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01.
arXiv (CS.CL) 2026-06-15

The Coin Flip Judge? Reliability and Bias in LLM-as-a-Judge Evaluation

LLM-as-a-Judge is now widely used to rank model outputs, train reward models, and populate public leaderboards, but its run-to-run reliability remains under-characterized. We study repeated identical evaluations on 29 tasks spanning 10 categories using two OpenAI judge models (GPT-4o-mini and GPT-4.1-mini), with 50 pairwise trials and 50 pointwise trials per question, supplemented by temperature and prompt-sensitivity ablations. Across judges, pairwise preferences flip on average 13.6% of the time, with 28% of questions exceeding a 20% flip rate and one question reaching 56%. GPT-4o-mini also exhibits a significant first-position bias (72% A-majority, p = 0.024). At the same time, mean pointwise score gaps are small (0.19–0.36 on a 10-point scale) and not statistically significant in aggregate, producing a pairwise–pointwise gap: judges frequently choose a winner even when their own scalar scores provide little evidence of a meaningful quality difference. Beyond within-judge instability, cross-judge agreement is only 76% ($\kappa = 0.51$), semantically equivalent prompt templates change majority outcomes in 25% of tested cases, and deterministic decoding reduces but does not eliminate inconsistency. A reliability curve analysis shows that, in our dataset, 11 repeated trials are needed for a majority vote to recover the 50-trial reference verdict with 95% probability on average, rising to 15 for high-variance questions. These findings suggest that single-trial LLM judging is often too noisy for high-stakes evaluation, and that multi-trial aggregation, position randomization, and explicit uncertainty reporting should be standard practice. Because both judges are from a single provider, cross-provider replication remains an important next step.

02.
arXiv (CS.LG) 2026-06-18

Shrinkage priors for Bayesian Substitute Confounders

arXiv:2606.18535v1 Announce Type: cross Abstract: Multi-cause observational studies contain information about unmeasured confounding through the dependence structure among causes. However, literal imputation of the unobserved confounder is often more complex than learning a lower-dimensional substitute score that preserves the shared assignment variation needed for stable causal adjustment. The deconfounder (Wang and Blei, 2019) and related substitute confounder methods exploit this idea, but flexible assignment models can fit the joint distribution of the causes while producing scores that over-encode the treatment vector, collapse overlap, or capture single-cause variation. We develop a Bayesian factor assignment framework for learning sparse substitute confounders that retain coarse multi-cause dependence with shrinkage priors. The theory is stated at the level of posterior concentration, factor score contraction, and overlap-preserving assignment geometry and therefore does not rely on a particular shrinkage prior. Under these conditions, the proposed regression-adjusted estimators are consistent for mean potential outcomes when the corresponding latent variable identification assumptions hold. Shrinkage priors provide a natural tool for latent structural learning: they favour low-dimensional factors supported by multiple causes, discourage effectively single-cause factors, and induce an ordering of the latent factors through progressive shrinkage. Synthetic experiments illustrate the roles of signal strength, outcome validity, and geometry-aware regularization. In an Alzheimer's Disease Neuroimaging Initiative (ADNI) baseline analysis, sparse substitute scores recover much of the adjustment obtained by directly conditioning on invasive cerebrospinal-fluid biomarkers, while collapse diagnostics identify when fitted factors reduce to individual observed measurements.

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

StylisticBias: A Few Human Visual Cues Drive Most Social Biases in MLLMs

Multimodal large language models (MLLMs) are increasingly deployed in personally and societally consequential settings, yet the visual cues that shape how these models judge people remain poorly understood. Prior work often compares different (groups of) individuals, making it difficult to separate appearance effects from identity differences. We introduce StylisticBias, a controlled benchmark for evaluating attribute-level social bias in MLLMs. We generate 500 photorealistic base faces and create about 50 single-attribute variations per face, producing about 25K images. This design keeps identity fixed and changes one visual attribute at a time. It lets us measure how specific cues shift model judgments. We evaluate six MLLMs across 25 binary social judgment scenarios. We find that age and body type dominate identity-level effects, while fashion style and other visual cues drive the largest attribute-level shifts. We further find that about 15 attributes account for nearly 80\% of the total variation, showing that bias is concentrated in a small set of visual cues. Sensitivity is strongest in judgments that are semantically aligned with appearance, especially socioeconomic and style-related judgments. We release StylisticBias as a benchmark for fine-grained bias evaluation in multimodal models. Code and dataset: https://github.com/timo-cavelius/StylisticBias and https://hf.co/datasets/shaghayegh/stylistic-bias-dataset.

04.
arXiv (quant-ph) 2026-06-11

Mixed-State Topological Order under Coherent Noise

arXiv:2411.03441v2 Announce Type: replace Abstract: Mixed-state phases of matter under local decoherence have recently garnered significant attention due to the ubiquitous presence of noise in current quantum processors. One of the key issues is understanding how topological quantum memory is affected by realistic coherent noise, such as random rotation noise and amplitude-damping noise. In this work, we investigate the intrinsic error threshold of the two-dimensional toric code (TC), a paradigmatic topological quantum memory, under these types of coherent noise by employing both analytical and numerical methods based on the doubled-Hilbert-space formalism. A connection between the mixed-state phase of the decohered TC and a non-Hermitian Ashkin-Teller-type statistical-mechanics model is established, and the mixed-state phase diagrams under the coherent noise are obtained. We find remarkable stability of mixed-state topological order under random rotation noise with axes near the $Y$-axis of qubits. We also identify intriguing extended critical regions at the phase boundaries, highlighting a connection with non-Hermitian physics. We argue that these phase boundaries provide upper bounds for the intrinsic error threshold, beyond which quantum error correction becomes impossible. We complement these findings by estimating the error thresholds for random rotation noise under standard quantum error correction, thereby providing lower bounds on the intrinsic error threshold.

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

Competition and Diversity in Generative AI

arXiv:2412.08610v3 Announce Type: replace-cross Abstract: Recent evidence, both in the lab and in the wild, suggests that the use of generative artificial intelligence reduces the diversity of content produced. The use of the same or similar AI models appears to lead to more homogeneous behavior. Our work begins with the observation that there is a force pushing in the opposite direction: competition. When producers compete with one another (e.g., for customers or attention), they are incentivized to create novel or unique content. We explore the impact competition has on both content diversity and overall social welfare. Through a formal game-theoretic model, we show that competitive markets select for diverse AI models, mitigating monoculture. We further show that a generative AI model that performs well in isolation (i.e., according to a benchmark) may fail to provide value in a competitive market. Our results highlight the importance of evaluating generative AI models across the breadth of their output distributions, particularly when they will be deployed in competitive environments. We validate our results empirically by using language models to play Scattergories, a word game in which players are rewarded for answers that are both correct and unique. Overall, our results suggest that homogenization due to generative AI is unlikely to persist in competitive markets, and instead, competition in downstream markets may drive diversification in AI model development.

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

Skill-Guided Continuation Distillation for GUI Agents

arXiv:2606.18890v1 Announce Type: new Abstract: Improving GUI agents typically relies on behavior cloning on expert trajectories. However, as the current policy deviates from the expert policy, it inevitably encounters policy-induced off-trajectory states during closed-loop execution, i.e., states that fall outside the expert trajectories. Since expert trajectories provide no demonstrations for these unseen states, such states receive no effective supervision, leaving the policy unable to select the correct action. To close this supervision gap, we propose Skill-Guided Continuation Distillation (SGCD), an iterative self-improvement framework. SGCD first runs the plain policy without skill guidance for a few steps to reach realistic off-trajectory states. From these states, a skill-guided policy then completes the task and produces successful continuations, which are mixed with expert trajectories to supply supervision over policy-induced off-trajectory states. The skills are extracted from both successful and failed rollouts, consisting of Continuation Plans, Critical Targets, Failure Traps, and Success Criteria. On OSWorld-Verified, SGCD improves the success rate of three base models from the low-30\% range to over 50\%, demonstrating its effectiveness and generality.

07.
medRxiv (Medicine) 2026-06-15

Multi-domain AD risk burden and plasma biomarkers in cognitively unimpaired adults

Introduction: Alzheimer's disease (AD) pathology accumulates decades before symptom onset, yet how the cumulative effect of genetic, familial, and modifiable lifestyle risk burden jointly affects plasma biomarker levels and trajectories in cognitively unimpaired older adults remains unknown. Methods: We analyzed data from 261 participants in the PREVENT-AD cohort. A composite risk score integrating APOE e4 status, polygenic score, family history, and modifiable/lifestyle risk was examined against six plasma biomarkers using linear regression and linear mixed-effects models. Results: APOE e4 was the strongest predictor of plasma biomarker levels. Higher composite risk burden was associated with elevated ptau181, ptau217, ptau217/Ab42, and GFAP levels, and lower Ab42/40 levels. A higher risk burden was predictive of accelerated ptau181 accumulation. Discussion: Cumulative AD risk burden is broadly associated with plasma biomarker levels and specifically predicts accelerated ptau181 accumulation in cognitively unimpaired older adults, supporting structured composite risk profiling as a framework for AD risk stratification.

08.
arXiv (CS.AI) 2026-06-19

PiDR: Physics-Informed Inertial Dead Reckoning for Autonomous Platforms

arXiv:2601.03040v2 Announce Type: replace-cross Abstract: A fundamental requirement for full autonomy is the ability to sustain accurate navigation in the absence of external data, such as GNSS signals or visual information. In these challenging environments, the platform must rely exclusively on inertial sensors, leading to pure inertial navigation. However, the inherent noise and other error terms of the inertial sensors in such real-world scenarios will cause the navigation solution to drift over time. Although conventional deep-learning models have emerged as a possible approach to inertial navigation, they are inherently black-box in nature. Furthermore, they struggle to learn effectively with limited supervised sensor data and often fail to preserve physical principles. To address these limitations, we propose PiDR, a physics-informed inertial dead-reckoning framework for autonomous platforms in situations of pure inertial navigation. PiDR offers transparency by explicitly integrating inertial navigation principles into the network training process through the physics-informed residual component. PiDR plays a crucial role in mitigating abrupt trajectory deviations even under limited or sparse supervision. We evaluated PiDR on real-world datasets collected by a mobile robot and an autonomous underwater vehicle. We obtained more than 29% positioning improvement in both datasets, demonstrating the ability of PiDR to generalize different platforms operating in various environments and dynamics. Thus, PiDR offers a robust, lightweight, yet effective architecture and can be deployed on resource-constrained platforms, enabling real-time pure inertial navigation in adverse scenarios.

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

PseudoBench: Measuring How Agentic Auto-Research Fuels Pseudoscience

As Large Language Model based agents enter autonomous scientific research, their ability to resist pseudoscience becomes increasingly important. Otherwise, such systems may rapidly generate plausible yet misleading studies that contaminate academic literature and erode trust in science. We present PseudoBench, an adversarial benchmark for evaluating whether agentic auto-research systems can identify and resist pseudoscientific narratives. PseudoBench contains 200 curated pseudoscientific claim-evidence pairs across five domains and evaluates agents through an end-to-end research pipeline from experiments to writing. Testing seven state-of-the-art agents, we find that current systems readily produce persuasive reports that align with pseudoscientific premises with near-zero refusal rates and the highest resistance of only 27.4%. Stronger agents risk packaging pseudoscience in more sophisticated scientific language, increasing its apparent credibility. These findings reveal an alarming capacity to fuel pseudoscience, calling for scientific alignment before widespread deployment.

10.
arXiv (CS.LG) 2026-06-15

Side-Channel Attacks Bypass Protection in 3D Printers

arXiv:2606.13952v1 Announce Type: cross Abstract: Active Motor Noise Cancellation (AMNC) ships in commercial fused deposition modeling (FDM) 3D printers as a hardware countermeasure against acoustic side-channel attacks that target intellectual property (IP). We present the first empirical evaluation of a deployed AMNC countermeasure, using a public dataset of synchronized acoustic and vibration recordings from two AMNC-equipped Bambu Lab printers across 12 object classes. AMNC fully neutralizes the acoustic channel: classification accuracy is indistinguishable from the 8.33% random baseline. The vibration channel, which AMNC does not target, still leaks. With summary statistics the leak is coarse and amplitude-driven (vibration accuracy approximately 31% pooled, 36-47% within-printer), while the waveform shape carries essentially nothing (frequency-only features at chance). A full-sequence temporal model that ingests the ordered evolution of the print raises accuracy to approximately 61%, and an order-shuffling control (approximately 33%) shows that a substantial component is genuinely sequential and tied to print progression. The leak is device-specific: a classifier trained on one printer transfers near chance to the other. We conclude that AMNC is an acoustic-only defense: vibration remains a partial, geometry-correlated side channel it does not address, but one that does not, on this dataset, support full geometric reconstruction; reconstruction-grade attacks would require the magnetic or power channels AMNC also leaves untouched. We release all code.

11.
arXiv (CS.LG) 2026-06-17

Conformalized Quantum DeepONet Ensembles for Scalable Operator Learning with Distribution-Free Uncertainty

arXiv:2605.00330v2 Announce Type: replace Abstract: Operator learning enables fast surrogate modeling of high-dimensional dynamical systems, but existing approaches face two fundamental limitations: quadratic inference complexity and unreliable uncertainty quantification in safety-critical settings. We propose Conformalized Quantum DeepONet Ensembles, a framework that addresses both challenges simultaneously. By leveraging Quantum Orthogonal Neural Networks (QOrthoNNs), we reduce operator inference complexity from O(n^2) to O(n), enabling scalable evaluation over fine discretizations. To provide rigorous uncertainty quantification, we combine ensemble-based epistemic modeling with adaptive conformal prediction, yielding distribution-free coverage guarantees. A key challenge in ensembling is that naive parallelism scales hardware resources linearly with the number of models. We resolve this by using Superposed Parameterized Quantum Circuits (SPQCs), which compress multiple ensemble members into a single circuit and enable simultaneous multi-model execution. Experiments on synthetic partial differential equations and real-world power system dynamics demonstrate that our approach achieves accurate predictions while maintaining calibrated uncertainty under realistic quantum noise. These results establish a practical pathway toward scalable, uncertainty-aware operator learning in quantum machine learning.

12.
arXiv (CS.AI) 2026-06-11

Erased but Not Forgotten: How Backdoors Compromise Concept Erasure

arXiv:2504.21072v3 Announce Type: replace-cross Abstract: The expansion of text-to-image diffusion models has raised concerns about harmful outputs, from fabricated depictions of public figures to sexually explicit imagery. To mitigate such risks, prior work has proposed concept erasure methods that aim to sever unwanted concepts from the model via fine-tuning, yet it remains unclear whether these approaches truly remove all links to the harmful concept or merely conceal superficial connections. In this work, we reveal a critical vulnerability, the Erasure Evasion Backdoor (EEB): an adversary binds a backdoor trigger to a concept slated for removal, and this malicious link survives subsequent erasure. We show that both black-box and white-box adversaries can instantiate this threat. Across six state-of-the-art erasure methods, including robust ones that explicitly search for alternative representations of the target concept, EEB consistently exposes harmful content: up to 82% success against celebrity-identity unlearning, up to 94% for object erasure, and up to 16 times amplification of explicit-content exposure. While EEB uncovers a blind spot in current erasure methods, it also provides a diagnostic tool for stress-testing future concept erasure techniques.

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

Tool-IQA: Augmenting Image Quality Assessment with Simple Tools

Vision-Language Models (VLMs) have been increasingly adopted for Image Quality Assessment (IQA). However, current methods typically employ a static one-shot scoring paradigm, despite the fact that humans assess image quality through dynamic visual inspection, e.g., selectively adjusting views to verify details and subtle artifacts. Specifically, relying solely on a single-pass observation introduces two primary limitations: first, perceiving the image only at a global scale restricts the assessment of finer local details; second, the original intensity distribution of the image may overwhelm the visibility, leading to insufficient inspection of image quality. To address these issues, we propose Tool-IQA, shifting the assessment mechanism from passive scoring to a tool-augmented workflow. In particular, we equip VLMs with simple yet effective view tools: a Magnifier to inspect local details, and a Gamma Corrector to uncover visibility and hidden artifacts. The assessment follows a structured pipeline that consists of an initial observation with rubric notes, a tool-augmented in-depth inspection, and a final quantification for calibrated quality score. Furthermore, to ensure efficient and purposeful tool callings, we introduce a batch-aware training strategy to reward tool interactions that can yield positive contributions rather than simply encouraging usage. Experiments on a variety of IQA benchmarks demonstrate that, with effective tool calling and calibrated assessment, our proposed Tool-IQA significantly outperforms existing state-of-the-art models, e.g., it achieves a PLCC of 0.854 on the challenging CLIVE dataset.

14.
arXiv (CS.AI) 2026-06-19

Improving End-to-End Speech Recognition for Dysarthric Speech through In-Domain Data Augmentation

arXiv:2606.19797v1 Announce Type: cross Abstract: Dysarthric speech recognition is crucial for facilitating effective communication among individuals with dysarthria. However, accurately recognizing dysarthric speech poses significant challenges due to varying severity levels and limited data availability. In this paper, we explore data augmentation techniques for dysarthric automatic speech recognition (ASR) systems by fine-tuning the End-to-End pre-trained Wav2Vec2 model, with a specific focus on severity levels. To address the challenges of data scarcity and the need for extensive data in fine-tuning pre-trained ASR systems for dysarthric speech, we investigate four prominent data augmentation methods: Speaking-Rate Modification (SRM), Pitch Modification (PM), Formant Modification (FM), and vocal tract Length Perturbation (VTLP), tailored to different aspects of dysarthria. The study uses individually fine-tuned Wav2Vec2 models for each severity class as baseline systems. Additionally, we conducted severity-specific fine-tuning of the ASR model using augmented data. Results demonstrate distinct efficacy patterns for each augmentation technique across severity levels. The best WERs were achieved with SRM ($s$=0.8) for low (9.02\%) and medium (38.11\%) severities, and with PM ($\tau$=0.8) for high severity (55.15\%), reflecting relative improvements of 30.02\%, 16.64\%, and 15.47\%, respectively. These results confirm the effectiveness of the augmentation methods in improving dysarthric ASR performance.

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

OmniPlan: An Adaptive Framework for Timely and Near-Optimal Network Planning Optimization

arXiv:2606.18105v1 Announce Type: cross Abstract: Network planning optimization is a fundamental problem across diverse domains, including transportation systems, communication networks, and power grids. It requires simultaneous optimization of multiple competing objectives under complex constraints. Existing network planning optimization frameworks rely on mixed integer programming (MIP) solvers, heuristics, and deep reinforcement learning (DRL) models to compute planning decisions. However, they lack effective adaptability to diverse and dynamic user intents, thus leading to the trade-off between execution time and optimality. In this paper, we propose OmniPlan, an adaptive framework that achieves both timeliness and near-optimality in network planning optimization. To achieve the adaptability lacking in existing solutions, OmniPlan employs a large language model (LLM)-based interpreter to convert heterogeneous natural-language intents into a unified and quantifiable user-preference vector. Then it employs a mixture-of-experts architecture that integrates MIP solvers, heuristics, and DRL models as specialized experts, where OmniPlan adapts to diverse intents by dynamically selecting timely and near-optimal experts. Finally, it incorporates a DRL-based expert configuration module that fine-tunes optimization objective weights to align planning decisions with user-specific preferences. We evaluate OmniPlan with a representative real-world workload, i.e., distributed machine learning (ML), where we leverage OmniPlan to offload a wide spectrum of ML inference tasks, e.g., decision trees, SVM, naive Bayes, XGBoost, and random forests, onto a network of hardware devices. Our experiments on a real-world testbed indicate that OmniPlan achieves near-optimal and low-execution-time offloading for real-world ML inference tasks, reducing latency by up to 97.8\% and network device resource consumption by up to 11.5\%.

16.
arXiv (CS.CV) 2026-06-17

NTIRE 2025 Challenge on Image Super-Resolution (x4): Methods and Results

This paper presents the NTIRE 2025 image super-resolution ($\times$4) challenge, one of the associated competitions of the 10th NTIRE Workshop at CVPR 2025. The challenge aims to recover high-resolution (HR) images from low-resolution (LR) counterparts generated through bicubic downsampling with a $\times$4 scaling factor. The objective is to develop effective network designs or solutions that achieve state-of-the-art SR performance. To reflect the dual objectives of image SR research, the challenge includes two sub-tracks: (1) a restoration track, emphasizes pixel-wise accuracy and ranks submissions based on PSNR; (2) a perceptual track, focuses on visual realism and ranks results by a perceptual score. A total of 286 participants registered for the competition, with 25 teams submitting valid entries. This report summarizes the challenge design, datasets, evaluation protocol, the main results, and methods of each team. The challenge serves as a benchmark to advance the state of the art and foster progress in image SR.

17.
medRxiv (Medicine) 2026-06-15

ICD-10 Code Ambiguity Obscures Treatment-Eligible Adults with Spinal Muscular Atrophy: A Single-Center Chart Review and Patient Outreach Study

Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.

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

Conditional Attribution for Root Cause Analysis in Time-Series Anomaly Detection

arXiv:2604.17616v3 Announce Type: replace Abstract: Root cause analysis (RCA) for time-series anomaly detection is critical for the reliable operation of complex real-world systems. Existing explanation methods often rely on unrealistic feature perturbations and ignore temporal and cross-feature dependencies, leading to unreliable attributions. We propose a conditional attribution framework that explains anomalies relative to contextually similar normal system states. Instead of using marginal or randomly sampled baselines, our method retrieves representative normal instances conditioned on the anomalous observation, enabling dependency-preserving and operationally meaningful explanations. To support high-dimensional time-series data, contextual retrieval is performed in learned low-dimensional representations using both variational autoencoder latent spaces and UMAP manifold embeddings. By grounding the retrieval process in the system's learned manifold, this strategy avoids out-of-distribution artifacts and ensures attribution fidelity while maintaining computational efficiency. We further introduce confidence-aware and temporal evaluation metrics for assessing explanation reliability and responsiveness. Experiments on the SWaT and MSDS benchmarks demonstrate that the proposed approach consistently improves root-cause identification accuracy, temporal localization, and robustness across multiple anomaly detection models. These results highlight the practical utility of conditional attribution for explainable anomaly diagnosis in complex time-series systems. Code and models are available at: https://github.com/dfki-av/Conditional-Attribution-for-Root-Cause-Analysis-in-Time-Series-Anomaly-Detection.

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

A2SG:Adaptive and Asymmetric Surrogate Gradients for Training Deep Spiking Neural Networks

Training deep spiking neural networks (SNNs) remains challenging due to sharp loss landscapes and temporal inconsistency caused by surrogate gradients. To address these challenges, we propose a unified framework: adaptive and asymmetric surrogate gradients A2SG. The adaptive gradients adjust an effective window for spatio-temporal adaptation, reducing spatial gradient variation and maintaining directional consistency of gradients over time. The asymmetric gradients reflect neuronal dynamics by assigning larger gradients to neurons with higher membrane potentials, and we prove that they yield lower variation than symmetric surrogates. Our analysis further establishes a direct connection between local gradient variation and the curvature of the loss landscape, providing a principled explanation for how A2SG promotes convergence to flatter minima and improves generalization. We conduct extensive experiments on diverse models, including CNN-based and Transformer-based SNNs, across various tasks such as image classification using both static and neuromorphic datasets, as well as segmentation. The results demonstrate that A2SG consistently improves accuracy and energy efficiency, establishing it as a general and reliable solution for training deep SNNs. Our code is available at https://github.com/KIST-NCL/A2SG.git.

20.
medRxiv (Medicine) 2026-06-17

Womens intentions and motivations towards health behaviour change before pregnancy: a cross-sectional survey of pregnant women in Australia

Introduction: The preconception period (i.e. the weeks and months before pregnancy) is a critical window during which parental health behaviours can influence pregnancy outcomes and the childs long-term health. Modifiable factors such as nutrition, physical activity, substance use, and environmental exposures play a key role, yet womens ability to adopt and sustain healthy behaviours is shaped by complex psychological, social and environmental influences. This study applies the Theory of Planned Behaviour to identify the beliefs underpinning womens preconception behaviours, with the aim of informing support for effective and sustained health behaviour change. Methods: An Australian national retrospective cross-sectional survey of pregnant women (18-49 years), recruited through social media platforms. The 92-item survey captured respondent socio-demographics, pregnancy status and health conditions, health behaviours, and beliefs regarding preconception health behaviours. Respondents level of pregnancy planning was categorised using the London Measure of Unplanned Pregnancy (LMUP). Items regarding preconception beliefs were structured in accordance with the Theory of Planned Behaviour, with a focus on regular exercise, healthy diet, and alcohol avoidance. These beliefs variables were analysed using structured equation modelling to identify paths between latent variables and the items used to estimate each concept. Results: The study was completed by 430 pregnant women of whom 72.7% had a planned pregnancy. Most had a partner, were university educated and in good health. Structural equation modelling showed intention strongly predicted exercise ({beta}=0.65), healthy diet ({beta}=0.54) and alcohol avoidance ({beta}=0.64). Perceived control and partner norms influenced intentions, whereas health professional norms had limited effect. Positive beliefs were associated with folate supplement use and smoking cessation. Conclusion: These findings highlight intention as a key driver of preconception health behaviours, with perceived control and partner influences playing a more significant role than individual beliefs or health professional input. Effective interventions should therefore address structural barriers and actively involve partners, while respecting womens autonomy. Overall, couples-focused, multi-level strategies are likely essential to support meaningful and sustained preconception health behaviour change.

21.
medRxiv (Medicine) 2026-06-16

Higher Population Coverage with Typhoid Conjugate Vaccine is Needed to Induce Herd Protection: Evidence from a Cluster-Randomized Trial in Urban Bangladesh

Introduction: A cluster randomized trial (CRT) in Bangladesh found that Vi-tetanus toxoid (Vi-TT) vaccine conferred 85% protection to vaccinees at 18 months of follow-up; however, it failed to confer significant herd protection to non-vaccinees. Methods: In the CRT, children aged 9 months to

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

A Deep Reinforcement Learning (DRL)-Based Transformer Method for Solving the Open Shop Scheduling Problem

arXiv:2606.13682v1 Announce Type: new Abstract: The open shop scheduling problem (OSSP) arises in many industrial and service settings but remains computationally challenging as the number of jobs and machines increases. While exact methods quickly become intractable, classical dispatching rules and metaheuristics may require substantial tuning to maintain solution quality at large scales. This study develops a Transformer-based scheduling policy for OSSP using an encoder-decoder architecture with multi-head attention. The model is trained on Taillard benchmark instances (4x4, 5x5, 7x7, and 10x10) using only the processing-time matrix as input and produces feasible schedules with makespans typically within 15-30% of best-known values. To evaluate scalability, the trained policy is applied without retraining to randomly generated instances from 40x40 to 100x100 and compared against classical dispatching heuristics, including SPT, LPT, MWKR, and EST. Across these large instances, the Transformer achieved average gaps of 12.89-15.12% relative to a standard lower bound. Compared with EST, the Transformer remained competitive, typically within a modest margin, while substantially outperforming SPT and LPT. These results indicate that a Transformer policy trained on small OSSP instances can generalize to substantially larger problems and provide a feature-light, learning-based alternative to classical dispatching rules.

23.
medRxiv (Medicine) 2026-06-18

Biomedical Capacity, Governance, and Health Security: A Dominican Republic Research Analysis of Stakeholder Perspectives

The COVID-19 pandemic exposed critical vulnerabilities in globally concentrated biomedical supply chains and accelerated interest in nearshoring and hemispheric health-security strategies. The Dominican Republic, already the third-largest medical device exporter in Latin America, occupies a strategically significant but institutionally constrained position within this realignment. This study evaluates stakeholder perceptions of the principal opportunities and barriers affecting biomedical ecosystem development in the Dominican Republic, with particular attention to governance, workforce capacity, and value-chain upgrading pathways. Methods. A concurrent mixed-methods design was employed, integrating a cross-sectional electronic survey of 142 purposively sampled domain experts (administered September-December 2025) with a qualitative executive consultation with senior government and industry leaders. Survey analyses combined descriptive statistics, one-sample t-tests against the scale neutral midpoint, chi-square goodness-of-fit tests, Friedman non-parametric ranking, Spearman rank correlations, and exploratory linear and logistic multivariable regression. Qualitative responses were analyzed using a framework approach grounded in the Triple Helix model of innovation systems. Results. Perceived government support was significantly below neutral (mean = 2.67, SD = 1.12; p = 0.034). Workforce shortages (83.3%) and weak academia-industry collaboration (71.4%) were the most frequently endorsed barriers ({chi}2(5) = 18.7, p = 0.002). Regulatory modernization (88.1%) and workforce development (85.7%) ranked as the highest-priority policy levers (Friedman p = 0.005). Clinical trials and contract research organization services were the dominant sub-sector priority (76.2%, binomial p < 0.001). In multivariable analysis, perceived government support, talent availability, and confidence in IP protection jointly explained 46% of the variance in sector competitiveness (R2 = 0.46, p < 0.001). Strong majority support existed for a formal public-private biomedical coordination authority (73.8%, p < 0.001).Conclusion. Institutional credibility and advanced human capital–rather than geography or market access–are the perceived binding constraints on the Dominican Republics biomedical trajectory. Regulatory modernization, targeted workforce investment, and the establishment of a national biomedical coordination authority represent the highest-leverage interventions for positioning the country as a hemispheric hub for biomedical manufacturing, clinical research, and health security.

24.
medRxiv (Medicine) 2026-06-17

Efficacy of a Gamified Digital Platform for Substance Use Education and Overdose Prevention Among College Students: a Pilot and Feasibility Study

Background: For US young adults aged 18-25 in the 2018-2024 period, fentanyl was involved in 78.2% of the 44,020 unintentional or undetermined-intent overdose deaths, most often co-involving stimulants and other non-opioid substances. While fatal overdose rates in this age group have fallen to their lowest recorded level, emergency medical services-attended non-fatal overdose events have reached record highs, shifting the decisive variable toward bystander recognition and response. College students report near-universal alcohol education but minimal education on the substances actually driving overdose mortality. Methods: We conducted a single-group pre-post evaluation of the DopaGE Portal, a gamified, mastery-based digital platform covering cocaine, MDMA, benzodiazepines, and opioid overdose response, deployed at a public university (UNL) and a multi-campus volunteer network (TACO). Paired pre/post surveys (N=42) measured self-efficacy (7 items; primary), behavioral intentions, risk perception, and knowledge/attitudes on 5-point scales, plus four factual knowledge questions. Paired t-tests, exact McNemar tests, and Benjamini-Hochberg correction across eight primary tests were applied. Institutional naloxone distribution at UNL was tracked as an ecological behavioral outcome. A mandated high-school cohort (N=94) provided supplementary acceptability data. Results: Self-efficacy increased from 2.82 to 4.46 (d=2.00, 95% CI 1.46-2.55; adjusted p

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PLOS Medicine 2026-06-02

Proteomic signatures of early retinal neurodegeneration in type 2 diabetes mellitus

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by Huangdong Li, Ziyu Zhu, Shaopeng Yang, Weijing Cheng, Shaoying Tan, Zhuoyao Xin, Lei Zhang, Zhuoting Zhu, Shida Chen, Wenyong Huang, Wei Wang Background Retinal neurodegeneration is an early and independent feature of diabetic retinal disease and has been proposed as a window into the systemic neural consequences of diabetes, yet accessible molecular biomarkers and individualized prediction tools remain scarce. We aimed to identify circulating plasma protein signatures of diabetic retinal neurodegeneration (DRN) and to translate them into a clinically usable risk prediction system. Methods and findings In this multi-cohort prospective observational study, we integrated high-throughput plasma proteomics with longitudinal optical coherence tomography (OCT) in two independent populations. The discovery cohort comprised 1,492 participants had baseline plasma proteomics and OCT, and 1,218 were followed with repeated OCT over 6 years in Guangzhou Diabetic Eye Study (GDES). DRN was quantified by the annualized OCT-derived retinal nerve fiber layer thinning rate. In multivariable analyses adjusted for age, sex, smoking, systolic blood pressure, HbA1c, and diabetes duration, we identified 71 plasma proteins associated with development and progression of DRN. These proteins mapped onto pathways governing inflammatory immune recruitment, extracellular matrix remodeling, and microvascular homeostasis, providing a plausible biological basis for DRN. We developed a proteomics-based DRN model (Pro-DRN) using eight machine learning (ML) algorithms, including XGBoost and LightGBM. In the independent test set, Pro-DRN achieved a C-index of 0.860, rising to 0.908 when integrated with clinical variables. Compared with six conventional models, Pro-DRN improved discrimination (ΔC-index 0.137 to 0.159; all P