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01.
arXiv (CS.CV) 2026-06-16

Learning Topology-Aware Implicit Field for Unified Pulmonary Tree Modeling with Incomplete Topological Supervision

Pulmonary trees extracted from CT images frequently exhibit topological incompleteness, such as missing or disconnected branches, which substantially degrades downstream anatomical analysis and limits the applicability of existing pulmonary tree modeling pipelines. Current approaches typically rely on dense volumetric processing, explicit graph reasoning, or generic point cloud completion priors, leading to limited efficiency, weak structural awareness, and reduced robustness under realistic structural corruption. We propose TopoField, a topology-aware implicit modeling framework that treats topology repair as a first-class modeling problem and enables unified multi-task inference for pulmonary tree analysis. TopoField represents pulmonary anatomy using sparse surface and skeleton point clouds and learns a continuous implicit field that supports topology repair without relying on complete or explicit disconnection annotations, by training on synthetically introduced structural disruptions over already incomplete trees. Building upon the repaired implicit representation, anatomical labeling and lung segment reconstruction are jointly inferred through task-specific implicit functions within a single forward pass. Extensive experiments on the Lung3D+ dataset demonstrate that TopoField consistently improves topological completeness and achieves accurate anatomical labeling and lung segment reconstruction under challenging incomplete scenarios. We further validate TopoField on real incomplete outputs from an external segmentation model, demonstrating its applicability to realistic segmentation pipelines. Owing to its implicit formulation, TopoField attains high computational efficiency, completing all tasks in just over one second per case, highlighting its practicality for large-scale and time-sensitive clinical applications.

02.
arXiv (CS.CL) 2026-06-18

Human-AI Coevolution Dynamics: A Formal Theory of Social Intelligence Emergence Through Long-Term Interaction

Current conversational AI systems have made significant progress in language generation, personalization, and long-context interaction. However, most existing methods model social behavior through isolated components such as emotion modeling, memory retrieval, or persona conditioning, lacking a unified framework to explain the emergence of stable social relationships and social intelligence in long-term human-AI interaction.To address this, we propose the Human-AI Coevolution Dynamics Framework (HACD-H), a formal model of human-AI interaction as a self-organizing social cognitive system. HACD-H integrates emotional adaptation, relational organization, social memory, and personality consistency into a unified dynamical framework and introduces principles including multi-timescale social cognition, relational attractors, trust basins, developmental phase transitions, and social cognitive energy dynamics.We construct a conversational dataset with approximately 14,700 interaction turns and develop a theory-driven empirical evaluation framework. Results reveal a hierarchy of temporal persistence in social cognition, stable relational attractors, phase-transition-like developmental patterns, and a structured social cognitive energy landscape. Social intelligence shows a significant negative correlation with social cognitive energy (r = -0.391, p < 0.001), and interaction trajectories exhibit progressive energy reduction over time.These findings suggest that social intelligence emerges from long-term social cognitive coevolution rather than isolated conversational capabilities. HACD-H provides a unified theoretical foundation for modeling adaptive human-AI social interaction and developing socially intelligent AI systems.

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

Tool-IQA: Augmenting Image Quality Assessment with Simple Tools

Vision-Language Models (VLMs) have been increasingly adopted for Image Quality Assessment (IQA). However, current methods typically employ a static one-shot scoring paradigm, despite the fact that humans assess image quality through dynamic visual inspection, e.g., selectively adjusting views to verify details and subtle artifacts. Specifically, relying solely on a single-pass observation introduces two primary limitations: first, perceiving the image only at a global scale restricts the assessment of finer local details; second, the original intensity distribution of the image may overwhelm the visibility, leading to insufficient inspection of image quality. To address these issues, we propose Tool-IQA, shifting the assessment mechanism from passive scoring to a tool-augmented workflow. In particular, we equip VLMs with simple yet effective view tools: a Magnifier to inspect local details, and a Gamma Corrector to uncover visibility and hidden artifacts. The assessment follows a structured pipeline that consists of an initial observation with rubric notes, a tool-augmented in-depth inspection, and a final quantification for calibrated quality score. Furthermore, to ensure efficient and purposeful tool callings, we introduce a batch-aware training strategy to reward tool interactions that can yield positive contributions rather than simply encouraging usage. Experiments on a variety of IQA benchmarks demonstrate that, with effective tool calling and calibrated assessment, our proposed Tool-IQA significantly outperforms existing state-of-the-art models, e.g., it achieves a PLCC of 0.854 on the challenging CLIVE dataset.

04.
arXiv (CS.CV) 2026-06-16

MeshLoom: Feed-Forward Non-Rigid Registration of Mesh Sequences

We present MeshLoom, a feed-forward registration network that directly reconstructs vertex deformations across mesh sequences. Our approach advances non-rigid registration beyond existing models, which are typically constrained by costly per-instance optimization, narrow object categories, pairwise-only inputs, or merely intermediate outputs. The network is simple and efficient, registering multiple meshes within seconds. At its core lies a topology-aware encoder–decoder design. Specifically, we first introduce a topology-aware point representation that encodes the anchor (reference) mesh's topology into its per-vertex features. This representation strengthens the network's understanding of the anchor-mesh geometry and disambiguates points that are Euclidean-close yet geodesically distant. We then propose a multi-modal encoder that fuses this anchor-mesh representation with complementary cues from each frame, such as shape latents and image features. These multi-source signals are compressed into a compact global motion embedding that captures dense inter-frame correspondence. A lightweight decoder then queries this global embedding with the anchor-mesh point representation, retrieving per-vertex deformations at target timestamps. Through extensive experiments across diverse motions and object categories, we show that MeshLoom achieves state-of-the-art results on non-rigid registration. In addition, we find that our global embedding-then-query paradigm naturally enables the network to generate deformations at intermediate timestamps, which extends MeshLoom to motion interpolation and mesh morphing. Project page: https://meshloom.github.io/ .

05.
medRxiv (Medicine) 2026-06-24

Cardiologists perspectives on sociocultural and structural factors shaping cardiovascular genetic testing

Introduction: Genetic testing is increasingly central to the diagnosis and management of cardiovascular genetic conditions. However, use and follow-through vary across patient populations. Examining clinician perspectives on sociocultural and structural factors influencing testing is important for understanding these differences and informing public health genomics research and implementation efforts. Methods: We conducted semi-structured interviews with 15 cardiologists from health systems across the United States who have integrated cardiogenetics in their practice. Interviews explored experiences diagnosing cardiovascular genetic conditions among patients from underrepresented backgrounds, as well as approaches to incorporating social and contextual information into care. Data were coded thematically and analyzed using a framework analysis guided by the Health Equity Implementation Framework and Social Determinants of Health domains. Results: Clinicians described multi-level factors shaping genetic testing practices, including patient-provider interactions, clinical workflows, health system infrastructure, and broader policy contexts. Key themes included challenges communicating complex genetic information across language and literacy differences; patient trust shaped by prior healthcare experiences; fragmented insurance coverage separating genetic testing from genetic counseling; and challenges interpreting variants of uncertain significance, particularly for populations underrepresented in genomic reference databases. Clinicians also described adaptive strategies, such as interdisciplinary collaboration, telehealth, and patient assistance programs, that supported testing in some settings but were often inconsistent or resource-dependent. Conclusion: Among cardiologists using genetic testing, system-level and sociocultural factors shape the feasibility and downstream use of cardiovascular genetic testing. Findings highlight considerations for public health-informed genomic infrastructure that accounts for social context, supports communication, and reduces reliance on individual clinician workarounds, with implications for clinical decision support and related public health genomics initiatives.

06.
medRxiv (Medicine) 2026-06-23

Respiratory support with Continuous Positive Airway Pressure in preterm neonates: an analysis of coverage and quality of care in 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania implementing with the NEST360 Alliance

Background: Prematurity is the leading cause of child deaths worldwide, with the highest neonatal mortality in sub Saharan Africa. Respiratory distress syndrome (RDS) is the leading mortality pathway in preterm neonates, but continuous positive airway pressure (CPAP) has high impact. This analysis reports CPAP coverage and quality of care for preterm neonates admitted to 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania. Methods: Analyses used individually linked neonatal inpatient data and cross-sectional health systems data. All admitted neonates were eligible for inclusion (January 2021 through December 2024). Service readiness for CPAP delivery and mean CPAP coverage were described for CPAP eligible newborns (weighing 1500g). Quality of care cascades were constructed to illustrate key indicators. Survival among CPAP eligible neonates was analysed using regression models, stratified by clinical severity scores. Results: 375,255 newborn admissions were analysed in 66 neonatal units. Functional CPAP availability varied with median 16% of days (IQR: 4 to 47%) classified as high demand (>1.5 eligible newborns per CPAP). Of 64,761 CPAP eligible neonates, 22,006 (34%, 95% CI 33 to 34%) received CPAP. All countries showed improvement in CPAP coverage, with Tanzanian hospitals recording 63% increase in mean coverage (p-value=0.001) over time. Quality of care cascades showed treatment was initiated 1 day for 42% (95% CI 41 to 43%) of eligible neonates receiving CPAP. Only 10% of neonates

07.
arXiv (CS.LG) 2026-06-11

Least-Action-Guided Diffusion for Physical Extrapolation

arXiv:2606.11277v1 Announce Type: new Abstract: Reliable extrapolation remains a central challenge for generative models in computational physics, because models trained over finite ranges of time, parameters, or geometries may produce physically inconsistent predictions outside the training distribution. We introduce a least-action-principle-guided diffusion, LAPG, a framework that promotes physical consistency during inference rather than relying solely on constraints imposed during training. The method combines a conditional score-based diffusion model with an action-derived physical guidance score. In the first stage, the learned score model generates an in-distribution proposal; in the second, an action-based variational prior refines this proposal toward the target out-of-distribution condition. This formulation turns the principle of least action into a differentiable inference-time correction mechanism and provides an alternative to pointwise residual penalties that often require empirical loss balancing. We evaluate LAPG on representative ordinary- and partial-differential-equation systems, including free fall, conservative and dissipative spring-mass dynamics, interacting point vortices, and potential flow over parameterized airfoils. In temporal, parameter, and geometric extrapolation tests, LAPG reduces phase drift, preserves dissipative decay, captures vortex motion, and improves the lift response of airfoil flows compared with training-time physics-informed baselines.

08.
bioRxiv (Bioinfo) 2026-06-16

THEOBROMA: an aggregated open database of 1.13 million natural products with per-compound license auditing, three-tier classification, and stereochemistry-aware deduplication

Natural products remain one of the most productive sources of pharmacologically active compounds for drug discovery, yet the current open aggregator landscape attributes licenses at database rather than compound granularity, with consequences that have become tangible as the field grows. A recent relicensing event in one constituent source (the September 2024 transition of the Natural Products Atlas to CC BY-NC 4.0) demonstrates how database-level licensing propagates across an aggregate and motivates the per-compound audit framework presented here. The same peer cohort separately leaves classification provenance and stereoisomer-family relations coarser than either layer warrants. THEOBROMA, accessible at url{https://theobroma.l3s.uni-hannover.de}, integrates 1{,}133{,}004 natural products from 29 open sources under a per-compound license audit that resolves each compound's license tier across all attesting sources under a most-restrictive-wins rule, identifying 900{,}170 compounds (79.4%) under open-use licenses and exposing the per-source attestation chain and resolved tier through a dedicated audit endpoint and a query-time license filter. A three-tier classification stratifies 89.3% coverage into 35.1% curated, 43.9% high-confidence inferred, and 10.3% exploratory tiers, with 486{,}215 stereoisomer families preserved by full 27-character InChIKey deduplication and exposed via a dedicated texttt{/api/stereoisomers/} endpoint and a radial-family display. Per-compound license provenance is the primary differentiator. Classification stratification and stereoisomer-family exposure add finer-grained access to two related axes, supporting license-compatible virtual screening and isomer-specific bioactivity analysis at corpus scale. As an evolving open resource, THEOBROMA pairs continuous pipeline maintenance with interactive geographic, taxonomic, and chemical-space exploration.

09.
arXiv (CS.AI) 2026-06-11

CoVar: Confidence-Variance-Guided Pseudo-Label Selection for Semi-Supervised Learning

arXiv:2601.11670v3 Announce Type: replace-cross Abstract: Pseudo-label selection in semi-supervised learning is commonly driven by maximum-confidence thresholds, yet confidence alone can be unreliable under model overconfidence and class imbalance. We propose CoVar, a confidence–variance framework that assesses pseudo-label reliability by jointly modeling Maximum Confidence (MC) and Residual-Class Variance (RCV). Starting from entropy minimization, we derive a second-order cross-entropy approximation showing that low-loss pseudo-labels are favored when MC is high and RCV is low, with a confidence-dependent penalty that becomes stronger for near-certain predictions. Based on this criterion, CoVar embeds predictions into a two-dimensional confidence–variance space and uses SVD-based spectral relaxation to separate reliable and unreliable predictions without hand-tuned confidence thresholds. Cluster-wise Gaussian weighting then converts this separation into per-sample training weights. The resulting weights can be integrated into existing semi-supervised segmentation and classification pipelines during training and introduce no inference-time overhead. Experiments on PASCAL VOC 2012, Cityscapes, CIFAR-10, CIFAR-100, SVHN, and STL-10 show clear gains on VOC and Cityscapes under matched backbones, as well as competitive or improved error rates on standard classification benchmarks. These results indicate that residual-class dispersion provides a useful signal complementary to confidence for robust pseudo-label selection.

10.
arXiv (CS.CL) 2026-06-15

BayLing-Duplex: Native Full-Duplex Speech Dialogue with a Single Autoregressive LLM

Real-time, full-duplex speech interaction is a key feature of next-generation spoken chatbots, allowing the model to listen and speak at the same time and to handle natural phenomena such as overlap, hesitation, and barge-in. Existing speech language models (SpeechLMs) such as LLaMA-Omni and GLM-4-Voice are still turn-based and rely on an external Voice Activity Detection (VAD) module to mark the end of the user's turn, which fundamentally limits their interactive ability. In this paper, we introduce BayLing-Duplex, a native full-duplex SpeechLM where a single autoregressive LLM decides when to listen, when to speak, and when to stop, with no auxiliary turn-taking module. The design adds only a few special tokens to the standard vocabulary, so it transfers across LLMs and reuses existing training and serving stacks with no architectural adaptation. Starting from the public GLM-4-Voice checkpoint and using only 400K full-duplex samples for fine-tuning followed by a lightweight DPO stage, BayLing-Duplex reaches 92% turn-taking success and 100% interruption success on InstructS2S-Eval, while improving the speech-response score from 2.17 to 3.39 over Moshi. BayLing-Duplex also matches or surpasses its turn-based counterpart on Llama Questions, Web Questions, and Alpaca-Eval, showing that simultaneous listen-and-speak modeling does not sacrifice response quality.

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

SPI: Query-Depth-Adaptive Indexing for Streaming RAG in Vector Databases

Vector databases (VecDBs) are increasingly deployed in retrieval-augmented generation (RAG) pipelines where query processing and document ingestion occur concurrently. The index layer needs to provide low-latency search while incorporating new vectors without frequent global rebuilding. Existing VecDB pipelines typically operate within a uniform representation regime, despite substantial variation in the semantic granularity required across queries. This motivates an index design that supports incremental updates while adapting retrieval depth to query distribution and complexity. We propose Semantic Pyramid Indexing (SPI), a VecDB-layer indexing framework that organizes embeddings into $L$ semantically aligned resolution levels and selects retrieval depth per query via a lightweight uncertainty-aware controller. SPI supports progressive coarse-to-fine ANN search, level-wise streaming insertion without global rebuilds, and distributed execution through LSH partitioning with asynchronous gRPC coordination. Unlike hierarchical ANN structures with fixed traversal rules (e.g., SPANN), SPI adapts resolution at query time while remaining compatible with FAISS and Qdrant backends. On MS MARCO and Natural Questions, SPI achieves competitive Recall@10 with lower latency under the same dense encoder family, yielding a 1.4–2.3$\times$ average retrieval latency reduction under fixed Recall@10 targets relative to comparable approximate-ANN baselines. A prototype scaling study up to 8 nodes shows $6.2\times$ throughput scaling (${\approx}73\%$ efficiency); the 16-node configuration is included for completeness but shows diminishing efficiency. We provide a top-$K$ stability guarantee: queries with sufficient retrieval margin return an identical top-$K$ set at a shallower level. Code and configurations are available at https://github.com/FastLM/SPI_VecDB.

12.
arXiv (quant-ph) 2026-06-16

Neural network inverse design of nanophotonic scintillators

arXiv:2606.16309v1 Announce Type: cross Abstract: Scintillators are materials converting high-energy radiation into optical light, essential in a range of technologies such as medical imaging systems and security scanners. Scintillator development and optimization have remained limited by the complexity of their underlying physics, involving stochastic cascades of electron-electron, electron-phonon, and electron-photon interactions. Such processes are typically modeled by non-differentiable Monte Carlo simulations, limiting the applicability of machine learning for scintillator development. Here we present a physics-informed neural network that learns the scintillation cascade process from the incident high-energy particle to photon emission, substantially accelerating scintillator design and optimization. Combining this neural network with photonic simulations enables end-to-end differentiable optimization of the scintillator geometry. This allows us to optimize for arbitrary figures of merit, such as specific target emission patterns.. We demonstrate the concept and characterize it relative to previous approaches by inverse design of nanophotonic scintillators for X-ray imaging.

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

Decoupling Search from Reasoning: A Vendor-Agnostic Grounding Architecture for LLM Agents

Production LLM agents increasingly depend on real-time search, yet native search grounding bundles retrieval policy, provider choice, evidence injection, cost, latency, and generation behavior behind a single model-provider boundary. This coupling makes grounding hard to inspect, tune, reuse, or port, and can trigger Search-Induced Verbosity that breaks strict output contracts. We present Decoupled Search Grounding (DSG), a vendor-agnostic boundary that moves grounding outside the reasoning model through an MCP-compatible gateway, exposing provider routing, source-aware context rendering, configured fallback, retrieval-depth control, and exact plus semantic caching as first-class controls. Across five frontier models on SimpleQA, FreshQA, and HotpotQA, native search leads on recency-sensitive FreshQA, but DSG exposes a stronger frontier when control matters: on SimpleQA it nearly matches native accuracy (86.1% vs. 87.7%) at 91% lower search cost, preserves concise answer contracts, and reaches a 99.4% warm-cache hit rate with 68% lower latency. Deployed as a shared production grounding layer for large-scale agentic workloads with interchangeable models, DSG matches or slightly exceeds native-search accuracy on an e-commerce query-understanding (QIU) workload while cutting search cost by over 98%. Real-time grounding is best treated as an optimizable interface boundary, not a fixed model feature.

14.
arXiv (CS.LG) 2026-06-19

Phase Transition for Stochastic Block Model with more than $\sqrt{n}$ Communities

arXiv:2509.15822v3 Announce Type: replace-cross Abstract: Predictions from statistical physics postulate that recovery of the communities in the Stochastic Block Model (SBM) with a fixed number $K$ of communities is possible in polynomial time above, and only above, the Kesten-Stigum (KS) threshold. This conjecture has given rise to a rich literature, proving that non-trivial community recovery is indeed possible in SBM above the KS threshold. Failure of low-degree polynomials (LDP) below the KS threshold was also proven, as long as $K\ll \sqrt{n}$, where $n$ is the number of nodes in the observed graph. When $K\geq \sqrt{n}$, Chin et al.(2025) recently proved that, in a sparse regime, community recovery in polynomial time is possible below the KS threshold by counting non-backtracking paths. This breakthrough led them to postulate a new threshold for the many-communities regime $K\geq \sqrt{n}$. In this work, we provide evidence supporting their conjecture:\\ 1- We prove that, for any graph density, LDP fail to recover communities below the threshold postulated by Chin et al.(2025) ;\\ 2- We prove that community recovery is possible in polynomial time above the postulated threshold, not only in the sparse regime considered in Chin et al.~(2025), but also in moderately sparse regimes, by counting occurrences of some specific motifs inspired by the LDP analysis.\\ In particular, counting self-avoiding paths of length $\log(n)$, which is closely related to spectral algorithms based on the Non-Backtracking operator, is optimal only in the sparse regime. More complex motifs based on the blow-up of a cycle must be considered in denser regimes.

15.
arXiv (CS.AI) 2026-06-11

Carbon-Aware Governance Gates: An Architecture for Sustainable GenAI Development

arXiv:2602.19718v2 Announce Type: replace-cross Abstract: The rapid adoption of Generative AI (GenAI) in the software development life cycle (SDLC) increases computational demand, which can raise the carbon footprint of development activities. At the same time, organizations are increasingly embedding governance mechanisms into GenAI-assisted development to support trust, transparency, and accountability. However, these governance mechanisms introduce additional computational workloads, including repeated inference, regeneration cycles, and expanded validation pipelines, increasing energy use and the carbon footprint of GenAI-assisted development. This paper proposes Carbon-Aware Governance Gates (CAGG), an architectural extension that embeds carbon budgets, energy provenance, and sustainability-aware validation orchestration into human-AI governance layers. CAGG comprises three components: (i) an Energy and Carbon Provenance Ledger, (ii) a Carbon Budget Manager, and (iii) a Green Validation Orchestrator, operationalized through governance policies and reusable design patterns.

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

Trust but Verify: Mitigating Medical Hallucinations via Post-Hoc Adversarial Auditing and Multi-Agent Feedback Loops

arXiv:2606.14149v1 Announce Type: new Abstract: Large Language Models (LLMs) are increasingly deployed in healthcare settings, yet their tendency to hallucinate poses risks when clinical decisions are involved. This study examine whether LLMs recommend recently banned or withdrawn pharmaceuticals when answering clinical questions and tests an agent-based method for reducing such errors. We developed a five-agent "Trust but Verify" system using a single LLM backbone. To measure regulatory knowledge obsolescence, we created an adversarial dataset of 103 clinical MCQs where historically correct answers now refer to banned substances. This scale ensures statistical significance across various therapeutic classes. We evaluated three open-access model families (GPT-OSS, Llama-3, Falcon-3) under vanilla and agentic conditions. Performance was measured via pointwise score, label accuracy, Hallucination Error Rate (HER), and Component Fidelity (CF) score. We also observed clinical safety regression in proprietary models. In default configurations, all models showed high hallucination rates, consistently selecting banned drugs that matched training data patterns. Our proposed agentic architecture reduced HER by approximately 53% across models. Pointwise scores shifted from -0.25 (unsafe recommendation) toward 0.0 (appropriate refusal). The safety audit intercepted dangerous outputs even when models' parametric knowledge favored the banned substance. The proposed multi-agent framework offers a model-agnostic method for enforcing regulatory compliance that prioritizes patient safety over fluent text generation. Our work demonstrates a practical approach for deploying autonomous AI systems in safety-critical healthcare settings. It shows how real-time regulatory data can be integrated into LLM pipelines to support clinical decision-making.

17.
medRxiv (Medicine) 2026-06-11

Wealth-Related Inequalities in Cesarean Section Utilization Among Facility-Based Births in Bangladesh: Evidence from Public and Private Healthcare Facilities

Authors:

Background Bangladesh has experienced a rapid increase in cesarean section (CS) utilization over the past two decades. While previous studies have documented socioeconomic disparities in CS use, evidence on how wealth-related inequalities differ between public and private healthcare facilities remains limited. This study assessed the magnitude and drivers of socioeconomic inequality in CS utilization among facility-based births in Bangladesh. Methods We analyzed data from 3,008 facility-based births reported in the 2022 Bangladesh Demographic and Health Survey (BDHS). Survey-weighted multivariable logistic regression was used to identify factors associated with CS utilization. Wealth-related inequality was assessed using concentration curves and the Erreygers-corrected concentration index (ECCI). Regression-based decomposition of the standard concentration index was performed to quantify the contribution of socioeconomic, demographic, and healthcare-related factors to observed inequalities overall and separately for public and private facilities. Results Overall, 71.2% of facility-based births were delivered by CS, with substantially higher prevalence in private facilities (84.2%) than in public facilities (35.9%). Women delivering in private facilities had markedly higher odds of CS than those delivering in public facilities (adjusted odds ratio [AOR]: 9.07; 95% confidence interval [CI]: 7.17-11.47). Significant pro-rich inequality was observed overall (ECCI: 0.154; 95% CI: 0.117-0.191), with inequality substantially greater in public facilities (ECCI: 0.189; 95% CI: 0.114-0.264) than in private facilities (ECCI: 0.049; 95% CI: 0.014-0.084). Decomposition analysis showed that household wealth was the dominant contributor to inequality, particularly the richest wealth quintile, accounting for 81.5% of overall inequality, 63.8% in public facilities, and 109.7% in private facilities. Conclusions Wealth-related inequalities in CS utilization remain substantial in Bangladesh despite widespread use of the procedure. Although pro-rich inequality exists across both sectors, inequality is considerably greater in public facilities and is driven by different mechanisms across facility types. Policies should simultaneously improve equitable access to medically necessary CS and reduce unnecessary procedures, particularly within the private sector.

18.
arXiv (quant-ph) 2026-06-24

Faster algorithm for achieving minimal-size quantum decision diagrams

arXiv:2606.24789v1 Announce Type: new Abstract: The decision diagram (DD) data structure enables fast linear-algebra calculations by bringing vectors into a normal form and subsequently merging equivalent ones, yielding a minimally-sized DD modulo the equivalence relation. A fruitful application area is quantum-circuit simulation, where the vectors represent quantum states. The Local Invertible Map Decision Diagram (LIMDD) type, merges LIM-equivalent (typically Pauli-gate equivalent) vectors, can efficiently simulate Clifford circuits as well as some high-T-count circuits, and has theoretically been proven exponentially faster for simulation than other well-developed data structures, including other common DD variants. However, these exponential advantages have not fully materialized yet in existing implementations, for which the normal-form procedure, which is a highly complex algorithm, is either absent or only partially implemented. We here present a novel normal-form algorithm for Pauli-LIMDDs, achieving a worst-case speedup from $O(n^3)$ to $O(n^2)$ for an $n$-qubit DD node with a single child node while keeping the $O(n^3)$ run time in case of two distinct children nodes. We implement the algorithm as part of QolDDer, our Pauli-LIMDD simulator for quantum circuits, written from scratch in C/C++. The implementation realizes the theoretically-proven advantages of Pauli-LIMDDs on Clifford circuits, is significantly faster than the existing LIMDD simulators on such circuits, and on a public quantum-circuit data set often outperforms them by an order of magnitude. In the future, we envision that our work will enable further application and development of LIMDD variants, not only for quantum design tasks, but also for analysis of linear-algebra-based systems in general.

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

BioDivergence: A Benchmark and Evaluation Framework for Hidden Contextual Contradictions in Biomedical Abstracts

Biomedical findings often seem to conflict across studies, but many of these differences are context-dependent rather than true contradictions. Variations in cohort, geography, assay protocol, disease subtype, and clinical setting can make both claims locally valid. Existing NLI and scientific claim-verification benchmarks reduce such cases to entailment, contradiction, or neutral, failing to capture the contextual structure behind divergence. To address this, we introduce BioDivergence, an evaluation framework with a six-class conflict taxonomy, a 13-axis divergence ontology, and four structured outputs per claim pair: conflict type, divergence axes, dominant confounder, and reconciliation explanation. We release BioDivergence-Silver-v1.0, an article-disjoint silver benchmark of 11,865 claim pairs across five biomedical domains, alongside a legacy deduplicated variant for comparison. Results show notable ranking differences between the two variants, with the fine-tuned reference model dropping about 12 points under the article-disjoint setting, while Mistral-7B-Instruct-v0.3 achieves 0.5523 accuracy and 0.3894 contextual-F1 on the 842-example primary test set. BioDivergence offers a more faithful way to distinguish contextual divergence from direct contradiction and to separate article-level memorization from genuine task learning.

20.
arXiv (CS.CL) 2026-06-18

RECOM: A Validity Discrimination Tradeoff in Automatic Metrics for Open Ended Reddit Question Answering

Automatic metrics are the default for evaluating LLM-generated text, yet a metric is quietly asked to do two jobs: tell genuine content alignment from surface coincidence (validity), and tell a better system from a worse one (discriminative power). On open-ended, opinion-driven question answering, the two are in tension. We introduce RECOM (Reddit Evaluation for Correspondence of Models), a contamination-free evaluation dataset of 15,000 r/AskReddit questions (September 2025), each paired with its authentic community replies, which postdate every evaluated model's training cutoff. Scoring five open-source LLMs (7–10B) against every reply each metric paired with a random-derangement noise floor we find that no metric does both jobs well. Cosine similarity separates real from random answers (Cohen's $d \approx 2$) but cannot rank the five models ($|d| < 0.1$); BERTScore precision appears to rank the models (raw $|d|$ up to 0.63), but once response length is controlled this collapses to $|d| = 0.09$ and its validity is weak ($d \approx 0.8$, versus cosine's $\approx 2$). Because every metric scores the same outputs, this validity–discrimination tradeoff is a property of the metrics, not the models, and we argue it stems from representation design. Three independent LLM judges reproduce the validity gap and likewise separate the five models only weakly. We recommend reporting metrics on both axes, with an explicit random-baseline floor. RECOM is publicly available at https://anonymous.4open.science/r/recom-D4B0

21.
medRxiv (Medicine) 2026-06-15

Long-read sequencing enables high-accuracy mitochondrial heteroplasmy detection in Parkinson's disease

Background: Low-frequency heteroplasmic mitochondrial DNA (mtDNA) variants are associated with aging and neurological diseases, including Parkinson's disease (PD). Targeted deep mtDNA sequencing using PacBio HiFi long reads has the potential to resolve heteroplasmy across the full mitochondrial genome with high accuracy. Methods: To validate Vega PacBio sequencing for detecting mtDNA heteroplasmy, we analyzed four predefined mixtures of two mtDNA haplotypes. We generated a single long-range PCR amplicon covering the entire mitochondrial genome. These amplicons were mixed at predefined ratios (minor mixture haplotype component: 5%, 2%, 1%, and 0.1%). Variant calling was performed using Mutserve2, and accuracy was assessed by calculating the F1 score from comparisons between expected and detected variants. Full-length mtDNA PacBio sequencing was applied to investigate heteroplasmy across fibroblast passages derived from five LRRK2 p.Gly2019Ser variant carriers (n=3 affected with PD and n=2 unaffected carriers). Changes in mtDNA heteroplasmy level and variant load were assessed longitudinally using a linear mixed model. Results: The single-amplicon approach enabled full-length haplotype resolution without amplification bias associated with overlapping PCR strategies. The F1 score of the predefined mixtures was 1.0 for heteroplasmy levels between 5% and 1% and remained high (0.91) at 0.1%. We detected n=10/62 variants discordant with the Illumina reference at the 0.1% mixture, but sensitivity remained very high at 1.00 in that mixture. Detected minor variants closely matched expected heteroplasmy levels, with average variant levels of 0.057 (5%), 0.022 (2%), 0.011 (1%), and 0.001 (0.1%). Across twelve fibroblast passages, we observed fewer mtDNA heteroplasmic variants ({beta}=-3.2, p=0.026). Increased heteroplasmic variant load over time was also associated with older age ({beta}=1.50, p=0.001) and PD affection status ({beta}=5.0, p=1.0 x 10-4) in LRRK2 variant carriers. Notably, we observed distinct patterns of heteroplasmic variants that either increased or decreased in heteroplasmy level across passages. Conclusion: PacBio HiFi sequencing, combined with a single-amplicon strategy, enables accurate full-length mtDNA heteroplasmy detection and longitudinal analysis, providing a valuable tool for studying mitochondrial variation and dynamics in disease.

22.
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.

23.
medRxiv (Medicine) 2026-06-23

Innate immunity associates with protection from pneumococcal colonisation, but colonisation does not confer capsule-independent protection

Nasopharyngeal colonisation with Streptococcus pneumoniae is a prerequisite for transmission and disease and represents an important immunising event. While colonisation induces serotype-specific immunity, the mechanisms underlying heterologous protection remain unclear. We developed a controlled human infection model using pneumococcal serotype 15B and investigated colonisation dynamics, immunogenicity, and cross-protection against subsequent heterologous challenge with serotype 6B. Fifty-four healthy adults were intranasally inoculated with 15B at escalating doses. Colonisation rates peaked at 31.4% with 8 x 10 CFU per naris, lower than those historically observed with 6B and 3 strains. Density was also lower than previously observed with other strains. In vitro assays demonstrated that 15B adhered more readily to epithelial cells than 6B, but was less efficiently internalised, potentially reducing attack rates and colonisation density. Colonisation with 15B induced capsular polysaccharide-specific serum IgG, but baseline humoral immune measures did not predict protection from acquisition. Prior colonisation with 15B did not reduce acquisition of 6B upon re-challenge. Analysis of nasal microbiopsy samples revealed distinct innate activation signatures. Resistance to colonisation was associated with elevated baseline MIP-1 and MIP-1{beta} responses upon in vitro stimulation, whereas carriage was associated with enhanced chemokine and IL-6 responses. Local innate immune activation, rather than circulating antibody responses alone, may therefore contribute to colonisation control. We demonstrate that experimental colonisation with 15B does not confer heterologous protection against 6B and highlight the importance of mucosal innate immune conditioning in serotype-independent defence. Strategies enhancing nasal innate immune recruitment and activation may be required for broader protection against pneumococcal colonisation.

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

A Resource for Enthymeme Detection in Controversial Political Discourse

Enthymemes, arguments with unstated premises or conclusions, are pervasive in persuasive discourse, yet their annotation remains notoriously subjective. We present a resource of 1,482 tweets from politically controversial discourse, annotated by five annotators for the presence of enthymemes and their argument structure, designed to study label variation. We first revisit the definition of enthymemes and propose annotation guidelines anchored in Walton's argumentation schemes, offering a structured and constrained approach that nonetheless preserves room for the interpretive nature of the task. This contrasts with past resources, which tend to eliminate disagreement, obscuring its sources and preventing investigation of its potential benefits for model performance. We further propose a complexity analysis of the task, identifying where annotation imposes high cognitive load and may give rise to inconsistent annotation. Our preliminary experiments show that models trained on annotator disagreement outperform models trained on hard majority-vote labels. We close by reflecting on how structural openness in enthymeme definitions and guidelines enables the study of variation in subjective inferential processes for future resources and downstream NLP applications concerned with human inference.