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

BigPower: Hierarchical Source-Level Module Power Estimation for CPUs with Large Language Models

arXiv:2606.13747v1 Announce Type: cross Abstract: Accurate power estimation is important for understanding and optimizing CPU power behavior, yet practical workflows often rely on simulation-derived information or post-silicon analysis. In this work, we present BigPower, a hierarchical source-level surrogate model for fine-grained module-level power estimation during CPU design. BigPower leverages large language model-based representations together with architectural hierarchy, module connectivity, configuration parameters, and workload context to estimate module-level power consumption directly from source-level design information, without requiring additional simulation during inference. Experimental results in the open-source XiangShan processor family demonstrate practical fine-grained power estimation across diverse configurations and workloads, offering an efficient alternative to conventional simulation-based workflows.

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

Rule2Text: A Framework for Generating and Evaluating Natural Language Explanations of Knowledge Graph Rules

Knowledge graphs (KGs) can be enhanced through rule mining; however, the resulting logical rules are often difficult for humans to interpret due to their inherent complexity and the idiosyncratic labeling conventions of individual KGs. This work presents Rule2Text, a comprehensive framework that leverages large language models (LLMs) to generate natural language explanations for mined logical rules, thereby improving KG accessibility and usability. We conduct extensive experiments using multiple datasets, including Freebase variants (FB-CVT-REV, FB+CVT-REV, and FB15k-237) as well as the ogbl-biokg dataset, with rules mined using AMIE 3.5.1. We systematically evaluate several LLMs across a comprehensive range of prompting strategies, including zero-shot, few-shot, variable type incorporation, and Chain-of-Thought reasoning. To systematically assess models' performance, we conduct a human evaluation of generated explanations on correctness and clarity. To address evaluation scalability, we develop and validate an LLM-as-a-judge framework that demonstrates strong agreement with human evaluators. Leveraging the best-performing model (Gemini 2.0 Flash), LLM judge, and human-in-the-loop feedback, we construct high-quality ground truth datasets, which we use to fine-tune the open-source Zephyr model. Our results demonstrate significant improvements in explanation quality after fine-tuning, with particularly strong gains in the domain-specific dataset. Additionally, we integrate a type inference module to support KGs lacking explicit type information. All code and data are publicly available at https://github.com/idirlab/KGRule2NL.

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

PhysMetrics.Weather: An Evaluation Framework for Physical Consistency in ML Weather Models

arXiv:2606.10642v2 Announce Type: replace Abstract: Machine learning weather prediction (MLWP) models have achieved impressive forecasting performance at a small fraction of the computational costs required for traditional physics-based methods. However, they are primarily (1) data-driven and (2) evaluated using pixel-wide error metrics (e.g., RMSE), so there are no guarantees that their forecasts are consistent with known physical laws. We introduce PhysMetrics$.$Weather, an evaluation framework that assesses the physical realism of MLWP models across three types of metrics: conservation, spectral, and dynamical. By quantifying physical realism, this tool guides the development of physics-informed architectures and helps evaluate whether MLWP models are reliable for operational use. Our framework is available on Github at https://github.com/Emmakast/PhysMetrics.Weather.

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

CausalDrive: Real-time Causal World Models for Autonomous Driving

World models have emerged as a promising paradigm for scaling autonomous driving (AD) data, yet existing video generative models fall short as interactive simulators. Layout-conditioned renderers rely on "oracle" future trajectories of all background agents, rendering them strictly non-reactive. Conversely, pure action-conditioned predictors lack semantic control over complex interactions and suffer from prohibitive diffusion latencies, hindering closed-loop policy learning. To bridge this gap, we present CausalDrive, a controllable, real-time foundation driving world renderer. CausalDrive operates solely on the initial front-view frame, the ego-vehicle's trajectory, and a macroscopic text prompt. By excluding future NPC layouts, we compel the model to intrinsically predict causal interactions, enabling text-driven control over Driving Sociology, allowing users to dynamically orchestrate diverse counterfactual reactions to identical ego-actions. To overcome the efficiency bottleneck and address the covariate shift in autoregressive generation, we propose a novel Context-Forced DMD architecture. This combines continuous flow-matching with a self-correcting distillation objective, achieving interactive speeds of 12 FPS. This breakthrough transforms the passive video generator into a playable neural simulator. We demonstrate its versatility across three downstream applications: (1) generative closed-loop evaluation with significantly mitigated collision artifacts, (2) large-scale Reinforcement Learning (RL) post-training driven by a Video2Reward module, and (3) real-time human-in-the-loop simulation. Extensive experiments validate that policies trained within CausalDrive's reactive scenarios exhibit superior interaction capabilities in the real world.

05.
arXiv (CS.AI) 2026-06-24

Ensemble Distributionally Robust Bayesian Optimisation with Continuous Context

arXiv:2605.07565v2 Announce Type: replace-cross Abstract: We study Bayesian Optimisation (BO) in settings where the objective function is influenced by uncontrollable environmental contexts governed by an unknown probability distribution. In practice, the contextual distribution must be estimated from empirical data, a process that inherently introduces distributional mismatch, producing sub-optimal results. While Distributionally Robust Optimisation (DRO) provides a framework to mitigate these risks, existing robust BO methods frequently suffer from high computational complexity, rely on discretisation of continuous context spaces, or impose restrictive assumptions on the structure of the ambiguity set. To overcome these limitations, we propose Ensemble Distributionally Robust Bayesian Optimisation (EDRBO). Our framework leverages the expressive power of ensemble surrogate models to approximate the black-box function while simultaneously accounting for contextual uncertainty. By utilising Wasserstein ball as ambiguity sets, EDRBO provides a robustified acquisition function that remains computationally tractable and natively handles continuous context spaces. We establish a rigorous theoretical foundation for our approach by proving sublinear cumulative regret guarantees of order $\mathcal{O}(\gamma_T \sqrt{T})$, where $\gamma_T$ represents the maximum information gain within the ensemble. Finally, we provide extensive empirical evaluations that corroborate our theory and demonstrate the state-of-the-art performance of EDRBO.

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

When Life Gives You BC, Make Q-functions: Extracting Q-values from Behavior Cloning for On-Robot Reinforcement Learning

arXiv:2605.05172v2 Announce Type: replace-cross Abstract: Behavior Cloning (BC) has emerged as a highly effective paradigm for robot learning. However, BC lacks a self-guided mechanism for online improvement after demonstrations have been collected. Existing offline-to-online learning methods often cause policies to replace previously learned good actions due to a distribution mismatch between offline data and online learning. In this work, we propose Q2RL, Q-Estimation and Q-Gating from BC for Reinforcement Learning, an algorithm for efficient offline-to-online learning. Our method consists of two parts: (1) Q-Estimation extracts a Q-function from a BC policy using a few interaction steps with the environment, followed by online RL with (2) Q-Gating, which switches between BC and RL policy actions based on their respective Q-values to collect samples for RL policy training. Across manipulation tasks from D4RL and robomimic benchmarks, Q2RL outperforms SOTA offline-to-online learning baselines on success rate and time to convergence. Q2RL is efficient enough to be applied in an on-robot RL setting, learning robust policies for contact-rich and high precision manipulation tasks such as pipe assembly and kitting, in 1-2 hours of online interaction, achieving success rates of up to 100% and up to 3.75x improvement against the original BC policy. Code and video are available at https://pages.rai-inst.com/q2rl_website/

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

Limits of spectral learning under noise

arXiv:2606.13067v1 Announce Type: new Abstract: Learning functional relationships from noisy data is a central problem in scientific inference. Spectral methods approximate unknown functions by expanding them in a basis and estimating the corresponding coefficients from data, but the stability of these coefficients under noise remains poorly understood. Here we study supervised regression with additive label noise using sparse spectral representations across multiple bases and dimensions. We show that noise induces a predictable drift in the learned coefficient vector whose magnitude depends on the effective number of active spectral modes. After whitening the empirical feature geometry, we derive a closed-form expression for the overlap between noisy and noiseless coefficient vectors, revealing a universal degradation curve governed by a single intrinsic noise scale. Numerical experiments across Fourier, Legendre, Bessel, and Haar bases confirm the theoretical prediction. The results demonstrate that spectral learning exhibits a fundamental noise threshold beyond which coefficient estimates become unstable, placing intrinsic limits on recovering functional structure from noisy data.

09.
arXiv (CS.CV) 2026-06-11

From Simulation to Real-World: An In-Field 6D Pose Dataset and Baseline for Robotic Strawberry Harvesting

Robotic strawberry harvesting requires precise 6D pose estimation; however, collecting 6D pose ground truth in real agricultural fields is inherently challenging. Existing 6D pose estimation methods have therefore relied solely on synthetic data that lacks scene-level realism, leaving their performance under real agricultural field conditions unquantified. In this work, we present, to the best of our knowledge, the first real-world 6D pose ground truth dataset of strawberries collected in actual agricultural fields (12,040 images). We also introduce a synthetic dataset rendered in NVIDIA Isaac Sim, featuring scene-level realism and domain randomization. Nevertheless, our experiments reveal that a significant sim-to-real gap persists, underscoring the necessity of real agricultural field data for reliable evaluation. We further quantify the sim-to-real gap through baseline 6D pose estimation results across backbone encoders, serving as a reference for future work. The real-world dataset will be made available upon acceptance.

10.
arXiv (CS.CL) 2026-06-16

PACUTE: Phonology-, Affix-, and Character-level Understanding of Tokens for Filipino

Large language models (LLMs) process text as sequences of subword tokens, which can obscure the character-level and morphological structure that underlies word formation. This limitation is most acute for languages with non-concatenative morphology, where standard tokenizers systematically misalign token boundaries with morpheme boundaries. We introduce PACUTE, a diagnostic benchmark of 4,600 tasks designed to evaluate morphological understanding in Filipino, a language characterized by productive infixation, reduplication, and diacritic-driven lexical distinctions that are typically absent from written text. PACUTE includes a hierarchical diagnostic framework of six compositional levels that localizes where morphological understanding breaks down. Evaluating open-weight LLMs and frontier commercial models, we find that open-weight models perform near chance on morpheme decomposition regardless of scale. Frontier models perform much better, often recovering individual affixes under contains-match scoring, but remain far below their character-level ceilings on compositional tasks of morpheme transformations and syllabification. These results identify productive morphological composition, rather than character access alone, as the persistent bottleneck for Filipino word-structure understanding.

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

Know Thy Reasoner: Not All Language Models Explore Alike

arXiv:2604.10827v2 Announce Type: replace Abstract: Compute scaling for LLM reasoning trades off exploring solution approaches (breadth) against refining promising ones (depth), yet why a given trade-off works, and why it often fails to transfer across models, remains unclear. We argue that the optimal strategy depends on the model's diversity profile, the spread of probability mass across solution approaches, and that this must be characterized before any exploration strategy is adopted. We formalize this with a framework decomposing reasoning uncertainty, deriving when depth-based refinement outperforms parallel sampling, and validate it across three model families at both inference and training. Our central finding is that the diversity regime dictates the strategy: low-diversity aligned models benefit from depth-based refinement with lightweight intrinsic signals, whereas high-diversity base models are often harmed by it, and instead need breadth or stronger signals to compensate.

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

Cross-modal Identity Mapping: Minimizing Information Loss in Modality Conversion via Reinforcement Learning

Large Vision-Language Models (LVLMs) often omit or misrepresent critical visual content in generated image captions. Minimizing such information loss will force LVLMs to focus on image details to generate precise descriptions. However, measuring information loss during modality conversion is inherently challenging due to the modal gap between visual content and text output. In this paper, we argue that the quality of an image caption is positively correlated with the similarity between images retrieved via text search using that caption. Based on this insight, we further propose Cross-modal Identity Mapping (CIM), a reinforcement learning framework that enhances image captioning without requiring additional annotations. Specifically, the method quantitatively evaluates the information loss from two perspectives: Gallery Representation Consistency and Query-gallery Image Relevance. Supervised under these metrics, LVLM minimizes information loss and aims to achieve identity mapping from images to captions. The experimental results demonstrate the superior performance of our method in image captioning, even when compared with Supervised Fine-Tuning. Particularly, on the COCO-LN500 benchmark, CIM achieves a 20% improvement in relation reasoning on Qwen2.5-VL-7B.

13.
arXiv (CS.AI) 2026-06-18

InstructTime++: Time Series Classification with Multimodal Language Modeling via Implicit Feature Enhancement

arXiv:2601.14968v2 Announce Type: replace-cross Abstract: Most existing time series classification methods adopt a discriminative paradigm that maps input sequences directly to one-hot encoded class labels. While effective, this paradigm struggles to incorporate contextual features and fails to capture semantic relationships among classes. To address these limitations, we propose InstructTime, a novel framework that reformulates time series classification as a multimodal generative task. Specifically, continuous numerical sequences, contextual textual features, and task instructions are treated as multimodal inputs, while class labels are generated as textual outputs by tuned language models. To bridge the modality gap, InstructTime introduces a time series discretization module that converts continuous sequences into discrete temporal tokens, together with an alignment projection layer and a generative self-supervised pre-training strategy to enhance cross-modal representation alignment. Building upon this framework, we further propose InstructTime++, which extends InstructTime by incorporating implicit feature modeling to compensate for the limited inductive bias of language models. InstructTime++ leverages specialized toolkits to mine informative implicit patterns from raw time series and contextual inputs, including statistical feature extraction and vision-language-based image captioning, and translates them into textual descriptions for seamless integration. Extensive experiments on multiple benchmark datasets demonstrate the superior performance of InstructTime++.

14.
arXiv (CS.CV) 2026-06-25

Enhancing Brain MRI Anomaly Detection and Reasoning with ROI Rethink and Synthetic Data

Medical vision-language models typically generate diagnoses through single-pass inference without indicating which image regions support their conclusions. This lack of spatial grounding limits clinical utility: outputs cannot be audited, and models may hallucinate findings on normal scans. We present BrReMark (Brain Rethink via ROI Marking), a framework that introduces explicit region marking into brain MRI diagnosis. The model first generates hypotheses about potential abnormalities and grounds them through explicit bounding box marking, then verifies conclusions by re-examining the marked evidence. Training combines supervised fine-tuning on structured reasoning trajectories with reinforcement learning using a composite reward over localization accuracy and diagnostic reasoning. Furthermore, we integrate a domain randomization-based pathology synthesis augmentation strategy to improve the model's generalizability to out-of-distribution (OOD) data. On internal benchmark, BrReMark improves mAP50 from 0.74% to 37.54% compared to the base model, while achieving 21.57% Clinical F1 and 45.26% diagnostic accuracy. On NOVA OOD benchmark, it also achieves competitive overall performance with a 45.7% reduction in false positives compared to the state-of-the-art, indicating reduced hallucination on rare pathologies. These findings suggest that explicit hypothesis-verification grounding is a practical path toward trustworthy open-ended brain MRI diagnosis across both in-distribution and OOD settings.

15.
arXiv (CS.CV) 2026-06-25

ArteryX: A Reliable End-to-End Toolbox for Standardized Intracranial Artery Feature Extraction from 3D TOF-MRA

Cerebrovascular research heavily relies on quantitative analysis of intracranial arteries from time-of-flight magnetic resonance angiography, yet existing processing pipelines remain limited by inconsistent artery labeling and a high manual correction burden. We present ArteryX, a toolbox for extracting features that standardizes artery classification across proximal and distal vascular territories. It integrates segmentation handling, isotropic processing, vessel-fused graph construction, and constrained landmark-based classification within a unified artery-specific feature reporting and reproducible workflow. The toolbox extracts morphological, topological, and complexity features including total length, mean radius, volume, surface area, branch count, tortuosity, and fractal dimensionality for standardized artery-segments. Test-and-validation were performed using three complementary datasets: (1)TopBrain-Challenge benchmarking with annotated arteries, (2)synthetic known-reference validation, and (3)exploratory in-vivo cohort of cerebral small vessel disease. In TopBrain analyses, ArteryX with supervised nnUnet segmentation showed minimal bias, while iCafe showed the highest bias and a large limit-of-agreement. ArteryX consistently demonstrated robust downstream quantification performance across segmentation sources (unsupervised/supervised). Agreement analyses showed minimal bias for radius and good sensitivity of extent-dependent metrics throughout the noisier segmentations compared to the state-of-the-art iCafe-toolbox. Furthermore, a stage-wise human-in-the-loop protocol showed lower intervention time than iCafe. In an in-vivo-cohort (48CSVD+, 20CSVD-), ArteryX-derived distal and territory-level features showed group-level differences, not evident with iCafe. To facilitate adoption-and-reproducibility, ArteryX is designed with versioned builds, tutorials, and documentation.

16.
arXiv (math.PR) 2026-06-16

Balanced affine Motzkin paths: Pearson geometry and global endpoint asymptotics

arXiv:2601.17634v2 Announce Type: replace Abstract: We study endpoint distributions of balanced affine weighted Motzkin paths. In the balanced case, the generating-function equation has Pearson-type characteristic geometry. We show that this geometry controls the terminal-height law globally: the characteristic escape time determines the limiting cumulant generating function, the large-deviation rate function, and the ray-scale asymptotics. Thus the usual Gaussian window is only the local quadratic approximation to a global Pearson-driven profile. For finite sizes, we prove a uniform Daniels saddlepoint approximation in the one-dominant-singularity regimes and identify the exceptional antipodal case requiring a lattice/interference correction.

17.
arXiv (quant-ph) 2026-06-24

Challenges in Barren Plateau Mitigation with Dynamic Parameterized Quantum Circuits

arXiv:2606.23751v1 Announce Type: new Abstract: Variational quantum algorithms (VQAs) are a promising paradigm for quantum advantage, yet their trainability is severely hampered by barren plateaus (BPs). Several works have proposed using dynamic parameterized quantum circuits (DPQCs) which intersperse unitary layers with parameterized CPTP maps (e.g. engineered dissipation, feedforward gadgets, or periodic resets), as a potential route around BPs. We unite this class of circuits into a formalization for DPQCs. We identify constraints on the nature and the structure of DPQCs if they are to prevent a significant number of parameters from becoming untrainable. We further show via purification and Pauli path analysis, a mechanism with which cost function anti-concentrates in DPQCs while still suffering from untrainability of a significant number of parameters. Our analysis reveals ways to design DPQCs that do not have an exponentially concentrated cost function, and our results suggest that BP mitigation via DPQCs is at least as hard as designing BP-free unitaries.

18.
arXiv (CS.AI) 2026-06-11

TileFuse: A Fused Mixed-Precision Kernel Library for Efficient Quantized LLM Inference on AMD NPUs

arXiv:2606.11357v1 Announce Type: cross Abstract: With the growing demand for on-device LLM inference, edge SoCs increasingly integrate NPUs to improve performance and energy efficiency under tight power and thermal budgets. However, practical LLM deployment on current client NPUs remains difficult: widely used quantization formats such as AWQ do not map cleanly onto many existing NPU software stacks, which are often proprietary and expose limited low-level control. In this work, we present TileFuse, a close-to-metal mixed-precision kernel library for AMD XDNA2 NPUs that targets transformer linear layers in quantized LLM inference. TileFuse brings practical low-bit formats such as AWQ-style W4A16 and W8A16 directly onto XDNA2, rather than forcing the model to be reshaped around an NPU-specific quantization scheme. TileFuse co-designs weight layout, metadata placement, mixed-precision microkernels, and array-level dataflow. Specifically, it fuses unpacking, dequantization, and GEMM/GEMV execution into a single kernel flow, introduces an interleaved pre-tiling layout that supports GEMM dimensions up to 32K, and redesigns GEMV dataflow to utilize the full 4x8 AIE array. Across kernel-level evaluations, TileFuse improves performance by up to 121.6% for GEMM and 281% for GEMV over full-precision baselines, while delivering more than 2x performance and energy-efficiency gains over strong iGPU baselines on GEMM. In end-to-end LLM experiments on Ryzen AI laptops, TileFuse achieves up to 2.0x lower prefilling latency with more than 64.6% lower energy consumption. Together, these results show that XDNA2 is a practical target for AWQ-style edge LLM inference and that native NPU support for off-the-shelf quantization can make NPUs substantially more usable in real client deployments.

19.
arXiv (CS.CL) 2026-06-16

On Defining Erasure Harms for NLP

The deployment of NLP systems has raised concerns about harms they might produce, including representational harms. Recent literature has begun to conceptualize and measure one such harm, the harm of erasure. Nevertheless, the field lacks a clear and cohesive conceptual foundation for identifying and measuring erasure. Existing conceptualizations of erasure are often broad – making it difficult to identify what is needed to establish and measure erasure – or else specific to particular settings – facilitating measurement for those settings but potentially challenging to adapt to other settings. To address this gap, we develop and propose a structured definition of erasure that clarifies what components are necessary for establishing whether erasure has occurred, which practitioners need to explicitly articulate and operationalize in order to measure erasure.

20.
arXiv (CS.CL) 2026-06-11

Cross-Layer Discrete Concept Discovery for Interpreting Language Models

Interpreting language models remains challenging due to the existence of residual stream, which linearly mixes and duplicates features across adjacent layers, causing single-layer analyses to miss this cross-layer structure. Cross-layer sparse autoencoders (SAEs) address layer mixing but operate in continuous space, where concepts split across many neurons without clear boundaries. We introduce Cross-Layer Vector Quantized-Variational Autoencoder (CLVQ-VAE), a novel framework which maps representations from a lower layer to a higher layer through a discrete vector-quantization bottleneck, collapsing duplicated residual-stream features into compact, interpretable concept vectors. Our approach combines top-k temperature-based sampling with exponential moving average (EMA) codebook updates, providing controlled exploration of the discrete latent space while maintaining codebook diversity. Across both encoder- and decoder-based models on ERASER-Movie, Jigsaw, and AGNews, CLVQ-VAE outperforms clustering, single-layer vector quantized-variational autoencoder (VQ-VAE), and sparse autoencoder (SAE) baselines across three evaluation axes: removing identified concepts drops model accuracy by up to 93%, LLM judges rank our concepts first in 66.7% of comparisons, and human annotators recover model predictions from our visualizations with 78% accuracy versus 54% for clustering.

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

Gaussian Mixture Attention: Linear-Time Sequence Mixing via Probabilistic Latent Routing

arXiv:2606.18283v1 Announce Type: new Abstract: The dense token-to-token interaction pattern of standard dot-product attention remains a central bottleneck in scaling Transformer architectures to long contexts. We introduce Gaussian Mixture Attention (GMA), a probabilistic attention-style sequence mixer that replaces explicit pairwise query–key comparison with routing through $K$ learned Gaussian mixture components. Queries and keys are mapped to posterior responsibility vectors over a shared latent routing space; their overlap defines an implicit responsibility-space affinity, while values are written into and read from a $K$-slot latent memory. By exploiting the associativity of matrix multiplication, GMA avoids materializing the induced $N\times N$ affinity matrix and instead uses two responsibility matrices whose dominant activation storage scales as $\mathcal{O}(NK)$ rather than $\mathcal{O}(N^2)$ for fixed $K$. We formulate bidirectional and causal variants of GMA, provide an end-to-end differentiable parameterization of the Gaussian mixture components, and analyze its responsibility-modulated gradient structure, constrained non-negative low-rank affinity interpretation, and local routing stability. Empirically, GMA exhibits the intended fixed-$K$ linear memory scaling and is competitive with attention-style baselines on long-context classification, while causal GMA improves over tested linear/random-feature attention variants on WikiText-103 but remains behind optimized causal SDPA and Mamba in the current implementation. Analysis of learned responsibilities further shows broad component usage and moderate alignment with surface-form token categories, supporting GMA as a probabilistic, interpretable, fixed-$K$ linear-time attention-style alternative rather than a universal replacement for optimized softmax attention or state-space models.

22.
medRxiv (Medicine) 2026-06-10

Human-centred design approaches to health facility design: Evidence from perinatal care settings in Ethiopia and Bangladesh

While significant progress has been made in perinatal outcomes over recent decades in low- and middle-income countries (LMICs), maternal and newborn quality improvement initiatives often fail to account for the spatial conditions in which they are implemented. Health systems are increasingly deploying evidence-based care models into built environments that are not optimally structured to meet the needs of its patient population. As the principal users, patients and health care workers can offer pragmatic insights about improving these structural designs. Our objective was to gather insights from patients, providers, and companions about how the physical design of their health facilities influenced their experience receiving or delivering perinatal care. We conducted a prospective observational study using a human-centred design (HCD) approach to analyse perceptions of the quality of perinatal care across two low resource settings: Ethiopia and Bangladesh. Using engagement and assessment tools, we conducted interviews, focus groups, facility walk-throughs, co-design workshops, and infrastructural assessments with patients, companions, providers, and Ministry of Health representatives. Descriptive statistics and thematic analysis were used to identify key learnings and develop recommendations. Across both countries, participants identified the need for facility layouts that better support privacy, mobility during labour, alternative birth positions, companion involvement, cultural and religious practices, sanitation, and provider visibility. Based on these insights, we developed six recommendations to better align health facility infrastructure with maternal and newborn care delivery needs. Our findings suggest that investments in health facility infrastructure may improve care experiences and help enable respectful, safe, and evidence-based maternal and newborn care. Alongside targeted spatial improvements, government authorities responsible for health facility planning should incorporate participatory design processes to ensure infrastructure reflects the needs of patients, companions, and providers and supports high-quality care delivery.

23.
medRxiv (Medicine) 2026-06-24

Repetitive Transcranial Magnetic Stimulation over Primary Somatosensory Cortex for Upper Limb Function in Stroke: An Exploratory Randomized Controlled Trial

Background: Stroke often causes Upper Limb (UL) functional impairments. The Primary Somatosensory Cortex (S1) plays an important role in motor learning. Repetitive Transcranial Magnetic Stimulation (rTMS) over S1 could enhance UL recovery. We aimed to explore its preliminary effects on UL motor activity and function post-stroke. Methods: An exploratory parallel-group randomized controlled trial in people with chronic stroke (>3 months) and moderate hemiparesis was conducted. Participants received 20 sessions of active or sham 5Hz rTMS over affected S1, with Robot-Assisted Therapy and Task-Oriented Training, 5 days/week for 4 weeks. The primary endpoint was UL motor activity (Action Research Arm Test, ARAT). Secondary measures were the UL Fugl-Meyer Assessment (UL-FMA) and sensory outcomes. Results: The baseline-adjusted mean difference (MD) in ARAT was 4.05 points [0.78, 7.33], favoring active stimulation. Secondary measures did not favor active stimulation (UL-FMA: MD = 2.62 [-1.51, 6.76]; sensory outcomes showed no between-group differences). Conclusion: High-frequency rTMS over S1 may enhance UL motor activity (ARAT), but no evidence for motor impairment (UL-FMA) or sensory domains was found. Compensation rather than restoration may underlie this improvement. Stimulation targets should match the intended recovery domain, although larger trials are needed to confirm these preliminary findings.

24.
arXiv (quant-ph) 2026-06-12

Candidate overtone shear horizontal SAW resonators in thin-film lithium niobate for intermodal acousto-optic modulation

arXiv:2606.12853v1 Announce Type: cross Abstract: The merits of thin-film surface acoustic wave (SAW) devices are pivotal to develop the high-performance intermodal acousto-optic modulators. In this work, we have proposed shear-horizontal (SH) SAW resonators for anticipated intermodal acousto-optic modulation on the thin-film lithium niobate platform. Through optimization of the cut angle of LN films, the SAW wavelength, and the thickness of interdigital transducer (IDT) electrodes, the calculated acousto-optic overlap factors utilizing SH0 modes are improved by more than an order of magnitude compared with those of Rayleigh modes. Furthermore, we have fabricated and characterized three kinds of proof-of-principle SH0 mode devices without/with grating reflectors. The electromechanical coupling coefficients (keff^2) and quality factors (Q) in the overtone resonators with grating reflectors are systematically evaluated, featuring the highest Q of 843 with the compromised keff^2 of 0.96%-4.72%. The results reveal that the temperature coefficients of frequency (TCF) of Rayleigh modes vary across various overtones, whereas the SH0 modes exhibit TCFs in the range of 32.3-68.9 ppm/C. Our fabricated SH0-mode overtone resonators demonstrate the capability of operating at power levels up to 29 dBm without electrode damage, offering a promising paradigm for robust and high-efficiency intermodal acousto-optic modulators with potential applications in integrated optical signal processing, microwave photonics,and quantum information technologies.

25.
medRxiv (Medicine) 2026-06-17

Multi-strain Probiotics Alter Gut Microbiota and Estrobolome Pathways in Primary Dysmenorrhea

Background: Exact cause of primary dysmenorrhoea is unknown but recent evidence uncovers a potential link between gut dysbiosis and benign gynaecological disorder via disruption of estrobolome. Methods: A randomized controlled trial to investigate the effects of multi-strain oral probiotics on primary dysmenorrhoea has been conducted. This is a secondary analysis comparing the stool microbiome in women with primary dysmenorrhoea and those without (control), and the effects of treatment with probiotics versus placebo. Results: Although microbial richness and evenness were comparable between groups (alpha diversity, p > 0.05), gut microbial community composition differed significantly (Bray Curtis PERMANOVA, p = 0.015), characterised by reduced Bifidobacterium adolescentis and Blautia and enrichment of Faecalibacterium in dysmenorrhoea, alongside condition-specific core taxa. Post-intervention analysis revealed significant shifts in microbial community structure between pre- and post-treatment groups (PERMANOVA, F = 2.11, p = 0.005), with probiotic supplementation inducing more consistent and directed microbiome changes than placebo, without altering alpha diversity (p > 0.05). Functional prediction showed no significant difference in overall beta glucuronidase pathway abundance (p > 0.05); however, dysmenorrhoea was associated with higher abundance of beta glucuronidase producing taxa (MaAsLin2, q < 0.05) that were differentially modulated by probiotic treatment. Conclusion: This discovery provides evidence on the microbial disruption in primary dysmenorrhoea as well as the benefit of probiotics to modulate the intestinal microbiota to improve the condition.