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01.
bioRxiv (Bioinfo) 2026-06-14

TopoMIL: Topology Improves Multiple Instance Learning in Diagnostic Microscopic Images

Microscopic images of cells and tissues are central to disease diagnosis. In computational pathology, multiple instance learning (MIL) has emerged as a key paradigm for analyzing numerous images within a single patient sample. While the representative distribution of cells in a sample is important for diagnosis, existing MIL frameworks largely overlook it. We introduce TopoMIL, a framework that extracts the representative topological structure of the sample and integrates it into the MIL classifier. Three topological representations are assessed, each with distinct advantages and computational costs. We evaluate TopoMIL on four histopathology and cytomorphology datasets, each presenting unique challenges. Integrating the sample's topological information into MIL enhances classification across average, max, attention-based, and transformer pooling, yielding AUCROC gains of 3.3%, 4.2%, 5.9%, and 0.5%, respectively, with moderate computational cost. Our work underscores the potential of TopoMIL as a scalable extension to existing morphology-based models in computational pathology.

02.
arXiv (CS.CL) 2026-06-19

ReNikud: Audio-Supervised Hebrew Grapheme-to-Phoneme Conversion

Grapheme-to-phoneme (G2P) conversion for Modern Hebrew is needed for applications like text-to-speech (TTS), but is challenging due to the language's abjad writing system, which leaves vowels largely unwritten, creating substantial ambiguity. Standard approaches first predict vowel diacritics (nikud) to produce International Phonetic Alphabet (IPA) transcriptions, but this is limited: vocalization data is scarce and laborious to produce, it does not specify features such as lexical stress, and it reflects formal grammatical rules rather than everyday spoken pronunciation. Direct sequence-to-sequence IPA prediction, meanwhile, struggles on limited data and fails to exploit the character-level alignment characteristic of abjads. Our method, ReNikud, overcomes these limitations with two key insights: (1) Weak audio supervision via a phoneme-based automatic speech recognition (ASR) pseudo-labeling pipeline on thousands of hours of unlabeled Hebrew audio, yielding phonemic transcriptions that reflect natural spoken norms without manual annotation. (2) A pseudo-vocalization architecture that predicts IPA phonemes at each character position, enforcing character-level alignment as an inductive bias. Results on existing Hebrew G2P benchmarks and the new targeted MILIM benchmark for spoken Hebrew show that ReNikud surpasses previous state-of-the-art methods. We will release our code and trained models to support further work on Hebrew TTS and speech technologies.

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

Task-Aware Structured Memory for Dynamic Multi-modal In-Context Learning

Multi-modal large language models (MLLMs) depend on in-context learning (ICL) for rapid task adaptation, but their scalability is severely limited by finite context windows and the growing cost of key-value (KV) caches in long multi-modal sequences. Existing memory compression approaches typically rely on rigid token removal or sample-dependent importance estimation, which introduces bias, disrupts semantic structure, particularly for visual representations, and yields static memories that cannot adapt to new queries. We introduce TASM (Task-Aware Structured Memory), a training-free framework that addresses these limitations through task-aware, structure-preserving, and dynamically accessible memory construction. TASM employs task-vector guided compression to replace sample-specific signals with a task-level direction that captures shared relevance across demonstrations. To preserve the underlying manifold, it applies semantics-aware token merging via bipartite graph matching, aggregating tokens without destructive pruning. Finally, TASM structures memory into a hierarchy comprising a compact Core Memory and a Latent Bank, facilitating query-adaptive dynamic retrieval. Evaluations confirm TASM maintains high performance under heavy compression, effectively balancing efficiency with adaptability.

04.
arXiv (CS.CV) 2026-06-17

Bridging Modality Disconnect in Self-Reflection via Closed-Loop Visually Grounded Verification

In the era of Vision-Language Models (VLMs), enhancing multimodal reasoning capabilities remains a critical challenge, particularly in handling ambiguous or complex visual inputs, where initial inferences often lead to hallucinations or logic errors. Existing VLMs often produce plausible yet ungrounded answers, and even when prompted to "reflect", their corrections may remain detached from the image evidence. To address this, we propose the MIRROR framework for Multimodal Iterative Reasoning via Reflection On visual Regions. By embedding visual reflection as a core mechanism, MIRROR is formulated as a closed-loop process comprising draft, critique, region-based verification, and revision, which are repeated until the output is visually grounded. To facilitate training of this model, we construct **ReflectV**, a visual reflective dataset for multi-turn supervision that explicitly contains reflection triggers, region-based verification actions, and answer revision grounded in visual evidence. Experiments on both general vision-language benchmarks and representative vision-language reasoning benchmarks show that MIRROR improves correctness and reduces visual hallucinations, demonstrating the value of training reflection as an evidence-seeking, region-aware verification process rather than a purely textual revision step.

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

Separable Neural Architectures as Physical World Models: from Mathematical Theory to Applications

arXiv:2606.14934v1 Announce Type: cross Abstract: This work introduces the Separable Neural Architecture (SNA), a function representational class combining neural approximation with tensor decomposition. The SNA decouples localized coordinate functions (atoms) from global interactions governed by a sparse, low-rank interaction object. This architecture possesses a compact and smooth inductive bias well-suited for solving partial differential equations (PDEs). When viewed as a Galerkin trial space under the variational SNA (VSNA) framework, the formulation satisfies classical variational guarantees under Lax-Milgram: well-posedness, quasi-optimality, convergence, and stability. In high-dimensional spatiotemporal–parametric PDEs, the VSNA mitigates the curse of dimensionality by scaling algebraically rather than exponentially. Exploiting an entirely factorized, tensor-native alternating least squares (ALS) optimization framework reduces this cost to linear in dimension. The VSNA is validated across elliptic, hyperbolic, and parabolic systems, demonstrating close alignment with predicted algebraic and spectral scaling rates. We showcase the SNA as a "solve once, query anywhere" physical world model via two engineering case studies: a 7D parametric manufacturing simulation and an experimental thermal-to-property inversion pipeline for Inconel 718. The VSNA executes a 1,000,000-query Monte Carlo sweep in 102s on a standard laptop CPU, yielding a 150,000x speedup over a full-grid finite element baseline hosted on an NVIDIA A100 GPU. It further enables real-time generative inverse-mode reconstructions under 100ms. These results demonstrate that the SNA serves as a compact mathematical substrate for continuous parameter manifolds to enable real-time inversion, optimization loops, and rapid uncertainty propagation.

06.
medRxiv (Medicine) 2026-06-12

Opportunistic CKD Screening in Hospitalized Patients

Background. Chronic kidney disease (CKD) affects 10-13% of adults worldwide but remains largely undiagnosed until advanced stages. Hospitalization provides an opportunity for early detection through opportunistic urine albumin-to-creatinine ratio (UACR) measurement. Methods. We conducted a prospective three-arm study of opportunistic CKD screening in general internal medicine wards at Hadassah Mt. Scopus (MS), Hadassah Ein Kerem (EK), and Shaare Zedek Medical Center (SZMC) in Jerusalem (Protocol HMO-23-0300). Adult inpatients without known CKD or recent UACR were enrolled. Pathological UACR was defined as [≥]30 mg/g. Confirmed CKD required two pathological measurements [≥]90 days apart (KDIGO-compatible). eGFR was computed using the 2021 CKD-EPI race-free equation. Pooled proportions were estimated by fixed-effects logit meta-analysis; odds ratios by DerSimonian-Laird random-effects models. Results. A total of 158 patients were enrolled (MS n=50, EK n=57, SZMC n=51). Pathological first UACR was identified in 43/158 patients (27.2%; 95% CI 21.3-34.1%; I2=0% across centers). Of 24 patients with a second UACR available, 14 (58%) confirmed CKD, yielding a pooled confirmed-CKD rate of 8.9% of all screened patients. In-hospital mortality was significantly higher among patients with pathological UACR (9.3% vs ~2%; Fisher's exact p=0.012). In per-center multivariate logistic regression, three predictors reached pooled significance: BUN (OR 1.10 per mg/dL, 95% CI 1.04-1.17, p=0.002, I2=0%), heart failure (OR 3.21, 95% CI 1.34-7.70, p=0.009, I2=0%), and diabetes mellitus (OR 2.54, 95% CI 1.11-5.82, p=0.028, I2=17%). Cardiac/vascular admissions had the highest pathological UACR rate (~42%); GI/hepatic admissions had 0%. Conclusions. Opportunistic inpatient UACR screening identifies previously unrecognized CKD in approximately 9% of general internal medicine patients, with consistent results across three independent centers. BUN elevation, heart failure, and diabetes are the strongest independent predictors. Pathological UACR carries significant short-term mortality risk, supporting integration of routine screening into inpatient care pathways.

07.
arXiv (CS.CV) 2026-06-19

SurgVista: Long-Horizon Surgical World Modeling with Plausible Instrument-Tissue Dynamics

Scaling robot policy learning for autonomous surgery is challenging, as expert demonstrations are expensive and in vivo exploration poses substantial safety risks. Surgical world models address this by generating realistic, action-conditioned future frames from an initial observation, but existing methods exhibit two persistent failure modes: spatial interaction incoherence, where visible instrument contact fails to induce spatially consistent tissue deformation, and temporal fidelity collapse, where prediction errors compound across autoregressive rollouts and progressively corrupt visual quality. We present SurgVista, a surgical world model that mitigates both failures through two training recipes. Deformation Consistency Regularization extracts scene-point trajectories from training videos and enforces cross-frame coherence through latent contrastive learning, strengthening physically consistent instrument-tissue dynamics. Drift Adaptation Training mitigates long-horizon drift by perturbing conditioning frames with online prediction residuals and photometric augmentations calibrated to long-horizon drift statistics, sustaining visual fidelity over extended rollouts. To enable rigorous evaluation, we further introduce SurgWorld-Bench, featuring diverse procedure types, long-range rollouts, and decoupled metrics for instrument-motion accuracy and tissue-response fidelity. Extensive experiments show that SurgVista consistently outperforms state-of-the-art methods across visual quality, temporal consistency, and interaction fidelity, with gains widening as the prediction horizon grows.

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

QuantKAN: A Unified Quantization Framework for Kolmogorov Arnold Networks

arXiv:2511.18689v3 Announce Type: replace Abstract: Kolmogorov–Arnold Networks (KANs) replace linear weights with spline-based functions, offering strong expressivity but posing challenges for low-precision deployment due to heterogeneous parameter distributions. We introduce QuantKAN, the first unified framework for quantization-aware training (QAT) and post-training quantization (PTQ) of KANs. The framework employs branch-aware quantizers for base and spline parameters and extends modern QAT and PTQ methods to spline-based layers across EfficientKAN, FastKAN, PyKAN, and KAGN. Experiments on MNIST, CIFAR-10/100, TinyImageNet, and ImageNet provide the first unified QAT/PTQ KAN benchmarks and show that DSQ is the most robust QAT method at aggressive low-bit settings, while GPTQ is the strongest PTQ method at moderate precision. Sensitivity analyses reveal architecture-specific failure modes: spline/basis parameters dominate in FastKAN, while base or scaling parameters dominate in EfficientKAN, GRAM, and PyKAN. Vivado HLS estimates on a Xilinx UltraScale+ device further suggest up to 3.32$\times$ throughput and 7.7$\times$ lower estimated dynamic energy per inference under W4A4, exposing a residual basis-evaluation tax that motivates basis-aware microarchitecture. QuantKAN is available at https://github.com/OSU-STARLAB/QuantKAN/.

09.
arXiv (CS.CV) 2026-06-15

Giving AI a Headache: Acoustic Adversarial Attacks to Computer Vision Applications

Artificial Intelligence (AI) is increasingly used to automate a variety of real-world computer vision (CV) applications, such as autonomous vehicle control, facial recognition, and security cameras. Recent research has shown that acoustic vibration can induce real physical motion in cameras, interfering with their internal stabilization mechanisms. Because the motion falls outside the conditions the stabilization system was designed to handle, the system introduces artifacts into the frame, causing AI-based CV models to misclassify, miss targets, or hallucinate objects. Previous work used ultrasonic frequencies (>20 kHz) to perform short-range attacks, which limits them to short distances due to the attenuation exhibited by high frequencies. In this work, we investigate acoustic attacks using lower frequencies in the audible range (

10.
medRxiv (Medicine) 2026-06-22

Paired plasma and EV-enriched plasma proteomics reveal nonredundant sepsis-associated host-response signatures in critical illness

Background: Plasma proteomics may identify host-response signatures in sepsis, but it is unclear whether extracellular vesicle (EV)-enriched plasma provides distinct or redundant information compared with plasma. We compared paired plasma and EV-enriched plasma proteomes in critically ill patients with sepsis and critically ill non-sepsis controls (CINS). Methods: In this prospective observational study, paired plasma and EV-enriched plasma samples were analyzed from 56 critically ill adults, including 40 patients with sepsis and 16 CINS patients. Protein abundance was quantified using liquid chromatography-tandem mass spectrometry. Analyses compared proteomic depth, protein overlap, global concordance between compartments, and differential protein abundance between CINS and sepsis. Exploratory Gene Ontology enrichment was performed as a supplementary analysis. Results: EV-enriched plasma expanded proteomic detection, identifying 2,476 filtered proteins compared with 506 in plasma. Only 386 proteins were detected in both compartments, while 2,090 were unique to EV-enriched plasma and 120 were unique to plasma. Among shared proteins, plasma and EV-enriched plasma showed modest global concordance across critically ill patients (Spearman coeff = 0.322, p = 9.19 x 10^-11), with similar findings in sepsis alone. Differential abundance analysis identified 11 sepsis-associated proteins in plasma and 22 in EV-enriched plasma. Only SAA1, SAA2, and IGFBP6 were significant in both compartments. Exploratory pathway analysis supported acute-phase and inflammatory enrichment in plasma sepsis-associated proteins, while EV-enriched signals were directionally plausible but did not meet prespecified FDR thresholds. Conclusion: Plasma and EV-enriched plasma proteomics capture related but nonredundant sepsis-associated host-response information in critically ill patients.

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

ZeSTA: Zero-Shot TTS Augmentation with Domain-Conditioned Training for Data-Efficient Personalized Speech Synthesis

arXiv:2603.04219v2 Announce Type: replace-cross Abstract: We investigate the use of zero-shot text-to-speech (ZS-TTS) as a data augmentation source for low-resource personalized speech synthesis. While synthetic augmentation can provide linguistically rich and phonetically diverse speech, naively mixing large amounts of synthetic speech with limited real recordings often leads to speaker similarity degradation during fine-tuning. To address this issue, we propose ZeSTA, a simple domain-conditioned training framework that distinguishes real and synthetic speech via a lightweight domain embedding, combined with real-data oversampling to stabilize adaptation under extremely limited target data, without modifying the base architecture. Experiments on LibriTTS and an in-house dataset with two ZS-TTS sources demonstrate that our approach improves speaker similarity over naive synthetic augmentation while preserving intelligibility and perceptual quality. Audio samples are available on our web page.

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

Entanglement Detection by Approximate Entanglement Witnesses

arXiv:2402.14755v2 Announce Type: replace Abstract: The problem of determining whether a given quantum state is separable is known to be computationally difficult. We develop an approach to this problem based on approximations of convex polytopes in high dimensions. By showing that a convex polytope constructed from a finite number of hyperplanes approximates the Euclidean ball arbitrarily well in high dimensions, we find evidence that a finite set of approximate entanglement witnesses is potentially sufficient to determine the entanglement of a state with high probability.

13.
arXiv (CS.AI) 2026-06-17

Geometry-Aware Post-Hoc Uncertainty Quantification in Operator Learning

arXiv:2606.17513v1 Announce Type: cross Abstract: Neural operators provide fast surrogates for PDEs but their deterministic predictions limit their use in tasks requiring uncertainty quantification (UQ), especially under geometric variability. Existing approaches primarily model uncertainty in network parameters, largely overlooking the geometry-aware representations learned by the operator itself. We propose REEF-GP (Residual on Embedded Features Gaussian Process), a post-hoc UQ framework that fits a GP to the residuals of a frozen neural operator whose internal embeddings define the kernel feature space. Rather than learning a separate feature map, REEF-GP adapts the operator's intrinsic coordinate-feature representations to construct geometry-aware uncertainties. To ensure stability and scalability on unstructured domains, REEF-GP incorporates spectral-normalized projections, heteroscedastic geometry-aware noise, and efficient subset-based training that avoids restrictive low-rank approximations. Across five PDE benchmarks with varying geometries, REEF-GP preserves predictive accuracy while achieving calibrated uncertainty estimates competitive with deep ensembles but at a fraction of their cost. Our approach remains robust under geometric distribution shift, with uncertainty concentrating in physically meaningful regions (e.g., shock fronts). Our results demonstrate that accurate and scalable post-hoc UQ for neural operators can be achieved directly in their learned feature space, offering a practical alternative to parameter-centric approaches.

14.
arXiv (CS.CV) 2026-06-15

What Drives Test-Time Adaptation for CLIP? A Controlled Empirical Study from an Update Perspective

Vision-Language Models (VLMs) such as CLIP have become a standard backbone for open-vocabulary recognition, yet their zero-shot predictions remain vulnerable to distribution shifts encountered at deployment. Test-Time Adaptation (TTA) has recently been extended to CLIP as a lightweight solution, leading to a rapidly growing body of TTA4CLIP methods. However, empirical progress in this area has largely outpaced our understanding of what truly drives adaptation, where their gains originate, and under which shifts they remain reliable. In this paper, we take a step back from the pursuit of state-of-the-art accuracy and conduct a systematic controlled study of TTA4CLIP. We first organize existing methods into three unified paradigms according to what is updated at test time. We then introduce TTABC, an open-source TTA Benchmark for CLIP, which standardizes evaluation protocols and integrates more than 20 representative methods. Our controlled empirical analysis focuses on three key areas. First, we determine the driving factors in parameter-based methods, revealing that adaptation gains are primarily driven by test-time evidence and reliable proxies rather than heavy optimization. Second, we explore evidence utilization beyond heavy parameter tuning, showing that competitive and efficient performance can be achieved through cross- or current-sample evidence and lightweight prototype updates. Finally, we demonstrate that there is no silver bullet for TTA: no single adaptation paradigm is universally optimal, and the preferred paradigm depends on the nature of shift. We hope our benchmark and study provide a clearer understanding of the current TTA4CLIP landscape and establish a foundation for further research.

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

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

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

16.
arXiv (math.PR) 2026-06-16

The Winner Takes It All

arXiv:2606.16885v1 Announce Type: cross Abstract: The winner-takes-all (WTA) process takes place on an arbitrary graph. There is an agent on each vertex of the graph, and active agents at neighboring vertices play games. In each game, a randomly chosen agent wins, while the loser is eliminated from subsequent games. The games are played at random times; each game finishes instantaneously, and the games cease when each active agent has only losers among its neighbors. On the one-dimensional lattice, the fraction of winners in the final state is $e^{-1}$, and we also determine the fractions $w_j$ of winners who won $j=0, 1, 2$ games. For the WTA process on a segment, we determine statistics of the total number of winners (the average, the variance, and all higher cumulants), the probabilities of reaching the final state with the minimum or maximum number of winners, and establish the behavior near the boundaries. For infinite regular trees with vertices of degree $d$, i.e., Bethe lattices with coordination number $d$, the fraction of winners is $(2/d)^{d/(d-2)}$.

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

Afrispeech Semantics: Evaluating Audio Semantic Reasoning in Spoken Language Models Across Domains and Accents

Audio language models (ALMs) are increasingly used for speech-based understanding, yet their ability to perform semantic reasoning beyond transcription, Text-to-Audio Retrieval, Captioning, and Question-Answering accuracy remains insufficiently benchmarked. In particular, the effects of accent variation, domain shift, and semantic over-inference on audio reasoning are poorly understood. We evaluate audio language models across five semantic and paralinguistic reasoning tasks: entailment, consistency, plausibility, accent drift, and accent restraint. Collectively, these tasks assess a model's ability to reason over spoken audio as the primary evidence source, including whether a textual hypothesis can be inferred, contradicted, or left undetermined by the audio, whether statements align or conflict with spoken content, whether claims are plausible given the discourse, and whether model predictions remain stable or appropriately constrained across accent variation. These findings highlight critical limitations in current audio reasoning evaluations and hope to provide guidance for more robust and equitable ALM design and assessment

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

Grids Often Outperform Implicit Neural Representations at Compressing Dense Signals

Implicit Neural Representations (INRs) have recently shown impressive results, but their fundamental capacity, implicit biases, and scaling behavior remain poorly understood. We investigate the performance of diverse INRs across a suite of 2D and 3D real and synthetic signals with varying effective bandwidth, as well as both overfitting and generalization tasks including tomography, super-resolution, and denoising. By stratifying performance according to model size as well as signal type and bandwidth, our results shed light on how different INR and grid representations allocate their capacity. We find that, for many tasks involving dense signals, a simple regularized grid with interpolation trains faster and to higher or comparable quality than any INR with the same number of parameters. We also find limited settings – namely fitting binary signals such as shape contours – where INRs outperform grids, to guide future development and use of INRs towards the most advantageous applications.

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

SED:Lightweight Saliency prediction for Event-based data via Distillation

Event-based saliency prediction has gained attention recently, as combining event cameras with saliency estimation can act as an upstream stage that naturally improves the efficiency of downstream eventbased perception at the edge. However, current approaches are either neuromorphic, underperforming on event-based saliency benchmarks, or too heavy for resource-constrained edge applications due to their reliance on transformers or 3D convolutions. Drawing inspiration from efficient convolutional modules, SED and aiming to exploit the temporal information in event data, we propose a lightweight network, trained through knowledge distillation, built on a Depthwise Spatio-Temporal Block (DSTconv) – a factorization of the 3D depthwise separable convolution. Relative to its teacher, our model reduces the model size from 180 MB to 0.32 MB (562x) and the parameter count from 45M to 81k (554x), while matching or outperforming it on the N-DHF1K and N-UCF Sports datasets. Moreover, it generalizes strongly beyond its training distribution, transferring from synthetic to real event data where a model trained from scratch fails.

20.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

22.
arXiv (quant-ph) 2026-06-16

Watching a Superconducting Coplanar Waveguide Heat Up with a Single Color Center

arXiv:2606.15398v1 Announce Type: new Abstract: Single color centers in diamond offer a local probe of their cryogenic environment, providing a direct way to quantify heating in spin-control hardware. Here, we establish a single spectrally stable tin-vacancy (SnV) center as an on-chip thermometer for a diamond membrane and use it to characterize microwave- and radio-frequency-induced heating in a superconducting coplanar waveguide patterned on the same chip. We first calibrate the temperature dependence of the optical C-transition frequency and linewidth from $20\,\mathrm{K}$ down to the few-kelvin regime. At lower temperatures, where the optical response becomes weakly temperature dependent, we use the spin-lattice relaxation time $T_1$ as a complementary thermometer and tune its sensitivity with the transverse magnetic-field component. Applying this local thermometer to a niobium coplanar waveguide, we observe magnetic-field-dependent superconducting breakdown under GHz drive, accompanied by abrupt heating of the diamond. In contrast, at $20\,\mathrm{MHz}$ and $400\,\mathrm{mT}$, relevant for nuclear-spin control, we detect no measurable heating up to the breakdown threshold of $9.4\,\mathrm{dBm}$, corresponding to $B_\mathrm{ac}\sim1.2\,\mathrm{mT}$. These results define a safe operating window for superconducting microwave and RF control structures in diamond-based quantum nodes.

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

Pre-AF 13: An Interpretable Atrial Fibrillation Risk Score Mined from Discharge Reports

Background. Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a major determinant of prognosis. Established AF risk scores rely on factors (older age, hypertension) nearly ubiquitous among patients with cardiovascular disease (CVD), offering limited stratification in this high-risk group. Most target long-term (5-10 year) rather than medium-term prediction. We developed interpretable ML models predicting AF risk over a 24-month and entire follow-up horizon in CVD patients using routinely collected hospital data. Methods. Single-center retrospective study of electronic health records from the National Research Cardiology Center (Russia) for patients aged >=18 with CVD but without pre-existing AF, hospitalized more than once between January 2012 and May 2019. A custom NLP pipeline transformed unstructured discharge reports into 73 structured features, combining a rule-based parser with transformer-based NER. Using LightAutoML we built a full model (73 features), a simple model (reduced subset), and a linear model for a bedside risk score. Performance was assessed by ROC AUC, compared with CHARGE-AF, C2HEST, MHS, and HAVOC, and interpreted via SHAP. Results. Of 80,576 records from 45,000 patients, 17,562 met inclusion criteria; 1,438 (8.19%) developed AF. The full model reached ROC AUC 0.735 (24-month) and 0.696 (entire follow-up); the simple model was nearly identical (0.725, 0.696). All non-linear models outperformed the four clinical risk scores (ROC AUC 0.53-0.64). The simple model uses 13 features and is named Pre-AF 13. SHAP identified age and left atrial volume as dominant predictors. A linear risk score (Pre-AF 9) stratified observed 24-month AF incidence from ~7% to 36%. Conclusion. Interpretable ML models built from routinely collected EHR data identify high-AF-risk CVD patients, outperforming established clinical risk scores.

24.
arXiv (CS.CV) 2026-06-11

Natural-Language Temporal Grounding in Hour-Long Videos is a Search Problem: A Benchmark and Empirical Decomposition

Temporal grounding–returning the interval $[t_s, t_e]$ for a natural-language query over a video–is the language interface to long-form video, yet has been studied on short videos; the dynamics of hour-scale natural-language grounding remain underexplored. We take the position that at hour-scale, the binding constraint is search, not recognition: Video-LLMs are bottlenecked not by localizing a nearby event, but–given a natural-language query–by searching for the relevant region of a long video. To test this, we release ExtremeWhenBench, the first open hour-scale grounding benchmark (2,273 queries over 194 videos, mean 75.7 min, max 9 hr) with an open-form query distribution. Every open Video-LLM collapses while a frame-level retrieval baseline outperforms them; a failure taxonomy attributes 85% of failures to search; and a retrieve-then-ground hybrid recovers 6.7x over the monolithic Video-LLM–mirroring retrieve-then-read in open-domain QA.

25.
arXiv (CS.CV) 2026-06-17

MLLMs Get It Right, Then Get It Wrong: Tracing and Correcting Late-Layer Textual Bias

When vision contradicts text, multimodal large language models (MLLMs) consistently favor text, even when images provide clear evidence otherwise. This bias poses risks for applications requiring visual grounding, yet its cause remains unclear. In this paper, we uncover a surprising finding: models often get it right initially, forming correct vision-based predictions in their intermediate layers, before changing their minds and favoring text in the final output. We call this "late-layer textual override". The visual information is encoded, it simply does not survive to the output. More intriguingly, we find that how predictions change reveals whether they're correct: 85% of failures shift toward text, while 89% of successes shift toward vision. This directional signature enables a simple but powerful intervention: when we detect a confident visual prediction being suppressed, we restore it. We propose CALRD (Conflict-Aware Layer Reference Decoding), a training-free method that recovers overridden predictions at inference time. Experiments across five MLLMs of varying architectures demonstrate up to 9.4% absolute improvements on conflict benchmarks while largely preserving standard performance, without training or external knowledge. It recovers what the model already knew but failed to preserve.