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01.
medRxiv (Medicine) 2026-06-12

Room-Specialized Mixture-of-Experts for In-Home ADL Recognition with Ambient Sensors

Monitoring activities of daily living (ADLs) in the home is a promising approach for tracking dementia progression in older adults. While ambient sensor-based ADL systems are well-studied, most existing ADL recognition systems rely on globally trained models that ignore the spatial organization of in-home activities. In real deployments, where training data are sparse and highly home-specific, global transformer models may fail to capture room-dependent behavioral structure. We propose a deterministic Mixture of Experts (MoE) architecture for in-home ADL recognition, in which each expert is a compact transformer specialized to one room of the home (bedroom, kitchen, bathroom, living area). Input segments are routed using a deterministic gating strategy based on room-level motion activity and time-of-day priors for sleep-related behaviors. Unlike learned routing networks, the proposed gate encodes domain knowledge about where ADLs are likely to occur, reducing model complexity under limited per-home training data. By decomposing ADL recognition into room-specific activity spaces, the proposed architecture reduces competition between dominant and low-frequency activities under highly imbalanced residential data. We evaluated the system on data collected via low-cost ambient sensors (motion, light, temperature, humidity) and Raspberry Pi edge devices across five homes, with ground-truth ADL labels provided by participants and caregivers. Across the five homes, the proposed MoE consistently outperformed global transformer, 1D CNN, and Random Forest baselines, achieving macro-F1 scores ranging from 0.60 to 0.88, highlighting the importance of home-specific modeling in real-world deployments. These findings suggest that room-aware expert specialization may provide a practical and interpretable strategy for low-data ADL recognition in real-world residential environments.

02.
arXiv (CS.AI) 2026-06-19

Uncertainty-Aware Reward Modeling for Stable RLHF

arXiv:2606.19818v1 Announce Type: cross Abstract: Reinforcement learning from human feedback (RLHF) aligns large language models by training reward models on preference data and optimizing policies to maximize predicted rewards. However, this pipeline faces two fundamental challenges: (1) reward models cannot signal when their predictions are unreliable, since they usually act as deterministic point estimators; and (2) modern group-based policy optimization can amplify unreliable reward signals, as exemplified by GRPO's uniform treatment of rewards during advantage computation. As policies explore increasingly diverse responses, these two limitations create a critical vulnerability: unreliable reward estimates may be granted disproportionate influence, triggering severe reward hacking. We propose Uncertainty-Aware Reward Modeling (UARM), which equips reward models with calibrated uncertainty via quantile-based conformal prediction and reweights GRPO advantages through heteroscedastic variance decomposition. Experiments across HelpSteer, UltraFeedback, and PKU-SafeRLHF demonstrate that UARM significantly improves reward model calibration, reduces reward hacking, and enhances downstream alignment quality compared to standard GRPO and uncertainty-agnostic baselines.

03.
bioRxiv (Bioinfo) 2026-06-11

DeePEn - A Depth sensitive benchmark for Protein Engineering

Recent progress in modeling techniques and high-throughput screening has significantly enhanced the accessibility of protein engineering. Nevertheless, further progress gets hindered by the lack of robust benchmarks that capture the practical challenges for real-world protein engineering. Here, we introduced DeePEn, a Depth-sensitive benchmark for Protein Engineering that quantifies a models generalization capabilities when predicting protein fitness at increasing mutational distance from the wildtype or training data. We defined distance as the number of simultaneous point mutations, i.e., single amino acid variants (SAVs), moving from wild-type to mutant (edit distance in computer science jargon). Specifically selecting four deep mutational scanning (DMS) datasets with sufficient multi-mutation data points from ProteinGym, we assessed recent predictive models, including general and biophysics-informed protein Language Models (pLMs), and a non-transformer neural network. Our results highlight how the performance of all models deteriorates with increasing mutational distance and that no single metric sufficiently captures the diverse requirements of protein engineering. To overcome these shortcomings, DeePEn provides a readily available resource for multi-metric benchmarking that focuses on the prediction of distant variants.

04.
arXiv (quant-ph) 2026-06-12

Coulomb crystallization of xenon highly charged ions in a laser-cooled Ca+ matrix

arXiv:2512.12266v2 Announce Type: replace-cross Abstract: We report on the sympathetic cooling and Coulomb crystallization of xenon highly charged ions (HCIs) with laser-cooled Ca$^+$ ions. The HCIs are produced in a compact electron beam ion trap, then charge selected, decelerated, and finally injected into a cryogenic linear Paul trap. There, they are captured into $^{40}$Ca$^+$ Coulomb crystals, and co-crystallized within them, causing dark voids in their fluorescence images. Fine control over the number of trapped ions and HCIs allows us to realize mixed-species crystals with arbitrary ordering patterns. By investigating Xe$^{q+}$–Ca$^+$ strings, we confirm the HCI charge states, measure their lifetime and characterize the mixed-species motional modes. Our system effectively combines the established quantum control toolbox for Ca$^+$ with the rich set of atomic properties of Xe highly charged ions, providing a resourceful platform for optical frequency metrology, searches for signatures of new physics, and quantum information science.

05.
arXiv (CS.CV) 2026-06-16

MoECa: Aligning Feature Reuse with Expert Decomposition in Diffusion Transformers

Diffusion Transformers with Mixture-of-Experts (DiT-MoE) improve model capacity under sparse activation, but diffusion inference is still bottlenecked by redundant computation across timesteps. Existing caching methods mainly operate at the token level, which becomes suboptimal in DiT-MoE because each token update is internally decomposed into multiple routed expert branches. Our analysis shows that cross-timestep redundancy in DiT-MoE is better characterized at the expert-branch level than at the whole-token level. Based on this observation, we propose MoECa, a fine-grained caching framework that performs branch-level feature reuse across timesteps. MoECa further introduces expert-aware adaptive control and synchronized cache updates across MoE and attention paths to maintain stable intermediate states. Experiments on multiple DiT-MoE models show that MoECa consistently achieves a better speed-quality trade-off than prior caching methods, with up to 2.83$\times$ inference speedup and minimal quality degradation.

06.
medRxiv (Medicine) 2026-06-17

Multi-strain Probiotics Alter Gut Microbiota and Estrobolome Pathways in Primary Dysmenorrhea

Background: Exact cause of primary dysmenorrhoea is unknown but recent evidence uncovers a potential link between gut dysbiosis and benign gynaecological disorder via disruption of estrobolome. Methods: A randomized controlled trial to investigate the effects of multi-strain oral probiotics on primary dysmenorrhoea has been conducted. This is a secondary analysis comparing the stool microbiome in women with primary dysmenorrhoea and those without (control), and the effects of treatment with probiotics versus placebo. Results: Although microbial richness and evenness were comparable between groups (alpha diversity, p > 0.05), gut microbial community composition differed significantly (Bray Curtis PERMANOVA, p = 0.015), characterised by reduced Bifidobacterium adolescentis and Blautia and enrichment of Faecalibacterium in dysmenorrhoea, alongside condition-specific core taxa. Post-intervention analysis revealed significant shifts in microbial community structure between pre- and post-treatment groups (PERMANOVA, F = 2.11, p = 0.005), with probiotic supplementation inducing more consistent and directed microbiome changes than placebo, without altering alpha diversity (p > 0.05). Functional prediction showed no significant difference in overall beta glucuronidase pathway abundance (p > 0.05); however, dysmenorrhoea was associated with higher abundance of beta glucuronidase producing taxa (MaAsLin2, q < 0.05) that were differentially modulated by probiotic treatment. Conclusion: This discovery provides evidence on the microbial disruption in primary dysmenorrhoea as well as the benefit of probiotics to modulate the intestinal microbiota to improve the condition.

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

IntSeqBERT: Learning Arithmetic Structure in OEIS via Modulo-Spectrum Embeddings

arXiv:2603.05556v2 Announce Type: replace Abstract: Integer sequences in the OEIS span values from single-digit constants to astronomical factorials and exponentials, making prediction challenging for standard tokenised models that cannot handle out-of-vocabulary values or exploit periodic arithmetic structure. We present IntSeqBERT, a dual-stream Transformer encoder for masked integer-sequence modelling on OEIS. Each sequence element is encoded along two complementary axes: a continuous log-scale magnitude embedding and sin/cos modulo embeddings for 100 residues (moduli $2$–$101$), fused via FiLM. Three prediction heads (magnitude regression, sign classification, and modulo prediction for 100 moduli) are trained jointly on 274,705 OEIS sequences. At the Large scale (91.5M parameters), IntSeqBERT achieves 95.85% magnitude accuracy and 50.38% Mean Modulo Accuracy (MMA) on the test set, outperforming a standard tokenised Transformer baseline by $+8.9$ pt and $+4.5$ pt, respectively. An ablation removing the modulo stream confirms it accounts for $+15.2$ pt of the MMA gain and contributes an additional $+6.2$ pt to magnitude accuracy. A probabilistic Chinese Remainder Theorem (CRT)-based Solver converts the model's predictions into concrete integers, yielding a 7.4-fold improvement in next-term prediction over the tokenised-Transformer baseline (Top-1: 19.09% vs. 2.59%). Modulo spectrum analysis reveals a strong negative correlation between Normalised Information Gain (NIG) and Euler's totient ratio $\varphi(m)/m$ ($r = -0.851$, $p < 10^{-28}$), providing empirical evidence that composite moduli capture OEIS arithmetic structure more efficiently via CRT aggregation.

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

Variable-Width Transformers

Scaling model size, specifically depth and width, has driven significant progress in transformer-based language models. However, most architectures maintain a constant width across all layers, allocating a fixed parameter and computation budget evenly despite different layers potentially playing distinct computational roles. In this work, we empirically investigate nonuniform capacity allocation across network depth by proposing a $\times$-shaped >

09.
arXiv (CS.CV) 2026-06-16

ATV-Net: Adaptive Triple-View Network with Dynamic Feature Fusion

Recent advances in semantic segmentation rely heavily on attention-based and transformer-style architectures that, while accurate, introduce considerable architectural complexity and computational cost. This paper asks whether a compact CNN-based segmentation head can remain competitive by adaptively selecting useful receptive-field evidence. We propose ATV-Net, an Adaptive Triple-View Network that attaches a lightweight head to a conventional backbone. The head organizes three complementary views – point-wise, neighborhood-level, and enlarged context – and fuses them through an Adaptive Decision Gate that generates image-dependent weights from global feature statistics. This allows the model to emphasize different receptive-field responses according to scene content, without dense attention or multi-scale aggregation. Experiments on Cityscapes and Pascal VOC 2012 show that ATV-Net achieves 80.31% mIoU on Cityscapes with ResNet-101 and 80.90% with ConvNeXt-Tiny, and 86.7% and 88.5% mIoU on Pascal VOC 2012, respectively, while requiring fewer GFLOPs than representative context-aggregation and attention-based heads. The results indicate that adaptive receptive-field selection remains a practical and effective design choice for CNN-based semantic segmentation.

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

Learning Directional Semantic Transitions for Longitudinal Chest X-ray Analysis

Chest X-ray (CXR) interpretation often requires longitudinal comparison to assess disease progression. Existing approaches typically rely on temporal feature fusion or inter-study discrepancy modeling, yet remain limited in capturing subtle progression semantics and overlook the inherently directional nature of disease trajectories. In this paper, we propose ProTrans, a novel vision-language pretraining framework that formulates disease progression as a directional semantic transition between paired CXR studies. ProTrans leverages radiology reports to anchor individual CXR representations within interpretable disease states, and introduces a learnable progression feature map to explicitly encode semantic shifts between states, aligned with report-derived progression descriptions. To enforce direction-aware perception, ProTrans incorporates a reversed temporal modeling process and imposes bidirectional reconstruction consistency across states and transitions, thereby disentangling directional semantics and promoting coherent trajectory modeling. Extensive experiments on longitudinal downstream tasks, including disease progression classification and progression captioning, demonstrate that ProTrans consistently outperforms existing methods, establishing a unified pretraining framework for longitudinal CXR understanding. https://github.com/RPIDIAL/ProTrans

11.
Nature Biotechnology 2026-06-05

Structural motif search across the protein universe with Folddisco

Authors:

Detecting similar protein structural motifs in large structure collections is computationally expensive. We developed Folddisco, a fast structural motif search tool that uses an index of position-independent geometric features, including side-chain orientation, combined with a rarity-based scoring system. Folddisco is 20-fold faster in querying and fourfold more storage-efficient than existing methods while improving accuracy. Folddisco is freely available online ( https://folddisco.foldseek.com ), along with a webserver ( https://search.foldseek.com/folddisco ). Folddisco enables protein structural motif search in million scale databases.

12.
arXiv (CS.CV) 2026-06-19

Spectral Query-Key Product Weight Steering for Training-Free VLM Hallucination Mitigation

Vision-language models (VLMs) often generate fluent but visually unsupported descriptions, especially by mentioning objects absent from the image. We propose QK Product Steering, a data-free, training-free, and zero-inference-cost weight edit for reducing object hallucination. The method directly edits the per-head query-key product, the operator that produces pre-softmax attention logits, by suppressing a small number of dominant singular modes in selected middle layers. The edited product is then mapped back to the query weights through a closed-form query-only update while keeping shared key weights fixed, making the edit compatible with grouped-query attention. We further decompose the QK product into symmetric and antisymmetric components to distinguish mutual content-similarity patterns from directional attention patterns. Across three GQA-based VLMs, QK Product Steering achieves an average relative CHAIR$_s$ reduction of $4.0\%$, while matched random-mode controls show negligible change. Interpretability ablations show that the hallucination signal is specific to dominant QK modes and is primarily localized to the symmetric mutual-attention channel. Overall, QK Product Steering offers a simple alternative to decoding-time mitigation, requiring no additional data, fine-tuning, or inference-time overhead while largely preserving general multimodal capability.

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

TCHG: Tri-Trust Conditioned Heterogeneous Graph Learning for Reliable Dynamic Trust Prediction

arXiv:2606.16611v1 Announce Type: new Abstract: Trust prediction infers latent user-user trust relations and provides important support for social recommendation, fake-review and manipulation detection, and risk identification. Graph neural networks have become a prominent approach to trust prediction because of their ability to learn network structures and complex trust dependencies. However, existing methods often rely on a unified representation of trust signals and do not disentangle heterogeneous trust evidence into separate evidence channels, failing to exploit the distinct roles that different evidence channels should play during trust modeling. To address this gap, this paper argues that trust evidence should not be treated as an undifferentiated input, but should be decomposed and used as functional control factors over graph propagation. We propose TCHG, a tri-trust conditioned heterogeneous graph learning framework that decomposes trust evidence into three channels and assigns them distinct functional roles in propagation: entity reliability governs message admission, interaction-behavior reliability modulates propagation strength, and contextual trust adjusts the propagation mode through context-conditioned operator selection. Since the three evidence channels evolve at different temporal scales, TCHG maintains independent temporal states with non-uniform decay rates to prevent rapidly changing contextual signals from overwriting slowly accumulated entity reliability. It further predicts trust probability and calibrates the output probability, improving predictive confidence under sparse or conflicting evidence. Extensive experiments on multiple public trust datasets show that TCHG achieves effective and reliable trust prediction compared with representative trust prediction and heterogeneous graph baselines.

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

The Initial Exploration Problem in Knowledge Graph Exploration

arXiv:2602.21066v2 Announce Type: replace Abstract: Knowledge Graphs (KGs) enable the integration and representation of complex information across domains, but their semantic richness and structural complexity create substantial barriers for lay users without expertise in semantic web technologies. When encountering an unfamiliar KG, such users face a distinct orientation challenge: they do not know what questions are possible, how the knowledge is structured, or how to begin exploration. This paper identifies and theorises this phenomenon as the Initial Exploration Problem (IEP). Drawing on theories from information behaviour and human-computer interaction, including ASK, exploratory search, information foraging, and cognitive load theory, we develop a conceptual framing of the IEP characterised by three interdependent barriers: scope uncertainty, ontology opacity, and query incapacity. We argue that these barriers converge at the moment of first contact, distinguishing the IEP from related concepts that presuppose an existing starting point or information goal. Analysing KG exploration interfaces at the level of interaction primitives, we suggest that many systems rely on epistemic assumptions that do not hold at first contact. This reveals a structural gap in the design space: the absence of interaction primitives for scope revelation, mechanisms that communicate what a KG contains without requiring users to formulate queries or interpret ontological structures. In articulating the IEP, this paper provides a theoretical lens for evaluating KG interfaces and for designing entry-point scaffolding that supports initial exploration.

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

Fourier Multi-Component and Multi-Layer Neural Networks: Unlocking High-Frequency Potential

arXiv:2502.18959v3 Announce Type: replace Abstract: The architecture of a neural network and the choice of its activation function are both fundamental to its performance. Equally important is ensuring that these two elements are well matched, as their alignment is key to effective representation and learning. In this paper, we introduce the Fourier Multi-Component and Multi-Layer Neural Network (FMMNN), a model that combines sine-type activations with the multi-component and multi-layer structure of MMNNs. In an FMMNN, each component is represented as a trainable linear combination of fixed random sine-type basis functions, while multi-layer composition generates more complex and adaptive high-frequency features. We establish that FMMNNs retain exponential expressive power for function approximation even under a low-rank architectural structure. We also analyze the optimization landscape of FMMNNs and find it to be substantially more favorable than that of standard fully connected neural networks, especially for high-frequency targets. In addition, we propose a scaled random initialization method for the first-layer weights in FMMNNs, which accelerates training and improves final performance when sufficient samples are available. Extensive numerical experiments support our theoretical insights, showing that FMMNNs achieve strong accuracy and favorable convergence behavior on oscillatory function-approximation benchmarks.

16.
arXiv (quant-ph) 2026-06-12

Theoretical Study for Generating Optical GKP State via a Single-Photon-Added Squeezed Vacuum

arXiv:2606.12467v1 Announce Type: new Abstract: A theoretical framework is developed to analyze the generation of the optical GKP state using a single-photon-added squeezed vacuum. This state, defined by the squeezing parameter $r$, is injected into a 50:50 beam splitter, and the optical GKP state is obtained through conditional measurement at one output port. The single-photon-added squeezed vacuum is especially prominent in this context because it provides a simpler and more experimentally accessible ingredient than Schrodinger cat states, while conditional measurement ensures projection onto a state that closely approximates the finite-energy GKP form. Fidelity is employed to quantify this closeness, and the analysis demonstrates that the scheme achieves a maximum fidelity of 85% at a squeezing level of $3.76 \ dB$. This performance surpasses approaches based on squeezed optical odd Schrodinger cat states, underscoring the single-photon-added squeezed vacuum as a practical and effective pathway toward fault-tolerant photonic quantum computing.

17.
arXiv (CS.AI) 2026-06-19

UltraQuant: 4-bit KV Caching for Context-Heavy Agents

arXiv:2606.20474v1 Announce Type: cross Abstract: Context-heavy agents place unusual pressure on the key-value (KV) cache: long prefixes are reused across many short turns, while concurrency determines whether the serving system can keep GPUs utilized. We study 4-bit KV-cache compression for this setting, using TurboQuant-style rotation and codebook quantization as a quality anchor and vLLM FP8 KV caching as the deployment anchor. We report three contributions. First, we frame 4-bit KV caching around multi-round agent workloads where task quality, cache residency, and serving throughput must be measured jointly. Second, we describe the practical design choices needed to make the 4-bit path robust, including asymmetric K/V treatment, Walsh-Hadamard rotation, QJL removal, and block-scale variants. Third, we present serving optimizations on AMD GPUs, including optimized decode-attention kernels and UltraQuant, an FP4 approximation path that uses FP8 queries, FP4 KV tensors, UE8M0 group scales, and native scaled-MFMA support on CDNA4. On a long-context, multi-turn agentic workload, UltraQuant cuts P50 time-to-first-token by 3.47x in the cache-pressured late rounds (2.3x across all rounds) and raises output throughput by 1.63x over the FP8 KV baseline.

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

Automatic identification of diagnosis from hospital discharge letters via weakly supervised Natural Language Processing

Identifying patient diagnoses from hospital discharge letters is essential for large-scale cohort selection and epidemiological research, but traditional supervised approaches require extensive manual annotation, which is often impractical for large textual datasets. We present a weakly supervised Natural Language Processing (NLP) pipeline for classifying Italian discharge letters without document-level manual annotation. The method extracts diagnosis-related sentences, generates semantic embeddings using a transformer model further pre-trained on Italian medical documents, and applies a two-level clustering procedure to derive weak labels that are then used to train a document-level classifier. The approach was evaluated in a case study on bronchiolitis using 33,176 discharge letters of children admitted to 44 emergency rooms or hospitals in the Veneto Region, Italy, between 2017 and 2020. The best weakly supervised model achieved an AUROC of 77.68% ($\pm4.30\%$), an AUPRC of 73.13% ($\pm4.93\%$), and an F1-score of 78.14% ($\pm4.89\%$) against manually annotated data. Performance surpassed unsupervised baselines and approached fully supervised models, while reducing the need for manual annotation by more than 1,500 hours for a dataset of this size. Similar model rankings were observed in a secondary validation on a smaller bronchitis dataset (3,188 discharge letters, 2020-2025), where the best weakly supervised model achieved an AUPRC of 76.72% ($\pm 5.02\%$). These results suggest the potential of weakly supervised NLP methods for scalable disease identification from clinical discharge letters.

19.
Nature Medicine 2026-06-15

Adaptive deep brain stimulation for dynamic gait control in Parkinson’s disease: a randomized feasibility trial

A randomized crossover study of five patients with Parkinson’s disease (PD) demonstrates that gait-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared with continuous stimulation. Gait dysfunction in PD is a major source of disability and is often insufficiently treated by continuous deep brain stimulation (cDBS). Although adaptive DBS (aDBS) has shown efficacy for other motor symptoms using β-based, state-driven neural signals, gait is a dynamic, cyclical behavior that may require temporally precise modulation. Here we evaluated a behavior-contingent aDBS approach that synchronizes stimulation to gait phase. We reported a single-center, blinded, randomized, crossover study evaluating the feasibility of identifying patient-specific biomarkers to drive aDBS. The primary outcome was feasibility of successful identification of gait-phase biomarkers to implement aDBS. Five participants with PD undergoing pallidal DBS and subdural electrode paddle implantation were enrolled. We successfully identified personalized gait-phase biomarkers from cortical or pallidal field potentials in all five patients and embedded them into a bidirectional neurostimulator. During acute in-clinic testing, aDBS improved step variability and step symmetry versus cDBS. Three participants subsequently completed a double-blinded, multi-day crossover phase. In this setting, aDBS maintained general motor symptom control, reduced falls and yielded patient-specific gait improvements. No adverse events occurred and aDBS was well tolerated. These findings establish the feasibility of biomarker-driven, movement-synchronized neuromodulation and support the development of a larger randomized trial to determine clinical efficacy. ClinicalTrial.gov registration: NCT04675398 . A randomized crossover study shows that gait-phase-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared to continuous stimulation in Parkinson’s disease.

20.
Nature (Science) 2026-06-08

Distributed control circuits across a brain-and-cord connectome

Just as genomes revolutionized molecular genetics, connectomes (maps of neurons and synapses) are transforming neuroscience. To date, the only organisms with complete connectomes are worms1–3, sea squirts4, and comb jellies5 (103–104 synapses). By contrast, the fruit fly is more complex (108 synaptic connections), with a brain that supports learning and spatial memory6,7 and an intricate ventral nerve cord analogous to the vertebrate spinal cord8–12. Here we report the first densely-reconstructed adult fly connectome that unites the brain and ventral nerve cord, and we leverage this resource to investigate principles of neural control. We show that effector neurons (motor neurons, endocrine cells, and efferent neurons targeting the viscera) are primarily influenced by sensory neurons in the same body part, forming local feedback loops. These local loops are linked by long-range circuits involving ascending and descending neurons organized into behavior-centric modules. Single ascending and descending neurons are often positioned to influence the voluntary movements of multiple body parts, together with the endocrine cells or visceral organs that support those movements. Brain regions involved in learning and navigation supervise these circuits. These results reveal an architecture that is distributed, parallelized, and embodied, reminiscent of distributed control architectures in engineered systems13,14.

21.
medRxiv (Medicine) 2026-06-17

Clinician knowledge and self-efficacy in snakebite management: A cross-sectional assessment in Northern Uganda

Background: Snakebite envenomation (SBE) is a major public health crisis in rural Uganda, yet it remains a neglected tropical disease. Effective management is often compromised by systemic barriers and a lack of clinician training. This study assessed clinician self-efficacy and objective knowledge regarding SBE management in Northern Uganda. Methods: A descriptive, cross-sectional study was conducted between February and July 2025 among 379 healthcare workers in Gulu, Omoro, and Pader districts. A validated questionnaire was used to collect data on socio-demographics, self-reported efficacy (scale 1-10), and objective knowledge. Knowledge scores [&ge;]70% were categorized as adequate. Multivariable logistic regression identified independent predictors of adequate knowledge, and Spearmans correlation ({rho}) assessed the relationship between knowledge and self-efficacy. Results: The participants had a mean age of 35.6 years (SD {+/-}7.3), were predominantly female (56.5%, 214/379), and most (83.6%, 317/379) practiced at Health Centre III level facilities. While 53.8% (204/379) reported prior training, 48.3% (183/379) of these had not received an update in over 10 years. Adequate knowledge was demonstrated by 51.5% (195/379) of participants. In the multivariable analysis, practicing in Omoro (adjusted odds ratio [aOR]: 0.3, 95% CI: 0.1-0.6, p < 0.001) or Pader (aOR: 0.2, 95% CI: 0.1-0.4, p < 0.001) was associated with lower odds of adequate knowledge compared to Gulu district. Prior training significantly increased the odds of adequate knowledge (aOR: 2.3, 95% CI: 1.3-4.2, p = 0.006). A moderate positive correlation was observed between self-efficacy and objective knowledge (Spearmans {rho} = 0.33, p < 0.0001). Conclusion: Approximately half of the frontline healthcare workers in Northern Uganda lack adequate knowledge on SBE management, with significant geographic differences and outdated training. The gap between clinician self-efficacy and objective knowledge poses a risk to patient safety. Regular, mandatory refresher training and targeted educational outreach to remote districts are required to reduce SBE-related morbidity and mortality.

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

DIMOS: Disentangling Instance-level Moving Object Segmentation

Moving instance segmentation (MIS) attracts increasing attention due to its broad applications in traffic surveillance, autonomous driving, and animal tracking. Event cameras record asynchronous brightness changes, providing high temporal resolution and dynamic range, which makes them highly sensitive to motion information. By fusing event and image features, motion cues from events can complement spatial details from images, enhancing the performance of MIS. However, current multimodal MIS methods still struggle to segment small moving instances, as event cameras often yield sparse features under limited resolution. Moreover, event features entangle appearance attributes with motion cues, which further restricts effective cross-modal fusion. To address these challenges, we first propose a dual-disentangling feature extraction framework that separates and extracts appearance and motion information within both image and event modalities, thereby improving feature density. Subsequently, a multi-granularity cross-modal alignment is introduced to align distributionally and semantically consistent features across modalities, enabling more effective fusion with rich spatial and temporal details. The experiment results demonstrate that our method achieves state-of-the-art performance in multimodal MIS, especially for small instances under challenging conditions such as fast motion and low-light settings.

23.
arXiv (quant-ph) 2026-06-11

Quantum thermodynamics of the Caldeira-Leggett model with non-equilibrium Gaussian reservoirs

arXiv:2405.00215v5 Announce Type: replace Abstract: We introduce a non-equilibrium version of the Caldeira-Leggett model in which a quantum particle is strongly coupled to a set of engineered reservoirs. The reservoirs are composed by collections of squeezed and displaced thermal modes, in contrast to the standard case in which the modes are assumed to be at equilibrium. The model proves to be very versatile. Strongly displaced/squeezed reservoirs can be used to generate an effective time dependence in the system Hamiltonian and can be identified as sources of pure work. In the case of squeezing, the time dependence is stochastic and breaks the fluctuation-dissipation relation, this can be reconciled with the second law of thermodynamics by correctly accounting for the energy used to generate the initial non-equilibrium conditions. To go beyond the average description and compute the full heat statistics, we treat squeezing and displacement as generalized Hamiltonians on a modified Keldysh contour. As an application of this technique, we show the quantum-classical correspondence between the heat statistics in the non-equilibrium Caldeira-Leggett model and the statistics of a classical Langevin particle under the action of squeezed and displaced colored noises. Finally, we discuss thermodynamic symmetries of the heat generating function, proving a fluctuation theorem for the energy balance and showing that the conservation of energy at the trajectory level emerges in the classical limit.

24.
medRxiv (Medicine) 2026-06-18

Evaluating Deep-Learning Based Quantification of Breast Arterial Calcification on Mammography for Cardiovascular Risk Assessment

Purpose: To develop and evaluate a deep learning model for automated quantification of breast arterial calcification (BAC) on screening mammography and to assess whether AI-derived BAC burden predicts major adverse cardiovascular events (MACE) in women. Methods: In this retrospective study, 202,006 women who underwent screening mammography without history of MACE were included. A BAC segmentation model was trained on an expert-annotated dataset using a multi-task U-Net with a ResNet-18 encoder to detect and segment BAC. BAC burden was quantified as area (mm{superscript 2}) from model-generated masks using DICOM pixel spacing and categorized by tertiles into low, intermediate, and high. The PREVENT score and incident MACE were identified from electronic health records. Cox proportional hazards models were developed to evaluate AI-derived BAC burden and PREVENT score alone, and combined models for 5 - and 10-year cardiovascular risk prediction. Results: Among 202,006 women (mean age 54.8{+/-}11.7 years), 23.1% had AI-detected BAC, and 7,701 (3.8%) developed incident MACE during a median follow - up of 7.5 years. On the geographically held-out test set, the BAC model achieved an AUROC of 0.97, Dice score of 0.6678, and Pearson correlation of 0.961 between AI-derived and manually annotated BAC burden. BAC burden increased with age and was higher among women who developed MACE. Five - year MACE incidence increased across BAC categories from 1.5% in women without BAC to 6.9% in those with high BAC burden. BAC burden alone showed modest prediction of MACE, with 5-year and 10-year AUROCs of 0.661 and 0.650, respectively, while PREVENT achieved AUROCs of 0.781 and 0.771. Adding BAC to PREVENT produced minimal improvement in discrimination. Conclusion: Deep learning-based BAC quantification from routine mammography is feasible, accurate, and associated with future cardiovascular risk. Although BAC added little to PREVENT for overall discrimination, it may serve as a scalable opportunistic imaging biomarker to identify women at elevated cardiovascular risk and support preventive care.

25.
PLOS Medicine 2026-05-06

Point-of-care early infant HIV diagnosis at birth in a pragmatic cluster-randomized trial in Mozambique and Tanzania: A comparative cost and cost-effectiveness study

Authors:

by Kira Elsbernd, Issa Sabi, Ilesh V. Jani, Chishamiso Mudenyanga, Siriel Boniface, Arlete Mahumane, Joaquim Lequechane, Falume Chale, Bindiya Meggi, Kassia Pereira, Raphael Edom, Anange F. Lwilla, W. Chris Buck, Nyanda Elias Ntinyinya, Michael Hoelscher, Till Baernighausen, Arne Kroidl, Stefan Kohler, the LIFE Study Consortium Background Timely access to early infant diagnosis (EID) is crucial for newborns with HIV, as late diagnosis can delay lifesaving antiretroviral treatment (ART). We assessed the comparative cost and cost-effectiveness of integrating point-of-care EID at birth into routine care in primary healthcare settings. Methods and findings This pre-specified secondary analysis was nested in the cluster-randomized LIFE study conducted at 28 primary healthcare facilities in Mozambique and Tanzania from October 2019 to September 2021. We estimated the health system cost of point-of-care birth plus 4–8-week HIV testing (very early infant diagnosis; VEID) compared to standard-of-care (SoC) testing at 4–8 weeks only, both with immediate ART initiation. We assessed the cost-effectiveness of VEID relative to SoC with respect to ART initiation within one week of life using Bayesian hierarchical models. As this is an intermediate outcome, incremental cost-effectiveness ratios (ICERs) cannot be directly compared to available life-year-based cost-effectiveness thresholds. To contextualize results, we derived the minimum life-years gained per early ART initiation required for VEID to meet standard thresholds in a break-even analysis.VEID was associated with a higher cost and resulted in earlier ART initiation than SoC in both countries. In Mozambique, VEID increased the proportion of infants initiating ART within one week of life by 90.0 (95% CrI [67.5, 98.5]) percentage points at an incremental cost of $2,632 (95% CrI [$2,249, $3,062]) per infant with HIV. In Tanzania, VEID increased early ART initiation by 59.9 (95% CrI [20.9, 89.5]) percentage points at an incremental cost of $6,263 (95% CrI [$5,394, $7,243]) per infant with HIV. The ICER was $2,924 and $10,458 in Mozambique and Tanzania, respectively and was sensitive to intrauterine transmission rate. These findings were limited by the lack of long-term health outcome data and reliance on an intermediate outcome. Based on the break-even analysis, we estimated that VEID would need to yield 6–32 life-years gained per additional early ART initiation to meet standard thresholds. Conclusions Adding birth testing improved early ART initiation but was unlikely to be cost-effective relative to standard thresholds given current prices, vertical transmission rates, and knowledge of long-term health benefits. Cost-effectiveness could be achieved at current costs if early ART translates to substantial long-term health benefits or if targeted to infants at high risk of vertical transmission.