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01.
arXiv (CS.CV) 2026-06-12

Dual-State Slot Attention: Decoupling Appearance and Identity for Video Object-Centric Learning

Unsupervised video object-centric learning aims to decompose dynamic scenes into persistent, object-level representations without supervision. However, existing slot-based methods struggle to maintain stable object identity in challenging settings such as rapid motion and partial occlusion. First, they typically encode both the per-frame appearance of an object and its identity across frames in a single slot vector, creating an objective conflict that leads to slot swapping: reconstruction requires sensitivity to transient visual changes, whereas temporal consistency requires invariance to them. Second, the token renormalization used in Slot Attention can amplify weakly attending slots, allowing them to absorb tokens from other objects and destabilize slot-to-object correspondence. We propose Dual-State Slot Attention (DSSA), a fully self-supervised framework that addresses these limitations by separating appearance from identity and by reducing spurious updates from weakly matching slots. DSSA decomposes each slot into a local state for per-frame appearance and an identity state for temporally stable object information, thereby aligning reconstruction and temporal consistency with separate representations. The identity state is updated through a learned recurrent transition that acts as a temporal filter on the local state, while competition-modulated aggregation (CMA) down-weights updates from weakly matching slots and prevents them from absorbing tokens from other objects. Experiments on MOVi-C, MOVi-D, and YouTube-VIS demonstrate that DSSA consistently improves segmentation quality and temporal consistency over prior methods, while also yielding stronger downstream object recognition and video dynamics prediction. Code and models will be made publicly available upon acceptance.

02.
arXiv (CS.CV) 2026-06-16

HadBalance: A Plug-and-Play Unified Global Geometric Prior Framework for Generalizable Biomedical Segmentation

Precise biomedical image segmentation is crucial for clinical diagnosis. Geometric cues (e.g., boundary, shape, and topology) can improve structural consistency, yet most are task-specific and lack a unified geometric foundation that generalizes across organs and modalities. We are motivated by the observation that several medical segmentation targets can be approximated as globally near-convex shapes. A convex region is one in which any two interior points can be connected by a line segment entirely contained within the region. In practice, medical targets may exhibit small local concavities or boundary irregularities; we refer to such globally convex-like shapes as near-convex. Motivated by this, we derive Hadwiger Shape Priors from Hadwiger's theorem as an interpretable global regularizer using three 2D measures: area A, perimeter P, and Euler characteristic chi, enabling transfer across organs and modalities. However, because medical datasets are shape-heterogeneous, enforcing near-convex priors uniformly can over-regularize non-convex anatomy with significant concavities, washing out concavities and fine details and degrading segmentation accuracy. To address this challenge, we propose Conflict-Aware Objective Balancing (CAOB), which integrates shape priors with segmentation in a gradient-aware manner. For each prior, CAOB removes only the gradient component that conflicts with segmentation while preserving the remaining aligned component, and adaptively regulates objective influences to prevent prior dominance. This enables stable use of shape priors on shape-heterogeneous data without erasing genuine concavities or fine structural details. We call this plug-and-play framework HadBalance.

03.
arXiv (CS.LG) 2026-06-16

Leveraging Physiological Signals to Predict Exam Outcomes with Machine Learning

arXiv:2606.14960v1 Announce Type: new Abstract: This study investigates the application of machine learning models to predict exam outcomes using physiological data collected during examination sessions. Physiological stress indicators, including electrodermal activity, heart rate, and skin temperature, were analyzed to uncover their association with academic performance. A variety of machine learning approaches were employed, ranging from standard models like logistic regression, random forest, and support vector machines to more advanced architectures, including transformers, long short-term memory (LSTM), and gated recurrent unit (GRU) models. This diversity aimed to capture the complex interactions within the data effectively. A key focus was assessing the adaptability of transformers in processing numerical data and evaluating their performance in this novel context. Standard performance metrics, such as accuracy, precision, recall, and F1-score, were used to compare model efficacy. The experimental results demonstrate that while deep learning models generally excel at capturing complex relationships in physiological data, simpler models like random forests can sometimes achieve superior performance while offering computational efficiency and interpretability. Furthermore, transformers demonstrated notable versatility, showcasing performances comparable to those of the LSTM and GRU models. This research underscores the importance of experimenting with a broad class of models that align with the objectives of the problem at hand, balancing precision, efficiency, and interpretability. By elucidating the relationships between physiological signals and academic performance, this study contributes to understanding stressors affecting students' mental health. It further promotes leveraging physiological data to enhance student well-being and academic outcomes.

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

Triangle Splatting SLAM

We present a dense RGB-D SLAM system using differentiable triangles as the 3D map representation. While 3D Gaussian Splatting has emerged as the leading method for novel-view synthesis, triangles remain the standard primitive for traditional rendering hardware, game engines, and downstream tasks requiring explicit geometry such as simulation, collision, and editing. Recent offline methods have demonstrated that an unstructured 'triangle soup' can be optimised into a photorealistic mesh via Delaunay triangulation across a set of posed images. Building upon this insight, we present the first dense SLAM system to employ Triangle Splatting to perform both tracking and mapping through online differentiable rendering of a triangle soup. The map can be converted into a connected mesh on-the-fly via restricted Delaunay triangulation, enabling new online capabilities such as mesh deformation and collision checking. On Replica and TUM-RGBD, our system outperforms baselines on 3D geometry, matches the camera-tracking accuracy, and enables online mesh-based scene editing.

05.
arXiv (quant-ph) 2026-06-17

Post-Selection Probability and Fidelity of Bidirectional Teleportation

arXiv:2606.17251v1 Announce Type: new Abstract: Understanding the scrambling of quantum information is central to many areas of quantum physics, including quantum thermalization, entanglement growth, and quantum information processing. Insights from these studies have, in turn, inspired the development of novel quantum protocols and algorithms. Recently, a bidirectional teleportation protocol was proposed to implement a digital SWAP operation between qubits by leveraging chaotic Hamiltonian evolution combined with measurement and post-selection. In this work, we provide a comprehensive study of two central quantities that characterize the protocol, the post-selection probability and the fidelity, taking into account possible errors in time-reversed dynamics. We show that these quantities can be expressed in terms of standard diagnostics in quantum dynamics, including the Loschmidt echo and its subsystem variant. The results unveil (1) the initial-state dependence of the fidelity and (2) the stability of the post-selection probability in integrable models. Our findings offer practical guidance for the implementation of the protocol on realistic quantum devices.

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

FP8 is All You Need (Part 1): Debunking Hardware FP64 as the HPC Holy Grail (June 13th version)

arXiv:2606.06510v2 Announce Type: replace-cross Abstract: Conventional HPC holds that native hardware FP64 is the irreducible foundation of scientific computing. On AI-optimized GPUs of the NVIDIA B300 generation and beyond, native FP64 throughput has collapsed to ~1.3 TFLOPS even as FP8 tensor throughput has grown to multiple PFLOPS. We argue something stronger than that this is survivable: the FP8 tensor-core matrix-multiply is the sole computational primitive on which double-precision scientific computing needs to be built. Every canonical kernel – dense and sparse linear algebra, spectral transforms, stencils – and every application composing them reduces, via the Chinese Remainder Theorem-based Ozaki Scheme II, to sequences of FP8 matrix operations; the only non-FP8 arithmetic is a bounded, fixed-width integer accumulation at reconstruction. Native FP64 is thereby demoted from a hardware requirement to a derived accuracy guarantee obtained by composition over the FP8 primitive. We organize the claim as a five-layer hierarchy – the FP8 op, Ozaki II, the basic kernels or Berkeley "dwarfs", composite solvers, and full applications – and, because the dwarf taxonomy already spans scientific computing, establish it by exhibiting the reduction for every dwarf rather than a sample. The claim is falsifiable, and we build the instrument that tests it: a Tensor-Memory Equilibrium (TME) model extending the Roofline with emulation parameters (alpha, beta, gamma). We identify register-level fusion as the mechanism that keeps emulation memory-bound, project recovered FP64 performance across B300 and Rubin against an H100 baseline, and close the kernel coverage with a companion FFT analysis and compensated reductions. The model could have returned a negative verdict; instead it passes across the dwarfs and their compositions. This is the analytical half of a two-part program, with a follow-on implementation to validate the thesis on real silicon.

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

A Qualitative Review of GenAI-Based Methods for Data Generation and Augmentation in Industrial Computer Vision Applications

AI-driven computer vision applications require a profound database to ensure predictable behaviors and performance. Such predictable behaviors are especially important for industrial applications in gaining trust from users. However, such a database is not readily available in industrial applications, and its acquisition is not trivial either. Active learning methods can be applied to ramp up data within a project deployment to iteratively increase the database, and thus the application predictability. Unfortunately, we observe that this often leads to a loss of user trust in the application, which is difficult to regain once lost. This leads to a "chicken-and-egg" dilemma in which neither the database nor the application is developed. In this work, we review state-of-the-art methods and approaches to further boost the database the initial active data ramp-up phase. Here, we focus on recent advancements in GenAI-based data generation and augmentation methods and review their adaptability on an industrial computer vision classification use case. Although we observe a potential for automatic data ramp-up, we also see a domain miss match in between the source (training environment) and target (industrial use-case) - regarding context defined in natural language and object characteristics.

08.
arXiv (CS.CV) 2026-06-12

OR-Action: Multi-Role Video Understanding with Fine-Grained Actions

Fine-grained understanding of operating room (OR) activity could enable workflow-aware assistance, yet remains difficult due to clutter, occlusions, and limited sensing. The prevailing approach to model this environment is scene graphs as an interpretable representation of OR interactions. Converting their frame-wise relational predictions into temporally extended, fine-grained actions however, is challenging without explicit temporal modeling. To enable a principled temporal evaluation of current OR understanding methods, we introduce the first action-centric benchmark built on a publicly available ego-exocentric OR dataset by defining a fine-grained, multi-role action taxonomy and generating dense action segments via distillation from ground-truth scene graph state changes. Experiments on this benchmark show that current scene graph prediction methods struggle to model temporal structure, even when adding explicit modeling through Graph Neural Networks. We therefore introduce a vision-only temporal model that outperforms graph-based methods significantly when using all available egocentric video as input. Building on this model we also introduce a novel multi- to single-view feature alignment strategy that improves single-view performance on multi-role action recognition, mitigating the need for extensive egocentric video capture. Benchmark and code will be released upon acceptance.

09.
arXiv (CS.LG) 2026-06-11

On the Stability of Growth in Structural Plasticity

arXiv:2605.15435v2 Announce Type: replace Abstract: Standard deep-learning pipelines usually choose the network architecture before training and keep it fixed throughout optimization. In contrast, a model can also be adapted by editing its structure during training, for example by pruning existing hidden-neuron units or growing new ones. Although growth is appealing for adaptive and continual systems, we show that it is not simply the inverse of pruning. Pruning selects among units that have participated in training from the start, whereas growth inserts new units into an already specialized optimization trajectory. We isolate this insertion problem and show that newborn units are often forward-active but backward-starved: they participate in the forward computation, yet receive much weaker gradient signal than incumbent units. This disadvantage is minor in small MLP benchmarks, but becomes clear in harder image-classification settings with a convolutional trunk. In these settings, \textsc{Grow} can achieve high final accuracy during the structural-editing procedure, while \textsc{Prune} is stronger when performance is averaged over the training trajectory or when the final sparse network is retrained from scratch. Interventions targeting optimizer state, insertion, selection, and trainability show that improving the integration of newborn units can improve adaptive performance, but does not automatically produce better final subnetworks. In continual-learning benchmarks stressing plasticity loss, \textsc{Grow} becomes competitive mainly when new units have enough time to integrate. Together, these results suggest that \textsc{Grow} should be evaluated not only as an architecture-search operator, but as a time-sensitive optimization process whose success depends on insertion stability.

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

GridVQA-X: A Framework for Evaluating Multimodal Explainability Methods

With the increasing development of Vision-Language Models, it becomes imperative that their predictions are readily explainable to relevant stakeholders. However, the field of explainability has not kept pace with the multimodal surge. While recent Multimodal Explainable AI (MxAI) methods generate explanations to attribute the interaction between different modalities, current evaluation protocols lack the ground truth required to distinguish between true cross-modal reasoning (e.g., spatial composition) and shallow cross-modal shortcuts (e.g., Bag-of-Words attribute matching). It remains unknown whether MxAI methods faithfully capture synergistic interactions or merely hallucinate reasoning on models acting as simple feature detectors. In this paper, we introduce GridVQA-X, the first diagnostic framework specifically designed to evaluate cross-modal explainability. Unlike natural datasets, GridVQA-X leverages a closed-world synthesis logic to generate unique, mathematically guaranteed explanations. We utilize this controlled environment to train paired ground-truth models on identical architectures: $M_{pure}$, which learns robust spatial-relational reasoning and $M_{spur}$, which is structurally forced to rely on cross-modal shortcuts. This behavioral divergence creates a rigorous testbed: a faithful explainer must report distinct reasoning pathways for each model. Our findings reveal that widely used methods fail to distinguish between models relying on genuine spatial-relational reasoning and those exploiting cross-modal shortcuts, highlighting a critical gap in capturing true cross-modal synergy and misrepresenting how multimodal models actually make decisions.

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

ERTS: Adversarial Robustness Testing of Ethical AI via Semantic Perturbation in a Bounded Consequence Space

arXiv:2606.13282v1 Announce Type: new Abstract: As AI systems are deployed in high-stakes ethical contexts such as healthcare triage, autonomous vehicle control, and employment screening, formal methods for evaluating their robustness against adversarial manipulation of ethical reasoning remain underdeveloped. This paper introduces the Ethical Robustness Testing System (ERTS), a closed-pipeline framework that: (1) encodes ethical dilemmas into a 22-dimensional Ethical Consequence Space (ECS) grounded in established ethical theory; (2) applies 17 semantic perturbation functions subject to 6 validity constraint classes including a novel semantic coherence constraint; (3) measures decision deviation via a 4-component Ethical Instability Index (EII); and (4) produces domain-adaptive pre-deployment robustness assessment verdicts. We evaluate 4 structured baseline models and 2 production LLMs (Gemini 2.0 Flash and Llama 3.2) across 50 ethical scenarios spanning 8 deployment domains, generating 1,500 adversarial test cases. Results demonstrate that only 33% of models achieve assessment clearance, with the local Llama-3.2 model proving particularly vulnerable to fairness corruption and information degradation attacks (ERS = 0.737). To the best of our knowledge, no existing framework combines a bounded ethical consequence space, semantic coherence constraints, and domain-adaptive assessment in a single adversarial testing pipeline.

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

LLM Jaggedness Unlocks Scientific Creativity

arXiv:2605.10574v3 Announce Type: replace Abstract: As artificial intelligence advances, models are not improving uniformly. Instead, progress unfolds in a jagged fashion, with capabilities growing unevenly across tasks, domains, and model scales. In this work, we examine this dynamic jaggedness through the lens of scientific idea generation. We introduce SciAidanBench, a benchmark of open-ended scientific questions designed to measure the scientific creativity of large language models (LLMs). Given a scientific question, models are asked to generate as many unique and coherent ideas as possible, with the total number of valid responses serving as a proxy for creative potential. Evaluating 19 base models across 8 providers (30 total variants including reasoning versions), we find that jaggedness manifests both across models and within models. First, in a cross-task comparison between general and scientific creativity, improvements in general creativity do not translate uniformly to scientific creativity, revealing divergent capability profiles across models. Second, at the prompt level, stronger models do not improve uniformly; instead, they exhibit high variability, with bursts of creativity on some questions and limited performance on others. Third, at the domain level, individual models display uneven strengths across scientific subfields, reflecting fragmented internal capability profiles. Finally, we show that this jaggedness can be harnessed. We explore mechanisms of inference-time compute, knowledge pooling, and brainstorming to combine models effectively and construct meta-model ensembles that outperform any single model. Our results position jaggedness not as a limitation, but as a resource, a structural feature of AI progress that, when understood and leveraged, can amplify LLM-driven scientific creativity.

13.
arXiv (CS.AI) 2026-06-19

IHBench: Evaluating Post-Interruption Recovery in Voice Agents with Structured Workflows

arXiv:2606.19595v1 Announce Type: cross Abstract: Voice agents deployed in structured workflows (customer service, healthcare scheduling, account management) must handle frequent user interruptions while maintaining progress through multi-step procedures. Existing benchmarks for speech-capable models focus on the timing of interruptions: barge-in detection, endpointing, and turn-taking dynamics. They leave unmeasured what happens after the interruption: does the agent resume the workflow at the correct step? Does it address the user's interjection? Does it avoid re-delivering content the user already heard? We introduce IHBench (Interruption Handling Benchmark), a benchmark that evaluates post-interruption recovery in voice agents executing state-machine-driven workflows across 10 enterprise domains. Six interruption types are injected at controlled points mid-utterance, with per-interruption evaluation rubrics generated alongside the data. Each interruption is scored on two axes: task fulfillment and recovery quality. We evaluate 27 audio-language model configurations from OpenAI, Google, and the open-weight community. Models vary widely, and recovery quality depends strongly on the interruption type. Across our experiments, closed-weight models are consistently more robust to interruptions than open-weight ones: they win far more often on task fulfillment, degrade roughly 3.3x more slowly as conversations grow longer, and show no audio-versus-text modality gap, whereas the open-weight models lose ground on all three. A human study validates the LLM judge against human annotators, and a cross-benchmark analysis against AudioMultiChallenge indicates that recovery quality is a largely distinct capability axis.

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

FloatDoor: Platform-Triggered Backdoors in LLMs

arXiv:2606.19535v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly deployed in sensitive settings such as software engineering, where their outputs directly shape downstream artifacts. Recent work has shown that an identical model can produce measurably different outputs depending on the deployment platform, a consequence of non-associative floating-point arithmetic and divergent kernel implementations. We study the security implications of this platform-dependent variability and uncover a novel attack surface on LLM deployments. We introduce FloatDoor, the first input-independent, platform-triggered backdoor attack against generative LLMs. The compromised model exhibits adversary-chosen behavior when served on a target platform and is otherwise benign. FloatDoor is realized through two lightweight LoRA adapters, one that amplifies inter-platform numerical divergence and one that binds the resulting platform signature to a malicious downstream task, while leaving aggregate model utility largely intact. FloatDoor exploits a pronounced time-of-check, time-of-use gap between model auditing and serving. We demonstrate FloatDoor on Qwen3-4B across a broad range of deployment targets, including NVIDIA GPUs, Google TPUs, AWS Graviton, and Alibaba Yitian-710. As a final case study, we show that FloatDoor reliably induces exploitable code vulnerabilities on a chosen target platform. Our results establish a new class of attacks on LLM deployments and underscore the pressing need for trusted model supply chains in sensitive, LLM-powered applications.

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

Recursive Agent Harnesses

Recursive language models (RLMs) showed that recursion over model calls is an effective strategy for long-context reasoning, and production coding agents have begun to write code that spawns subagents at scale, most recently in Anthropic's dynamic workflows. We name and study the pattern between these two lines of work, where the recursive unit is a full agent harness with filesystem tools, code execution, and planning rather than a model call with no tools. We call this the Recursive Agent Harness (RAH) and frame it as harness recursion, the code-first extension to the model recursion of RLMs. A parent agent generates and runs an executable script that spawns subagent harnesses in parallel for fine-grained workloads and uses structured function calls for small subtasks. We provide a controlled evaluation on long-context reasoning. With the backbone held fixed at GPT-5 to match the published Codex and RLM baselines, RAH improves the Codex coding-agent baseline from 71.75% to 81.36% on Oolong-Synthetic (199 samples, 13 context-length buckets up to 4M tokens), a gain attributable to the harness rather than the model. With a stronger backbone, Claude Sonnet 4.5, the same design reaches 89.77%.

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

Notation Matters: A Benchmark Study of Token-Optimized Formats in Agentic AI Systems

Large language models in Agentic AI systems consume tool schemas and execution results and emit tool invocations as structured data. The default language for that exchange, JSON, was designed for application-to-application interchange rather than token efficiency, so its structural elements impose substantial token overhead. Recent work proposes token-optimized alternatives such as TOON (Token-Oriented Object Notation) and TRON (Token Reduced Object Notation) as more compact replacements, but these formats have been evaluated only on isolated comprehension or generation tasks. Whether their token reductions hold inside end-to-end agentic loops therefore remains an open question. We evaluate TOON and TRON on four agentic benchmarks (BFCL, MCPToolBenchPP, MCP-Universe, StableToolBench) and five open-weight LLMs, decoupling input compression from output compression to measure comprehension and generation independently. TRON reduces tokens by up to 27% with accuracy within 14pp of the JSON baseline. TOON achieves up to 18% reduction at a similar 9pp accuracy cost, but additionally cascades on multi-turn parsing failures and collapses parallel tool-call output for most models. The code is available at: https://github.com/lkutschka/notation-matters

17.
arXiv (CS.LG) 2026-06-11

Few-Shot Resampling for Scalable Statistically-Sound Data Mining

arXiv:2606.11235v1 Announce Type: new Abstract: A key step in knowledge discovery is the evaluation of data mining results. In several applications, including pattern mining, graph analysis, and others, this step includes the evaluation of the statistical significance of the results, to avoid spurious discoveries due only to noise or random fluctuations in the data. While specialized procedures have been developed for some specific applications, resampling-based approaches are widely used, in particular for complex analyses where analytical results cannot be derived. However, current resampling-based approaches require the generation and analysis of thousands of resampled datasets, and are therefore impractical for large datasets or computationally intensive analyses. In this paper, we introduce FewRS, a simple and effective resampling-based approach to assess the statistical significance of data mining results with rigorous guarantees on the probability of false discoveries. Our approach can be used in every situation where resampling-based approaches are applied. FewRS builds on our derivation of a novel bound to the supremum deviation of test statistics representing the quality of data mining results. We prove that FewRS needs to generate and analyze an extremely small number of resampled datasets, leading to a highly scalable approach with wide applicability. We test our approach on common tasks such as pattern mining and network analysis. In all cases, our approach results in a reduction of up to two orders of magnitude in running time compared to the state of the art, while preserving high statistical power, enabling the statistical validation of data mining results on large-scale real-world datasets.

18.
bioRxiv (Bioinfo) 2026-06-19

Geometric Deep Learning Reveals Ligandable and Cryptic RNA Binding Small Molecule Pockets (SMARTPocket)

RNAs are important therapeutic targets, however identifying ligandable small-molecule binding pockets remains a major barrier to RNA-targeted drug discovery. Here, SMARTPocket, an atomic-level geometric deep learning framework for predicting RNA-small molecule binding pockets directly from three-dimensional structure is introduced. SMARTPocket represents RNA as full-atom point clouds and uses transfer learning from more than 110,000 protein binding interface structures to overcome the limited number of experimentally elucidated RNA-ligand complexes. Across four established single-chain benchmarks and three broader curated benchmarks, SMARTPocket consistently outperforms existing RNA pocket predictors and general biomolecular modeling approaches. The model generalizes to apo RNA structures when conformational changes are modest, identifies cryptic ligandable pockets, and recapitulates experimentally validated binding sites in the SARS-CoV-2 frameshifting element and an RNA aptamer evolved to bind small molecules. SMARTPocket-guided docking further improves near-native RNA-ligand pose recovery and computational efficiency compared with blind docking. These results establish SMARTPocket as a generalizable framework for structure-based identification of ligandable RNA pockets and for accelerating discovery of RNA-targeted small molecules.

19.
PLOS Medicine 2026-05-06

Pathways of emergency care for severely ill children in Nigerian and Ugandan hospitals: A process mapping study

作者:

by Rami Subhi, Abiodun Sogbesan, Dan Muramuzi, Mikael Burhin, Ayobami A. Bakare, Adegoke G. Falade, Freddy E. Kitutu, Freddie Ssengooba, Carina King, Sumit Kane, Belinda Dawson-McClaren, Hamish R. Graham, the MOXY-Implementation Research Collaboration Background Child mortality remains high in countries with weak emergency care systems. Facility organisation for paediatric emergency care is heterogeneous and under-described. We examined how hospitals in Uganda and Nigeria are organised to deliver emergency care for neonates and children. Methods and findings We conducted a qualitative, multi-method study in 26 purposively selected secondary and tertiary facilities in Uganda and Nigeria from October 2023 to December 2024. Embedded researchers documented patient pathways, resources for care, and care processes for severely ill children (

20.
medRxiv (Medicine) 2026-06-22

Starting, stopping and restarting. Patterns of Methylphenidate Use over 14 years in a large public health system

Background Persistence with stimulant medication is poor in children and adolescents with ADHD, and the evidence base is derived predominantly from high-income countries. We describe methylphenidate utilisation patterns and predictors of 12-month retention across 14 years in a large South African public health service. Methods Retrospective cohort study using routine pharmacy data from the Western Cape provincial health service (2011-2024). Children aged 5-18 at first prescription were included. Treatment episodes were defined as continuous prescription sequences with no gap exceeding 90 days and classified as initiations or restarts. Logistic regression modelled 12-month retention against early visit frequency and formulation type as pre-specified exposures. Findings 421,925 prescription events for 23,243 children across 115 facilities generated 65,885 treatment episodes. Median age at first prescription was 10 years (IQR 8-12); 77.6% were male. Kaplan-Meier 12-month survival was 28.2% for initiations and 15.4% for restarts, substantially below high-income country comparators. A quarter of all initiating prescriptions were not followed by a subsequent dispensing event; nearly 40% of patients had three or more treatment episodes. Early visit frequency was the strongest predictor of 12-month retention (high vs low: OR 2.85, 95% CI 2.65-3.06). The sustained-release formulation effect was present but attenuated on multivariable adjustment. Treatment re-initiations showed a marked seasonal pattern consistent with the South African school calendar. Interpretation Twelve-month retention was markedly lower than high-income country rates. Against a backdrop of high attrition, both early visit frequency and sustained-release formulation access predicted persistence; clinical engagement and reducing structural barriers to access are modifiable factors in this setting. Funding None.

21.
medRxiv (Medicine) 2026-06-15

Bidirectional associations between cannabis use, oddball performance, and P3 event-related potential

Importance: Cannabis use remains prevalent in youth despite concerns regarding its potential impact on cognitive function. Unraveling whether the association between cannabis use and cognition is partially due to preexisting differences or primarily related to use is vital to understanding underlying mechanisms. Objective: To estimate the longitudinal association between cannabis initiation and cognitive trajectories, indexed by task performance and P3 event-related potential (ERP), and to estimate whether baseline cognition is associated with cannabis initiation. Design: Data were analyzed from the ongoing longitudinal Collaborative Study on the Genetics of Alcoholism (COGA) cohort, which was followed up approximately every 2-5 years from 2004 to 2025. Setting: 6 sites across the United States. Participants: Adolescent and young adult offspring of past COGA participants and control families who reported on their cannabis use and who had Visual Oddball (VOP) performance and P3 ERP data (N=4814; 52.4% female, 68.4% white) were grouped based on the timing of cognitive data collection relative to cannabis initiation into Pre-onset (n=2,449; [&ge;]1 assessment) and Post-onset (n=998; [&ge;]3 assessments) subsamples. Main Outcomes and Measures: VOP measures include performance accuracy (%), reaction times (ms), and P3 amplitude (V) and latency (ms) during target trials. Cannabis measures included lifetime use of cannabis (i.e., ever used) and age at first use. Results: High P3 amplitude, and prolonged P3 latency and reaction time were associated with a reduced hazard of cannabis initiation (All Hazards Ratio, [H.R.s]< 0.91, p's

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

Your "Pro" LLM Subscription May Actually Be "Free": Exposing Fingerprint Spoofing Risks in LLM Inference Services

As Large Language Model (LLM) APIs become ubiquitous, users increasingly rely on black-box fingerprinting to verify that providers are serving the advertised premium models. However, these methods may overlook adversarial providers who manipulate model weights to cheat the fingerprint process. We introduce a novel threat termed fingerprint spoofing, where a malicious provider stealthily serves a weaker model that has been parameter-efficiently fine-tuned to mimic a stronger model, thereby evading user-side fingerprinting. We first formally prove that user-side resource constraints (i.e., finite query budgets and weak fingerprinting classifiers) make current fingerprinting vulnerable to fingerprint spoofing. Guided by this theoretical analysis, we propose GhostPrint, a cost-effective attack framework leveraging surrogate modeling, reward-ranked fine-tuning, and knowledge distillation. Extensive evaluations in both static and continual fingerprinting settings demonstrate that GhostPrint allows weak models to consistently bypass representative fingerprint methods while maintaining utility at a low fine-tuning cost, exposing a critical vulnerability in current LLM fingerprinting pipelines.

23.
medRxiv (Medicine) 2026-06-22

Understanding and Usefulness of Effect Size and Certainty of Evidence: A Cross-sectional Survey of Evidence-Based Practice Competencies Among Registered Dietitians

Introduction: Understanding of absolute and relative estimates (i.e., effect size), and certainty of evidence corresponding to those estimates, is a fundamental evidence-based practice competency to promote informed clinical decision-making. While research has been conducted in the medical profession, there is no published research on these competencies in the nutrition and dietetics profession. Methods: Among registered dietitians, our main objectives were to assess (1) their understanding and perceived usefulness of three absolute and two relative estimate approaches to assess effect size, (2) their perceived usefulness of certainty of evidence, and (3) factors influencing their understanding and perceived usefulness. We conducted a web-based, cross-sectional survey among dietitians recruited from the Academy of Nutrition and Dietetics (United States). Participants received effect estimates based on hypothetical dietary interventions vs. usual diet for reducing myocardial infarction risk. Results: Of the 11,050 dietitians who received the survey link, 210 participated (2.0% response rate), and only completers (n=114) were included in the analysis. Participants demonstrated a similar understanding of the relative (27.6%) and absolute (27.5%) estimates, with Risk Difference (30.7% correct responses) being the best understood approach and Number Needed to Treat (24.6%) being the least. The understanding of five approaches was not different than random guessing (p>0.05). While perceived usefulness scores were similar between five approaches, they were highest when data was presented as Relative Risk [mean (SD): 4.82 (1.50)]. Dietitians rated the usefulness of certainty of evidence favorably [mean (SD): 5.07 (1.83), on a 7-point scale), and no factors were associated with correct understanding. Conclusion: Dietitians may have limited understanding of how to interpret effect sizes, a finding consistent with surveys of other health professionals. To optimize informed decision-making between dietitians and clients, dietetic programs and continuing education platforms should consider additional training on interpreting effect sizes and certainty of evidence for effect sizes.

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

Stochastic dominations for FK percolation and sharp thinning thresholds for the Ising energy field

arXiv:2606.13648v1 Announce Type: new Abstract: At first glance, one would imagine that the energy field of the Ising model, the set of edges whose endpoints share the same spin, is stochastically monotone as a function of the coupling constants. However, this is not generally the case. In this paper, we introduce two weaker notions of stochastic domination that make this result true: $p$–weak and $p$–weak$^\dagger$ domination. Both of these notions depend on a parameter $p$ and we find the optimal values $p$ and $p^\dagger$ so that these dominations hold. One of the key ingredient to obtain some of the results is a new stochastic domination relating FK percolations with different parameters $q,\tilde{q}\geq 1$ that is of independent interest.

25.
arXiv (quant-ph) 2026-06-15

Nanostructure modelling with early fault tolerant quantum computers

arXiv:2606.06442v2 Announce Type: replace Abstract: Semiconductor nanostructures are central to many developing technologies. Notably, double quantum dots are especially important for semiconductor spin-qubit architectures, quantum sensing applications, and quantum-dot solar cells. Accurate modelling is highly desirable but conventional methods can struggle when dynamics involve more than two interacting electrons. In this work, we present a quantum simulation framework capable of addressing multi-electron double quantum dots. We adopt an efficiently scaling 1$^st$ quantised representation of the system and develop algorithms based on both Trotterisation and Qubitisation. Incorporating insights from classical simulations enables us to produce resource estimates that are more realistic than those obtained from theoretical error bounds. Using a standard surface code model with physical noise at $10^{-3}$, our results indicate that the ground-state energy of four electrons in a double quantum dot can be estimated in approximately 22 hours using 226k physical qubits, or an eight-electron system in 3.3 days with 314k qubits (with runtimes falling dramatically when more qubits are available). We anticipate that incorporating recent advances in surface code architectures may reduce these costs significantly further. Our results suggest that early fault-tolerant quantum computers may become valuable tools for designing mature-era quantum technologies.