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01.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

作者:
Xie↗Bian↗Yu↗He↗

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

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02.
arXiv (CS.CL) 2026-06-11

When Roleplaying, Do Models Believe What They Say?

作者:
Benjamin Sturgeon↗David Africa↗Sid Black↗

Language models can state that "the Earth orbits the Sun" and, when role-playing Aristotle, assert the opposite. Recent work argues that persona adoption is fundamental to how language models operate, with models constantly selecting the most appropriate persona for a given context. Does such role-playing merely change the model's outputs, or does it also affect what the model internally represents as truthful? We study this question with linear truth probes, applying them to LLMs role-playing historical personas whose likely beliefs differ from modern consensus. For each persona, we compare false claims the persona would likely have endorsed (*era-believed*) with topic-matched false claims they would not have endorsed (*era-false*). Across prompting, in-context learning, and supervised fine-tuning, persona induction suppresses era-believed statements less than equally false alternatives, yet they remain classified as false overall. Role-play therefore shifts what these models say more than what they internally represent as true. We contrast this with models trained on harmful advice that exhibit Emergent Misalignment (EM). Across three model families (Qwen 2.5 14B, Qwen 3 8B, and Llama 3.3 70B), their false claims move substantially toward the true region of probe space, are defended under challenge roughly half the time versus about a sixth for role-play, and are used in downstream reasoning. Role-play and Emergent Misalignment thus are points on a spectrum of belief internalization, where role-play changes what a model says with little representational change, while Emergent Misalignment shifts the internal representation of false claims without fully marking them as true.

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03.
arXiv (CS.AI) 2026-06-17

S4oP: Operator-level Pruning of Structured State Space Models for Resource-Constrained Devices

作者:
Marco Deano↗Filippo Ziche↗Nicola Bombieri↗

arXiv:2606.18096v1 Announce Type: cross Abstract: Structured State Space Models (SSMs), including the S4 and S4D architectures, have recently emerged as powerful alternatives to attention-based models for capturing long-range dependencies in sequential data. Despite their strong empirical performance, deploying these models in time- and resource-constrained settings remains challenging due to their computational and memory demands. In this paper, we propose a novel incremental, operator-level pruning approach for S4- and S4D-based models that significantly reduces inference cost while preserving predictive performance. To the best of our knowledge, this is the first work to systematically investigate structured operator pruning for SSMs. Our method progressively prunes model operators by interleaving structured masking with fine-tuning, while jointly monitoring accuracy and inference latency. We implement this approach within a unified training and evaluation framework that enables systematic exploration of efficiency-accuracy trade-offs. Experiments across multiple benchmark datasets show that pruning up to 70% of the model operators preserves the performance of the original models in most cases, while substantially reducing inference latency. These results demonstrate that structured operator pruning is an effective and previously unexplored strategy for improving the efficiency of SSMs and facilitate their deployment in practical, resource-constrained scenarios.

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

The Curse and Blessing of Mean Bias in FP4-Quantized LLM Training

作者:
Hengjie Cao↗Zhendong Huang↗Mengyi Chen↗Yifeng Yang↗Fang Dong↗Anrui Chen↗Ruijun Huang↗Xin Zhang↗Mingzhi Dong↗Yujiang Wang↗Jinlong Hou↗Qin Lv↗…

arXiv:2603.10444v2 Announce Type: replace-cross Abstract: FP4 training promises substantial memory and compute savings for large language models, but remains fragile because blockwise quantization is dictated by extreme activation magnitudes, which inflate dynamic range and compress long-tail signals. We identify a counterintuitive source of this failure: dominant activation outliers are not merely arbitrary sparse events, but are largely induced by a coherent rank-one mean bias, whose direction aligns with the leading anisotropic spectral component. This mean component strengthens during training, is amplified and reshaped by attention and FFN operators, and increasingly dominates top activation magnitudes. Crucially, this discovery reveals that a seemingly complex outlier-suppression problem admits a truly simple solution: isolate the coherent mean before quantization. We therefore propose Averis, a mean-residual splitting quantization method that separates the mean component using only reductions and elementwise subtractions before FP4 quantization. Across Qwen3 0.6B Dense trained on 100B tokens and Qwen3 7B A1.5B MoE trained on 50B tokens, Averis enables robust W4A4G4 FP4 training, reducing BF16 loss gaps to 1.19%/0.81% versus 2.05%/1.10% for NVIDIA's recently released Hadamard-based outlier-smoothing method, while limiting downstream gaps to 0.89/0.71 points. With only 2.20% end-to-end overhead over vanilla NVFP4, about 30% of NVIDIA's Hadamard-based design, Averis provides a hardware-efficient path to stable low-bit LLM training. Complementary to Hadamard, Averis further reduces the Qwen3-0.6B loss and downstream gaps to 0.94% and 0.73 points when combined. Code is available at: https://anonymous.4open.science/r/averis-504D.

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05.
Nature (Science) 2026-06-10

A 5.3-million-year-old deep-sea whale necropolis in the Diamantina Zone

作者:
Xiaotong Peng↗

Whale falls are biodiversity oases at seabeds1–6, yet their record from the oceans has remained sparse and fragmentary6,7. Here we report the discovery of a vast whale necropolis in the Diamantina Zone (4,616- to 7,001-m depth), extending about 1,200 km along the sea floor of the southeastern Indian Ocean. This area has a deep and extensive accumulation comprising five modern natural whale-fall communities and 476 fossil cetaceans recorded. We show that carcasses host specialized communities dominated by brittle stars, bone-boring worms and chemosynthesis-based bivalves and that the fossil record in this area comprises both extant and extinct deep-diving beaked whales. Isotopic dating shows that whale falls in this region have occurred since at least 5.3 million years ago. These findings reshape the understanding of the limits and biogeography of whale-fall ecosystems and establish some deep sea floors as a fossil archive for tracing cetacean evolution over geological time. Researchers uncovered an enormous deep-sea accumulation of whale remains in the southeastern Indian Ocean, showing long-term, specialized ecosystems and an extensive fossil record that offers new insight into deep-ocean biodiversity and whale evolutionary history.

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

ReFree: Towards Realistic Co-Speech Video Generation via Reward-Free RL and Multilevel Speech Guidance

作者:
Salaheldin Mohamed↗M. Hamza Mughal↗Rishabh Dabral↗Christian Theobalt↗

Speech-driven talking character animation seeks to generate life-like portrait videos that convey natural conversation behavior, aligning facial motion with spoken audio. Although recent advances in video generation have substantially improved realism in video-based animation, achieving both accurate lip articulation and expressive behavior remains challenging. Existing approaches typically trade off precise phoneme-to-lip synchronization against dynamic facial expressions and head motion, yielding animations that are either accurate yet rigid, or expressive but poorly synchronized. We address this challenge by proposing ReFree-S2V, a flow-matching speech-to-portrait animation framework that builds upon a pretrained video generation model to achieve fine-grained speech articulation and high-level expressive cues in speech-driven portrait animation. This model introduces a multi-level speech representation capturing phonetic and prosodic information at both local and global granularities. These representations are selectively injected into transformer blocks via learnable level selectors, enabling both accurate lip synchronization and natural expressive motion. To achieve natural head movements, we further introduce a novel reward-free reinforcement learning scheme into flow-matching training to discourage perceptually implausible motion without relying on handcrafted synchronization metrics or reward models, or the high cost of human preference annotation. Extensive experiments demonstrate that ReFree-S2V achieves state-of-the-art performance, significantly outperforming existing methods in both quantitative lip-sync accuracy and qualitative human evaluations of naturalness and expressivity.

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

Model soups need only one ingredient

作者:
Alireza Abdollahpoorrostam↗Nikolaos Dimitriadis↗Adam Hazimeh↗Pascal Frossard↗

arXiv:2602.09689v2 Announce Type: replace Abstract: Fine-tuning large pre-trained models on a target distribution often improves in-distribution (ID) accuracy, but at the cost of out-of-distribution (OOD) robustness as representations specialize to the fine-tuning data. Weight-space ensembling methods, such as Model Soups, mitigate this effect by averaging multiple checkpoints, but they are computationally prohibitive, requiring the training and storage of dozens of fine-tuned models. In this paper, we introduce MonoSoup, a simple, data-free, hyperparameter-free, post-hoc method that achieves a strong ID-OOD balance using only a single checkpoint. Our method applies Singular Value Decomposition (SVD) to each layer's update and decomposes it into high-energy directions that capture task-specific adaptation and low-energy directions that introduce noise but may still encode residual signals useful for robustness. MonoSoup then uses entropy-based effective rank to automatically re-weigh these components with layer-wise coefficients that account for the spectral and geometric structure of the model. Experiments on CLIP models fine-tuned on ImageNet and evaluated under natural distribution shifts, as well as on Qwen language models tested on mathematical reasoning and multiple-choice benchmarks, show that this plug-and-play approach is a practical and effective alternative to multi-checkpoint methods, retaining much of their benefits without their computational overhead.

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08.
arXiv (CS.AI) 2026-06-18

UBP2: Uncertainty-Balanced Preference Planning for Efficient Preference-based Reinforcement Learning

作者:
Mohamed Nabail↗Leo Cheng↗Jingmin Wang↗Nicholas Rhinehart↗

arXiv:2606.19328v1 Announce Type: cross Abstract: Preference-based RL provides an approach to learning reward models from pairwise comparisons of behaviors, bypassing the need for explicit reward design. However, existing methods typically rely on passive data collection and suffer from poor sample efficiency, especially during the early stages of learning. We introduce a model-based approach that actively directs exploration by jointly reasoning over uncertainties in the reward, dynamics, and value functions. Our method, Uncertainty-Balanced Preference Planning (UBP2), uses ensembles of reward, dynamics, and value function models to evaluate candidate trajectories according to a unified score that combines expected reward, terminal value, and epistemic uncertainty. Planning under this objective yields an explicit tradeoff between exploitation and information acquisition without requiring ad hoc exploration heuristics. Under standard regularity assumptions, we establish sublinear regret guarantees for both finite-horizon and infinite-horizon settings. Empirically, experiments on the Meta-World benchmark show UBP2 achieves substantially higher sample efficiency than model-free preference-based methods and non-optimistic model-based baselines.

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09.
arXiv (CS.CV) 2026-06-16

PATCH: Action-Chunk-Conditioned Latent Patch Innovation Monitoring for Robot Manipulation

作者:
Yanan Zhou↗Ranpeng Qiu↗Yincong Chen↗Jiajie Cui↗Weiming Zhi↗

Learning-based manipulation policies have made substantial progress in real-world robot manipulation, particularly for short-horizon action generation. However, deployment in open workspaces remains fragile under unexpected local scene dynamics, such as moving objects, transient occlusions, or disturbances near the intended motion. Existing runtime monitors often rely on global observation anomalies, policy uncertainty, or frame-level visual changes, and struggle to distinguish task-relevant execution risk from benign visual variation. We introduce PATCH, an action-chunk-conditioned latent patch innovation monitor for deployment-time intervention. Given the active action chunk, PATCH defines a projected execution corridor, predicts latent patch evolution inside it, and accumulates persistent residuals unexplained by the robot's own motion. These residuals form a localized intervention signal that allows PATCH-Router to pause execution, select an available recovery source, and resume the original policy once localized innovation subsides. Experiments on real robot rollout data show that PATCH produces more stable and context-relevant triggers than competing runtime monitors. Real-robot deployment further demonstrates monitor-driven intervention and policy resumption for disturbance-aware manipulation. Project Page: https://yananzhou5555.github.io/PATCH/.

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

ReproRepo: Scaling Reproducibility Audits with GitHub Repository Issues

作者:
Shanda Li↗Qiuhong Anna Wei↗Jingwu Tang↗Valerie Chen↗Nihar B Shah↗Tim Dettmers↗Yiming Yang↗Ameet Talwalkar↗

Reproducing research results from papers and released code is central to scientific progress. Existing works have introduced benchmarks to evaluate whether LLM agents can assist with reproducibility, but they are difficult to scale due to their reliance on substantial manual effort for data curation and evaluation. We introduce ReproRepo, a scalable framework for reproducibility evaluation that leverages human-raised GitHub issues as naturally occurring supervision on realistic reproduction blockers. We instantiate ReproRepo on 1,149 recent machine learning papers from major conferences and evaluate four frontier model-agent configurations. Our results show that LLM agents, even without executing code, can identify many real-world reproducibility problems from paper-repository pairs: the best agent in our study, namely Codex with GPT-5.5, surfaces at least one semantically related human-reported blocker for ~90% of papers in the study. Further analysis shows that agents are particularly effective for surfacing visible failures and identifying the right semantic region, but may still be insufficient in exact localization. ReproRepo can serve as a reusable, scalable framework for future evaluations of LLM agents on real-world reproducibility auditing. Our code is released at https://github.com/LithiumDA/ReproRepo.

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11.
medRxiv (Medicine) 2026-06-18

From Paper Letters to an Integrated Digital Workflow: Improving Efficiency, Reliability, and Engagement in Health Guidance

作者:
Kakizaki↗Hirafuji↗Araba↗Yoshida↗Aoki↗

Background: Post-checkup health guidance in Japan has traditionally relied on paper-based communication and manual administrative processes. These workflows are time-consuming, prone to transcription errors, and can delay timely engagement with health guidance recipients. Objective: To assess whether replacing a paper-based workflow with an integrated digital system using Microsoft Access, robotic process automation (RPA), and web-based responses could improve administrative efficiency, operational reliability, and engagement among health guidance recipients. Methods: This single-site quality improvement initiative redesigned the existing letter-based workflow. Access served as a central interface for managing recipients and generating guidance letters. RPA (EzRobot) automated repetitive clerical and billing-related tasks. A web form accessed via a QR code enabled recipients to respond digitally. Outcomes included manual administrative handling time per case, occurrence of transcription-related errors, health guidance completion rate, and guidance duration distribution. Results: Following implementation, staff active handling time per case decreased from approximately 10 minutes to less than 1 minute (approximately 30 seconds), while automated RPA execution typically required about 4-5 minutes per case without staff input. No transcription-related errors were detected during the post-implementation observation period. Health guidance completion rates improved from 28.3% to 39.2% (chi-square test, P=200 days decreased from 30.5% to 20.9% and cases with >=240 days decreased from 13.6% to 8.9% (R4 n=59, R5 n=158). Conclusion: An integrated Access-RPA-Web workflow was associated with improvements in administrative efficiency and operational reliability in post-checkup health guidance while retaining human verification and exception handling. This pragmatic, non-AI-dependent approach may offer a useful model for process-level improvement in preventive care settings.

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

Closing the Reflection Gap: A Free Calibration Bonus for Agentic RL

作者:
Yinglun Zhu↗

arXiv:2606.14211v1 Announce Type: new Abstract: LLMs are increasingly deployed as agents that interact with external environments and observe feedback such as execution results, error messages, and tool outputs. A well-functioning agent should be able to leverage this feedback to accurately assess its own performance. Yet we find a persistent reflection gap: LLM agents tend to mis-assess their own outputs after observing concrete environment feedback – even for questions they correctly answered – and standard RL barely helps due to a credit-assignment mismatch. To close this gap, we propose RefGRPO, a simple yet effective fix that augments standard RL algorithms with two key ingredients: a free calibration bonus computed by contrasting the agent's own reflection with the actual outcome (requiring no additional reward model, LLM judge, or external annotation), and a dynamic schedule on its coefficient. Compared to standard RL baselines, our method simultaneously improves reflection calibration (e.g., reduces underconfidence rate $44.4\% \to 7.7\%$) and task accuracy (e.g., $75.1\% \to 76.5\%$) on text-to-SQL across five benchmarks. The resulting calibrated reflection turns the agent into its own verifier grounded in environment feedback, which further enables (i) better self-improvement that uses reflections as pseudo-rewards without outcome supervision, and (ii) more effective test-time selective prediction by committing only to rollouts flagged as correct.

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13.
arXiv (CS.CV) 2026-06-12

DiskChunGS: Large-Scale 3D Gaussian SLAM Through Chunk-Based Memory Management

作者:
Casimir Feldmann↗Maximum Wilder-Smith↗Vaishakh Patil↗Michael Oechsle↗Michael Niemeyer↗Keisuke Tateno↗Marco Hutter↗

Recent advances in 3D Gaussian Splatting (3DGS) have demonstrated impressive results for novel view synthesis with real-time rendering capabilities. However, integrating 3DGS with SLAM systems faces a fundamental scalability limitation: methods are constrained by GPU memory capacity, restricting reconstruction to small-scale environments. We present DiskChunGS, a scalable 3DGS SLAM system that overcomes this bottleneck through an out-of-core approach that partitions scenes into spatial chunks and maintains only active regions in GPU memory while storing inactive areas on disk. Our architecture integrates seamlessly with existing SLAM frameworks for pose estimation and loop closure, enabling globally consistent reconstruction at scale. We validate DiskChunGS on indoor scenes (Replica, TUM-RGBD), urban driving scenarios (KITTI), and resource-constrained Nvidia Jetson platforms. Our method uniquely completes all 11 KITTI sequences without memory failures while achieving superior visual quality, demonstrating that algorithmic innovation can overcome the memory constraints that have limited previous 3DGS SLAM methods.

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14.
arXiv (CS.LG) 2026-06-19

Predicting gestational age at birth in the context of preterm birth from multi-modal fetal MRI

作者:
Diego Fajardo-Rojas↗Megan Hall↗Daniel Cromb↗Mary A. Rutherford↗Lisa Story↗Emma C. Robinson↗Jana Hutter↗

arXiv:2606.20172v1 Announce Type: new Abstract: Preterm birth is associated with significant mortality and a risk for lifelong morbidity. The complex multifactorial aetiology hampers accurate prediction and thus optimal care. A pipeline consisting of bespoke machine learning methods for data imputation, feature selection, and regression models to predict gestational age (GA) at birth was developed and evaluated from comprehensive multi-modal morphological and functional fetal MRI data from 333 control cases and 93 preterm birth cases. The GA at birth predictions were classified into term and preterm categories and their accuracy, sensitivity, and specificity were reported. An ablation study was performed to further validate the design of the pipeline. Performance was evaluated using stratified 10-fold cross-validation. The pipeline achieves an R2 score of 0.13 and a mean absolute error of 2.74 weeks. It also achieves a 0.77 accuracy, 0.59 sensitivity, and 0.82 specificity across folds. The predominant features selected by the pipeline include cervical length and statistics derived from placental T2* values. The confluence of fast, motion-robust and multi-modal fetal MRI techniques and machine learning prediction allowed the prediction of the gestation at birth. This information is essential for any pregnancy. To the best of our knowledge, preterm birth had only been addressed as a classification problem in the literature. Therefore, this work provides a proof of concept. Future work will increase the cohort size to allow for finer stratification within the preterm birth cohort. Our code is available at https://github.com/dfajardorojas/ml-for-preterm-birth-.

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15.
arXiv (quant-ph) 2026-06-16

Lattice surgery for near-term experimental logical qubit entanglement creation in planar architectures

作者:
Lukas B\"odeker↗\'Aron M\'arton↗Luis Colmenarez↗Ilya Besedin↗Andreas Wallraff↗Markus M\"uller↗

arXiv:2606.15190v1 Announce Type: new Abstract: In the era of early fault-tolerant quantum computing, basic demonstrations of entanglement operations between a few logical qubits are at the frontier of recent developments in quantum computing. In this work, we describe in detail, at both the logical and physical qubit levels, a logical teleportation protocol between two surface code logical qubits based on lattice surgery. We address several aspects of the teleportation protocol pertinent to superconducting qubit architectures. We explore the modularity constraints in the number and location of stabilizer readouts and compare variants of the teleportation protocol in this regard. Additionally, we investigate potential performance improvements related to in-sequence decision logic and the optimal size of the interface region between two surface code patches on a superconducting chip. Based on our simulations, we show possible near-term improvements in lattice surgery protocols that facilitate fault-tolerant quantum computing in superconducting circuit architectures.

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

APEX: Adaptive Principle EXtraction A Three-Layer Self-Evolution Framework for Production AI Agents

作者:
Ya-Chuan Chen↗Tien-Jen Lai↗Hsiang-Wei Hu↗

arXiv:2606.15363v1 Announce Type: new Abstract: Self-improvement in AI agents has emerged as a key research frontier: systems that modify their own prompts, workflows, and decision rules based on accumulated operational experience. The state-of-the-art Self-Harness framework [1] achieves 14–21% improvement on Terminal-Bench-2.0 by mining failure clusters and patching the agent harness. However, Self-Harness optimises only one dimension – the prompt harness – leaving behavioural principles and workflow topology unchanged. We propose APEX (Adaptive Principle EXtraction), a three-layer co-evolution framework that simultaneously evolves: (L1) the harness via failure-mode patching, (L2) behavioural principles via success-trace distillation [2], and (L3) the agent workflow topology via structural fitness-based selection [6]. We implement APEX on Joe [13], a production-grade super AI Agent built on NVIDIA Nemotron and designed as an Edge AI Agent Factory for the NVIDIA Agent Challenge 2026, managing a 15-node compute fleet using 114 real task traces collected over 18 days. APEX achieves an APEX Health Score of 0.570 (+90% vs. baseline 0.300) in a single evolutionary run, distilling 6 novel reusable principles and selecting a research-first workflow topology scoring 0.900 (+20%). Our results demonstrate that multi-dimensional co-evolution substantially outperforms single-axis harness optimisation, at a cost of only 4 LLM calls (~270 s) on a local qwen2.5-coder:32b instance.

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17.
medRxiv (Medicine) 2026-06-17

Determinants of non-utilization of insecticide-treated nets among children under five in Rwanda: analyses of the 2024 Rwanda malaria indicator survey

作者:
Eduah↗K. N↗A. O↗

Background Insecticide-treated nets (ITNs) are effective for preventing malaria among children under five years, who bear a disproportionate burden of malaria. This study assessed the prevalence and determinants of ITN non-utilization among children under five in Rwanda using data from the 2024 Rwanda Malaria Indicator Survey (RMIS).Methodology This cross-sectional study utilized nationally representative data from the 2024 RMIS. Analyses were restricted to children under five residing in households that owned at least one ITN. The outcome was non-utilization of ITN, defined as not sleeping under an ITN the night preceding the survey. Survey-weighted descriptive statistics were used to estimate the prevalence of ITN non-utilization. Factors associated with non-utilization were identified using a survey-weighted Poisson regression model. Adjusted prevalence ratios (aPRs), 95% confidence intervals and p-values were reported.Results A total of 1,979 children were included in the study. The weighted prevalence of ITN non-utilization among children under five years was 20.11% (95% CI: 17.81 - 22.63). After adjusting for other factors, children aged 2 - 3 years were associated with an 83% higher prevalence of ITN non-utilization compared with those aged [&le;]1 year (aPR = 1.83, 95% CI: 1.423 - 2.352, p < 0.001). Compared with households that owned only one ITN, children in households with three or more ITNs were associated with a 76% lower prevalence of ITN non-utilization (aPR = 0.24, 95% CI: 0.171 - 0.332, p < 0.001). Children living in households with 5 - 7 members were associated with an 87% higher prevalence of ITN non-utilization compared with those in households with 1 - 4 members (aPR = 1.87, 95% CI: 1.476 - 2.358, p < 0.001).Conclusion The findings suggest that ITN utilization among children is influenced not only by household access to nets but also by household composition and dynamics that shape the allocation and use of available preventive resources.

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

Million-scale multimodal pollen microscopy with expert-guided foundation models

作者:
Andr\'as Biricz↗Bj\"orn Gedda↗Don\'at Magyar↗Antonio Spanu↗J\'anos Fillinger↗P\'eter Pollner↗Istv\'an Csabai↗

Automated pollen identification from microscopy remains a bottleneck in aerobiology, palaeoecology and biodiversity monitoring, because scalable systems must generalise across specimen preparation, scanner settings and geographic origins while retaining palynological interpretability. To address this gap, we present a million-scale multimodal pollen microscopy resource, Pollen AI Atlas, assembled from pure-species whole-slide bright-field images spanning four geographic origins, four scanner settings and 46 taxon labels across 31 botanical families. Seeded by one manually selected exemplar per source slide, token-level mining and filtering produced 1,511,390 released grain detections with 99.6\% proposal precision in expert-curated test regions. Each detection was paired with machine-generated grain-level morphological captions from five open-weight vision-language models, guided by expert-verified palynological anchors, yielding structured descriptions of aperture systems, wall ornamentation, shape and size. Among the evaluated models, Gemma4 provided the most controlled primary caption set, combining tight length control, no leakage and the strongest text-retrieval performance. Baseline benchmarks with frozen visual features reached 88.16\% top-1 accuracy, while cross-regional retrieval showed that caption-derived text embeddings remained robust when image similarity degraded (mAP@20 0.811 versus 0.262). Released data, annotations, captions, splits, code, and weights provide a benchmark for pollen recognition, cross-regional domain adaptation and domain-specific multimodal microscopy learning.

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

Attention-Based Prototype Calibration for Multi-Rater Few-Shot Medical Image Segmentation

作者:
Truong Vu↗Minh Khoi Ho↗Yutong Xie↗

Few-shot medical image segmentation methods typically assume a single ground-truth annotation, overlooking systematic variability across expert raters commonly observed in clinical datasets. We propose an attention-based prototype calibration framework for few-shot multi-rater segmentation that models rater-specific deviations from a consensus representation in prototype space. A lightweight yet principled attention operator directly refines rater prototypes without modifying the backbone feature extractor, making the approach fully compatible with existing prototype-based few-shot segmentation methods. This design preserves semantic consistency while enabling personalized segmentation outputs with minimal computational overhead. Experiments on multi-rater medical imaging datasets demonstrate consistent improvements over baseline prototype approaches, highlighting the effectiveness of structured prototype calibration for modeling annotation variability. Our code is available at https://github.com/truong2710-cyber/JAPC.

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

Transfer Learning for FHIR Questionnaire Terminology Binding

作者:
Maxim Gorshkov↗

Electronic prior authorization workflows require FHIR Questionnaire items to carry LOINC codes, yet most items in the HL7 Da Vinci CDS-Library lack these bindings. We treat this as a retrieval problem: given a Questionnaire item's text, find the correct LOINC code in a pool of 97,314 active codes. We compare six methods (TF-IDF, frozen MiniLM, BioBERT, BioLORD, contrastively fine-tuned MiniLM, and a TF-IDF+GPT reranker) on a 54-item evaluation set spanning three query styles (natural question, medium, and terse). No single method wins on every metric. BioLORD, a frozen encoder pre-trained on biomedical ontology definitions, has the best top-rank accuracy (R@1 = 0.185, MRR = 0.246) despite seeing no task-specific data, while a contrastive fine-tune on raw LHC-Forms pairs takes R@5 (0.389) and R@10 (0.426). A distribution-shift ablation shows why the fine-tune in our main table is not the strongest one: adding GPT-generated paraphrases to the raw pairs drops R@5 from 0.389 to 0.296, so the augmented union underperforms raw-only training on every metric except R@1. Performance peaks at 5k training pairs. Error analysis on BioLORD's R@1 failures shows that wrong-specificity and ambiguous-text cases together account for 59% of errors.

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

The Hidden Cost of Approximation in Online Mirror Descent

作者:
Ofir Schlisselberg↗Uri Sherman↗Tomer Koren↗Yishay Mansour↗

arXiv:2511.22283v2 Announce Type: replace Abstract: Online mirror descent (OMD) is a fundamental algorithmic paradigm that underlies many algorithms in optimization, machine learning and sequential decision-making. The OMD iterates are defined as solutions to optimization subproblems which, oftentimes, can be solved only approximately, leading to an inexact version of the algorithm. Nonetheless, existing OMD analyses typically assume an idealized error free setting, thereby limiting our understanding of performance guarantees that should be expected in practice. In this work we initiate a systematic study into inexact OMD, and uncover an intricate relation between regularizer smoothness and robustness to approximation errors. When the regularizer is uniformly smooth, we establish a tight bound on the excess regret due to errors. Then, for barrier regularizers over the simplex and its subsets, we identify a sharp separation: negative entropy requires exponentially small errors to avoid linear regret, whereas log-barrier and Tsallis regularizers remain robust even when the errors are only polynomial. Finally, we show that when the losses are stochastic and the domain is the simplex, negative entropy regains robustness-but this property does not extend to all subsets, where exponentially small errors are again necessary to avoid suboptimal regret.

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22.
arXiv (CS.CL) 2026-06-16

LiFT: Local Search via Linear Programming for Overfitting-Controlled Transformers

作者:
Abhishek Shukla↗Anikeit Khanna↗Ankur Sinha↗Faiz Hamid↗

This paper proposes a Linear Programming (LP)-based local search framework for fine-tuning pretrained transformer models with explicit control against overfitting. The approach formulates transformer fine-tuning as a bilevel optimization-based regularization problem, in which model parameters and regularization hyperparameters are jointly updated. Information collected during initial warm-up iterations, including validation gradients and training Hessian information, is used to construct a local descent direction by solving an LP that minimizes a scaled directional derivative while preserving training optimality. This validation-aware descent direction enables focused local updates of both parameters and regularization hyperparameters, reducing overfitting without requiring repeated full retraining cycles. The resulting method, termed Linear Programming-based Fine-Tuning (LiFT) for transformers, differs from conventional fine-tuning by systematically identifying task-specific updates rather than relying on heuristic or grid-based hyperparameter selection. Experiments on GPT-2 Small fine-tuned on WikiText-2 demonstrate that LiFT enables effective adaptation through selective tuning of transformer blocks and regularization parameters, yielding consistent improvements in test perplexity across multiple layer configurations and regularization settings, with particularly pronounced gains in overfitting-prone scenarios. Beyond empirical performance, LiFT establishes a principled connection between transformer fine-tuning, bilevel optimization, local search, and regularization theory.

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23.
arXiv (CS.CL) 2026-06-16

Pretraining A Large Language Model using Distributed GPUs: A Memory-Efficient Decentralized Paradigm

作者:
Jinrui Zhang↗Chaodong Xiao↗Aoqi Wu↗Xindong Zhang↗Lei Zhang↗

Pretraining large language models (LLMs) typically requires centralized clusters with thousands of high-memory GPUs (e.g., H100/A100). Recent decentralized training methods reduce communication overhead by employing federated optimization; however, they still need to train the entire model on each node, remaining constrained by GPU memory limitations. In this work, we propose SParse Expert Synchronization (SPES), a memory-efficient decentralized framework for pretraining mixture-of-experts (MoE) LLMs. SPES trains only a subset of experts per node, substantially lowering the memory footprint. Each node updates its local experts and periodically synchronizes with other nodes, eliminating full-parameter transmission while ensuring efficient knowledge sharing. To mitigate limited per-expert data utilization under sparse expert updates, we introduce an expert-merging warm-up strategy, where experts exchange knowledge early in training, to rapidly establish foundational capabilities. With SPES, we train a 2B-parameter MoE LLM using 16 standalone 48GB GPUs over internet connections, which achieves competitive performance with centrally trained LLMs under similar computational budgets. We further demonstrate scalability by training a 7B model from scratch and a 9B model upcycled from a dense checkpoint, both of which match prior centralized baselines. Our code is available at https://github.com/zjr2000/SPES.

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24.
arXiv (CS.CV) 2026-06-17

HLS-GPT: A Generative Pretrained Transformer (GPT) for Continental-Scale NASA Harmonized Landsat and Sentinel-2 (HLS) Reflectance Reconstruction Across All Bands on Arbitrary Dates

作者:
Junjie Li↗Hankui K. Zhang↗David P. Roy↗

Recent deep learning methods for Landsat and Sentinel-2 reflectance time series reconstruction remain limited by restricted spectral coverage, limited geographic scalability, or patch-based designs with short temporal contexts. We present HLS-GPT, a large-scale generative pretrained Transformer model for reconstructing NASA Harmonized Landsat Sentinel-2 30 m surface reflectance for all bands, any date, and any pixel location. HLS-GPT uses a hierarchical Transformer architecture to handle the different spectral band configurations of Landsat and Sentinel-2 and operates on single-pixel 12-month time series. To capture geographic and seasonal variability, the model was trained with nine years of HLS time series from more than 0.25 million training pixels across the conterminous United States. A random cropping and masking strategy extracts 12-month periods with varying start dates across epochs, masks 50% of valid observations, and trains the model to reconstruct the masked reflectance values from the remaining observations. Evaluation using more than 62,000 independent test pixels shows robust reconstruction under diverse land surface conditions, including complex crop phenology and sparse, irregular observations. Leave-one-observation-out evaluation achieved reconstruction RMSE below 0.026 for all HLS spectral bands, with relative RMSE below 35% for visible bands and below 13% for other bands. Red-edge band errors were comparable to red and near-infrared errors despite the absence of red-edge bands on Landsat. Sensitivity analyses that randomly masked 10% to 90% of test observations showed only modest degradation when 10% to 50% of observations were masked, with all-band RMSE below 0.028. Image reconstruction over nine independent 109 by 109 km CONUS HLS tiles further demonstrates that HLS-GPT outperforms two conventional methods and the NASA-IBM Prithvi model.

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

Context-Aware Optimization of Follow-Up Intervals for Type 2 Diabetes Care Using Markov Decision Processes

作者:
Parisa Lotfibagha↗Kristen Miller↗William J. Gallagher↗Elizabeth B. Selden↗Muge Capan↗

arXiv:2606.19092v1 Announce Type: cross Abstract: Chronic disease management relies on regular patient-provider interactions to follow-up on disease progression and control. For Type 2 Diabetes (T2D), current guidelines prescribe fixed time intervals between subsequent primary care visits for all patients, overlooking heterogeneity in clinical trajectories and patient characteristics. This study introduces a Contextual Markov Decision Process (CMDP) model to optimize subpopulation-specific follow-up interval decisions using Electronic Health Record (EHR) data from 22,154 T2D patients across 10 primary care clinics. Contexts are identified by: i) dimensionality reduction of variables representing the individual health trajectories utilizing Principal Component Analysis, and ii) assigning patients to contexts via principal components and additional patient-level features using clustering. Two distinct contexts emerged, representing a lower- and a higher-risk subpopulation. CMDP-derived policies recommend: (i) follow-up within 1 month if lab value at current visit is unmeasured; (ii) up to 3 months for elevated lab values or recent hospitalizations; and (iii) 6 to 12 months for sustained glycemic control, with shorter follow-up intervals for patients in high-risk context. The optimal policies achieved lower expected cumulative cost than benchmarks (e.g., in the higher-comorbidity context, the CMDP policy reduced cost by about 34.8%, and in the lower-comorbidity context by about 6.4%, relative to an American Diabetes Association-like fixed interval follow-up policy. These findings demonstrate how context-aware approaches can inform adaptive follow-up strategies, and have the potential to advance chronic care management in primary care by synthesizing machine learning and probabilistic decision models.

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