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01.
arXiv (CS.CV) 2026-06-19

SSD: Spatially Speculative Decoding Accelerates Autoregressive Image Generation

Autoregressive models excel in visual generation by treating images as 1D sequences of discrete tokens, mirroring language modeling. However, this flattening discards the intrinsic 2D spatial locality of visual signals, creating severe computational bottlenecks during inference. We introduce Spatially Speculative Decoding (SSD), a framework that aligns the predictive objective with the natural geometry of images. Rather than predicting only the immediate next token in a 1D sequence, our model simultaneously predicts the adjacent horizontal token and the token directly below it. By capitalizing on this 2D spatial correlation, spatially speculative decoding overcomes the memory wall in visual inference. Our approach accelerates autoregressive image generation by up to 13.3x while maintaining high fidelity on DPG-Bench and GenEval. Our results suggest that respecting the underlying geometry of vision unlocks massive computational efficiencies, paving the way for real-time, high-resolution autoregressive generative models.

02.
arXiv (quant-ph) 2026-06-16

No Universal Purification in Quantum Mechanics

arXiv:2509.21111v2 Announce Type: replace Abstract: Many central tasks in fundamental physics and quantum information processing are possible only insofar as mixed quantum states can be made purer. In this work, we prove that the linearity and positivity of quantum mechanics impose general restrictions on quantum purification, unveiling a new fundamental principle of quantum information processing. We first establish that no quantum operation can transform a finite number of copies of an unknown quantum state or channel into an exactly pure output that depends non-trivially on the input, thereby ruling out an important form of universal purification in both static and dynamical settings. Building on this, we show that, upon relaxing the requirement of exact purity, one can establish quantitative sample-complexity lower bounds for approximate purification that hold for arbitrary physically allowed strategies, whose scaling matches the performance of purification-related tasks across several different areas of quantum information processing. Moreover, this lower bound leads to a generalized standard quantum limit for learning arbitrary functions of a quantum state, greatly extending earlier results based on quantum Fisher information and revealing a deep connection between purification and quantum learning. Extending this principle to other important settings, we establish, for the first time, an exponential sample-complexity lower bound for approximate pure dilation state preparation and a no-go theorem for approximate bosonic Gaussian state purification with passive Gaussian operations, establishing much more stringent limitations under practical operational constraints.

03.
arXiv (math.PR) 2026-06-19

The t-Split Two-Periodic Aztec Diamond Model

arXiv:2606.19507v1 Announce Type: new Abstract: In this work we consider an Aztec diamond model split into two unequal regions which are asymptotically fixed in size. Each region is weighted with a distinct two-periodic weighting. We refer to this model as the t-split two-periodic Aztec diamond, to signify its difference from the previous work title Split Two-Periodic Aztec Diamond, where the model was split into two equal regions. We derive an integral expression for the correlation kernel of the model and give a partial description of the scaling limit behavior, along with a conjecture for the remainder. We refer to the larger and smaller sides of the model as the dominant and non-dominant sides, and to the location of the weight change as the interface. The dominant side exhibits a limit shape that depends only on its own weighting and is identical to that of the two-periodic Aztec diamond, while the non-dominant side appears to have a novel limit shape that depends on both weightings and the location of the interface. Lastly, we consider the complete limit shape in the case where the dominant side two-periodic parameter goes to 0.

04.
arXiv (CS.LG) 2026-06-12

From Parameters to Feature Space: Task Arithmetic for Backdoor Mitigation in Model Merging

arXiv:2606.12498v1 Announce Type: cross Abstract: Model merging (MM) has gained significant attention as a cost-effective approach to integrate multiple task-specific models into a unified model. However, recent work reveals that MM is highly susceptible to backdoor attacks. Existing defenses based on task arithmetic often fail to eliminate backdoors without substantially degrading clean-task performance, owing to their reliance on direct parameter-space editing. To address this gap, we propose Linear Feature Path Minimization (LFPM), a backdoor mitigation framework for model merging, which introduces an anti-backdoor task vector into the backdoored merged model. Unlike prior approaches, LFPM formulates the backdoor robustness of the merged model from a unified feature-space perspective under the Cross-Task Linearity (CTL) framework, which leverages the approximate linearity of features across tasks. This perspective guides the optimization of the anti-backdoor task to suppress backdoors while preserving clean-task performance. Furthermore, we introduce an effective optimization mechanism based on gradient accumulation and loss path-integral, ensuring robust backdoor suppression along the interpolation path. Extensive experiments demonstrate that LFPM consistently exhibits strong robustness against backdoor attacks in both full fine-tuning and Parameter-Efficient Fine-Tuning (PEFT) settings.

05.
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.

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

Tree-Structured Orthonormal Decomposition of the Aitchison Simplex

arXiv:2606.11646v1 Announce Type: new Abstract: Compositional data – vectors encoding relative proportions – arise across scientific domains, including ecology, geochemistry, and genomics. The features in these data often come with known hierarchical structure (e.g., taxonomies, phylogenies, ontologies), yet existing methods either ignore this structure, discard the intrinsic Aitchison geometry, are designed for binary trees, or yield incomplete coordinate systems. We describe PolyILR, a canonical orthonormal decomposition of the Aitchison tangent space aligned with any tree topology. Our construction defines a weighted local geometry at each internal node capturing full branching structure, then lifts these to a global orthonormal basis where every coordinate corresponds to a specific tree location. On microbiome and single-cell benchmarks, PolyILR yields stable, interpretable features and enables inference at multiscale tree resolution. We also establish a novel theoretical connection to softmax classifiers, suggesting possible applications to probabilistic modeling.

07.
arXiv (CS.CV) 2026-06-15

Point Cloud Upsampling through Patch-based Frequency Superposition

In recent years, neural networks have become the dominant models in most point cloud upsampling methods. Although these approaches are achieving good results, they do have drawbacks, such as a lack of interpretability and data dependency. Moreover, they have to be trained on a dataset that is similar to the test data in order to perform well. To avoid these disadvantages, we propose Point Cloud Upsampling through Patch-based Frequency Superposition (PUtPFS), an optimization-based approach that selects subsets of points and estimates the surface of this set through superpositioning spatial frequencies. Then, new points are placed on this surface. By successively selecting points in the least dense regions of the point cloud, a uniform upsampling can be reached. With this method, we surpass the current best upsampling results in the commonly considered point-to-surface distance. Furthermore, we achieve the best Chamfer and Hausdorff distance among the optimization-based approaches. As an additional advantage, our method does not need any training data and is mathematically interpretable.

08.
arXiv (CS.LG) 2026-06-17

RadSEM: A Finding-by-Finding Metric for Clinical Consistency in Radiology Reports

arXiv:2606.17062v1 Announce Type: cross Abstract: Radiology report evaluation must distinguish clinical compatibility from surface similarity, because negation, laterality, or normal-abnormal polarity can reverse a finding. We propose RadSEM (Radiology Sentence-Level Evaluation Metric), a constrained LLM-assisted metric for reference-based evaluation of radiology Findings. RadSEM rewrites reference and generated reports into ordered atomic finding sentences, each expressing one site-finding proposition. It then performs contradiction-constrained many-to-many matching: incompatible pairs such as "effusion" and "no effusion" receive no credit, while compatible granularity differences can receive partial credit. A deterministic stage weights pairs by part-whole and abnormal-detail relationships, counts unmatched findings, and produces an abnormal-focused weighted F1 score. Thus, the LLM supports structured rewriting and local alignment rather than acting as an opaque judge. We evaluate RadSEM with SSREE, a controlled monotonicity stress test built from 2,448 de-identified reports expanded into five graded corruption levels. RadSEM achieves Kendall tau_b of 0.957, all-pairs concordance of 97.8%, adjacent concordance of 95.0%, and strict five-level ordering for 81.9% of reports, outperforming radiology-specific and general text metrics while avoiding the failure in which polarity-inverted reports regain lexical overlap. On the same SSREE set, RadSEM outperforms the Ref-anchored RadSEM-Alt policy, improving adjacent concordance from 90.7% to 95.0% and strict ordering from 67.2% to 81.9%. On a 599-triplet synonym/antonym subset, RadSEM prefers synonyms in 597 cases (99.67%). These results suggest that explicit finding units, contradiction-aware matching, and abnormal-focused deterministic scoring make report scoring more interpretable and sensitive to clinically meaningful errors. Code is available at https://github.com/jdh-algo/RadSEM.

09.
arXiv (CS.AI) 2026-06-18

Maturing Markov Decision Processes: Decision Making under Increasing Information and Shrinking Action Sets

arXiv:2606.18820v1 Announce Type: cross Abstract: Sequential decision problems often exhibit an asymmetric evolution of information and decision flexibility: as a decision cycle unfolds, the agent receives richer information while feasible actions expire due to operational cutoffs, commitments, or resource constraints. Standard MDP formulations typically flatten this structure into stage-dependent state descriptions and action masks, thereby obscuring the nested information–action asymmetry that determines which decisions are urgent and which can be deferred. We introduce Maturing Markov Decision Processes (MMDPs), a formulation built around this information–action asymmetry. We characterize one of its key consequences through an expiring-action priority principle, which identifies the actions that must be resolved before the next stage. Motivated by this structure, we develop a structure-aware reinforcement learning framework with stage-aware policy design, expiring-action abstraction, and search-augmented learning with distillation. Experiments on a controlled multi-supplier replenishment problem, simplified cash-management environments of increasing complexity, and a production-scale simulator show that explicitly modeling this asymmetry improves learning efficiency and becomes increasingly valuable as decision problems scale.

10.
arXiv (CS.AI) 2026-06-19

Multi-LCB: Extending LiveCodeBench to Multiple Programming Languages

arXiv:2606.20517v1 Announce Type: new Abstract: LiveCodeBench (LCB) has recently become a widely adopted benchmark for evaluating large language models (LLMs) on code-generation tasks. By curating competitive programming problems, constantly adding fresh problems to the set, and filtering them by release dates, LCB provides contamination-aware evaluation and offers a holistic view of coding capability. However, LCB remains restricted to Python, leaving open the question of whether LLMs can generalize across the diverse programming languages required in real-world software engineering. We introduce Multi-LCB, a benchmark for evaluating LLMs across twelve programming languages, including Python. Multi-LCB transforms Python tasks from the LCB dataset into equivalent tasks in other languages while preserving LCB's contamination controls and evaluation protocol. Because it is fully compatible with the original LCB format, Multi-LCB will automatically track future LCB updates, enabling systematic assessment of cross-language code generation competence and requiring models to sustain performance well beyond Python. We evaluated 24 LLMs for instruction and reasoning on Multi-LCB, uncovering evidence of Python overfitting, language-specific contamination, and substantial disparities in multilingual performance. Our results establish Multi-LCB as a rigorous new benchmark for multi-programming-language code evaluation, directly addressing LCB's primary limitation and exposing critical gaps in current LLM capabilities.

12.
arXiv (CS.CL) 2026-06-11

BaltiVoice: A Speech Corpus and Fine-tuned Whisper ASR System for the Balti Language

作者:

We present BaltiVoice, a 16.8-hour read-speech corpus for Balti (ISO 639-3: bft), a Tibetic language spoken in Gilgit-Baltistan, Pakistan, with no prior publicly available ASR resources. The corpus contains 10,060 validated utterances in native Nastaliq script, derived from Mozilla Common Voice recordings. Fine-tuning OpenAI Whisper-small yields a Word Error Rate (WER) of 26.74% and a Character Error Rate (CER) of 8.67% on a 538-utterance speaker-disjoint validation set, down from a zero-shot baseline of 159.19% WER and 152.52% CER. A Whisper-base fine-tuned on the same data achieves 44.54% WER and 15.61% CER, confirming that model capacity matters for this low-resource setting. The dataset, fine-tuned model, and a live transcription demo are publicly available on HuggingFace.

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

ASyMOB: Algebraic Symbolic Mathematical Operations Benchmark

Large language models (LLMs) are increasingly applied to symbolic mathematics, yet existing evaluations often conflate pattern memorization with genuine reasoning. To address this gap, we present ASyMOB, a high-resolution dataset of 35,368 validated symbolic math problems spanning integration, limits, differential equations, series, and hypergeometrics. Unlike prior benchmarks, ASyMOB systematically perturbs each seed problem using symbolic, numeric, and equivalence-preserving transformations, enabling a fine-grained assessment of generalization. Our evaluation reveals three key findings: (1) most models' performance collapses under minor perturbations, while top systems exhibit an apparent regime shift in robustness; (2) integrated code tools stabilize performance, particularly for weaker models; and (3) we identify examples where Computer Algebra Systems (CAS) fail while LLMs succeed, as well as problems solved only via a hybrid LLM-CAS approach, highlighting a promising integration frontier. ASyMOB serves as a principled diagnostic tool for measuring and accelerating progress toward building verifiable, trustworthy AI for scientific discovery.

14.
arXiv (math.PR) 2026-06-17

Optional Stopping for Superhedging Supermartingales

arXiv:2606.17452v1 Announce Type: new Abstract: Superhedging supermartingales, introduced by the authors in previous work, are non-probabilistic processes defined via subadditive outer integrals that carry a purely financial interpretation in terms of superhedging cost. Building on the Leinert-König theory of non-lattice integration, the present paper establishes several results that are classical in probability theory but whose non-probabilistic proofs require fundamentally new arguments: (i) a tower inequality for the conditional outer integral \overline{\sigma}_j applied at stopping times, reducing to equality when the integrand is conditionally integrable; (ii) three versions of Doob's optional stopping theorem, organised by the class of supermartingale and the range of the stopping times; and (iii) Dubins' upcrossing inequality in both finite- and infinite-time horizons. A key structural result, property (K)-a.e., identifies conditions under which the two superhedging operators \overline{\sigma}_j and \overline{I}_j coincide on non-negative functions, extending the scope of all preceding results to the positive operator \overline{I}_j. None of the proofs invoke classical measure-theoretic tools; in particular, (classical) integrability and measurability are not assumed. The analogues of classical stochastic results acquire a purely financial interpretation and, in this way, gain depth and generality by providing a context that is independent of any a priori probabilistic structure.

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

ClaimFlow: Tracing the Evolution of Scientific Claims in NLP

Scientific papers advance $claims$ that later work supports, extends, or sometimes refutes. Yet existing methods for citation and claim analysis capture only fragments of this dialogue. In this work, we make these interactions explicit at the level of individual scientific claims. We introduce $\texttt{ClaimFlow}$, a claim-centric view of the NLP literature, built from $1{,}617$ ACL Anthology papers $(1979 - 2025)$ that are manually annotated with $5{,}689$ claims and $4{,}871$ cross-paper claim relations, indicating whether a citing paper $\texttt{supports}$, $\texttt{extends}$, $\texttt{qualifies}$, $\texttt{refutes}$, or references a cited claim as $\texttt{background}$. Building on $\texttt{ClaimFlow}$, we define a new task – $Claim Relation Classification$ – which requires models to infer the scientific stance toward a cited claim from the text and citation context. Evaluating neural models and large language models on this task, we report baseline performance of $0.81$ macro-F1, suggesting that the task is tractable while leaving room for improvement. We then scale this framework to $\sim$$13k$ NLP papers to study claim evolution across decades of NLP research. We show that $63.5\%$ claims are never reused; only $11.1\%$ are ever challenged. Widely propagated claims are more often $reshaped$ through qualification and extension than supported or refuted. Overall, $\texttt{ClaimFlow}$ offers a lens for examining how ideas shift and mature within NLP.

16.
arXiv (CS.AI) 2026-06-11

AI Researchers Must Help Lead Arms Control to Mitigate Military AI Risks

arXiv:2606.11533v1 Announce Type: cross Abstract: The advancement of AI capabilities compels researchers and the public to be more aware of its potential worldwide impact. A pressing near-term concern is the regulation of military AI applications. Armament manufacturers and defense contractors are increasingly investing in AI capabilities and forging partnerships with AI companies, creating a burgeoning coalition that demands military leaders, arms control diplomacy experts, and AI researchers collaborate to ensure a safer future. While AI researchers often focus on the long-term implications of superintelligent AI, this approach may not adequately address the immediate challenges posed by AI in military applications. Success requires acknowledging and mitigating the emerging risks of frontier AI models that plan to be integrated into defense applications, like military AI systems. Arms control has reduced past catastrophic risks, so lessons learned from nuclear deterrence can guide AI safety and security research towards innovations in verification and diplomacy. AI researchers, however, must assist in leading the technical research that clearly defines and alleviates instability in military settings. Given these new responsibilities and the lack of sufficiently reliable solutions, we argue that AI researchers must take a leading role in advancing arms control research to minimize risk in military AI applications.

17.
arXiv (CS.LG) 2026-06-15

Optimal Hidden-Target Learning for Online Inventory Optimization on General Convex Sets

arXiv:2606.14679v1 Announce Type: new Abstract: Online inventory optimization (OIO) is online convex optimization with physical memory: inventory carryover makes the feasible action set depend on the past. A natural principle, used in stochastic inventory learning and recently in OIO under a single linear capacity constraint, is to maintain a hidden target chosen by an online learner and implement its projection onto the currently feasible order-up-to set. We prove that this simple principle is optimal for OIO on arbitrary bounded convex capacity sets. With online gradient descent as the base learner, the method improves the best known regret guarantee for OIO on general convex sets from inverse to inverse-square-root dependence on the common-demand probability, and we prove a matching lower bound. The same principle gives the first polylogarithmic regret guarantee for strongly convex losses and the first dynamic regret guarantee adapting to Euclidean path variation on general convex capacity sets. The analysis introduces a norm alignment principle: the right state variable is the distance from the hidden target to the feasible set, measured in the same norm as the projection. Under norm alignment, this distance evolves pathwise as a scalar queue, with target movement as arrival and common demand as service. This reduction to one-dimensional queue control resolves the state dependence and extends the guarantees to general convex capacity sets, beyond the reach of prior productwise approaches. Experiments on synthetic and real-world inventory data corroborate the theory.

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

Out-of-Distribution (OOD) Detectors for Open-Set RF Fingerprinting

arXiv:2606.12718v1 Announce Type: new Abstract: Radio-frequency (RF) fingerprinting systems must operate in open-world environments where signals from unknown transmitters and temporal drift introduce distribution shift at test time. Out-of-distribution (OOD) detection provides a natural framework for this problem, yet its application to RF fingerprinting (RFF) remains limited. A key barrier to their adoption is that most OOD detectors require auxiliary OOD data for parameter tuning, an assumption that is difficult to satisfy in RF environments where representative OOD data is impractical to collect. In this work, we introduce a promising set of OOD detection methods from the machine learning literature to open-set RFF domain. We present these methods within a unified mathematical framework based on information theory, which is a natural framework for communication systems. Our framework allows for the systematic analysis of methods and development of new methods. We further demonstrate the applicability of recent work on tuning OOD detectors without given OOD tuning data for open-set RFF. We evaluate on the POWDER RF fingerprinting dataset, showing that detectors tuned without any given OOD data achieve performance comparable to baselines with access to true OOD tuning data and greatly out-perform baseline approaches without access to true OOD tuning data, showcasing the practical viability for the RFF problem.

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

FUSE: Quantifying Uncertainty in Vision-Language Models by Bayesian Fusing Epistemic and Aleatoric Uncertainty

Vision-language models (VLMs) are playing an increasingly important role across multiple domains. In many applications, such as robotics, it is crucial to quantify the uncertainty in the output of these models. } We develop FUSE, a probabilistic framework for capturing two complementary sources of uncertainty in vision-language modeling: (i) aleatoric embedding-level uncertainty derived from input data vision-language ambiguity, and (ii) epistemic model-level uncertainty estimated from the semantic response diversity of VLMs. Our approach formulates a Bayesian fusion mechanism that analytically combines these uncertainty sources to produce a scalar measure of uncertainty. This measure can be used to reliably predict the model's output correctness for downstream applications. We demonstrate that our method outperforms baselines and achieves SOTA uncertainty calibration.

20.
medRxiv (Medicine) 2026-06-15

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

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

21.
medRxiv (Medicine) 2026-06-16

Re-evaluating the Cross-Sectional Prevalence of Severe Age-Related Hearing Loss Using Extreme Value Statistics

作者:

Standard demographic models of age-related hearing loss (presbycusis) predominantly utilize symmetric functions, such as log-normal distributions for age-binned thresholds and 4-parameter logistic curves for prevalence estimates. While these models capture early-to-moderate degradation effectively, they structurally struggle to characterize the heavy tails associated with severe clinical impairment. In this study, we present a statistical critique using a secondary analysis of the historical Medical Research Council (MRC) National Study of Hearing (1980-1986) dataset. By applying Generalized Extreme Value (GEV) distribution theory, we demonstrate that as severity increases, the underlying statistical geometry of hearing loss shifts. The asymmetric, heavy-tailed GEV distribution provides a parsimonious description of severe impairment, requiring fewer parameters than standard symmetric models. However, we explicitly acknowledge that utilizing static population data to infer progression introduces an ecological fallacy. Furthermore, the dataset's historical nature embeds unquantified generational cohort effects. We conclude that while extreme value statistics offer a compelling mathematical framework for modeling the variance of severe presbycusis, true longitudinal datasets are required to isolate physiological degradation from historical cohort variance.

22.
medRxiv (Medicine) 2026-06-22

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

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.

23.
arXiv (CS.CV) 2026-06-15

CausalMotion: Structured Physical Reasoning as Keyframe and Trajectory Guidance for Training-Free Video Generation

Recent advances in diffusion-based video generation have significantly improved visual quality and short-term temporal coherence. However, existing methods still struggle to produce videos with physically consistent and causally plausible dynamics, especially in scenarios involving long-horizon interactions. This limitation arises from the fact that video diffusion models primarily learn physical consistency implicitly, while vision-language models can directly model physical laws. Based on this idea, in this work, we propose CausalMotion, a training-free framework that injects explicit physical reasoning into video generation through structured intermediate representations. Our key idea is to decouple reasoning from generation by leveraging a vision-language model to decompose a text prompt into a sequence of causally consistent keyframes and object-centric motion trajectories. These representations are then aligned and integrated as soft constraints to guide a pretrained video diffusion model during inference. This design enables explicit modeling of object dynamics and causal transitions without requiring additional training or supervision. Extensive experiments show that our method consistently improves physical plausibility and temporal coherence, particularly in dynamics-intensive scenarios, while maintaining high perceptual video quality.

24.
arXiv (math.PR) 2026-06-12

Sticky CIR process with potential: invariant measure and exact sampling

arXiv:2605.13648v4 Announce Type: replace Abstract: We study the sticky Cox–Ingersoll–Ross (CIR) process in one dimension, a diffusion on $[0,\infty)$ with a sticky boundary condition at the origin, arising as the marginal process in a sparse Bayesian inference framework based on Hadamard–Langevin dynamics. For the parameter range $\delta\in(1,2)$, in which the origin is accessible but not absorbing, we prove well-posedness of the process and uniqueness of its invariant measure, which is a mixture of a point mass at zero and a weighted gamma-type density on the interior. We derive an explicit Green's function for the resolvent in terms of confluent hypergeometric functions, and use this to construct an exact sampler for the invariant measure in the zero-potential case. For a non-trivial potential $G$, we establish existence and uniqueness of the tilted invariant measure via a Girsanov change of measure, and develop two sampling algorithms: a Metropolis–Hastings corrected sampler that targets the invariant measure exactly, and a cheaper, biased unadjusted Langevin algorithm (ULA) for a boundary-clamped variant of which we prove a first-order expansion of the stationary bias with an explicit constant: the leading error is a rank-one transfer of mass $K_\star h|\log h| $ onto the atom, so the total-variation bias is of exact order $h|\log h | $ – independent of $\delta$ – whenever the potential has nonzero boundary drift. Numerical experiments confirm the predicted behaviour: the Metropolis–Hastings sampler achieves the target invariant measure at all step sizes, while the ULA bias follows the proven first-order law, including its constant.

25.
medRxiv (Medicine) 2026-06-22

Spatial Analysis and Multilevel Determinants of Hypertension in Zambia: Analysis of the 2017 WHO STEPS Survey

Background: Hypertension is the leading modifiable cardiovascular risk factor globally, with the fastest-growing burden in low- and middle-income countries. This study aimed to estimate national hypertension prevalence, map provincial patterns, assess spatial clustering, and identify individual and community-level determinants among Zambian adults using the 2017 WHO STEPS survey. Methods: This cross-sectional study used data from the 2017 WHO STEPS survey, a nationally representative sample of 4,301 adults aged 18-69 years. Hypertension was defined as systolic BP [&ge;]140 mmHg, diastolic BP [&ge;]90 mmHg, or current antihypertensive use. Spatial autocorrelation was assessed via Moran's I and LISA. Four nested generalised linear mixed models with PSU-level random intercepts identified individual and community-level determinants. Results: Overall weighted hypertension prevalence was 24.0%. Lusaka recorded the highest prevalence (30.2%), followed by Southern (29.9%) and Muchinga (28.3%) provinces; Western Province had the lowest (12.4%). Spatial clustering was statistically significant but modest (Moran's I = 0.0247, p < 0.001). Between-cluster variation reduced from ICC = 5.9% to 1.8% in the full model, indicating geographic differences were largely explained by individual characteristics. Age was the strongest predictor; adults aged 60-69 had nearly sevenfold higher odds than those aged 18-29 (AOR 6.92, 95% CI: 4.95-9.66). Women had lower odds than men (AOR 0.64, 95% CI: 0.52-0.79). Obesity (AOR 2.34), overweight (AOR 1.65), high cholesterol (AOR 1.40), diabetes (AOR 1.35), and single marital status (AOR 1.34) were independently significant. Western Province showed consistently lower odds than Central Province (AOR 0.48). Conclusion: Hypertension affects one in four Zambian adults, driven primarily by age, sex, obesity, dyslipidaemia, and diabetes. Geographically prioritised interventions, including community health worker-led screening programmes in Lusaka and Southern Province, would maximise population-level impact. Population-level salt reduction and alcohol policies represent cost-effective complementary strategies. Longitudinal studies with finer spatial resolution are needed to clarify causal pathways underlying observed geographic clustering and inform SDG Target 3.4 progress.