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01.
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.

02.
arXiv (CS.AI) 2026-06-17

Distributed General-Purpose Agent Networks: Architecture, Key Mechanisms, and Prototypes

arXiv:2606.17368v1 Announce Type: new Abstract: Large language models have accelerated the transition from passive conversational assistants to autonomous agents that can understand goals, plan actions, invoke tools, and execute multi-step tasks. Yet the capability of a single agent remains constrained by its local data, tool permissions, runtime environment, and governance boundary. This paper studies distributed general-purpose agent networks: open peer-to-peer networks in which heterogeneous agents deployed on personal devices, edge nodes, or autonomous computing environments can discover one another, establish trust, negotiate cooperation rules, and execute open-ended tasks. We argue that such networks cannot be obtained by simply combining existing peer-to-peer overlays with conventional multi-agent systems. Unlike traditional P2P networks, agent networks must propagate semantic declarations about intentions, capabilities, states, and cooperation constraints. We therefore propose a layered architecture centered on a protocol adaptation layer that connects upper-level task semantics with lower-level network operations. Based on this architecture, the paper identifies three core mechanism problems: semantic announcement propagation for collaborator discovery, verifiable identity and multi-topic reputation for cooperation governance, and semantic-gradient mechanism design for open task execution. For each problem, we present a technical route, including bodyless gossip with sequential logs, BAID-based identity binding with MG-EigenTrust reputation, and a Stackelberg-style mechanism-generation loop driven by semantic attribution feedback. We further report prototype overhead results for BAID-style tiered verification and mechanism-level simulations of MG-EigenTrust under cross-topic disguise-collusion attacks. The resulting framework provides a system-level foundation for open, trustworthy, and scalable agent collaboration.

03.
medRxiv (Medicine) 2026-06-24

An Automated, Pathologist-free Gleason Grade Stratifies Disease-free Interval Comparably to Expert Grading from a Single Out-of-distribution Slide

Automated Gleason grading now matches expert pathologists on the cohorts where systems are developed and tuned, but deployment-relevant gaps remain: whether an automated grade, applied without site-specific tuning or pathologist oversight, stratifies outcome comparably to expert grading on slides from unseen institutions and in cross-specimen applications. We tested this for disease-free interval (DFI), a curated recurrence endpoint. A production gland-level prostate diagnostic (PathTools Prostate v11.0) was applied frozen and uncalibrated to 298 diagnostic whole-slide images from 274 TCGA-PRAD radical-prostatectomy patients, a cohort outside its development distribution and needle-core-biopsy training data, contributed by 25 source sites under heterogeneous digitization; tissue was detected automatically with no expert region annotation. From the output we derived an ISUP grade group and continuous high-grade content, and evaluated each grade as a standalone predictor of DFI (24 events) by Harrell's c-index with 95% bootstrap confidence intervals, a paired between-method bootstrap, and Kaplan-Meier curves with the log-rank test. The automated grade reproduced the clinical grade group at quadratic-weighted kappa = 0.62 (95% CI 0.53-0.70; 48% exact, 86% within one group), within the expert inter-observer range. As the sole predictor it stratified recurrence (log-rank p = 0.022; c-index 0.69, 95% CI 0.58-0.79), and the continuous high-grade fraction was robustly prognostic (hazard ratio 1.37 per SD, p = 0.029; c-index 0.71, 0.61-0.81). Standalone discrimination was not statistically separable from the clinical grade (c-index 0.78, 0.69-0.86; paired {triangleup} c-index spanning zero), and in a joint model the automated grade added nothing beyond it, consistent with both measuring a shared morphological axis. From a single out-of-distribution slide with no pathologist oversight, the automated grade provides standalone recurrence stratification not statistically separable from whole-gland expert grading, demonstrating robust generalizability beyond training data; reported as a continuous high-grade fraction, it offers reproducible, expert-free, grade-equivalent risk stratification for harmonizing large archival or genomically-profiled cohorts.

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

Learning from almost nothing: How neural networks survive heavy input corruption

arXiv:2606.11319v1 Announce Type: new Abstract: Learning from imperfect data is a central theme in machine learning, connecting practical questions of robustness to fundamental questions of learnability. Here we examine attribute noise: learning from corrupted inputs while keeping the labels intact, a setting that has received considerably less analytical attention than its label-noise counterpart. We consider two types of corruption models: additive noise and replacement noise. Through experiments with multi-layer perceptrons (MLPs) on corrupted classification datasets, we find that neural networks remain robust, maintaining well-above-chance accuracy even when inputs are >90% corrupted – far beyond human recognition. To understand this robustness, we analyze infinite-width networks in the heavy-corruption regime using a mean-field-inspired approach and derive a leading-order decision rule for the classification outcome: the network implements a prototype rule, the nearest-class-mean, assigning each test point to the class whose training-set average it most closely resembles. This leading-order decision rule is universal across a broad range of MLP architectures, holding for any depth, as well as a wide class of activation functions and noise distributions. The same centroid mechanism closely matches finite-width network behavior in our experiments and provides an interpretable and analytically tractable account of why learning can succeed even when individual training examples carry almost no signal.

05.
arXiv (CS.CV) 2026-06-18

GUMP-Net: An interpretable model-data-driven intelligent algorithm for multi-class pelvic segmentation

Pelvic segmentation is one of the most important and fundamental research problems in precise and intelligent diagnosis and treatment, as well as surgical planning and navigation for pelvic fractures. By combining an improved geodesic active contour model with deep neural networks, we propose GUMP-Net, an interpretable model-data-driven intelligent algorithm for multi-class pelvic segmentation, in which three network modules are designed to constitute the overall segmentation framework together: the object detection module for automatic level set initialization, the edge detector module for learning an anatomy-aware edge detector function and the iteration module for deep level set evolution. Leveraging the advantages of level set representation and deep learning, GUMP-Net shows more accurate, robust and consistent segmentation performance, especially in small training data situation, compared to the state-of-the-art methods. Extensive experiments on pelvic datasets demonstrate the rationality and effectiveness of the proposed algorithm. Further experiments extended to ankle dataset indicate broader applications to other anatomies. The proposed algorithm not only provides an efficient segmentation method for complex fracture reduction, but also gives an interpretable geometric perspective for understanding deep learning segmentation.

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

Accelerated Convex Optimization via Hamiltonian Dynamics with Deterministic Integration Time

arXiv:2606.17260v1 Announce Type: cross Abstract: We develop Hamiltonian dynamics-based algorithms for smooth convex optimization that achieve accelerated rates of convergence. By exploiting contraction of averaged Hamiltonian flow trajectories rather than requiring contraction at trajectory endpoints, we show that Hamiltonian dynamics-based optimization methods admit deterministic and accelerated convergence guarantees, extending prior work that is limited to quadratic objectives or holds only in expectation. We analyze an idealized continuous-time algorithm and derive practical discrete-time implementations with optimal first-order complexity, thereby establishing Hamiltonian dynamics as a useful algorithmic primitive for deterministic accelerated convex optimization.

07.
arXiv (CS.LG) 2026-06-12

Ride, Track, and Recover: Pilot Randomized Trial of a Wearable Digital Self-Management Intervention During a Veteran Endurance-Cycling Program

arXiv:2606.13529v1 Announce Type: cross Abstract: Post-traumatic stress disorder (PTSD) in veterans is characterized by persistent hyperarousal and comorbid anxiety and depressive symptoms that are difficult to monitor and manage outside clinical settings. Thirteen veterans participating in a Project Hero cycling event in Texas were randomized by computer-generated sequence in a naturalistic setting to two arms: (1) digital intervention plus physical activity, or (2) physical activity only, plus a third at-home monitoring control cohort consisting of 7 veterans selected from the broader Project Hero veteran community. Continuous smartwatch sensing combined heart rate and accelerometer features to detect hyperarousal events, which were confirmed in real time by participants. Weekly self-report measures of anxiety, depression, and PTSD severity were collected. Generalized additive mixed models characterized nonlinear trajectories over time. Baseline-normalized hyperarousal trajectories differed significantly across conditions, with the digital intervention group (n=7) showing structured stabilization compared to late-study escalation in the physical-only group (n=3). Both cycling groups exhibited acute symptom improvements during the endurance event; however, the digital intervention group demonstrated a higher overall maintenance of gains. The at-home control group (n=4) showed gradual symptom declines. Perceived precision of ML detections varied substantially across individuals and was positively associated with symptom severity, with higher-severity participants confirming a greater proportion of detected events. These results suggest that coupling wearable detection with digital self-management tools may support stabilization of hyperarousal and symptom improvement while emphasizing the importance of personalization and human-centered design in wearable mental health systems.

08.
medRxiv (Medicine) 2026-06-18

Automated Airways Characterization and Assessment of Cystic Fibrosis from CT Imaging

Background Advancements in medical imaging have enabled non-invasive diagnosis and staging of cystic fibrosis (CF) using CT scans, revealing dilated airways, an increased number of visible airways, and airway generation splits in these patients. However, manual characterization of airways remains time-consuming and challenging due to the numerous structural changes, thereby limiting clinical feasibility. This study aims to develop an automated algorithm to characterize airways from segmented lung CT scans and apply this to a retrospective population. This approach reduces the time required to analyze images and obtain disease-staging results. Methods This framework consists of two stages. The first stage extracts and skeletonizes the airway tree from lung CTs, while the second stage measures lung features, including airway volumes, branch counts, generation splits, diameters, and cross-sectional areas. This permits comprehensive characterization for use in clinical assessment. Results The airways analysis was performed on 169 CT volumes ranging in age from 6 to 18 years of age, revealing substantial differences in detected airway branches, generation splits, and normalized airway volume between the control and CF groups. The framework also measures airway diameters and cross-sectional areas, revealing an increase in the number of small airways in cystic fibrosis patients, due to early bronchiectasis. These findings align with previous research and demonstrate the framework's ability to accurately quantify airway changes in patients with CF. Discussion The framework extracts entire airway trees, facilitating measurements of volume, branch count, diameters, and cross-sectional areas, which change with CF severity and/or treatment. However, partial lung atelectasis can limit the accuracy of airway detection in moderate-to-severe cases. Funding NIA U54 AG054345 and NIA R21 AG07857501

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

ATOM-Bench: A Real-World Benchmark for Atomic Skills and Compositional Generalization in Manipulation Policies

arXiv:2606.16826v1 Announce Type: cross Abstract: Generalist manipulation policies are increasingly presented as foundation models for robotic control, but their real-world generalization remains difficult to diagnose. A policy may succeed on demonstrated tasks while still failing to execute fine-grained atomic skills or recombine learned skills in new task structures. We introduce ATOM-Bench, a real-world benchmark for evaluating both atomic skills and compositional generalization in manipulation policies. ATOM-Bench factorizes tabletop manipulation into motor atoms and instruction atoms, and contains 30 atomic tasks and 24 held-out compositional tasks across paired single-arm and dual-arm robot tracks. We collect 3,000 human demonstrations for atomic fine-tuning and release both the demonstration data and evaluation rollout data to support reproducible real-world evaluation. Policies are fine-tuned on atomic tasks and evaluated on both atomic skill acquisition and held-out compositional tasks. We further introduce Atomic Score (AS) and Compositional Failure Share (CFS) to distinguish failures caused by weak atomic skills from failures caused by limited compositional reuse. Through 2,700 physical rollouts on five representative manipulation policies, we find that current policies can acquire simple instruction-grounding skills, but still struggle with fine-grained motor atoms, counting, and logical filtering. More importantly, strong atomic performance does not reliably transfer to held-out compositional tasks. ATOM-Bench provides a diagnostic testbed for studying whether failures arise from weak motor execution, poor instruction grounding, or limited compositional reuse.

10.
arXiv (quant-ph) 2026-06-16

Information Is Not Physical: Possibility Spaces, Erasure, and the Structure of Unrealized Alternatives

arXiv:2606.15120v1 Announce Type: cross Abstract: The slogan ``information is physical,'' introduced by Rolf Landauer and developed through quantum information theory and black-hole thermodynamics, has achieved near-axiomatic status in modern physics. Yet the ontological status of information remains surprisingly underexamined: most discussions either reduce information to a form of energy or treat it as a purely mathematical object. This paper proposes a third position. I argue that information is neither a physical substance nor a free-floating abstraction, but rather the structure of physically realizable alternatives – a counterfactual structure that a physical system instantiates in virtue of the possibility space available to it. Building on Shannon's combinatorial definition, the Landauer principle, the no-cloning theorem, and the black-hole information paradox, I show that the informational content of any physical event is constituted by the set of outcomes that could have occurred but did not. This counterfactual reading dissolves several persistent confusions: it explains why erasing information dissipates heat without making information ``material,'' why quantum superposition is informationally richer than any classical mixture, and why information loss in black holes is physically significant beyond mere bookkeeping. The proposal sits within a structural-realist framework but departs from standard structural realism by locating the relevant structure in modal, not merely actual, relations. I conclude by sketching implications for the foundations of quantum mechanics, quantum gravity, and scientific ontology more broadly.

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

Objective Quality Assessment of Point Clouds Using Multi-scale Implicit Structural Similarity

The unstructured and irregular nature of points poses a significant challenge for accurate point cloud quality assessment (PCQA), particularly in establishing accurate perceptual feature correspondence. To tackle this, we propose the Multi-scale Implicit Structural Similarity Measurement (MS-ISSM). Unlike traditional point-to-point matching, MS-ISSM utilizes radial basis function (RBF) to represent local features continuously, transforming distortion measurement into a comparison of implicit function coefficients. This approach effectively circumvents matching errors inherent in irregular data. Additionally, we propose a ResGrouped-MLP quality assessment network, which robustly maps multi-scale feature differences to perceptual scores. The network architecture departs from traditional flat multi-layer perceptron (MLP) by adopting a grouped encoding strategy integrated with residual blocks and channel-wise attention mechanisms. This hierarchical design allows the model to preserve the distinct physical semantics of luma, chroma, and geometry while adaptively focusing on the most salient distortion features across High, Medium, and Low scales. Experimental results on multiple benchmarks demonstrate that MS-ISSM outperforms state-of-the-art metrics in both reliability and generalization. The source code is available at: https://github.com/ZhangChen2022/MS-ISSM.

12.
medRxiv (Medicine) 2026-06-23

THE SILENT STRUGGLE: EXPLORING THE EFFECTS OF COMMUNICATION BREAKDOWNS IN HEALTHCARE DELIVERY IN THE NORTHERN REGION OF GHANA

Abstract Effective health communication is central to patient-centred care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing Semi-Structured interviews with purposively sampled twenty patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted Content Analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinderer patient openness and the quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact on treatment and assistive practice, specifically in culturally diverse environment and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers. Abstract Effective health communication is central to patient-centered care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing semi-structured interviews with twenty purposively sampled patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted content analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinder patient openness and quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact treatment and assistive practice, specifically in culturally diverse environments and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers.

13.
arXiv (CS.CV) 2026-06-24

Resonant Minds: Closed-Loop Social Avatars with Theory of Mind

Creating lifelike digital humans with genuine social intelligence requires unifying cognitive reasoning and multimodal generation within a coherent framework. Current approaches treat these as separate tasks: Large Language Models excel at dialogue but lack embodied expression, while diffusion-based talking head models achieve visual fidelity but ignore social cognition. To bridge this gap, we propose a closed-loop dual-agent framework integrating perception, social reasoning, and expression into a continuous interaction cycle. The perception module analyzes partners' multimodal behaviors from video, while the social reasoning module infers hidden mental states through Theory of Mind and selects responses via an ensemble mechanism. The expression module then generates emotion-controllable videos that jointly synthesize speaker speech and facial expressions with listener reactive behaviors, capturing bidirectional dynamics absent in prior work. We further construct a hierarchical Persona-Scenario dataset with psychologically grounded personas and private social goals to support evaluation under information asymmetry. Experiments on this dataset demonstrate competitive or superior performance on both dialogue quality and video generation metrics. Notably, our method surpasses even the full-information Script mode on key dialogue quality dimensions, suggesting that explicit mental state inference under uncertainty can elicit more thoughtful dialogue than unrestricted information access. Project page: https://resonantminds.github.io/.

14.
arXiv (CS.CV) 2026-06-24

Neural Particle Automata: Learning Self-Organizing Particle Dynamics

We introduce Neural Particle Automata (NPA), a Lagrangian generalization of Neural Cellular Automata (NCA) from static lattices to dynamic particle systems. Unlike classical Eulerian NCA where cells are pinned to pixels or voxels, NPA model each cell as a particle with a continuous position and internal state, both updated by a shared, learnable neural rule. This particle-based formulation yields clear individuation of cells, allows heterogeneous dynamics, and concentrates computation only on regions where activity is present. At the same time, particle systems pose challenges: neighborhoods are dynamic, and a naive implementation of local interactions scale quadratically with the number of particles. We address these challenges by replacing grid-based neighborhood perception with differentiable Smoothed Particle Hydrodynamics (SPH) operators backed by memory-efficient, CUDA-accelerated kernels, enabling scalable end-to-end training. Across tasks including morphogenesis, point-cloud classification, and particle-based texture synthesis, we show that NPA retain key NCA behaviors such as robustness and self-regeneration, while enabling new behaviors specific to particle systems. Together, these results position NPA as a compact neural model for learning self-organizing particle dynamics.

15.
medRxiv (Medicine) 2026-06-15

Identifying the risk profile of anemia subtypes and hemodynamic obstetric complications in relation to peripartum cardiomyopathy

Background: Peripartum cardiomyopathy (PPCM) is a leading cause of maternal mortality worldwide, with worse outcomes associated with African Ancestry and delayed presentation. However, the mechanisms underlying PPCM are incompletely understood. Objective: Use a large, nationwide cohort to explore associations between PPCM and underexplored perinatal risk factors and complications of childbirth. Methods: Public hospital discharge data were obtained from eleven U.S. states between 2003-2019. Delivery hospitalizations, patient characteristics and obstetric complications were identified using ICD-9 and -10 CM codes. Only cases with unique patient identifiers enabling readmission analysis were included. The primary outcome was incident PPCM coded between 30 days antepartum and 150 days postpartum. Results: Of 7,424,916 delivering patients, 5,488 patients were diagnosed with PPCM. Patients with PPCM had higher rates of anemia, anemia of chronic disease (ACD), iron deficiency anemia (IDA), sickle cell disease (SCD), sickle cell trait (SCT), red blood cell (RBC) transfusion, and postpartum hemorrhage (PPH) (p

16.
medRxiv (Medicine) 2026-06-22

Effect of Lowering the Drink-Driving Blood Alcohol Limit in Scotland on Road Traffic Crashes: a Synthetic Difference-in-Differences Study

Objective: To evaluate the road safety impact arising from Scotlands 2014 reduction in the legal blood alcohol concentration (BAC) limit for drivers, and to assess whether the effect of the reform varied across different spatial contexts. Design: A quasi-experimental statistical longitudinal study using a Synthetic Difference-in-Differences (SDID) approach. Setting: Small-area panel data for Great Britain, with areas (Middle-layer Super Output Areas, MSOAs, in England and Wales and Intermediate Zones, IZs, in Scotland) classed into control and treatment groups according to whether they were exposed to Scotlands BAC reform. The control and treatment groups comprise 7088 spatial units in England and Wales and 852 spatial units in Scotland, respectively, observed over the period 2008-2019. Participants: The study primarily analyses police-reported road traffic collision data from the UK Department for Transports STATS19 system. Data were analysed at the MSOA/IZ level. This is a secondary dataset, and we therefore did not involve patients or the public in formulating the research question, determining outcome measures, or designing and conducting the study. Main Outcome Measures: The main outcome measures were log-transformed rates of total road traffic crashes, and (weekend) night-time crashes (22:00-04:00) per 100,000 population. The latter is used as a proxy measure for drunk driving. Results: Our results indicate that the reduction in the legal BAC limit led to statistically significant declines in road traffic crash rates. Aggregate estimates suggest reductions of 12.0% (95% confidence interval (CI): [-13.7%, -10.3%]) in total crashes, 15.6% (95% CI: [-20.7%, -10.2%]) in night-time crashes, and 12.4% (95% CI: [-16.7%, -7.9%]) in weekend night-time crashes. We also find substantial heterogeneity in treatment effects across spatial contexts. Effects were strongest in rural and less densely populated areas, where reductions exceeded 16% (95% CI: [-18.7%, -13.9%]) for total crashes and reached up to 29.6% (95% CI: [-35.8%, -22.8%]) for night-time and 21.4% (95% CI: [-28.3%, -13.9%]) for weekend night-time crashes. Moderate but statistically significant effects were also observed in dense urban areas, whereas effects in suburban and transitional areas were smaller and not statistically significant. Conclusions: Our analysis suggests that lowering the legal BAC limit in Scotland led to meaningful reductions in road traffic crashes, particularly during higher-risk periods and in rural areas. The findings further suggest that the effectiveness of BAC regulation may vary across local contexts, highlighting the importance of accounting for spatial heterogeneity when evaluating road safety policies.

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

SpecLoR: Spectral Lookahead Rectification for Motion-Coherent Text-to-Video Generation

Flow Matching has enabled robust text-to-video generation via latent ODE sampling. However, velocity approximation and numerical discretization errors inevitably accumulate, causing sampling trajectories to drift. Consequently, generated videos often suffer from severe spatiotemporal inconsistencies. Nevertheless, directly correcting these drifted, noisy latents is challenging: (i) timestep-dependent noise obscures reliable structural cues; (ii) spatial interventions risk disrupting intricate local geometry while incurring heavy computational costs. To address this, we propose Spectral Lookahead Rectification (SpecLoR), a plug-and-play inference method that bypasses noise via lookahead prediction, and circumvents spatiotemporal entanglement by shifting corrections to the frequency domain, where universal statistical priors of natural videos are readily available. First, during early sampling stages, SpecLoR looks ahead to estimate the clean latent $z_{t,0}$ and computes its 3D spatiotemporal spectrum. Next, SpecLoR rectifies the amplitude spectrum to match the prior, leaving the phase intact. Finally, the corrected state is re-noised to resume ODE integration. Experiments on Wan2.2 demonstrate that SpecLoR significantly reduces physical artifacts and enhances motion coherence across multiple benchmarks with minimal computational overhead (4 additional NFEs).

18.
arXiv (CS.AI) 2026-06-24

ScaleToT: Generalizing Structured LLM Reasoning for Billion-Scale Low-Activity User Modeling

arXiv:2606.24605v1 Announce Type: new Abstract: Accurate user modeling often depends on rich interaction histories, which are unavailable for billions of low-activity users. Large Language Models (LLMs) can infer latent user states from static profiles, but this reasoning becomes unreliable when profiles are sparse, and applying an LLM to billions of users is prohibitively expensive. We present ScaleToT, which learns structured reasoning from a small LLM-processed subset and extends it to the broader low-activity user population. To improve reasoning reliability, ScaleToT constructs typed user-state chains with a bounded entropy-guided Tree-of-Thought (ToT) refinement procedure. To make this structured reasoning usable from sparse profiles, the teacher-curated chains are used to train a student model on static profiles through supervised fine-tuning (SFT) and Outcome-Driven Segment-Aware Implicit Reward Policy Optimization (OSIPO). ScaleToT then transfers the student's reasoning representations to a lightweight profile encoder, providing shared reasoning signals for the remaining users without LLM inference. We evaluate ScaleToT on lifetime value (LTV) prediction in a billion-scale advertising deployment. A randomized online A/B test increased LT30 by 6.738\%, while offline reasoning covered only 7.32\% of the potential population, greatly reducing compute cost compared with full-population reasoning.

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

AP-GRPO: Anchor-Gated Phonetic Alignment with Policy Optimization for Pathological Speech Reconstruction

arXiv:2606.15540v1 Announce Type: cross Abstract: Pathological speech from patients with neurodegenerative and neuromotor disorders is often acoustically distorted and linguistically fragmented, making pathological speech reconstruction necessary to recover intended textual content from distorted and incomplete speech recordings. Crucially, such recordings are rarely uniformly degraded: some words or short phrases remain reliable and can serve as audible anchors for reconstructing the corrupted surrounding content. We introduce Anchor-gated Phonetic Group Relative Policy Optimization (AP-GRPO), a GRPO framework with phonetic reward that aligns speech language models (SLMs) through audible-anchor preservation and inter-anchor phonetic compatibility to the original speech signal. AP-GRPO consists of: (i) an anchor-gated reward that matches reliable audible anchors in clear regions; and (ii) an inter-anchor phonetic alignment reward that evaluates whether recovered contents are phonetically supported by the corresponding corrupted inter-anchor speech span. Across four disease conditions, AP-GRPO improves faithful speech reconstruction, and the learned anchor constraint automatically adapts to each condition and thus reveals interpretable disease-specific profiles: conditions with severe articulatory degradation require stronger anchor enforcement, whereas milder impairment or linguistically impaired conditions rely more on phonetic alignment for inter-anchor recovery.

20.
arXiv (CS.CV) 2026-06-24

PointVG-R: Internalizing Geometric Reasoning in MLLMs for Precise Pointing Localization via Visual Chain of Thought

Pointing-based visual grounding requires models to precisely locate target objects by deciphering complex spatial relationships between the visual scene and pointing gestures. Traditional methods typically encode input images into static feature representations and perform reasoning primarily within the linguistic domain, often overlooking the rich perceptual cues and explicit spatial geometry inherent in images. In this study, we aim to mitigate the cognitive vulnerability of models in interpreting gestural spatial relations by proposing PointVG-R, a reasoning-guided Multi-modal Large Language Model (MLLM). PointVG-R introduces geometric-aware reasoning for pointing-based grounding, enabling the model to think with images through the strategic integration of Reinforcement Learning (RL) and cold-start data. Specifically, we design a novel geometric reasoning pipeline that simulates the iterative cognitive process humans employ when interpreting pointing gestures. Furthermore, we construct EgoPoint-CoT, a high-quality visual Chain-of-Thought (CoT) dataset featuring detailed reasoning trajectories to guide the model via Supervised Fine-Tuning (SFT) and RL. To address the varying quality of learning signals encountered during training, we further propose an Adaptive Importance Weighting strategy based on Group Variance, which dynamically adjusts reward signals to optimize the learning process. Experimental results demonstrate that PointVG-R achieves SOTA performance, outperforming the baseline by $15.86$ points in mIoU. Extensive ablation studies further validate the efficacy of our proposed modules. Code: https://github.com/lingli1724/PointVG-R.

21.
arXiv (CS.AI) 2026-06-16

Driving, Fast or Slow? Neuro-Symbolic Guidance for Motion Prediction in Multi-Modal Ground Mobility

arXiv:2606.15251v1 Announce Type: cross Abstract: Accurate and interpretable motion prediction for heterogeneous traffic spaces, including pedestrians, bicycles, cars, and trucks, is essential for safe autonomous navigation. Nevertheless, state-of-the-art approaches remain predominantly black-box, lacking explicit encoding of the regulatory and behavioral constraints of real-world mobility. We propose Trajectory Compliance-Shaping (TraCS), a neuro-symbolic framework that augments existing black-box motion prediction backbones with interpretable and probabilistic first-order logic. To do so, TraCS employs an agentic code-generation pipeline to bridge the gap between natural-language descriptions of traffic regulations and probabilistic motion prediction. Furthermore, TraCS employs a reactive data-streaming inference engine that maintains and efficiently updates compliance landscapes as scenes evolve. To prevent TraCS from overconfidently steering the backbone's predictions in the wrong direction, we propose a neural confidence rating learned as a context-aware attenuation of the compliance signal. We demonstrate on the Argoverse 2 benchmark how TraCS consistently improves state-of-the-art prediction backbones, showing that probabilistic and symbolic compliance reasoning is a broadly applicable and computationally efficient complement to purely neural motion predictors.

22.
medRxiv (Medicine) 2026-06-11

Plasma protein prioritisation in rheumatoid arthritis reveals druggable targets and shared biology with cardiovascular diseases

Abstract Background Rheumatoid arthritis (RA) is an autoimmune inflammatory disease with complex and incompletely understood molecular mechanisms. Understanding circulating proteins associated with RA may improve understanding of disease biology and clarify its pathological links with cardiometabolic comorbidities. Methods A proteome-wide two-sample Mendelian randomisation (MR) drug target analysis was conducted using plasma proteins measured in 54,219 participants from the UK Biobank Pharma Proteomics Project as exposures and RA and cardiometabolic diseases as the outcomes. Summary statistics for RA included 53,663 cases and 1,070,200 controls. Colocalisation analysis was performed to confirm shared single causal variants and prioritise RA proteins supported by both MR and colocalisation. The prioritised proteins were then evaluated in the Accelerating Medicines Partnership RA Phase II synovial single-cell dataset for cell-type expression patterns. Druggability was then assessed followed by analysis of genetic overlap between RA-associated proteins and cardiometabolic diseases. Results 37 plasma proteins had a causal effect on RA risk, supported by combined evidence from MR and conditional colocalisation. In synovial tissue, TPPP3, RARRES2, AKAP12, and GGT5 were predominantly expressed in stromal and endothelial cell clusters. Druggability assessment identified IFNGR2, IL6R, CD40, and FCGR2B as Tier 1 targets. However, several biologically relevant proteins, including RARRES2, AKAP12, TPPP3, and SNX2, had limited available druggability data. Genetic overlap analysis demonstrated shared protein signals between RA and cardiovascular diseases, including overlap of RARRES2 and TPPP3 with coronary artery disease (CAD) and FCGR2B with atrial fibrillation (AF). To approximate the therapeutic effect of target inhibition, the direction of effect estimates for proteins showing overlap between RA-CAD and RA-AF was reversed. Conclusion This study identified circulating proteins involved in RA pathogenesis and reveals shared mechanisms between RA and cardiovascular diseases. While some proteins showed clear translational potential targets, several prioritised proteins had limited available druggability information and could not be confidently classified. Addressing these gaps may help identify new targets relevant to RA management. Future work should also use phenome-wide MR studies to evaluate potential on-target adverse effects of protein inhibition across RA-CAD and RA-AF.

23.
arXiv (CS.AI) 2026-06-15

MA-ProofBench: A Two-Tiered Evaluation of LLMs for Theorem Proving in Mathematical Analysis

arXiv:2606.13782v1 Announce Type: new Abstract: Large Language Models (LLMs) have made notable progress in automated theorem proving, yet existing formal benchmarks remain limited in both mathematical coverage and difficulty. Most are concentrated in areas that are easier to formalize, such as algebra and elementary number theory, and provide limited coverage of subfields that require deeper reasoning, including mathematical analysis. To address this gap, we introduce MA-ProofBench, to the best of our knowledge, the first formal theorem-proving benchmark dedicated to Mathematical Analysis. The benchmark contains 200 formalized theorems covering 6 core topics and 27 subcategories, including measure and integration theory, complex analysis, and functional analysis. The problems are divided into two difficulty levels, an undergraduate level (Level I, 100 problems) and a Ph.D. qualifying level (Level II, 100 problems), to evaluate how well LLMs perform formal reasoning at different mathematical depths. Each problem is constructed through a human-led, LLM-assisted formalization pipeline followed by independent expert review, ensuring that the formal statements remain faithful to the original mathematics. We evaluate a range of recent general-purpose reasoning models and formal theorem provers on MA-ProofBench. However, most models perform poorly: even the best-performing model, GPT-5.5, achieves only 16% Pass@8 on Level I and 5% on Level II, while most models stay close to 0% on Level II. Further analysis identifies Mathlib hallucinations and incomplete proofs as the two dominant failure modes, while an evaluation on the natural-language version of the benchmark exposes a clear gap between informal and formal reasoning. MA-ProofBench is intended to serve as a reliable reference for tracking progress in formal mathematical reasoning in advanced domains.

24.
arXiv (CS.CV) 2026-06-18

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

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

25.
arXiv (quant-ph) 2026-06-16

Optimizing Wigner Negativity in Scattering Processes Using Energetic Cost Functions

arXiv:2606.15101v1 Announce Type: new Abstract: Wigner negativities (WNs) are key signatures of non-Gaussian bosonic states and essential resources for quantum technologies. We study their generation in the scattering of coherent pulses by a two-level atom coupled to a one-dimensional reservoir, a unitary and energy-preserving platform. Optimization in this multimode setting is hindered by the complexity of evaluating Wigner functions. We overcome this challenge by introducing energetic cost functions that identify output modes most likely to host large negativities. First using incoherent energy and then isolating a genuinely non-Gaussian contribution, we demonstrate a strong correlation between these quantities and WNs. This correlation extends beyond short, intense pulses to encompass pulses of finite energy, where photons are scattered while the two-level atom is driven. Focusing on the energy-efficiency of the process, we show that maximally efficient generation takes place for one input photon, on average, spectrally mode-matched with the atom.