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01.
arXiv (CS.AI) 2026-06-18

Clin-JEPA: A Multi-Phase Co-Training Framework for Joint-Embedding Predictive Pretraining on EHR Patient Trajectories

arXiv:2605.10840v3 Announce Type: replace-cross Abstract: We present Clin-JEPA, a multi-phase co-training framework for joint-embedding predictive (JEPA) pretraining on EHR patient trajectories. JEPA architectures have enabled latent-space planning in robotics and high-quality representation learning in vision, but extending the paradigm to EHR data – to obtain a single backbone that simultaneously forecasts patient trajectories and serves diverse downstream risk-prediction tasks without per-task fine-tuning – remains an open challenge. Existing JEPA frameworks either discard the predictor after pretraining (I-JEPA, V-JEPA) or train it on a frozen pretrained encoder (V-JEPA 2-AC), leaving the encoder unaware of the rollout signal that the retained predictor must use at inference; co-training the encoder and predictor under a shared JEPA prediction objective would supply this grounding, but naïve co-training is unstable, with representation collapse and online/target drift causing autoregressive rollout to diverge. Clin-JEPA's five-phase pretraining curriculum – predictor warmup, joint refinement, EMA target alignment, hard sync, and predictor finalization – addresses each failure mode by phase, stably co-training a Qwen3-8B-based encoder and a 92M-parameter latent trajectory predictor. On MIMIC-IV ICU data, three independent evaluations support the framework: (1) latent $\ell_1$ rollout drift uniquely converges ($-$15.7%) over 48-hour horizons while baselines and ablations diverge (+3% to +4951%); (2) the encoder learns a clinically discriminative latent geometry (deteriorating-patient cohorts displace 4.83$\times$ further than stable patients in latent space, vs $\leq$2.62$\times$ for baseline encoders); (3) a single backbone outperforms strong tabular and sequence baselines on multi-task downstream evaluation. Clin-JEPA achieves mean AUROC 0.851 on ICareFM EEP and 0.883 on 8 binary risk tasks (+0.038 and +0.041 vs baseline average).

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

Machine-learned particle flow as a foundation model for collider physics

arXiv:2606.14373v1 Announce Type: cross Abstract: The workflow from particle collision to physics analysis passes through a series of reconstruction steps that are traditionally modular and disconnected, with no shared representation linking low-level detector data to high-level analysis tasks. We show that casting event reconstruction as a machine learning problem naturally produces such a shared representation. We repurpose a machine learning model trained for particle-flow reconstruction (MLPF) to perform three distinct analysis tasks: jet flavor identification, jet energy regression, and missing momentum regression. By appending the per-particle latent representations learned during reconstruction as additional input features, we substantially improve over baselines that use kinematic features alone. We further demonstrate that a single linear layer trained using only the latent representations achieves competitive performance against state-of-the-art baseline architectures, and outperforms the baseline for missing momentum regression with approximately 35 times fewer parameters. These results demonstrate that the latent representations learned during reconstruction encode essential physics information needed for downstream analysis, establishing MLPF as a foundation model and offering a concrete step toward an end-to-end pipeline from detector data to physics analysis.

04.
arXiv (CS.LG) 2026-06-11

Coverage Guarantees for Pseudo-Calibrated Conformal Prediction under Distribution Shift

arXiv:2602.14913v2 Announce Type: replace Abstract: Conformal prediction (CP) offers distribution-free marginal coverage guarantees under an exchangeability assumption, but these guarantees can fail if the data distribution shifts. We analyze the use of pseudo-calibration as a tool to counter this performance loss under a bounded label-conditional covariate shift model. Using tools from domain adaptation, we derive a lower bound on target coverage in terms of the source-domain loss of the classifier and a Wasserstein measure of the shift. Using this result, we provide a method to design pseudo-calibrated sets that inflate the conformal threshold by a slack parameter to keep target coverage above a prescribed level. Finally, we propose a source-tuned pseudo-calibration algorithm that interpolates between hard pseudo-labels and randomized labels as a function of classifier uncertainty. Numerical experiments show that our bounds qualitatively track pseudo-calibration behavior and that the source-tuned scheme mitigates coverage degradation under distribution shift while maintaining nontrivial prediction set sizes.

05.
arXiv (CS.AI) 2026-06-11

Noise-Guided Transport for Imitation Learning

arXiv:2509.26294v2 Announce Type: replace-cross Abstract: We consider imitation learning in the low-data regime, where only a limited number of expert demonstrations are available. In this setting, methods that rely on large-scale pretraining or high-capacity architectures can be difficult to apply, and efficiency with respect to demonstration data becomes critical. We introduce Noise-Guided Transport (NGT), a lightweight off-policy method that casts imitation as an optimal transport problem solved via adversarial training. NGT requires no pretraining or specialized architectures, incorporates uncertainty estimation by design, and is easy to implement and tune. Despite its simplicity, NGT achieves strong performance on challenging continuous control tasks, including high-dimensional Humanoid tasks, under ultra-low data regimes with as few as 20 transitions.

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

Energy Use of AI Inference, Efficiency Pathways, and Test-Time Scaling

arXiv:2509.20241v2 Announce Type: replace Abstract: As AI inference scales to billions of queries, estimates of per-query energy use are increasingly important for capacity planning, efficiency interventions, and policy. Yet many public estimates assume non-production settings, leading to systematic overestimation. We introduce a bottom-up framework estimating inference energy from token throughput, node power, and overhead under large-scale deployment assumptions. For frontier-scale models (>200B parameters) on H100 nodes, we estimate a median energy of 0.31 Wh/query (IQR 0.16-0.60), indicating widely cited estimates are overstated by 4-20x. In test-time scaling scenarios 15x longer than typical queries, the median energy rises 13x to 3.91 Wh (IQR 2.15-7.05). Across models, serving systems, and hardware, we estimate 8-20x line-of-sight energy reductions. At datacenter scale, serving 1 billion queries/day requires 0.7 GWh; if 10% are long queries, demand rises to 1.7 GWh/day. With efficiency interventions, it falls to 0.8 GWh/day, mitigating the energy impact of test-time scaling.

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

ROVE: Unlocking Human Interventions for Humanoid Manipulation via Reinforcement Learning

arXiv:2606.17011v1 Announce Type: cross Abstract: Human interventions provide crucial corrective signals for post-training Vision-Language-Action (VLA) models. However, enabling seamless humanoid interventions is a formidable systems challenge due to complex whole-body kinematics and dexterous-hand control. Consequently, the collected intervention trajectories are often suboptimal, and methods that rely on human interventions as expert supervision can absorb hesitant, inefficient, or even erroneous behaviors. To address both the system and algorithmic challenges, we propose ROVE, a reinforcement learning framework for humanoid VLA post-training with imperfect human interventions. First, ROVE introduces a human-in-the-loop pipeline capable of collecting deployment and intervention data for humanoid manipulation. Second, it utilizes Optimistic Value Estimation (OVE) to prioritize high-value behaviors from mixed-quality trajectories. To further robustify value estimation, we incorporate cross-embodiment human experience videos to provide rich supervision for long-tailed failure and recovery modes. The resulting critic yields informative advantage signals, steering the VLA actor to focus on high-value behaviors rather than indiscriminately imitating all actions. On challenging real-world contact-rich and fine-grained humanoid manipulation tasks, ROVE outperforms experience-learning baselines and consistently improves across multiple rollout-intervention iterations.

08.
arXiv (CS.AI) 2026-06-16

Quantum Machine Learning for Industrial Applications

arXiv:2606.14822v1 Announce Type: cross Abstract: Recent advances in Machine Learning have transformed numerous industrial sectors, yet classical paradigms face fundamental limitations: rapidly growing data volumes, rising computational costs, significant energy consumption, and the physical scaling limits of conventional hardware architectures. Quantum computing has emerged as a promising computational paradigm to address these challenges, giving rise to the field of Quantum Machine Learning (QML). In this thesis, the theoretical foundations of QML are investigated, with a focus on near-term and future practical applications. Three central challenges are addressed: the trainability of variational quantum circuits, their expressivity, and their resistance to efficient classical simulation. The trainability of Hamming-weight preserving variational quantum circuits is first studied, and theoretical guarantees are established that resolve an open conjecture on the absence of barren plateaus for this circuit family. Subspace-preserving QML algorithms are then introduced, including photonic circuits and quantum convolutional neural networks, and are designed to mimic classical ML subroutines while offering polynomial quantum advantage. Finally, variational quantum circuits are analyzed as quantum Fourier models, and a framework is derived to jointly characterize expressivity and trainability, from which conditions are obtained under which quantum models provably separate from their classical counterparts. These contributions are intended to advance the theoretical roadmap for harnessing near-term and future quantum technologies in real-world applications.

09.
arXiv (CS.AI) 2026-06-19

Augmenting Game AI with Deep Reinforcement Learning

arXiv:2606.20210v1 Announce Type: new Abstract: Immersion in video games depends not only on graphics, audio, and game mechanics, but also on the quality of in-game characters. Producing believable characters, or game AI, remains a significant challenge as behavioral complexity is hard to capture with hand-coded systems. Game AI is a source of immersion and engagement; however, the limitations stemming from the challenges of creating game AI often lead to frustration and the breaking of the illusion of realism within the game. The introduction of machine learning models opens the door to creating more believable, authentic, and relatable characters in games. The promise is that they either learn from interacting with the game, or from player data, to develop true human-like behavior. In this paper, we envision more applications of reinforcement learning for game AI in the future. For this to materialize, current research limitations are prohibitive to broad deployment across game genres. Therefore, we propose a framework for training reinforcement learning models with a set of requirements in mind that are suited towards game AI and game development. We present examples of games with reinforcement learning-augmented game AI and describe the practicalities of deploying player-facing machine learning agents in modern games. Furthermore, we identify bottlenecks and hard problems in these areas, which we believe offer promising research directions to accelerate the adoption of machine learning in game AI for the video game industry.

10.
medRxiv (Medicine) 2026-06-11

Foundation model-based tool for automated ulcerative colitis histology scoring demonstrates non-inferiority to pathologists across multiple scoring indices

In clinical trials for ulcerative colitis (UC), pathologists assess disease severity through standardized histological indices, including the Geboes Score, Robarts Histopathology Index (RHI), and Nancy Histologic Index (NHI). Despite strong associations with clinical outcomes, histologic scoring suffers from inter- and intra-reader variability, and consensus criteria for histologic remission remain uncertain. Through a consortium approach, we developed an artificial intelligence-based measurement (AIM) tool for scoring histology in UC mucosal biopsies (AIM-HI UC). This model, trained on a large dataset of UC biopsies (N=10,230), utilizes additive multiple instance learning models leveraging PLUTO, a pathology foundation model, that predict each of the Geboes subgrades, from which the Geboes grade-level score, RHI, and NHI can be calculated. Evaluation of this model on a standalone verification set including clinical trial specimens established algorithm non-inferiority and/or superiority relative to standard qualified pathologists through comparison of algorithm-consensus and pathologist-consensus agreement metrics (non-inferior if difference >-0.1, superior if difference >0, inclusive of confidence intervals). AIM-HI UC was determined to be non-inferior to pathologists (N=3) for the prediction of all seven Geboes subgrades, grade-level Geboes, RHI, NHI, histologic improvement (GS

11.
arXiv (CS.AI) 2026-06-19

A Tool for the Synthesis of Adaptive Probabilistic Processors Based on the Ising Model

arXiv:2606.19533v1 Announce Type: cross Abstract: This work presents a tool for the synthesis and simulation of probabilistic architectures for solving combinatorial optimization problems by mapping them to the Ising model. The proposed approach automatically constructs the Ising Hamiltonian and determines the number of probabilistic elements (p-bits) based on problem characteristics such as size and topology. Furthermore, the tool introduces an adaptive strategy for selecting the most suitable update algorithm among Gibbs Sampling, Simulated Annealing (SA), Simulated Quantum Annealing (SQA), and cluster-based methods. Experimental results using benchmark problems demonstrate improved convergence behavior and flexibility compared to fixed approaches. The proposed framework enables systematic evaluation of probabilistic computing strategies and supports the development of future hardware implementations based on MTJs and p-bits.

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

GAE: Unleashing Physical Potential of VLM with Generalizable Action Expert

Vision-language models demonstrate strong reasoning and planning abilities, yet grounding these predictions into precise robot actions remains a central challenge. Existing Vision-Language-Action methods typically entangle reasoning and action generation, leading to limited generalization. We propose Generalizable Action Expert (GAE), a task-agnostic model that converts sparse geometric plans into dense robot actions. Our approach introduces a sparse geometric interface: the VLM predicts sparse 3D waypoints representing high-level intention, while GAE maps these waypoints together with real-time point cloud observations to continuous action trajectories. GAE is pretrained on a large-scale pointcloud-trajectory dataset comprising 150k trajectories from both simulation and real-world robots. To further improve efficiency and generalization, we introduce an Action Pre-training, Pointcloud Fine-tuning (APPF) scheme that decouples learning action dynamics from geometry grounding. After pretraining, GAE is frozen and reused across downstream tasks, requiring only lightweight fine-tuning of the VLM to produce the sparse interface. Experiments show that our method achieves strong performance and generalization across diverse visual domains, camera viewpoints, and natural language instructions.

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

Greedy Coordinate Diffusion: Effective and Semantically Coherent Adversarial Attacks via Diffusion Guidance

arXiv:2606.15531v1 Announce Type: new Abstract: Fine-tuning aligned language models on benign tasks (e.g. math tutoring) systematically breaks safety guardrails, even when training data contains no harmful content. While mechanistic approaches have shed light on where alignment resides in model weights, they do not by provide a general formal framework for deriving guarantees about when fine-tuning degrades it – leaving the field without principled tools for predicting or preventing alignment collapse. We develop a local geometric framework through geometric analysis of parameter-space trajectories and apply it to understand the fragility of alignment in fine-tuning. While first-order analysis suggests orthogonal updates are safe, we prove this is illusory: the curvature of the fine-tuning loss induces second-order acceleration that can induce second-order drift into alignment-sensitive regions. We formalize a construct of our framework as the Alignment Instability Condition (AIC), three geometric properties that, when present, are sufficient to guarantee degradation. Our main result proves quartic onset of alignment degradation along gradient-flow trajectories, determined by how sharply alignment depends on specific parameters and how strongly tasks couple to these parameters. These findings yield formal sufficient conditions under which static first-order protection can fail under gradient descent. We further empirically validate the framework's foundations, showing that the Fisher Information Matrix provides a proxy for the degree of safety degradation across diverse fine-tuning.

14.
arXiv (CS.LG) 2026-06-12

NetCause: Counterfactual Learning for Root Cause Analysis in Large-Scale Networks

arXiv:2606.13543v1 Announce Type: cross Abstract: Can a learned model capture how faults propagate through a large-scale network and use this knowledge to causally attribute customer impact to its underlying root cause? Existing root cause analysis techniques often rely on static rules, correlation heuristics, or topology-local reasoning, which struggle to generalize in dynamic environments where faults propagate across complex physical and logical dependencies. We present NetCause, a self-supervised learning-based framework that models network incidents as graph-temporal processes and uses counterfactual simulation to rank candidate root causes. This approach produces an interpretable ranking of root cause hypotheses and integrates naturally with operator-defined mitigation and remediation actions. We train the model on over 1,500 incidents collected over six months from a leading cloud provider's production network and evaluate it on 31 expert-labeled incidents. NetCause consistently improves root cause ranking quality in the regime most relevant to operational decision-making, achieving a 16.1% accuracy improvement over a rule-based heuristic baseline. While training is computationally intensive, inference is lightweight, requiring only seconds of GPU runtime per incident (well below typical telemetry collection latencies).

16.
arXiv (quant-ph) 2026-06-15

Real-time pseudo entropy and modular-Hamiltonian correlations

arXiv:2606.14208v1 Announce Type: cross Abstract: Pseudo entropy is a complex-valued generalization of entanglement entropy defined from a reduced transition matrix. We study the pseudo entropy associated with a real-time transition matrix between an initial pure state and its unitary time evolution. For a subsystem $A$, we show that the short-time behavior of real-time pseudo entropy is governed by the correlation between the physical Hamiltonian $H$ and the modular Hamiltonian $K_A=-\log\rho_A$ of the initial reduced state, $ S_A(t,0)=S_A(0)-it \langle K_A(H-\langle H\rangle)\rangle + \mathcal{O}(t^2)$. For Hermitian dynamics, the initial imaginary response is controlled by the symmetrized covariance of $H$ and $K_A$ with an overall minus sign, while the initial real response is governed by their commutator. Thus the imaginary part of real-time pseudo entropy is not merely a branch artifact: it is a time-oriented modular response generated by the correlation between microscopic time evolution and subsystem coarse graining. We clarify the relation of this result to the known first law of pseudo entropy, derive an all-order expression in a Schmidt-diagonal model, recover thermal pseudo entropy as a special case, illustrate the covariance/commutator decomposition in a two-qubit model, and confirm the covariance response in transverse-field Ising-chain quenches, including a finite-size study of a modular susceptibility near the Ising critical region. We discuss how this amplitude-level oriented response can be related to ordinary entropy production, and also give a concrete $\mathcal{PT}$-symmetric toy-model illustration of the non-Hermitian extension.

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

Evaluating and Enhancing Negation Comprehension in Remote Sensing MLLMs

arXiv:2606.20177v1 Announce Type: cross Abstract: Multimodal Large Language Models (MLLMs) have demonstrated remarkable success in various Remote Sensing (RS) tasks. However, their ability to comprehend negation remains underexplored, limiting deployment in real-world applications where models must explicitly identify what is false or absent, e.g., emergency responders need to locate non-flooded routes for evacuation. To comprehensively study this limitation, we introduce RS-Neg, the first benchmark to evaluate negation understanding across region-level to scene-level tasks. Specifically, we design an automated data generation pipeline for RS imagery, using LLMs to synthesize diverse negation queries, and introduce a dynamic visual focus module for verification. Our evaluation reveals that advanced RS MLLMs struggle with negation, exhibiting hallucinations and substantial performance degradation. To close this gap, we propose NeFo, a novel test-time learning method that explicitly incorporates the logical role of negation into the model optimization. Remarkably, using about 5\% unlabeled test samples, NeFo significantly improves the negation understanding of models and shows strong generalization to unseen tasks. Code and data will be released upon acceptance.

18.
Nature Medicine 2026-06-10

Brain Health for Economic Resilience: a data-driven framework for the brain-positive economic transition

Announced in this Comment and in collaboration with Nature Medicine is the convening of the Brain Health for Economic Resilience Commission, a global, transdisciplinary effort to define, measure and operationalize brain health and cognitive capacity as foundational drivers of economic resilience.

19.
Nature Medicine 2026-06-15

Plasma proteomic signatures of cellular aging predict human disease

Aging is asynchronous across cells and organs. Here we tested whether plasma proteomics can be used to analyze cell type-specific aging. From analyses of over 7,000 plasma proteins measured in 60,542 individuals, we developed machine learning models to estimate the biological age of over 40 cell types spanning neuronal, immune, glial, endocrine, epithelial and musculoskeletal origins. We observed that 20–25% of individuals exhibited accelerated aging in a single cell type and 1–3% in 10 or more cell types. Cellular aging signatures were associated with disease status and predicted incident disease and mortality over 15 years of follow-up. Individuals with the APOE4 genotype showed older astrocytes but younger macrophages compared to APOE3 carriers, whereas the APOE2 genotype had inverse associations. Moreover, extreme astrocyte aging tripled the risk of incident Alzheimer’s Disease in individuals with two APOE4 alleles, while youthful astrocytes reduced risk. Individuals with extremely aged compared to youthful skeletal myocytes exhibited a 12.7-fold higher risk of developing amyotrophic lateral sclerosis. In individuals who smoked, extreme respiratory epithelial cell aging was associated with a 58% higher lung cancer risk compared to smoking alone. Specific cellular vulnerabilities and cumulative cellular aging burden influenced survival, with youthful immune and neuronal cell types conferring protective effects. Finally, we developed a polycellular aging risk score that stratified mortality risk across cohorts and proteomics platforms. These findings establish a framework for quantifying human physiology at cellular resolution, revealing heterogeneous aging trajectories and their impact on disease susceptibility and resilience. The biological age of individual cell types can be evaluated using plasma proteomics, revealing diverse aging profiles across more than 40 cell types and links between the accelerated aging of specific cell types and disease.

20.
bioRxiv (Bioinfo) 2026-06-22

Reference-guided immune recovery matching prioritizes traditional Chinese medicine ingredients

Therapeutic prioritization from single-cell transcriptomes requires a target that is closer to treatment response than disease-signature reversal. In immune diseases, post-treatment recovery may follow patient- and cell-type-specific trajectories rather than a simple return along the pretreatment disease axis. We developed ImmuneNavi, a healthy-reference-anchored recovery-matching workflow for ranking traditional Chinese medicine ingredients from paired PBMC data. The workflow maps heterogeneous PBMC cohorts to a common healthy immune coordinate system, constructs patient-cell-type disease and recovery states, and processes ITCM treated-control profiles into a fixed ingredient perturbation bank. Patient and ingredient states are represented in matched gene, pathway and transcription-factor views, allowing the model to combine local transcriptional direction with more stable program-level features. A matcher trained on one paired treatment cohort preserved recovery-aligned ingredient rankings in independent PBMC cohorts without redefining the feature space, candidate set or preprocessing procedure. This provides a reusable transcriptomic pipeline for moving from paired immune-state measurements to prioritized natural-product candidates for experimental follow-up.

21.
arXiv (CS.AI) 2026-06-17

A Machine-Learned Comorbidity Index

arXiv:2606.17450v1 Announce Type: new Abstract: Traditional comorbidity scores (e.g., Charlson and Elixhauser) are widely used for risk adjustment and patient stratification, but they have two key limitations: (i) they are largely mortality-centric and do not align well with other clinical outcomes, and (ii) their linear, rule-based structure cannot capture nonlinear, outcome-specific risk relationships. We propose a Machine-Learned Comorbidity Index (MLCI) that maps diagnosis codes to a single scalar by maximizing the normalized Hilbert-Schmidt Independence Criterion (nHSIC) between the learned score and multiple clinical outcomes. MLCI captures nonlinear risk-outcome dependence and is supported by a theory that characterizes when a unified, informative admission-level ordering can be achieved across outcomes. Empirical results on multiple benchmark electronic health record (EHR) datasets show that MLCI outperforms strong baselines across multiple evaluation metrics.

22.
arXiv (CS.LG) 2026-06-11

Modelling magnetic material properties with uncertainty-aware neural networks

arXiv:2606.11870v1 Announce Type: cross Abstract: Machine learning is increasingly applied to accelerate the discovery of novel materials by exploring large compositional and structural design spaces. Yet, the scarcity of high-quality data and the frequent need for out-of-distribution prediction introduce substantial uncertainty, making the assessment of model reliability essential. In this work, we investigate uncertainty quantification as a means to evaluate model confidence in the context of permanent magnet research. In a first study, we benchmark classical and modern machine learning models for predicting intrinsic magnetic properties, focusing on the quality of their uncertainty estimates. We apply Gaussian negative log-likelihood loss and dropout-based Bayesian approximation as practical strategies for estimating predictive uncertainty. In a second study, we transfer these architectural features for uncertainty estimation to a more complex task: predicting coercivity from microstructural information using a graph neural network. Together, these studies demonstrate that uncertainty quantification not only enhances the trustworthiness of predictions but is also transferable across different modeling tasks.

23.
medRxiv (Medicine) 2026-06-15

An epidemiological scenario for Mass Events During the World Cup

This brief work discusses potential superspreading events that may occur during the World Cup in Mexico. The study is particularly focused on the city of Guadalajara due to a large recent outbreak in January and February and insufficient vaccine coverage prior to 2026. Keywords: Superspreading; measles outbreak; branching process; individual reproduction number; World Cup

24.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

25.
arXiv (CS.LG) 2026-06-15

More with LESS – Local Scene Representations for Tactile Imaging

arXiv:2606.14344v1 Announce Type: new Abstract: Tactile imaging seeks to reconstruct the internal structure of soft objects through touch sensing, with applications in medical diagnosis and robotic manipulation. Recent self-supervised learning approaches have shown promising results, but rely on global, unstructured representations and robot-controlled sensing, limiting generalization and practical use. We propose Local Encoder for Spatial Sensing (LESS), an object-centric tactile representation that exploits the local nature of touch. The tactile scene is modeled as a grid of recurrent encoders with local receptive fields, whose states are fused to reconstruct 2D or 3D images of internal structure. This compositional design enables strong generalization: models trained on single-inclusion phantoms accurately image objects with multiple inclusions and varying sizes. The local structure further supports spatial uncertainty estimation. In addition, we enable hand-held tactile imaging via external pose tracking and human-like palpation data, and extend tactile imaging to full 3D reconstruction.