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01.
medRxiv (Medicine) 2026-06-12

Design, Implementation, and Evaluation of a Shadowing Program for Medical Students in the Basic Sciences Phase

Introduction Shadowing, as an educational method based on active observation, can foster a realistic understanding of professional roles and enhance the communication skills of medical students. This study aimed to design, implement, and evaluate a shadowing program for basic sciences medical students. Methods This development study was conducted based on the ADDIE model in five phases. The study population consisted of 799 medical students in semesters 2 to 5. The stages included Analysis (determining needs through literature review and expert panels), Design (specifying learning environments and evaluation methods), Development (preparing guides and educational tools), Implementation (within the Medical Ethics course), and Evaluation (using questionnaires and reflection forms). Findings This study aimed to design and evaluate an educational shadowing program based on the ADDIE model. In the Analysis phase, the profiles of 799 students and learning objectives were determined. In the Design phase, a structured program for four types of shadowing was designed. In the Development phase, all guides and educational tools were prepared. In the Implementation phase, the program was carried out with complete coverage and adherence to ethical considerations. Finally, the program evaluation showed that "Motivation to become a good physician" (3.75-3.95) and "Enhancing empathy" (3.50-3.94) received the highest scores, while "Increasing understanding of the basic science-clinical connection" (2.53-2.89) and "Willingness to attend on holidays" (1.87-2.31) received the lowest scores. Conclusion The findings indicate that implementing the shadowing program is an effective method for strengthening the professional attitudes and academic motivation of medical students. However, the program did not significantly improve students perception of the basic science-clinical connection, indicating a need for curricular refinement. The continuation and extension of this program to other levels and fields of medical sciences are recommended.

02.
arXiv (CS.LG) 2026-06-16

When Does q-error Predict Plan Regret? Three Regimes of Cardinality-Estimation Error

arXiv:2606.15600v1 Announce Type: cross Abstract: Cardinality-estimation (CE) research ranks estimators by q-error, yet it is well known that q-error is an imperfect proxy for query-plan quality. We give a measurement-driven account of when it is a good proxy and when it is not, and why. Modeling plan selection as an argmin over a piecewise-linear cost landscape, we find that plan regret (the cost of the chosen plan relative to the optimal, under true cardinalities) is governed by plan-cost geometry in a regime-dependent way. (i) For small errors, a true-point condition number kappa predicts regret and out-predicts q-error; its predictive power decays to zero as error grows, as a local linearization must. (ii) For large errors – where deployed learned estimators operate – an estimator-independent average-case sub-optimality measure ACS-infinity predicts which queries are regret-prone (Spearman rho ~ 0.54 on STATS-CEB), while q-error is nearly uninformative at the query level (rho ~ 0.05). (iii) The worst case is Haritsa's maximum sub-optimality (MSO). The three are one cost-ratio spectrum under three weightings. We prove a limit law ACS-infinity = sum_k r_k pi_k with cardinality-independent combinatorial weights, and validate every claim on STATS-CEB and JOB-light with four released estimators under pre-registered decision rules, and confirm on real PostgreSQL runtime that ACS-infinity predicts regret where q-error does not. The contribution is conceptual and empirical – an average-case companion to worst-case robust query optimization, and a characterization of when an accuracy metric tracks plan quality – rather than a new estimator. Code and the full pre-registration are public.

03.
arXiv (CS.CV) 2026-06-18

Architectural Bias in Face Presentation Attack Detection: A Comparative Study of Vision Transformers and Convolutional Neural Networks

Face Presentation Attack Detection (PAD) systems constitute a critical security layer in biometric authentication; however, existing approaches exhibit systematic performance disparities across demographic groups, disproportionately affecting individuals with darker skin tones. This paper presents a comparative empirical investigation of whether Vision Transformer architectures reduce demographic bias in face PAD systems relative to convolutional baselines. Experiments are conducted on the CASIA-SURF Cross-Ethnicity Face Anti-Spoofing (CeFA) dataset. Three architectures are evaluated: a Multimodal ViT-Tiny trained from scratch, a ResNet18 CNN baseline, and a pretrained DeiT-S fine-tuned on CeFA across African, East Asian, and zero-shot Central Asian demographic groups. DeiT-S achieves the highest overall accuracy of 97.27% and the lowest EER of 0.86%, outperforming ResNet18 at 90.15% accuracy. In terms of fairness, DeiT-S reduces the inter-ethnic ACER gap between African and East Asian subjects to 0.13%, compared to 0.75% reported in an LBP-based work [6], representing an 83% reduction. Most notably, while ResNet18 records a BPCER of 10.44% on zero-shot Central Asian subjects, DeiT-S maintains 2.89% on the same unseen group, demonstrating a 3.6x generalization advantage. These results suggest that pretrained Vision Transformers achieve superior PAD accuracy, produce smaller demographic performance gaps, and generalize more equitably across unseen demographic groups, indicating that cross-demographic fairness in PAD may partly be influenced by architectural design.

04.
arXiv (CS.LG) 2026-06-19

Full-Self Diagnostics (FSD): Physics-Grounded Visual Biomarker Inference from Smartphone Video via Inverse Problems and Operator Learning

arXiv:2606.19372v1 Announce Type: cross Abstract: We present Full-Self Diagnostics (FSD), a unified mathematical framework for recovering latent physiological states from unconstrained 9-second facial videos captured by consumer smartphones. The approach integrates five mutually reinforcing components: (1) a physics-based forward model derived from the radiative transfer equation and chromophore absorption that maps camera observables to biomarker concentrations; (2) an information-theoretic observability theory proving that multi-channel visual signals (spectral, pulse, respiratory, micro-expression, and oculomotor) contain strictly increasing mutual information with physiological state; (3) a stable, Tikhonov-regularized inverse problem with domain-uniform identifiability guarantees; (4) an operator-learning formulation that enables generalization across devices, resolutions, and populations; and (5) a supervised learning procedure, interpretable as stochastic variational inference, that continuously refines the model from paired biosensor ground truth with performance improving proportionally to one over the square root of the number of paired observations. Empirical validation on 38812 real-world paired scans across 59 subjects demonstrates practical performance. Self-collected data from the lead author (glucose range 35-550 mg/dL) yields MARD of 29.86 percent with 97.57 percent of predictions in Clarke Error Grid Zones A+B and only 0.27 percent in the dangerous Zone E. A well-managed diabetic participant achieves MARD of 17 percent in the narrower 70-180 mg/dL band. These results confirm that consumer-grade facial video encodes sufficient structured information for clinically relevant, non-invasive biomarker inference under fully unconstrained conditions, with performance scaling predictably as more paired data becomes available.

05.
medRxiv (Medicine) 2026-06-15

Anti-Platelet Factor 4 Antibody Clonal Heterogeneity and MGUS Status in HIT

Background Monoclonal gammopathy of thrombotic significance (MGTS) is a recently described chronic prothrombotic condition characterized by monoclonal anti-PF4 antibodies that are detected above the polyclonal antibody background in patient sera (i.e. present as monoclonal gammopathy of undetermined significance, MGUS). Due to conflicting data in the published literature on antibody clonality in heparin-induced thrombocytopenia (HIT), we evaluated clonality and abundance of anti-PF4 antibodies in HIT, including investigating whether an MGUS, if present in HIT, represents the causative anti-PF4 antibody. Methods Blood samples from 15 patients with HIT were subject to Platelet Factor 4-dependent antigen-based and functional tests. The unmanipulated serum antibody repertoire and isolated anti-PF4 antibodies were subjected to mass spectrometric evaluation. Results Two of the 15 HIT patients had an IgG MGUS. Notably, anti-PF4 antibodies were not synonymous with the MGUS antibody in either of the two patients. Eight of the 15 patients demonstrated monoclonal anti-PF4 antibodies, however, none of the anti-PF4 antibodies were detectable as an MGUS upon evaluation of the entire serum antibody repertoire, reflecting their low abundance. In the seven patients with multiple anti-PF4 antibodies, non-monoclonality was confirmed by analysis of deglycosylated antibody heavy chains. Conclusions Anti-PF4 HIT antibodies are monoclonal in approximately 50% of HIT patients, however, antibody abundance is low such that they are not detectable over the polyclonal IgG background (i.e. are MGUS-negative), differentiating HIT from MGTS. This observation helps explain the transient nature of HIT relative to the persistent prothrombotic state seen in MGTS.

06.
arXiv (CS.CV) 2026-06-24

Compact Object-Level Representations with Open-Vocabulary Understanding for Indoor Visual Relocalization

Indoor visual relocalization plays a critical role in emerging spatial and embodied AI applications. However, prior research was predominantly devoted to low-level vision schemes, struggling to perceive scene semantics and compositions, which limits both interpretability and applicability. In this paper, we explore the issue of how to organize rich object information in a scene, including semantics, layout, and geometry, into a structured map representation, thereby utilizing object units exclusively to drive the camera relocalization task. To this end, we propose OpenReLoc, a camera relocalization system designed to provide scene understanding and accurate pose estimation capabilities. Leveraging recent foundation models, we first introduce a multi-modal mechanism to integrate open-vocabulary semantic knowledge for effective 2D-3D object matching. Additionally, we design object-oriented reference frames as position priors, paired with a reference frame selection strategy based on the Distance-IoU (DIOU), enabling extension to scalable scenes. Moreover, to ensure stable and accurate pose optimization, we also propose a dual-path 2D Iterative Closest Pixel loss guided by object shape. Experimental results demonstrate that OpenReLoc achieves superior relocalization recall and accuracy across various datasets. Our source code will be released upon acceptance.

07.
arXiv (CS.LG) 2026-06-24

Verifiable Foundation Models for Robot Safety

arXiv:2606.23754v1 Announce Type: cross Abstract: Deploying foundation models for robot control raises a central challenge: the expressive power that enables rich, multimodal perception also makes these models opaque and difficult to analyze formally, rendering them intractable for existing verification tools. In this paper, we present FEARL (Foundation-Enabled Assured Robot Learning), a framework that addresses this tension through a modular architectural decomposition. FEARL separates the policy into a large Controller (C) responsible for high-dimensional perception and task reasoning, and a small Safety module (S) that receives low-dimensional observations from dedicated safety sensors together with a bounded context embedding from C and produces the final action. Since many robot safety requirements, such as collision avoidance and workspace boundary constraints, can be expressed over these safety sensor observations, formal verification can be applied to S rather than to the full foundation-model backbone. This makes formal analysis tractable with existing tools while preserving the Controller's expressive power for task reasoning. To show that the decomposed policy remains capable of solving diverse tasks, we evaluate FEARL on three simulated robotic domains using multiple Controller backbones and training procedures, including pretrained off-the-shelf vision-language-action models. We further transfer the learned policy from one of our simulated tasks to a physical robot, suggesting that the low-dimensional safety interface supports practical sim-to-real transfer.

08.
medRxiv (Medicine) 2026-06-23

Timing of S. aureus-related mortality in a large randomized clinical trial: Implications for future study design

Background: Longer follow-up periods in clinical trials for S. aureus bacteremia (SAB) may capture unrelated deaths, adding random noise that risks biasing trial results towards the null. Objective: To evaluate the timing and infection-relatedness of deaths within a large SAB clinical trial platform. Design: Blinded duplicate adjudication of trial deaths using a modified 7-point Likert-Scale. A third reviewer settled disagreements. Setting: 37 Canadian hospitals participating in the S. aureus Network Adaptive Platform (SNAP) Trial. Participants: 1515 adult patients recruited to SNAP between February 2022 and May 2026. Measurements: Timing and relatedness of 90-day deaths categorized as at least possibly SAB-related not likely to be SAB-related. Optimal follow-up cut-off was determined using Youden's index and graphically. Results: 247 deaths occurred; 97 (39.3%) were adjudicated as at least possibly SAB-related and 150 (60.7%) as not likely related. For probably/definitely related deaths, interrater agreement was 85.0% (Gwet's AC 0.73, substantial); for at least possibly related, it was 77.3% (Gwet's AC 0.55, moderate). Median survival was significantly shorter for SAB-related deaths (12 vs. 30.5 days; difference: 19 days earlier, 95% CI: 12-26, p

09.
arXiv (math.PR) 2026-06-24

Negative index, matchings, and nonnegative eigenvalues of tridiagonal stochastic matrices

arXiv:2606.21122v2 Announce Type: replace Abstract: We study negative eigenvalues of $n\times n$ stochastic matrices whose off-diagonal support is constrained by a sparse graph. The main tool is a matching-based inertia principle: if $G$ is bipartite with matching number $\mu(G)$, $S$ is a real symmetric matrix supported on $G$ with nonnegative diagonal entries and whose negative index (i.e. number of negative eigenvalues counted with their multiplicities) is denoted by $\nu_{-}(S) $, then \[ \nu_{-}(S)\leq \mu(G). \] In particular, every $n\times n$ nonnegative tridiagonal stochastic matrix $P$ satisfies $ \nu_{-}(P)\leq \left\lfloor \frac{n}{2}\right\rfloor. $ Consequently, after ordering the eigenvalues of $P$ in the decreasing order, we have $ \lambda_{\lceil n/2\rceil}(P)\geq0, \ and hence \ \lambda_2(P)\geq0, \mbox{ for } n\geq3. $ This gives an all-dimensional strengthening of the previously known $4\times4$ tridiagonal stochastic result. Next, we show that this tridiagonal bound is sharp in every dimension in both reducible and irreducible cases. Finally, we explore some possible extension and raise some open questions.

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

REVEAL++: Differentiable Phenotypic Grouping for Vision-Language Retinal Modeling of Alzheimer's Disease Risk

arXiv:2606.19522v1 Announce Type: new Abstract: The retina offers a noninvasive window into neurodegenerative disease, capturing subtle structural patterns associated with a risk of future cognitive decline. Vision-language alignment frameworks such as REVEAL have shown that pairing retinal fundus images with structured clinical risk narratives improves early prediction of Alzheimer's disease (AD). A key design choice in these approaches is the use of phenotypic grouping, where individuals with similar risk profiles are treated as multi-positive pairs during contrastive learning. However, existing methods operationalize phenotypic similarity as a discrete construct, relying on hard group assignments that impose rigid supervision and decouple group formation from representation learning. We propose a continuous formulation of phenotypic structure within contrastive learning. Rather than assigning samples to fixed clusters, we model inter-subject similarity as a differentiable weighting function derived from intra-modality embedding similarities in both retinal images and risk profiles. These weights define soft multi-positive relationships through a continuous aggregation operator, enabling graded supervision that reflects the spectrum nature of disease risk. We further introduce a soft-target contrastive objective that jointly learns cross-modal alignment and phenotypic structure in an end-to-end manner. Evaluated on UK Biobank retinal imaging data for incident AD prediction, the proposed framework consistently outperforms discrete group-based contrastive learning and standard vision-language baselines. By treating phenotypic similarity as a learnable, continuous signal rather than a fixed grouping rule, our approach provides a principled and robust foundation for population-scale neurodegenerative risk modeling from multi-modal retinal and clinical data.

11.
arXiv (CS.CV) 2026-06-16

Sinkhorn-CPD: Robust point cloud registration via unbalanced entropic optimal transport

Coherent Point Drift (CPD) is widely used for rigid point cloud registration because of its soft correspondences and closed-form parameter updates. However, CPD's target-side marginal constraint forces every observation, including outliers, to receive exactly unit probability mass. This assumption degrades registration accuracy under heavy outliers and partial overlap. Optimal transport (OT) methods can handle missing mass through unbalanced formulations, but require hand-tuned annealing schedules. In this paper, we propose Sinkhorn-CPD, which replaces CPD's target-side marginal constraint with dual Kullback-Leibler penalties, allowing the algorithm to discard outliers on both sides. The resulting formulation is a fully unbalanced entropic optimal transport problem, which can be efficiently solved by generalized Sinkhorn iterations. Moreover, Sinkhorn-CPD preserves the closed-form Procrustes and variance updates of CPD. In our method, the variance sigma^2 plays the role of the entropic regularization parameter, which induces an automatic annealing schedule from diffuse to sharp correspondences without manual temperature tuning. Experiments on synthetic, cross-category, and scan-to-CAD benchmarks show that Sinkhorn-CPD achieves state-of-the-art accuracy, with strong robustness to outliers and partial overlap.

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

StarOR: Synergizing Tree Search and Test-Time Reinforcement Learning for Optimization Modeling

arXiv:2606.15197v1 Announce Type: cross Abstract: Optimization modeling is inherently hierarchical, requiring a precise sequence of symbolic commitments. Traditional learning-based automated optimization modeling methods improve modeling policies through large-scale annotated or curated training data, but are costly to adapt to new problem distributions. Meanwhile, one-shot generation remains brittle in hierarchical modeling, where early symbolic errors can propagate into invalid formulations. Test-time scaling offers a promising alternative by enabling structural exploration with additional instance-level computation; however, existing search-based methods typically rely on a fixed policy, causing repeated rollouts to inherit similar modeling biases and providing limited credit assignment for intermediate decisions. To address these limitations, we propose StarOR, a synergistic search-and-adaptation framework that couples MCTS with Test-Time Reinforcement Learning for optimization modeling. StarOR decomposes the modeling process into four stages and updates a transient LoRA adapter via GRPO at each non-terminal node. By using MCTS-generated siblings as local comparison sets, StarOR transforms search-time exploration into instance-specific policy refinement. Moreover, an unsupervised multi-faceted reward system provides fine-grained feedback for intermediate formulation decisions without ground-truth labels. Experiments across five optimization benchmarks show that StarOR achieves state-of-the-art performance even with a 4B backbone, outperforming existing methods and the frontier LLMs.

13.
arXiv (CS.LG) 2026-06-11

Geometric bias in eigenspace perturbation under random heterogeneous noise

arXiv:2606.11263v1 Announce Type: cross Abstract: Spectral methods rely fundamentally on the stability of principal eigenspaces under random perturbations. Classically, this stability is quantified by the Davis-Kahan and Wedin theorems, which bound the eigenspace error using the operator norm of the noise and the relevant spectral gaps. While these worst-case bounds are sharp for arbitrary deterministic perturbations, they can be wasteful in the low-rank signal-plus-random-noise setting, as they fail to capture the fine-grained interaction between the signal geometry and the noise distribution. In this paper, we study the spectral perturbation of signal-plus-noise matrices corrupted by sparse, random noise with an arbitrary, inhomogeneous variance profile. We demonstrate that under heterogeneous noise variances, the empirical eigenvectors suffer a systematic, deterministic geometric bias that is entirely invisible to classical perturbation bounds. By leveraging the Quadratic Vector Equation (QVE) and establishing fine-grained isotropic local laws, we derive near-optimal, non-asymptotic perturbation bounds for the leading eigenspaces in the operator and $2\to\infty$ norms. The bounds separate the usual signal-to-noise contribution, stochastic fluctuations, and structured geometric bias terms determined by the alignment between the signal eigenspaces and the row-wise variance profile.

14.
arXiv (CS.AI) 2026-06-24

Catastrophic Compositional Generation: Why Vanilla Diffusion Models Fail to Extrapolate

arXiv:2606.23920v1 Announce Type: cross Abstract: The task of compositional generation involves using a conditional generative model, trained only on a subset of the possible conditions, to produce samples from compositionally-defined target distributions such as a geometric combination of the source distributions. In this work, we argue that this task is often infeasible for vanilla conditional diffusion models: we conjecture that no inference-time technique can efficiently produce samples from the target distribution in certain well-motivated settings. This idea is supported by theory-guided generalization arguments and carefully-designed experiments on both synthetic and realistic data. In particular, while recent methods such as Feynman-Kac correction reduce inference-time approximation error, our results show that score estimation error has a more catastrophic effect on performance when the target distribution is out-of-distribution with respect to the sources, highlighting the need for a different approach to this task.

15.
arXiv (CS.AI) 2026-06-16

MiroBench: Benchmarking Realism in Agentic Simulation of Real-world Discussions

arXiv:2606.14715v1 Announce Type: cross Abstract: LLM agents are increasingly used to simulate real world interactions, but it remains unclear whether simulated behaviors preserve the content patterns and interaction dynamics of real human behaviors. Existing evaluations remain fragmented, which makes it difficult to compare systems or measure progress. In this paper, we focus on Reddit discussions as a concrete first step toward evaluating real-world social simulation. Reddit threads provide public, topic-grounded, multi-party interactions where people share experiences, debate, seek advice, express emotion, and collectively respond to products, events, and social issues. These discussions offer an observable window into broader social behavior, making them a useful setting for testing whether LLM agents can reproduce not only fluent text, but also the distributional patterns and interaction dynamics of real online communities. We introduce MiroBench, a benchmark for Reddit discussion simulation built from 4,292 real Reddit threads. MiroBench uses statistical tests to compare generated and real discussions across four major aspects: repetition and semantic uniformity, narrative content, toxicity and aggression, and structural complexity. Experiments across five domains and five models show that current simulators remain distributionally mismatched with real Reddit threads, while a lightweight prompt-based improvement procedure provides only limited gains. MiroBench offers a concrete benchmark for measuring, diagnosing, and improving realism in LLM-based social simulation.

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

Managing Task Execution for Unknown Workloads in Batteryless IoT: A Hardware-Agnostic Evaluation

arXiv:2606.24340v1 Announce Type: new Abstract: In recent years, the Internet of Things (IoT) paradigm has been shifting toward batteryless, energy-harvesting architectures. Sustaining reliable operation in these systems requires intelligent management of highly volatile stored energy. As edge applications grow in complexity, traditional energy-aware schedulers struggle with unpredictable workloads due to their reliance on static execution thresholds or pre-measured, hardware-specific task profiles. To overcome this, we propose two novel, hardware-agnostic dynamic scheduling strategies treating applications as a "black box," requiring no prior energy information: a model-free Reinforcement Learning (RL) agent and an on-the-fly Approximated Prediction (AP) method. We evaluate these methods against an adaptive task rate approach (AsTAR) and optimized static thresholds using a custom-built, physically accurate simulation framework driven by real-world solar data and dynamic LoRa transmission profiles. Rather than claiming universal superiority, our analysis exposes the distinct operational trade-offs of each method: the AP approach delivers lightweight, near-oracle task throughput; the RL agent provides tunable survival-execution balancing; and AsTAR excels at execution pacing across long energy gaps. Finally, we demonstrate that while these advanced strategies provide critical resilience for severely constrained systems with small capacitors, devices with larger energy buffers can efficiently rely on simpler, less computationally expensive static policies.

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

FoleyGenEx: Unified Video-to-Audio Generation with Multi-Modal Control, Temporal Alignment, and Semantic Precision

We present FoleyGenEx, a unified video-to-audio (VTA) framework integrating multi-modal control, frame-level temporal alignment, and fine-grained semantics, enabling synchronized, versatile audio synthesis for diverse tasks. Existing VTA methods either have multi-modal control but weak temporal alignment or strong alignment but lack reference audio conditioning and semantic precision. FoleyGenEx fills this gap via three core innovations: a conditional injection mechanism for audio-controlled VTA and Foley extension, a multi-modal dynamic masking strategy preserving training synchronization, and an adverb-based data augmentation algorithm leveraging signal processing and large language models to enhance textual supervision with nuanced semantics. Experiments on AudioCaps, VGGSound, and Greatest Hits demonstrate its competitive controllable VTA performance against existing methods. Demo samples are available at https://foleygenex.github.io/FoleyGenEx.

18.
medRxiv (Medicine) 2026-06-10

"We don't complain; it's just part of being a woman": frequency, knowledge, and sociocultural beliefs about dysmenorrhoea in a South African university cohort

Introduction Dysmenorrhoea is highly prevalent globally and interferes with engagement in education, work, social participation, and quality of life. Although evidence suggests that sociocultural beliefs influence how menstrual pain is understood and managed, relatively little research has explored dysmenorrhoea-related knowledge and beliefs within South Africa. This study aimed to (1) determine the frequency of dysmenorrhoea, (2) assess dysmenorrhoea-related knowledge and compare knowledge between menstruating and non-menstruating individuals, and (3) explore commonly held generational, cultural, and religious beliefs related to dysmenorrhoea in a South African university cohort. Methods We analysed data collected as part of a cross-sectional survey conducted among staff and students at a South African university. Participants completed demographic questions, items assessing dysmenorrhoea-related knowledge, and an adapted Working Ability, Location, Intensity, Days of Pain, Dysmenorrhoea (WaLIDD) questionnaire. Participants were also invited to provide free-text responses describing generational, cultural, and religious beliefs about dysmenorrhoea. Quantitative data were analysed descriptively and compared between menstruating and non-menstruating participants. Free-text responses were analysed using reflexive thematic analysis. Results A total of 863 participants completed the survey, including 578 current or past menstruators. The frequency (95%CI) of dysmenorrhoea was 75.4% (71.7-78.9). Most participants were classified as having moderate (53%) or severe (31%) dysmenorrhoea on the WaLIDD scale. Awareness of dysmenorrhoea was higher among participants who had menstruated than among those who had never menstruated (80.4% vs 55.3%, p

19.
arXiv (CS.AI) 2026-06-16

AIChilles: Automatically Uncovering Hidden Weaknesses in AI-Evolved Systems

arXiv:2606.15834v1 Announce Type: new Abstract: The computer systems community has recently seen growing interest in AI-driven system evolution, where AI agents iteratively rewrite systems. Frameworks such as AdaEvolve and Engram report 12-60% score improvements over human-designed algorithms. While these results are promising, there are practical concerns if these AI-evolved programs can perform worse on unseen workloads and exhibit scalability regressions. Given the speed and scale of AI-generated code, we need automated mechanisms to uncover such identify hidden weaknesses in AI-evolved systems programs. To this end, we develop AIChilles that takes as input a baseline program $P$ and an AI-evolved program $P'$, AIChilles searches for valid workloads where $P'$ regresses relative to $P$ in correctness, runtime, memory usage, or output quality. To tackle the diversity in system applications, weakness types and potential bugs, AIChilles combines deterministic workload-parameter extraction, agent-based constraint inference, differential oracles, and code-frequency coverage to discover diverse failures. Across five system applications and 30 AI-evolved programs, AIChilles finds 49 distinct hidden weaknesses. We also show that explicitly including AIChilles in the AI-driven development lifecycle can mitigate several of these weaknesses.

20.
PLOS Medicine 2026-05-14

Antibody fine specificity correlates with protection from malaria for the RTS,S vaccine in young African children: A post hoc analysis of a phase IIb randomised controlled trial

作者:

by Alessia Hysa, D. Herbert Opi, Joshua Waterhouse, Sandra Chishimba, Jessica L. Horton, Natalie Kingston, Hans J. Netter, David Wetzel, Michael Piontek, Gaoqian Feng, Jahit Sacarlal, Carlota Dobaño, Liriye Kurtovic, James G. Beeson Background The RTS,S/AS01 malaria vaccine was recently approved for implementation in children, but only provides modest and short-lived efficacy against malaria. RTS,S targets a portion of the Plasmodium falciparum (Pf) circumsporozoite protein (CSP), comprising the central NANP-repeat region and C-terminal domain. Mechanisms of immunity and correlates of protection for the RTS,S vaccine are not well defined, hindering progress towards generating highly effective CSP-based vaccines. Methods and findings We investigated epitope specificity and cross-reactivity of vaccine-induced antibodies to six peptides representing CSP epitopes in the N-terminal and central NANP-repeat region. We evaluated antibody reactivity in preclinical mouse vaccine studies, among CSP-specific monoclonal antibodies (mAbs), and in a large RTS,S phase IIb clinical trial in young children 1–4 years old (n = 735).The preclinical mouse vaccine studies and CSP-specific mAbs were used to initially evaluate IgG responses to the six peptides. Mice immunised with the central NANP-repeat region had IgG with cross-reactivity to an epitope in the N-terminal region. Additionally, we demonstrated that a single CSP-specific mAb could display cross-reactivity to several CSP epitopes. Through post hoc quantification and analysis of antibody responses in the RTS,S phase IIb clinical trial, we found that a subset of children generated IgG with specificity for a short NANP-repeat epitope (NANP2; amino acid sequence: NANPNANP) and cross-reactivity to an N-terminal epitope (J1; amino acid sequence: KQPADGNPDPNANPN). Notably, children with high IgG responses to NANP2 and J1 had a significantly reduced risk of clinical malaria, compared to children with low responses (IgG to NANP2 (aHR: 0.838 (95% CI [0.716, 0.981]; p = 0.028)) and J1 (aHR: 0.718 (95% CI [0.611, 0.844]; p 

21.
medRxiv (Medicine) 2026-06-10

Developing a Unified Criminal Justice Pathway into Drug and Alcohol Treatment from Police Custody: A Public Health Service Evaluation and Pathway-Design Project in Blackpool, United Kingdom

Introduction: Blackpool, England's most deprived local authority, has the highest drug-related death rate in the country. People in police custody with problem substance use are a key Core20PLUS5 inclusion-health group, yet referral from the police into structured drug and alcohol treatment is fragmented and relies heavily on self-report. We evaluated the current police-to-treatment route in Blackpool and designed an evidence-informed unified pathway. Materials and Methods: A mixed-methods service evaluation and pathway-design project was conducted during a six-month General Practice / Public Health rotation. Routinely collected referral data from Horizon (the local specialist drug and alcohol service) covering the 47-month period from December 2019 to October 2023 were analysed. Findings were triangulated with national policy, the Project ADDER and Liaison and Diversion evaluations, and the international evidence on police-led pre-arrest diversion. Results: Of 5,900 total referrals into Horizon over 47 months, only 269 (4.56%) originated from the police. Police referrals accounted for fewer than 5% of monthly referrals in 30 of 47 months, for 5 to 9.9% in 16 months, and for >/= 10% in only one month (10.8%, December 2022). Blackpool recorded 76 drug-misuse deaths in 2019-21 (19.4 per 100,000, approximately four times the England rate). A six-step unified pathway is proposed: Initiate Referral (opt-out, from ADDER Police and Liaison and Diversion); Initial Assessment; Tailored Treatment Plan; Continuous Support; Collaboration and Monitoring; and Evaluation and Adjustment. Conclusions: Police contact is markedly under-used as a gateway to treatment despite Blackpool having the highest drug-related mortality in England. An opt-out, multi-agency pathway anchored in Core20PLUS5 has the potential to narrow the treatment gap, reduce re-offending, and address the structural health inequalities that drive premature mortality.

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

Regulating the Machine Contributor: Governance and Policy Alignment in Open Source

arXiv:2606.14594v1 Announce Type: cross Abstract: AI-assisted software development has moved from line-level autocomplete to agents that can plan changes, edit files, and submit pull requests with limited human supervision. Open-source software, however, evolves through a process designed for humans: contributor agreements, codes of conduct, and review norms all assume a legally accountable person who can attest to provenance and answer reviewer questions. Autonomous and semi-autonomous AI contributors strain those assumptions, and the 2025-2026 record of agent-driven incidents, AI-generated nuisance volume, and platform-level shutdowns shows that the gap is operationally consequential. Several open-source organisations have responded with contribution policies, but the result is fragmented, and its alignment with emerging AI governance frameworks (EU AI Act, NIST AI RMF with the UC Berkeley Agentic AI Profile, ISO/IEC 42001 and 23894) is unmapped at the contribution level. We compare policies across six organisations (SymPy, LLVM, matplotlib, OpenInfra, the Apache Software Foundation, and the Linux Foundation) using Most-Similar Systems Design with indicator-based coding and process tracing for SymPy and LLVM. From this we derive a six-dimensional taxonomy (disclosure, responsibility, human oversight, licensing, enforcement, maintainer workload), an ordinal Policy Maturity Score, and a mapping of documented agent incidents onto the dimensions each policy fails to govern. Aligning the dimensions with the regulatory frameworks above identifies overlapping gaps neither side currently closes, and we close by sketching the shape of a harmonised tiered framework and the empirical evaluation needed to calibrate it.

23.
arXiv (CS.AI) 2026-06-11

Forecasting Future Behavior as a Learning Task

arXiv:2606.11445v1 Announce Type: new Abstract: Trust in an AI system is often anchored by explanations of how it works, which one then uses to forecast its behavior on new inputs. For large reasoning models (LRMs), this conventional route is particularly difficult to follow: explanation methods for single token generations do not naturally generalize to long trajectories, and the trajectories themselves are often not faithful when read as natural language. We propose an alternative that bypasses the explanation step: treat behavior forecasting as a learnable task and train Behavior Forecasters that operates on a single reasoning trajectory to make the same forecasts one would typically seek from an explanation. The forecaster's training data is obtained by querying the LRM with no human annotation, and its inference is done in a single forward pass. We instantiate this approach on two tasks: how likely the LRM is to repeat its answer on re-runs, and how removing parts of the input changes its answer. We evaluate this approach on both tasks across three diverse reasoning datasets and find that trained Behavior Forecasters are more accurate than GPT-5.4 and Claude Opus-4.6 reading the same trajectories as naive readers, at a small fraction of their inference cost. We find that fine-tuning the backbone end-to-end and initializing it from the target LRM are each necessary for strong performance. These results show that the reasoning trajectory carries information about the LRM's future behavior that goes beyond what naive reading conveys.

24.
medRxiv (Medicine) 2026-06-15

Shortened blastocyst vitrification achieves live birth rates comparable to standard protocols: an analysis of 3168 cryotransfers

Study question Do shortened blastocyst vitrification and warming protocols provide comparable live birth rates (LBR) and obstetrical and perinatal outcomes to traditional vitrification and warming protocols? Summary answer Shortened vitrification and warming protocols provide comparable LBR, obstetric and perinatal outcomes to traditional protocols. Shortened vitrification coupled with traditional multi step warming benefitted women >35yrs. What is known already Embryo viability following cryopreservation is dependent on blastomere survival and functional integrity, both impacted by ice crystal formation and osmotic gradients. Recent innovations in cryopreservation challenge the need for stepwise dehydration and rehydration protocols. While one step ''fast'' blastocyst warming protocols seem to provide equivalent clinical outcomes to traditional ''slow'' protocols, fewer studies investigate whether blastocyst dehydration rates can be similarly increased. A thorough safety and effectiveness evaluation remains necessary for both treatment success and offspring health. Study design, size, duration Three clinics within a network participated in this retrospective consecutive cohort study, with cycle data collected for 3603 warmed blastocysts resulting in 3168 frozen blastocyst transfers in 2170 patients between 2023 and 2025. We modelled the relationship between ''fast'' versus ''slow'' protocols and outcomes with Generalized Additive Models, and linear and logistic regressions where appropriate. Two tailed chi square with Yates correction was used to examine pregnancy loss and obstetrical and perinatal outcomes; p0.05). Importantly, women 35yrs or older at vitrification (n=1715 transfers) profited from a F/S strategy, which provided a significant increase in live birth rates (OR:1.42 [1.02-1.98] p=0.038) compared to S/S. The same improved live birth following a F/S strategy were also seen in embryos of lower quality (OR:1.78 [1.12-2.83] p=0.015), suggesting of a protective effect of this cryopreservation strategy on the developmental competence of impaired germplasm. Limitations, reasons for caution Factors affecting the results may be unaccounted for by the study retrospective nature. Wider implication of the findings Overall, shortened, ''faster'' vitrification and warming protocols provide comparable reproductive outcomes to traditional ones. The combination of shorter exposure to cryoprotectant (CPA) during vitrification and stepwise osmotic gradient during warming provided significant clinical benefits specifically to patients >35 and lower quality embryos, pointing to the possibility of adapting vitrification protocols to specific patients populations and optimizing their clinical outcomes.

25.
arXiv (CS.CV) 2026-06-15

Towards Mitigating Hallucinations in Large Vision-Language Models by Refining Textual Embeddings

Hallucinations in Large Vision-Language Models (LVLMs) remain a persistent challenge, often stemming from inadequate integration of visual information during multimodal reasoning. A key cause is the model's over-reliance on textual priors and underutilization of visual cues, leading to outputs that are linguistically fluent but visually inaccurate. For example, given an image of an empty kitchen countertop, an LVLM might hallucinate a "bowl of fruit" or "cup of coffee", relying on language associations rather than visual evidence. Most LVLMs incorporate visual features by appending them to the input stream of a pre-trained LLM and training on large-scale vision-language datasets. Our systematic analysis reveals that this strategy often leads to over-dependence on textual information due to the inherent bias of LLMs towards language-dominant representations. This imbalance skews attention towards the text over visual content, weakening the model's ability to ground outputs in visual inputs. To address this, we propose a simple yet effective visual feature incorporation method that encourages the model to learn visually-informed textual embeddings distinct from those of the base LLM and promotes a more balanced attention distribution. Experimental results across multiple hallucination benchmarks demonstrate that our method significantly reduces hallucinations and fosters more balanced multimodal reasoning. Notably, our approach achieves substantial gains, including +9.33% on MMVP-MLLM, +2.99% on POPE-AOKVQA, up to +3.4% on Merlin, and +3% on the hard-data split of HallusionBench.