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01.
arXiv (CS.CV) 2026-06-11

Parameter-Efficient Adapter Tuning for Tabular-Image Multimodal Learning

作者:

Tabular-image multimodal learning aims to improve predictive modeling by jointly using structured tabular attributes and visual data. Although pretrained encoders provide strong modality-specific representations, full fine-tuning can be computationally expensive, while keeping encoders frozen may limit task-specific adaptation. We propose the Tabular-Image Adapter (TI-Adapter), a modality-specific adapter-based fine-tuning framework for efficient multimodal adaptation. TI-Adapter freezes the pretrained tabular encoder and learns an adapter after the extracted tabular embedding, while adapting the image branch with embedding-level and bottleneck-level adapters instead of full fine-tuning. Experiments on 20 tabular-image datasets show that TI-Adapter achieves competitive or better predictive performance than full fine-tuning while using substantially fewer trainable parameters. Ablation studies further demonstrate the importance of adapter placement for balancing performance and practical efficiency.

02.
medRxiv (Medicine) 2026-06-10

Frozen elephant trunk repair in heritable thoracic aortic disease: Impact of genetic aortopathy on long-term outcomes - A multicenter analysis

Aims This multicenter study aims to compare outcomes of total aortic arch replacement (TAR) using the frozen elephant trunk (FET) technique in patients with and without heritable thoracic aortic disease (HTAD) and to assess whether HTAD influences postprocedural adverse aortic events (AAEs). Methods From 06/2007 to 05/2024, aortic databases from 13 European centers were screened for HTAD patients undergoing TAR with FET. All consecutive dissection and aneurysm non-HTAD patients from the four core centers served as comparator. The primary outcome was AAE, a composite of diameter progression, distal stent graft induced new entry (dSINE), malperfusion, rupture and pseudoaneurysm at 5 years after FET implantation. Results Of 2739 FET patients, 196 (7.2%) were diagnosed with HTAD. The control group consisted of 867 non-HTAD FET patients. Marfan syndrome was the most common condition (72%), followed by Loeys-Dietz syndrome (11%), vascular Ehlers-Danlos syndrome (5.6%) and Turner syndrome (2.0%). Seventeen (8.8%) patients were diagnosed with ns-HTAD. At 5 years 46 (24%) AAEs occurred in the HTAD group, 169 (20%) in the non-HTAD group (p=0.2). Diameter progression was the most common event (10% vs. 12%; p=0.6), followed by dSINE (5.8% vs. 4.5%; p=0.5), malperfusion (4.2% vs. 3.3%; p=0.5), rupture (2.1% vs. 0.7%; p=0.09) and pseudoaneurysm (0.5% vs. 0.2%; p=0.5). Conclusions The FET technique appears safe and effective for acute and chronic aortic disease in HTAD patients, with outcomes comparable to non-HTAD cases and no increase in graft-related complications, challenging traditional concerns about stent graft use in genetically mediated aortic disease.

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

Beyond Text-to-SQL: An Agentic LLM System for Governed Enterprise Analytics APIs

Enterprise analytics aims to make organizational data accessible for decision-making, yet non-technical users still face barriers when using traditional business intelligence tools or Text-to-SQL systems. While recent Text-to-SQL approaches based on Large Language Models (LLMs) promise natural language access to structured data, they fall short in enterprise settings where analytics pipelines rely on governed APIs rather than raw databases. In practice, these APIs encapsulate complex business logic to ensure consistency, auditability, and security. However, delegating mathematical or aggregation logic to an LLM introduces reliability and compliance risks. To this end, we present Analytic Agent, an LLM-based agentic system that translates natural language intents into secure interactions with enterprise analytics APIs. Evaluated on 90 real enterprise use cases constructed by domain experts, it reliably interprets user goals, validates permissions, executes governed queries, and generates compliant visualizations through multi-step reasoning and policy-aware orchestration.

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

Protein Design with Agent Rosetta: A Case Study for Specialized Scientific Agents

arXiv:2603.15952v2 Announce Type: replace Abstract: Large language models (LLMs) are capable of emulating reasoning and using tools, creating opportunities for autonomous agents that execute complex scientific tasks. Protein design provides a natural testbed: although machine learning (ML) methods achieve strong results, these are largely restricted to canonical amino acids and narrow objectives, leaving unfilled need for a generalist tool for broad design pipelines. We introduce Agent Rosetta, an LLM agent paired with a structured environment for operating Rosetta, the leading physics-based heteropolymer design software, capable of modeling non-canonical building blocks and geometries. Agent Rosetta iteratively refines designs to achieve user-defined objectives, combining LLM reasoning with Rosetta's generality. We evaluate Agent Rosetta on design with canonical amino acids, matching specialized models and expert baselines, and with non-canonical residues – where ML approaches fail – achieving comparable performance. Critically, prompt engineering alone often fails to generate Rosetta actions, demonstrating that environment design is essential for integrating LLM agents with specialized software. Our results show that properly designed environments enable LLM agents to make scientific software accessible while matching specialized tools and human experts.

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

TAROT: Task-Adaptive Refinement of LLM-prior Graphs for Few-shot Tabular Learning

arXiv:2606.11640v1 Announce Type: cross Abstract: Few-shot tabular learning provides a cost-effective approach for real-world applications where annotation is costly and collecting sufficient samples for new tasks is difficult. Existing Traditional and LLM-based methods have demonstrated effectiveness in few-shot scenarios. However, traditional methods need additional training on unlabeled or generated data, which incur significant computational overhead. In addition, LLM-based methods that directly feed raw tabular data into LLMs raise privacy and compliance concerns. More importantly, both paradigms largely overlook the semantic relationships between features, which provide structural and semantic prior for constructing a semantic graph. Semantic graph is essential for modeling meaningful feature interactions in few-shot scenarios. In this paper, we propose TAROT, a GNN-based framework that encodes the structural and semantic prior by constructing and refining a task-adaptive semantic graph from this prior, thereby improving predictive performance in few-shot tabular learning. TAROT first encodes heterogeneous tabular data into unified node semantic representations via a Unified Semantic Tabular Node Encoder (USTNE). Then, it prompts LLMs to infer the semantic relationship between features based on the task description and feature names to construct a semantic graph. To mitigate structural noise introduced by the hallucination of LLMs, TAROT introduces Task-adaptive Semantic Graph Refinement that prunes spurious or task-unrelated edges and adds missing task-related ones, aligning the graph structure with the downstream objective. Finally, a GNN performs message passing over the refined graph to capture task-related semantic dependencies for prediction. Extensive experiments on various few-shot tabular learning benchmarks demonstrate the superior performance of TAROT, establishing it as a state-of-the-art approach in this domain.

07.
arXiv (CS.AI) 2026-06-19

Context-Aware Hierarchical Bayesian Modeling of IVF Laboratory Environmental Conditions

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

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

Mechanisms of Introspective Awareness

arXiv:2603.21396v5 Announce Type: replace Abstract: Recent work has shown that LLMs can sometimes detect when steering vectors are injected into their residual stream and identify the injected concept – a phenomenon termed "introspective awareness." We investigate the mechanisms underlying this capability in open-weights models. First, we find that it is behaviorally robust: models detect injected steering vectors at moderate rates with 0% false positives across diverse prompts and dialogue formats. Notably, this capability emerges specifically from post-training; we show that preference optimization algorithms like DPO can elicit it, but standard supervised finetuning does not. We provide evidence that detection cannot be explained by simple linear association between certain steering vectors and directions promoting affirmative responses. We trace the detection mechanism to a two-stage circuit in which "evidence carrier" features in early post-injection layers detect perturbations monotonically along diverse directions, suppressing downstream "gate" features that implement a default negative response. This circuit is absent in base models and robust to refusal ablation. Identification of injected concepts relies on largely distinct later-layer mechanisms that only weakly overlap with those involved in detection. Finally, we show that introspective capability is substantially underelicited: ablating refusal directions improves detection by +53%, and a trained bias vector improves it by +75% on held-out concepts, both without meaningfully increasing false positives. Our results suggest that this introspective awareness of injected concepts is robust and mechanistically nontrivial, and could be substantially amplified in future models. Code: https://github.com/safety-research/introspection-mechanisms.

09.
arXiv (CS.LG) 2026-06-19

Fisher-Geometric Sharpness and the Implicit Bias of SGD toward Flat Minima

arXiv:2606.20469v1 Announce Type: new Abstract: A widely held intuition in deep learning is that stochastic gradient descent (SGD) implicitly favors flat minima and that flat minima generalize better, but standard Euclidean measures of flatness such as the trace or maximum eigenvalue of the loss Hessian are not invariant under reparametrizations that preserve the network function, which undermines the theoretical foundations of this narrative. In this study we resolve this issue by grounding flatness in the Riemannian geometry of the statistical manifold induced by the Fisher Information Matrix (FIM). We define Riemannian sharpness mathematically and prove that it is invariant under smooth, function-preserving reparametrizations, which directly addresses the critique of Dinh et al. in the paper ``Sharp minima can generalize for deep nets''.We note that this invariance is a property of the true FIM; the diagonal empirical estimator used in practice (and in all experiments below) inherits invariance only approximately, and exact invariance under arbitrary reparametrizations would require structured estimators such as K-FAC. We formalize the gradient noise of mini-batch SGD as having a covariance structure proportional to the FIM, derive the stationary distribution of the resulting stochastic differential equation, and then show that the probability mass is exponentially concentrated at Riemannian-flat minima. A PAC-Bayes generalization bound controlled explicitly by SR formally links this geometric bias to test performance. Our experiments on MNIST and CIFAR-10 confirm that SR reliably tracks generalization in ways that Euclidean sharpness does not, and that its scaling with $\eta/B$ matches the theoretical predictions. Together these results provide a rigorous, reparametrization-invariant account of why flat minima generalize.

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

An Extensive Benchmark for Single-round and Multi-round Instruction-based Image Editing

In recent years, there have been notable advancements in the area of instruction-based image editing (IIE), which focuses on the automatic alteration of input images using a model. Nevertheless, assessing the effectiveness of these editing models poses a considerable challenge due to the intricate nature of instructions and the wide variety of edits. To tackle this problem, one urgent task in this domain is the development of a robust evaluation framework that can precisely gauge the quality of editing outcomes and offer valuable benchmarks to guide future improvements. To address this challenge, we present a comprehensive evaluation benchmark named I2EBench2.0, designed for single-round and multi-round assessment of IIE models. I2EBench2.0 has four key features: 1) Evaluation Across Single and Multi-rounds: I2EBench2.0 simultaneously evaluates both single-round and multi-round instruction-based edits, assessing the precision and consistency of the edits. 2) Extensive Evaluation Criteria: I2EBench2.0 encompasses a broad range of criteria, evaluating both high-level and low-level aspects of each IIE model. Specifically, it incorporates 16 dimensions for single-round evaluations and 7 for multi-round evaluations. 3) Alignment with Human Judgment: To ensure our benchmark aligns with human evaluation, we conducted a comprehensive user study for each criterion. 4) Research-driven Insights: By analyzing the strengths and weaknesses of current IIE models across all 16 single-round and 7 multi-round dimensions, we provide critical insights aimed at directing future research in this area. We tested eight recently developed IIE models using I2EBench2.0 and derived academic insights through meticulous comparison and analysis. The related code, dataset, and images generated by all IIE models are available on GitHub: https://github.com/cocoshe/I2EBench.

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

Self-Generated Error Training for Token Editing in Diffusion Language Models

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Token-to-token (T2T) editing lets LLaDA2.1 revise committed tokens during block-diffusion decoding. The released recipe trains this editor on random vocabulary corruptions, but at inference the editor sees the model's own fluent, high-confidence draft errors instead. We study this training-inference mismatch and propose self-generated T2T, which performs a no-gradient draft pass, fills masked positions with predicted tokens, and supervises recovery in a second pass under these self-generated corruptions. We implement the update as a short LoRA continued-pretraining pass on LLaDA2.1-mini and evaluate on several benchmarks under the official Q-Mode T2T procedure with unchanged inference parameters. The method generally improves accuracy while reducing T2T edit intensity, mitigating failure modes such as final-digit transcription errors after otherwise correct reasoning and excessive self-correction before short factual answers.

12.
arXiv (CS.CL) 2026-06-17

Unintended Effects of Geographic Conditioning in Large Language Models

Modern conversational AI systems frequently rely on user metadata to localize responses, yet the unintended regional biases introduced by this hidden context remain poorly understood. In this work, we evaluate location leakage: the phenomenon where a model generates geographic references despite receiving a geographically neutral user prompt. Across both creative writing and open-ended Q&A prompts, even state-of-the-art LLMs systematically favor region-specific outputs when exposed to location metadata, with leakage spiking by up to 793 times above baseline (e.g., from 0.04% to 31.7% for Llama 3.1-8B, and 21.3% and 8.8% for Qwen3-8B and Claude Sonnet 4.6, respectively). Our analysis further shows a novel structural conditioning effect: replacing the injected location with the placeholder "Unknown" still elevates leakage by up to 72 times above baseline, demonstrating that the user profile frame itself, independent of any geographic content, acts as a generative conditioning signal.

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

GOT-JEPA: Generic Object Tracking with Model Adaptation and Occlusion Handling using Joint-Embedding Predictive Architecture

The human visual system tracks objects by integrating current observations with previously observed information, adapting to target and scene changes, and reasoning about occlusion at fine granularity. In contrast, recent generic object trackers are often optimized for training targets, which limits robustness and generalization in unseen scenarios, and their occlusion reasoning remains coarse, lacking detailed modeling of occlusion patterns. To address these limitations in generalization and occlusion perception, we propose GOT-JEPA, a model-predictive pretraining framework that extends JEPA from predicting image features to predicting tracking models. Given identical historical information, a teacher predictor generates pseudo-tracking models from a clean current frame, and a student predictor learns to predict the same pseudo-tracking models from a corrupted version of the current frame. This design provides stable pseudo supervision and explicitly trains the predictor to produce reliable tracking models under occlusions, distractors, and other adverse observations, improving generalization to dynamic environments. Building on GOT-JEPA, we further propose OccuSolver to enhance occlusion perception for object tracking. OccuSolver adapts a point-centric point tracker for object-aware visibility estimation and detailed occlusion-pattern capture. Conditioned on object priors iteratively generated by the tracker, OccuSolver incrementally refines visibility states, strengthens occlusion handling, and produces higher-quality reference labels that progressively improve subsequent model predictions. Extensive evaluations on seven benchmarks show that our method effectively enhances tracker generalization and robustness.

14.
arXiv (CS.AI) 2026-06-12

The KG-ER Conceptual Schema Language

arXiv:2508.02548v3 Announce Type: replace-cross Abstract: We propose KG-ER, a conceptual schema language for knowledge graphs that describes the structure of knowledge graphs independently of their representation (relational databases, property graphs, RDF) while helping to capture the semantics of the information stored in a knowledge graph.

15.
arXiv (CS.CV) 2026-06-12

Augmentation techniques for video surveillance in the visible and thermal spectral range

In intelligent video surveillance, cameras record image sequences during day and night. Commonly, this demands different sensors. To achieve a better performance it is not unusual to combine them. We focus on the case that a long-wave infrared camera records continuously and in addition to this, another camera records in the visible spectral range during daytime and an intelligent algorithm supervises the picked up imagery. More accurate, our task is multispectral CNN-based object detection. At first glance, images originating from the visible spectral range differ between thermal infrared ones in the presence of color and distinct texture information on the one hand and in not containing information about thermal radiation that emits from objects on the other hand. Although color can provide valuable information for classification tasks, effects such as varying illumination and specialties of different sensors still represent significant problems. Anyway, obtaining sufficient and practical thermal infrared datasets for training a deep neural network poses still a challenge. That is the reason why training with the help of data from the visible spectral range could be advantageous, particularly if the data, which has to be evaluated contains both visible and infrared data. However, there is no clear evidence of how strongly variations in thermal radiation, shape, or color information influence classification accuracy. To gain deeper insight into how Convolutional Neural Networks make decisions and what they learn from different sensor input data, we investigate the suitability and robustness of different augmentation techniques...

16.
Nature (Science) 2026-06-09

People are turning to AI chatbots to plug gaps in health information

A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies. A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies.

17.
arXiv (CS.CL) 2026-06-12

Epistemic Constitutionalism Or: how to avoid coherence bias

作者:

Large language models increasingly function as artificial reasoners: they evaluate arguments, assign credibility, and express confidence. Yet their belief-forming behavior is governed by implicit, uninspected epistemic policies. This paper argues for an epistemic constitution for AI: explicit, contestable meta-norms that regulate how systems form and express beliefs. Source attribution bias provides the motivating case: I show that frontier models enforce identity-stance coherence, penalizing arguments attributed to sources whose expected ideological position conflicts with the argument's content. When models detect systematic testing, these effects collapse, revealing that systems treat source-sensitivity as bias to suppress rather than as a capacity to execute well. I distinguish two constitutional approaches: the Platonic, which mandates formal correctness and default source-independence from a privileged standpoint, and the Liberal, which refuses such privilege, specifying procedural norms that protect conditions for collective inquiry while allowing principled source-attending grounded in epistemic vigilance. I argue for the Liberal approach, sketch a constitutional core of eight principles and four orientations, and propose that AI epistemic governance requires the same explicit, contestable structure we now expect for AI ethics.

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

A Neuro-Symbolic Approach to Strategy Synthesis for Strategic Logics

arXiv:2606.17962v1 Announce Type: cross Abstract: Reasoning about what agents can achieve through strategic interaction is a core challenge in Multi-Agent Systems (MAS). Logics for strategic ability, such as ATL, provide rigorous methods, but their adoption is often hindered by the computational cost of strategy synthesis. We introduce a neuro-symbolic framework that integrates large language models (LLMs) into the model-checking pipeline for MAS. The LLM acts as a strategy-generation oracle, proposing candidate strategies that are then formally validated by a standard MAS model checker. This generate-and-certify architecture uses LLM guidance to navigate large combinatorial strategy spaces while preserving formal soundness: generated strategies are accepted only when certified by the verifier. We instantiate the framework for bounded strategic reasoning in NatATL and introduce the first NatATL strategy-synthesis dataset, consisting of 4211 instances. Experiments with an open-weight Qwen3-32B model show that our certified pipeline achieves 92\% accuracy on strategy-synthesis outcomes.

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

Time-spectral control of accidental coincidences in daylight entanglement-based free-space QKD

arXiv:2606.17365v1 Announce Type: new Abstract: Daylight entanglement-based free-space quantum key distribution (QKD) is limited by accidental coincidences from receiver-admitted background light. We develop and experimentally validate a receiver-level framework linking receiver bandwidth, accepted temporal width, and background-noise density to Bob singles, sifted-key rate, error rate, and quantum bit error rate (QBER) in telecom-wavelength BBM92 QKD. Indoor sweeps show that useful sifted counts saturate near the source-matched bandwidth, whereas broader bandwidth or higher background mainly increases accidental contamination. Increasing the accepted temporal width leaves Bob singles nearly unchanged but directly raises QBER by enlarging the random-overlap probability. A two-dimensional design map shows that the temporal-window margin contracts rapidly with increasing background-to-signal ratio, while the bandwidth margin remains comparatively broad near source-matched filtering. A 10 m rooftop daylight experiment demonstrates operation in the predicted low-accidental regime, yielding a mean sifted-key rate of 2,811 cps and a mean QBER of 4.43%.

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

Multi-Turn Reflective Masking Elicits Reasoning in Mask Diffusion Models

While reasoning on autoregressive (AR) models is often performed by chain-of-thought reasoning and reflection, their refinement of previous outputs still relies on fully sequential generation, even when only local edits are needed. In contrast, the masking mechanism in Mask Diffusion Models (MDMs) naturally supports explicit local edits on previous outputs, allowing selective refinement without discarding previous answers and generating another from scratch. While this property more closely aligns with how humans correct mistakes by iterative local refinement, existing MDMs do not support multi-turn masking and denoising. We propose Reflective Masking (RM), which elicits such an intrinsic reasoning capability in MDMs via lightweight post-training. RM provides a native test-time scaling, where an MDM iteratively revisits and revises its prior outputs based on evolving context. To exploit insights from previous turns like AR reasoning, we further introduce History Reference, a parameter-free mechanism that leverages intermediate denoising states during revision. Our approach requires no architectural changes and is easily applicable to existing MDMs. Across diverse tasks and modalities, including text generation, Sudoku, and image editing, Reflective Masking consistently outperforms standard masking-based baselines and demonstrates strong generality, positioning RM as a fundamental primitive for reasoning on MDMs.

21.
arXiv (CS.AI) 2026-06-19

Repurposing a Speech Classifier for Guided Diffusion-Based Speech Generation

arXiv:2606.20457v1 Announce Type: cross Abstract: Classifier guidance is a way to control diffusion generation by using a noise-conditioned classifier to steer the sampling process toward a target class. One drawback of classifier guidance is that it requires two separately trained models: a classifier and a diffusion model. We therefore study a more compact alternative in which a conventionally trained speech classifier is repurposed as the backbone for diffusion generation. Starting from a frozen noise-conditioned classifier in log-Mel space, we attach a lightweight subnetwork that reuses intermediate classifier representations and train only this subnetwork under a Denoising Score Matching objective. Our work shows that a pretrained classifier can be repurposed for conditional generation, providing an appealing bridge between discriminative modeling and conditional speech synthesis resulting in high speech quality within a single-backbone model, with reduced memory footprint and computational cost.

22.
arXiv (CS.AI) 2026-06-15

Hybrid Open-Ended Tri-Evolution Makes Better Deep Researcher

arXiv:2606.13710v1 Announce Type: new Abstract: Deep research and agent evolution serve as de-facto tasks for AI agents in real-world applications toward artificial general intelligence. The former enables autonomous retrieval and integration of information in open-ended environments to tackle open-ended research tasks, yet it is constrained by the static parametric deep research capabilities of agent systems. The latter allows agents to autonomously interact with the environment to gain experiences that evolve model capabilities. However, its effectiveness has been widely validated only on verifiable tasks with standard answers, leaving a gap with open-ended research tasks. To bridge these two critical tasks, we propose the Hybrid Open-Ended Tri-Evolution (HOTE) framework, which leverages hybrid-mode reinforcement learning to facilitate the collaborative evolution of a proposer, solver and judge based on web-scale knowledge, moving toward autonomous evolving agents in open-ended tasks and environments. Extensive experiments on three long-form deep research benchmarks demonstrate that the 8B model trained via HOTE surpasses the strongest static open 8-32B models as well as those trained by state-of-the-art deep research training methods with less time overhead, and further verify that the evolution of all three modules in HOTE is indispensable.

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

Deep Residual Injection for Full-Spectrum Forensic Signal Perception in Multimodal Large Language Models

Multimodal large language models (MLLMs) have been increasingly adopted in forensics for their robust semantic understanding. As AI-generated images become realistic, semantic-level inconsistencies alone are often insufficient for reliable detection. This motivates a critical question: whether MLLMs can achieve full-spectrum forensic signal perception, i.e., capturing low-level generator artifacts without sacrificing pre-trained semantic knowledge. We further perform a layer-wise analysis of forensic signal perception in MLLMs, showing that semantic information is primarily formed in the early-to-middle layers, whereas direct fine-tuning for artifact learning disrupts these semantic representations. Based on this insight, we propose Deep Visual Residual MLLM (Deep-VRM) to preserve early semantic processing while injecting artifact-specific visual signals as a residual path into an intermediate layer, where they are fused with semantic token representations and propagated through subsequent trainable layers. This enables later layers to jointly model semantic reasoning and signal-level forensic cues, and surprisingly, the model learns to adaptively leverage different levels of forensic signals depending on the input, achieving robust and generalizable detection performance. Extensive experiments show that our method achieves state-of-the-art across most benchmarks. The code and data are available at https://github.com/KQL11/Deep-VRM.

25.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.