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01.
arXiv (CS.AI) 2026-06-19

Triangular Consistency as a Universal Constraint for Learning Optical Flow

arXiv:2606.19938v1 Announce Type: cross Abstract: We propose triangular consistency as a first-principled constraint for optical flow, which is agnostic to network architecture, supervision type, and dataset, and applies to both image-pair and multi-frame settings. This simple but powerful constraint is to compose two flows to induce a third flow and enforce consistency among the three. The composed flows may arise from (i) image pairs, yielding cycle consistency; (ii) multiple video frames, producing longer-range motion through temporal chaining; or (iii) image pairs combined with controlled synthetic transformations, which becomes data augmentation. This triangular consistency introduces negligible computational overhead and requires no additional annotations. Since it is derived directly from the geometry of optical flow, it does not rely on model-specific assumptions and serves as a ``universal'' plug-and-play component for optical flow training. Experiments show consistent improvement across supervised, unsupervised, and transfer learning settings.

02.
arXiv (CS.CV) 2026-06-16

Unlocking Diffusion Hierarchies: Adaptive Timestep Selection for Zero-Shot Segmentation

Zero-shot segmentation has recently shown notable improvement by leveraging the rich visual priors in large-scale text-to-image diffusion models, such as Stable Diffusion. However, current diffusion-based methods often face limitations due to the trade-off between spatial resolution and contextual information, as well as their reliance on a single static timestep for feature extraction. To overcome these challenges, our work introduces two key advancements. First, our Contextual Similarity Maps fuse high-resolution attention maps with rich U-Net encoder features, providing both fine-grained and robust per-pixel representations. Second, we identify an emergent hierarchical semantic progression within the denoising process of various diffusion models: representations transition from part-level abstractions at earlier timesteps to object-level abstractions at later stages. Leveraging this insight, we introduce a mechanism to adaptively select the optimal timestep for each pixel. Extensive experiments demonstrate that our method consistently outperforms existing zero-shot segmentation baselines, validating the efficacy of combining contextual features with dynamic, hierarchical timestep selection.

03.
medRxiv (Medicine) 2026-06-12

The Clinical Characteristics and mortality outcomes of Atrial fibrillation complicating Heart failure with reduced ejection fraction: A prospective study from South Africa

Background: A growing burden of cardiovascular risk factors has raised cardiovascular disease-related mortality in Sub-Saharan Africa (SSA), driving higher prevalence of heart failure with reduced ejection fraction (HFrEF) and its complication with atrial fibrillation (AF). No prospective study has examined AF's clinical impact on HFrEF in SSA. Aim: To determine AF prevalence in HFrEF, describe HFrEF-AF clinical characteristics, and determine AF's impact on mortality. Methods: In this prospective observational study at a tertiary hospital in Johannesburg, 136 HFrEF patients were enrolled and categorised as HFrEF- SR (sinus rhythm) or HFrEF-AF. Baseline clinical characteristics and biochemistry were recorded. Comprehensive echocardiography including left atrial strain by 2D speckle-tracking was performed. Median follow-up was 30.6 months. Results: AF was present in 28 patients (21%). The mean age was 58.7 {+/-} 14.9 years (52.9% male) and differed between groups (p < 0.001). Hypertensive heart disease was the leading cause of HFrEF (36%). Compared with SR, HFrEF-AF patients had poorer health status (KCCQ 27 [16-43] vs 45 [32-60], p < 0.001) and lower left atrial strain (26.2 {+/-} 11.3%, p < 0.001). Guideline-directed medical therapy was suboptimal in the AF group: anticoagulation use was higher than SR (60% vs 9.5%, p < 0.001) but overall inadequate; HFrEF-AF patients received lower median doses of carvedilol (15.6 mg vs 25 mg, p = 0.002) and enalapril (10 mg vs 20 mg, p = 0.004), and fewer received spironolactone (50% vs 75.3%, p = 0.013). Survival was significantly lower in HFrEF-AF (0.41 [0.22-0.61]) versus SR (0.73 [0.61-0.82], p < 0.001). Independent predictors of mortality included prior stroke, lower TAPSE and KCCQ, and higher E/e' and heart rate. Conclusion: AF is common among HFrEF patients in this SSA cohort (though lower than in high-income countries) and associates with worse clinical status, suboptimal therapy, and higher mortality.

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

Synthetic Homes: A Multimodal Generative AI Pipeline for Residential Building Data Generation under Data Scarcity

arXiv:2509.09794v5 Announce Type: replace Abstract: Computational models have emerged as powerful tools for multi-scale energy modeling research at the building and urban scale, supporting data-driven analysis across building and urban energy systems. However, these models require large amounts of building parameter data that is often inaccessible, expensive to collect, or subject to privacy constraints. We introduce a modular, multimodal generative Artificial Intelligence (AI) framework that integrates image, tabular, and simulation-based components and produces synthetic residential building datasets from publicly available county records and images, and present an end-to-end pipeline instantiating this framework. To reduce typical Large Language Model (LLM) challenges, we evaluate our model's components using occlusion-based visual focus analysis. Our analysis demonstrates that our selected vision-language model achieves greater visual focus than a GPT-based alternative for building image processing. We also assess realism of our results against a national reference dataset, finding that our synthetic data overlaps more than 95% for three of the four selected variables. This work reduces dependence on costly or restricted data sources, lowering barriers to building-scale energy research and Machine Learning (ML)-driven urban energy modeling, and therefore enabling scalable downstream tasks such as energy modeling, retrofit analysis, and urban-scale simulation under data scarcity.

05.
arXiv (CS.LG) 2026-06-16

Single-Round Clustered Federated Learning via Data Collaboration Analysis for Non-IID Data

arXiv:2601.09304v2 Announce Type: replace Abstract: Federated Learning (FL) enables distributed learning across multiple clients without sharing raw data. When statistical heterogeneity across clients is severe, Clustered Federated Learning (CFL) can im-prove performance by grouping similar clients and training cluster-wise models. However, most CFL approaches rely on multiple communication rounds for cluster estimation and model updates, which limits their practicality under tight constraints on communication rounds. We propose Data Collaboration-based Clustered Federated Learning (DC-CFL), a single-round framework that completes both client clustering and cluster-wise learning, using only the information shared in DC analysis. DC-CFL quantifies inter-client similarity via total variation distance between label distributions, estimates clusters using hierarchical clustering, and performs cluster-wise learning via DC analysis. Experiments on multiple open datasets under representative non-IID conditions show that DC-CFL achieves accuracy comparable to multi-round baselines while requiring only one communication round. These results indicate that DC-CFL is a practical alternative for collaborative AI model development when multiple communication rounds are impractical. Our source code is publicly available at https://github.com/souta-suga/DC-CFL.

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

Fluently Lying: Adversarial Robustness Can Be Substrate-Dependent

The primary tools used to monitor and defend object detectors under adversarial attack assume that when accuracy degrades, detection count drops in tandem. This coupling was assumed, not measured. We report a counterexample observed on a single model: under standard PGD, EMS-YOLO, a spiking neural network (SNN) object detector, retains more than 70% of its detections while mAP collapses from 0.528 to 0.042. We term this count-preserving accuracy collapse Quality Corruption (QC), to distinguish it from the suppression that dominates untargeted evaluation. Across four SNN architectures and two threat models (l-infinity and l-2), QC appears only in one of the four detectors tested (EMS-YOLO). On this model, all five standard defense components fail to detect or mitigate QC, suggesting the defense ecosystem may rely on a shared assumption calibrated on a single substrate. These results provide, to our knowledge, the first evidence that adversarial failure modes can be substrate-dependent.

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

VeriGraph: Towards Verifiable Data-Analytic Agents

LLM-based agents have demonstrated strong capabilities in data-intensive analytical tasks, yet their outputs are rarely verifiable: a reliance on linear text trajectories makes their reasoning difficult to audit. In particular, deterministic computations over raw data and semantic deductions over natural-language claims are often entangled in an unstructured stream, leaving numerical conclusions hard to reproduce and qualitative judgments hard to inspect. To address this, we propose VeriGraph, a traceable neuro-symbolic reasoning framework that enables agents to construct an explicit heterogeneous evidence directed acyclic graph (DAG) during execution. VeriGraph introduces three evidence-expansion primitives, namely computational, grounding, and derivational expansion, to connect raw data, interpreter variables, computed results, and natural-language claims in a unified graph. Under this formulation, structural traceability is reduced to graph reachability from raw data sources to terminal claims, while semantic support is measured by claim-level evidence evaluation. To improve graph construction, we further design a graph-based policy optimization strategy with a composite reward that jointly supervises answer correctness, computational integrity, and derivational coherence. Experiments on four benchmarks show that VeriGraph-8B achieves the highest overall score among all baselines. More importantly, VeriGraph produces auditable evidence graphs with substantially stronger claim grounding, achieving a 87.61\% Grounding Rate under our claim-level evidence support evaluation. These results suggest that explicit evidence-graph construction is a promising path toward verifiable data-analytic agents. Our code is available at https://github.com/ignorejjj/VeriGraph.

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

Hölder++: Improving the Quality-Coherence Trade-off in Multimodal VAEs

arXiv:2606.13381v1 Announce Type: new Abstract: Existing approaches for multimodal variational autoencoders (VAEs) face a trade-off between generative quality and coherence-i.e., they struggle to generate realistic and diverse samples that, at the same time, are semantically consistent across modalities. A recent work shows that using a simple approximation to Hölder pooling as an aggregation method improves coherence over the SOTA MMVAE+, despite assuming a single shared representation across all modalities. Yet, it slightly compromises sample diversity. Inspired by this insight, we propose Hölder++, a novel multimodal VAE that improves the generative quality-coherence trade-off through: (i) the first implementation of Hölder pooling without any approximation for multimodal VAEs; (ii) an extended architecture that models distinct shared and private (i.e., modality-specific) representations (Hölder+); and (iii) hierarchical inference that further enhances the disentanglement between the shared and private representations (Hölder++). Our experiments corroborate that Hölder++ consistently improves the generative quality-coherence trade-off, yields more structured latent spaces, and learns shared representations that are informative for downstream tasks.

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

NaturalFlow: Reducing Disruptive Pauses for Natural Speech Flow in Simultaneous Speech-to-Speech Translation

Simultaneous speech-to-speech translation aims to enable near-real-time communication by minimizing latency, offering a compelling, real-time alternative to the high latency of consecutive translation. However, the excessive pursuit of low latency often results in fragmented chunk-wise speech. Consequently, listeners are subjected to an unnatural acoustic flow punctuated by frequent pauses, which could increase their cognitive load. To bridge this gap, we introduce a fluency-aware optimization framework designed to discover the sweet spot between the low-latency benefits of simultaneous translation and the natural flow of consecutive translation. Our framework minimizes inter-chunk silences by leveraging model-internal signals, including linguistic diversity and induced temporal variability in speech durations. Experiments on short- and long-form benchmarks show that our framework produces natural speech flow while maintaining competitive latency and translation quality.

10.
arXiv (CS.LG) 2026-06-15

Deep Doubly Debiased Longitudinal Effect Estimation with ICE G-Computation

arXiv:2602.12379v2 Announce Type: replace Abstract: Estimating longitudinal treatment effects is essential for sequential decision-making but is challenging due to treatment-confounder feedback. While Iterative Conditional Expectation (ICE) G-computation offers a principled approach, its recursive structure suffers from error propagation, corrupting the learned outcome regression models. We propose D3-Net, a framework that mitigates error propagation in ICE training and then applies a robust final correction. First, to interrupt error propagation during learning, we train the ICE sequence using Sequential Doubly Robust (SDR) pseudo-outcomes, which provide bias-corrected targets for each regression. Second, we employ a multi-task transformer with a covariate simulator head for auxiliary supervision, regularizing representation learning, and a target network to stabilize training dynamics. For the final estimate, we discard the SDR correction and instead use the uncorrected nuisance models to perform Longitudinal Targeted Minimum Loss-Based Estimation (LTMLE) on the original outcomes. This second-stage, targeted debiasing ensures robustness and optimal finite-sample properties. Comprehensive experiments demonstrate that our model, D3-Net, robustly reduces bias and variance across different horizons, counterfactuals, and time-varying confoundings, compared to existing state-of-the-art ICE-based estimators.

11.
arXiv (CS.LG) 2026-06-16

Coercivity and Local Convergence of Physical Learning in Linear Circuits

arXiv:2606.15443v1 Announce Type: cross Abstract: Physical learning methods train physical networks to perform computational tasks using only local update rules, exploiting the physics of the system to handle the global transfer of information. We provide the first local convergence analysis of three such methods – Equilibrium Propagation (EP), Coupled Learning (CL), and a new method we call Adjoint Coupled Learning (AL) – for linear circuits, in the limit of small-nudging for both discrete and continuous time. EP and AL perform gradient descent on a natural loss function, while CL follows modified dynamics with an additional cubic correction. Assuming the existence of a solution, we identify a coercivity condition, expressed as a rank condition on a matrix built from the network's incidence structure, under which the training loss decays exponentially and the parameters converge to the solution manifold. We show that coercivity can fail by exhibiting a kite circuit in which a symmetry causes the coercivity constant to degenerate on the solution manifold, but prove using Sard's theorem that such degeneracies are non-generic: coercivity holds at every point of the solution manifold for almost every choice of desired output.

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

Attention-Based Prototype Calibration for Multi-Rater Few-Shot Medical Image Segmentation

Few-shot medical image segmentation methods typically assume a single ground-truth annotation, overlooking systematic variability across expert raters commonly observed in clinical datasets. We propose an attention-based prototype calibration framework for few-shot multi-rater segmentation that models rater-specific deviations from a consensus representation in prototype space. A lightweight yet principled attention operator directly refines rater prototypes without modifying the backbone feature extractor, making the approach fully compatible with existing prototype-based few-shot segmentation methods. This design preserves semantic consistency while enabling personalized segmentation outputs with minimal computational overhead. Experiments on multi-rater medical imaging datasets demonstrate consistent improvements over baseline prototype approaches, highlighting the effectiveness of structured prototype calibration for modeling annotation variability. Our code is available at https://github.com/truong2710-cyber/JAPC.

13.
medRxiv (Medicine) 2026-06-24

Matrix matters: head-to-head concordance of serum and plasma for NULISAseq CNS Disease Panel

Blood-based proteomic profiling is now widely applied in neurodegenerative and neuroinflammatory disease, yet the choice between serum and plasma remains poorly characterised for high-multiplex platforms. Many legacy biobanks hold mainly serum, whereas most current NUcleic-acid-Linked Immuno-Sandwich Assay (NULISA) studies use plasma. We compared the 130-protein NULISAseq central nervous system (CNS) Disease Panel head-to-head in matched serum and plasma collected at the same draw from 62 participants (30 neurodegenerative, 19 demyelinating, 13 healthy controls). Agreement was measured with Spearman correlation (rho), Lin's concordance correlation coefficient (CCC), the intraclass correlation coefficient (ICC) and the mean paired serum-to-plasma difference (dNPQ). Concordance was moderate to high: 123 of 130 proteins reached significance and 18 reached rho >= 0.90, with a median rho of 0.72 (range 0.10-0.988). Proteins fell into three tiers. Cytoskeletal markers (NEFH rho=0.988; NEFL rho=0.947) and glial GFAP (rho=0.949, |dNPQ|

14.
arXiv (quant-ph) 2026-06-19

GPU-accelerated semidefinite programming for causal games

arXiv:2606.20519v1 Announce Type: new Abstract: The process matrix formalism describes quantum correlations in scenarios without a fixed causal order between local laboratories. Operational signatures of such correlations can be investigated through causal games. A paradigmatic example is the Guess-Your-Neighbour's-Input game, in which two parties attempt to guess each other's inputs. Correlations compatible with any definite, or probabilistically mixed, causal order cannot achieve a winning probability exceeding $1/2$. The best process-matrix strategy currently known attains a value of approximately $0.6218$ using local dimension $d=5$, while the strongest known dimension-independent upper bound is $0.7592$. In this work, we investigate whether increasing the local dimension beyond $d = 5$ can narrow this gap. To this end, we employ a see-saw optimization scheme in which each step is formulated as a semidefinite program. For scalability, we develop a custom implementation of the SCS solver in which the dominant computational cost, the projection onto the positive-semidefinite cone, is offloaded to a GPU, yielding a six-fold speedup. Using this implementation, we explore local dimensions up to $d = 8$, and we do not find significant improvements over the value at $d=5$. Our results suggest that either qualitatively different strategies are required to approach the known upper bound, or that the bound itself is not tight.

15.
arXiv (CS.CV) 2026-06-16

Beer-Lambert Guided Representation Learning for Unsupervised Anomaly Detection in Sub-THz Food Inspection Images

Food manufacturing requires reliable inspection systems to detect foreign material contamination and maintain product safety. Sub-THz transmission imaging provides material-dependent attenuation characteristics that are useful for detecting low-density contaminants in food products. However, existing unsupervised anomaly detection methods mainly rely on RGB-pretrained visual representations, which may not adequately capture the transmission behavior of Sub-THz images. This paper proposes a Beer-Lambert guided representation learning framework for unsupervised anomaly detection in Sub-THz food inspection images. The proposed method introduces an attenuation decomposition module as an auxiliary regularization module that constrains student representations through attenuation reconstruction during training. In addition to the conventional one-class setting, we introduce a Leave-One-Food-Out protocol to evaluate generalization capability under unseen food categories. Experimental results on the Inline-Food-Inspection-THz dataset show that the proposed method improves overall anomaly detection performance over the baseline method.

16.
arXiv (CS.LG) 2026-06-17

Geometrical fairness in graph neural networks

arXiv:2606.17684v1 Announce Type: cross Abstract: Graph-based learning methods have become increasingly prominent due to their strong performance across diverse applications. Among these, recent frameworks grounded in diffusion processes provide a unifying perspective that extends traditional graph neural network formulations while addressing limitations of standard message-passing mechanisms. Despite these advances, concerns remain regarding the fairness of such models, as they may propagate or amplify biases present in the data. In this work, we introduce a fairness-aware adaptation of graph-based diffusion by modifying the underlying Laplacian operator. Our approach incorporates multiple complementary transformations, including subspace projections, spectral adjustments, and frequency-based filtering, to mitigate bias-related components. Leveraging the intrinsic smoothing properties of graph diffusion, we provide a principled analysis of the resulting behavior and establish theoretical insights into fairness properties. We evaluate the proposed framework on both synthetic and real-world datasets, demonstrating that it achieves competitive performance while improving fairness metrics with limited additional computational cost.

17.
arXiv (quant-ph) 2026-06-15

Interpreting Bohm-like quantum potentials in "Computing quantum waves exactly from classical action"

arXiv:2605.20443v3 Announce Type: replace Abstract: The recent posting arXiv:2605.02621 [14], commenting on the article rspa.2025.0413 [7], argues that the proof of Lemma 3.1 in [7] is missing the spatial derivative of the density, which would lead to a Bohm-like quantum potential. This technical note shows why the propagated density is independent of space in the Feynman propagator construction of Lemma 3.1. This is done by extending the proof of Lemma 3.1 explicitly with Bohm-like quantum potential terms along the stationary action paths, and then showing that these terms are exactly zero. In [7], this property can also be verified directly on most examples (double slit, Aharonov-Bohm, potential well, harmonic oscillator, tunneling, EPR, QED), as well as in the derivations of the Pauli, Dirac, and Maxwell equations. For more general nonlinear actions, a time rescaling may be required to guarantee this space independence along stationary paths. In the hydrogen atom example, this time rescaling can be computed in closed form. In contrast to the general wave of the Madelung solution [9] Lemma 3.1 of [7] is defined first for a propagator, and a general wave is then constructed in a second step. Recall that a propagator is a specific quantum wave, which is initialized at $t=0$ with a Dirac impulse at a given initial position or momentum. In turn, a general wave is constructed in a second step by superposing a distribution of initial conditions using the propagator. This key difference is why the Bohm-like quantum potential terms disappear in the construction [7] (specifically, in the first step) while the Bohm potential in the Madelung analysis does not. This fundamental difference is also consistent with the fact that the wave construction in [7] extends naturally to relativistic contexts, while Bohmian non-locality notoriously prevents such extensions. Keywords - Response to arXiv:2605.02621, in relation to rspa.2025.0413

18.
arXiv (CS.AI) 2026-06-19

Computational Identifiability

arXiv:2606.19361v1 Announce Type: cross Abstract: Identification conditions describe the computability of a target query or parameter of interest as a function of the type and amount of information available. In causal identification, this information is often expressed in the form of a causal graph, and data are observed or collected for some subset of variables in the graph. Target queries may be for a single effect alone or for a class of effects in a given model. The derivation of an identification algorithm then defines mathematically the process by which the desired causal effect(s) can be uniquely determined, theoretically, in expectation. Identifiability in expectation, or 'theoretical identifiability,' generally assumes asymptotic properties, infinite data, or other mathematically idealized conditions. In this paper, we explore a fundamental distinction between this theoretical, idealized notion of identifiability and a proposed alternative that is computation-bound. The framework we propose - 'computational identifiability' - is to instead define a finite computational search procedure for an empirical estimator. If this process finds an estimator empirically, within a desired error tolerance, then identifiability is satisfied, conditional on the specified assumptions of the search (i.e., a prior distribution over the parameters) and conditional on the search procedure itself. Through several experiments, we demonstrate how this framework allows us to answer fine-grained, practical identification questions, such as identification with small finite samples, with ambiguous graphical criteria, with mixed observational-interventional data, and across counterfactual data and estimands. Code is available at https://github.com/lbynum/metadentify.

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

Reliable Conformal Prediction for Ordinal Classification Using the Ranked Probability Score

arXiv:2606.24959v1 Announce Type: cross Abstract: Ordinal classification (OC) arises in high-stakes domains such as medicine and finance, where uncertainty quantification must account for the severity of ordinal errors. Conformal prediction (CP) provides distribution-free prediction sets with marginal coverage guarantees; however, its practical effectiveness depends critically on the choice of nonconformity function. We introduce a CP method for ordinal classification based on the ranked probability score (RPS), a proper scoring rule defined over cumulative predictive distributions. Although it reflects ordinal risk quite naturally, it has largely been neglected in conformal ordinal prediction (COP). When used as a measure of nonconformity, RPS yields median-centered contiguous prediction sets by construction. The method is model-agnostic, supports both assessed and grouped ordered categorical outcomes, and permits efficient implementation compared to greedy interval selection procedures. Across multiple ordinal image and tabular datasets, RPS-based CP produces contiguous prediction sets and strikes a favorable balance between prediction set width and the magnitude of ordinal miscoverage relative to existing CP methods.

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

OmniPlan: An Adaptive Framework for Timely and Near-Optimal Network Planning Optimization

arXiv:2606.18105v1 Announce Type: cross Abstract: Network planning optimization is a fundamental problem across diverse domains, including transportation systems, communication networks, and power grids. It requires simultaneous optimization of multiple competing objectives under complex constraints. Existing network planning optimization frameworks rely on mixed integer programming (MIP) solvers, heuristics, and deep reinforcement learning (DRL) models to compute planning decisions. However, they lack effective adaptability to diverse and dynamic user intents, thus leading to the trade-off between execution time and optimality. In this paper, we propose OmniPlan, an adaptive framework that achieves both timeliness and near-optimality in network planning optimization. To achieve the adaptability lacking in existing solutions, OmniPlan employs a large language model (LLM)-based interpreter to convert heterogeneous natural-language intents into a unified and quantifiable user-preference vector. Then it employs a mixture-of-experts architecture that integrates MIP solvers, heuristics, and DRL models as specialized experts, where OmniPlan adapts to diverse intents by dynamically selecting timely and near-optimal experts. Finally, it incorporates a DRL-based expert configuration module that fine-tunes optimization objective weights to align planning decisions with user-specific preferences. We evaluate OmniPlan with a representative real-world workload, i.e., distributed machine learning (ML), where we leverage OmniPlan to offload a wide spectrum of ML inference tasks, e.g., decision trees, SVM, naive Bayes, XGBoost, and random forests, onto a network of hardware devices. Our experiments on a real-world testbed indicate that OmniPlan achieves near-optimal and low-execution-time offloading for real-world ML inference tasks, reducing latency by up to 97.8\% and network device resource consumption by up to 11.5\%.

21.
PLOS Medicine 2026-05-22

Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993–2025: A systematic review and meta-analysis

by Nicole A. Swartwood, Nanki Singh, Seyed Alireza Mortazavi, Melike Hazal Can, Hening Cui, Do Kyung Ryuk, Peter MacPherson, Katherine C. Horton, Nicolas A. Menzies Background Global and national initiatives to combat tuberculosis (TB) have expanded over recent years. Despite this, the TB burden remains high in some population groups, with men recognized as having elevated TB risks. Summary measures of sex differences in TB prevalence were last estimated in 2016. Since then, many additional prevalence surveys have been conducted, including in the highest TB burden countries. We conducted a systematic review of sex-stratified TB prevalence survey data published over 1993–2025, to provide updated estimates of male-to-female (M:F) TB prevalence ratios and determine whether sex-related disparities in TB burden have closed over time. Methods and findings We identified surveys reporting community-representative, sex-stratified estimates of pulmonary TB prevalence in low- and middle-income countries (LMICs), including surveys from an earlier review (covering January 1993–March 2016) and a new systematic review (covering 1st December 2015–13th October 2025). This review was prospectively registered with PROSPERO (CRD42024503853) and included searches of PubMed, Embase, Global Health, the Cochrane Library, Africa Index Medicus, LILACS, and SciELO. We extracted data on bacteriologically confirmed and smear-positive TB prevalence among adults (aged ≥ 15 years), stratified by sex. Risk of bias was evaluated using eight criteria specific to prevalence surveys. We fit multi-level Bayesian regression models with study- and country-level random effects to estimate the M:F ratio of TB prevalence (male prevalence divided by female prevalence), overall and for key subgroups. In meta-regression analyses, we estimated how prevalence ratios varied over time and according to known TB risk factors and TB case definitions.We identified 10,124 publications and extracted data from 100 eligible studies representing 102 unique prevalence surveys and 4,658,310 participants (45.6% male) in 33 LMICs. TB prevalence was higher in men than women in 90/102 of the included surveys, with a pooled M:F prevalence ratio of 2.02 (95% credible interval (CrI): 1.71, 2.34) for bacteriologically confirmed TB and 2.38 (95% CrI: 1.91, 2.90) for smear-positive TB. Time trend analyses showed a 2.0% (95% CrI: −0.2, 4.5%) average annual change in the M:F ratio of bacteriologically confirmed TB over the study period. The M:F prevalence ratio was estimated to be higher for countries with greater excess HIV prevalence among men, and countries with greater gender equity (as measured by the United Nation’s Gender Development Index). The estimated M:F prevalence ratio was also higher for surveys that did not restrict testing to individuals reporting TB symptoms. Study limitations include heterogeneity in survey methods and definitions, as well as limited data from the Americas, Eastern Mediterranean, and Europe WHO world regions and post-COVID-19 period. Conclusions Men in LMICs consistently experience TB at a higher prevalence than women. Time trend estimates are uncertain, but consistent with widening sex differences in TB prevalence over the last three decades, despite efforts to address the risk factors underlying this excess TB burden.

23.
medRxiv (Medicine) 2026-06-12

Design, Implementation, and Evaluation of a Shadowing Program for Medical Students in the Basic Sciences Phase

Introduction Shadowing, as an educational method based on active observation, can foster a realistic understanding of professional roles and enhance the communication skills of medical students. This study aimed to design, implement, and evaluate a shadowing program for basic sciences medical students. Methods This development study was conducted based on the ADDIE model in five phases. The study population consisted of 799 medical students in semesters 2 to 5. The stages included Analysis (determining needs through literature review and expert panels), Design (specifying learning environments and evaluation methods), Development (preparing guides and educational tools), Implementation (within the Medical Ethics course), and Evaluation (using questionnaires and reflection forms). Findings This study aimed to design and evaluate an educational shadowing program based on the ADDIE model. In the Analysis phase, the profiles of 799 students and learning objectives were determined. In the Design phase, a structured program for four types of shadowing was designed. In the Development phase, all guides and educational tools were prepared. In the Implementation phase, the program was carried out with complete coverage and adherence to ethical considerations. Finally, the program evaluation showed that "Motivation to become a good physician" (3.75-3.95) and "Enhancing empathy" (3.50-3.94) received the highest scores, while "Increasing understanding of the basic science-clinical connection" (2.53-2.89) and "Willingness to attend on holidays" (1.87-2.31) received the lowest scores. Conclusion The findings indicate that implementing the shadowing program is an effective method for strengthening the professional attitudes and academic motivation of medical students. However, the program did not significantly improve students perception of the basic science-clinical connection, indicating a need for curricular refinement. The continuation and extension of this program to other levels and fields of medical sciences are recommended.

24.
arXiv (quant-ph) 2026-06-24

Quantum turbulence in the many-body regime

arXiv:2606.23822v1 Announce Type: cross Abstract: We discuss phenomenology associated with turbulent hydrodynamics in quantum fluids from a condensed-matter perspective. We begin with weakly-interacting superfluids, often modeled by a mean-field theory governed by the Gross-Pitaevskii equation. Considering the effect of quantum fluctuations beyond the mean-field approximation, we propose a study of many-body quantum effects in turbulent hydrodynamics, especially near zero temperature. We motivate examples of quantum many-body systems where such effects may be uncovered. These include bosons confined in a periodic potential in low spatial dimensions (one and two), and the associated quantum critical point of the superfluid-insulator transition, realized in present-day ultracold-atom and quantum computing platforms. We conclude by listing a set of (open) questions that may be answered using modern quantum many-body techniques. This article is part of the theme issue 'Frontiers of turbulence and statistical physics'.

25.
arXiv (CS.AI) 2026-06-16

Nightjar: Dynamic Adaptive Speculative Decoding for Large Language Models Serving

arXiv:2512.22420v5 Announce Type: replace-cross Abstract: Speculative decoding (SD) accelerates LLM inference by verifying draft tokens in parallel. However, this method presents a critical trade-off: it improves throughput in low-load, memory-bound systems but degrades performance in high-load, compute-bound environments due to verification overhead. Existing speculative decoding methods use fixed lengths and cannot adapt to workload changes or decide when to stop speculation. The cost of restarting speculative inference also remains unquantified. Under high load, the benefit of speculation diminishes, while retaining the draft model reduces KV cache capacity, limiting batch size and degrading throughput. To overcome this, we propose Nightjar, a resource-aware adaptive speculative framework. It first adjusts to the request load by dynamically selecting the optimal speculative length for different batch sizes. Crucially, Nightjar proactively disables speculative decoding when the MAB planner determines that speculation is no longer beneficial, and during the disabled phase, offloads the draft model to the CPU only under GPU memory pressure. This reclaims memory for the KV cache, thereby facilitating larger batch sizes and maximizing overall system throughput. Experiments show that Nightjar achieves up to 14.76% higher throughput than standard speculative decoding and up to 20.18% lower latency in the main benchmark suite under dynamic request arrival rates for real-time LLM serving scenarios.