthesizing contributions from 20 finalist teams out of 116 registrants, this report benchmarks the latest technical innovations and provides a comprehensive snapshot of the current state-of-the-art in unconstrained image restoration.

04.
arXiv (CS.AI) 2026-06-15

The Weight Norm Sets the Grokking Timescale: A Causal Delay Law

arXiv:2606.13753v1 Announce Type: cross Abstract: Grokking is the delayed onset of generalization in neural networks, arising long after they fit the training data. Whether the weight norm causes this delay is disputed: some studies report a critical norm at the transition, others observe grokking with no fixed norm at all. We settle this by intervening on the norm during training rather than only observing it. Under free training with weight decay, networks grok when the weight norm reaches a value Wc that varies little across seeds and learning rates (CV 1 to 2 percent) and grows with the modular base as a power law. When we instead clamp the norm to a fixed multiple rho of Wc and hold it there, the network still groks, but the delay follows T_grok proportional to exp(alpha rho). One exponent, alpha near 7.5, fits this delay across four moduli (R^2 = 0.996). Over the swept ranges the held norm moves the delay by about 19x and the learning rate by only about 2x, and holding the norm above Wc slows grokking rather than preventing it. A final LayerNorm removes the dependence by decoupling weight scale from the network function; without it the exponential law returns. This pinned-norm delay is the exponential counterpart to the logarithmic delay predicted for a freely contracting norm.

05.
arXiv (CS.CL) 2026-06-19

Segment-Level Mandarin Chinese Speech-Based Cognitive Impairment Detection via an Autoencoder with Contrastive Learning

\noindentBackground and Objective: Speech has emerged as a low-cost and non-invasive digital biomarker with considerable potential for cognitive impairment detection. However, limited labeled data and cross-dataset variability remain major challenges for robust speech-based screening systems. \par\noindentMethods: We developed a segment-level representation learning framework for speech-based cognitive impairment detection. Speech recordings were divided into short segments and converted into spectrogram representations. To improve robustness under limited-data conditions, offline and online augmentation strategies were combined with autoencoder-based representation learning and contrastive objectives to enhance discriminative latent representations. \par\noindentResults: Experiments conducted on four independent Mandarin Chinese speech datasets demonstrated stable and competitive performance in both binary and three-class classification tasks, with particularly notable improvements in the clinically challenging three-class setting. Ablation studies further supported the effectiveness of the proposed framework. \par\noindentConclusions: The findings suggest that segment-level speech representation learning may provide a scalable and practical approach for cognitive impairment screening in resource-constrained clinical settings.

06.
PLOS Medicine 2026-06-02

Prognostic value of cervical length for spontaneous preterm birth in asymptomatic women with singleton pregnancy: An individual participant data meta-analysis

Authors:

by Kelly Hughes, David Nguyen, Mason Aberoumand, Heather Ford, Erin Clarke, Nuria Banos Lopez, Margaret Dziadosz, Richard Fischer, Renato T. Souza, Jose Guilherme Cecatti, Kelly Orzechowski, Courtney Olson-Chen, Alberto Borges Peixoto, Vorapong Phupong, Joshua Rosenbloom, Moeun Son, Athena Souka, Liu Du, Michael Sean Esplin, Roberta Granese, Simi Gupta, Brenda Kazemier, Lindsay Kindinger, Pihla Kuusela, Jeanine Van der Ven, Omer Weitzner, Evelyn Minis, Alba Farras Llobet, Heather Frey, Rashmi Bagga, Siddhidatri Mishra, Elizabeth Patberg, Philip Bennett, Megan Hall, Andrew Shennan, Shaun Brennecke, Shakila Thangaratinam, Anna Lene Seidler, Ben Willem Mol, Rui Wang Background Spontaneous preterm birth (SPTB) is the leading cause of perinatal and early childhood mortality worldwide. Studies have generally suggested that mid-trimester transvaginal sonographic cervical length

07.
arXiv (CS.AI) 2026-06-17

MapSatisfyBench: Benchmarking Satisfaction-Aware Map Agents through Behavior-Grounded Implicit Decision Factors

arXiv:2606.17453v1 Announce Type: new Abstract: Large language model agents are increasingly integrated into map services. Since map services are embedded in everyday-life scenarios rather than professional task settings, users often express their needs informally, resulting in underspecified queries with many unspoken needs, namely, implicit decision factors that are critical for user satisfaction. Although clarification is an effective way to mitigate this issue, it increases user burden in daily interaction, and a capable agent should first proactively recover such factors from available information sources. However, evaluating this ability is challenging. The first challenge is to determine which implicit decision factors are suitable for evaluation. A factor is evaluable only if it affects user acceptance and can be recovered from information available to the agent before it responds. Second, user satisfaction cannot be reliably represented by a single reference answer, requiring a benchmark that converts satisfaction-relevant factors into objective and quantifiable evaluation targets. To address these challenges, we propose a restore-identify-filter framework that reconstructs complete user needs from behavior-chain evidence, identifies implicit decision factors, and retains only those supported by pre-query evidence. Building on this methodology, we construct MapSatisfyBench from large-scale, real-world anonymized user data and annotate ground truth from five dimensions and enables full-chain evaluation of satisfaction-aware map agents. Experiments show that current agents generally perform well on explicit task completion, but remain limited in satisfying implicit decision factors and proactively acquiring the evidence needed for satisfaction-aware decisions. These findings establish MapSatisfyBench as a benchmark for shifting map-agent evaluation from task completion toward satisfaction-aware spatial decision making.

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

Z-Plane Neural Networks: Bounded Geometric Activation Replaces ReLU and LayerNorm

arXiv:2606.15669v1 Announce Type: cross Abstract: Modern deep neural networks rely on Euclidean scalar activations (e.g., ReLU) and global normalization techniques (e.g., LayerNorm) to prevent gradient instability in deep architectures. However, these mechanisms inherently cause dead neurons, discard critical directional information, and destroy the orthogonality of feature representations. Inspired by the frequency-modulation transmission of biological axons, we propose the Z-Plane Neural Network, which maps hidden states into 2D phasor bundles on a hypersphere. We introduce a novel geometric activation function, Radial Bounding($\mathbf{x} / \max(1, \|\mathbf{x}\|_2)$), which limits the energy magnitude while preserving the phase (direction). We demonstrate mathematically that this isotropic activation maintains 1-Lipschitz continuity and prevents gradient vanishing by preserving tangential gradients. Empirically, a 100-layer Z-Plane Multi-Layer Perceptron (MLP)-entirely devoid of ReLU and LayerNorm-successfully converges on the MNIST dataset with 98.34% accuracy and absolute numerical stability, proving that bounded geometric activation alone is sufficient for stable deep learning.

09.
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.

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

FDIO: Frequency Decomposed Inertial Odometry

Pedestrian inertial odometry (PIO) estimates autonomous pedestrian motion using only acceleration and angular velocity measurements collected by an inertial measurement unit (IMU), making it highly valuable for consumer level localization applications. However, under a dual device acquisition setting, IMU signals collected by a freely carried mobile device are inherently composite signals in which the global motion of the human torso is coupled with perturbations induced by local limb motion. This coupling makes accurate human motion modeling more challenging. To address this issue, this paper proposes frequency decomposed inertial odometry (FDIO). The proposed method first decomposes input IMU signals into low frequency and high frequency components using a Laplacian pyramid. It then adopts a Mamba module to model long range motion information from the low frequency component and uses a multi scale convolution module to extract fine grained local dynamic features from the high frequency component. Experiments on five public PIO datasets show that FDIO achieves an average absolute trajectory error of 3.221~m and an average relative trajectory error of 2.550~m, reducing the errors by 33.3\% and 16.7\% compared with the RoNIN ResNet baseline, respectively. These results validate the effectiveness of the proposed frequency decomposition strategy. To the best of our knowledge, this work is among the first efforts to introduce Mamba and a frequency decomposition architecture into inertial odometry.

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

ROSE: Benchmarking the Perception-to-Action Gap in Multimodal Models

arXiv:2606.19965v1 Announce Type: cross Abstract: Multimodal large language models (MLLMs) are increasingly expected to act on visual information, yet the same scene may require different actions under different task contexts. How reliably can a model turn the same visual evidence into the action required by the current context? To answer this question, we introduce \textsc{ROSE} (Reference-conditioned Oddity and Symbolic Execution), a controlled benchmark that holds the visual scene fixed while varying region constraints and required symbolic outputs. Through coupled counting and coordinate-action tasks, \textsc{ROSE} tests whether models can infer an implicit majority reference and act on the resulting fine-grained visual evidence under changing contexts. Across nine recent MLLMs, performance drops by as much as 44.5 percentage points from counting-oriented tasks to region-conditioned action, despite 98.8\% human performance. The gap persists on paired scenes and regions for which the same model returns the correct count, while global-click and matched local controls show that coordinate grounding explains only part of the loss, revealing a distinct, model-dependent bottleneck in turning shared visual evidence into context-specific actions.

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

Agentomics: Economic Foundations for the Valuation, Attribution, and Pricing of AI Agents in Human-AI Workflows

Authors:

arXiv:2606.14769v1 Announce Type: cross Abstract: Agentic AI systems are increasingly being deployed as productive resources in organizational workflows, yet existing evaluation methods primarily measure isolated technical performance rather than economic contribution. This paper introduces Agentomics, a workflow-based framework for valuing, attributing, and pricing human and artificial agents. The framework models a workflow as a configuration of heterogeneous agents whose collective performance determines gross value, deployment cost, reliability, and expected failure loss. Workflow value is treated as a team-level quantity that may include complementarities, substitution effects, bottlenecks, and nonlinear production; additive stage-level value is only a special case. Building on this workflow model, the paper formulates AI deployment as a coalition-formation problem and defines coalition value as the incremental net surplus generated relative to a benchmark human workflow. The Shapley value is then used to attribute economic surplus among participating AI agents, yielding a principled connection among valuation, accountability, and market pricing. The resulting Shapley pricing equilibrium provides a normative benchmark for assessing whether agent prices reflect expected marginal contribution. A security-operations case study illustrates how the framework accounts for productivity gains, deployment costs, reliability losses, and coalition-level complementarities in hybrid human–AI workflows.

13.
arXiv (math.PR) 2026-06-11

On the spatio-temporal increments of nonlinear parabolic SPDEs and the open KPZ equation

arXiv:2508.05032v3 Announce Type: replace Abstract: We study spatio-temporal increments of the solutions to nonlinear parabolic SPDEs on a bounded interval with Dirichlet, Neumann, or Robin boundary conditions. We identify the exact local and uniform spatio-temporal moduli of continuity for the sample functions of the solutions. These moduli of continuity results imply the existence of random points in space-time at which spatio-temporal oscillations are exceptionally large. We also establish small-ball probability estimates and Chung-type laws of the iterated logarithm for spatio-temporal increments. Our method yields extension of some of these results to the open KPZ equation on the unit interval with inhomogeneous Neumann boundary conditions. Our key ingredients include new strong local non-determinism results for linear stochastic heat equation under various types of boundary conditions, and detailed estimates for the errors in linearization of spatio-temporal increments of the solution to the nonlinear equation.

14.
arXiv (CS.CV) 2026-06-12

A Multi-Modal Framework with Cross-Subject Pseudo-Labeling and Semantic Alignment for Micro-Gesture Recognition

Micro-gestures (MGs) are spontaneous and subtle body movements that frequently convey hidden human emotions. Recognizing MGs in untrimmed videos remains highly challenging due to their extremely low signal-to-noise ratio, severe long-tailed class distribution, and the inherent domain shift encountered in cross-subject evaluation scenarios. In this paper, we propose a comprehensive multi-modal framework for Track 1 of the 4th MiGA-IJCAI Challenge. To capture fine-grained representations, we design a saliency-guided multi-modal extraction pipeline integrating 68-keypoint skeleton joint coordinates, 3D heatmap volumes, and high-resolution RGB visual features. We introduce a gentle square-root smoothed weighting mechanism paired with an Orthogonal Semantic Embedding Loss to protect tail classes without compromising overall recognition capabilities. More importantly, to bridge the cross-subject generalization gap, we propose a Cross-Modal Pseudo-Labeling (CMPL) strategy for unsupervised domain adaptation, which significantly boosts single-modal robustness. A temperature-scaled soft-voting mechanism is finally utilized to alleviate overconfidence during late fusion. Extensive experiments demonstrate that our framework achieves a competitive F1-score of 68.13\%, securing the 4th place.

15.
Nature (Science) 2026-06-08

Fifty years since a simple equation described the chaos of biology

An exploration of chaos theory in population dynamics showed that unpredictable systems can often be modelled using surprisingly simple mathematics. An exploration of chaos theory in population dynamics showed that unpredictable systems can often be modelled using surprisingly simple mathematics.

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

PlaceRep: Geospatial Place Representation Learning from Large-Scale Point-of-Interest Data

arXiv:2507.02921v4 Announce Type: replace-cross Abstract: Learning effective representations of urban environments requires capturing spatial structure beyond fixed administrative boundaries. Existing geospatial representation learning approaches typically aggregate Points of Interest (POIs) into pre-defined administrative regions such as census units or ZIP code areas, assigning a single embedding to each region. However, POIs often form semantically meaningful groups that extend across, within, or beyond these boundaries, defining places that better reflect human activity and urban function. To address this limitation, we propose PlaceRep, a geospatial representation learning method that constructs place-level representations by clustering spatially and semantically related POIs. PlaceRep summarizes large-scale POI graphs from U.S. Foursquare data to produce general-purpose urban region embeddings while automatically identifying places across multiple spatial scales. By eliminating model pre-training, PlaceRep provides a scalable and efficient solution for multi-granular geospatial analysis. Experiments using the tasks of population density estimation and housing price prediction as downstream tasks show that PlaceRep outperforms most state-of-the-art graph-based geospatial representation learning methods and achieves up to a x100 speedup in generating region-level representations on large-scale POI graphs. The implementation of PlaceRep is available at https://github.com/mohammadhashemii/PlaceRep.

17.
arXiv (CS.LG) 2026-06-15

Time Series Causal Discovery via Context-Conditioned and Causality-Augmented Pretraining

arXiv:2605.26759v2 Announce Type: replace Abstract: Causal discovery from time series is critical for many real-world applications, such as tracing the root causes of anomalies. Existing approaches typically rely on dataset-specific optimization, making it difficult to transfer their causal discovery capabilities to new time series governed by diverse causal mechanisms. In this paper, we propose PTCD, a novel Pretraining framework for Time-series Causal Discovery, which improves cross-task generalization through context-conditioned modeling and transferable causal augmentation. To model complex temporal causal dependencies, PTCD employs a dual-scale iterative attention mechanism to capture window-level causal relationships, and a Gaussian mixture with a context-level routing mechanism to handle heterogeneous exogenous distributions. To further address distribution shifts across causal graphs, PTCD adopts a pretraining paradigm on synthetic datasets that integrates intervention-based learning and a causal mixup strategy, promoting stable causal discovery and stronger generalization. Extensive experiments on multiple real-world out-of-distribution (OOD) datasets demonstrate that PTCD excels in both causal discovery and root cause identification.

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

Functional Equivalence in Attention: A Comprehensive Study with Applications to Linear Mode Connectivity

arXiv:2606.17830v1 Announce Type: cross Abstract: Neural network parameter spaces are inherently non-injective, as distinct parameter configurations can realize identical functions through functional equivalence. While this symmetry is well understood in classical fully connected and convolutional models, it becomes substantially more intricate in modern attention-based architectures. Existing analyses of multihead attention have largely focused on the vanilla formulation, overlooking positional encodings that fundamentally reshape architectural symmetries. In this work, we provide a formal study of functional equivalence in Transformers with positional encodings. Focusing on the two most widely used variants–sinusoidal and rotary positional encodings (RoPE)–we show that sinusoidal encodings preserve the equivalence structure of vanilla attention, whereas rotary encodings significantly reduce the symmetry group, thereby enhancing expressivity. This offers a principled explanation for the growing prominence of RoPE in practice. We further examine how positional encodings affect linear mode connectivity, and through an alignment algorithm, empirically demonstrate that the presence and variability of connectivity across Transformer settings crucially depend on the positional encoding.

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

Attention-Based Estimation of the Individual Treatment Benefit Probability under Dose Variation

arXiv:2606.13821v1 Announce Type: new Abstract: Estimating the probability that a treatment outperforms a control for an individual patient, called the Individual Probability of Treatment Benefit (IPTB), offers a clinically intuitive alternative to population-average metrics. However, existing methods for IPTB estimation are largely confined to binary treatment settings, despite the prevalence of dose-varying interventions in clinical practice. We propose a general framework for IPTB estimation with ordinal outcomes under discrete dose assignments, called Dose-AIPTB (Dose Attention-based IPTB). Our approach recasts the problem as binary classification over the unobserved sign of the individual treatment effect, constructing pseudo-labels from covariate-similar pairwise comparisons and aggregating them via attention mechanisms or Nadaraya-Watson kernel regression. This formulation naturally accommodates multiple discrete dose levels, extending beyond the binary treatment paradigm. Through numerical experiments on real-world and synthetic data under covariate shift, varying sample sizes, and heterogeneous outcomes, we demonstrate that attention-based aggregation consistently outperforms kernel alternatives. The framework provides a foundation for personalized dose selection grounded in individual-level benefit probabilities. Codes implementing the model are publicly available at https://github.com/NTAILab/AIPTBDose.

20.
arXiv (CS.CV) 2026-06-16

ST-DiffEye: Diffusion-based Continuous Gaze Generation via Joint Scanpath-Trajectory Modeling

We study the problem of human gaze modeling, which aims to generate the gaze patterns a viewer produces while observing a visual stimulus. Gaze is primarily captured through two modalities: continuous eye-tracking trajectories, which describe fine-grained motion dynamics, and discrete scanpaths, which describe high-level fixation structure. Because gaze varies substantially across viewers and trials, we treat this variability as a defining property rather than noise and model gaze as a stochastic generative process. Existing generative gaze models supervise on only one of these two representations in isolation. We hypothesize that trajectories and scanpaths describe gaze at complementary scales and are jointly informative during training, and test this hypothesis through ST-DiffEye, a joint trajectory-scanpath diffusion framework that couples both modalities by concatenating them as an additional raw input channel, requiring no architectural overhead beyond an input and output channel expansion. We further introduce a principled evaluation framework based on the Continuous Ranked Probability Score (CRPS), which generalizes any existing sequence similarity metric into a proper scoring rule that jointly assesses the accuracy and diversity of generated gaze. Experiments on task-driven visual search, covering both target-present and target-absent scenarios, and on free-viewing benchmarks demonstrate state-of-the-art performance. These results, along with detailed ablations, confirm the benefit of joint modeling and the value of distribution-aware evaluation in capturing the intrinsic variability of human gaze. Project webpage: https://st-diffeye.github.io/

21.
medRxiv (Medicine) 2026-06-19

Cardiometabolic multimorbidity and care experiences in primary healthcare among Brazilian adults aged 50 and over (ELSI-Brazil)

Background: Population aging and the rising burden of non-communicable diseases have increased the prevalence of cardiometabolic multimorbidity (CM-MM) among older adults. Patient-reported experience measures (PREMs) are recognized as essential components of healthcare quality assessment, yet evidence on primary care experiences among individuals with CM-MM remains scarce. Objective: To analyze primary care experiences according to the presence of cardiometabolic multimorbidity among Brazilians aged 50 years and older. Methods: Cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021; n = 9,949). CM-MM was defined as the self-reported coexistence of two or more of the following conditions: hypertension, diabetes mellitus, dyslipidemia, acute myocardial infarction, and stroke. Primary care experiences were assessed using a validated 12-item instrument organized into four domains: first-contact access, longitudinality, communication, and care coordination. Associations were estimated using Poisson regression adjusted for sociodemographic, health conditions, and healthcare utilization variables, with stratified analysis by Family Health Strategy (FHS) coverage. Results: CM-MM prevalence was 25.5%, with a progressive increase by age and an inverse gradient by education. Individuals with CM-MM reported significantly more positive experiences in longitudinality (mean index 2.53 vs. 2.34; adjusted PR = 1.22; 95%CI 1.12-1.33; p < 0.001) and, to a lesser extent, in communication (mean index 2.68 vs. 2.58; adjusted PR = 1.10; 95%CI 1.00-1.20; p = 0.041). No statistically significant differences were found in first-contact access or care coordination. After stratified by FHS coverage, the observed differences in longitudinality and communication were no longer statistically significant. Conclusions: CM-MM was associated with more positive primary care experiences in longitudinality and communication. The absence of differentiated experiences in first-contact access and coordination highlights structural gaps in primary care responsiveness to individuals with greater clinical complexity. Keywords: Multimorbidity; Cardiometabolic diseases; Primary Care; Patient-reported experience measures; Older adults; ELSI-Brazil.

22.
arXiv (CS.CL) 2026-06-19

Granularity-Regulated Adaptive Computational Efficiency for Optimal Verification in Test-Time Scaling

Test-time scaling (TTS) has emerged as a powerful paradigm for improving the reasoning performance of large language models (LLMs) by investing additional compute at inference time. A central component of TTS is the verifier, which selects or scores candidate solutions to guide the search process. While prior work has explored the benefit of verification, a fundamental question remains underexplored: what is the optimal granularity of verification under a given compute budget? Coarse-grained outcome reward models (ORMs) and fine-grained process reward models (PRMs) represent two extremes, yet neither alone achieves compute-optimality across all regimes. In this paper, we establish a unified theoretical framework, called GRACE (\underline{G}ranularity-\underline{R}egulated \underline{A}daptive \underline{C}omputational \underline{E}fficiency), that characterizes the optimal verification granularity as an explicit function of problem difficulty, verifier accuracy, and compute budget. We prove that there exists a phase transition: fine-grained verification dominates when either the compute budget is large or the problem is hard, whereas coarse-grained verification is preferred in the low-budget, easy-problem regime. Our theory unifies Best-of-$N$, beam search, and step-level MCTS within a single Pareto-optimality framework, and motivates an adaptive granularity strategy that provably achieves the compute-performance Pareto frontier. Empirical results on MATH-500, GSM8K, and AIME benchmarks corroborate all four theoretical claims, with our adaptive strategy outperforming fixed-granularity baselines by up to 3.1\% accuracy at matched compute.

23.
PLOS Medicine 2026-06-09

Prediction of hospitalisation in young children with pneumonia in Malawi: A machine learning-based approach

by Patrick Staunton, Mohammad Adib Makrooni, Master Chisale, Billy Nyambolo, Joseph Wu, Damien McCarthy, Mark Ledwidge, Yasir Bin Nisar, Chris Watson, Balwani Mbakaya, Cathal Seoighe, Joe Gallagher Background Globally, pneumonia remains the single biggest cause of mortality in children under 5 years of age. This study sought to train and test a prediction model for hospitalisation within 7 days after initial presentation in 2- to 59-month-old Malawian children with WHO-defined pneumonia in primary care and compare its performance to existing risk prediction models. Methods and findings BIOTOPE is a cohort study of children with pneumonia in a primary healthcare setting in Malawi. The training cohort involved nine primary care centres and the testing cohort involved two primary care centres in Northern Malawi. The training cohort was recruited between December 2022 and April 2023 while the testing cohort was recruited in 2016. Participants were consecutive children aged 2–59 months presenting with cough and/or difficulty breathing and who were diagnosed as WHO-defined pneumonia in primary care of any severity. The training cohort was used to train and validate a machine learning model with a prespecified primary outcome defined as hospitalisation and/or death within 7 days as the outcome. This model was then further evaluated in the testing cohort.Median age was 15 months (interquartile range 8−27) in the training and 17 months (interquartile range 9−29) in the external testing cohort (52.1% and 54.4% male, respectively). Hospitalisation occurred in 14.3% (294) of the training cohort and 12.1% (55) of the testing cohort. There was one death in the training cohort only. WHO danger signs were present in 17.6% (360) and 15.9% (70) of children in the training and testing cohorts, respectively. The optimal machine learning model achieved an area under the receiver operating characteristic and precision recall curves of 0.87 and 0.57, respectively, in the testing cohort outperforming existing risk prediction models; furthermore, this model produced an expected calibration error of 0.16 (a logistic regression model using severity status as the response variable and the log odds of the machine learning model’s calibrated probabilities produced an intercept estimate of −0.32 and a slope estimate of 1.13). Key limitations include the use of hospitalisation and/or death as a severity outcome, which may reflect health system factors rather than true disease severity, that mortality-based comparisons were not possible due to low mortality in these primary care cohorts, and that comparator tools were developed for hospital populations rather than primary care populations. Conclusion This machine learning score outperformed traditional pneumonia risk scores in predicting hospitalisation within 7 days in Malawian children presenting to primary care. Traditional pneumonia risk scores diminish in performance when externally applied to new datasets suggesting they may not generalise well beyond their original derivation settings. Mortality-related findings are not applicable as there was only one death in this cohort. Overall these findings support the potential of machine learning to meaningfully improve early identification of children at risk of severe pneumonia in low-resource primary care settings. Further external validation and clinical impact studies are needed to confirm these results.

24.
arXiv (CS.CL) 2026-06-12

Small LLMs for Biomedical Claim Verification: Cost-Effective Fine-Tuning, Structural Dataset Shortcuts, and Cross-Domain Generalization

Authors:

Large Language Models such as GPT-4o and GPT-5 achieve strong zero-shot performance on biomedical claim verification, but cost and opacity limit scalable use. We fine-tune three small LLMs: Phi-3-mini (3.8B), Qwen2.5-3B, and Mistral-7B, via QLoRA on SciFact and HealthVer, providing the first study of QLoRA models against GPT-4o and fine-tuned BioLinkBERT encoders. Mistral-7B QLoRA surpasses both GPT-4o and GPT-5 (up to 12% F1 gain) at a fractional cost using just 1,008 training examples. We conduct extensive in-domain and cross-domain evaluation: models trained on SciFact tested on HealthVer and vice versa, at matched sizes to isolate dataset structure from data quantity. We identify a previously unreported structural artifact in SciFact that inflates in-domain scores, and show through bidirectional out-of-domain evaluation that training on structurally sound data enables robust cross-domain transfer. We plan to release all code and adapter checkpoints.

25.
bioRxiv (Bioinfo) 2026-06-18

A data-driven rediscovery of the specificity-conferring code of adenylation domains in nonribosomal peptide synthetases

Nonribosomal peptide synthetases (NRPSs) are large modular enzymes that assemble structurally diverse peptides, many of pharmacological importance, including antibiotics and immunosuppressants. Within each NRPS module, the adenylation (A) domain selects the substrate to be incorporated, a choice governed by a small set of residues lining the binding pocket. For two decades, computational prediction of A-domain substrate specificity has relied on residue sets - most prominently the Stachelhaus code and the 34-residue "8 Angstrom code" - that were defined by spatial proximity to the substrate rather than by demonstrated predictive value. Here we revisit which residues govern substrate specificity from a purely data-driven perspective. We assembled a non-redundant dataset of 5,366 A-domain sequences (4,693 bacterial and 673 fungal) and used information-theoretic measures to rank alignment positions by their statistical association with substrate identity, without restricting candidate positions to any predefined structural shell. This procedure yielded two compact, kingdom-specific codes: IG15B (15 positions) for bacterial and IG13F (13 positions) for fungal A-domains. Both match or exceed the predictive accuracy of the 34-residue 8 Angstrom code while using fewer than half its positions, and both independently recover the majority of the classical Stachelhaus positions. Notably, our analysis identifies four positions (242, 280, 281, and 284) that lie outside all conventional codes yet carry non-redundant specificity information and co-localize with classical determinants on two helices flanking the binding pocket. These positions provide new candidate sites for the rational engineering of A-domain specificity.