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01.
arXiv (CS.CL) 2026-06-11

The Periodic Table of LLM Reasoning: A Structured Survey of Reasoning Paradigms, Methods, and Failure Modes

Large Language Models (LLMs) have achieved strong performance across natural language processing tasks, yet reliable reasoning remains an open challenge. Although modern LLMs show progress in structured inference, multi-step problem solving, and contextual understanding, their reasoning behavior is often inconsistent and sensitive to prompting strategies, task design, and model scale. This survey provides a systematic analysis of more than 300 recent papers from arXiv, Semantic Scholar, Google Scholar, Papers with Code, and the ACL Anthology to examine how reasoning capabilities emerge in LLMs and where they fail. We make three main contributions. First, we introduce a structured taxonomy of LLM reasoning research, covering Chain-of-Thought reasoning, multi-hop reasoning, mathematical reasoning, common sense reasoning, visual and temporal reasoning, code and algorithmic reasoning, retrieval-augmented reasoning, tool-augmented and agentic reasoning, and reinforcement learning-based reasoning. Second, we analyze methodological trends across these paradigms, including prompting methods, model architectures, training objectives, reward modeling, and evaluation benchmarks. Third, we synthesize recurring limitations and failure modes, such as reasoning hallucinations, brittle multi-step inference, weak causal abstraction, and poor cross-domain generalization. By organizing a rapidly expanding literature, this survey offers a unified view of the current capabilities and limitations of reasoning in LLMs. We also identify emerging research directions, including meta-reasoning, self-evolving reasoning frameworks, multimodal reasoning, and socially grounded reasoning. Overall, this work aims to serve as a reference for developing more robust, interpretable, and generalizable reasoning systems in future language models.

02.
arXiv (CS.CV) 2026-06-16

Variational Test-time Optimization for Diffusion Synchronization

Collaborative generation, which coordinates multiple diffusion trajectories to extend the capabilities of pretrained priors, has emerged as a powerful paradigm for extending the applicability of diffusion models. Among existing approaches, diffusion synchronization provides a scenario-agnostic solution by introducing general guidance mechanisms. However, current synchronization approaches rely heavily on heuristics and still require task-specific tailoring, which limits their generalizability and performance. In this work, we mathematically derive a synchronization framework based on optimal control, providing a principled explanation of diffusion synchronization. During sampling, we optimize control variables to guide multiple trajectories toward coherent solutions while remaining close to the underlying diffusion prior. Our method operates entirely at test-time without additional training, thereby enabling broad applicability across diverse generation scenarios when combined with strong pretrained priors. We demonstrate consistent improvements over baselines on three representative collaborative generation tasks, covering a wide range of modalities and applications. Beyond performance gains, our work establishes a novel foundation for collaborative generation, opening a principled path toward extending pretrained generative models to new collaborative generation settings.

03.
arXiv (CS.LG) 2026-06-17

Learning in Matching Games with Bandit Feedback

arXiv:2506.03802v2 Announce Type: replace Abstract: We introduce a learning problem in a generalized two-sided matching market, where agents select actions to interact with their match. Specifically, we consider a setting in which matched agents engage in zero-sum games with initially unknown payoff matrices, and we investigate whether a centralized procedure can learn an equilibrium from bandit feedback. We adopt the solution concept of a matching equilibrium, where a matching \( \mathfrak{m} \) and a set of agent strategies \( X \) form an equilibrium if no agent has an incentive to deviate from \( (\mathfrak{m}, X) \). To quantify deviations of a candidate solution \( (\mathfrak{m}, X) \) from the equilibrium \( (\mathfrak{m}^\star, X^\star) \), we introduce the notion of matching instability, which serves as a regret measure for the learning problem. We propose a UCB-based algorithm in which agents form preferences and select actions according to optimistic estimates of the payoffs. Our analysis establishes a sublinear, instance-independent regret upper bound, further supported by empirical evidence.

04.
arXiv (quant-ph) 2026-06-11

Lowest order Carleman linearization for low Reynolds long-term behaviour of fluid flow simulations

arXiv:2605.23380v2 Announce Type: replace Abstract: It is shown that the lowest (second) order truncation of the Carleman linearization of the fluid equations (C2) recovers the late stage of the evolution, namely the steady-state solution, although to a decreasing degree of accuracy at increasing Reynolds number. This asymptotic property is first proved analytically for the decaying logistic with external forcing and then shown to hold to a significant degree of accuracy also for the more complex case of two-dimensional Kolmogorov-like fluid flow at low Reynolds numbers, below $Re \sim 10$. This time-asymptotic property may open interesting prospects for the quantum simulation of low-Reynolds steady-state fluid flows.

05.
arXiv (CS.LG) 2026-06-19

EQPO: Equitable Group Relative Policy Optimization for Clinical Reasoning

arXiv:2510.19893v2 Announce Type: replace Abstract: Medical AI systems demonstrated impressive diagnostic performance, yet they routinely show uneven accuracy across demographic groups, disadvantaging underrepresented populations. Although multimodal reasoning foundation models have pushed clinical diagnosis forward, reinforcement learning-based post-training tends to absorb and magnify the biases present in majority-dominated training corpora. We propose Equitable Group Relative Policy Optimization (EQPO), a hierarchical reinforcement learning method that encourages balanced learning across heterogeneous clinical populations by adaptively reweighting samples according to subgroup representation, task difficulty, and data source. As demographic annotations are frequently missing in real-world clinical data, EQPO additionally applies unsupervised clustering to recover latent subpopulations when they are unavailable. On 7 diagnostic benchmarks covering 5 modalities (X-ray, CT, dermoscopy, mammography, ultrasound), EQPO reduces F1 standard deviation by 43.9% and the maximum cross-group F1 gap by 42.7% on QoQ-Med3-8B over vanilla GRPO, and narrows predictive parity gaps by 27.2% on MedGemma-4B over bias-mitigated RL baselines while raising F1 by 12.5% even without any demographic labels. Examining the training trajectory shows that EQPO steadily improves fairness over the course of optimization, in contrast to baseline methods whose fairness degrades as training proceeds, and the discovered implicit groups remain stable and align with masked demographic attributes. We further release EquiMedGemma-4B and EquiQoQ-Med3-8B, equitability-aware clinical VLLMs that attain state-of-the-art accuracy with markedly smaller demographic gaps.

06.
arXiv (math.PR) 2026-06-12

Sphere Packings in Higher Dimension (after Boaz Klartag)

arXiv:2606.13313v1 Announce Type: cross Abstract: Let $\delta_n^L$ be the maximal density of a lattice sphere packing in the $n$-dimensional Euclidean space. We explain how Boaz Klartag proved the inequality $\delta_n^L \geq c n^2 2^{-n}$ where $c>0$ is a universal constant. In higher dimension, even for non-lattice sphere packings, this new lower bound is a substantial improvement. Klartag's proof uses the probabilistic method in two different ways. The first, very standard, relies on the statistical properties of a uniformly chosen random lattice. The second, completely new, studies the stochastic evolution of an ellipsoid constrained to contain non nonzero lattice points in the interior.

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

GPT-Based Fast Simulation of CLAS12 Detector Hits via Conditional Autoregressive Generation

arXiv:2606.16035v1 Announce Type: cross Abstract: Modern particles physics experiments have demonstrated an increasing need for fast, high-fidelity detector simulation as detector components have improved and subsequent computational requirements approach the limits of available resources. Recently, deep generative models have emerged as a promising alternative to traditional Monte-Carlo methods, with recent works drawing inspiration from large language models (LLMs) and self-supervised next-token prediction methods. In this work, we present an application of a GPT-style autoregressive transformer as a fast surrogate model for the calorimeter inside the CLAS12 experiment at the Thomas Jefferson National Accelerator Facility. The model is conditioned on incident momentum and generates realistic detector hits autoregressively across all nine calorimeter layers as sequences of strip, ADC, and TDC tokens. We demonstrate that the model faithfully reproduces hit multiplicity, spatial distributions, energy deposits, and the energy-momentum response of the electromagnetic calorimeter. The generator achieves inference rates exceeding 700 events per second on a single GPU, providing a substantial speedup over traditional Geant4-based simulations while maintaining physics fidelity essential for high-luminosity experimental programs.

08.
medRxiv (Medicine) 2026-06-22

Genetic modifiers of psychiatric, motor, and cognitive symptoms in Huntington's disease

The Enroll HD natural history platform provides rich longitudinal phenotypes enabling genome wide analyses across diverse clinical domains. Psychiatric symptoms are a major source of morbidity in Huntington's disease (HD), yet the genetic architecture underlying their onset is poorly understood. We analyzed ~18,000 people with HD (PwHD) to define genetic determinants of ages at psychiatric, motor, and cognitive symptom onset, and HD diagnosis. GWAS meta analysis recapitulated 11 established modifiers of motor onset and identified a novel locus spanning RAB3B/ZFYVE9 associated with age at violent/aggressive behavior onset. Exome wide analyses in Enroll HD participants implicated rare variants in FAN1, PMS1, POLD1, and HTT. Several HD modifiers of motor and cognitive symptom onset (MSH3, FAN1, HTT) also influenced psychiatric symptom onset, whereas PMS1 and POLD1 showed significant association with motor symptom onset. Psychiatric polygenic scores predicted psychiatric symptom onset, revealing a hybrid architecture combining psychiatric liability in general population with HD- or repeat expansion disease (RED) specific pathways.

09.
medRxiv (Medicine) 2026-06-17

LLM-Driven Extraction of NI-RADS and Imaging Tumor Characteristics to Enhance Oropharyngeal Cancer Survivorship Surveillance

Abstract Purpose Radiologic surveillance is essential for oropharyngeal cancer (OPC) survivors, guiding recurrence detection and follow-up strategies. The Neck Imaging Reporting and Data System provides a standardized framework for post-treatment risk reporting at both the primary tumor site (pNI-RADs) and cervical lymph nodes (nNI-RADS). Comprehensive surveillance additionally requires assessment of disease status, including the primary tumor, nodal involvement, and distant metastases. These clinical results are often embedded as unstructured data within free-text radiology reports. We hypothesized that a large language model (LLM) can reliably extract NI-RADS score criteria and summarize key imaging features from unstructured radiology text, achieving high concordance with expert review. Methods Previously untreated OPC patients who received definitive cancer therapy were identified. Eligible imaging reports included post-treatment head and neck CT, MRI, or FDG PET/CT scans containing narrative and impression text. Examinations lacking narrative or impression text, containing pre-existing NI-RADS annotations, or involving non-surveillance imaging modalities were excluded. A total of 200 reports were randomly selected from 7,076 eligible examinations for manual abstraction using a three-reviewer consensus framework to establish a reference dataset. Using the Palantir Foundry Pipeline Builder, a GPT-5-based LLM was deployed to extract pNI-RADS and nNI-RADS scores, and key imaging features of disease status from these reports. Performance was evaluated using exact agreement and F1-based metrics. Results Agreement for no evidence of disease (score of 1) was 93.3% (126/135; F1 = 0.94) and 90.3% (130/144; F1 = 0.93) for pNI-RADS and nNI-RADS, respectively. For NI-RADS [≥]2, exact category agreement was 73.1% (38/52; macro-F1 = 0.75) for pNI-RADS and 64.3% (27/42; macro-F1 = 0.56) for nNI-RADS. Quadratic weighted {kappa} was 0.81 and 0.59, respectively. For post-treatment disease surveillance variables, agreement was 94.9% (149/157; F1 = 0.87) for primary tumor presence, 89.1% (164/184; F1 = 0.87) for nodal disease presence, and 94.7% (126/133; F1 = 0.70) for distant metastasis detection. Specificity was high across disease-status variables (0.95-0.99), with negative predictive values of 0.95 for primary tumor, 0.87 for nodal disease, and 0.99 for distant metastasis. Conclusions Our LLM-based information retrieval and classification approach for radiographic treatment response from unstructured, multidimensional imaging reports achieved high performance for disease exclusion and moderate performance for detecting suspected residual and/or new disease. This pipeline supports scalable and standardized surveillance data capture for longitudinal monitoring, clinical analytics, and survivorship research in head and neck oncology.

10.
arXiv (CS.AI) 2026-06-11

Towards an Inferentialist Account of Information Through Proof-theoretic Semantics

arXiv:2605.05368v5 Announce Type: replace-cross Abstract: Information is one of the most widely-discussed concepts of the current era. However, a great deal of insightful work notwithstanding, it is yet to be given wholly convincing logical or mathematical foundations. Without them, we lack adequate reasoning tools for understanding the complex ecosystems of systems upon which the society depends. We seek to rectify this by taking a first step towards developing an inferentialist semantic theory of information. There are three key interacting components. First, conceptual analysis: the metaphysics of information. Dretske expressed the key concepts of information in terms of intentionality, truth, and transmissibility. We replace truth with inferability, and trace the consequences of this replacement. Second, logic: proof-theoretic semantics (P-tS) provides a mathematical-logical realization of inferentialist reasoning. Using P-tS, we develop the first steps towards a mathematical-logical theory of an inferentialist primitive unit of information, the 'inferon'. This proof-theoretic approach counterpoints the model-theoretic view of information articulated in situation theory. Furthermore, we argue that it facilitates addressing all three components of van Benthem and Martinez's categorization of the understandings of information, as range, as correlation, and as code. Our focus is on information-as-correlation. Third, systems: the P-tS tools we develop provide the basis for a mathematical account of distributed systems modelling – a key tool from informatics for understanding the organization of information processing systems. This yields a reasoning-based theory of information flow in models of distributed systems. Overall, we seek to give a conceptually rigorous mathematical-logical account of information and its role within informatics, grounded in inference and reasoning.

11.
medRxiv (Medicine) 2026-06-18

Digital self-efficacy as a potential intermediary between vision impairment and daily internet use among older adults: A cross-sectional analysis of HINTS 2024

Background: Older adults with vision impairment often experience barriers to using digital technology. The indirect associations between vision impairment and digital access and skills via digital self-efficacy and frustration among older adults remain largely unknown. Objective: This study aimed to 1) explore factors associated with digital access, skills, self-efficacy, and frustration among older adults with vision impairment; 2) examine associations between vision impairment and digital access, skills, self-efficacy, and frustration among older adults; and 3) examine whether digital self-efficacy and frustration may help explain associations between vision impairment and digital access and skills among older adults. Methods: This was a cross-sectional study using nationally representative data from the Health Information National Trends Survey (HINTS) 2024. Respondents aged 60 and older were included. Vision impairment was assessed using a self-reported item. Outcomes included self-reported digital access, skills, self-efficacy, and frustration. Survey-weighted multivariable logistic regression and generalized structural equation modeling were conducted, adjusting for age, sex, race/ethnicity, education, and the number of comorbidities. Results: Among 3,149 older adults (mean [SD] age, 70.7 [10.0] years; 45.6% female), 7.1% (n=223) reported vision impairment. Among older adults with vision impairment, 65.6% (95% CI, 53.5% to 75.9%) used the internet daily, and 79.5% (95% CI, 66.8% to 88.2%) used a smartphone in the past 12 months. In multivariable logistic regression analyses among older adults with vision impairment, older age was associated with lower odds of daily internet use (OR, 0.84; 95% CI, 0.79 to 0.90), smartphone use (OR, 0.85; 95% CI, 0.75 to 0.97), wearable device use (OR, 0.88; 95% CI, 0.79 to 0.97), and using the internet to send a message to a healthcare provider (OR, 0.87; 95% CI, 0.80 to 0.93). Older adults who self-identified as racial and ethnic minority groups (e.g., Black/African American, Hispanic) had lower odds of daily internet use (OR, 0.15; 95% CI, 0.05 to 0.50) and using the internet to send a message to a healthcare provider (OR, 0.17; 95% CI, 0.04 to 0.73) compared with Non-Hispanic White older adults. Vision impairment was associated with lower odds of daily internet use (OR, 0.60; 95% CI, 0.37 to 0.99) and digital self-efficacy (OR, 0.53; 95% CI, 0.32 to 0.86). Digital self-efficacy was associated with higher odds of daily internet use (OR, 2.95; 95% CI, 2.04 to 4.26). Generalized structural equation modeling identified an indirect association between vision impairment and daily internet use via digital self-efficacy (coefficient, -0.68; 95% CI, -1.24 to -0.12). Conclusions: Findings suggest that reduced digital self-efficacy may help explain the observed association between vision impairment and daily internet use among older adults. Interventions targeting digital self-efficacy, including accessible interface designs, personalized coaching, and peer support, may help bridge the digital divide among older adults with vision impairment.

12.
arXiv (CS.CV) 2026-06-17

Geometry-Consistent Endoscopic Representations for Image-Guided Navigation via Structured Foundation Model Adaptation

Accurate vision-based navigation in monocular endoscopy is difficult due to limited depth cues, weak tissue texture, non-rigid deformation, and substantial appearance variation across domains, all of which complicate pose estimation, depth prediction, and image-to-anatomy alignment. Although recent vision foundation models have shown promise, their learned representations often remain insufficiently geometry-consistent, hindering stable feature correspondence and limiting their reliability for downstream navigation tasks. We propose a unified framework for learning geometry-consistent and domain-robust image representations for monocular endoscopy. The framework combines a synthetic data pipeline that provides accurate geometric supervision with Hierarchy-Aware Geometry-Semantic Adaptation, a structured alternative to standard LoRA that inserts low-rank adapters selectively across the transformer hierarchy and couples them with layer-wise training objectives to encourage geometric correspondence in intermediate features and semantic consistency in deeper features. Experiments on public and proprietary datasets show improved geometric and semantic representation quality, leading to better performance on downstream navigation tasks including pose estimation and monocular depth estimation. The learned representations show favorable synthetic-to-real transfer on clinical bronchoscopy and provide a useful initialization for adaptation to sinus endoscopy and colonoscopy under limited supervision. The framework also shows favorable scaling with model size and training data. These results support hierarchy-aware, geometry-guided adaptation as a practical approach for endoscopic representation learning.

13.
arXiv (math.PR) 2026-06-16

Cluster sizes in subcritical soft Boolean models

arXiv:2404.13730v2 Announce Type: replace Abstract: We consider the soft Boolean model, a model that interpolates between the Boolean model and long-range percolation, where vertices are given via a stationary Poisson point process. Each vertex carries an independent Pareto-distributed radius and each pair of vertices is assigned another independent Pareto weight with a potentially different tail exponent. Two vertices are now connected if they are within distance of the larger radius multiplied by the edge weight. We determine the tail behaviour of the Euclidean diameter and the number of points of a typical maximally connected component in a subcritical percolation phase. For this, we present a sharp criterion in terms of the tail exponents of the edge-weight and radius distributions that distinguish a regime where the tail behaviour is controlled only by the edge exponent from a regime in which both exponents are relevant. Our proofs rely on fine path-counting arguments identifying the precise order of decay of the probability that far-away vertices are connected.

14.
arXiv (CS.CV) 2026-06-17

Quantum Enchanced Multi-Scale CNN with Bi-directional Mamba for Crop Field Analysis

Hyperspectral image (HSI) crop analysis is essential for precision agriculture because it captures rich spectral and spatial information for accurate crop monitoring and assessment. However, HSI classification remains challenging due to high spectral dimensionality, spatial complexity, class imbalance, and limited labeled samples. To address these challenges, this paper proposes a BiSpectral Mamba-based framework that combines multi-scale convolutional feature extraction, spectral attention, bidirectional state-space modeling, and quantum-inspired learning. A multi-scale CNN backbone first extracts hierarchical spatial-spectral representations through feature fusion across multiple resolutions. A spectral attention mechanism then emphasizes informative bands while suppressing redundant and noisy channels. The refined features are processed by a BiSpectral Mamba module that captures long-range dependencies in both forward and backward directions by modeling hyperspectral feature maps as sequential tokens. In addition, class-weighted optimization and feature fusion strategies are incorporated to improve training stability and mitigate class imbalance. Experimental evaluation on the UAVHSI-Crop dataset demonstrates the effectiveness of the proposed framework, achieving an overall accuracy of 84.83%. The results show that integrating convolutional, attention-based, and state-space modeling components enables robust spatial-spectral feature learning for crop classification. The proposed framework also shows potential for broader agricultural and remote sensing applications, including crop disease detection, yield prediction, and soil moisture estimation, while highlighting the effectiveness of structured state-space and quantum-inspired architectures for hyperspectral image analysis.

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

Can Post-Training Turn LLMs into Good Medical Coders? An Empirical Study of Generative ICD Coding

Automated International Classification of Diseases (ICD) coding is a core medical-coding task for billing, epidemiology, and clinical decision support. Generative large language models (LLMs) are often reported as weak medical coders, but this finding mainly comes from inference-time settings such as prompting, retrieval, reranking, or tool use, leaving the role of task-specific post-training underexplored. We present a controlled empirical study of post-training for generative ICD coding, comparing discriminative baselines with LLM coders across prompting, supervised fine-tuning, and reinforcement learning under a common protocol and metric set. To our knowledge, this is the first study to evaluate RL-based post-training for generative LLM coders in ICD coding. We further introduce PHI, a diagnostic curriculum that extends GRPO to refine missed-code cases. Our results show that prompting-only evaluation substantially underestimates the potential of LLMs for ICD coding. SFT provides the main capability jump, GRPO further improves code-set prediction beyond SFT, and PHI provides targeted gains on macro-level performance. These findings suggest that the main bottleneck is not the generative formulation alone, but how the model is adapted and optimized for full-taxonomy recall. We release our code, data splits, and checkpoints at https://github.com/AlexandreWANG915/LLM4ICD.

16.
arXiv (quant-ph) 2026-06-17

A Lindbladian for holographic Brownian motion

arXiv:2606.17909v1 Announce Type: cross Abstract: We derive a Lindbladian description of holographic Brownian motion in the high-temperature regime. Starting from the influence functional for a trailing string endpoint, we identify the corresponding quantum master equation and prove that it is completely positive and trace-preserving. We determine the coefficients of the Lindbladian explicitly for two holographic backgrounds: the BTZ black hole and the AdS$_5$ black brane, restricting in the latter case to the endpoint fluctuation along the $x^1$-direction. We then analyze the time evolution of phase-space moments, energy relaxation, and steady states.

17.
arXiv (quant-ph) 2026-06-16

Noise-Adaptive Predictive Dynamical Decoupling

arXiv:2606.15769v1 Announce Type: new Abstract: Protecting quantum coherence against realistic environmental noise remains one of the fundamental obstacles to scalable quantum technologies. We develop a noise-adaptive dynamical decoupling framework that combines analytical open-quantum-system modeling with machine-learning-based forecasting for a qubit interacting with random telegraph noise. Unlike conventional dynamical decoupling protocols based on fixed pulse schedules, the proposed approach continuously forecasts short-time coherence evolution and adaptively applies control pulses according to the instantaneous noise dynamics. We investigate stationary and non-stationary environments spanning both Markovian and non-Markovian regimes. Numerical simulations demonstrate that the machine-learning-assisted adaptive control strategy substantially outperforms conventional periodic dynamical decoupling while using a comparable number of control pulses. The improvement becomes particularly pronounced in non-Markovian and non-stationary regimes, where memory effects, coherence revivals, and temporally evolving noise strongly limit the effectiveness of static pulse protocols. These results establish predictive machine-learning-assisted dynamical decoupling as a promising and scalable framework for adaptive quantum control in realistic noisy quantum devices.

18.
arXiv (CS.AI) 2026-06-17

Learning Fair Pareto-Optimal Policies in Multi-Objective Reinforcement Learning

arXiv:2606.18111v1 Announce Type: cross Abstract: Fairness is an important aspect of decision-making in multi-objective reinforcement learning (MORL), where policies must ensure both optimality and equity across multiple, potentially conflicting objectives. While single-policy MORL methods can learn fair policies for fixed user preferences using welfare functions such as the generalized Gini welfare function (GGF), they fail to provide the diverse set of policies necessary for dynamic or unknown user preferences. To address this limitation, we formalize the fair optimization problem in multi-policy MORL, where the goal is to learn a set of Pareto-optimal policies that ensure fairness across all possible user preferences. Our key technical contributions are threefold: (1) We show that for concave, piecewise-linear welfare functions (e.g., GGF), fair policies remain in the convex coverage set (CCS), which is an approximated Pareto front for linear scalarization. (2) We demonstrate that non-stationary policies, augmented with accrued reward histories, and stochastic policies improve fairness by dynamically adapting to historical inequities. (3) We propose three novel algorithms, which include integrating GGF with multi-policy multi-objective Q-Learning (MOQL), state-augmented multi-policy MOQL for learning non-statoinary policies, and its novel extension for learning stochastic policies. We evaluate our algorithms across various domains and compare our methods against the state-of-the-art MORL baselines. The empirical results show that our methods learn a set of fair policies that accommodate different user preferences.

19.
PLOS Medicine 2026-05-06

Point-of-care early infant HIV diagnosis at birth in a pragmatic cluster-randomized trial in Mozambique and Tanzania: A comparative cost and cost-effectiveness study

by Kira Elsbernd, Issa Sabi, Ilesh V. Jani, Chishamiso Mudenyanga, Siriel Boniface, Arlete Mahumane, Joaquim Lequechane, Falume Chale, Bindiya Meggi, Kassia Pereira, Raphael Edom, Anange F. Lwilla, W. Chris Buck, Nyanda Elias Ntinyinya, Michael Hoelscher, Till Baernighausen, Arne Kroidl, Stefan Kohler, the LIFE Study Consortium Background Timely access to early infant diagnosis (EID) is crucial for newborns with HIV, as late diagnosis can delay lifesaving antiretroviral treatment (ART). We assessed the comparative cost and cost-effectiveness of integrating point-of-care EID at birth into routine care in primary healthcare settings. Methods and findings This pre-specified secondary analysis was nested in the cluster-randomized LIFE study conducted at 28 primary healthcare facilities in Mozambique and Tanzania from October 2019 to September 2021. We estimated the health system cost of point-of-care birth plus 4–8-week HIV testing (very early infant diagnosis; VEID) compared to standard-of-care (SoC) testing at 4–8 weeks only, both with immediate ART initiation. We assessed the cost-effectiveness of VEID relative to SoC with respect to ART initiation within one week of life using Bayesian hierarchical models. As this is an intermediate outcome, incremental cost-effectiveness ratios (ICERs) cannot be directly compared to available life-year-based cost-effectiveness thresholds. To contextualize results, we derived the minimum life-years gained per early ART initiation required for VEID to meet standard thresholds in a break-even analysis.VEID was associated with a higher cost and resulted in earlier ART initiation than SoC in both countries. In Mozambique, VEID increased the proportion of infants initiating ART within one week of life by 90.0 (95% CrI [67.5, 98.5]) percentage points at an incremental cost of $2,632 (95% CrI [$2,249, $3,062]) per infant with HIV. In Tanzania, VEID increased early ART initiation by 59.9 (95% CrI [20.9, 89.5]) percentage points at an incremental cost of $6,263 (95% CrI [$5,394, $7,243]) per infant with HIV. The ICER was $2,924 and $10,458 in Mozambique and Tanzania, respectively and was sensitive to intrauterine transmission rate. These findings were limited by the lack of long-term health outcome data and reliance on an intermediate outcome. Based on the break-even analysis, we estimated that VEID would need to yield 6–32 life-years gained per additional early ART initiation to meet standard thresholds. Conclusions Adding birth testing improved early ART initiation but was unlikely to be cost-effective relative to standard thresholds given current prices, vertical transmission rates, and knowledge of long-term health benefits. Cost-effectiveness could be achieved at current costs if early ART translates to substantial long-term health benefits or if targeted to infants at high risk of vertical transmission.

20.
arXiv (CS.AI) 2026-06-19

SleepMaMi: A Universal Sleep Foundation Model for Integrating Macro- and Micro-structures

arXiv:2602.07628v2 Announce Type: replace Abstract: While the shift toward unified foundation models has revolutionized many deep learning domains, sleep medicine remains largely restricted to task-specific models that focus on localized micro-structure features. These approaches often neglect the rich, multi-modal context of Polysomnography (PSG) and fail to capture the global macro-structure of a full night's sleep. To address this, we introduce SleepMaMi , a Sleep Foundation Model engineered to master both hour-long sleep architectures and fine-grained signal morphologies. Our framework utilizes a hierarchical dual-encoder design: a Macro-Encoder to model full-night temporal dependencies and a Micro-Encoder to capture short-term characteristics from biosignals. Macro-Encoder is trained via Demographic-Guided Contrastive Learning, which aligns overnight sleep patterns with objective subject metadata, such as age, sex and BMI to refine global representations. Micro-Encoder is optimized via a hybrid Masked Autoencoder (MAE) and multi-modal contrastive objective. Pre-trained on a massive corpus of $>$20,000 PSG recordings (158K hours),SleepMaMi outperforms or matches state-of-the-art existing foundation models across a diverse suite of downstream tasks, demonstrating superior generalizability and label-efficient adaptation for clinical sleep analysis.

21.
arXiv (CS.CV) 2026-06-11

MedVeriSeg: Teaching LISA-Like Medical Segmentation Models to Verify Query Validity Without Extra Training

Despite recent progress in text-prompt-based medical image segmentation, existing LISA-like MLLM-based methods typically generate masks regardless of whether the target specified in the query is present, leading to hallucinated segmentation. In this work, we propose MedVeriSeg, a training-free query verification framework that enables LISA-like medical segmentation models to reject false segmentation queries. MedVeriSeg first quantifies the response quality between the [SEG] token and image features through a Similarity Response Quality Scoring Module. To further improve robustness, it employs a Lightweight Routed Multi-Agent Verification Module, which fuses quantitative score evidence with qualitative agent evidence to comprehensively verify the validity of the query. To support systematic evaluation, we construct MedVeriSeg-Bench, a benchmark designed for query verification in medical image segmentation. Experimental results demonstrate that MedVeriSeg effectively identifies false segmentation queries and reduces hallucinated segmentation, while maintaining a high acceptance rate for valid queries, thereby largely preserving the segmentation utility of LISA-like medical segmentation models.

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

Exploiting Search in Symbolic Numeric Planning with Patterns

arXiv:2606.16329v1 Announce Type: new Abstract: In this paper, we present a procedure for numeric planning based on Symbolic Pattern Planning (SPP). Given a numeric planning problem $\Pi$, a pattern $\prec$ is a sequence of actions used to define a formula encoding the subsequences of $\prec$ executable from a starting state $S$. Cardellini, Giunchiglia, and Maratea (2024a) follow the Planning as Satisfiability approach by defining, at each step $n \ge 0$, a formula $\Pi^\prec_n$ in which $(i)$ the pattern $\prec$ is computed only for $n=0$ in the initial state $I$ of $\Pi$, and then exploited at each step $n$, $(ii)$ the starting state $S$ is set to $I$, and $(iii)$ the set $G$ of goals is required to hold in the last state that can be reached by one of the subsequences of $\prec$ concatenated $n$ times. The procedure begins with $n=0$, terminates as soon as $\Pi^\prec_n$ is satisfiable, and otherwise proceeds by incrementing $n$. In this paper, possibly at each step, $(i)$ we symbolically search for an intermediate state $P$ reachable from $I$, closer to a goal state, $(ii)$ dynamically recompute the pattern $\prec_h$ – to be used in the next step – in $P$, $(iii)$ refine the pattern $\prec_g$ used to reach $P$, and $(iv)$ start the new search from the state $S$ which can be either the initial state $I$ or the last computed intermediate state $P$, exploiting the computed patterns $\prec_g$ and $\prec_h$ to define the pattern $\prec$ to be used in the search. In particular, at each step, we define a formula $\Pi^{\prec}_{S,P}$ encoding the existence of a state $P'$ closer than $P$ to a goal state, with $P'$ reachable from the starting state $S$ when using the pattern $\prec$. We present different techniques for producing such formulas, each corresponding to a different strategy for exploring the search space. We prove their correctness and completeness, the latter under certain conditions.

23.
arXiv (CS.AI) 2026-06-12

Counterfactual Explanations for Deep Two-Sample Testing

arXiv:2606.04009v2 Announce Type: replace-cross Abstract: Two-sample testing is a fundamental tool for detecting distributional differences across scientific domains, but classical tests (including kernel-based tests) can be ineffective on high-dimensional structured data such as images. Recent deep two-sample tests improve sensitivity in these settings by learning informative representations, yet they provide limited insight into which data features drive rejection of the null hypothesis $H_0$. To address this issue, we propose a counterfactual explanation framework for deep two-sample testing that generates sample-level edits moving observations from a source group toward a target group while explicitly reducing the discrepancy measured by the test. Our method combines a diffusion autoencoder with a pretrained deep two-sample test model and optimizes a maximum mean discrepancy (MMD) objective in the test model's representation space to produce plausible counterfactuals. We quantify distribution-level effects through changes in the test statistic and the resulting two-sample p-values. We evaluate the method on synthetic 2D shape datasets and two MRI cohorts. Across both settings, the counterfactual transformations consistently increase p-values relative to the original samples, indicating that the edited source set becomes statistically closer to the target distribution under the test. We measure minimality using LPIPS to ensure the counterfactuals remain close to the original samples. The resulting edits provide interpretable evidence of the features associated with the detected group differences. On MRI, the localized changes are consistent with known anatomical differences between cohorts.

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

LentiAvatar: Pseudo-Multiview Reconstruction and Subpixel Prism Rendering for Real-Time Stereoscopic Communication

Real-time stereoscopic video communication has long been a goal of immersive telepresence, yet practical systems still require specialized capture rigs or reduce remote users to a single portrait view. We present LentiAvatar, a Gaussian head-avatar system that connects monocular avatar capture with subpixel-encoded glasses-free lenticular display for real-time autostereoscopic communication. From a monocular portrait video, LentiAvatar reconstructs a controllable head avatar and optimizes it for the lateral viewing zones induced by the display. The method uses natural head turns as pseudo-multiview (PMV) supervision to constrain regions that are otherwise weakly observed in monocular training, including hair, ears, jaw contours, and neck boundaries. Reliable side frames are yaw-binned, aligned to virtual cameras, and supervised within a strict head-and-hair domain; contour-aware losses and staged regularization further suppress ghosting, alpha leakage, and depth instability while preserving lateral detail. At runtime, LentiAvatar renders 32 virtual views and encodes them into a 4K lenticular raster with calibrated subpixel-routing masks. The live-tracker prototype sustains 10.65 FPS, and a subject-specific distilled driver raises the same display pipeline to 38.49 FPS.

25.
arXiv (CS.CV) 2026-06-12

An Improved Generative Adversarial Network for Micro-Resistivity Imaging Logging Restoration

An improved GAN-based imaging logging image restoration method is presented in this paper for solving the problem of partially missing micro-resistivity imaging logging images. The method uses FCN as the generative network infrastructure and adds a depth-separable convolutional residual block to learn and retain more effective pixel and semantic information; an Inception module is added to increase the multi-scale perceptual field of the network and reduce the number of parameters in the network; and a multi-scale feature extraction module and a spatial attention residual block are added to combine the channel attention. The multi-scale module adds a multi-scale feature extraction module and a spatial attention residual block, which combine the channel attention mechanism and the residual block to achieve multi-scale feature extraction. The global discriminative network and the local discriminative network are designed to gradually improve the content and semantic structure coherence between the restored parts and the whole image by playing off each other and the generative network. According to the experimental results, the average structural similarity measure of the five sets of imaged logging images with different sizes of missing regions in the test set is 0.903, which is an improvement of about 0.3 compared with other similar methods. It is shown that the method in this study can be used for the restoration of micro-resistivity imaging log images with good improvement in semantic structural coherence and texture details, thus providing a new deep learning method to ensure the smooth advancement of the subsequent interpretation of micro-resistivity imaging log images.