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

Chronological Blindness: Benchmarking Temporal Reasoning in Vision-Language Models with CHRONOSIGHT

Human perception of visual scenes is inherently temporal. We instinctively recognise whether a fruit is ripening or rotting, whether construction is progressing or being demolished, and approximately how much time separates two photographs of the same subject. Whether large vision-language models (VLMs) share this competence remains an open and practically important question. We introduce CHRONOSIGHT, a rigorously controlled benchmark evaluating five dimensions of visual temporal reasoning: CHRONORANK (chronological ordering of image sequences), CHRONOLOCATE (ordinal stage localisation from a single image), CHRONODELTA (estimation of time elapsed between two images on a logarithmic scale), CHRONOREVERSE (detection of temporally reversed sequences), and CHRONOODD (identification of a temporal outlier within a set). The benchmark comprises 1{,}000 items across eight process families (biological growth, food transformation, physical weathering, construction, environmental change, human ageing, astronomical phenomena, and urban dynamics) spanning timescales from minutes to millennia. We evaluate eight open-source VLMs (500 M to 19 B parameters) under two prompting regimes and collect human performance baselines. Human performance averages 0.89 across tasks; the best open model (Qwen2.5-VL-7B) reaches 0.40 under direct prompting, a gap we term chronological blindness. Lightweight LoRA fine-tuning on 151 examples raises CHRONODELTA accuracy from near-zero to 0.43, transferring zero-shot to related tasks (CHRONOODD: 0.37; CHRONOREVERSE: 0.64)suggesting the bottleneck is partly instruction following rather than visual perception. Benchmark, code, and predictions will be released upon acceptance.

02.
arXiv (CS.LG) 2026-06-19

Influence-Guided Concolic Testing of Transformer Robustness

arXiv:2509.23806v2 Announce Type: replace-cross Abstract: Concolic testing for neural networks alternates concrete execution with constraint solving to search for inputs that flip model decisions. We present a concolic tester for Transformer classifiers that uses SHAP estimates to rank pending path predicates by their impact on the current prediction. To support self-attention with multiple heads in execution backed by SMT solving, we implement attention semantics in pure Python that are compatible with the solver and make the softmax boundary explicit by concretizing exponentiation arguments. We evaluate our method on CIFAR-10 across three compact Transformer classifiers, ResNet18, and VGG16 under a one-pixel budget and a 900s horizon. Across the 500 model–input pairs in this matched comparison, our method achieves 60% success, compared with 15% for a differential evolution baseline that treats the model as a black box. In the primary two-layer Transformer branch-ordering study, SHAP-based predicate prioritization raises success from 56% to 60% and reduces median attack time by 51%. These results show that influence-guided path exploration can make concolic testing a practical way to find adversarial examples in Transformer models.

03.
arXiv (CS.LG) 2026-06-15

Direct/adaptive-mixture phase-gradient learning for neural-network quantum states with complex phase structure

arXiv:2606.13912v1 Announce Type: cross Abstract: Neural-network quantum states (NQS) are a leading variational tool for quantum many-body physics, yet their optimization is fragile whenever the ground state carries a non-trivial sign or complex phase structure, a situation generic to gauge fields, broken time-reversal symmetry, and fermionic statistics. We trace this fragility to the stochastic estimator of the phase gradient rather than to network expressiveness. The phase sector of the Monte Carlo energy gradient is a noisy score-function estimator; differentiating the local energy instead yields a direct estimator that is unbiased for the same phase force, has far lower variance, and requires only a separated amplitude–phase ansatz. Demonstrated on a 100-site flux ladder, a small network trained this way reaches $0.89\%$ median error, where tuned standard baselines plateau at $1.8\%$ and wider or deeper standard-gradient networks degrade from $8.4\%$ to $24.6\%$. The advantage carries over to chiral XXX chains: the direct estimator again converges to a markedly lower error than the standard one, across $\alpha$ and size; it grows with flux and vanishes in zero-flux controls. An adaptive-mixture of the two estimators is provably never worse in variance than the better endpoint at the optimal mixing coefficient, with seed-resolved diagnostics tracing much of the gain to eliminating failed runs. Estimator design thus emerges as a first-class lever for complex-valued neural quantum states.

04.
bioRxiv (Bioinfo) 2026-06-10

Bias-mitigated microbiome inference refines coronary artery disease signature

作者:

Roughly half the cells in the human body are microbial, and changes in these communities are increasingly implicated in cardiovascular, metabolic, and oncological diseases. Yet identifying which taxa truly differ in abundance, differential abundance (DA), is distorted by four major sources of bias: loss of total microbial load, taxa measurement efficiencies, arbitrary pseudocounts required to handle pervasive zeros, and contamination which has recently driven retractions. No existing DA method accounts for all four. Here we introduce BootDA, a non-parametric bootstrap-based method that explicitly models each bias source without data transformations, pseudocounts, parametric assumptions, or assuming that most taxa are non-DA. In semi-parametric simulations preserving the sparsity (>70% zeros) and correlation structure of real 16S amplicon data, BootDA achieved the highest sensitivity among tested methods, including ANCOM-BC2, LinDA, MaAsLin 3, and Wilcoxon tests, while controlling the false discovery rate. Performance was retained in low biomass settings when contamination contributed ~50% of counts, and without negative controls, indicating de novo decontamination capability. Applied to a coronary artery disease cohort, BootDA refined the original signature to two co-enriched genera, Klebsiella and Gemmiger, and excluded likely contaminants. BootDA is available as an R package and could generalise to other sparse, high dimensional biological data.

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

FineREX: Fine-Tuned NER-RE for Human Smuggling Knowledge Graphs

Court proceedings contain valuable evidence about human smuggling networks, but this information is often buried within unstructured, jargon-heavy legal documents. While large language models (LLMs) can support knowledge graph construction through automated information extraction, existing approaches rely on general-purpose models that are not tailored to the entity and relationship definitions required in this domain. We introduce FineREX, a streamlined knowledge graph construction pipeline built around a fine-tuned LLM for named entity recognition and relationship extraction (NER-RE). Using a manually annotated dataset of $512$ text chunks, FineREX achieves absolute improvements of 15.50% and 31.46% in entity and relationship F1-score, respectively, compared to a larger general-purpose baseline. These gains translate into higher-quality knowledge graphs, reducing legal noise by nearly half and lowering node duplication on long documents from 17.78% to 11.17%. By eliminating document rewriting and redundant extraction stages, FineREX also reduces end-to-end processing time by 50.0%. Our results demonstrate that domain-specific fine-tuning can substantially outperform larger general-purpose models while improving both the quality and efficiency of knowledge graph construction for illicit network analysis.

06.
PLOS Computational Biology 2026-06-23

CARGO: A cytometry analysis framework via Regularized graph optimal-transport

by Abida Sanjana Shemonti, Grzegorz B. Gmyrek, Katrien L. A. Quintelier, Sofie Van Gassen, Yvan Saeys, Marcella Willemsen, Joachim G. J. V. Aerts, Eva V. E. Madsen, J. Paul Robinson, Alex Pothen, Bartek Rajwa Conventional data visualization techniques in single-cell analysis (such as two-dimensional dot plots, SPADE, PCA, t-SNE, or UMAP) often fall short in enabling an intuitive understanding of high-parameter flow cytometry data. These methods tend to oversimplify complex biological relationships, lack biologically meaningful interpretations, and offer no principled framework for downstream quantitative analysis. To address these limitations, we present a graph-based (network-based) visualization framework grounded in optimal transport theory. In this framework, cell populations are defined by their marker-expression profiles, and inter-population similarity is quantified using an efficiently computable optimal transport formulation known as the Sinkhorn distance. Our approach produces biologically consistent two-dimensional graph layouts using a phenotype-aware Hamming distance. Structural differences between sample graphs are characterized through a customized graph-edit distance that captures changes in population size, marker expression, and relationships between populations. We demonstrate our methods on two flow cytometry datasets: one from a clinical trial of dendritic cell-based immunotherapy in malignant peritoneal mesothelioma, involving 14 patients sampled at three time points with 14-color panels, and another from FlowCAP-II, which involved 43 acute myeloid leukemia patient samples analyzed with 7-color panels. Our framework produces robust, quantitative visual summaries of cell populations and supports statistical analysis based on graph edit distances, thereby offering new insights into disease progression and treatment response. Ultimately, our method bridges the gap between flow cytometry data visualization and biological interpretation.

07.
medRxiv (Medicine) 2026-06-22

Climatic Drivers of Malaria risk in Children Under Five: A Large-Scale Analysis of individual-level data for 350,000 children in 26 Sub-Saharan African Countries

Background Malaria risk is influenced by climatic conditions, and children under five are particularly vulnerable due to their limited acquired immunity. We investigate the association between climatic factors and malaria risk in 350,000 children aged 5-59 months in sub-Saharan Africa over 18 years. Methods We included children aged 5-59 months with malaria tests from Demographic and Health Surveys (DHS) in 26 sub-Saharan African countries between 2006 and 2023. We linked these data to high-resolution climate exposures: temperature, precipitation, soil moisture, actual evapotranspiration and specific humidity. We fitted a mixed-effect logistic regression model incorporating Distributed Lag Non-linear Models (DLNM) over 1-6 month lag window for each exposure, controlling for seasonality and long-term trends. We examined effect modification by maternal education, household wealth, residential type, water source, sanitation facility, child age and sex, use of insecticide-treated bed nets (ITNs), and the age of the household head. Results Malaria prevalence was 19.5%. Malaria risk was highest at 24 degrees (OR: 1.45, 95% CI: [1.36, 1.54]), followed by a decline at higher temperatures. This elevated risk was mainly driven by short-term exposures (1-2 months). Precipitation increased risk up to 59 ~ 120 mm (1.10, [1.07, 1.12]), after which heavier rainfall reduced risk, particularly at short- to medium-term lags (1-4 months). Soil moisture was associated with increasing risk up to ~80 mm (1.11, [1.08, 1.14]), with a plateau at higher levels. Evapotranspiration showed a strong, near-linear positive association with malaria risk. Higher specific humidity levels (>14 g/kg) presented a lower risk, reaching a 45% reduction at 17 g/kg (0.55, [0.49, 0.61]), with the strongest protective effects at short-term lags (1-2 months). Elevated malaria risk at low and moderate average temperatures was particularly evident among children who did not sleep under an ITN net. Conclusion Malaria risk in children under five is strongly shaped by climatic factors, with complex and delayed associations. The findings provide evidence to guide targeted interventions and early-warning strategies for vulnerable populations.

08.
arXiv (CS.CL) 2026-06-11

Experience Makes Skillful: Enabling Generalizable Medical Agent Reasoning via Self-Evolving Skill Memory

Medical agent systems are increasingly expected to support interactive clinical decision making rather than only static question answering. In such settings, effective agents must reuse prior experience across evolving cases, yet existing memory mechanisms often retain raw historical traces that are redundant, noisy, and difficult to govern. More importantly, they rarely distinguish which memories are truly useful for future reasoning. This limits their ability to accumulate compact and reliable experience for long-horizon clinical reasoning. To close this gap, we propose SkeMex, a post-deployment self-evolution framework that improves medical agents through a skill-based memory without updating model weights. SkeMex distills informative interaction trajectories into structured skills that encode reusable procedural knowledge, and organizes them into a multi-branch repository spanning general, task-specific, and action-level experience. To determine which memories should be reused and retained, SkeMex estimates context-dependent utility from environment feedback and uses it to guide value-aware retrieval and repository governance. A closed-loop ``Read–Write–Assess–Govern" lifecycle further supports continual evolution by writing new skills, updating utilities, promoting useful memories, and removing harmful entries. Experiments across diverse clinical tasks show that SkeMex consistently outperforms representative memory-based agents in both offline and online settings. It also generalizes across model backbones and supports transferable skill memory. All data and code will be released publicly.

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

Pixel-TTS: Image based Text Rendering for Robust Text-to-Speech

Recent advances in pixel-based text modeling show that representing text as images enables models to exploit visual cues for language understanding. Grounding text in its visual form allows structurally similar characters with different Unicode encodings to produce similar embeddings, benefiting cross-lingual and zero-shot scenarios. Conventional text-based approaches treat each character independently, limiting generalization to unseen characters and requiring embedding expansion during cross-lingual adaptation. We propose Pixel-TTS, the first framework for visually grounded speech synthesis. It renders text as images and projects them through a 2D convolutional layer to generate embeddings. This design eliminates embedding matrix expansion during fine-tuning while improving robustness to unseen characters and orthographic variations. Extensive experiments show Pixel-TTS achieves competitive performance with strong baselines, faster convergence and robust zero-shot generalization.

10.
arXiv (CS.LG) 2026-06-17

Randomized Midpoint Method for Log-Concave Sampling under Constraints

arXiv:2405.15379v3 Announce Type: replace-cross Abstract: In this paper, we study the problem of sampling from log-concave distributions supported on convex and compact sets, with a particular focus on the randomized midpoint discretization of both overdamped and kinetic Langevin diffusions in constrained domains. We revisit the proximal framework for handling constraints through projection operators and develop a more general formulation that encompasses Euclidean, Bregman, and Gauge projections. The resulting smooth approximation allows a unified and tractable analysis of Langevin algorithms and their variants under constraints. Within this framework, we establish convergence guarantees in Wasserstein-$q$ $(q\geqslant 1)$ distances between the smooth surrogate and the target distribution. We further derive complementary lower bounds, showing that the results are near-optimal in order. Building upon this tight approximation analysis, we obtain new convergence guarantees for the randomized midpoint Langevin algorithms and refined bounds for both vanilla and kinetic Langevin Monte Carlo methods under constraints, thereby advancing the theoretical understanding of constrained diffusion-based sampling.

11.
arXiv (CS.LG) 2026-06-18

Clustering and Pruning in Causal Data Fusion

arXiv:2505.15215v3 Announce Type: replace-cross Abstract: Data fusion, the process of combining observational and experimental data, can enable the identification of causal effects that would otherwise remain non-identifiable. Although identification algorithms have been developed for specific scenarios, do-calculus remains the only general-purpose tool for causal data fusion, particularly when variables are present in some data sources but not others. However, approaches based on do-calculus may encounter computational challenges as the number of variables increases and the causal graph grows in complexity. Consequently, there exists a need to reduce the size of such models while preserving the essential features. For this purpose, we propose pruning (removing unnecessary variables) and clustering (combining variables) as preprocessing operations for causal data fusion. We generalize earlier results on a single data source and derive conditions for applying pruning and clustering in the case of multiple data sources. We give sufficient conditions for inferring the identifiability or non-identifiability of a causal effect in a larger graph based on a smaller graph and show how to obtain the corresponding identifying functional for identifiable causal effects. Examples from epidemiology and social science demonstrate the use of the results.

12.
Science (Express) 2026-05-07

Induction of broadly neutralizing HIV antibodies by a two-step mechanism informs vaccine design | Science

作者: 未知作者

A major obstacle confronting HIV-1 vaccine and cure research is the lack of an outbred animal model for rapid and consistent induction of broadly neutralizing antibodies (bNAbs). We designed an epitope-focused simian-human immunodeficiency virus (SHIV.5MUT) that elicited broad and potent V3-glycan-targeted antibodies within a year of infection in 14 of 22 macaques compared with 0 of 14 control animals. SHIV.5MUT elicited bNAbs by a two-step mechanism, inducing an initial wave of V1-directed antibodies that selected for Envs with shortened, hypoglycosylated V1 loops, which in turn primed V3-glycan bNAb precursors. Rhesus bNAbs were immunogenetically and structurally diverse, closely resembling human V3-glycan bNAbs. Env-bNAb coevolution revealed a diverse repertoire of bNAb precursors and the Env variants that matured them, yielding a molecular blueprint for vaccine design.

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

Iterative Tool Usage Exploration for Multimodal Agents via Step-wise Preference Tuning

Multimodal agents, which integrate a controller e.g., a vision language model) with external tools, have demonstrated remarkable capabilities in tackling complex multimodal tasks. Existing approaches for training these agents, both supervised fine-tuning and reinforcement learning, depend on extensive human-annotated task-answer pairs and tool trajectories. However, for complex multimodal tasks, such annotations are prohibitively expensive or impractical to obtain. In this paper, we propose an iterative tool usage exploration method for multimodal agents without any pre-collected data, namely SPORT, via step-wise preference optimization to refine the trajectories of tool usage. Our method enables multimodal agents to autonomously discover effective tool usage strategies through self-exploration and optimization, eliminating the bottleneck of human annotation. SPORT has four iterative components: task synthesis, step sampling, step verification, and preference tuning. We first synthesize multimodal tasks using language models. Then, we introduce a novel trajectory exploration scheme, where step sampling and step verification are executed alternately to solve synthesized tasks. In step sampling, the agent tries different tools and obtains corresponding results. In step verification, we employ a verifier to provide AI feedback to construct step-wise preference data. The data is subsequently used to update the controller for tool usage through preference tuning, producing a SPORT agent. By interacting with real environments, the SPORT agent gradually evolves into a more refined and capable system. Evaluation in the GTA and GAIA benchmarks shows that the SPORT agent achieves 6.41% and 3.64% improvements, underscoring the generalization and effectiveness introduced by our method. The project page is https://SPORT-Agents.github.io.

14.
bioRxiv (Bioinfo) 2026-06-11

PhyloZoo: a unified framework for phylogenetic network analysis in Python

作者:

Reticulate evolutionary processes (events in which lineages merge, such as hybridization, recombination, and horizontal gene transfer) are widespread across nature but cannot be represented by phylogenetic trees alone. Phylogenetic networks have therefore become an important modelling tool, yet existing software is typically tied to specific inference paradigms and provides limited support for working with multiple network representations in a unified and programmable environment. PhyloZoo is an open-source Python framework that lowers the barrier to developing practical, easy-to-use software for phylogenetic network analysis. It provides data structures and algorithms covering the main representations used in the field, together with dedicated visualization tools and robust I/O for all major phylogenetic file formats. A particular emphasis lies on semi-directed phylogenetic networks, which explicitly represent root uncertainty and have so far received limited support in existing software. By offering a shared foundation for developing interoperable tools and a combinatorial layer that supports computational proofs and theoretical exploration, PhyloZoo enables reproducible workflows for applied, methodological, and theoretical studies of reticulate evolution. Availability and implementation: PhyloZoo is implemented in Python and installable from PyPI, with source code, documentation, and examples available at https://github.com/nholtgrefe/phylozoo.

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

Incentives Of EdTech: A Systematic Review Of EduNLP Research

While the Natural Language Processing community has dedicated significant resources in developing educational technologies (EdTech) that support this shift, it remains unclear whose interests are being best served among the stakeholders of education. In this paper, we present a systematic literature review of 204 papers published in venues of the Association for Computational Linguistics' Special Interest Group on Building Educational Applications in 2024 and 2025, and validate these against EdTech papers from the wider ACL Anthology. By examining stakeholder inclusion and the prioritisation of research tasks, our findings reveal a critical tension: a push and pull between private-sector incentives and the foundational needs of educational infrastructure. Our analysis reveals that teachers are systematically under-represented as beneficiaries of research (33.3%) despite being the most affected, that real-world deployment remains rare (9.8%), and that ethical engagement tends toward acknowledgement rather than action. Drawing on exemplary papers in our corpus, we offer concrete recommendations for more responsible EduNLP research practices.

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

Discovering Lattice Reduction Strategies via Self-Play

arXiv:2606.15301v1 Announce Type: cross Abstract: The Lenstra-Lenstra-Lovász (LLL) algorithm is a seminal contribution to computer science used for lattice basis reduction, yet its polynomial-time outputs produce bases that are far from optimal as the dimension grows. We show that deep reinforcement learning can discover strictly superior, generalizable reduction strategies by interacting with the primitive action space of LLL. We formulate lattice reduction as a single-player Markov Decision Process (MDP) and train a deep residual network using an AlphaZero-style self-play pipeline augmented with adaptive-horizon MCTS (Monte Carlo Tree Search), which couples multi-step network predictions with an entropy-gated expansion mechanism. The resulting policy, DeltaStar, is trained exclusively on small $8$-dimensional $q$-ary lattices and requires fewer primitive row operations than LLL. Crucially, it generalizes zero-shot to unseen moduli and higher dimensions up to $n=32$ without retraining.

17.
medRxiv (Medicine) 2026-06-23

Acute Ischemic Stroke Detection on Non-Contrast CT: A Deep Learning Approach

Acute ischemic stroke (AIS) is a leading cause of disability and death while effective treatment requires quick and accurate diagnosis. Non-contrast CT (NCCT) is widely used in the initial screening of AIS, but stroke detection is challenging because early changes on NCCT are subtle or indistinguishable. Using hyperacute NCCTs as inputs and diffusion-weighted MRI as ground truth, we trained a deep learning algorithm to classify patients with AIS and segment the stroke lesions. We hypothesized that this approach would accurately detect hyperacute tissue density changes on NCCT. For the classification task, our ResNet50 model delivered the best performance (with 98.5% accuracy, 97.4% precision, and 100% recall on an evaluation set). Classification performance remained strong when restricted to lesions smaller than 5 mL, which constituted the majority of our evaluation cases. For the segmentation task accomplished using a range of U-Net architectures, performance was acceptable for large lesions and declined sharply for smaller lesions. Together, these findings demonstrate the feasibility of deep learning for AIS detection and represent a step towards faster triage and treatment for stroke patients.

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

Muon$^p$: Muon with Fractional Spectral Powers

arXiv:2606.13867v1 Announce Type: new Abstract: Muon is an increasingly widely used optimizer that replaces a gradient $G=USV^\top$ with its polar factor $UV^\top$, thereby flattening the singular spectrum. However, full flattening discards singular-value information that may matter for adaptation. We introduce Muon$^p$, a Muon-style optimizer that instead uses fractional spectral-power updates $US^pV^\top$ for rational $p\in(0,1)$, interpolating between Muon and gradient descent. To make it practical, we prove that fractional spectral powers cannot be computed by any fixed univariate polynomial iteration, and furthermore derive low-degree odd bivariate recurrences that approximate $US^pV^\top$ using only matrix multiplications, preserving Muon's matrix-multiplication-only structure and compute complexity. We show that Muon$^p$ maximizes the linear improvement in loss under the Schatten $q$-norm for $q=1+\frac{1}{p}$. Empirically, Muon$^p$ is especially effective for finetuning: on billion-scale models, Muon$^p$ improves validation perplexity and downstream task performance. We further analyze when Muon$^p$ is less suitable, through the lens of spectral geometry. Our results reveal important insights on when preserving the singular spectrum can bring significant gains, and introduce a principled way to achieve them.

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

Do Large Language Models Always Tell The Same Stories?

Recent advances in large language models (LLMs) have enabled the generation of high-quality prose, yet the question of whether these models are capable of generating diverse outputs remains contested. In this work, we investigate the diversity of LLM-generated stories through the framework of narrative similarity. Using a contrastive framework and a dataset of human-written stories and prompts from r/WritingPrompts, we collect narrative similarity judgments across 10 representative LLMs, utilizing both human evaluations and three different automatic annotation methods. Our findings reveal a consistent trend: LLM-generated narratives are consistently more similar to each other than human-written stories are. We demonstrate that frontier models in particular converge on a ``mean'' generic narrative that approximates individual human stories but lacks the collective diversity of human authors. Finally, we show that common mitigation strategies, including negative prompting and temperature scaling, fail to meaningfully address this homogeneity.

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

Amortized Probabilistic Retrieval of Atmospheric CO2 from OCO-2 Spectra Using Deep Learning with Laplace Approximations and Normalizing Flows

arXiv:2606.17413v1 Announce Type: new Abstract: Space-based monitoring of atmospheric carbon dioxide (CO2) is essential for constraining the global carbon budget. NASA's Orbiting Carbon Observatory-2 (OCO-2) estimates column-averaged dry-air mole fractions of CO2 (XCO2) using high-resolution spectra. However, current operational retrieval algorithms are computationally expensive and do not properly quantify uncertainties. We present a novel deep learning framework that addresses these challenges. Due to the difficulties of ground-truth data for real satellite observations, we develop and validate our approach using a high-fidelity simulation dataset. This dataset, created to support OCO-2 uncertainty quantification (UQ), incorporates realistic forward model errors. Our architecture encodes spectral bands using a multi-branch neural network and estimates posteriors of the full CO2 column or desired summaries thereof using two scalable UQ methods: Laplace approximations and normalizing flows. Our approach has five key advantages relative to operational "full-physics" solvers: (1) Amortization: Inference is orders of magnitude faster, enabling real-time processing of massive data streams; (2) Model error robustness: By training on simulations that explicitly include model discrepancies, our method accounts for systematic errors often neglected by standard inversions; (3) Point estimate accuracy: We achieve superior predictive accuracy compared to baseline methods; (4) Improved UQ: The probabilistic outputs yield better-calibrated uncertainty estimates; and (5) Non-Gaussian posteriors: When utilizing normalizing flows, our framework successfully models complex, asymmetric posterior distributions, overcoming the limitations of the Gaussian assumption. These results suggest that simulation-based deep learning is a viable path toward next-generation operational processing systems.

21.
PLOS Medicine 2026-06-01

Prenatal exposure to asthma medications and risk of neurodevelopmental disorders and educational difficulties: A systematic review and meta-analysis

by Lama A. Shakhshir, Alexia Karain, Jill P. Pell, Claire E. Hastie, Scott M. Nelson, Michael Fleming Background Since asthma exacerbations during pregnancy risk maternal and fetal health, continued medication is important. However, some studies have reported adverse neurodevelopmental outcomes following prenatal exposure to asthma medication. Therefore, this systematic review aimed to collate the existing evidence on the associations between prenatal exposure to asthma medication and neurodevelopmental and educational outcomes. Methods and findings A systematic review was conducted in accordance with PRISMA guidelines and the PECO framework. PubMed, Medline and Embase databases were searched for studies investigating prenatal exposure to one or more asthma medication and neurodevelopmental or educational outcomes published, in English, between January 2003 and September 2024, and updated in November 2025. Studies of asthma medication used for other indications were excluded. Study quality was assessed using the Newcastle-Ottawa scale. Random-effects meta-analyses were conducted where appropriate and heterogeneity was evaluated using Cochran’s Q and I2 tests.Of 16,824 studies identified by the initial search, seven were eligible for inclusion. All investigated beta-2-adrenergic agonists (B2AA), with one including B2AA as mono- and polytherapy—and one study also investigated inhaled corticosteroids (ICS) exposure. Two reported associations with autism spectrum disorder (ASD) and one with attention-deficit hyperactivity disorder (ADHD). An updated search identified one additional eligible study, which examined both ADHD and ASD, as well as other neurodevelopmental disorders. The included eight studies (n = 3,867,170 participants) comprised cohort (n = 5) and case-control (n = 3) designs and reported inconsistent results. Meta-analysis of three studies (n = 1,380,871) indicated significant associations with ASD for exposure to B2AA both preconception (aOR 1.34, 95% CI [1.19,1.52]) and during pregnancy (aOR 1.29, 95% CI [1.16,1.42]). Heterogeneity was low, with no evidence of significant publication bias. Limitations of the included studies comprised residual confounding and exposure misclassification. Additionally, studies included in the meta-analysis were few in number and did not adequately distinguish between medication effects and underlying maternal asthma. Conclusion Meta-analysis suggested an association between prenatal exposure to B2AA and ASD. An association with ADHD, reported in a single study, requires corroboration. To date, based on our search strategy, no association has been reported with communication skills, motor skills, problem-solving and personal-social skills, or cerebral palsy.

22.
arXiv (CS.CV) 2026-06-18

Pre-Deployment Robustness Stress Testing for CT Segmentation Systems Using Clinically Motivated Multi-Corruption Augmentation

Deep learning-based CT segmentation systems often achieve high accuracy on clean benchmark images, but their performance may degrade under heterogeneous clinical imaging conditions such as noise, resolution loss, contrast variation, intensity shift, and artifacts. This instability can limit reliable deployment in real-world medical imaging workflows. We propose Robustness via Augmented Multi-corruption Pipeline (RAMP), a robustness-oriented augmentation framework for CT segmentation. RAMP combines anatomically constrained spatial perturbations, CT intensity transformations, and stochastic multi-corruption composition to expose models to clinically plausible image degradation during training. Across two CT segmentation evaluation settings, RAMP achieved the strongest corrupted-image performance and the smallest clean-to-corrupted robustness gap. In the five-organ noisy evaluation benchmark, RAMP improved mean corrupted Dice from 0.610 to 0.753 and reduced the robustness gap from 0.264 to 0.064 compared with the nnU-Net baseline. In Abdomen1K, RAMP improved mean corrupted Dice from 0.633 to 0.789 and reduced the robustness gap from 0.290 to 0.070. Although RAMP did not achieve the highest clean-image Dice, it substantially mitigated worst-case segmentation collapse under severe image degradation. These results suggest that multi-corruption augmentation can serve as a practical pre-deployment strategy for improving the reliability of CT segmentation systems in heterogeneous clinical environments.

23.
arXiv (CS.AI) 2026-06-18

Towards Multi-Agent-Simulation-Based Community Note Evaluation

arXiv:2606.18268v1 Announce Type: cross Abstract: Community-based fact-checking that relies on cross-consensus is expanding rapidly on social media platforms. However, the delay and low-ratio of cross-consensus community fact-checks rated by human contributors remains a significant challenge. To address this, we first created ComRate, a large-scale dataset comprising 2.5 million community notes and over 209 million ratings sourced from $\mathbb{X}$. We then propose MultiCom, a persona-guided multi-agent rating framework for community note evaluation. MultiCom simulates diverse rater population by clustering contributors in a matrix-factorized rater space and prompting persona agents to generate structured assessments based on the official community notes rating schema. These agents output structured and explainable judgments, such as confidence, agreement signals and reasons. An out-of-fold calibrated aggregation algorithm combines features such as raw votes and diagnostic reason signals for reliable prediction. Extensive evaluations demonstrate that MultiCom outperforms alternative methods, achieving an average accuracy of 84.7% (balanced accuracy 68.3%, macro-F1 60.1%) on the evaluation set.

24.
PLOS Medicine 2026-06-12

Placenta accreta spectrum in the 21st century: Challenging dogma and redefining disorder

by Eric Jauniaux, Helena C. Bartels, Yalda Afshar Placenta accreta spectrum (PAS) is a serious pregnancy complication caused by abnormal placental attachment to the uterus. In this Perspective, Eric Jauniaux and colleagues discuss emerging evidence that challenges our long-held pathophysiological understanding of PAS, and argue that a critical reassessment of definition, diagnosis, and management is overdue. In this Perspective, Jonathan Evans and colleagues discuss why restricting access to joint replacement surgery based on BMI alone is not supported by evidence, and highlight how such rest rictions risk exacerbating stigma, inequity and avoidable harm to those who would benefit from surgery.

25.
medRxiv (Medicine) 2026-06-23

Respiratory support with Continuous Positive Airway Pressure in preterm neonates: an analysis of coverage and quality of care in 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania implementing with the NEST360 Alliance

Background: Prematurity is the leading cause of child deaths worldwide, with the highest neonatal mortality in sub Saharan Africa. Respiratory distress syndrome (RDS) is the leading mortality pathway in preterm neonates, but continuous positive airway pressure (CPAP) has high impact. This analysis reports CPAP coverage and quality of care for preterm neonates admitted to 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania. Methods: Analyses used individually linked neonatal inpatient data and cross-sectional health systems data. All admitted neonates were eligible for inclusion (January 2021 through December 2024). Service readiness for CPAP delivery and mean CPAP coverage were described for CPAP eligible newborns (weighing 1500g). Quality of care cascades were constructed to illustrate key indicators. Survival among CPAP eligible neonates was analysed using regression models, stratified by clinical severity scores. Results: 375,255 newborn admissions were analysed in 66 neonatal units. Functional CPAP availability varied with median 16% of days (IQR: 4 to 47%) classified as high demand (>1.5 eligible newborns per CPAP). Of 64,761 CPAP eligible neonates, 22,006 (34%, 95% CI 33 to 34%) received CPAP. All countries showed improvement in CPAP coverage, with Tanzanian hospitals recording 63% increase in mean coverage (p-value=0.001) over time. Quality of care cascades showed treatment was initiated 1 day for 42% (95% CI 41 to 43%) of eligible neonates receiving CPAP. Only 10% of neonates