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

Token-Level Entropy Reveals Demographic Disparities in Language Models

We ask whether demographic identity, signaled by a name alone, systematically reshapes the generative distribution of a language model. Measuring full-vocabulary Shannon entropy at temperature zero across six open-weight base models and 5,760 implicit sentence-completion prompts (e.g., "Tanisha walked into the office on a Monday morning and"), we find that Black-associated names produce higher first-token entropy than White-associated names across all six architectures - opposite to the output-level homogeneity bias documented under explicit demographic prompting (Lee et al., 2024) - and Black-associated names always produce greater entropy above identity-neutral baselines than White-associated names ($\Delta\Delta > 0$ in all six models). Women-associated names co-occur with lower first-token entropy (DL-pooled $\hat\beta = -0.041, p = .019$) and more homogeneous outputs ($\hat\alpha = +0.024, p < .001$) than men-associated names - a pattern convergent with homogeneity bias; race and gender effects are additive. Instruction tuning does not attenuate the race gap (matched-format DL-pooled $\hat{\beta}=+0.153$). Running the same templates with explicit group labels instead of names yields null race effects in 10 of 12 models where implicit probing is significant - establishing that probing methodology is a primary determinant of which distributional structure is recovered.

02.
arXiv (quant-ph) 2026-06-19

Measuring Rényi entropy with an Echo Protocol

arXiv:2504.05237v3 Announce Type: replace Abstract: We present efficient and practical protocols to measure the second Rényi entropy, whose exponential is known as the purity. Our approach is based on expressing the purity in terms of transition probabilities generated by an echo-type forward-backward evolution sequence, making it applicable to quantum many-body systems. Notably, our approach does not rely on random-noise averaging, a feature that can be extended to protocols to measure out-of-time-order correlation functions, as we demonstrate. By way of example, we show that our protocols can be practically implemented in superconducting qubit-based platforms, as well as in cavity-QED trapped ultra-cold gases.

03.
arXiv (CS.LG) 2026-06-15

Neural ARFIMA model for forecasting BRIC exchange rates with long memory

arXiv:2509.06697v3 Announce Type: replace-cross Abstract: Exchange rate forecasting remains a challenging problem, particularly for emerging economies, where the observed time series exhibit pronounced long-memory dependence, nonlinear dynamics, and sensitivity to macro-financial drivers. Classical models such as ARFIMA capture long-range persistence but fail to adequately represent nonlinear relationships, while modern machine learning approaches often neglect the underlying long-memory structure in macroeconomic series. To address this gap, we propose a Neural AutoRegressive Fractionally Integrated Moving Average (NARFIMA) model that integrates ARFIMA-based long-memory modeling with neural networks for nonlinear function approximation, while incorporating exogenous macroeconomic and uncertainty indicators. The framework provides a unified approach for capturing persistence, nonlinear dynamics, and external shocks. We establish asymptotic stationarity of the NARFIMA process and develop conformal prediction intervals for distribution-free uncertainty quantification. Empirical results for BRIC exchange rates show that NARFIMA consistently outperforms a broad range of forecasting benchmarks across multiple horizons, underscoring the importance of explicitly modeling long-memory dependence in exchange rate dynamics. The `narfima' R package provides an implementation of our approach.

04.
medRxiv (Medicine) 2026-06-16

Reporting patterns of adverse drug withdrawal events using individual case safety reports in United States and European databases

Introduction: Adverse drug withdrawal events (ADWEs) are a key safety concern with deprescribing but are infrequently reported in trials. Although pharmacovigilance systems have advanced our understanding of medication-related harms, it is unclear how extensively these systems have been used for ADWEs. Objectives: To examine the reporting patterns of ADWEs for all drugs recorded in United States and European pharmacovigilance databases between 2004 and 2023. Methods: A retrospective study was conducted using two pharmacovigilance databases, the publicly available FDA-FAERS dataset and EMA-EV Level 2A (individual-level) dataset. ADWE cases were identified using relevant MedDRA preferred terms. Data on patient characteristics, reporter type, drugs, indication, ADWE outcomes, dechallenge/rechallenge, seriousness criteria, time to onset, duration, and causality were summarised. Results: A total of 158,505 ADWE reports were analysed (FDA-FAERS: 145,514; EMA-EV: 12,987), with mean ages of 46.1 (FDA; 55.3% female) and 45.5 years (EMA; 57.1% female). The frequently reported drug classes were opioids (FDA: oxycodone, 29.8%; EMA: buprenorphine, 19%), antidepressants (FDA: duloxetine, 32%; EMA: venlafaxine, 25.9%) and gabapentinoids (FDA: pregabalin, 6.7%; EMA: pregabalin, 6.0%). The most common adverse outcomes were other serious medical conditions (FDA=63.9%; EMA=46.0%), hospitalisation (FDA=15.9%; EMA=28.3%), and disability (FDA=13.3%; EMA=6.2%) and these outcomes varied significantly based on sex and age group (p

05.
arXiv (CS.CL) 2026-06-11

Short Chains, Deep Thoughts: Balancing Reasoning Efficiency and Intra-Segment Capability via Split-Merge Optimization

While Large Reasoning Models (LRMs) have demonstrated impressive capabilities in solving complex tasks through the generation of long reasoning chains, this reliance on verbose generation results in significant latency and computational overhead. To address these challenges, we propose CoSMo (Consistency-Guided Split-Merge Optimization), a framework designed to eliminate structural redundancy rather than indiscriminately restricting token volume. Specifically, CoSMo utilizes a split-merge algorithm that dynamically refines reasoning chains by merging redundant segments and splitting logical gaps to ensure coherence. We then employ structure-aligned reinforcement learning with a novel segment-level budget to supervise the model in maintaining efficient reasoning structures throughout training. Extensive experiments across multiple benchmarks and backbones demonstrate that CoSMo achieves superior performance, improving accuracy by 3.3 points while reducing segment usage by 28.7\% on average compared to reasoning efficiency baselines.

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

How to sketch a learning algorithm

Authors:

arXiv:2604.07328v3 Announce Type: replace Abstract: How does the choice of training data influence an AI model? This broad question is of central importance to interpretability, privacy, and basic science. At its technical core is the data deletion problem: after a reasonable amount of precomputation, quickly predict how the model would behave in a given situation if a given subset of training data had been excluded from the learning algorithm. We present a data deletion scheme capable of predicting model outputs with vanishing error $\varepsilon$ and failure probability $\delta$ in the deep learning setting. Our precomputation and prediction algorithms are only $\tilde{O}(\log(1/\delta)/\varepsilon^2)$ factors slower than regular training and inference, respectively. The storage requirements are those of $\tilde{O}(\log(1/\delta)/\varepsilon^2)$ models. Our proof is based on an assumption that we call stability. In contrast to the assumptions made by prior work, stability appears to be fully compatible with learning powerful AI models. In support of this, we show that stability is satisfied in a minimal set of experiments with microgpt. Our code is available at https://github.com/SamSpo1/microgpt-sketch. At a technical level, our work is based on a new method for locally sketching an arithmetic circuit by computing higher-order derivatives in random complex directions. Forward-mode automatic differentiation allows cheap computation of these derivatives.

07.
arXiv (CS.AI) 2026-06-19

Process-Verified Reinforcement Learning for Theorem Proving via Lean

arXiv:2606.20068v1 Announce Type: new Abstract: While reinforcement learning from verifiable rewards (RLVR) typically has relied on a single binary verification signal, symbolic proof assistants in formal reasoning offer rich, fine-grained structured feedback. This gap between structured processes and unstructured rewards highlights the importance of feedback that is both dense and sound. In this work, we demonstrate that the Lean proof assistant itself can serve as a symbolic process oracle, supplying both outcome-level and fine-grained tactic-level verified feedback during training. Proof attempts are parsed into tactic sequences, and Lean's elaboration marks both locally sound steps and the earliest failing step, yielding dense, verifier-grounded credit signals rooted in type theory. We incorporate these structured rewards into a GRPO-style reinforcement learning objective with first-error propagation and first-token credit methods that balances outcome- and process-level advantages. Experiments with STP-Lean and DeepSeek-Prover-V1.5 show that tactic-level supervision outperforms outcome-only baselines in most settings, delivering improvements on benchmarks such as MiniF2F and ProofNet. Beyond empirical gains, our study highlights a broader perspective: symbolic proof assistants are not only verifiers at evaluation time, but can also act as process-level reward oracles during training. This opens a path toward reinforcement learning frameworks that combine the scalability of language models with the reliability of symbolic verification for formal reasoning.

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

Low-Energy Reduced RISC-V Instruction Subset Processor for Tsetlin Machine Inference at the Edge

arXiv:2606.19964v1 Announce Type: new Abstract: Tsetlin Machine (TM) is a logic-based machine learning approach that relies on simple bitwise operations and finite-state automata, which makes it attractive for edge AI deployments. Recent work has focused on co-processor and accelerator designs based on Tsetlin Machines (TMs). Although these designs achieve high performance, they typically depend on tightly coupled interfaces, microcode-style programming, and external host processors, limiting flexibility and ease of programming. In this work, we present a domain-specific RISC-V microprocessor architecture and design flow tailored for TM inference. Leveraging the modular structure of RISC-V, we design a reduced instruction subset processor that retains programmability while targeting improved performance and lower energy consumption for TM workloads. Instruction profiling is employed to guide instruction reduction, followed by datapath and control path simplifications tailored to TM inference. Both the baseline RV32IM core and the proposed reduced core are evaluated across multiple datasets and compared with Binarized Neural Networks (BNNs), which serve as a hardware-efficient baseline due to their reliance on bitwise operations during inference. Results show that TM achieves comparable or higher accuracy (e.g., up to 88.18% on CIFAR-2 compared to 60.0% for BNN) while reducing execution time by up to 98% across multiple datasets. Furthermore, the proposed design achieves an average $29.7\times$ reduction in energy consumption, demonstrating its effectiveness for programmable and efficient edge AI systems.

09.
arXiv (CS.LG) 2026-06-18

Wasserstein Policy Learning for Distributional Outcomes

arXiv:2606.19117v1 Announce Type: cross Abstract: Offline policy learning has received growing attention in causal inference. The primary objective is to learn a policy (individualized treatment rule) as a mapping from covariates to treatment that maximizes the empirical welfare defined as the mean of scalar-valued potential outcomes. In this paper, we study offline policy learning with distribution-valued outcomes, where each potential outcome is a probability measure on $\mathbb{R}$ and the reward is defined through a utility functional applied to the Wasserstein barycenter of induced outcome distributions. We establish statistical guarantees for the policy learning framework based on both Inverse Probability Weighting (IPW) and Doubly Robust (DR) estimators. By handling the challenging uniform deviation over the product of the combinatorial policy class and the infinite-dimensional quantile domain, we prove that the finite-sample regret has leading dependence $\widetilde{\mathcal{O}}(\sqrt{\mathrm{N-dim}(\Pi)/N})$. In the one-dimensional Wasserstein setting and under the stated regularity conditions, the leading regret rate is still governed by the policy-class complexity. Moreover, we provide a minimax lower bound establishing the sharpness of the leading dependence on $N$ and $\mathrm{N-dim}(\Pi)$.

10.
medRxiv (Medicine) 2026-06-22

Climatic Drivers of Malaria risk in Children Under Five: A Large-Scale Analysis of individual-level data for 350,000 children in 26 Sub-Saharan African Countries

Background Malaria risk is influenced by climatic conditions, and children under five are particularly vulnerable due to their limited acquired immunity. We investigate the association between climatic factors and malaria risk in 350,000 children aged 5-59 months in sub-Saharan Africa over 18 years. Methods We included children aged 5-59 months with malaria tests from Demographic and Health Surveys (DHS) in 26 sub-Saharan African countries between 2006 and 2023. We linked these data to high-resolution climate exposures: temperature, precipitation, soil moisture, actual evapotranspiration and specific humidity. We fitted a mixed-effect logistic regression model incorporating Distributed Lag Non-linear Models (DLNM) over 1-6 month lag window for each exposure, controlling for seasonality and long-term trends. We examined effect modification by maternal education, household wealth, residential type, water source, sanitation facility, child age and sex, use of insecticide-treated bed nets (ITNs), and the age of the household head. Results Malaria prevalence was 19.5%. Malaria risk was highest at 24 degrees (OR: 1.45, 95% CI: [1.36, 1.54]), followed by a decline at higher temperatures. This elevated risk was mainly driven by short-term exposures (1-2 months). Precipitation increased risk up to 59 ~ 120 mm (1.10, [1.07, 1.12]), after which heavier rainfall reduced risk, particularly at short- to medium-term lags (1-4 months). Soil moisture was associated with increasing risk up to ~80 mm (1.11, [1.08, 1.14]), with a plateau at higher levels. Evapotranspiration showed a strong, near-linear positive association with malaria risk. Higher specific humidity levels (>14 g/kg) presented a lower risk, reaching a 45% reduction at 17 g/kg (0.55, [0.49, 0.61]), with the strongest protective effects at short-term lags (1-2 months). Elevated malaria risk at low and moderate average temperatures was particularly evident among children who did not sleep under an ITN net. Conclusion Malaria risk in children under five is strongly shaped by climatic factors, with complex and delayed associations. The findings provide evidence to guide targeted interventions and early-warning strategies for vulnerable populations.

11.
arXiv (CS.LG) 2026-06-18

Sequential Hiring of Contingent Workers Through Learning-Based Optimization

arXiv:2606.18438v1 Announce Type: cross Abstract: In this paper, we study a sequential workforce management problem in a contingent labor setting with uncertainty in both worker production and labor supply. A firm seeks to maximize cumulative profit by maintaining an active team of fixed size while learning worker productivity over time. We emphasize two critical operational frictions in this problem: replacing workers is costly, and workers may not be available immediately for hiring because of, for example, prior job commitments, scheduling constraints, or onboarding procedures. Thus, hiring decisions take effect only after a random delay. We formulate this problem as a stochastic multi-play bandit with costly switching and delayed actions, and develop a learning-based hiring policy, DR-UCB (DelayedReplacement-UCB), that makes replacement and hiring decisions sequentially through learning cycles. In each cycle, the policy uses real-time production data to determine when to initiate workforce changes and which workers to replace and hire. We show that the leading-order regret of the proposed policy matches its lower bound in its dependence on the time horizon. Our numerical experiments show that DR-UCB outperforms benchmark policies.

12.
arXiv (CS.LG) 2026-06-19

Direct Advantage Estimation for Scalable and Sample-efficient Deep Reinforcement Learning

arXiv:2606.20411v1 Announce Type: new Abstract: Direct Advantage Estimation (DAE) has been shown to improve the sample efficiency of deep reinforcement learning algorithms. However, its reliance on full environment observability limits its applicability in realistic settings, and its requirement to model transition probabilities incurs substantial computational overhead for high-dimensional observations. In the present work, we address both limitations. First, we extend the theoretical framework of DAE to partially observable domains with minimal modifications. Second, we reduce its computational complexity by introducing discrete latent dynamics models that efficiently approximate transition probabilities. We evaluate our approach on the Arcade Learning Environment and find that DAE scales effectively with function approximator capacity while retaining high sample efficiency.

13.
arXiv (CS.CV) 2026-06-15

Dual Cross-Attention Siamese Transformer for Rectal Tumor Regrowth Assessment in Watch-and-Wait Endoscopy

Increasing evidence supports watch-and-wait (WW) surveillance for patients with rectal cancer who show clinical complete response (cCR) at restaging following total neoadjuvant treatment (TNT). However, accurate methods to early detect local regrowth (LR) from follow-up endoscopy images during WW are essential to manage care and prevent distant metastases. Hence, we developed a Siamese Swin Transformer with Dual Cross-Attention (SSDCA) to combine longitudinal endoscopic images at restaging and follow-up and distinguish cCR from LR. SSDCA leverages pretrained Swin Transformers to extract domain agnostic features and enhance robustness to imaging variations. Dual cross attention is implemented to emphasize features from the paired scans without requiring any spatial alignment to predict response. SSDCA as well as Swin-based baselines were trained using image pairs from 135 patients and evaluated on a held-out set of image pairs from 62 patients. SSDCA produced the best balanced accuracy (81.76% $\pm$ 0.04), sensitivity (90.07% $\pm$ 0.08), and specificity (72.86% $\pm$ 0.05). Robustness analysis showed stable performance irrespective of artifacts including blood, stool, telangiectasia, and poor image quality. UMAP clustering of extracted features showed maximal inter-cluster separation (1.45 $\pm$ 0.18) and minimal intra-cluster dispersion (1.07 $\pm$ 0.19) with SSDCA, confirming discriminative representation learning. Code and weights available at: https://github.com/Jotanator/SSDCA

14.
arXiv (CS.CL) 2026-06-17

VoidPadding: Let [VOID] Handle Padding in Masked Diffusion Language Models so that [EOS] Can Focus on Semantic Termination

MDLMs generate text by denoising a preallocated masked response canvas, making response-length modeling central to instruction tuning. Existing MDLMs often inherit the autoregressive convention of using repeated \texttt{[EOS]} tokens for padding during instruction tuning, giving \texttt{[EOS]} a dual role as both a semantic terminator and a padding token. We show that this dual role is a root cause of \texttt{[EOS]} overflow under large-block decoding. To decouple these roles, we propose VoidPadding, which introduces \texttt{[VOID]} for padding and reserves \texttt{[EOS]} for termination. During inference, the learned \texttt{[EOS]} signal enables early stopping, while the learned \texttt{[VOID]} signal guides adaptive response canvas expansion. On Dream-7B-Instruct, VoidPadding improves the block-size-averaged four-task mean across mathematical reasoning and code generation benchmarks by \(+17.84\) points over the original model and \(+6.95\) points over RainbowPadding, while reducing decoding NFE by 55.7\% on average. Code is available at https://github.com/Haru-LCY/VoidPadding.

15.
arXiv (quant-ph) 2026-06-12

Quantum walk-based optimisation for capacitated vehicle routing with homogeneous and heterogeneous fleets

arXiv:2606.12856v1 Announce Type: new Abstract: The capacitated vehicle routing problem (CVRP) is an appealing candidate for quantum optimisation due to its combinatorial complexity and practical importance. However, the problem's constrained search space poses a challenge for such quantum algorithms. We introduce a quantum walk-based optimisation algorithm (QWOA) for the CVRP with homogeneous or heterogeneous vehicle fleets, addressing this challenge through a continuous-time quantum walk over a product space that coincides with combinatorial structures intrinsic to the CVRP solution space. Relative to the prior QWOA-based formulation, this approach reduces the per-layer gate complexity from $\mathcal{O}(n^{3}\log n)$ to $\mathcal{O}(n^{2}\log n)$ and supports a circuit parameterisation schedule generated by a fixed number of classical parameters. Exact state-vector simulation on instances with up to $n=8$ customers and $K=3$ vehicles demonstrates improved convergence to low-cost solutions using markedly fewer objective function evaluations, with the advantage broadening as problem size increases. These results identify structured product-space walks as a promising tool for optimisation over constrained combinatorial spaces.

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

Mitigating Visual Hallucinations in Multimodal Systems through Retrieval-Augmented Reliability-Aware Inference

Multimodal large language models (MLLMs) have demonstrated strong capabilities in vision-language understanding and natural-language response generation. However, these systems can still produce overconfident predictions and hallucination-like outputs, particularly when the visual evidence is weak, ambiguous, or semantically inconsistent. Most existing approaches focus on improving multimodal representation alignment or retrieval-augmented generation, while providing limited mechanisms to quantify instance-level prediction reliability or identify incorrect visual outputs. This work proposes a retrieval-augmented reliability-aware inference framework for trustworthy multimodal visual understanding. The proposed framework constructs an external visual evidence database using pretrained visual embeddings and nearest-neighbor retrieval over normalized feature representations. Retrieved evidence is used to estimate prediction trustworthiness through multiple reliability indicators, including similarity strength, class-support agreement, evidence margin, entropy-based uncertainty, and an aggregate reliability score. Based on these signals, a decision gate determines whether the system should accept the prediction, answer with caution, or abstain/fallback when evidence is insufficient. A multimodal response-generation layer then produces a final user-facing response conditioned on the reliability decision. Experiments on ImageNet-100 demonstrate that the proposed reliability-aware framework improves accepted prediction accuracy from 85.84\% to 88.88\% at 89.04\% coverage. The hallucination-like accepted wrong-answer rate is reduced from 14.16\% to 11.12\%. These results show that integrating retrieval evidence, reliability estimation, and selective decision gating can improve calibration and reduce overconfident visual errors without retraining large multimodal models.

17.
PLOS Medicine 2026-05-21

U = U for all: Advancing equity in HIV prevention

by Thiago S. Torres, Paula M. Luz Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U = U). However, U = U literacy remains unevenly understood and shared, and stigmas persist. Equitable and accurate awareness of U = U requires culturally tailored interventions, improved provider education, and supportive policy environments beyond biomedical evidence alone. Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U=U). However, U=U literacy remains unevenly understood and shared, and stigmas persist. In this Perspective, Thiago Torres and Paula Luz outline what is needed to improve equity and accuracy in global awareness and education of U=U.

18.
arXiv (CS.LG) 2026-06-16

deFOREST: Fusing Optical and Radar satellite data for Enhanced Sensing of Tree-loss

arXiv:2510.14092v2 Announce Type: replace-cross Abstract: In this paper we develop a deforestation detection pipeline that incorporates optical and Synthetic Aperture Radar (SAR) data. A crucial component of the pipeline is the construction of anomaly maps of the optical data, which is done using the residual space of a discrete Karhunen-Lo\'{e}ve (KL) expansion. Anomalies are quantified using a concentration bound on the distribution of the residual components for the nominal state of the forest. This bound does not require prior knowledge on the distribution of the data. This is in contrast to statistical parametric methods that assume knowledge of the data distribution, an impractical assumption that is especially infeasible for high dimensional data such as ours. Once the optical anomaly maps are computed they are combined with SAR data, and the state of the forest is classified by using a Hidden Markov Model (HMM). We test our approach with Sentinel-1 (SAR) and Sentinel-2 (Optical) data on a $92\,km \times 92\,km$ region in the Amazon forest. The results show that both the hybrid optical-radar and optical only methods achieve high accuracy that is superior to the recent state-of-the-art hybrid method. Moreover, the hybrid method is significantly more robust in the case of sparse optical data that are common in highly cloudy regions.

19.
arXiv (CS.LG) 2026-06-24

Reconstructing GRACE Terrestrial Water Storage with Spatio-Temporal Graph Neural Networks: An Application to South America

arXiv:2606.23833v1 Announce Type: new Abstract: Terrestrial water storage (TWS) integrates snow, soil moisture, surface water, and groundwater and is a key indicator of how climate variability and human activity reshape the global water cycle. The GRACE and GRACE-FO satellite missions provide the only direct, globally consistent observations of TWS change, but their record only begins in 2002 which is too short for many climate-scale analyses. We present a deep learning application that reconstructs monthly GRACE-like TWS anomalies (TWSA) back to 1940 by learning the relationship between daily ERA5 meteorological forcing (precipitation, evapotranspiration, runoff) and monthly GRACE observations. In contrast to prior reconstruction approaches based on grid-cell-wise regression, CNNs, or LSTMs, we adapt a multi-variate time series graph neural network (MTGNN) architecture, which was originally developed for mobility and traffic forecasting on urban sensor networks to this satellite-geodesy task. Spatial dependencies are encoded in a static, interpretable hybrid adjacency matrix that combines geodesic proximity with lagged correlations of climatic time series, capturing both local hydrological coupling and large-scale teleconnections. The reconstruction achieves a grid-cell Pearson correlation of 0.69, a basin-mean correlation of 0.94, and a near-zero bias, and it reproduces the spatial fingerprints of the 2015/16 El Niño and 2020/21 La Niña events. A systematic comparison with established reconstruction approaches (GTWS-MLrec, RM-REC, GRAiCE) shows that the graph-based model is statistically competitive at basin scale, reaching a correlation within 0.025 of the best baseline while using only roughly half to a tenth of the predictors the other models require and revealing characteristic weaknesses in arid regions in all models. The complete implementation is publicly available at github.com/hcu-cml/MTGNN-TWS-Reconstruction-GRACE

20.
arXiv (CS.LG) 2026-06-11

Learning from almost nothing: How neural networks survive heavy input corruption

arXiv:2606.11319v1 Announce Type: new Abstract: Learning from imperfect data is a central theme in machine learning, connecting practical questions of robustness to fundamental questions of learnability. Here we examine attribute noise: learning from corrupted inputs while keeping the labels intact, a setting that has received considerably less analytical attention than its label-noise counterpart. We consider two types of corruption models: additive noise and replacement noise. Through experiments with multi-layer perceptrons (MLPs) on corrupted classification datasets, we find that neural networks remain robust, maintaining well-above-chance accuracy even when inputs are >90% corrupted – far beyond human recognition. To understand this robustness, we analyze infinite-width networks in the heavy-corruption regime using a mean-field-inspired approach and derive a leading-order decision rule for the classification outcome: the network implements a prototype rule, the nearest-class-mean, assigning each test point to the class whose training-set average it most closely resembles. This leading-order decision rule is universal across a broad range of MLP architectures, holding for any depth, as well as a wide class of activation functions and noise distributions. The same centroid mechanism closely matches finite-width network behavior in our experiments and provides an interpretable and analytically tractable account of why learning can succeed even when individual training examples carry almost no signal.

21.
medRxiv (Medicine) 2026-06-19

Cardiometabolic multimorbidity and care experiences in primary healthcare among Brazilian adults aged 50 and over (ELSI-Brazil)

Background: Population aging and the rising burden of non-communicable diseases have increased the prevalence of cardiometabolic multimorbidity (CM-MM) among older adults. Patient-reported experience measures (PREMs) are recognized as essential components of healthcare quality assessment, yet evidence on primary care experiences among individuals with CM-MM remains scarce. Objective: To analyze primary care experiences according to the presence of cardiometabolic multimorbidity among Brazilians aged 50 years and older. Methods: Cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021; n = 9,949). CM-MM was defined as the self-reported coexistence of two or more of the following conditions: hypertension, diabetes mellitus, dyslipidemia, acute myocardial infarction, and stroke. Primary care experiences were assessed using a validated 12-item instrument organized into four domains: first-contact access, longitudinality, communication, and care coordination. Associations were estimated using Poisson regression adjusted for sociodemographic, health conditions, and healthcare utilization variables, with stratified analysis by Family Health Strategy (FHS) coverage. Results: CM-MM prevalence was 25.5%, with a progressive increase by age and an inverse gradient by education. Individuals with CM-MM reported significantly more positive experiences in longitudinality (mean index 2.53 vs. 2.34; adjusted PR = 1.22; 95%CI 1.12-1.33; p < 0.001) and, to a lesser extent, in communication (mean index 2.68 vs. 2.58; adjusted PR = 1.10; 95%CI 1.00-1.20; p = 0.041). No statistically significant differences were found in first-contact access or care coordination. After stratified by FHS coverage, the observed differences in longitudinality and communication were no longer statistically significant. Conclusions: CM-MM was associated with more positive primary care experiences in longitudinality and communication. The absence of differentiated experiences in first-contact access and coordination highlights structural gaps in primary care responsiveness to individuals with greater clinical complexity. Keywords: Multimorbidity; Cardiometabolic diseases; Primary Care; Patient-reported experience measures; Older adults; ELSI-Brazil.

22.
arXiv (CS.LG) 2026-06-11

Energy Use of AI Inference, Efficiency Pathways, and Test-Time Scaling

arXiv:2509.20241v2 Announce Type: replace Abstract: As AI inference scales to billions of queries, estimates of per-query energy use are increasingly important for capacity planning, efficiency interventions, and policy. Yet many public estimates assume non-production settings, leading to systematic overestimation. We introduce a bottom-up framework estimating inference energy from token throughput, node power, and overhead under large-scale deployment assumptions. For frontier-scale models (>200B parameters) on H100 nodes, we estimate a median energy of 0.31 Wh/query (IQR 0.16-0.60), indicating widely cited estimates are overstated by 4-20x. In test-time scaling scenarios 15x longer than typical queries, the median energy rises 13x to 3.91 Wh (IQR 2.15-7.05). Across models, serving systems, and hardware, we estimate 8-20x line-of-sight energy reductions. At datacenter scale, serving 1 billion queries/day requires 0.7 GWh; if 10% are long queries, demand rises to 1.7 GWh/day. With efficiency interventions, it falls to 0.8 GWh/day, mitigating the energy impact of test-time scaling.

23.
medRxiv (Medicine) 2026-06-17

Performance of five risk stratification tools for paediatric pneumonia against WHO scores using data from the PediCAP trial in sub-Saharan Africa

Background Risk stratification tools for childhood pneumonia have been proposed to improve identification of children at highest risk of death, particularly in low-resource settings. However, their added value over the WHO Integrated Management of Childhood Illness (IMCI) criteria and danger signs remains uncertain. Methods We conducted a secondary analysis of a multi-country randomised controlled trial of children without HIV hospitalised with pneumonia in Mozambique, South Africa, Uganda, Zambia, and Zimbabwe. We evaluated the performance of five published risk scores alongside WHO IMCI severity classification and danger signs. Discrimination for (1) in-hospital mortality, (2) 28-day mortality, and (3) 28-day readmission or death was assessed using area under the receiver operating characteristic curve (AUC). Comparative performance and clinical utility were examined. Results Of the 1010 participants, 18 (1.8%) died in hospital, 22 (2.2%) died in hospital or in the 7 days post-discharge, and 63 (6.2%) died or were readmitted by day 28. Univariate case-fatality rates were highest for variables associated with malnutrition, convulsions, and hypoxaemia. All risk scores demonstrated moderate discrimination for in-hospital and in-hospital+7-day mortality (AUC range approximately 0.75-0.84), with no meaningful differences between models, and performed similarly to the WHO danger signs and IMCI severity classification. In contrast, all approaches performed poorly in predicting 28-day readmission or death (AUC approximately 0.54-0.58). No risk score consistently outperformed simple clinical criteria. Conclusions In this multi-country dataset, we found no evidence that published paediatric pneumonia risk scores meaningfully outperform WHO IMCI-based clinical assessment for predicting mortality. The relatively small number of mortality events limits precision, and modest differences cannot be excluded. These findings suggest that, in low-resource settings, strengthening implementation of existing WHO clinical criteria may be more effective than adopting more complex prediction tools.

24.
medRxiv (Medicine) 2026-06-17

The Unreliable Judges: Assessing Reproducibility and Self-Preference Bias of LLMs as Free-Text Evaluators

Large Language Models (LLMs) are transforming clinical practice and research, but their adoption requires rigorous evaluation. While human assessment is ideal, its cost has driven the widespread use of LLMs as evaluators. We introduce an open-source reciprocal framework comparing 71 human experts against six LLMs. AI evaluators show a strong self-preference bias, yet neither group reliably identified whether a response was human- or AI-generated. AI scores correlated with surface features such as length and lexical diversity, whereas human scores did not. By probing the evaluator's hidden states and applying targeted steering, we show that verbosity is a major causal driver of the bias. Moreover, shuffling question-response pairings shows that long responses keep high scores even when they no longer answer the question, whereas short ones do not, demonstrating that AI judges reward verbosity largely independently of content alignment. Finally, API-based and batch inference inflate stochasticity, underscoring the need for controlled deployment.

25.
medRxiv (Medicine) 2026-06-22

Modelling the decadal expansion of West Nile virus in Italy: the role of climatic, anthropogenic, and macroecological drivers

Abstract BACKGROUND West Nile virus (WNV) is a growing health burden in Italy. Anticipating human infection risk is hampered by the pathogen's complex ecology, highlighting the need for comprehensive early-warning tools. AIM We aimed to model municipal-level WNV risk in Italy and characterize its decadal expansion in Italy, providing a comprehensive ecological understanding of viral emergence. METHODS We applied a machine learning framework to annual human WNV case data from 2014 to 2024. The model integrated a suite of environmental, socio-economic, and macroecological predictors to generate risk projections. We evaluated the model's performance through multiple validation settings. We also performed an anticipation test for the 2025 epidemic season, using 2024 environmental data to assess the model's predictive accuracy against observed 2025 human cases. RESULTS Our model achieved robust performance (True Skill Statistic > 0.4) and captured WNV progressive expansion from 184 predicted positive municipalities in 2014 to 2,012 in 2024 (an 11-fold increase in 11 years). Seasonal minimum temperature was the primary risk driver, followed by monitoring year and population density, indicating active spatial spread. Environmental suitability consistently preceded clinical detection. Municipalities with cases in 2023-2024 exhibited significantly higher predicted suitability during 2018-2022 than those without cases (average risk 0.58 vs 0.20). Our model successfully identified emerging risk hotspots along the Adriatic coast and southern Italy before the official human spillover of 2025. CONCLUSION Embedding macroecological drivers into WNV risk modelling provides an improved understanding of drivers of rapid WNV expansion. Our model enables proactive risk mapping, surveillance efforts, and targeted public health measures.