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01.
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.

02.
arXiv (quant-ph) 2026-06-24

Dimensionality Reduction of QAOA Parameter Space with Kernel PCA for Max-Cut

arXiv:2606.23718v1 Announce Type: new Abstract: The Quantum Approximate Optimization Algorithm (QAOA) is a leading variational algorithm for combinatorial optimization on near term quantum devices. As circuit depth increases, the number of optimization parameters grows, making the search landscape increasingly nonlinear and difficult to optimize. Previous studies have shown that optimal QAOA parameters often lie on a low dimensional manifold that can be approximated using Principal Component Analysis (PCA) at shallow circuit depths. However, the effectiveness of PCA decreases at higher depths because the underlying parameter manifold becomes increasingly nonlinear. In this work, we investigate Kernel Principal Component Analysis (KPCA) with a radial basis function kernel as a nonlinear dimensionality reduction technique for QAOA parameter optimization. The model is trained using 200 graphs from each of 3 graph families, namely Erdos-Renyi, Barabasi-Albert, and Watts-Strogatz, with graph sizes ranging from 7 to 10 nodes. Performance is evaluated on 30 test graphs containing 12 nodes at circuit depths 1, 2, 4, and 8. Experimental results demonstrate that KPCA consistently outperforms PCA at deeper circuit depths across all graph families. At depth 8, KPCA achieves approximation ratios above 0.86, while PCA declines to approximately 0.81 to 0.83. Both methods reduce the number of quantum circuit evaluations by more than 93 percent relative to unrestricted QAOA optimization. These findings suggest that nonlinear kernel methods more effectively capture the structure of the QAOA parameter manifold and provide a practical approach for scaling variational quantum optimization to deeper circuits.

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

CottonLeafVision: An Explainable and Robust Deep Learning Framework for Cotton Leaf Disease Classification

Globally, cotton is a highly economically beneficial crop, as the textile industry heavily depends on it. So, the precise identification and detection of cotton leaf disease is crucial for economic stability. The development goal of "CottonLeafVision" is to accurately classify and detect cotton leaf disease. With this goal, we have evaluated multiple pretrained Deep Convolutional Neural Networks, including DenseNet201, InceptionV3, and VGG19 on a publicly available cotton leaf disease image dataset. This image dataset includes seven classes, six disease classes, and one healthy class, collected under various field conditions reflecting real-world challenges. Among these pretrained models, with DenseNet201, we have achieved the highest classification accuracy of 98%. To enhance the model reliability and interpretability, we have implemented different techniques and methods such as Gradient-weighted Class Activation Mapping (Grad-CAM), occlusion sensitivity analysis and adversarial training to increase the noise resistance of the model. Finally, we have developed a prototype in order to utilize the model's capabilities on real life agriculture. This paper shows the deep learning model's capabilities to classify the disease in real-life cotton disease management situations.

05.
arXiv (quant-ph) 2026-06-12

Global Control with the Tavis-Cummings Interaction

arXiv:2606.12906v1 Announce Type: new Abstract: We study the controllability of a system of qubits under global control, where control pulses act identically on all qubits. Specifically, we consider a collection of qubits identically coupled to a single bosonic mode, or harmonic oscillator, via the Jaynes-Cummings interaction. This collective coupling, known as the Tavis-Cummings (TC) interaction, has been realized in several quantum computing platforms, including superconducting and atomic qubit systems. Although the qubits do not interact directly with one another, they can become entangled through their common coupling to the bosonic mode. We characterize the group of unitaries that can be implemented on the joint Hilbert space of the qubits and bosonic mode using the TC interaction together with a global $z$ field $J_z$, corresponding to identical z rotations on all qubits. We show that for n>2 qubits the set of realizable unitaries is restricted by an "accidental" symmetry of the TC Hamiltonian, distinct from its "standard" U(1) and permutational symmetries. On the other hand, we find that the Hamiltonian $J_z^2$ breaks this accidental symmetry and, together with the TC interaction and $J_z$, achieves semi-universality: it allows the implementation of arbitrary unitaries that respect permutational and U(1) symmetry, up to certain constraints on the center of the group. In a companion paper, we further analyze this remarkable accidental symmetry and show that it can be understood through Schwinger's bosonic model of angular momentum.

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

Mutual Distillation of Dual-Foundation Models for Semi-Supervised PET/CT Segmentation

Organ segmentation from PET/CT is critical for quantitative analysis and radiotherapy planning in oncology. To ease the high annotation cost of PET/CT segmentation, semi-supervised learning (SSL) provides a practical and effective solution for developing deep models with limited labeled data. Recent developments in visual foundation models have demonstrated remarkable adaptability with improved efficiency. In this work, we propose a mutual distillation framework that seamlessly exploits both structural and functional foundation models, which act as modality-specific generalists for distilling knowledge from structural CT and metabolic PET imaging. By bridging the gap between the task-specific precision of student models and the segmentation priors of generalist foundation models, we propose MuDuo, a mutual distillation framework that synergistically leverages SAM-Med3D for CT and SegAnyPET for PET to distill their knowledge into a lightweight student network. Our approach eliminates the need for manual prompts while maximizing the utility of unlabeled data for automatic segmentation, achieving state-of-the-art performance on the AutoPET dataset with only 5 labeled cases. Our source code is available at https://github.com/Wu-beining/MuDuo.

07.
medRxiv (Medicine) 2026-06-19

"Us with them": Co-designing a caesarean section consent and debriefing intervention in West Cameroon

Background Women-centred maternity care is a rights issue that determines the use of services. Such care ensures responsiveness to womens needs which is enacted through shared decision-making, review and response. In the West Region of Cameroon, informed consent (IC) and Debriefing for caesarean section (c-section) have been shown to be suboptimal or absent. This paper describes the participatory design of a quality-improvement hospital-based intervention. Methods From February to May 2025, we conducted a co-design process with three groups of stakeholders: 59 post c-section women and community representatives, 78 frontline c-section providers, and 29 directors of public and private hospitals. We followed four phases: planning, conducting, evaluating, and reporting. The conduct phase comprised five all-day workshops with post c-section women and community representatives, followed by five all-day workshops with the c-section providers. Finally, we held an 11th workshop with the hospital directors to scrutinize suggested interventions, evaluate their feasibility, and establish a consensus on their components. We described the intervention using the TIDieR (Template for Intervention Description and Replication) checklist. We documented the co-design process, using open-ended narratives to delineate interventions, and carried out real-time synthesis on visual aids (whiteboards and flipcharts). Intervention feasibility was quantified using a structured ad hoc matrix, while insights on facilitators and barriers were captured through qualitative free-text entries. We coupled data collection with constant comparison and triangulation through contemporaneous field notes, photographic documentation, and thematic mapping of stakeholders perceptions and interactive dynamics. Results Participants perspectives on the co-design were positive, and their motivation were very high although less than 50% reported previous involvement in co-design processes. More than 80% of participants found rated the co-design process as either good or very good. The final intervention comprised four components: (i) an in-service training; (ii) a standard operating procedure including a harmonised consent form and debriefing checklist; (ii) systematic supportive supervision, monitoring & evaluation; and (iv) a routine clinical audit. Each group of stakeholders upheld specific dimensions of the consent and debrief intervention. Post c-section women and community members emphasized emotional support, written discharge advice after debriefing, and zero tolerance of suboptimal consent and debriefing practices. Frontline c-section providers insisted on robust documentation for medico-legal protection. Hospitals Directors emphasized capacity-building and cultural friendliness. All the groups supported womans autonomous decision making. The intervention feasibility was rated high or very high by hospital directors except for the financial, infrastructural and technical domains. Conclusion This co-design process yielded a context-specific, multi-component intervention that was well accepted and deemed feasible across stakeholders. It provides a methodological approach to strengthening informed consent and debriefing as core elements of women-centred, accountable maternity care, and warrants implementation.

08.
arXiv (CS.LG) 2026-06-17

OmniPlan: An Adaptive Framework for Timely and Near-Optimal Network Planning Optimization

arXiv:2606.18105v1 Announce Type: cross Abstract: Network planning optimization is a fundamental problem across diverse domains, including transportation systems, communication networks, and power grids. It requires simultaneous optimization of multiple competing objectives under complex constraints. Existing network planning optimization frameworks rely on mixed integer programming (MIP) solvers, heuristics, and deep reinforcement learning (DRL) models to compute planning decisions. However, they lack effective adaptability to diverse and dynamic user intents, thus leading to the trade-off between execution time and optimality. In this paper, we propose OmniPlan, an adaptive framework that achieves both timeliness and near-optimality in network planning optimization. To achieve the adaptability lacking in existing solutions, OmniPlan employs a large language model (LLM)-based interpreter to convert heterogeneous natural-language intents into a unified and quantifiable user-preference vector. Then it employs a mixture-of-experts architecture that integrates MIP solvers, heuristics, and DRL models as specialized experts, where OmniPlan adapts to diverse intents by dynamically selecting timely and near-optimal experts. Finally, it incorporates a DRL-based expert configuration module that fine-tunes optimization objective weights to align planning decisions with user-specific preferences. We evaluate OmniPlan with a representative real-world workload, i.e., distributed machine learning (ML), where we leverage OmniPlan to offload a wide spectrum of ML inference tasks, e.g., decision trees, SVM, naive Bayes, XGBoost, and random forests, onto a network of hardware devices. Our experiments on a real-world testbed indicate that OmniPlan achieves near-optimal and low-execution-time offloading for real-world ML inference tasks, reducing latency by up to 97.8\% and network device resource consumption by up to 11.5\%.

09.
arXiv (CS.AI) 2026-06-12

Variational Learning for Insertion-based Generation

arXiv:2606.02133v3 Announce Type: replace-cross Abstract: Non-monotonic sequence generation methods, such as masked diffusion models, provide a flexible alternative to left-to-right autoregressive modeling by allowing tokens to be generated in non-fixed and prescribed orders. Despite their practical advantages, most existing non-monotonic models are order-agnostic and rely on a fixed-length grid, limiting their ability to support variable-length generation and adaptive insertion order. In this work, we introduce a probabilistic framework for learning insertion order in variable-length insertion models. We formalize a bijective correspondence between insertion trajectories and permutations, which enables an exact reparameterization of the data likelihood as a sum over permutations. Building on this result, we propose the Insertion Process (IP), a stochastic generative model that jointly learns where to insert, what to insert, and when to terminate, trained via permutation-based variational inference. Unlike prior fixed-canvas approaches, IP natively supports variable-length generation and learns data-driven preferences over insertion orders. Experiments on goal-conditioned planning and molecular string generation demonstrate that learning insertion order improves both modeling quality and generalization in domains without a canonical left-to-right structure.

10.
arXiv (CS.LG) 2026-06-19

Evaluating deep learning models for fault diagnosis of a rotating machinery with epistemic and aleatoric uncertainty

arXiv:2412.18980v2 Announce Type: replace Abstract: Uncertainty-aware deep learning (DL) models recently gained attention in fault diagnosis as a way to promote the reliable detection of faults when out-of-distribution (OOD) data arise from unseen faults (epistemic uncertainty) or the presence of noise (aleatoric uncertainty). In this paper, we present the first comprehensive comparative study of state-of-the-art uncertainty-aware DL architectures for fault diagnosis in rotating machinery, where different scenarios affected by epistemic uncertainty and different types of aleatoric uncertainty are investigated. The selected architectures include sampling by dropout, Bayesian neural networks, and deep ensembles. Moreover, to distinguish between in-distribution and OOD data in the different scenarios two uncertainty thresholds, one of which is introduced in this paper, are alternatively applied. Our empirical findings offer guidance to practitioners and researchers who have to deploy real-world uncertainty-aware fault diagnosis systems. In particular, they reveal that, in the presence of epistemic uncertainty, all DL models are capable of effectively detecting, on average, a substantial portion of OOD data across all the scenarios. However, deep ensemble models show superior performance, independently of the uncertainty threshold used for discrimination. In the presence of aleatoric uncertainty, the noise level plays an important role. Specifically, low noise levels hinder the models' ability to effectively detect OOD data. Even in this case, however, deep ensemble models exhibit a milder degradation in performance, dominating the others. These achievements, combined with their shorter inference time, make deep ensemble architectures the preferred choice.

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

Activation Functions, Statistics and Learning of Higher-Order Interactions in Restricted Boltzmann Machines

arXiv:2605.19178v2 Announce Type: replace-cross Abstract: The great success of neural networks primarily arises from the presence of the large number of weight parameters combined with nonlinearities in the input-output relationship of single neurons. In this work, we study the relationship between the statistical properties of the weights and the nonlinearity of the hidden unit in Restricted Boltzmann Machines (RBMs) on the one side, and the distribution induced on binary visible units. We do this for four commonly used activation functions: Linear, Step, ReLU, and Exponential, and make qualitative predictions about the ability of these models to learn distributions with strong higher order interactions over the visible nodes. We show that in general, in an ensemble of RBMs with Gaussian weights, these distributions are rare and hard to learn, except when the hidden unit activation function is an Exponential.

12.
Nature Medicine 2026-06-12

Efficacy and target engagement of dopamine agonist pramipexole for anhedonic depression: a randomized placebo-controlled trial

Anhedonia is a core and disabling symptom of mood disorders with limited treatment options. We evaluated the efficacy and safety of the dopamine agonist pramipexole in patients with mood disorders characterized by clinically significant anhedonia. In this single-center, randomized, double-blind, placebo-controlled trial, adults with major depressive disorder, dysthymia or bipolar depression and elevated Snaith−Hamilton Pleasure Scale (SHAPS) scores were assigned (1:1) to flexible dose, once-daily oral pramipexole as add-on treatment or placebo for 9 weeks. The primary outcome was change in SHAPS score from baseline to week 9. Analyses were conducted in the modified intention-to-treat population. Eighty-five participants were randomized, and 82 were included in the analysis. The primary outcome was met: pramipexole was associated with a greater reduction in SHAPS scores compared to placebo (mean difference: −4.04, 95% confidence interval: −6.89 to −1.18, P = 0.006, Hedges’ g = 0.62). Exploratory analyses indicated that pramipexole was associated with increased light physical activity and relative preservation of reward-related ventral striatal activation. Improvements in anhedonia were sustained during a 6-month open-label extension. Pramipexole was generally well tolerated compared to placebo. Pramipexole significantly improved anhedonia and showed a favorable safety profile, supporting its potential as an augmentation strategy in mood disorders. ClinicalTrials.gov identifiers: NCT05355337 and NCT05825235 . Pramipexole, in patients with major depressive disorder, dysthymia or bipolar depression, reduced Snaith−Hamilton Pleasure Scale scores significantly compared to placebo.

13.
arXiv (CS.CV) 2026-06-12

Why Commodity WiFi Sensors Fail at Multi-Person Gait Identification: A Systematic Analysis Using ESP32

WiFi Channel State Information (CSI) has shown promise for single-person gait identification, raising interest in its use for contactless biometrics, continuous authentication, and passive identification. However, the feasibility of multi-person identification on low-cost commodity devices remains unclear. A critical question is whether weak multi-person performance is primarily an algorithmic limitation, or whether it reflects a more fundamental sensing ceiling on commodity WiFi hardware. We address this question through a systematic empirical study using commodity ESP32 WiFi sensors. We evaluated six different signal separation methods–FastICA, SOBI, PCA-ICA, NMF, Wavelet, and Tensor decomposition–across seven scenarios spanning 1-10 people in both controlled and realistic indoor environments. To investigate beyond classification accuracy, we introduce three diagnostic metrics: intra-subject variability (ISV), inter-subject distinguishability (ISD), and performance degradation rate (PDR). In all methods, performance remains moderate (39%-56% accuracy), with limited evidence that algorithmic choice alone solves the problem. The best-performing method, NMF, reaches 56% accuracy, while all methods exhibit extremely high feature-space overlap (97%-99%), unstable within-subject representations, and marked environmental sensitivity. These findings suggest that, under commodity ESP32 CSI constraints, dense multi-person gait identification is limited more by sensing quality and spatial diversity than by the chosen separation algorithm. Our results have direct implications for security and privacy: they call into question the practicality of commodity WiFi CSI as a robust multi-user biometric primitive for authentication, while also placing important bounds on the passive identification capabilities achievable with low-cost off-the-shelf WiFi hardware.

14.
arXiv (CS.LG) 2026-06-18

Exponentially many initializations to avoid barren plateaus

arXiv:2606.18515v1 Announce Type: cross Abstract: Barren plateaus are stated as an average-case phenomenon: pick an ansatz, initialize it naively, and concentration follows. This has led to the common view that a potential cure for barren plateaus is simply to initialize the parameters more carefully. Here we show that the situation is subtler. We introduce a first-moment framework that gives a simple operator-level diagnostic for when an initialization may escape the fully concentrated barren-plateau fixed point, and for comparing the biases induced by different initialization strategies. Our framework recovers several known initialization schemes such as identity and Gaussian initialization, but also shows that barren-plateau avoidance is highly non-unique. Indeed, many shifted, biased, and non-symmetric parameter distributions can avoid concentration, and these choices need not be equivalent. In fact, our results show that one can generate exponentially many families of inequivalent initialization strategies. Then, our numerics indicate that different first-moment-distinct initializations can lead to different attained minima, suggesting that avoiding barren plateaus via smart initializations can trade the exponential concentration problem for the challenge of selecting the right trainable pocket amongst many options.

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

Physics-Distilled Neural Network enabled by Large Language Models for Manufacturing Process-Property Predictive Modeling

arXiv:2606.11605v1 Announce Type: cross Abstract: Predicting process-property relationships in manufacturing is often challenged by high experimental costs and the limited interpretability of complex 'black-box' models. This paper proposes a novel knowledge distillation framework designed to achieve high-accuracy predictions in data-scarce scenarios. The framework integrates analytical physics priors, which are systematically extracted from scientific literature via Large Language Models, into a privileged teacher model. We employ a Graph-Masked Attention layer to capture the complex physical dependencies among input variables showing strict setpoints or a combination of static and high-frequency temporal signatures. This privileged knowledge is distilled into a lightweight student predictor for inference. The feasibility and robustness of the framework are evaluated through a comprehensive experiment across five diverse manufacturing processes. To ensure statistical reliability, given the small dataset sizes, a repeated K-fold cross-validation technique is employed to quantify model stability and generalization. Results indicate that the proposed framework consistently achieves high predictive accuracy across all evaluated domains. Most importantly, the architecture demonstrates significant fault tolerance by maintaining robust predictive performance even in scenarios where LLM-derived analytical priors are suboptimal or incomplete. Furthermore, the student predictor achieves an inference frequency exceeding 6000 Hz, which facilitates real-time edge deployment on standard industrial hardware. This work provides a scalable solution for bridging the gap between theoretical physics and real-time industrial monitoring in data-limited environments.

16.
arXiv (CS.AI) 2026-06-24

Uncertainty-Aware Longitudinal Forecasting of Alzheimer's Disease Progression Using Deep Learning

arXiv:2606.24604v1 Announce Type: new Abstract: Longitudinal modelling of Alzheimer's disease progression is clinically useful only if it can describe not just the most likely next diagnosis, but how a patient may evolve over time and how reliable that forecast is. Most deep learning approaches reduce this problem to single-step classification, treating cognitively normal, mild cognitive impairment, and dementia as flat categories while providing limited insight into how uncertainty accumulates across future visits. We propose a probabilistic framework that combines ordinal diagnosis prediction, multi-horizon trajectory generation, and decomposed uncertainty estimation. A Temporal Fusion Transformer encoder is adapted with a CORAL ordinal output layer, asymmetric loss weighting, and converter oversampling to respect disease-stage ordering and improve sensitivity to MCI-to-dementia transitions. Conditioned on the learned patient-context representation, an autoregressive Mixture Density Network generates five-year probabilistic trajectories for diagnosis state, CDR Sum of Boxes, MMSE orientation, and hippocampal volume. On ADNI, the model outperforms linear, recurrent, and transformer baselines for next-visit diagnosis prediction, with the strongest gains on MCI-versus-dementia discrimination. Generated trajectories achieve near-nominal 90% credible interval coverage, widening uncertainty across the forecast horizon, and biomarker dynamics consistent with expected Alzheimer's disease progression. We further separate aleatoric from epistemic uncertainty using analytic mixture variance and a five-member bootstrap ensemble, which provides the strongest encoder diversity and output-level epistemic signal. Epistemic uncertainty is higher for rare progression archetypes, MCI and dementia patients, and under external evaluation on OASIS-3, where it increases alongside prediction error.

17.
medRxiv (Medicine) 2026-06-16

Exercise Training Improves Skeletal Muscle Insulin Sensitivity and Reprograms the Adipose Transcriptome in Heavier Monozygotic Twins

Exercise training improves skeletal muscle insulin sensitivity, yet its effects on white adipose tissue remain incompletely understood. We investigated how adiposity and exercise training influence insulin-stimulated glucose uptake in skeletal muscle and abdominal subcutaneous adipose tissue (ASAT), alongside adaptations in gene expression and DNA-methylation. Ten monozygotic twin pairs discordant for BMI underwent [18F]FDG-PET/CT imaging of skeletal muscle (vastus lateralis, VL) and ASAT during a euglycemic-hyperinsulinaemic clamp before and after six months of exercise training. VL and ASAT biopsies were analyzed using mRNA-sequencing and reduced representation bisulfite sequencing. Exercise training improved whole-body and VL insulin sensitivity in leaner and heavier co-twins (p

18.
arXiv (CS.AI) 2026-06-25

Evaluating Scene-based In-Situ Item Labeling for Immersive Conversational Recommendation

arXiv:2604.09698v2 Announce Type: replace-cross Abstract: The growing ubiquity of Extended Reality (XR) is driving Conversational Recommendation Systems (CRS) toward visually immersive experiences. We formalize this paradigm as Immersive CRS (ICRS), where recommended items are highlighted directly in the user's scene-based visual environment and augmented with in-situ labels. While item recommendation has been widely studied, the problem of how to select and evaluate which information to present as immersive labels remains an open problem. To this end, we introduce a principled categorization of information needs into explicit intent satisfaction and proactive information needs and use these to define novel evaluation metrics for item label selection. We benchmark IR-, LLM-, and VLM-based methods across three datasets and ICRS scenarios: fashion, movie recommendation, and retail shopping. Our evaluation reveals three important limitations of existing methods: (1) they fail to leverage scenario-specific information modalities (e.g., visual cues for fashion, meta-data for retail), (2) they present redundant information that is visually inferable, and (3) they poorly anticipate users' proactive information needs from explicit dialogue alone. In summary, this work provides both a novel evaluation paradigm for in-situ item labeling in ICRS and highlights key challenges for future work.

19.
medRxiv (Medicine) 2026-06-17

Cross-Device Adaptation of Mirai for Mammography-Based Breast Cancer Risk Prediction

Fine-tuning can adapt pretrained medical imaging models to new clinical datasets, but device-specific domain shifts may limit generalizability. We evaluated Mirai, a mammography-based deep learning model for breast cancer risk prediction, in a large screening cohort containing Hologic and General Electric (GE) full-field digital mammography systems, including GE Premium View (GE PV) and Tissue Equalization (GE TE) post-processing software. Native Mirai showed lower performance on TE images than on Hologic or PV images. Fine-tuning on TE images improved TE performance, particularly for short-term risk prediction, but substantially reduced performance on Hologic images, consistent with catastrophic forgetting. To mitigate this effect, we developed a device-invariant model using interleaved multi-device sampling and conditional adversarial training. This approach largely restored Hologic performance while maintaining improved TE performance, providing better robustness across heterogeneous imaging platforms. Comparison of cumulative and annual risk AUCs over a five-year time horizon further showed that performance gains were driven mainly by short- and intermediate-term predictions. These findings highlight both the value and dangers of device-specific fine-tuning and support balanced domain-adaptation strategies for deploying mammography-based risk models across diverse clinical imaging environments.

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

Scalar-Stepsize Nonuniform Monte Carlo Optimistic Policy Iteration: A Certified Counterexample

arXiv:2606.15978v1 Announce Type: new Abstract: Tsitsiklis proved convergence of Monte Carlo optimistic policy iteration under a uniform update structure and identified nonuniform update frequencies as a delicate obstruction. We give a certified negative answer for the natural scalar-stepsize, unnormalized asynchronous state-value recursion with fixed nonuniform state-selection probabilities. In a three-state, two-action discounted MDP, the nonuniform update frequencies induce a diagonally scaled greedy-policy mean field with a certified nonconstant attracting hybrid periodic orbit. With a bounded unbiased geometric-horizon estimator and Robbins–Monro stepsizes, the original stochastic recursion remains trapped near the cycle with positive probability and therefore fails to converge. The example pinpoints a geometric obstruction: uniform sampling gives radial residual contraction, whereas scalar nonuniform sampling anisotropically distorts the residual dynamics and can generate switched attracting cycles.

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

FedReLa: Imbalanced Federated Learning via Re-Labeling

Federated learning has emerged as the foremost approach for decentralized model training with privacy preservation. The global class imbalance and cross-client data heterogeneity naturally coexist, and the mismatch between local and global imbalances exacerbates the performance degradation of the aggregated model. The agnosticism of global class distribution poses significant challenges for data-level methods, especially under extreme conditions with severe class absence across clients. In this paper, we propose FedReLa, a novel data-level approach that tackles the coexistence of data heterogeneity and class imbalance in federated learning. By re-labeling samples with a feature-dependent label re-allocator, FedReLa corrects biased global decision boundaries without requiring knowledge of the global class distribution. This modular, model-agnostic approach can be integrated with algorithmic methods to deliver consistent improvements without additional communication overhead. Through extensive experiments, our method significantly improves the accuracy of minority classes and the overall accuracy on stepwise-imbalanced and long-tailed datasets, outperforming the previous state of the art.

22.
arXiv (quant-ph) 2026-06-25

Halo-Independent Quantum Sensor Probes of Low-Velocity Dark Matter

arXiv:2606.25129v1 Announce Type: cross Abstract: We present a halo-independent framework for sub-GeV dark matter (DM) direct detection using quantum sensors with sub-eV energy thresholds. Such detectors enable access to low DM velocities and may be sensitive to departures from the Standard Halo Model that are challenging to probe with conventional direct DM detection experiments. The method expresses the DM scattering event rate in terms of a detector and particle model-dependent response function, and a universal halo function common to all experiments to be determined from data. This allows the local DM velocity distribution to be constrained. As representative implementations, we consider TES (Al) and MKID (TiN)-like sensors and show that their differing material responses probe complementary regimes of the DM velocity distribution. Applying the framework to mock data derived from several benchmark local halo models, we demonstrate how the assumed halo function could be reconstructed. This framework demonstrates the potential of quantum sensors as a new avenue for mapping the local DM velocity distribution.

23.
arXiv (CS.CL) 2026-06-16

Emergent retokenization symmetry in large language models: phenomenology and applications

Tokenization introduces representational redundancy: under a fixed token vocabulary, every byte string admits many valid token encodings, or segmentations, that decode to the same surface string. However, given a prompt, most language model tokenizers break this representational symmetry by returning a canonical segmentation. Training only on canonical segmentations should influence inference behavior, and there is little reason to expect models to respect segmentation symmetry on downstream tasks. We find that this symmetry partially emerges during training. Here, we probe this emergent symmetry through experiments testing token compositional understanding, representation diversity, and task focused benchmark performance. We primarily use retokenization – replacing a prompt's canonical tokenization with an alternative segmentation while preserving its bytes exactly. Relative to other prompt perturbations, retokenization is unusually clean because it isolates segmentation effects without changing syntax, semantics or surface form. We use retokenization to study sensitivity and robustness to semantically identical input representations across pretraining and post-training. Moreover, this partial retokenization symmetry suggests a distinct inference-time sampling axis. While temperature sampling generates diverse outputs from the model using its next-token probability distribution, retokenization generates diversity from the model's internal computations through semantically equivalent input representations. We find that while this retokenization sampling strategy can hurt performance on easy problems, it can also recover solutions that conventional sampling does not find. Overall, our work presents retokenization as a simple yet powerful probe of large language models, shedding light on compositional understanding and prompt sensitivity, and offering a novel sampling strategy.

24.
arXiv (quant-ph) 2026-06-19

Quantum Batteries as Work Sources for Phase-Locked Parametric Amplification

arXiv:2606.20306v1 Announce Type: new Abstract: Quantum batteries have been proposed as locally precharged work sources for superconducting quantum technologies, suggesting a route to reduce continuously supplied microwave drives. Here we ask whether the pump tone of a quantum-limited parametric amplifier can be replaced, or strongly duty-cycled, by a finite bosonic quantum battery. Quantizing the pump of a nondegenerate parametric amplifier exposes a resource distinction hidden in the classical description: stored pump energy can generate signal-idler photons, but pump phase coherence is required to generate a phase-locked amplifier field. In a closed trilinear model, coherent and phase-randomized coherent pumps with the same photon-number distribution produce comparable pair numbers, yet only the coherent pump produces anomalous two-mode coherence and an EPR-squeezed interference dip. Including leakage, we collect the emitted fields into cascaded temporal modes. At matched collector bandwidth, the coherent pump gives \(I_{\min}^{(f)}=0.553\), whereas the phase-randomized pump gives \(I_{\min}^{(f)}=1.94\) at nearly identical collected energy. Weak amplitude squeezing slightly improves the dip by reducing finite-pump number fluctuations while preserving the coherent displacement. Thus battery-powered parametric amplification requires phase-coherent stored energy, possibly assisted by number-noise reduction, rather than stored energy alone.

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arXiv (CS.CL) 2026-06-17

VoidPadding: Let [VOID] Handle Padding in Masked Diffusion Language Models so that [EOS] Can Focus on Semantic Termination

MDLMs generate text by denoising a preallocated masked response canvas, making response-length modeling central to instruction tuning. Existing MDLMs often inherit the autoregressive convention of using repeated \texttt{[EOS]} tokens for padding during instruction tuning, giving \texttt{[EOS]} a dual role as both a semantic terminator and a padding token. We show that this dual role is a root cause of \texttt{[EOS]} overflow under large-block decoding. To decouple these roles, we propose VoidPadding, which introduces \texttt{[VOID]} for padding and reserves \texttt{[EOS]} for termination. During inference, the learned \texttt{[EOS]} signal enables early stopping, while the learned \texttt{[VOID]} signal guides adaptive response canvas expansion. On Dream-7B-Instruct, VoidPadding improves the block-size-averaged four-task mean across mathematical reasoning and code generation benchmarks by \(+17.84\) points over the original model and \(+6.95\) points over RainbowPadding, while reducing decoding NFE by 55.7\% on average. Code is available at https://github.com/Haru-LCY/VoidPadding.