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

TextResNet: Decoupling and Routing Optimization Signals in Compound AI Systems via Deep Residual Tuning

arXiv:2602.08306v2 Announce Type: replace Abstract: Textual Gradient-style optimizers (TextGrad) enable gradient-like feedback propagation through compound AI systems. However, they do not work well for deep chains. The root cause of this limitation stems from the Semantic Entanglement problem in these extended workflows. In standard textual backpropagation, feedback signals mix local critiques with upstream contexts, leading to Attribution Ambiguity. To address this challenge, we propose TextResNet, a framework that reformulates the optimization process to achieve precise signal routing via four key innovations. Firstly, in the forward pass, it enforces Additive Semantic Deltas to preserve an Identity Highway for gradient flow. Secondly, in the backward pass, it introduces Semantic Gradient Decomposition via a Semantic Projector to disentangle feedback into causally independent subspaces. Thirdly, it implements Causal Routing, which routes projected signals to their specific components. Finally, it performs Density-Aware Optimization Scheduling to leverage the disentangled signals to dynamically allocate resources to key system bottlenecks. Our results show that TextResNet not only achieves superior performance compared to TextGrad, but also exhibits remarkable stability for agentic tasks in compound AI systems where baselines collapse. Code is available at https://github.com/JeanDiable/TextResNet.

02.
PLOS Medicine 2026-06-12

Comparison of count-based and clustering definitions of multimorbidity and their association with prevalence of multimorbidity, health profiles, and mortality: A cohort study of UK Biobank participants

by Gabriella C. Silva, Aurore Fayosse, Louis Jacob, Séverine Sabia, Archana Singh-Manoux, Benjamin Landré Background Multimorbidity, the presence of several chronic conditions, is linked to higher mortality and healthcare use and thus poses a major challenge for aging populations. While most studies rely on simple counts of conditions, clustering approaches have been proposed to describe patterns of co-occurring diseases. We aimed to evaluate the extent to which these methodological choices influence prevalence and association with health profiles and mortality. Methods and findings Using UK Biobank baseline data (n = 474,397), collected between 2006 and 2010, we compared six count-based definitions of multimorbidity based on different condition lists (extended, most prevalent, or body systems) and thresholds (≥2 versus ≥3 conditions). We also applied a clustering analysis to characterize subtypes of multimorbidity among participants with at least two chronic conditions. We compared prevalence and associations with concurrent health outcomes (polypharmacy, self-rated health, frailty, falls, surgery, chronic pain), blood-based measures (C-reactive protein, Cystatin-C, HDL, LDL Cholesterol, IGF-1), and 3- and 10-year mortality risks. Analyses were undertaken separately in men and women using multivariable regression models adjusted for sociodemographic characteristics and body mass index. Multimorbidity prevalence ranged from 1.0% (cluster-based) to 35.3% (count-based). Count-based definitions using lists with more conditions yielded higher prevalence. Higher thresholds identified more severe health profiles on all measured health outcomes, blood-based measures, but not higher mortality risks. Associations with blood-based measures were more pronounced using clustering, with the highest differences from the standard definition distributed across clusters. Odds ratios for 3-year mortality ranged from 1.44 [1.26; 1.64] to 4.60 [3.73; 5.62] for men and 1.35 [1.07; 1.69] to 3.83 [2.78; 5.14] for women. For 10-year mortality, they ranged from 1.42 [1.34; 1.50] to 3.86 [3.46; 4.30] in men and 1.29 [1.21; 1.39] to 3.33 [2.93; 3.77] for women, with clustering identifying groups with low prevalence and high mortality risks. Findings should be interpreted in light of the selected nature of the UK Biobank cohort and the cross-sectional assessment of several health indicators. Conclusion Operational definitions of multimorbidity substantially influence prevalence estimates, while associations with mortality appear more robust across count-based approaches. Clustering analyses provide complementary insights into heterogeneity within multimorbid populations. Future translational studies are warranted to determine how multimorbidity definitions can be optimized to ultimately improve clinical management and health outcomes in practice.

03.
arXiv (CS.CV) 2026-06-11

Frozen Foundation-Model Embeddings Discard Small-Lesion Signal in Chest Radiography: Implications for Pre-Deployment Evaluation

Frozen vision-transformer (ViT) foundation-model embeddings increasingly serve as the substrate for downstream chest-radiography (CXR) pipelines, yet where small-scale, low-contrast signal is retained or lost in the frozen forward pass has not been systematically quantified across architectures, pretraining domains, and objectives. We probed five frozen ViTs (RAD-DINO, DINOv2-B/14, DINOv3 ViT-7B, BiomedCLIP, MedSigLIP) and a frozen DINO-pretrained ResNet-50 architectural control across three large CXR cohorts (NIH-CXR14, MIMIC-CXR, Emory-CXR; aggregate pool n=492,724) and ChestX-Det10 (n=3,543; 1,462 small-lesion bounding boxes across Calcification, Nodule, Mass). Each model was evaluated with a small-scale-perturbation panel and a region-aware bounding-box-stratified probe on real lesions, comparing three pooling modes from the same forward pass: classification token (CLS), patch-mean (mean over all final-layer patch tokens), and bounding-box-restricted patch-local. On the perturbation panel, CLS embeddings sat at the chance floor (area under the ROC curve [AUC] 0.500-0.524); patch-mean was indistinguishable from CLS on iso-blur and reticular-fine cells but rose with CLS on larger directional-blur footprints, while disease AUC on globally decided tasks ranged 0.642-0.913. Patch-local probes recovered AUC ~1.0 from the same forward pass (per-model mean improvement +0.412 to +0.488); the ResNet-50 control reproduced the chance floor. On ChestX-Det10, image-level CLS classification showed within-class small-versus-large stratum gaps up to +0.243 AUC; bounding-box-level patch-local pooling on the same forward pass recovered AUC >= 0.899 on every (model x class) cell. Frozen ViT embeddings silently suppress small-scale signal at the global-aggregation step; the signal is recoverable from patch tokens conditional on a region of interest.

04.
medRxiv (Medicine) 2026-06-16

Upper airway disease in primary ciliary dyskinesia: Clinical management and factors influencing decision-making, a multicentre analysis

Background Upper airway disease is common in primary ciliary dyskinesia (PCD), but management evidence is limited. We aimed to describe management practices and identify factors influencing management decisions. Methods Using data from the Ear-Nose-Throat (ENT) Prospective International Cohort of patients with PCD (EPIC-PCD) and an ENT-specialist survey across participating centres, we described management practices recorded at routine follow-up. We assessed clinical factors associated with practices via mixed-effects logistic regression models. In a subgroup of patients, we assessed factors associated with initiation or discontinuation of practices. Results We included 579 patients: median age 15 years, 46% female. Nasal rinsing (54%) and nasal corticosteroids (22%) were most frequently prescribed. Among 466 patients with available data, 47 had grommets (10%) and 42 hearing aids (9%). Nasal corticosteroids and rinsing were more frequently prescribed in patients with polyps (odds ratio [OR] 3.74, 95% confidence interval [CI] 1.80-7.76; OR 3.39, 95% CI 1.37-8.37) or turbinate hypertrophy (OR 1.89, 95% CI 1.03-3.47; OR 2.89, 95% CI 1.55-5.38), and upper airway nebulisation in patients with frequent nasal symptoms (OR 2.86, 95% CI 1.11-7.39). Management practices differed between centres, as seen also by the specialists survey responses. In 177 patients with multiple visits, initiation of nasal rinsing was associated with frequent nasal symptoms (OR 3.18, 95% CI 1.24-8.18) and turbinate hypertrophy (OR 3.21, 95% CI 1.20-8.59). Conclusion Upper airway disease management in PCD varies and is partly guided by symptom burden and clinical findings. This variation across centres highlights the need for care standardisation and PCD-specific management guidelines.

05.
medRxiv (Medicine) 2026-06-15

An epidemiological scenario for Mass Events During the World Cup

This brief work discusses potential superspreading events that may occur during the World Cup in Mexico. The study is particularly focused on the city of Guadalajara due to a large recent outbreak in January and February and insufficient vaccine coverage prior to 2026. Keywords: Superspreading; measles outbreak; branching process; individual reproduction number; World Cup

06.
PLOS Computational Biology 2026-06-04

Cell differentiation can underpin the reproducibility of morphogenesis

by Dominic K. Devlin, Austen R. D. Ganley, Nobuto Takeuchi Morphogenesis of complex body shapes is reproducible despite the noise inherent in the underlying morphogenetic processes. However, how these morphogenetic processes work together to achieve this reproducibility remains unclear. Here, we ask how this reproducibility is achieved by evolving complex morphologies in a multi-scale, computational model. Each morphology consists of a population of cells on a two-dimensional grid using the Cellular Potts Model framework. Each cell contains a genome that encodes a gene regulatory network, morphogens for cell-cell signalling, and proteins that determine cell behaviours. By repeatedly simulating our model with different initial conditions under selection for shape complexity, we obtained a “zoo” of evolved morphologies. We find that these evolved, complex morphologies are reproducible in a sizeable fraction of simulations, despite no direct selection for reproducibility. We show that high reproducibility is caused by spatially segregating moving cells that “shape” morphologies from stationary cells that “maintain” morphologies during morphogenesis. Strikingly, most highly reproducible morphologies also evolved cell differentiation, where proliferative, moving progenitor cells irreversibly differentiate into non-dividing, stationary differentiated cells at tissue boundaries. These results suggest that cell differentiation observed in natural development plays a fundamental role in morphogenesis in addition to the production of specialised cell types. This previously unrecognised role of cell differentiation has major implications for our understanding of how morphologies are generated and regenerated.

07.
arXiv (quant-ph) 2026-06-15

Quantum geometrical description of hole spin qubits far away from the $\Gamma$-point

arXiv:2606.14683v1 Announce Type: cross Abstract: Hole spin qubits provide one of the leading platforms for spin-based quantum computing due to their large intrinsic spin-orbit interaction (SOI), which enables fast electrical manipulation. The SOI of planar quantum dots has mostly been investigated in theoretical studies by examining the SOI already present in the two-dimensional hole gas (2DHG). Here, we study the SOI created by the in-plane confinement by deriving non-perturbative effective Hamiltonians numerically for hole spin qubits. We find that the quantum geometry of the 2DHG naturally emerges, leading to a meaningful non-perturbative definition of pseudospin valid far away from the $\Gamma$-point. The SOI of the 2DHG and of the in-plane confinement have different forms; therefore, they cannot be turned off simultaneously, ruining the perfect spin-orbit switch functionality of spin qubits. We construct effective Hamiltonians using the symmetry approach for various low-dimensional hole systems: (i) a heavy-hole confined in a SiGe/Ge/SiGe heterostructure, (ii) a light-hole confined in SnGe/Ge, (iii) a gate-defined nanowire in SiGe/Ge/SiGe, and (iv) a hole confined in a Ge/Si core/shell nanowire. The non-perturbative effective Hamiltonians provide results with excellent agreement with the full Hamiltonians.

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

Prompt Perturbation for Reliable LLM Evaluation over Comparison Graphs

Evaluating large language models (LLMs) is important for understanding their capabilities, comparing competing systems, and supporting the deployment of reliable models in practice. For open-ended tasks, pairwise evaluation has become a popular paradigm, in which two responses to the same prompt are compared and the resulting judgments are aggregated into an overall ranking. A central challenge of this paradigm is intransitivity: the induced comparison outcomes may fail to support any coherent global ranking. For example, one may observe cyclic preferences such as $A \succ B \succ C \succ A$, or inconsistencies involving ties such as $A \equiv B\equiv C\neq A$. Such contradictions make the resulting leaderboard unstable and challenging to interpret. In this paper, we propose a prompt perturbation framework for improving the consistency of pairwise LLM evaluation. Our approach generates perturbed variants of each prompt, uses the resulting comparison graphs to identify and filter out structurally inconsistent comparison patterns, and then applies standard ranking methods to the filtered comparisons. A key feature of the proposed framework is that graph-level structural consistency is incorporated explicitly into the evaluation pipeline before ranking aggregation. This provides a simple and principled way to reduce cyclic inconsistencies and improve the reliability of LLM rankings.

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

Large Language Models for Agentic NetOps and AIOps: Architectures, Evaluation, and Safety

arXiv:2605.12729v2 Announce Type: replace-cross Abstract: Large language models are increasingly being used to support network operations (NetOps) and artificial intelligence for IT operations (AIOps), including incident investigation, root-cause analysis, configuration synthesis, and limited self-healing. In both NetOps and AIOps, this shift is changing how tasks are managed. Agent-based operations work as workflows, from gathering evidence to taking action, following permissions, policies, and checks, and providing rollback options when necessary. This is crucial because operational decisions can have instant impacts. To make the argument concrete, we organise the relevant literature around the hierarchy of autonomy, tool scope, evidence traces, and assurance contracts. These contracts define what an agent may observe, propose, and execute. They also define the checks that must pass before any action is allowed. A consistent pattern appears across work on telemetry query recommendation, diagnosis, root-cause analysis, configuration synthesis, change planning, and limited self-healing. Operational reliability does not come chiefly from the model itself. It depends on the machinery around the model. We also argue that evaluation should go beyond static question answering. Agentic NetOps and AIOps systems require workflow-centred evaluation, including trace quality, bounded tool use, safe proposal generation, replay in sandboxed environments, and canary trials with rollback-aware scoring. Without these measures, a system may appear robust yet remain too fragile. Finally, we examine security, privacy, and governance risks that become acute when agents sit close to operational control surfaces. Taken together, the survey concludes that progress in intelligent NetOps and AIOps will depend on treating autonomy as a constrained operational control problem, whose outputs must be reliable, auditable, and securely deployable.

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

Distilling Drifting Transformers with Representation Autoencoders

arXiv:2606.15553v1 Announce Type: cross Abstract: Representation Autoencoders (RAEs) have improved diffusion and flow models by semantically richer latent space owing to the strongly label-wise clustered DINO features in the pretrained encoders. Yet in the distillation stage, the severe anisotropy and large curvatures caused by the rich semantic representations would hinder the convergence and performance, making the trajectory-based distillation unstable. In this work, we argue that the RAE latent space is compatible with distillation via the newly proposed Drifting Models. We first quantitatively study the curvatures and isotropy statistics across different autoencoders, and theoretically reveal that Drifting Model itself is highly likely to fail on extremely scattered spaces like reconstruction-based VAEs. These motivate us to apply the drifting paradigm directly to representation autoencoders. Our proposed method, Drift-RAE, distills pretrained flow models in RAE latent spaces using Drifting, together with insightful modifications that improve training stability by thereotically aligning drifting fields with other frameworks. Regarding the experimental evidences, we achieve 1.77 FID on ImageNet 256 dataset using only 10k distillation steps, surpassing state-of-the-art RAE distillation methods and appearing comparative with the original Drifting Model without requiring an auxiliary MAE feature extractor. The code will be made publicly available.

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

From Self-Supervised Speech Models to Mixture-of-Experts for Robust Anti-Spoofing

arXiv:2606.14639v1 Announce Type: cross Abstract: Recent advances in speech generation have significantly improved the naturalness of synthetic speech, making spoofing detection increasingly challenging. A key limitation of current anti-spoofing systems is their limited robustness to unseen synthesis methods. In this work, we transform a self-supervised speech representation model into a Mixture-of-Experts (MoE) architecture to improve generalization. Feed-forward blocks in selected encoder layers are replaced by multiple expert networks controlled by a layer-wise gating mechanism, allowing experts to capture complementary acoustic patterns while preserving the representations learned during self-supervised pretraining. We further analyze the architectural choices affecting the performance of this MoE conversion and investigate the activation behavior of the experts. The proposed approach is evaluated on 14 spoofing datasets and reduces the macro EER from 5.46% to 4.81%, corresponding to 11.9% relative improvement over the baseline.

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

EqCollide: Equivariant and Collision-Aware Deformable Objects Neural Simulator

arXiv:2506.05797v2 Announce Type: replace Abstract: Simulating collisions of deformable objects is a fundamental yet challenging task due to the complexity of modeling solid mechanics and multi-body interactions. Existing data-driven methods often suffer from lack of equivariance to physical symmetries, inadequate handling of collisions, and limited scalability. Here we introduce \name, the first end-to-end equivariant neural fields simulator for deformable objects and their collisions. We propose an equivariant encoder to map object geometry and velocity into latent control points. A subsequent equivariant Graph Neural Network-based Neural Ordinary Differential Equation models the interactions among control points via collision-aware message passing. To reconstruct velocity fields, we query a neural field conditioned on control point features, enabling continuous and resolution-independent motion predictions. Experimental results on 2D and 3D scenarios show that \name achieves accurate, stable, and scalable simulations across diverse object configurations. It achieves $24.34\%$ to $57.62\%$ lower rollout MSE, even compared with the best-performing baseline model. Furthermore, \name could generalize to more colliding objects and extended temporal horizons, and stay robust to input transformed with group action. Code is available at: https://github.com/AI4Science-WestlakeU/EqCollide

13.
arXiv (CS.CV) 2026-06-12

Language-Guided Abstraction for Visual Reasoning

The Abstraction and Reasoning Corpus (ARC) is viewed as a critical avenue to Artificial General Intelligence (AGI), as it enables models to learn abstract transformation rules from few-shot examples and then generalize to new tasks. However, prevalent ARC methodology is either pure language or vision-only (i.e., VARC). The former depends heavily on LLMs, consuming billions of parameters. The latter often struggles to capture high-level semantics, leading to overfitting on pixel-level patterns. To bridge this gap, we propose L-VARC, a novel framework that enhances visual reasoning via a language-guided Learning Using Privileged Information (LUPI) branch. Specifically, we design a Semantic Compression Module by feeding a unified, task-agnostic prompt into DeepSeek-V3. In this way, the raw LARC (a crowd-sourced language description dataset) can be substantially refined and structured, fitting with the context length constraint of standard text encoders (e.g., CLIP). Moreover, we design a Cross-Attention Projector to align visual features with semantic embeddings, aiming to guide the training of the ARC model. Notably, the LUPI branch is taken in the training process and will be discarded during inference, thereby yielding a lightweight model with a mere 18 million parameters. Extensive experiments demonstrate that our L-VARC effectively leverages linguistic priors to boost visual reasoning and outperforms state-of-the-art. Ablation studies further confirm the contribution of the two new designs towards the L-VARC framework. The code is available at https://github.com/GZHU-DVL/L-VARC.

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

Lesion-DDPM: Lesion-Enhanced 3D Diffusion for MS MRI Synthesis

3D FLAIR MRI is widely recommended as one of the standard MRI sequences for brain imaging in multiple sclerosis (MS), but publicly available MS datasets remain relatively small and vary across scanners, acquisition protocols, and lesion patterns. This scarcity and variability hinder the development of robust neuroimaging machine learning models and are particularly challenging for generative models that aim to synthesize images while preserving small, sparse lesions. We propose Lesion-DDPM, a 3D conditional diffusion framework for lesion-aware FLAIR synthesis that incorporates multi-level anatomical mask injection together with a lesion-weighted reconstruction loss to emphasize lesion voxels while maintaining global brain structure. Using a curated subset of the MSLesSeg dataset, we compare Lesion-DDPM with representative state-of-the-art GAN- and diffusion-based models, assessing both image-generation metrics and downstream 3D U-Net segmentation. In our experiments, Lesion-DDPM achieved the lowest lesion-region reconstruction error among all methods. In a downstream 3D U-Net lesion segmentation task, a model trained only on Lesion-DDPM-generated scans and evaluated on real MRIs reached a Dice score of 0.616 compared with 0.569 for the best competing synthetic dataset. When Lesion-DDPM images were added to the real training set, the Dice score further increased to 0.685.

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

ERN-Net : Evolving Reason Node-Net for Document Binarization

This paper presents ERN-Net, an Evolving Reason Node-Net for efficient document image binarization. ERN-Net enhances degradation-sensitive regions, such as faint strokes, broken characters, and noisy backgrounds, through evolving reason nodes and multi-scale reasoning. We further compare ResNet-101, ConvNeXt-Tiny, and ConvNeXt-Base, and find that ConvNeXt-Tiny provides the best practical trade-off between accuracy and memory usage. In addition, DIBCO-based pretraining improves binarization performance without increasing model memory consumption, requiring only about 1.5 additional training hours. Experiments on DIBCO-style benchmarks show that ERN-Net is effective under low-data and low-memory settings.

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

Bridging the Gap: Enabling Natural Language Queries for NoSQL Databases through Text-to-NoSQL Translation

arXiv:2502.11201v3 Announce Type: replace-cross Abstract: NoSQL databases are core data infrastructure, yet natural-language access to them remains underdeveloped: correct query generation must recover how a non-relational data model represents entities, nested paths, arrays, missing fields, and dynamic keys. This paper studies Text-to-NoSQL, translating natural-language requests into executable NoSQL queries, instantiated with MongoDB aggregation pipelines over schema-less document stores. We present TEND, short for Text-to-NoSQL Dataset, an execution-verified benchmark with 1,210 MongoDB-native tasks across 11 databases. To our knowledge, TEND is the first Text-to-NoSQL benchmark whose database worlds are MongoDB-native by design: experts manually define collection boundaries, nested arrays, optional and sparse paths, polymorphic shapes, and dynamic-key conventions; these worlds are populated with real data and verified through frozen MongoDB execution, so TEND evaluates schema-less document reasoning rather than SQL-to-MQL transfer. We further introduce SAG, a Schema-as-Data Grounding solver that induces path and value grounding from stored-document evidence before bounded MQL generation, execution-grounded repair, and result-consistency selection. Evaluation uses bounded column-tolerant execution accuracy (EXC) as the headline metric, complemented by a graded result-set F1 and a mutually exclusive execution-outcome decomposition. Experiments show that LLMs with strong NL2SQL performance degrade substantially on TEND, validating Text-to-NoSQL as a distinct schema-less document reasoning problem.

17.
arXiv (CS.LG) 2026-06-18

FOSC-X: An Extended Framework for Optimal Local Cuts and Non-Horizontal Cluster Selection from Clustering Hierarchies

arXiv:2606.18972v1 Announce Type: cross Abstract: Extracting a flat clustering solution from a hierarchy is a common task in practical cluster analysis and can be formulated as an optimisation problem. Existing approaches focus on finding a single optimal solution. We introduce FOSC-X, a framework for extracting the top-M globally optimal flat clusterings from local, non-horizontal cuts of a hierarchical cluster tree, while optionally enforcing constraints on the number of clusters. This enables automatic identification of multiple high-quality alternative clusterings that capture different aspects of the hierarchical structure. Without constraints, the top-M problem can be solved in polynomial time using dynamic programming, exploiting the property that locally optimal partial candidates within subtrees can be combined to form globally optimal solutions while automatically determining the number of clusters. However, this can lead to solutions with numbers of clusters that are ultimately undesirable – e.g., too large to be meaningful or practically analysed within a particular application domain. Imposing cluster-count constraints breaks the optimality property underlying the unconstrained dynamic programming approach, since locally optimal partial candidates may no longer combine into feasible globally optimal solutions. FOSC-X addresses this challenge through a dynamic programming strategy that maintains compact sets of feasible candidates using lower and upper feasibility bounds while pruning infeasible or dominated combinations. The resulting method guarantees optimal rankings of the top-M solutions with linear-time complexity in the number of cluster nodes and dataset size, both with and without cluster-count constraints. Experiments show that FOSC-X efficiently reveals alternative clustering structures overlooked by single-solution extraction methods.

18.
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) 2026-06-19

Superhuman Safe and Agile Racing through Multi-Agent Reinforcement Learning

arXiv:2605.22748v2 Announce Type: replace-cross Abstract: Autonomous systems have achieved superhuman performance in isolation or simulation, yet they remain brittle in shared, dynamic real-world spaces. This failure stems from the dominant single-agent paradigm for physical applications, where other actors are ignored or treated as environmental noise, preventing effective coordination. Here we show that multi-agent reinforcement learning provides the essential safety scaffolding required for real-world interaction. Using high-speed quadrotor racing as a high-stakes testbed, we train agents to navigate complex aerodynamic interactions and strategic maneuvering with a variable number of racers. Through league-based self-play, agents evolve sophisticated anticipatory behaviors, including proactive collision avoidance, overtaking, and handling multi-agent physical interactions, including aerodynamic downwash. Our agents outperform a champion-level human pilot in multi-player races at speeds exceeding 22 m/s, while simultaneously reducing collision rates by 50 % compared to state-of-the-art single-agent baselines. Crucially, training with diverse artificial agents enables zero-shot generalization to safer human interaction. These results suggest that the path to robust robotic co-existence lies not in isolated safety constraints, but in the rigorous demands of multi-agent interaction. Multimedia materials are available at: https://rpg.ifi.uzh.ch/marl

21.
medRxiv (Medicine) 2026-06-15

VarEx: A Large Language Model Pipeline for Automated Extraction of Exposures, Outcomes, and Covariates from Epidemiologic Studies

Objective: Observational studies are essential for investigating risk factors for Alzheimer's disease and related dementias (ADRD), but inconsistent reporting and selection of covariates can contribute to residual confounding, omitted-variable bias, and reduced reproducibility. We developed and evaluated VAREX (Variable Extraction), a large language model (LLM)-based information extraction framework designed to automatically identify exposures, outcomes, and covariates from epidemiologic studies and populate structured evidence repositories. Materials and Methods: VAREX combines retrieval-augmented generation, biomedical language-model embeddings, semantic chunking, cross-encoder reranking, and prompt-engineered LLM workflows to extract epidemiologic variables from full-text biomedical articles. The framework was evaluated using a reference-standard corpus of observational studies examining blood pressure variability (BPV) and Alzheimer's disease-related dementias (ADRD), together with external validation datasets involving other exposure-outcome relationships. Extracted variables were compared with independently curated human reference standards using semantic matching and one-to-one assignment procedures. Covariates were additionally classified into ten epidemiologically relevant semantic categories. Results: In the primary BPV[-&gt;]ADRD corpus (10 studies), VAREX achieved a precision of 0.91, recall of 0.84, and F1-score of 0.87 for variable extraction. Covariate classification accuracy was 0.90, yielding a strict extraction-and-classification F1-score of 0.78. External validation datasets demonstrated comparable performance across diverse epidemiologic domains, with extraction F1-scores ranging from 0.73 to 0.85. Category-level performance was strongest for health behaviors (F1=0.96), sociodemographic variables (F1=0.90), and medication exposures (F1=0.89). Compared with published estimates of manual systematic-review effort, VAREX reduced processing time from approximately 61 minutes to 9 minutes per article, representing an 85.7% reduction in review time. Discussion: These findings demonstrate that LLM-based information extraction can accurately identify and classify epidemiologic variables across heterogeneous observational-study designs. Automated extraction enables scalable construction of structured repositories of exposures, outcomes, and covariates while substantially reducing the labor required for evidence synthesis and systematic reviews. Conclusion: VAREX provides an effective framework for automated extraction and classification of epidemiologic variables from the biomedical literature. By supporting large-scale evidence synthesis and structured knowledge resource development, VAREX may facilitate more rigorous observational research, improved confounder identification, and enhanced reproducibility in epidemiology.

22.
arXiv (CS.CV) 2026-06-15

Scratched Lenses, Shifted Depth: Passive Camera-Side Optical Attacks

Physical adversarial attacks on vision systems are typically studied through scene manipulation, such as adversarial patches or projections, where the adversary controls what the camera observes. Camera-side attacks using stickers or auxiliary optics have also been explored, but they treat attacks as image-space perturbations from designed patterns. This misses how physical imperfections interact with scene-dependent lighting and optics. We identify a threat: passive lens-side damage that is persistent yet trigger-conditioned, producing optical artifacts that bias geometric inference under particular visual conditions. We instantiate this threat through Scratch-induced Lens Adversarial Streak Hijacking SLASH, a physical-world attack caused by small scratches on a camera lens or protective cover. Scratches interact with bright light sources and specular reflections to create structured streak artifacts that distort depth cues. Since the perturbation is fixed in the optical path but triggered by the scene, it is both persistent and selective. We formulate the attack in optical space, model the scratch pattern as a trigger-conditioned optical channel, and optimize one fixed configuration across diverse viewing conditions. We evaluate SLASH on monocular depth estimation and monocular 3D object detection in digital and real-world settings. Under the fixed-scratch constraint, directional depth shifts reach up to 32% relative error for monocular depth estimation, with consistent effects on monocular 3D object detection. Physical experiments confirm transfer to real camera recordings, inducing depth shifts above the model's natural prediction baseline. These findings reveal an attack surface where benign-looking hardware imperfections act as latent, scene-triggered adversarial mechanisms, challenging assumptions about physical robustness and motivating defenses for secure vision systems.

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

A Comprehensive Survey of Knowledge-Based Vision Question Answering Systems: The Lifecycle of Knowledge in Visual Reasoning Task

Knowledge-based Vision Question Answering (KB-VQA) extends general Vision Question Answering (VQA) by not only requiring the understanding of visual and textual inputs but also extensive range of knowledge, enabling significant advancements across various real-world applications. KB-VQA introduces unique challenges, including the alignment of heterogeneous information from diverse modalities and sources, the retrieval of relevant knowledge from noisy or large-scale repositories, and the execution of complex reasoning to infer answers from the combined context. With the advancement of Large Language Models (LLMs), KB-VQA systems have also undergone a notable transformation, where LLMs serve as powerful knowledge repositories, retrieval-augmented generators and strong reasoners. Despite substantial progress, no comprehensive survey currently exists that systematically organizes and reviews the existing KB-VQA methods. This survey aims to fill this gap by establishing a structured taxonomy of KB-VQA approaches, and categorizing the systems into main stages: knowledge representation, knowledge retrieval, and knowledge reasoning. By exploring various knowledge integration techniques and identifying persistent challenges, this work also outlines promising future research directions, providing a foundation for advancing KB-VQA models and their applications.

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

Send a SCOUT First: Pre-hoc Reasoning for Adaptive Detector Allocation in Prompt-Injection Defense

arXiv:2605.30837v2 Announce Type: replace-cross Abstract: Prompt-injection detectors are heterogeneous: each is strong on a different slice of attacks, and none is always reliable. Yet existing systems still treat detection as a fixed single-detector pipeline, committing every request to one detector's blind spots. We reframe defense as detector allocation: given a heterogeneous pool, decide per request which detectors to run and whether to escalate to an LLM judge. Our framework SCOUT (Scalable and Controllable Outcome-prediction for Uncertainty-aware Triage) makes this decision dynamic by predicting each detector's per-sample reliability and latency from how it behaved on similar past inputs, and exposes a single safety-utility threshold to the operator (where utility bundles benign-pass rate and wall-clock). To evaluate this setting, we build SCOUT-450, a benchmark that captures the structurally complex, agent-facing injections that older prompt-injection sets under-represent. On SCOUT-450, a safety-oriented operating point reduces attack-success rate by 46% and total wall-clock by 40% relative to an always-on GPT-4o judge, at a 5.1-point benign-utility drop. SCOUT also transfers to three external benchmarks (BIPIA, IPI, and IHEval), improving the safety-utility frontier.

25.
arXiv (CS.CL) 2026-06-18

Towards Scalable Customization and Deployment of Multi-Agent Systems for Enterprise Applications

Large language model (LLM)-based multi-agent systems demonstrate strong performance on complex reasoning and task execution, enabling broad enterprise applications. However, production deployment remains challenging due to domain-specific customization requirements and high latency and inference costs in agentic workflows. We propose a unified framework for customization and efficient deployment of multi-agent systems in real-world settings. The first stage, Agentic Model Customization, combines continual pretraining, supervised fine-tuning, and preference optimization to adapt a compact model to specialized domains while retaining strong agentic capabilities. The second stage, Inference Optimization, integrates speculative decoding and FP8 quantization with targeted calibration to enable cost-efficient serving with minimal quality loss. Across enterprise workloads, our framework enables rapid domain adaptation and achieves a 4.48x speedup in throughput while maintaining performance and improving robustness on long-tail scenarios.