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

Prediction Bottlenecks Don't Discover Causal Structure (But Here's What They Actually Do)

arXiv:2605.09169v2 Announce Type: replace-cross Abstract: A Mamba state-space model trained only for next-step prediction appears to recover Granger-causal structure through a simple readout $S = |W_{out} W_{in}|$, with early experiments suggesting the phenomenon generalized across architectures and benefited from interventional data at $p < 10^{-5}$. We package the protocol used to test that claim – standardized synthetic generators (VAR/Lorenz/CauseMe-style), three intervention semantics ($do(X=c)$, soft-noise, random-forcing), edge-provenance cards on three real datasets, and size-matched control arms – as a reusable falsification benchmark, and walk the claim through it in five stages. The method-level claim does not survive: (i) a plain linear bottleneck does as well or better; (ii) tuned Lasso beats the bottleneck on synthetic CauseMe-style benchmarks, and on Lorenz-96 (the only real benchmark with unambiguous ground truth) classical PCMCI and Granger lead a tight cluster in which the bottleneck trails; (iii) the headline intervention advantage is roughly 60% a sample-size confound, and the residual disappears under standard $do(X=c)$ interventions, surviving only under a non-standard random-forcing scheme; (iv) even that residual reproduces, with a larger effect, in classical bivariate Granger – the effect is method-agnostic. What survives is a narrow characterization result; the benchmark is the lasting artifact, and each stage above is one of its control arms.

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

Discriminative Span as a Predictor of Synthetic Data Utility via Classifier Reconstruction

In many real-world computer vision applications, including medical imaging and industrial inspection, binary classification tasks are characterized by a severe scarcity of positive samples. A widely adopted solution is to generate synthetic positive data using image-to-image transformations applied to negative samples. However, a fundamental challenge remains: how can we reliably assess whether such synthetic data will improve downstream model performance? In this work, we propose a geometry-driven metric that predicts the utility of synthetic data without requiring model training. Our approach operates in the embedding space of a pre-trained foundation model and represents the dataset through difference vectors between samples. We evaluate whether the weight vector of a linear classifier can be expressed within the subspace spanned by these variations by measuring the relative projection error. Intuitively, if the variations induced by synthetic data capture task-relevant directions, their span can approximate the classifier, resulting in low projection error. Conversely, poor synthetic data fails to span these directions, leading to higher error. Across multiple datasets and architectures, we show that this metric exhibits strong correlation with downstream classification performance of CNNs trained on mixtures of real negative and synthetic positive data. These findings suggest that the proposed metric serves as a practical and informative tool for evaluating synthetic data quality in data-scarce settings.

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

Long-Context Modeling via GSS-Transformer Hybrid Architecture with Learnable Mixing

Modeling long-range dependencies remains a central challenge in natural language processing. Transformer architectures achieve strong performance via self-attention but scale quadratically ($O(N^2)$) with sequence length, while State Space Models (SSMs) scale linearly ($O(N)$) but suffer from a selective recall bottleneck, struggling to retrieve precise information from compressed states. This creates a fundamental tradeoff between efficiency and perplexity. To tackle these challenges, we propose the Parallel Hybrid Architecture (PHA), which runs Gated State Spaces (GSS), Grouped Query Attention (GQA), and Feed-Forward Networks (FFNs) as independent parallel branches fused by a learnable mixing mechanism. Instead of forcing SSMs to approximate attention or serializing the two paradigms, PHA allows each branch to specialize: GSS captures global context, while attention performs selective retrieval, with FFN providing complementary processing. On WikiText-103, PHA achieves 16.51 PPL at 125M parameters, outperforming Hedgehog (16.70) and H3-125M (23.70). Scaling to 180M parameters yields 16.42 PPL, which gives comparable results with the pure attention baseline while delivering 24\% higher throughput and up to 40\% lower memory usage at long contexts. On OpenWebText, our 125M model achieves 19.72 PPL, outperforming standard Transformers (20.60) and GSS hybrid baselines (19.80). These results demonstrate that separating sequence modeling paradigms into parallel specialists enables Transformer-level perplexity with substantially improved efficiency for long-context language modeling.

05.
Nature (Science) 2026-06-10

Light-induced quantum friction of carbon nanotubes in water

Friction slows down moving objects at both macroscopic and microscopic scales1. At the electronic level, quantum friction describes direct transfer of momentum between a liquid and the electrons of a solid2. Owing to its microscopic nature, this phenomenon remains experimentally challenging to capture3. Here we show that near-infrared fluorescent single-walled carbon nanotubes (SWCNTs) exhibit light-induced quantum friction in water. It is measured by observing an excitation-power-dependent linear decrease of around 50% in the diffusion constants of functionalized SWCNTs in aqueous solution. This effect disappears when excitons are localized, as in the case of SWCNTs with quantum defects. We further show that the chemical manipulation of exciton concentration by molecules that increase or decrease SWCNT fluorescence also modulates the diffusion constant by up to a factor of 2. Optical pump terahertz (THz) probe spectroscopy shows an instantaneous response (around 30 cm−1) that we assign to direct exciton–water coupling in the range of water Debye modes. It is followed by an increasing (&gt;100 ps) response in the range of intermolecular translational modes of the hydrogen bond network of water (&gt;100 cm−1), resembling heating. Classical molecular dynamics simulations further support a mechanism in which the fluctuating dipole moments of excitons create frictional forces. These findings establish light-induced quantum friction between excitons in SWCNTs and water and show that electronic excitations can be used to control nanoscale motion and fluid properties. Near-infrared&nbsp;fluorescent carbon nanotubes exhibit light-induced quantum friction in water, in which exciton interactions slow nanoscale motion and enable optical control of diffusion and fluid dynamics.

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

LOCUS: Local Visual Cue Search for Enhancing Fine-Grained Perception in Multimodal Large Language Models

Multimodal Large Language Models (MLLMs) remain unreliable on fine-grained visual perception, even when high-resolution inputs preserve the necessary local details. We identify this limitation as visual context rot: decisive evidence may exist in the full image, yet fail to be reliably selected and used amid redundant visual context. We propose LOCUS (LOcal visual CUe Search), a training framework that teaches MLLMs to internalize local evidence search through a verifiable proxy task. During training, LOCUS provides a local crop as a visual cue and optimizes the model to recover its spatial support in the full image using an IoU-based reward. The visual cue is used only during training, leaving the standard image-question inference interface unchanged. Experiments across fine-grained perception, hallucination, general understanding, and reasoning benchmarks show that LOCUS improves localization-sensitive visual understanding while preserving broad capabilities. Attention analyses further indicate stronger focus on task-relevant evidence regions, suggesting that training-time visual cue search provides an effective route to internalized fine-grained evidence selection.

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

A Hybrid, Multi-Layered Pipeline for Phishing and Threat Classification: Independently Validated URL and NLP Engines with a Calibrated Multi-Channel Fusion Stage

Phishing is a multi-modal threat. We present a hybrid pipeline that scores each modality with its own engine and fuses the results. Three engines are built, deployed, and independently benchmarked: a four-stage URL stack (Domain Guard, lexical model, threat intelligence, and an asymmetric L2 fusion sidecar); a generalization-hardened DistilBERT NLP classifier whose held-out real-phishing recall rises from 0.8% to 87.3%; and a threat-intelligence synchronizer with end-to-end OpenTelemetry instrumentation confirming 1:1 message conservation. A decision-level fusion stage, characterized on a 10,677-email whole-system benchmark, reaches F1=0.914 with a calibrated probabilistic-OR over URL, header, and phishing-probability channels while reducing held-out real-spam false positives to 3.6%. Because that benchmark uses proxy URL and header channels and an operating point still needing recalibration, we present it as a preliminary integrated result. For deployable detection, the limiting factor is how well a model generalizes, not how accurately it scores data drawn from its own training distribution.

08.
arXiv (CS.LG) 2026-06-24

Density-Informed Pseudo-Counts for Calibrated Evidential Deep Learning

arXiv:2602.01477v2 Announce Type: replace-cross Abstract: Evidential Deep Learning (EDL) is a popular framework for uncertainty-aware classification that models predictive uncertainty via Dirichlet distributions parameterized by neural networks. Despite its popularity, its theoretical foundations and behavior under distributional shift remain poorly understood. In this work, we provide a principled statistical interpretation by proving that EDL training corresponds to amortized variational inference in a hierarchical Bayesian model with a tempered pseudo-likelihood. This perspective reveals a major drawback: standard EDL conflates epistemic and aleatoric uncertainty, leading to systematic overconfidence on out-of-distribution (OOD) inputs. To address this, we introduce Density-Informed Pseudo-count EDL (DIP-EDL), a new parametrization that decouples class prediction from the magnitude of uncertainty by separately estimating the conditional label distribution and the marginal covariate density. This separation preserves evidence in high-density regions while shrinking predictions toward a uniform prior for OOD data. Theoretically, we prove that DIP-EDL achieves asymptotic concentration. Empirically, we show that our method enhances interpretability and improves robustness and uncertainty calibration under distributional shift.

09.
arXiv (CS.CL) 2026-06-24

An Approach to Simultaneous Acquisition of Real-Time MRI Video, EEG, and Surface EMG for Articulatory, Brain, and Muscle Activity During Speech Production

Speech production is a complex process spanning neural planning, motor control, muscle activation, and articulatory kinematics. While the acoustic speech signal is the most accessible product of the speech production act, it does not directly reveal its causal neurophysiological substrates. We present the first simultaneous acquisition of real-time (dynamic) MRI, EEG, and surface EMG, capturing several key aspects of the speech production chain: brain signals, muscle activations, and articulatory movements. This multimodal acquisition paradigm presents substantial technical challenges, including MRI-induced electromagnetic interference and myogenic artifacts. To mitigate these, we introduce an artifact suppression pipeline tailored to this tri-modal setting. Once fully developed, this framework is poised to offer an unprecedented window into speech neuroscience and insights leading to brain-computer interface advances. The source code and data are available.

10.
arXiv (CS.CV) 2026-06-16

Differentiable Packing of Irregular 3D Objects with Adaptive Container Estimation

Most existing approaches either fix the container in advance or optimize only a single container dimension through an outer search loop, leaving the remaining dimensions as a manual tuning problem. We present a differentiable packing framework that jointly optimizes all 6N object pose parameters and all three container side lengths inside a single gradient-based loop. The formulation combines six physics-inspired, differentiable loss terms computed directly on triangle meshes through axis-aligned bounding-box proxies. An adaptive squeezing mechanism periodically tightens the container whenever the overlap loss falls below a pair-count-scaled threshold, producing a large initial drop in container volume, followed by small refinements. All pairwise computations are written in tensor-broadcasting form, giving a 3.4 to 54 times speedup over a reference loop-based implementation. The pipeline is implemented in Python and PyTorch, with no physics engine, FFT library, or convex decomposition. On multiple object categories, the method produces containers that are 11 to 32 percent smaller than time-matched DBLF and simulated-annealing baselines at N =100, while running in under 4 minutes per instance on a single consumer GPU.

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

Handling Feature Heterogeneity with Learnable Graph Patches

arXiv:2606.17667v1 Announce Type: cross Abstract: In recent years, the rapid development of foundation models and graph pre-training technologies has spurred increasing interest in constructing a universal pre-trained graph model or Graph Foundation Model (GFM). However, a significant challenge is that existing models are unable to address feature heterogeneity in graph data without textual information, which hinders the transferability of graph models across different datasets. To bridge this gap, we propose the concept of learnable graph patches, which we regard as the smallest semantic units of any graph data. We decompose the graph into learnable graph patches by unfolding the node features and constructing corresponding patch structures separately. We then design a framework that mines transferable information from graph data across domains. Specifically, after extracting graph patches, we propose a patch encoder to extract knowledge from each unit and a patch aggregator to learn how the units are combined into a whole. Due to its domain-agnostic nature, the model can be applied to downstream data across different domains. Furthermore, we analyze the connection between our method and existing graph models, as well as the transferability of the node embeddings it generates. Empirically, our method not only achieves the capability to use multi-domain graphs for pre-training, but also shows enhanced performance across various downstream datasets and tasks. Moreover, we observe consistent improvement in downstream performance as the volume of pre-training data increases.

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

DINO-Med3D: Bridging Dimension and Domain Gaps in Volumetric Segmentation via Progressive Adaptation

Although DINOv3 has demonstrated remarkable semantic discrimination in natural imagery, its direct application to volumetric medical segmentation is hindered by inherent dimension and domain disparities. To resolve these issues, we propose DINO-Med3D, a two-stage progressive framework that repurpose the pre-trained DINOv3 encoder for 3D medical tasks. In the first stage, we mitigate the dimension gap by introducing a multi-slice embedding module that incorporates pseudo-3D context, while simultaneously employing a segmentation proxy task to adapt representations learned from natural scenes to the medical domain. Subsequently, we further enhance volumetric understanding by adding lightweight 3D adapters into the frozen backbone to enforce global inter-slice continuity. Finally, to compensate for the spatial information loss inherent in the embedding process, we design a parallel detail recovery stream to explicitly preserve high-frequency boundary cues. Extensive experiments on five public datasets demonstrate that our approach successfully adapts DINOv3 to the medical domain and significantly outperforms state-of-the-art baselines.

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

Allure of Craquelure: A Variational-Generative Approach to Crack Detection in Paintings

Recent advances in imaging technologies, deep learning and numerical performance have enabled non-invasive detailed analysis of artworks, supporting their documentation and conservation. In particular, automated detection of craquelure in digitized paintings is crucial for assessing degradation and guiding restoration, yet remains challenging due to the possibly complex scenery and the visual similarity between cracks and crack-like artistic features such as brush strokes or hair. We propose a hybrid approach that models crack detection as an inverse problem, decomposing an observed image into a crack-free painting and a crack component. A deep generative model is employed as powerful prior for the underlying artwork, while crack structures are captured using a Mumford–Shah-type variational functional together with a crack prior. Joint optimization yields a pixel-level map of crack localizations in the painting.

14.
bioRxiv (Bioinfo) 2026-06-11

GeroEngine: Generative single-cell aging trajectories reveal a bidirectionally traversable identity core and direction-specific inflammatory remodeling

作者:

Single-cell RNA sequencing (scRNA-seq) maps aging tissues at high resolution but is destructive, preventing longitudinal tracking; dropout and zero-inflation artifacts, amplified by shift-invariant linear simulations, confound age-associated variability. We developed GeroEngine, a technical-artifact-aware framework combining VAE-based trajectory simulation, LOPO cross-validation, linear baselines, reverse traversal, and reverse-directed network inference. In microglia and HSCs, the VAE reduced technical-artifact carryover while preserving trajectory heterogeneity and improving alignment to artifact-reduced reference manifolds. Consensus GeroTargets and GeroRegulators defined tissue-specific GeroNetworks organized into three pillars: lineage/replication identity collapse, a sex-dimorphic endocrine/stress core, and inflammatory remodeling. Forward and reverse simulations aligned to the common young[-&gt;]old aging axis revealed a sign-coherent, direction-specific program: identity/replication targets were bidirectionally recovered, whereas MHC/NF-{kappa}B inflammatory programs were preferentially forward-recovered. These results support identity collapse as a deep traversable core of aging and nominate upstream homeostatic restoration over downstream inflammatory suppression.

15.
bioRxiv (Bioinfo) 2026-06-21

GENATATORs: ab initio Gene Annotation With DNA Language Models

Inference of gene structure and location from genome sequences - known as de novo gene annotation - is a fundamental task in biological research. However, sequence grammar encoding gene structure is complex and poorly understood, often requiring costly transcriptomic data for accurate gene annotation. In this work, we benchmark current solutions and develop new methods of gene annotation. We show that pretrained DNA language model (DNA LM) embeddings do not capture the features necessary for precise gene segmentation, and that task-specific fine-tuning remains essential. We comprehensively evaluate the impact of model architecture, training strategy, receptive field size, dataset composition, and data augmentations on gene segmentation performance. We revisit standard evaluation protocols, showing that commonly used per-token and per-sequence metrics fail to capture the challenges of real-world gene annotation. We introduce and theoretically justify new biologically grounded metrics, along with benchmarking datasets that better capture annotation quality. We show that fine-tuned DNA LMs outperform existing annotation tools, generalizing across species separated by hundreds of millions of years from those seen during training, and providing segmentation of previously intractable non-coding transcripts and untranslated regions of protein-coding genes. Our results thus provide a foundation for new biological applications centered on accurate gene annotation.

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

Navigating Distribution Shifts in Medical Image Analysis: A Survey

Medical Image Analysis (MedIA) has become indispensable in modern healthcare, enhancing clinical diagnostics and personalized treatment. Despite the remarkable advancements supported by deep learning (DL) technologies, their practical deployment faces challenges posed by distribution shifts, where models trained on specific datasets underperform on others from varying hospitals, or patient populations. To address this issue, researchers have been actively developing strategies to increase the adaptability of DL models, enabling their effective use in unfamiliar environments. This paper systematically reviews approaches that apply DL techniques to MedIA systems affected by distribution shifts. Rather than organizing existing methods by technical characteristics, we explicitly bridge real-world clinical constraints – such as limited data accessibility, strict privacy requirements, and heterogeneous collaboration protocols – with the technical paradigms able to address them. By establishing this connection between operational constraints and methodological evolution, we categorize existing works into Joint Training, Federated Learning, Fine-tuning, and Domain Generalization, each aligned with specific healthcare scenarios. Beyond this taxonomy, our empirical analysis suggests that, as domain information becomes progressively less accessible across these paradigms, performance improvements become increasingly constrained, and further uncovers a gradual shift in methodological focus from explicit distribution alignment toward uncertainty-aware modeling, ultimately pointing to the need for more deployability-aware design in real-world MedIA.

17.
arXiv (CS.CL) 2026-06-16

Connecting Speech to Words through Images

How can we learn the mapping between written words and their spoken counterparts in the absence of explicit textual supervision? We present a visually grounded method for building a vocabulary of spoken words using only images and their spoken descriptions. First, image captioning systems are used to build a vocabulary of written words representing salient visual concepts in the images. For each word, we then find utterances whose image captions contain that word. Then we use an unsupervised word discovery technique to align these utterances to locate instances of the target word. The result is spoken word segments that are linked to written words – all accomplished without any text supervision. In spoken word retrieval and keyword spotting experiments, the proposed approach outperforms a strong neural baseline while being more interpretable. These results demonstrate the feasibility of the approach in English and motivate future work on low-resource languages without transcripts.

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

Communication-Efficient Verifiable Attention for LLM Inference

arXiv:2606.16352v1 Announce Type: cross Abstract: Computation integrity of remote large language model (LLM) serving can be questionable. For conventional deep neural networks (DNNs), the existing TEE-shielded DNN partitioning (TSDP) approach uses Trusted Execution Environment (TEE) to compute non-linear components and verify the integrity of linear components offloaded to an untrusted GPU. However, directly applying TSDP to Transformer-based LLMs incurs significant TEE computation and TEE-GPU communication overhead. This paper presents Communication-efficient TEE-GPU Attention (\textsc{VeriAttn}) for accelerating verifiable LLM inference. \textsc{VeriAttn} offloads both linear and non-linear computations of attention to the GPU, while TEE performs verification. Moreover, for prefill, \textsc{VeriAttn} uses a two-level pipeline to overlap data movement, TEE pre-/post-processing, and GPU computation. For decoding, when the key-value cache exceeds available GPU memory, \textsc{VeriAttn} partitions attention across TEE and GPU to reduce repeated key-value transfers. Evaluation on an Intel TDX platform shows that \textsc{VeriAttn} achieves 2.60-3.38$\times$ and 3.86-5.42$\times$ acceleration over TSDP for 6k-token prompts and 10k-token outputs during prefill and decoding, respectively.

20.
arXiv (CS.CL) 2026-06-17

Top-Theta Attention: Sparsifying Transformers by Compensated Thresholding

We present Top-Theta (Top-$\theta$) Attention, a training-free method for sparsifying transformer attention during inference. Our key insight is that static, per-head thresholds can be calibrated to retain the desired constant number of significant elements per attention row. This approach enables content-based sparsity without retraining, and it remains robust across data domains. We further introduce compensation techniques to preserve accuracy under aggressive sparsification, establishing attention thresholding as a practical and principled alternative to top-k attention. We provide extensive evaluation on natural language processing tasks, showing that Top-$\theta$ achieves 3-10x reduction in V-cache usage and up to 10x fewer attention elements during inference while degrading no more than 1% in accuracy.

21.
arXiv (CS.AI) 2026-06-19

Overcoming Labelled Data Scarcity for Defect Classification in Scanning Tunneling Microscopy

arXiv:2506.01678v2 Announce Type: replace-cross Abstract: Scanning tunnelling microscopy (STM) is a powerful technique for imaging surfaces with atomic resolution, providing insight into physical and chemical processes at the level of single atoms and molecules. A regular task of STM image analysis is the identification and labelling of features of interest against a uniform background. Performing this manually is a labour-intensive task, requiring significant human effort. To reduce this burden, we propose an automated approach to the segmentation of STM images that uses both few-shot learning and unsupervised learning. Our technique offers greater flexibility compared to previous supervised methods; it removes the requirement for large manually annotated datasets and is thus easier to adapt to an unseen surface while still maintaining a high accuracy. We demonstrate the effectiveness of our approach by using it to recognise atomic features on three distinct surfaces: Si(001), Ge(001), and TiO$_2$(110), including adsorbed AsH$_3$ molecules on the silicon and germanium surfaces. Our model exhibits strong generalisation capabilities, and following initial training, can be adapted to unseen surfaces with as few as one additional labelled data point. This work is a significant step towards efficient and material-agnostic, automatic segmentation of STM images.

22.
arXiv (CS.CV) 2026-06-12

SAM-Deep-EIoU: Selective Mask Propagation for Multi-Object Tracking

Multi-object tracking has a heavy-tailed difficulty distribution: most frames are easy for a lightweight base tracker, while a small fraction are intrinsically hard. Video object segmentation (VOS) models can often preserve identity through the hard frames where the base tracker fails, but they are much more expensive in compute and memory. We propose selective mask propagation, a tracking algorithm that dispatches from a base tracker to a VOS model only on windows where an assignment-uncertainty signal fires. The base tracker's output is modified only when the VOS model makes a confident prediction that contradicts the base tracker's identity assignment; weak or inconclusive predictions preserve the base output. The method is training-free, treats both the base tracker and the VOS model as black boxes, and can benefit from replacing the VOS component with a more capable model. On DanceTrack, selective mask propagation improves three different base trackers. On SportsMOT, where identity preservation is central to sports analytics, SAM3-Deep-EIoU with global track association achieves state-of-the-art performance on the benchmark with 86.8 HOTA.

23.
arXiv (CS.CV) 2026-06-24

Trustworthy Image Authentication using Forensic Knowledge Graphs

Advances in generative AI have made image falsification highly realistic, demanding trustworthy authentication systems. Existing forensic detectors can target certain forgery types but lack interpretability, while vision-language models (VLMs) provide explanations but cannot exploit forensic traces for reliable detection. We propose Forensic Knowledge Graphs (FKGs), a unified framework that integrates forensic evidence extraction, structured reasoning, and human-interpretable explanation. Our FKG structure encodes forensic traces along with their causal dependencies and links to scene content. To generate accurate FKGs, we introduce a novel forensic authentication network and an Iterative Context Refinement strategy that guides VLMs to produce faithful, grounded explanations. We also present FKG-50K, a dataset of 50,000 realistic forgeries with ground-truth FKGs. Experiments demonstrate that FKG outperforms both forensic detectors and VLMs in detection, forgery identification and localization, and forensic justification.

24.
arXiv (quant-ph) 2026-06-17

Kinematic properties of the Pauli equation

arXiv:2606.17548v1 Announce Type: new Abstract: Based on the Wigner-Vlasov formalism, this paper investigates the kinematic properties of the Pauli equation. It is shown that the probability current associated with the Pauli equation can be represented as a superposition of two currents with certain expansion coefficients. Each of these currents corresponds to a particular component of the spinor. The expansion coefficients effectively serve as weighting functions that determine the probability contribution of the corresponding spinor component. Therefore, each spin projection corresponds to its own probability flux. A new system of the Hamilton-Jacobi equations and also a system of motion equations in electromagnetic fields are obtained, taking into account the interaction between the spin and the magnetic field. To illustrate how these equations can be applied we have investigated the quantum system kinematics in detail using an exact solution of the Pauli equation in the presence of a uniform magnetic field and an asymmetric quadratic potential.

25.
medRxiv (Medicine) 2026-06-11

A continental-scale scenario modelling framework for evaluating infant RSV immunisation strategies across Europe

Background. The recent approval of long-acting monoclonal antibodies (la-mAbs) and a maternal vaccine (MV) in the EU enables universal RSV prevention in infants. Modelling studies are widely used to quantify the population-level impact of alternative immunisation strategies. However, existing assessments of new RSV immunisation products focus on national or sub-national settings. Methods. We developed an age-stratified, stochastic compartmental model of RSV transmission for 28 EU/EEA countries. It combines literature-based parameters on RSV natural history and product efficacy with country-specific demographic and contact patterns. After model calibration against age- and country-specific RSV hospitalisation rates, we designed scenarios for both la-mAbs and MV at four coverage levels, with and without catch-up immunisation for infants under six months at season onset. We then evaluated each scenario against a no-immunisation baseline. Results. At 95% coverage, the cross-country median reduction in RSV hospitalisations over one season in infants under 12 months is 29.9% for la-mAbs (country median range: 27.7-33.9%) and 22.4% for MV (20.0-25.6%), scaling linearly with coverage. Out of all averted hospitalisations, 78.3% (90% CI: [67.3, 92.7]%) are concentrated in infants aged 0-2 months for la-mAbs and 72.7% (90% CI: [61.4, 88.6]%) for MV. A catch-up campaign nearly doubles the overall reduction in RSV hospitalisations. Conclusions. Despite country-specific heterogeneities, impact of la-mAbs and MV is comparable across settings and herd-immunity effects are largely negligible. This supports harmonised European guidelines on coverage targets. Seasonal catch-up campaigns emerge as an effective lever to maximise the impact of immunisation programmes.