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01.
arXiv (CS.AI) 2026-06-15

Sensitivity Shaping for Latent Modeling

arXiv:2606.14585v1 Announce Type: cross Abstract: Generative dynamics models enable planning in challenging robotic systems, but safe deployment requires reliably detecting policy-induced out-of-distribution (OOD) transitions. Existing methods typically treat the learned dynamics as fixed and attach post hoc support surrogates. We show that these surrogates can fail when the dynamics are locally insensitive to critical action choices: unsupported control actions may produce latent predictions that resemble demonstrated transitions, suppressing OOD signals despite large true predictive errors. To address this, we introduce support-conditioned control-sensitivity regularization, which promotes sensitive local response to control input changes in learned dynamics in high-support training regions. This preserves control-induced variation while limiting unstable extrapolation due to weak empirical support. Experiments in vision-based obstacle avoidance, manipulation, and real-robot navigation show improved OOD detection and safer closed-loop planning.

02.
arXiv (CS.CV) 2026-06-24

Neural Particle Automata: Learning Self-Organizing Particle Dynamics

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

03.
arXiv (CS.LG) 2026-06-16

DemoDiffusion: One-Shot Human Imitation using pre-trained Diffusion Policy

arXiv:2506.20668v3 Announce Type: replace-cross Abstract: We propose DemoDiffusion, a simple method for enabling robots to perform manipulation tasks by imitating a single human demonstration, without requiring task-specific training or paired human-robot data. Our approach is based on two insights. First, the hand motion in a human demonstration provides a useful prior for the robot's end-effector trajectory, which we can convert into a rough open-loop robot motion trajectory via kinematic retargeting. Second, while this retargeted motion captures the overall structure of the task, it may not align well with plausible robot actions in-context. To address this, we leverage a pre-trained generalist diffusion policy to modify the trajectory, ensuring it both follows the human motion and remains within the distribution of plausible robot actions. Unlike approaches based on online reinforcement learning or paired human-robot data, our method enables robust adaptation to new tasks and scenes with minimal effort. In real-world experiments across 8 diverse manipulation tasks, DemoDiffusion achieves 83.8\% average success rate, compared to 13.8\% for the pre-trained policy and 52.5\% for kinematic retargeting, succeeding even on tasks where the pre-trained generalist policy fails entirely. Project page: https://demodiffusion.github.io/

04.
arXiv (CS.LG) 2026-06-15

PERRY: Policy Evaluation with Confidence Intervals using Auxiliary Data

arXiv:2507.20068v2 Announce Type: replace Abstract: Off-policy evaluation (OPE) methods estimate the value of a new reinforcement learning (RL) policy prior to deployment. Recent advances have shown that leveraging auxiliary datasets, such as those synthesized by generative models, can improve the accuracy of OPE methods. Unfortunately, such auxiliary datasets may also be biased, and existing methods for using data augmentation within OPE lack principled uncertainty quantification. In high stakes domains like healthcare, reliable uncertainty estimates are important for ensuring safe and informed deployment of RL policies. In this work, we propose two methods to construct valid confidence intervals for OPE with data augmentation. The first provides a confidence interval over $V^{\pi}(s)$, the policy value conditioned on an initial state $s$. To do so we introduce a new conformal prediction method suitable for Markov Decision Processes (MDPs) with continuous state spaces, extending prior work to higher-dimensional settings. Second, we consider the more common task of estimating the average policy performance over all initial states, $V^{\pi}$; we introduce a method that draws on ideas from doubly robust estimation and prediction powered inference. Across simulators spanning inventory management, robotics, healthcare, and a real healthcare dataset from MIMIC-IV, we find that our methods can effectively leverage auxiliary data and consistently produce confidence intervals that cover the ground truth policy values, unlike previously proposed methods. Our work enables a future in which OPE can provide rigorous uncertainty estimates for high-stakes domains.

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

CT-VDETR: Semi-supervised 3D Trauma Detection in Computed Tomography (CT) scans using Dense Vertex Relative Position Encoding

Accurate detection and localization of traumatic injuries in abdominal CT remain challenging because voxel-level annotations are limited and expensive to obtain. We present a label-efficient framework for 3D abdominal trauma detection that combines self-supervised pretraining with semi-supervised transformer-based detection. First, we use Masked Image Modeling (MIM) on 1098 CT volumes to pretrain a 3D U-Net encoder for anatomical representation learning. Next, we adapt V-DETR to dense volumetric CT through a feature adapter that converts the encoder feature grid into a compact token sequence for transformer decoding. The pretrained encoder is then integrated with V-DETR and 3D Vertex Relative Position Encoding (3D V-RPE) to improve the localization of irregularly shaped injuries. Finally, semi-supervised teacher-student consistency regularization leverages 2,000 additional unlabeled volumes during detector training. To the best of our knowledge, this is the first application of a 3D DETR-style detector to the RSNA abdominal trauma detection task. On this benchmark, the proposed method achieves 31.33% test mAP@0.50 using only 78 labeled training volumes, corresponding to a 1.53x improvement over supervised-only training. These results show that combining medical-domain pretraining with semi-supervised learning is an effective strategy for label-scarce 3D medical detection.

06.
medRxiv (Medicine) 2026-06-18

Expert in Ultrasound Skills: Feasibility of an IMU-video platform to describe technical profiles during focused cardiac ultrasound. Pilot study

Background: Focused cardiac ultrasound (FoCUS) is operator dependent and requires coordinated probe manipulation, image interpretation and iterative visual feedback. Existing assessment approaches often emphasize final image quality or expert rating. We developed Expert in Ultrasound Skills (EXUS) , a platform that synchronizes transducer-mounted inertial measurement unit (IMU) data with ultrasound video, and evaluated its technical feasibility during FoCUS acquisition. Methods: This observational pilot study included 6 operators performing two repetitions of a four-view FoCUS protocol, yielding 12 analytical sessions and 48 planned acquisitions. Feasibility was defined by acquisition completion, video availability, start/stop events, fused IMU-video windows, temporal coverage, complete human label entries and IMU integrity. A 100-image Likert rating task was used to summarize pairwise inter-rater agreement for still-frame image quality assessment. Results: All 48 planned acquisitions were completed with video, start/stop events, fused windows and complete human label entries. Temporal coverage was at least 90% in 47/48 acquisitions. IMU integrity endpoints exceeded the 80% threshold: 43/48 acquisitions had no extreme IMU-derived artifact, 43/48 had no active-segment IMU restart and 44/48 had no complete motion flatline. Mean pairwise exact agreement for the Likert task was 38.9%, with mean quadratic-weighted Cohen's kappa of 0.564. Post hoc profiles varied across duration, visual quality, mechanical load and motor efficiency. Conclusions: EXUS was technically feasible for synchronized IMU-video capture during FoCUS. The pilot supports multimodal acquisition data as a way to describe technical profiles and generate formative feedback hypotheses, but the post hoc indices are not validated competency measures. Keywords: focused cardiac ultrasound; point-of-care ultrasound; inertial measurement unit; medical education; deliberate practice

07.
arXiv (CS.AI) 2026-06-17

Knowledge Reutilization in Meta-Reinforcement Learning

arXiv:2606.18132v1 Announce Type: new Abstract: Meta-reinforcement learning enables fast adaptation by extracting shared structure from related tasks, but existing end-to-end methods often couple task inference with embodiment-specific control. This coupling can obscure non-parametric task semantics, reduce sample efficiency, and limit cross-agent reuse. We propose a meta-knowledge reutilization framework that learns task-level knowledge on a dynamics-simplified agent and transfers it to heterogeneous agents. The framework uses a Bayesian non-parametric prior to organize latent task modes and a high-level policy to generate task-level magnitude guidance. To bridge reusable task knowledge with different embodiments, we introduce a semantic-magnitude interface and a lightweight temporal adaptor, which convert frozen meta-knowledge into temporally aligned subgoals for embodiment-specific low-level controllers. Experiments on multiple locomotion agents show that our framework reduces final-step tracking error by 94.75% – 99.79% compared with recent state-of-the-art baselines and achieves comparable deployment performance with about 23.8% of their interaction data.

08.
medRxiv (Medicine) 2026-06-22

AFFORDABILITY OF INTOXICATION FROM CHEAP ETHANOL: EVIDENCE FROM RETAIL ALCOHOL MARKETS IN UGANDA

Background: Alcohol affordability is a determinant of consumption and alcohol-related harm. In many low- and middle-income countries (LMICs), informal production, variable alcohol strength, and non-standard packaging complicate conventional affordability measures, limiting evidence on the economic accessibility of alcohol and the cost of intoxication. Objective: To assess the affordability of intoxication in Uganda by estimating the cost of obtaining ethanol to reach intoxication across alcohol products, packaging types, and retail contexts. Methods: Data were collected on 824 alcoholic beverages from urban, rural, and urban-slum retail markets. Ethanol-standardized pricing (price per gram of alcohol) was calculated, and the cost of consuming 60 g of ethanol was estimated. Multivariate regression identified determinants of ethanol affordability. Results: Affordability varied by product type and packaging. Opaque beers and illicit spirits provided the cheapest pathways to intoxication, with median costs of UGX 1,200-1,500 per 60 g of ethanol. Plastic packaging was associated with lower ethanol costs than glass packaging. Ethanol prices differed across formal and informal markets (p < 0.01), while rural areas and urban informal settlements had 20-25% lower costs than urban areas. Regulatory status alone did not predict affordability. Conclusions: In Ugandas diverse alcohol market, affordability is driven by access to ethanol rather than beverage price alone. Low-cost, high-strength alcohol sold through informal channels enables intoxication at minimal expense, among disadvantaged populations. Implications: Alcohol policies should target ethanol content through minimum unit pricing, alcohol-content-based taxation, and regulation of informal markets and packaging practices to reduce harmful consumption and inequities.

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

Beyond Uniform Tokens: Adaptive Compression for Time Series Language Models

Large language models (LLMs) have enabled time series (TS) analysis by jointly modeling numerical observations and textual context through a shared token interface. However, TS tokens and prompt tokens exhibit fundamentally different information structures, making uniform token processing inefficient. In this paper, we study token efficiency in TS language modeling from an asymmetric-token perspective. We show that TS tokens have highly uneven spectral contributions, where many tokens share redundant frequency patterns while a small subset preserves critical temporal evidence. We also observe that prompt-token influence attenuates with model depth, suggesting that full prompt retention across all layers is unnecessary. Based on these findings, we develop an adaptive token budgeting framework that compresses TS tokens via frequency-domain structure and progressively reduces prompt tokens across layers. Experiments across forecasting, classification, imputation, and anomaly detection demonstrate up to 7.68$\times$ inference acceleration and performance gains in 78\% of evaluated settings, showing the effectiveness of asymmetric token compression for scalable TS foundation models.

10.
arXiv (CS.CV) 2026-06-11

From Content to Knowledge: Lightning Fast Long-Video Understanding with Neural Knowledge Representations

We propose a new paradigm for long video understanding by treating a long video as a Neural Knowledge Representation (NKR). NKR represents video contents neither as a stream of tokens nor pre-organized databases, but as an individual small portion of network weights attached to the VLM backbone. The NKR weights are optimized to encapsulate the video's semantic content via a novel Agentic Knowledge Distillation (AKD) process, where an agent automatically synthesizes dense descriptions and question-answer pairs to distill the video's knowledge into the NKR. While AKD serves as a comprehensive, one-time encoding phase, the resulting NKR transforms the video into a portable, reusable asset. At inference, the lightweight NKR is mounted onto a frozen Vision-Language Model (VLM), enabling direct, query-based understanding without reloading or re-encoding the original video. This approach decouples video length from inference cost, offering high amortized efficiency for multi-turn video understanding. Experiments on the LVBench benchmark show our method achieves performance comparable to state-of-the-art approaches while reducing end-to-end latency by over two orders of magnitude, opening new possibilities for interactive long-video understanding.

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

StereoFactory: A Unified Merging Framework for Robust Stereo Matching

Stereo matching has advanced through foundation models trained on large-scale datasets, yet this paradigm suffers from a scalability bottleneck: incorporating new data requires costly joint retraining. Model merging offers a scalable post-hoc alternative by integrating knowledge from specialized models after source checkpoints are available. However, existing merging methods typically retain all available models or rely on greedy inclusion, which can preserve harmful task-vector interference. We propose StereoFactory, a coarse-to-fine evolutionary framework for adaptive model merging. Stage~1 employs a genetic algorithm to search the combinatorial space of model subsets, determining which models should participate. Stage~2 addresses module-level knowledge specialization (different functional modules exhibit distinct preferences for knowledge sources) through CMA-ES optimization of architecture-adaptive routing over the selected task vectors, with optional module-level scaling. Experiments across two architectures and four benchmarks demonstrate that StereoFactory consistently achieves the best four-benchmark average under the same checkpoint pool, reducing the average error from 3.80 to 3.30 on NMRF and from 2.88 to 2.19 on FoundationStereo relative to the strongest controlled baseline. The post-hoc search requires only 2.7–3.7\% of the corresponding joint-retraining wall-clock time. Analysis reveals that knowledge contributions are inherently module-specific, and selected subsets can transfer across architectures with minimal degradation. Code will be publicly released upon acceptance at: https://github.com/XiandaGuo/StereoFactory.

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

CARE: Competence-Aware Reward Shaping for Adaptive Reasoning Length in Video-MLLMs

In multimodal video reasoning, reinforcement learning-based methods typically rely on simplistic and inflexible reasoning-length control strategies that fail to adapt to the model's evolving competence. This mismatch may suppress necessary exploration at early stages, while encouraging redundant reasoning and inefficient decoding once the model becomes more competent. In this paper, we propose CARE, a competence-aware reward shaping framework for adaptive reasoning length optimization in multimodal reasoning. Specifically, CARE maintains a smoothed competence estimate via an exponential moving average of pass rates, and uses it to route training into progressive stages that shift the reward preference from exploration-oriented long-form reasoning to efficiency-oriented concise reasoning. To avoid conflating verbosity with intrinsic task complexity, CARE further normalizes reasoning effort with batch-level statistics, and introduces a posterior amplifier to strengthen reward signals for unexpectedly strong performance on historically difficult samples. The proposed mechanism is seamlessly integrated into the GRPO training pipeline and incurs no additional inference-time overhead. Extensive experiments on multiple video reasoning and general video understanding benchmarks demonstrate that CARE consistently improves reasoning accuracy, stabilizes reinforcement learning, and significantly enhances token efficiency. Moreover, CARE exhibits a characteristic inverted-U trajectory of reasoning length during training, and yields shorter yet more informative reasoning traces at convergence, indicating effective adaptive allocation of reasoning budget. We provide the source code for our proposed CARE framework and experiments at https://github.com/1Pansy/Video-CARE.

13.
arXiv (CS.CV) 2026-06-17

AIGS-Net: Compact Illumination Field Modeling via 2D Gaussian Splatting for Fast Low-Light Image Enhancement

Existing low-light image enhancement methods often face a bottleneck between the representation capacity of illumination-field modeling and computational complexity. To address this issue, this paper proposes an Adaptive Illumination Gaussian Splatting Network (AIGS-Net), an ultra-lightweight architecture for fast low-light enhancement. Unlike conventional static priors, AIGS-Net constructs an input-adaptive 2D Gaussian Splatting illumination field. The opacity of Gaussian basis functions is dynamically modulated by relative luminance statistics of the input image, and spatially varying illumination compensation is rendered through ordered alpha compositing. To guide adaptive illumination compensation efficiently, a zero-parameter nonlinear multiscale contextual encoding module is introduced to extract low-frequency structures and local contrast cues without additional convolutional weights. To suppress noise amplification and sensor-induced color bias, AIGS-Net integrates noise-mask estimation, locked single-channel Gamma mapping, cross-channel consistency regularization, and target color-alignment constraints. Experiments on LOL and LSRW benchmarks show that AIGS-Net improves detail recovery and color fidelity while requiring only approximately 40 learnable parameters, achieving an effective trade-off between enhancement quality and extreme inference efficiency.

14.
arXiv (CS.CV) 2026-06-16

CropTrack: A Tracking with Re-Identification Framework for Precision Agriculture

Multiple-object tracking (MOT) in agricultural environments presents major challenges due to repetitive patterns, similar object appearances, sudden illumination changes, and frequent occlusions. Contemporary trackers in this domain rely on the motion of objects rather than appearance for association. Nevertheless, they struggle to maintain object identities when targets undergo frequent and strong occlusions. The high similarity of object appearances makes integrating appearance-based association nontrivial for agricultural scenarios. To solve this problem we propose CropTrack, a novel MOT framework based on the combination of appearance and motion information. CropTrack integrates a reranking-enhanced appearance association, a one-to-many association with appearance-based conflict resolution strategy, and an exponential moving average prototype feature bank to improve appearance-based association. Evaluated on publicly available agricultural MOT datasets, CropTrack demonstrates consistent identity preservation, outperforming traditional motion-based tracking methods. Compared to the state of the art, CropTrack achieves significant gains in association accuracy and identification precision scores with a lower number of identity switches.

15.
arXiv (quant-ph) 2026-06-11

Fun with Graph States: Nonlocal Bell Pairs and the Arf Invariant

arXiv:2606.06582v2 Announce Type: replace Abstract: We study inner products and partial amplitudes of graph states–a commonly employed class of quantum states, which are specified by graphs. We find that the magnitudes of these quantities are simply related to the rank of the adjacency matrix of the graph over F_2 while the phase is determined by the Arf invariant of its quadratic refinement. These facts motivate a nonlocal tensor factorization of the Hilbert space, with respect to which all graph states are products of Bell pairs with unentangled ancillae. These results may illuminate the quantum advantage in the framework of Measurement-Based Quantum Computation and suggest that graph states can be usefully visualized in the language of algebraic topology. In addition, we develop a specialized technique for computing expectation values of qubit-wise permutations in graph states, which is useful for calculating multi-invariants.

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

A Comparative Study of Deep Learning Architectures for Multi-Horizon Behavioural Forecasting for Mobile Health

arXiv:2606.14604v1 Announce Type: cross Abstract: Wearable devices and smartphones generate rich behavioural time series that can support proactive health interventions, yet systematic comparisons of modern forecasting architectures for these data are lacking. In particular, it remains unclear how models generalise across populations, how different architectures respond to participant-level fine-tuning and how forecasting accuracy degrades across multi-day horizons. We benchmark six deep learning architectures, two zero-shot Foundation Models (FM) and statistical baselines on three public datasets encompassing over 800 participants, reporting per-feature metrics for step counts, screen time and sleep duration across 1-8 day horizons. We further conduct a per-feature personalisation study across all six architectures and assess FM transferability across dataset sizes and temporal granularities. Our key findings are: (i) no single architecture dominates, PatchTST leads among trained models while the three runners-up (TCN, MLP, Transformer) show no meaningful performance difference; (ii) the FM TimesFM matches or exceeds trained models zero-shot, especially in low-data regimes and (iii) participant-level fine-tuning reduces per-feature RMSE by 16-60\%, with sleep benefiting most and step counts least. These results provide practical guidance on architecture selection, FM applicability and personalisation strategies for mobile health forecasting. To the best of our knowledge, this is the first study to jointly evaluate modern deep learning, FMs and personalisation for multi-horizon behavioural forecasting from wearables.

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

Hierarchical Modeling of ICD Codes in EHR Foundation Models

arXiv:2606.15447v1 Announce Type: new Abstract: Electronic health record foundation models typically treat ICD diagnosis codes as flat tokens, overlooking the clinically meaningful hierarchical structure that captures disease families, subcategories, and fine-grained diagnostic detail. As a result, existing EHR representation learning methods do not explicitly exploit the hierarchical structure already present in the coding system. In this work, we study ICD-10-CM hierarchy as a general inductive bias for clinical representation learning. We investigate two complementary mechanisms for incorporating hierarchy: first, by augmenting diagnosis sequences in a BERT-style transformer with tokens corresponding to different levels of the ICD hierarchy, and second, by injecting hierarchy into graph-based code representations through hierarchy-aware edges combined with diagnosis co-occurrence structure. Across these settings, we evaluate whether explicit hierarchy improves downstream prediction, which levels of the hierarchy are most useful, whether hierarchy encoding improves transfer across datasets, and how hierarchy reshapes embedding similarity structure. We conduct experiments on two large-scale real-world clinical datasets: MIMIC-IV, used for pretraining and in-domain evaluation, and eICU, used to assess cross-dataset transfer via frozen encoder probing. Our findings show that explicitly encoding ICD hierarchy improves over flat code representations in both in-domain and cross-dataset settings, while revealing that the most useful level of hierarchy depends on both the task and the modeling approach. More broadly, we focus on hierarchy-aware EHR representation learning and show that the benefits of encoding hierarchy are generalizable across modeling settings and hierarchy levels.

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

Geometry-Preserving in 3D Gaussian Splatting for LiDAR-Camera Extrinsic Calibration

Accurate LiDAR-camera calibration is essential for robust multi-modal perception. Targetless approaches avoid manual setup but remain limited by the scarcity of discriminative cross-modal features. Recent methods address this by reconstructing the scene within a differentiable model, enabling extrinsic optimization through dense photometric supervision. Among these, 3D Gaussian Splatting (3DGS) has been widely adopted as a geometric proxy that bridges LiDAR and camera within a single differentiable framework. However, since 3DGS was originally designed for novel view synthesis, existing methods tend to prioritize rendering quality, causing the proxy geometry to drift from the true LiDAR structure. We propose a framework that preserves the metric geometry of the Gaussian proxy by aggregating multi-view LiDAR observations for dense depth supervision and blocking photometric gradients from updating the Gaussian spatial parameters. We validate our method on public driving datasets, where it consistently outperforms existing targetless methods in calibration accuracy.

19.
arXiv (quant-ph) 2026-06-17

SPICE-Q and Large-Scale Quantum Chip Production

arXiv:2606.17907v1 Announce Type: new Abstract: We propose SPICE-Q, a SPICE-inspired design-technology co-optimization framework for superconducting quantum processors. Rather than replacing tools such as HFSS, Qiskit Metal, pyEPR, SQcircuit, SQuADDS, scqubits, or QuTiP, SPICE-Q aims to connect them through a unified, traceable data chain spanning process rules, layout, electromagnetic simulation, energy-participation-ratio and circuit quantization, Hamiltonian extraction, noise analysis, cryogenic test, and manufacturing feedback. The central mapping is from process and PDK constraints to layout geometry, electromagnetic modes, equivalent circuit parameters, effective Hamiltonians, and finally metrics such as frequency, coupling, anharmonicity, decoherence, readout performance, and yield. This flow must capture Josephson-junction variability, transmon frequency allocation, resonator and Purcell constraints, coupler crosstalk, microwave routing, 3D interconnects, material/interface loss, package modes, and wafer-scale process statistics. By introducing standardized model interfaces, statistical parameter models, model cards, version governance, and closed-loop calibration from cryogenic and fabrication data, SPICE-Q frames superconducting quantum-chip design as an engineering workflow rather than a collection of isolated simulations. We argue that scalable and fault-tolerant quantum processors will require such a continuous model chain from device physics and electromagnetic fields to quantum dynamics, noise, manufacturability, and system-level yield.

20.
medRxiv (Medicine) 2026-06-22

A Plasmodium vivax controlled human infection and transmission model to evaluate interventions across the life cycle

Background Plasmodium vivax is an underappreciated cause of malaria disease burden. No reproducible and standardized full life-cycle controlled human malaria infection (CHMI) model to accelerate development of novel interventions is available. Methods This transmission-CHMI trial was conducted in Nijmegen, Netherlands. Healthy, malaria-naive adults were sequentially enrolled into three cohorts of four and inoculated with the asexual blood-stage isolate PvW1. Primary endpoint was proportion of oocyst-positive laboratory-reared Anopheles stephensi mosquitoes. The sequential design allowed for adaptations between cohorts. At parasitemia >10 parasites/microL or symptom onset, participants received oral gametocyte-sparing treatment (GST): mepacrine (Cohort 1 and 3; 100 mg at 0, 8 16 hours, then once daily for 3 days) or piperaquine (Cohort 3; 480 mg single-dose). Transmission was assessed by direct skin feeding (DSF) and membrane feeding assay (DMFA) with and without enrichment of gametocytes. End-of-study treatment was atovaquone-proguanil (1000/400 mg once daily for 3 days). The trial was registered: NL-OMON57011. Findings Participants were enrolled between September 17, 2024 and March 25, 2025, all (12/12) developed parasitemia and transmitted PvW1 to mosquitoes. No serious adverse events occurred. Most adverse reactions were related to malaria. Mepacrine and piperaquine reduced asexual parasitemia while preserving gametocytemia and transmission. Peak transmission occurred within 3 days after GST and depended on the parasite developmental cycle, with highest gametocyte-infectivity ~48 h post ring-stage. In Cohort 3, mosquito infection reached 100% in all transmission assays. Median peak oocyst counts were 24 (IQR: 14-31) for DSF, 17 (12-19) for DMFA, and 150 (116-199) for enriched DMFA. A two-fold increase in pre-GST maximal parasitemia was associated with 20 additional oocysts (95% CI 8,6-32) in enriched DMFA. Sporozoites were viable in primary human hepatocytes. Interpretation A PvW1 transmission-CHMI is reproducible and safe, enabling P. vivax sporozoite production, relapse models and evaluation of transmission-blocking interventions.

21.
medRxiv (Medicine) 2026-06-15

Iron deficiency testing among people with incident heart failure in primary care

Background: Given around 50% of people with heart failure have a degree of iron deficiency, guidelines recommend screening. It is uncertain to what extent this is done in primary care and whether testing is equitable. Aim: To report the proportion of people with incident heart failure who undergo a ferritin test within 12 months. Design and setting: Retrospective primary care cohort study using Clinical Practice Research Datalink Aurum data, between 2016 and 2021. Methods: We report the proportion of adults with an incident diagnosis of heart failure who received a ferritin test within 12 months. Multivariable logistic regression was used to examine the odds of testing based on key demographic covariates and co-morbidities. Results: Among 105,749 individuals with an incident diagnosis of heart failure (mean age 71.6 years, SD 14.3), only 35,688 (33.7%) received a ferritin test within the subsequent year. Increasing age (odds ratio 1.25 per 10-year increase, 95% CI: 1.24-1.27), female sex (male sex OR 0.86, 0.84-0.89) and Asian ethnicity (OR 1.70, 1.59-1.80) were all associated with increased odds of testing as were diagnoses of coeliac disease (OR 1.86, 1.58-2.21), type 1 diabetes (OR 1.82, 1.51-2.19) and cirrhosis (OR 1.64, 1.43-1.87). There was geographic variation in testing, even in adjusted analyses. Conclusion: In a large primary care dataset, two thirds of people with incident heart failure did not receive a ferritin test for iron deficiency within a year of diagnosis demonstrating a gap in current practice and an opportunity for improvements in service delivery.

22.
arXiv (CS.CL) 2026-06-18

Efficient Hallucination Detection for LLMs Using Uncertainty-Aware Attention Heads

While large language models (LLMs) have become highly capable, they remain prone to factual inaccuracies, commonly referred to as "hallucinations." Uncertainty quantification (UQ) offers a promising way to mitigate this issue, but most existing methods are computationally intensive and/or require supervision. In this work, we propose Recurrent Attention-based Uncertainty Quantification (RAUQ), an unsupervised and efficient framework for identifying hallucinations. The method leverages an observation about transformer attention behavior: when incorrect information is generated, certain "uncertainty-aware" attention heads tend to reduce their focus on preceding tokens. RAUQ automatically detects these attention heads and combines their activation patterns with token-level confidence measures in a recurrent scheme, producing a sequence-level uncertainty estimate in just a single forward pass. Through experiments on twelve datasets spanning question answering, summarization, and translation across nine different LLMs, we show that RAUQ consistently outperforms state-of-the-art UQ baselines. Importantly, it incurs minimal overhead, requiring less than 1\% additional computation. Since it requires neither labeled data nor extensive parameter tuning, RAUQ serves as a lightweight, plug-and-play solution for real-time hallucination detection in white-box LLMs.

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

CAGE: Curvature-Aware Gradient Estimation For Accurate Quantization-Aware Training

arXiv:2510.18784v3 Announce Type: replace Abstract: Despite significant work on low-bit quantization-aware training (QAT), there is still an accuracy gap between such techniques and native training. To address this, we introduce CAGE (Curvature-Aware Gradient Estimation), a new QAT method that augments the straight-through estimator (STE) gradient with a curvature-aware correction designed to counteract the loss increase induced by quantization. CAGE is derived from a multi-objective view of QAT that balances loss minimization with the quantization constraints, yielding a principled correction term that depends on local curvature information. On the theoretical side, we introduce the notion of Pareto-optimal solutions for quantized optimization, and establish that CAGE yields strong convergence guarantees in the smooth non-convex setting. In terms of implementation, our approach is optimizer-agnostic, but we provide a highly-efficient implementation that leverages Adam statistics. CAGE significantly improves upon the prior state-of-the-art methods in terms of accuracy, for similar computational cost: for QAT fine-tuning, it halves the compression accuracy loss relative to the prior best method, while for QAT pre-training of Llama models, its accuracy for 3-bit weights-and-activations (W3A3) matches the accuracy achieved at 4-bits (W4A4) with the prior best method. The official implementation can be found over https://github.com/IST-DASLab/CAGE .

24.
arXiv (CS.CV) 2026-06-16

Lost at the End: Primacy Bias in Multimodal Retrieval-Augmented Question Answering

Knowledge-based visual question answering (KB-VQA) lets vision-language systems answer questions that exceed their parametric knowledge by conditioning a reader on passages retrieved from a Wikipedia-scale knowledge base. In pure-text long-context LLMs, retrieved-context use follows the U-shaped "lost-in-the-middle" effect of Liu et al. (2024): information at the start and end of context is used, the middle is lost. Whether this transfers to deployed multimodal KB-VQA is open. To close this gap, we design the first controlled probe of reader-side position dependence in multimodal KB-VQA: a gold-position protocol in which only the gold passage's prompt slot varies within question. We run it on three open-source 7B/8B VLM readers and two KB-VQA benchmarks at k up to 20. The shape flips from U to primacy: gold-at-first beats gold-at-last by 16 to 26 points on every reader-by-benchmark cell, an effect we call "Lost at the End". Three targeted ablations narrow the cause: a text-only control shows the multimodal setting amplifies an already-present text-mode primacy 2.2 to 4.5 times, and image-position and distractor-shuffle ablations together pin the locus to prompt slot 0 of the instruction-tuned reader. On a frozen reader, three retrieval-side fixes (MMR, oracle reranking, rank-based reordering) all leave the gap intact (no separable improvement). Our findings indicate that recall@k is the wrong metric for deployed KB-VQA and that closing the gap requires reader-side intervention; we release our protocol as a controlled instrument for evaluating such interventions.

25.
arXiv (CS.CV) 2026-06-18

PEFT-MedSAM: Efficient Fine-Tuning of Medical Foundation Models for Explainable Skin Lesion Segmentation

Automated segmentation of skin lesions using deep learning models for dermoscopic images can be very helpful in finding melanomas earlier than they would normally be detected. However, most deep learning methods available do not perform well. The aim of this paper is to present a parameter-efficient fine-tuning method called PEFT-MedSAM for adapting the Medical Segment Anything Model (MedSAM) to automatically segment dermoscopic skin lesions. The PEFT-MedSAM method uses only the lightweight mask decoder for training the model while keeping the pre-trained image encoder and prompt encoder frozen. The experiments performed on the ISIC 2018 benchmark dataset shows that PEFT-MedSAM obtains a dice coefficient of .9411 and an intersection over union value of .8918 when compared to both a fully trained U-Net baseline (.8715 dice coefficient) and zero-shot MedSAM inference (.8997 dice coefficient). The external validation of the model using PH2 dataset shows .9467 dice coefficient with +/- .0310 standard deviation. Supportive evidence for these claims include a p-value less than .0001 for Wilcoxon signed rank tests comparing the two datasets and bootstrap-estimated 95% confidence intervals of [.9364,.9447] that represent the estimated range of possible values for the average dice coefficient obtained by repeating the test. To increase clinical trustworthiness, we used Grad-CAM explainability along with a pointing game based evaluation methodology to evaluate the CNN baseline model on the validation set. The results showed that we had an accuracy rate of 98.27% on the validation set of 519 images and confirmed that the model classified regions containing skin lesions.