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

Beyond Layer Importance in Layer-wise Sparsity: An Inter-Layer Perturbation-Absorption Perspective

The considerable layer-wise redundancy in large language models (LLMs) has established non-uniform sparsity allocation across layers as the standard pruning approach for efficient compression. Existing layer-wise allocation methods that estimate allocation strategy from local signals such as activation outliers or weight spectra mainly derive from local layer importance, whereas the final post-pruning performance is also influenced by the network's subsequent compensatory capacity. In this paper, we directly characterize this property through controlled perturbation experiments. We make the following empirical findings. First, layers exhibit highly heterogeneous responses to pruning-scale perturbations. In most cases, early layers amplify perturbations, while middle and late layers actively absorb them, with relative L2 drift decreasing monotonically across depth and direction realigning toward the unperturbed hidden-state trajectory. Second, absorption is a large-perturbation phenomenon. Under small perturbations the network exhibits amplification across all layers, and the transition to absorption occurs smoothly as perturbation magnitude grows to pruning scale. This enriches the linearized accumulation theory underlying related works. Building on these findings, we define an absorption coefficient per layer and propose absorption-aware correction, an orthogonal augmentation that improves OWL and AlphaPruning by reducing perplexity by 7.13% and boosting zero-shot accuracy by 1.02% across multiple model families at 70% sparsity.

02.
arXiv (CS.AI) 2026-06-12

Prism: Cost-Efficient Multi-LLM Serving via GPU Memory Ballooning

arXiv:2505.04021v3 Announce Type: replace-cross Abstract: Inference providers must maintain availability for many LLMs, including low-volume but essential models, making resource efficiency increasingly important as token prices fall. Analysis of production traces reveals a dynamic bursty-group pattern in which sets of models become active together and shift over time; existing space- and time-sharing approaches lack principled mechanisms to adapt to this variability, forcing trade-offs between SLO adherence and efficiency. We observe that elastic memory allocation can unify spatial and temporal sharing. Based on this insight, we have developed Prism, a memory-centric LLM co-serving framework that applies memory ballooning to reclaim memory across models and support both forms of sharing under a single scheme. Prism's balloon driver, referred to as kvcached, has been open-sourced at https://github.com/ovg-project/kvcached, and deployed in production environments across 10K+ GPUs.

03.
arXiv (CS.AI) 2026-06-19

AAPA: Adversarially Anchored Preference Alignment for Post-Training of Large Language Models

arXiv:2509.25148v2 Announce Type: replace Abstract: Post-training alignment of large language models often combines supervised fine-tuning (SFT) on expert demonstrations with reinforcement learning (RL) from preference or verifiable feedback. SFT provides a useful behavioral anchor but can overfit to static demonstrations, whereas RL encourages exploration but may drift from expert behavior or exploit imperfect rewards. We propose AAPA (Adversarially Anchored Preference Alignment), a plug-in framework that augments existing post-training objectives with a sentence-level adversarial anchoring signal. AAPA compares policy rollouts with offline, pre-collected expert responses using a fixed lightweight discriminator, and therefore requires neither online teacher inference nor discriminator co-training during policy optimization. The same anchoring term can be added to SFT, GRPO, and CHORD while preserving their original training pipelines. Experiments on instruction-following benchmarks show that AAPA consistently improves the corresponding base objectives across model scales. In particular, the staged AAPA configuration improves over a strong GRPO baseline by 5.77\% on \texttt{Qwen3-0.6B} and 3.75\% on \texttt{Qwen3-4B}. Further analyses on response length, log-probability distributions, and discriminator variants suggest that adversarial anchoring provides a stable semantic grounding signal for preference optimization. Code is available at \url{https://github.com/IsFaqq/AAPA}.

04.
arXiv (CS.AI) 2026-06-17

Physics-Informed Attention Mechanism and Generalization Capability of Deep Learning-Based Grain Growth Evolution Prediction

arXiv:2606.17235v1 Announce Type: cross Abstract: Machine Learning (ML) models for grain growth prediction are typically trained on idealized synthetic data, yet practical applications require generalization to conditions outside the training distribution. This study evaluated the Out-Of-Distribution (OOD) generalization capability of the trained model from our previous study across three test cases, including experimental microstructures, microstructures characterized by a bimodal grain size distribution, and abnormal grain growth. To further probe whether physics-informed architectural design could improve robustness under these different conditions, a boundary-masked attention mechanism was proposed specifically for grain growth, constraining attention to grain boundary pixels. Both the baseline and the proposed physics-informed attention model were evaluated without retraining or fine-tuning on the OOD data. Both models successfully generalized to all three test cases, yet the boundary-masked attention mechanism provided substantial improvements, with the most notable gains for microstructures characterized by a bimodal grain size distribution, where Structural Similarity Index Measure (SSIM) improved from \num{0.6221} to \num{0.7609} and mean grain size ($\overline{R}$) error decreased from \operatorname{SI}{8.75}{\percent} to \operatorname{SI}{3.57}{\percent}. The attention heatmap analysis revealed that the boundary-masked attention model learned to concentrate attention on large grain boundaries in a manner consistent with curvature-driven grain growth physics, emerging from training without being explicitly encoded into the architecture. These results indicate that models trained on synthetic data can generalize to diverse OOD conditions without retraining, and that physics-informed attention may improve accuracy when the boundary morphology matches the training domain.

05.
arXiv (CS.AI) 2026-06-12

Neuro-Symbolic Agents for Regulated Process Automation: Challenges and Research Agenda

arXiv:2606.13405v1 Announce Type: new Abstract: LLM-based agents are entering regulated industries where they automate judgment intensive quality management processes. We argue that symbolic structures already embedded in these domains, including regulations, typed process models, and compliance constraints, should be treated not merely as external monitoring mechanisms but as core architectural components that shape the agent's decision-making and behavior. We propose compliance-by-construction as a complementary paradigm to guardrail-based monitoring: a structural foundation that prevents control-flow violations, while guardrails remain essential for catching semantic errors. We identify a structured set of neuro-symbolic research challenges on foundational and capability level and show that addressing them jointly enables compliance-by-construction. We call on the neuro-symbolic community to engage with regulated process automation as a high impact research domain.

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

Edit3DGS: Unified Framework for Dynamic Head Editing via 2D Instruction-Guided Diffusion and 3D Gaussian Splatting

We present Edit3DGS, a unified framework for dynamic 3D head editing that integrates 2D instruction-guided diffusion with 3D Gaussian splatting. Unlike prior approaches that separately address frame-based edits or static 3D reconstruction, our method couples semantic controllability in the image domain with photorealistic, temporally consistent 3D representations. Given an input video, editable facial regions are masked and modified using a text-conditioned diffusion model to support fine-grained operations such as expression transformation, attribute modification, and appearance refinement. The edited frames are then aggregated through 3D Gaussian splatting to produce a coherent, high-fidelity avatar that preserves both identity and motion dynamics. To enforce consistency, Edit3DGS incorporates multi-view batch editing and lightweight inpainting strategies that recover lost expressions across timesteps. Experimental results demonstrate that our framework enables controllable, artifact-free head editing with smooth temporal transitions, offering practical applications in virtual avatars, immersive communication, film production, and interactive media.

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

CreativeBench: Benchmarking and Enhancing Machine Creativity via Self-Evolving Challenges

The saturation of high-quality pre-training data has shifted research focus toward evolutionary systems capable of continuously generating novel artifacts, leading to the success of AlphaEvolve. However, the progress of such systems is hindered by the lack of rigorous, quantitative evaluation. To tackle this challenge, we introduce CreativeBench, a benchmark for evaluating machine creativity in code generation, grounded in a classical cognitive framework. Comprising two subsets – CreativeBench-Combo and CreativeBench-Explore – the benchmark targets combinatorial and exploratory creativity through an automated pipeline utilizing reverse engineering and self-play. By leveraging executable code, CreativeBench objectively distinguishes creativity from hallucination via a unified metric defined as the product of quality and novelty. Our analysis of state-of-the-art models reveals distinct behaviors: (1) scaling significantly improves combinatorial creativity but yields diminishing returns for exploration; (2) larger models exhibit ``convergence-by-scaling,'' becoming more correct but less divergent; and (3) reasoning capabilities primarily benefit constrained exploration rather than combination. Finally, we propose EvoRePE, a plug-and-play inference-time steering strategy that internalizes evolutionary search patterns to consistently enhance machine creativity.

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

AnchorKV: Safety-Aware KV Cache Compression via Soft Penalty with a Refusal Anchor

arXiv:2606.17872v1 Announce Type: cross Abstract: Large language models (LLMs) outperform earlier architectures on generative inference and long-context tasks, but their large size introduces significant challenges in memory usage, energy cost, and on-device deployment. Since scaling pre-trained language models improves downstream capability [zhao2023survey], the key-value (KV) cache becomes a dominant inference bottleneck. Recent KV cache compression methods [jo2025fastkv,li2024snapkv,zhou2024dynamickv] reduce this cost by retaining only a subset of attention-relevant tokens. However, while these approaches preserve accuracy on benign workloads, their compression policies either fail to defend against jailbreak attacks [jiang2024robustkv] or degrade safety alignment under aggressive eviction. We propose AnchorKV, a drop-in modification to KV cache compression that biases token retention scores away from directions in key space associated with harmful prompts. AnchorKV constructs an offline safety anchor by adapting a difference-of-means representation engineering approach [arditi2024refusal,zou2023representation] to the layer-specific key projection space used in KV caching. Based on this anchor, a soft penalty token selection rule trades a small amount of utility for substantially improved safety alignment, while reducing to the original compressor when the penalty is zero.

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

Diffusion-based Cumulative Adversarial Purification for Vision Language Models

Vision Language Models (VLMs) have shown remarkable capabilities in multimodal understanding, yet their susceptibility to adversarial perturbations poses a significant threat to their reliability in real-world applications. Despite often being imperceptible to humans, these perturbations can drastically alter model outputs, leading to erroneous interpretations and decisions. This paper introduces DiffCAP, a novel diffusion-based purification strategy that can effectively neutralize adversarial corruptions in VLMs. We theoretically establish a provable recovery region in the forward diffusion process and meanwhile quantify the convergence rate of semantic variation with respect to VLMs. These findings manifest that adversarial effects monotonically fade as diffusion unfolds. Guided by this principle, DiffCAP leverages noise injection with a similarity threshold of VLM embeddings as an adaptive criterion, before reverse diffusion restores a clean and reliable representation for VLM inference. Through extensive experiments across six datasets with three VLMs under varying attack strengths in three task scenarios, we show that DiffCAP outperforms existing defense techniques by a substantial margin. Notably, DiffCAP significantly reduces both hyperparameter tuning complexity and the required diffusion time, thereby accelerating the denoising process. Equipped with theorems and empirical support, DiffCAP provides a robust and practical solution for securely deploying VLMs in adversarial environments. The source code is available at https://github.com/JasonFu1998/DiffCAP.

10.
arXiv (CS.AI) 2026-06-11

Position: Stop Anthropomorphizing Intermediate Tokens as Reasoning/Thinking Traces!

arXiv:2504.09762v4 Announce Type: replace Abstract: Intermediate token generation (ITG), where a model produces output before the solution, has become a standard method to improve the performance of language models on reasoning tasks. These intermediate tokens have been called \say{reasoning traces} or even \say{thinking traces} – implicitly anthropomorphizing the traces, and implying that these traces resemble steps a human might take when solving a challenging problem, and as such can provide an interpretable window into the operation of the model's thinking process to the end user. In this position paper, we present evidence that this anthropomorphization isn't a harmless metaphor, and instead is quite dangerous – it confuses the nature of these models and how to use them effectively, and leads to questionable research. We call on the community to avoid such anthropomorphization of intermediate tokens.

11.
arXiv (CS.LG) 2026-06-19

Learning to Emulate Chaos: Adversarial Optimal Transport Regularization

arXiv:2604.21097v2 Announce Type: replace-cross Abstract: Chaos arises in many complex dynamical systems, from weather to power grids, but is difficult to accurately model with data-driven methods such as machine learning emulators. While emulators are promising tools for accelerating simulations and solving inverse problems, they still struggle to learn chaotic dynamics, where sensitivity to initial conditions renders exact long-term forecasts infeasible, especially given noisy data. Recent work instead trains emulators to match the statistical properties of chaotic attractors, but these approaches often rely on handcrafted summary statistics or large, diverse multi-environment datasets. In this work, we propose a family of adversarial optimal transport objectives that can jointly learn high-quality summary statistics and a physically consistent emulator from a single noisy trajectory. We theoretically analyze and experimentally validate a Sinkhorn divergence formulation (2-Wasserstein) and a WGAN-style dual formulation (1-Wasserstein) of our approach. Numerical experiments across a variety of chaotic systems, including ones with high-dimensional spatiotemporal chaos, show that emulators trained using our proposed objectives have significantly improved long-term statistical fidelity.

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

Benchmarking AI Agents for Addressing Scientific Challenges Across Scales

arXiv:2606.12736v1 Announce Type: new Abstract: AI agents are increasingly being developed to accelerate scientific discovery, yet their practical capabilities in real research settings remain poorly understood. Existing benchmarks for AI agents rarely capture the complexity, heterogeneity, and extended reasoning required by scientific work, whereas benchmarks for scientific tasks often reduce research to static, direct problems and provide limited support for interactive evaluation. Here, we introduce SciAgentArena, a systematic benchmark for evaluating AI agents in real-world scientific research scenarios drawn from emerging needs across multiple domains. SciAgentArena comprises approximately 200 tasks with stepwise verification and an interactive, agent-agnostic environment for assessing diverse AI agents. Using this benchmark, we find that current agents can contribute effectively to well-specified data-analysis workflows, particularly when the task structure and evaluation criteria are clear. However, their performance remains uneven across scientific contexts: agents struggle to generate genuinely novel insights, sustain self-directed exploration, and formulate robust solutions for open-ended research questions. We further characterize common failure modes across agents and identify opportunities for improving their reliability, autonomy, and scientific reasoning. Together, SciAgentArena provides a practical framework for measuring progress in AI agents for science and for guiding the design of future agents capable of addressing complex scientific challenges. Full codes, tasks, and datasets can be accessed via this link: https://sciagentarena.github.io/.

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

GrapNet: A Programmable Dynamic-Architecture Neural Graph Substrate

作者:

arXiv:2606.18923v1 Announce Type: new Abstract: Programmability is a missing first-class interface in fixed-tensor neural networks: editing a relation, freezing a subgraph, auditing a local function, or changing the execution backend should be an operation on the neural program rather than ad-hoc parameter surgery. GrapNet studies this graph-as-network setting. The graph is the architecture and executable program, not an input data graph. Each compute node owns its next-layer child references and a trainable allocation vector aligned with those references; deleting a relation physically removes both the child reference and the corresponding allocation coordinate. Structural rules and execution policies live outside the node core, so the same child-owned graph can be grown, frozen, structurally edited, grouped into trainable family blocks, routed by attention over active relations, or lowered to dense snapshots after topology stabilizes. GrapNet composes with conventional modules through a vector-valued parent interface: dense layers, CNN encoders, ResNet feature extractors, attention blocks, and transformer representations can all feed one sensory GrapNode per coordinate. The evaluation is organized as a programmability stress suite rather than as a new replay benchmark. In a matched ten-seed Split Fashion-MNIST study, a plastic GrapNet+ER head reaches 63.16 percent seen-class accuracy versus 51.08 percent for a parameter-larger dense MLP+ER under the same seen-class loss and replay memory, with paired delta 12.08 points and p=1.3e-5. On Split CIFAR-10 with a frozen ImageNet ResNet-18 encoder, the same substrate improves the online head over MLP-256 by 3.81 points, with p=0.0026. These results support GrapNet as an editable neural graph substrate whose core value is structural programmability with faithful execution views.

14.
arXiv (CS.AI) 2026-06-17

Combating Data Laundering in LLM Training

arXiv:2604.01904v3 Announce Type: replace-cross Abstract: Post-hoc unauthorized-training data detection for large language models (LLMs) typically assumes a query-with-originals regime: rights holders query a target LLM with raw proprietary data and assess whether the model assigns them stronger memorization-based detection signals, e.g., higher confidence or lower loss, than held-out non-training reference texts. We show that this regime becomes brittle under data laundering, where the target LLM is trained on semantics-preserving but stylistically or structurally transformed surrogates of proprietary data to obfuscate provenance. Since training-time exposure occurs in the laundered form, memorization signals may no longer appear on the originals, collapsing the candidate-reference signal separation that standard detectors rely on. We counter this threat by studying laundering-aware detection with raw proprietary data, a held-out reference corpus, and query access to the target LLM, while the laundering transformation is undisclosed. Since exact recovery of the laundered corpus is infeasible, we infer a detection-useful synthesis process via an auxiliary LLM that maps originals into training-like queries. To make this search tractable, we introduce Synthesis Data Reversion (SDR), which constrains the unbounded space of natural-language transformations through a goal-details abstraction: a high-level transformation goal, e.g., "lyrical rewriting", and fine-grained details, e.g., "with vivid imagery". SDR identifies the most likely goal and iteratively refines details so synthesized queries elicit stronger target-model detection signals. Evaluated on the MIMIR benchmark against diverse laundering practices and target LLM families (Pythia, Llama2, and Falcon), SDR consistently restores detection signals, offering a practical auditing layer against data laundering.

15.
arXiv (CS.AI) 2026-06-11

SPEA2$^+$: Improved Density Estimation in SPEA2 with Provable Runtime Guarantees

arXiv:2606.12382v1 Announce Type: cross Abstract: The Strength Pareto Evolutionary Algorithm 2 (SPEA2) is a popular and prominent evolutionary algorithm for solving multi-objective optimisation problems. Despite its popularity, theoretical analyses of SPEA2 have only appeared recently. Moreover, these analyses focus exclusively on how SPEA2 handles non-dominated solutions and disregard the algorithmic components responsible for handling dominated solutions. We conduct a first runtime analysis of SPEA2 for which these components are analysed. We prove that, unlike other prominent algorithms, including NSGA-II, NSGA-III and SMS-EMOA under the same setting of constant population size and duplicate elimination, SPEA2 is unable to cover the Pareto front of the OneTrapZeroTrap benchmark efficiently. Our results indicate that using k-th nearest-neighbour distance in the fitness assignment provides an insufficient signal to maintain diversity among dominated individuals. To address this issue, we propose an improved variant, SPEA2$^+$, that considers all pairwise distances. The new algorithm achieves the same performance guarantees as the other prominent algorithms on OneTrapZeroTrap, while matching the performance of the original SPEA2 on simpler problems. Experimental results complement our theoretical findings.

16.
arXiv (quant-ph) 2026-06-19

Optimized Quantum States for Sensing in the Presence of Loss and Phase Noise

arXiv:2606.19649v1 Announce Type: new Abstract: Squeezed vacuum lets gravitational-wave detectors and other quantum sensors surpass the standard quantum limit, and is optimal in the loss-limited regime; phase noise breaks this optimality. Numerically optimizing the quantum Fisher information across the loss and phase-noise landscape, we identify non-Gaussian states that outperform any Gaussian state. These fall into three classes: Fock-like, cubic-phase-like, and states with discrete rotational symmetry. Limiting the average number of photons in the input state to $\bar{n}=5$, with $1-\eta = 5\%$ photon loss and 200 mrad phase noise, the non-Gaussian advantage reaches up to 2.2 dB. Furthermore, we observe that the non-Gaussian advantage can persist even when the measurement strategy is homodyne detection.

17.
Nature (Science) 2026-06-12

‘Student Geng’ ignites research-integrity scandal in China after calling out senior academics<b> </b>

作者:

Video blogger’s viral accusations of data manipulation in Nature journals have sparked intense debate and speedy institutional investigations. Video blogger’s viral accusations of data manipulation in Nature journals have sparked intense debate and speedy institutional investigations.

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

EndoCoT: Scaling Endogenous Chain-of-Thought Reasoning in Diffusion Models

Recently, Multimodal Large Language Models (MLLMs) have been widely integrated into diffusion frameworks primarily as text encoders to tackle complex tasks such as spatial reasoning. However, this paradigm suffers from two critical limitations: (i) MLLMs text encoder exhibits insufficient reasoning depth. Single-step encoding fails to activate the Chain-of-Thought process, which is essential for MLLMs to provide accurate guidance for complex tasks. (ii) The guidance remains invariant during the decoding process. Invariant guidance during decoding prevents DiT from progressively decomposing complex instructions into actionable denoising steps, even with correct MLLM encodings. To this end, we propose Endogenous Chain-of-Thought (EndoCoT), a novel framework that first activates MLLMs' reasoning potential by iteratively refining latent thought states through an iterative thought guidance module, and then bridges these states to the DiT's denoising process. Second, a terminal thought grounding module is applied to ensure the reasoning trajectory remains grounded in textual supervision by aligning the final state with ground-truth answers. With these two components, the MLLM text encoder delivers meticulously reasoned guidance, enabling the DiT to execute it progressively and ultimately solve complex tasks in a step-by-step manner. Extensive evaluations across diverse benchmarks (e.g., Maze, TSP, VSP, and Sudoku) achieve an average accuracy of 92.1%, outperforming the strongest baseline by 8.3 percentage points. The code and dataset are publicly available at https://internlm.github.io/EndoCoT/.

20.
arXiv (CS.CV) 2026-06-16

Semantic Flip: Synthetic OOD Generation for Robust Refusal in Embodied Question Answering and Spatial Localization

Detecting unanswerable user queries remains essential for the reliable deployment of real-world embodied agents. However, modern vision-language models (VLMs) often generate overly confident answers even when the available visual memory cannot support the query. Such overconfidence poses various task-dependent risks. The agent may provide misleading information to the user in Embodied Question Answering and select an arbitrary coordinate and physically guide the user there in spatial reasoning for navigation. Despite these high stakes, only a few prior studies directly address when and how an embodied VLM should respond with "I do not know." This work proposes Semantic Flip, a simple yet effective framework that synthesizes auxiliary out-of-distribution (OOD) samples for embodied refusal without requiring external OOD annotations. The key idea is to independently transform the query and video memory to construct auxiliary OOD pairs that lack sufficient visual grounding. These synthesized pairs enable training a lightweight rejection module on top of a frozen pretrained VLM. The module attaches to any existing VLM-based pipeline without retraining the underlying model. Across two complementary benchmarks, Semantic Flip consistently outperforms strong prompting baselines. This work also introduces SpaceReject, a new refusal benchmark for spatial localization with deliberately unanswerable queries over long video memory, where Semantic Flip achieves an $F_1$ score of 0.9559. The source codes and datasets are publicly available at https://github.com/ndb796/SemanticFlip.

21.
arXiv (math.PR) 2026-06-18

On a class of reflected McKean-Vlasov Stochastic Differential Equations with jumps

arXiv:2606.18433v1 Announce Type: new Abstract: This paper investigates a class of reflected McKean-Vlasov Stochastic Differential Equations driven by both Brownian motion and a compensated Poisson random measure. We establish the existence and uniqueness of solutions and provide moments estimates for the state processes.

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

Low-Latency Real-Time Audio Game Commentary System via LLM-Based Parallel Text Generation

We present a low-latency real-time audio game commentary system that generates spoken commentary directly from live gameplay video. In this end-to-end setting, a key bottleneck is accumulated waiting time; conventional pipelines capture frames, generate text, and synthesize speech sequentially for each utterance, and do not request the next generation until speech playback has completed. This strict sequentiality causes long and unnatural silence between utterances. To address this latency bottleneck, our system runs text generation in parallel with speech playback and buffers multiple candidate utterances ahead of time, enabling immediate synthesis at playback boundaries. Experiments on fast-paced game videos show that our parallel design reduces the mean inter-utterance silence from 9.6 seconds to 0.3 seconds compared to sequential baselines. It also improves similarity to professional speaking–silence timing patterns by over 40 %, and a user study with 120 experienced game players confirms significantly improved perceived speaking rhythm. Our demo video is available at: https://youtu.be/pmrRUlvav8M.

23.
medRxiv (Medicine) 2026-06-17

Treatment of Multi-Drug-Resistant Tuberculosis with Second-Line All-Oral Drugs in Ghana: Incidence of Adverse Events.

Introduction: The treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging due to the toxicity of second-line medications and suboptimal treatment outcomes. This study aimed to determine the incidence of adverse events and identify factors associated with these events in patients undergoing treatment for MDR-TB with second-line all-oral drugs in Ghana. Methods: This retrospective cohort study reviewed the medical records of 384 MDR-TB patients treated with second-line all-oral drugs at selected health facilities in Ghana, including the Greater Accra Regional Hospital, Eastern Regional Hospital, and Kumasi South Hospital. Data were extracted using the Kobo Collect tool, capturing patient demographics, baseline clinical and laboratory characteristics, treatment regimens, and adverse events. The study period spanned from 2020 to August 2024. Results: The study included a total of 384 MDR-TB patients, with a mean age of 45 years (SD = 15). The majority of patients were male (65.78%), and most were within the 45-64 years age group (33.85%), followed by those aged 25-44 years (31.25%). Regionally, the highest number of cases were reported from the Greater Accra Region (39.06%), followed by the Eastern Region (31.25%) and Kumasi South Hospital (29.69%). Approximately one in four patients (25%) presented with comorbidities, with HIV being the most common (19.5%). The most frequently reported adverse events were diarrhea (14%), dizziness (13.7%), and vomiting (12.3%). Most of these were mild to moderate in severity and tended to decrease as treatment progressed. Severe adverse events, such as leukopenia and acute kidney injury, were rare, occurring in less than 5% of patients. Over the course of treatment, gastrointestinal adverse events such as vomiting and nausea showed a significant decline, indicating possible patient adaptation or improved clinical management. Results from the multivariate Poisson regression analysis revealed that age and comorbidities were significant predictors of adverse events. Patients aged 65 years and above had a 56% lower risk of developing adverse events compared to younger patients (Adjusted Risk Ratio [aRR] = 0.44, 95% CI: 0.25-0.79, p = 0.005). Conversely, patients with comorbid conditions such as diabetes or hypertension were approximately 2.6 times more likely to experience adverse events compared to those without comorbidities (aRR = 2.65, 95% CI: 1.58-4.43, p < 0.001). The effect of sex was not statistically significant after adjustment (aRR = 1.03, 95% CI: 0.70-1.50, p = 0.86). At the end of the treatment period, 74.9% of patients achieved successful outcomes, including both those who were cured and those who completed treatment without being classified as cured. However, 25.1% had unsuccessful outcomes, which included treatment failure, relapse, or death. Conclusion: In conclusion, adverse events are common in the treatment of MDR-TB with second-line All-Oral drugs, with gastrointestinal adverse events being the most prevalent. These findings highlight the importance of monitoring and managing adverse events to optimize treatment outcomes for MDR-TB patients in Ghana.

24.
medRxiv (Medicine) 2026-06-18

Empirical Validation and Predictive Utility of the Perinatal Grief Scale in Men after Perinatal Loss

Background. The Perinatal Grief Scale (PGS) is a widely used instrument for assessing grief following pregnancy loss, yet no study has validated it specifically in men despite documented use in several studies. This gap is critical given fathers' persistent underrepresentation in perinatal bereavement research and the absence of empirically supported screening thresholds for this population. Methods. This cross-sectional validation study used data from the OPALE project (Observatory on PerinatAL hEalth) conducted by the CiaoLapo Foundation in Italy. Among 276 fathers who experienced stillbirth or miscarriage, we examined criterion validity by testing the association between PGS scores and trauma-related symptomatology assessed via three validated instruments: the Revised Impact of Event Scale (RIES, n=103), National Stressful Events Survey Short Scale (NSESSS, n=95), and SCL-90 (n=173). We systematically tested multiple threshold combinations to identify optimal discriminative performance. Results. The PGS demonstrated excellent criterion validity. The optimal threshold (PGS >=92) showed sensitivity 81.0%, specificity 81.8%, and Youden's J index 0.628. Fathers scoring >=92 had 19.12 times the odds of high trauma symptoms (95% CI: 9.35 to 39.14, p

25.
arXiv (CS.CL) 2026-06-12

HKVM-RAG: Key-Value-Separated Hypergraph Evidence Organization for Multi-Hop RAG

Multi-hop RAG poses a data-engineering problem beyond passage matching: under fixed retrieval budgets, a system must organize retrieved text into evidence units that expose answer chains. Dense retrievers score passages independently, while graph-based memories make associations explicit but often rely on pairwise or entity-centered keys that fragment multi-hop evidence. We present HKVM-RAG, a key-value-separated evidence-organization layer. It assembles answer-path hyperedges from cached passage-level LLM evidence tuples and uses them as retrieval keys, while retaining passage text as answer values. To isolate key-space design, our fixed-substrate protocol holds the tuple cache, candidate passages, reader, and evaluation budget constant across pairwise graph and hypergraph variants. Weighted hypergraph key-value retrieval improves over KG-PPR by +3.426 F1 on 2WikiMultiHopQA and +3.592 F1 on MuSiQue; HotpotQA shows that higher structured support coverage need not yield standalone answer-F1 gains. We therefore study WHG-KV as an evidence-control signal rather than a dense-retrieval replacement. Oracle and train-to-dev analyses identify support selection as repairable, and a dense-aware controller combines frozen ColBERTv2 and HKVM rank/score features using out-of-fold HKVM predictions. It reaches 88.846, 65.073, and 85.810 F1 on the three benchmarks, improving over ColBERTv2 by +11.084, +6.763, and +5.966 F1. Source-level ablations show that matched non-WHG structured signals do not match the WHG-KV gains. These results provide bounded evidence that key-value-separated hypergraph organization can serve as a reusable evidence-control mechanism for multi-hop RAG.