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

Automated jailbreak attack targeting multiple defense strategies

arXiv:2606.16751v1 Announce Type: cross Abstract: Large language models (LLMs) have demonstrated remarkable capabilities across a wide range of tasks. However, their safety remains a critical concern due to their susceptibility to adversarial prompt-based attacks. In this paper, we present UNIATTACK, an adversarial testing framework designed from a defense-oriented perspective to systematically construct effective black-box attack prompts. Unlike prior approaches that rely on static templates or iterative model-specific tuning, UNIATTACK extracts minimal but high-impact attack features from diverse existing attacks, optimizes them via a specialized attacker LLM, and composes them into flexible templates through automated refinement process. This feature-centric construction enables one-shot attacks that generalize across multiple models and safety categories, providing a practical tool for assessing LLM robustness. Our evaluation results shows that compared to the baselines, UNIATTACK achieves an average attack success rate (ASR) improvement of 64.63\%-248.82\% on models deployed with multi-layered defense mechanisms and it only takes 0.03\%-4.96\% cost of the baselines. UNIATTACK artifact is available at https://anonymous.4open.science/r/UniAttack-Artifact-30F1.

02.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

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

Loss Landscape Poisoning: Targeted Extraction of Unseen Training Data from LLMs

arXiv:2606.17110v1 Announce Type: cross Abstract: Large Language Models are increasingly trained on proprietary or sensitive data, from private healthcare and financial records to user conversations containing secrets. Ensuring the privacy of such data against extraction attacks has become a central concern. In this paper, we ask whether an attacker who can poison a portion of the training data can facilitate the leakage of a separate target record they have no access to. We answer in the affirmative and show that such leakage can be induced by a poisoning mechanism that reshapes the model's local loss landscape around the target completion. Our key insight is that poisoning to create a sharp loss minimum at the target, surrounded by elevated loss on nearby alternatives, forces the model to memorize the target as the unique low-loss solution in its neighborhood. The attack requires no architectural changes, and generalizes across centralized and federated learning settings. We demonstrate that the attack amplifies privacy leakage across language (up to 100% successful extraction), and vision-language models (up 90% successful extraction). We show that the attack is thwarted when the model is trained to be differentially private. However, we introduce a new attack that directly probes the loss landscape bypassing even differential privacy defenses.

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

SpikeTAD: Spiking Neural Networks for End-to-End Temporal Action Detection

Video understanding is a crucial part of computer vision, with numerous application scenarios. With the increasing popularity of mobile devices, an increasing number of efforts are trying to deploy video understanding models on them. However, existing video understanding models are difficult to deploy due to their large size and prohibitive power consumption. Spiking Neural Networks (SNNs) have shown bioplausibility and low power advantages over Artificial Neural Networks (ANNs), especially on neuromorphic chips which are regarded as essential components of future mobile devices. However, excessively long conversion time-steps and severe performance degradation problems limit their application. To solve the problems above, we explore the application of SNNs on temporal action detection (TAD), which is an important task in video understanding, and propose the first SNN-based end-to-end TAD architecture coined as SpikeTAD. While maintaining extremely low power consumption, SpikeTAD achieves an average mAP of 67.2% in THUMOS14 and 37.42% in ActivityNet-1.3, demonstrating the feasibility of a low-power TAD model. Our code is available at https://github.com/MCG-NJU/SpikeTAD.

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

OccAny: Generalized Unconstrained Urban 3D Occupancy

Relying on in-domain annotations and precise sensor-rig priors, existing 3D occupancy prediction methods are limited in both scalability and out-of-domain generalization. While recent visual geometry foundation models exhibit strong generalization capabilities, they were mainly designed for general purposes and lack one or more key ingredients required for urban occupancy prediction, namely metric prediction, geometry completion in cluttered scenes and adaptation to urban scenarios. We address this gap and present OccAny, the first unconstrained urban 3D occupancy model capable of operating on out-of-domain uncalibrated scenes to predict and complete metric occupancy coupled with segmentation features. OccAny is versatile and can predict occupancy from sequential, monocular, or surround-view images. Our contributions are three-fold: (i) we propose the first generalized 3D occupancy framework with (ii) Segmentation Forcing that improves occupancy quality while enabling mask-level prediction, and (iii) a Novel View Rendering pipeline that infers novel-view geometry to enable test-time view augmentation for geometry completion. Extensive experiments demonstrate that OccAny outperforms all visual geometry baselines on 3D occupancy prediction task, while remaining competitive with in-domain self-supervised methods across three input settings on two established urban occupancy prediction datasets. Our code is available at https://github.com/valeoai/OccAny .

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

ReMoT: Reinforcement Learning with Motion Contrast Triplets

We present ReMoT, a unified training paradigm to systematically address the fundamental shortcomings of VLMs in spatio-temporal consistency – a critical failure point in navigation, robotics, and autonomous driving. ReMoT integrates two core components: (1) A rule-based automatic framework that generates ReMoT-16K, a large-scale (16.5K triplets) motion-contrast dataset derived from video meta-annotations, surpassing costly manual or model-based generation. (2) Group Relative Policy Optimization, which we empirically validate yields optimal performance and data efficiency for learning this contrastive reasoning, far exceeding standard Supervised Fine-Tuning. We also construct the first benchmark for fine-grained motion contrast triplets to measure a VLM's discrimination of subtle motion attributes (e.g., opposing directions). The resulting model achieves state-of-the-art performance on our new benchmark and multiple standard VLM benchmarks, culminating in a remarkable 25.1% performance leap on spatio-temporal reasoning tasks.

07.
arXiv (quant-ph) 2026-06-16

Quantum learning with a single-atom sensor

arXiv:2606.15071v1 Announce Type: new Abstract: The ability to gather information and to act upon it is at the core of every learning agent. But what is the impact of quantum mechanics on an agent's ability to sense external inputs and to translate them into actions? Here we address the question for a prototype task of learning agency at the quantum scale: rotating a single spin based on information gathered by a single atom. We determine the ultimate performance limit for this task, revealing a fundamental tradeoff between entanglement at the sensing stage and coherence at the action stage: if the single-atom sensor is not entangled with the quantum system serving as the agent's internal memory, then the best learning strategy requires a coherent transfer of quantum information from the sensor to the system that controls the agent's actions. In contrast, if the sensor is initially entangled with the agent's memory, then the transfer of quantum information is no longer necessary. Our results indicate that the quantum properties of the sensor radically affect the optimal way to convert external stimuli into actions, revealing a link between quantum sensing and the behavior of quantum agents.

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

Autonomous Event-Driven Multi-Agent Orchestration for Enterprise AI at Scale

arXiv:2606.20058v1 Announce Type: new Abstract: Enterprise AI aims to move toward continuous event monitoring, detection, and action across specialist agents, yet existing multi-agent systems largely assume discrete request-response workflows and remain underexplored at enterprise scale. We evaluate DAG Plan and Execute and ReAct across 208 production-derived enterprise scenarios spanning Persona (

09.
arXiv (CS.CV) 2026-06-16

BBR-Net: Boundary-Balanced Replay for Continual Medical Image Segmentation

Continual learning for medical image segmentation remains challenging under domain shift because replay-based methods often preserve appearance information without explicitly modeling anatomical structure. This study investigates whether structural consistency governs knowledge retention in continual cardiac ultrasound segmentation. We propose the Boundary-Balanced Replay Network (BBR-Net), which selects replay samples using boundary-aware priority and class balance to preserve anatomically informative regions. The method is evaluated on CAMUS and CardiacNet under forward (CAMUS to CardiacNet) and reverse (CardiacNet to CAMUS) task orders. In the forward setting, BBR-Net retains source-task performance close to an offline joint-training reference, while markedly reducing catastrophic forgetting and preserving competitive target-task adaptation. Ablation results show that boundary-aware prioritization contributes to retention and improves the balance between source-task preservation and target-task adaptation when combined with class-aware sampling. In contrast, the reverse setting reveals that structure-aware replay fails when initial representations are learned from noisy and structurally inconsistent data. To isolate this effect, we conduct a controlled structural perturbation analysis by progressively corrupting source-task boundaries while keeping the dataset, architecture, and training protocol fixed. Forgetting increases consistently as structural reliability decreases, suggesting that replay effectiveness is strongly influenced by the quality of stored structural information, rather than by memory capacity alone. These findings indicate that preserving anatomical structure under domain shift is a central factor in continual medical image segmentation, and that replay mechanisms should account for structural reliability to support robust knowledge retention.

10.
arXiv (CS.CV) 2026-06-18

Prior-guided Fusion of Multimodal Features for Change Detection from Optical-SAR Images

Multimodal change detection (MMCD) identifies changed areas in multimodal remote sensing data, demonstrating significant application value in land use monitoring and urban sustainable development. However, literature MMCD approaches exhibit limitations in both cross-modal interaction and exploiting modality-specific characteristics. This leads to insufficient modeling of fine-grained change information, thus hindering the precise detection of semantic changes. To address these problems, we propose STSF-Net, a framework designed for MMCD between optical and SAR images. STSF-Net jointly models modality-specific and spatio-temporal common features to enhance change representations. Specifically, modality-specific features are exploited to capture genuine semantic change signals, while spatio-temporal common features are embedded to suppress pseudo-changes caused by differences in imaging mechanisms. Furthermore, we introduce an optical and SAR feature fusion strategy that adaptively adjusts multimodal feature importance based on semantic priors obtained from visual foundation models. Finally, we introduce the novel Delta-SN6 dataset, the first openly-accessible multiclass MMCD benchmark consisting of very-high-resolution fully polarimetric SAR and optical images. Experimental results on Delta-SN6, BRIGHT, and Wuhan datasets demonstrate that our method outperforms the state-of-the-art by 3.21%, 0.87%, and 1.32% in mIoU, respectively.

11.
arXiv (CS.AI) 2026-06-15

An interpretable unsupervised representation learning for high precision measurement in particle physics

arXiv:2511.22246v2 Announce Type: replace-cross Abstract: Unsupervised learning has been widely applied to various tasks in particle physics. However, existing models lack precise control over their learned representations, limiting physical interpretability and hindering their use for accurate measurements. We propose the Histogram AutoEncoder (HistoAE), an unsupervised representation learning network featuring a custom histogram-based loss that enforces a physically structured latent space. Applied to silicon microstrip detectors, HistoAE learns an interpretable two-dimensional latent space corresponding to the particle's charge and impact position. After simple post-processing, it achieves a charge resolution of $0.25\,e$ and a position resolution of $3\,\mu\mathrm{m}$ on beam-test data, comparable to the conventional approach. These results demonstrate that unsupervised deep learning models can enable physically meaningful and quantitatively precise measurements. Moreover, the generative capacity of HistoAE enables straightforward extensions to fast detector simulations.

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

DiffCoord: Differentiable Coordination for Distributed Multi-Agent Trajectory Optimization

arXiv:2509.01630v3 Announce Type: replace Abstract: Integrating the Alternating Direction Method of Multipliers (ADMM) with Differential Dynamic Programming (DDP) provides a scalable framework for distributed multi-agent trajectory optimization. In practice, ADMM is typically truncated for computational efficiency, tightly coupling parameters that would otherwise separately govern coordination quality and task performance. In this paper, we propose Differentiable Coordination (DiffCoord), a unified framework that jointly meta-learns these coupled parameters for the truncated ADMM-DDP pipeline. These parameters are generated by agent-wise neural networks for task adaptation, and the same networks are shared among isomorphic agents to enable scalability to varying agent counts. We achieve efficient meta-learning by differentiating the ADMM-DDP pipeline end-to-end. Notably, this yields an auxiliary ADMM-LQR distributed gradient solver that computes and coordinates meta-gradients with respect to these parameters. This solver inherits the computational structure of the pipeline, enabling reuse of key computation results and efficient parallelization over agents and along trajectory horizons. We validate DiffCoord through numerical and physical experiments on a cooperative aerial transport system, where it reconfigures quadrotor formations for safe 6-DoF load manipulation in tight spaces. It adapts robustly to varying team sizes and load dynamics, while reducing per-agent gradient computation time by up to 70% compared with state-of-the-art trajectory-gradient methods.

13.
arXiv (CS.LG) 2026-06-12

ResidualPlanner+: a scalable matrix mechanism for marginals and beyond

arXiv:2305.08175v5 Announce Type: replace-cross Abstract: Noisy marginals are a common form of confidentiality protecting data release and are useful for many downstream tasks such as contingency table analysis, construction of Bayesian networks, and even synthetic data generation. Privacy mechanisms that provide unbiased noisy answers to linear queries (such as marginals) are known as matrix mechanisms. We propose ResidualPlanner and ResidualPlanner+, two highly scalable matrix mechanisms. ResidualPlanner is both optimal and scalable for answering marginal queries with Gaussian noise, while ResidualPlanner+ provides support for more general workloads, such as combinations of marginals and range queries or prefix-sum queries. ResidualPlanner can optimize for many loss functions that can be written as a convex function of marginal variances (prior work was restricted to just one predefined objective function). ResidualPlanner can optimize the accuracy of marginals in large scale settings in seconds, even when the previous state of the art (HDMM) runs out of memory. It even runs on datasets with 100 attributes in a couple of minutes. Furthermore, ResidualPlanner can efficiently compute variance/covariance values for each marginal (prior methods quickly run out of memory, even for relatively small datasets). ResidualPlanner+ provides support for more complex workloads that combine marginal and range/prefix-sum queries (e.g., a marginal on race, a range query on age, and a combined race/age tabulation that answers age range queries for each race). It even supports custom user-defined workloads on different attributes. With this added flexibility, ResidualPlanner+ is not necessarily optimal, however it is still extremely scalable and outperforms the prior state-of-the-art (HDMM) on prefix-sum queries both in terms of accuracy and speed.

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

All-Mem: Agentic Lifelong Memory via Dynamic Topology Evolution

Lifelong interactive agents are expected to assist users over months or years, which requires continually writing long term memories while retrieving the right evidence for each new query under fixed context and latency budgets. Existing memory systems often degrade as histories grow, yielding redundant, outdated, or noisy retrieved contexts. We present All-Mem, an online/offline lifelong memory framework that maintains a topology structured memory bank via explicit, non destructive consolidation, avoiding the irreversible information loss typical of summarization based compression. In online operation, it anchors retrieval on a bounded visible surface to keep coarse search cost bounded. Periodically offline, an LLM diagnoser proposes confidence scored topology edits executed with gating using three operators: Split, Merge, and Update, while preserving immutable evidence for traceability. At query time, typed links enable hop bounded, budgeted expansion from active anchors to archived evidence when needed. Experiments on LoCoMo and LongMemEval-s show improved retrieval and QA over representative baselines. The code is available at https://github.com/LvCan926/All-Mem.

15.
arXiv (CS.CV) 2026-06-11

Natural-Language Temporal Grounding in Hour-Long Videos is a Search Problem: A Benchmark and Empirical Decomposition

Temporal grounding–returning the interval $[t_s, t_e]$ for a natural-language query over a video–is the language interface to long-form video, yet has been studied on short videos; the dynamics of hour-scale natural-language grounding remain underexplored. We take the position that at hour-scale, the binding constraint is search, not recognition: Video-LLMs are bottlenecked not by localizing a nearby event, but–given a natural-language query–by searching for the relevant region of a long video. To test this, we release ExtremeWhenBench, the first open hour-scale grounding benchmark (2,273 queries over 194 videos, mean 75.7 min, max 9 hr) with an open-form query distribution. Every open Video-LLM collapses while a frame-level retrieval baseline outperforms them; a failure taxonomy attributes 85% of failures to search; and a retrieve-then-ground hybrid recovers 6.7x over the monolithic Video-LLM–mirroring retrieve-then-read in open-domain QA.

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

SAM3 Self-Distillation for Fine-Grained GOOSE 2D Semantic Segmentation

作者:

We describe our 4th-place entry to the ICRA 2026 GOOSE 2D Fine-Grained Semantic Segmentation Challenge, which reached a composite mean Intersection-over-Union (mIoU) of 69.73% on the official 1,815-image test set. Our model adapts the image encoder of a recent visual foundation model, Segment Anything Model 3 (SAM3), with a lightweight decoder. Beyond this, we contribute two techniques and one empirical finding: (i) a self-distillation scheme that re-uses SAM3 itself, prompted with ground-truth boxes, as a teacher on the classes where it outperforms our own model; (ii) an image-level multi-scale test-time augmentation scheme that restores multi-scale inference for a fixed-input-size model by rescaling the image rather than the model input; and (iii) the finding that an aggressive photometric distortion from a winning 2025 GOOSE 2D entry, transplanted onto our pipeline, is its single largest source of improvement.

17.
arXiv (quant-ph) 2026-06-12

Efficient certification of intractable quantum states with few Pauli measurements

arXiv:2511.07300v2 Announce Type: replace Abstract: Efficient verification of quantum computational resources is crucial as experiments advance toward fault-tolerance. Universal quantum computation can be achieved by consuming resource states through simple Pauli measurements, yet a significant gap remains between states that are easy to certify and those required for universality. We focus on Clifford-enhanced Product States, a class of resource states obtained by applying Clifford circuits to a product of single-qubit, potentially magic, states. While essential for universal computation, the certification of such states has previously relied on query oracles that are \#P-hard to implement, leaving their efficient, oracle-free verification an open challenge. In this work, we demonstrate that such classically intractable resource states can be efficiently verified using only Pauli measurements. Our protocol achieves sample- and time-efficiency in both i.i.d.\ and adversarial settings. This work fills a gap in Pauli-based certification, providing a new practical pathway to verify resource states that drive universal Pauli-based quantum computation.

18.
arXiv (CS.LG) 2026-06-19

DisjunctiveNet: Neural Symbolic Learning via Differentiable Convexified Optimization Layers

arXiv:2605.30456v2 Announce Type: replace Abstract: Many learning tasks in science and engineering are characterized by sparse datasets, which limits the effectiveness of purely data-driven approaches. At the same time, these problems are often accompanied by rich domain knowledge derived from physical laws, operational requirements, and expert heuristics. Such knowledge is frequently expressed as rules involving logical propositions and linear inequalities. Existing neuro-symbolic methods typically enforce these rules approximately through soft penalties, assume input-independent rules when designing specialized architectures, or rely on non-differentiable post-processing at inference time to achieve hard constraint satisfaction. While recent advances in differentiable optimization layers enable end-to-end feasibility enforcement within neural networks, extending these approaches to logical or mixed-integer rules remains challenging due to inherent nonconvexity. In this work, we propose a unified end-to-end framework for enforcing hard, input-dependent mixed integer linear constraints within neural networks. Our approach represents rules as disjunctive constraints and applies hierarchical convex relaxations to obtain convex hull formulations. These relaxations yield tractable linear constraints that can be embedded as differentiable optimization layers while enabling exact rule satisfaction. We demonstrate the effectiveness of the proposed framework on real-world datasets, achieving perfect rule satisfaction and strong predictive performance.

19.
arXiv (quant-ph) 2026-06-17

Impulse Decoding of Quantum LDPC Codes: Equivalence of Degeneracy and Code-Shortening

arXiv:2606.18240v1 Announce Type: new Abstract: Quantum error correction is essential for building scalable quantum computers. Within the stabilizer formalism, the Calderbank-Shor-Steane framework constructs quantum codes from pairs of classical linear codes. A distinctive feature in this setting is degeneracy, where multiple equivalent error estimates exist-a phenomenon that has no classical counterpart, and the lack of a meaningful classical coding-theoretic interpretation of which has remained a gap in the literature. In this paper, we demonstrate that degeneracy is closely related to the classical operation of shortening of a linear block code. Interestingly, the shortening here takes place at the decoder rather than at the encoder. Leveraging this insight, we present a parallel decoding scheme for quantum low-density parity-check codes, which we term impulse decoding, that significantly outperforms belief propagation with ordered statistics decoding, as well as several other existing techniques, under both code-capacity and circuit-level noise, with significantly lesser complexity. We then present another algorithm based on decoding of residual errors, which when combined with impulse decoding achieves further performance improvement under circuit-level noise.

20.
PLOS Medicine 2026-05-06

Point-of-care early infant HIV diagnosis at birth in a pragmatic cluster-randomized trial in Mozambique and Tanzania: A comparative cost and cost-effectiveness study

by Kira Elsbernd, Issa Sabi, Ilesh V. Jani, Chishamiso Mudenyanga, Siriel Boniface, Arlete Mahumane, Joaquim Lequechane, Falume Chale, Bindiya Meggi, Kassia Pereira, Raphael Edom, Anange F. Lwilla, W. Chris Buck, Nyanda Elias Ntinyinya, Michael Hoelscher, Till Baernighausen, Arne Kroidl, Stefan Kohler, the LIFE Study Consortium Background Timely access to early infant diagnosis (EID) is crucial for newborns with HIV, as late diagnosis can delay lifesaving antiretroviral treatment (ART). We assessed the comparative cost and cost-effectiveness of integrating point-of-care EID at birth into routine care in primary healthcare settings. Methods and findings This pre-specified secondary analysis was nested in the cluster-randomized LIFE study conducted at 28 primary healthcare facilities in Mozambique and Tanzania from October 2019 to September 2021. We estimated the health system cost of point-of-care birth plus 4–8-week HIV testing (very early infant diagnosis; VEID) compared to standard-of-care (SoC) testing at 4–8 weeks only, both with immediate ART initiation. We assessed the cost-effectiveness of VEID relative to SoC with respect to ART initiation within one week of life using Bayesian hierarchical models. As this is an intermediate outcome, incremental cost-effectiveness ratios (ICERs) cannot be directly compared to available life-year-based cost-effectiveness thresholds. To contextualize results, we derived the minimum life-years gained per early ART initiation required for VEID to meet standard thresholds in a break-even analysis.VEID was associated with a higher cost and resulted in earlier ART initiation than SoC in both countries. In Mozambique, VEID increased the proportion of infants initiating ART within one week of life by 90.0 (95% CrI [67.5, 98.5]) percentage points at an incremental cost of $2,632 (95% CrI [$2,249, $3,062]) per infant with HIV. In Tanzania, VEID increased early ART initiation by 59.9 (95% CrI [20.9, 89.5]) percentage points at an incremental cost of $6,263 (95% CrI [$5,394, $7,243]) per infant with HIV. The ICER was $2,924 and $10,458 in Mozambique and Tanzania, respectively and was sensitive to intrauterine transmission rate. These findings were limited by the lack of long-term health outcome data and reliance on an intermediate outcome. Based on the break-even analysis, we estimated that VEID would need to yield 6–32 life-years gained per additional early ART initiation to meet standard thresholds. Conclusions Adding birth testing improved early ART initiation but was unlikely to be cost-effective relative to standard thresholds given current prices, vertical transmission rates, and knowledge of long-term health benefits. Cost-effectiveness could be achieved at current costs if early ART translates to substantial long-term health benefits or if targeted to infants at high risk of vertical transmission.

21.
arXiv (CS.AI) 2026-06-11

Sample-Efficient Hypergradient Estimation for Decentralized Bi-Level Reinforcement Learning

arXiv:2603.14867v4 Announce Type: replace-cross Abstract: Many strategic decision-making problems, such as environment design for warehouse robots, can be naturally formulated as bi-level reinforcement learning (RL), where a leader agent optimizes its objective while a follower solves a Markov decision process (MDP) conditioned on the leader's decisions. In many situations, a fundamental challenge arises when the leader cannot intervene in the follower's optimization process; it can only observe the optimization outcome. We address this decentralized setting by deriving the hypergradient of the leader's objective, i.e., the gradient of the leader's strategy that accounts for changes in the follower's optimal policy. Unlike prior hypergradient-based methods that require extensive data for repeated state visits or rely on gradient estimators whose complexity can increase substantially with the high-dimensional leader's decision space, we leverage the Boltzmann covariance trick to derive an alternative hypergradient formulation. This enables efficient hypergradient estimation solely from interaction samples, even when the leader's decision space is high-dimensional. Additionally, to our knowledge, this is the first method that enables hypergradient-based optimization for 2-player Markov games in decentralized settings. Experiments highlight the impact of hypergradient updates and demonstrate our method's effectiveness in both discrete and continuous state tasks.

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

Sorries Are Not the Hard Part: An Expert-Review Case Study of a Semi-Autonomous Formalization

arXiv:2606.13925v1 Announce Type: new Abstract: Large language models can often close proof gaps in interactive theorem provers, but a verified theorem is not the same thing as a reusable library contribution. We study this distinction through a detailed case study: a semi-autonomous formalization of Grothendieck's vanishing theorem. The initial version compiles with no sorries, but an expert review found serious problems in definitions, theorem generality, file organization, and the API. We then ran a review-driven refactor and compression process and obtained a second expert review. The before-and-after comparison shows a sharp split: agents adapted well to local, mechanically checkable feedback, but remained weak at choosing definitions and designing APIs. We argue that autoformalization should be evaluated not only by closed sorries, but by whether the resulting formalization survives expert review.

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

Compatibility-Aware Dynamic Fine-Tuning for Large Language Models

Supervised Fine-Tuning (SFT) is the predominant paradigm for aligning large language models (LLMs), yet it suffers from optimization instability and limited generalization. Recent work attributes this issue to pathological gradient scaling and proposes Dynamic Fine-Tuning (DFT) to correct it at the token level. However, DFT assumes all demonstrations are equally suitable learning targets, an assumption violated by the strong heterogeneity of large-scale instruction data, where demonstration-policy mismatch induces high-variance updates at the sample level. We introduce Compatibility-Aware Dynamic Fine-Tuning (CADFT), a principled extension of DFT that controls sample-level optimization variance. CADFT derives a dynamic, policy-dependent compatibility signal from model likelihoods to modulate supervised updates, suppressing high-variance gradients from incompatible demonstrations. We further propose a delayed, low-frequency compatibility-guided rewriting strategy to transform persistently incompatible demonstrations into learnable targets. We show that CADFT can be interpreted as a variance-controlled estimator that generalizes token-level stabilization in DFT to the sample level. Extensive experiments demonstrate improved stability, generalization, and cold-start reinforcement learning initialization, while remaining fully supervised and independent of explicit reward modeling.

24.
arXiv (quant-ph) 2026-06-12

Hamiltonian-Aware ADAPT Variational Quantum Eigensolver for Molecular Ground-State Simulation

arXiv:2606.13118v1 Announce Type: new Abstract: Designing compact ansätze in Variational Quantum Eigensolver (VQE) is crucial for solving energetic problems of practical molecules on near-term quantum devices. However, existing Adaptive Derivative-Assembled Pseudo-Trotter (ADAPT) ansätze face two challenges: improper operator selection and accumulation of degraded operators. In this paper, we propose the Hamiltonian-Aware (HA) ADAPT-VQE algorithm to address these issues. First, we establish a novel excitation operator selection criterion. It breaks the local constraint of existing criteria by incorporating Hamiltonian information, prioritizes physically meaningful excitation operators, and incurs no extra classical or quantum computational overhead. Furthermore, we develop a problem-adaptive method for discriminating and pruning redundant excitation operators stemming from improper selection and inevitable degradation. This method balances redundant operator pruning and convergence guarantee, and is applicable to ansätze with arbitrary scales. Systematic numerical experiments on typical strongly correlated molecular systems demonstrate that our HA-ADAPT-VQE avoids energy plateaus and outperforms baseline algorithms in terms of energy error, ansatz size, and measurement cost. This work offers an efficient, robust ansatz construction paradigm, facilitating the development and practical deployment of large-scale VQE in quantum chemistry.

25.
arXiv (CS.AI) 2026-06-12

BASENet: Band-Adapted Speech Enhancement Network with Cross-Band Attention

arXiv:2606.12662v1 Announce Type: cross Abstract: Speech enhancement models typically apply uniform capacity across all frequencies, disregarding the non-uniform spectral resolution of human hearing. We propose BASENet, a frequency-adapted architecture that partitions the spectrum into Bark-scale bands and assigns each a scaled-capacity encoder derived from critical-band density, automatically granting deeper branches to perceptually dense low frequencies and lighter ones to high frequencies. A cross-band attention module captures harmonic dependencies across bands through compact frequency-pooled representations at linear complexity. Built on inverted residual blocks with dense connectivity and a convolutional recurrent network, BASENet achieves 3.55 PESQ and STOI~96% on VoiceBank+DEMAND with only 0.83M parameters and 7.3 G~MACs, the fewest parameters among all methods with PESQ > 3.50. A causal variant (3.44 PESQ) surpasses several non-causal baselines, confirming suitability for real-time streaming on resource-constrained devices.