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

Towards Advanced Mathematical Reasoning for LLMs via First-Order Logic Theorem Proving

Large language models (LLMs) have shown promising first-order logic (FOL) reasoning capabilities with applications in various areas. However, their effectiveness in complex mathematical reasoning involving multi-step FOL deductions is still under-researched. While LLMs perform competitively on established mathematical reasoning benchmarks, they struggle with multi-step FOL tasks, as demonstrated by Deepseek-Prover-V2-7B's low accuracy (4.2%) on our proposed theorem proving dataset. This issue arises from the limited exploration of diverse proof strategies and the potential for early reasoning mistakes to undermine entire proofs. To address these issues, we propose DREAM, a self-adaptive solution that enhances the Diversity and REAsonability of LLMs' generation strategies. DREAM incorporates an Axiom-Driven Strategy Diversification mechanism to promote varied strategic outcomes and a Sub-Proposition Error Feedback to help LLMs reflect on and correct their proofs. Our contributions include pioneering advancements in LLMs' mathematical reasoning through FOL theorem proving, introducing a novel inference stage solution that improves performance by 0.6% to 6.4%, and providing a curated dataset of 447 mathematical theorems in Lean 4 format for evaluation.

02.
arXiv (math.PR) 2026-06-11

Heat kernel estimates for Markov processes with blowing-up jump kernels

arXiv:2512.24807v2 Announce Type: replace Abstract: In this paper, we establish sharp two-sided heat kernel estimates for a large class of purely discontinuous symmetric Markov processes on closed subsets $F$ of $\mathbb{R}^d$, whose jump kernels blow up on a Borel subset $\Sigma$ of $F$. We assume that $F\setminus \Sigma$ is a $\kappa$-fat set and is dense in $F$. To the best of our knowledge, this is the first work establishing sharp heat kernel estimates for jump processes whose jump kernels blow up on part of the state space. The jump kernels under consideration take the form $J(x,y)=|x-y|^{-d-\alpha}{\mathcal B}(x,y)$, where $\alpha\in (0,2)$ and the function ${\mathcal B}(x,y)$ blows up at a subset $\Sigma$ of $F$. A fundamental obstacle is that the tails of the jump measures are not uniformly bounded, and hence standard techniques in heat kernel analysis do not provide a priori off-diagonal estimates. To overcome this difficulty, we develop a new approach based on weighted integral estimates for the heat kernel that are sensitive to both the blow-up behavior of the jump kernel and the geometry of $F\setminus \Sigma$. Examples of processes falling within our general framework include traces of isotropic $\alpha$-stable processes in $C^{1,\rm Dini}$ sets, processes in Lipschitz sets arising in connection with the nonlocal Neumann problem, and a large class of resurrected self-similar processes in the closed upper half-space.

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

RAVA: Retrieval-Augmented Viewpoint Alignment for Subject-Driven Image Generation

Reference-driven image generation has made rapid progress on identity preservation, but reliable viewpoint control across different subjects remains poorly understood. The difficulty is not merely generating a new image of the target subject: the model must infer the implicit viewpoint of one subject and transfer it to another subject using only image-level evidence, without camera poses, depth, or ray-based conditions. In this setting, existing generators conditioned on multiple image references often rely on spurious semantic correlations, which lead to viewpoint drift, part-level structural mismatches, and missing or unsupported target-specific content. We formulate this challenge as cross-subject viewpoint alignment and propose RAVA, a retrieval-augmented framework that supplies explicit geometric evidence before generation. RAVA first learns a cross-instance viewpoint embedding that retrieves target-subject images aligned with the anchor viewpoint, then applies a LogDet-based subset selection strategy to retain a compact reference set that is both view-consistent and structurally complementary. The selected references are finally consumed by a fine-tuned multi-reference image generator. Experiments show that generic semantic embeddings are nearly random for this task, while the proposed retriever substantially improves viewpoint retrieval quality. On cross-subject generation, RAVA consistently outperforms zero-shot baselines and stronger retrieval alternatives under the same generation backbone. These results indicate that cross-subject viewpoint alignment benefits from retrieval-augmented geometric grounding rather than relying on end-to-end generation alone.

04.
arXiv (CS.CV) 2026-06-11

Density Ridge Selective Prediction for LLM and VLM Hallucination Detection under Calibration Label Scarcity

Hallucination detection in large language and vision-language models is increasingly framed as selective prediction, where a detector assigns a confidence score and abstains when confidence is low. Unsupervised sampling detectors (Semantic Entropy) avoid labels but plateau in quality, while supervised probes attain stronger in-distribution scores yet degrade sharply when calibration labels are scarce. We recover the response manifold of an LLM as the density ridge of a kernel density estimate built on a six-dimensional kinematic feature map of hidden state generation trajectories. A test generation is scored by the negated Euclidean distance from its projected feature point to the nearest ridge vertex, yielding a low-dimensional geometric skeleton of the stochastic output distribution. We evaluate against Semantic Entropy, topological methods, and log-probability on six QA benchmarks (HaluEval-QA, TriviaQA, GSM8K, POPE, ScienceQA, A-OKVQA) using eight text and vision LLMs in a deliberately label-scarce protocol ($n_{cal}{=}200$ queries, $N{=}5$ generations). Our ridge-based score beats on AUROC with 5-20 points gain, while demonstrating tempered degradation under calibration-label scarcity.

05.
arXiv (CS.AI) 2026-06-15

Optimizing Agentic Reasoning with Retrieval via Synthetic Semantic Information Gain Reward

arXiv:2602.00845v3 Announce Type: replace Abstract: Agentic reasoning enables large reasoning models (LRMs) to dynamically acquire external knowledge, but yet optimizing the retrieval process remains challenging due to the lack of dense, principled reward signals. In this paper, we introduce InfoReasoner, a unified framework that incentivizes effective information seeking via a synthetic semantic information gain reward. Theoretically, we redefine information gain as uncertainty reduction over the model's belief states, establishing guarantees, including non-negativity, telescoping additivity, and channel monotonicity. Practically, to enable scalable optimization without manual retrieval annotations, we propose an output-aware intrinsic estimator that computes information gain directly from the model's output distributions using semantic clustering via bidirectional textual entailment. This intrinsic reward guides the policy to maximize epistemic progress, enabling efficient training via Group Relative Policy Optimization (GRPO). Experiments across seven question-answering benchmarks demonstrate that InfoReasoner consistently outperforms strong retrieval-augmented baselines, achieving up to 5.4% average accuracy improvement. Our work provides a theoretically grounded and scalable path toward agentic reasoning with retrieval. The code is available at https://github.com/dl-m9/InfoReasoner

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

EM-NeSy: Expectation Maximization for Neurosymbolic Learning

arXiv:2606.14463v1 Announce Type: new Abstract: Neurosymbolic (NeSy) models integrate neural networks and symbolic reasoning for robust and interpretable AI. State-of-the-art NeSy models require that the symbolic component is expressed in a differentiable way, often complicating the use of approximate inference. We propose EM-NeSy which casts probabilistic NeSy learning as an instance of the Expectation-Maximization (EM) algorithm. In the expectation step, we compute the posterior over the neurally predicted symbols conditioned on the label via probabilistic inference. In the maximization step, we update the neural parameters based on this posterior using gradient descent only through the neural component. This formulation unlocks the full potential of the EM algorithm for NeSy learning. It allows NeSy to extend naturally to approximate reasoning without any additional modifications or differentiability requirements of the symbolic component. Furthermore, it recovers the standard end-to-end gradient-based NeSy setting under exact inference. Our experimental results demonstrate the scalability and computational efficiency of EM-NeSy.

07.
arXiv (CS.AI) 2026-06-11

KAN-MLP-Mixer: A comprehensive investigation of the usage of Kolmogorov-Arnold Networks (KANs) for improving IMU-based Human Activity Recognition

arXiv:2605.19031v2 Announce Type: replace Abstract: Kolmogorov-Arnold Networks (KANs) have demonstrated an exceptional ability to learn complex functions on clean, low-dimensional data but struggle to maintain performance on noisy and imperfect real-world datasets. In contrast, conventional multi-layer perceptrons (MLPs) are far more tolerant to noise and computationally efficient. Replacing all MLP components with KANs in HAR models often degrades accuracy and computation efficiency, highlighting an open challenge: how to combine KANs' precision with MLPs' noise robustness and efficiency. To address this, we systematically explore various placements of KAN modules within deep HAR networks and propose a hybrid architecture that strategically synergizes the strengths of both paradigms, which uses a KAN-based input embedding layer, retains MLP layers for intermediate feature mixing, and introduces a specialized LarctanKAN module for final activity classification. Across eight public HAR datasets, the hybrid KAN-MLP model achieves an average macro F1 score relative improvement of 5.33\% compared pure-MLP model, significantly outperforming standalone KAN and MLP baselines. Furthermore, integrating this hybrid strategy into other state-of-the-art HAR architectures consistently boosts their performance. Our findings demonstrate that a carefully orchestrated combination of KAN, MLP, or other conventional neural components yields more robust and accurate HAR models for real-world wearable sensing environments.

08.
arXiv (CS.AI) 2026-06-18

Optimizing Lithium Production Decisions under Geological, Demand, and Pricing Uncertainties: A POMDP Framework for Multi-Objective Decision Making

arXiv:2606.18598v1 Announce Type: new Abstract: Decision making in lithium production is challenging, whether from an investor's perspective or a strategic production standpoint. Determining which mines to open and when to open them involves not only geological and price uncertainties, but also complexities around the choice of extraction method, from direct lithium extraction to hard rock mining. Prior work explored models of this problem and different methods to optimize mining decisions; these models did not account for uncertainty in pricing, uncertainty in demand, or different mining technologies to extract lithium. Incorporating different pricing models and extraction technology into these models enables more robust strategies for determining not only when and where to open a mine, but also which method of production to pursue. We frame the problem as a partially observable Markov decision process (POMDP) and solve using belief state planning methods to get optimal decision making. In our study, we show that POMDP solvers outperform human inspired heuristics by dynamically adapting to shifting lithium price regimes (static, linear, exponential, and stochastic) through belief state planning and explicit uncertainty management. By optimally sequencing exploration, production, and technology choice, the framework achieves higher demand fulfillment and more balanced economic environmental outcomes over the projects lifetime in all different pricing and deposit scenarios.

09.
arXiv (CS.AI) 2026-06-19

Confidence Calibration for Multimodal LLMs: An Empirical Study through Medical VQA

arXiv:2606.19950v1 Announce Type: cross Abstract: Multimodal Large Language Models (MLLMs) show great potential in medical tasks, but their elicited confidence often misaligns with actual accuracy, potentially leading to misdiagnosis or overlooking correct advice. This study presents the first comprehensive analysis of the relationship between accuracy and confidence in medical MLLMs. It proposes a novel method that combines Multi-Strategy Fusion-Based Interrogation (MS-FBI) with auxiliary expert LLM assessment, aiming to improve confidence calibration in Medical Visual Question Answering (VQA). Experiments demonstrate that our method reduces the Expected Calibration Error (ECE) by an average of 40\% across three Medical VQA datasets, significantly enhancing MLLMs' reliability. The findings highlight the importance of domain-specific calibration for MLLMs in healthcare, offering a more trustworthy solution for AI-assisted diagnosis.

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

Quantized Stochastic Primal-Dual Methods for Distributed Optimization under Relaxed Global Geometry

arXiv:2606.11339v1 Announce Type: cross Abstract: We study distributed optimization with stochastic gradients and finite-bit communication modeled by random (unbiased) quantization. We propose q-PDGD, a quantized stochastic primal-dual method, and analyze it under relaxed global geometry. Under restricted secant inequality (RSI), a constant step-size yields linear contraction to an explicit neighborhood determined by gradient noise, quantization distortion, and network connectivity, while a diminishing step-size achieves O(1/k) convergence without shared-minimizer assumptions. Under Polyak-Lojasiewicz (PL) inequality, we obtain linear-to-neighborhood convergence in the same stochastic quantized setting. Our results match the best-known centralized stochastic rates in oracle complexity, and are supported by experiments demonstrating the predicted tradeoffs between quantization level, step-size choice, and graph structure.

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

Automated Creativity Evaluation of Language Models Across Open-Ended Tasks

Large language models (LLMs) have achieved remarkable progress in language understanding, reasoning, and generation, sparking growing interest in their creative potential. Realizing this potential requires systematic and scalable methods for evaluating creativity across diverse tasks. However, most existing creativity metrics are tightly coupled to specific tasks, embedding domain assumptions into the evaluation process, and limiting scalability and generality. To address this gap, we introduce an automated, domain-agnostic framework for quantifying LLM creativity across open-ended tasks. Our approach separates the measurement apparatus from the creative task itself, enabling scalable, task-agnostic assessment. Divergent creativity is measured using semantic entropy, a reference-free and robust metric for novelty and diversity, validated against human annotations, LLM-based novelty judgments and baseline diversity measures. Convergent creativity is assessed via a novel retrieval-based multi-agent judge framework that delivers context-sensitive evaluation of task fulfilment with over 60% improved efficiency. We validate our framework in three qualitatively distinct domains: problem-solving (MacGyver), research ideation (HypoGen), and creative writing (BookMIA), using a broad suite of LLMs. Empirical results show that our framework reliably captures key facets of creativity, including novelty, diversity, and task fulfilment, and reveal how model properties, such as size, temperature, recency, and reasoning, impact creative performance. Our work establishes a reproducible and generalizable standard for automated LLM creativity evaluation, paving the way for scalable benchmarking and accelerating progress in creative AI.

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

AI Adoption Across a Multinational Workforce: Sociotechnical Conditions for GenAI Acceptance in Human Resources

arXiv:2606.17887v1 Announce Type: cross Abstract: Generative AI (GenAI) deployment in the workplace is accelerating rapidly. Nevertheless, questions of who adopts, who benefits, and who is left behind and why are still understudied. In this paper, we investigate these dynamics in the context of a multinational tech company transitioning from a legacy Human Resources (HR) search system to a GenAI-supported system, analyzing search log data, survey data (n=25), and ten semi-structured interviews. Our findings show that adoption depended on the fit between the GenAI system's design assumptions and employees' work positionalities (role, spoken language, tenure). Further, we find that employees' trust in GenAI answers was built through source-checking, comparison among systems, and seeking input from colleagues or HR when in doubt. Our contribution is twofold. First, we provide empirical evidence of workplace GenAI adoption during a live organizational transition, showing that adoption is influenced by factors such as situational fit, search literacy, and trust calibration. It is also further shaped by knowledge conditions such as the system's content quality, employee training, and guidance. Second, we translate these findings into design considerations for inclusive deployment and adoption in high-stakes environments such as HR. We argue that organizations should design systems considering the role and context-sensitive benefits they yield to different social groups. They also need to treat the organizational knowledge infrastructure as AI infrastructure to improve the accountability and usability of GenAI systems

13.
arXiv (CS.LG) 2026-06-16

Semi-Supervised Noise Adaptation: Transferring Knowledge from Noise Domain

arXiv:2606.00558v2 Announce Type: replace Abstract: Transfer learning aims to facilitate the learning of a target domain by transferring knowledge from a source domain. The source domain typically contains semantically meaningful samples (*e.g.*, images) to facilitate effective knowledge transfer. However, a recent study observes that the noise domain constructed from simple distributions (*e.g.*, Gaussian distributions) can serve as a surrogate source domain in the semi-supervised setting, where only a small proportion of target samples are labeled while most remain unlabeled. Based on this surprising observation, we formulate a novel problem termed *Semi-Supervised Noise Adaptation* (SSNA), which aims to leverage a synthetic noise domain to improve the generalization of the target domain. To address this problem, we first establish a generalization bound characterizing the effect of the noise domain on generalization, based on which we propose a Noise Adaptation Framework (NAF). Extensive experiments demonstrate that NAF effectively leverages the noise domain to tighten the generalization bound of the target domain, leading to improved performance. The codes are available at https://github.com/AIResearch-Group/SSNA.

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

Data-Driven Decoding of Russell's Circumplex Model of Affect

Affective computing increasingly relies on deep learning to represent emotions, yet latent spaces often remain opaque, high-dimensional black boxes. This paper investigates whether Transformers' embeddings recover the geometric regularities of Russell's circumplex model. We unify two complementary experiments testing the hypothesis that, after training models on text and speech, their resulting latent spaces encode a topology consistent with valence-arousal and reproduce human-like neighborhood relations. Specifically, we evaluate deep representations extracted from Transformer-based text (RoBERTa) and speech (wav2vec 2.0) encoders, along with a multimodal Transformer fusion architecture, across naturalistic datasets like MSP-Podcast and controlled LLM-generated stimuli. Our analysis reveals that multimodal fusion of text and audio yields perfect topological alignment with Russell's primary emotion ordering. Furthermore, in a zero-shot setting using generic text embeddings, projected fine-grained emotion terms fall close to their established human-mapped coordinates. Our contribution is a novel, data-driven framework for validating emotion models, demonstrating that Russell's circumplex structure is intrinsically encoded in the embeddings of these modalities rather than being solely an artifact of human labeling, thereby bridging the gap between psychological theory and representation learning.

15.
arXiv (quant-ph) 2026-06-11

Nonlocal continuous-variable gates by amplified optical connections

arXiv:2603.12866v2 Announce Type: replace Abstract: Nonlocal quantum gates, coupling quantum systems located at a distance, are crucial for distributed quantum computing. To this aim, high-capacity optical noiseless connections between different processing units are essential for transmitting large amounts of information per mode. Simultaneously, optical quantum computing offers future high-speed multimode quantum processors. We propose a library of feasible protocols to implement a necessary nonlocal continuous-variable (CV) quantum nondemolition (QND) gate between two distant users sharing a quantum channel and exploiting classical communication. The users are endowed with a newly achieved high-fidelity and large-bandwith element - single-pass phase-sensitive optical parametric amplifier (OPA), that allows for both online squeezing and channel-loss compensation. The use of OPAs enhances quality of the resulting gate in terms of both excess noise and entangling capability. The proposed schemes are also applicable to CV cluster state fusion, providing a first step towards development of distributed CV measurement-based quantum computation.

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

MoReBench: Evaluating Procedural and Pluralistic Moral Reasoning in Language Models, More than Outcomes

As AI systems progress, we rely more on them to make decisions with us and for us. To ensure that such decisions are aligned with human values, it is imperative for us to understand not only what decisions they make but also how they come to those decisions. Reasoning language models, which provide both final responses and (partially transparent) intermediate thinking traces, present a timely opportunity to study AI procedural reasoning. Unlike math and code problems which often have objectively correct answers, moral dilemmas are an excellent testbed for process-focused evaluation because they allow for multiple defensible conclusions. To do so, we present MoReBench: 1,000 moral scenarios, each paired with a set of rubric criteria that experts consider essential to include (or avoid) when reasoning about the scenarios. MoReBench contains over 23 thousand criteria including identifying moral considerations, weighing trade-offs, and giving actionable recommendations to cover cases on AI advising humans moral decisions as well as making moral decisions autonomously. Separately, we curate MoReBench-Theory: 150 examples to test whether AI can reason under five major frameworks in normative ethics. Our results show that scaling laws and existing benchmarks on math, code, and scientific reasoning tasks fail to predict models' abilities to perform moral reasoning. Models also show partiality towards specific moral frameworks (e.g., Benthamite Act Utilitarianism and Kantian Deontology), which might be side effects of popular training paradigms. Together, these benchmarks advance process-focused reasoning evaluation towards safer and more transparent AI.

17.
arXiv (CS.CV) 2026-06-15

Rethinking Global Average Pooling: Your Classifier Is Secretly a Multi-Instance Learner

作者:

Modern image classifiers widely adopt global average pooling (GAP) followed by a linear classification head. This linearity ensures that the image-level logits equal the average of logits obtained by applying the classification head pointwise to the feature grid prior to GAP. Consequently, standard classifiers may inherently retain spatial class evidence that remains recoverable even when the image-level prediction is incorrect. This structure naturally suggests a multiple-instance learning (MIL) interpretation, where an image is viewed as a bag of spatial instances. Within this formulation, we demonstrate that standard classifiers trained with a single label per image can still learn the intended classification task in multi-object scenes. We further exploit this property to decompose image-level logits into a prediction grid, providing a post-hoc diagnostic to extract spatial class evidence that GAP otherwise obscures. Our systematic evaluation reveals that off-the-shelf models consistently recover the ground-truth class within foreground regions. The MIL interpretation further suggests that common classifier failures reflect known limitations of mean aggregation.

18.
medRxiv (Medicine) 2026-06-15

Evaluation of AI-Generated Synthetic Data for Clinical Research in Secondary Cardiovascular Prevention among Dyslipidemia Patients

Background: Access to high-quality clinical data is essential for advancing medical research and developing effective medical statistical and Artificial Intelligence models. However, privacy regulations and logistical barriers often hinder timely access to real-world data. Synthetic data offer a promising solution, preserving the statistical characteristics of original datasets while protecting patient privacy. Objectives: This study investigates the use of synthetic data for secondary cardiovascular prevention in patients with dyslipidemia, using two real-world datasets from Centro Cardiologico Monzino. Methods: Given the high dimensionality and limited sample size of the datasets, we employed a custom generative framework based on Large Language Models (LLMs). Pre-trained LLMs were fine-tuned on original clinical records to synthesize tabular data replicating source-data distributions. Fine-tuning was performed within the Centro Cardiologico Monzino's secure infrastructure to ensure data sovereignty. We evaluate clinical utility and privacy using fidelity and privacy metrics, identifying the optimal generative model and benchmarking against traditional anonymization methods. Results: Synthetic data achieved a superior trade-off than classically anonymized datasets. Real and synthetic datasets showed strong agreement, with significant distributional differences limited to few variables. Models trained on synthetic data replicated key associations from the original dataset, including therapy modification and creatine phosphokinase as predictors of SAMS, and pharmacological intensity as the main driver of LDL-C reduction. Conclusions: Results support the feasibility of using synthetic data as a proxy for real-world datasets in exploratory analyses and model development. Despite slight attenuation of some effect sizes, preserved clinical relationships reinforce the validity of synthetic data in medical research.

19.
bioRxiv (Bioinfo) 2026-06-11

Sequence-Based Therapeutic Peptide Classification with Augmented Negative Sampling

Therapeutic peptides offer high target specificity, low toxicity, and the ability to modulate protein-protein interactions, yet experimental functional characterization remains costly and slow. Computational prediction of therapeutic function directly from sequence could accelerate peptide screening and enable generative design pipelines, but requires reliable discrimination between therapeutic and non-therapeutic peptides. Existing multi-label predictors cover few functions, rely on limited datasets, and exhibit high glspl{fpr}, limiting their practical utility. We present a lightweight CNN classifier trained on the most comprehensive therapeutic peptide database to date (54,655 peptides, 48 functional categories). A key contribution is a statistically motivated negative sampling strategy using Markov models to generate diverse synthetic decoys at multiple difficulty levels. When evaluated on this controlled decoy benchmark, the FRP is reduced from over 60% for previous models to 2.1% for our approach. Our fine-tuned five-model ensemble achieves 78.9% Micro F1 and 54.6% Macro F1 while requiring only amino acid sequences as inputs. Analysis using a sparse L1-constrained variant of our model shows that convolutional filters capture conserved functional motifs and statistically improbable non-therapeutic patterns, with downstream layers combining these signals, providing mechanistic evidence that the network learns biologically meaningful structure. In a generalization task on the TPpred-LE benchmark, our model achieves 55.3% Micro F1 and 38.6% Macro F1, comparable to TPpred-LE trained on its native dataset (57.9%/38.1%) while predicting four times more therapeutic functions with four times fewer parameters. Code and models will be made available at https://github.com/terra-quantum-public/tq-therapep-ai.

20.
PLOS Medicine 2026-05-20

Associations between hematologic dynamics during pregnancy and obstetric complications: A retrospective observational study

by Veronica Tozzo, Rachel Petherbridge, Kaitlyn James, Sarah Hsu, Deepti Pant, Chloe Michalopoulos, Brody H. Foy, Tanayott Thaweethai, Christopher Mow, Jacqueline Maya, Carolina Batlle Camero, Lydia Shook, Kathryn J. Gray, Logan Mauney, John M. Higgins, Camille E. Powe Background Pregnancy alters hematologic state as measured by complete blood count (CBC), but the longitudinal changes in CBC indices that define healthy pregnancies are not well established. In a large cohort based at an academic health system in the United States, we aimed to define reference intervals and typical longitudinal changes in CBC indices during pregnancy. We then tested for associations between extreme CBC values for gestational age or extreme longitudinal changes in CBC indices and obstetric complications. Methods and findings We studied nine CBC indices in individuals with singleton pregnancies who delivered after 30 weeks’ gestation and presented for prenatal care prior to 20 weeks. The electronic health record (EHR)-based Maternal Health Cohort (Massachusetts General Hospital; 1998–2016) formed our discovery cohort of 45,992 pregnancies, 18% of which had relevant complications. We developed a validation cohort of 48,868, 27% with complications from EHR data in the Mass General Brigham healthcare system from 2016 to 2024. In pregnancies without complications in the discovery cohort, we derived gestational-age-specific reference intervals (2.5th–97.5th percentile) and established typical intra-pregnancy longitudinal changes. In the validation cohort, we then tested CBC values outside of the 26–29 weeks’ gestation reference interval and CBC rare changes (uncommon changes in magnitude and direction) between 7–14 and 26–29 weeks’ gestation for association with a composite outcome (hypertensive disorders of pregnancy, small for gestational age birthweight, preterm birth) and its individual components using generalized estimating equations. Derived reference intervals differed from those in the literature for mean red cell volume, mean red cell hemoglobin, red cell count, and mean red cell hemoglobin concentration; reference intervals for other indices were similar to those previously published. In validation, hematocrit, hemoglobin, and red cell count values above their gestational-age specific reference intervals were associated with increased risk of the composite obstetric outcome: odds ratios (ORs) of 1.4 (95% CI [1.2, 1.5] p 

21.
medRxiv (Medicine) 2026-06-10

Human-centred design approaches to health facility design: Evidence from perinatal care settings in Ethiopia and Bangladesh

While significant progress has been made in perinatal outcomes over recent decades in low- and middle-income countries (LMICs), maternal and newborn quality improvement initiatives often fail to account for the spatial conditions in which they are implemented. Health systems are increasingly deploying evidence-based care models into built environments that are not optimally structured to meet the needs of its patient population. As the principal users, patients and health care workers can offer pragmatic insights about improving these structural designs. Our objective was to gather insights from patients, providers, and companions about how the physical design of their health facilities influenced their experience receiving or delivering perinatal care. We conducted a prospective observational study using a human-centred design (HCD) approach to analyse perceptions of the quality of perinatal care across two low resource settings: Ethiopia and Bangladesh. Using engagement and assessment tools, we conducted interviews, focus groups, facility walk-throughs, co-design workshops, and infrastructural assessments with patients, companions, providers, and Ministry of Health representatives. Descriptive statistics and thematic analysis were used to identify key learnings and develop recommendations. Across both countries, participants identified the need for facility layouts that better support privacy, mobility during labour, alternative birth positions, companion involvement, cultural and religious practices, sanitation, and provider visibility. Based on these insights, we developed six recommendations to better align health facility infrastructure with maternal and newborn care delivery needs. Our findings suggest that investments in health facility infrastructure may improve care experiences and help enable respectful, safe, and evidence-based maternal and newborn care. Alongside targeted spatial improvements, government authorities responsible for health facility planning should incorporate participatory design processes to ensure infrastructure reflects the needs of patients, companions, and providers and supports high-quality care delivery.

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

Learning Fair Pareto-Optimal Policies in Multi-Objective Reinforcement Learning

arXiv:2606.18111v1 Announce Type: cross Abstract: Fairness is an important aspect of decision-making in multi-objective reinforcement learning (MORL), where policies must ensure both optimality and equity across multiple, potentially conflicting objectives. While single-policy MORL methods can learn fair policies for fixed user preferences using welfare functions such as the generalized Gini welfare function (GGF), they fail to provide the diverse set of policies necessary for dynamic or unknown user preferences. To address this limitation, we formalize the fair optimization problem in multi-policy MORL, where the goal is to learn a set of Pareto-optimal policies that ensure fairness across all possible user preferences. Our key technical contributions are threefold: (1) We show that for concave, piecewise-linear welfare functions (e.g., GGF), fair policies remain in the convex coverage set (CCS), which is an approximated Pareto front for linear scalarization. (2) We demonstrate that non-stationary policies, augmented with accrued reward histories, and stochastic policies improve fairness by dynamically adapting to historical inequities. (3) We propose three novel algorithms, which include integrating GGF with multi-policy multi-objective Q-Learning (MOQL), state-augmented multi-policy MOQL for learning non-statoinary policies, and its novel extension for learning stochastic policies. We evaluate our algorithms across various domains and compare our methods against the state-of-the-art MORL baselines. The empirical results show that our methods learn a set of fair policies that accommodate different user preferences.

23.
medRxiv (Medicine) 2026-06-17

Short-term relaxation after cervical rotatory manipulation is more closely associated with somatosensory input than cracking sound: a randomized controlled EEG study

Background Cervical rotatory manipulation is commonly used for neck-related symptoms and is often accompanied by a cracking sound. This sound is frequently regarded as a sign of successful manipulation, but whether it contributes substantially to the immediate relaxation response remains unclear. Objective This study examined whether short-term relaxation after cervical rotatory manipulation is more closely related to manipulation-associated sensory input than to the cracking sound cue alone. Methods In this single-session, three-arm, parallel randomized controlled study, 54 healthy volunteers were allocated to cervical rotatory manipulation, sham manipulation, or sham manipulation plus simulated cracking sound. Subjective outcomes were assessed before and after intervention, including positive affect, negative affect, comfort, and satisfaction. Eyes-closed resting-state electroencephalography was recorded before and after intervention. Prespecified neural outcomes included frontal alpha power, frontal alpha/beta ratio, occipital individual alpha frequency, and alpha-band fronto-parietal and fronto-temporal functional connectivity. Results Cervical rotatory manipulation produced greater improvements in positive affect, comfort, and satisfaction than sham manipulation or sham manipulation plus simulated cracking sound, whereas negative affect remained generally stable across groups. These subjective responses were accompanied by short-term electroencephalography changes, particularly in frontal alpha/beta and alpha-band fronto-parietal and fronto-temporal functional connectivity. Changes in frontal alpha/beta ratio were positively associated with changes in positive affect. In contrast, simulated cracking sound alone did not reproduce the full subjective or electroencephalography response observed after real manipulation. Conclusions The immediate relaxation response after cervical rotatory manipulation appears to be more closely related to manipulation-associated sensory input than to the cracking sound cue alone. These findings provide preliminary neurophysiological evidence for distinguishing real manipulation effects from sound-related contextual cues.

24.
arXiv (quant-ph) 2026-06-11

A quantum implementation of high-order power method for estimating geometric entanglement of pure states

arXiv:2405.19134v3 Announce Type: replace Abstract: Entanglement is one of the fundamental properties of a quantum state and is a crucial differentiator between classical and quantum computation. There are many ways to define entanglement and its measure, depending on the problem or application under consideration. Each of these measures may be computed or approximated by multiple methods. However, hardly any of these methods can be run on near-term quantum hardware. This work presents a quantum adaptation of the iterative high-order power method for estimating the geometric measure of entanglement of multi-qubit pure states using rank-1 tensor approximation. This method is executable on early fault-tolerant (hybrid) quantum hardware and does not depend on quantum memory. We simulate this algorithm and mitigate the effects of noise on the results of the computation using a theoretical model based on a known mitigation approach, which assumes a global depolarising noise channel.

25.
medRxiv (Medicine) 2026-06-17

Investigating shared genetic overlap of immune-mediated inflammatory diseases and cardiometabolic diseases

Abstract Background: Immune-mediated inflammatory diseases (IMIDs) are associated with increased risk of cardiometabolic diseases. Investigating genetic overlap among these conditions can provide insights into their clinical management. Methods: Genetic correlation was assessed using linkage disequilibrium score regression (LDSC). Then, a meta-analysis was conducted using Association Analysis Based on SubSETs (ASSET) to pinpoint independent single nucleotide polymorphisms (SNPs) shared across the diseases. Each independent SNP was then used to define a genomic window (+/-500KB) for colocalisation analysis and Local Analysis of [co]Variant Association (LAVA) to offer multiple layers of regional pleiotropic evidence. Over-representation analysis was then run to identify enriched biological pathways, which then were used for drug target analysis. Results: The LDSC analysis showed a significant global genetic correlation for rheumatoid arthritis (RA) and cardiometabolic diseases including hypertension, coronary artery disease (CAD), heart failure (HF), stroke, atrial fibrillation (AF), and type two diabetes mellitus (T2DM) ranging from rg = 0.09 to 0.24. ASSET meta-analysis identified 164 independent SNPs shared across RA and the cardiometabolic diseases with P < 5 x 10- in the overall one-sided meta-analysis P-value, FDR < 0.05 in both individual GWASs, and TRUE phenotype matrix. Colocalisation analysis revealed multiple loci with strong evidence (Posterior probabilities [&ge;] 80) of single causal SNPs between the trait pairs. LAVA analysis was then used as an additional layer of confirmation for the findings generated by ASSET and colocalisation and thus several loci were highlighted. Over-representation analysis showed significant enriched immune-related pathways across RA-hypertension, RA-CAD, RA-AF, and RA-T2DM trait pairs. Drug target analysis highlighted several drugs which could be further tested for their effectiveness in RA and its common comorbidities. Conclusion: The findings revealed a shared genetic architecture and key immune-related biological pathways underlying RA and its associated cardiometabolic comorbidities. The identified genes and drugs provide opportunities for further therapeutic assessment which could improve clinical management strategies.