Explore the Frontier of Global Academia

01.

medRxiv (Medicine) 2026-06-22 DOI: HASH:f9d6691f8aac92f15c53341c5a819564

The direct economic impact of surgical non-response in orthopaedic hip, knee, and spine surgery for osteoarthritis: a cost-utility analysis

Authors:

Rampersaud↗Y. R↗Perruccio↗A. V↗Collett↗Sundararajan↗Du↗J. T↗Montoya↗Power↗J. D↗Canizares↗…

Background Annually, nearly 2 million hip, knee, and spinal inpatient surgeries are performed in Canada and the US for osteoarthritis (OA), costing over $37 billion in hospital expenditures. However, 15-30% of patients experience limited or no improvement, resulting in poor value for money. This study evaluated the one-year cost-utility of joint and spine procedures for OA by comparing non-responders to responders, considering various responder definitions. Methods Individual micro-costing data were collected for 1,175 elective hip, knee, and spine patients enrolled in the Longitudinal Evaluation in the Arthritis Program - Osteoarthritis (LEAP-OA) between 2014 and 2018. Quality-adjusted life years (QALYs) were derived using the SF-6D utility index. One-year incremental cost-utility ratios (ICURs) were calculated from the hospital perspective. Results Responder rates varied by definition, ranging from 78%-94% for hip replacements, 64%-90% for knee replacements, 60%-64% for spine fusions, and 50%-68% for spine decompressions. Corresponding ICURs were: $45,956-$51,773/QALY for responders versus $108,593-$485,762/QALY for non-responders for hip replacements; $54,831-$71,151/QALY for responders versus $200,486-$1,203,596/QALY for non-responders for knee replacements; $65,980-$74,422/QALY for responders versus $262,039-$729,686/QALY for non-responders for spine fusions; and $29,947-$42,168/QALY for responders versus $63,195-$662,586/QALY for non-responders for spine decompressions. Conclusions While surgical response rates were highly dependent on the responder definition, ICURs for non-responders were significantly higher than those for responders across all definitions. Beyond the negative impact on patients, there is a compelling economic argument for investment in improved pre-operative identification of patients at risk of surgical non-response. Such efforts could enable more personalized, value-based care pathways and reduce the provision of low-value surgical interventions.

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02.

arXiv (CS.AI) 2026-06-18 DOI: arXiv:2606.18393

Learning-Based Decision Making for Combustion Phasing Control in Multi-Fuel CI Engines with Latent Fuel Reactivity Estimation

Authors:

Rajasree Sarkar↗Aditya Satish Patil↗Arunava Banerjee↗Ihsan Berk Altiner↗Zongxuan Sun↗Kenneth Kim↗Chol-Bum Mike Keown↗

arXiv:2606.18393v1 Announce Type: cross Abstract: Multi-fuel compression-ignition engines offer fuel flexibility but introduce uncertain, time-varying fuel reactivity, represented by cetane number (CN), which complicates cycle-to-cycle combustion-phasing control. This work formulates CA50 regulation under latent CN variation as a partially observable sequential decision problem and systematically evaluates controllers with increasing temporal and representational capacity, including LinUCB, history-augmented contextual bandits, observation-only DDPG, recurrent DDPG, and a proposed GRU-guided RL framework. A Gaussian-process surrogate trained on experimental multi-fuel engine data provides a controlled and reproducible evaluation environment. Results show that myopic and fixed-history bandit methods degrade under CN variation, observation-only RL suffers from latent-state aliasing, and generic recurrence is insufficient when CN evolves rapidly. The proposed framework learns a compact GRU-based representation of fuel reactivity from combustion history and conditions both actor and critic on this estimated signal rather than oracle CN. By training the policy on the same imperfect fuel-reactivity information available at deployment, the controller avoids train-deploy inconsistency in conventional online estimate-then-control pipelines. Across unseen CN trajectories, the policy achieves stable CA50 regulation with mean absolute tracking error below 0.25{\deg} CA at the training setpoint, while producing smooth, physically consistent SOI and glow-plug-power actuation. These results show that combustion control under latent, continuously evolving fuel dynamics requires more than standalone estimation or generic recurrence. By aligning fuel-reactivity inference with control policy learning, the proposed framework enables reactivity-aware decision-making using the same estimated state available during deployment.

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03.

arXiv (CS.LG) 2026-06-11 DOI: arXiv:2511.14427

Self-Supervised Multisensory Pretraining for Contact-Rich Robot Reinforcement Learning

Authors:

Rickmer Krohn↗Vignesh Prasad↗Gabriele Tiboni↗Georgia Chalvatzaki↗

arXiv:2511.14427v4 Announce Type: replace-cross Abstract: Effective contact-rich manipulation requires robots to synergistically leverage vision, force, and proprioception. However, Reinforcement Learning agents struggle to learn in such multisensory settings, especially amidst sensory noise and dynamic changes. We propose MultiSensory Dynamic Pretraining (MSDP), a novel framework for learning expressive multisensory representations tailored for task-oriented policy learning. MSDP is based on masked autoencoding and trains a transformer-based encoder by reconstructing multisensory observations from only a subset of sensor embeddings, leading to cross-modal prediction and sensor fusion. For downstream policy learning, we introduce a novel asymmetric architecture, where a cross-attention mechanism allows the critic to extract dynamic, task-specific features from the frozen embeddings, while the actor receives a stable pooled representation to guide its actions. Our method demonstrates accelerated learning and robust performance under diverse perturbations, including sensor noise, and changes in object dynamics. Evaluations in multiple challenging, contact-rich robot manipulation tasks in simulation and the real world showcase the effectiveness of MSDP. Our approach exhibits strong robustness to perturbations and achieves high success rates on the real robot with as few as 6,000 online interactions, offering a simple yet powerful solution for complex multisensory robotic control. Website: https://msdp-pearl.github.io/

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04.

arXiv (CS.AI) 2026-06-19 DOI: arXiv:2606.20493

Contagion Networks: Evaluator Bias Propagation in Multi-Agent LLM Systems

Authors:

Zewen Liu↗

arXiv:2606.20493v1 Announce Type: cross Abstract: When large language models serve as evaluators in multi-agent systems, their systematic evaluation biases propagate through the agent network. We introduce Contagion Networks, a formal framework for measuring how evaluator biases spread across interacting LLM agents. In a controlled 3-agent experiment using DeepSeek-chat with three distinct evaluator bias profiles (structured, balanced, evidence-based), we measure the Cross-Agent Contagion Matrix Gamma_3 and find that evaluator biases consistently propagate between agents (gamma in [0.157, 0.352]), even within the same underlying model. We identify three propagation regimes governed by the spectral radius rho(Gamma_N), and demonstrate that homogeneous-model agents produce contagion coefficients 3-5x weaker than cross-model coefficients observed in prior work (MM-EPC: gamma approx 0.85-1.3), placing them in the suppression regime. We show that increasing evaluator committee size from k=1 to k=3 reduces effective contagion by 72.4%, providing an actionable mitigation strategy. We release the open-source Contagion Network experimental framework.

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05.

arXiv (quant-ph) 2026-06-16 DOI: arXiv:2508.14152

Towards Interpretability of Neural Quantum States

Authors:

Fabian D\"oschl↗Annabelle Bohrdt↗

arXiv:2508.14152v2 Announce Type: replace Abstract: Neural quantum states (NQS) have emerged as a powerful variational ansatz for representing quantum many-body wave functions. Their internal mechanisms, however, remain poorly understood. We investigate the role of correlations for NQS-like quantum state representation by employing a correlation-based interpretable neural network architecture and then proving our observations using Boolean function theory. The correlator neural network demonstrates that, even for simple product states, up to all system-size correlation orders in the chosen computational basis are required to represent a quantum state faithfully. We explain these observations using Fourier expansion, which reveals the correlator basis as the effective basis of the internal NQS structure, the resulting necessity for high-order correlations that is supported by an entanglement bound that scales with the correlation order, consequences of linear dependencies in constrained Hilbert spaces for correlation requirements, and connections between spin basis rotations and the correlator basis. Furthermore, we analyze how neural networks achieve high correlation orders by increasing the magnitude of the network weights, which can be compensated by increasing the network depth. Lastly, we discuss how activation functions, network architectures, and choice of reference basis influence correlation requirements. Our results provide new insights and a better understanding of the internal structure and requirements of NQS, enabling a more systematic use of NQS in future research.

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06.

arXiv (CS.CV) 2026-06-16 DOI: arXiv:2601.16713

A Human-in-the-Loop Label Error Detection Framework Applied to Arabic-Script HTR Datasets

Authors:

Sana Al-azzawi↗Elisa Barney↗Marcus Liwicki↗

Despite recent advances, Handwritten Text Recognition (HTR) for Arabic-script languages still lags behind Latin-script HTR. Part of the problem is dataset quality. To help closing this gap, we propose a two-stage framework (CER-HV) for detecting label errors. Stage 1 (CER) is a Character-Error-Rate-based noise detector built on a Convolutional Recurrent Neural Network (CRNN) architecture. Stage 2 (HV) is the Human-In-The-Loop (HITL) Verification of noisy samples detected by the first stage. Applying the CER-HV framework on multiple Arabic-script datasets can identify samples with label errors including transcription, segmentation, orientation, and non-text content errors that can markedly affect HTR performance. These errors were identified by the first stage of the framework with up to 90percent (top-50) precision. We also show that our CRNN achieves state-of-the-art performance across five of the six evaluated datasets, reaching 8.46 percent Character Error Rate (CER) on KHATT (Arabic), 8.22 percent on PHTI (Pashto), 10.59 percent on Ajami, and 10.11% on Muharaf (Arabic), all without any data cleaning. We establish a new baseline of 11.3 percent CER on the PHTD (Persian) dataset. Applying CER-HV improves evaluation CER by up to 1.8 percentage points after dataset cleaning and retraining. Although our experiments focus on documents written in an Arabic-script language, the framework is general and can be applied to other text recognition datasets

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07.

arXiv (CS.AI) 2026-06-11 DOI: arXiv:2604.24662

Information bottleneck for learning the phase space of dynamics from high-dimensional experimental data

Authors:

K. Michael Martini↗Eslam Abdelaleem↗Paarth Gulati↗Ilya Nemenman↗

arXiv:2604.24662v2 Announce Type: replace-cross Abstract: Identifying the dynamical state variables of a system from high-dimensional observations is a central problem across physical sciences. The challenge is that the state variables are not directly observable and must be inferred from raw high-dimensional data without supervision. Here we introduce DySIB (Dynamical Symmetric Information Bottleneck) as a method to learn low-dimensional representations of time-series data by maximizing predictive mutual information between past and future observation windows while penalizing representation complexity. This objective operates entirely in latent space and avoids reconstruction of the observations. We apply DySIB to an experimental video dataset of a physical pendulum, where the underlying state space is known. The method, with hyperparameters of the learning architecture set self-consistently by the data, recovers a two-dimensional representation that matches the dimensionality, topology, and geometry of the pendulum phase space, with the learned coordinates aligning smoothly with the canonical angle and angular velocity. These results demonstrate, on a well-characterized experimental system, that predictive information in latent space can be used to recover interpretable dynamical coordinates directly from high-dimensional data.

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08.

arXiv (CS.CL) 2026-06-19 DOI: arXiv:2606.20527

StylisticBias: A Few Human Visual Cues Drive Most Social Biases in MLLMs

Authors:

Shaghayegh Kolli↗Timo Cavelius↗Nafiseh Nikeghbal↗Samantha Dalal↗Jana Diesner↗

Multimodal large language models (MLLMs) are increasingly deployed in personally and societally consequential settings, yet the visual cues that shape how these models judge people remain poorly understood. Prior work often compares different (groups of) individuals, making it difficult to separate appearance effects from identity differences. We introduce StylisticBias, a controlled benchmark for evaluating attribute-level social bias in MLLMs. We generate 500 photorealistic base faces and create about 50 single-attribute variations per face, producing about 25K images. This design keeps identity fixed and changes one visual attribute at a time. It lets us measure how specific cues shift model judgments. We evaluate six MLLMs across 25 binary social judgment scenarios. We find that age and body type dominate identity-level effects, while fashion style and other visual cues drive the largest attribute-level shifts. We further find that about 15 attributes account for nearly 80\% of the total variation, showing that bias is concentrated in a small set of visual cues. Sensitivity is strongest in judgments that are semantically aligned with appearance, especially socioeconomic and style-related judgments. We release StylisticBias as a benchmark for fine-grained bias evaluation in multimodal models. Code and dataset: https://github.com/timo-cavelius/StylisticBias and https://hf.co/datasets/shaghayegh/stylistic-bias-dataset.

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09.

arXiv (CS.AI) 2026-06-19 DOI: arXiv:2511.08378

Bid Farewell to Seesaw: Towards Accurate Long-tail Session-based Recommendation via Dual Constraints of Hybrid Intents

Authors:

Xiao Wang↗Ke Qin↗Dongyang Zhang↗Xiurui Xie↗Shuang Liang↗

arXiv:2511.08378v4 Announce Type: replace-cross Abstract: Session-based recommendation (SBR) aims to predict anonymous users' next interaction based on their interaction sessions. In the practical recommendation scenario, low-exposure items constitute the majority of interactions, creating a long-tail distribution that severely compromises recommendation diversity. Existing approaches attempt to address this issue by promoting tail items but incur accuracy degradation, exhibiting a "see-saw" effect between long-tail and accuracy performance. We attribute such conflict to session-irrelevant noise within the tail items, which existing long-tail approaches fail to identify and constrain effectively. To resolve this fundamental conflict, we propose HID (Hybrid Intent-based Dual Constraint Framework), a plug-and-play framework that transforms the conventional "see-saw" into "win-win" through introducing the hybrid intent-based dual constraints for both long-tail and accuracy. Two key innovations are incorporated in this framework: (i) Hybrid Intent Learning, where we reformulate the intent extraction strategies by employing attribute-aware spectral clustering to reconstruct the item-to-intent mapping. Furthermore, discrimination of session-irrelevant noise is achieved through the assignment of the target and noise intents to each session. (ii) Intent Constraint Loss, which incorporates two novel constraint paradigms regarding the diversity and accuracy to regulate the representation learning process of both items and sessions. These two objectives are unified into a single training loss through rigorous theoretical derivation. Extensive experiments across multiple SBR models and datasets demonstrate that HID can enhance both long-tail performance and recommendation accuracy, establishing new state-of-the-art performance in long-tail recommender systems.

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10.

arXiv (CS.AI) 2026-06-17 DOI: arXiv:2308.14329

SSIL: Self-Supervised Imitation Learning for End-to-End Driving

Authors:

Jin Bok Park↗Jinkyu Lee↗Muhyun Back↗Hyun Min Han↗Tianwei Ma↗Sang Min Won↗Sung Soo Hwang↗Il Yong Chun↗

arXiv:2308.14329v4 Announce Type: replace-cross Abstract: In autonomous driving, the end-to-end (E2E) driving approach that predicts vehicle control signals directly from sensor data is rapidly gaining attention. To learn a safe E2E driving system, one needs an extensive amount of driving data and human intervention. Vehicle control data is constructed by many hours of human driving, and it is challenging to construct large vehicle control datasets. Often, publicly available driving datasets are collected with limited driving scenes, and collecting vehicle control data is only available by vehicle manufacturers. To address these challenges, this paper proposes the first self-supervised learning framework, Self-Supervised Imitation Learning (SSIL), for E2E driving. The proposed SSIL framework can learn vision-based E2E driving networks without using driving command data or a pre-trained model. To construct pseudo steering angle data, proposed SSIL predicts a pseudo target from the vehicle's poses at the current and previous time points that are estimated with light detection and ranging sensors. In addition, we propose a new cross-attention-based conditioning approach (CACA) for a vision encoder in E2E driving, where a high-level instruction serves as the conditioning signal for visual information. Our numerical experiments with three different benchmark datasets demonstrate that the proposed SSIL framework achieves very comparable E2E driving accuracy with the supervised learning counterpart. Furthermore, the proposed pseudo-label predictor outperformed an existing one using proportional integral derivative controller, and proposed CACA achieved superior performance over existing conditioning approaches.

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11.

arXiv (CS.AI) 2026-06-16 DOI: arXiv:2603.23249

A Learning Method with Gap-Aware Generation for Heterogeneous DAG Scheduling

Authors:

Ruisong Zhou↗Haijun Zou↗Li Zhou↗Chumin Sun↗Zaiwen Wen↗

arXiv:2603.23249v2 Announce Type: replace-cross Abstract: Efficient scheduling of directed acyclic graphs (DAGs) is a core problem in large-scale data-intensive computing systems, where query plans, data-processing workloads, and computation graphs consist of dependent tasks competing for limited heterogeneous resource pools. In practice, achieving high-performance execution requires schedulers to adapt across environments with varying resource pools and task types, while generating schedules under tight runtime budgets. We propose WeCAN, an end-to-end reinforcement learning framework for heterogeneous DAG scheduling that addresses task-pool compatibility coefficients and generation-induced optimality gaps. It adopts a two-stage single-pass design: a single forward pass produces task-pool scores and global parameters, followed by a generation map that constructs schedules without repeated network calls. Its weighted cross-attention encoder models task-pool interactions gated by compatibility coefficients, and is size-agnostic to environment fluctuations. Moreover, widely used list-scheduling maps can incur generation-induced optimality gaps from restricted reachability. We introduce an order-space analysis that characterizes the reachable set of generation maps via feasible schedule orders, explains the mechanism behind generation-induced gaps, and yields sufficient conditions for gap elimination. Guided by these conditions, we design a skip-extended realization with an analytically parameterized decreasing skip rule, which enlarges the reachable order set while preserving single-pass efficiency. Experiments on real-world TPC-H query DAGs, resource-intensive workload datasets, and ML-compiler computation graphs demonstrate improved makespan over strong baselines, with inference time comparable to classical heuristics and faster than multi-round neural schedulers.

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12.

arXiv (CS.LG) 2026-06-12 DOI: arXiv:2605.00432

Optimal Spatio-Temporal Decoupling for Bayesian Conformal Prediction

Authors:

Yu-Hsueh Fang↗Chia-Yen Lee↗

arXiv:2605.00432v2 Announce Type: replace Abstract: Online conformal prediction must balance fast adaptation to distribution shift against stable coverage: feedback-driven methods react quickly but become volatile, while strongly discounted Bayesian methods lag and inflate intervals at tight coverage. We introduce State-Adaptive Bayesian Conformal Prediction (SA-BCP), which forms the predictive quantile as a gated convex combination of long-term temporal inertia and local spatial evidence from a kernel density estimate, controlled by a single interpretable evidence threshold $K$. We establish three results: (i) asymptotic marginal validity of the resulting intervals; (ii) a closed-form expression for the MSE-optimal threshold, $K^*_{\mathrm{MSE}}=\alpha(1-\alpha)/M^{\mathcal{T}}$, trading the coverage-indicator (Bernoulli) variance against the temporal structural bias $M^{\mathcal{T}}$; and (iii) a rolling-origin procedure for selecting $K$ online – consistent under stationarity, with $O(\sqrt{T\log N})$ regret against the best fixed $K$ and, for a segmented variant, a sublinear dynamic-regret bound under bounded drift. Across four financial-volatility and weather datasets, three target coverage levels, and eight baselines (including the strongest recent conditional-quantile methods, SPCI and KOWCPI), SA-BCP attains at-or-above-nominal coverage in most settings while producing substantially sharper intervals – up to roughly $3\times$ lower Winkler score than discounted Bayesian CP at the tightest coverage – and a coverage-matched audit confirms these efficiency gains are not an artifact of under-coverage. We disclose one principal limitation: a volatility-specialized conformal-GARCH competitor remains more efficient on its home volatility-base series, though it does not transfer across domains.

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13.

arXiv (CS.AI) 2026-06-16 DOI: arXiv:2606.16440

NeuronFabric: A Software Reference Architecture for On-Chip Transformer Training with Local Adam

Authors:

Evgeny Ukladchikov↗

arXiv:2606.16440v1 Announce Type: cross Abstract: Publicly documented accelerator architectures generally separate training computation from optimizer-state updates or rely on external memory and host orchestration. This paper presents NeuronFabric, a software reference architecture intended for future FPGA and ASIC implementations of transformer training with local Adam updates. A complete C# prototype implements forward pass, backpropagation, and Adam optimization without external machine-learning frameworks. The goal is to validate numerical correctness and memory requirements before hardware implementation. The evaluated model is a 334K-parameter autoregressive transformer (d=88, H=4, f=264, L=4, vocab=256) trained on the Shakespeare corpus. The BF16W configuration achieves evaluation loss 1.5426 after 80K samples, compared with 1.5224 for an FP32 GPU reference, while producing coherent character-level text. The paper introduces BF16W, which stores weights in BF16 while retaining Adam optimizer moments in FP32. This reduces memory requirements for on-chip training. A 334K-parameter FP32 model with Adam moments requires approximately 4.0 MB, matching the BRAM capacity of a Xilinx ZCU102 device. The BF16W variant requires approximately 3.34 MB, leaving memory available for activation storage. We describe the vocabulary-budget constraint observed during earlier experiments, quantify BF16W memory savings, and outline FPGA training as the next stage of development. No FPGA measurements are included in this paper. This publication serves as a public architectural disclosure and software reference implementation for future FPGA and ASIC exploration of the NeuronFabric architecture.

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14.

arXiv (CS.AI) 2026-06-11 DOI: arXiv:2606.12086

IntElicit: Eliciting and Assessing Contextualized Creativity via Dialogue Policy Optimization

Authors:

Mingjia Li↗Jin Wu↗Hong Qian↗Wenhao Huang↗Yiyang Huang↗Yiwen Zhang↗Chanjin Zheng↗Xiangfeng Wang↗Aimin Zhou↗Jiajun Guo↗

arXiv:2606.12086v1 Announce Type: new Abstract: Contextualized assessment offers high ecological validity for evaluating creativity but introduces a critical challenge: observed performance may be confounded with cognitive proficiency (domain knowledge) and agency (willingness to engage). Meanwhile, in the age of generative AI, creative problem solving increasingly occurs in tool-mediated and human–AI interactive environments, making fully static assessment less aligned with contemporary creative practice. To address these issues, this paper proposes IntElicit, a framework for eliciting and assessing contextualized creativity via dialogue policy optimization. IntElicit functions as a constrained adaptive AI Interviewer: it provides non-directive knowledge and agency scaffolds in multi-turn interaction to reduce non-creative confounders, while preserving participants' responsibility for generating the creative content being evaluated. Specifically, to tackle sparse rewards and potential reward hacking (e.g., answer dictation) in open-ended educational dialogue, IntElicit introduces a decomposed process reward mechanism. This mechanism aligns the policy with pedagogical elicitation, rewarding prompts that draw out participant reasoning rather than producing optimal answers on their behalf. Extensive experiments, including participant simulation and a human subject study (N=64), show that IntElicit improves elicited creative outcomes over expert-designed baselines. Together, the results suggest that interactive elicitation can reveal creative potential that static FPSP-style assessment may miss, providing a formative and diagnostic lens for contextualized creativity assessment in AI-mediated learning contexts.

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15.

arXiv (CS.LG) 2026-06-12 DOI: arXiv:2606.13221

From Uncertain Judgments to Calibrated Rankings: Conformal Elo Estimation for LLM Evaluation

Authors:

Bora Kargi↗David Salinas↗

arXiv:2606.13221v1 Announce Type: new Abstract: Evaluating new large language models typically requires costly human annotation campaigns at scale. LLM-as-a-judge offers a cheaper alternative, but judge scores carry systematic errors - such as position bias, self-preference, or intransitivity - that can strongly miscalibrate the resulting rankings. We quantify the resulting judge-human disagreement at two complementary levels. At the local level, we estimate per-battle uncertainty from the judge's own score differences by propagating calibrated win probabilities rather than hard labels into the Bradley-Terry procedure. This alone provides a drastic improvement to Elo estimation accuracy, bringing LLM-derived ratings within 17.9 Elo MAE of human-derived ones when averaged over 55 held-out models on LMArena. At the global level, we apply split conformal prediction to the residual gap between LLM-derived and human-derived Elo ratings across held-out models, producing prediction intervals with distribution-free marginal coverage guarantees that account for irreducible LLM-human disagreement. Together, these two layers yield a low-cost evaluation tool that provides developers with calibrated Elo estimates and honest uncertainty bounds, without access to large-scale human annotations.To facilitate reproducibility, we release our code at https://github.com/kargibora/SoftElo .

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16.

Nature Medicine 2026-06-09 DOI: HASH:a2496a839fb80f44db72e35257802d74

Adjuvanted inactivated rabies virus-vectored Lassa virus vaccine in healthy adults: a phase 1 trial

Authors:

Justin R. Ortiz↗

Lassa fever causes substantial morbidity and mortality in West Africa, and no licensed vaccine is available. We evaluated LASSARAB, an inactivated rabies virus-vectored Lassa virus (Josiah strain) glycoprotein complex vaccine. We conducted a randomized, controlled, dose-escalation phase 1 trial. Participants (total n = 54) received two intramuscular doses of LASSARAB containing 700 (n = 15), 1,400 (n = 15) or 2,800 (n = 14) relative units of antigen formulated with the TLR-4 agonist 3D-6-acyl PHAD-SE adjuvant, or licensed rabies vaccine control (n = 10), administered 28 days apart. This protocol-defined interim analysis reports the primary safety evaluation and secondary immunogenicity assessments through day 61. There were no prespecified hypotheses or formal power calculations. All primary safety end points demonstrated an acceptable safety profile. After dose 1, local solicited adverse events occurred in 86.7–100.0% of LASSARAB groups and 80% of controls; systemic events in 33.3–71.4% and 60.0% of controls. After dose 2, local solicited adverse events occurred in 66.7–86.7% of LASSARAB groups and 55.6% of controls; systemic events in 53.3–71.4% of LASSARAB groups and 55.6% of controls. Events were predominantly mild and self-limited. Unsolicited adverse events occurred in 28.6–60.0% of LASSARAB groups and 20.0% of controls. No serious adverse event, immune-mediated condition or sensorineural hearing loss occurred. Safety laboratory abnormalities occurred in 13.3–66.7% of LASSARAB groups and 30.0% of controls (14 mild, 6 moderate and none severe). After two doses, Lassa virus GPC IgG ELISA seroconversion (≥fourfold rise) was achieved in 100.0% (44 of 44) of LASSARAB recipients and 0.0% (0 of 10) of controls. Rabies glycoprotein IgG ELISA seroconversion (≥fourfold rise) and neutralizing antibody by rapid fluorescent focus inhibition test (RFFIT) seroprotection (≥0.5 IU ml−1) were also 100% across all groups, including controls. LASSARAB + 3D-6-acyl phosphorylated hexaacyl disaccharide (PHAD)-SE demonstrated a favorable safety profile and immunogenicity against Lassa and rabies viruses. The per-protocol final study report will include safety and durability through day 394. ClinicalTrials.gov identifier NCT06546709 . An interim report of a first-in-human phase 1 trial found an adjuvanted, combination inactivated rabies-vectored, Lassa fever vaccine (LASSARAB + 3D-6-acyl PHAD-SE) to be safe and induced immunogenicity to both Lassa and rabies viruses in healthy participants.

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17.

arXiv (CS.LG) 2026-06-19 DOI: arXiv:2606.19920

Deep-Unfolded Coordination

Authors:

Hunter Kuperman↗Minchan Jung↗Rahul V. Ghosh↗Alex Oshin↗Evangelos A. Theodorou↗

arXiv:2606.19920v1 Announce Type: cross Abstract: Distributed optimization is a highly scalable and structurally transparent technique to solve multi-agent robotics problems; however, such methods often suffer from the need for highly-specialized, problem-specific hyperparameter tunings. In this work, we propose Deep Coordinator, a deep-unfolding framework that learns to dynamically adjust the hyperparameters of ADMM-DDP, a popular distributed solver for robotics tasks, at solve-time in response to optimizer performance. Our architecture consists of unrolling a fixed number of ADMM-DDP iterations into a neural network with learnable functions between layers mapping the optimizer state to the next hyperparameters. To the best of our knowledge, Deep Coordinator is the first deep-unfolding framework to adapt the penalty parameters of a non-convex optimizer at solve-time; we show that the mainstream supervised approach can yield degenerate solutions when training such models, and propose an unsupervised learning scheme. On simulations with fleets of cars and quadrotors, Deep Coordinator produces trajectories of comparable quality 6.18-9.44x faster than conventional solvers. Furthermore, Deep Coordinator retains its performance benefits when deployed to systems up to 8x larger than trained on.

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18.

arXiv (CS.AI) 2026-06-16 DOI: arXiv:2606.15474

Who Drifted: the System or the Judge? Anytime-Valid Attribution in LLM Evaluation Pipelines

Authors:

Yitao Li↗

arXiv:2606.15474v1 Announce Type: new Abstract: Continuous evaluation of LLM products relies on a strong LLM judge treated as ground truth: a cheap monitor scores every interaction and a team is paged when the score drifts down. But the judge is itself a model behind an API, and a silent version bump or scoring-prompt update changes how it scores – so every drift alarm is ambiguous between a worse product and a changed judge. We resolve the ambiguity with a fixed, human-labeled anchor set that the current judge re-scores at a steady interleave, a second betting e-process on the judge-versus-human gap, and a guard-window rule returning a verdict in {none, system, judge}. We prove anytime-validity, one-way identification (only the judge can move the anchors), an attribution race whose design law is that the anchors must out-run the main process they guard, and process orthogonality. On two real judge changes, a silent version bump is detected as judge drift in 60/60 runs with zero judge-to-system misattribution, and a contaminating strict-prompt change is correctly attributed on 110 of 120 runs at guard width 300 – while the industry-default rolling z-test false-alarms on 75% of drift-free streams. Every experiment replicates on a second domain (TL;DR summarization) with nothing re-tuned, and where the domains differ the differences are the ones the race predicts: the strict-prompt change shifts scores harder there, so the anchors fire faster and attribution becomes perfect (240/240). The monitor runs at approximately 0.64 of the cost of strong-judging every item, or 0.21 in a cheaper-but-deafer regime.

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19.

medRxiv (Medicine) 2026-06-15 DOI: HASH:84c0015950bd8d7e9749e9fe901b893e

ECHOCARDIOGRAPHY ABNORMALITIES IN PREECLAMPSIA WITH SEVERE FEATURES.

Authors:

Rathod↗A. T↗Sarojini↗PC↗S. R↗Deshmukh↗Fathima↗S. A↗

Purpose To determine the frequency of echocardiographic abnormalities in women with preeclampsia with severe features. To describe the spectrum and types of echocardiographic abnormalities associated with preeclampsia with severe features. Method This is a Prospective observational study conducted in Vani Vilas hospital attached to Bangalore Medical College and Research Institute, Bangalore from January 2023 to December 2025. 560 pregnant women diagnosed with severe preeclampsia(SPE) were included in the study. Chronic hypertension without superimposed preeclampsia, underlying cardiac diseases and previous history of peripartum cardiomyopathy were excluded from the study. Transthoracic echocardiography-TTE (2D ECHO) was done to evaluate cardiac structure and function. Echocardiographic abnormalities identified during the study were documented and analysed using descriptive statistical methods. Results Abnormalities in ECHO was noted in 23.03%. A unique finding was the documentation of elevated pulmonary artery systolic pressures (PASP) suggestive of Pulmonary Hypertension (PH) (PASP >35 mm HG) among 20.25% of the participants. It was also the commonest abnormality on ECHO. Mild PH was the commonest (15.71%), moderate PH was seen in 3.92% and severe PH in 0.71% of cases. Next most frequent abnormality was moderate to severe valvular regurgitation (10%), followed by left ventricular hypertrophy (5.53%). Diastolic dysfunction (DD) was seen in 3.92%, systolic dysfunction(SD) in 3.57%, chamber dilatation in 3.57% and LV global hypokinesia in 3.03% cases of SPE Conclusion Preeclampsia with severe features (SPE) is associated with 23.03% abnormalities on echocardiography. SPE is associated with systolic dysfunction, diastolic dysfunction, chamber dilatation, valvular regurgitation, left ventricular hypertrophy and pulmonary hypertension.

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20.

medRxiv (Medicine) 2026-06-22 DOI: HASH:d7bb4d8aa53638f8013da5842d04391f

Accounting for uncertainty in the expected treatment effect substantially increases the sample size required for randomised trials: implications for the feasibility of clinical trials in anaesthesia and critical care

Authors:

Sidebotham↗Barlow↗

Background Multicentre trials in anaesthesia and critical care report low rates of statistically significant differences. This finding may partly reflect conventional sample size methods, which assume a fixed treatment effect. Assurance methods use a design prior to represent uncertainty in the expected treatment effect, which may provide a more realistic way of estimating sample sizes. Methods We calculated power curves across a range of effect sizes, design priors, and sample sizes using frequentist and Bayesian assurance methods and compared the sample sizes required to achieve 80% and 90% power to the conventional method. We standardised the design priors across effect sizes using the coefficient of variation. We derived a theoretical limit for achievable power. We validated a normal approximation to the Bayesian posterior distribution. Results Frequentist and Bayesian assurance methods produced similar power curves across all scenarios. At a coefficient of variation of 0.5 - reflecting realistic prior uncertainty in the expected effect size - both methods required sample sizes that were approximately 1.5 to 3.5 times larger than the conventional method. The theoretical power limit depends only on the coefficient of variation of the design prior and holds true across all effect sizes. The normal approximation to the Bayesian posterior distribution matched the results obtained from Markov chain Monte Carlo sampling. Conclusions Incorporating clinical uncertainty in the expected effect size substantially increases the sample size required to achieve adequate power, which has important implications for the feasibility of randomised trials in anaesthesia and critical care.

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21.

arXiv (math.PR) 2026-06-16 DOI: arXiv:2606.15630

Excursion Fluctuations and Spectral Universality in Gaussian Fields

Authors:

Dmitry Beliaev↗Akshay Hegde↗

arXiv:2606.15630v1 Announce Type: new Abstract: We study the large-scale spatial fluctuations of excursion volumes for a class of smooth stationary Gaussian fields. In the case of Berry's random wave model in dimension $d \geq 2$, we show that the spatial fluctuations for fixed $u>0$ converge to the fractional Gaussian field $(-\Delta)^{-1/4}W$ in the space of tempered distributions $\mathcal S'(\mathbb{R}^d)$, where $W$ is the $d$-dimensional Gaussian white noise. This explains the long-range correlations in the apparent filament structure of the Random Plane Wave model. For a class of smooth planar Gaussian fields whose spectral density has a power-law singularity at the origin, we prove convergence to fractional Gaussian fields with an index determined by the singularity exponent. More generally, the results illustrate that, for stationary random measures, large-scale spatial fluctuations are determined by the behaviour of the spectral measure density exponent near zero.

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22.

arXiv (CS.CV) 2026-06-11 DOI: arXiv:2606.11740

UniReason-Med: A Shared Grounded Reasoning Interface for 2D-to-3D Transfer in Medical VQA

Authors:

Mengzhuo Chen↗Yan Shu↗Chi Liu↗Hongming Piao↗Xidong Wang↗Derek Li↗Bryan Dai↗

We study whether grounded reasoning supervision from abundant 2D medical images can improve 3D medical VQA when both input types are aligned through a common reasoning interface. We introduce UniReason-Med, a single-checkpoint framework that processes either a 2D image or a slice-serialized 3D volume at inference time, generating interleaved textual reasoning and localized visual evidence through shared box syntax, region-token injection, and a common grounded reasoning policy. To train this interface, we construct UniMed-CoT, a 220K instruction-tuning dataset with interleaved textual reasoning and grounded visual evidence, including 170K 2D and 50K 3D samples. Through supervised fine-tuning followed by outcome-level reinforcement learning, UniReason-Med learns to generate grounded reasoning traces without IoU/Dice-based localization rewards during RL. Data-mixture and component ablations show that joint 2D+3D grounded supervision substantially improves 3D reasoning over 3D-only training, while grounding and region-token injection consistently benefit both 2D and 3D tasks. These results suggest that a shared grounded reasoning interface can transfer reasoning structure from 2D images to slice-serialized volumetric medical understanding. The code and data are publicly available at https://github.com/IQuestLab/unireason-med.

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23.

arXiv (CS.CL) 2026-06-19 DOI: arXiv:2606.19544

Reliability without Validity: A Systematic, Large-Scale Evaluation of LLM-as-a-Judge Models Across Agreement, Consistency, and Bias

Authors:

Justin D. Norman↗Michael U. Rivera↗D. Alex Hughes↗

LLM-as-a-Judge has become the dominant evaluation paradigm for language models, but judge validation in practice relies on exact-match agreement, a metric that does not correct for chance and systematically overstates discriminative ability. We present the largest systematic evaluation of LLM-as-a-Judge to date: 21 judges from nine providers across MT-Bench, JudgeBench, and RewardBench, evaluated under three protocols (agreement, consistency, bias audit) over 118 runs and approximately 541,000 individual judgments. Four findings emerge, consistent across the full cohort, including the April 2026 frontier: kappa deflation between exact match and Cohen's kappa is universal (33–41 pp on MT-Bench), judge rankings shift by up to 14 positions across benchmarks, high test–retest reliability (>0.95) coexists with severe position bias (>0.10) in two production-deployed judges (instantiating a consistency–bias paradox), and verbosity bias is small (

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24.

medRxiv (Medicine) 2026-06-17 DOI: HASH:027c819f7f2e9515d65b444cc67c8ff0

Performance of five risk stratification tools for paediatric pneumonia against WHO scores using data from the PediCAP trial in sub-Saharan Africa

Authors:

Nalwanga↗Clements↗Musiime↗Mulenga↗Mujuru↗H. A↗Sidat↗Buck↗W. C↗Madhi↗Bielicki↗J. A↗…

Background Risk stratification tools for childhood pneumonia have been proposed to improve identification of children at highest risk of death, particularly in low-resource settings. However, their added value over the WHO Integrated Management of Childhood Illness (IMCI) criteria and danger signs remains uncertain. Methods We conducted a secondary analysis of a multi-country randomised controlled trial of children without HIV hospitalised with pneumonia in Mozambique, South Africa, Uganda, Zambia, and Zimbabwe. We evaluated the performance of five published risk scores alongside WHO IMCI severity classification and danger signs. Discrimination for (1) in-hospital mortality, (2) 28-day mortality, and (3) 28-day readmission or death was assessed using area under the receiver operating characteristic curve (AUC). Comparative performance and clinical utility were examined. Results Of the 1010 participants, 18 (1.8%) died in hospital, 22 (2.2%) died in hospital or in the 7 days post-discharge, and 63 (6.2%) died or were readmitted by day 28. Univariate case-fatality rates were highest for variables associated with malnutrition, convulsions, and hypoxaemia. All risk scores demonstrated moderate discrimination for in-hospital and in-hospital+7-day mortality (AUC range approximately 0.75-0.84), with no meaningful differences between models, and performed similarly to the WHO danger signs and IMCI severity classification. In contrast, all approaches performed poorly in predicting 28-day readmission or death (AUC approximately 0.54-0.58). No risk score consistently outperformed simple clinical criteria. Conclusions In this multi-country dataset, we found no evidence that published paediatric pneumonia risk scores meaningfully outperform WHO IMCI-based clinical assessment for predicting mortality. The relatively small number of mortality events limits precision, and modest differences cannot be excluded. These findings suggest that, in low-resource settings, strengthening implementation of existing WHO clinical criteria may be more effective than adopting more complex prediction tools.

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25.

arXiv (CS.CV) 2026-06-16 DOI: arXiv:2606.15772

Ellipse Meets Bit-Planes: A Novel Approach to RNFL based Glaucoma Detection Using Advanced Image Processing and Deep Learning

Authors:

Snigdha Paul↗Sambit Mallick↗Anindya Sen↗

This work proposes an integrated pipeline for automatic glaucoma detection method from easily available colour fundas images based on an adaptive algorithm for ellipse-based polar transformation, to enhance the analysis of the Retinal Nerve Fiber Layer (RNFL) as the primary biomarker for observing glaucomatous changes, regardless of optic disc and macula position. Utilizing this transformation, we introduce two distinct frameworks tailored to different operational needs. The first framework, a deep learning-inspired feature fusion approach, achieves a 99.3% detection rate, ideal for settings where high precision is essential, despite higher computational demands. The second framework employs a novel image-processing algorithm based on bit-plane slicing, offering 92.31% accuracy and optimized for environments requiring rapid inference with minimal resource consumption. Both frameworks provide scalable and cost-effective solutions for early glaucoma detection. This study highlights the potential of RNFL-based diagnostic tools in addressing the global challenge of glaucoma, particularly in underserved regions.

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