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01.
arXiv (CS.CV) 2026-06-16

Learn Temporal Consistency For Robust Satellite Video Detector

Satellite video object detection (SVOD) for oriented and fine-grained objects plays an important role in satellite applications. Most existing SVOD methods only focus on one or a few coarse-grained categories of moving objects and represent objects with horizontal bounding boxes. They have difficulty extracting complete, accurate, and consistent information about objects in whole satellite videos. In this paper, we propose a satellite video object detection framework based on Temporal Consistency Learning (TCL). TCL adeptly detects oriented and fine-grained objects by leveraging the rich temporal contexts within satellite videos. The framework integrates three key modules: temporal and fine-grained feature aggregation (TFA), structure encoding (SE), and temporal consistency constraint (TCC). TFA and TCC modules facilitate consistent representation learning across frames, while the SE module encodes both appearance and structural information for precise fine-grained recognition. Experimental results on the SAT-MTB benchmark dataset demonstrate TCL's superior performance, achieving a new state-of-the-art oriented and fine-grained detection accuracy of 47.7% mAP–a 4.8% improvement over the baseline. Furthermore, our TCL framework readily accommodates existing image-based detectors, leading to enhanced detection accuracies.

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

AgentFairBench: Do LLM Agents Discriminate When They Act?

arXiv:2606.16723v1 Announce Type: new Abstract: Large language model (LLM) agents increasingly take actions (screening applicants, recommending credit, triaging patients), yet fairness for LLMs is still measured by grading answers. We introduce AgentFairBench, a cheap, reproducible, multi-domain benchmark for demographic disparity in the actions of LLM agents. Grounded in a companion framework, the Bias Conduction Framework (BCF, restated here), it spans three regulator-anchored domains: hiring, lending, and medical triage. Synthetic, demographic-neutral profiles are evaluated in counterfactual matched sets that vary only a name-coded race x gender signal (in the Bertrand Mullainathan tradition), under four agent scaffolds of increasing agency (direct, chain-of-thought, multi-agent deliberation, tool-augmented). A NumPy-only harness computes counterfactual flip rate, mean absolute score difference (MASD), action-rate disparity, and tool-invocation disparity, with bootstrap confidence intervals, paired tests, and false-discovery-rate control, for single-digit dollars per model. A live leaderboard with a held-out private split and a contamination canary admits external models by submission. Our pilot (864 decisions plus a test-retest replication) carries a methodological lesson: comparing a six-group score spread against a two-run noise difference overstates disparity by ~ 2.4X through statistic arity alone. Against an arity matched noise floor and an omnibus group test, claude haiku 4 5 shows no demographic effect above sampling noise (0 of 120 pairwise and 0 of 9 omnibus contrasts survive correction); a planted-bias test confirms the instrument detects disparity when present. The contribution is a sound, sensitive, adoption-ready instrument, the arity matched null methodology, and open artifacts to scale it. Code, data, and harness are released under open licenses, with an anonymized review artifact.

03.
arXiv (CS.CV) 2026-06-17

EventDrive: Event Cameras for Vision-Language Driving Intelligence

Event cameras sense the world through asynchronous brightness changes with microsecond latency and high dynamic range, offering motion fidelity far beyond frame-based sensors and capturing temporal structure that conventional exposures often miss. These properties make events a powerful complement to RGB in autonomous driving, especially under blur, glare, and rapid motion, where frame-based perception can become unreliable. However, existing event-aware vision-language models remain limited to generic perception and do not reveal how event sensing contributes to reasoning and decision-making across the full driving loop. We present EventDrive, a large-scale benchmark and model suite that unifies event streams, RGB frames, and language supervision across four core dimensions: Perception, Understanding, Prediction, and Planning, covering captions, structured QA, grounding, motion-state recognition, trajectory forecasting, and planning tasks. Building on this foundation, EventDrive-VLM introduces a multi-horizon event pyramid and a temporal-horizon mixture-of-experts module to adaptively encode and fuse asynchronous and frame-based information for downstream reasoning. Comprehensive evaluation across diverse tasks shows that event streams provide substantial gains in temporal precision, motion awareness, and robustness, bringing event sensing into the center of driving intelligence.

04.
arXiv (CS.CV) 2026-06-16

VEPHand: View-Efficient Photometric Hand Performance Capture at Scale

Robust, high-fidelity 3D hand capture, while fundamental to digital human creation, remains challenging with practical multi-view systems that balance rich photometry with the geometric ambiguities of reconstruction arising from limited viewpoint density. This paper presents an end-to-end pipeline for dynamic hand performance capture and registration, specifically designed for view-efficient setups ($\sim$20 views). We address key challenges with two primary innovations. First, to overcome reconstruction difficulties like limited view overlap and background clutter, our mask-free neural method robustly extracts detailed hand geometry and appearance from unmasked images using scene parameterization and scenario-specific density regularization. Second, addressing registration challenges such as accurately capturing non-linear skin deformations and ensuring plausible results during severe self-contact, we propose a physics-inspired framework. It aligns reconstructions to a personalized hand model by optimizing intrinsic volumetric offsets within its canonical tetrahedral mesh, alongside pose parameters. This approach, supported by robust losses and optimization, captures fine surface deformations, ensures plausible results under severe articulation and self-contact, and demonstrates strong tolerance to input noise. We demonstrate the scalability and robustness of our automated pipeline on an extensive dataset of over 12,000 sequences, from which we also derive a large-scale, high-quality synthetic 2D/3D hand dataset for training downstream tasks. This showcases its effectiveness for single hands, intricate two-hand interactions, and natural hand-object manipulations. Our method achieves state-of-the-art reconstruction fidelity in view-efficient, unmasked scenarios and highly accurate registration. Our project page are available at https://zyshen021.github.io/VEPHand/.

05.
arXiv (CS.LG) 2026-06-18

Fair Online Resource Allocation

arXiv:2606.18679v1 Announce Type: cross Abstract: We study the problem of fair online resource allocation, motivated by applications such as refugee resettlement and airline scheduling, where agents arrive sequentially and must be assigned to facilities with limited capacities. We introduce a model that maximizes the overall welfare subject to resource constraints and a Lipschitz fairness requirement, which ensures that similar agents arriving in the same batch receive similar expected outcomes. We first analyze the offline problem, proving that the value of the optimal fair allocation is at least an $\Omega(1/\gamma)$ fraction of the optimal unfair allocation, where $\gamma$ is the fairness coefficient, thereby bounding the price of fairness. For the online setting, we propose an algorithm based on dual mirror descent that enforces fairness constraints within batches while estimating optimal dual variables. We prove that this algorithm achieves sublinear regret relative to the optimal offline fluid benchmark. Finally, we validate our theoretical results using real-world data from the Refugee Economies Programme, demonstrating the algorithm's performance and examining the trade-offs between welfare maximization and fairness enforcement.

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

Service-Induced Congestion in Memory-Constrained LLM Serving

arXiv:2606.15555v1 Announce Type: cross Abstract: In large language model (LLM) serving, each request accumulates persistent graphics processing unit (GPU) memory during service as its key-value cache grows with every generated token. Under high concurrency, aggregate memory usage therefore increases endogenously over time: the service process itself creates future capacity pressure. When memory capacity is exceeded, systems evict active requests, discarding cached state and restarting them later, which wastes computation and reduces throughput. We develop a discrete-time dynamical model of memory-constrained LLM inference that captures admission, memory growth, and eviction under continuous batching. In the saturated-input regime, the system admits both eviction-free fixed points and limit cycles with evictions. For homogeneous workloads, we show that the eviction-free equilibrium is unstable and that, except for a Lebesgue-measure-zero exact-capture set, the system converges to a unique worst-case limit cycle that is asymptotically stable outside this exceptional set, with throughput losses as large as 50%. For heterogeneous workloads, we prove a stability criterion in the two-class common-input setting and explain how the survival-polynomial mechanism generalizes to multiple classes and heterogeneous-input lengths. Under an input-dominated scaling regime, coprime decoding lengths stabilize the eviction-free equilibrium, while non-coprime lengths create synchronized modes that drive instability. These results characterize when workload heterogeneity desynchronizes completions and helps stabilize memory-constrained serving. More broadly, we identify service-induced congestion as a structural instability mechanism and derive scheduling design principles for sustaining high throughput.

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

Adaptive Domain Models: Bayesian Evolution, Warm Rotation, and Principled Training for Geometric and Neuromorphic AI

arXiv:2603.18104v5 Announce Type: replace Abstract: Prevailing AI training assumes reverse-mode automatic differentiation over IEEE-754 arithmetic. The memory overhead of training relative to inference, optimizer complexity, and structural degradation of geometric properties through training are consequences of this arithmetic substrate. This paper develops an alternative training architecture grounded in three prior results: the Dimensional Type System and Deterministic Memory Management framework (Haynes 2026), which establishes stack-eligible gradient allocation and exact quire accumulation as design-time verifiable properties; the Program Hypergraph (Haynes 2026), which establishes grade preservation through geometric algebra computations as a type-level invariant; and the b-posit bounded-regime design (Jonnalagadda et al. 2025), which makes posit arithmetic tractable across hardware targets conventionally considered inference-only. Their composition enables depth-independent training memory bounded to approximately twice the inference footprint, grade-preserving weight updates, and exact gradient accumulation, applicable uniformly to loss-function-optimized and spike-timing-dependent neuromorphic models. We introduce *Bayesian distillation*, a mechanism by which the latent prior structure of a general-purpose model is extracted through the ADM training regime, resolving the data-scarcity bootstrapping problem for domain-specific training. For deployment, we introduce *warm rotation*, an operational pattern in which an updated model transitions into an active inference pathway without service interruption, with correctness formalized through PHG certificates and signed version records. The result is a class of domain-specific AI systems that are smaller and more precise than general-purpose models, continuously adaptive, verifiably correct with respect to the physical structure of their domains, and initializable from existing models.

08.
arXiv (quant-ph) 2026-06-15

Certifying Macroscopic Quantum Mechanics via Hypothesis Testing with Finite Data

arXiv:2506.22092v2 Announce Type: replace Abstract: We address the challenge of certifying quantum behavior with single macroscopic massive particles, subject to decoherence and finite data. We propose a hypothesis testing framework that distinguishes between classical and quantum mechanics based on position measurements. While interference pattern visibility in single-particle quantum superposition experiments has been commonly used as a sufficient criterion to falsify classical mechanics, we show that, from a hypothesis testing perspective, it is neither necessary nor efficient. Focusing on recent proposals to prepare macroscopic superposition states of levitated nanoparticles, we show that the likelihood ratio test – which leverages differences across the entire probability distribution – provides an exponential reduction in measurements needed to reach a given confidence level. These results generalize to a broad class of quantum states, and offer a principled, efficient method to falsify classical mechanics in interference experiments, relaxing the experimental constraints faced by current efforts to test quantum mechanics at the macroscopic scale.

09.
arXiv (CS.AI) 2026-06-15

TwinBI: An Agentic Digital Twin for Efficient Augmented Interactions with Business Intelligence Dashboards

arXiv:2606.13731v1 Announce Type: new Abstract: Business intelligence (BI) increasingly combines dashboard interaction with LLM-based assistance, but these two modes often fall out of sync during multi-step analysis. As users switch between direct dashboard manipulation and natural-language queries, it becomes difficult to preserve a consistent analytical state across filters, hierarchies, metrics, and chart context. We present TwinBI, an agentic digital-twin framework that couples an LLM-based agent system with an executable BI dashboard state. TwinBI unifies conversational interaction, dashboard manipulation, semantic grounding, and provenance tracking through a shared analytical state reconstructed from a unified interaction log. It also exposes artifacts such as schema views, SQL, logs, and an /insights command for state-grounded analytical summaries. We evaluate TwinBI in two complementary ways. In a controlled A/B benchmark with the same backbone agent, TwinBI improves exact-match accuracy from 43.3% to 63.3%, partial-credit accuracy from 48.3% to 70.8%, and substantially reduces timeout rate from 40.0% to 10.0% relative to Dashboard alone. In a usability study, participants benefited from the integrated dashboard-and-chat workflow, with high task accuracy, moderate workload, and favorable ratings for state-aware interaction mechanisms. These results suggest that TwinBI improves both agent-level analytical reliability and user-facing analytical support by turning visible dashboard state into richer actionable context. Our dataset and source code are available at: https://github.com/simonjisu/TwinBI

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

Analyzing and Improving Fine-grained Preference Optimization in Medical LVLMs

Large Vision-Language Models (LVLMs) have achieved strong performance across medical imaging tasks, yet they remain prone to factual inconsistencies, poor visual grounding, and misalignment with clinically meaningful feedback. Existing post-training alignment approaches, including Direct Preference Optimization (DPO) and its variants, face three critical limitations in the medical domain: (1) sequence-level reward signals treat clinically critical tokens identically to generic filler text; (2) reliance on static supervised fine-tuning references as preferred responses introduces an off-policy distribution shift, steering optimization toward stylistic artifacts over clinical correctness; and (3) alignment objectives lack explicit visual grounding constraints, leaving models insensitive to subtle yet diagnostically decisive pathological features. Our method leverages a bidirectional token-wise KL regularizer alongside a visual-contrastive grounding objective that pairs clean and lesion-corrupted images to penalize responses generated without adequate visual evidence. Together, these components form a fine-grained, on-policy alignment framework that constructs preference pairs by minimally editing model-generated outputs, correcting only clinically erroneous spans while preserving the original linguistic style. Extensive experiments across medical imaging tasks and clinical text generation benchmarks validate the effectiveness of our approach.

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

GameCraft-Bench: Can Agents Build Playable Games End-to-End in a Real Game Engine?

Game generation is an emerging application of coding agents, requiring models to transform natural-language specifications into playable interactive systems. Unlike traditional coding tasks, game generation takes place within a game engine, where scripts, scenes, assets, rendering, and runtime interactions must jointly produce coherent gameplay. We formalize end-to-end game generation as the problem of producing a complete game artifact that realizes a specification through observable player-game interaction in a target environment. We argue that evaluating this setting requires three desiderata: Engine Grounding, Artifact Completeness, and Interactive Verification. We propose an interaction-grounded evaluation framework that assesses executable gameplay through replayed demonstrations and rubric-guided multimodal judging. We instantiate this framework as GameCraft-Bench, a benchmark comprising 140 Godot tasks across 15 game families. Evaluations of frontier coding agents show that end-to-end game generation remains highly challenging: the strongest agent achieves only 41.46%, and most agents score below 40%. Further analysis reveals that while agents often implement recognizable mechanics, they struggle to deliver complete games with sufficient content, functional visual feedback, and coherent presentation. See https://tongxuluo.github.io/gamecraft-bench-website for demos, code, and data.

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

CEVAR: Centerline Embedding Extraction for Endovascular Aneurysm Repair

Long-term mortality rates after endovascular aneurysm repair (EVAR) remain elevated due to post-EVAR rupture caused by loss of seal in stent graft sealing zones. Structured CT review using centerline measurements improves detection, but current workflows require manual centerline editing and expert operators. We propose a transformer framework for automated, protocol-driven sealing zone assessment that combines 3D centerline tracking with embedding-based geometric prediction. Two state-of-the-art image-to-graph models are evaluated for aorto-iliac centerline extraction from follow-up CT and for measurement of stent position, vessel diameters, and seal lengths according to EVAR4C protocol. Across the full test set and a challenging no-contrast subset, the proposed fully automatic method outperforms the commercial semi-automatic workflow.

13.
arXiv (CS.AI) 2026-06-18

TLA-Prover: Verifiable TLA+ Specification Synthesis via Preference-Optimized Low-Rank Adaptation

arXiv:2606.06133v2 Announce Type: replace-cross Abstract: TLA+ is a formal specification language for verifying distributed systems and safety-critical protocols. Large language models (LLMs) frequently produce TLA+ specifications that fail the TLC model checker for semantic reasons. Across 25 LLMs, the best public baseline is 26.6% syntactic parse and 8.6% semantic model-check. We present TLA-Prover, a 20-billion-parameter model for TLA+ specification synthesis. Training combines supervised fine-tuning (SFT) on verified examples with repair-based group-relative policy optimization (GRPO). In the GRPO stage, the model learns to fix its own rejected specifications. We also train a direct preference optimization (DPO) variant from the same SFT checkpoint as an ablation. TLC provides the reward signal directly, with no learned reward model. Four tiers grade each output: Bronze (parses), Silver (no warnings), Gold (passes TLC), and Diamond. To reach Diamond, the model's correctness property is automatically altered in a small way; TLC must then detect a violation. If TLC still passes, the property was always-true and contributes nothing; the output fails Diamond. TLA-Prover reaches 9/30 (i.e. pass@1 = 30%) at both Gold and Diamond on a held-out 30-problem benchmark. This is roughly 3.5x the 8.6% untuned baseline. The DPO variant reaches 20% at Diamond. Gold and Diamond coincide at every checkpoint; this prevents the trivial-property failure mode.

14.
arXiv (quant-ph) 2026-06-16

Optimising Entanglement Distillation Policies

arXiv:2606.14908v1 Announce Type: new Abstract: Entanglement distillation is a fundamental operation in quantum information processing used to obtain higher-fidelity entangled pairs from a supply of less entangled quantum states using local operations aided by classical communication (LOCC). In a physically relevant setting, where states with an initial fidelity of $f_0$, probabilistically generated over multiple, $m$, memory pairs distributed between two parties, Alice and Bob, are pairwise distilled, the optimal policy identifies the system-configuration dependent sequence of entanglement generation and distillation operations that need to be performed in order to minimize the expected time to reach some target fidelity $f_T>f_0$. Here, we formulate and systematically analyze this task as a Markov decision problem and using a value iteration algorithm, obtain optimal deterministic policies that minimize the expected waiting time required to reach a target fidelity. Our results show that the expected waiting time under the optimal policy decreases with increasing generation probability $p$ and number of quantum memories $m$ - as expected. In contrast, it exhibits non-monotonic behavior with respect to $f_0$ for a fixed fidelity gap, $(\Delta f = f_T-f_0)$. While the optimal policy consistently outperforms baseline policies such as the greedy, nested and entanglement pumping policies, its relative advantage is regime-dependent, being determined by the system parameters ($p,f_0,f_T,m$), and exhibits a nontrivial dependence on the fidelity gap $\Delta f$. Our results highlight the value of formulating entanglement distillation as a Markov decision problem, enabling the systematic design of policies that achieve target fidelity thresholds for quantum information tasks in realistic resource-constrained settings.

15.
arXiv (CS.CL) 2026-06-19

HydraHead: From Head-Level Functional Heterogeneity to Specialized Attention Hybridization

The quadratic complexity of attention poses a critical bottleneck for long-context processing, spurring interest in hybrid attention designs. Most open-source hybrid models adopt a layer-wise strategy. Yet, prior work has noted the inherent difficulty of integrating Linear Attention (LA) with Full Attention (FA), suggesting that the design space of attention hybridization remains underexplored. To probe this space, we conduct interpretability analysis and observe that layers exhibit block-wise functional similarity, while individual heads within the same layer display distinct functional specialization despite sharing input features. This head-level heterogeneity suggests that the head dimension provides a natural and principled granularity for fusing heterogeneous attention signals. Building on this insight, we introduce HydraHead, a novel architecture that hybridizes FA and LA along the head axis. HydraHead features two key innovations: (1) an interpretability-driven selection strategy that identifies retrieval-critical heads and preserves FA only for them, and (2) a scale-normalized fusion module that reconciles the distributional gap between FA and LA head outputs. By leveraging a three-stage transfer pipeline with parameter reuse and distillation, we achieve high-performance hybrid models with minimal training overhead. Under a unified training setup, HydraHead outperforms other hybrid designs in long-context tasks while maintaining strong general reasoning. With interpretability-driven head selection, it matches a 3:1 layer-wise hybrid's long-context performance at a 7:1 LA-to-FA ratio. Crucially, trained on only 15B tokens, HydraHead achieves over 69% improvement over the baseline at 512K context length, approaching Qwen3.5, a leading model of comparable size with a native context length of 256K. This highlights the significant scaling potential of head-level hybridization.

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

Generative modelling powered by room-temperature polariton condensates

arXiv:2606.15344v1 Announce Type: cross Abstract: Generative modelling requires efficient stochastic nonlinear transformations and physical platforms that can naturally realise them. We experimentally demonstrate that nonlinear optical systems operating in the strong light-matter coupling regime can serve as physical transformation layers for conditional generative modelling. Specifically, we develop a workflow in which room-temperature exciton-polariton condensates formed in organic dye microcavities act as a physical stochastic transform within a generative adversarial network and enable conditional digit-to-image translation. By using the nonlinear many-body dynamics and intrinsic stochasticity of polariton condensates, the workflow outperforms baseline approaches based on digitally injected perturbations. We find that polariton-enabled sampling via generative adversarial network (Polariton GAN) yields improved inception score, digit preservation accuracy and structural similarity compared with both digital sampling and laser-based systems. We further show that spatially correlated output variations can naturally regularise adversarial training and enhance output diversity. Our results establish polariton condensation as a new computational resource for generative modelling, opening a pathway towards physics-enhanced machine learning systems.

17.
medRxiv (Medicine) 2026-06-11

Ferritin across long-term conditions in England: cross-sectional primary care study

Background Iron deficiency (ID) is a readily treatable condition once identified. Ferritin is the primary diagnostic marker, but cut-offs vary and inflammation complicates interpretation in patients with long-term conditions (LTCs). Aim To describe ferritin distribution and the prevalence of threshold-defined low ferritin in adults with and without LTCs in primary care. Design and setting Cross-sectional observational study using routinely collected electronic health records from a national primary care database in England (1st January 2015 to 31st December 2021). Method Adults with >1 ferritin test in Clinical Practice Research Datalink (CPRD) Aurum were included. LTCs were identified using validated primary-care code lists. Outcomes included ferritin distribution and threshold-defined ID prevalence using World Health Organization (WHO) (

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

K-Prism: A Knowledge-Guided and Prompt Integrated Universal Medical Image Segmentation Model

Medical image segmentation is fundamental to clinical decision-making, yet existing models remain fragmented. They are usually trained on single knowledge sources and specific to individual tasks, modalities, or organs. This fragmentation contrasts sharply with clinical practice, where experts seamlessly integrate diverse knowledge: anatomical priors from training, exemplar-based reasoning from reference cases, and iterative refinement through real-time interaction. We present $K-Prism$, a unified segmentation framework that mirrors this clinical flexibility by systematically integrating three knowledge paradigms: (i) $semantic priors$ learned from annotated datasets, (ii) $in-context knowledge$ from few-shot reference examples, and (iii) $interactive feedback$ from user inputs like clicks or scribbles. Our key insight is that these heterogeneous knowledge sources can be encoded into a dual-prompt representation: 1-D sparse prompts defining $what$ to segment and 2-D dense prompts indicating $where$ to attend, which are then dynamically routed through a Mixture-of-Experts (MoE) decoder. This design enables flexible switching between paradigms and joint training across diverse tasks without architectural modifications. Comprehensive experiments on 18 public datasets spanning diverse modalities (CT, MRI, X-ray, pathology, ultrasound, etc.) demonstrate that K-Prism achieves state-of-the-art performance across semantic, in-context, and interactive segmentation settings.

19.
arXiv (CS.CV) 2026-06-16

Context-Aware RL for Agentic and Multimodal LLMs

Large language models (LLMs) often fail when answering requires identifying a small but decisive piece of evidence within a long or complex context, such as a single line in a tool trace or a subtle detail in an image. We propose ContextRL, a context-aware reinforcement learning (RL) method that improves long-horizon reasoning and multimodal performance through an indirect auxiliary objective. Instead of supervising only the final answer, ContextRL presents the model with a query, an answer, and two highly similar contexts, and rewards it for selecting the context that supports the query–answer pair, thereby encouraging fine-grained grounding. We construct contrastive context data in two domains: for coding agents, trajectories serve as contexts, yielding 1k pairs built via condition filtering; for multimodal reasoning, images serve as contexts, yielding 7K pairs built via generative editing and similarity search. ContextRL achieves average gains of +2.2% over standard GRPO on 5 long-horizon benchmarks, and +1.8% across 12 diverse visual question answering benchmarks. To disentangle the effect of the proposed objective from that of additional data, we compare against data-augmentation baselines that repurpose the same contrastive contexts as standard query–context–answer examples. These baselines provide little to no improvement, showing that the gains arise from the proposed context-selection objective rather than from the contrastive data alone.

20.
medRxiv (Medicine) 2026-06-15

Toward a National Registry for Inborn Errors of Immunity in Peru: A Qualitative Implementation Study

Background: Peru lacks an integrated information system for patients with Inborn Errors of Immunity (IEI). Although disease registries are essential tools for data management and health planning, their success depends on implementation science approaches that account for local contextual factors. This study reports Phase I of a three-phase mixed-methods implementation project to design and develop a national IEI registry. Methods: Phase I consisted of a phenomenological qualitative study exploring stakeholder perspectives. Semi-structured focus groups and in-depth interviews were conducted with 29 key stakeholders across four groups: policy-makers, clinical experts, end-users (immunologists, residents, allied health personnel), and patient organization representatives. Interviews followed a guide structured around four a priori domains (structure, navigation, feasibility, and perception of existing systems). Discussions were conducted in Spanish, audio-recorded, transcribed verbatim, and coded using ATLAS.ti. A hybrid thematic analysis combining deductive and inductive coding was performed. Data elements proposed for the registry were triangulated with qualitative findings. Results: Thirty-six initial codes were consolidated into 15 categories, which were further integrated into four overarching themes conceptualized as pathways toward intention to use: (1) Environment, where governance, regulatory backing, and sustainable financing were identified as key enablers, while limited interoperability emerged as a structural barrier; (2) Technical Dimension, emphasizing usability, alignment with clinical workflow, and a hierarchical data architecture (demographic, clinical, therapeutic); (3) Users, highlighting clinical leadership, protected time, digital readiness, and perceived usefulness as stronger motivators than financial incentives; and (4) Patients, underscoring data protection, transparency, trust, and advocacy as essential for legitimacy and sustainability. Conclusions: A national IEI registry in Peru is perceived as necessary and feasible if implemented with strong regulatory foundations, interoperable design, robust data security, and user-centered architecture. These findings informed the development of an initial functional prototype and the operational plan for Phase II, focused on usability evaluation.

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

Reward Modeling for Multi-Agent Orchestration

Multi-Agent Systems (MAS) built on Large Language Models (LLMs) require effective orchestration to coordinate specialized agents, yet training such orchestrators is hindered by limited supervision and high computational cost. We propose Orchestration Reward Modeling (OrchRM), a self-supervised framework for evaluating orchestration quality without human annotations. OrchRM leverages intermediate artifacts from multi-agent executions to construct win-lose pairs for Bradley-Terry reward model training. Unlike existing MAS test-time scaling and orchestrator training frameworks that rely on costly sub-agent rollouts, OrchRM operates directly at the orchestration level, enabling efficient and high-performing reward-guided orchestrator training and MAS test-time scaling. OrchRM improves training efficiency by up to 10x in token usage while improving MAS test-time scaling performance by up to 8% in accuracy. These gains consistently transfer across multiple domains, including mathematical reasoning, web-based question answering, and multi-hop reasoning, demonstrating orchestration-level reward modeling as a scalable direction for robust multi-agent orchestration. Code will be available at https://github.com/Wang-ML-Lab/OrchRM.

23.
medRxiv (Medicine) 2026-06-17

The interaction between chronic hepatitis B (CHB) and Metabolic dysfunction-associated steatotic liver disease (MASLD) in a diverse central London population

Introduction: The overlap between chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health challenge. We investigated the impact of MASLD and metabolic comorbidity in a diverse London viral hepatitis clinic. Methods: This retrospective cross-sectional study (May 2018-Feb 2024) included adults with CHB having controlled attenuation parameter (CAP) measurements. MASLD was defined as CAP >264 dB/m plus [≥]1 cardiometabolic factor (CMF). We used univariable and multivariable models to examine MASLD's relationship with liver stiffness and hepatitis B viral load (HBV VL). Results: Among 323 individuals (67% male, median age 36), most were from Black (35%) or non-white British/Irish (29%) backgrounds. Overall, 64% had [≥]1 CMF, and 20% had MASLD. The CHB/MASLD group was significantly older (median 43 vs 35 years, p

24.
arXiv (CS.LG) 2026-06-17

Tight $L_\infty$ Sample Complexity for Low-Degree and Sparse Boolean Polynomials

arXiv:2606.17319v1 Announce Type: cross Abstract: Motivated by the optimization of bounded binary black-box functions, we study the problem of learning polynomial surrogates over the Boolean hypercube. To ensure that optimizing the surrogate yields good solutions for the underlying objective, we require uniform $L_\infty$-error guarantees rather than the usual $L_2$-type guarantees. We characterize the minimax sample complexity of uniform estimation under subgaussian noise for two classes of bounded polynomials. First, for polynomials of degree at most $d$ on $n$ variables, the sample complexity scales as $n^{d+1}$. Second, for $s$-sparse Fourier-Walsh polynomials with $s \leq n$, it scales as $ns^2$. These rates differ structurally from the noiseless setting, where uniform exact recovery scales as $n^d$ and $ns$, respectively. Our lower bounds hold even for arbitrary adaptive learners, showing that the additional factors are intrinsic to the noisy cases. Standard Fourier-analysis tools for the $L_2$-norm do not naturally extend to the $L_\infty$-setting in a way that yields uniform guarantees. Our proofs overcome this difficulty by relying on suitably chosen auxiliary norms that serve as proxies for controlling the $L_\infty$-error. Together, our results provide a tight characterization of the sample complexity of learning optimization-safe polynomial surrogates.

25.
Nature Medicine 2026-06-11

Clinical Profile and Genomic Characterization of the 2026 Bundibugyo Virus Index Case in Uganda

Bundibugyo virus disease (BVD) remains a high-consequence threat in Eastern and Central Africa, where cross-border mobility, nonspecific early symptoms, and delayed recognition can obscure transmission. In this case report, we describe Uganda’s 2026 BVD index case: a male patient who traveled from the Democratic Republic of the Congo to Uganda and was admitted to a private hospital in Kampala on 11 May 2026 after more than two weeks of vomiting and diarrhea, with epigastric pain, weakness, and hiccups. He deteriorated rapidly, developing acute kidney injury, pulmonary edema, hepatic dysfunction, hypoxemia, delirium, atrial flutter, possible disseminated intravascular coagulation, and multiorgan failure, and died on 14 May. A posthumous EDTA whole-blood specimen tested at the Central Emergency Response and Surveillance Laboratory was positive for orthoebolavirus RNA and confirmed as Bundibugyo virus (BDBV) by RT-qPCR. Sequencing achieved 99% genome coverage at ≥100× depth. The 2026 BDBV genome formed a distinct lineage approximately equidistant from the 2007–2008 Butalya and 2012 Isiro variants, differing by 216–227 nucleotides (~1.2% sequence divergence). Here, we demonstrate the value of fatality surveillance, private-sector surveillance, diagnostic optimization through national specimen referral, and rapid molecular-genomic diagnostics for early detection, transmission chain interruption, and public health response coordination.