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

Coping in Crisis: Computational Modeling of Coping Styles in Digital Crisis Discourse During the 2023 Turkiye Earthquake

How do people cope when disaster strikes and can we detect it at scale, in real time, from what they write? This study addresses that question using over one million Turkish-language tweets posted in the aftermath of the February 6, 2023 earthquake in Turkiye, which unfolded in a deeply polarized political context just months before a national election. Drawing on Lazarus and Folkman's (1984) coping theory, we develop a multi-label BERTurk classifier to detect three coping styles (problem-focused, emotion-focused, and meaning-making) across four theoretically motivated crisis phases. BERTurk achieves a macro F1 of 0.693, substantially outperforming a zero-shot mDeBERTa baseline (macro F1 = 0.324). Applied to the full corpus, the classifier reveals a clear temporal trajectory: problem-focused coping dominates the urgency phase and declines sharply, emotion-focused coping rises and stabilizes, and meaning-making increases monotonically. Anger correlates most strongly with meaning-making (Spearman r = 0.387), suggesting it functions as a mobilizing force toward blame attribution rather than practical action. These findings demonstrate that coping theory can be reliably operationalized in real-world digital crisis data and that doing so can help humanitarian organizations tailor their responses to where a population actually is.

02.
arXiv (CS.CL) 2026-06-19

Learning to Prompt: Improving Student Engagement with Adaptive LLM-based High-School Tutoring

LLMs can personalize education, although current static-prompt tutoring systems struggle to adapt to diverse academic disciplines. We develop and test a system with subject-aware prompting, based on 14 pedagogical features (e.g., tutor scaffolding, student understanding) extracted from raw transcripts. We first train a prompt routing model in a simulation environment, and then deploy it for online adaptation with actual high-school students. The simulation benchmark shows the router outperforming two static baselines ($0.694$ vs. $0.647$ and $0.64$, $p

03.
medRxiv (Medicine) 2026-06-17

Clinical Study Protocol of the 'Biomarkers of Severity of COVID-19 Patients' (BIOMARCOVID) Project

Introduction The coronavirus disease 2019 (COVID-19) pandemic has challenged health care systems worldwide, in certain areas exceeding hospital capacities and human resources. This has underscored the importance of having better tools to predict the outcome of potentially severe respiratory infections such as SARS-CoV-2. Predicting COVID-19 severity may allow physicians to better manage ICU beds and increase the chances of patient survival through appropriate management. During the toughest months of the pandemic, most physicians tried to identify patients that might develop severe forms based primarily on clinical features on admission (e.g., BMI, age). In this context, significant research has focused on identifying comorbidities, clinical manifestations, and routine blood biomarkers to predict disease severity. However, despite the demonstrated value of untargeted metabolomics in assessing severity, limited data exist on its use for identifying novel metabolite biomarkers that could improve both the sensitivity and specificity of outcome prediction. Our goal is to identify metabolite biomarkers that could enhance the predictive accuracy of standard medical biology data and clinical parameters. Methods and analysis This is a retrospective, observational, monocentric cohort study conducted at the Centre Hospitalier Universitaire Grenoble Alpes (CHUGA). The maximum number of eligible patients admitted for PCR-confirmed COVID-19 between March and December 2020 will be included. Severity outcome is defined using the WHO 10-category ordinal scale (mild: categories 4-5; severe: >5). Blood samples were collected within 48 hours of admission and analyzed for 62 routine blood tests and untargeted multiplatform LC-MS/MS metabolomics across four national platforms. Statistical analysis will include logistic regression with variable selection for the primary aim, and multi-block chemometric integration of clinical, biological, and metabolomics data as a secondary aim. Ethics and dissemination A study steering committee has been formed to ensure the accuracy of the collected data by thoroughly reviewing it prior to the data lock. All aspects of the study comply with ethical standards, including approval by the CHUGA institutional review board and adherence to CNIL Reference Methodology MR004 for the protection of participants' rights, privacy, and confidentiality. This study is registered on the French Health Data Hub (number F20210218154851). Results will be disseminated through peer-reviewed publications, presentations at national and international scientific and clinical conferences, and reports shared with key healthcare system stakeholders.

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

Approximating Whittle-Matern Fields over Discretized Manifolds

arXiv:2606.13827v1 Announce Type: cross Abstract: Markovian Whittle-Matérn fields have been convergently approximated by discrete Gauss Markov Random Fields (GMRFs) with sparse precision matrices using a Finite Element approximation of the two-parameter family, \[ (\kappa^2 - \Delta)^{\alpha/2} u = \mathcal{W}, \;\; \kappa \in \mathbb{R}, \; \alpha \in \mathbb{N}. \] of SPDEs. Using recent developements in the analysis of Discrete Exterior Calculus (DEC), we present a different, yet closely related, convergent GMRF approximation to these Matérn fields over complete, boundaryless Riemannian manifolds discretized as well-centered simplicial complexes. This convergent method (i) is agnostic to $\alpha, \kappa$ and thus allows a universal approximation scheme for the precision and covariance matrices of the entire $(\alpha, \kappa)$-family of GMRFs, so they may be inferred rather than guessed. (ii) inherently models pointwise and piecewise-smoothed measurements of a random field and approximates both equally well (iii) is computationally independent of the interpolants used - it suffers no overhead if one convergent interpolant were replaced with another suitable interpolant over the same mesh. Furthermore, we show that, on discretizations that are well-connected in a precise sense, and volume-concentrated, the precision matrices are spectral functions of a graph-laplacian. We provide a low rank approximator to the family of such Matérn GMRFs and mention a use case: reducing the number of measurements needed to model the GMRF by compressed-sensing.

05.
arXiv (CS.AI) 2026-06-11

Improving Generalization and Data Efficiency with Diffusion in Offline Multi-agent RL

arXiv:2307.01472v2 Announce Type: replace Abstract: We present a novel Diffusion Offline Multi-agent Model (DOM2) for offline Multi-Agent Reinforcement Learning (MARL). Different from existing algorithms that rely mainly on conservatism in policy design, DOM2 enhances policy expressiveness and diversity based on diffusion model. Specifically, we incorporate a diffusion model into the policy network and propose a trajectory-based data-reweighting scheme in training. These key ingredients significantly improve algorithm robustness against environment changes and achieve significant improvements in performance, generalization and data-efficiency. Our extensive experimental results demonstrate that DOM2 outperforms existing state-of-the-art methods in all multi-agent particle and multi-agent MuJoCo environments, and generalizes significantly better to shifted environments {(in $28$ out of $30$ settings evaluated)} thanks to its high expressiveness and diversity. Moreover, DOM2 is ultra data efficient and requires no more than $5\%$ data for achieving the same performance compared to existing algorithms (a $20\times$ improvement in data efficiency).

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

Is Spurious Correlation Removal Always Learnable?

arXiv:2606.12930v1 Announce Type: new Abstract: Invariant learning can fail even when the invariant structure is statistically identifiable. We show a conditional computational barrier: under a black-box samplable supervised sparse recovery primitive motivated by average-case sparse-recovery reductions, there exist samplable multi-environment instances with a one-dimensional predictive invariant subspace ($k=1$) that are learnable with polynomial samples by exhaustive search, while any polynomial-time constant-accuracy recovery algorithm would contradict the primitive. We further quantify environment diversity by a separation parameter $\gamma$, which controls identifiability and the curvature of invariance objectives. Under sufficient diversity and local Gaussian regularity, the minimax risk is $\mathbb{E}[\dist(\hat{V},V_{\mathrm{inv}})^2]=\Theta(k(d-k)/(n|\mathcal{E}|))$, and under label-induced shifts a phase transition occurs at $n^*\propto k(d-k)/(|\mathcal{E}|\gamma^2)$ with refined estimation error scaling proportional to $1/\gamma^2$. Synthetic and real datasets illustrate the predicted gaps and transitions and motivate simple diversity diagnostics.

07.
arXiv (quant-ph) 2026-06-19

Quantum Kernels are Spectral Tensor Networks

arXiv:2606.20402v1 Announce Type: new Abstract: Quantum kernels admit Fourier representations whose frequencies are determined by the data-encoding gates of the underlying feature map. We show that entangling tensor kernels are matrix product operator factorizations of the corresponding Fourier coefficient tensors, thereby identifying quantum kernels as spectral tensor networks. By grouping gate-level frequency configurations that yield the same feature-wise frequency, we obtain a grouped Fourier form that induces a more compact spectral tensor network representation of the kernel. We further show that kernel target alignment serves as a bridge between the Fourier and tensor network views. On a grid that resolves the accessible Fourier modes, it becomes the Frobenius cosine similarity between Fourier coefficient tensors. Our numerical experiments show that layered quantum kernels admit accurate representations with small bond dimension, revealing a compressibility governed by correlations between Fourier modes. This compressibility provides a diagnostic of classical representability and of whether kernel evaluation is likely to remain classically tractable.

08.
arXiv (CS.LG) 2026-06-11

Adjoint Method versus Physics-Informed Neural Networks in PDE-Constrained Inverse Problems

arXiv:2606.12337v1 Announce Type: cross Abstract: Inverse problems governed by partial differential equations (PDEs) are central to computational mechanics and are commonly solved by adjoint-based optimization, while physics-informed neural networks (PINNs) have emerged as a flexible alternative. Their relative performance remains difficult to assess because the two approaches are often compared under different formulations, parameterizations, optimizers, and regularization choices. We present a fair comparison of adjoint optimization and PINNs for PDE-constrained inverse problems. From a common abstract formulation, we instantiate both methods on identical domains, governing equations, observation models, and regularization terms, while matching the optimizer, unknown parameterization, and arithmetic precision wherever applicable. The benchmarks include unsteady Burgers, noisy Darcy permeability inversion, three-dimensional Allen–Cahn reaction identification, and unsteady Navier–Stokes viscosity identification. The results show that the representation of the unknown largely determines the preferred method: grid-based fields favor the discrete adjoint, whereas neural representations are native to PINNs and relevant for closure and constitutive modeling. For time-dependent problems, adjoint inversion can be dominated by trajectory storage and differentiation, while PINNs provide satisfactory reconstructions at lower cost. A PINN-warm-started adjoint strategy then recovers adjoint-level accuracy at substantially reduced cost.

09.
Nature (Science) 2026-06-09

How ice forms is a mystery — now scientists are cracking the case

Theories about how ice crystals grow in cooling liquids are wildly inaccurate when compared with experimental data, but studies are starting to illuminate the earliest moments in freezing. Theories about how ice crystals grow in cooling liquids are wildly inaccurate when compared with experimental data, but studies are starting to illuminate the earliest moments in freezing.

10.
arXiv (CS.LG) 2026-06-17

Edge Flow: A Tractable and Predictive Continuous-Time Model for Gradient Descent at the Edge of Stability

arXiv:2606.18080v1 Announce Type: new Abstract: Gradient descent in deep learning may operate at the edge of stability (EoS), a regime in which the largest eigenvalue of the loss Hessian hovers near the stability threshold $2/\eta$, where $\eta$ is the learning rate. Classical analysis tools such as gradient flow and the descent lemma do not apply here, motivating the search for a continuous-time model valid at EoS. We propose Edge Flow, a system of three coupled ordinary differential equations that provides a tractable, faithful, and predictive model of gradient descent dynamics at EoS. Edge Flow decomposes the dynamics into a center, an oscillation direction, and an oscillation magnitude. The center follows a modified gradient flow on a symmetrized loss; the direction tracks a top eigenvector of the Hessian via Rayleigh quotient dynamics; and the magnitude grows or decays exponentially depending on whether the sharpness exceeds or falls below the threshold $2/\eta$. Crucially, sharpness stabilization emerges from the coupled dynamics via a self-stabilization feedback loop. Discretizing Edge Flow only requires two gradient evaluations and one Hessian–vector product at each iteration. We demonstrate empirically that Edge Flow tracks the dynamics of gradient descent at least as faithfully as previously proposed continuous-time EoS models, while in addition resolving the oscillation of the sharpness at the onset of EoS, and that it provides a principled framework for understanding and mitigating instabilities in this regime.

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

Connect the Dots: Training LLMs for Long-Lifecycle Agents with Cross-Domain Generalization Via Reinforcement Learning

This work presents a general framework for training large language models (LLMs) to "Connect the Dots" (CoD), a meta-capability required by long-lifecycle agents: as an LLM-based AI agent gets deployed in an environment, it solves a long sequence of tasks while continuously exploring the environment, learning from its own experiences, and iteratively self-updating its context about the environment, thereby achieving progressively better performance on future tasks conditioned on the updated context. Major components of the CoD framework include: (1) algorithm design and infrastructure for end-to-end reinforcement learning (RL) with long rollout sequences interleaving solve-task and update-context episodes; (2) tasks and environments for incentivizing and eliciting the targeted meta-capability in LLMs during training, as well as for faithfully measuring progress during evaluation. We present proof-of-concept implementations of the CoD framework, including a GRPO-style RL algorithm with fine-grained credit assignment, as well as tasks and environments tailored to the targeted meta-capability (rather than domain-specific LLM capabilities or standard task-by-task RL). Empirical results validate the efficacy of end-to-end RL training in the CoD setting, and demonstrate the potential for out-of-distribution generalization – within the training domains, across different domains, and from CoD to Ralph-loop settings – of the elicited meta-capability. Our investigation of CoD connects several lines of prior works, and opens up new opportunities for advancing LLMs and AI agents. To facilitate further research and applications, we release our implementations at \url{https://github.com/agentscope-ai/Trinity-RFT/tree/research/cod/examples/research_cod}.

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

EARS: Explanatory Abstention for Reliable Sub-Agent Modeling in Large-scale Multi-Agent Systems

In large-scale enterprise settings, centralized multi-agent systems (MAS) are increasingly adopted, in which a coordinator delegates user requests to lightweight, domain-specialized sub-agents. While this architecture improves modularity, scalability, and cost efficiency, its reliability depends not only on accurate routing but also on sub-agents' ability to calibrate their responses to capability constraints. In particular, sub-agents built on smaller fine-tuned models often struggle with such calibration, leading them to over-answer ambiguous, underspecified, misrouted, or unsupported requests and produce hallucinated outputs instead of actionable feedback. To address this challenge, we present EARS (Explanatory Abstention for Reliable Sub-Agent Modeling), a production-oriented framework that reframes sub-agent abstention as an inter-agent communication protocol: a sub-agent does not merely abstain, but exposes an actionable failure state to the coordinator. EARS curates human-agent interaction data using an ensemble of calibrated LLM-as-a-Judge models, producing structured abstention labels and rationales under a taxonomy of sub-agent failure modes. These data are used to fine-tune sub-agents to detect failure conditions and return rationales for coordinator-level clarification, rerouting, or fallback. We evaluate EARS in a large-scale production e-commerce assistant supporting enterprise business intelligence workflows. EARS improves the overall response pass rate from 68.5% to 78.9%, demonstrating that sub-agent-side explanatory abstention improves MAS reliability.

13.
arXiv (CS.LG) 2026-06-19

On the QUEST for Uncertainty Quantification via Highest Density Regions

arXiv:2606.19569v1 Announce Type: new Abstract: Uncertainty quantification (UQ) is essential for reliable decision-making in safety-critical applications in probabilistic machine learning. For regression problems, dominant scalar UQ approaches - notably, those based on proper scoring rules - measure uncertainty via pointwise predictive risk. This can lead to counterintuitive results when the target statistic is not the conditional expectation. We propose an alternative framework, in which uncertainty is characterised by the volume of the most probable subset of a distribution's support. QUEST (Quantifying Uncertainty via highest dEnSiTy regions) is a novel approach to UQ based on the concentration of Lebesgue measure at a distribution's peak(s), evaluated at one or more values of a robustness parameter $\alpha$. We establish connections between our measures and classical statistics from information theory and economics. We show that, unlike popular alternatives based on proper scoring rules, QUEST measures of epistemic and aleatoric uncertainty satisfy a set of axioms adapted from the UQ literature, including monotonicity under distributional spread and invariance to location shifts. Selective prediction benchmarks confirm that QUEST performs favourably against standard measures such as variance and differential entropy.

14.
arXiv (CS.CV) 2026-06-15

Manga109-v2026: Revisiting Manga109 Annotations for Modern Manga Understanding

Manga is a culturally distinctive multimodal medium and one of the most influential forms of Japanese popular culture. As AI systems increasingly target manga understanding, OCR, and translation, Manga109 has become a foundational dataset for manga-related AI research. However, the current Manga109 dataset contains inaccurate transcriptions and coarse annotations, which do not align well with modern OCR and multimodal manga understanding tasks. In this work, we revisit the dialogue text annotations of Manga109 and identify five categories of annotation issues, including inaccurate transcriptions, missing text regions, overlapping dialogue and onomatopoeia, and under-segmented speech balloons. To address these issues, we combine OCR-based issue detection and manual revision to construct Manga109-v2026, revising approximately 29,000 dialogue annotations. Our revisions better align Manga109 with modern OCR and multimodal manga understanding systems while preserving expressive structures characteristic of manga.

15.
bioRxiv (Bioinfo) 2026-06-20

Seed variation impacts clustering stability in Single-Cell RNA-Seq and can be mitigated by StAbility-BasEd-Reassignment (SABER)

Single-cell RNA-seq clustering is commonly treated as reproducible once a random seed is fixed, yet the choice of seed itself may alter cell assignments and downstream interpretation. We systematically quantified seed-induced clustering variability by running Louvain and Leiden clustering across 100 seeds in Seurat and Scanpy on 28 single-cell RNA-seq datasets from the Human Cell Atlas and IMMUcan. Using Element-Centric Consistency, we found that seed choice affected a substantial fraction of cells, with Scanpy showing more unstable assignments than Seurat on average, 40.46% versus 26.78% unstable cells, respectively. This increased stability came at a marked computational cost: Seurat required approximately 19-fold higher median memory than Scanpy. Seed-dependent clustering variability also propagated to cell-type annotation, particularly among transcriptionally related populations including macrophage/monocyte, endothelial/epithelial and T/NK cell states. To mitigate this instability, we developed StAbility-BasEd Reassignment (SABER), a Scanpy-based framework that identifies seed-sensitive cells across repeated clusterings and reassigns them to stable cluster cores using cosine similarity. SABER improved clustering quality while preserving annotation concordance and reduced median memory usage 3.5-fold compared with Seurat-Louvain. Our results identify seed choice as an underappreciated source of variability in single-cell analysis and provide a scalable strategy to improve clustering robustness.

16.
arXiv (math.PR) 2026-06-11

Construction of ergodic IDLA forests in $\mathbb{Z}^d$

arXiv:2506.10476v2 Announce Type: replace Abstract: We prove the existence of infinite-volume IDLA forests in $\mathbb{Z}^d$ , with $d \geq 2$, based on a multi-source IDLA protocol. Unlike IDLA aggregates, the laws of the IDLA forests studied here depend on the trajectories of particles, and then do not satisfy the famous Abelian property. Their existence is due to a stabilization result (Theorem 1.1, our main result) that we establish using percolation tools. Although the sources are infinitely many, we also prove that each of them play the same role in the building procedure, which results in an ergodicity property for the IDLA forests (Theorem 1.2).

17.
medRxiv (Medicine) 2026-06-16

Preventing postpartum depression through mitigating breastfeeding grief: A convergent parallel mixed methods study

Background: Women who did not meet their breastfeeding goals often experience breastfeeding grief (BG) and may be likely to have postpartum depression (PD). Furthermore, PD is nearly twice as common in African American (AA) women as in Non-Hispanic White women. No research exists on BG and its role in PD. This study examined the BG experiences of AA women and its possible contributions to PD symptoms. Methods: A convergent parallel mixed methods design was used. A purposive sample of 16 AA women with children aged 6 months to 2 years with BG participated in individual semi-structured interviews about their experiences of BG and completed an online survey including the Edinburgh Postnatal Depression Scale (EPDS). Qualitative and quantitative data were analyzed using reflexive thematic analysis and descriptive statistics, respectively. Both data were integrated using joint display of data and side-by-side comparison. Results: The mean age of participants was 29.5 years. Four meaning-based themes about BG were generated including: We looked forward to breastfeeding, But it did not go as expected, So we grieve, and These would have helped. From quantitative results, 87.5% of participants reported a history of PD symptoms and almost 44% had EPDS scores >11. All participants reported that experiencing BG contributed to their PD symptoms. Findings suggest that BG influenced PD symptoms in AA women without prior diagnosis of depression. Conclusions: Qualitative and quantitative findings from this novel exploratory study revealed an overlap that AA women with BG report PD symptoms. Clinicians should support women to achieve their breastfeeding goals to prevent BG and PD. Keywords: African American; Breastfeeding grief; Mental health; Mixed methods; Postpartum depression

18.
arXiv (CS.AI) 2026-06-17

From Democracies to Autocracies: How AI Systems Enable Authoritarianism by Design

arXiv:2606.17286v1 Announce Type: cross Abstract: AI-enabled authoritarianism is not confined to autocracies. In this paper, we provide greater transparency by investigating and mapping the lifecycles of six AI systems deployed in different political regimes, ranging from the US to China. By drawing on an extensive range of sources (academic publications, investigative research reports, third-party evaluations, media interviews, government procurement notices), we conduct a systematic, qualitative comparison across systems to identify the critical technical and operational features that enable authoritarianism within their respective political contexts. We find that enabling features include the centralization and co-optation of administrative data for law enforcement and political punishment, regulatory gaps that fail to deter misuse, weak user compliance that nullifies human oversight mechanisms, and the encoding of protected group traits that identify members of vulnerable populations. We find that these features are present across systems deployed in autocratic and democratic regimes, albeit in varying configurations. We also find that both centralized and fragmented AI systems can contribute to authoritarianism by exploiting governance gaps: centralized systems directed by executive authorities, particularly within security and military institutions, are often not subjected to formal oversight mechanisms, while fragmented systems diffuse accountability between stakeholders, paving the way for entrenchment. These findings reveal that AI-enabled authoritarianism is distributed, resulting from design and operational choices made by developers, administrators, and users alike. We conclude with recommendations for developers and policymakers to mitigate these risks.

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

A Definition of Good Explanations and the Challenges Explaining LLM Outputs

arXiv:2606.14838v1 Announce Type: new Abstract: How to define a good explanation is a long-standing philosophical debate which has found recent renewed interest in the context of AI outputs. Explainability is crucial for AI adoption in many contexts, but in order to produce good explanations of AI systems, we must first have an understanding of what good explanations are. In this paper we propose a definition inspired by the notion of counterfactual explanations, however we argue that one must also take into account the interlocutor's prior beliefs in each fact that could be offered in an explanation. We explore the ramifications of this definition for AI explainability and, in particular, why LLM outputs are difficult to produce good explanations for.

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

GRACE: Step-Level Benchmark for Faithful Reasoning over Context

Many reasoning tasks require models to reason over input context, from document-grounded question answering to rule-based deduction. Chain-of-Thought (CoT) prompting produces traces that appear transparent, yet individual steps can silently deviate from the source evidence, even when the final answer is correct. Existing methods detect hallucinations at the response level but fail to identify where in the chain a failure occurs or what type it is. We introduce GRACE, the first human-annotated step-level faithfulness benchmark with a data-driven error taxonomy for context-grounded textual reasoning. GRACE covers CoT traces from 10 models across 4 source datasets, with each step annotated for faithfulness, error category, and natural language explanation. A data-driven taxonomy, discovered bottom-up via unsupervised clustering, organizes failures into two tracks: GRACE-Inference (deductive errors) and GRACE-Grounding (factual grounding errors), with four categories each. The evaluation set is human-annotated and challenging by design. Our experiments reveal substantial headroom for current models. In addition, integrating step-level faithfulness signals into reinforcement learning pipelines improves both downstream accuracy and reasoning reliability.

21.
arXiv (CS.CV) 2026-06-16

Navigating Distribution Shifts in Medical Image Analysis: A Survey

Medical Image Analysis (MedIA) has become indispensable in modern healthcare, enhancing clinical diagnostics and personalized treatment. Despite the remarkable advancements supported by deep learning (DL) technologies, their practical deployment faces challenges posed by distribution shifts, where models trained on specific datasets underperform on others from varying hospitals, or patient populations. To address this issue, researchers have been actively developing strategies to increase the adaptability of DL models, enabling their effective use in unfamiliar environments. This paper systematically reviews approaches that apply DL techniques to MedIA systems affected by distribution shifts. Rather than organizing existing methods by technical characteristics, we explicitly bridge real-world clinical constraints – such as limited data accessibility, strict privacy requirements, and heterogeneous collaboration protocols – with the technical paradigms able to address them. By establishing this connection between operational constraints and methodological evolution, we categorize existing works into Joint Training, Federated Learning, Fine-tuning, and Domain Generalization, each aligned with specific healthcare scenarios. Beyond this taxonomy, our empirical analysis suggests that, as domain information becomes progressively less accessible across these paradigms, performance improvements become increasingly constrained, and further uncovers a gradual shift in methodological focus from explicit distribution alignment toward uncertainty-aware modeling, ultimately pointing to the need for more deployability-aware design in real-world MedIA.

22.
medRxiv (Medicine) 2026-06-15

Reaching out-of-school girls with HPV vaccination: A qualitative evaluation in six low- and middle-income countries using the RE-AIM framework

Background Infection with human papillomavirus (HPV), the primary cause of cervical cancer, disproportionately affects women in low- and middle-income countries (LMICs). While school-based vaccination of adolescent girls against HPV is highly effective, this strategy systematically excludes out-of-school (OOS) girls. Using the RE-AIM framework, we explored strategies to reach OOS girls with HPV vaccination across six African and Asian LMICs. Methods We conducted semi-structured key informant interviews with 32 vaccination program stakeholders from Cambodia, Cameroon, Kenya, Malawi, Mozambique, and Uganda between May and September 2024. Interviews explored countries implementation successes, challenges, and strategies to reach OOS girls with HPV vaccination and sustainability considerations. Data were analyzed using a hybrid team-based thematic analysis approach guided by the RE-AIM framework. Results Community outreach-based strategies, typically integrated into routine immunization outreach, were identified as the most effective approach to reach OOS girls with HPV vaccination. Targeted strategies, such as locating outreach clinics in community venues frequented by OOS girls (e.g., churches, markets) enhanced implementation. Perceived effectiveness of these strategies varied across participants, and formal assessment of effectiveness was constrained by the absence of disaggregated vaccination coverage data by school enrollment status. Some subpopulations of OOS girls (i.e., girls in nomadic or migrant communities, urban OOS girls) were not readily reached through standard outreach approaches, prompting implementation of adapted and tailored strategies for these subpopulations. Costs associated with conducting outreach in harder-to-reach areas were major barriers to reaching OOS girls, presenting challenges to the sustainability and cost-effectiveness of these approaches. Conclusions Routine community outreach platforms were widely perceived as most effective for reaching OOS girls. Strengthening disaggregated monitoring systems, adapting outreach for harder-to-reach subpopulations of OOS girls, and financing delivery models for tailored outreach strategies will be critical to improving equitable HPV vaccine coverage among OOS girls.

23.
PLOS Computational Biology 2026-06-22

Towards modeling phage therapy

by Rob J. de Boer, Robert Schooley, Alan S. Perelson Patients infected with life-threatening multi-drug resistant (MDR) bacteria have been treated with cocktails of bacteriophages. This is a complicated form of personalized medicine as the phages given to a patient have to be selected beforehand on the basis of their lytic capacity of the infecting bacteria. Because bacteria rapidly become resistant, the evolution of resistance to a diverse cocktail of phages is a complicated dynamical process, during which competing bacterial strains replace one another by accumulating several resistance mechanisms, each of which may involve a fitness cost. As a consequence, it is typically not known why a particular phage therapy succeeded or failed, and how one can optimize the composition of the cocktails to maximize the rate of success. To improve upon this, we extend an existing in vivo-calibrated mouse model into a novel mathematical model for the human situation, and include multiple phages infecting multiple bacterial strains, differing in their resistance to each of the phages. We adjust several parameter estimates of the bacterial model to the human situation, and use the model to describe a successful case of phage therapy involving several cocktails, each containing several phages. In the model, treatment success crucially depended on pretreatment resistance levels, and on the diversity and the timing of the cocktails. Once an appropriate cocktail is found, it is less important to further optimize the infection rates of the phages. Resistant bacterial strains expand rapidly when sensitive strains decline, and the higher the infectivity of the phages, the faster resistant strains expand. Because resistance evolves rapidly, it is best to provide a diverse set of phages right from the start of therapy, i.e., to hit hard and early, and create a high genetic barrier to bacterial resistance.

24.
arXiv (quant-ph) 2026-06-16

Real-space spectral functions of three-dimensional billion-size topological non-Hermitian matter with tensor networks

arXiv:2606.16424v1 Announce Type: cross Abstract: Non-Hermitian systems host a wide range of unconventional topological phenomena while large-scale simulations in finite three dimensional systems remain challenging because of the rapidly growing number of sites. In particular, higher-order topological corner modes are often studied only in small lattices, where strong finite-size effects can mask their intrinsic behavior. Here, we develop a tensor-network framework that combines quantics tensor cross interpolation with the kernel polynomial method, enabling compact representations of large non-Hermitian tight-binding Hamiltonians and direct calculations of real-space spectral functions for systems exceeding one billion lattice sites. Using this approach, we investigate three-dimensional non-Hermitian higher-order topological insulators with with structured real-space geometries. The unprecedented system size enables direct access to the macroscopic regime and allows corner-mode spectral responses to be resolved in genuinely three-dimensional systems.By tuning the loss strength, we identify distinct in-gap corner modes across weak- and strong-loss regimes.Our results establish tensor-network algorithms as a powerful strategy to perform real-space spectral calculations in exceptionally large non-Hermitian systems.