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01.
arXiv (CS.LG) 2026-06-15

Beyond a Single Explanation of the Adam–SGD Gap

arXiv:2606.14259v1 Announce Type: new Abstract: Prior work has identified several factors that can contribute to the performance gap between Adam and SGD, spanning data aspects, architecture design, and optimization properties. Yet these explanations are often studied in isolation, leaving their relative importance unclear. In this work, we revisit these hypotheses through a controlled empirical study across vision, language, genomics, and graph tasks, spanning modern and classical architectures, and carefully designed training setups. Our results suggest that no single factor consistently explains the Adam–SGD gap. For instance, the Adam advantage can (1) persist under a uniform vocabulary distribution yet nearly disappear under a heavy-tailed one; (2) reverse in favor of SGD in softmax-attention models; and (3) become larger under soft architectural modifications, e.g., when ReLU is replaced by a GeLU nonlinearity. This suggests that the gap arises from nontrivial data and architecture interactions, rather than from a single common factor. Yet, we observe a pattern across our settings: a crossover batch size at which the relative advantage shifts from SGD to Adam as the batch size scales. These empirical results are captured by our theoretical gap model, which predicts this batch-size-dependent crossover. Our perspective helps reconcile several existing hypotheses while offering practical insights across domains.

02.
arXiv (CS.AI) 2026-06-12

Rethinking RAG in Long Videos: What to Retrieve and How to Use It?

arXiv:2606.13141v1 Announce Type: new Abstract: Retrieval-augmented generation is moving beyond text into long, egocentric video, where systems must select query-relevant chunks across multiple modalities and temporal granularities. Yet progress in VideoRAG is limited by two gaps: existing benchmarks allow queries to be answered without the video, obscuring retrieval errors, and prior methods apply a single modality-granularity configuration per query, ignoring chunk-level variability. We address both by introducing V-RAGBench, a benchmark of $\langle$query, evidence chunk, answer$\rangle$ triplets that enables faithful, decoupled evaluation of retrieval and generation, and CARVE, a simple method that runs parallel retrievers across configurations and employs chunk-adaptive reranking to identify the winning configuration for each chunk. Each chunk then enters the generator under its winning configuration selected during retrieval, yielding an interleaved evidence form where the chunk-level decision propagates across both stages. CARVE outperforms eight recent VideoRAG baselines, with the chunks supplied to the generator interleaving multiple configurations rather than sharing a single one, a behavior unattainable by query-level methods.

03.
arXiv (quant-ph) 2026-06-19

Impossibility of superluminal signalling rules out causal loops in conical spacetimes

arXiv:2606.20476v1 Announce Type: cross Abstract: In PRL 129, 110401 it was shown that it is theoretically possible to have operationally detectable causal loops without violating the principle of no superluminal signalling (NSS) in (1+1)-Minkowski spacetime. Whether or not such causal loops are also possible in $d > 1$ spatial dimensions, has remained a key open question. We resolve this question by showing that in a wide class of "conical" spacetimes, including Minkowski with d > 1, NSS does rule out all operationally detectable causal loops, in classical, quantum and post-quantum theories. This establishes that the relationship between the relativistic principles of NSS and no causal loops depends inherently on the geometry of spacetime.

04.
arXiv (CS.LG) 2026-06-19

Full-Self Diagnostics (FSD): Physics-Grounded Visual Biomarker Inference from Smartphone Video via Inverse Problems and Operator Learning

arXiv:2606.19372v1 Announce Type: cross Abstract: We present Full-Self Diagnostics (FSD), a unified mathematical framework for recovering latent physiological states from unconstrained 9-second facial videos captured by consumer smartphones. The approach integrates five mutually reinforcing components: (1) a physics-based forward model derived from the radiative transfer equation and chromophore absorption that maps camera observables to biomarker concentrations; (2) an information-theoretic observability theory proving that multi-channel visual signals (spectral, pulse, respiratory, micro-expression, and oculomotor) contain strictly increasing mutual information with physiological state; (3) a stable, Tikhonov-regularized inverse problem with domain-uniform identifiability guarantees; (4) an operator-learning formulation that enables generalization across devices, resolutions, and populations; and (5) a supervised learning procedure, interpretable as stochastic variational inference, that continuously refines the model from paired biosensor ground truth with performance improving proportionally to one over the square root of the number of paired observations. Empirical validation on 38812 real-world paired scans across 59 subjects demonstrates practical performance. Self-collected data from the lead author (glucose range 35-550 mg/dL) yields MARD of 29.86 percent with 97.57 percent of predictions in Clarke Error Grid Zones A+B and only 0.27 percent in the dangerous Zone E. A well-managed diabetic participant achieves MARD of 17 percent in the narrower 70-180 mg/dL band. These results confirm that consumer-grade facial video encodes sufficient structured information for clinically relevant, non-invasive biomarker inference under fully unconstrained conditions, with performance scaling predictably as more paired data becomes available.

05.
arXiv (CS.CV) 2026-06-11

EventRadar: Long-Range Visual UAV Discovery through Spatiotemporal Event Sensing

Unauthorized unmanned aerial vehicle (UAV) activity around airports, public venues, and other sensitive sites has made protected-airspace monitoring increasingly important. A practical sensing system must search a wide angular region, find small long-range targets, and return both bearing support and UAV-specific evidence before a restricted perimeter is breached. Existing UAV detection paths often rely on spatially organized evidence, such as body extent, silhouette, or track continuity. At long range, however, these cues become difficult to preserve and verify as the target footprint weakens and its image-plane support shrinks. EventRadar follows a complementary cue: propeller-induced temporal periodicity, which recent event-camera sensing studies have shown can reveal UAV-specific motion after appearance becomes weak. We extend this cue to kilometer-scale active sensing with an event-camera prototype. Scene-Anchored Geometry Evidence (SAGE) fuses scanning events with IMU pose to maintain a bearing-indexed scene memory, separating transient candidate support from persistent background clutter. Comb-guided Harmonic-Group Learned Iterative Shrinkage and Thresholding Algorithm (CHG) then treats each candidate as a weak high-rate timing signal and recovers phase-insensitive harmonic evidence with fixed compute. Compared with related event-camera baselines on 700-1500 m UAV event recordings, EventRadar achieves 0.990 mAP$_{.3}$ and 0.949 F1$_{.3}$, reduces FN$_{.3}$ to 0.009, and shows real-time feasibility in prototype profiling.

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

BIM-Edit: Benchmarking Large Language Models for IFC-Based Building Information Modeling

arXiv:2606.20146v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly applied to computer-aided design (CAD) to generate design artifacts from textual instructions. In engineering practice, this requires more than creating new geometry, models must also understand existing scenes, edit them correctly, and preserve semantics and relations. However, many CAD benchmarks focus on creating new models rather than editing existing ones, and mostly evaluate geometric correctness. We introduce BIM-Edit, a benchmark for evaluating LLMs on natural-language editing of Building Information Models (BIM) represented in the Industry Foundation Classes (IFC) format. BIM provides a challenging testbed because building models encode geometry together with semantic and relational structure. BIM-Edit contains 324 editing tasks spanning 11 realistic building models and 36 synthetic scenes. Tasks are expressed using three instruction categories - direct, spatial, and topological - covering both explicit and scene-grounded edits. We evaluate outputs along three dimensions: geometric accuracy, semantic validity, and topological consistency. Across evaluated LLMs, the best-performing model achieves only 49.5% average score across the three metrics, and no model fully solves more than 3.4% of tasks. These results demonstrate a substantial gap between current LLM capabilities and the requirements of structured engineering design workflows.

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

Mental Health AI Safety Claims Must Preserve Temporal Evidence

arXiv:2605.08827v2 Announce Type: replace Abstract: The safety of mental health AI is often judged at the wrong temporal scale. Current evaluations typically score isolated responses, endpoint outcomes, or aggregate dialogue quality, while clinically consequential failures may arise from the order and accumulation of interactions themselves, including delayed escalation, repeated reinforcement, dependency formation, failed repair, and gradual deterioration across turns. This paper argues that this mismatch is not merely a limitation of evaluation coverage but a source of invalid safety conclusions. We introduce Temporal Safety Non-Identifiability, a formal account of why safety properties that depend on sequence, timing, accumulation, or recovery cannot be certified by protocols that discard those features. From this formalization, we develop SCOPE (Safety Claims Over Preserved Evidence) as a general principle for aligning safety claims with the evidence an evaluation actually retains, and instantiate it as SCOPE-MH, a mental-health instantiation of this reporting standard. We operationalize SCOPE-MH through a proof-of-concept on the AnnoMI dataset of expert-annotated motivational interviewing conversations, which reveals mechanisms of failure that per-turn behavior scoring does not represent. We propose SCOPE-MH as a diagnostic complement to existing evaluation infrastructure and argue that evaluation preserving temporal evidence is necessary, not optional, for safety-critical mental health AI deployment.

08.
arXiv (CS.AI) 2026-06-16

AC-ODM: Actor–Critic Online Data Mixing for Sample-Efficient LLM Pretraining

arXiv:2505.23878v2 Announce Type: replace-cross Abstract: Optimizing pretraining data composition is pivotal for LLM generalization. While dynamic mixing outperforms static strategies by capturing evolving training dynamics, current methods fail to reconcile computational efficiency with sample efficiency and structural flexibility for diverse pipelines.We introduce Actor–Critic Online Data Mixing (AC-ODM), which approaches data mixing from a reinforcement learning perspective with a parameterized policy that we theoretically prove to act as a dynamic linear surrogate maximizing the constructive interference of gradients. To enhance practical flexibility, AC-ODM supports two operational modes: (i) a proxy mode for fixed, pre-prepared corpora, where a policy learned on a small model is transferred to a larger target; and (ii) a non-proxy mode for direct end-to-end training from scratch without priors. Empirically, AC-ODM significantly outperforms prior methods in convergence speed and downstream accuracy across various architectures. On Pythia-1B, it reaches optimal validation perplexity using up to 66% fewer training steps than competitive baselines, delivering a 27.5% relative improvement in MMLU accuracy and a 2.23 x higher pass@1 on HumanEval, all while incurring a virtually negligible (0.4%) per-step wall-clock increase and only 2% additional memory overhead. Code is available at https://github.com/DANG-ai/AC-ODM.

09.
arXiv (CS.CL) 2026-06-17

Are you speaking my languages? On spoken language adherence in multimodal LLMs

While Large Language Model (LLM) based Automatic Speech Recognition (ASR) enables seamless multilingual use, models often misidentify the output language, compromising transcription fidelity and downstream application quality. To preserve flexibility and code-switching capabilities, we propose a soft prompting approach that hints at potential spoken languages without strictly constraining the output. We formally define this challenge as a lack of language adherence, introduce a novel metric to quantify violations, and evaluate three mitigation strategies: (1) zero-shot prompting for robust guidance under uncertainty, (2) supervised fine-tuning (SFT) to improve prompt adherence, and (3) Chain-of-Thought (CoT) reasoning to enforce adherence during decoding. We present a comparative analysis of these methods across multiple languages, evaluating effectiveness in reducing the language violation while maintaining overall ASR performance. Finally, we discuss trade-offs to guide strategy selection under various compute constraints.

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

AmchiBias: Measuring Stereotypical Bias in Goan Identity Groups with a Minimal Pair Dataset in English and Konkani

Socio-cultural stereotypical bias is an important consideration in the development and deployment of NLP systems. It is however often considered only at the national level, despite rich subnational socio-cultural structures. We present AmchiBias, the first benchmark for measuring socio-cultural stereotypical bias for the Indian state of Goa with its unique historically multicultural setting. It covers various Goan identity groups and comprises 313 minimal pairs across eight sociodemographic dimensions in both English and Devanagari Konkani. We then evaluate stereotypical bias in five multilingual encoder models on this benchmark. We find near-chance scores in Konkani, reflecting language incompetence for general multilingual models and a lack of Goan cultural competence for Indian language models. Queried in English, models with a stronger Indian language coverage show higher bias for pan-Indian groups than hyperlocal Goan groups. This suggests the English signal reflects pan-Indian pretraining associations rather than genuine Goan cultural knowledge. Our findings highlight a critical gap in low-resource multilingual NLP evaluation for hyperlocal community identities.

11.
arXiv (CS.LG) 2026-06-18

Neural Network Implementation of the Renormalization Group for Fault Diagnosis with Class Imbalance

arXiv:2606.18326v1 Announce Type: new Abstract: The application of machine learning models in practical tasks faces challenges such as class imbalance and multidimensional noise. This paper proposes RGNet, a neural network architecture based on the concept of the renormalization group (RG), for hierarchical coarse-graining of the feature space. The model sequentially compresses the input dimensionality and concatenates all scales before classification, allowing it to capture both local details and global patterns. The notion of RG-flows is introduced - interpretable low-dimensional representations whose visualization via t-SNE reveals a discrete curvilinear structure confirming the effectiveness of coarse-graining. Experimental results are presented on the imbalanced AI4I dataset. The obtained results demonstrate that RGNet is a universal, interpretable, and competitive solution for fault prediction in applications with imbalanced classes.

12.
PLOS Computational Biology 2026-06-22

Adhesion and polarity-driven morphogenesis: Mechanisms and constraints in tissue formation

by Yoshiyuki T. Nakamura, Chikara Furusawa, Kunihiko Kaneko Embryonic development in multicellular organisms exhibits diverse morphogenetic patterns, which can generally be categorized into fundamental types such as monolayer and multilayer spheres, as well as cell masses. Furthermore, we identify two distinct processes for the formation of spherical structures. These basic patterns are thought to be governed by the microscopic properties of intercellular adhesion. However, the specific mechanisms linking the microscopic factors to the emergence of distinct macroscopic morphogenetic patterns remain poorly understood. In this study, we explore how different morphogenetic patterns arise by employing a computational model that incorporates intercellular adhesion and polarity. Our results demonstrate that all fundamental morphogenetic patterns can be generated through the interplay of two key parameters: the polarity strength of the cell and the regulation of polarity via mechanical signals. Furthermore, analytical considerations reveal key mechanisms underlying the formation of these patterns. These findings highlight the critical role of physical constraints in morphogenesis and suggest potential applications to the design of artificial tissues and organoids.

13.
arXiv (quant-ph) 2026-06-11

Q-DICE: Quantum Distributed Interconnect Compiler and Emulator

arXiv:2606.11340v1 Announce Type: new Abstract: As distributed quantum computing (DQC) offers a leading path towards scalable quantum computation, the ability to benchmark distributed algorithms under realistic conditions becomes critical for system co-design. However, without access to physical systems, researchers lack tools to evaluate distribution protocols. We introduce Q-DICE (Quantum Distributed Interconnect Compiler and Emulator), a hardware-aware emulation environment for benchmarking distributed quantum circuits on classical simulators and on NISQ-era monolithic hardware. This work provides three core contributions: (1) a programmatic scheme to construct distributed QPU backends, utilizing two novel techniques - QPU slicing and stitching - to facilitate distributed circuit mapping, (2) a methodology for modeling nonlocal link noise using physically motivated Kraus operators and stochastic error channels, and (3) a boundary-aware circuit mapping algorithm enforcing distributed QPU topology constraints during transpilation. Together, these components constitute a distribution-aware compiler and noise-modeling engine that faithfully enforces the physical limitations of distributed quantum hardware within existing execution environments. We validate Q-DICE against a multitude of experimentally demonstrated quantum circuits, including a distributed Grover's search on optically linked trapped-ion hardware, achieving a worst-case fidelity deviation of 4% between simulated and experimental results. These findings demonstrate Q-DICE's capacity to accurately reproduce real distributed quantum system behavior across platforms, streamlining experimentation with distributed quantum algorithms and architectures.

14.
arXiv (CS.AI) 2026-06-15

Sorries Are Not the Hard Part: An Expert-Review Case Study of a Semi-Autonomous Formalization

arXiv:2606.13925v1 Announce Type: new Abstract: Large language models can often close proof gaps in interactive theorem provers, but a verified theorem is not the same thing as a reusable library contribution. We study this distinction through a detailed case study: a semi-autonomous formalization of Grothendieck's vanishing theorem. The initial version compiles with no sorries, but an expert review found serious problems in definitions, theorem generality, file organization, and the API. We then ran a review-driven refactor and compression process and obtained a second expert review. The before-and-after comparison shows a sharp split: agents adapted well to local, mechanically checkable feedback, but remained weak at choosing definitions and designing APIs. We argue that autoformalization should be evaluated not only by closed sorries, but by whether the resulting formalization survives expert review.

15.
arXiv (CS.LG) 2026-06-18

Concept Modulation Models: A Unified Framework for Identifiability and Extrapolation

arXiv:2606.18509v1 Announce Type: new Abstract: Reliable generalization in conditional latent variable models requires understanding both identifiability and extrapolation: how observed variation across attributes determines latent structure, and how that structure determines distributions at unseen attributes. However, existing identifiability and extrapolation guarantees are largely model-specific, with separate analyses in nonlinear ICA, causal representation learning, perturbation modeling, and related conditional latent variable models. We introduce concept modulation models (CMMs), an attribute-indexed class of conditional generative models with structure $A\to \Lambda \to C\to X$, where attributes select modulators, modulators induce latent concept laws, and concepts generate observed features. CMMs lift transition-based identifiability to conditional settings by showing that feature agreement on observed attributes induces a latent concept transition constrained by the CMM class. We express these constraints through attribute potentials, log-density ratios between attribute-conditioned concept laws, separating the generic lifting step from model-specific rigidity arguments. The same potentials control extrapolation: agreement at unseen attributes holds exactly when the transported attribute-potential identities extend to those attributes. This yields algebraic extrapolation criteria, identifies the common potential-based proof objects behind several existing identifiability and extrapolation results, and, when combined with the model-specific rigidity arguments in those works, recovers their stated conclusions.

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

The Model Knows, the Decoder Finds: Future Value Guided Particle Power Sampling

arXiv:2605.02427v3 Announce Type: replace Abstract: A recurring pattern in "reasoning without training" is that base LLMs already assign non-trivial probability mass to correct multi-step solutions; the bottleneck is locating these modes efficiently at inference time. Power sampling provides a principled way to bias decoding toward such modes by targeting p_theta(x)^alpha with alpha > 1, but practical approximations must account for future-dependent correction factors that determine which prefixes remain promising. We introduce Auxiliary Particle Power Sampling (APPS), a blockwise particle algorithm for approximating the sequence-level power target with a bounded population of partial solutions. APPS propagates hypotheses in parallel using proposal-corrected power reweighting and refines their survival through future-value-guided selection at resampling boundaries. This redistributes finite compute across competing prefixes rather than committing to a single unfolding path, while providing a direct scaling knob in the particle count and predictable peak memory. We instantiate the future-value signal with short-horizon rollouts and also study an amortized variant that replaces rollouts with a lightweight learned selection head. AMore broadly, APPS improves the accuracy–runtime trade-off of training-free decoding, further supporting the view that inference-time power approximation can recover gains often attributed to post-training.

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

Theoretical Grounding of Out-Of-Distribution Detection With Reinforcement Learning Optimizer

Out-of-distribution (OOD) detection in dynamic open-world environments requires a model to continually adapt to evolving data distributions while generalizing to covariate-shifted inputs and rejecting semantic-shifted OOD examples. Most existing OOD detection methods optimize only the current-step objective and do not explicitly account for how post-deployment environment changes affect future OOD behavior. In this paper, we establish a theoretical grounding for dynamic OOD detection using a reinforcement learning (RL)-guided optimizer that explicitly favors updates that reduce the semantic OOD false positive rate over time. We develop a novel augmented optimizer that uses an RL-guided correction term on top of standard gradient descent (GD) and show its improvement over both future-domain generalization and semantic-OOD rejection. We analyze temporal error decomposition in terms of model-change and environment-change generalization errors and develop a new theoretical framework for comparing the generalization errors under both GD and RL-guided optimizers.

18.
arXiv (CS.CV) 2026-06-16

ReportQA: QA-Based Radiology Report Evaluation

Radiology report evaluation is essential for advancing automated report generation. Natural language generation metrics have limited clinical relevance. Clinical efficacy (CE) metrics evaluate important medical findings, but focus mainly on presence and cover only a limited set of entities. Due to heavy reliance on manual annotations, it is difficult for CE metrics to extend clinical entities or attributes. In clinical practice, radiology reports serve as a medium for information transfer. Clinicians use them to perform downstream diagnostic tasks without directly inspecting images. Based on this insight, we propose ReportQA, a clinical-related and flexible radiology report evaluation framework, supporting detailed quantitative analysis of radiology report generation systems. We first collect datasets covering multiple imaging modalities and anatomical regions. We then construct knowledge trees of clinical entities and attributes with radiologist guidance, and use large language models (LLMs) to extract structured information from raw reports. Next, we generate QA pairs from predefined templates and apply quality control through self-filtering and report-based filtering. During evaluation, the report is treated as context, and an LLM acts as a judge model to answer the QA pairs. Based on the resulting QA accuracy, we introduce QAScore metric. Compared with existing metrics, QAScore shows better alignment with radiologist judgments. Experiments on multiple state-of-the-art vision-language models reveal that current report-based inference paradigms struggle to learn fine-grained clinical representations and exhibit strong negative prior biases. In contrast, question-driven inference provides a more effective alternative. For reproducibility and extensibility, we release the knowledge trees, structured reports, and QA pairs, along with the pipeline code for QA construction and evaluation.

19.
arXiv (math.PR) 2026-06-18

Milstein-type Schemes for Hyperbolic SPDEs

arXiv:2512.19647v4 Announce Type: replace-cross Abstract: This article studies the temporal approximation of hyperbolic semilinear stochastic evolution equations with multiplicative Gaussian noise by Milstein-type schemes. We take the term hyperbolic to mean that the leading operator generates a contractive, not necessarily analytic $C_0$-semigroup. Optimal convergence rates are derived for the pathwise uniform strong error \[ E_h^\infty := \Big(\mathbb{E}\Big[\max_{1\le j \le M}\|U_{t_j}-u_j\|_X^p\Big]\Big)^{1/p} \] on a Hilbert space $X$ for $p\in [2,\infty)$. Here, $U$ is the mild solution and $u_j$ its Milstein approximation at time $t_j=jh$ with step size $h>0$ and final time $T=Mh>0$. For sufficiently regular nonlinearity and noise, we establish strong convergence of order one, with the error satisfying $E_h^\infty\lesssim h\sqrt{\log(T/h)}$ for rational Milstein schemes and $E_h^\infty \lesssim h$ for exponential Milstein schemes. This extends previous results from parabolic to hyperbolic SPDEs and from exponential to rational Milstein schemes. Moreover, root-mean-square error estimates are strengthened to pathwise uniform estimates. Numerical experiments validate the convergence rates for the stochastic Schrödinger equation. Further applications to Maxwell's and transport equations are included.

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

Next-Latent Prediction Transformers Learn Compact World Models

arXiv:2511.05963v4 Announce Type: replace Abstract: Transformers replace recurrence with a memory that grows with sequence length and self-attention that enables ad-hoc lookups over past tokens. Consequently, they lack an inherent incentive to compress history into compact latent states with consistent transition rules. This often leads to learning solutions that generalize poorly. We introduce Next-Latent Prediction (NextLat), which extends standard next-token training with self-supervised predictions in the latent space. Specifically, NextLat trains a transformer to learn latent representations that are predictive of its next latent state given the next token. Theoretically, we show that these latents provably converge towards belief states, compressed information about the history necessary to predict the future. This simple auxiliary objective injects a recurrent inductive bias into transformers while leaving their architecture, parallel training efficiency, and inference unchanged. NextLat effectively encourages transformers to form compact internal world models with coherent belief states and transition dynamics – crucial properties not guaranteed by standard next-token prediction alone. Empirically, across benchmarks in world modeling, reasoning, planning, and language modeling, NextLat demonstrates significant gains over standard next-token prediction and other baselines in downstream accuracy, representation compression, and lookahead planning. Furthermore, NextLat enables variable-length self-speculative decoding, accelerating inference by up to 3.3x in language modeling. NextLat offers a simple yet effective paradigm for learning compact, predictive representations in transformers that generalize better. Our code is available at https://github.com/JaydenTeoh/NextLat.

21.
medRxiv (Medicine) 2026-06-22

Early-life nutritional environment is associated with late-life cognition in the Health and Retirement Study, a pellagra epidemic natural experiment

Early-life exposures are important to several late-life health outcomes. We sought to study the effect of an in utero nutritional environment and its interaction with Alzheimer's disease (AD) genetic risk on late-life cognitive function. We used a natural experiment created by the pellagra epidemic, a nutritional disease caused by a vitamin B3 deficiency, to evaluate the association between in utero pellagra epidemic exposure and late-life cognitive function in the Health and Retirement Study (N = 18,285). We also evaluated whether the in utero exposure could modify the AD polygenic score's (PGS) effect on cognition. In utero pellagra epidemic exposure was significantly associated with cognition ({beta} = -0.025). However, these effects were not isolated to the prenatal period as exposure during childhood periods also had an effect. The interaction between the in utero exposure and the AD PGS was significant, where the genetic effect on cognition was amplified with increasing (progressively worse) in utero exposure levels. These associations imply that the early-life nutritional environment affects late-life cognitive function and that these effects can modify genetic risk.

22.
Nature Medicine 2026-06-09

Adjuvanted inactivated rabies virus-vectored Lassa virus vaccine in healthy adults: a phase 1 trial

Lassa fever causes substantial morbidity and mortality in West Africa, and no licensed vaccine is available. We evaluated LASSARAB, an inactivated rabies virus-vectored Lassa virus (Josiah strain) glycoprotein complex vaccine. We conducted a randomized, controlled, dose-escalation phase 1 trial. Participants (total n = 54) received two intramuscular doses of LASSARAB containing 700 (n = 15), 1,400 (n = 15) or 2,800 (n = 14) relative units of antigen formulated with the TLR-4 agonist 3D-6-acyl PHAD-SE adjuvant, or licensed rabies vaccine control (n = 10), administered 28 days apart. This protocol-defined interim analysis reports the primary safety evaluation and secondary immunogenicity assessments through day 61. There were no prespecified hypotheses or formal power calculations. All primary safety end points demonstrated an acceptable safety profile. After dose 1, local solicited adverse events occurred in 86.7–100.0% of LASSARAB groups and 80% of controls; systemic events in 33.3–71.4% and 60.0% of controls. After dose 2, local solicited adverse events occurred in 66.7–86.7% of LASSARAB groups and 55.6% of controls; systemic events in 53.3–71.4% of LASSARAB groups and 55.6% of controls. Events were predominantly mild and self-limited. Unsolicited adverse events occurred in 28.6–60.0% of LASSARAB groups and 20.0% of controls. No serious adverse event, immune-mediated condition or sensorineural hearing loss occurred. Safety laboratory abnormalities occurred in 13.3–66.7% of LASSARAB groups and 30.0% of controls (14 mild, 6 moderate and none severe). After two doses, Lassa virus GPC IgG ELISA seroconversion (≥fourfold rise) was achieved in 100.0% (44 of 44) of LASSARAB recipients and 0.0% (0 of 10) of controls. Rabies glycoprotein IgG ELISA seroconversion (≥fourfold rise) and neutralizing antibody by rapid fluorescent focus inhibition test (RFFIT) seroprotection (≥0.5 IU ml−1) were also 100% across all groups, including controls. LASSARAB + 3D-6-acyl phosphorylated hexaacyl disaccharide (PHAD)-SE demonstrated a favorable safety profile and immunogenicity against Lassa and rabies viruses. The per-protocol final study report will include safety and durability through day 394. ClinicalTrials.gov identifier NCT06546709 . An interim report of a first-in-human phase 1 trial found an adjuvanted, combination inactivated rabies-vectored, Lassa fever vaccine (LASSARAB + 3D-6-acyl PHAD-SE) to be safe and induced immunogenicity to both Lassa and rabies viruses in healthy participants.

23.
medRxiv (Medicine) 2026-06-15

Midwifery Practice in Conflict Contexts: Lived Experiences from Somalia and Nigeria

Background: Midwives are a central cadre in the health system, particularly in conflict-affected settings where they are sometimes the primary or even only skilled providers available. Yet, despite their critical role, there is limited qualitative evidence capturing their lived experiences and how these shape workforce entry, retention, and overall well-being. Methods: Drawing on a phenomenological research methodology, this qualitative study was embedded within a larger prospective longitudinal cohort of midwifery students and graduates in Somalia and Nigeria. We conducted focus group discussions with graduate midwives (n=48 in Nigeria; n=63 in Somalia) to explore their experiences transitioning into the workforce and their realities working in health systems impacted by conflict and violent insecurity. Data were analysed using inductive thematic analysis. Results: Five themes emerged from the data: (1) job search and workforce entry, which was described as fraught with challenges and shaped by a set of formal systems in Nigeria but informal networks and structural barriers in Somalia (2) working conditions that were marked by resource scarcity, infrastructural challenges, and heavy and unreasonable workloads, (3) safety, security and coping strategies that differed across the two contexts but reflected persistent exposure to violence and a reliance on ad hoc and personal coping in lieu of systematic protection, (4) community perceptions of midwives, shaped and constrained by social and gender norms and (5) mental health and emotional wellbeing, highlighting stress, burnout and moral injury experienced by this cadre. Conclusion: Our findings highlight the profound challenges faced by midwives working in conflict-affected settings, and they shine a light on the urgent need to support and invest in this critical and predominantly female health workforce.

24.
Nature Medicine 2026-06-17

General-purpose chatbots outperform clinical AI tools on physicians’ real-world questions

Authors: Unknown Author

Specialized clinical AI tools are entering medical practice with little independent testing. In a head-to-head evaluation across two public benchmarks and real questions from physicians, three general-purpose frontier large language models outperformed two leading clinical AI tools, which performed no better than Google search AI overview.

25.
arXiv (CS.CL) 2026-06-19

Large Language Models Hack Rewards, and Society

Reinforcement learning (RL) has become a dominant post-training paradigm, enabling large language models (LLMs) to learn from rewards. We observe that societal regulations are structurally similar to reward functions. They define measurable outcomes, thresholds, and exceptions, while often leaving institutional intent only partially specified. We hypothesise that the RL training process may exploit these gaps and therefore ask whether models' well-known tendency to hack reward functions during RL can scale into a more consequential failure mode named societal hacking: discovering loopholes in the rules society runs on. To study this phenomenon, we introduce SocioHack, a sandbox of 72 societal environments, and find that within these environments, reward hacking naturally emerges and leads to regulatory loophole discovery. Models learn to hack the social rules and generate strategies that remain technically compliant while defeating regulatory intent, and current LLM safeguards provide only limited mitigation. Therefore, collecting in-the-wild feedback for model training requires greater caution, and we need a next-generation post-training paradigm for safely iterating LLMs in real society.=