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01.
Nature (Science) 2026-06-17

Lethal plague outbreaks in Lake Baikal hunter-gatherers 5,500 years ago

Plague is among the most devastating diseases in human history1. However, early strains of the plague-causing bacterium Yersinia pestis lacked virulence factors that are required for the bubonic form until around 3,800 years ago2,3. Consequently, the morbidity and mortality of early plague strains remain unclear. Here we describe early plague strains that are associated with two phases of outbreaks among mid-Holocene hunter-gatherers near Lake Baikal in southeast Siberia, beginning from about 5,500 years ago. These outbreaks occur across four hunter-gatherer cemeteries, with a 39% detection rate for plague infection. By reconstructing kinship pedigrees, we show that small familial groups were affected, consistent with human-to-human spread of disease, and that the first outbreak occurred within a single generation. The infections appear to have resulted in acute mortality, especially among children (aged 8 to 11 years). We further note functional differences, including in the ypm superantigen locus, which is also present in present day Yersinia pseudotuberculosis. The new strains diverge ancestrally to known Y. pestis and constrain the timing of its emergence, indicating that this happened before approximately 5,700 years ago. These findings show that plague outbreaks happened earlier than previously thought and were indeed lethal. We contend that the occurrence of outbreaks among mid-Holocene hunter-gatherer communities well outside the sphere of Late Neolithic Europe challenges the notion that higher population densities and lifestyle changes during the Neolithic agricultural transition were prerequisites for plague epidemics. Analyses of ancient DNA from hunter-gatherers near Lake Baikal in southeast Siberia around 5,500 years ago indicate that highly virulent Yersinia pestis emerged earlier than previously estimated, far from the next known cases of infection in Late Neolithic Europe.

02.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

03.
arXiv (CS.AI) 2026-06-12

ERTS: Adversarial Robustness Testing of Ethical AI via Semantic Perturbation in a Bounded Consequence Space

arXiv:2606.13282v1 Announce Type: new Abstract: As AI systems are deployed in high-stakes ethical contexts such as healthcare triage, autonomous vehicle control, and employment screening, formal methods for evaluating their robustness against adversarial manipulation of ethical reasoning remain underdeveloped. This paper introduces the Ethical Robustness Testing System (ERTS), a closed-pipeline framework that: (1) encodes ethical dilemmas into a 22-dimensional Ethical Consequence Space (ECS) grounded in established ethical theory; (2) applies 17 semantic perturbation functions subject to 6 validity constraint classes including a novel semantic coherence constraint; (3) measures decision deviation via a 4-component Ethical Instability Index (EII); and (4) produces domain-adaptive pre-deployment robustness assessment verdicts. We evaluate 4 structured baseline models and 2 production LLMs (Gemini 2.0 Flash and Llama 3.2) across 50 ethical scenarios spanning 8 deployment domains, generating 1,500 adversarial test cases. Results demonstrate that only 33% of models achieve assessment clearance, with the local Llama-3.2 model proving particularly vulnerable to fairness corruption and information degradation attacks (ERS = 0.737). To the best of our knowledge, no existing framework combines a bounded ethical consequence space, semantic coherence constraints, and domain-adaptive assessment in a single adversarial testing pipeline.

04.
medRxiv (Medicine) 2026-06-16

Investigating naming error patterns after non-invasive brain stimulation and language treatment in persons with aphasia

Abstract Background: Transcranial direct current stimulation (tDCS) paired with behavioral language therapy can improve naming in persons with aphasia (PWA), yet naming errors persist. Little is known about how naming error patterns change after non-invasive brain stimulation is combined with language treatment. Aims: To examine whether right cerebellar tDCS plus computerized aphasia therapy changes the types of naming errors in people with chronic aphasia across timepoints, and to determine whether effects differ by cerebellar tDCS polarity (anode vs. cathode). Methods and Procedures: In a randomized, double-blind, sham-controlled, within-subject crossover study, we retrospectively analyzed behavioral data from 24 individuals with post-stroke aphasia. Each participant completed two 15-session intervention periods (3-5 sessions/week) with active cerebellar tDCS + computerized aphasia therapy and sham + computerized aphasia therapy, separated by a two-month washout. General linear models (GLMs) assessed longitudinal changes in six error types (semantic, phonological real word, phonological nonword, no response, mixed, unrelated) on an untrained picture naming task (Philadelphia Naming Test; PNT) and a trained task (Naming 80; N80). Additional GLMs evaluated polarity effects with 2 (Group: anode vs. cathode) x 2 (Treatment) interactions, and treatment-order effects with 2 (Group: tDCS-first vs. sham-first) x 2 (Treatment) interactions. Outcomes and Results: Active cerebellar tDCS did not significantly change error types for trained items (N80). For untrained items (PNT), active tDCS reduced several error types relative to sham, with the clearest and most durable reduction in phonological nonword errors; more moderate reductions occurred for phonological real word and unrelated errors. Mixed errors showed a marginally opposite pattern, tending to increase after tDCS and decrease after sham. Polarity analyses indicated broadly similar effects across anodal and cathodal stimulation overall, but only the anode group showed a reliable treatment effect for phonological nonword errors on the PNT. Treatment-order analyses revealed no significant order effects. Conclusions: Our results indicate a shift in naming error types, particularly after tDCS treatment for the untrained naming task (PNT). These findings may help guide the course of treatment approaches of those with aphasia and what error naming pattern types may show changes post stroke when combining non-invasive brain stimulation and computerized aphasia therapy. Clinical Trial Registration: Cerebellar Transcranial Direct Current Stimulation and Aphasia Treatment [NCT02901574] Keywords: aphasia, naming errors, non-invasive brain stimulation, cerebellar tDCS, computerized aphasia treatment

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

Learning to Emulate Chaos: Adversarial Optimal Transport Regularization

arXiv:2604.21097v2 Announce Type: replace-cross Abstract: Chaos arises in many complex dynamical systems, from weather to power grids, but is difficult to accurately model with data-driven methods such as machine learning emulators. While emulators are promising tools for accelerating simulations and solving inverse problems, they still struggle to learn chaotic dynamics, where sensitivity to initial conditions renders exact long-term forecasts infeasible, especially given noisy data. Recent work instead trains emulators to match the statistical properties of chaotic attractors, but these approaches often rely on handcrafted summary statistics or large, diverse multi-environment datasets. In this work, we propose a family of adversarial optimal transport objectives that can jointly learn high-quality summary statistics and a physically consistent emulator from a single noisy trajectory. We theoretically analyze and experimentally validate a Sinkhorn divergence formulation (2-Wasserstein) and a WGAN-style dual formulation (1-Wasserstein) of our approach. Numerical experiments across a variety of chaotic systems, including ones with high-dimensional spatiotemporal chaos, show that emulators trained using our proposed objectives have significantly improved long-term statistical fidelity.

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

PatchWorld: Gradient-Free Optimization of Executable World Models

Text-agent environments are typically modeled as partially observable Markov decision processes (POMDPs), assuming that the simulator's latent state and transition dynamics are hidden from the agent. Yet little work has examined whether executable code can be induced to serve as a world model for prediction and planning under partial observability. We introduce PatchWorld, a gradient-free framework that turns offline trajectories into executable Python world models through counterexample-guided code repair. Instead of predicting the next observation with a black-box model, PatchWorld induces symbolic belief-state programs whose action updates can be inspected, replayed, and locally patched. Across seven AgentGym environments, PatchWorld-Simple achieves the highest code-based planning score among evaluated methods, reaching 76.4\% macro success in live one-step lookahead while invoking no LLM calls inside the world-model prediction module itself. We further find that a human-specified residual-memory bias improves surface observation fidelity but weakens decision utility. This exposes a tradeoff in executable world models, since improving observation fidelity can come at the expense of action-discriminative dynamics, and vice versa. Code is available at https://github.com/HKBU-KnowComp/PatchWorld.

07.
arXiv (CS.CL) 2026-06-18

As Easy as Rocket Science: Assessing the Ability of Large Language Models to Interpret Negation in Figurative Language

Figurative language and negation are two areas that challenge current language models, however, both are widely used throughout written and spoken language. Large language models (LLMs) are also widely used in everyday contexts where they cannot necessarily be tuned for a specific dataset. It is therefore essential to understand the ability of LLMs to correctly interpret text that includes both negation and figurative language. To investigate this, we develop a set of new annotations to an existing dataset of figurative language, and test a range of language models on the dataset. We find that the combination of negation and figurativeness can present a particular challenge, and that performance overall and across different negation types is particularly dependent on the prompt style used.

08.
bioRxiv (Bioinfo) 2026-06-18

A unified smoothing framework for protein domain bigram model

Biomolecular sequences can be represented as strings over an alphabet, an analogy that has motivated many applications of computational linguistic techniques to biological problems. However, such methods must be adapted to the characteristic scale and organization of biomolecular data. Here, we consider the problem of bigram smoothing for multidomain protein architectures, where domain bigram frequency data is extremely sparse and differs from textual data in alphabet size, string length distribution, the relationship between bigram and unigram frequencies, tandem repeat lengths, and the distribution of domain adjacencies. Moreover, some domain combinations are unobserved because they are biologically incompatible, others because the data are incomplete. A smoothing method that distinguishes these two cases is required. We propose a unified smoothing framework based on interpolation that can be tuned to accommodate different bigram data characteristics. Within this framework, we design specific model variants suited to protein domain bigram data: these assign low adjusted counts to pairs that are likely incompatible, while making appropriate adjustments for undersampled pairs. We demonstrate empirically that this approach distinguishes the two cases while preserving the characteristic signatures of multidomain data.

09.
arXiv (CS.CV) 2026-06-16

Beyond Scalar Rewards by Internalizing Reasoning into Score Distributions

Reward models are central to text-to-image post-training, but visual preference is subjective and better represented as a distribution over rubric scores than as a deterministic scalar. Existing scalar, score-token, and pairwise reward models over-compress uncertainty and fine-grained score differences, while reasoning-based generative rewards provide stronger judgments but are costly to deploy and difficult to use as direct optimization signals. We propose Z-Reward, a teacher-student reward modeling framework that decouples reasoning-heavy judgment from efficient reward deployment. The teacher is a large VLM that uses reasoning to infer rubric-aligned score distributions, and is trained with Group-wise Direct Score Optimization (GDSO), which combines policy-gradient rewards from distribution expectations with direct pointwise and pairwise supervision on score distributions and score gaps. The student is trained with Reasoning-Internalized Score Distillation (RISD), which transfers the teacher's reasoning-conditioned score distribution into a compact VLM without requiring explicit reasoning chains at inference time. On our internally annotated evaluation set, the 27B GDSO teacher reaches 89.6% human preference accuracy, outperforming SFT, RewardDance, and GRPO, while the 9B RISD student reaches 88.6%, outperforming the OPD baseline and closely matching the larger teacher. We further show that Z-Reward can serve as a differentiable reward signal for text-to-image optimization, yielding a 41.3% net human-preference improvement over the SFT baseline.

10.
arXiv (CS.CL) 2026-06-15

Simulating Students' Java Programming Errors with Large Language Models

Understanding student errors in the programming is a cornerstone of programming education, yet obtaining a representative set of student errors for any newly designed task remains slow and costly, since authentic submissions only accumulate after extensive classroom deployment. This paper explores whether large language models (LLMs) can serve as scalable proxies for students by simulating realistic logical errors in code submissions. Using the CodeWorkout dataset of 74,000+ unique student Java submissions across 37 problems, we evaluate five LLMs under three mainstream prompting strategies: Input-Output (IO), Chain-of-Thought (CoT), and iterative Self-Refine. We assess performance along two key dimensions: diversity (the range of distinct error patterns) and alignment (alignment with authentic student mistakes), and examine how these vary by struggling level of programming tasks. Our quantitative findings reveal that while all models generate diverse errors, their alignment to human submissions diverges: Claude Sonnet 4 achieves the most balanced performance. In addition, we conducted a blinded expert annotation study (N = 401) comparing synthetic and authentic errors. This qualitative analysis confirms that the generated errors are functionally indistinguishable from authentic student errors. Moreover, higher-struggling-level problems elicit more diverse but less student-like errors. These results highlight trade-offs in using LLMs to simulate human learners and suggest design considerations for integrating synthetic errors into teachable agents, intelligent tutoring systems, and large-scale learning analytics.

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

Continuous-time Optimal Stopping through Deep Reinforcement Learning

arXiv:2606.17545v1 Announce Type: new Abstract: Simulation based solvers for optimal stopping problems must discretize the stopping decision. Under classical dynamic programming, a coarse exercise grid with only a few stopping opportunities can materially undervalue the optimal expected reward, whereas on a very fine grid, approximation errors accumulate through the backward recursion. To remove this limitation, we develop a new reinforcement-learning inspired algorithm that enables us to learn the exercise rule at arbitrarily fine time resolution. Our CARLOS (Continuous-time Adaptive Reinforcement Learning for Optimal Stopping) algorithm utilizes an aggregate deep neural network (ADNN) to learn a joint space-time decision boundary. Starting from a coarse time grid, we progressively increase the frequency of stopping opportunities, while in parallel training the ADNN to refine its timing-value estimates. We moreover design an adaptive sampling strategy that gradually concentrates training effort near the stopping boundary. Benchmarked results show that CARLOS delivers higher prices than existing Bermudan solvers, approaching the American upper bound, and achieves high computational efficiency relative to non-RL comparators.

12.
arXiv (CS.CV) 2026-06-16

Physics-Driven Zero-Shot MRI Reconstruction with Non-local Image Priors

Zero-Shot Self-Supervised Learning (ZS-SSL) has emerged as a promising paradigm for accelerated Magnetic Resonance Imaging (MRI) reconstruction, eliminating the reliance on fully-sampled external datasets. However, learning solely from a single under-sampled scan suffers from supervision scarcity and optimization instability, often leading to overfitting or artifacts. To address these challenges, we propose a robust physics-driven ZS-SSL framework that synergizes physical consistency with image-domain non-local priors. Our method introduces three core innovations: (1) a Coil Sensitivity Map (CSM)-Guided Dynamic Repository, which stabilizes the training trajectory by filtering physically inconsistent artifacts based on coil sensitivity constraints; (2) a SPIRiT-based regularization, which enforces k-space self-consistency via a learned correlation kernel and stochastic masking; (3) a Non-Local Self-Similarity (NSS) Pixel Bank, which leverages the high-fidelity reference established by the former modules to explicitly mine non-local anatomical similarities, thereby augmenting supervision in the image domain. Extensive experiments on the FastMRI dataset demonstrate that our approach achieves state-of-the-art performance, particularly under high acceleration factors, effectively bridging the gap between zero-shot learning and supervised methods. The code is available at https://github.com/Zolento/NS-SSL.

13.
arXiv (CS.CV) 2026-06-16

Projection and Quantisation: A Unifying View of Learning to Hash, from Random Projections to the RAG Era

作者:

Approximate nearest-neighbour search underpins large-scale retrieval and retrieval-augmented generation, yet its methods are studied in communities that seldom read one another. We argue that they form one field with three design choices. We develop the projection-quantisation-organisation lens: every method places its projections, places its quantisation thresholds, and organises the resulting codes for search. We test the lens with a reproducible measurement, released as the open BitBudget benchmark, and report three findings. First, the quantisation axis delivers the largest memory savings: a one-bit code with full-precision re-ranking matches uncompressed quality for six of seven embedders, the scanned code one thirty-second of the float's size. Second, the orderings the lens anticipates, including a learned-embedding regime where binary codes overtake an inverted-file product quantiser at a matched byte budget, recur as the embedding is enlarged. Third, given class labels, an eight-byte supervised code more than doubles the retrieval quality of the two-kilobyte task-agnostic float it replaces. We also recast the semantic identifiers of generative retrieval as quantisation codes. The main contribution is a single, tested account of compact-code search, from random projections to the retrieval-augmented era.

14.
PLOS Medicine 2026-05-06

Pathways of emergency care for severely ill children in Nigerian and Ugandan hospitals: A process mapping study

作者:

by Rami Subhi, Abiodun Sogbesan, Dan Muramuzi, Mikael Burhin, Ayobami A. Bakare, Adegoke G. Falade, Freddy E. Kitutu, Freddie Ssengooba, Carina King, Sumit Kane, Belinda Dawson-McClaren, Hamish R. Graham, the MOXY-Implementation Research Collaboration Background Child mortality remains high in countries with weak emergency care systems. Facility organisation for paediatric emergency care is heterogeneous and under-described. We examined how hospitals in Uganda and Nigeria are organised to deliver emergency care for neonates and children. Methods and findings We conducted a qualitative, multi-method study in 26 purposively selected secondary and tertiary facilities in Uganda and Nigeria from October 2023 to December 2024. Embedded researchers documented patient pathways, resources for care, and care processes for severely ill children (

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

Revisiting LLM Adaptation for 3D CT Report Generation: A Study of Scaling and Diagnostic Priors

Recent advances in multimodal learning, including large language models (LLMs) and vision-language models (VLMs), have demonstrated strong adaptability to natural images. However, extending their use to the medical domain, particularly for volumetric (3D) images, is challenging due to high computational complexity, volumetric dependencies and the semantic gap between visual features and clinical terminology. Naively fine-tuning LLMs on limited medical data often leads to overfitting and clinical hallucination, where linguistic fluency is prioritized over clinical factuality. In this study, we investigate parameter-efficient adaptation strategies for volumetric CT report generation and introduce RAD3D-Prefix, a lightweight diagnostic-prior conditioning framework that minimizes the need for extensive parameter training. This module integrates image embeddings with multi-label diagnostic classification logits, preserving critical clinical details while bridging the semantic gap. By keeping the LLM frozen, our method requires minimal trainable parameters and mitigates the risk of overfitting on small, domain-specific datasets. Through a systematic study spanning LLMs from 96.1M to 1.6B parameters, we find that fine-tuning is most beneficial for smaller LLMs, whereas freezing larger (~1B+ LLMs and training only lightweight projection layers provides a superior trade-off between performance, generalization, and computational efficiency. Across multiple automatic metrics and a clinical reader study, RAD3D-Prefix outperforms comparable parameter-efficient baselines and demonstrates strong out-of-domain generalization while using substantially fewer trainable parameters than fully fine-tuned alternatives.

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

A Practical Evaluation Method for Long-Form Simultaneous Speech-to-Speech Translation

Simultaneous speech-to-speech translation (SimulS2ST) enables real-time cross-lingual communication, but existing evaluation has focused largely on short or pre-segmented speech rather than long-form, continuous input. Prior approaches are difficult to reproduce and make assumptions that do not hold for end-to-end systems. We present a practical evaluation method for long-form SimulS2ST. Given source speech, pre-segmented source transcripts, and reference translations, we run automatic speech recognition (ASR) and forced alignment on the generated target speech to recover token-level timestamps, then apply a sentence-embedding-based aligner to match the target text to its corresponding source sentences. This enables sentence-level computation of latency and quality metrics, including YAAL and xCOMET, which are then aggregated into final system-level scores. Experiments on representative SimulS2ST systems show that the method is effective in practice and reveal that current systems suffer from substantial latency accumulation on long speech.

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

Extracting Governing Equations from Latent Dynamics via Multi-View Contrastive Learning

arXiv:2606.13260v1 Announce Type: new Abstract: Identifying latent dynamical systems from noisy, high-dimensional measurements is a central problem at the intersection of representation learning, system identification, and scientific discovery. We present DYSCO, a multi-view temporal contrastive learning algorithm that jointly recovers latent trajectories and the governing dynamics from such observations, by leveraging multiple independent noisy views of the same underlying process to disentangle signal from noise. By parameterizing the dynamics in a structured functional basis, our framework further enables symbolic recovery of the governing equations within an affine gauge. We offer theoretical guarantees for strong identification up to an affine indeterminacy, extending prior identifiability results to the realistic setting of noisy nonlinear observations. Empirically, we demonstrate accurate recovery of both latent trajectories and flow fields across a diverse set of dynamical regimes (e.g., chaotic, oscillatory, and metastable) under both Gaussian and Poisson observation noise, the latter being particularly relevant for neural recordings.

18.
arXiv (CS.LG) 2026-06-15

Time Series Causal Discovery via Context-Conditioned and Causality-Augmented Pretraining

arXiv:2605.26759v2 Announce Type: replace Abstract: Causal discovery from time series is critical for many real-world applications, such as tracing the root causes of anomalies. Existing approaches typically rely on dataset-specific optimization, making it difficult to transfer their causal discovery capabilities to new time series governed by diverse causal mechanisms. In this paper, we propose PTCD, a novel Pretraining framework for Time-series Causal Discovery, which improves cross-task generalization through context-conditioned modeling and transferable causal augmentation. To model complex temporal causal dependencies, PTCD employs a dual-scale iterative attention mechanism to capture window-level causal relationships, and a Gaussian mixture with a context-level routing mechanism to handle heterogeneous exogenous distributions. To further address distribution shifts across causal graphs, PTCD adopts a pretraining paradigm on synthetic datasets that integrates intervention-based learning and a causal mixup strategy, promoting stable causal discovery and stronger generalization. Extensive experiments on multiple real-world out-of-distribution (OOD) datasets demonstrate that PTCD excels in both causal discovery and root cause identification.

19.
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.

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

Replay What Matters: Off-Policy Replay for Efficient LLM Reinforcement Unlearning

LLM unlearning has emerged as a cost-effective alternative to full retraining for removing hazardous knowledge from pretrained models while preserving general utility. Recent RL-based methods such as RULE reformulate unlearning as learning a refusal behavior, but their on-policy optimization repeatedly samples from the same forget and retain/boundary prompts throughout training. We identify a critical inefficiency in this process: easy cases quickly converge and provide little useful gradient signal, while hard cases near the forget/retain boundary continue to produce low-reward rollouts that are discarded after a single use. To address this issue, we propose ReRULE, an off-policy replay enhancement for reinforcement unlearning. ReRULE stores low-reward hard-case rollout groups in a replay buffer during early GRPO training and reuses them in later stages through importance-sampled off-policy updates, redirecting computation toward boundary cases that still require learning. Theoretically, we show that ReRULE yields a tighter hard-case convergence bound than pure on-policy RULE. Empirically, ReRULE improves MUSE-Books Retain Quality from 46.3 to 56.2 while adding only 5–11% training time across benchmarks. Its limited improvement on the simpler TOFU setting further supports the intended conditional behavior: replay is most beneficial when the hard/easy disparity is pronounced.

21.
arXiv (math.PR) 2026-06-12

Averaging principles for nonautonomous multiscale McKean-Vlasov stochastic systems

arXiv:2606.12820v1 Announce Type: new Abstract: This paper investigates a class of nonautonomous multiscale McKean-Vlasov stochastic systems. By leveraging the nonautonomous Poisson equation, we rigorously establish both strong and weak averaging principles, accompanied by explicit convergence rates. Notably, the coefficients of the averaging equations derived in the general case retain dependence on the scaling parameter $\varepsilon$. However, under the additional assumptions that the fast-scale coefficients are either asymptotically convergent or time-periodic, we demonstrate that the slow component converges, in the strong or weak sense, to averaging equations with coefficients independent of $\varepsilon$.

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

Physics-Aware Auxiliary Losses Improve Out-of-Distribution Generalization of a GNN Synthesizability Filter

arXiv:2606.12651v1 Announce Type: new Abstract: Machine-learning drug-discovery pipelines increasingly rely on generative models that propose molecules far from the data used to train downstream synthesizability filters. Existing filters (SAScore, SCScore, RAscore, DeepSA) are purely statistical and degrade in exactly this out-of-distribution (OOD) regime. We ask whether cheap, closed-form physical priors, used as auxiliary supervision on a graph neural network (GNN), improve OOD generalization. We add two auxiliary losses to a GINE backbone: a topological complexity regression supervised by the Bertz index, and a strain-energy soft penalty supervised by MMFF94 force-field energy. On a 65,177-molecule corpus (HIV, Tox21, COCONUT) labeled by SAScore thresholds we reproduce a strong in-distribution baseline, then evaluate a 4-way ablation (baseline / +complexity / +strain / +both) on a single-source OOD split (train on drug-like HIV+Tox21, test on COCONUT natural products), repeated over 5 seeds with paired bootstrap confidence intervals. All three physics-aware variants give a small but statistically significant OOD improvement over the baseline (mean OOD AUC 0.9774): +complexity Delta = +0.0060 (95% CI [+0.0023, +0.0102]), +strain Delta = +0.0032 ([+0.0008, +0.0052]), +both Delta = +0.0066 ([+0.0038, +0.0093]); every interval excludes zero, and the combination is best. The variants are indistinguishable in-distribution, so the effect is visible only under OOD evaluation. We are explicit that the effects are modest, and we report a cautionary methodological finding: a single-seed version of this experiment produced a qualitatively different (non-monotone) story that did not survive multi-seed evaluation.

23.
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.

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

Coherent Dark State Formation of a Lead-Vacancy Spin Qubit in Diamond

arXiv:2605.27841v2 Announce Type: replace Abstract: A lead-vacancy (PbV) center in diamond exhibits coherent emission above the liquid helium temperature, making it highly attractive for quantum network applications. Here, we report the magneto-optical and spin properties of PbV centers in diamond. We record a spin lifetime of 12 ms at 7.5 K under large off-axis magnetic field. Furthermore, we observe formation of the coherent dark state by coherent population trapping and estimate a spin dephasing time of 177 ns at 6.5 K. This work demonstrates the outstanding thermal robustness of the PbV spin compared to other group-IV centers above 4 K.

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arXiv (CS.AI) 2026-06-16

Visualizing Uncertainty: Spatial Maps of Missing and Conflicting Evidence in Deep Learning

arXiv:2606.15767v1 Announce Type: cross Abstract: Understanding when and why deep neural networks are uncertain is crucial for deploying reliable machine learning systems in safety-critical domains. While existing uncertainty quantification methods provide scalar measures of model confidence, they offer limited insight into which spatial regions of an input contribute to different types of uncertainty. We propose a novel visualization framework, Uncertainty Activation Map (UAM), that combines Evidential Deep Learning (EDL) with Full-Gradient Class Activation Mapping (FullGrad) to generate interpretable spatial uncertainty activation maps. Our approach distinguishes between two fundamental types of uncertainty: vacuity, representing lack of evidence, and dissonance, capturing conflicting evidence between competing hypotheses. By leveraging the complete gradient decomposition property of FullGrad and the principled uncertainty quantification of Subjective Logic, our method produces theoretically grounded visualizations that highlight specific image regions responsible for model uncertainty. With this framework, vacuity and dissonance activation maps are generated by computing belief-weighted attributions, enabling identification of where models lack knowledge versus where they encounter ambiguous evidence. Extensive evaluations across multiple benchmark datasets demonstrate that the proposed framework effectively addresses the critical gap between uncertainty quantification and explainability, providing intuitive visual feedback to assess model reliability in complex visual recognition tasks.