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01.
arXiv (math.PR) 2026-06-15

Mixing Times for the Facilitated Exclusion Process

arXiv:2402.18999v2 Announce Type: replace Abstract: The facilitated simple exclusion process (FEP) is a one-dimensional exclusion process with a dynamical constraint. We establish bounds on the mixing time of the FEP on the segment, with closed boundaries, and the circle. The FEP on these spaces exhibits transient states that, if the macroscopic density of particles is at least $1/2$, the process will eventually exit to reach an ergodic component. If the macroscopic density is less than $1/2$ the process will hit an absorbing state. We show that the symmetric FEP (SFEP) on the segment $\{1,\ldots,N\}$, with $k>N/2$ particles, has mixing time of order $N^{2}\log(N-k)$ and exhibits the pre-cutoff phenomenon. For the asymmetric FEP (AFEP) on the segment, we show that there exists initial conditions for which the hitting time of the ergodic component is exponentially slow in the number of holes $N-k$. In particular, when $N-k$ is large enough, the hitting time of the ergodic component determines the mixing time. For the SFEP on the circle of size $N$, and macroscopic particle density $\rho \in(1/2,1)$, we establish bounds on the mixing time of order $N^{2}\log N$ for the process restricted to its ergodic component. We also give an upper bound on the hitting time of the ergodic component of order $N^{2}\log N$ for a large class of initial conditions. The proofs rely on couplings with exclusion processes (both open and closed boundaries) via a novel lattice path (height function) construction of the FEP.

02.
arXiv (CS.CV) 2026-06-18

PorTEXTO: A European Portuguese Benchmark for Visual Text Extraction

European Portuguese (pt-PT) is largely absent from OCR benchmarks, which skew toward high-resource languages. The few benchmarks that cover pt-PT focus on historical artifacts and literature. This work addresses modern OCR applications, introducing PorTEXTO, the first benchmark for contemporary and culturally relevant pt-PT visual text extraction. To ascertain quality, we employ an annotation pipeline combining transcriptions from a frontier LVLM with exhaustive review by native speakers. We observe a sharp performance drop from synthetic to real world samples in most models, and find that, currently, specialized multilingual data is a better driver for pt-PT performance than model size or resolution budget, motivating the release of open pt-PT OCR resources.

03.
arXiv (quant-ph) 2026-06-25

Efficient Quantum Circuits for Coherent Conversion Between General First- and Second-Quantized Many-Body Representations

arXiv:2606.25029v1 Announce Type: new Abstract: Quantum simulation at fixed particle number admits two equivalent descriptions, a first-quantized (particle) representation and a second-quantized (occupation-number) representation. Their quantum resource costs differ sharply across computational tasks, so the ability to convert coherently between them is valuable. We construct an explicit unitary $Q$, with inverse $Q^\dagger$, that maps a first-quantized state to its fixed-$N$ occupation-number form while diagnosing the input's particle-exchange symmetry. The conversion is therefore symmetry-agnostic at the input yet fully resolved at the output, and it applies uniformly to bosonic, fermionic, and parastatistical sectors. At its foundation lies a structural identification that we place at the center of this work: the quantum Schur transform supplied by Schur-Weyl duality is the non-abelian Fourier transform of the commuting pair $(S_N,U(d))$, and the occupation-number representation is its weight basis, retaining only the labels shared by both factors, the irrep $\lambda$ and the $\mathfrak{u}(d)$ weight. This reduction is lossless for bosons and fermions, while a canonical Gelfand-Tsetlin promise renders it one-to-one for the remaining sectors. Algorithmically, $Q$ composes the strong Schur transform with reversible arithmetic that computes occupations as successive row-sum differences of the Gelfand-Tsetlin pattern, yielding gate complexity $\mathrm{poly}(N,d,\log(1/\epsilon))$. The converted state is prepared efficiently in quantum memory. Any classical algorithm that outputs it explicitly, however, pays a cost set by the sector dimension, which is polynomial of degree $N$ in $d$ at fixed $N$ and exponential in $N$ when $d=\Theta(N)$. Finally, an efficient classical sampler for the induced occupation-number distribution would yield one for arbitrary quantum circuits, contrary to standard complexity assumptions.

04.
arXiv (CS.AI) 2026-06-16

Guiding Federated Graph Recommendation with LLM-encoded knowledge

arXiv:2606.15277v1 Announce Type: cross Abstract: Graph-based recommender systems are highly effective at extracting collaborative signals from user–item interactions, and federated learning (FL) allows these models to be trained while preserving user privacy. However, aggregating graph representations across distributed, non-IID clients remains a challenge; structural embeddings learned locally often misalign, and naive averaging fails to capture meaningful cross-client relationships. Most existing federated graph methods rely exclusively on structural aggregation, neglecting the rich, global semantic context available in large language models (LLMs). In this paper, we propose a novel framework that uses LLM-encoded knowledge to guide federated graph recommendation. Specifically, clients learn structural representations from local graphs while simultaneously summarizing their typical interaction patterns into compact semantic vectors via a frozen LLM. The central server then uses these LLM-encoded semantic signals to discover related preference patterns across clients, guiding the selective aggregation of their structural representations. This enables semantically informed cross-client collaboration without exposing raw data. Extensive experiments on standard benchmarks show that guiding structural alignment with LLM-encoded knowledge consistently improves recommendation accuracy over existing federated graph baselines.

05.
PLOS Medicine 2026-06-23

Prevalence and epidemiological patterns of <i>Neisseria gonorrhoeae</i> infection in sub-Saharan Africa, 1964–2025: Systematic review, meta-analyses, and meta-regressions

作者:

by Aisha Osman, Hina Akram, Bayan Alemrayat, Sumaya Al-Maraghi, Manale Harfouche, Laith J. Abu-Raddad Background Neisseria gonorrhoeae (NG) infection is a global health concern because of its morbidity and increasing antimicrobial resistance. Sub-Saharan Africa is believed to carry a disproportionately high burden of NG infection, but the epidemiology of NG infection in this region has not been comprehensively synthesized. This study systematically reviewed and analyzed NG prevalence in sub-Saharan Africa to characterize prevalence patterns and identify populations at risk. Methods and findings A systematic review was conducted and reported following PRISMA guidelines. Embase, PubMed, Scopus, and Web of Science were searched from inception to June 4, 2025. Eligible studies reported NG prevalence in sub-Saharan Africa. Random-effects meta-analyses generated pooled prevalence estimates, and random-effects meta-regression analyses identified associations and sources of heterogeneity.Nine hundred fifty publications contributed 1,604 prevalence measures spanning 1964–2025. In the general population, pooled urogenital prevalence was 3.2% (95% confidence interval (CI): 2.9–3.5), with substantial between-study heterogeneity and a wide prediction interval, indicating considerable variation in prevalence across settings. Prevalence was high in key populations: among female sex workers, 11.5% (95% CI: 9.9–13.2) for urogenital and 2.0% (95% CI: 0.4–4.5) for anorectal infection; and among men who have sex with men, 2.8% (95% CI: 2.4–3.3) for urogenital, 8.3% (95% CI: 5.8–11.0) for anorectal, and 5.7% (95% CI: 3.6–8.3) for oropharyngeal infection. Symptomatic men exhibited high urogenital prevalence (51.5%; 95% CI: 47.5–55.5), and symptomatic women showed 9.0% (95% CI: 7.7–10.4). Among women with adverse pregnancy or birth outcomes, urogenital prevalence was 8.6% (95% CI: 5.3–12.6). Meta-regression analyses explained over half of the variability in prevalence, showing a long-term decline of 1% per year, a clear population type gradient, subregional differences, and decreasing prevalence with increasing age, but no variation by sex. These findings may be affected by variability in data availability across countries, anatomical sites, and population groups, as well as heterogeneity across included studies. Conclusions NG prevalence remains markedly high in this region but has declined over time. These findings highlight the need for strengthened surveillance, expanded prevention and diagnostic strategies, and continued monitoring of gonococcal antimicrobial resistance to support effective control efforts in sub-Saharan Africa.

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

JupOtter: Cell-Level Bug Detection in Jupyter Notebooks

arXiv:2606.23877v1 Announce Type: cross Abstract: Jupyter Notebooks are an increasingly popular coding environment used across many domains, especially in Python-based data science and scientific computing. Originally used for prototyping and interactive exploration, notebooks are increasingly used to develop more complex programs, leading to a rapid rise in buggy notebooks on platforms like GitHub. To address this trend, we present JupOtter, a bug detection system designed specifically for Jupyter Notebooks. JupOtter features three novel contributions: (1) a notebook-specific tokenization strategy that preserves cell structure, (2) a cell-level bug prediction technique, and (3) a new labeled dataset, OtterDataset, containing over 21,000 notebooks annotated for fine-grained cell-level bug detection. JupOtter achieves cell-level bug detection F1 scores that surpass static analyzers and large language models in two out of three evaluation datasets.

07.
arXiv (quant-ph) 2026-06-25

Quantum metrology of electric and magnetic dipole moments: ultimate limits and optimal regimes

arXiv:2606.25510v1 Announce Type: new Abstract: The characterization of electric and magnetic dipole moments (EDM and MDM) in quantum systems is central to fundamental physics and quantum sensing. While EDM searches provide powerful probes of CP violation within and beyond the Standard Model, precise MDM estimation is crucial for high-precision magnetometry and the development of quantum sensors. In this work, we address the ultimate precision limits for separate and simultaneous estimation of both dipole moments in a generic two-level system coupled to electromagnetic fields. We analyze three classes of quantum probes/strategies: unitary and depolarizing dynamics, and thermal equilibrium states. For each, we derive the quantum Fisher information (matrix), identify optimal probes, and determine the ideal operating conditions, such as evolution times and temperatures, that maximize estimation precision. We further assess the compatibility and sloppiness of the statistical models, showing that orthogonal dipole moments configurations enable joint estimation of EDM and MDM, whereas parallel configurations are intrinsically sloppy, permitting only the estimation of a single parameter combination. Our results provide a unified metrological framework for estimation schemes ranging from neutron EDM searches to molecular magnetometry, and highlight the distinct roles of coherence, noise, and thermalization in multiparameter quantum sensing of dipole moments.

08.
arXiv (CS.CL) 2026-06-24

Metis: Bridging Text and Code Memory for Self-Evolving Agents

Self-evolving agents improve over time by distilling experience from past executions and reusing it in future tasks. Existing systems represent such experience either as natural-language text injected into the agent context or as code exposed as callable tools. However, the choice between these representations is typically made at design time rather than derived from the characteristics of the experience itself, leaving the trade-offs between them poorly understood. We present the first controlled study that isolates text memory and code memory over an identical set of experiences. Our results show that the two forms exhibit complementary trade-offs in construction cost, execution efficiency, and transferability, such that neither representation alone is sufficient. Guided by these findings, we propose Metis, a self-evolving agent system built on a hierarchical dual-representation memory. Metis organizes textual experience into execution plans, environment facts, and common pitfalls, and selectively crystallizes recurring plans into validated callable tools. This design combines the broad applicability of text memory with the execution efficiency of code memory while incurring tool-generation cost only when justified by repeated reuse. We evaluate Metis on AppWorld, a challenging benchmark for interactive agents. The results show that Metis improves task accuracy by up to 20.6% over ReAct while reducing execution cost by up to 22.8%. Compared with representative self-evolving agent systems, Metis consistently achieves a better balance between accuracy, execution efficiency, and memory-construction cost.

09.
arXiv (CS.CV) 2026-06-18

Cosmos 3: Omnimodal World Models for Physical AI

We introduce Cosmos 3, a family of omnimodal world models designed to jointly process and generate language, image, video, audio, and action sequences within a unified mixture-of-transformers architecture. By supporting highly flexible input-output configurations, Cosmos 3 seamlessly unifies critical modalities for Physical AI – effectively subsuming vision-language models, video generators, world simulators, and world-action models into a single framework. Our evaluation demonstrates that Cosmos 3 establishes a new state-of-the-art across a diverse suite of understanding and generation tasks, demonstrating omnimodal world models as scalable, general-purpose backbones for embodied agents. Our post-trained Cosmos 3 models were ranked as the best open-source Text-to-Image and Image-to-Video models by Artificial Analysis, and the best policy model by RoboArena at the time the technical report was written. To accelerate open research and deployment in Physical AI, we make our code, model checkpoints, curated synthetic datasets, and evaluation benchmark available under the Linux Foundation's OpenMDW-1.1 License at https://github.com/nvidia/cosmos and https://huggingface.co/collections/nvidia/cosmos3. The project website is available at https://research.nvidia.com/labs/cosmos-lab/cosmos3.

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

Neural ensemble Kalman filter: Data assimilation for compressible flows with shocks

arXiv:2602.23461v2 Announce Type: replace-cross Abstract: Data assimilation (DA) for compressible flows with shocks is challenging because many classical DA methods generate spurious oscillations and nonphysical features near uncertain shocks. We focus here on the ensemble Kalman filter (EnKF). We show that the poor performance of the EnKF may be attributed to the bimodal forecast distribution that can arise in the vicinity of an uncertain shock location; this violates the assumptions underpinning the EnKF, which assume a forecast which is close to Gaussian. To address this issue we introduce the new neural EnKF. The basic idea is to systematically embed neural function approximations within ensemble DA by mapping the forecast ensemble of shocked flows to the parameter space (weights and biases) of a deep neural network (NN) and to subsequently perform DA in that space. The nonlinear mapping encodes sharp and smooth flow features in an ensemble of NN parameters. Neural EnKF updates are therefore well-behaved only if the NN parameters vary smoothly within the neural representation of the forecast ensemble. We show that such a smooth variation of network parameters can be enforced via physics-informed transfer learning, and demonstrate that in so-doing the neural EnKF avoids the spurious oscillations and nonphysical features that plague the EnKF. The applicability of the neural EnKF is demonstrated through a series of systematic numerical experiments with the inviscid Burgers' equation, the Sod shock tube, and a two-dimensional blast wave.

12.
arXiv (CS.AI) 2026-06-24

SAFARI: Scaling Long Horizon Agentic Fault Attribution via Active Investigation

arXiv:2606.24626v1 Announce Type: new Abstract: As autonomous agents tackle increasingly complex multi-step, multi-agent tasks, their execution trajectories have scaled beyond the constraints of even the largest context windows. Current methods for effectively diagnosing agent failures load the full trajectory into an LLM's context window, which suffers from attention dilution and fails when agentic traces inevitably exceed context limits. To address this, we introduce SAFARI (Scaling long-horizon Agentic Fault AttRibution via active Investigation), a framework that replaces linear context loading with a tool-augmented diagnostic loop. By equipping LLMs with a specialized toolbox to read and search trajectory segments alongside a persistent Short-Term Memory (STM) for cross-turn reasoning, SAFARI effectively decouples diagnostic accuracy from architectural context limits. Our experiments demonstrate that SAFARI outperforms state-of-the-art results by 20% on the Who&When dataset within a 1M token budget, and by 19% on TRAIL GAIA subset on a 25K token budget. Most significantly, SAFARI maintains a 0.58 precision even when the target fault resides 5x beyond the model's native context window, a scenario where traditional evaluators fail entirely.

13.
PLOS Computational Biology 2026-06-02

A comparative study of simulation-based inference methods for epidemic models with identifiability considerations

作者:

by Geunsoo Jang, K. Selçuk Candan, Gerardo Chowell Epidemic models play a critical role in understanding transmission dynamics, generating forecasts, and informing public health interventions when they are properly calibrated to epidemiological data. Traditional Bayesian inference methods rely on the likelihood function to update prior knowledge using observed data. However, for realistic epidemic models, likelihood functions are often analytically intractable or computationally prohibitive, which can limit the applicability of these methods. Simulation-based inference provides a promising alternative by approximating posterior distributions through forward simulations rather than an explicit likelihood evaluation. In this study, we present a systematic comparison of four approaches: Approximate Bayesian Computation (ABC), Neural Posterior Estimation (NPE), a neural method with temporal embedding, and Preconditioned Neural Posterior Estimation (PNPE), which integrates elements of both classical and neural techniques. These methods are evaluated across epidemic models of increasing complexity under fixed simulation budgets and varying levels of observational noise, with explicit attention to both structural and practical identifiability. Our results show that neural methods generally improve posterior fidelity and predictive accuracy compared with ABC under constrained simulation budgets. PNPE achieved strong performance in several simulation settings, whereas temporal embeddings improved inference in models with complex epidemic dynamics by capturing sequential dependencies. These gains come with important trade-offs: PNPE required substantially greater computational resources and, unlike fully amortized NPE-based methods, may require reconditioning for each new observation. In contrast, ABC remained computationally efficient and provided reasonable, though often more conservative, posterior estimates. Overall, our findings highlight trade-offs among computational efficiency, posterior accuracy, uncertainty calibration, and inference reusability, suggesting that method selection should depend on model complexity, data quality, identifiability, and available computational resources.

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

What Type of Inference is Active Inference?

arXiv:2606.04935v2 Announce Type: replace Abstract: Active inference casts decision-making as inference, with the Expected Free Energy (EFE) unifying goal-directed and information-seeking behavior. Recent work showed that EFE minimization can be written as Variational Free Energy (VFE) minimization on a generative model augmented with epistemic priors. We prove that the VFE of the augmented model can be rewritten as the VFE of the predictive model plus explicit entropy-correction terms, making the EFE contribution transparent. We then show that proper EFE-based planning requires combining these epistemic corrections with a planning correction that turns marginal inference into policy optimization, yielding a full variational characterization of EFE-based planning. This clarifies which corrections are needed for cross-entropy planning and for full EFE-based planning. The same entropy-corrected formulation leads to a detailed message-passing scheme for EFE-based planning together with simpler ablations. Experiments on three grid-world environments show that full EFE-based planning outperforms ablations that omit either the planning correction or the epistemic corrections.

15.
arXiv (CS.CV) 2026-06-19

Distill Once, Adapt Life-Long: Exploring Dataset Distillation for Continual Test-Time Adaptation

Continual Test-Time Adaptation (CTTA) aims to maintain model performance under evolving target domains by adapting online without labeled data. However, practical deployments often cannot retain the source dataset due to privacy or licensing constraints, and purely source-free CTTA methods tend to become unstable under long-term distribution shift, suffering from compounding self-training errors and catastrophic forgetting. We introduce DO-ALL (Distill Once, Adapt Life-Long), a plug-and-play framework that revisits source information in a compact and privacy-conscious form via Dataset Distillation (DD). Before deployment, DO-ALL performs DD to produce a small set of synthetic distilled anchors that summarize the source distribution. During adaptation, each target sample is matched with its most semantically aligned anchor, which provides a stable reference for various CTTA via source replay, representation alignment, and manifold-smoothing regularization. DO-ALL can be seamlessly integrated into existing CTTA algorithms, consistently improving long-term robustness across CIFAR100-C, ImageNet-C, and the CCC benchmark. This demonstrates the potential of leveraging DD to enable stable and continuous adaptation without retaining raw source data. The code is available at https://github.com/blue-531/DOALL.

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

HairPort: In-context 3D-aware Hair Import and Transfer for Images

Transferring hairstyles between images is an important but challenging task in computer graphics, computer vision, and visual effects. It enables users to explore new looks without physically altering their hair, with applications in virtual try-on systems, augmented reality, and entertainment. Most prior works operate best under small pose gaps, and they fall short under large viewpoint and scale differences, where missing hair content must be synthesized rather than transferred. We propose HairPort, a 3D-aware hairstyle transfer framework that attempts to solve these issues by explicitly separating hair removal from transfer and enforcing geometric consistency before synthesis. We introduce a Bald Converter, which produces realistic bald versions of faces through LoRA-based in-context adaptation of FLUX.1 Kontext. To train our Bald Converter, we introduce a new dataset, Baldy, containing 6,000 paired bald and original images across diverse identities and conditions. We also use a 3D-Aware Transfer Pipeline that reconstructs and re-renders the reference hairstyle from the target viewpoint before compositing it onto the source image. Being 3D aware, our method supports large pose and scale discrepancies between the source and target. Finally, a conditional flow-matching generator synthesizes the transferred result from the bald source and geometry-aligned reference guidance. Together, our method enables accurate, pose-consistent, and identity-preserving hairstyle transfer, outperforming existing methods both qualitatively and quantitatively.

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

HEPTv2: End-to-End Efficient Point Transformer for Charged Particle Reconstruction

arXiv:2606.20437v1 Announce Type: cross Abstract: Charged-particle tracking – reconstructing trajectories from sparse detector measurements – is a fundamental high-energy-physics inference problem and a canonical example of learning under extreme combinatorial ambiguity. At the High-Luminosity Large Hadron Collider (HL-LHC), tracking must remain accurate and efficient despite unprecedented collision densities. Graph neural networks perform strongly, but incur substantial costs from graph construction and processing, while transformer-based approaches rely on auxiliary stages that prevent end-to-end optimization. To address this, we present HEPTv2, an end-to-end point-transformer architecture that reconstructs tracks from detector hits in one trainable pipeline. HEPTv2 combines a locality-aware point encoder with a track decoder that predicts complete trajectories without graph-building, clustering, or filtering. The encoder uses locality-sensitive hashing in detector coordinate space to preserve tracking-relevant geometry while enabling efficient local attention. The decoder resolves ambiguities through sectorized decoding and direct hit-to-track prediction under joint encoder-decoder supervision, allowing the full pipeline to be optimized end-to-end. On TrackML, HEPTv2 achieves 98.6% double-majority tracking efficiency at a 0.8% fake rate, while requiring only $\sim$15~ms inference time and 0.4~GB peak memory per event on a NVIDIA A100 GPU. Latency and memory scale approximately linearly for events with up to $5\times10^5$ hits. HEPTv2 establishes a new state of the art in the accuracy-latency trade-off, improving efficiency by 4.5% over the strongest prior transformer and by 1.1–2.2% over optimized graph-based pipelines, while reducing latency by factors of 7 and 38–52, respectively. These results show end-to-end transformers can deliver the accuracy and efficiency required for real-time particle reconstruction at the HL-LHC.

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

A Recipe for Long-Context Reasoning in Large Language Models via On-Policy Optimization and Distillation

Existing approaches to post-train models for long-context tasks face complementary limitations: (i) supervised fine-tuning (SFT) provides stable supervision but suffers from exposure bias; (ii) reinforcement learning methods such as Group Relative Policy Optimization (GRPO) train on model-generated trajectories but struggle with long-horizon credit assignment and sparse rewards; and (iii) on-policy distillation (OPD) provides dense token-level guidance but does not directly optimize task rewards. We study these complementary strategies for long-context alignment and derive a recipe that combines GRPO with OPD-style teacher guidance: the student learns from its own rollouts using outcome-level rewards, while a stronger teacher provides dense token-level regularization in place of the standard reference policy. This is especially useful when process-level supervision is difficult to obtain. To support this study, we introduce LongBlocks, a synthetic multilingual dataset spanning multi-hop reasoning, contextual grounding, and long-form generation. Through controlled ablations, we isolate the roles of cold-start initialization, teacher anchoring, and data mixing, showing that our recipe yields a more stable and effective path to long-context reasoning than GRPO or OPD while preserving short-context capabilities.

19.
medRxiv (Medicine) 2026-06-24

Clinical care site data integration reveals heterogeneity in EHR phenotyping and healthcare utilization patterns

Objective: Genomic research using electronic health record (EHR)-linked biobanks is influenced by heterogeneity in the clinical settings (care sites) where encounters occur. We developed two methods leveraging care site data: ClinicScan identifies where phenotype documentation occurs, and ClinicWAS identifies specialty utilization patterns associated with a risk factor. Materials and Methods: We extracted care sites for each clinical encounter at an academic medical center and mapped each to a clinical specialty. ClinicScan summarizes the specialty distribution of a user-specified diagnosis; ClinicWAS fits a logistic regression for each care site to identify specialty encounters associated with a user-specified risk factor. We applied ClinicScan to depression to test whether requiring a psychiatry encounter strengthened the association between a polygenic risk score (PRS) and a depression phenotype, and ClinicWAS to a coronary heart disease (CHD) PRS to identify sites enriched for high-risk patients. Results: Across 64,983,257 encounters, 2,544 care sites mapped to 57 specialties. Most depression diagnoses occurred in primary care (30.3%) and psychiatry (19.8%). Requiring a psychiatry encounter strengthened the PRS-phenotype association (OR=1.30, 95% CI 1.26-1.35) versus two or more diagnosis codes alone (OR=1.21, 95% CI 1.19-1.24). CHD ClinicWAS identified 19 associated care sites, including 5 catheterization labs. Men and women with high genetic risk (PRS[&ge;]95th percentile) underwent catheterization for CHD 3.1 (1.5-4.6) and 4.6 (2.5-6.7) years earlier than normal-risk participants, respectively. Discussion: Care site data capture phenotype heterogeneity that otherwise distorts EHR-based phenotypes and obscures high-risk subpopulations. Conclusion: Clinical care site data are an under-utilized resource in EHR-linked biobanks.

20.
medRxiv (Medicine) 2026-06-11

Incremental costs of transitioning from four to eight WHO-recommended antenatal care visits in Uganda: A costing analysis from a societal perspective

Background In 2016, the World Health Organization revised its antenatal care (ANC) recommendation from four to eight visits. For low- and middle-income countries like Uganda, where achieving even four visits remains a challenge, this transition has significant cost implications for both the health system and households. This study estimated the incremental costs of adopting the eight-visit model from a societal perspective. Methods The study was conducted in six government health facilities in southwestern Uganda. A micro-costing approach estimated health facility costs (personnel, equipment, consumables, and overhead). Costs incurred at patients end (transport, ultrasound, medical expenses, and time) were collected from 785 women using a questionnaire, with all costs in 2025 USD. Results For an average of 4.3 visits, total cost per woman was $100.1: facility costs $43.7 (43.7%), and patient costs $56.4 (56.3%). Transitioning to eight visits would increase total cost by $57.8 (57.8%), of which $36.4 (63.0%) would fall on households, equivalent to 68.8% of average monthly household income. Total costs would rise by 55.4% ($115.5 to $179.5) at Health Center IVs and 64.3% ($102.3 to $168.1) at Health Center IIIs, with facility costs up 43.4% and 62.9% and patient costs up 61.2% and 65.7%, respectively. Conclusion Transitioning to eight ANC visits would impose a large financial burden on households, with the incremental patient cost equivalent to more than two-thirds of average monthly household income. Equitable implementation requires improving availability of medicines and diagnostics, subsidizing transport, exploring telemedicine or community-based models, and improving efficiency at lower-tier health centers.

21.
arXiv (CS.AI) 2026-06-18

Reinforcement Learning Foundation Models Should Already Be A Thing

arXiv:2606.18812v1 Announce Type: cross Abstract: Foundation models for language and vision are powered by internet-scale data, while structured domains (tabular prediction, time-series forecasting, graph learning, reinforcement learning) are not. The substitute is synthetic data, which shifts the burden from collection to prior design. Such priors already exist for many structured tasks: TabPFN and its successors solve tabular classification with a transformer pretrained on a synthetic Bayesian prior. We make two points. First, reinforcement learning is the conspicuous gap: sampling a synthetic MDP is as feasible as sampling a synthetic tabular dataset, yet no in-context RL work treats prior design as a primary objective. Second, MDPs admit a fixed-size sufficient statistic, independent of the episodes observed and tabular in shape, which makes them directly amenable to the attention-based architectures used for tabular foundation models, with a policy head replacing the supervised target. Together these define the agenda for an RL foundation model. As a proof of concept, we train one model entirely on synthetic MDPs and show that, with no task-specific tuning, it solves held-out tabular benchmarks in context, both online and offline: online, in far fewer episodes than UCB-VI and tabular Q-learning, and offline, competitively with VI-LCB.

22.
arXiv (CS.AI) 2026-06-19

OnDeFog: Online Decision Transformer under Frame Dropping

arXiv:2606.19721v1 Announce Type: cross Abstract: In challenging real-world reinforcement learning applications, communication delays or sensor failures often cause frame dropping, in which the agent cannot receive the dropped states and associated rewards. To address the performance degradation caused by frame dropping, the Decision Transformer under Random Frame Dropping (DeFog) was developed by incorporating additional mechanisms into the decision transformer to tackle frame dropping. Although DeFog can mitigate performance degradation in frame-dropping environments, since DeFog is an offline learning method, it struggles to effectively generalize to novel states not adequately represented in the training dataset. In this study, we propose OnDeFog, which integrates the mechanisms in DeFog with the online decision transformer (ODT), an online reinforcement learning method that learns policies through direct environmental interaction. Comprehensive experimental evaluation demonstrates that our proposed OnDeFog achieves superior performance compared to ODT in environments characterized by high dropping frame rate and outperforms DeFog on datasets containing a large amount of low-reward data.

23.
arXiv (CS.AI) 2026-06-11

APPO: Agentic Procedural Policy Optimization

arXiv:2606.12384v1 Announce Type: cross Abstract: Recent advances in agentic Reinforcement Learning (RL) have substantially improved the multi-turn tool-use capabilities of large language model agents. However, most existing methods assign credit over coarse heuristic units, such as tool-call boundaries or fixed workflows, making it difficult to identify which intermediate decisions influence downstream outcomes. In this work, we study agentic RL from two perspectives: where to branch and how to assign credit after branching. Our pilot analysis shows that influential decision points are broadly distributed throughout the generated sequence rather than concentrated at tool calls, while token entropy alone does not reliably reflect their impact on final outcomes. Motivated by these observations, we propose Agentic Procedural Policy Optimization (APPO), which shifts branching and credit assignment from coarse interaction units to fine-grained decision points in the sequence. APPO selects branching locations using a Branching Score that combines token uncertainty with policy-induced likelihood gains of subsequent continuations, enabling more targeted exploration while filtering out spurious high-entropy positions. It further introduces procedure-level advantage scaling to better distribute credit across branched rollouts. Experiments on 13 benchmarks show that APPO consistently improves strong agentic RL baselines by nearly 4 points, while keeping efficient tool-calls and maintaining behavior interpretability.

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

DriveStack-VLA: Render-Teacher Alignment for BEV-Based DeepStack Vision-Language-Action Model

Vision-Language-Action driving models convert a pretrained Vision-Language Model into a driving policy, allowing them to use world knowledge and follow language guidances. However, existing VLA driving models still lack driving-oriented spatial intelligence: their policies are mainly grounded on perspective image tokens and language priors, while precise motion planning requires metric geometry, top-down scene structure, and attention to safety-critical perceptual cues. This limitation makes current models vulnerable to weak visual geometry modeling and perceptual coverage in expert demonstrations. In this paper, we present DriveStack-VLA, a framework built upon a large VLM backbone. To strengthen the spatial grounding of VLA driving, we develop dual visual modeling components. We inject a Bird-Eye-View representation into the Large Language Model decoder through a DeepStack-style connection, and propose Render-Teacher Alignment to align the perceptual focus of real images with that of rasterized images. Furthermore, to bridge the gap in multimodal trajectory selection, we introduce a head-based self-critique module that ranks sampled trajectories and conditionally refines the best one. DriveStack-VLA achieves 91.6 PDMS on NAVSIMv1, 91.0 EPDMS on NAVSIMv2 (with the human penalty filter enabled), and a driving score of 79.49 with a success rate of 56.36\% on the closed-loop Bench2Drive. More visualizations are available on our project page: https://anonymous.4open.science/w/drivestack-vla/.

25.
arXiv (CS.CV) 2026-06-11

UniReason-Med: A Shared Grounded Reasoning Interface for 2D-to-3D Transfer in Medical VQA

We study whether grounded reasoning supervision from abundant 2D medical images can improve 3D medical VQA when both input types are aligned through a common reasoning interface. We introduce UniReason-Med, a single-checkpoint framework that processes either a 2D image or a slice-serialized 3D volume at inference time, generating interleaved textual reasoning and localized visual evidence through shared box syntax, region-token injection, and a common grounded reasoning policy. To train this interface, we construct UniMed-CoT, a 220K instruction-tuning dataset with interleaved textual reasoning and grounded visual evidence, including 170K 2D and 50K 3D samples. Through supervised fine-tuning followed by outcome-level reinforcement learning, UniReason-Med learns to generate grounded reasoning traces without IoU/Dice-based localization rewards during RL. Data-mixture and component ablations show that joint 2D+3D grounded supervision substantially improves 3D reasoning over 3D-only training, while grounding and region-token injection consistently benefit both 2D and 3D tasks. These results suggest that a shared grounded reasoning interface can transfer reasoning structure from 2D images to slice-serialized volumetric medical understanding. The code and data are publicly available at https://github.com/IQuestLab/unireason-med.