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

RAMAC: Multimodal Risk-Aware Offline Reinforcement Learning and the Role of Behavior Regularization

arXiv:2510.02695v3 Announce Type: replace-cross Abstract: In safety-critical domains where online data collection is infeasible, offline reinforcement learning (RL) is attractive only if policies achieve high returns without catastrophic lower-tail risk. Prior work on risk-averse offline RL achieves safety at the cost of either (i) value/model-based pessimism or (ii) restricted policy classes that limit expressiveness, whereas diffusion/flow-based expressive generative policies have largely been used in risk-neutral settings. We introduce Risk-Aware Multimodal Actor-Critic (RAMAC), a simple, modular, model-free framework that couples an expressive generative actor (e.g., diffusion/flow) with a distributional critic and optimizes a composite objective that combines Conditional Value-at-Risk (CVaR) with behavioral cloning (BC), enabling risk-sensitive learning in complex multimodal scenarios. Since out-of-distribution (OOD) actions are a major driver of catastrophic failures in offline RL, we further provide an objective-level analysis showing that controlling behavior divergence via BC suppresses OOD actions and stabilizes CVaR. Instantiating RAMAC with a diffusion actor, we illustrate these insights on a 2-D risky bandit and evaluate on Stochastic-D4RL, observing consistent gains in $\mathrm{CVaR}_{0.1}$ while maintaining strong returns. The code and experimental results are available on the \href{https://kaifukazawa.github.io/ramac-project/} {project website}

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

GAE: Unleashing Physical Potential of VLM with Generalizable Action Expert

Vision-language models demonstrate strong reasoning and planning abilities, yet grounding these predictions into precise robot actions remains a central challenge. Existing Vision-Language-Action methods typically entangle reasoning and action generation, leading to limited generalization. We propose Generalizable Action Expert (GAE), a task-agnostic model that converts sparse geometric plans into dense robot actions. Our approach introduces a sparse geometric interface: the VLM predicts sparse 3D waypoints representing high-level intention, while GAE maps these waypoints together with real-time point cloud observations to continuous action trajectories. GAE is pretrained on a large-scale pointcloud-trajectory dataset comprising 150k trajectories from both simulation and real-world robots. To further improve efficiency and generalization, we introduce an Action Pre-training, Pointcloud Fine-tuning (APPF) scheme that decouples learning action dynamics from geometry grounding. After pretraining, GAE is frozen and reused across downstream tasks, requiring only lightweight fine-tuning of the VLM to produce the sparse interface. Experiments show that our method achieves strong performance and generalization across diverse visual domains, camera viewpoints, and natural language instructions.

03.
arXiv (CS.CL) 2026-06-16

SCAR: Semantic Continuity-Aware Retrieval for Efficient Context Expansion in RAG

Fixed-length chunking in Retrieval-Augmented Generation (RAG) often leads to boundary fragmentation, where critical evidence is split across segments, degrading retrieval recall. While static windowing and parent retrieval improve recall, they introduce significant token overhead. We propose SCAR (Semantic Continuity-Aware Retrieval), an adaptive retrieval policy that selectively expands neighboring chunks by weighing query-neighbor relevance against a structural continuity penalty. SCAR uses a relative expansion threshold tied to each retrieved chunk's own query-relevance, yielding an approximately scale-invariant decision rule that transfers across embedding models without recalibration. Across four diverse corpora (RFC, GDPR, a 10-K report, and a Merger agreement; N=320 queries; 160 boundary-fragmented), SCAR achieves 92.8% recall on boundary-fragmented queries with only 7.84 chunks, a 22.9% reduction compared to static windowing (10.16 chunks). Paired bootstrap tests (B=10,000) confirm the chunk reduction is highly significant (p

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

MedRLM: Recursive Multimodal Health Intelligence for Long-Context Clinical Reasoning, Sensor-Guided Screening, Evidence-Grounded Decision Support, and Community-to-Tertiary Referral Optimization

Real-world clinical decision support requires reasoning over heterogeneous and longitudinal patient information rather than answering isolated medical questions. However, current medical large language models and retrieval-augmented generation systems often rely on single-step prompting or retrieval, which can be fragile when clinical evidence is distributed across long electronic health records, medical images, sensor streams, guidelines, and referral constraints. This paper proposes MedRLM, a Recursive Multimodal Health Intelligence framework for long-context clinical reasoning, sensor-guided screening, and community-to-tertiary referral support. Instead of compressing all patient information into one prompt, MedRLM treats the patient case as an external clinical environment that can be recursively inspected, decomposed, retrieved, verified, and synthesized. The framework coordinates specialized agents for clinical text, longitudinal EHR, medical imaging, physiological sensor signals, guideline retrieval, uncertainty auditing, and referral planning. It further introduces a Clinical Evidence Graph Memory to connect patient-specific observations with retrieved evidence, standardized definitions, sensor-derived biomarkers, and referral criteria. A sensor-guided recursive triggering mechanism activates deeper reasoning when abnormal physiological or behavioral patterns are detected, while uncertainty-gated refinement supports clinician review for high-risk or low-confidence cases. We also outline a real-data evaluation design using public and credentialed clinical datasets spanning EHR, radiology, ECG, ICU time series, and referral-proxy outcomes. MedRLM aims to move medical AI from static question answering toward auditable, multimodal, and workflow-aware clinical decision support.

05.
arXiv (CS.CV) 2026-06-16

Continuous Splatting meets Retinex: Continuous Gaussian Splatting and Implicit Reflectance Modeling for Low-Light Image Enhancement

Low-light image enhancement aims to recover clear images from low-illumination observations and is crucial for high-level downstream vision tasks. However, existing methods frequently encounter color distortion and structural artifacts when balancing global smooth illumination adjustment and local high-frequency detail recovery. To address these issues, we propose CGS-Retinex as the first low-light image enhancement framework based on explicit-implicit joint modeling. Our framework deeply integrates continuous Gaussian splatting with Retinex theory. Specifically, we represent the image grid as a continuous parameter field and propose a continuous Gaussian renderer to estimate the spatially continuous global illumination distribution. This approach fundamentally eliminates grid artifacts caused by discrete Gaussian sampling. Furthermore, we introduce an implicit neural representation to model reflectance independently. We leverage shallow high-frequency features to guide the network in accurately reconstructing degraded texture details. Within the Retinex framework, we incorporate physics-inspired brightness consistency constraints and illumination smoothness regularization to enable explicit illumination and implicit reflectance to maintain proper exposure and achieve high-fidelity recovery of high-frequency structures and colors. Extensive experiments demonstrate that CGS-Retinex significantly suppresses dark-region noise and overexposure while achieving exceptional high-frequency structural fidelity and color restoration by precisely decoupling illumination and texture. This work establishes a novel continuous physical representation paradigm for low-light image enhancement.

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

Where Will They Go? Modelling Multimodal Pedestrian Manoeuvres from Ego-centric Videos

Pedestrian trajectory prediction from an ego-centric camera is challenging since it depends on complex interactions with vehicles and scene context, as well as the intention of the pedestrian. By modelling correlation and intent from the historical and future trajectories of the pedestrian, it will usually result in a multimodal (i.e. multiple modes) distribution. Existing stochastic predictors often sample multiple futures from a single unimodal distribution, which can yield sub-optimal 'mixed-mode' trajectories that lie between distinct motion patterns and become implausible in real scenes. In this paper, we propose MMPM, a mode-aware framework that separately models future trajectory distributions into semantically meaningful modes based on the pedestrian's crossing behavior. MMPM consists of two modules: behavior-aware Pedestrian Interaction Module (PIM) that jointly captures pedestrian-vehicle and pedestrian-environment interactions by introducing gaze, head and hand gesture, and a CVAE-based Mode-aware Trajectory Predictor (MTP) module to model the future trajectory distributions on two modes, crossing and non-crossing the road, separately. A query-based decoder further enforces mode consistency during decoding. Experiments on PIE and JAAD datasets show that our method surpasses state-of-the-art baselines. Our proposed MTP is model-agnostic, which can be integrated into existing frameworks such as BiTrap-NP and SGNet-ED to further improve future trajectory prediction performance. We additionally introduce a data-driven validation protocol that matches predictions to spatio-temporally consistent ground-truth trajectories, demonstrating improved frame-wise displacement errors over previous work.

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

MagPlus: Bridging Micro-to-Regular Facial Expressions through Learnable Magnification

Facial micro-expressions are subtle and short-lived facial movements that provide important cues about genuine human emotions. However, modeling and generating them remains difficult because annotated micro-expression data is limited and the underlying facial motions are extremely weak. Existing micro-expression generation methods therefore often suffer from limited quality, weak robustness, and poor generalization. We propose MagPlus, a transferable micro-expression processing pipeline that connects micro-expression analysis with standard facial animation models. Instead of training a dedicated generator from scratch, MagPlus learns to magnify subtle facial motions into the range of regular facial expressions, transforming micro-expressions into signals that are compatible with existing facial expression processing models. The magnified sequence is then used by a standard facial expression model for tasks such as transfer and synthesis. A complementary DeMagPlus module then restores the generated motion back to realistic micro-expression intensity levels while preserving the synthesized dynamics. We evaluate the framework using four facial animation models: FOMM, FSRT, MetaPortrait, and EmoPortraits. None of these models are trained on micro-expression data. Experiments show that MagPlus-DeMagPlus enables pretrained macro-expression models to generate more realistic micro-expression motion without retraining the backbones.

08.
arXiv (CS.AI) 2026-06-16

SkillsBench: Benchmarking How Well Agent Skills Work Across Diverse Tasks

arXiv:2602.12670v4 Announce Type: replace Abstract: Agent Skills are structured packages of procedural knowledge that augment large language model (LLM) agents at inference time. Despite rapid adoption, there is no standard way to measure whether they actually help. We present SkillsBench, a benchmark whose current inventory contains 87 tasks across 8 domains paired with curated Skills and deterministic verifiers. Our latest aggregate evaluation runs the 87-task benchmark under matched no-Skills and curated-Skills conditions for 18 model-harness configurations. Curated Skills raise the average pass rate from 33.9% to 50.5% (+16.6 percentage points; 25.5% normalized gain), with configuration-level gains ranging from +4.1 to +25.7 pp. Focused Skills with at most three modules outperform larger or exhaustive bundles, and smaller models with Skills can match larger models without them. SkillsBench establishes paired evaluation as the foundation for rigorous measurement of Skill efficacy on agentic, expertise-heavy work.

09.
bioRxiv (Bioinfo) 2026-06-14

Generative design of antigen-specific T-cell receptor sequences with a conditional diffusion model

T cell receptor (TCR)-based immunotherapy holds immense potential for treating cancers and infectious diseases, where highly antigen-specific TCR recognition is crucial for adaptive immunity against tumors and pathogens. Engineering or de novo generation of the complementarity-determining region 3 (CDR3) loops of TCRs using artificial intelligence offers a powerful alternative to designing reactive TCRs rather than laborious experimental screening. However, current in silico approaches are constrained by weak conditional guidance, limited flexibility, and a lack of rigorous functional validation. To address these limitations, we introduce TCRDiff, a generative diffusion framework for designing antigen-specific TCRs conditioned on peptide-MHC (pMHC) targets and germline-encoded variable genes. By leveraging pre-trained knowledge from massive T-cell repertoires and TCR-pMHC recognition data, TCRDiff generates CDR3{beta} sequences with state-of-the-art fidelity to native binding TCRs through a denoising diffusion process. Furthermore, incorporating the interface geometry features generated TCR-pMHC complexes with superior structural plausibility. As a proof of concept, we deployed TCRDiff in a systematic pipeline to design candidate TCRs for immunotherapy. In vitro activation assays validated that TCRDiff-generated TCRs specifically recognize the MAGE-A3 epitope with minimized off-target cross-reactivity. Together, TCRDiff establishes a powerful, validated computational paradigm to accelerate the development of TCR-based immunotherapies.

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

The Risk Shadow of Principal Component Analysis: When 99.9999% Variance Preservation Causes Catastrophic Decision Errors

arXiv:2606.14533v1 Announce Type: new Abstract: Principal Component Analysis (PCA) preserves variance, not the information needed to detect rare catastrophic events. This paper proves the existence of a {\it Risk Shadow}: PCA can retain over 99.9999 percent of total variance while completely erasing all signal about rare, high-impact failures. When this happens, even the best possible classifier operating on the PCA representation reduces to a constant predictor. The root cause is a fundamental mismatch between variance maximization and tail risk awareness. To break the shadow, we introduce Expectile PCA (ExPCA) and Tail-Preserving PCA (TP-PCA), two methods that reweight the data covariance toward high-impact events. We prove theoretically that ExPCA strictly outperforms PCA in retaining rare-event information, and we validate our claims on synthetic data and a real-world credit card fraud detection benchmark. Our results call for a fundamental rethinking of variance-based dimensionality reduction in high-stakes decisions.

11.
arXiv (quant-ph) 2026-06-19

Quantum correlations in QBism's reconstruction program

arXiv:2606.07485v2 Announce Type: replace Abstract: QBism recasts quantum theory as a normative framework for an agent's probability assignments, with the Born rule taking the form of a consistency condition known as the Urgleichung. Motivated by this perspective, qplex theories provide a broader class of probabilistic models in which the sets of valid states and measurements are constrained by QBist-inspired geometric conditions. While qplexes have been extensively studied for single systems, their implications for bipartite correlations remain largely unexplored. In this work, we investigate bipartite correlations in qplex theories by expressing joint expectation values as inner products between suitably defined $C$-vectors. This geometric formulation allows Bell-type inequalities to be studied as optimization problems over qplex-compatible probability assignments. We first analyze the CHSH scenario and show that the shared inner-product structure of the $C$-vectors restricts the maximal value to the Tsirelson bound $2\sqrt{2}$. We then turn to the three-outcome CGLMP inequality $I_{2233}$ and find that the same qplex-derived norm and inner-product constraints allow a violation of up to $\leq 2+2\sqrt(3)/3 \approx 3.1547$ versus the quantum maximum of $\approx 2.8729$, thereby exhibiting super-quantum correlations. These results show that qplex geometry captures enough structure to reproduce an important quantum bound in the two-outcome case, but not enough to recover the full set of quantum correlation constraints. The analysis therefore suggests that additional principles are needed to complete the QBist reconstruction of quantum theory.

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

Smoothness Errors in Dynamics Models and How to Avoid Them

arXiv:2602.05352v3 Announce Type: replace Abstract: Modern neural networks have shown promise for solving partial differential equations over surfaces, often by discretizing the surface as a mesh and learning with a mesh-aware graph neural network. However, graph neural networks suffer from oversmoothing, where a node's features become increasingly similar to those of its neighbors. Unitary graph convolutions, which are mathematically constrained to preserve smoothness, have been proposed to address this issue. Despite this, in many physical systems, such as diffusion processes, smoothness naturally increases and unitarity may be overconstraining. In this paper, we systematically study the smoothing effects of different GNNs for dynamics modeling and prove that unitary convolutions hurt performance for such tasks. We propose relaxed unitary convolutions that balance smoothness preservation with the natural smoothing required for physical systems. We also generalize unitary and relaxed unitary convolutions from graphs to meshes. In experiments on PDEs such as the heat and wave equations over complex meshes and on weather forecasting, we find that our method outperforms several strong baselines, including mesh-aware transformers and equivariant neural networks.

13.
PLOS Computational Biology 2026-05-29

Structural and dynamic basis of NOD2 tandem CARD association and NOD1/2–RIP2 signaling complexes

by Jitendra Maharana, Aritra Bej, Debasish Biswal, Debashis Panda, Arjun Sharma NOD1 and NOD2, founding members of the NOD-like receptor (NLR) family, play a crucial role in host defense against bacterial infections. Recognition of peptidoglycan-derived ligands triggers ATP-dependent oligomerization of the NACHT domain, exposing the CARD domains that recruit the adaptor protein RIP2 via CARD–CARD interactions to activate the NF-κB signaling cascade. Although NOD1/2-RIP2 interactions and RIP2CARD filament assembly are established, the precise interfaces that stabilize hetero–CARD filaments remain poorly defined. Here, we integrate in silico structural modeling with molecular dynamics (MD) simulations to elucidate structurally compatible arrangements of NOD1–RIP2 and NOD2–RIP2 hetero–CARD filaments. Our results reveal that NOD1CARD subunits form a structurally compatible homomeric scaffold via canonical (type-I–III) interfaces, accommodating multiple tiers of RIP2CARD rings at both filament termini. Meanwhile, the NOD2 tandem CARDs adopt multiple discrete conformations, reflecting a more intricate structural mechanism. In stable filament conformations, tandem CARDs converge at the type-II interface, with RIP2CARD rings stacking onto CARDa (top-down) and CARDb (bottom-up) interfaces, highlighting the structural role of NOD2CARDb in RIP2-mediated CARD–CARD interaction. In silico mutagenesis, involving charge-reversal and alanine scanning of key interfacial residues, disrupts NOD1–RIP2 and NOD2–RIP2 interactions at both top-down and bottom-up interfaces, leading to rapid interface destabilization within 0.1–0.4 μs of simulation. Together, these results reveal conserved and receptor-specific mechanisms governing NOD1/2–RIP2 CARD–CARD interactions and provide deeper structural and dynamic insights into the complex structural mechanisms for NLR-mediated inflammatory signaling.

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

Investigating Human-Model Discrepancies in Speech Quality Assessment via Acoustic and Prosodic Perturbations

Mean opinion score (MOS) prediction models are widely used as proxy metrics in text-to-speech (TTS) research, yet their ability to capture quality differences beyond acoustic fidelity remains unclear. We investigate this via controlled perturbations on speech: acoustic degradation, prosodic errors, and manipulation of speaker-specific characteristics such as pitch and speaking rate. We obtained MOS predictions for these speech samples from both human listeners and the model, and analyzed the differences in their perceptual characteristics. Results show that most models track acoustic degradation well, while all are insensitive to prosodic errors despite large subjective score drops. For speaker characteristics, models exhibit a double dissociation: strong mean fundamental frequency (F0) biases absent in human ratings, yet insensitivity to speaking rate and F0 variability that humans notice. These findings highlight limitations of scalar MOS prediction beyond acoustic fidelity.

15.
arXiv (CS.LG) 2026-06-18

Stochastic Adaptive Gradient Descent Without Descent

arXiv:2509.14969v2 Announce Type: replace Abstract: We introduce a new adaptive step-size strategy for convex optimization with stochastic gradient that exploits the local geometry of the objective function only by means of a first-order stochastic oracle and without any hyper-parameter tuning. The method comes from a theoretically-grounded adaptation of the Adaptive Gradient Descent Without Descent method to the stochastic setting. We prove the convergence of stochastic gradient descent with our step-size under various assumptions, and we show that it empirically competes against tuned baselines.

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

A Neuromorphic Reinforcement Learning Framework for Efficient Pathfinding in Robotic Mobile Fulfillment Systems

arXiv:2606.20031v1 Announce Type: cross Abstract: Dynamic environmental changes, confined workspaces, and stringent real-time constraints make pathfinding in Robotic Mobile Fulfillment Systems (RMFS) a challenging problem for conventional search- and rule-based methods, which typically suffer from high computational complexity and long decision latency. While reinforcement learning (RL) has emerged as a powerful alternative, deploying learned policies with extreme energy efficiency on resource-constrained hardware remains an open challenge. We present SDQN-RMFS, an end-to-end framework that achieves high-fidelity deployment of an RL-trained policy from a full-precision artificial neural network (ANN) through to a neuromorphic chip. By computing only when triggered by sparse events, this framework unlocks ultra-low-power RMFS pathfinding. Our full-stack pipeline operates as follows: an ANN policy is first efficiently trained via a collision-allowing strategy to densify informative trajectories, and then converted into a spiking neural network (SNN) via a hard-label knowledge distillation approach. This effectively addresses the output distribution mismatch, preserving policy capability across the ANN-to-SNN pipeline while substantially reducing inference latency. Hardware experiments demonstrate up to 11,281$\times$ energy savings and a nearly two-fold reduction in latency compared to a high-performance GPU baseline, while maintaining decision quality on par with the original trained policy. These results establish physical neuromorphic inference as a practical and energy-sustainable pathway for large-scale RMFS operations.

17.
arXiv (CS.CL) 2026-06-19

CogniFold: Always-On Proactive Memory via Cognitive Folding

Existing agent memory remains predominantly reactive and retrieval-based, lacking the capacity to autonomously organize experience into persistent cognitive structure. Toward genuinely autonomous agents, we introduce CogniFold, a brain-inspired "always-on" agent memory designed for the next generation of proactive assistants. CogniFold continuously folds fragmented event streams into self-emerging cognitive structures, bootstrapping progressively higher-level cognition from incoming events and accumulated knowledge. We ground this by extending Complementary Learning Systems (CLS) theory from two layers (hippocampus, neocortex) to three, adding a prefrontal intent layer. Emulating the prefrontal cortex as the locus of intentional control and decision-making, CogniFold achieves this through graph-topology self-organization: cognitive structures proactively assemble under the stream, merge when semantically similar, decay when stale, relink through associative recall, and surface intents when concept-cluster density crosses a threshold. We evaluate structural formation using CogEval-Bench, demonstrating that CogniFold uniquely produces memory structures that match cognitive expectations and concept emergence. Furthermore, across eight downstream benchmarks – two probing long-term conversational memory (LoCoMo, LongMemEval) and six spanning other cognitive domains – we validate that CogniFold simultaneously performs robustly on conventional memory tasks. Our code is available at https://github.com/OpenNorve/CogniFold.

18.
Nature (Science) 2026-06-10

Light-induced quantum friction of carbon nanotubes in water

Friction slows down moving objects at both macroscopic and microscopic scales1. At the electronic level, quantum friction describes direct transfer of momentum between a liquid and the electrons of a solid2. Owing to its microscopic nature, this phenomenon remains experimentally challenging to capture3. Here we show that near-infrared fluorescent single-walled carbon nanotubes (SWCNTs) exhibit light-induced quantum friction in water. It is measured by observing an excitation-power-dependent linear decrease of around 50% in the diffusion constants of functionalized SWCNTs in aqueous solution. This effect disappears when excitons are localized, as in the case of SWCNTs with quantum defects. We further show that the chemical manipulation of exciton concentration by molecules that increase or decrease SWCNT fluorescence also modulates the diffusion constant by up to a factor of 2. Optical pump terahertz (THz) probe spectroscopy shows an instantaneous response (around 30 cm−1) that we assign to direct exciton–water coupling in the range of water Debye modes. It is followed by an increasing (>100 ps) response in the range of intermolecular translational modes of the hydrogen bond network of water (>100 cm−1), resembling heating. Classical molecular dynamics simulations further support a mechanism in which the fluctuating dipole moments of excitons create frictional forces. These findings establish light-induced quantum friction between excitons in SWCNTs and water and show that electronic excitations can be used to control nanoscale motion and fluid properties. Near-infrared fluorescent carbon nanotubes exhibit light-induced quantum friction in water, in which exciton interactions slow nanoscale motion and enable optical control of diffusion and fluid dynamics.

19.
arXiv (quant-ph) 2026-06-11

The quantum harmonic oscillator and the real Hilbert space

arXiv:2606.12060v1 Announce Type: new Abstract: The harmonic oscillator is considered within generalized frameworks using complex and quaternionic numbers. The classical oscillator is considered in terms of a complex position function, and quantum oscillators are examined in terms of complex wave functions, and in terms of quaternionic wave functions as well. Both of the quantum solutions are obtained within the real Hilbert space formalism. The results reveal the complex and quaternionic descriptions as suitable frameworks for non-stationary processes, including damped oscillations, forced oscillations, and additionally self-interacting processes that cannot be appropriately described otherwise.

20.
medRxiv (Medicine) 2026-06-15

HPV Self-Sampling in Cervical Screening: A Rapid Review

Introduction Cervical cancer is the fourth largest cause of cancer deaths in women. HPV self-sampling could increase uptake of cervical screening. This rapid review aimed to determine the accuracy, concordance, uptake and acceptability of self-sampling over clinician-collected samples in high income countries. Method We followed Cochrane Rapid Reviews Methods. Top-up of 4 systematic reviews and meta-analyses was performed. Narrative data synthesis was conducted and meta-analysis where applicable. Databases searched were MEDLINE, EMBASE, CENTRAL and clinical trial registries. Risk of bias was assessed using AMSTAR 2, QUADAS, the Cochrane Risk of Bias (RoB), or the Nudelman and Otto, 2020 tool, depending on the study type. Findings The review included 39 studies for accuracy, 38 studies for concordance, 37 uptake and 48 studies for acceptability. Self-sampling has similar accuracy as clinician-collected samples when PCR-based assays are used. The overall agreement of self-sampling and clinician-collected samples was 87.1%(95%CI;85.6-88.6) with a kappa value of 0.70(95%CI;0.67-0.73). Mail-to-all strategies had higher uptake with participation differences of 11.3%(95%CI:8.4-14.2) in the intention-to-treat analysis and 7.7%(95%CI:4.7-10.8) in the per protocol analysis. Self-sampling is acceptable to non-attendees (91%(95%CI;85.3-94.6). Conclusion and Recommendation Self-sampling shows good performance on the four clinical effectiveness indicators of accuracy, concordance, uptake and acceptability.

21.
arXiv (CS.LG) 2026-06-15

An Attention-based Model for Robust Forecasting with Missing Modality

arXiv:2606.13970v1 Announce Type: cross Abstract: Learning with missing modalities is a fundamental challenge in multimodal robot learning, as real-world robotic systems often operate in environments with incomplete sensor data. Attention-based models are appealing for processing multimodal data because they can handle multiple modalities with a single backbone network. However, most multimodal models assume that all modalities are available during both training and inference, limiting their applicability in robotic perception and decision-making. In this paper, we introduce a multimodal model designed to handle missing modalities during both training and inference. The model is formulated as a conditional variational autoencoder (CVAE) and incorporates a transformer-based architecture that leverages attention mechanisms to learn a unified, fixed-dimensional representation, even when some modalities are missing. We show that our proposed model can be trained with missing modalities while approximating a robust representation of all modalities. We evaluate our approach on five multimodal datasets across two robot learning tasks: human trajectory prediction and robot manipulation forecasting. Experimental results demonstrate that our model effectively learns from incomplete data and is superior to prior multimodal fusion approaches.

22.
PLOS Medicine 2026-05-22

Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993–2025: A systematic review and meta-analysis

by Nicole A. Swartwood, Nanki Singh, Seyed Alireza Mortazavi, Melike Hazal Can, Hening Cui, Do Kyung Ryuk, Peter MacPherson, Katherine C. Horton, Nicolas A. Menzies Background Global and national initiatives to combat tuberculosis (TB) have expanded over recent years. Despite this, the TB burden remains high in some population groups, with men recognized as having elevated TB risks. Summary measures of sex differences in TB prevalence were last estimated in 2016. Since then, many additional prevalence surveys have been conducted, including in the highest TB burden countries. We conducted a systematic review of sex-stratified TB prevalence survey data published over 1993–2025, to provide updated estimates of male-to-female (M:F) TB prevalence ratios and determine whether sex-related disparities in TB burden have closed over time. Methods and findings We identified surveys reporting community-representative, sex-stratified estimates of pulmonary TB prevalence in low- and middle-income countries (LMICs), including surveys from an earlier review (covering January 1993–March 2016) and a new systematic review (covering 1st December 2015–13th October 2025). This review was prospectively registered with PROSPERO (CRD42024503853) and included searches of PubMed, Embase, Global Health, the Cochrane Library, Africa Index Medicus, LILACS, and SciELO. We extracted data on bacteriologically confirmed and smear-positive TB prevalence among adults (aged ≥ 15 years), stratified by sex. Risk of bias was evaluated using eight criteria specific to prevalence surveys. We fit multi-level Bayesian regression models with study- and country-level random effects to estimate the M:F ratio of TB prevalence (male prevalence divided by female prevalence), overall and for key subgroups. In meta-regression analyses, we estimated how prevalence ratios varied over time and according to known TB risk factors and TB case definitions.We identified 10,124 publications and extracted data from 100 eligible studies representing 102 unique prevalence surveys and 4,658,310 participants (45.6% male) in 33 LMICs. TB prevalence was higher in men than women in 90/102 of the included surveys, with a pooled M:F prevalence ratio of 2.02 (95% credible interval (CrI): 1.71, 2.34) for bacteriologically confirmed TB and 2.38 (95% CrI: 1.91, 2.90) for smear-positive TB. Time trend analyses showed a 2.0% (95% CrI: −0.2, 4.5%) average annual change in the M:F ratio of bacteriologically confirmed TB over the study period. The M:F prevalence ratio was estimated to be higher for countries with greater excess HIV prevalence among men, and countries with greater gender equity (as measured by the United Nation’s Gender Development Index). The estimated M:F prevalence ratio was also higher for surveys that did not restrict testing to individuals reporting TB symptoms. Study limitations include heterogeneity in survey methods and definitions, as well as limited data from the Americas, Eastern Mediterranean, and Europe WHO world regions and post-COVID-19 period. Conclusions Men in LMICs consistently experience TB at a higher prevalence than women. Time trend estimates are uncertain, but consistent with widening sex differences in TB prevalence over the last three decades, despite efforts to address the risk factors underlying this excess TB burden.

23.
medRxiv (Medicine) 2026-06-16

Infections and suicide and self-harm: a population-based matched cohort study

Background Infections have been associated with adverse mental health outcomes, including suicide, but evidence beyond severe or central nervous system infections is limited. We investigated associations between a range of acute infections and subsequent suicide/self-harm outcomes. Methods We conducted six infection-specific matched cohort studies using English primary care records from the Clinical Practice Research Datalink Aurum (2007-2024), linked to hospital admissions and mortality data. Adults ([≥]18 years) with a primary care record of infection (gastroenteritis, lower respiratory tract [LRTI], skin/soft-tissue [SSTI], urinary tract [UTI], sepsis, meningitis/encephalitis [positive control]) were matched (age, sex, practice, calendar period) to up to five comparators without infection. We estimated hazard ratios (HRs) for suicide/self-harm outcomes using Cox regression, stratified by matched set and implicitly adjusting for matching factors, with additional adjustment for deprivation, lifestyle factors, and comorbidities. We examined whether associations varied over time, by infection severity, antimicrobial treatment, sex, and prior mental health conditions. Findings Cohorts ranged from 18,192 individuals with meningitis/encephalitis (matched to 90,915 without) to 398,099 with SSTI (matched to 1,743,747). After adjustment, individuals with infection had a higher hazard of suicide/self-harm outcomes than comparators across all cohorts: sepsis (HR 1.79, 95% CI 1.65-1.93), gastroenteritis (1.62, 1.55-1.70), meningitis/encephalitis (1.56, 1.32-1.84), UTI (1.41, 1.33-1.50), SSTI (1.37, 1.31-1.43), and LRTI (1.37, 1.31-1.44). Risk was highest in the year post-infection, attenuating over time, and was higher among severe infections and those without prior mental health conditions. Interpretation Common acute infections recorded in primary care are associated with increased risk of suicide and self-harm, particularly following severe infections and in the year post-infection. Findings support suicide risk monitoring following acute infection, particularly among individuals without prior mental health conditions, and highlight infection prevention as a potentially modifiable strategy in vulnerable populations. Funding Wellcome and La Caixa. Copyright This work is licensed under a Creative Commons Attribution (CC BY) licence.

24.
arXiv (quant-ph) 2026-06-15

Compact graphs and quantum automorphisms

arXiv:2606.13928v1 Announce Type: new Abstract: Compact graphs are graphs for which the fractional automorphism polytope has no genuinely fractional vertices. This paper proposes a quantum analogue of this idea by evaluating the fundamental magic unitary of the quantum automorphism group on states, which we show to produce a closed convex set of doubly stochastic matrices sitting between the classical automorphism polytope and the full fractional automorphism polytope. Our main result is that the natural quantum analogue of compactness is classical, that is, a quantum compact graph is classically compact. We also relate this set to the quantum orbital algebra and obtain a hierarchy of classical and quantum compactness pseudo notions. The framework recovers familiar consequences of compactness through commutants and suggests quantum analogues of generous transitivity and distance-transitivity. We also isolate examples and open problems indicating where quantum symmetries may strictly refine the classical compactness theory.

25.
medRxiv (Medicine) 2026-06-11

Electrical signatures of divergent connectivity in the human subgenual cingulate cortex

Background: Major depressive disorder remains a leading cause of disability. While subgenual cingulate cortex (sgCC) deep brain stimulation (DBS) shows promise for medically refractory depression, clinical outcomes have been heterogeneous, suggesting that individual differences in neural circuitry engagement may critically influence therapeutic efficacy. We aimed to define the electrophysiological signatures of sgCC efferent connectivity using single-pulse electrical stimulation (SPES) with intracranial stereo-EEG (sEEG) to inform rational targeting and physiological biomarkers for sgCC-DBS. Methods: In four patients undergoing clinically indicated sEEG for seizure mapping, SPES was delivered through sgCC pairs, while distributed brain stimulation-evoked potentials (BSEPs) were recorded across cortical and subcortical sites. Responses were characterized using Canonical Response Parameterization to extract reproducible waveforms and per-trial reliability. Results: sgCC stimulation elicited reproducible, spatially organized BSEPs across frontal, limbic, and paralimbic networks, aligning with known anatomical pathways. Frontal recruitment featured robust, lateralized orbitofrontal activation favoring the ipsilateral central, medial OFC and bilateral ventromedial prefrontal responses. Limbic effects demonstrated bilateral cingulate activation with stronger ipsilateral recruitment and lateralized amygdala and hippocampal responses. Paralimbic engagement included insular responses with subject-specific anterior predominance and bi-hemispheric temporal-polar slow-wave deflections. Conclusion: These findings provide direct electrophysiological evidence of distributed, lateralized sgCC divergent network connectivity in the human brain, offering physiologic confirmation of its role in affective circuitry. The observed topography and laterality have direct applications for sgCC-DBS targeting and implicate BSEP signatures as candidate biomarkers to guide patient-specific therapy.