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01.
arXiv (CS.AI) 2026-06-16

Retrieve, Don't Retrain: Extending Vision Language Action Models to New Tasks at Test Time

arXiv:2606.15631v1 Announce Type: cross Abstract: Extending a vision-language-action (VLA) policy to a new task typically requires task-specific teleoperated demonstrations and per-task fine-tuning, making adaptation costly in both data collection and compute. In this paper, we show that this target-side per-task adaptation cost can be replaced by retrieval. Our retrieval-augmented policy is trained once on paired demonstrations from the target embodiment (query) and a cheaper embodiment (pool, e.g., human-hand video), then frozen. New tasks are added at deployment by appending pool-side demonstrations to a retrieval pool. The frozen policy conditions on retrieved trajectories at every control step, so new tasks are absorbed by indexing data rather than updating parameters. Fine-tuning is needed only to take on a new, unseen embodiment, not for each new task. We show that retrieval improves policies beyond a specific backbone, including standard VLA policies, but its effect is especially pronounced in Cosmos Policy, a video-generation-based world-action model (WAM). In this setting, retrieval supplies coarse task progression, while the WAM's future-image objective provides an additional visual consistency signal that strengthens the retrieval-conditioned actions. On PushT, we study how retrieval provides a reusable high-level motion prior for cross-embodiment generalization to unseen goal angles, while on RoboTwin 2.0 our method outperforms cross-embodiment baselines on unseen tasks, and we additionally demonstrate the method on a real robot.

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

Hallucination Detection and Correction in Medical VLMs via Counter-Evidence Verification

Vision-Language models (VLMs) reliability in medical diagnosis is challenged by trust-undermining hallucinations. Existing hallucination detection approaches mainly focus on identifying factual inconsistencies between generated text and reference data. While some studies analyze where models attend in images, they seldom verify whether such attention truly reflects the visual evidence supporting the generated text. To address this gap, we propose Co}unter-Evidence Verification (CoEV), a training-free plug-and-play framework that detects and corrects hallucinations through evidence-based factual consistency verification. CoEV performs bidirectional verification between textual assertions and visual evidence, testing whether each statement is supported by its corresponding evidence region, and assigns each statement into a four-quadrant diagnostic map capturing combinations of text factuality and visual grounding. CoEV detects hallucinated content and serves as a post hoc refinement tool, correcting hallucinations without retraining. Extensive experiments on four medical datasets show that CoEV combats hallucinations in VLMs.For hallucination detection, CoEV consistently outperforms existing methods, improving average PR-AUC and ROC-AUC by 3.0% and 3.9% absolute points respectively, with notable gains of up to 18.5% in specific VQA scenarios. For hallucination correction, it improves Micro-F1 by up to 12.5%, reduces hallucination rates by over 11.9% on medical report generation, and also boosts medical VQA accuracy. These results show that CoEV enables reliable detection and correction of hallucinations, providing clinicians with dependable, evidence-based cues for diagnosis. Code will be released upon acceptance.

03.
arXiv (CS.CV) 2026-06-12

ECA: Efficient Continual Alignment for Open-Ended Image-to-Text Generation

Incremental Learning (IL) for Open-ended Image-to-Text Generation (OpenITG) enables models to continuously generate accurate, contextually relevant text for new images while preserving previously acquired knowledge. Unlike prior studies, this paper addresses a more practical scenario in which the predominant category of visual data shifts over time as environments evolve. In this context, we introduce a new notion of continual alignment, which incrementally adapts the alignment module within pre-trained VLMs to preserve high-quality cross-modal representations. Based on this idea, we propose Efficient Continual Alignment (ECA), a novel exemplar-free IL approach for OpenITG. The key challenge is enabling the model to acquire new, task-specific features while minimizing interference with the established alignment without accessing raw data from previous tasks. To address this, ECA employs three core mechanisms: a Mixture of Query (MoQ) module that adapts task-specific query tokens, a Fisher Dynamic Expansion (FeDEx) that dynamically expands model structure based on a Fisher Information Matrix (FIM)-based metric, and an embedding dictionary with Dictionary Replay (DR) to retain past knowledge. To evaluate ECA's performance, we construct four new IL OpenITG benchmarks that better reflect real-world scenarios. Experimental results demonstrate that ECA significantly mitigates catastrophic forgetting and improves IL performance compared to baseline methods. Code and benchmarks are available at https://github.com/Snowball0823/ECA.

04.
arXiv (quant-ph) 2026-06-17

Induced Resource Theories and Harvesting via Quantum Probes

arXiv:2606.17287v1 Announce Type: new Abstract: We consider scenarios in which a quantum system with a well-defined resource theory is used as a probe to interact with an environment, such as a quantum field, for which a resource-theoretic description is absent or incomplete. We clarify if and how the harvesting of a resource in the probe can tell us about the state of the environment. This is particularly ambiguous when the probe-environment interaction is not a free operation, or the concept of such free operations cannot be defined altogether. We propose a framework and precise conditions under which it becomes possible to interpret resource generation on the probe as evidence of resources in the environment, thereby introducing an effective notion of resources for the latter. Our results clarify in which sense resources can be said to be harvested from the environment and provide a systematic way to analyse such processes beyond fully controlled resource-theoretic settings. More generally, this work may provide a step towards a more general understanding of the interplay of different quantum resources.

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

Quantifying and Auditing LLM Evaluation via Positive–Unlabeled Learning

arXiv:2606.19057v1 Announce Type: cross Abstract: Large Language Models (LLMs) are increasingly used as judges for scalable evaluation, yet such LLM–as–a–Judge systems exhibit systematic biases that are decoupled from semantic quality, most notably verbosity bias. Meanwhile, human supervision is costly and typically selective, yielding reliable positive judgments but leaving most outputs unlabelled and potentially mixed in quality. We formulate LLM evaluation under selective human supervision as a positive–unlabelled learning problem and propose a geometric auditing framework based on Partial Optimal Transport. By aligning a small set of human–verified positives with a reliable subset of unlabelled outputs in a fixed embedding space, our method identifies human–consistent preferences and corrects biased judges without retraining. Experiments demonstrate improved alignment with human preferences, increased robustness to presentation biases, and interpretable confidence estimates, offering a scalable and statistically grounded alternative to existing LLM–as–a–judge pipelines.

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

Benchmarking Vision-Language Models for Microscopic Plant Image Understanding

Microscopic imaging provides essential visual evidence for studying plant biology and pathology at the cellular and subcellular levels. However, existing benchmarks on vision-language models primarily focus on macroscopic plant imagery, while the microscopic domain remains underexplored. To address this gap, we present PlantMicro, a comprehensive benchmark for evaluating vision-language models (VLMs) in microscopic plant imagery. PlantMicro integrates more than 5,000 images collected across diverse hosts, biological domains, and imaging modalities. Building on this diversity, we design a set of complementary tasks that capture different facets of microscopic image understanding. To support these tasks, we construct over 9,000 VQA pairs that systematically evaluate the capabilities of VLMs. Experiments on PlantMicro show that current VLMs struggle with fine-grained recognition and biologically grounded reasoning. For example, GPT-5 achieves 34.93% accuracy on the pathogen classification task, which is only modestly above the random-guessing baseline. The results highlight a significant gap in current VLMs' ability to comprehend plant microscopic images. PlantMicro provides a standardized foundation for advancing VLMs toward reliable and comprehensive microscopy-level plant understanding.

07.
arXiv (CS.AI) 2026-06-24

Sensing Intelligence as a Trainable Metamaterial Property

arXiv:2605.23967v2 Announce Type: replace-cross Abstract: In biological systems, sensing is not performed by the brain alone: the body deforms, vibrates, and filters external stimuli before they are transduced into neural signals. In engineered systems, this processing burden is placed largely on electronics and computation, while the mechanical body is usually designed only for strength and stability. Here, we present sensing intelligence as a trainable property of the body. We show that the geometry of a metamaterial can be optimized to reshape external stimuli into internal signals that are easier for a neural network to interpret. Rather than hand-designing this physical preprocessing, we let the neural network train its own body for sensing by backpropagating the sensing loss to the body's design parameters through differentiable simulation. Across numerical and experimental sensing scenarios, the optimized body improves sensing accuracy by up to fivefold or reduces the number of required electronic sensors by nearly an order of magnitude.

08.
arXiv (CS.LG) 2026-06-15

When Language Representations Interact: Separability and Cross-Lingual Effects in LLMs

arXiv:2606.14347v1 Announce Type: new Abstract: Large language models exhibit strong multilingual capabilities, however, their internal representations are difficult to interpret. Understanding these interactions is important for ensuring reliable behavior in multilingual systems. Recent work has shown that causal-geometric structure can explain how certain concepts are encoded as approximately linear and separable directions, but whether this framework extends to multilingual models, where language identity is correlated and hierarchical, is underexplored. We apply causal-geometric analysis to multilingual LLMs, studying 28 bilingual contrasts across three models, allowing us to analyze when languages behave as approximately independent factors and when structured dependencies persist. We find evidence that language concepts admit stable linear representations that are largely separable under a covariance-adjusted (causal) inner product, with structured deviations reflecting linguistic similarity. Moreover, languages within the same family (such as Germanic or Romance) exhibit a simplex-like geometric structure, suggesting hierarchical organization. These results extend causal-geometric interpretability to multilingual settings and provide insight into how separability and similarity may exist in multilingual LLM representations, motivating interpretability analyses that diagnose when and how structured dependencies between concepts can be anticipated. This has implications for trustworthy deployment, as residual structure between languages may lead to unintended cross-lingual effects when models are monitored or intervened upon.

09.
arXiv (CS.LG) 2026-06-17

HeteRo-Select: Informativeness as the Participation Driver in Heterogeneous Federated Learning

arXiv:2508.06692v2 Announce Type: replace Abstract: Federated learning systems typically allocate gradient compression by link speed. This is sensible when bandwidth and data informativeness align. However, under non-IID data, these signals often decorrelate or invert. A bandwidth-driven allocator then risks compressing the most informative gradients hardest. We propose HeteRo-Select, a framework that replaces bandwidth with a per-client informativeness score as the primary driver of compression. The score jointly governs three decisions per round: client selection, compression ratio, and server aggregation weight, with bandwidth retained only as a hard ceiling. Score-proportional selection provably reduces the effective heterogeneity of the chosen subset; score-proportional compression provably lowers aggregate top-$k$ error at fixed traffic. Under the exact FedCG simulation protocol, HeteRo-Select delivers a $1.78\times$ speedup and an $18.2\%$ reduction in traffic on CIFAR-10. The same configuration, unchanged, scales from a $7{,}850$-parameter logistic regression to an $11.27$M-parameter ResNet-18, hitting the accuracy target on three of four benchmarks. When bandwidth and informativeness are deliberately anti-correlated, the method still achieves the target accuracy with less traffic than the normal-bandwidth run.

10.
arXiv (CS.AI) 2026-06-19

MetaResearcher: Scaling Deep Research via Self-Reflective Reinforcement Learning in Adversarial Virtual Environments

arXiv:2606.19893v1 Announce Type: new Abstract: Deep research agents have demonstrated remarkable capabilities in autonomous information gathering and synthesis, yet their training remains constrained by the static nature of simulated environments, the limits of fact-retrieval-only task designs, and the inefficiency of outcome-based reinforcement learning. In this work, we propose MetaResearcher, a novel framework that scales deep research agent training across four synergistic dimensions. First, we introduce an Evolving Virtual World that injects temporal dynamics and adversarial misinformation into the training environment, forcing agents to develop source credibility assessment and temporal conflict resolution skills. Second, we design Discovery-Oriented Tasks – including hypothesis generation and contradiction resolution – that transcend simple fact retrieval and push agents toward genuine research behaviors. Third, we propose a Self-Reflective Meta-Reward mechanism within the GRPO framework that jointly optimizes for answer correctness, search path efficiency, reflection depth, and tool call diversity, directly addressing the repetitive action loop problem observed in prior work. Fourth, we introduce a Heterogeneous Multi-Agent Swarm architecture comprising specialized Scout, Filter, and Synthesizer models that learn collaborative research strategies through coordinated reinforcement learning. Built upon the LiteResearcher infrastructure, MetaResearcher requires zero marginal API cost for training while targeting substantial improvements in both benchmark performance (GAIA, Xbench-DS) and epistemic robustness under adversarial conditions. We present the complete framework design, training methodology, and planned experimental validation.

11.
medRxiv (Medicine) 2026-06-10

"We don't complain; it's just part of being a woman": frequency, knowledge, and sociocultural beliefs about dysmenorrhoea in a South African university cohort

Introduction Dysmenorrhoea is highly prevalent globally and interferes with engagement in education, work, social participation, and quality of life. Although evidence suggests that sociocultural beliefs influence how menstrual pain is understood and managed, relatively little research has explored dysmenorrhoea-related knowledge and beliefs within South Africa. This study aimed to (1) determine the frequency of dysmenorrhoea, (2) assess dysmenorrhoea-related knowledge and compare knowledge between menstruating and non-menstruating individuals, and (3) explore commonly held generational, cultural, and religious beliefs related to dysmenorrhoea in a South African university cohort. Methods We analysed data collected as part of a cross-sectional survey conducted among staff and students at a South African university. Participants completed demographic questions, items assessing dysmenorrhoea-related knowledge, and an adapted Working Ability, Location, Intensity, Days of Pain, Dysmenorrhoea (WaLIDD) questionnaire. Participants were also invited to provide free-text responses describing generational, cultural, and religious beliefs about dysmenorrhoea. Quantitative data were analysed descriptively and compared between menstruating and non-menstruating participants. Free-text responses were analysed using reflexive thematic analysis. Results A total of 863 participants completed the survey, including 578 current or past menstruators. The frequency (95%CI) of dysmenorrhoea was 75.4% (71.7-78.9). Most participants were classified as having moderate (53%) or severe (31%) dysmenorrhoea on the WaLIDD scale. Awareness of dysmenorrhoea was higher among participants who had menstruated than among those who had never menstruated (80.4% vs 55.3%, p

12.
arXiv (CS.CL) 2026-06-19

Uncertainty Decomposition for Clarification Seeking in LLM Agents

Recent position papers argue that the classical aleatoric/epistemic uncertainty framework is insufficient for interactive large language model (LLM) agents and call for underspecification-aware, decomposed, and communicable uncertainty representations that can unlock new agent capabilities such as proactive clarification seeking and shared mental-model building. Practical deployment constraints – black-box APIs, interactive latency budgets, and the absence of labeled trajectories – rule out logprob-based, multi-sampling, and training-based methods, leaving prompt-based estimation as the most viable family for surfacing such signals at deployment time. We answer this call with a simple prompt-based decomposition that separates action confidence from request uncertainty (u), enabling the agent to ask for clarification when the task specification is ambiguous. To evaluate it, we introduce two clarification-augmented benchmarks (WebShop-Clarification and ALFWorld-Clarification) in which 50% of tasks are deliberately underspecified, and systematically compare the proposed decomposition against ReAct+UE and Uncertainty-Aware Memory (UAM) across five LLM backbones (GPT-5.1, DeepSeek-v3.2-exp, GLM-4.7, Qwen3.5-35B, GPT-OSS-120B) on these variants together with the standard WebShop, ALFWorld, and REAL benchmarks for fault detection. Averaged across the five backbones, the proposed decomposition improves clarification F1 on ALFWorld-Clarification by 73% over ReAct+UE and by 36% over UAM, and leads clarification F1 on every backbone on WebShop-Clarification and on four of five backbones on ALFWorld-Clarification, indicating that the gains generalize beyond a single LLM.

13.
Nature (Science) 2026-06-22

Daily briefing: First-ever ‘nuclear’ clocks put atomic clocks in the shade

作者:

Two research teams have created a new, long-awaited type of timekeeper. Plus, how backlash has saved an ocean-monitoring network targeted by Trump and how our cultural heritage is put at risk by climate change. Two research teams have created a new, long-awaited type of timekeeper. Plus, how backlash has saved an ocean-monitoring network targeted by Trump and how our cultural heritage is put at risk by climate change.

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

Machine Learning Classification and Portfolio Construction: Does the Loss Function Matter?

arXiv:2108.02283v3 Announce Type: replace-cross Abstract: Classification outperforms regression across matched machine learning models in portfolio construction. A stacking ensemble of gradient boosted tree, random forest, and neural network yields a value-weighted annualized Sharpe ratio of 1.83 for classification and 1.11 for regression. This outperformance persists in multiclass settings, across subsamples, and after transaction costs. Spanning tests show that classification retains economically large alphas after we control for regression, whereas regression alphas shrink substantially once we control for classification. These results indicate that classification extracts more return information than matched regression. Our diagnostics trace classification's advantage to sharper and more precise separation of return deciles.

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

On-Policy Distillation with Curriculum Turn-level Guidance for Multi-turn Agents

arXiv:2606.15912v1 Announce Type: cross Abstract: Multi-turn agents that plan, invoke tools, and interact with environments offer a promising paradigm for solving complex tasks, yet their capabilities typically rely on very large models whose inference cost is prohibitive in practice.On-Policy Distillation (OPD) is a natural recipe for transferring such capabilities to smaller students, but we find that it suffers a characteristic failure mode in this setting: small student errors compound across turns and push the trajectory out of the teacher's familiar state distribution, so the teacher's supervision becomes least reliable precisely where the student needs it most.We propose Guided On-Policy Distillation (Guided-OPD), a simple yet effective algorithm that mixes teacher- and student-generated turns within each rollout and schedules the teacher's intervention probability along a curriculum that decays to zero.Strong guidance keeps early trajectories close to the teacher distribution and is then gradually withdrawn to recover the purely on-policy regime used at inference.On ALFWorld, ScienceWorld, and WebShop, distilling Qwen3 students from a Qwen3-30B-A3B teacher, Guided-OPD improves Score by 21.1\% and Success Rate by 25.5\% over vanilla OPD on average, with larger gains on smaller students.

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

Agents All the Way Down; A Methodology for Building Custom AI Agents from Substrate to Production

arXiv:2606.11869v1 Announce Type: cross Abstract: Custom AI agents areagents that live inside their own application, talk to their own data and tools, enforce their own security boundaries, and carry their own brand and audit trail. What separates them from the general-purpose tier is fit, not capability: each is built for one job, by the engineer who will maintain it. No published practice sets out how to build one end to end. The pieces are everywhere (function-calling APIs, the Model Context Protocol, code agents to pair with), but the practice that chains them lives in podcasts, blogs, and leaked system prompts. This paper writes that practice down as a methodology, Agents All the Way Down: two preconditions crossed once and kept, then three practices repeated for the agent's life. The preconditions are (P1) Substrate, the LLM as a software component, framed as tools, then system, then messages under prompt-caching; and (P2) Building blocks: function calling, MCP, CLI orchestration, the liteshell pattern, the agent loop, skills, characters, hooks, and scaffolding. The practices are (P3) prototype with a general-purpose agent; (P4) harvest, fold, and ship the result as a CLI, the Turtle pattern; and (P5) agent-tests-agent, in which a general-purpose agent drives it through behavioural scenarios, a complement to classical testing, not a replacement. The working loop is P3 to P4 to P5 and back, and one corollary falls out for free: multi-agent orchestration is just CLI composition. The methodology is framework-free by construction. It was distilled from the AAC, a custom agent for the open-source LAMB platform, built in about ten days by one developer with an AI pair-programmer and in production . We present it as a transferable practice, independent of any language or framework.

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

Context-Aware Hierarchical Bayesian Modeling of IVF Laboratory Environmental Conditions

arXiv:2606.20459v1 Announce Type: new Abstract: IVF pregnancy rates are routinely modeled using patient-level variables, while high-resolution laboratory environmental data remain underutilized. We show that this is a missed opportunity. Rather than relying on raw sensor averages, we engineer 55 context-aware temporal features, including rolling thermal stability, simultaneous temperature-humidity adherence, peak stress duration, and post-stress recovery speed, that capture the dynamics of incubator microenvironments. On 61 weeks of data from an Asian IVF clinic, these features reduce cross-validated prediction error to 1.27%, compared to 3-5% for raw averages. We then train a hierarchical Bayesian Beta regression model that shares environmental effects across an Asian and a Northern European clinic via partial pooling, while preserving site-specific baselines. On held-out data from the Northern European clinic, the model achieves R2 = 0.86 and a 64% error reduction for the 35-39 age group over a naive baseline, demonstrating that structured environmental monitoring contains clinically meaningful, transferable signal.

18.
arXiv (CS.AI) 2026-06-16

QPILOTS: Efficient Test-Time Q-Steering for Flow Policies

arXiv:2606.14801v1 Announce Type: cross Abstract: Flow-matching and diffusion policies are expressive action generators, but optimizing them with temporal-difference reinforcement learning (RL) remains difficult. Effective policy extraction requires exploiting the critic's action gradient, yet directly backpropagating this signal through a multi-step denoising process can be numerically unstable. Existing methods work around this either by discarding gradient information, distilling the policy into a simpler one-step actor, or repeatedly fine-tuning the denoising policy as the critic improves. We propose QPILOTS, a method that leaves the original policy unmodified and steers the denoising process at inference time. At each denoising step, instead of evaluating the critic on the noisy intermediate action where critic predictions are unreliable, we first project that intermediate state to an estimate of the final clean action and compute the critic gradient there. We introduce two variants: QPILOTS-U uses a fast single-point approximation, while QPILOTS-M draws differentiable posterior samples via a learned auxiliary network. On a standard offline-to-online RL benchmark, QPILOTS achieves the best aggregate performance, reaching an average success rate of 90% across 50 tasks. We also apply QPILOTS to steer a large, frozen, pretrained Vision-Language Action (VLA) foundation model, outperforming or matching prior inference-time approaches across six manipulation tasks in simulation.

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

RWGBench: Evaluating Scholarly Positioning in Related Work Generation

arXiv:2606.24894v1 Announce Type: cross Abstract: Large language models have shown strong fluency in scientific writing, yet the evaluation of related work generation (RWG) remains limited. Existing RWG evaluations largely inherit summarization-oriented metrics, using lexical or semantic similarity to reference sections as proxies for quality. However, related work writing is fundamentally a citation-level scholarly positioning task: it requires selecting, organizing, and framing prior work to clarify how a target paper relates to, differs from, and contributes beyond existing research.As a result, models may generate coherent and semantically-relevant text while exhibiting academically critical failures, such as inappropriate citation selection or misplaced references, that conventional metrics do not capture.To this end, we introduce RWGBench, a benchmark that evaluates RWG from the perspective of citation decision-making rather than text similarity. RWGBench is constructed from a large-scale collection of 40,108 computer science papers and a retrieval corpus of 1.09 million documents, with a carefully curated test set comprising 100 papers and their corresponding published related work sections.We propose a multi-dimensional evaluation framework that assesses citation selection, contextual appropriateness, organization, and discourse structure.Experiments reveal systematic limitations in current systems that are obscured by standard evaluations, while Oracle studies further disentangle retrieval-level and generation-level bottlenecks. Human evaluation further shows that our citation-centric metrics align substantially better with expert judgment than surface-level text metrics. RWGBench offers a citation-centric testbed for developing and evaluating related work generation systems that are better aligned with scholarly writing practices.

20.
arXiv (CS.LG) 2026-06-16

Efficient Reinforcement Learning by Guiding World Models with Non-Curated Data

arXiv:2502.19544v3 Announce Type: replace Abstract: Leveraging offline data is a promising way to improve the sample efficiency of online reinforcement learning (RL). This paper expands the pool of usable data for offline-to-online RL by leveraging abundant non-curated data that is reward-free, of mixed quality, and collected across multiple embodiments. Although learning a world model appears promising for utilizing such data, we find that naive fine-tuning fails to accelerate RL training on many tasks. Through careful investigation, we attribute this failure to the distributional shift between offline and online data during fine-tuning. To address this issue and effectively use the offline data, we propose two techniques: i) experience rehearsal and ii) execution guidance. With these modifications, the non-curated offline data substantially improves RL's sample efficiency. Under limited sample budgets, our method achieves nearly twice the aggregate score of learning-from-scratch baselines across 72 visuomotor tasks spanning 6 embodiments. On challenging tasks such as locomotion and robotic manipulation, it outperforms prior methods that utilize offline data by a decent margin.

21.
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.

22.
medRxiv (Medicine) 2026-06-16

Care Delivery Gap framework: a proof-of-concept patient-reported measure of guideline-referenced care-process omissions in sickle cell disease

Abstract Background:Sickle cell disease (SCD) is concentrated in sub-Saharan Africa, where delivery of guideline-referenced care remains challenging. Current evaluation approaches rely largely on access indicators and clinical outcomes, which do not directly measure care delivery. We developed the Care Delivery Gap (CDG) framework, a patient-reported approach for identifying care-process omissions, and conducted a proof-of-concept study to assess feasibility and explore variation across income strata. Methods: We conducted a cross-sectional framework-development study involving a proof-of-concept sample of 52 individuals with SCD or caregivers recruited through clinics and moderated SCD communities across Africa, North America, and Europe between June 2025 and March 2026. The CDG framework assessed patient-reported omissions in specialist involvement, follow-up continuity, cardiovascular screening, and biochemical surveillance. Analyses were descriptive. Results: Substantial multi-domain care-process omissions were identified despite high reported healthcare engagement. Across geographic income strata, cardiovascular screening was reported by 4/35 (11%) LMIC versus 16/17 (94%) HIC participants, and regular follow-up within the preceding 12 months by 14/35 (40%) versus 16/17 (94%), respectively. High CDG scores, representing 1 omissions across three or four domains, occurred in 20/35 (57%) LMIC compared with 1/17 (6%) HIC participants. Similar disparities were observed across specialist review and vitamin B12 surveillance domains. Conclusion: A structured patient-reported framework identified multi-domain omissions in guideline-referenced SCD care, including among individuals reporting healthcare access. The divergence between access indicators and reported care delivery suggests that service contact alone may not reflect care quality. The framework provides a feasible foundation for future process-level quality measurement in high-burden settings.

23.
arXiv (CS.LG) 2026-06-19

Evaluating deep learning models for fault diagnosis of a rotating machinery with epistemic and aleatoric uncertainty

arXiv:2412.18980v2 Announce Type: replace Abstract: Uncertainty-aware deep learning (DL) models recently gained attention in fault diagnosis as a way to promote the reliable detection of faults when out-of-distribution (OOD) data arise from unseen faults (epistemic uncertainty) or the presence of noise (aleatoric uncertainty). In this paper, we present the first comprehensive comparative study of state-of-the-art uncertainty-aware DL architectures for fault diagnosis in rotating machinery, where different scenarios affected by epistemic uncertainty and different types of aleatoric uncertainty are investigated. The selected architectures include sampling by dropout, Bayesian neural networks, and deep ensembles. Moreover, to distinguish between in-distribution and OOD data in the different scenarios two uncertainty thresholds, one of which is introduced in this paper, are alternatively applied. Our empirical findings offer guidance to practitioners and researchers who have to deploy real-world uncertainty-aware fault diagnosis systems. In particular, they reveal that, in the presence of epistemic uncertainty, all DL models are capable of effectively detecting, on average, a substantial portion of OOD data across all the scenarios. However, deep ensemble models show superior performance, independently of the uncertainty threshold used for discrimination. In the presence of aleatoric uncertainty, the noise level plays an important role. Specifically, low noise levels hinder the models' ability to effectively detect OOD data. Even in this case, however, deep ensemble models exhibit a milder degradation in performance, dominating the others. These achievements, combined with their shorter inference time, make deep ensemble architectures the preferred choice.

24.
arXiv (math.PR) 2026-06-15

Real-order moments, tail representations, and logarithmic means

arXiv:2606.14019v1 Announce Type: cross Abstract: This paper develops a unified framework for the study of real-order moments of arbitrary random variables. General integral representations are established in terms of cumulative distribution functions and survival functions, covering continuous, discrete, and mixed distributions supported on the whole real line. These formulas extend the classical tail-integral identities for nonnegative random variables and provide a common treatment of positive, fractional, and negative moments. For discrete distributions, explicit series representations are derived in terms of cumulative probabilities, yielding simple criteria for the existence of moments. Applications are presented for the zeta and Skellam distributions, illustrating how tail behavior determines moment finiteness and how moments can be represented geometrically through cumulative distribution functions. In addition, a representation for logarithmic moments is obtained, linking logarithmic means, Laplace transforms, and the classical Frullani identity. The results provide a unified perspective on moment representations and establish useful connections between tail probabilities, distribution functions, Laplace transforms, and moment existence.

25.
bioRxiv (Bioinfo) 2026-06-11

Revealing trajectories of multi-modal voxel-level changes in neurodegenerative diseases using latent event mapping

Neurodegenerative diseases are driven by pathological mechanisms that can be indirectly measured in vivo using multi-modal neuroimaging. However, current computational methods that aim to reconstruct trajectories of voxel-level changes in the brain are either not computationally scalable or fully interpretable, limiting their ability to reveal associations between disease progression and underlying mechanisms. Here we introduce Latent Event Mapping (LEMING), a generative unsupervised modelling technique that learns a latent map of disease events along a common pseudo-timeline of events. We apply LEMING to amyloid PET and structural MRI data from the Alzheimer's Disease Neuroimaging Initiative to reveal the first voxel-level trajectories of events in Alzheimer's disease. Notably, we show how LEMING can provide new insights into progression-dependent disease mechanisms. We find that acetylcholine receptor density is significantly positively associated with both late-stage amyloid and atrophy events, suggesting that either these receptors are targeted later in disease progression, or that amyloid does not play an active role. This has strong implications for therapeutics that target acetylcholine receptors, particularly for early-stage intervention strategies.