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01.
arXiv (CS.LG) 2026-06-17

Monotonic Kolmogorov-Arnold Networks: A Theoretical and Empirical Study of Monotonicity as an Inductive Bias

arXiv:2606.17886v1 Announce Type: new Abstract: Monotonicity has been a long-running architectural inductive bias for neural networks, motivated by tabular, scientific, and economic settings where outputs are known to respond monotonically to certain inputs. Existing approaches are MLP- or flow-based and lack per-edge functional transparency; the only Kolmogorov–Arnold Network (KAN) variant with monotonicity, MonoKAN, enforces the constraint only on a restricted parameter subset and requires a projection-style training procedure. We close this gap with MKAN, a KAN with hard monotonicity guaranteed for all parameter values via exponential reparameterization of B-spline coefficients, positive edge weights, and a monotone base activation. Training reduces to standard unconstrained gradient descent. Our headline theoretical contribution is a representation-cost theorem: any $C^K, K >0$ feature extractor inducing a ball-shaped semantic-neighborhood partition admits a monotone realization of the equivalent neighborhood structure at $N' = N^* + k \le 2N^*$, where $k$ is the number of non-monotone coordinates of the original. The bound is architecture-agnostic and gives a principled sizing rule for monotone encoders. Empirically, MKAN is competitive with state-of-the-art monotone NNs on the SMM/ICML-2024 benchmark while being the only method that combines hard unconstrained monotonicity with KAN's per-edge functional transparency; the $2N^*$ prediction is validated in a self-supervised feature-size sweep on four real datasets, and on a controlled monotone-generative dataset MKAN recovers ground-truth factors with substantially higher Spearman alignment than KAN, MLP, and linear baselines.

02.
arXiv (quant-ph) 2026-06-19

Mapping molecular polariton transport via pump-probe microscopy

arXiv:2504.15501v4 Announce Type: replace Abstract: We demonstrate how the transport properties of molecular polaritons in optical cavities can be extracted from a microscopic modeling of pump-probe spectroscopy. Our approach combines a mean-field treatment of the light-matter Hamiltonian with a perturbative expansion of both light and matter components, along with spatial coarse-graining. This approach extends semiclassical cavity spectroscopy to multimode light-matter interactions, providing full access to spatially resolved transient spectra. By simulating a microscopy experiment with counter-propagating pump and probe pulses, we compute the differential transmission and show how molecular dephasing and persistent dark exciton populations drive sub-group-velocity transport of the root-mean-square displacement. We analyze transport across the polariton dispersion, showing how velocity renormalization correlates with excitonic weight, consistent with experimental observations, and further its dependence on the rate of molecular dephasing. Our results highlight the need to consider measured spectroscopic observables when characterizing transport in polaritonic systems.

03.
arXiv (CS.CL) 2026-06-25

Efficient and Trainable Language Model Test-Time Scaling via Local Branch Routing

Test-time scaling improves language-model reasoning, but existing approaches often face a difficult trade-off: long chain-of-thought sampling remains single-threaded, while sentence- or solution-level search can be computationally expensive and hard to train end-to-end. We introduce Local Branch Routing (LBR), a token-level test-time scaling framework that expands a small local lookahead tree, forwards all sampled branches through the language model, and uses a lightweight router to select the depth-1 subtree to commit. By routing over the hidden states of candidate local futures, LBR allows each token decision to use evidence beyond the root next-token distribution while avoiding full solution-level search. The resulting prune-shift-grow decoding process preserves discrete branch identities and defines a tractable tree-trajectory likelihood: newly grown nodes are counted when first sampled, and router decisions are assigned explicit probabilities. This enables end-to-end reinforcement learning with verifiable rewards, jointly optimizing the base model and router under the same likelihood-ratio principle as discrete-token RLVR. On synthetic hierarchical-planning tasks, LBR shows that post-candidate hidden states provide useful routing evidence. On mathematical reasoning benchmarks, LBR improves both Pass@1 and Pass@32 over discrete chain-of-thought, vanilla discrete-token RLVR, and RL-compatible soft-token branching baselines. These results suggest that lightweight local branching offers an efficient, trainable, and discrete form of language-model test-time scaling.

04.
bioRxiv (Bioinfo) 2026-06-18

Calculation of sequence space coverage in a mutagenesis library

Directed evolution requires screening of large mutagenesis libraries, but accurate calculation of library sizes needed to discover functional variants remains challenging. Existing models provide baseline estimates, yet current computational approaches for finding the best variants scale poorly with library complexity. Here, we introduce a scalable algorithmic framework to compute exact discovery probabilities in saturation mutagenesis libraries with no requirement for explicit sequence enumeration. By aggregating variants into a composition log–sum distribution and applying log-space convolution across randomisation blocks, it is possible to extend this to massive sequence spaces and mixed codon schemes. By inverting these calculations, absolute mathematical ceilings for experimental design are established. Ultimately, this framework provides a rapid, quantitative tool to balance the statistical coverage-diversity trade-off within the limitations of laboratory screening. Finally, this is implemented as an open-source web application (SSCC) that allows researchers to construct heterogeneous library designs and compute required sampling depths, coverage probabilities, and absolute randomisation limits.

06.
Nature (Science) 2026-06-22

Will AI spark a scientific renaissance — or a diffuse monoculture?

作者:

Artificial intelligence’s ability to enrich science will depend not only on model capability, but also on whether researchers, reviewers and funders reward originality over speed. Artificial intelligence’s ability to enrich science will depend not only on model capability, but also on whether researchers, reviewers and funders reward originality over speed.

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

NTS-CoT: Mitigating Hallucinations in LLM-based News Timeline Summarization with Chain-of-Thought Reasoning

The rapid updates of online news make tracking event developments challenging, highlighting the need for timeline summarization (TLS). Hallucinations, where LLM-generated content deviates from source news, still remain a critical issue in LLM-based TLS and are not well studied in existing works. To bridge this gap, we identify two primary types of hallucinations: unfaithful content during news summarization and information omission in date-event summarization. Then, we propose NTS-CoT, a novel framework that leverages Chain-of-Thought (CoT) reasoning to mitigate hallucinations in TLS. The framework consists of three key modules: i) Element-CoT to capture essential news elements for faithful summarization, ii) Date Selection to combine temporal saliency and event prominence for timestamp selection, and iii) Causal-CoT to infer causal relationships and reduce omissions in date-event summarization. Extensive experiments, including quantitative analysis on three TLS benchmarks and human evaluation, demonstrate that NTS-CoT outperforms state-of-the-art baselines, effectively mitigating hallucinations and improving LLM-based TLS performance. Our source code is available at https://anonymous.4open.science/r/NTS-CoT .

08.
arXiv (CS.CV) 2026-06-12

Ex-Omni: Enabling 3D Facial Animation Generation for Omni-modal Large Language Models

Omni-modal large language models (OLLMs) aim to unify multimodal understanding and generation, yet extending them to jointly produce speech and 3D facial animation remains largely unexplored despite its importance for natural human-computer interaction. A key challenge is the mismatch between the discrete semantic reasoning of LLMs and the dense temporal dynamics required for 3D facial motion. We propose Expressive Omni (Ex-Omni), an open-source model that augments OLLMs with native speech-accompanied 3D facial animation. Ex-Omni decouples semantic reasoning from temporal generation through a blendshape-aware speech unit generator and a blendshape decoder, where speech units provide temporal scaffolding and hidden speech representations carry facially relevant cues. We further introduce a unified token-as-query gated fusion (TQGF) mechanism for controlled semantic injection, as well as InstructS2SF-1200K, a dataset consisting of 1200K samples for pre-training. Extensive experiments show that Ex-Omni maintains competitive speech understanding and generation ability while achieving better audio-visual synchronization and lower face-generation latency than cascaded pipelines.

09.
arXiv (CS.AI) 2026-06-12

Structured Testbench Generation for LLM-Driven HDL Design and Verification-Oriented Data Curation

arXiv:2606.12983v1 Announce Type: new Abstract: Automated testbench generation has become a critical bottleneck in large language model (LLM)-driven Register Transfer Level (RTL) workflows, where large numbers of candidate designs must be verified rapidly and reliably. Existing prompt-based approaches treat testbench generation as unconstrained code synthesis, yielding stochastic outputs with high token cost, low reproducibility, and insufficient coverage. To address this gap, we present STG, a Structured Testbench Generation framework that exploits the inherent structure of hardware designs to generate deterministic testbenches. As a direct verification tool, STG runs 720x faster than an iterative LLM-based testbench generation flow and higher rate of successful compilation, achieves higher coverage, and reduces false-pass verdicts on incorrect DUTs. STG also helps identify errors in RTL generation benchmarks by exposing faulty benchmark testbenches. As a data curation engine, it is 11x faster than LLM-based filtering on a single CPU core with 127x less energy, and the resulting distilled models provide state-of-the-art performance in our multi-benchmark evaluation. As a test-time scaling oracle, it reduces node count by 14-47\%. Our models are available at https://huggingface.co/collections/AS-SiliconMind/siliconmind-v12.

10.
arXiv (CS.CL) 2026-06-24

Transformer-Based Language Models Across Domain Verticals: Architectures, Applications and Critical Assessment

Transformer-based language models have become the default substrate for natural language processing and the pace of new releases has made it hard for practitioners to separate durable ideas from the noise of incremental announcements. This review works at two levels. At the level of mechanism, we organise the main transformer families into a working taxonomy, covering encoder-only, decoder-only, encoder-decoder, long-context, permutation-based, and generator-discriminator variants. We then extend the discussion to post-2023 developments that changed the picture in practice: instruction tuning, reinforcement learning from human feedback, direct preference optimisation, mixture-of-experts scaling, retrieval augmentation and the current flagship model families from OpenAI, Anthropic, Google, Meta, Mistral and DeepSeek. At the level of use, we survey deployments across healthcare, finance, legal, education, customer service, creative writing and scientific work. Based on this we link each to the specific capabilities that make a transformer the appropriate tool. The contribution of this paper is a critical assessment that is based on the survey. We compare architectures on four axes that matter to deployment decisions, we quantify the trade-off between parameter count and energy cost. We also discuss how alignment methods, data provenance and benchmark saturation change what it means to call a model "state of the art". The final section lists the research questions that we think deserve more attention.

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

Diffusion Language Models: An Experimental Analysis

Large Language Models (LLMs) have revolutionized language modeling through autoregressive generation, enabling strong performance across a wide range of tasks. Recently, Diffusion Language Models (DLMs) have emerged as an alternative paradigm that generates text through iterative denoising rather than next-token prediction, allowing parallel refinement of entire sequences. While numerous diffusion-based architectures have been proposed, differences in evaluation protocols, datasets, inference budgets, and generation hyperparameters make it difficult to compare their capabilities and understand the trade-offs they offer. In this work, we present a systematic experimental analysis of modern DLMs. Specifically, we evaluate eight state-of-the-art DLMs across eight benchmarks spanning reasoning, coding, translation, knowledge, and structured problem solving, while explicitly considering both generation quality and computational efficiency. Beyond downstream evaluation, we analyze the impact of key inference-time factors, including denoising steps, context length, block size, and parallel unmasking strategies, and complement large-scale experiments with controlled comparisons of smaller models trained under identical conditions. Our analysis highlights the strengths and limitations of diffusion-based language modeling across different tasks, architectures, and inference budgets. We show that the behavior of DLMs is strongly influenced by generation-time design choices, leading to distinct trade-offs between performance and computational efficiency. Overall, our study provides practical insights into the capabilities and deployment characteristics of contemporary DLMs.

12.
arXiv (CS.CV) 2026-06-18

Hierarchical Multi-Modal Retrieval for Knowledge-Grounded News Image Captioning

Traditional image captioning methods often struggle to generate comprehensive, context-rich descriptions, especially for details not directly observable from visual cues. To overcome this, we propose a novel retrieval-augmented image captioning framework that generates captions with deeper insights, such as object attributes, event context, and underlying significance, by leveraging external knowledge. Our approach features a hierarchical multi-modal article retrieval mechanism that moves beyond monolithic text entities. This retrieval considers article structure-aware features, including weighted textual components (e.g., headlines, body sections) and visual placement patterns, alongside multi-faceted similarity computations (content–visual, visual–visual, and discourse positioning). A subsequent contextual relevance refinement stage further enhances the retrieved information. The retrieved articles then serve as the knowledge base for caption generation: first, a VLM generates a concise image description; second, we segment relevant information from the retrieved articles based on this description; and finally, an LLM utilizes both the description and extracted knowledge to generate a comprehensive, contextually detailed caption. We participated in the ACM Multimedia EVENTA 2025 Challenge and achieved 5th place with an overall score of 0.2824 on the private test set of the OpenEvent-V1 dataset. Source code is publicly released at https://github.com/mf0212/EVENTA-Challange.

13.
arXiv (quant-ph) 2026-06-19

Transfer-matrix functions for algebraically decaying interactions in variational infinite matrix product states

作者:

arXiv:2606.20522v1 Announce Type: cross Abstract: Variational infinite matrix product state (iMPS) calculations usually make Hamiltonians with algebraically decaying interactions compatible with standard MPO algorithms by first replacing the target Hamiltonian with a finite-pole sum-of-exponentials surrogate, thereby introducing a Hamiltonian-representation residual. We formulate the fixed-$D$ variational energy without introducing such a surrogate. For a fixed finite-$D$ MPS, the algebraic tail can be summed directly through the connected transfer matrix: the tail $e^{\mathrm{i} Qr}/r^\alpha$ is represented by the matrix function $F_{\alpha,Q}(\widetilde{T}_A)$, with $F_{\alpha,Q}(z)=\operatorname{Li}_\alpha(e^{\mathrm{i} Q}\,z)/z$. We evaluate the resulting matrix-function action using a Krylov method and obtain stable gradients by combining a Fréchet adjoint with implicit fixed-point differentiation. Benchmarks on long-range free fermions and the inverse-square Heisenberg family, including the Haldane–Shastry point, validate the transfer-matrix-function formulation. A long-range Ising-chain calculation illustrates a practical consequence of avoiding a finite-pole Hamiltonian representation. At a fixed, independently known critical field, finite-pole surrogate Hamiltonians can bias a critical diagnostic away from criticality, whereas the matrix-function calculation retains the expected critical signatures of the target algebraic Hamiltonian.

14.
arXiv (CS.LG) 2026-06-19

Kolmogorov-Arnold Reservoir Computing

arXiv:2606.19984v1 Announce Type: new Abstract: Reservoir computing offers a lightweight framework for forecasting dynamical systems but may struggle to capture long-range dependencies due to limited representational capacity. Conventional reservoir computing recurrently uses trainable reservoirs with hyperparameter sensitivity, while the next-generation reservoir computing removes recurrence at the cost of rapidly growing feature dimensions. Here, we develop Kolmogorov-Arnold Reservoir Computing (KARC), which replaces reservoirs with explicit basis-function expansions inspired by the Kolmogorov-Arnold representation theorem. We rigorously show that KARC is a lightweight design of Kolmogorov-Arnold networks (KANs), preserving the potential expressive capacity of KANs while admitting efficient closed-form training of reservoir computing. At comparable cost, KARC outperforms existing reservoir computing methods on challenging benchmarks including partial differential equations. It can also be integrated with generative diffusion models for text-to-image generation. This work thus establishes a principled bridge between reservoir computing and KANs, enabling efficient and high-fidelity dynamical system forecasting.

15.
arXiv (CS.AI) 2026-06-12

Multi-Field Hybrid Retrieval-Augmented Generation for Maritime Accident Root Cause Analysis

arXiv:2606.13249v1 Announce Type: new Abstract: Maritime accident adjudication reports contain critical tribunal findings for root cause analysis (RCA), yet retrieving relevant precedents and drafting consistent reports from decades of records remains labor-intensive. This paper proposes a multi-field hybrid retrieval-augmented generation (RAG) framework for automated maritime RCA, utilizing a comprehensive dataset of 13,329 Korea Maritime Safety Tribunal (KMST) reports (1971-2025). We transform raw adjudications into a structured knowledge base of "incident cards", indexing three distinct fields-Summary, Causes, and Disposition-alongside a hierarchical L1/L2 cause taxonomy. Our retrieval strategy employs a field-aware hybrid approach, fusing sparse and dense rankings via Reciprocal Rank Fusion (RRF). Given the lack of large-scale expert relevance labels, we evaluate retrieval performance using ceiling-normalized recall and nDCG based on a metadata-derived proxy relevance score. Experimental results demonstrate that our proposed retrieval significantly outperforms baseline methods, improving NormRecall@100 from 0.18 to 0.55. Furthermore, grounding the generator on the retrieved precedents enhances RCA generation quality over an LLM-only baseline, increasing the LLM-as-a-judge score from 3.34 to 3.72. These findings suggest that field-aware RAG can substantially streamline maritime safety investigation workflows by enabling faster precedent search and more consistent, evidence-based RCA drafting.

16.
arXiv (quant-ph) 2026-06-17

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

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

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

Debiasing Without Protected Attributes: Latent Concept Erasure from Textual Profiles

Most fairness research in NLP assumes direct access to protected attributes such as gender, race, or nationality. In practice, however, such information is often unavailable due to privacy constraints, missing metadata, or legal restrictions, even though models may infer it from indirect textual cues. This raises a key question: can debiasing succeed without direct access to sensitive attributes? We propose H-SAL, which performs post-hoc concept and attribute erasure using self-description text as an implicit debiasing signal. To support this setting, we introduce a multi-domain Stack Exchange-based fairness benchmark for helpfulness prediction that includes both explicit and implicit signals, enabling comparison between standard debiasing with protected labels and debiasing without access to sensitive information. Across encoder and decoder-only language models, we find that implicit self-description often matches or outperforms explicit-label-based debiasing. Our results broaden representation-level fairness research and provide a new benchmark for studying debiasing under realistic data constraints.

18.
bioRxiv (Bioinfo) 2026-06-14

Virtual phenotypic screening discovers novel scaffolds inhibiting the PI3K/mTOR pathway

Phenotypic drug discovery has yielded many first-in-class small-molecule drugs by discovering modulators of disease phenotypes in physiologically relevant cellular systems. However, high-content phenotypic assays lack the ultra-high-throughput scalability of target-based screens. Recent advances in virtual screening present an opportunity to address this bottleneck, but have been limited to simple phenotypes like viability, restricted to small repurposing libraries, or lack in-depth biological validation. Here, we present PhenoCompass, a multimodal co-embedding model that aligns compound structures and high-content phenotypic imaging to enable virtual phenotypic screening over billion-compound libraries. Following training on the Joint Undertaking in Morphology dataset with more than 100,000 Cell Painting compound profiles, retrospective validation with historical biochemical high-throughput screening data demonstrates that PhenoCompass ranks compounds according to their biochemical target engagement. Leveraging PhenoCompass, we performed a prospective screen of 3.8 billion Enamine REAL compounds for inhibitors of PI3K/mTOR pathway, a critical signaling cascade whose aberrant activation is a common tumor driver. This search identified 11 novel compounds with pathway-consistent Cell Painting readout and diverse scaffolds, a 54-fold enrichment over the training set. Orthogonal validation experiments using a FOXO3A reporter assay and direct kinase inhibition confirmed seven structurally novel inhibitors with distinct mechanisms of action. These results highlight the convergence of diverse molecular target profiles onto a shared morphological pathway signature and establish PhenoCompass as a robust framework for high-content phenotypic virtual screening.

19.
arXiv (CS.CV) 2026-06-25

ScalingAR: Scaling Confidence for Autoregressive Image Generation

Test-time strategies have shown remarkable success in improving large language models, but their application to next-token prediction (NTP) autoregressive (AR) image generation remains largely underexplored. Existing test-time scaling (TTS) methods for visual autoregressive models (VAR) rely on frequent partial decoding and external reward models, which are inefficient and often ineffective for NTP-based image generation due to the inherent instability of intermediate decoding results. To address these limitations, we propose ScalingAR, a novel test-time scaling framework tailored for NTP-based AR image generation. ScalingAR introduces token entropy as a confidence signal and operates at two complementary levels: (i) Profile Level, integrates intrinsic uncertainty and conditional utilization into a unified confidence state, and (ii) Policy Level, leverages this state for adaptive trajectory pruning and dynamic guidance scheduling. Without requiring early decoding or auxiliary rewards, ScalingAR achieves significant improvements across diverse benchmarks. Experiments show that ScalingAR (I) improves base models by $12.5\%$ on GenEval and $15.2\%$ on TIIF-Bench, (II) reduces visual token consumption by $62.0\%$ while outperforming baselines, and (III) enhances robustness, mitigating performance degradation by $26.0\%$ in challenging scenarios. These results establish ScalingAR as a robust and efficient test-time scaling solution for autoregressive image generation.

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

Evaluating Open-Source LLMs for Multi-Label ATT&CK Technique Classification on CTI Reports

arXiv:2606.18166v1 Announce Type: cross Abstract: Classifying Cyber Threat Intelligence (CTI) using MITRE Adversarial Tactics, Techniques, and Common Knowledge (ATT&CK) is essential for proactive defense, but historically required extensive human effort. Pre-Large Language Model (LLM) automation sped up this process, but could not resolve the complex language and multi-step attack patterns found in unstructured CTI reports. LLMs addressed previous limitations by using contextual reasoning to understand unstructured text. However, current evaluations rely on simplified, single-technique sentences that ignore the complexity of real-world CTI reports, which often leads to inflated performance results. Consequently, the baseline performance of open-source LLMs on complex unstructured CTI reports remains unevaluated. To address this gap, we constructed a ground-truth dataset of 2,076 human-annotated sentences (1,281 technique-positive, 795 negative) from 83 complex unstructured CTI reports. These sentences were mapped to 114 unique ATT&CK techniques using a six-phase annotation process, achieving \k{appa} = 0.68 inter-annotator agreement. Using this dataset, we evaluated seven open-source LLMs ranging from 8B to 236B parameters across prompt strategy and temperature configurations. The highest-performing LLM achieved a micro-averaged F1 score of 0.22, establishing the empirical baseline for multi-label ATT&CK classification on complex unstructured CTI. Parameter size showed a statistically significant positive correlation with F1 score. Prompt strategy and temperature produced no statistically significant gains across model configurations. These results indicate that current open-source LLMs are insufficient for production-grade ATT&CK classification. The dataset, benchmark, and findings provide a reproducible foundation for future CTI research.

21.
arXiv (math.PR) 2026-06-24

Uniform Sampling from High-dimensional Spectral Norm Balls

arXiv:2606.24134v1 Announce Type: new Abstract: Motivated by an application in machine learning optimization, this paper focuses on the challenges of sampling a matrix uniformly from the unit spectral norm ball. It is proven that all singular values of sampled matrices converge to 1 almost surely as the matrix dimensions increase. This result provides the theoretical justification for a proposed simple sampling method applicable for large dimension sizes matching matrices found in modern large language models. Experimental results demonstrate both the convergence of the singular values, as well as the exact and proposed approximate sampling methods.

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

VLADriveBench: Evaluating CoT-Action Relationship in VLA for Autonomous Driving

Vision-language-action (VLA) models generate chain-of-thought (CoT) reasoning alongside driving trajectories, but existing benchmarks evaluate only trajectory quality and do not assess whether the CoT is relevant, consistent, or causally connected to the driving action. We introduce VLADriveBench, a framework that combines observational metrics (mentioning, hallucination, contradiction, action alignment) with a CoT intervention protocol to provide complementary views of the CoT-action relationship. Applying VLADriveBench to three models across two architectures, we find that the two analyses can diverge sharply: ORION scores highest on observational alignment yet its CoT is epiphenomenal, while Alpamayo v1.5 scores lower yet its CoT is strongly causal, with visual salience gating the extent of CoT influence.

23.
medRxiv (Medicine) 2026-06-19

Within-host pathogen population diversity predicts treatment response in tuberculosis

Background: Tuberculosis (TB) treatment outcomes remain suboptimal, and standard clinical diagnostics cannot reliably identify patients at high risk of treatment failure or relapse at the time of diagnosis. While within-host Mycobacterium tuberculosis genetic diversity is hypothesized to reflect the viable bacterial burden and adaptive capacity of the infection, its clinical prognostic value remains unknown. Methods: We conducted a prospective cohort study of 364 patients with newly diagnosed, rifampicin-susceptible pulmonary TB in South Africa. Patients received standard 6-month therapy and were monitored for up to two years to ascertain composite unfavorable outcomes (treatment failure, death, or relapse). To accurately detect low-frequency (unfixed) genetic variants and eliminate reference bias artifacts, we mapped medium to high depth short-read sequences against matched, patient-specific long-read assemblies. The association between baseline pathogen genetic diversity and clinical outcomes was evaluated using multivariable Cox proportional-hazards models. Results: After bioinformatic filtering, true unfixed variants were relatively rare but significantly enriched in genes mediating pathogen adaptation and drug tolerance, including transporter proteins and two-component regulatory systems. Within-host bacterial genetic diversity (i.e., the total number of unfixed variants) ranged from 0-20, with a median of 1 per patient. In survival analysis adjusting for known clinical risk factors–including HIV status, prior TB, baseline smear positivity, and radiographic lung involvement–baseline within-host genetic diversity emerged as a strong, independent predictor of unfavorable treatment outcomes. For patients with greater than 3 unfixed variants at diagnosis, each increase of 5 unfixed variants was associated with more than double the risk of a composite unfavorable outcome (adjusted Hazard Ratio, 2.36; 95% CI, 1.27 to 4.39; p=0.007). Conclusions: Baseline within-host pathogen genetic diversity is an independent predictor of unfavorable TB treatment outcomes. As sequencing becomes increasingly integrated into routine diagnostics, quantifying unfixed variants is an accessible approach that promises to risk-stratify patients and guide the duration of individualized regimens.

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

T2D-Bench: Evidence-Gated Evaluation of LLM Outputs for Type 2 Diabetes Using a Multi-Layer Clinical-Lifestyle Knowledge Graph

arXiv:2606.24145v1 Announce Type: new Abstract: Large language models (LLMs) can produce clinically fluent recommendations for type 2 diabetes while failing to satisfy guideline constraints or explicitly justify lifestyle-related glycemic claims. We present T2D-Bench, a reproducible benchmark and evidence-gated evaluation framework for testing whether LLM outputs satisfy explicit, graph-checkable evidence requirements. T2D-Bench is built on a multi-layer clinical-lifestyle knowledge graph that combines a biomedical spine (UMLS, DrugBank, SIDER), computable ADA Standards of Care rules, and lifestyle knowledge connected through a mechanistic bridge to glycemic laboratory effects. Across 100 structured vignettes spanning diagnosis, medication safety, and adversarial lifestyle conflicts, baseline outputs failed benchmark-defined evidence-path checks in 35% of cases for GPT-4o-mini and 33% for GPT-4o. The evidence gate detects unsupported omissions and uses constrained revision to bring outputs into verifier-level compliance with benchmark-defined evidence requirements. These results show that computable evidence constraints can make unsupported clinical omissions explicit, measurable, and correctable in diabetes-focused LLM outputs.

25.
medRxiv (Medicine) 2026-06-15

Midwifery Practice in Conflict Contexts: Lived Experiences from Somalia and Nigeria

Background: Midwives are a central cadre in the health system, particularly in conflict-affected settings where they are sometimes the primary or even only skilled providers available. Yet, despite their critical role, there is limited qualitative evidence capturing their lived experiences and how these shape workforce entry, retention, and overall well-being. Methods: Drawing on a phenomenological research methodology, this qualitative study was embedded within a larger prospective longitudinal cohort of midwifery students and graduates in Somalia and Nigeria. We conducted focus group discussions with graduate midwives (n=48 in Nigeria; n=63 in Somalia) to explore their experiences transitioning into the workforce and their realities working in health systems impacted by conflict and violent insecurity. Data were analysed using inductive thematic analysis. Results: Five themes emerged from the data: (1) job search and workforce entry, which was described as fraught with challenges and shaped by a set of formal systems in Nigeria but informal networks and structural barriers in Somalia (2) working conditions that were marked by resource scarcity, infrastructural challenges, and heavy and unreasonable workloads, (3) safety, security and coping strategies that differed across the two contexts but reflected persistent exposure to violence and a reliance on ad hoc and personal coping in lieu of systematic protection, (4) community perceptions of midwives, shaped and constrained by social and gender norms and (5) mental health and emotional wellbeing, highlighting stress, burnout and moral injury experienced by this cadre. Conclusion: Our findings highlight the profound challenges faced by midwives working in conflict-affected settings, and they shine a light on the urgent need to support and invest in this critical and predominantly female health workforce.