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01.
arXiv (CS.CL) 2026-06-12

LLM-based Embeddings: Attention Values Encode Sentence Semantics Better Than Hidden States

Sentence representations are foundational to many Natural Language Processing (NLP) applications. While recent methods leverage Large Language Models (LLMs) to derive sentence representations, most rely on final-layer hidden states, which are optimized for next-token prediction and thus often fail to capture global, sentence-level semantics. This paper introduces a novel perspective, demonstrating that attention value vectors capture sentence semantics more effectively than hidden states. We propose Value Aggregation (VA), a simple method that pools token values across multiple layers and token indices. In a training-free setting, VA outperforms other LLM-based embeddings, even matches or surpasses the ensemble-based MetaEOL. Furthermore, we demonstrate that when paired with suitable prompts, the layer attention outputs can be interpreted as aligned weighted value vectors. Specifically, the attention scores of the last token function as the weights, while the output projection matrix ($W_O$) aligns these weighted value vectors with the common space of the LLM residual stream. This refined method, termed Aligned Weighted VA (AlignedWVA), achieves state-of-the-art performance among training-free LLM-based embeddings, outperforming the high-cost MetaEOL by a substantial margin. Finally, we highlight the potential of obtaining strong LLM embedding models through fine-tuning Value Aggregation.

02.
arXiv (CS.AI) 2026-06-16

HCP-MAD:Heterogeneous Consensus-Progressive Reasoning for Efficient Multi-Agent Debate

arXiv:2604.09679v2 Announce Type: replace-cross Abstract: Multi-Agent Debate (MAD) is a collaborative framework in which multiple agents iteratively refine solutions through the generation of reasoning and alternating critique cycles. Current work primarily optimizes intra-round topologies and inter-round interactions separately, limiting the adaptation of token costs to task complexity. This work introduces Heterogeneous Consensus-Progressive Reasoning for Efficient Multi-Agent Debate (HCP-MAD), leveraging consensus as a dynamic signal to facilitate progressive reasoning. The core motivation is that a majority of straightforward tasks can be effectively resolved via lightweight pair-agent debates, while complex tasks require expanded collaboration. Firstly, Heterogeneous Consensus Verification conducts rapid consensus verification using a pair of heterogeneous agents for early stopping. Next, Heterogeneous Pair-Agent Debate applies an adaptive stopping criterion to terminate mutual critique of reasoning traces. Finally, the unresolved tasks are addressed through Escalated Collective Voting by aggregating diverse perspectives from additional agents. Experiments across six benchmarks show that HCP-MAD enhances accuracy while substantially reducing token costs. Code is https://github.com/fuyu66/HCP-MAD.

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

HypOProto: Hyperbolic Ordinal Prototypes for Left Ventricular Filling Pressure Classification

Echocardiography (echo) is a widely used imaging modality for assessing cardiac function, with Left Ventricular Filling Pressure (LVFP) serving as a critical physiological marker for conditions such as heart failure. Standard LVFP classification into normal vs elevated categories relies on the Doppler-derived $E/e'$ ratio, which is operator-dependent and often unavailable in resource-limited settings, motivating methods that infer LVFP directly from B-mode echo. Existing deep learning approaches achieve high performance but remain largely black-box, limiting clinical interpretability. We propose HypOProto, a hyperbolic, ordinal prototype-based framework for interpretable LVFP classification using a frozen, explainable foundation model backbone. HypOProto arranges prototypes along the physiological $E/e'$ scale, placing borderline cases near the hyperboloid root where small angular differences separate similar cases, while normal and elevated cases occupy outward positions reflecting increasing diagnostic certainty. This hyperbolic geometry encodes clinically meaningful ordinal relationships and improves interpretability. We also introduce a novel Hyperbolic Prototype Angular Separation (HyperPAS) loss, enforcing inter-class prototype separation in hyperbolic space. HypOProto achieves SOTA performance while maintaining transparency, and highlights clinically relevant regions in visualizations. This work represents the first prototype-based framework for LVFP classification in echo. Our code can be found at https://github.com/DeepRCL/HypOProto.

04.
arXiv (CS.CV) 2026-06-16

Pixels to Proofs: Probabilistically-Safe Latent World Model Control via Parallel Conformal Robust MPC

We present SLS^2, a framework for safe feedback motion planning from pixels using robust model predictive control (MPC) in learned latent world models. Our approach trains an action-conditioned joint-embedding world model with compact Markovian latent states, enabling efficient gradient-based trajectory optimization through learned latent dynamics. To enforce safety for the true system despite imperfect latent predictions, we inform a GPU-accelerated system level synthesis (SLS) robust MPC scheme with conformal prediction to obtain calibrated latent error bounds and robust latent-space constraint sets. We further learn and conformalize a latent constraint checker, allowing the SLS planner to impose probabilistic safety constraints during closed-loop execution. We evaluate our method on vision-based control tasks, where it improves both goal-reaching performance and safety over latent world-model and safe-planning baselines.

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

LLM-as-an-Investigator: Evidence-First Reasoning for Robust Interactive Problem Diagnosis

arXiv:2606.13220v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly used as interactive assistants for technical problem solving. However, when users provide incomplete descriptions or plausible but unverified explanations, LLMs may prematurely align with these assumptions and propose solutions before collecting sufficient evidence. We refer to this behavior as user-driven sycophancy: the tendency of an LLM to reinforce a user-provided hypothesis instead of testing alternative explanations. This paper introduces LLM-as-an-Investigator, an evidence-first agentic AI methodology for robust problem diagnosis. The approach is implemented through a Solution Investigator Agent, which estimates the ambiguity of an initial problem description, generates candidate hypotheses, asks targeted clarification questions, and updates hypothesis probabilities after each answer. Rather than producing an immediate response, the agent continues the investigation until the evidence makes one candidate explanation stronger than the alternatives. To evaluate the approach, we build a benchmark from solved technical forum threads in mechanical, electrical, and hydraulic domains. We use a three-agent evaluation pipeline in which a Problem-Solution Extractor Agent converts solved threads into structured cases, a Ground-Truth Evaluator Agent simulates the user while hiding the known solution, and the tested assistant attempts to recover the solution through dialogue. The experiments compare standard assistants, reasoning-oriented LLMs, and the proposed investigator-based model across LLM backbones. In addition to diagnostic accuracy, we analyze how standard assistants follow misleading user hypotheses in diagnostic cases. The results show that the proposed approach identifies the problem more accurately than direct prompting and reasoning-only baselines, while its evidence-first protocol helps reduce user-induced conversational bias.

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

Coercivity and Local Convergence of Physical Learning in Linear Circuits

arXiv:2606.15443v1 Announce Type: cross Abstract: Physical learning methods train physical networks to perform computational tasks using only local update rules, exploiting the physics of the system to handle the global transfer of information. We provide the first local convergence analysis of three such methods – Equilibrium Propagation (EP), Coupled Learning (CL), and a new method we call Adjoint Coupled Learning (AL) – for linear circuits, in the limit of small-nudging for both discrete and continuous time. EP and AL perform gradient descent on a natural loss function, while CL follows modified dynamics with an additional cubic correction. Assuming the existence of a solution, we identify a coercivity condition, expressed as a rank condition on a matrix built from the network's incidence structure, under which the training loss decays exponentially and the parameters converge to the solution manifold. We show that coercivity can fail by exhibiting a kite circuit in which a symmetry causes the coercivity constant to degenerate on the solution manifold, but prove using Sard's theorem that such degeneracies are non-generic: coercivity holds at every point of the solution manifold for almost every choice of desired output.

07.
bioRxiv (Bioinfo) 2026-06-16

Orion: Towards Lab Automation with Computer-Using Agents

Laboratory discovery increasingly depends on computational workflows that connect experimental data to analysis, interpretation and follow-up hypotheses. Yet these workflows remain constrained by labor-intensive use of specialized software, visual inspection through graphical user interfaces, and integration of knowledge across multiple sources. Here, we present Orion, a computer-using AI agent for biomedical image analysis and interpretation that moves towards lab automation by automating this computational layer of laboratory work. Orion combines large language models with terminal execution, GUI control and adaptive multi-step reasoning in a shared computing environment. It can inspect visual data, operate standard scientific software, mine web resources and conduct end-to-end analysis and interpretation workflows without requiring bespoke software integrations. Across benchmarks, Orion achieved over 90% accuracy on biomedical database and literature retrieval tasks, learned to use the popular tools CellProfiler and QuPath for quantitative analysis of cellular and tissue images, respectively, and facilitated autonomous discovery in experimental imaging data. In 100 hours of autonomous exploration of a large-scale perturbation imaging dataset, Orion generated 52 research reports, of which human scientist review prioritized 22 plausible mechanistic hypotheses. These results show that computer-using AI agents can substantially expand the reach of laboratory automation, providing a scalable and auditable route from experimental imaging data to quantitative analysis, reports and biologically grounded hypotheses.

08.
arXiv (math.PR) 2026-06-11

Capital Asset Pricing Model with Size Factor and Normalizing by Volatility Index

arXiv:2411.19444v5 Announce Type: replace-cross Abstract: The Capital Asset Pricing Model (CAPM) relates a well-diversified stock portfolio to a benchmark portfolio. We insert size effect in CAPM, capturing the observation that small stocks have higher risk and return than large stocks, on average. For some size-based stock portfolios, dividing their returns by the Volatility Index makes them closer to independent and normal. In this article, we combine these ideas to create a new discrete-time model, which includes volatility, relative size, and CAPM. We fit this model using real-world data, prove the long-term stability, and connect this research to Stochastic Portfolio Theory. We fill important gaps in our previous article on CAPM with the size factor.

09.
arXiv (CS.AI) 2026-06-19

Towards Engineering Scaling Laws with Pretraining Data Composition

arXiv:2606.19781v1 Announce Type: cross Abstract: Neural scaling laws describe how model performance improves as a power law in compute, model size, and dataset size. While well-established for large language models, these relationships are emerging for large models in particle physics. As with language, empirical studies show that the performance scales as a power law. However, unlike natural language or image domains, fundamental physics has high-fidelity simulators that produce synthetic data cheaply. This favors scaling regimes where additional data is cheaper than additional parameters, and allows the pretraining dataset itself to be engineered to influence the scaling. For the task of classifying hadronic jets produced in collisions of high-energy particle beams, we show that the scaling behavior can be engineered towards requiring more data rather than larger models by inclusion of pretraining data which is more diverse and better aligned with the downstream classification task.

10.
arXiv (CS.CV) 2026-06-16

Effective and Low-cost Lane-based Map Localization for Vehicle-Centric Route Generation

Driver-centric route representation plays a vital role in intuitive driving guidance systems. This paper presents OLRA, a low-cost, map-localization-based framework that derives driver-view-aligned routes by matching map-based navigation routes with camera-detected lane markings. This alignment process mutually enhances vehicle localization accuracy and visual route consistency. To bridge the evaluation gap across different paradigms, we introduce practical route evaluation metrics and benchmark OLRA against OpenPilot, a representative direct-generation approach. Experimental results on the nuScenes dataset demonstrate that OLRA outperforms OpenPilot in complex road segments and in route estimation at distance beyond 20 meters, achieving lower overall Euclidean error. This study is expected to promote future research in low-cost, maplocalization-based route generation methods.

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

Hybrid ANN-SNN Pipeline with Local Plasticity

arXiv:2606.20151v1 Announce Type: cross Abstract: This work proposes a hybrid ANN-SNN pipeline that effectively leverages the rich embeddings of pretrained artificial neural networks (ANNs) to enable high-performance spiking neural networks (SNNs). The architecture couples a pretrained EfficientNet encoder with a CoLaNET spiking classifier. We convert the encoder's activations into spike trains via rate-coding and train the subsequent SNN classifier using local, biologically inspired learning rules, bypassing end-to-end gradient propagation. This approach achieves 99.09% accuracy on a 64-class ImageNet benchmark, demonstrating performance on par with conventional deep networks. The work presents a biologically plausible and efficient framework for adapting powerful pretrained encoders to downstream spiking neural network tasks.

12.
bioRxiv (Bioinfo) 2026-06-11

VFUSE: Virulent Feature Understanding with Sparse autoEncoders

Generative models have shown remarkable progress in a variety of domains such as protein design, but such power enables the opaque generation of hazardous proteins. In this work, we introduce VFUSE (Virulent Feature Understanding with Sparse autoEncoders), a mechanistic interpretability approach that trains SAEs on diffusion-transformer activations to audit protein models for hazard-aware features. We apply VFUSE to RoseTTAFold3 and RFDiffusion3, popular open-weight models for protein folding and synthesis. We find that for certain blocks, linear probes detect hazardous designs significantly better when fit in the SAE latent space over the original model's representations: improving interpretability without sacrificing model performance. Furthermore, we identify monosemantic features from the SAE that fire only on hazardous designs at up to AUROC 0.84 (q < 10-13).

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

Posterior Twins: Distributional Behavioral Simulation for Enterprise Decisions

作者:

arXiv:2606.16415v1 Announce Type: new Abstract: Enterprise behavioral simulation requires more than producing a plausible response. Many decisions depend on the shape of a population under a proposed action: which segments accept, defect, hesitate, or move into risk-sensitive states. This paper introduces Posterior Twins, a memory-grounded digital-twin approach that represents likely behavior as an updated distribution under a specific decision context. We evaluate a family of Twinning Labs behavioral-model operating points on a 226-example held-out behavioral-response benchmark and report both modal accuracy and Wasserstein-1 distance. The results show that modal accuracy and distributional fidelity identify different operating regimes. TL-Twin Alpha achieves the lowest observed Wasserstein-1 distance in the reported result set ($W_1 = 1.16$), while TL-Twin Delta and TL-Twin Gamma provide balanced operating points near the modal-accuracy frontier. The paper frames these results as a systems result: governed memory, behavioral model routing, scenario orchestration, distributional aggregation, and auditability are necessary for turning simulated behavior into reusable enterprise decision evidence.

14.
arXiv (math.PR) 2026-06-16

Universality in the target arrival statistics of non-conservative search processes

arXiv:2606.16025v1 Announce Type: cross Abstract: Stochastic search processes in which searchers are continuously introduced to and removed from a target search domain are fundamental to a wide class of physical and artificial systems. The theory of such non-conservative search processes is, however, much less developed than for search processes with a fixed number of particles. Here we exploit a natural mapping between non-conservative stochastic search and queueing theory to derive the full time-dependent distribution of target arrivals under minimal assumptions on the underlying search process. Remarkably, we find that the steady-state inter-arrival time distribution is exactly exponential, regardless of the details of the search process, showing a robust universality that emerges directly from the queueing framework. Thus, counterintuitively, the arrival statistics of a non-conservative search process are much simpler than sequential search-and-capture processes involving a fixed number of searchers. This has major implications for target resource accumulation, where the delivery of resources is counter-balanced by their downstream consumption.

15.
arXiv (CS.LG) 2026-06-16

Asymptotically Optimal Sequential Testing with Markovian Data

arXiv:2602.17587v3 Announce Type: replace-cross Abstract: We study one-sided and $\alpha$-correct sequential hypothesis testing for data generated by an ergodic, finite-state Markov chain. The null hypothesis is that the unknown transition matrix belongs to a prescribed set $P$ of stochastic matrices, and the alternative corresponds to a disjoint set $Q$. We establish a non-asymptotic instance-dependent lower bound on the expected stopping time of any valid sequential test under the alternative, which is asymptotically tight. Our novel analysis improves the existing lower bounds, which are either asymptotic or provably sub-optimal in this setting. Our lower bound incorporates both the stationary distribution and the transition structure induced by the unknown Markov chain. We further propose an optimal test whose expected stopping time matches this lower bound asymptotically as $\alpha \to 0$. We illustrate the usefulness of our framework through applications to sequential detection of model misspecification in Markov Chain Monte Carlo and to testing structural properties, such as the linearity of transition dynamics, in Markov decision processes. Our findings yield a sharp and general characterization of optimal sequential testing procedures under Markovian dependence.

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

High-dimensional coherence to entanglement transduction under canonical noise

arXiv:2606.16695v1 Announce Type: new Abstract: We develop an analytical framework for coherence-to-entanglement conversion in bipartite high-dimensional quantum systems, so-called qunits. An arbitrary coherent input qunit is coupled to an incoherent ancilla through a generalized controlled-shift operation, producing a maximally correlated bipartite state. By analyzing the partial transpose of the output state, we establish an exact dimension-independent connection between the input coherence and the generated entanglement. We then study how this conversion is affected by three standard noise processes applied after the conversion step: phase damping, global depolarizing noise, and independent amplitude damping. The resulting expressions show that these channels degrade entanglement in qualitatively different ways. Phase damping leads to a uniform attenuation of the entanglement generated from coherence, depolarizing noise introduces pairwise thresholds associated with entanglement sudden death, and amplitude damping produces an asymmetric decay governed by relaxation toward the ground state. For maximally coherent inputs, the general results reduce to simple closed-form behavior, allowing direct comparison of the three noise mechanisms as the system dimension increases. In particular, global depolarizing noise exhibits a dimension-dependent sudden-death threshold, while amplitude damping leads to a smooth suppression in the maximally coherent case. These results provide useful analytical benchmarks for high-dimensional resource conversion and for assessing noisy entanglement generation in qudit-based quantum-information settings.

17.
arXiv (CS.AI) 2026-06-12

Boosting Direct Preference Optimization with Penalization

作者:

arXiv:2606.12505v1 Announce Type: cross Abstract: Offline preference optimization has become a practical substitute for reinforcement learning from human feedback, but pairwise objectives such as Direct Preference Optimization (DPO) and its variants use only the chosen and rejected responses stored in a static dataset. This leaves a useful signal unused: the response that the reference model itself would generate for the same prompt. We propose Direct Preference Optimization with Penalization (DPOP), a simple extension of DPO that augments the base preference loss with a gated penalty on reference-greedy responses. DPOP activates this penalty only when the current policy still assigns a lower likelihood to the preferred response than to the rejected response. On AlpacaEval 2.0, DPOP improves length-controlled win rate over DPO, SimPO, and AlphaDPO on both Llama-3-8b-it and Gemma-2-9b-it, achieving relative gains of 5.3\% and 4.4\% over baselines on the two models, respectively. Ablations further show that a SimNPO-style length-normalized penalty is stronger than NPO and token-level unlikelihood in this setting.

18.
arXiv (quant-ph) 2026-06-12

From 2D Yang-Mills to Calogero-Sutherland via a colored particle

arXiv:2606.13388v1 Announce Type: cross Abstract: We study Yang-Mills theory coupled to a particle on a cylinder, where gauge invariance and compactness reduce the dynamics to a finite dimensional quantum system. In the Abelian case, this yields a model equivalent to the Landau problem on a torus, with a degenerate ground state structure. We generalize this construction to non-Abelian gauge groups and show that, for SU(N), the system reduces to a one dimensional quantum many body problem with a singular Calogero-Sutherland-type interaction.

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

Infant Spontaneous Movement Noise Improves Exploration in Deep RL

arXiv:2606.16590v1 Announce Type: cross Abstract: Exploration in deep reinforcement learning (RL) is commonly implemented as temporally uncorrelated white noise. However, recent works show that temporally correlated colored noise can improve exploration efficiency by producing smooth trajectories with better coverage of the state space. We inquire whether action noise inspired by infant spontaneous movements can also improve exploration in deep RL. We find that the power spectral densities of babies' end-effector velocities follow a colored noise process where the spectral exponent increases with age. Inspired by this developmental pattern, we introduce a mechanism that progressively increases the temporal auto-correlation of exploration noise during RL training, matching the infant statistics. Experiments across several RL environments show that infant-inspired noise produces structured exploratory behavior and can improve learning efficiency compared to conventional exploration strategies. These findings suggest that human motor and cognitive development can provide useful guidance for designing learning mechanisms in artificial agents. Our code is available at https://github.com/trieschlab/baby-noise-rl.

20.
arXiv (CS.CV) 2026-06-16

Automated 3D Kinematic Monitoring for Circadian Activity and Anomaly Detection in Juvenile Fish

Precision aquaculture faces a "phenotyping bottleneck" in tracking high-resolution behavioral traits, as conventional methods cannot quantify instantaneous three-dimensional (3D) physical exertion. To address this, we present a high-throughput 3D behavioral phenotyping framework integrating deep learning object detection with binocular stereo vision for real-time monitoring of juvenile tilapia in high-density environments. The system automates non-contact body length estimation and reconstructs 3D swimming trajectories from absolute spatial coordinates. By eliminating 2D perspective distortions, this approach precisely quantifies 3D velocity and acceleration, marking the first estimation of true physical swimming speeds in free-roaming juveniles. Results show the framework successfully establishes circadian locomotor baselines, serving as an early warning system for physiological stress and providing an objective metric for fish vitality.

21.
arXiv (CS.CL) 2026-06-17

A Multifaceted Analysis of Social Biases in Large Language Models

Large language models (LLMs) have rapidly become indispensable tools for acquiring information and supporting human decision-making. However, ensuring that these models uphold fairness across varied contexts is critical to their safe and responsible deployment. In this study, we undertake a comprehensive examination of four widely adopted LLMs, probing their underlying biases and inclinations across the dimensions of politics, ideology, alliance, language, and gender. Through a series of carefully designed experiments, we investigate their political neutrality using news summarization, ideological biases through news stance classification, tendencies toward specific geopolitical alliances via United Nations voting patterns, language bias in the context of multilingual story completion, and gender-related affinities as revealed by responses to the World Values Survey. Results indicate that while the LLMs are aligned to be neutral and impartial, they still show biases and affinities of different types.

22.
arXiv (CS.CL) 2026-06-19

FineREX: Fine-Tuned NER-RE for Human Smuggling Knowledge Graphs

Court proceedings contain valuable evidence about human smuggling networks, but this information is often buried within unstructured, jargon-heavy legal documents. While large language models (LLMs) can support knowledge graph construction through automated information extraction, existing approaches rely on general-purpose models that are not tailored to the entity and relationship definitions required in this domain. We introduce FineREX, a streamlined knowledge graph construction pipeline built around a fine-tuned LLM for named entity recognition and relationship extraction (NER-RE). Using a manually annotated dataset of $512$ text chunks, FineREX achieves absolute improvements of 15.50% and 31.46% in entity and relationship F1-score, respectively, compared to a larger general-purpose baseline. These gains translate into higher-quality knowledge graphs, reducing legal noise by nearly half and lowering node duplication on long documents from 17.78% to 11.17%. By eliminating document rewriting and redundant extraction stages, FineREX also reduces end-to-end processing time by 50.0%. Our results demonstrate that domain-specific fine-tuning can substantially outperform larger general-purpose models while improving both the quality and efficiency of knowledge graph construction for illicit network analysis.

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

JailbreakOPT: Tool-Assisted Iterative Jailbreak Prompt Optimization

arXiv:2606.11425v1 Announce Type: cross Abstract: Jailbreak attacks expose persistent safety weaknesses in large language models (LLMs), but existing stateless single-turn methods face a trade-off: hand-crafted prompts are expressive but static, while iterative prompt optimization can adapt but often relies on low-level mutations that require many target queries. We propose JailbreakOPT, a tool-assisted framework for improving iterative single-turn jailbreak prompt optimization. JailbreakOPT organizes diverse atomic jailbreak prompts into an attack tool library and composes them through a unified intra-episode optimization abstraction to generate stronger standalone attack prompts. To reuse experience across attack episodes, JailbreakOPT further frames tool selection as a contextual bandit problem and applies contextual Thompson sampling to guide exploration and exploitation based on past outcomes. Experiments across multiple target LLMs and attack goals show that JailbreakOPT improves attack success rate (ASR) while reducing the number of attacks until success (No.A) compared with atomic single-turn attacks and existing iterative optimization baselines. This paper may contain offensive or harmful content.

24.
arXiv (CS.LG) 2026-06-12

Computationally tractable robust differentially private mean estimation

作者:

arXiv:2606.12654v1 Announce Type: cross Abstract: We develop a new, differentially private mean estimator called the balloon mean. The main features of the balloon mean are that it is computationally tractable and enjoys robustness to outlying observations. It is based on an iterative clipping procedure over expanding Mahalanobis balls, or ``balloons.'' The method satisfies zero-concentrated differential privacy and depends on a small number of interpretable tuning parameters. We provide theoretical guarantees under heavy-tailed and contaminated elliptical models, characterizing its statistical performance and robustness to outliers. Extensive simulations demonstrate that the balloon mean is robust to heavy-tailed and contaminated data, and outperforms existing differentially private mean estimators in contaminated settings.

25.
medRxiv (Medicine) 2026-06-15

Toward a National Registry for Inborn Errors of Immunity in Peru: A Qualitative Implementation Study

Background: Peru lacks an integrated information system for patients with Inborn Errors of Immunity (IEI). Although disease registries are essential tools for data management and health planning, their success depends on implementation science approaches that account for local contextual factors. This study reports Phase I of a three-phase mixed-methods implementation project to design and develop a national IEI registry. Methods: Phase I consisted of a phenomenological qualitative study exploring stakeholder perspectives. Semi-structured focus groups and in-depth interviews were conducted with 29 key stakeholders across four groups: policy-makers, clinical experts, end-users (immunologists, residents, allied health personnel), and patient organization representatives. Interviews followed a guide structured around four a priori domains (structure, navigation, feasibility, and perception of existing systems). Discussions were conducted in Spanish, audio-recorded, transcribed verbatim, and coded using ATLAS.ti. A hybrid thematic analysis combining deductive and inductive coding was performed. Data elements proposed for the registry were triangulated with qualitative findings. Results: Thirty-six initial codes were consolidated into 15 categories, which were further integrated into four overarching themes conceptualized as pathways toward intention to use: (1) Environment, where governance, regulatory backing, and sustainable financing were identified as key enablers, while limited interoperability emerged as a structural barrier; (2) Technical Dimension, emphasizing usability, alignment with clinical workflow, and a hierarchical data architecture (demographic, clinical, therapeutic); (3) Users, highlighting clinical leadership, protected time, digital readiness, and perceived usefulness as stronger motivators than financial incentives; and (4) Patients, underscoring data protection, transparency, trust, and advocacy as essential for legitimacy and sustainability. Conclusions: A national IEI registry in Peru is perceived as necessary and feasible if implemented with strong regulatory foundations, interoperable design, robust data security, and user-centered architecture. These findings informed the development of an initial functional prototype and the operational plan for Phase II, focused on usability evaluation.