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01.
medRxiv (Medicine) 2026-06-22

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

Authors:
Namasambi↗Migisha↗Ankunda↗Matovu↗Lanyero↗Sagyiri↗Okello↗E. O↗Katongole↗Eyu↗Kwesiga↗Bulage↗…

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[≤]50%, MR[≤]25%, OPV[≤]10%, DPT[≤]15%, and Ugandas planning thresholds: BCG[≤]70%, MR[≤]40%, OPV[≤]15%, DPT[≤]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 ([≤]15% and [≤]10%) for most of the study period, while BCG generally remained below the WHO threshold ([≤]50%) and MR frequently exceeded the WHO threshold ([≤]25%) but remained within Uganda's planning threshold ([≤]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.

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02.
arXiv (CS.LG) 2026-06-16

SSNAPS: Audio-Visual Separation of Speech and Background Noise with Diffusion Inverse Sampling

Authors:
Yochai Yemini↗Yoav Ellinson↗Rami Ben-Ari↗Sharon Gannot↗Ethan Fetaya↗

arXiv:2602.01394v2 Announce Type: replace-cross Abstract: This paper addresses the challenge of audio-visual single-microphone speech separation and enhancement in the presence of real-world environmental noise. Our approach is based on generative inverse sampling, where we model clean speech and ambient noise with dedicated diffusion priors and jointly leverage them to recover all underlying sources. To achieve this, reformulate a recent inverse sampler to match our setting. We evaluate on mixtures of 1, 2, and 3 speakers with noise and show that, despite being entirely unsupervised, our method consistently outperforms leading supervised baselines in WER across all conditions. We further extend our framework to handle off-screen speaker separation. Moreover, the high fidelity of the separated noise component makes it suitable for downstream detection of the acoustic scene. Code and pretrained models will become available upon acceptance. Demo page: https://ssnaps2026.github.io/ssnaps2026/

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03.
arXiv (CS.AI) 2026-06-25

AeroCast: Probabilistic 3D Trajectory Prediction for Non-Cooperative Aerial Obstacles via Transformer-MDN Architecture

Authors:
Syed Izzat Ullah↗Jose Baca↗

arXiv:2606.25122v1 Announce Type: cross Abstract: Autonomous aerial vehicles operating in shared airspace must predict the future positions of non-cooperative obstacles to plan evasive maneuvers before a collision becomes unavoidable. Unlike cooperative systems that share intent, non-cooperative obstacles such as birds, uncontrolled drones, or debris exhibit multi-modal motion that deterministic predictors cannot adequately represent. Existing methods either rely on recurrent encoders that propagate temporal information sequentially, limiting their ability to capture long-range kinematic precursors of maneuver initiation, or produce point forecasts that provide no distributional information to downstream planners. This paper presents AeroCast, a probabilistic trajectory prediction framework that combines a Transformer encoder with a Mixture Density Network output head to predict per-timestep Gaussian mixture distributions over future three-dimensional displacements. A translation-invariant consecutive displacement encoding and a calibration-oriented training objective address the input design and mode-degeneracy challenges specific to mixture-based aerial trajectory prediction. On a hybrid real-and-synthetic quadrotor corpus spanning nine motion categories, AeroCast reduces Average Displacement Error and Final Displacement Error by approximately 50% relative to the baselines over a five-second horizon, and achieves the lowest negative log-likelihood and Continuous Ranked Probability Score among all compared methods. Ablation analysis identifies velocity input and model capacity as the primary contributors to prediction quality, and positional encoding as essential for long-horizon trajectory coherence. AeroCast inference completes in 0.1ms per sample, compatible with real-time onboard deployment at 100Hz.

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04.
arXiv (math.PR) 2026-06-19

The t-Split Two-Periodic Aztec Diamond Model

Authors:
Meredith Shea↗

arXiv:2606.19507v1 Announce Type: new Abstract: In this work we consider an Aztec diamond model split into two unequal regions which are asymptotically fixed in size. Each region is weighted with a distinct two-periodic weighting. We refer to this model as the t-split two-periodic Aztec diamond, to signify its difference from the previous work title Split Two-Periodic Aztec Diamond, where the model was split into two equal regions. We derive an integral expression for the correlation kernel of the model and give a partial description of the scaling limit behavior, along with a conjecture for the remainder. We refer to the larger and smaller sides of the model as the dominant and non-dominant sides, and to the location of the weight change as the interface. The dominant side exhibits a limit shape that depends only on its own weighting and is identical to that of the two-periodic Aztec diamond, while the non-dominant side appears to have a novel limit shape that depends on both weightings and the location of the interface. Lastly, we consider the complete limit shape in the case where the dominant side two-periodic parameter goes to 0.

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05.
bioRxiv (Bioinfo) 2026-06-18

Calculation of sequence space coverage in a mutagenesis library

Authors:
Florez Prada↗Uguzzoni↗Hart↗D. J↗

Directed evolution requires screening of large mutagenesis libraries, but accurate calculation of library sizes needed to discover functional variants remains challenging. Existing models provide baseline estimates, yet current computational approaches for finding the best variants scale poorly with library complexity. Here, we introduce a scalable algorithmic framework to compute exact discovery probabilities in saturation mutagenesis libraries with no requirement for explicit sequence enumeration. By aggregating variants into a composition log–sum distribution and applying log-space convolution across randomisation blocks, it is possible to extend this to massive sequence spaces and mixed codon schemes. By inverting these calculations, absolute mathematical ceilings for experimental design are established. Ultimately, this framework provides a rapid, quantitative tool to balance the statistical coverage-diversity trade-off within the limitations of laboratory screening. Finally, this is implemented as an open-source web application (SSCC) that allows researchers to construct heterogeneous library designs and compute required sampling depths, coverage probabilities, and absolute randomisation limits.

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

Small edits, large models: How Wikipedia advocacy shapes LLM values

Authors:
Jasmine Brazilek↗Maria Navas↗Alexa Gnauck↗

Can a small group of volunteers shape how AI systems discuss animal welfare, just by editing Wikipedia? We show that they can. Wikipedia appears in nearly every major language model training dataset and is weighted more heavily than web-crawled text. The Pro-Animal Wikipedians (PAW), a group of advocates who add sourced animal welfare content to relevant articles, have made 125 edits across 115 pages. Using gradient-based data attribution (Bergson; MAGIC), we traced how these edits influence language model behavior. TrackStar retrieval attribution on Llama 3.1 8B found that PAW-edited sections made up 68 percent of the highest-attributed documents for animal welfare queries (p < 0.0001) but only 52 percent for unrelated queries about the same companies (p = 0.53): the model links PAW content specifically to animal welfare topics, not to the entities in general. MAGIC counterfactual influence estimation on Llama-3.2-1B, run across five random training-order seeds, gave the same picture even more sharply: in every seed, the top-10 most influential documents on animal welfare queries were all PAW edits (10 of 10, 5 of 5 seeds), while on general queries the same top-10 sat at chance (4 to 6 of 10). Mean PAW influence exceeded mean control influence on animal welfare queries with p < 0.0001 in every seed, an effect 6 to 30 times larger than on general queries. Leave-subset-out validation gave Spearman rho = 1.00 for all 10 runs. When we fine-tuned separate models on PAW content versus control content, each model performed better specifically on the type of text it was trained on: the PAW-trained model cut perplexity on animal welfare text from 12.4 to 8.4, while the control-trained model cut perplexity on control text from 16.1 to 11.4. A small, coordinated Wikipedia editing campaign therefore measurably shapes how language models handle the topics those edits address.

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07.
arXiv (CS.CV) 2026-06-24

Bridging the Manifold Gap: Riemannian Residual Line Search for One-Step Image Editing

Authors:
Hongzhu Yi↗Zhongtian Luo↗Tong Li↗Yiyan Fan↗Jungang Xu↗

One-step diffusion editors are fast because they avoid inversion and iterative optimization, but a single transport update must be aggressive enough to realize the target prompt and conservative enough to preserve the source image–and no fixed update strength satisfies both demands across edit types. We treat this tension as a post-hoc candidate-selection problem on top of energy-field transport rather than as a new editing model. Our proposed method, Riemannian Residual Line Search, first builds a stronger edit by estimating the local time curvature of the prompt-delta field and projecting the corrected direction back onto the update norm of the original first-order energy-field transport estimation. It then forms a small residual path from the source image to this strong edit, retains the original first-order output as one candidate, and picks the final image by maximizing target-prompt CLIP alignment. On a 700-sample PIE-Bench++ evaluation across 10 edit type IDs, our method achieves state-of-the-art (SOTA) performance among current one-step update algorithms.

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

HanDyVQA: A Video QA Benchmark for Fine-Grained Hand-Object Interaction Dynamics

Authors:
Masatoshi Tateno↗Gido Kato↗Hirokatsu Kataoka↗Yoichi Sato↗Takuma Yagi↗

Hand-object interaction (HOI) inherently involves dynamics where human manipulations produce distinct spatio-temporal effects on objects. However, existing semantic HOI benchmarks focused either on manipulation or on the resulting effects at a coarse level, lacking fine-grained spatio-temporal reasoning to capture the underlying dynamics in HOI. We introduce HanDyVQA, a fine-grained video question-answering benchmark that comprehensively covers both the manipulation and effect aspects of HOI. HanDyVQA comprises six complementary question types (Action, Process, Objects, Location, State Change, and Object Parts), totalling 11.1K multiple-choice QA pairs. Collected QA pairs recognizing manipulation styles, hand/object motions, and part-level state changes. HanDyVQA also includes 10.3K segmentation masks for Objects and Object Parts questions, enabling the evaluation of object/part-level reasoning in video object segmentation. We evaluated recent video foundation models on our benchmark and found that even the best-performing model, Gemini-2.5-Pro, reached only 73% average accuracy, which is far from human performance (97%). Further analysis shows the remaining challenges in spatial relationship, motion, and part-level geometric understanding. We also found that integrating explicit HOI-related cues into visual features improves performance, offering insights for developing future models with a deeper understanding of HOI dynamics.

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09.
PLOS Computational Biology 2026-06-22

GrassSV – hybrid method to detect structural variants in high throughput DNA-seq data

Authors:
Dominik Witczak↗

by Dominik Witczak, Krzysztof Sychla, Julia Wysocka, Artur Laskowski, Wojciech Frohmberg, Marta Glowacka, Alicja Dzik, Piotr Lukasiak, Jacek Blazewicz, Aleksandra Swiercz Genetic diversity is crucial for populations to adapt and survive in dynamic environments. This diversity arises from genetic mutations, which manifest in the genome as structural variants (SVs). Several types of SVs exist, but not all are equally easy to detect. Current SV detection tools tend to specialize in certain SV types or require the use of multiple tools to obtain a comprehensive variant profile, which increases computational cost and complexity. While some methods excel at identifying breakpoints, they often struggle with accurately classifying variant types, and their precision depends strongly on data quality and sequencing technology. At present, the majority of available genomic data originates from high-quality short reads, which remain the most affordable sequencing technology. In this manuscript, we introduce GrassSV, a novel and computationally efficient method that employs a hybrid pattern-matching approach to detect all major classes of structural variants using short-read sequencing data. GrassSV integrates depth-of-coverage analysis with contig-based pattern recognition to ensure both sensitivity and precision while minimizing false positives and runtime. Its robustness was demonstrated on the human Genome in a Bottle dataset, as well as on synthetic data derived from the yeast genome, where it achieved high accuracy across all SV types at a lower computational cost compared to existing methods. This makes GrassSV a practical alternative to multi-tool pipelines typically required for comprehensive SV detection. GrassSV is available at https://github.com/Domomod/GrassSV under GPL-3.0 license and the benchmark at: https://github.com/Domomod/GrassBenchmark.

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

Probing in the Wild: A Case Study of Self-Supervised Speech Representations on Mandarin Sub-dialects with Unsupervised Articulatory Analysis

Authors:
Shu Shang↗Fuliang Weng↗Zeqian Hu↗Yaqian Zhou↗

While self-supervised speech models have achieved strong performance across speech tasks, relatively little is known about how their internal phonetic representations behave under fine-grained dialect variation. Existing probing studies typically rely on curated corpora with manual phonetic annotations, limiting their applicability to naturally occurring dialect speech. We present a case study of articulatory feature representations in a Mandarin self-supervised speech model using an entirely unlabeled probing pipeline. Phone sequences are generated using a language-agnostic universal phone recognizer and mapped to articulatory feature vectors, enabling frame-level probing without manual annotation. Our results reveal a structured pattern in articulatory feature decodability across Mandarin sub-dialects. Acoustically salient features such as labiality and stridency remain comparatively stable, whereas features associated with finer spectral distinctions exhibit larger dialect-dependent variation. This variation is driven primarily by elevated decodability for Beijing speech relative to other Mandarin sub-dialects. Layer-wise analyses further show distinct representational dynamics for these feature groups. These findings suggest that language-agnostic articulatory probing can be applied to real-world dialect corpora and that dialect sensitivity in self-supervised speech representations is unevenly distributed across articulatory dimensions.

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11.
arXiv (CS.CV) 2026-06-16

XMedFusion: A Knowledge-Guided Multimodal Perception and Reasoning Framework for Autonomous Medical Systems

Authors:
Hamza Riaz↗Arham Haroon↗Maha Baig↗Muhammad Dawood Rizwan↗Muhammad Naseer Bajwa↗Muhammad Moazam Fraz↗

Autonomous medical and robotic systems increasingly rely on intelligent perception and reasoning capabilities to interpret visual data and support clinical decision making. Radiology report generation represents a critical component of such automated diagnostic workflows, yet existing end-to-end multimodal models often suffer from weak visual grounding, resulting in unreliable interpretations and omission of subtle clinical findings. This paper presents XMedFusion, a modular AI framework designed as an intelligent perception and reasoning module for autonomous medical systems. The proposed framework decomposes visual information into coordinated functional components that emulate expert-driven analysis, including a visual perception agent that extracts image-grounded evidence, a knowledge graph construction agent that structures clinically relevant findings, and a retrieval-guided drafting process that ensures a consistent reporting structure. A synthesis agent iteratively integrates visual and structured evidence through reasoning-driven verification to produce reliable and interpretable diagnostic outputs. Experimental evaluation on a public chest radiograph dataset demonstrates significant improvements over baseline vision-language models, achieving gains from 0.0493 to 0.3359 in BLEU-1, 0.0863 to 0.2440 in ROUGE-L, and 0.0829 to 0.1708 in METEOR, along with substantial improvements in semantic evaluation metrics such as Consistency (2.38 to 7.80) and Accuracy (2.34 to 6.93). The results highlight the effectiveness of structured multi-agent perception and reasoning for enhancing robustness, transparency, and automation in intelligent medical imaging systems, enabling integration into autonomous healthcare and robotic diagnostic workflows.

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12.
arXiv (CS.LG) 2026-06-18

Stealthy World Model Manipulation via Data Poisoning

Authors:
Yibin Hu↗Xiaolin Sun↗Zizhan Zheng↗

arXiv:2606.18697v1 Announce Type: new Abstract: Model-based learning agents use learned world models to predict future states, plan actions, and adapt to new environments. However, the process of updating world models from collected experience creates a training-time attack surface: adversarially poisoned fine-tuning trajectories can manipulate the learned dynamics and thereby corrupt downstream planning. In this paper, we propose SWAAP, the first two-stage data poisoning framework for learned world models. In the first stage, SWAAP identifies a harmful target world model that induces low-return behavior under planning while remaining close to clean dynamics, using first-order bilevel optimization enabled by a transition-gradient theorem. In the second stage, SWAAP realizes this target through stealth-constrained gradient matching, modifying only a limited fraction of fine-tuning transition targets so that the induced training gradients steer the victim model toward the adversarial target, while a prediction-error regularizer encourages the poisoned targets to remain close to the world model's natural approximation error. To assess attack stealthiness, we evaluate defenses and detectability across three stages of the poisoning pipeline: pre-training detection of poisoned transitions, robust training during fine-tuning, and test-time monitoring of the resulting world model. Across diverse continuous-control tasks, SWAAP causes substantial performance degradation while keeping poisoned transitions close to clean data and evading the evaluated non-adaptive residual/CUSUM/TRIM-style defenses. These results reveal a practical vulnerability in world-model adaptation pipelines and highlight the need for robustness methods that protect both world-model training data and learned dynamics.

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13.
arXiv (quant-ph) 2026-06-19

Impossibility of superluminal signalling rules out causal loops in conical spacetimes

Authors:
Maarten Grothus↗V. Vilasini↗

arXiv:2606.20476v1 Announce Type: cross Abstract: In PRL 129, 110401 it was shown that it is theoretically possible to have operationally detectable causal loops without violating the principle of no superluminal signalling (NSS) in (1+1)-Minkowski spacetime. Whether or not such causal loops are also possible in $d > 1$ spatial dimensions, has remained a key open question. We resolve this question by showing that in a wide class of "conical" spacetimes, including Minkowski with d > 1, NSS does rule out all operationally detectable causal loops, in classical, quantum and post-quantum theories. This establishes that the relationship between the relativistic principles of NSS and no causal loops depends inherently on the geometry of spacetime.

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

Beyond Scalar Distances: Semantic Attribute Gradients from Frozen MLLMs for Visual Embeddings

Authors:
Shubhang Bhatnagar↗Dheeraj Baiju↗Narendra Ahuja↗

Vision encoders for retrieval are typically trained with class-label supervision: each training pair reduces to a scalar that uniformly pushes the embedding apart or pulls it together, as if every visual attribute either differed or matched. A multimodal large language model (MLLM), shown the same pair, can articulate those attributes and use them to predict whether the images share a class. We propose SAGA, a framework that turns this language-grounded, attribute-aware perception into a training signal for the encoder itself. Specifically, we use Group Relative Policy Optimization (GRPO) to reward the MLLM for correct predictions on the vision encoder's tokens. Since correct predictions require those tokens to expose the specific attributes that differ or match between the pair, the gradient pushes the encoder to encode them, replacing the uniform pair-level scalar with attribute-resolved supervision. An auxiliary attention-distillation loss anchors the encoder's embedding to tokens the MLLM attended to, and a standard metric-learning loss shapes the embedding geometry for nearest-neighbour retrieval. The MLLM is frozen throughout and discarded at inference, matching the deployment cost of a metric-learning baseline. SAGA improves Recall@1 by 3 to 6 points over state-of-the-art baselines on CUB-200-2011, Cars-196, FGVC-Aircraft, and iNaturalist Aves on zero-shot image retrieval.

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

Learning New Tasks via Reusable Skills: Skill-Compositional Experts for Embodied Continual Learning

Authors:
Shuaike Zhang↗Shaokun Wang↗Haoyu Tang↗Jianlong Wu↗Liqiang Nie↗

Embodied Continual Learning (ECL) aims to enable robots to continually acquire new manipulation tasks while retaining previously learned behaviors under closed-loop control. Compared with conventional continual learning, ECL suffers from more severe catastrophic forgetting. Feature drift accumulated under closed-loop control progressively propagates through sequential decision-making, leading to degradation of previously learned behaviors. A key challenge in ECL lies in structured skill reuse across continually evolving tasks, since existing methods primarily focus on skill learning without explicitly organizing them for coherent task execution. To address this issue, we propose SCE, a Skill-Compositional Experts framework for ECL. SCE builds a skill base via Compositional Skill Grounding (CSG), which decomposes task demonstrations into reusable skills. Based on this, Dual Execution-and-Transition Experts (DETE) enable new task learning through skill composition, where one branch ensures skill execution and the other supports transitions between skills for coherent behavior. Experiments on LIBERO benchmarks and real-world manipulation tasks demonstrate that SCE consistently improves retention and overall task performance. Further feature drift analyses and ablation studies verify the effectiveness of our method. Project website: https://eqcy.github.io/sce/.

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

Active Reference Acquisition in Few-Shot Font Generation

Authors:
Shinnosuke Matsuo↗

Few-shot font generation aims to synthesize the remaining glyphs of a font given one or a few reference glyphs while preserving stylistic consistency, thereby supporting font designers in efficiently completing a typeface. Existing methods primarily focus on improving generation quality given a fixed reference set. However, when the current reference glyphs are insufficient to represent the target style, few-shot font generation may fail to produce satisfactory results. In practical scenarios, additional reference glyphs can often be obtained from the designer when necessary. Accordingly, we propose a new framework, Active Reference Acquisition in Few-Shot Font Generation, in which the model sequentially decides which character to acquire next as an additional reference. Furthermore, we propose a reference part-coverage-based acquisition function to efficiently query the designer. Motivated by the observation that font styles are well characterized by local structural parts, we represent each glyph using a histogram of local features and select query characters that maximize the expected part coverage of the reference set. By prioritizing characters that contain parts not yet covered by the current references, the proposed method progressively expands the diversity of visual parts in the reference set. As a result, generation quality is improved with fewer queries. Experiments on the Google Fonts dataset demonstrate that the proposed method achieves higher generation quality than random querying and reference-agnostic baselines. The code is available at https://github.com/matsuo-shinnosuke/ActiveRef-FontGen.

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

A Technical Taxonomy of LLM Agent Communication Protocols

Authors:
Linus Sander↗Habtom Kahsay Gidey↗Alexander Lenz↗Alois Knoll↗

arXiv:2606.19135v1 Announce Type: cross Abstract: As large language models (LLMs) advance and multi-agent systems aim to overcome the limits of standalone agents, robust communication protocols are becoming essential infrastructure for distributed agent networks. Nonetheless, the fragmented protocol landscape presents a significant interoperability challenge. This study develops a technical taxonomy to classify and analyze LLM agent communication protocols. Following an established iterative method, we defined the taxonomy's purpose, meta-characteristic, and ending conditions, then performed five iterations, three empirical-to-conceptual and two conceptual-to-empirical, on nine actively maintained open-source protocols with demonstrable adoption. The taxonomy comprises five dimensions: counterparty, payload, interaction state, discovery mechanism, and schema flexibility. Classification reveals recurring architectural patterns: all sampled agent-to-agent protocols combine hybrid payloads with session-state persistence; most protocols support multiple predefined schemas, and two negotiate schemas at runtime, indicating a trend toward schema flexibility; decentralized discovery remains rare. Analysis suggests short-term convergence pressure toward protocols unifying agent-to-agent and agent-to-context (tool and data) communication. Long-term, however, no single protocol is likely to maximize versatility, efficiency, and portability simultaneously. The field will more likely evolve toward a federated, layered protocol stack. The framework guides protocol selection and highlights open research gaps such as privacy and policy enforcement.}

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18.
medRxiv (Medicine) 2026-06-11

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

Authors:
Lewis↗Andrews↗Laing↗

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

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

EMFusion: Uncertainty-Aware Conditional Diffusion Model for Multivariate Narrow-band Exposure Forecasting

Authors:
Zijiang Yan↗Yixiang Huang↗Jianhua Pei↗Hina Tabassum↗Luca Chiaraviglio↗

arXiv:2512.15067v4 Announce Type: replace-cross Abstract: The rapid growth in wireless infrastructure has increased the need to accurately estimate and forecast electromagnetic field (EMF) levels to ensure ongoing compliance, assess potential health impacts, and support efficient network planning. While existing studies rely on univariate forecasting of wideband aggregate EMF data, multivariate narrow-band EMF forecasting is needed to capture the inter-operator and inter-frequency variations essential for proactive network planning. To this end, this paper introduces EMFusion, a conditional diffusion-based EMF forecasting framework that integrates diverse contextual factors, such as time of day, season, and holidays, while providing uncertainty-aware probabilistic forecasts. The proposed architecture features a residual U-Net backbone enhanced by a cross-attention mechanism that dynamically integrates external conditions to guide the generation process. Furthermore, EMFusion integrates an imputation-based sampling strategy that treats forecasting as a structural inpainting task, ensuring temporal coherence even with irregular measurements. Unlike standard point forecasters, EMFusion generates empirical probabilistic prediction intervals from the learned conditional distribution, providing uncertainty-aware probabilistic forecasting rather than simple point estimation. Numerical experiments conducted on the multivariate narrow-band EMF datasets demonstrate that EMFusion with the contextual information of working hours outperforms the baseline models with or without conditions. The proposed EMFusion outperforms the best baseline by 23.85% in continuous ranked probability score (CRPS) and 13.93% in normalized root mean square error.

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20.
Nature (Science) 2026-06-10

Deep learning four decades of human migration

Authors:
Thomas Gaskin↗

Human migration is a fundamental driver of global demographic change, shaping population structure, labour markets and social policy across countries1–3. Although long-term migration patterns are often linked to economic development4, they can shift rapidly in response to shocks such as conflict, environmental crises and political change5. Despite its importance, migration remains difficult to measure consistently: existing data are sparse, concentrated in high-income settings and are fragmented across incompatible definitions, temporal resolutions and data types6–8. Past efforts have relied on partial datasets, including flow records, stock estimates and model-based reconstructions with limited coverage9–14. A central challenge is therefore to construct a globally consistent, high-resolution account of migration flows over time. Here we present a new dataset of annual origin-destination migration across 230 countries and regions from 1990 to the present, integrating diverse data sources into a unified modelling framework. By combining official statistics, census-based stocks, net migration estimates and past flow reconstructions, our approach produces temporally detailed and spatially comprehensive estimates that substantially extend existing resources. Using an ensemble of deep recurrent neural networks informed by geographic, economic, cultural and political covariates, we capture both persistent trends and short-term responses to changing conditions—all while propagating uncertainty to generate confidence bounds. Our results outperform existing five-year flow estimates on held-out data and provide finer temporal resolution, revealing previously obscured dynamics in global migration patterns. This framework highlights regions in which uncertainty remains high and data collection is most urgently needed. By releasing all data, code and trained models, we provide a transparent and reproducible foundation for future work. These advances enable a more timely and detailed understanding of human mobility, with implications for research and policy in an increasingly dynamic global system. A global annual migration-flow dataset (1990–2024) is produced using deep-learning models and diverse sources to estimate movements across 230 countries with improved temporal resolution, coverage and uncertainty estimates.

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21.
arXiv (CS.CV) 2026-06-25

Position: Reasoning After Perception Means Reasoning Without Vision

Authors:
Hongcheng Gao↗Zihao Huang↗Jingyi Tang↗Lin Xu↗Xinhao Li↗Haoyang Li↗Yue Liu↗Minhua Lin↗Xinlong Yang↗Taihang Hu↗Ge Wu↗Balong Bi↗…

A common belief in multimodal research is that the perceptual weaknesses of vision–language models can be compensated by stronger language reasoning (e.g., chain-of-thought, in-context learning, or external tools). We challenge this assumption. We argue that for a broad class of visual tasks hard to specify in language, failures stem from a structural fatality where the temporal decision of when to reason strictly dictates the spatial constraint of where reasoning takes place. When visual reasoning is deferred to language generation, current architectures do not merely delay computation; they displace it from the continuous visual representation to a discrete textual space. Consequently, the sequential ``Perception-then-Reasoning'' paradigm degenerates perception into a passive, one-off feature encoding process, rendering it functionally equivalent to ``Reasoning-in-Text-Space'', where task-critical spatial signals are collapsed before reasoning begins. We substantiate this claim with the Turing Eye Test (TET): tasks that must be resolved in visual space and are hard to verbalize; results show text-only reasoning cannot remedy these perceptual failures. Our findings suggest rethinking the architectural divide: shifting from reasoning about perception to reasoning within perception. This facilitates actively reasoning-driven perception that operates directly on pixel-level visual representations, rather than within a collapsed textual space.

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22.
medRxiv (Medicine) 2026-06-10

A risk-of-contagion index using a Bayesian based model for the COVID-19 epidemic in Mexico

Authors:
Corona-Moreno↗Acuna-Zegarra↗M. A↗Santana-Cibrian↗Velasco-Hernandez↗J. X↗

During the COVID-19 pandemic, limited testing capacity and reporting delays complicated epidemic surveillance and decision-making in Mexico. We calibrated textit{covidestim}, a Bayesian nowcasting model, to estimate the total SARS-CoV-2 infections from reported cases and deaths using Mexican surveillance data. Disease-progression distribution priors were calibrated using Mexico City records and validated through comparisons with national seroprevalence surveys, hospitalization data, and annual reported severe-case rates across all states. Using the reconstructed estimates of active infections, we implemented an event-based risk framework that quantifies the probability of encountering at least one infectious individual in gatherings of different sizes. This probability was subsequently translated into a four-level epidemiological traffic-light indicator and computed at both state and municipality levels. The resulting estimates revealed substantial spatial heterogeneity that is obscured by state-level aggregation, particularly in states with marked differences between urban and rural municipalities. To evaluate consistency with public-health indicators, we compared the proposed risk classification with the official Mexican epidemiological traffic-light system, considering interpretable gathering sizes relevant to public-health decision making. Weekly reports derived from this framework were delivered to policymakers in the State of Queretaro in Mexico, as an anticipation tool for school reopening and public-space management. This demonstrates that this Bayesian reconstruction of infections combined with event-based risk metrics can provide an interpretable and generalizable municipality-level complement to routine surveillance systems, particularly in regions with limited testing capacity and heterogeneous local transmission dynamics.

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23.
arXiv (CS.LG) 2026-06-25

Gaussian Mean Field Variational Inference can Overestimate Predictive Variance

Authors:
James Odgers↗Ben Riegler↗Siddharth Swaroop↗Vincent Fortuin↗

arXiv:2606.25745v1 Announce Type: cross Abstract: Mean Field Variational Inference (MFVI) is widely understood to underestimate posterior variance. By analysing conjugate Bayesian Linear Regression (BLR), we show that this characterization is incomplete: while MFVI underestimates the variance in parameter space, it can overestimate the predictive variance compared to the exact posterior. We show that if the MFVI posterior underestimates predictive variances in some directions, it necessarily overestimates them in others. Crucially, this overestimation occurs in directions where the training data concentrates. This leads to the surprising result that, for a test point drawn from the training distribution, MFVI's expected predictive variance exceeds that of the exact posterior. We demonstrate a pathological case of this effect, where the MFVI posterior fails to reduce predictive variance compared to the prior on in distribution data. We connect these results to the Cold Posterior Effect, arguing that varying the temperature can correct this overestimation, yielding predictions closer to those of the exact posterior. We validate our theory on synthetic and real-world regression tasks.

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24.
arXiv (math.PR) 2026-06-19

Critical parameters of germ-monotone families of branching random walks

Authors:
Daniela Bertacchi↗Fabio Zucca↗

arXiv:2602.21062v2 Announce Type: replace Abstract: We introduce a broad class of families of branching random walks on a countable set $X$, which we refer to as germ-monotone branching random walks (GMBRWs). The processes in each family are parametrized by a positive parameter $\lambda>0$, which controls the overall reproductive speed, and they are monotonically increasing in $\lambda$ with respect to the germ order, a notion that extends classical stochastic domination. This framework encompasses a wide range of models, including classical continuous-time branching random walks, as well as discrete-time counterparts of certain non-Markovian processes such as ageing branching random walks. We define a general notion of critical parameter $\lambda(A)$ associated with each subset $A \subseteq X$, which serves as a threshold separating almost sure extinction in $A$ from positive probability of survival in $A$. This unifies and extends the classical global and local critical parameters $\lambda_w$ and $\lambda_s$, which can be recovered as special cases. We then investigate how modifications of the reproduction laws, either on a finite set or on a more general subset of $X$, affect these critical parameters. Our results extend earlier contributions in the literature.

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25.
arXiv (CS.AI) 2026-06-19

Bid Farewell to Seesaw: Towards Accurate Long-tail Session-based Recommendation via Dual Constraints of Hybrid Intents

Authors:
Xiao Wang↗Ke Qin↗Dongyang Zhang↗Xiurui Xie↗Shuang Liang↗

arXiv:2511.08378v4 Announce Type: replace-cross Abstract: Session-based recommendation (SBR) aims to predict anonymous users' next interaction based on their interaction sessions. In the practical recommendation scenario, low-exposure items constitute the majority of interactions, creating a long-tail distribution that severely compromises recommendation diversity. Existing approaches attempt to address this issue by promoting tail items but incur accuracy degradation, exhibiting a "see-saw" effect between long-tail and accuracy performance. We attribute such conflict to session-irrelevant noise within the tail items, which existing long-tail approaches fail to identify and constrain effectively. To resolve this fundamental conflict, we propose HID (Hybrid Intent-based Dual Constraint Framework), a plug-and-play framework that transforms the conventional "see-saw" into "win-win" through introducing the hybrid intent-based dual constraints for both long-tail and accuracy. Two key innovations are incorporated in this framework: (i) Hybrid Intent Learning, where we reformulate the intent extraction strategies by employing attribute-aware spectral clustering to reconstruct the item-to-intent mapping. Furthermore, discrimination of session-irrelevant noise is achieved through the assignment of the target and noise intents to each session. (ii) Intent Constraint Loss, which incorporates two novel constraint paradigms regarding the diversity and accuracy to regulate the representation learning process of both items and sessions. These two objectives are unified into a single training loss through rigorous theoretical derivation. Extensive experiments across multiple SBR models and datasets demonstrate that HID can enhance both long-tail performance and recommendation accuracy, establishing new state-of-the-art performance in long-tail recommender systems.

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