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01.
arXiv (quant-ph) 2026-06-12

Quantum Otto engine powered by an anisotropic Heisenberg XYZ model under independent local magnetic fields

arXiv:2606.12877v1 Announce Type: new Abstract: We study a quantum Otto heat engine whose working substance is an anisotropic two-qubit Heisenberg XYZ model. Independent local magnetic fields are used to control each spin individually. The influence of the longitudinal coupling, anisotropy, transverse coupling, and local fields on the net work output and efficiency is systematically examined. Reducing the longitudinal coupling is found to markedly improve both the maximum work and the peak efficiency. The engine performance reaches an optimum at a particular value of the anisotropy parameter. A local work analysis clarifies how work is produced during the cycle. Because of the asymmetric local fields and the intrinsic spin-spin interaction, the two qubits play markedly different thermodynamic roles; the interaction term itself contributes crucially to the total work. We further analyze the variation of quantum entanglement, quantified by concurrence, along the cycle. The results indicate that a pronounced change in entanglement between the hot and cold isomagnetic strokes is closely correlated with the efficiency enhancement. This work offers new insight into the operating principles and control of quantum Otto heat engines.

02.
arXiv (CS.AI) 2026-06-11

Robust Privacy: Inference-Stage Privacy through Certified Robustness

arXiv:2601.17360v2 Announce Type: replace-cross Abstract: An adversary observing a model's released prediction can infer sensitive attributes of the queried input, or even reconstruct representatives of the model's training data. The inference interface thus acts as a side channel for privacy leakage. We introduce Robust Privacy (RP), an inference-stage privacy notion inspired by certified robustness: if a model's prediction is provably invariant within a radius-R neighborhood around an input x with confidence at least $1-\alpha$, then x enjoys $(R,\alpha)$-Robust Privacy, under which we prove that any adversary observing the released prediction has at most $\alpha/2$ advantage in distinguishing x from any input within distance R of x. Building on RP, we formalize Robust Attribute Privacy (RAP), an attribute-level privacy notion that characterizes the set of sensitive-attribute values that remain compatible with a released prediction. On a classification task, RP increases the median length of the RAP-compatible inference interval from 23.50 to 29.96, reducing attribute-inference precision. Model inversion attacks, often treated as a training-stage threat, in fact rely on fine-grained signals leaked through the inference interface; RP masks these signals at the inference stage, reducing attack success rate (ASR) from 73% to 4% on a black-box inversion attack. This direct targeting of the leakage channel enables RP to dominate DP-SGD and randomized response in the privacy-utility tradeoff space: RP retains 98.4% accuracy at 21% ASR, whereas DP-SGD must drop accuracy to 61.7% to reach a comparable ASR. Across both experiments, increasing the smoothing sample size N strengthens privacy and improves utility together. Finally, we examine model distillation as a scope boundary and show that RP mitigates attribute-level and instance-level inference-stage privacy leakage, but not function-level extraction through model distillation.

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

Contrastive Action-Image Pre-training for Visuomotor Control

Existing vision encoders for robotics face a fundamental bottleneck: robotic datasets lack the scale necessary for large-scale pre-training. Prior work circumvents this data scarcity by turning to internet-scale image and language data or egocentric human video. While these models show promise, neither paradigm learns from paired vision and action data, which downstream visuomotor control policies require. However, robot trajectories, the most direct source of this paired signal, are not available at pre-training scale, motivating us to extract action signals from abundant human video instead. To this end, we introduce CAIP (Contrastive Action-Image Pre-training), a vision encoder that treats human hand poses from large-scale egocentric video as a proxy for end-effector actions. By extracting 3D hand keypoints, a representation that aligns naturally with downstream robot action spaces, CAIP learns a unified action-image representation through a contrastive objective. Leveraging 32,041 hours of egocentric human video and only 88 hours of robotic manipulation data, CAIP outperforms state-of-the-art vision encoders including DINOv2, SigLIP, MVP, and R3M. Evaluated on a challenging real-world dexterous manipulation setup using Dexmate Vega and Sharpa Wave hands, CAIP yields performance gains of more than 30% on tasks involving folding, pouring, and fine-grained manipulation. Our results show that our method of contrastive action-centric pre-training yields a scalable path to achieving robust visual representations better suited for physical interaction.

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

Goal-Autopilot: A Verifiable Anti-Fabrication Firewall for Unattended Long-Horizon Agents

作者:

Long-horizon LLM agents are not trusted to run unattended: with no human watching, they confidently report success they never verified. We treat honesty – bounding what an agent may claim at termination – as a first-class metric for unattended autonomy, distinct from capability. We present Autopilot, an execution model that makes silent fabricated success structurally impossible rather than merely rarer. Autopilot externalizes all working state into a durable, gated finite-state machine that a scheduler advances one stateless tick at a time; a hard floor forbids any terminal "done" claim whose falsifiable gate did not actually execute and pass. We prove a No-False-Success theorem – under gate soundness, floor enforcement, and plan coverage, termination implies the goal holds – whose only trust points are empirically measurable, and show the worst case degrades to an honest stall, never a fabricated success. Because each tick rehydrates only the state machine, per-step context cost is constant in the horizon. Across a 3,150-cell paired corpus (70 tasks $\times$ 3 systems $\times$ 3 models $\times$ 5 seeds, including 50 SWE-bench Lite tasks across 11 OSS repos), Autopilot fabricates on 0.95% of cells [95% CI 0.38–1.62] while Reflexion and StateFlow baselines fabricate on 8.10% [6.48–9.81] and 25.05% [22.48–27.62] respectively. The headline contrast lives in the hard regime: on SWE-bench Lite, the firewall reduces fabrication from 33.7% (StateFlow) to 0.67%, a paired difference of $-33.07$ pp [95% CI $-36.53, -29.73$]. The mechanism is the gate, not the model: all ten Autopilot fabrications come from the strongest model, while two weaker mid-tier models never fabricate across 700 paired cells. The firewall trades coverage for honesty by design – an honest stall is recoverable; a confident wrong output shipped downstream is not.

05.
arXiv (CS.CV) 2026-06-17

MeiBRD: Meta-Learning Intraoperative Biomechanical Residual Deformation

Accurate intraoperative liver registration is challenging due to substantial soft-tissue deformation yet sparse intraoperative measurements. Biomechanical models regularize this ill-posedness with prior knowledge but exhibit persistent prediction bias due to simplifying assumptions, while data-driven learning solutions struggle with data efficiency, generalization, and physical plausibility. We propose a hybrid registration framework that adapts a biomechanical prior using sparse intraoperative correspondences. Rather than learning a full deformation field, we learn a residual deformation function that corrects linear biomechanical predictions, modeled as a graph neural diffusion function with geometry-aware attention over the 3D liver mesh. To enable long-range information transfer of sparse observations, we take a novel perspective of sparse intraoperative measurements as context samples where input-output pairs of the residual deformation function are fully observed, casting the problem into learning-to-learn this residual function from intraoperative context samples with feedforward meta-learners. Experiments on a deformable liver phantom dataset demonstrate improved registration accuracy and generalization compared to rigid, biomechanical, and data-driven baselines, particularly for out-of-distribution geometries and deformations.

06.
medRxiv (Medicine) 2026-06-16

Optimal Clinical Trials Platform for Progressive Multiple Sclerosis (OCTOPUS): protocol for an international, multi-arm, multi-stage, platform, randomized controlled, double-blind, phase 3 clinical trial.

Introduction Current treatments for multiple sclerosis (MS) do not address the pathological processes of neurodegeneration and chronic demyelination. This, coupled with the significant challenges of translating promising phase 2 results to phase 3 trial success, highlights the need for more efficient trial designs, such as platform multi-arm multi-stage (MAMS) trial approaches. MAMS trials have demonstrated success in areas such as oncology and infectious diseases. They are typified by a statistically robust core trial design that allows the addition of further treatment arms and utilisation of interim outcome analyses at pre-defined timepoints, to determine whether to terminate a treatment arm early or proceed to the final outcome analysis. To address the challenges in progressive multiple sclerosis (PMS) treatment discovery, the Optimal Clinical Trials Platform for PMS (OCTOPUS) trial was developed. It currently utilises MRI whole-brain atrophy as its interim outcome measure and the clinically relevant composite Expanded Disability Status Scale Plus (EDSS-Plus) as its final outcome measure. A rigorous and systematic drug selection process that assessed preclinical in vitro and animal model evidence, along with additional human data, led to the prioritisation of R/S-alpha lipoic acid (R/S-ALA) and metformin for testing against placebo, targeting pathobiological mechanisms relevant to PMS. All participants will be eligible to receive the current standard of care, including disease-modifying treatments (DMTs). Method and analysis OCTOPUS will be a multi-centre, randomised, placebo-controlled, double-blind, phase 3, MAMS trial of participants aged 25 to 70 years (inclusive) with PMS and an EDSS score of 4.0 to 8.0 (inclusive). Steady progression must be the major cause of increasing disability rather than relapse in the preceding 2 years. In the trial s first candidate drug cycle, participants will be allocated to R/S-ALA, metformin, or placebo in a 1:1:1 ratio. Cycle 1 active treatments will start as R/S-ALA 600 mg once daily, increased after 4 weeks to 600 mg twice daily, or metformin 1 g once daily, increased after 4 weeks to 1 g twice daily. The trial will be multinational, with participation from 28 hospitals across the UK and 10 hospitals in Australia. Clinician-reported measures will include: the EDSS-Plus and the individual components: EDSS, Timed 25 Foot Walk (T25FW); 9 Hole Peg Test (9HPT); Symbol Digit Modalities Test (SDMT); Sloan Low Contrast Visual Acuity (SLCVA); and Relapse assessment. Patient-reported outcomes include MS specific walking, fatigue, pain, and impact scales. We will include a health economic analysis. Analysis stage 1 will require randomisation of 125 participants per arm and utilise MRI percentage brain volume change (PBVC) with the Structural Image Evaluation using Normalisation of Atrophy (SIENA) technique from baseline to 78 weeks. A positive outcome in analysis stage 1 will detect a 0.15% per year whole brain atrophy difference with a one-sided alpha of 0.35 and power of 95%, ensuring a low probability of erroneously rejecting a treatment arm at this stage. Any arms that show a positive effect will proceed to final analysis stage 2. Analysis stage 2 will require 600 participants per arm. Participants included in stage 1 will also be included in the stage 2. Analysis stage 2 will evaluate time to 6-month confirmed disability progression in the EDSS-Plus, in order to detect a 25% hazard ratio reduction with 90% power and an alpha of 0.05. Assuming one treatment arm proceeds to analysis stage 2, the trial will recruit approximately 1,200 participants and last about 6 years. This is approximately two-thirds the size and half the duration of separately conducted two-arm phase 2 and 3 trials. Ethics and dissemination The protocol was approved by the London Hampstead REC (22/LO/0622). This manuscript is based on protocol version 8.0, 28th August 2025. The findings of this trial will be disseminated through peer-reviewed publications and conference presentations. There will be a close communication strategy developed with the UK MS Society (MSS) and full patient and public involvement and engagement (PPIE). Trial registration ISRCTN: 14048364 EudraCT number: 2021-003034-37 CTA 20363/0445 IRAS number: 1003943 Secondary identifying numbers: ND001, CPMS 54274 Strengths and limitations - The OCTOPUS trial will be the first platform multi-arm multi-stage phase 3 trial in PMS, offering the potential to significantly expedite clinical trial processes with advantages in cost- and time-efficiency, focusing specifically on the poorly treated pathobiological processes of chronic neurodegeneration and demyelination - It will begin by assessing two promising drug candidates, immediate-release metformin and R/S-ALA, and will expand over the duration of the trial to include more drug arms under the same trial master protocol - The flexible and statistically robust trial design means that several components of the design (such as the early analysis stage 1 interim outcome) can be updated in line with evolving scientific knowledge - It will ultimately be the largest ever investigator-initiated phase 3 trial in PMS - It will include a range of national and international trial sites, including neuroscience centres and district general hospitals - It will have a high inclusion limit for age (up to 70 years) and disability (up to EDSS 8.0) - Several components (the telephone EDSS and virtual patient-reported outcome measures) will be amenable to remote collection increasing inclusivity and thus addressing public and participant suggestions, while minimising the risk of missing data - The main challenges in this trial design are the statistical and methodological complexity involved in design and implementation, and interpretation of interim trial results. Conclusion The trial launched cycle 1 in January 2023. Analysis stage 1 recruitment of 375 participants was achieved in November 2024, enabling planned interim analysis stage 1 to be conducted by late 2026 (Figure 1). On the 1st of June 2026, in the UK, 24 sites are active with a further 4 in set-up as part of stage 2, and in the Australian extension, Platform Adaptive Trial for Remyelination and Neuroprotection in Multiple Sclerosis (PLATYPUS), 1 site is active, with 9 additional sites in set-up.

07.
arXiv (CS.CV) 2026-06-18

Architectural Bias in Face Presentation Attack Detection: A Comparative Study of Vision Transformers and Convolutional Neural Networks

Face Presentation Attack Detection (PAD) systems constitute a critical security layer in biometric authentication; however, existing approaches exhibit systematic performance disparities across demographic groups, disproportionately affecting individuals with darker skin tones. This paper presents a comparative empirical investigation of whether Vision Transformer architectures reduce demographic bias in face PAD systems relative to convolutional baselines. Experiments are conducted on the CASIA-SURF Cross-Ethnicity Face Anti-Spoofing (CeFA) dataset. Three architectures are evaluated: a Multimodal ViT-Tiny trained from scratch, a ResNet18 CNN baseline, and a pretrained DeiT-S fine-tuned on CeFA across African, East Asian, and zero-shot Central Asian demographic groups. DeiT-S achieves the highest overall accuracy of 97.27% and the lowest EER of 0.86%, outperforming ResNet18 at 90.15% accuracy. In terms of fairness, DeiT-S reduces the inter-ethnic ACER gap between African and East Asian subjects to 0.13%, compared to 0.75% reported in an LBP-based work [6], representing an 83% reduction. Most notably, while ResNet18 records a BPCER of 10.44% on zero-shot Central Asian subjects, DeiT-S maintains 2.89% on the same unseen group, demonstrating a 3.6x generalization advantage. These results suggest that pretrained Vision Transformers achieve superior PAD accuracy, produce smaller demographic performance gaps, and generalize more equitably across unseen demographic groups, indicating that cross-demographic fairness in PAD may partly be influenced by architectural design.

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

Active Inference with a Self-Prior in the Mirror-Mark Task

arXiv:2604.09673v2 Announce Type: replace-cross Abstract: The mirror self-recognition test evaluates whether a subject touches a mark on its own body that is visible only in a mirror, and is widely used as an indicator of self-awareness. In this study, we present a computational model in which this behavior emerges spontaneously through a single mechanism, the self-prior, without any external reward. The self-prior, implemented with a Transformer, learns the density of familiar multisensory experiences; when a novel mark appears, the discrepancy from this learned distribution drives mark-directed behavior through active inference. A simulated infant, relying solely on vision and proprioception without tactile input, discovered a sticker placed on its own face in the mirror and removed it in approximately 70% of cases without any explicit instruction. Expected free energy decreased significantly after sticker removal, confirming that the self-prior operates as an internal criterion for distinguishing self from non-self. Cross-modal sampling further demonstrated that the self-prior captures visual–proprioceptive associations, functioning as a probabilistic body schema. These results provide a concise computational account of the key behavior observed in the mirror test and suggest that the free energy principle can serve as a unifying hypothesis for investigating the developmental origins of self-awareness. Code is available at: https://github.com/kim135797531/self-prior-mirror

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

PointDiffusion: Diffusion-Based Scene Completion in the Point Cloud Domain

Reconstructing dense 3D scenes from sparse LiDAR point clouds is a fundamental challenge in autonomous driving, where latent diffusion models offer a promising solution. However, existing approaches rely on object-level autoencoders that collapse into unstable global representations at outdoor scale and suffer from ground truth data corrupted by odometry drift that systematically degrades supervision quality. Furthermore, multi-step diffusion inference incurs prohibitive latency for real-time deployment. We propose a novel multi-token Gaussian VAE with cross-attention pooling for stable scene-scale LiDAR compression, combined with an anchor-based ICP ground truth refinement pipeline that eliminates drift-induced noise from training supervision. Together, these components enable a scaffold-free single-step diffusion completion model that achieves an approximately 16x reduction in squared Chamfer distance on SemanticKITTI seq. 08 (0.396 m^2 to 0.024 m^2), surpasses LiDiff and ScoreLiDAR by 17-19% and 10-11%, respectively, and operates at 25-143x lower inference latency. Our results demonstrate that data quality dominates model design in this regime and that multi-token latent spaces provide a stable first stage for latent diffusion-based scene completion.

10.
bioRxiv (Bioinfo) 2026-06-16

Programmatic access to ICTV virus taxonomy through a public ontology API

The International Committee on Taxonomy of Viruses (ICTV) is responsible for developing and maintaining a universal virus taxonomy. As the reference framework for organising the viral world, it is essential for virology and related fields. Despite its widespread use in research and public health, programmatic access to ICTV taxonomy has remained limited, posing challenges for integration, versioning, and interoperability across databases and bioinformatics resources requiring up-to-date virus taxonomy. To address this, we developed a public and sustainable solution leveraging ontology-based APIs. Successive ICTV Master Species List (MSL) releases were transformed into a structured ontology and deployed as a unified representation through the Ontology Lookup Service (OLS). The framework also provides ICTV-NCBI mappings and helper libraries for integration into downstream systems. This enables, for the first time, public programmatic retrieval of current and historical virological taxon names, taxonomic relationships, metadata, and persistent identifiers through stable endpoints. More broadly, this work illustrates a general strategy for transforming structured biological datasets into semantically enriched graph resources exposed through scalable public APIs. These developments enhance interoperability, reduce manual curation, and support FAIR-aligned taxonomic data management in virology and pandemic preparedness.

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

Scenario-based Probing and Steering Cultural Values in Large Language Models–Extended Version

Large Language Models (LLMs) are deployed across cultural contexts but often reflect homogenized values inherited from training data. Evaluations of cultural alignment typically rely on direct prompting with survey-style questions, which frequently elicit neutral or safety-aligned responses and fail to capture underlying model preferences. We propose a framework for probing and steering latent cultural representations in LLMs along the two Inglehart–Welzel axes of the World Values Survey (WVS). By translating social value questions into scenario-based behavioral dilemmas, we extract token-level probabilities to measure implicit values and apply activation steering, optionally combined with country-conditioned prompting, to shift model behavior without retraining. Across three open-source LLMs and four target cultures, we find substantial variation in steerability and identify latent entanglement, where interventions along one cultural dimension induce shifts along another. This coupling mirrors correlations in human WVS data and persists across activation, prompt, and hybrid steering. It constrains axis-independent alignment, though general task performance is largely preserved.

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

Elastic ODYN: Differentiable Optimization for Infeasible Control and Learning in Robotics

arXiv:2606.16564v1 Announce Type: cross Abstract: Robotic systems routinely encounter conflicting objectives, modeling errors, and degenerate contact conditions that render quadratic programs (QPs) infeasible. Yet most optimization solvers and differentiable QP layers assume feasibility, leading to numerical failures, unstable gradients, or solver breakdown when constraints cannot be simultaneously satisfied. We present Elastic ODYN, a primal–dual non-interior-point QP solver that handles infeasibility through smooth squared-$\ell_2$ elastic relaxations. The resulting formulation remains well posed under ill-conditioning and degeneracy, supports warm starting, and converges to closest-to-feasible solutions when no feasible point exists. A lightweight refinement stage recovers physically meaningful dual variables from the elastic solution. Building on this framework, we develop Elastic OdynLayer, a differentiable QP layer with stable gradients under infeasibility, and Elastic OdynSQP, an infeasibility-aware SQP method that resolves inconsistent subproblems and intrinsically infeasible optimal control tasks through selective constraint relaxation. We evaluate the framework on benchmark QPs, singular contact mechanics, differentiable parameter identification, and quadrupedal and humanoid trajectory optimization. Across all settings, Elastic ODYN consistently outperforms state-of-the-art elastic QP solvers in robustness, warm-start performance, and convergence reliability, enabling optimization, simulation, control, and learning beyond the feasibility assumptions of existing methods.

13.
arXiv (CS.LG) 2026-06-19

QMaxCal: Path-Space Regularization for Open Quantum Control via Girsanov's Theorem

arXiv:2606.19947v1 Announce Type: cross Abstract: Reliable quantum control in the presence of decoherence requires policies that combat the effect of environmental noise on the controlled dynamics. Open quantum systems under continuous monitoring generate classical measurement records whose drift depends on the noise experienced by the system; the records of two evolutions sharing the same decoherence channels differ only in this drift, so Girsanov's theorem yields a closed-form, differentiable estimator of the KL divergence between their trajectory distributions. We instantiate this estimator with two physically motivated reference measures, yielding two regularizers that both drive the system toward states where the effects of decoherence are minimal: the Wiener KL (KL_W), which is empirically more effective under certain conditions on the noise model, and the drift-variance regularizer (R_DV), which works for all noise models. Both are qualitatively distinct from existing penalties on control fluence or smoothness: they penalize the observable consequences of control on the decoherence channels rather than the control amplitude itself. The regularizers outperform unregularized gradient-based and reinforcement-learning baselines across a range of open quantum systems – including single- and multi-qubit benchmarks and a multi-qubit chain calibrated to a published snapshot of the IBM Kingston processor – along several axes of evaluation: final-state fidelity, robustness to mismatch in the assumed noise model (gains grow from +17 pp at training noise to +27 pp under 2.5x noise mismatch), and occupation of forbidden states. The regularizers reduce infidelity by up to 50%, with ~16% gains on the calibrated IBM Kingston chain.

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

Recursive Scaling in Masked Diffusion Models

arXiv:2606.18022v1 Announce Type: new Abstract: Masked diffusion models (MDMs) have recently emerged as a promising paradigm for sequence generation. Scaling MDMs is conventionally achieved by increasing the parameter count or the number of denoising steps. We introduce Recursive Masked Diffusion Models (R-MDMs), which add recursive depth as a third scaling axis by repeatedly applying the same denoising transformer within each diffusion step. Recursion enables iterative refinement of the output through parameter reuse, increasing effective model depth without increasing parameter count. Across structured generation tasks, including Sudoku and Countdown, we show that R-MDMs achieve substantially improved parameter efficiency: a model with $L$ recursive iterations often matches the performance of non-recursive baselines with roughly $L\times$ more parameters. Moreover, recursive refinement can partially substitute for additional denoising steps, allowing recursive models to reach the same generation quality with fewer forward passes at inference time. These results suggest that recursive depth is a practically useful scaling mechanism for MDMs, improving both parameter efficiency and the allocation of test-time compute.

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

A Multimodal Approach to Alzheimer's Diagnosis: Geometric Insights from Cube Copying and Cognitive Assessments

arXiv:2512.16184v2 Announce Type: replace Abstract: Early and accessible detection of Alzheimer's disease (AD) remains a critical clinical challenge, and cube-copying tasks offer a simple yet informative assessment of visuospatial function. This work proposes a multimodal framework that converts hand-drawn cube sketches into graph-structured representations capturing geometric and topological properties, and integrates these features with demographic information and neuropsychological test (NPT) scores for AD classification. Cube drawings are modeled as graphs with node features encoding spatial coordinates, local graphlet-based topology, and angular geometry, which are processed using graph neural networks and fused with age, education, and NPT features in a late-fusion model. Experimental results show that graph-based representations provide a strong unimodal baseline and substantially outperform pixel-based convolutional models, while multimodal integration further improves balanced classification performance and discriminative ability. SHAP-based interpretability analysis identifies specific graphlet motifs associated with corner integrity and edge continuity as key predictors, closely aligning with clinical observations of distorted cube drawings in AD. Together, these findings establish graph-based analysis of cube-copying behavior as an interpretable, non-invasive, and scalable framework for Alzheimer's disease screening.

16.
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.

17.
medRxiv (Medicine) 2026-06-16

AI-assisted continuous-time modelling of metastatic breast cancer reveals subtype-specific spatiotemporal organ interactions

Metastatic breast cancer is one of the leading causes of premature mortality among women worldwide. A major barrier to optimal care is the marked heterogeneity in both the temporal dynamics of metastatic spread and the organ-specific spatial distribution of metastases. Existing analyses do not adequately capture this complexity, as they either neglect temporal dependencies or assume independence between metastasic sites. As a result, it remains unclear how established metastases influence subsequent organ-specific dissemination. We address this question using patient-level longitudinal trajectories from a large multicentre real-world metastatic breast cancer registry, combined with an AI-assisted disease-progression modelling framework based on continuous-time Markov chains that represent combinations of metastatic sites and the non-uniform and practice-driven timing of radiologic response assessments, as encountered in routine clinical care. We present a stochastic model determined by progression rates, which are parameterised to capture baseline organ-specific transition risks, patient-level covariates, and pairwise inter-organ interaction effects. High-dimensional treatment information is incorporated using an large language model based encoding. We find that metastatic spread follows non-independent, subtype-specific spatiotemporal patterns, with subtype-specific inter-organ interaction patterns that shape progression. Visceral metastases, particularly lung and liver metastasis, are associated with an increased hazard of subsequent brain metastasis, with effects varying across hormone receptor-positive, HER2-positive, and triple-negative subtypes. Together, these findings define a clinically relevant spatiotemporal architecture of metastatic progression in breast cancer. This framework enables refined mechanism-informed risk stratification and provides a data-driven rationale for targeted and risk-adapted – rather than symptom-triggered – surveillance strategies.

18.
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.

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

Reload-Mamba: Hierarchical Anti-Dilution State-Space Modeling for Multi-Class Semantic Segmentation

Mamba-based state space models offer linear-time long-range modeling for high-resolution dense prediction, but sequential state-space propagation can attenuate boundary-sensitive and detail-sensitive responses that are critical in multi-class semantic segmentation. We propose Reload-Mamba, a semantic segmentation framework that addresses this propagation-induced response dilution through three segmentation-specific designs: (i) a boundary-supervised local detail prior that is explicitly trained with ground-truth boundary masks to identify regions requiring response restoration; (ii) a class-uncertainty-aware Reload Gate that incorporates per-pixel class entropy from a pre-reload auxiliary head as an additional gating signal, a formulation that is informative only under multi-class dense prediction; and (iii) a hierarchical multi-level Reload mechanism that applies anti-dilution refinement at three decoder levels and fuses the restored representations top-down. Built upon a ConvNeXt-Tiny encoder with a multi-scale decoder and four-directional Mamba scanning with pixel-wise directional attention, Reload-Mamba achieves 47.9% single-scale (48.9% multi-scale) mIoU on ADE20K and 83.2% single-scale mIoU on Cityscapes. With ResNet-101 + COCO pre-training under the standard DeepLab-style protocol, Reload-Mamba reaches 87.8% mIoU on PASCAL VOC 2012 val. Controlled ablations show that each of the three segmentation-specific designs contributes beyond a direct port of the prior anti-dilution architecture proposed for binarization, cumulatively improving over the direct-port baseline by +2.2 mIoU on ADE20K.

20.
arXiv (CS.LG) 2026-06-19

Adversarial Dependence Minimization

arXiv:2502.03227v2 Announce Type: replace Abstract: Minimally redundant representations are typically learned by minimizing feature covariance. However, covariance-based methods fail to eliminate all dependencies/redundancies, as linearly uncorrelated variables can still exhibit nonlinear relationships. To address this, we introduce ADM, a differentiable algorithm that minimizes statistical dependence between feature dimensions through an adversarial game: auxiliary networks identify dependencies, while the encoder removes them. We prove that mutual independence is achieved at the global optimum, empirically verify convergence, and study three potential applications: extending PCA to nonlinear decorrelation, improving generalization in image classification, and preventing dimensional collapse in self-supervised learning. By promoting statistically independent representations, ADM paves the way for learning more robust, compressed, and generalizable representations across diverse applications.

21.
arXiv (math.PR) 2026-06-12

Explosion and non-explosion in pure birth Crump–Mode–Jagers branching processes

arXiv:2601.06850v2 Announce Type: replace Abstract: In this short note, we provide an explicit sufficient condition for non-explosion of Crump–Mode–Jagers branching processes with pure birth reproduction. It shows that the standard sufficient condition for explosion, namely the convergence of the series of reciprocals of the birth rates, is – at least for rate sequences without excessive oscillations – remarkably close to being necessary. At the same time, it is not necessary in full generality: we construct a counterexample which also yields a general preferential attachment tree without fitness with an infinite path and no vertices of infinite degree, thereby answering an open question previously raised in the literature.

22.
arXiv (CS.LG) 2026-06-18

Structural MRI Synthesis for Alzheimer's Disease via Conditional Diffusion on Anatomical Masks

arXiv:2606.18354v1 Announce Type: cross Abstract: Recent advances in generative machine learning models have significantly improved medical imaging, offering promising solutions for data augmentation, privacy preservation, and improved model generalization. However, synthesizing high-quality structural MRI data for Alzheimer's Disease (AD) remains challenging due to the subtle, region-specific, and progressive anatomical changes associated with neurodegeneration. In this paper, we extend the Med-DDPM conditional diffusion model – originally designed for brain tumor synthesis – to generate 3D structural MRIs specifically tailored to AD. We adopted Med-DDPM due to its established stability and structural fidelity compared to other generative models, which makes it particularly suitable for capturing the subtle anatomical changes characteristic of AD. Our approach conditions the diffusion process on anatomical segmentation masks derived from the ADNI dataset, incorporating key AD-relevant brain structures into the generation process. We systematically evaluate the quality and utility of the synthetic images by training segmentation models on real, synthetic, and hybrid (mixed) datasets. Experimental results demonstrate that segmentation models trained exclusively on synthetic data achieve comparable Dice scores (0.6532) to those trained on real data (0.6513), while exhibiting significantly enhanced recall. Notably, models trained on hybrid datasets (mixing real and synthetic images) outperform both real and synthetic-only baselines, achieving a Dice score of 0.7244. These findings underscore the successful use of conditional diffusion models for generating anatomically accurate, AD-specific synthetic MRIs, and highlight their potential for enhancing training data availability, improving diagnostic accuracy, and promoting research reproducibility in neuroimaging studies.

23.
arXiv (CS.AI) 2026-06-12

ReSum: Synergizing LLM Reasoning and Summarization with Reinforcement Learning

arXiv:2606.13316v1 Announce Type: new Abstract: Reinforcement Learning with Verifiable Rewards (RLVR) is a central technique for improving long-horizon reasoning in Large Language Models (LLMs). However, existing RLVR methods often encourage unnecessarily long reasoning rollouts, which can degrade reasoning coherence and exhaust the available context budget. Existing approaches to long-context organization often depend on external mechanisms to organize rollouts, rather than enabling the model to manage its own reasoning trajectory. To address this limitation, we propose ReSum, a novel RLVR framework that enables LLMs to compress and organize their reasoning trajectories through self-summarization. Our pilot studies show that self-summarization stabilizes generation by lowering token-level entropy, and that introducing a ``summarization'' phrase can substantially mitigate errors propagated from an incorrect rollout prefix. Motivated by these findings, ReSum adopts a summarization-aware adaptive rollout mechanism that contrastively evaluates whether self-summarization benefits the ongoing reasoning process. Specifically, when the model spontaneously triggers self-summarization, ReSum masks the summarization phrase to create a contrastive branch; for non-summarization positions, it instead randomly injects the phrase to create a matched branch. We further design a summarization-aware advantage to enable finer-grained comparison between contrastive rollout trajectories. Extensive experiments show that ReSum improves performance at an average of 4\% while reducing rollout length by 18.6\%.

24.
arXiv (CS.CL) 2026-06-16

Learning When to Sample: Confidence-Aware Selective Sampling for Efficient Chain-of-Thought Reasoning

Large language models (LLMs) can achieve strong reasoning performance through chain-of-thought (CoT) reasoning, yet they often generate unnecessarily long reasoning paths that incur high inference cost. Self-consistency-based approaches push accuracy higher still, but they require sampling and aggregating multiple reasoning trajectories, leading to substantial computational overhead. In this paper, we introduce a confidence-aware selective sampling framework that, at inference time, analyzes a single reasoning trajectory to adaptively determine whether to rely on that trajectory alone or trigger multi-path sampling. The framework uses trajectory-level numeric features and sentence-level linguistic features extracted from reasoning states to guide selective multi-path reasoning. We train it on MedQA and evaluate it in-domain on MedQA and under calibration-only transfer on MathQA, MedMCQA, and MMLU, without further fine-tuning. Experimental results show that the proposed framework maintains comparable performance to full and efficient multi-path reasoning baselines, with accuracy changes of $-0.41 \pm 0.58$ and $-0.31 \pm 0.58$ percentage points, respectively, while reducing token usage by $71.7 \pm 5.0%$ and $36.6 \pm 9.1%$. These findings demonstrate that reasoning trajectories contain rich signals for uncertainty estimation, enabling a simple, transferable mechanism to balance accuracy and efficiency in LLM reasoning.

25.
arXiv (CS.CV) 2026-06-11

Parameter-Efficient Adapter Tuning for Tabular-Image Multimodal Learning

作者:

Tabular-image multimodal learning aims to improve predictive modeling by jointly using structured tabular attributes and visual data. Although pretrained encoders provide strong modality-specific representations, full fine-tuning can be computationally expensive, while keeping encoders frozen may limit task-specific adaptation. We propose the Tabular-Image Adapter (TI-Adapter), a modality-specific adapter-based fine-tuning framework for efficient multimodal adaptation. TI-Adapter freezes the pretrained tabular encoder and learns an adapter after the extracted tabular embedding, while adapting the image branch with embedding-level and bottleneck-level adapters instead of full fine-tuning. Experiments on 20 tabular-image datasets show that TI-Adapter achieves competitive or better predictive performance than full fine-tuning while using substantially fewer trainable parameters. Ablation studies further demonstrate the importance of adapter placement for balancing performance and practical efficiency.