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01.
bioRxiv (Bioinfo) 2026-06-18

Structure-Based Immunoinformatics Design of a CTB-Adjuvanted Multi-Epitope Mucosal Vaccine Against Helicobacter pylori

Background: Helicobacter pylori coloniz the gastric mucosa of nearly half of the global population and is classified as a Group I carcinogen by the World Health Organization due to its strong association with gastric cancer. The growing prevalence of antibiotic-resistant H. pylori strains significantly compromises current therapeutic strategies, emphasizing the urgent need for effective prophylactic approaches. Research design and methods; In this study, a novel multi-epitope vaccine was designed targeting H. pylori, incorporating epitopes from four key virulence proteins: BabB, SabB, SabA, and VacA. Using an immunoinformatics-guided structural vaccinology approach, B- and T-cell epitopes were predicted, prioritized based on immunogenicity, conservation, population coverage, and non-homology to human proteins, and assembled into the final vaccine construct. To enhance immunogenicity and specifically stimulate mucosal immune responses, the cholera toxin B subunit (CTB) was fused at the N-terminal via an EAAAK linker, a novel application in H. pylori multi-epitope vaccines. The PADRE universal epitope and additional linkers were incorporated to optimize epitope presentation and helper T-cell activation. Results: Comprehensive evaluations of physicochemical, antigenic, allergenic, and toxic properties were conducted, followed by secondary and tertiary structure modeling, refinement, and validation. Conformational B-cell epitopes were mapped, and molecular docking, binding affinity analysis, energy minimization, and molecular dynamics simulations confirmed structural stability and receptor interactions. Codon optimization and in silico cloning predicted efficient expression in Escherichia coli, while immune simulations suggested robust humoral and cellular responses. Conclusions: This study presents a promising multi-epitope vaccine candidate against H. pylori, offering a rational framework for future experimental validation and potential clinical application.

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

FLiP: Towards understanding and interpreting multimodal multilingual sentence embeddings

This paper presents factorized linear projection (FLiP) models for understanding pretrained sentence embedding spaces. We train FLiP models to recover the lexical content from multilingual (LaBSE), multimodal (SONAR) and API-based (Gemini) sentence embedding spaces in several high- and mid-resource languages. We show that FLiP can recall more than 75% of lexical content from the embeddings, significantly outperforming existing non-factorized baselines. Using this as a diagnostic tool, we uncover the modality and language biases across the selected sentence encoders and provide practitioners with intrinsic insights about the encoders without relying on conventional downstream evaluation tasks. Our implementation is public https://github.com/BUTSpeechFIT/FLiP.

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

Sum-of-Squares Degree Barriers for the Reweighted-Hinge Method in Robust Halfspace Learning: A Christoffel-Function Characterization

作者:

arXiv:2606.17215v1 Announce Type: new Abstract: A certificate that removes outliers sees the data only through its low-degree moments, and an adversary exploits exactly this, hiding corruption where the clean data already looks typical, in the blind spot no bounded-degree test resolves. That blind spot turns out to have an exact size: the Christoffel function of the clean marginal, the very quantity modern data analysis thresholds to detect outliers, here read from the adversary's side as the corruption a bounded-degree certificate cannot remove. We turn this inversion into the organizing principle of the reweighted-hinge approach to robustly learning $\gamma$-margin halfspaces under malicious noise (Shen, 2025; Zeng and Shen, 2025): the governing resource is the Sum-of-Squares degree of the outlier-removal certificate, and the resolution principle states that the maximal corruption mass which can hide at a center $c$ from a degree-$2t$ certificate is exactly the Christoffel function $\lambda_{t+1}(c)$ of the clean marginal. Three consequences follow, all against the certificate method (not information-theoretic). A margin-degree tradeoff: certifying the dense pancake to error $\epsilon$ costs SoS degree $\Omega(\log(1/\epsilon))$ or margin $\Omega(\sqrt{\log(1/\epsilon)}/\sqrt{d})$, explaining why the $\log(1/\epsilon)$ margin Shen (2025) records is forced, with a weighted-Chebyshev reduction making the threshold $2t=\Theta((|c|/s)^2)$ tight modulo one classical weighted-extremal estimate. A degree-$2$ outlier barrier: the resolution principle realized as an explicit instance on which degree $2$ is stuck at $\eta^{1/2}$ while degree $4$ escapes, locating the method's small breakdown rate in the degree, not the analysis. And a degree-$2t$ algorithm tracing the frontier $\eta^{1-1/2t}$ (recovering Shen (2025) at $t=1$), whose gain is an explicit constant, capped by the pancake density and shown unimprovable by the degree-$2$ barrier.

04.
arXiv (CS.AI) 2026-06-15

FactoryLLM: A Safe and Open-Source AI Playground for Evaluating LLMs in Smart Factories

arXiv:2606.14119v1 Announce Type: new Abstract: Fault diagnostics and recovery in smart factories is challenging because critical information is dispersed across manuals of multiple machines which are interconnected through the manufacturing process. Large Language Models (LLMs) can provide a promising approach. In this paper, we propose FactoryLLM, a safe and open-source AI playground designed for evaluating different LLM-based retrieval-augmented generation (RAG) models by analysing documents from multiple machines across the manufacturing process. FactoryLLM enables the user to configure the LLM, and assess performance when reasoning over multiple documents, through a dual evaluation setup using both RAGAS and NVIDIA's LLM-as-a-Judge metrics. FactoryLLM is safe because it allows users to run local or open-source LLMs without sharing sensitive industrial data, providing a controlled environment for experimentation. We demonstrate the efficacy of FactoryLLM through a case study which involves an Autonomous Intelligent Vehicle and its Mobile Planner software, evaluating three LLMs across 30 maintenance queries derived from approximately 600 pages of cross-machine documentation. The results suggest that FactoryLLM is effective in cross-machine document reasoning: every model achieved a groundedness score above 0.88. The full code and documentation for community to test FactoryLLM with their manufacturing specific scenarios are publicly available.

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

Instance-Aware Knowledge Distillation for Semi-Supervised Learning of an On-Board Multi-Task Dense Prediction Model for Collision Avoidance System

Collision avoidance systems have evolved toward camera-based deep learning approaches for driving scene understanding. However, deployment in edge environments such as country clubs is constrained by limited computational resources and unreliable communication infrastructure. Moreover, constructing large-scale datasets for the target domain involves substantial annotation cost. To address these limitations, we propose an instance-aware knowledge distillation framework for semi-supervised learning. Specifically, we generate pseudo labels that mitigate teacher bias by leveraging domain priors from the teacher and instance-centric knowledge from foundation models. The trained lightweight student is deployed in the proposed collision avoidance system and performs multiple dense prediction tasks in real-time. The system detects frontal obstacles and encodes their spatial information into controller area network messages for automated guided vehicle operation. To achieve this, we construct a large-scale country club dataset and perform field validation of the proposed system. Experimental results demonstrate that the student outperforms the large teacher in instance segmentation while mitigating performance degradation in monocular depth estimation. Compared with the teacher, the student reduces FLOPs by 22.68$\times$ and parameters by 14.33$\times$, achieving 6.46 FPS on a low-cost edge device.

06.
arXiv (CS.AI) 2026-06-17

Treatment Response Optimized Clinical Decision Support AI System via Digital Twin Simulation

arXiv:2606.17405v1 Announce Type: new Abstract: Clinical decision support AI systems (CDSASs) must adapt to evolving patient conditions in real-time while adhering to strict safety constraints. We present an online adaptive framework that integrates Treatment Effect (TE) estimation to quantify clinical benefits, a patient Digital Twin (DT) to simulate treatment trajectories, and Reinforcement Learning (RL) for sequential decision-making. The AI system is initially trained on historical medical records and operates in a continuous learning loop. To ensure safety, a rule-based module monitors vital signs and blocks contraindicated treatments. Cases with strong internal model disagreement are flagged for clinician review, simulated in our experiments via a pre-trained outcome model. We validate our framework using both a synthetic clinical simulator and a real-world ovarian cancer dataset from The Cancer Genome Atlas (TCGA). In both simulated and clinical settings, our method demonstrated superior effectiveness and stability in recommending treatments compared to standard computational baselines. Furthermore, the AI system maintains low latency and requires expert consultation for only a minority of cases in our experimental validation, demonstrating its potential as a safe, clinician-supervised tool for personalized medicine that continuously improves through practical use.

07.
arXiv (CS.CL) 2026-06-11

The Long Tail, Not the Front Page: Cold-Start Prediction of Crowd Highlight Salience

A social highlighter's most useful signal – which passages a crowd of readers marks – exists only for documents people have already read. Can the aggregate crowd salience of a document be predicted from its text before its marks accumulate? Prior work on this data found that zero-shot language models recover highlight locations worse than a trivial lead (position) baseline, so we ask whether a model trained on the highlight corpus can beat that baseline. Using a pre-registered ladder of models and a by-document cluster bootstrap, we find a small but robust edge: a logistic ranker over sentence embeddings and positional/contextual features beats the lead baseline by +0.044 average precision (95% CI [+0.029, +0.058]; clears a pre-registered margin delta=0.03 in 97% of resamples, and stable across pipeline re-runs). Two unsupervised extractive baselines (centroid, LexRank-style centrality) lose to lead, and the trained model beats them by +0.108, so the edge is not recovered by generic unsupervised proxies – it reflects learning from real reader marks. In product terms, precision@3 rises from 0.25 to 0.39 (+55% relative) and the model beats lead on 69% of documents. An ablation attributes the edge to the raw embedding (+0.014) and training augmentation (+0.010), each with a positive CI. The edge is not a temporal-generalization failure, and we find no evidence that content drift or near-duplicate leakage explains it. A standardized regression shows the advantage is governed mainly by document popularity (lower popularity, larger edge) and by label reliability. It nearly vanishes only on the most popular content; there it is the lead baseline that strengthens, not the model that weakens. Because our evaluation conditions on documents that eventually accumulated readers, these results are a retrospective cold-start simulation.

08.
arXiv (CS.LG) 2026-06-11

Spectrally Regularized Latent Flow Matching for Turbulence Generation

arXiv:2606.11691v1 Announce Type: new Abstract: Latent diffusion and flow matching have emerged as leading approaches for synthetic turbulence generation, yet they systematically under-represent dissipation-range amplitudes. We introduce a latent flow matching framework with a spectrally regularized compression stage that directly targets this failure mode. On a 256^2 DNS dataset at Re_f \approx 2250, replacing an MSE-trained VAE with a zone-weighted log-spectral objective raises deep-dissipation retained spectral power from 25% to 94% in reconstruction and from 20% to 79% in unconditional generation. The improved latent representation also yields a substantially better sampling cost-fidelity tradeoff: the MSE-trained latent space imposes a fundamental quality ceiling near DD bias -0.70 that no integrator or step-count can overcome, while the spectrally regularized latent space reaches DD bias -0.117 at just 20 function evaluations. Mechanistically, encoder-decoder swap experiments show that the improvement is driven primarily by encoder-induced latent reorganization rather than decoder capacity, while a support-amplitude decomposition reveals that MSE-trained models behave as conservative suppression models, minimizing pointwise error by attenuating intermittent high-wavenumber structure. Both pipelines recover the second-order structure function and the correct sign of S_3, indicating the correct cascade direction without explicit supervision. A small residual gap in the magnitude of S_3 suggests that phase-coherent triadic organization remains a complementary axis to amplitude fidelity for future generative turbulence models.

09.
medRxiv (Medicine) 2026-06-17

Cost-effectiveness of measles rapid diagnostic tests for replacing or expanding laboratory testing in Ethiopia

Background: In low- and middle-income countries, laboratory testing to rapidly detect measles outbreaks is limited by infrastructure availability and high costs. This study estimates the potential impact and cost-effectiveness of measles rapid diagnostic tests (RDTs) if implemented nationally in Ethiopia to either replace or expand current testing. Methods: An agent-based model to simulate measles outbreaks was calibrated to Ethiopian measles surveillance data. Modelled outbreak outcomes were aggregated over a 10-year period. Scenarios included using RDTs to (1) replace laboratory testing; (2) replace epidemiological linkage; and (3) increase case detection, in addition to replacing laboratory testing and epidemiological linkage. Testing and outbreak response costs (in 2025 US$) were obtained from Ethiopian Public Health Institute from a government perspective. Total costs and disability-adjusted life years (DALYs) for each scenario were compared to baseline. Results: All scenarios were cost saving compared to baseline. Replacing laboratory testing with RDTs saved US$4.2M (3.2M-4.9M) over 10-years, but due to very low testing rates the benefits of eliminating laboratory testing delays were offset by missed cases from the lower RDT sensitivity, leading to similar outbreak detection times and DALYs. Replacing epidemiological linkage with RDTs had similar DALYs but increased the cost savings to US$9.7M. Using RDTs to double case detection reduced outbreak detection time from 113 to 80 days, averted 17,000 DALYs, and saved US$4.3M. Conclusions: In Ethiopia, use of measles RDTs could be cost saving, and if used to expand testing could prevent measles infections through faster outbreak detection and response.

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

Towards a future space-based, highly scalable AI infrastructure system design

arXiv:2511.19468v2 Announce Type: replace-cross Abstract: If AI is a foundational general-purpose technology, we should anticipate that demand for AI compute – and energy – will continue to grow. The Sun is by far the largest energy source in our solar system, and thus it warrants consideration how future AI infrastructure could most efficiently tap into that power. This work explores a scalable compute system for machine learning in space, using fleets of satellites equipped with solar arrays, inter-satellite links using free-space optics, and Google tensor processing unit (TPU) accelerator chips. To facilitate high-bandwidth, low-latency inter-satellite communication, the satellites would be flown in close proximity. We illustrate the basic approach to formation flight via an 81-satellite cluster of 1 km radius, and describe an approach for using high-precision ML-based models to control large-scale constellations. Trillium TPUs are radiation tested. They survive a total ionizing dose equivalent to a 5 year mission life without permanent failures, and are characterized for bit-flip errors. Launch costs are a critical part of overall system cost; a learning curve analysis suggests launch to low-Earth orbit (LEO) may reach $\lesssim$\$200/kg by the mid-2030s.

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

Improving and Evaluating Hand-Object Interaction Detection

Understanding hands and the objects they interact with, both directly and through tools, is a key step for tasks ranging from action perception to 3D reconstruction and robotics. Our paper provides several contributions to the Hand-Object Interaction (HOI) understanding literature: (1) HOI-DETR, a new framework that introduces hand-object and object-object interactions to the Co-DETR architecture to produce a state-of-the-art method; (2) a comprehensive HOI evaluation suite of 4 diverse datasets, including a video benchmark derived from the HD-EPIC dataset and fresh annotations that improve the Hands23 benchmark and (3) a trained checkpoint that significantly improves the state of the art across Hands23, HOIST, FineBio, and HD-EPIC, including mAP gains of over 20 percentage points on Hands23 and FineBio. Our ablations confirm the contributions of each model component.

13.
arXiv (CS.CV) 2026-06-17

Structured Adversarial Camouflage via Voronoi Diagrams

Pixel-wise adversarial patches are computationally heavy and often visually detectable, limiting utility in security-critical systems. We present adversarial Voronoi camouflage that optimizes only seed-point locations under fixed, printable palettes using a soft assignment, producing structured, splinter camouflage-like patterns without additional regularization. Evaluated on person detection with COCO-style AP@[.5:.95], naive placement (Inria -> COCO) performs comparably bad, while garment-level application via segmentation mask (3DPeople) results in a significant AP drop. The attack transfers to out-of-domain backgrounds and across detector families (YOLOv9/10/11/12), indicating robustness in black-box settings. Repainting with different palettes largely nullifies the effect, and single-color tweaks show limited tolerance (

14.
arXiv (CS.CV) 2026-06-15

Gefen: Optimized Stochastic Optimizer

AdamW is a default optimizer for modern deep learning, but its first and second moment states add roughly two parameter-sized buffers to training memory. We propose Gefen, a memory-efficient optimizer that automatically shares second-moment estimates across parameter blocks and quantizes the first moment using a learned codebook, thereby reducing AdamW's memory footprint by ~8x while maintaining the same performance, corresponding to a reduction of 6.5 GiB per billion parameters. The method is motivated by a theoretical result showing that large mixed Hessian entries constrain the ratio of squared gradients toward one, suggesting that Hessian-aligned parameters are natural candidates for sharing second-moment statistics. Since computing Hessians is impractical at scale, Gefen infers block structure from the initial squared gradients, requiring no architecture-specific metadata or hyperparameters beyond AdamW defaults. Gefen learns an exact histogram-based dynamic-programming quantization codebook and reuses the same blocks for first-moment scaling. Across diverse experiments, Gefen achieves the lowest peak optimizer memory among the compared AdamW-like methods while maintaining AdamW-level performance. In FSDP and DDP training, the reduced memory footprint enables larger microbatches and improves throughput significantly over AdamW, providing a practical drop-in replacement with lower memory usage that can increase throughput and enable training larger models or using larger batch sizes. We provide the complete Python implementation, including fused CUDA kernels at https://github.com/ndvbd/Gefen

15.
arXiv (quant-ph) 2026-06-17

An energy-based uncertainty principle and low-energy state preparation

作者:

arXiv:2603.15495v2 Announce Type: replace Abstract: Preparing low-energy states of many-body Hamiltonians is a central challenge in quantum computing, quantum complexity, and condensed matter physics. Existing approaches often get trapped in suboptimal states such as high-energy eigenstates or, more generally, low-variance states that resist further energy reduction. In this work, we explore a different perspective: instead of optimizing with respect to a single Hamiltonian, we leverage the fact that many systems admit families of Hamiltonians that share similar low-energy subspaces but differ at higher energies. We show that this redundancy can be turned into an algorithmic resource by establishing an energy-based uncertainty principle, which implies that these Hamiltonians cannot simultaneously admit low-variance states at higher energies. This suggests a simple strategy of alternating energy-lowering steps across such Hamiltonians, which we investigate numerically on several models. We also introduce a sparse variant where the uncertainty principle yields quadratically larger variance at higher energies, leading to more pronounced energy change. Overall, this work suggests a range of open questions at the interface of random matrix theory, local Hamiltonians and low-energy state preparation, aimed at understanding when such approaches are practical and how they can be analyzed rigorously.

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

LM-SPT: LM-Aligned Semantic Distillation for Speech Tokenization

With the rapid progress of speech language models (SLMs), discrete speech tokens have emerged as a core interface between speech and text, enabling unified modeling across modalities. Recent speech tokenization approaches aim to isolate semantic information from low-level acoustics to better align with language models (LMs). In particular, previous methods use self-supervised learning (SSL) teachers such as HuBERT to extract semantic representations, which are then distilled into a semantic quantizer to suppress acoustic redundancy as well as capture content-related latent structures. However, these tokenizers often operate at relatively high frame rates, producing token sequences significantly longer than their textual counterparts and hindering seamless integration with pretrained LMs. Although recent methods attempt to reduce the token rate by applying uniform average pooling to SSL features, this can over-smooth content-bearing regions and dilute the structural information, thereby potentially limiting the LM alignment. To address this, we propose LM-SPT, an LM-aligned speech tokenization method based on semantic speech-resynthesis distillation. Instead of directly matching teacher and student features via pooling, LM-SPT resynthesizes speech from semantic tokens only and minimizes the discrepancy between representations extracted from the original and resynthesized waveforms using a frozen, LM-aligned speech encoder. This indirect supervision avoids rigid temporal alignment and encourages dedicated semantic units that are more semantically aligned with LMs under reduced frame rates. Experimental results show that the proposed LM-SPT consistently outperforms previous semantic-enhanced speech tokenizers when applied to SLMs for the tasks of automatic speech recognition and text-to-speech, even without compromising the speech reconstruction fidelity at the codec level.

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

Entropy-Gated Latent Recursion

arXiv:2606.16620v1 Announce Type: cross Abstract: Inference-time scaling has become the dominant lever for improving language-model reasoning, but existing methods derive rollout diversity from a single source: stochastic token-level sampling. We argue that this single-axis sampling space is fundamentally limiting, and identify a second, fully deterministic and complementary axis: the layer span $L$ at which a frozen model's top decoder layers are recursively re-applied at high-uncertainty tokens. Different choices of $L$ produce distinct rollouts that solve different subsets of problems, with no stochasticity. We instantiate this axis through Entropy-Gated Latent Recursion (EGLR), a training-free decoding procedure that re-applies the top-$L$ layers for at most $K_{\max}$ iterations until the next-token distribution converges. Combined with $T$ temperature samples, EGLR turns a single-axis stochastic rollout pool into an $L\times T$ Cartesian sampling space at almost the same per-rollout cost. We characterize this space across $8$ instruction-tuned models and $6$ math reasoning benchmarks, and show that the $L$-axis is genuinely complementary to temperature: on MATH-500 with Qwen2.5-3B-Instruct, the joint $L\times T$ oracle reaches $91.6\%$, $+8.2$ percentage points beyond the temperature-only oracle ($83.4\%$) and $+10.4$ points beyond the layer-only oracle ($81.2\%$), confirming that the two axes capture genuinely complementary problems. The expanded rollout pool provides richer per-prompt candidates for any downstream procedure that consumes rollouts, including self-consistency, best-of-$N$ with verifiers, and group-relative RL training (GRPO), opening a new direction for inference-time scaling that does not rely on stochastic noise.

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

Mixtures of Subspaces for Bandwidth Efficient Context Parallel Training

arXiv:2606.16384v1 Announce Type: new Abstract: Pretraining language models with extended context windows enhances their ability to leverage rich information during generation. Existing methods split input sequences into chunks, broadcast them across multiple devices, and compute attention block by block which incurs significant communication overhead. While feasible in high-speed clusters, these methods are impractical for decentralized training over low-bandwidth connections. We propose a compression method for communication-efficient context parallelism in decentralized settings, achieving a remarkable compression rate of over 95\% with negligible overhead and no loss in convergence. Our key insight is to exploit the intrinsic low-rank structure of activation outputs by dynamically constraining them to learned mixtures of subspaces via efficient reparameterizations. We demonstrate scaling billion-parameter decentralized models to context lengths exceeding 100K tokens on networks as slow as 300Mbps, matching the wall-clock convergence speed of centralized models on 100Gbps interconnects.

19.
arXiv (math.PR) 2026-06-17

Limit theorems for descents and inversions of shelf-shuffles

arXiv:2510.00343v2 Announce Type: replace Abstract: We prove central limit theorems for the number of descents and inversions of permutations produced by shelf-shuffles. These are a model for casino card shuffling machines. We show the asymptotic normality of the number of descents in two limiting regimes depending on the ratio of cards to shelves. On the other hand, we study the inversions by employing a modification of the techniques from Islak's analysis of the statistics of riffle shuffles. In particular, we obtain a bound for the rate of convergence for inversions that is independent of the number of shelves.

20.
arXiv (CS.CV) 2026-06-12

Comparing Commercial Depth Sensor Accuracy for Medical Applications

Depth estimation has numerous medical and surgical applications. We benchmark four depth sensors on a porcine bone specimen, a porcine belly specimen, and a silicone kidney phantom using stylus-sampled references. These objects contain several real-world challenges, including homogeneous surfaces, specular surfaces, and subsurface scattering. The comparison includes stereo, structured-light, and time-of-flight sensors at a distance of approximately 50 cm. Specifically, the Intel RealSense D405 (Intel RealSense, United States), PMD Flexx2 (pmdtechnologies, Germany), Stereolabs ZED 2i (Stereolabs, France), and Zivid 2M+ 60 (Zivid, Norway) are compared. The Zivid 2M+ 60 performed best across all objects and metrics considered in this work. The ZED ranked second for real tissue, but last on the phantom.

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

ANSR-DT: A Neuro-Symbolic Framework for Adaptive and Explainable Digital Twins

arXiv:2501.08561v4 Announce Type: replace Abstract: Digital twins are increasingly used to monitor and optimize industrial systems, yet many existing frameworks remain difficult to interpret, slow to adapt, and limited in their ability to incorporate explicit domain knowledge. This paper presents ANSR-DT, an adaptive neuro-symbolic framework that unifies temporal anomaly detection, symbolic reasoning, and reinforcement-learning-based decision support within a single digital twin pipeline. ANSR-DT combines a CNN-LSTM model for multivariate pattern recognition with Prolog-based reasoning that converts learned signals into explicit rules, enabling transparent diagnoses and traceable decision paths. A PPO-based adaptation layer further refines operational responses under changing conditions while preserving interpretability. Experiments against 8 baselines show that ANSR-DT delivers competitive predictive performance together with stable rule extraction, scalable symbolic reasoning, and actionable explanations. Additional validation on the Skoltech Anomaly Benchmark (SKAB) further indicates that the framework transfers beyond synthetic settings. These findings position ANSR-DT as a practical foundation for trustworthy, adaptive, and explainable industrial digital twins.

22.
medRxiv (Medicine) 2026-06-16

Enteral docosahexaenoic and arachidonic acid supplementation and retinopathy of prematurity: a re-analysis of randomized controlled trials in preterm infants

Background. A recent meta-analysis by Dang et al. [1] concluded that enteral supplementation with docosahexaenoic acid (DHA), with or without arachidonic acid (ARA) did not significantly affect retinopathy of prematurity (ROP) outcomes in preterm infants. Of four eligible trials that supplemented both DHA and ARA, only two contributed to each ROP outcome analyzed, and severe ROP was not assessed. Methods. We replicated the eligibility criteria and search strategy of Dang et al., restricted to trials that supplemented both DHA and ARA, and reanalyzed three ROP endpoints (any ROP, ROP requiring treatment, and severe ROP [stage 3 and/or treated]) using complete outcome records from all eligible trials. Crude risk ratios (RR) were pooled by Mantel-Haenszel fixed-effect meta-analysis. Gestational age-adjusted odds ratios (adjOR) were pooled on the log scale by inverse-variance random-effects meta-analysis with restricted maximum likelihood (REML) estimation of between-study variance and Hartung-Knapp confidence intervals. Results. Five trials were included; one trial was identified in our replicated search but was excluded by Dang et al. without a stated rationale. The pooled estimate for any ROP was consistent with Dang et al. (RR 0.87 [95% CI 0.71-1.08]; adjOR 0.70 [0.46-1.08]). For ROP requiring treatment, the crude RR suggested a lower risk but did not reach statistical significance (RR 0.60 [0.35-1.04]), whereas the gestational age-adjusted estimate indicated lower odds (adjOR 0.47 [0.23-0.94]). For severe ROP, DHA+ARA supplementation produced a significant protective effect in both unadjusted and adjusted models (RR 0.56 [0.36-0.86]; adjOR 0.42 [0.19-0.96]). Conclusions. When all eligible trials contribute to each endpoint and severe ROP is included as an outcome, enteral DHA+ARA supplementation reduces severe ROP and is associated with lower odds of ROP requiring treatment after adjustment for gestational age. These findings differ from the conclusions of Dang et al. and support reconsideration of DHA+ARA supplementation as a strategy to reduce sight-threatening ROP in preterm infants.

23.
arXiv (CS.AI) 2026-06-16

RAID: Semantic Graph Diffusion for True Cold-Start and Cross-Lingual Forecasting

arXiv:2606.16925v1 Announce Type: new Abstract: Time-series foundation models show strong transfer performance when given a non-empty history window. However, true cold-start scenarios, where a new item has no prior observations, violate this assumption. We propose RAID (Retrieval-Augmented Iterative Diffusion) a framework, which replaces history-based correlation learning with metadata-driven semantic retrieval and graph-conditioned diffusion. RAID maps textual metadata into a shared semantic space using a frozen multilingual embedding model and constructs an inductive retrieval graph that extends naturally to unseen items. It first forms a base forecast by aggregating information from semantically related neighbors, then refines this forecast with a gated diffusion module to model residual uncertainty. Under a strict true cold-start protocol, RAID outperforms strong foundation models and competitive baselines on both forecasting accuracy and prediction interval coverage, while reducing inference latency by an order of magnitude through non-autoregressive decoding. The shared semantic space also enables zero-shot cross-lingual transfer, allowing a model trained on English descriptions to generalize to items described in other languages without direct supervision.

24.
medRxiv (Medicine) 2026-06-17

Identifying anaphylaxis using weakly-supervised prediction models and natural language processing

Objectives Scalable computable phenotyping algorithms are critical for conducting high-throughput disease-outcome research in large, distributed-data electronic health record (EHR) and claims data settings. We developed and evaluated a claims- and EHR-based computable phenotyping algorithm for anaphylaxis, a rare acute condition that is challenging to accurately identify using claims data alone. Materials and Methods Potential anaphylaxis events came from two healthcare systems (Kaiser Permanente Washington [KPWA] and Vanderbilt University Medical Center [VUMC]). We engineered features from clinical text using automated natural language processing (NLP) methods. We then developed a phenotyping algorithm using four NLP- and diagnosis code-based silver labels (proxies for the gold-standard labels). Gold-standard abstracted outcomes were used to evaluate algorithm performance. Results The largest area under the receiver operating characteristic curve (AUC) was 0.931 for an NLP-based silver-label model at KPWA. Depending on the model and healthcare system site, positive predictive value (PPV) and sensitivity at the threshold of predicted probability that maximized F1 score ranged from 0.52 to 0.77 (PPV) and 0.78 to 1 (sensitivity). Discussion NLP-based silver-label models had large AUC at KPWA but not at VUMC. This may be because clinical text at KPWA is only available for outpatient encounters and secure messaging. High sensitivity for identifying anaphylaxis can be obtained using our best-performing models. Conclusion The best-performing models had better PPV and sensitivity tradeoffs than prior bespoke anaphylaxis models with costly, manually curated features. The simplicity of the approach compared to traditional phenotyping methods allows it to be deployed easily at multiple health care systems.

25.
medRxiv (Medicine) 2026-06-19

"Us with them": Co-designing a caesarean section consent and debriefing intervention in West Cameroon

Background Women-centred maternity care is a rights issue that determines the use of services. Such care ensures responsiveness to womens needs which is enacted through shared decision-making, review and response. In the West Region of Cameroon, informed consent (IC) and Debriefing for caesarean section (c-section) have been shown to be suboptimal or absent. This paper describes the participatory design of a quality-improvement hospital-based intervention. Methods From February to May 2025, we conducted a co-design process with three groups of stakeholders: 59 post c-section women and community representatives, 78 frontline c-section providers, and 29 directors of public and private hospitals. We followed four phases: planning, conducting, evaluating, and reporting. The conduct phase comprised five all-day workshops with post c-section women and community representatives, followed by five all-day workshops with the c-section providers. Finally, we held an 11th workshop with the hospital directors to scrutinize suggested interventions, evaluate their feasibility, and establish a consensus on their components. We described the intervention using the TIDieR (Template for Intervention Description and Replication) checklist. We documented the co-design process, using open-ended narratives to delineate interventions, and carried out real-time synthesis on visual aids (whiteboards and flipcharts). Intervention feasibility was quantified using a structured ad hoc matrix, while insights on facilitators and barriers were captured through qualitative free-text entries. We coupled data collection with constant comparison and triangulation through contemporaneous field notes, photographic documentation, and thematic mapping of stakeholders perceptions and interactive dynamics. Results Participants perspectives on the co-design were positive, and their motivation were very high although less than 50% reported previous involvement in co-design processes. More than 80% of participants found rated the co-design process as either good or very good. The final intervention comprised four components: (i) an in-service training; (ii) a standard operating procedure including a harmonised consent form and debriefing checklist; (ii) systematic supportive supervision, monitoring & evaluation; and (iv) a routine clinical audit. Each group of stakeholders upheld specific dimensions of the consent and debrief intervention. Post c-section women and community members emphasized emotional support, written discharge advice after debriefing, and zero tolerance of suboptimal consent and debriefing practices. Frontline c-section providers insisted on robust documentation for medico-legal protection. Hospitals Directors emphasized capacity-building and cultural friendliness. All the groups supported womans autonomous decision making. The intervention feasibility was rated high or very high by hospital directors except for the financial, infrastructural and technical domains. Conclusion This co-design process yielded a context-specific, multi-component intervention that was well accepted and deemed feasible across stakeholders. It provides a methodological approach to strengthening informed consent and debriefing as core elements of women-centred, accountable maternity care, and warrants implementation.