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01.
arXiv (CS.AI) 2026-06-17

Curiosity-Critic: Cumulative Prediction Error Improvement as a Tractable Intrinsic Reward for World Model Training

arXiv:2604.18701v3 Announce Type: replace-cross Abstract: Local prediction-error-based curiosity rewards focus on the current transition without considering the world model's cumulative prediction error across all visited transitions. We introduce Curiosity-Critic, which grounds its intrinsic reward in the improvement of this cumulative objective, and show that it admits a tractable per-step surrogate: the difference between the current prediction error and the asymptotic error baseline of the current state transition. We estimate this error baseline online with a learned critic co-trained alongside the world model; since the critic only has to learn how hard a transition is to predict, its estimate of the irreducible noise floor converges well before the world model saturates, redirecting exploration toward learnable transitions. The reward is higher for learnable transitions and collapses toward zero for stochastic ones, thereby separating epistemic (reducible) from aleatoric (irreducible) prediction error online. Prior prediction-error curiosity formulations, from Schmidhuber (1991) to learned-feature-space variants, emerge as special cases corresponding to specific approximations of this error baseline. Experiments on a stochastic grid world show that Curiosity-Critic outperforms prediction-error, visitation-count, and Random Network Distillation methods in training speed and final world model accuracy.

02.
arXiv (quant-ph) 2026-06-15

Multi-entropy in random tensor networks

arXiv:2606.04470v2 Announce Type: replace-cross Abstract: We study the evaluation of Rényi multi-entropies $S^{(q)}_n$ in Random Tensor Network (RTN) states in the large bond-dimension limit. For the case of Rényi index $n=2$ and arbitrary number of parties $q$, we prove that that multi-entropies are determined by minimal multiway cuts through the network. When the minimal multiway cut is degenerate, we characterize the full minimizer set via compatible families of minimal cuts and give a criterion for all minimizers to come from ordinary cut partitions. For $n=2$, this gives a natural generalization of the minimal cut description of bipartite entanglement to multipartite systems with arbitrarily many parties. For the case of integer $n>2$, we show that the minimal multiway cut conjecture is in general not true by providing explicit counter examples for both the single random tensor and for the network built from isometric tilings. We discuss the implication for our results on the multipartite entanglement structures in RTN and holography.

03.
arXiv (CS.LG) 2026-06-18

Self-attention-based non-linear basis transformations for compact latent space modelling of dynamic optical fibre transmission matrices

arXiv:2406.07775v2 Announce Type: replace Abstract: Multimode optical fibres are hair-thin strands of glass that efficiently transport light. They promise next-generation medical endoscopes that provide unprecedented sub-cellular image resolution deep inside the body. However, confining light to such fibres means that images are inherently scrambled in transit. Conventionally, this scrambling has been compensated by pre-calibrating how a specific fibre scrambles light and solving a stationary linear matrix equation that represents a physical model of the fibre. However, as the technology develops towards real-world deployment, the unscrambling process must account for dynamic changes in the matrix representing the fibre's effect on light, due to factors such as movement and temperature shifts, and non-linearities resulting from the inaccessibility of the fibre tip when inside the body. Such complex, dynamic and nonlinear behaviour is well-suited to approximation by neural networks, but most leading image reconstruction networks rely on convolutional layers, which assume strong correlations between adjacent pixels, a strong inductive bias that is inappropriate for fibre matrices which may be expressed in a range of arbitrary coordinate representations with long-range correlations. We introduce a new concept that uses self-attention layers to dynamically transform the coordinate representations of varying fibre matrices to a basis that admits compact, low-dimensional representations suitable for further processing. We demonstrate the effectiveness of this approach on diverse fibre matrix datasets. We show our models significantly improve the sparsity of fibre bases in their transformed bases with a participation ratio, p, as a measure of sparsity, of between 0.01 and 0.11. Further, we show that these transformed representations admit reconstruction of the original matrices with < 10% reconstruction error, demonstrating the invertibility.

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

SVoT: State-aware Visualization-of-Thought for Spatial Reasoning via Reinforcement Learning

arXiv:2606.11770v1 Announce Type: new Abstract: Spatial reasoning remains a challenge for Multimodal Large Language Models (MLLMs), as it requires reliable multi-hop inference over both intermediate states and state transitions. Current studies often leave intermediate states unverified and treat state transitions as implicit processes, which limits reliability in multi-hop spatial reasoning. To address this, we propose State-aware Visualization-of-Thought (SVoT), a reinforcement learning framework that generates interleaved, verifiable intermediate states and visualizations. SVoT integrates transition reasoning chains into the generation processes, enabling the model to verify action preconditions and effects through interleaved textual and visual reasoning. We train SVoT via Group Relative Policy Optimization (GRPO), instantiating verification through reward design and evaluating the efficacy of different fine-grained rewards. As existing benchmarks reduce state transitions to single-variable updates, substantially simplifying the problems, we establish five domains by extending classical environments and introducing two novel domains, Pacman and Gather, that require multi-object interactions and numerical reasoning. These domains support systematic evaluation of multi-hop spatial reasoning with quantitative verification of generated intermediate states and transition reasoning. SVoT with transition-aware supervision achieves state-of-the-art performance across the introduced domains, yielding up to a 65% absolute accuracy gain on out-of-distribution test sets.

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

When Do We Need LLMs? A Diagnostic for Language-Driven Bandits

arXiv:2604.05859v2 Announce Type: replace Abstract: We study Contextual Multi-Armed Bandits (CMABs) for non-episodic decision-making problems where the context includes both textual and numerical information (e.g., recommendation systems, dynamic portfolio adjustments, offer selection; all frequent problems in finance). While Large Language Models (LLMs) are increasingly applied to these settings, utilizing LLMs for reasoning at every decision step is computationally expensive, and uncertainty estimates are difficult to obtain. To address this, we introduce LLMP-UCB, a bandit algorithm that derives uncertainty estimates from LLMs via repeated inference. However, our experiments demonstrate that lightweight numerical bandits operating on text embeddings (dense or Matryoshka) match or exceed the accuracy of LLM-based solutions at a fraction of their cost. We further show that embedding dimensionality is a practical lever on the exploration-exploitation balance, enabling cost-performance tradeoffs without prompt complexity. Finally, to guide practitioners, we propose a geometric diagnostic based on the arms' embeddings to decide when to use LLM-driven reasoning versus a lightweight numerical bandit. Our results provide a principled deployment framework for cost-effective, uncertainty-aware decision systems with broad applicability across AI use cases.

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

Marginal Alignment Does Not Guarantee Joint-Distribution Fidelity: An Official-Reference Audit of Nemotron-Personas-Korea with Cross-Locale Replication

Synthetic persona datasets cite alignment with official demographics as a basis for trust, yet downstream users consume them as joint structures across age, sex, region, occupation, education, name, and institutional status. Marginal alignment does not imply that these joints are preserved. We propose the Independence-Assumption Footprint (IAF), an audit primitive that operates on the attribute combinations a dataset card itself documents as treated independently. For each such combination, IAF compares the synthetic joint against an external official or institutional reference, using direct joint tables where available and rule-implied checks otherwise. Applied to NVIDIA Nemotron-Personas-Korea (one million Korean synthetic personas), IAF finds that NPK aligns with KOSIS marginals while three joints fail. The major-by-occupation distribution against the KEIS graduate universe carries a large conditional mismatch. The age profile of military service is institutionally inconsistent. Female representation in male-dominated occupations is substantially over-flattened toward parity, with the strict screening verdict mapping-dependent and age-robust under direct standardisation. A transferability demonstration across six further NPK locales finds locale-dependent rather than universal diagnostics, with reference-taxonomy cardinality confounding cross-locale flag counts. For synthetic personas used as silicon samples, marginal claims must therefore be paired with disclosure-anchored joint audits before reuse. The released audit artefacts (reference manifests, occupational crosswalks, derived metrics, reproducibility scripts) instantiate this protocol on the NPK family and are released for retargeting at other synthetic persona resources.

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

AI4SE and SE4AI Exploration: A Decade Looking Back and Forward

arXiv:2606.19630v1 Announce Type: new Abstract: The March 2020 INCOSE INSIGHT special issue on AI and Systems Engineering (SE) became the most downloaded issue in the publication's history and launched a research community that now draws over 250 registrants to its annual workshop. In this article, we trace the progress in AI and SE across three phases (labeled here foundational, applied, and LLM inflection) based on the authors' reading of the field's core papers, and describe our opinions of where the community has converged and where critical gaps remain. Separately, a human-AI agreement literature review leveraging both human expertise and six AI models was performed to assess the relevance of 1,712 INCOSE INSIGHT articles and 889 SERC publications. The results identify five critical research gaps and offer guidance for practitioners navigating AI adoption, assurance, and workforce transformation in SE. We share the agreement data and the AI4SE/SE4AI Explorer web application so readers can compare their own relevance judgments with the human and AI raters.

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

Representing Piecewise-Linear Functions by Functions with Minimal Arity

arXiv:2406.02421v2 Announce Type: replace-cross Abstract: Any continuous piecewise-linear function $F\colon \mathbb{R}^{n}\to \mathbb{R}$ can be represented as a linear combination of $\max$ functions of at most $n+1$ affine-linear functions. In our previous paper [``Representing piecewise linear functions by functions with small arity'', AAECC, 2023], we showed that this upper bound of $n+1$ arguments is tight. In the present paper, we extend this result by establishing a correspondence between the function $F$ and the minimal number of arguments that are needed in any such decomposition. We show that the tessellation of the input space $\mathbb{R}^{n}$ induced by the function $F$ has a direct connection to the number of arguments in the $\max$ functions.

09.
arXiv (CS.AI) 2026-06-15

tap: A File-Based Protocol for Heterogeneous LLM Agent Collaboration

作者:

arXiv:2606.14445v1 Announce Type: cross Abstract: Existing multi-agent software development systems have proposed many forms of agent collaboration, including role-based collaboration and automated code review. However, many systems assume a common runtime, a central conversation server, or the same API family. Under these assumptions, LLM agents from different vendors cannot easily exchange messages directly from their own execution environments while dividing development and review work on a shared codebase. This paper presents tap, a file-based collaboration protocol that allows Claude (Anthropic) and Codex (OpenAI) to collaborate on one codebase without shared memory or an identical runtime. The core of tap is a file-first design that preserves markdown files with metadata as original messages, combines a file inspection path (file communication, Tier 1) with real-time notification paths for Claude and Codex (real-time communication, Tier 2), and isolates work through separate git worktrees. Even if real-time notification fails or a receiver restarts, the message file remains available and the same content can be inspected again. In a 27-day, 37-generation self-applied operation where tap was used to develop and review itself, we collected 209 tap-related pull requests and 717 operational artifacts. An analysis of 375 review artifacts showed that the share of reviews recording at least one defect or requested change was 69.8% for heterogeneous model pairs and 53.1% for homogeneous model pairs. These results show that tap, which combines file-based message preservation with real-time notification, operates in a real production repository, and that combining heterogeneous models and execution environments can broaden review perspectives. tap is distributed as the open-source npm package @hua-labs/tap (v0.5.2).

10.
arXiv (CS.AI) 2026-06-12

Beyond Problem Solving: UOJ-Bench for Evaluating Code Generation, Hacking, and Repair in Competitive Programming

arXiv:2606.12864v1 Announce Type: cross Abstract: Despite strong performance in competitive programming, the role of Large Language Models (LLMs) in supporting human learning in the same setting remains largely unexplored. In this work, we introduce UOJ-Bench, a benchmark designed to evaluate not only the problem-solving ability of LLMs, but also their ability to identify errors in human-written code – a crucial educational activity traditionally supported by running test cases over online judge systems. UOJ-Bench consists of three distinct tasks: code generation, code hacking, and code repair, all constructed from real-world code submissions on the Universal Online Judge (UOJ) and evaluated through UOJ's native judging infrastructure. Our results show that under one-shot evaluation, even the strongest models fail to identify errors in more than 50% of a set of submissions that have been found to be incorrect by UOJ users. While test-time scaling improves success rates to above 90%, the substantial computational costs incurred from model inference limit its practicality for large-scale deployment. Despite these limitations, we find that the best-performing models under test-time scaling can uncover errors in over 5% of full-score submissions across roughly 30 problems, suggesting that frontier LLMs can already provide complementary signals beyond standard judging systems.

11.
arXiv (CS.CL) 2026-06-16

StagePilot: Stage-Level Planning for Long-Horizon Dialogue Simulation in Cybergrooming

Cybergrooming is an evolving threat to youth, requiring proactive educational interventions. We address this by modeling dialogue progression as a structured planning problem over stage-wise interactions. We propose StagePilot, a dialogue framework that separates stage-level planning from response generation, in which the model selects the next stage under constrained transitions and generates responses conditioned on it, enabling coherent and realistic progression. Reinforcement learning is used to learn stage-level policies from offline data, optimizing for both emotional alignment and goal-consistent progression. Our empirical experiments show that StagePilot generates more structured, coherent dialogue trajectories and reduces conversational stagnation compared to baselines; notably, the IQL+AWAC variant reaches the final stage more often while maintaining over 70% positive or neutral responses, yielding a 43% relative improvement.

12.
arXiv (math.PR) 2026-06-11

On the Wasserstein distance between a hyperuniform point process and its mean

arXiv:2404.09549v3 Announce Type: replace Abstract: We study the existence of bounds on the expected $p$-Wasserstein distance between a random measure and its mean under the assumption that the $p$-th centered moments of the counting statistics are controlled uniformly in space. The average Wasserstein transport cost is shown to be bounded from above and from below by some multiples of the number of points. $D$-dimensional versions of those results are also obtained. As a corollary, we prove that for any value of $p\geq 1$ the Ginibre point process can be seen as a perturbed lattice with identically distributed perturbations with a finite $p$-th moment.

13.
arXiv (quant-ph) 2026-06-19

Impossibility of superluminal signalling rules out causal loops in conical spacetimes

arXiv:2606.20476v1 Announce Type: cross Abstract: In PRL 129, 110401 it was shown that it is theoretically possible to have operationally detectable causal loops without violating the principle of no superluminal signalling (NSS) in (1+1)-Minkowski spacetime. Whether or not such causal loops are also possible in $d > 1$ spatial dimensions, has remained a key open question. We resolve this question by showing that in a wide class of "conical" spacetimes, including Minkowski with d > 1, NSS does rule out all operationally detectable causal loops, in classical, quantum and post-quantum theories. This establishes that the relationship between the relativistic principles of NSS and no causal loops depends inherently on the geometry of spacetime.

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

EdgeZSAD: Practical Zero-Shot Anomaly Detection on Edge Devices

Industrial inspection needs zero-shot anomaly detection (ZSAD) that remains useful under edge deployment constraints. Recent methods often rely on ViT-L foundation backbones (~300M parameters), which exceed the memory and operator budget of typical embedded hardware. We study this regime through EdgeZSAD, a compact reference system built around a TinyViT-21M-512 backbone, an asymmetric global-local readout (EdgeGLR), and a reproducible source-side training recipe (Real-IAD-DR). We train a single checkpoint in a source-trained, target-unseen protocol and evaluate it across six industrial benchmarks. Across three independent runs, the resulting model reaches an average image AUROC of 91.6 on MVTec-AD and 88.2 on VisA, while remaining directly deployable on Jetson Orin Nano Super (TensorRT FP16) and RB5 Gen2 (QNN GPU FP16). Across the six device-rescored benchmarks, image-AUROC drift stays below 0.2 points, indicating that the exported graph preserves host-side ranking behavior in the evaluated deployment setting.

15.
arXiv (CS.AI) 2026-06-12

scLLM-DSC: LLM-Knowledge Enhanced Cross-Modal Deep Structural Clustering for Single-Cell RNA Sequencing

arXiv:2606.13007v1 Announce Type: cross Abstract: Clustering is fundamental to scRNA-seq analysis, serving as a cornerstone for identifying cell populations and resolving tissue heterogeneity. However, existing methods focus on mining numerical statistical patterns, suffering from semantic agnosticism by neglecting the intrinsic biological functions encoded by genes. While Large Language Models (LLMs) offer promising semantic capabilities, their direct adaptation to cell clustering is hindered by the structural mismatch between generative pre-training objectives and discriminative downstream tasks. To bridge this gap, we propose scLLM-DSC, a novel LLM-Knowledge Enhanced Cross-Modal Deep Structural Clustering framework. Diverging from data-driven paradigms, scLLM-DSC establishes a semantically-grounded representation by synergizing two views: a Knowledge-Driven Semantic View derived from NCBI gene priors and contextualized Cell2Sentence embeddings, and a Structure-Aware Topological View extracted via a graph-guided encoder. Crucially, we introduce a cross-modal contrastive alignment mechanism to enforce consistency between biological semantics and transcriptomic features within a unified latent space. Extensive benchmarks demonstrate that scLLM-DSC significantly outperforms eleven state-of-the-art baselines in clustering accuracy.

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

Exact Posterior Score Estimation for Solving Linear Inverse Problems

Diffusion and flow-based models learn powerful data priors by training a denoiser to reverse Gaussian corruption. To use this prior to solve a linear inverse problem, one needs to sample from the posterior, but the score that the prior provides is the unconditional score, not the posterior score. Existing methods either steer a fixed pretrained denoiser with approximate measurement-matching corrections, or train a conditional restoration model that abandons the denoising structure of the prior. We derive the exact posterior score in closed form for linear Gaussian inverse problems under general Gaussian interpolants, and show that posterior sampling reduces to a denoising problem at an operator-dependent shifted pivot under an anisotropic noise covariance. We turn this identity into Exact Posterior Score (EPS), a denoising training objective that preserves the input/output structure of standard pretraining and can therefore be trained from scratch or fine-tuned from a pretrained denoiser. At inference, EPS uses the same sampler as the underlying backbone, with no likelihood gradients or projections. We evaluate EPS on five linear inverse problems across FFHQ and ImageNet, where it outperforms training-free and training-based baselines on fidelity, perceptual, and distributional metrics, while using roughly an order of magnitude fewer denoiser evaluations than gradient-based posterior samplers.

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

Airport Terminal Passenger Queue Forecasting for Departure Gates and Security Checkpoints

arXiv:2606.07622v2 Announce Type: replace Abstract: Accurate passenger queue forecasting in airport terminals is essential for efficient departure operations, as it enables proactive congestion management. However, time-varying passenger demand and heterogeneous facility usage across multiple departure facilities make forecasting challenging. In this work, we propose a passenger queue forecasting framework that learns historical passenger flow patterns from operational data. The proposed model employs a Transformer-based architecture to capture temporal dependencies and inter-facility correlations using past queue length and waiting time at departure gates and security checkpoints, together with passenger throughput at check-in islands. The learned representations are mapped to two facility-specific prediction heads to predict queue length and waiting time at departure gates and security checkpoints. Experimental results demonstrate accurate forecasts up to two hours ahead. The proposed approach offers practical real-time decision support for proactive queue management and staff reallocation in airport terminal operations.

18.
arXiv (CS.CV) 2026-06-12

NavWAM: A Navigation World Action Model for Goal-Conditioned Visual Navigation

Goal-conditioned visual navigation requires a robot to act under partial observability by anticipating how its motion will change the future egocentric view and whether that change brings it closer to the goal. Navigation world models provide such visual foresight, but they remain prediction modules that require an external planner to convert predicted futures into closed-loop control. We propose Navigation World Action Model (NavWAM), a diffusion-transformer policy that turns navigation world-model prediction into executable action by representing future observations, goal-progress values, and action chunks in a shared latent sequence. By learning future prediction jointly with the action and value targets that determine closed-loop behavior, NavWAM makes visual foresight directly usable for robot control. We build NavWAM through simulation pretraining and real-robot adaptation, and evaluate it on image-goal navigation against planning-based world models and a representative direct navigation policy. Across offline benchmarks and closed-loop real-robot deployment, NavWAM improves over planning-based world-model baselines in our evaluations while using the default policy mode without CEM-style action search. Project page: https://dachii-azm.github.io/navwam/

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

PRISM: A 3D Probabilistic Neural Representation for Interpretable Shape Modeling

arXiv:2602.11467v2 Announce Type: replace Abstract: Understanding how anatomical shapes evolve in response to developmental covariates - and quantifying their spatially varying uncertainties - is critical in healthcare research. Existing approaches typically rely on global time-warping formulations that ignore spatially heterogeneous dynamics. We introduce PRISM, a novel framework that bridges implicit neural representations with uncertainty-aware statistical shape analysis. PRISM models the conditional distribution of shapes given covariates, providing spatially continuous estimates of both the population mean and covariate-dependent uncertainty at arbitrary locations. A key theoretical contribution is a closed-form Fisher Information metric that enables efficient, analytically tractable local temporal uncertainty quantification via automatic differentiation. Experiments on three synthetic datasets and one clinical dataset demonstrate PRISM's strong performance across diverse tasks - from modeling shape evolution to personalized shape prediction and anomaly detection - within a unified framework, while providing interpretable and clinically meaningful uncertainty estimates.

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 (CS.CV) 2026-06-11

4DP-QA: Scalable QA for 4D Perception in Vision Language Models

Despite recent advances, Vision Language Models (VLMs) still struggle to grasp the dynamics of the world. We note that the ability to reason about a 4D scene, challenging in itself, is further complicated by two factors. First, VLMs observe motion indirectly via its projection onto 2D images. Second, existing datasets fail to disentangle object and camera motion. To address these challenges, we present a QA generation pipeline that focuses on motion-related scene understanding. We take particular care of the entanglement of camera and object motion by casting tracking in both the traditional way and in a novel, fixed reference system, dubbed True-Motion Tracking, which provides an intuitive description of motion. From this pipeline, we generate a large-scale training dataset of 400K samples, 4DP-QA (4D Perception QA), and a 2.2K-sample benchmark, 4DP-QA-Bench. Training existing models on our dataset yields performance improvements on an external benchmark, validating the effectiveness of our method.

22.
arXiv (quant-ph) 2026-06-17

Efficient time-series prediction on NISQ devices via time-delayed quantum extreme learning machine

arXiv:2602.21544v2 Announce Type: replace Abstract: We proposed a time-delayed quantum extreme learning machine (TD-QELM) for efficient time-series prediction on noisy intermediate-scale quantum (NISQ) devices. By encoding multiple past inputs simultaneously, TD-QELM achieves shallow circuit depth independent of sequence length, thereby, mitigating noise accumulation and reducing computational complexity. Experiments using the NARMA benchmark on both noiseless simulations and IBM's 127-qubit processor demonstrate that TD-QELM consistently outperforms conventional quantum reservoir computing in prediction accuracy and noise robustness. These results highlight TD-QELM as a practical and scalable framework for time-series learning on current NISQ hardware.

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

Learning with Simulators: No Regret in a Computationally Bounded World

arXiv:2606.13576v1 Announce Type: new Abstract: Understanding the minimal assumptions necessary for generalization is the fundamental question in learning theory. Unfortunately, most results rely heavily on independence (or some proxy thereof) of the data-generating process, while results for strongly dependent data are far more limited. Towards addressing this gap, we introduce the framework of simulatable processes, where the learner has access to a simulator that approximates the distribution generating the data (which may be an arbitrarily complex and dependent process). Surprisingly, given access to such a simulator, we show that we can recover the same learning guarantees as in the classical setting with independent data, namely, error bounds that depend on the VC dimension. Further, we use this framework to study the power of conditional sampling and show strict statistical and computational advantages in this setting. As a highlight of our framework, we exhibit a single algorithm that simultaneously learns any given VC class under all processes samplable in bounded polynomial time, with regret controlled by the time-bounded Kolmogorov complexity of the process. This provides a significant conceptual broadening of the classical PAC model.

24.
medRxiv (Medicine) 2026-06-15

Midwifery Practice in Conflict Contexts: Lived Experiences from Somalia and Nigeria

Background: Midwives are a central cadre in the health system, particularly in conflict-affected settings where they are sometimes the primary or even only skilled providers available. Yet, despite their critical role, there is limited qualitative evidence capturing their lived experiences and how these shape workforce entry, retention, and overall well-being. Methods: Drawing on a phenomenological research methodology, this qualitative study was embedded within a larger prospective longitudinal cohort of midwifery students and graduates in Somalia and Nigeria. We conducted focus group discussions with graduate midwives (n=48 in Nigeria; n=63 in Somalia) to explore their experiences transitioning into the workforce and their realities working in health systems impacted by conflict and violent insecurity. Data were analysed using inductive thematic analysis. Results: Five themes emerged from the data: (1) job search and workforce entry, which was described as fraught with challenges and shaped by a set of formal systems in Nigeria but informal networks and structural barriers in Somalia (2) working conditions that were marked by resource scarcity, infrastructural challenges, and heavy and unreasonable workloads, (3) safety, security and coping strategies that differed across the two contexts but reflected persistent exposure to violence and a reliance on ad hoc and personal coping in lieu of systematic protection, (4) community perceptions of midwives, shaped and constrained by social and gender norms and (5) mental health and emotional wellbeing, highlighting stress, burnout and moral injury experienced by this cadre. Conclusion: Our findings highlight the profound challenges faced by midwives working in conflict-affected settings, and they shine a light on the urgent need to support and invest in this critical and predominantly female health workforce.

25.
medRxiv (Medicine) 2026-06-10

Optimisation of steatotic liver disease screening algorithm for resource-poor settings using machine learning

Background The European Association for the Study of the Liver (ESAL) - Steatotic Liver Disease (SLD) screening algorithm involves two steps; initial screening with FIB-4 followed by referral for vibration-controlled transient elastography (VCTE) in patients likely to have significant fibrosis (SF). However, VCTE is not widely available in resource-limited settings. Aim To optimise the EASL SLD screening algorithm for resource-poor settings using machine learning (ML). Methods We analysed data from 964 adults aged [&ge;]35 years who underwent VCTE at a tertiary referral centre in Sri Lanka between November 2024 and 2025. Multiple ML models using different methods and variable combinations were trained on 80% of the dataset and tested on the remaining 20%. Best models were selected based on performance and externally validated using data from 430 patients who underwent VCTE before November 2024. Model performance was compared with the FIB-4 using confusion matrices. Results A Random Forest model incorporating age, AST, ALT, and platelet count separately, rather than using FIB-4, outperformed. The all-variable ML model showed the best predictive performance for SF, with accuracy of 77.2%, recall of 0.762, precision of 0.778, and AUC-ROC of 0.818. The variables used in the model, in descending order of feature importance, were AST, platelet count, BMI, ALT, age, diabetes mellitus, hypertension, dyslipidaemia, sex, family history, hypothyroidism, diabetes complication and smoking. External validation demonstrated 75.1% accuracy and an AUC of 0.779. When used as the first step of the SLD screening algorithm, the all-variable ML model identified 37 (17.1%) additional true positives and reduced false-negative diagnoses by 50% compared with FIB-4. Conclusions ML-based models were more effective than the FIB-4 score as the first-line screening tool for VCTE referral, substantially improving the identification of patients with significant fibrosis in this South Asian cohort.