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02.
medRxiv (Medicine) 2026-06-16

Adverse Childhood Experiences and Growth Outcomes in Childhood: A Longitudinal EHR-Based Study

作者:
Palmer↗Shyr↗Morley↗T. J↗Shelley↗Han↗Simmons↗J. H↗Bejan↗Walsh↗Ruderfer↗D. M↗…

Question Are adverse childhood experiences (ACEs) associated with altered growth trajectories in childhood? Findings In this cohort study of 412,549 children and adolescents, ACEs were associated with lower height throughout childhood, earlier pubertal timing, and shorter final stature. Height differences emerged approximately 2 years before ACE documentation and were greatest among those with earlier documentation. Meaning These findings suggest that early adversity affects physical growth in children and may serve as a measurable indicator of the biological consequences of early-life stress, especially in those with documentation of ACEs prior to the onset of typical pubertal growth. Importance Adverse childhood experiences (ACEs) are among the strongest risk factors for long-term mental and physical health complications, yet their impact on physical growth in childhood remains incompletely understood. Objective To determine the association of ACEs on childhood growth trajectories and growth dynamics. Design, Setting and Participants Retrospective cohort study using longitudinal electronic health record data. Data was collected from participants between February 1999 and August 2025. A large academic medical center biobank linked to deidentified electronic health records in the southeastern United States. A total of 412,549 individuals with at least 2 recorded height measurements between the ages of 2 and 20 were included in the primary analysis. Growth curve analyses were performed in a subset of 199,844 individuals with at least 3 height measurements spanning at least 2 years. Genetic analyses were performed in a subset of 10,114 individuals of primarily European ancestry. Exposure(s) Documented exposure to adverse childhood experiences before age 18 years identified through a natural language processing algorithm. Main Outcome(s) and Measure(s) Height-for-age z-scores across childhood, final attained height, and growth curve parameters estimated using SuperImposition by Translation and Rotation (SITAR) modeling. Results Among 412,549 participants, 18,502 (4.5%) had clinically documented ACEs during childhood. ACE documentation was associated with lower height-for-age z-scores throughout childhood and adolescence. Final attained height was significantly lower among ACE-documented individuals, with mean differences of -3.0 cm among males (174.0 cm vs 177.0 cm, p < 0.001) and -1.3 cm among females (161.8 cm vs 163.1 cm, p < 0.001). Height differences emerged approximately 2 years before clinical ACE documentation. Earlier age at first ACE documentation was associated with progressively shorter final attained height, with each year decrease in age at ACE documentation associated with a decrease in final height of -0.20 cm in females and -0.35 cm in males. Those with first ACE documented prior to pubertal age also showed the most pronounced growth dynamic differences, with males demonstrating a mean reduction in size of 5.25 cm (95% CI, -6.79 cm to -3.70 cm) and 1.26-year earlier pubertal timing (95% CI, -1.50 to -1.03 years), and females demonstrating a reduction in growth curve size of 3.62 cm (95% CI, -4.83 to -2.41 cm) and 1.14-year earlier pubertal timing (95% CI, -1.29 to -0.99 years). Conclusions and Relevance In this large clinical cohort, clinically documented ACEs were associated with time-dependent reductions in stature, earlier pubertal timing, and short final attained height. These findings suggest that early childhood adversity may have lasting effects on physical development and highlight growth trajectories as a potential marker of the biological consequences of early-life stress.

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03.
bioRxiv (Bioinfo) 2026-06-11

SPARK: A Systems-level Computational Framework for Reconstructing Transcriptomic State Organisation in Lung Adenocarcinoma

作者:
Kulkarni↗Sengupta↗Kumar↗

Lung adenocarcinoma (LUAD) exhibits substantial molecular heterogeneity, which complicates tumour stratification and limits the ability of mutation-centric models to capture tumour behaviour and predict patient outcomes. This study investigates whether coordinated transcriptomic programs can provide a systems-level representation of tumour states. Bulk RNA-sequencing data from the TCGA-LUAD cohort were analysed to reconstruct pathway-level transcriptomic organisation using a stability-optimised network framework (SPARK). This analysis identified eight transcriptomic modules representing coordinated biological processes active across tumours. Module activity scores were subsequently used to derive a composite Transcriptomic Risk Score through elastic-net Cox proportional hazards modelling. The resulting risk score showed a significant association with overall survival in the discovery cohort and improved prognostic discrimination beyond clinical variables. An independent evaluation in the CPTAC-LUAD cohort confirmed the prognostic signal and preserved risk stratification across patient groups. Unsupervised clustering of module activity further revealed three transcriptomic patient groups characterised by distinct biological programs, genomic alteration patterns, and survival outcomes. Single-cell analysis also demonstrated that the identified transcriptomic modules reflect coordinated organisation of the tumour-immune-stromal ecosystem across cellular compartments. Together, these findings suggest that LUAD heterogeneity can be organised into coordinated transcriptomic programs with measurable clinical relevance, providing a systems-level framework for representing tumour molecular states.

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04.
arXiv (CS.AI) 2026-06-11

Estimating Tail Risks in Language Model Output Distributions

作者:
Rico Angell↗Raghav Singhal↗Zachary Horvitz↗Zhou Yu↗Rajesh Ranganath↗Kathleen McKeown↗He He↗

arXiv:2604.22167v2 Announce Type: replace-cross Abstract: Language models are increasingly capable and are being rapidly deployed on a population-level scale. As a result, the safety of these models is increasingly high-stakes. Fortunately, advances in alignment have significantly reduced the likelihood of harmful model outputs. However, when models are queried billions of times in a day, even rare worst-case behaviors will occur. Current safety evaluations focus on capturing the distribution of inputs that yield harmful outputs. These evaluations disregard the probabilistic nature of models and their tail output behavior. To measure this tail risk, we propose a method to efficiently estimate the probability of harmful outputs for any input query. Instead of naive brute-force sampling from the target model, where harmful outputs could be rare, we operationalize importance sampling by creating unsafe versions of the target model. These unsafe versions enable sample-efficient estimation by making harmful outputs more probable. On benchmarks measuring misuse and misalignment, these estimates match brute-force Monte Carlo estimates using 10-20x fewer samples. For example, we can estimate probability of harmful outputs on the order of 10^-4 with just 500 samples. Additionally, we find that these harmfulness estimates can reveal the sensitivity of models to perturbations in model input and predict deployment risks. Our work demonstrates that accurate rare-event estimation is both critical and feasible for safety evaluations. Code is available at https://github.com/rangell/LMTailRisk

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05.
Nature (Science) 2026-06-17

Revealing competitive interfacial reactions in high-energy Li–S batteries

作者:
Shiyuan Zhou↗

Charge transfer at solid–liquid interfaces plays a critical role in various energy-storage systems1, particularly under dynamically varying reactant concentrations. Deciphering these intricate reaction pathways remains a substantial challenge, notably in lithium–sulfur (Li–S) batteries, in which achieving high energy density requires efficient conversion of highly concentrated lithium polysulfides (LiPSs)2,3. However, the mechanisms governing lithium sulfide (Li2S) deposition and dissolution under lean electrolyte conditions remain poorly understood. Here, using in situ liquid-cell electron microscopy, we directly visualize concentration-driven phase segregation at the electrode–electrolyte interface. Within these high-concentration interfacial layers (HCILs), competitive surface and solution dictate the charge-transfer dynamics and ultimately govern Li2S deposition at different phase boundaries. Density functional theory (DFT) calculations reveal that the aggregation of LiPSs alters molecular geometry, electronic properties and orbital hybridization, collectively facilitating charge transfer through highly concentrated LiPSs clusters. Guided by these insights, we design optimized electrodes that balance interfacial reaction pathways, enabling fast charging (4 C, 26.8 mA cm−2) and achieving high energy densities exceeding 400 Wh kg−1. These findings provide mechanistic understanding of interfacial reactions under practical working conditions and offer a design strategy to advance Li–S batteries. Visualization of concentration-driven phase segregation within high-concentration interfacial layers in the context of high-energy lithium–sulfur batteries using liquid-cell electrochemical transmission electron microscopy reveals competitive interfacial reactions under lean electrolyte conditions at different phase boundaries.

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06.
medRxiv (Medicine) 2026-06-11

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

作者:
Lewis↗Andrews↗Laing↗

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

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07.
arXiv (CS.LG) 2026-06-17

Learning in Matching Games with Bandit Feedback

作者:
Andreas Athanasopoulos↗Christos Dimitrakakis↗

arXiv:2506.03802v2 Announce Type: replace Abstract: We introduce a learning problem in a generalized two-sided matching market, where agents select actions to interact with their match. Specifically, we consider a setting in which matched agents engage in zero-sum games with initially unknown payoff matrices, and we investigate whether a centralized procedure can learn an equilibrium from bandit feedback. We adopt the solution concept of a matching equilibrium, where a matching \( \mathfrak{m} \) and a set of agent strategies \( X \) form an equilibrium if no agent has an incentive to deviate from \( (\mathfrak{m}, X) \). To quantify deviations of a candidate solution \( (\mathfrak{m}, X) \) from the equilibrium \( (\mathfrak{m}^\star, X^\star) \), we introduce the notion of matching instability, which serves as a regret measure for the learning problem. We propose a UCB-based algorithm in which agents form preferences and select actions according to optimistic estimates of the payoffs. Our analysis establishes a sublinear, instance-independent regret upper bound, further supported by empirical evidence.

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08.
bioRxiv (Bioinfo) 2026-06-11

AGZArank: Investigating epitope-conditioned antibody binder ranking with structure-derived synthetic supervision

作者:
Sadykov↗Khamidullina↗Sultankulov↗Seitkali↗

Computational antibody design methods can generate large libraries of candidate binders for a target epitope, but prioritizing which candidates to test experimentally remains a major bottleneck. Existing scoring approaches, including physics-based affinity estimators, structure-prediction-derived confidence measures, and inverse-folding likelihood models, provide useful proxy signals but are not explicitly optimized for early enrichment of binders among many structurally similar candidates. Here we investigate epitope-conditioned antibody binder ranking as a dedicated learning problem and introduce AGZArank, a geometric deep learning framework trained with structure-derived synthetic supervision based on normalized pseudo-energy targets. On a benchmark of 45 experimentally validated antibody-antigen interfaces, AGZArank recovered the true binder within the top ten candidates in 44.4% of cases and showed stronger generalization on post-2021 structures than ProteinMPNN, ESM-IF, and PRODIGY. Ablation experiments indicate that ranking performance depends primarily on training scale and alignment between the optimization objective and retrieval-based evaluation, rather than architectural complexity alone. These results support candidate prioritization as a distinct and tractable problem in computational antibody design.

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09.
arXiv (CS.CV) 2026-06-12

SAM-Deep-EIoU: Selective Mask Propagation for Multi-Object Tracking

作者:
Alexander Holmberg↗

Multi-object tracking has a heavy-tailed difficulty distribution: most frames are easy for a lightweight base tracker, while a small fraction are intrinsically hard. Video object segmentation (VOS) models can often preserve identity through the hard frames where the base tracker fails, but they are much more expensive in compute and memory. We propose selective mask propagation, a tracking algorithm that dispatches from a base tracker to a VOS model only on windows where an assignment-uncertainty signal fires. The base tracker's output is modified only when the VOS model makes a confident prediction that contradicts the base tracker's identity assignment; weak or inconclusive predictions preserve the base output. The method is training-free, treats both the base tracker and the VOS model as black boxes, and can benefit from replacing the VOS component with a more capable model. On DanceTrack, selective mask propagation improves three different base trackers. On SportsMOT, where identity preservation is central to sports analytics, SAM3-Deep-EIoU with global track association achieves state-of-the-art performance on the benchmark with 86.8 HOTA.

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10.
medRxiv (Medicine) 2026-06-11

Decoding the Genetic Architecture of Autistic Traits in the Aging Population

作者:
Tian↗Rao↗Sui↗Gao↗Meng↗Han↗Wang↗

Autism research has mostly focused on diagnostic frameworks in childhood. However, autistic traits including social skills, communication, attention switching, attention to detail, and imagination may also vary in many undiagnosed individuals beyond childhood, and the genetic architecture of autistic traits in undiagnosed aging adults remains poorly understood. Here, we performed an exome-wide association study of autistic traits in adults aged >=40 from the UK Biobank (n = 161,269) and independently validated key findings in the SPARK cohort (n = 142,357). We identified exome-wide significance at 17q21.31, represented by a lead variant associated with social skills (rs199533, beta = 0.081, P = 2.04e-11). In addition, we identified an independent signal for communication (rs12632110, beta = 0.042, P = 3.07e-12) and two independent signals for attention switching (rs690733, beta = 0.046, P = 4.26e-12; rs2164272, beta = -0.047, P = 1.73e-12). Gene-based analyses further implicated loss-of-function variation in ZSCAN2 (beta = 1.00, P = 2.44e-6), which was associated with communication differences. Enrichment analyses revealed preferential expression of implicated genes in the cerebral cortex, while phenotypic and neuroimaging analyses linked those variants to cortical brain structure and regional volume. Taken together, these findings delineate the genetic architecture of autistic traits in the aging population and link genetic variation to downstream molecular and neuroanatomical mechanisms.

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

Evaluating Factual Density in Multi-Source RAG: A Study in Medical AI Accuracy

作者:
Michael R. DeMarco↗

Retrieval-Augmented Generation (RAG) is the current industry standard for grounding AI in real-world facts. Traditional retrieval methods rely on keyword matching and topic proximity, ranking content based on how closely it sounds like the user's query. What they do not measure is how many verified facts the content actually contains. This structural gap, termed the Expert Blindness Effect, causes standard RAG pipelines to consistently bury high-density factual evidence in favor of lexically dominant text on the same topic. To address this gap, this paper introduces Factual Density (FD*), a novel retrieval optimization signal that measures the proportion of verified atomic claims relative to total token count. Using the NexusAgentics Ghost Audit preprocessing pipeline, raw text is scored for factual specificity using probabilistic factuality analysis to filter content before corpus ingestion. An initial formulation introduced a severe document-length confound (Pearson R = -0.8636, p = 2.27e-07). Implementing Z-score normalization within length bins resolved this bias, validating FD* as a length-independent density signal (p = 0.0749). Evaluated against the HealthFC benchmark (750 health claims labeled Supported, Refuted, or No Evidence by medical experts), FD*-optimized retrieval was the only condition to achieve 100% systematic review saturation in top-5 results, surfacing Cochrane evidence that standard cosine similarity ranked outside the top ten. Ground truth verification confirmed 25 mappings across seven HealthFC-supported claims. While full statistical validation across n=50 queries remains future work due to constraints on corpus-benchmark alignment, these findings establish factual density reranking as a low-cost, high-impact intervention for improving factual precision in health RAG architectures.

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12.
arXiv (CS.AI) 2026-06-16

Sample from What You See: Visuomotor Policy Learning via Diffusion Bridge with Observation-Embedded Stochastic Differential Equation

作者:
Zhaoyang Liu↗Mokai Pan↗Zhongyi Wang↗Kaizhen Zhu↗Haotao Lu↗Haipeng Zhang↗Jingya Wang↗Ye Shi↗

arXiv:2512.07212v3 Announce Type: replace Abstract: Imitation learning with diffusion models has advanced robotic control by capturing the multi-modal action distributions. However, existing methods typically treat observations only as high-level conditions to the denoising network, rather than integrating them into the stochastic dynamics of the diffusion process itself. As a result, the sampling is forced to begin from random noise, weakening the coupling between perception and control and often yielding suboptimal performance. We propose BridgePolicy, a generative visuomotor policy that directly integrates observations into the stochastic dynamics via a diffusion-bridge formulation. By constructing an observation-informed trajectory, BridgePolicy enables sampling to start from a rich and informative prior rather than random noise, substantially improving precision and reliability in control. A key difficulty is that diffusion bridge normally connects distributions of matched dimensionality, while robotic observations are heterogeneous and not naturally aligned with actions. To overcome this, we introduce a semantic aligner to unify the visual and state inputs and align the observations with action representations, making diffusion bridge applicable to heterogeneous robot data. Extensive experiments across 52 simulation tasks on three benchmarks and 5 real-world tasks demonstrate that BridgePolicy consistently outperforms state-of-the-art generative policies. Our code is available at https://jianghcsr.github.io/BridgePolicy_page/.

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13.
medRxiv (Medicine) 2026-06-22

Agentic Artificial Intelligence for Hospital Readmission Review: A Single-Center Blinded Evaluation and Exploratory Qualitative Analysis

作者:
Gensheimer↗M. F↗Adhikari↗Parmer-Chow↗Liu↗Ma↗Shieh↗

Background: Manual review of 30-day hospital readmissions can identify actionable quality and safety problems, but it is labor-intensive. We developed and evaluated an agentic AI workflow for evidence-grounded readmission review. Materials and methods: We studied adult patients with unplanned 30-day readmission after discharge from a medicine hospitalist service at a single academic health system. An AI agent using a large language model queried a database containing notes, encounters, procedures, laboratory results, and other clinical data, and completed the same structured readmission-review rubric used by physicians. In the primary comparative evaluation, 20 randomly selected readmissions from 2025 were each reviewed by two physicians and the AI system. Blinded physician evaluators rated review quality. After rubric refinement, the AI workflow was applied to 100 recent readmissions in an exploratory expanded-cohort analysis of recurring improvement opportunities. Results: In the primary comparative evaluation, the AI classified 9/20 readmissions (45%) as preventable, compared with 19/40 physician reviews (47.5%). Blinded overall quality ratings were similar for AI and physician reviews (4.35 vs. 4.20 on a 1-5 scale; mean difference 0.15, 95% CI -0.20 to 0.48; p=0.49), as were factuality/support and usefulness/actionability ratings. No AI hallucinations were identified during factuality review. Agreement on preventability and primary readmission category was low for both AI-human and human-human comparisons. The AI system cost $0.23 per chart; physician reviewers took a median of 15 minutes, corresponding to an estimated $42.43 per chart. In the exploratory expanded-cohort analysis, AI-assisted review identified recurring vulnerabilities in post-discharge follow-up plans, incomplete inpatient workups, medication-safety transitions, and indwelling-device transitions. Conclusions: Agentic AI produced readmission reviews with similar blinded quality ratings to physician reviews in this small single-center primary comparative evaluation and supported identification of recurring quality-improvement themes in the exploratory expanded-cohort analysis. Preventability judgments remained variable among both AI and physicians, underscoring the need for human oversight and prospective evaluation before operational use.

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14.
arXiv (CS.LG) 2026-06-16

Photon: Federated LLM Pre-Training

作者:
Lorenzo Sani↗Alex Iacob↗Zeyu Cao↗Royson Lee↗Bill Marino↗Yan Gao↗Dongqi Cai↗Zexi Li↗Wanru Zhao↗Xinchi Qiu↗Nicholas D. Lane↗

arXiv:2411.02908v2 Announce Type: replace Abstract: Scaling large language models (LLMs) demands extensive data and computing resources, which are traditionally constrained to data centers by the high-bandwidth requirements of distributed training. Low-bandwidth methods like federated learning (FL) could enable collaborative training of larger models across weakly-connected GPUs if they can effectively be used for pre-training. To achieve this, we introduce Photon, the first complete system for federated end-to-end LLM training, leveraging cross-silo FL for global-scale training with minimal communication overheads. Using Photon, we train the first federated family of decoder-only LLMs from scratch. We show that: (1) Photon can train model sizes up to 7B in a federated fashion while reaching an even better perplexity than centralized pre-training; (2) Photon model training time decreases with available compute, achieving a similar compute-time trade-off to centralized; and (3) Photon outperforms the wall-time of baseline distributed training methods by 35% via communicating 64x-512xless. Our proposal is robust to data heterogeneity and converges twice as fast as previous methods like DiLoCo. This surprising data efficiency stems from a unique approach combining small client batch sizes with extremely high learning rates, enabled by federated averaging's robustness to hyperparameters. Photon thus represents the first economical system for global internet-wide LLM pre-training.

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15.
arXiv (CS.CL) 2026-06-11

Dual-Stance Evaluation of Sycophancy: The Structure of Agreement and the Limits of Intervention

作者:
Matthew James Buchan↗

Activation steering can shift LLM behaviour, but standard evaluations do not typically test whether a sycophancy-reduction direction also suppresses agreement with factually correct statements. We introduce dual-stance evaluation, which tests both stances of each topic, and apply it to centroid-difference steering on Llama-3-8B-Instruct. We find a dissociation: the model represents sycophantic and factual agreement in geometrically distinct subspaces, yet the steering direction projects equally onto both and cannot differentially target either. The direction accordingly reduces agreement with factually correct statements (e.g. that the Earth is round) as well as sycophantic ones. All other static properties of the two activation groups are matched, suggesting the behavioural dissociation arises from generation dynamics or from finer-grained structure that residual-stream analysis cannot resolve. The pattern illustrates a general gap: representations that are readable from activations may not be writable through them.

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16.
arXiv (CS.LG) 2026-06-12

Clipping Makes Distributed and Federated Asynchronous SGD Robust to Stragglers

作者:
Samuel Erickson↗Mikael Johansson↗

arXiv:2606.13287v1 Announce Type: new Abstract: In modern machine learning, parallelization of training is an important strategy for increasing scale. Asynchronous stochastic gradient descent (ASGD), which maximizes the utilization of available hardware by avoiding waiting for slow workers. However, with constant step sizes, the convergence of ASGD is nonetheless affected negatively by slow workers due to large delays in updates. At the same time, it has been empirically observed in asynchronous training of deep learning models that gradient clipping "stabilizes" training. In this work, we provide a theoretical justification for this behavior, as we show that clipping removes the dependence of the maximum delay in the oracle complexity. We employ a sub-Weibull model of gradient noise which generalizes sub-Gaussian and sub-exponential distributions to more heavy-tailed distributions, motivated by empirical observations in deep learning. We show convergence in expectation, and the first time in asynchronous optimization, convergence with high probability.

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17.
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

作者:
Erkison Ewomazino Odih↗

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.

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18.
medRxiv (Medicine) 2026-06-22

How knowledge shapes community stigma and social support for women seeking abortion in the Democratic Republic of Congo: A cross-sectional study.

作者:
Etsou↗Kanda↗Ngwanza↗Mpoyi↗Bokamba↗Mulunda↗J.-C↗Lobo↗

Background The Democratic Republic of Congo (DRC) bears one of the highest maternal mortality ratios globally (746 per 100,000 live births), with nearly 11% of deaths attributable to complications of unsafe abortion. Despite ratification of the Maputo Protocol and related national policies, access to safe abortion remains limited, largely due to entrenched stigma. Social support, encompassing emotional, informational, and instrumental assistance, is critical in shaping womens abortion-seeking behaviors and health outcomes. This study examines the influence of community-level knowledge on stigma and social support for women seeking abortion care. Methods A cross-sectional survey was conducted from May 2024 to June 2024 among 1,715 adults in Kinshasa and North Kivu provinces. Analyses focused on a sub-sample of 574 respondents reporting familiarity with women who had undergone abortion. Structural Equation Modeling (SEM) was applied to estimate direct and indirect pathways linking community knowledge, stigma, and social support. Results Two core knowledge indicators, recognition of abortion as a safe medical procedure and awareness of legal conditions for access, were significantly associated with outcomes. A one-unit increase in knowledge corresponded to a 0.39-point increase in social support and a 0.19-point reduction in stigma. Enhanced knowledge promoted empathetic attitudes, reinforced practical support, and mitigated moralizing judgments toward women seeking abortion. Conclusions Strengthening community knowledge emerges as a strategic lever to reduce abortion-related stigma and enhance social support in the DRC. These findings underscore the importance of integrating stigma-reduction and knowledge-enhancement interventions into reproductive health programs to improve womens access to safe and dignified abortion care.

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19.
bioRxiv (Bioinfo) 2026-06-11

GermRL: Alleviating The Germline Bias In Autoregressive Antibody Language Models Through Reinforcement Learning

作者:
Ludwig↗Chungyoun↗Gray↗J. J↗

Antibodies are powerful therapeutics whose antigen specificity arises from sequence diversity shaped during development. Recently, language models trained on large antibody repertoire datasets have enabled the generation and screening of novel candidates, but these models retain a strong germline bias. As AI adoption increases in therapeutic workflows, it is crucial to develop models that harness the diversity of antibodies necessary for the discovery of mutations that encode desirable properties. Previous work explored the germline bias in masked antibody language models, yet the bias in generative autoregressive language models has not yet been addressed. Here, we present GermRL, a lightweight and modular reinforcement learning (RL) framework capable of alleviating the germline bias in pre-trained antibody autoregressive language models through group relative policy optimization (GRPO). GermRL achieves consistent one-shot generation of antibodies that satisfy specified mutation thresholds from germline while maintaining structural plausibility. Under the lowest and highest mutation thresholds tested (5 and 35 mutations from germline), GermRL scores 0.992 and 0.950 pass@1, respectively, compared to 0.398 and 0.034 for the pre-trained language model. Within GermRL, we introduce a key pair of modifications to GRPO that increase training efficiency by discouraging reward hacking under our antibody application. Furthermore, comparison of RL generated and natural antibody sequences reveals how RL based optimization can explore alternative evolutionary mutational patterns and residue compositional strategies while preserving key global properties of natural antibodies, including identifiable germline assignments, embedding-level similarity and comparable developability profiles. Thus, RL-trained generative models optimized to promote antibody mutations through diversity from germline provide a promising framework for navigating the antibody sequence landscape, enabling exploration of novel yet biologically plausible candidates for therapeutic design.

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

AIChilles: Automatically Uncovering Hidden Weaknesses in AI-Evolved Systems

作者:
Yajie Zhou↗Ao Li↗Ashwin Silla↗Zaoxing Liu↗Vyas Sekar↗

arXiv:2606.15834v1 Announce Type: new Abstract: The computer systems community has recently seen growing interest in AI-driven system evolution, where AI agents iteratively rewrite systems. Frameworks such as AdaEvolve and Engram report 12-60% score improvements over human-designed algorithms. While these results are promising, there are practical concerns if these AI-evolved programs can perform worse on unseen workloads and exhibit scalability regressions. Given the speed and scale of AI-generated code, we need automated mechanisms to uncover such identify hidden weaknesses in AI-evolved systems programs. To this end, we develop AIChilles that takes as input a baseline program $P$ and an AI-evolved program $P'$, AIChilles searches for valid workloads where $P'$ regresses relative to $P$ in correctness, runtime, memory usage, or output quality. To tackle the diversity in system applications, weakness types and potential bugs, AIChilles combines deterministic workload-parameter extraction, agent-based constraint inference, differential oracles, and code-frequency coverage to discover diverse failures. Across five system applications and 30 AI-evolved programs, AIChilles finds 49 distinct hidden weaknesses. We also show that explicitly including AIChilles in the AI-driven development lifecycle can mitigate several of these weaknesses.

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21.
arXiv (CS.CV) 2026-06-11

SDQM: Synthetic Data Quality Metric for Object Detection Dataset Evaluation

作者:
Ayush Zenith↗Arnold Zumbrun↗Neel Raut↗Jing Lin↗

The performance of machine learning models depends heavily on training data. The scarcity of large-scale, well-annotated datasets poses significant challenges in creating robust models. To address this, synthetic data generated through simulations and generative models has emerged as a promising solution, enhancing dataset diversity and improving the performance, reliability, and resilience of models. However, evaluating the quality of this generated data requires an effective metric. We introduce the Synthetic Dataset Quality Metric (SDQM) to assess data quality for object detection tasks without requiring model training to converge. This metric enables more efficient generation and selection of synthetic datasets, addressing a key challenge in resource-constrained object detection tasks. In our experiments, SDQM demonstrated a strong correlation with the mean average precision (mAP) scores of YOLO11, a leading object detection model, whereas previous metrics only exhibited moderate or weak correlations. In addition, it provides actionable insights into improving dataset quality, minimizing the need for costly iterative training. This scalable and efficient metric sets a new standard for evaluating synthetic data. The code for SDQM is available at https://github.com/ayushzenith/SDQM

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22.
arXiv (CS.CL) 2026-06-12

Agent-based models for the evolution of morphological alternation patterns

作者:
Aravinth Kulanthaivelu↗Richard Sproat↗

Why is the past of English "go" the apparently unrelated "went"? Such alternations are frequent in languages. They neither aid communication nor learnability, yet they can be persistent, surviving over centuries or millennia. We present a multi-agent simulation of the emergence of morphological stem and inflection alternations. Alternate forms arise by phonological changes or, as with "go/went", from lexical alternatives associated with a subset of the population. When an agent 'hears' another agent use a novel form for a slot in the paradigm of a word (say, the past tense of go), they will with some probability adopt that form, possibly spreading its use to other slots in the paradigm that shared the same original form. Thus alternative forms can spread through the population and become entrenched as stem or inflectional marker alternants. Unlike many previous computational studies, our system allows for naturalistic lexical forms, realistic phonological rules, lexicons with hundreds or thousands of entries, and agent populations in the tens or hundreds. It supports several network topologies, diffusion patterns and agent adoption policies. One issue with such simulations is evaluation: how realistic is the resulting morphology compared to those of real languages? We introduce the AI Historical Linguist, a novel Large Language Model-driven system that models a debate between two historical linguists. We use this to compare a set of real language morphologies, disguised morphologies, and experimentally evolved morphologies. The results suggest that among the factors that favor more plausible morphologies are scale-free social networks and random Bernoulli adoption of forms. We also present three case studies modeling attested historical changes, allowing us to test what might have happened if history had been different. All code and data are released.

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

DPC-VQA: Decoupling Quality Perception and Residual Calibration for Video Quality Assessment

作者:
Xinyue Li↗Shubo Xu↗Zhichao Zhang↗Zhaolin Cai↗Yitong Chen↗Guangtao Zhai↗

Recent multimodal large language models (MLLMs) have shown promising performance on video quality assessment (VQA) tasks. However, adapting them to new scenarios remains expensive due to large-scale retraining and costly mean opinion score (MOS) annotations. In this paper, we argue that a pretrained MLLM already provides a useful perceptual prior for VQA, and that the main challenge is to efficiently calibrate this prior to the target MOS space. Based on this insight, we propose DPC-VQA, a decoupling perception and calibration framework for video quality assessment. Specifically, DPC-VQA uses a frozen MLLM to provide a base quality estimate and perceptual prior, and employs a lightweight calibration branch to predict a residual correction for target-scenario adaptation. This design avoids costly end-to-end retraining while maintaining reliable performance with lower training and data costs. Extensive experiments on both user-generated content (UGC) and AI-generated content (AIGC) benchmarks show that DPC-VQA achieves competitive performance against representative baselines, while using less than 2% of the trainable parameters of conventional MLLM-based VQA methods and remaining effective with only 20% of MOS labels. The code will be released upon publication.

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24.
arXiv (quant-ph) 2026-06-19

Smooth time-dependent control of dipolar Bose-Einstein condensates

作者:
Chris Whitty↗Aitor Ala\~na↗Michele Modugno↗Xi Chen↗G\'eza T\'oth↗Andreas Ruschhaupt↗Eugene Ya. Sherman↗

arXiv:2606.20507v1 Announce Type: cross Abstract: We consider protocols for control of dipolar Bose-Einstein condensates where the critical role is played by the long-range anisotropic interatomic magnetic dipole-dipole interaction. The phase diagram of such a condensate has been explored theoretically and experimentally with certain values of the interatomic scattering length corresponding to superfluid and supersolid phases, where supersolidity appears as a modulation in the ground state density. Preparation of this modulated ground state is challenging, since excitations appear as a result of a finite-time evolution required to produce qualitative changes in the wavefunction density. To solve this problem we consider the time-dependent control of a dipolar Bose-Einstein condensate using shortcuts to adiabaticity techniques, concentrating on design of the time-dependent scattering length, a parameter of the system easily tunable by contemporary experiments. The first technique is the variational approach based on the Euler-Lagrange equations for a separable ansatz describing the evolution of the superfluid state. Secondly, we study the transition from superfluid to supersolid using a direct optimization protocol. We discuss the fidelity of the developed protocols in terms of the evolution time.

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25.
arXiv (CS.AI) 2026-06-17

Brep2Shape: Boundary and Shape Representation Alignment via Self-Supervised Transformers

作者:
Yuanxu Sun↗Yuezhou Ma↗Haixu Wu↗Guanyang Zeng↗Muye Chen↗Jianmin Wang↗Mingsheng Long↗

arXiv:2602.07429v2 Announce Type: replace-cross Abstract: Boundary representation (B-rep) is the industry standard for computer-aided design (CAD). While deep learning shows promise in processing B-rep models, existing methods suffer from a representation gap: continuous approaches offer analytical precision but are visually abstract, whereas discrete methods provide intuitive clarity at the expense of geometric precision. To bridge this gap, we introduce Brep2Shape, a novel self-supervised pre-training method designed to align abstract boundary representations with intuitive shape representations. Our method employs a geometry-aware task where the model learns to predict dense spatial points from parametric Bézier control points, enabling the network to better understand physical manifolds derived from abstract coefficients. To enhance this alignment, we propose a Dual Transformer backbone with parallel streams that independently encode surface and curve tokens to capture their distinct geometric properties. Moreover, the topology attention is integrated to model the interdependencies between surfaces and curves, thereby maintaining topological consistency. Experimental results demonstrate that Brep2Shape offers significant scalability, achieving state-of-the-art accuracy and faster convergence across various downstream tasks.Code is available at this repository: https://github.com/thuml/Brep2Shape.

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