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01.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

02.
arXiv (CS.CV) 2026-06-15

ShearFuse-UNet: Hadamard, DCT, and Shearlet Transform Fusion for Next-Day Wildfire Spread Prediction

We propose ShearFuse-UNet, a lightweight and computationally efficient deep learning model for next-day wildfire spread prediction from multi-modal satellite data. The model integrates three complementary transform-domain branches inside each encoder block of a U-Net backbone: a 2D Fast Walsh-Hadamard Transform (WHT) branch, a 2D Discrete Cosine Transform (DCT) branch, and a cone-adapted digital Shearlet residual branch. The WHT and DCT branches establish orthogonal latent spaces with learnable spectral scaling and fixed soft-thresholding, while the Shearlet branch provides anisotropic, multi-directional feature decomposition that explicitly encodes the elongated edge structures characteristic of fire fronts. A learned SpectralFusion gate adaptively combines the WHT and DCT responses, and the Shearlet reconstruction is added as a residual. This three-branch design bears a loose structural analogy to transformer self-attention: the WHT and DCT branches provide complementary spectral representations that are adaptively fused, while the Shearlet branch contributes directional content through a residual pathway. Unlike self-attention, the proposed design relies on fixed mathematical transforms rather than learned projection operators, reducing parameter count and computational cost. Evaluated on the WildfireSpreadTS dataset, ShearFuse-UNet achieves an F1 score of 0.596 with only 267k parameters, outperforming a ResNet18-based U-Net (14M parameters, F1 = 0.589) and demonstrating a highly favorable accuracy-efficiency trade-off. Results on the Google Next-Day Wildfire Spread dataset further validate these findings across a different benchmark.

04.
PLOS Medicine 2026-05-27

Sequential chemo-immunotherapy followed by standard versus reduced thoracic radiotherapy for older and/or frail stage III non-small-cell lung cancer: A randomized open-label cohort trial

作者:

by Wei-Xiang Qi, Shuyan Li, Mengdi Wang, Huan Li, Feifei Xu, Lei Yao, Biao Yu, Linlin Chen, Gang Cai, Cheng Xu, Xianwen Sun, Zhiyao Bao, Jiayi Chen, Yi Xiang, Shengguang Zhao Background The appropriateness of concurrent chemoradiotherapy (cCRT) for older or clinically vulnerable stage III unresectable non-small-cell lung cancer (NSCLC) patients remains contentious. Furthermore, the survival implications of de-escalating thoracic radiotherapy (RT) intensity in this population have not been conclusively elucidated. Methods and findings We conducted a phase II randomized, open-label, two-cohort (non-comparative) trial at a tertiary hospital in China (NCT05557552). Between September 30, 2022 and April 30, 2024, we enrolled 56 older and/or frail patients with stage III NSCLC who were ineligible for cCRT. The primary endpoint was the 1-year progression-free survival (PFS) rate estimated using the Kaplan–Meier method. Secondary endpoints included objective response rate (ORR), overall survival (OS), and safety. In the intention-to-treat (ITT) set, which included all 56 randomized patients who received at least one dose of study treatment, the 1-year PFS was 84.3% (95% confidence interval [CI] [70.3%, 98.3%]) in the standard RT group and 70.7% (95% CI [54.3%, 87.1%]) in the reduced RT group. In the per-protocol set (53 patients), the 1-year PFS was 82.9% (95% CI [68.9%, 98.8%]) in the standard RT group and 73.4% (95% CI [58.3%, 92.4%]), with a median follow-up of 24 months. Among 56 patients in the safety analysis set, 71.4% of patients experienced grade 3/4 adverse events (AEs) in the standard RT group and 53.6% in the reduced RT group. One patient (3.6%) in the reduced RT and three patients (10.7%) in the standardized RT experienced grade 5 AEs. The main limitations are the non-comparative design, small sample size, and lack of power to establish non-inferiority or superiority. Conclusion The current study suggested that reduced RT combined with sequential chemo-immunotherapy might be feasible for older/frail patients intolerant to cCRT, showing numerically similar survival outcomes. These exploratory findings warrant confirmation in larger, adequately powered randomized trials. Trial registration The trial had been registered on ClinicalTrials.gov on Sep 30, 2022.ClinicalTrials.gov NCT05557552

05.
arXiv (quant-ph) 2026-06-15

Nanostructure modelling with early fault tolerant quantum computers

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

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

Reading between the Lines: Leveraging Large Language Models for Global Dementia and Depression Assessment from Clinical Interviews

Dementia and depression are the most prevalent neuropsychiatric disorders in geriatric populations, and their overlapping symptoms pose major challenges for differential diagnosis. In this study, we investigate open-weights Large Language Models (LLMs) for predicting dementia and depression severity from speech samples collected during standardized history taking interviews with 154 German-speaking subjects. We introduce an observer-based Global Depression Scale (GDS-D) aligned with the established Global Deterioration Scale (GDS), enabling parallel global staging of affective and cognitive symptoms. We compare three LLMs (Mistral 3.1, DeepHermes, Qwen3) in two settings: (1) zero-shot prediction and (2) LLM-based feature extraction for Support Vector Regression, using human and pause-enriched transcripts. Results show that LLMs effectively predict depression severity in zero-shot settings (best MAE of 0.60), while dementia assessment benefits substantially from structured feature extraction (best MAE of 0.78), reducing errors by up to 35% over zero-shot baselines. Pause-enriched transcripts achieve competitive performance with human transcriptions, demonstrating the viability of fully automatic screening pipelines for differential neuropsychiatric assessment.

07.
arXiv (CS.CV) 2026-06-12

VISA: VLM-Guided Instance Semantic Auditing for 3D Occupancy World Models

Semantic 3D occupancy provides a voxelized world state for autonomous driving and robot decision making, but object and rare-class errors can affect free-space interpretation, collision checking, and temporal state propagation. We show that a common VLM strategy, aligning 3D voxel or object features with crop-caption embeddings, improves text-space similarity without reliably improving closed-set occupancy mIoU. Motivated by this mismatch, we propose VISA, a training-time semantic auditing approach for existing occupancy world models. VISA queries an offline VLM on a representative crop of each physical object instance, obtains a structured audit with class hypotheses, plausible confusions, reliability, attributes, and evidence, and propagates it along the object track. The audit is grounded to matched 3D object voxels and distilled into semantic logits through reliability-weighted taxonomy, attribute-factor, and scene-level audit graph losses, while inference remains unchanged and requires no VLM. On nuScenes, averaged across three runs, VISA improves OccWorld from 19.06 to 20.05 mIoU and GaussianWorld from 21.36 to 21.91 mIoU; on GaussianWorld, object mIoU improves from 18.18 to 19.16 and rare-class mIoU from 15.60 to 16.79. These results suggest that VLMs are better suited to closed-set occupancy as reliability-aware semantic auditors than as generic caption-embedding targets.

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

Moving Out: Physically-grounded Human-AI Collaboration

arXiv:2507.18623v4 Announce Type: replace-cross Abstract: The ability to adapt to physical actions and constraints in an environment is crucial for embodied agents (e.g., robots) to effectively collaborate with humans. Such physically grounded human-AI collaboration must account for the increased complexity of the continuous state-action space and constrained dynamics caused by physical constraints. However, most existing collaboration benchmarks are discrete or do not consider physical attributes and constraints. To address this, we introduce Moving Out, a human-AI collaboration benchmark that resembles a wide range of collaboration modes affected by physical attributes and constraints, such as moving heavy items together and coordinating actions to move an item around a corner. Moving Out consists of two challenges and human-human interaction data to comprehensively evaluate models' abilities to adapt to diverse human behaviors and unseen physical attributes. To give embodied agents the capability to collaborate with humans under physical attributes and constraints, we propose a novel method, BASS (Behavior Augmentation, Simulation, and Selection), to enhance the diversity of agents and their understanding of the outcome of actions. We systematically compare BASS and state-of-the-art models in AI-AI and human-AI experiments, showing that BASS can effectively collaborate with both unseen AI and humans. The project page is available at https://live-robotics-uva.github.io/movingout_ai/.

09.
arXiv (quant-ph) 2026-06-17

Emergent de Sitter Space and Non-Unitary Tensor Networks from Non-Hermitian Quantum Criticality

arXiv:2606.17983v1 Announce Type: new Abstract: Extending the holographic principle to de Sitter (dS) spacetimes remains one of the most vital open frontiers in quantum gravity, where a microscopic, bottom-up tensor-network framework that relates boundary quantum data to emergent de Sitter spacetime is still lacking. In this work, we first show the emergence of de Sitter spacetime from boundary entanglement by formulating a non-unitary continuous multi-scale entanglement renormalization ansatz (cMERA) for a concrete non-Hermitian critical fermion chain. Within this emergent spacetime, we analyze the associated geodesics and show that they act as extremal Ryu-Takayanagi (RT) surfaces undergoing a smooth timelike-to-null transition. Remarkably, we demonstrate that this continuum trajectory dictates a distinct tensor-network architecture in which the bond-counting contribution naturally truncates at the discrete timelike-to-null transition toward the deep infrared. In the resulting architecture, the null ray along the horizon is represented by zero-cost links, since the associated cut severs no tensor legs. This network structure successfully reproduces the logarithmic scaling of non-unitary critical entanglement entropy, offering a bond-counting picture for the de Sitter RT formula. Our results provide the long-sought dS/(c)MERA correspondence at the level of both emergent spacetime and discrete holographic entanglement.

10.
arXiv (CS.CV) 2026-06-18

Learned Radius Estimation for UDF-Based Point Cloud Reconstruction

Surface reconstruction from point clouds is important for consumer-grade 3D capture, including AR/VR and indoor scanning. Local-patch Unsigned Distance Field (UDF) methods are lightweight and generalizable, but their accuracy depends on the support radius, traditionally fixed or selected by a one-dimensional curvature heuristic that cannot capture heterogeneous local geometry. We propose a learned per-query radius selector that predicts a continuous support radius and plugs into a frozen LoSF-UDF backbone. The selector is trained using off-grid target radii obtained by parabolic interpolation of cached UDF error curves. Experiments show improved fine-scale reconstruction accuracy.

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

Unlocking air traffic flow prediction through microscopic aircraft-state modeling

arXiv:2605.10083v2 Announce Type: replace Abstract: Short-term air traffic flow prediction in terminal airspace is essential for proactive air traffic management. Existing approaches predominantly model traffic flow as aggregated time series. However, traffic dynamics are governed by aircraft states and their interactions in continuous airspace. Such aggregation obscures fine-grained information, including aircraft kinematics, boundary interactions, and control intent. Here we present AeroSense, a state-to-flow modeling paradigm that predicts future traffic flow directly from instantaneous airspace situations represented as dynamic sets of aircraft states derived from ADS-B trajectories. By establishing an end-to-end mapping from microscopic aircraft states to future regional traffic flow, AeroSense preserves aircraft-level dynamics while naturally accommodating varying traffic density without relying on historical look-back windows. Experiments on a large-scale real-world dataset show that AeroSense exhibits admirable predictive accuracy and robustness over aggregation-based forecasting approaches, particularly during high-density traffic periods. These findings suggest that aircraft-state situation modeling provides a promising alternative to conventional time-series forecasting in air traffic flow management.

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

MPMWorlds: Material-Point-Method Simulations for Inferring and Extrapolating Physical Dynamics

To study the ability to infer physical dynamics from videos and extrapolate them forward in time, we assemble a dataset of 2D Material Point Method (MPM) physical simulations covering rich physical phenomena such as deformable objects, fluids, kinetic objects, and emitters. We study code generation and video diffusion approaches on this dataset, identifying their strengths and weaknesses by varying the amount of physically relevant side information. The code generation model, beyond giving a working demonstration of automatic synthesis of MPM simulations, reveals that such an approach struggles with inferring physical parameters from visual input, but relative to video diffusion, produces physically and temporally stable extrapolations forward in time, while the video diffusion model more strongly identifies geometric properties from visual input but produces physically implausible extrapolations.

13.
Science (Express) 2026-04-16

Protein-templated synthesis of dinucleotide repeat DNA by an antiphage reverse transcriptase | Science

作者: 未知作者

Defense-associated reverse transcriptases (DRTs) are widespread bacterial anti-phage systems that use unconventional mechanisms of polynucleotide synthesis. We show that DRT3, which comprises two distinct RTs (Drt3a and Drt3b) and a noncoding RNA (ncRNA), synthesizes alternating poly(GT/AC) double-stranded DNA. Cryo–electron microscopy structures at 2.6 Å resolution reveal a D3-symmetric 6:6:6 complex of Drt3a, Drt3b, and ncRNA. Drt3a produces the poly(GT) strand using a conserved ACACAC template within the ncRNA. Notably, Drt3b synthesizes a complementary, protein-primed poly(AC) strand in the complete absence of a nucleic acid template, using conserved active site residues specific to Drt3b to enforce precise base alternation. These findings expand the functional landscape of nucleic acid polymerases, revealing a protein-templated mechanism for sequence-specific DNA synthesis.

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

GeoRoPE: Ground-Aware Rotary Adaptation for Remote Sensing Foundation Models

Remote-sensing foundation models (RSFMs) benefit from pretraining on imagery from multiple sensors and ground sampling distances (GSDs), but such exposure alone does not resolve scale mismatch during downstream adaptation. A fixed token-grid offset can correspond to different ground distances across sensors, making grid-based positional priors physically inconsistent. Meanwhile, heterogeneous spatial granularity means that compact urban regions and homogeneous landscapes may require different positional sensitivities even under the same GSD. Therefore, we propose {GeoRoPE}, a ground-aware, RoPE-compatible, and parameter-efficient spatial adaptation method for RSFMs. GeoRoPE recalibrates token-level positional interactions from two complementary aspects. First, Geo-Coordinate Calibration (GCC) rescales raw token-grid offsets according to the ground distance represented by one token-grid step, producing geo-calibrated relative coordinates across GSDs. Second, Geo-Frequency Calibration (GFC) adjusts the native RoPE frequency with a relation-specific factor, enabling position sensitive adaptation to scene-dependent spatial granularity. GeoRoPE is injected into pretrained RSFMs through a lightweight adapter, preserving the frozen spatial prior while adding geo-aware positional corrections. Experiments across multiple RSFMs, sensors, resolutions, and downstream tasks demonstrate that GeoRoPE improves cross-resolution robustness and scale-sensitive representation learning.

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

Neural ARFIMA model for forecasting BRIC exchange rates with long memory

arXiv:2509.06697v3 Announce Type: replace-cross Abstract: Exchange rate forecasting remains a challenging problem, particularly for emerging economies, where the observed time series exhibit pronounced long-memory dependence, nonlinear dynamics, and sensitivity to macro-financial drivers. Classical models such as ARFIMA capture long-range persistence but fail to adequately represent nonlinear relationships, while modern machine learning approaches often neglect the underlying long-memory structure in macroeconomic series. To address this gap, we propose a Neural AutoRegressive Fractionally Integrated Moving Average (NARFIMA) model that integrates ARFIMA-based long-memory modeling with neural networks for nonlinear function approximation, while incorporating exogenous macroeconomic and uncertainty indicators. The framework provides a unified approach for capturing persistence, nonlinear dynamics, and external shocks. We establish asymptotic stationarity of the NARFIMA process and develop conformal prediction intervals for distribution-free uncertainty quantification. Empirical results for BRIC exchange rates show that NARFIMA consistently outperforms a broad range of forecasting benchmarks across multiple horizons, underscoring the importance of explicitly modeling long-memory dependence in exchange rate dynamics. The `narfima' R package provides an implementation of our approach.

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

Knockoffs-based False Discovery Rate Control and Simplification for Deep Neural Networks

arXiv:2606.04404v2 Announce Type: replace-cross Abstract: The deep neural network is a widely used framework in machine learning that has been widely applied in various fields. However, deep neural networks often involve a large number of parameters and inputs, many of which may be irrelevant to the goal or true output. These parameters and input variables not only increase computational complexity, but also contribute to additional computational cost. One solution to this problem is knockoff methods, which have proven successful in controlling false discovery rates in high-dimensional regression. Building on the knockoff methods and using the regularised neural network, this paper proposes three variable screening methods under the condition of controlling false discovery rates: one layer filter, multiple layers filter, and variable weight aggregation filter. In comparison with existing algorithms, we find that our algorithms show satisfactory performance.

17.
arXiv (CS.CV) 2026-06-12

ASTER: Latent Pseudo-Anomaly Generation for Unsupervised Time-Series Anomaly Detection

Time-series anomaly detection (TSAD) is critical in domains such as industrial monitoring, healthcare, and cybersecurity, but it remains challenging due to rare and heterogeneous anomalies and the scarcity of labelled data. This scarcity makes unsupervised approaches predominant, yet existing methods often rely on reconstruction or forecasting, which struggle with complex data, or on embedding-based approaches that require domain-specific anomaly synthesis and fixed distance metrics. We propose ASTER, a framework that generates pseudo-anomalies directly in the latent space, avoiding handcrafted anomaly injections and the need for domain expertise. A latent-space decoder produces tailored pseudo-anomalies to train a Transformer-based anomaly classifier, while a pre-trained LLM enriches the temporal and contextual representations of this space. Experiments on three benchmark datasets show that ASTER achieves state-of-the-art performance and sets a new standard for LLM-based TSAD.

18.
arXiv (quant-ph) 2026-06-17

Dimension-Free Approximate Tensorization of Quantum Hypercontractivity for Qudit Depolarizing Semigroups

arXiv:2606.17729v1 Announce Type: new Abstract: We prove almost tensorization for hypercontractivity and logarithmic-Sobolev constants for a class of reversible quantum Markov semigroups satisfying the positive off-diagonal scaling (PODS) property. This class includes qubit examples and generalized depolarizing semigroups with respect to full-rank states in arbitrary finite dimensions. For any such semigroup $(\Phi_t)_{t\ge 0}$ and every tensor power $n$, we show that the log-Sobolev constant of the product semigroup $\Phi_t^{\otimes n}$ is at least $2/(3\ln 2)$, approximately 0.96, times the log-Sobolev constant of the single-site semigroup $\Phi_t$, independently of $n$ and the local dimension $d$. The proof first establishes exact tensorization of the $(q,2)$-hypercontractive inequality for integer $q$, in particular $q=3$, and then extends the estimate to all real $q>2$ by complex interpolation; the standard implication from hypercontractivity to logarithmic-Sobolev inequalities yields the stated almost tensorization result. As an application of the same method, we also obtain sharp $(q,2)$-hypercontractivity estimates for qubit depolarizing channels.

19.
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.

20.
arXiv (CS.AI) 2026-06-18

Data Intelligence Agents: Interpreting, Modeling, and Querying Enterprise Data via Autonomous Coding Agents

arXiv:2606.19319v1 Announce Type: cross Abstract: Production data integration is bottlenecked by repeated, lossy handoffs between data owners, engineers, and analysts who must collaboratively discover, structure, and query enterprise data. We present Data Intelligence Agents (DIA), a system of three agents (Data Interpreter, Schema Creator, and Query Generator) that compresses this workflow by treating autonomous coding agents (ACAs) as a first-class abstraction: rather than emitting text, the agents generate, execute, validate, and repair concrete artifacts, draw on a shared memory for experience reuse, and surface each for review by domain experts. DIA is deployed in production for enterprise customers. We study the Query Generator in depth and evaluate it in fully autonomous mode across seven SQL benchmarks spanning four task categories and four dialects. It matches or surpasses the best published results on all seven, demonstrating that an architecture grounded in execution, built on ACAs and a shared memory, generalizes across the data intelligence workload with adaptation confined to natural-language instructions.

21.
arXiv (CS.CV) 2026-06-12

Efficient, Robust, and Anti-Collusion Fingerprinting of Image Diffusion Models

Model fingerprinting, embedding user-specific identifiers (fingerprints) into generated outputs, has recently emerged as a popular solution to protect the intellectual property rights (IPR) of generative text-to-image (T2I) models and prevent unauthorized redistribution. In this work, we reveal a previously unexplored systematic vulnerability in existing generative model fingerprinting methods: they lack robustness against collusion attacks, where multiple attackers combine their models to remove or obscure the fingerprints. To address this issue, we take the first step towards a robust fingerprinting method for T2I models with anti-collusion capabilities. The proposed method encodes strings of bits, namely fingerprints, into the coefficients of a personalized normalization module (PNM) incorporated into T2I models, so that fingerprints can be reliably recovered from any generated image. To defend against collusion attacks and prevent unauthorized model redistribution, we introduce an anti-collusion mechanism based on lossless function-invariant parameter transformations. This mechanism significantly degrades the image generation quality of colluded models, making them effectively unusable. Moreover, our method allows developers to efficiently create multiple copies of fingerprinted T2I models by reparameterizing the PNM without the need for retraining. We also introduce a worst-case optimization strategy to improve robustness against model-level attacks. Our experiments demonstrate that the proposed method achieves high fidelity and robustness across multiple T2I image generation and editing tasks, with fingerprint extraction accuracy exceeding 99.5%. Compared with existing methods, our method demonstrates, for the first time, a notable proactive robustness to collusion attacks by significantly increasing the FID of colluded models.

22.
arXiv (CS.CV) 2026-06-17

CASR: A Robust Cyclic Framework for Arbitrary Large-Scale Super-Resolution with Distribution Alignment and Self-Similarity Awareness

Arbitrary-Scale SR (ASISR) remains fundamentally limited by cross-scale distribution shift: once the inference scale leaves the training range, noise, blur, and artifacts accumulate sharply. We revisit this challenge from a cross-scale distribution transition perspective and propose CASR, a simple yet highly efficient cyclic SR framework that reformulates ultra-magnification as a sequence of in-distribution scale transitions. This design ensures stable inference at arbitrary scales while requiring only a single model. CASR tackles two major bottlenecks: distribution drift across iterations and patch-wise diffusion inconsistencies. The proposed SSAM module aligns structural distributions via superpixel aggregation, preventing error accumulation, while SARM module restores high-frequency textures by enforcing correlation-guided consistency and preserving self-similarity structure through correlation alignment. Despite using only a single model, our approach significantly reduces distribution drift, preserves long-range texture consistency, and achieves superior generalization even at extreme magnification.

23.
arXiv (CS.AI) 2026-06-17

Learning Cardiac Electrophysiology Digital Twins Through Agentic Discovery of Hybrid Structure

arXiv:2606.18154v1 Announce Type: new Abstract: Building personalized cardiac electrophysiology (EP) digital twins requires identifying the appropriate model structure for each patient, not merely fitting parameters. Traditional methods rely on experts to manually prescribe hybrid physics-neural architectures, which requires deep domain expertise and does not transfer across patients. Recent works have applied large language models (LLMs) to generate or act as hybrid models. However, despite their promising generalization capacity, these LLM-based methods lack the structural priors needed for stable cardiac simulations. Hence, we propose LEADS, a framework that formulates cardiac EP domain knowledge as a structured action space and utilizes an LLM agent to discover hybrid models. The agent follows an iterative reasoning-and-action loop to select, combine, and refine hybrid models, whilst gradient descent handles parameter fitting. The proposed LEADS designs every candidate model towards physically grounded, interpretable, and numerically stable, while allowing open-ended architectural discovery. We validate LEADS on synthetic data with three ground-truth reaction models and on real cardiac EP data, demonstrating that it outperforms both human-designed hybrid models and other LLM-based hybrid modeling.

24.
arXiv (CS.AI) 2026-06-19

The Scaffold Effect: How Prompt Framing Drives Apparent Multimodal Gains in Clinical VLM Evaluation

arXiv:2603.28387v2 Announce Type: replace Abstract: Trustworthy clinical AI requires that performance gains reflect genuine evidence integration rather than surface-level artifacts. We evaluate 12 open-weight vision-language models (VLMs) on binary classification across two clinical neuroimaging cohorts, \textsc{FOR2107} (affective disorders) and \textsc{OASIS-3} (cognitive decline). Both datasets come with structural MRI data that carries no reliable individual-level diagnostic signal. Under these conditions, smaller VLMs exhibit gains of up to 58\% F1 upon introduction of neuroimaging context, with distilled models becoming competitive with counterparts an order of magnitude larger. A contrastive confidence analysis reveals that merely mentioning MRI availability in the task prompt accounts for 70-80\% of this shift, independent of whether imaging data is present, a domain-specific instance of modality collapse we term the scaffold effect. Expert evaluation reveals fabrication of neuroimaging-grounded justifications across all conditions, and preference alignment, while eliminating MRI-referencing behavior, collapses both conditions toward random baseline. Our findings demonstrate that surface evaluations are inadequate indicators of multimodal reasoning, with direct implications for the deployment of VLMs in clinical settings.

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

Policy-aware Vector Search: A Vision for Fine Grained Access Control in Vector Databases

arXiv:2606.19803v1 Announce Type: cross Abstract: Vector databases are increasingly used in security sensitive contexts with Retrieval Augmented Generation and organizational AI pipelines; however, their security capabilities remain limited. Specifically, Fine-grained Access Control (FGAC) which is required to ensure that data access adheres to user-specific policies is not fully supported in modern vector databases. Unlike relational databases, vector databases combine structured and unstructured attributes to provide semantic, approximate query results, which complicates FGAC implementation. This creates an inherent tension between enforcing FGAC policies correctly, achieving high ANN search recall and maintaining low query latency. In this paper, we present a vision for Policy-aware Vector Search by formalizing the FGAC policy model in vector databases as well as the enforcement problem. We compare various enforcement strategies, present preliminary findings, and identify key open challenges for future research in policy-aware vector search.