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01.
arXiv (CS.CL) 2026-06-11

Evaluating Factual Density in Multi-Source RAG: A Study in Medical AI Accuracy

Retrieval-Augmented Generation (RAG) is the current industry standard for grounding AI in real-world facts. Traditional retrieval methods rely on keyword matching and topic proximity, ranking content based on how closely it sounds like the user's query. What they do not measure is how many verified facts the content actually contains. This structural gap, termed the Expert Blindness Effect, causes standard RAG pipelines to consistently bury high-density factual evidence in favor of lexically dominant text on the same topic. To address this gap, this paper introduces Factual Density (FD*), a novel retrieval optimization signal that measures the proportion of verified atomic claims relative to total token count. Using the NexusAgentics Ghost Audit preprocessing pipeline, raw text is scored for factual specificity using probabilistic factuality analysis to filter content before corpus ingestion. An initial formulation introduced a severe document-length confound (Pearson R = -0.8636, p = 2.27e-07). Implementing Z-score normalization within length bins resolved this bias, validating FD* as a length-independent density signal (p = 0.0749). Evaluated against the HealthFC benchmark (750 health claims labeled Supported, Refuted, or No Evidence by medical experts), FD*-optimized retrieval was the only condition to achieve 100% systematic review saturation in top-5 results, surfacing Cochrane evidence that standard cosine similarity ranked outside the top ten. Ground truth verification confirmed 25 mappings across seven HealthFC-supported claims. While full statistical validation across n=50 queries remains future work due to constraints on corpus-benchmark alignment, these findings establish factual density reranking as a low-cost, high-impact intervention for improving factual precision in health RAG architectures.

02.
arXiv (CS.CV) 2026-06-15

Orchestra-o1: Omnimodal Agent Orchestration

The recent success of agent swarms has shifted the paradigm of large language model (LLM)-based agents from single-agent workflows to multi-agent systems, highlighting the importance of agent orchestration for task decomposition and collaboration. However, existing orchestration frameworks are limited to a narrow set of modalities and struggle to generalize to more complex settings where heterogeneous modalities coexist and interact. This limitation becomes particularly pronounced in omnimodal scenarios, where tasks require the unified understanding and coordination of diverse inputs such as text, image, audio, and video. In this work, we propose Orchestra-o1, an omnimodal agent orchestration framework designed to support efficient agent collaboration across multiple modalities. Orchestra-o1 introduces a unified orchestration mechanism that enables modality-aware task decomposition, online sub-agent specialization, and parallel sub-task execution. This scalable design allows agent systems to effectively tackle complex real-world tasks involving heterogeneous information sources, surpassing the second-best approach by 10.3% accuracy on the OmniGAIA benchmark. Furthermore, we introduce decision-aligned group relative policy optimization (DA-GRPO), an efficient agentic reinforcement learning approach for training Orchestra-o1-8B, which also achieves state-of-the-art performance against all existing open-source omnimodal agents.

03.
Science (Express) 2026-06-11

Laser phase plate improves structure determination of small proteins by cryo-EM | Science

作者: 未知作者

Phase plates can in principle overcome the poor image contrast in electron cryo–microscopy (cryo-EM) and the resulting limits on the structural reconstruction of small proteins. However, previous designs have been unstable and compromised the high-resolution signal. They have thus been unable to surpass results achieved by standard cryo-EM. Here, we show that the laser phase plate (LPP), installed in a custom, modern Titan Krios microscope, enhances the resolution in single-particle reconstruction of small proteins by improving specimen-motion correction, recovery of information from the early frames, as well as particle visualization, 3D classification, and alignment. These advances use standard defocus ranges and reconstruction procedures, but open the door to LPP-tailored protocols offering further improvements by leveraging the LPP demonstrated here.

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

The Linguistics Olympiads: Towards a New Corpus for Linguistics Research?

Linguistics olympiad problems (LOPs) are a category of self-sufficient puzzles consisting of a scaled-down corpus representative of certain linguistic phenomena, from which the solver must deduce a primitive set of rules of the language and then translate a new set of elements. The linguistics olympiads (LOs) have become a worldwide phenomenon with 43 different territories taking part in the International Linguistics Olympiad (IOL) 2025. While the typology and solving strategies of LOPs have been analysed, their scientific facet and connections to academic linguistics have yet to be explored. LOPs are directly connected to many linguistic fields, e.g., linguistic typology, linguistic relativity, and linguistics fieldwork. Recently, LOPs have become a research focus as benchmarks for large language models, thus highlighting their usefulness in computational linguistics. Nevertheless, they have not yet been integrated into mainstream linguistics research. This paper attempts to open new directions of including this particular type of puzzle in academic research by offering a structured evaluation of LOPs as linguistic data sources and proposes criteria for their responsible use in academic research. Starting from a set of over 1800 LOPs, this study critically examines the potential of LOPs as a novel corpus for linguistics research by discussing their strengths and limitations as tools, as well as the areas of linguistics into which these problems could fit. This work forms the foundation for a broader initiative aimed at bridging the gap between LOs and academic linguistics, by establishing a robust theoretical framework for LOPs.

05.
arXiv (math.PR) 2026-06-16

Delayed acceptance sampling with Hamiltonian proposal subchains for random field materials inference

arXiv:2606.14743v1 Announce Type: cross Abstract: This paper focuses on accelerating Markov chain Monte Carlo sampling in Bayesian inverse problems in which forward model evaluations dominate the computational cost. It builds on several established ingredients previously used in related scenarios: delayed acceptance, neural network surrogate models, Hamiltonian proposals, and proposal subchains. The main framework is the delayed-acceptance Metropolis-Hastings algorithm of Christen and Fox (2005). The first-stage proposal distribution is constructed from a subchain of Hamiltonian trajectories targeting the surrogate posterior. For each fixed surrogate model, the Hamiltonian subchain and delayed-acceptance correction define a kernel invariant with respect to the exact posterior. In the present work, the surrogate is updated only during a burn-in phase, after which the production run uses a fixed surrogate model. The sampling framework is implemented in Python using parallel processes. Several chains are generated in parallel and share a single surrogate model trained during burn-in on all collected data. The forward model is treated as a black box; therefore, the application area is broad. However, the main motivation is efficient solution of geotechnical inverse problems with material properties represented by Gaussian random fields. In this study, the sampling framework is applied to a geotechnical inverse problem in which hydraulic conductivity and porosity are modeled as non-stationary Gaussian random fields approximated using truncated Karhunen-Loeve expansions. Based on a precomputation, the truncation dimensions are chosen separately for hydraulic conductivity and porosity. The forward model outputs are pore pressure values at control points and selected observation times. These are compared with in situ pore pressure measurements collected over one year during the Tunnel Sealing Experiment in an underground laboratory in Canada.

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

Tamed Feynman-Kac diffusion processes: Killing-branching intertwine

arXiv:2605.07824v2 Announce Type: replace-cross Abstract: Relaxation to equilibrium of a drifted Brownian motion is quantified by a transition probability density function, whose main (multiplicative) entry is an inferred Feynman-Kac kernel of the Schr\"{o}dinger semigroup operator. Although seemingly devoid of a natural probabilistic significance (except for its explicit path integral definition), the pertinent kernel relaxes to equilibrium as well. The implicit Feynman-Kac potential ${\cal{V}}(x)$, continuous, confining and bounded from below, may take negative values. If positive, ${\cal{V}}(x)$ can be interpreted as the killing rate of the decaying diffusion process. In case of relaxing F-K kernels the killing effects are tamed (often overcompensated). The taming inavoidably appears in conjunction with the existence of the negativity subdomains of ${\cal{V}}(x)$ in $R$. If locally ${\cal{V}}(x) < 0$, its sign inversion $- {\cal{V}}(x)$ can be interpreted as the branching (cloning, alternatively bifurcation) rate in the course of the other wise free random motion. The arising killed diffusion processes with branching, we interpret as the possible path-wise background of tamed (relaxing) Feynman-Kac diffusions. We present acomputer-assisted path-wise arguments, towards a consistency of the killing/branching taming scenario, for a number of nonlinear model systems in one space dimension. Special attention is paid to Feynman-Kac potential shapes in the double well form, where an analytic access to eigenvalues and eigenfunctions is scarce. Throughout the paper the dynamics refers to the positive real time. Since the Newton-type equations of motion for admissible classical trajectories have a Euclidean form (due to the sign inverted force term), we give a brief resume of a couple of their explicit solutions, without recourse to the Euclidean time intuitions, and the instanton lore of related quantum model systems.

07.
arXiv (CS.CV) 2026-06-16

AURA: Active-Response Attribution under Treatment Ambiguity in Bacterial Cytological Profiling

When a bacterial sample is exposed to several antibiotics, not every applied drug necessarily acts: if the organism is resistant to one of them, that drug leaves no morphological trace. The clinically meaningful quantity is therefore not which antibiotics were applied, but which ones were active. We show that these two are sharply decoupled in real E. coli microscopy - naively assuming the applied combination equals the active one is correct only about 37% of the time - yet existing computational tools are ill-suited to recovering the active set. Forward perturbation models such as scGen, CPA, and IMPA are designed to predict appearance from treatment, not the reverse, and inverting them degrades sharply; discriminative image classifiers tend to memorise strain- and batch-specific texture and fail to transfer across experimental replicates. We introduce AURA, which reframes the task as constrained, energy-based inverse attribution. Its central inductive bias is that the active set must be a subset of the applied set; this collapses the candidate space and lets AURA infer the active subset of applied antibiotics by decomposing residual morphology into antibiotic response atoms and selecting the subset with the lowest reconstruction energy, using no strain label at test time. AURA-E adds evidence-aware abstention, withholding a prediction when candidate explanations remain near-equally plausible. On cross-replicate transfer in an E. coli cytological profiling dataset, AURA recovers the active antibiotic combination with 95.47% exact-match accuracy.

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

Relational Structural Causal Models

arXiv:2606.14892v1 Announce Type: new Abstract: An artificial intelligence must have a model of its environment that is causal, supporting reasoning about interventions and counterfactuals, and also combinatorial, supporting generalization to unseen combinations of objects. In this work, we formally study when and how such a model can be learned. We develop relational structural causal models, extending structural causal models (Pearl 2009) to settings where objects and their relations vary. First, we show how answers to not only causal but also observational queries about unseen combinations of objects can not be identified without further assumptions. To enable such identification–including in the presence of unobserved confounding–we define relational causal graphs and derive symbolic identification criteria. Finally, we propose relational neural causal models, a provably correct approach that outperforms non-relational baselines on simulated traffic scenes with varying cars, signals, and pedestrians.

09.
arXiv (CS.CV) 2026-06-18

Hilbert-Geo: Solving Solid Geometric Problems by Neural-Symbolic Reasoning

Geometric problem solving, as a typical multimodal reasoning problem, has attracted much attention and made great progress recently, however most of works focus on plane geometry while usually fail in solid geometry due to 3D spatial diagrams and complex reasoning. To bridge this gap, we introduce Hilbert-Geo, the first unified formal language framework for solid geometry, including an extensive predicate library and a dedicated theorem bank. Based on this framework, we propose a Parse2Reason method containing two steps of first parsing then reasoning. In the parsing step, we utilize conditional description language (CDL), a formalized language composed of predicates specifically designed to construct geometric conditions, to represent both problem description (natural text) and solid diagrams (visual image). In the reasoning step, we leverage those formal CDL and the theorem bank to perform relational inference and algebraic computation, generating strictly correct, verifiable, and human-readable reasoning processes. Notably, our proposed Hilbert-Geo is also applicable to plane geometry. To advance geometric reasoning, we curate two expert-annotated dataset SolidFGeo2k and PlaneFGeo3k, which are furnished with geometric formal language annotations, solutions and answers. Extensive experiments show that our proposed method achieves the state-of-the-art (SOTA) performance 77.3% in SolidFGeo2k and 84.1% in MathVerse-Solid (one small subset in MathVerse dedicated to solid geometry), substantially outperforming leading MLLMs, such as Gemini-2.5-pro (54.2% on SolidFGeo2k) and GPT-5 (62.9% on MathVerse-Solid). In addition, our method achieves the SOTA accuracy 80.2% in PlaneFGeo3k, demonstrating the generality of the Hilbert-Geo in geometric reasoning. Our code and datasets are released at https://github.com/PremiLab-Math/Hilbert-Geo.

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

LLMs as ASP Programmers: Self-Correction Enables Task-Agnostic Nonmonotonic Reasoning

arXiv:2604.27960v2 Announce Type: replace Abstract: Recent large language models (LLMs) have achieved impressive reasoning milestones but continue to struggle with high computational costs, logical inconsistencies, and sharp performance degradation on high-complexity problems. While neuro-symbolic methods attempt to mitigate these issues by coupling LLMs with symbolic reasoners, existing approaches typically rely on monotonic logics (e.g., SMT) that cannot represent defeasible reasoning – essential components of human cognition. We present "LLM+ASP," a framework that translates natural language into Answer Set Programming (ASP), a nonmonotonic formalism based on stable model semantics. Unlike prior "LLM+ASP" approaches that require manually authored knowledge modules, domain-specific prompts, or evaluation restricted to single problem classes, our framework operates without any per-task engineering and applies uniformly across diverse reasoning tasks. Our system utilizes an automated self-correction loop where structured feedback from the ASP solver enables iterative refinement. Evaluating across six diverse benchmarks, we demonstrate that: (1) stable model semantics allow LLMs to naturally express default rules and exceptions, outperforming SMT-based alternatives by significant margins on nonmonotonic tasks; (2) iterative self-correction is the primary driver of performance, effectively replacing the need for handcrafted domain knowledge; (3) compact in-context reference guides substantially outperform verbose documentation, revealing a "context rot" phenomenon where excessive context hinders constraint adherence.

11.
medRxiv (Medicine) 2026-06-22

Study protocol: Feasibility and clinical implications of real-time cerebral autoregulation monitoring in major noncardiac surgery with the Medtronic Cotrending algorithm (AUTOREGULATE-NONCARDIAC-COTRENDING)

Background: Perioperative hypotension is associated with postoperative organ injury. However, trials of hypotension avoidance have not found meaningful improvements in postoperative cardiovascular, renal, neurological or functional outcomes. One possible explanation is that organ perfusion depends on patients individual autoregulatory ranges. Hence, technology enabling monitoring of the autoregulatory status of vital organs, e.g. the brain, could provide a physiologic basis for personalising of blood pressure targets. However, current established methodologies for monitoring cerebral autoregulation in noncardiac surgery, e.g. the cerebral oximetry index (COx), are limited by performance and usability. The Medtronic Cotrending algorithm has been developed to provide automated, near real-time assessment of cerebral autoregulation. While feasibility was demonstrated in cardiac surgery, its applicability in major noncardiac surgery remains unknown. This study aims to evaluate the technical feasibility and clinical implications of Cotrending-based cerebral autoregulation monitoring in major noncardiac surgery. Objectives: Primary objective: To evaluate the technical feasibility of using the Medtronic Cotrending algorithm to monitor intraoperative cerebral autoregulation in real-time during major noncardiac surgery, drawing comparisons to the COx algorithm. Secondary objectives: to investigate the potential clinical implications of Cotrending-based cerebral autoregulation monitoring. Design: Single-centre, prospective cohort study. Setting: Swiss tertiary care centre Patients: Patients enrolled in AUTOREGULATE-NONCARDIAC who were monitored intraoperatively with the Medtronic INVOS(TM) 5100 near-infrared spectroscopy (NIRS) system. Outcomes: Technical feasibility outcomes include success rate of determination of the lower limit of cerebral autoregulation, intraoperative uptime, time to first estimate of the lower limit of cerebral autoregulation, sensitivity to external factors and to data artefacts; agreement of Cotrending-derived lower limit of cerebral autoregulation with COx-derived lower limit of cerebral autoregulation. Conclusions: N/A Trial registration: Clinicaltrials.gov NCT07630129

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

SENTINEL: Failure-Driven Reinforcement Learning for Training Tool-Using Language Model Agents

Language model agents are increasingly effective in solving realistic tasks through multi-turn tool use. However, training reliable tool-using agents remains challenging in practice. While reinforcement learning provides an on-policy paradigm for improving agents from their own environment interactions, its effectiveness depends heavily on the training task distribution. When tasks are fixed before training, the task distribution can become increasingly mismatched with the policy's evolving capabilities, causing many rollouts to be spent on uninformative tasks. We propose SENTINEL, a failure-driven reinforcement learning framework that turns the Solver's rollout failures into targeted training tasks. SENTINEL follows a Controller–Proposer–Solver loop: the Controller analyzes failed trajectories and summarizes recurring error patterns, the Proposer generates executable tasks that stress these weaknesses, and the Solver is trained on the targeted tasks. On Tau2-Bench Retail with Qwen3-4B-Thinking-2507, SENTINEL improves Pass\^{}1 from 66.4 to 74.9 and outperforms RL on general synthetic tasks across Pass\^{}k metrics. These results demonstrate that model failures provide an effective and scalable source of targeted training signal for improving tool-using language model agents.

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

From Compression to Deployment: Real-Time and Energy-Efficient FastGRNN on Ultra-Constrained Microcontrollers

arXiv:2606.17249v1 Announce Type: cross Abstract: The dominant trajectory of modern machine learning has been to scale up: larger models, larger accelerators, larger memory budgets. Yet a multi-year global semiconductor supply constraint and the growing energy and carbon cost of always-online inference expose the fragility of this trajectory and motivate the opposite direction: refactoring AI and ML algorithms to fit the small, ubiquitous microcontrollers already in mass production in wearables, sensors, and edge appliances. We present an end-to-end open-source reproduction of FastGRNN, a compact gated recurrent cell, deployed on two bare-metal targets: the 8-bit Arduino (ATmega328P) and the 16-bit MSP430 (no hardware multiplier; 16 KB Flash; 512 B SRAM). Our compression pipeline combines low-rank weight factorization, iterative hard-thresholding sparsity, and per-tensor Q15 post-training quantization with explicit activation calibration. The deployed model occupies 566 bytes of weights and achieves macro F1 = 0.918 (seed 0; five-seed Q15 mean 0.853+-0.107) on the HAPT test set. It matches a PyTorch reference at 100% prediction agreement across 3,399 test windows (MCU seed 0; 99.91-100% C-equivalent across five seeds). Both platforms sustain real-time 50 Hz streaming inference (9.21 ms per sample on Arduino; 13 ms on MSP430), where a 256-entry sigmoid/tanh look-up table delivers a 30.5x speedup on the multiplier-less MSP430. Four contributions extend the original FastGRNN paper: (i) cross-platform bit-equivalent deterministic inference; (ii) characterization of recurrent warm-up latency (median 74 samples, 1.48 s; worst-case 125 samples, 2.50 s over 100 test windows); (iii) a deployable look-up-table recipe for multiplier-less embedded targets; and (iv) hardware energy characterization showing 17.7 mW active inference power,

14.
Nature Biotechnology 2026-06-05

Multiplexed, precise genome engineering in monocots with twin prime editing systems

作者:

Simultaneously introducing diverse genomic edits remains a challenge in crop genome engineering. Here we describe a twin prime editing-based knockout (TKO) system that installs stop codon clusters (SCCs) for precise translational termination with minimal in-frame mutations. TKO achieves knockout efficiencies of up to 70.5%, 58.6% and 75.1% in rice, maize and wheat protoplasts, respectively, and produces heritable knockout alleles in 96.8% of regenerated rice plants. In hexaploid wheat, TKO outperforms Cas9 4.2-fold in generating triple-homolog knockouts, largely by reducing in-frame mutations. Orthogonal TKO editors with sequence-divergent SCCs enable simultaneous knockout of up to ten genes without cross-interference. Integration of TKO with conventional prime editing establishes TRIM1 (TKO editor-enabled gene rupture and development of integrated multitype genome modification system) for simultaneous knockout and precise editing, achieving a 22.8% coediting of four genes in rice. TRIM2 extends this capacity to kilobase-scale modifications through a prime editor–recombinase system, enabling a 4.9-kb insertion (1.2% efficiency) and gene knockout (up to 79.8%) in protoplasts. Plant genome editing is multiplexed with twin prime editing.

15.
medRxiv (Medicine) 2026-06-22

A Randomized, Controlled, Double Blind Clinical Study to Evaluate Use of Hydron Alkaline Ionised Water (HAIW) in Healthy Participants

Background and Objectives: Alkaline Ionized Water (AIW) is considered among the highest quality healthy drinking water worldwide and is widely discussed for its various health benefits. Hydron Alkaline Ionized Water (HAIW) is produced through electrolysis, resulting in a stable pH of approximately 9.5 with a negative Oxidation Reduction Potential (ORP), making it an antioxidant beverage. The objective of this study was to evaluate the safety of HAIW and its effects on digestion, sleep, energy, and overall quality of life in healthy participants compared to Packaged Drinking Water (PDW). Materials and Methods: A randomized, controlled, double blind, prospective clinical study was conducted in which a total of 24 healthy participants between the age group of 21 to 40 years were randomized in a 1:1 ratio to either HAIW Group or Packaged Drinking Water Group with equal gender distribution. Participants were hospitalized for 7 days and asked to consume at least 3 litres of the assigned water daily. Primary outcomes were safety-related laboratory parameters and adverse event monitoring. Secondary outcomes included assessment of digestion (appetite, digestion, bowel habits), urine parameters, sleep quality, freshness after waking, fatigue, energy/stamina/strength, quality of life, and global assessment Results: All 24 participants completed the study with no dropouts. Baseline demographics were comparable between the two groups. Assessment of primary safety-related laboratory parameters including Complete Blood count, liver function tests, renal function tests, blood sugar, Electrocardiogram and serum electrolytes showed non-significant change from baseline to 7 days and remained within normal limits in both groups, with non-significant difference between groups (p>0.05). HAIW showed significantly better improvement in appetite, digestion, and bowel habits from Day 2 onwards compared to Packaged drinking water. Sleep quality and freshness after waking up showed significant improvement from Day 3 and Day 2 respectively in the HAIW and PDW group, with significantly better improvement in HAIW group. Fatigue scores showed significant reduction at Day 6 and 7 in both groups with non-significant difference between groups. A total of 5 adverse events were reported (3 in HAIW, 2 in PDW), all unrelated to study products and were mild in nature. Global assessment showed excellent to good overall safety and tolerability in both groups. Conclusion: HAIW was well tolerated by all participants without any adverse effects. All laboratory safety parameters remained within normal range. HAIW demonstrated significant improvements in digestive function (appetite, digestion, bowel habits), sleep quality, and freshness after waking as compared to PDW. The study concludes that HAIW can be safely consumed. HAIW improves digestive and sleep-related functions.

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

Attribute Inference from Interactive Targeted Ads

作者:

arXiv:2606.15209v1 Announce Type: new Abstract: Targeted advertising systems can pair audiences selected by advertisers with ad units that expose visible user actions. When an interaction remains linked to the campaign that elicited it, the advertiser may receive an observation tied to a user rather than only an aggregate report. We model that channel as a noisy oracle for attribute inference. The model separates targeting predicates, exposure, interaction, and disclosure. These boundaries capture the gap between eligibility and delivery, and the gap between interaction and advertiser visibility. We build a reproducible benchmark using synthetic populations calibrated with public data, each with known sensitive labels. A generated campaign semantics layer provides topic variants and response priors. The simulator generates the ground truth, event traces, disclosed observations, and metrics. The evaluation compares Bayesian, supervised, positive and unlabeled, and adaptive attacks under common campaign and disclosure definitions. The final evaluation uses four topic variants, seven simulator seeds, and two interaction settings. Repeated campaigns with identity exposure produce measurable but bounded inference signal. At $160$ campaigns, Bayesian and supervised attacks reach about $0.64$ AUC in the main setting and about $0.65$ AUC in the higher interaction setting. Disclosure policy is the strongest control. Aggregate reporting removes the evaluated oracle input tied to users. Type filtering and randomized disclosure reduce the released signal. The result is a model, artifact, and defense evaluation method for privacy in interactive targeted advertising. The code is available at https://github.com/P-HOW/Interactive-Ad-Oracle.

17.
medRxiv (Medicine) 2026-06-22

Referral pathways, ETAT triage acuity, and inpatient outcomes among children presenting to a national tertiary paediatric emergency unit in Ghana: a prospective cohort study

Emergency referral systems in sub-Saharan Africa are fragmented, and children reaching tertiary facilities through different referral pathways often arrive in advanced clinical states. Prospective data simultaneously characterising referral patterns, triage acuity at presentation, diagnostic case mix, and inpatient mortality at a national tertiary paediatric emergency unit are lacking from West Africa. This prospective cohort study enrolled 675 consecutively presenting children aged one month to 12 years at the Paediatric Emergency Unit of Korle Bu Teaching Hospital, Accra, Ghana, from February to December 2019. The primary outcome was all-cause inpatient mortality. Key variables collected included referral status and facility tier, Emergency Triage Assessment and Treatment (ETAT) triage category, ICD-10 diagnostic classification, Oyedeji socioeconomic classification, and time from symptom onset to PEU registration. Crude odds ratios were computed for all candidate predictors. Multivariable logistic regression was conducted using complete case analysis (n = 613). Of 675 children, 63.0% (n = 425) were referred from another health facility; referred children had higher ETAT emergency triage category rates than self-presenting children (32.7% vs 27.6%, p < 0.001). Overall inpatient mortality was 9.9% (67/675). Mortality varied by referral source: 16.7% among secondary/regional hospital referrals, 11.0% among lower-tier facility referrals (district, municipal, CHAG, polyclinic, private, health centre, and maternity home facilities combined, n = 356), 7.6% among self-presenting children, and 7.4% among tertiary referrals. Overall, 30.8% of children were classified as ETAT emergencies on arrival, with case fatility rate of 21.6%. The three most common diagnostic domains were respiratory conditions (17.2%), blood and haematological disorders (17.0%), and digestive presentations (16.4%). Inpatient mortality was highest in neoplastic disease (33.3%, n = 30) and circulatory presentations (31.0%, n = 29). In the primary multivariable analysis (n = 613, 51 events; events-per-variable ratio 4.2), no referral tier was independently associated with inpatient mortality after adjustment. Referral from secondary/regional hospitals showed a borderline non-significant association (adjusted odds ratio 3.09, 95% CI 0.96 to 9.90, p = 0.058). School going children (60-119 months) had higher odds of inpatient death than infants (adjusted odds ratio 5.56, 95% CI 1.16 to 26.53, p = 0.032), as did adolescents (adjusted odds ratio 10.01, 95% CI 2.15 to 46.69, p = 0.003). ETAT emergency category and lower socioeconomic status were not independently significant in this model. A pre-specified sensitivity analysis using the full analytic cohort (n = 674, events-per-variable ratio 6.7) with collapsed referral categories did not confirm any referral tier association; ETAT emergency category and lower SES were independently associated in the sensitivity model. All multivariable estimates should be regarded as exploratory. This prospective cohort provides simultaneous characterisation of referral patterns, ETAT triage acuity, diagnostic case mix, and inpatient mortality at a national tertiary paediatric emergency unit in West Africa. The referral-mortality gradient and high ETAT emergency category proportion document the severity of illness arriving through different referral pathways at this facility. The association between secondary/regional hospital referral and inpatient mortality is hypothesis-generating and requires replication in an adequately powered multicentre study before any service-level conclusions can be drawn.

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

Querying Counterfactuals on Tissue Graphs with Supervised Disentanglement

arXiv:2606.08493v2 Announce Type: replace-cross Abstract: Tissue graph counterfactuals ask how a cell's expression would change under altered spatial neighbor contexts. Such queries are central to predicting cell behavior in tissues, but lack a unified definition, with existing methods targeting specific intervention types or treating cells as i.i.d. In this work, we first formalize tissue graph counterfactuals as a class of spatial interventions that either rewire connections between cells (edge perturbation) or modify the expression of their neighbors (node perturbation). We then introduce Cellina (https://cellina.readthedocs.io) - a framework that uses supervised disentanglement to decompose a cell's intrinsic state from its spatial context, using the latter as a conditioning input for counterfactual predictions. Across benchmarks spanning over 2.5 million spatially-resolved cells in colorectal cancer and mouse brain, Cellina outperforms spatially-informed and non-spatial competitors in in-silico graph perturbations, disentanglement, and scalability. Additionally, we show that Cellina reveals biologically distinct cancer subdomains in an unsupervised manner and enables targeted neighbor perturbation simulations.

20.
medRxiv (Medicine) 2026-06-22

Reform of the intermediate level of the health system in the Democratic Republic of the Congo: Adaptations and limits in the stabilization of the personnel of the Provincial Health Division: A cohort study.

Background: Human resources are one of the pillars of health systems. Since the World Health Organization's report on human resources issues, several countries have integrated this component into the various reforms aimed at strengthening their health systems. This study aims to explore the effects of reforming the intermediate level of a health system operating in a fragile state context. Methodology Our study was conducted in the Democratic Republic of Congo (DRC). It was a cohort study of the staff of the 14 Provincial Health Divisions (PHD) out of the 26 existing in the DRC. We established a database of the staff of these 14 PHD from 2016, just after the implementation of the intermediate level reform and the allocation of this staff by the Ministry of Health. We did a recall in 2021, in each of these PHD to survey this staff through a structured questionnaire and supplemented by the files of the agents available in each PHD. Sociodemographic, economic and academic variables were collected and analyzed. Data were entered into an Excel 2016 database and processed with SPSS software version 25. The chi-square test was used for comparison of proportions with a statistical significance level of p < 0.05. Risk ratios ratios (RR) and their 95% confidence intervals were calculated as measures of association. The error threshold was set at 5%. Results A total of 657 agents with an average age of 45.2 years had been identified in 2016 at the start of the survey and in 2021, 118 or 18% of them were no longer part of the PHD agents. Among the causes of absence noted: 48% of agents placed on leave, 16% promoted to other functions within the health system, 16% desertion and dismissal and 11% cases of death. 19.8% of absentees are executives, 19.5% men against 10.3% women; 22.3% of absentees in unstable provinces against 16.6% in stable ones. The factors associated with the absence of agents in the PHD remain the reaching of retirement age [RR (95% CI) = 5.5 (1.2-24.9) ]and male agents [RR (95% CI) = 3.2 (1.3-7.9)]. Among the agents who remained, 92% kept their initial position, 6% were subject to an internal permutation accompanied by a promotion. The factors associated with the stability of human resources at the level of the Provincial Health Division are: female gender, manager with experience or seniority > 5 years, Age > 35 years, Stable province, Presence of a partner bonus. Conclusion Even in a crisis and fragile context, health system reform is possible. It is possible to organize staff recruitment through a selection process independent of the political authorities of the Ministry of Health and supported by the technical services of the Ministry and partners . Experience and the presence of a financial bonus are motivating factors for staff stability. The involvement of Technical and Financial Support Partners in the recruitment process helped the Ministry of Health to minimize political influence in the recruitment of middle-level executives.

21.
arXiv (CS.LG) 2026-06-19

Pseudo-Formalization for Automatic Proof Verification

arXiv:2605.20531v2 Announce Type: replace-cross Abstract: Reliable verification of proofs remains a bottleneck for training and evaluating AI systems on hard mathematical reasoning. Fully formal proofs, in languages like Lean, are easy to verify because they are unambiguous and modular. Most proofs, particularly those written by AI systems, have neither property, and translating them into formal languages remains challenging in many frontier math settings. We propose Pseudo-Formalization (PF), a proof format that captures the modularity and precision of formal proofs while retaining the flexibility of natural language. A Pseudo-Formal proof is decomposed into self-contained modules, each stating its premises, conclusion, and proof in natural language. To verify the correctness of a regular natural language proof, an LLM translates it to Pseudo-Formal and then verifies each module independently, an algorithm we call Block Verification (BV). We evaluate PF+BV on two benchmarks spanning olympiad and research-level mathematics, where it pareto-dominates LLM-as-judge baselines on error-finding precision and recall. To support future work, we release our research-level proof verification benchmark ArxivMathGradingBench.

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

Group-Sparse Matrix Factorization for Transfer Learning of Word Embeddings

Unstructured text provides decision-makers with a rich data source in many domains, ranging from product reviews in retail to nursing notes in healthcare. To leverage this information, words are typically translated into word embeddings – vectors that encode the semantic relationships between words – through unsupervised learning algorithms such as matrix factorization. However, learning word embeddings from new domains with limited training data can be challenging, because the meaning/usage may be different in the new domain, e.g., the word ``positive'' typically has positive sentiment, but often has negative sentiment in medical notes since it may imply that a patient tested positive for a disease. In practice, we expect that only a small number of domain-specific words may have new meanings. We propose an intuitive two-stage estimator that exploits this structure via a group-sparse penalty to efficiently transfer learn domain-specific word embeddings by combining large-scale text corpora (such as Wikipedia) with limited domain-specific text data. We bound the generalization error of our transfer learning estimator, proving that it can achieve high accuracy with substantially less domain-specific data when only a small number of embeddings are altered between domains. Furthermore, we prove that all local minima identified by our nonconvex objective function are statistically indistinguishable from the global minimum under standard regularization conditions, implying that our estimator can be computed efficiently. Our results provide the first bounds on group-sparse matrix factorization, which may be of independent interest. We empirically evaluate our approach compared to state-of-the-art fine-tuning heuristics from natural language processing.

23.
arXiv (CS.CL) 2026-06-15

Retrospective Progress-Aware Self-Refinement for LLM Agent Training

LLM-based agents trained with reinforcement learning optimize step-wise action prediction but lack metacognitive awareness of task progress, inducing a gap that hinders long-horizon scaling. A pilot study reveals that online progress prompting hurts performance while retrospective demonstrations help, yet this capability cannot emerge from outcome-reward training alone. We present RePro, Retrospective Progress-Aware Training, a framework that trains agents to self-generate progress signals via a forward-then-reflect rollout paradigm: the agent executes actions online, then retrospectively reassesses its step-wise progress given the completed trajectory and known outcome. RePro initializes with a Retrospection Warmup that teaches reflection format from minimal external demonstrations, then further trains through RePro-PO with a composite reward that produces self-generated signals without continuous external supervision. Experiments on WebShop, ALFWorld, and Sokoban show that RePro enhances the Qwen family's performance, with up to $12\%$ absolute success rate gains.

24.
medRxiv (Medicine) 2026-06-15

Cost-Performance Evaluation of Large Language Models for Aspect-Based Sentiment Analysis of HCAHPS Patient Comments: A Validation Study

Background: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) free-text comments contain actionable feedback, but timely, scalable, and affordable sentiment analysis remains challenging for health systems that rely on third-party vendors. Objectives: To evaluate cost-performance tradeoffs between a cost-optimized and a flagship large language model (LLM) for aspect-based sentiment analysis of HCAHPS comments, using human inter-rater agreement as a reproducibility benchmark. Methods: We analyzed 512 free-text HCAHPS comments collected from two community hospitals in calendar year 2023. Six trained reviewers (medical students, recent medical graduates, and practicing internists) independently assigned positive, negative, or neutral labels to each comment-aspect pair; the majority label among three reviewers formed the consensus reference standard. Two OpenAI models - GPT-5-nano (cost-optimized) and GPT-5 (flagship) - were prompted in a zero-shot setting via the OpenAI API. We calculated pairwise Cohen's {kappa} to establish a human inter-rater baseline, then compared each model's labels to the consensus using Cohen's {kappa}, accuracy, weighted F1, and per-call cost and latency. Results: Mean human inter-rater agreement was {kappa} = 0.79 (substantial). Both LLMs exceeded this baseline (cost-optimized {kappa} = 0.85; flagship {kappa} = 0.85) with nearly identical accuracy (0.92) and weighted F1 (0.93 vs. 0.93). Performance was strong on positive (F1 ~ 0.97) and negative (F1 ~ 0.90) classes but poor on the underrepresented neutral class (F1

25.
arXiv (CS.LG) 2026-06-15

Closed-loop discovery of out-of-distribution processing protocols by evolutionary search and uncertainty-aware learning

arXiv:2606.13859v1 Announce Type: cross Abstract: Many materials and chemical systems exhibit history-dependent responses, where functional outcomes are governed not only by final-state variables but by the time-dependent sequence of fields, temperatures, or chemical potentials applied during operation. Discovering new processing protocols is therefore a high-dimensional search problem in which the control variable is an entire waveform or sample history, and conventional strategies either remain confined to conservative interpolative families or become prohibitively measurement intensive. Here, a closed-loop workflow is introduced that couples evolutionary search over a compact waveform representation with uncertainty-aware deep kernel learning to generate, rank, and experimentally validate candidate protocols. Applied to ferroelectric thin films, with the scanning-probe tip-bias waveform as the protocol and the nonlinear electromechanical response as the reward, the workflow discovers waveform families that enhance nonlinearity by de-aging the film. Spatially resolved before/after measurements show that the best-performing waveforms selectively activate pre-existing, weakly pinned domain-wall segments, whereas the worst drive long-range irreversible switching. This framework reframes protocol tuning as out-of-distribution discovery, generalizable to synthesis and annealing trajectories, battery formation protocols, and other high-dimensional control problems.