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01.
medRxiv (Medicine) 2026-06-19

Rumination as a cognitive vulnerability factor in perinatal bereavement: evidence from the CARING study

Purpose. Perinatal loss is associated with a high risk of persistent psychological distress, including prolonged grief, depression, anxiety, and post-traumatic stress symptoms. Cognitive processes such as rumination may play a crucial role in maintaining and amplifying distress following loss, yet their specific contribution in perinatal bereavement remains underexplored. Methods. The CARING (Cognitive Analysis and Rumination INvestigation in perinatal Grief) study employed a cross-sectional design involving 298 parents who experienced perinatal loss within the previous five years. Participants completed an anonymous online survey including measures of depressive rumination (Ruminative Response Scale, RRS), angry rumination (Anger Rumination Scale, ARS), perinatal grief (Perinatal Grief Scale, PGS), general psychopathology (SCL-90), and post-traumatic stress symptoms (NSESSS). Non-parametric analyses were conducted to examine associations between rumination patterns and psychological outcomes. Results. Higher levels of rumination were significantly associated with greater perinatal grief, depressive and anxiety symptoms, and post-traumatic stress. Depressive rumination showed consistently stronger associations with all outcomes compared to angry rumination. Participants presenting both depressive and angry rumination exhibited the highest levels of grief intensity, psychological distress, and PTSD symptoms, suggesting a graded relationship between rumination patterns and severity of distress. Rumination levels were not significantly associated with gestational age at loss or with having received psychological support. Conclusions. Rumination, particularly in its depressive form, appears to function as a transdiagnostic cognitive vulnerability factor in perinatal bereavement. These findings highlight rumination as a potential target for early screening and tailored psychological interventions aimed at reducing long-term distress following perinatal loss.

02.
medRxiv (Medicine) 2026-06-11

Wealth-Related Inequalities in Cesarean Section Utilization Among Facility-Based Births in Bangladesh: Evidence from Public and Private Healthcare Facilities

作者:

Background Bangladesh has experienced a rapid increase in cesarean section (CS) utilization over the past two decades. While previous studies have documented socioeconomic disparities in CS use, evidence on how wealth-related inequalities differ between public and private healthcare facilities remains limited. This study assessed the magnitude and drivers of socioeconomic inequality in CS utilization among facility-based births in Bangladesh. Methods We analyzed data from 3,008 facility-based births reported in the 2022 Bangladesh Demographic and Health Survey (BDHS). Survey-weighted multivariable logistic regression was used to identify factors associated with CS utilization. Wealth-related inequality was assessed using concentration curves and the Erreygers-corrected concentration index (ECCI). Regression-based decomposition of the standard concentration index was performed to quantify the contribution of socioeconomic, demographic, and healthcare-related factors to observed inequalities overall and separately for public and private facilities. Results Overall, 71.2% of facility-based births were delivered by CS, with substantially higher prevalence in private facilities (84.2%) than in public facilities (35.9%). Women delivering in private facilities had markedly higher odds of CS than those delivering in public facilities (adjusted odds ratio [AOR]: 9.07; 95% confidence interval [CI]: 7.17-11.47). Significant pro-rich inequality was observed overall (ECCI: 0.154; 95% CI: 0.117-0.191), with inequality substantially greater in public facilities (ECCI: 0.189; 95% CI: 0.114-0.264) than in private facilities (ECCI: 0.049; 95% CI: 0.014-0.084). Decomposition analysis showed that household wealth was the dominant contributor to inequality, particularly the richest wealth quintile, accounting for 81.5% of overall inequality, 63.8% in public facilities, and 109.7% in private facilities. Conclusions Wealth-related inequalities in CS utilization remain substantial in Bangladesh despite widespread use of the procedure. Although pro-rich inequality exists across both sectors, inequality is considerably greater in public facilities and is driven by different mechanisms across facility types. Policies should simultaneously improve equitable access to medically necessary CS and reduce unnecessary procedures, particularly within the private sector.

03.
arXiv (CS.AI) 2026-06-18

Correcting Sensor-Induced Distribution Drift with Wasserstein Adversarial Learning

arXiv:2606.18561v1 Announce Type: cross Abstract: The quality of recorded data depends on the stability of the sensor system that acquires it. Sensor motion and aging can degrade the performance and stability of downstream data-driven methods. We present a Wasserstein-GAN-inspired approach for unsupervised inference of physically interpretable transformation parameters that map a changed detector response distribution back to a nominal reference distribution. In contrast to standard generative modeling, the generator is used as a learnable calibration transformation whose trainable weights represent the sought parameters, while the critic provides a distributional distance signal via the Wasserstein objective. We validate the approach on a tracking-detector toy model with controlled layer shifts and demonstrate its application on high-granularity Geant4-simulated calorimeter data with cell-wise aging effects. The method recovers aging coefficients for individual cells with correlation to ground truth and improves agreement between calibrated and reference energy-sum distributions, while exhibiting the expected degradation at increasing channel-to-channel noise levels. These results indicate that adversarial distribution matching can serve as a data-driven component of calibration strategies in settings where direct labels for degradation parameters are unavailable.

04.
arXiv (CS.CV) 2026-06-18

Reasoning as Intersection: Consensus-Frame Alignment for Visual Focus in Video-MLLMs

Reinforcement learning has improved the reasoning ability of large language models, but applying outcome-only rewards to video multimodal large language models (Video-MLLMs) provides limited guidance on which visual evidence should support the answer. Inspired by multisensory integration, where consistent cues can enhance the salience and reliability of perceptual estimates, we introduce Consensus Frame GRPO (CF-GRPO), a temporal-annotation-free process-level reward framework for evidence-aware video reasoning. CF-GRPO constructs a consensus frame prior from intrinsic video cues, including temporal coverage, scene-transition cues, and query-conditioned visual relevance. It then computes a model-side frame-use score from visual and response representations and optimizes their agreement through the Consensus Frame Reward (CFR). With salience-aware sparse aggregation and distribution sharpening, CFR provides a high-contrast reward signal without requiring human temporal annotations. Experiments show that VideoCFR achieves competitive performance across complex video reasoning benchmarks and improves several metrics over representative Video-MLLM and RL baselines, while the consensus prior provides an interpretable view of the evidence frames emphasized during training. The implementation is available at https://github.com/1Pansy/VideoCFR.

05.
arXiv (CS.CL) 2026-06-19

Your Mouse and Eyes Secretly Leak Your Preference: LLM Alignment using Implicit Feedback from Users

To align a Large Language Model (LLM), most existing methods collect explicit human feedback and train a reward model to predict the human preference based on the response text. These existing methods have two key limitations. First, the users rarely provide explicit feedback for LLM responses, which makes the high-quality preference annotation expensive to collect. Second, the methods do not leverage implicit human feedback, which has proven vital to the economic moats of Internet giants. To quantify the value of implicit feedback, we build a new dataset called IFLLM, which collects 1336 multi-turn questions from the 59 Mechanical Turk workers, their mouse trajectories, and eye gazing points to the LLMs' responses from their webcams. IFLLM shows that the users have very diverse types of gazing behavior and mouse trajectories. Our reward model based on the implicit user feedback boosts the accuracy of the text-based reward model from 55% to 64% and nearly triples the relative response quality improvements after applying the DPO to eight LLMs, demonstrating the value of implicit feedback in the wild. Our data collection website, dataset, and codes can be found at https://github.com/themehulpatwari/llm-implicit-feedback/.

06.
medRxiv (Medicine) 2026-06-10

Global and local genetic overlap among ME/CFS, irritable bowel syndrome and psychiatric traits: a hypothesis-generating analysis

作者:

Background. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and irritable bowel syndrome (IBS) frequently co-occur following infection, yet shared genetic architecture at the locus level has not been systematically characterised. Aims. To estimate global and local genetic correlations between ME/CFS (including infection-onset subgroup), IBS, major depressive disorder (MDD) and loneliness/isolation, and characterise ME/CFS cell-type heritability enrichment. Method. GWAS summary statistics: DecodeME (15,579 ME/CFS; 9,738 infection-onset), FinnGen R9 (9,296 IBS), PGC MDD Wave 2 (45,396) and UK Biobank loneliness (N=455,364). LDSC for global correlations; LAVA for local correlations across 2,495 loci; MAGMA for cell-type enrichment (Descartes Human atlas); coloc.abf for colocalisation. Results. All pairwise global correlations were significant after Bonferroni correction, including ME/CFS-all-MDD (rg=0.598, 95% CI 0.46-0.74) and ME/CFS-all-IBS (rg=0.573, 0.39-0.75). Of 4,232 local tests, 16 reached FDR

07.
arXiv (CS.CV) 2026-06-16

From Static Inference to Dynamic Interaction: A Survey of Streaming Large Language Models

Standard Large Language Models (LLMs) are predominantly designed for static inference with pre-defined inputs, which limits their applicability in dynamic, real-time scenarios. To address this gap, the streaming LLM paradigm has emerged. However, existing definitions of streaming LLMs remain fragmented, conflating streaming generation, streaming inputs, and interactive streaming architectures, while a systematic taxonomy is still lacking. This paper provides a comprehensive overview and analysis of streaming LLMs. First, we establish a unified definition of streaming LLMs based on data flow and dynamic interaction to clarify existing ambiguities. Building on this definition, we propose a systematic taxonomy of current streaming LLMs and conduct an in-depth discussion on their underlying methodologies. Furthermore, we explore the applications of streaming LLMs in real-world scenarios and outline promising research directions to support ongoing advances in streaming intelligence. We maintain a continuously updated repository of relevant papers at https://github.com/EIT-NLP/Awesome-Streaming-LLMs.

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

NoiseTilt: Noise-Tilted Reverse Kernels for Diffusion Reward Alignment

arXiv:2606.18066v1 Announce Type: new Abstract: We introduce the Noise-Tilted Reverse Kernel (NTRK), a reward-guided diffusion sampler that injects reward gradients through the noise term, leaving the pretrained reverse kernel unchanged and requiring only a single sample per step. Reward-guided sampling at inference time has greatly expanded the versatility of pretrained diffusion models. Yet existing methods face a trade-off. Gradient-based guidance shifts the reverse mean, steering generation but pushing intermediate states outside the region that the model was trained on and degrading quality. Search-based methods preserve quality but gain no gradient signal. No prior method achieves both. NTRK resolves this by keeping the reverse mean fixed and biasing the noise term toward high reward. We introduce a whitening operator, the central mechanism behind NTRK, that makes the reward gradient safe to inject as noise without losing its guiding signal. Across various reward alignment tasks, NTRK outperforms recent state-of-the-art baselines without losing sample quality. Remarkably, on aesthetic generation, NTRK surpasses the reward of the best baseline at 500 NFEs using only 25 NFEs, a 20$\times$ reduction in compute.

09.
arXiv (quant-ph) 2026-06-19

Application and quantum properties of superpositions of oppositely squeezed states

arXiv:2511.03204v2 Announce Type: replace Abstract: We show that superpositions of oppositely squeezed states – non-Gaussian Schr{\"{o}}dinger-cat-like states – exhibit enhanced nonclassical features and provide an entanglement advantage in the small-squeezing regime. These states possess photon-number structures distinct from conventional coherent-state cat states, and we analyze their Wigner functions and the entanglement generated when they are injected into a 50-50 beam splitter. As a practical application, we demonstrate that they enable a high-quality heralded single-photon source whose second-order intensity correlation function is smaller than that obtained from a pure two-mode squeezed vacuum state. We further propose a linear-optical heralding scheme that approximates these superpositions without requiring strong Kerr nonlinearities. Our results indicate that the superposition of oppositely squeezed states is a promising non-Gaussian resource for quantum information processing, particularly for single-photon generation.

10.
arXiv (CS.LG) 2026-06-12

Uncertainty Estimation for Molecular Diffusion Models

arXiv:2606.13451v1 Announce Type: new Abstract: Diffusion models have seen wide adoption for 3D molecular generation, yet they offer no principled signal of when a generated molecule is likely to be of low quality. We propose a post-hoc method for estimating per-sample uncertainty in pretrained molecular diffusion models. Building on a Laplace approximation of the denoising network, we measure the variability of the noise prediction across the generation trajectory. Empirically, we show that the resulting uncertainty score is informative of sample quality, exhibiting a negative correlation with established sample-level quality metrics. We further study how the proposed uncertainty score can be used to filter generated samples, improving model performance via test-time scaling.

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

Goal2Pixel: Grounding Goals to Pixels for Vision-Language Navigation

Vision-language models (VLMs) have become a common foundation for vision-and-language navigation in continuous environments (VLN-CE). Yet most VLM-based methods cast navigation as low-level action prediction, an interface that is ambiguous, tied to short-horizon motion primitives, and inefficient due to repeated VLM querying. We propose Goal2Pixel, a pure pixel-based paradigm that reformulates VLN-CE as navigable pixel grounding. Rather than predicting actions, Goal2Pixel uses the image plane as a unified spatial interface between VLM reasoning and robot motion: the model predicts a visible navigable pixel to the agent, which is back-projected into a 3D waypoint for forward navigation. For non-forward actions, we append auxiliary directive regions to the image plane, where the left/right/bottom regions are interpreted as turning left, turning right, and stopping, respectively. To enable long-horizon navigation, we propose a visibility-aware keyframe memory for compact and informative history representation. To adapt pretrained VLMs to navigable pixel grounding, we introduce semantic embeddings and coordinate-aware auxiliary losses. Goal2Pixel achieves competitive state-of-the-art performance while requiring fewer VLM inference calls than prior methods. On R2R-CE Val-Unseen it achieves 54.1% SR and 52.5% SPL with just 7.75 VLM calls per episode, 6x fewer than the 46.62 required by direct action prediction at 32.9% SR. The same trend holds on RxR-CE.Project Page: https://baobao0926.github.io/Goal2Pixel/.

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

Task-Aligned Stability Analysis of Vision-Language Models for Autonomous Driving Hazard Detection

Vision-language models (VLMs) are increasingly used for scene understanding in autonomous driving, but robustness analysis often relies on task-agnostic embedding stability alone. We study whether corruption-induced embedding drift predicts changes in a task-aligned hazard score derived from CLIP image-text similarities. Using controlled corruptions on BDD100K road scenes, we compare embedding drift against margin drift, defined as the change in hazard score under perturbation. The relationship is highly corruption-dependent: some families exhibit strong coupling between representation drift and decision drift, while others induce hazardous decision instability despite relatively modest embedding change. Furthermore, corruption families differ in failure direction: most suppress hazard detections via false negatives, while occlusion instead triggers false alarms, suggesting that benchmark design should account for asymmetric failure modes, not just overall instability rates. These results suggest that robustness benchmarks should include task-aligned stability measures in addition to embedding-level perturbation statistics.

13.
arXiv (CS.CV) 2026-06-16

Fusing Transferred Priors and Physics-based Decomposition for Underwater Image Enhancement

The underwater images are captured within diverse water-medium conditions, leading to complex degradation, including color bias, low contrast, and blur effect. Recently, learning-based methods have demonstrated their potential for underwater image enhancement (UIE). However, most of the previous work focus on the training strategy or network design to make the enhanced result aligned well with the labels in datasets, ignoring that the labels are selected from the enhanced results of previous UIE methods and these pseudo-labels are noisy. Consequently, the performance of their models is not satisfactory to a certain extent. However, collecting the true labels of the underwater images is challenging. In this work, we propose a transfer learning-based UIE that does not require underwater images to have paired noisy or true labels for learning. Instead, the UIE task is first divided into global color correction, haze removal, and background noise suppression following the underwater physics. Then multiple types of prior from other vision tasks are leveraged as cross-domain supervision in each step. In this way, a novel UIE is available via transfer learning, and the physics-aligned UIE decomposition provides theoretical soundness. Qualitative and quantitative experiments demonstrate that our proposal based on physics and priors fusion achieves SOTA performance in the UIE task and effectively boosts downstream vision tasks, significantly outperforming benchmark methods. Project repo: https://github.com/Haru2022/P2-UIE.

14.
arXiv (CS.CV) 2026-06-11

How Seemingly Inconsequential Design Choices Dictate Performance of LLMs in Pathology

General-purpose large language models (LLMs) are routinely used as baselines when evaluating specialized pathology models on whole-slide images (WSIs). Because WSIs exceed contemporary model context limits, LLM baselines routinely use small, high-magnification patches processed independently via majority voting, without systematic evaluation of seemingly inconsequential design choices such as patch size, patch count, and magnification. Generalist LLMs have consistently underperformed specialized systems, reinforcing the perception that domain-specific training or architectural adaptation is necessary for pathology tasks involving WSIs. Here, we conduct a systematic factorial analysis of four input design factors: inference mode, patch size, magnification, and patch count. We demonstrate that prior studies have overstated the gap between specialized models and general-purpose LLMs by choosing non-optimized input configurations. On the MultiPathQA benchmark, switching to a single balanced configuration (large patches at lower magnification, processed jointly) raises GPT-5 from 15.1% to 39.5% on cancer-type classification (TCGA) and from 38.1% to 62.9% on organ classification (GTEx). Per-task optimization yields further gains up to 43.9% (TCGA) and 71.6% (GTEx). The same configuration generalizes to two other models and to a fully held-out CPTAC cohort, where it improves Gemini 3 Flash by 23.4 percentage points without any task-specific tuning.

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

Beyond Native Success: Auditing Deployment-Interface Exposure of CLIP Backdoors

Contrastive Language-Image Pre-training models are widely reused across downstream interfaces, including feature extraction, retrieval, reranking, and selection. Existing CLIP backdoor, however, usually validate attacks on a small attack-native task, leaving unclear whether the same poisoned checkpoint remains exposed, weakens, or becomes not applicable when reused through other interfaces. We introduce DIFE, a Deployment-Interface Footprint Evaluation framework that audits backdoored CLIP checkpoints across deployment interfaces. DIFE makes various evaluations comparable by specifying each interface's component readout, trigger channel, target event, reference condition, and metric. DIFE also introduces effective-footprint diagnosis to identify the reusable CLIP component or component combination that carries exposure and explains where risk transfers. Auditing reproduced CLIP backdoors with DIFE reveals a structured landscape: native success is not a checkpoint-level risk certificate, exposure follows component footprints, text-side poisoning does not yield textual-encoder control, and some coupled attacks remain mechanism-bound. This audit reveals a import gapin existing CLIP backdoors: a textual encoder that itself becomes a reusable carrier of adversarial behavior. We therefore introduce BadTextTower to fill this gap. BadTextTower produces strong text-conditioned retrieval, reranking, and selection exposure while leaving visual-only reuse nearly clean.

16.
arXiv (CS.LG) 2026-06-15

Federated Learning for Feature Generalization with Convex Constraints

arXiv:2606.14416v1 Announce Type: new Abstract: Federated learning (FL) often struggles with generalization due to heterogeneous client data. Local models are prone to overfitting their local data distributions, and even transferable features can be distorted during aggregation. To address these challenges, we propose FedCONST, an approach that adaptively modulates update magnitudes based on the parameter strength of the global model. This prevents over-emphasizing well-learned parameters while reinforcing underdeveloped ones. Specifically, FedCONST employs linear convex constraints to ensure training stability and preserve locally learned generalization capabilities during aggregation. A Gradient Signal to Noise Ratio (GSNR) analysis further validates the effectiveness of FedCONST in enhancing feature transferability and robustness. As a result, FedCONST effectively aligns local and global objectives, mitigating overfitting and promoting stronger generalization across diverse FL environments, achieving state-of-the-art performance.

17.
arXiv (math.PR) 2026-06-15

Stability of Synthetic Ricci Curvature Lower Bounds for Inverse Limit Extended Metric Measure Spaces

arXiv:2606.14322v1 Announce Type: cross Abstract: We show that every Polish extended metric measure space arises as an inverse limit of metric measure spaces up to isomorphism. We then prove that synthetic Ricci curvature lower bounds and several functional inequalities, including the log-Sobolev, Talagrand, Poincaré, and dimension-free Harnack inequalities are stable under inverse limit. We discuss applications to infinite-dimensional spaces, including abstract Wiener spaces and their quotient spaces.

18.
arXiv (CS.CV) 2026-06-19

SpatialSV: Internalizing Interpretable 3D Spatial Awareness in MLLMs via Task-Oriented Visual Supervision

Unlocking the spatial intelligence of multimodal large language model (MLLMs) is crucial for understanding and interacting with the 3D world. Prevailing approaches typically inject spatial priors via external tools, which impose significant inference overhead, or rely on latent feature distillation, which remains uninterpretable and lacks fine-grained geometric constraints. To address these issues, we propose SpatialSV, a framework designed to internalize robust 3D spatial awareness within MLLMs while simultaneously offering inherent interpretability. Deviating from passive feature imitation, SpatialSV employs task-oriented visual supervision, compelling the model to actively lift its 2D visual features into explicit 3D representations, including depth maps, camera poses, and point clouds. Crucially, this 2D-to-3D lifting process provides a transparent window into the model's representations: the resulting 3D reconstructions serve as an intuitive proxy for visualizing and diagnosing the quality of the model's intrinsic spatial knowledge. Extensive experiments across multiple models and benchmarks demonstrate the effectiveness of SpatialSV in enhancing and interpreting MLLMs' spatial intelligence. Furthermore, the framework exhibits strong generalization in semi-supervised settings, validating its potential to leverage unlabeled visual data for scalable, interpretable spatial representation learning.

19.
Nature (Science) 2026-06-12

‘Student Geng’ ignites research-integrity scandal in China after calling out senior academics<b> </b>

作者:

Video blogger’s viral accusations of data manipulation in Nature journals have sparked intense debate and speedy institutional investigations. Video blogger’s viral accusations of data manipulation in Nature journals have sparked intense debate and speedy institutional investigations.

20.
arXiv (CS.CL) 2026-06-19

Source-Grounded Data Generation for Text-to-JSON Learning

From financial filings to clinical records, legacy industries rely heavily on long, unstructured documents to store high-value information. Reliably extracting this information into structured, machine-readable representations is a key prerequisite to making the contents accessible to automated systems. JSON is a natural target for such structured extraction, yet constructing reliable and scalable text-to-JSON training data remains challenging. To address this gap, we propose STAGE (Spreadsheet-grounded Text-to-JSON Artifact GEneration), a source-grounded data generation pipeline that constructs reports and JSON schema by using LLMs for scalable synthesis while validating ground-truth values against the underlying spreadsheet. Evaluations on STAGE-Eval, our source-grounded benchmark with an 851-example test set, show that STAGE produces stronger training data than existing approaches. This improves Qwen3-4B exact match from 31.37% to 74.27% and value accuracy from 45.46% to 90.69%.

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

Calibrating Decision Robustness via Inverse Conformal Risk Control

arXiv:2510.07750v3 Announce Type: replace-cross Abstract: Robust optimization safeguards decisions against uncertainty by optimizing against worst-case scenarios, yet their effectiveness hinges on a prespecified robustness level that is often chosen ad hoc, leading to either insufficient protection or overly conservative and costly solutions. Recent approaches using conformal prediction construct data-driven uncertainty sets with finite-sample coverage guarantees, but they still fix coverage targets a priori and offer little guidance for selecting robustness levels. We propose a new framework that provides distribution-free, finite-sample guarantees on both miscoverage and regret for any family of robust predict-then-optimize policies. Our method constructs valid estimators that trace out the miscoverage–regret Pareto frontier, enabling decision-makers to reliably evaluate and calibrate robustness levels according to their cost–risk preferences. The framework is simple to implement, broadly applicable across classical optimization formulations, and achieves sharper finite-sample performance. This paper offers a principled data-driven methodology for guiding robustness selection and empowers practitioners to balance robustness and conservativeness in high-stakes decision-making.

22.
arXiv (math.PR) 2026-06-16

Purely unrectifiable sets, fractal percolation and graphs of functions

arXiv:2606.15745v1 Announce Type: cross Abstract: This paper contains a survey of some of the results of the author related to unrectifiablity and is an extended version of the author's talk given at the Second Winter School Geometric Measure Theory Rectifiability vs. Pure Unrectifiability in Hanghzou, China. These results include irregular/purely unrectifiable $1$-sets on the graphs of continuous functions like the Takagi, the Weierstrass-Cellerier and the typical (in the sense of Baire) continuous function. It is also discussed that there exists $ {\alpha}_{0}\alpha_0$. The background of the $1$-unrectifiability is discussed in more detail.

23.
arXiv (quant-ph) 2026-06-16

Scalable generation of heralded single photons via active feed-forward switching of a fiber delay line

arXiv:2606.16741v1 Announce Type: new Abstract: Quasi-deterministic single-photon generation is a key requirement for many photonic quantum technologies. Photon sources based on spontaneous parametric down-conversion (SPDC) are widely used for producing high-quality photons; however, the probabilistic nature of the process limits the generation of synchronized multi-photon states. Here, we demonstrate temporal synchronization of multiple photon-generation events using a free-space-fiber hybrid delay line with feed-forward control, enabling fast and efficient switching and scalable operation. Narrow-band, telecom-wavelength photons compatible for fiber transmission are heralded from a monolithic cavity SPDC source and synchronized across 20 time bins. This yields a sixfold enhancement in synchronized rates and enables multi-photon synchronization, with only a marginal increase of higher-order photon-number contributions.

24.
medRxiv (Medicine) 2026-06-17

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

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

25.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.