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

Critical Percolation as a Synthetic Data Model for Interpretability

arXiv:2606.20347v1 Announce Type: new Abstract: Neural networks learn features that reflect the hierarchical, multi-scale structure of natural data. Synthetic datasets used to evaluate interpretability methods typically lack this structure, limiting their value as realistic toy models. To close this gap, we introduce a family of synthetic datasets consisting of hierarchical functions defined on critical mean-field percolation clusters embedded in a high-dimensional data space. The percolation data consists of sparse, low-dimensional fractal clusters with a power-law size distribution. Latent variables modeling a taxonomic hierarchy generate each data point's target value. The data model is analytically tractable with known critical exponents that fix its properties without requiring hyperparameter tuning. We leverage a mapping between percolation clusters, random trees, and additive coalescence to propose an almost linear-time algorithm to jointly sample a random tree and its hierarchical latent decomposition, enabling data generation at arbitrary scale. Using probing experiments, we find that the model's ground-truth latent variables can be linearly decoded from neural network activations. Together, sparsity, self-similarity, power-law statistics, and analytical tractability make critical percolation a principled testbed for interpretability research.

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

Neural Phase Correlation

Correspondence is fundamentally relational: it seeks the unknown transformation between two observations of a common scene, not the content of either. Yet the dominant learning-based methods do not represent the transformation as a first-class object in the architecture. They encode each image independently and let a learned similarity function or a deep decoder discover the mapping implicitly. Phase correlation is the canonical exception, measuring the inter-image relationship directly in the Fourier domain, but the rigidity of its fixed basis confines it to global translation. We introduce a learned generalization of phase correlation that lifts this restriction by learning the basis on which the transformation decomposes. The same algebraic primitive extends to dense non-rigid deformations and to unitary dynamics. On the ACDC cardiac-MRI benchmark the framework matches or exceeds prior published baselines on both registration directions. On CAMUS echocardiography it matches state-of-the-art without auxiliary scoring or adaptive-smoothness mechanisms. Applied to time-evolved wavefunction pairs of the 1-D quantum harmonic oscillator, the same framework recovers the Hermite-function eigenstates and the quantized energy levels of the unknown Hamiltonian from observation pairs alone.

03.
arXiv (math.PR) 2026-06-19

The t-Split Two-Periodic Aztec Diamond Model

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.

04.
arXiv (CS.LG) 2026-06-11

Holding the FP8 Quality Ceiling at 8-Bit Weights and Activations: INT8 and GGUF Post-Training Quantization of Ideogram 4.0 for Consumer GPUs

arXiv:2606.12280v1 Announce Type: new Abstract: Post-training quantization lets large text-to-image diffusion transformers run on consumer GPUs, yet the hardware-specific trade-offs are seldom measured directly. We quantize Ideogram 4.0 - a 9.3B flow-matching diffusion transformer (DiT), shipped as two separate-weight copies of a single-stream 34-layer backbone for classifier-free guidance and conditioned by a Qwen3-VL-8B encoder - for Ampere RTX 3090 GPUs, which lack FP8 tensor cores. Our INT8 W8A8 recipe (per-channel weights, per-token dynamic activations, SmoothQuant, and mixed-precision protection of a small high-fragility layer set) holds the FP8 quality ceiling: on a 200-prompt benchmark the paired same-seed bootstrap CI for INT8-FP8 includes zero on both Pick and CLIP, while INT8 improves on NF4 by $+1.9$ CLIP (95% CI $[+1.21,+2.64]$, excluding zero). A per-category OCR analysis, to our knowledge unreported for this model class, confirms text legibility is preserved, and an ablation isolates protection of the FFN down-projections as the dominant quality lever. Our GGUF Q4_K quantization beats NF4 at equal on-disk size and is the Pareto winner on the quality-memory frontier, with paired confidence intervals excluding zero (Q8_0 is quality neutral). Finally, we characterize where 8-bit quantization helps and where it does not: INT8's weights match FP8's footprint rather than shrink it, so a speed gain on Ampere awaits a fused INT8 kernel.

05.
arXiv (CS.LG) 2026-06-15

PCR-CA: Parallel Codebook Representations with Contrastive Alignment for Multiple-Category App Recommendation

arXiv:2508.18166v5 Announce Type: replace-cross Abstract: Modern app store recommender systems struggle with multiple-category apps, as traditional taxonomies fail to capture overlapping semantics, leading to suboptimal personalization. We propose PCR-CA (Parallel Codebook Representations with Contrastive Alignment), an end-to-end framework for improved CTR prediction. PCR-CA first extracts compact multimodal embeddings from app text, then introduces a Parallel Codebook VQ-AE module that learns discrete semantic representations across multiple codebooks in parallel – unlike hierarchical residual quantization (RQ-VAE). This design enables independent encoding of diverse aspects (e.g., gameplay, art style), better modeling multiple-category semantics. To bridge semantic and collaborative signals, we employ a contrastive alignment loss at both the user and item levels, enhancing representation learning for long-tail items. Additionally, a dual-attention fusion mechanism combines ID-based and semantic features to capture user interests, especially for long-tail apps. Experiments on a large-scale dataset show PCR-CA achieves a +0.76% AUC improvement over strong baselines, with +2.15% AUC gains for long-tail apps. Online A/B testing further validates our approach, showing a +10.52% lift in CTR and a +16.30% improvement in CVR, demonstrating PCR-CA's effectiveness in real-world deployment. The new framework has now been fully deployed on the Microsoft Store.

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

Towards Provably Fair Machine Learning: Bayesian Approaches For Consistent and Transparent Predictions

arXiv:2606.12615v1 Announce Type: new Abstract: ML classifiers deployed in high-stakes domains produce predictions whose quality varies systematically across subgroups. For granular subgroups defined by intersections of multiple features, predictions are often inconsistent with the observed data: the model's outputs contradict the evidence available for that subgroup. This problem is exacerbated by regularisation, which improves aggregate performance by collapsing small subgroups into larger groups, disproportionately affecting demographic minorities. We define two requirements for consistent prediction: determinism (identical individuals receive identical predictions) and statistical consistency (we cannot reject, at significance level alpha, the hypothesis that the predictions for a subgroup were drawn from the Bayesian optimal target distribution inferred for that subgroup). From these requirements we derive the Fair Bayesian classifier, which enforces both across every group and subgroup simultaneously and abstains whenever no consistent deterministic prediction is possible. On three benchmark datasets (Adult, COMPAS, and Bank Marketing), standard classifiers produce statistically inconsistent predictions for a substantial proportion of subgroups. Our classifier achieves zero consistency error by construction while exceeding baseline accuracy and multicalibration on every dataset tested. Statistical consistency provides a principled foundation for prediction quality with direct implications for algorithmic fairness. Minority demographics are disproportionately concentrated in small subgroups, precisely where frequentist inference is least reliable; addressing this inference problem is therefore a necessary step toward fair ML. By enforcing Bayesian consistency at the finest resolution the data supports, the our classifier demonstrates that exhaustive subgroup fairness with principled abstention is achievable in practice.

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

LLM Judges Have Dark Current: A Psychometric Datasheet for LLM-as-a-Judge Evaluation

LLM-as-a-judge systems are now routinely used for open-ended model evaluation, where human preference annotation is costly, slow, and difficult to reproduce. Yet these judges are often reported as scalar accuracy, win-rate, or agreement devices. We argue that a judge should instead be reported as a measurement instrument. We introduce a Judge Datasheet protocol that measures dark current under true-vacuum inputs, stable cross-sensitivity to same-quality surface variation, positional false preference, target sensitivity on a controlled quality ladder, and the criterion or operating point induced by tie instructions. The direction-stability decomposition reveals that apparent Delta0 preference can be stable surface response or disguised position bias. In a three-judge open-weight case study, Llama-3.1-8B shows high dark current and presentation-conflicted Delta0 behavior, Qwen2.5-14B is vacuum-clean and target-sensitive but mixes stable and positional over-discrimination, and Qwen2.5-32B is vacuum-clean with low stable cross-sensitivity and low positional false preference. A strict tie criterion eliminates Qwen32B Delta0 false preference but absorbs marginal Delta1 target signals into ties while preserving Delta5 sensitivity. The results show that prompting moves the criterion, not the resolution. We do not claim that the downstream mechanism hypothesis that motivated this work is confirmed; the contribution is a metrological protocol for measuring the measuring device before downstream claims are made.

08.
arXiv (CS.LG) 2026-06-19

A Solver-Free Training Method for Predict-then-Optimize

arXiv:2606.19587v1 Announce Type: cross Abstract: We propose a scalable method for training prediction (machine learning) models in the predict-then-optimize paradigm, where model outputs serve as coefficients for a subsequent linear optimization task. Directly minimizing the empirical decision regret is intractable for linear programming and combinatorial optimization since the decision mapping is piecewise constant, and the gradients are zero almost everywhere. While existing methods address this by smoothing the differentiation process, they suffer from scalability issues, since a computationally expensive solver call is required for every gradient evaluation. To address this, we propose a decision-focused learning pipeline based on a measure transformation principle, which yields a new surrogate loss that is completely optimization-solver-free during training. We establish theoretical guarantees, including Fisher consistency and excess risk bounds. Empirically, our method achieves decision quality competitive with state-of-the-art methods while reducing training time by orders of magnitude.

10.
arXiv (quant-ph) 2026-06-25

Recursive QLSTM with Dynamic Variational Quantum Circuit Adaptation

arXiv:2606.24932v1 Announce Type: new Abstract: Recent advances in quantum computing and machine learning have motivated the development of quantum models for sequential data processing. In this paper, we propose a Recursive Quantum Long Short-Term Memory model, or Recursive QLSTM, which extends QLSTM through metacore-based recursive constructions. We numerically test the model under different input sequence lengths, metacore designs, and recursive rules, and identify the best-performing architecture among these variants. For this selected model, we further provide theoretical arguments explaining why its recursive structure improves temporal information propagation and enhances learning performance. Our results suggest that Recursive QLSTM offers a flexible and effective framework for quantum recurrent learning over input time series of various lengths.

11.
Nature Medicine 2026-06-17

General-purpose chatbots outperform clinical AI tools on physicians’ real-world questions

作者: 未知作者

Specialized clinical AI tools are entering medical practice with little independent testing. In a head-to-head evaluation across two public benchmarks and real questions from physicians, three general-purpose frontier large language models outperformed two leading clinical AI tools, which performed no better than Google search AI overview.

12.
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/ .

13.
arXiv (CS.CL) 2026-06-25

RAS: Measuring LLM Safety Through Refusal Alignment

Safety evaluation of large language models (LLMs) is commonly performed by querying models with unsafe or jailbreak prompts and judging whether their outputs violate a safety policy. Although useful, output-level evaluation is expensive, sensitive to judge choice, and easily tied to fixed question banks. We propose **SafeVec**, a white-box evaluation procedure that measures safety from internal representations rather than generated answers. **SafeVec** first extracts layer-wise refusal directions from a safety-aligned reference model, then selects stable layer windows where safe and unsafe behaviors are separable, and finally scores a target model by measuring whether its hidden states align with these refusal directions under unsafe and jailbreak prompts. The resulting metric, **RAS** (**R**efusal **A**lignment **S**core), maps representation-level refusal alignment to a calibrated 0-100 safety score. Across `Llama`, `Gemma`, and `Qwen` model families, RAS separates aligned models from uncensored and abliterated variants, tracks output-level attack success rate, and is substantially faster than judge-based evaluation. These results suggest that refusal alignment provides a compact and efficient signal for white-box LLM safety evaluation.

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

STAR-NT: Spatiotemporal Acceleration of Real-Time Neural Transparency Rendering

arXiv:2606.16747v1 Announce Type: cross Abstract: Neural order-independent transparency delivers high-quality rendering of overlapping transparent surfaces, but its geometry passes and network input generation remain costly, particularly on mobile and legacy hardware. We present a spatiotemporal acceleration framework that exploits spatial and temporal coherence to reduce this overhead while preserving visual quality. Spatially, we use adaptive quadtree-based screen-space subdivision to scale geometry pass resolution according to local color variance. Temporally, selected frames reuse the previous transparency result through depth-based reprojection instead of full rendering. Together, these optimizations reduce rendering cost and integrate efficiently into existing real-time rendering pipelines.

15.
arXiv (CS.CV) 2026-06-12

What's Old is New Again: Classical Dimensionality Reduction for Efficient Saliency-Guided Biometric Attack Detection

Saliency-guided training is a paradigm in visual recognition that encourages models to focus on the most relevant image regions during learning. While its application in biometric presentation attack detection (PAD) has shown strong benefits in robustness and generalization, adoption is often limited by the high cost, domain specificity, and limited scalability of existing saliency acquisition methods, such as human annotations over a limited dataset. We present a novel, cost-efficient, and highly-scalable approach to saliency acquisition using maps inspired by classical dimensionality reduction techniques: PCA and LDA. Our proposed methods generate saliency maps directly from raw training data, requiring no human annotation nor domain knowledge. We contextualize the effectiveness of these saliency sources in three saliency-explored domains (iris PAD, synthetic face detection, fingerprint PAD) and demonstrate its scalability in two saliency-novel domains (fingerprint vein PAD and ID card PAD). Across all domains tested, models trained using dimensionality reduction-sourced saliency maps exceed baseline and sometimes SOTA saliency methods without any resource investment or domain-specific tooling. Our findings overcome an important yet unaddressed barrier to saliency-guided training for biometric attack detection and beyond.

16.
arXiv (CS.LG) 2026-06-19

Adversarial Dependence Minimization

arXiv:2502.03227v2 Announce Type: replace Abstract: Minimally redundant representations are typically learned by minimizing feature covariance. However, covariance-based methods fail to eliminate all dependencies/redundancies, as linearly uncorrelated variables can still exhibit nonlinear relationships. To address this, we introduce ADM, a differentiable algorithm that minimizes statistical dependence between feature dimensions through an adversarial game: auxiliary networks identify dependencies, while the encoder removes them. We prove that mutual independence is achieved at the global optimum, empirically verify convergence, and study three potential applications: extending PCA to nonlinear decorrelation, improving generalization in image classification, and preventing dimensional collapse in self-supervised learning. By promoting statistically independent representations, ADM paves the way for learning more robust, compressed, and generalizable representations across diverse applications.

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

Leave-One-Out-, Bootstrap- and Cross-Conformal Anomaly Detectors

arXiv:2402.16388v4 Announce Type: replace-cross Abstract: The need for uncertainty quantification in anomaly detection systems has become increasingly important. In this context, effectively controlling Type I error rates without inflating Type II error rates in these systems can build trust and reduce costs associated with false discoveries. The field of conformal anomaly detection emerges as a promising approach for providing respective statistical and finite-sample validity guarantees through model calibration. However, reliance on calibration data imposes practical limitations, especially in low-data regimes. In this work, we formally define and evaluate leave-one-out-, bootstrap-, and cross-conformal methods for conformal anomaly detection, building on methods from the field of conformal prediction. Looking beyond the classical split-conformal approach, we show that derived methods for calculating resampling-conformal $p$-values offer a practical compromise between the data efficiency of full-conformal (transductive) approaches and the computational efficiency of split-conformal (inductive) methods. We validate derived methods and quantify their improvements for a range of one-class classifiers and datasets.

18.
medRxiv (Medicine) 2026-06-10

A Three-Tier Operational Benchmark for Evaluating Large Language Models on Hospital Medication Safety

Objective. To introduce PsiBench, a clinically validated medication-safety benchmark for evaluating large language models (LLMs) against the standards used to certify hospital computerized provider order entry (CPOE) and electronic health record (EHR) systems, and a non-overlapping three-tier evaluation framework separating highest-stakes discrimination, the operational CDS regime, and category-correct alerting. Materials and Methods. PsiBench comprises 492 medication-safety scenarios across 11 safety categories, created by clinical pharmacology experts whose work underpins an annualized testing procedure used by more than 2,000 U.S. hospitals. The three-tier framework partitions the scenarios non-overlappingly: Discrimination (98 scenarios, 50 fatal vs 48 deception, near-balanced 51%/49%); Operational (394 scenarios, 261 serious unsafe plus 133 safe including 41 Excessive Alerts reclassified as operational negatives); and Attribution (311 alert-required scenarios). We evaluated 40 frontier LLMs from 10 providers over 3 runs per scenario at temperature 0.2 (or the provider default where temperature is not configurable), yielding 59,040 evaluations conducted April 21-23, 2026. Results. Headline binary performance on the full benchmark spans a wide range across the 40 models: F1 78.5%-92.3%, accuracy 65.4%-89.8%, sensitivity 81.4%-100.0%, specificity 6.1%-81.8%. Leading models by F1 (o4-mini 92.3%; o3 92.2%) pair high sensitivity with meaningful specificity; three models saturate sensitivity at 100% but fall below 25% specificity, indistinguishable from a naive always-alert classifier. The wide spread on a single headline metric motivates tier-specific analyses, developed in a separate clinical paper. Discussion and Conclusion. PsiBench and the three-tier framework operationalize a rigorous evaluation rubric for LLM medication safety, grounded in two decades of national hospital audit experience. The framework generalizes to any binary medication-safety classifier (rule-based, conventional ML, or LLM-driven), supporting tier-aware model selection and post-deployment surveillance.

19.
arXiv (CS.AI) 2026-06-17

Catastrophic Forgetting is Low-Rank: A Function-Space Theory for Continual Adaptation

arXiv:2606.18024v1 Announce Type: cross Abstract: Catastrophic forgetting in continual adaptation is usually studied through parameter drift, replay, or distillation, but these views do not identify which output-space directions are vulnerable. We give a function-space account in the NTK regime: new-task training induces old-task prediction drift through the cross-task kernel, yielding a closed-form predictor for the forgetting vector before any new-task gradient step. In frozen-backbone linear-head PEFT-CL, where the model is linear in the trainable parameters, the predictor is exact up to numerical precision; for nonlinear adapters/full fine-tuning, it is a local NTK approximation. The same expression reveals that forgetting concentrates in a small number of old-task NTK eigenmodes and under frozen linear heads gives a Kronecker scaling rule for the vulnerable rank. These results clarify the relation to prior NTK-overlap theory, explain why parameter-space regularizers can miss output-space interference, and motivate a targeted spectral regularizer.

21.
arXiv (quant-ph) 2026-06-11

Compressed minimum-purity time evolution for late-time quantum dynamics

arXiv:2606.11392v1 Announce Type: cross Abstract: Unitary time evolution of initially simple quantum many-body states rapidly generates entanglement and complex correlations, which limits direct numerical simulations. The late-time dynamics of physical observables, however, typically exhibits an effective simplicity in the form of hydrodynamics or kinetic theory. This leads to the question whether microscopic equations of motion can remain accurate and tractable up to long time scales by discarding irrelevant information in a controlled manner. Here, we introduce compressed minimum-purity time evolution (CoMPuTE) as an approach to keep track of a consistent set of reduced local density matrices, closing the hierarchical equations of motion using a minimum-purity principle. In benchmark applications we demonstrate (i) accurate description of energy diffusion in the one-dimensional mixed-field Ising model, (ii) the applicability to genuinely out-of-equilibrium Floquet dynamics starting from a pure state, and (iii) the limitations of the local reduced density matrix approximation when describing transport in the XXZ chain at $\Delta=1$ that is governed by increasingly non-local integrals of motion. The CoMPuTE method enhances computational efficiency in comparison to the closely related local-information time evolution algorithm, opening a possible route towards an extension to systems in higher spatial dimensions.

22.
arXiv (CS.CV) 2026-06-16

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

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.

23.
arXiv (math.PR) 2026-06-25

Dragon curves in Littlewood roots

arXiv:2606.25440v1 Announce Type: cross Abstract: A Littlewood polynomial is a polynomial whose coefficients lie in $\{- 1, +1\}$. While the majority of roots of a Littlewood polynomial of large degree are near the unit circle, numerical experiments suggest that when plotting the roots of all Littlewood polynomials of a given large degree, striking fractal structures appear away from the unit circle. These fractals resemble the attractor of a certain iterated function system and are known as dragon curves. In this note, we provide a rigorous explanation of this phenomenon, along with an analysis of a random variant, saying that such fractal behavior is typical.

24.
medRxiv (Medicine) 2026-06-10

Seasonality, source type, and women's water labor: A longitudinal mixed-methods study in Kenya and Honduras

Women shoulder the majority of water collection labor globally, yet how their water collection and water-related work experiences may change over time or by water source type remains insufficiently understood. We conducted a longitudinal, mixed-methods study in rural Kenya and Honduras to understand how women's experiences collecting water and performing water-related work varied between (a) two time points, (b) improved and unimproved water source types, and (c) water source location. Data were collected in 2023 and 2024 using interviews, observation, GPS-enabled watches, and scales to measure time and distance traveled, water weight and volume carried, and calories expended. 133 women participated in data collection (66 Kenya, 67 Honduras). We compared women's experience data by time point (2023 vs. 2024), source type (improved vs. unimproved), and source location (off-premises vs. on-premises) (t-test, Mann-Whitney U test). We also mapped participants' routes and activities to show which sources were visited, when, and for what activities. In Kenya, mean water collection time, distance, and caloric expenditure were significantly lower and water volume was significantly higher in 2024 when there were unexpected rains compared to 2023 when there was a persistent drought. When comparing source types during the 2023 drought, journeys to improved sources took significantly less time and energy and covered less distance than journeys to unimproved sources. These differences were not observed during the rainy conditions of 2024 when unimproved sources were closer and more accessible. In Honduras, water collection and water work burdens did not differ significantly by time point or source type. We found women with on-premises water access to still expend considerable time and caloric expenditure engaging in water work within their household compounds. Findings from Kenya suggest that water infrastructure improvements can reduce women's water collection burdens, though benefits may depend on and vary by season and source location. Findings from Honduras show that water labor does not end once water is in the household. Rather, substantial time and energy are expended carrying out water-related work even when sources are on premises, suggesting that efforts to assess water labor need to extend beyond collection alone. To meaningfully reduce burdens and ensure improved water sources are utilized during all seasons, initiatives need to consider source location, seasonal variability, and work beyond collection. Evaluations to assess infrastructure impacts on women's labor and well-being are needed and long overdue.

25.
medRxiv (Medicine) 2026-06-24

Risk factors for suicide and repeat self-harm: a cohort study of adults with hospital-presenting self-harm

Background:Previous self-harm elevates the risk of repeat self-harm and suicide, but the prognostic value of events and clinician observations around the index event is unclear. We evaluated established and exploratory risk factors for suicide and repeat self-harm among patients presenting to emergency psychiatric units after a suicide attempt or nonsuicidal self-injury (NSSI). Methods: Multicentre cohort study in Sweden (n = 804). Outcomes were suicide and repeat self-harm at 1-year and 5-year follow-up, ascertained through linked national registers. Established risk factors included psychiatric diagnoses, prior suicidal behaviour, and sociodemographic characteristics; exploratory factors comprised past-week self-reported symptom changes and clinician observations. LASSO-regularised Cox regression models were fitted for established (n=21) and exploratory (n=11) risk factors. Results: During five-year follow-up, 285 (35%) individuals had a new episode of self-harm and 41 (5%) died by suicide. No risk factors reached statistical significance for suicide, although male sex was retained after regularisation (1-year hazard ratio [HR] = 3.57 [95% CI 0-8.33]; 5-year HR = 2.5 [0.03-4.55]). Three established risk factors were significantly associated with repeat self-harm: psychiatric inpatient care in the three months before the index event (1-year HR = 1.85 [1.3-2.6]; 5-year HR = 1.72 [1.23-2.65]), previous suicide attempt (1-year HR = 2.01 [0.79-2.4]; 5-year HR = 2.19 [1.27-2.6]), and borderline personality disorder (1-year HR = 1.82 [1.13-3]; 5-year HR = 1.67 [0.14-2.75]). Among exploratory risk factors, clinician-observed hopelessness (1-year HR = 1.72 [1.1-2.3]; 5-year HR = 1.51 [1.03-1.91]) and personality disorder features (1-year HR = 1.48 [0.96-2.05]; 5-year HR = 1.47 [1.04-1.95]) were associated with repeat self-harm. Conclusions: Risk factor profiles for repeat self-harm were consistent at 1 and 5 years. Beyond established risk factors, clinician-observed hopelessness and personality disorder features emerged as markers of risk, suggesting that qualitative clinician assessments may yield prognostic information not available from medical records alone.