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01.
medRxiv (Medicine) 2026-06-15

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

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

02.
arXiv (quant-ph) 2026-06-17

An energy-based uncertainty principle and low-energy state preparation

作者:

arXiv:2603.15495v2 Announce Type: replace Abstract: Preparing low-energy states of many-body Hamiltonians is a central challenge in quantum computing, quantum complexity, and condensed matter physics. Existing approaches often get trapped in suboptimal states such as high-energy eigenstates or, more generally, low-variance states that resist further energy reduction. In this work, we explore a different perspective: instead of optimizing with respect to a single Hamiltonian, we leverage the fact that many systems admit families of Hamiltonians that share similar low-energy subspaces but differ at higher energies. We show that this redundancy can be turned into an algorithmic resource by establishing an energy-based uncertainty principle, which implies that these Hamiltonians cannot simultaneously admit low-variance states at higher energies. This suggests a simple strategy of alternating energy-lowering steps across such Hamiltonians, which we investigate numerically on several models. We also introduce a sparse variant where the uncertainty principle yields quadratically larger variance at higher energies, leading to more pronounced energy change. Overall, this work suggests a range of open questions at the interface of random matrix theory, local Hamiltonians and low-energy state preparation, aimed at understanding when such approaches are practical and how they can be analyzed rigorously.

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

Sensor-Conditioned Representation Learning via Scene-Relevant Observation Quotients

arXiv:2606.16210v1 Announce Type: new Abstract: Learned representations in intelligent sensing systems are often evaluated by reconstruction fidelity or downstream prediction accuracy, but these criteria do not specify which latent distinctions are justified by the sensing process. In sensor-conditioned environments, nuisance factors can change measurements without changing the scene, while distinct scenes may be indistinguishable under limited sensing capability. This paper formulates sensor-conditioned representation correctness as preserving sensing-supported scene distinctions while suppressing nuisance-induced and sensor-unsupported variation. We introduce the scene-relevant observation quotient, a representation target induced by sensing-supported distinguishability after nuisance canonicalization, and develop Observation-Quotient Tucker-Structured Autoencoding (OQ-TSAE), a scene-nuisance factorized framework with diagnostics for false distinction, false merge, nuisance sensitivity, and latent ordering consistency. Experiments on a controlled benchmark show that quotient-consistent supervision improves representation-correctness diagnostics over reconstruction-oriented, metric-learning, and contrastive-learning baselines. Sensitivity, perturbation, and ablation studies show the importance of quotient-aligned supervision, reliable quotient relations, and quotient geometry. Complementary real-radar experiments show that a reconstruction-only OQ-TSAE variant retains competitive downstream utility, robustness under observation degradation, and low seed-to-seed variability. These results suggest that sensor-conditioned representations should be evaluated not only by predictive utility, but also by whether their latent geometry preserves sensing-justified scene distinctions.

04.
arXiv (CS.CL) 2026-06-15

Sub-Token Routing for KV Cache Compression

Transformer inference often requires a large KV cache, especially for long-context language modeling and multimodal generation. Existing compression methods usually reduce cache cost by selecting, evicting, quantizing, or compressing cached tokens, or by reducing the visual-token sequence before language-model inference. We introduce sub-token routing, a KV-compression method that adds a finer control axis inside retained tokens. It splits each retained value vector into groups and keeps only selected groups, while leaving query and key states unchanged. The method is designed to work after token-level reduction. First, a token-reduction method determines which tokens are retained. Then, sub-token routing compresses the value states inside those retained tokens. Experiments under matched KV budgets show that adding sub-token routing improves token-level reduction performance in both LLM and VLM settings, including Quest on LLaMA-2-7B and Qwen2.5-7B, and FastV/VisionZip across LLaVA and Qwen-VL models. The gains are larger at smaller KV budgets, suggesting that value-group routing is especially useful when further token removal becomes costly. Overall, token-level reduction and sub-token routing provide complementary ways to reduce KV cost.

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

Data-driven Control with Real-time Uncertainty Compensation for Multi-Fuel Engines

arXiv:2606.16171v1 Announce Type: cross Abstract: Multi-fuel compression ignition (CI) engines offer superior power density and fuel flexibility. However, achieving consistent and optimal combustion phasing across a wide range of operating conditions remains a major challenge, particularly in the presence of modeling uncertainties. This paper presents a novel, data-driven real-time uncertainty compensation framework for combustion control in multi-fuel CI engines. The proposed approach introduces a pseudo-engine speed that enables dynamic adaptation of control inputs in response to uncertainty affecting the engine. To model the underlying combustion process, a Gaussian Process Regression (GPR) model is first trained on available input-output data, capturing the nonlinear and fuel-dependent behavior across varying operating conditions. Control inputs are then synthesized through model inversion of the learned GPR surrogate and augmented with an uncertainty compensator designed to mitigate deviations caused by dynamic variations in operating conditions and model inaccuracies. This integrated control strategy allows for real-time input corrections within a finite number of combustion cycles. Theoretical analysis establishes finite-time convergence guarantees for the proposed controller. Simulation results demonstrate that the proposed method steers the combustion phasing to the desired value in real-time, providing a scalable and adaptive control solution for multi-fuel CI engine operation.

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

TimeROME-DLM: Temporal Causal Tracing and Low-Rank Inference-Time Knowledge Editing for Masked Diffusion Language Models

arXiv:2606.12841v1 Announce Type: cross Abstract: Masked diffusion language models (MDLMs) such as LLaDA now rival autoregressive (AR) LLMs, but every existing knowledge-editing and unlearning method (ROME, MEMIT, etc.) targets AR transformers and either makes assumptions that fail under iterative denoising, or requires gradient updates whose backward-pass activations cost tens of GB of extra VRAM and which collapse MDLMs at standard learning rates. We introduce TimeROME-DLM, the first training-free, gradient-free, inference-time knowledge-editing framework for MDLMs. It couples two components: a Temporal Indirect Effect (TIE) causal-tracing protocol that identifies, for each fact, the coordinate whose intervention most strongly drives the object prediction at later denoising steps; and a closed-form, low-rank residual edit memory that aggregates subject keys and target deltas across all forget facts and applies a single ridge-regularised update at that coordinate at every diffusion forward, with sparsification to limit utility spillover. Backbone weights stay frozen; only three hyperparameters (alpha, lambda, q) are tuned on a small validation split. On TOFU forget01 with TOFU-finetuned LLaDA-8B-Base, TimeROME-DLM cuts forget-set log-probability by roughly 83 nats. The same configuration transfers to LLaDA-8B-Instruct, Dream-7B, MMaDA-8B, DiffuLLaMA-7B, and LLaDA-MoE-1.4B. It keeps retain-set log-probability nearly flat (within ~1 nat at the utility-safe operating point) across 50 sequentially inserted facts, delivers a four- to fourteen-fold wall-clock speedup with zero additional VRAM over the strongest converged training-time baseline, and scales sub-linearly to 400 facts. TimeROME-DLM closes the locate-then-edit gap between AR LLMs and MDLMs at a fraction of the computational cost.

07.
arXiv (CS.CV) 2026-06-18

DreamReg: Belief-Driven World Model for 2D-3D Ultrasound Registration

Ultrasound (US) is widely used for surgical navigation, yet real-time registration between intraoperative 2D slices and preoperative 3D volumes remains challenging due to partial observability, speckle noise, and the action-dependent US acquisition. Existing methods are one-shot or short-horizon, making it hard for them to gather evidence over time or capture how surgeons adjust probe motion based on on-screen feedback. We propose DreamReg, a belief-driven world-model framework that formulates 2D-3D registration as belief updating over rigid transformations. DreamReg maintains a latent belief state that summarizes past observations and poses information, and continuously refines the transformation through learned dynamics as new slices arrive. During training, DreamReg is exposed to probe-motion trajectories that mimic clinical scanning behavior and learns to update its belief by conditioning pose refinement on the current US observation. During inference, DreamReg refines registration via internal imagination: it rolls out the learned world model to simulate candidate probe motions and their predicted observations, and integrates these imagined outcomes to converge to an accurate rigid transformation. Experiments on CAMUS and u-RegPro datasets demonstrate improved robustness and competitive registration accuracy for real-time guidance compared with state-of-the-art methods.

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

MDForge: Agentic Molecular Dynamics Pipeline Design under Sparse Simulator Feedback

Molecular dynamics (MD) is the canonical in-silico method for atomistic molecular science, simulating molecular behavior from first-principle physics. Designing an MD pipeline for a new system requires substantial expert knowledge: running it on even one molecule is expensive, ruling out trial-and-error. We automate this expert pipeline-design process with an LLM agent. Unlike existing MD agents that orchestrate a predefined tool set, we treat pipeline design as open-ended code generation in which the agent's behavior is reshaped online by verbal reward. Specifically, we build MDForge, an LLM agent whose in-context update rule densifies the sparse reward via a multi-agent debate among physics experts. On three SAMPL host-guest binding free-energy benchmarks, MDForge automatically designs MD pipelines competitive with human experts. Deployed on a library of unseen candidate guests, its CB[7] pipeline discovers a novel binder that wet-lab competition NMR confirms is a high-affinity, picomolar CB[7] binder. Our data and code are available at https://github.com/Zehong-Wang/MDForge.

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

STAR: SpatioTemporal Adaptive Reward Allocation for Text-to-Image RL Post-Training

arXiv:2606.17979v1 Announce Type: new Abstract: Existing RL post-training methods for text-to-image generation usually convert the final-image reward into a single scalar advantage and apply it with the same strength to the entire generative trajectory. However, text-to-image generation naturally has temporal and spatial structure: different denoising steps are responsible for different generation stages, and the content that truly determines text alignment often appears only in part of the image. This granularity mismatch makes it difficult for policy updates to focus on the generative components that actually affect the reward. To address this issue, we propose SpatioTemporal Adaptive Reward (STAR) Allocation for RL post-training of text-to-image diffusion and flow models. STAR uses text-image attention inside the generative model and starts from the core content that the user truly cares about in the prompt. It constructs spatial allocation maps that dynamically vary across denoising steps and rollouts, and allocates the same group-relative advantage to more relevant latent regions with almost no additional computational overhead. STAR then applies stronger policy updates to these regions through a spatially resolved policy objective. We use Stable Diffusion 3.5 Medium as the base model and evaluate on three tasks: GenEval, OCR text rendering, and PickScore. Experimental results show that STAR improves compositional semantic alignment, text rendering, and preference optimization without changing the external reward source, achieving $\mathbf{0.9759}$, $\mathbf{0.9757}$, and $\mathbf{23.60}$ on GenEval, OCR, and PickScore, respectively.

10.
arXiv (CS.LG) 2026-06-19

When to Trust, How to Distill: Multi-Foundation Model Guidance for Lightweight, Robust Scientific Time Series Forecasting

arXiv:2606.19363v1 Announce Type: new Abstract: The deployment of Time-Series Foundation Models (TSFMs) in physical sciences is hindered by a critical trade-off: while these models encode rich, universal temporal dynamics, they suffer from severe distributional misalignment when applied zero-shot to specific scientific domains, and their computational cost prohibits deployment in edge-computing sensor networks. We address a fundamental challenge: How can we extract latent structural knowledge from misaligned foundation models (FM) to train lightweight, specialized forecasters? We propose Gated Uncertainty-Aware Routing for Distillation (Guard), a novel framework that reframes multiteacher distillation as an instance-wise decision process with two adaptive mechanisms: (1) a Contextual Router that dynamically selects the most relevant teacher based on local input statistics, exploiting complementarity across diverse foundation models; and (2) an Uncertainty-Gated Temperature mechanism that acts as a "circuit-breaker," automatically attenuating distillation strength when teacher confidence diverges from domain reality. We evaluate our proposed lightweight framework on four climate-critical domains: meteorology, ecosystem carbon flux, soil moisture, and energy grids. Our method significantly reduces RMSE relative to a fixed-weight multi-teacher distillation baseline, successfully distilling knowledge from pretrained FMs (teachers) even when they exhibit suboptimal zero-shot accuracy due to distribution shift between the original and target data domains. We demonstrate that these domain-misaligned teachers can still serve as critical correctives, outperforming the globally superior FMs on 28.5% of the hardest instances. Ultimately, this enables high-precision scientific forecasting suitable for resource-constrained edge deployment. Code is available at https://github.com/RupasreeDey/GUARD-KDD2026.

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

Attention Expansion: Enhancing Keyphrase Extraction from Long Documents with Attention-Augmented Contextualized Embeddings

Pre-trained language models (PLMs) have achieved strong performance in keyphrase extraction (KPE), largely due to their ability to generate rich contextualized representations. However, long-document KPE remains challenging because salient keyphrase evidence may be scattered across distant document sections that cannot be jointly captured within the limited context window of most PLMs. Although long-context large language models (LLMs) can process broader textual contexts, their computational cost limits their practicality for efficient and high-throughput KPE. To overcome this limitation, we propose an attention expansion mechanism that augments PLM token representations with information from surrounding out-of-context chunks using pre-trained word embeddings. The proposed mechanism expands the effective contextual scope of PLM-based KPE models without requiring full-document attention or expensive LLM-based inference. We evaluate our approach across five PLM backbones, including general-purpose, scientific, task-specific, and long-context encoders, using two training regimes and five benchmark corpora from scientific and news domains. Experimental results demonstrate that attention expansion consistently enhances KPE performance across all evaluation settings, outperforming state-of-the-art models and yielding notable improvements in F1 score. The improvements extend to domain-specific, task-specialized, and native long-context models, showing that the proposed mechanism provides complementary information rather than merely compensating for limited input length. These results establish attention expansion as an efficient and effective strategy for long-document KPE.

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

Arbitrary control over multimode wave propagation for machine learning

arXiv:2402.17750v2 Announce Type: replace-cross Abstract: Controlled multimode wave propagation can enable more space-efficient photonic processors than architectures based on discrete components connected by single-mode waveguides. Instead of defining discrete elements, one can sculpt the continuous substrate of a photonic processor to perform computations through multimode interference in two dimensions. Here we designed and demonstrated a device with a refractive index that can be rapidly reprogrammed across space, allowing arbitrary control of wave propagation. The device, a two-dimensional programmable waveguide, uses parallel electro-optic modulation of the refractive index of a slab waveguide with about $10^4$ programmable spatial degrees of freedom. We implemented neural network inference on benchmark tasks with up to $49$-dimensional vectors in a single pass, without digital pre-processing or post-processing. Theoretical and numerical analyses further indicated that two-dimensional programmable waveguides may offer not only a constant-factor reduction in device area but also a scaling benefit, with the area required growing as $N^{1.5}$ rather than $N^2$.

13.
arXiv (math.PR) 2026-06-17

Moments in Rough Bergomi and Boundary Attainment in Rough Heston

arXiv:2606.07482v2 Announce Type: replace Abstract: We address two open questions in the rough volatility literature. First, we prove finite positive moments for the rough Bergomi price process, and for a wider class of Gaussian Volterra Bergomi models, in the whole subcritical range under negative correlation. More precisely, if \(\rho\in[-1,0)\), then \(\E[S_T^p]

14.
arXiv (CS.LG) 2026-06-12

Robustness Verification of Recurrent Neural Networks with Abstraction Refinement

arXiv:2606.12490v1 Announce Type: new Abstract: Certified local robustness verification for recurrent neural networks (RNNs) is challenging because approximation errors introduced by nonlinear relaxations can propagate through recurrent connections and accumulate over time. As a result, scalable linear bound propagation methods often become overly conservative and fail to certify inputs that are in fact robust, especially when many pre-activation intervals cross zero. We propose an abstraction-refinement framework for RNN verification that partitions such intervals to remove the dominant relaxation error: on each refined branch, ReLU becomes exact, and smooth activations such as tanh and sigmoid admit substantially tighter linear envelopes. To control the combinatorial cost of splitting in long sequences, we introduce a SHAP-guided timestep selection strategy that ranks hidden states by their contribution to the verification objective and refines only the most critical timesteps in temporal order. Experiments on CIFAR10 and MNIST stroke benchmarks demonstrate consistent improvements in verification success and robustness-margin tightness over abstraction-only baselines, while exposing clear runtime trade-offs between ReLU and tanh models.

15.
medRxiv (Medicine) 2026-06-18

Antimicrobial-resistant E. coli in human, animal and environmental reservoirs in rural Bangladeshi households with young children

In low-income countries, ESBL-producing Escherichia coli (ESBL-EC) is frequently detected in humans, animals and household environments, indicating widespread exposure to antimicrobial resistance (AMR). Established risk factors such as antibiotic use do not explain the high community carriage of AMR in all settings; identifying the dominant exposure pathways can inform interventions against AMR. We aimed to investigate (i) animal-human-environment sharing of AMR by assessing associations between the abundance of ESBL-EC in the household environment, domestic animal feces and young children's stool and (ii) household factors associated with ESBL-EC abundance in these reservoirs. We enrolled 112 households from the CRADLE trial in rural Bangladesh. We enumerated ESBL-EC in drinking water, food, child hand rinses, outdoor soil, indoor floor swabs, chicken and cow feces, and stool from children aged 6 months. We recorded indicators of sanitation, animal ownership/management, human and animal antibiotic use, and child exposure behaviors using structured questionnaires and spot checks. The highest prevalence of ESBL-EC was in child stool (95.6%) and animal feces (82.3-96.9%), followed by soil (48.2%) and floors (36.6%); < 10% of food, child hands and drinking water harbored ESBL-EC. The abundance of ESBL-EC in child stool was not associated with its abundance in any sampled matrix; the abundance in chicken but not cow feces showed positive correlations with soil, floors, child hands, and drinking water (correlation coefficients: 0.19-0.39, p-values < 0.05). Higher-quality latrines (improved, pour-flush, with slab) were associated with lower ESBL-EC abundance across matrices; unsafe animal management (animals roaming or spending the night inside the home) was associated with higher abundance. Child antibiotic use and exposure behaviors (soil ingestion, time spent on floor) were not associated with ESBL-EC abundance in child stool. We observed high AMR colonization among young children and domestic animals in rural Bangladesh not explained by traditional fecal-oral exposure pathways. Future studies should explore additional pathways and assess whether sanitation and animal management improvements can reduce AMR.

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

Scalar-pathway fidelity improves physical accuracy in short-range equivariant interatomic potentials

arXiv:2606.15892v1 Announce Type: new Abstract: Accurate interatomic potentials enable molecular dynamics of materials, molecules, and interfaces beyond density-functional-theory length and time scales. Equivariant neural network potentials have improved the representation of local geometry. However, their deployable energy surfaces ultimately manifest through invariant scalar channels, whose aggregation and spectral resolution remain comparatively underexamined. Here we use Physics-Aware Neighborhood (PAN) pooling and Physics-Guided Spectral (PGS) mixers as controlled scalar-pathway probes: lightweight, symmetry-preserving modifications that act only on \(\ell=0\) channels while leaving the equivariant tensor backbone unchanged. Using MACE as a high-body-order mechanistic scaffold, PAN adds coordination-sensitive amplitude modulation, whereas PGS augments edge and readout scalar features with radial and tapered spectral bases. Across metallic Ag, covalent Si, a short-range ionic LiF/Li–F subset, and MD17/rMD17 molecules, this scalar-pathway correction reduces MACE force errors by 22–27\% and energy errors by 19–22\%; on systems with stress labels, stress errors decrease by 27–28\%, at approximately 5\% additional inference-FLOPs cost. Directionally consistent gains in Allegro and NequIP further indicate that the correction is portable across distinct short-range equivariant backbones, although effect sizes remain architecture-dependent. These results identify scalar-pathway fidelity as a practical design dimension for short-range equivariant interatomic potentials.

18.
arXiv (quant-ph) 2026-06-11

Handbook of Error-Correcting Codes

arXiv:2606.11484v1 Announce Type: new Abstract: Barcode scans, clear phone calls, reliable data storage, satellite communication, and large-scale quantum computation are all made possible by error correction. We present a handbook version of The Error Correction Zoo, a curated reference of methods for protecting classical or quantum information from errors during storage and transmission. The handbook includes descriptions of these error-correcting codes and a classification according to the symbols they use. It also catalogues relations among codes and related objects such as sphere packings, lattices, designs, groups, and classical and quantum phases of matter. The collection is intended both as a rigorous reference and as a practical aid for tracing the web of code relationships and uncovering new connections.

19.
arXiv (math.PR) 2026-06-17

Diffuse Interface Energies with Microscopic Heterogeneities II: Rare Events

arXiv:2606.17968v1 Announce Type: cross Abstract: We analyze Allen-Cahn functionals with stationary ergodic coefficients in the regime where the length scale $\delta$ of the heterogeneities is much smaller (microscopic) than the interface width $\epsilon$ (mesoscopic). In a companion paper, we show that if the ratio $\epsilon^{-1} \delta$ vanishes fast enough as $\epsilon \to 0$, then the functionals converge to an effective surface energy where the energy density is determined by homogenization effects originating at microscopic scales. Here we prove that if the ratio $\epsilon^{-1} \delta $ vanishes too slowly, the limit of the functional may actually be smaller than this homogenized energy. We refer to this as the rare events regime. In the case of the random checkerboard in dimension one, we use large deviations techniques to give a complete description of the rare events regime, showing that the limiting energy depends in a nontrivial way on the limit of $\epsilon^{-1} \delta | \log \epsilon |$. We further construct, in any dimension, examples of random media in which rare events become relevant at algebraic scales $\delta \approx \epsilon^{1 + \alpha}$ for an arbitrary $\alpha > 0$, as well as almost periodic examples in which atypical configurations play the same role as rare events.

20.
arXiv (CS.CL) 2026-06-12

Small LLMs for Biomedical Claim Verification: Cost-Effective Fine-Tuning, Structural Dataset Shortcuts, and Cross-Domain Generalization

作者:

Large Language Models such as GPT-4o and GPT-5 achieve strong zero-shot performance on biomedical claim verification, but cost and opacity limit scalable use. We fine-tune three small LLMs: Phi-3-mini (3.8B), Qwen2.5-3B, and Mistral-7B, via QLoRA on SciFact and HealthVer, providing the first study of QLoRA models against GPT-4o and fine-tuned BioLinkBERT encoders. Mistral-7B QLoRA surpasses both GPT-4o and GPT-5 (up to 12% F1 gain) at a fractional cost using just 1,008 training examples. We conduct extensive in-domain and cross-domain evaluation: models trained on SciFact tested on HealthVer and vice versa, at matched sizes to isolate dataset structure from data quantity. We identify a previously unreported structural artifact in SciFact that inflates in-domain scores, and show through bidirectional out-of-domain evaluation that training on structurally sound data enables robust cross-domain transfer. We plan to release all code and adapter checkpoints.

21.
arXiv (CS.LG) 2026-06-18

Beyond AHI: An Interpretable Causal-Discovery-Guided Framework for Sleep Recovery in Connected Health

arXiv:2606.18506v1 Announce Type: new Abstract: Objective sleep assessment relies on polysomnography (PSG), yet clinical impact is often better reflected in patient-reported outcomes (PROs) such as sleepiness and fatigue. Existing summary indices, including the Apnea-Hypopnea Index (AHI), provide limited insight into the multidomain physiology underlying functional recovery. We propose an interpretable, causal-discovery–guided framework for deriving a hierarchical Sleep Recovery Score (SRS) from multimodal PSG. Using two large population cohorts (MESA: n=1540; MrOS: n=825), we apply directed acyclic graph (DAG) learning to identify candidate physiological drivers spanning respiratory burden, hypoxic burden, sleep fragmentation, sleep architecture, and autonomic regulation. Although derived from clinical PSG, these domains map naturally to sensing streams increasingly available in connected health technologies, including wearable ECG, oximetry, and sleep-stage estimation devices. To preserve mechanistic plausibility, we introduce a two-stage screening process that combines physiology-based constraints with constrained LLM-assisted auditing to identify and remove structural confounders and construct-overlapping variables. Across cohorts, these five domains emerge as recurrent physiological domains associated with recovery, and the resulting SRS shows up to 2.5$\times$ stronger alignment with perceived recovery than AHI. By linking multimodal sleep physiology to patient-centered outcomes through an interpretable, bias-aware, and domain structured framework, this work provides a practical foundation for recovery modeling across both clinical sleep studies and emerging smart and connected health settings.

22.
medRxiv (Medicine) 2026-06-18

Cost-effectiveness of a virtual fracture clinic versus traditional in-person fracture clinic care for adults with acute simple fractures: a protocol for a health economic evaluation within the RECITAL trial

ABSTRACT Introduction Traditional in-person fracture clinics are often overcrowded and inconvenient for patients. Virtual fracture clinics aim to address some of these concerns by improving the efficiency of the orthopaedic service and reducing unnecessary interventions while maintaining safety and quality of care. The RECITAL trial is a non-inferiority randomised controlled trial comparing follow-up care provided at a virtual fracture clinic for people with acute simple fractures to follow-up care provided at an in-person fracture clinic. This study describes the protocol for an economic evaluation of RECITAL where the primary aim is to investigate the cost-effectiveness of a virtual fracture clinic compared with traditional in-person fracture clinic care from a health system perspective. Methods and analysis The RECITAL trial recruited 312 participants with acute simple fractures and randomised them to receive follow-up care provided at a virtual fracture clinic or follow-up care provided at an in-person fracture clinic. We will conduct a within-trial analysis from a health system perspective (primary analysis), as well as a health service, patient and societal perspective. The economic evaluation will estimate the difference in the cost of resource inputs on an intention to treat basis used by participants in the two arms of the trial, allowing comparisons to be made between the in-person and virtual fracture clinics. Data for intervention costs and healthcare utilisation will be collected from trial records, hospital electronic medical records and district performance units. The results of the economic evaluation will be expressed in terms of incremental cost per utility weight gained at 12 weeks and will be plotted on a cost-effectiveness plane. Bootstrapping by resampling will be used to estimate 95% confidence intervals around costs and outcomes, and to calculate the confidence intervals around the incremental cost-effectiveness ratio. A cost-effectiveness acceptability curve (CEAC) will be plotted, which will provide information about the probability that an intervention is cost-effective, given the level of a decision makers willingness to pay for each additional outcome. Ethics and Dissemination The trail was approved by the SLHD Ethics Review Committee (RPAH Zone) (X23-0200 and 2023/ETH01038). The findings will be disseminated through a peer-reviewed journal and conference presentations. Trial registration number The trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR; 12623000934640)

23.
arXiv (CS.CV) 2026-06-16

MIRAGE: Runtime Scheduling for Multi-Vector Image Retrieval with Hierarchical Decomposition

To effectively leverage user-specific data, retrieval augmented generation (RAG) is employed in multimodal large language model (MLLM) applications. However, conventional retrieval approaches often suffer from limited retrieval accuracy. Recent advances in multi-vector retrieval (MVR) improve accuracy by decomposing queries and matching against segmented images. They still suffer from sub-optimal accuracy and efficiency, overlooking alignment between the query and varying image objects and redundant fine-grained image segments. In this work, we present an efficient scheduling framework for image retrieval - MIRAGE. First, we introduce a novel hierarchical paradigm, employing multiple intermediate granularities for varying image objects to enhance alignment. Second, we minimize redundancy in retrieval by leveraging cross-hierarchy similarity consistency and hierarchy sparsity to minimize unnecessary matching computation. Furthermore, we configure parameters for each dataset automatically for practicality across diverse scenarios. Our empirical study shows that, MIRAGE not only achieves substantial accuracy improvements but also reduces computation by up to 3.5 times over the existing MVR system.

24.
arXiv (CS.AI) 2026-06-16

InstantForget: Update-Free Backdoor Unlearning with Inference-Time Feature Reset

作者:

arXiv:2606.15730v1 Announce Type: cross Abstract: Backdoor unlearning aims to remove a malicious trigger behavior from a deployed model while preserving clean utility. We study the update-free inference-time setting, where model parameters remain frozen. First, we audit a common projection assumption under oracle paired clean and triggered features. Projection succeeds mainly on BadNets and leaves WaNet, Blended, and SIG at 0.683, 0.888, and 0.941 ASR on CIFAR-10 ResNet-18. This failure is not explained by spectral compactness, spatial locality, or subspace misalignment. It is predicted by a logit-triplet gap involving the target margin, target-logit drop, and non-target logit rise. We then introduce InstantForget, a clean-calibrated gated reset that flags anomalous features with a Mahalanobis score and moves only flagged features toward a neutral non-target representation. With one fixed operating point selected on held-out triggered validation, InstantForget reduces average ASR to 0.071 across four non-adaptive CIFAR-10 triggers without triggered samples or parameter updates at deployment. It also reaches 0.981 detection AUROC and transfers to six of eight tested backbones. Reported failures under WaNet, ModelNet10 point blend, two backbone geometries, and adaptive feature-compactness attacks define the method's scope.

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

NEST: Narrative Event Structures in Time for Long Video Understanding

Recent progress in vision-language models has enabled the processing of increasingly long video sequences, but the ability to handle extended token streams does not translate to understanding of narrative structure in long videos. Existing long video benchmarks focus on needle-in-a-haystack retrieval rather than evaluating how low-level actions form events, how events interact across time, and how narratives progress, for example, whether a model can connect an early setback, such as a job loss to a later relationship breakup, despite long gaps, intervening scenes, or flashbacks that reframe what occurred. We introduce NEST (Narrative Event Structures in Time for Long Video Understanding), a dataset of 1005 full-length movies (avg. 98 minutes), each annotated with 102 multimodal narrative events grounded in visual content, dialogue, and audio. NEST captures multimodal narrative events with structured annotations grounded in visual content, dialogue, and audio, and links them through relations that reflect narrative structure, including temporal ordering, hierarchical composition, and long-range dependencies. We introduce baselines for event trigger detection (ETD), event localization (EL), event argument extraction (EAE), and event relation extraction (ERE). The benchmark is highly challenging for grounded event discovery, with ETD below 8%, EL under 6%, and EAE below 11%. In contrast, ERE is more tractable once events are given, reaching 35.45% F1 zero-shot and 44.42% F1 after fine-tuning.