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01.
medRxiv (Medicine) 2026-06-12

High coverage, persistent gaps: quality of Antenatal Care and its determinants in Zambia based on the 2024 Demographic and Health Survey.

Authors:
Tukamuhebwa↗P. M↗Nuwabaine↗

Abstract Background Evaluating antenatal care (ANC) quality is critical to reducing maternal and neonatal mortality. In Zambia, despite high basic ANC attendance, comprehensive national evidence on the clinical content and quality of services remains limited. This study assessed the coverage of WHO-recommended ANC interventions and identified factors associated with care quality using the latest national data. Methods A cross-sectional analysis was conducted using data from the 2024 Zambia Demographic and Health Survey. The final analytic sample comprised 4,829 women aged 15-49 with a live birth in the preceding 5 years. A composite index of 15 selected, equally weighted WHO-recommended components evaluated clinical assessment, counseling/screening, preventive interventions, and utilization. Survey-weighted Poisson regression estimated adjusted incidence rate ratios (aIRRs) for the count of ANC components received. Results The mean ANC quality score was 12.5 out of 15 (95% CI: 12.4-12.6), and 78.5% (95% CI: 77.0-80.0) of women achieved adequate ANC ([≥] 12/15 components). While individual clinical and counseling coverage generally exceeded 90%, only 47.2% (95% CI: 45.3-49.0) of women initiated care during the first trimester, and just 4.8% (95% CI: 4.1-5.6) achieved [≥] 8 ANC contacts. Maternal education was the strongest and most stable predictor of quality across all models. Compared to no education, higher education was associated with an 8.0% higher expected quality score (aIRR = 1.080, 95% CI: 1.051-1.110). Lower ANC quality was significantly associated with unwanted pregnancies (aIRR = 0.970, 95% CI: 0.956-0.993) and with residence in Western (aIRR = 0.923, 95% CI: 0.897-0.951) and North Western (aIRR = 0.966, 95% CI: 0.937-0.996) provinces. Absence of distance barriers and residence in Eastern, Luapula, and Copperbelt provinces were associated with higher quality scores. Conclusion While average ANC component coverage in Zambia is high, critical gaps persist in early initiation and total contact frequency. Care adequacy is strongly influenced by maternal education, relationship status, pregnancy intention, and regional inequities. These findings underscore the need for interventions targeted at uneducated women, preventing unintended pregnancies, and underserved regions such as Western and North Western Provinces. Keywords: Antenatal care quality, ANC content, Zambia, maternal education.

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02.
arXiv (quant-ph) 2026-06-19

Computing noise-canceling observables via Pauli propagation

Authors:
Andrew Eddins↗Caleb Johnson↗Alberto Baiardi↗Francesco Tacchino↗Ewout van den Berg↗Roy Elkabetz↗Vinay Tripathi↗Swarnadeep Majumder↗Max Rossmannek↗Liran Shirizly↗Abhinav Kandala↗

arXiv:2606.20441v1 Announce Type: new Abstract: The pursuit of quantum advantage is driving the co-evolution of quantum processors and classical simulation methods. Despite advances in scale and quality, the accuracy of quantum simulation is ultimately limited by error rates and sampling overheads. Similarly, while classical simulation methods such as Pauli propagation have made remarkable progress, their accuracy is ultimately limited by the exponential growth of operator paths and the truncations needed to control memory and runtime. Here we show that these complementary limitations can be mitigated by embedding Pauli propagation within a hybrid error-mitigation framework that reduces quantum sampling overhead while achieving lower truncation errors with fewer classical resources than traditional Pauli propagation alone. In this framework, a target observable is classically propagated through noise-canceling inverse channels, producing a modified observable that is measured directly on a quantum processor. We prototype two implementations and benchmark their performance numerically on canonical models that challenge traditional Pauli propagation. We also perform experiments on a quantum processor using 56 superconducting qubits, revealing the tradeoffs of their respective truncation strategies. These results illustrate how classical and quantum resources can be orchestrated to extend observable estimation beyond the limits of either approach alone, providing a foundation for quantum-centric supercomputing and future demonstrations of quantum advantage.

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03.
arXiv (CS.AI) 2026-06-16

Variance Reduction for Non-Log-Concave Sampling with Applications to Inverse Problems

Authors:
M. Berk Sahin↗Ahmet Ege Tanriverdi↗Behzad Sharif↗Abolfazl Hashemi↗

arXiv:2606.16257v1 Announce Type: cross Abstract: Sampling from high-dimensional, non-log-concave distributions with unnormalized densities is a fundamental challenge in machine learning, particularly when the exact gradient of the potential is unavailable and must be approximated via stochastic gradients that exhibit high variance under a fixed budget of gradient computations per iteration. Although variance reduction techniques such as SGD with momentum, STORM, and PAGE have demonstrated improved convergence properties in non-convex optimization, their implications for sampling from non-log-concave distributions remain largely unexplored. In this work, we develop the first unified analysis of these estimators for sampling from non-log-concave distributions. We establish improved non-asymptotic convergence rates in $\varepsilon$-relative Fisher information and, under a Poincaré inequality assumption, in squared total variation distance, and further prove weak convergence to the target distribution. We extend our analysis to solving inverse problems with score-based generative priors. We empirically validate our theory and demonstrate that, under a fixed gradient computations per iteration, variance-reduction techniques consistently improve sample quality in two standard imaging applications.

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

SGFormer++: Semantic Graph Transformer for Incremental 3D Scene Graph Generation

Authors:
Mengshi Qi↗Changsheng Lv↗Zijian Fu↗Xianlin Zhang↗Huadong Ma↗

In this paper, we propose SGFormer++, a novel Semantic Graph Transformer for 3D scene graph generation (SGG), which aims to parse point cloud scenes into semantic structural graphs, where nodes denote detected object instances and edges encode their pairwise relationships, with the core challenge lying in modeling complex global scene structure. While existing graph convolutional network (GCN)-based methods suffer from over-smoothing and limited receptive fields, SGFormer++ leverages Transformer layers as its backbone to enable global message passing. Specifically, we introduce two key components tailored for 3D SGG: (1) a Graph Embedding Layer++ that efficiently integrates edge-aware global context with linear computational complexity, and (2) a Semantic Injection Layer++ that enriches visual features with linguistic priors from large language models (LLMs) and vision-language models (VLMs), boosting semantic representation without introducing extra trainable parameters. To further address the practical challenge of incremental SGG (I-SGG), where new relationship categories arrive sequentially, we equip SGFormer++ with a novel Spatial-guided Feature Adapter, which calibrates predicate features using subject-object spatial geometry to counter scale variation, and a Cascaded Binary Prediction Head that mitigates catastrophic forgetting via task-incremental classifier expansion and logit distillation. Extensive experiments on the 3DSSG benchmark demonstrate that SGFormer++ achieves state-of-the-art performance in both standard and incremental settings: it yields a significant 4.49% absolute improvement in Predicate A@1 under the incremental setting. Code and data are available at: https://github.com/Andy20178/SGFormer.

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05.
arXiv (CS.CV) 2026-06-11

How Seemingly Inconsequential Design Choices Dictate Performance of LLMs in Pathology

Authors:
Kian R. Weihrauch↗Thomas A. Buckley↗William Lotter↗Arjun K. Manrai↗

General-purpose large language models (LLMs) are routinely used as baselines when evaluating specialized pathology models on whole-slide images (WSIs). Because WSIs exceed contemporary model context limits, LLM baselines routinely use small, high-magnification patches processed independently via majority voting, without systematic evaluation of seemingly inconsequential design choices such as patch size, patch count, and magnification. Generalist LLMs have consistently underperformed specialized systems, reinforcing the perception that domain-specific training or architectural adaptation is necessary for pathology tasks involving WSIs. Here, we conduct a systematic factorial analysis of four input design factors: inference mode, patch size, magnification, and patch count. We demonstrate that prior studies have overstated the gap between specialized models and general-purpose LLMs by choosing non-optimized input configurations. On the MultiPathQA benchmark, switching to a single balanced configuration (large patches at lower magnification, processed jointly) raises GPT-5 from 15.1% to 39.5% on cancer-type classification (TCGA) and from 38.1% to 62.9% on organ classification (GTEx). Per-task optimization yields further gains up to 43.9% (TCGA) and 71.6% (GTEx). The same configuration generalizes to two other models and to a fully held-out CPTAC cohort, where it improves Gemini 3 Flash by 23.4 percentage points without any task-specific tuning.

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06.
PLOS Computational Biology 2026-06-23

A novel biclustering algorithm for mining m<sup>6</sup>A co-methylation patterns based on beta-binomial distribution and data screening strategy

Authors:
Zhaoyang Liu↗

by Zhaoyang Liu, Yuteng Xiao, Dao Xiang, Hao Shi, Kaijian Xia Studies have shown that m6A plays a key role in different life processes such as RNA metabolism, physiology and pathology. However, due to the complexity of life processes, its specific regulatory details are still not revealed. The computational approach based on co-methylation pattern mining of m6A sequencing data can assist in revealing its mechanism and save time and economic cost, however, the current algorithms suffer from the problems of insufficient robustness to low signal-to-noise data and unreliable performance. Based on this, this paper proposes an enhanced beta-binomial distribution biclustering algorithm (EBBM) based on data screening strategy. This algorithm is based on the framework of Bayesian, adopts Gibbs sampling method for parameter inference, and introduces the data screening strategy in the process of parameter inference, which effectively removes the problem that the low signal-to-noise data in the original sequencing data of m6A affects the reliability of the clustering results. The simulation experiment results show that this algorithm can effectively deal with the interference of low signal-to-noise data and accurately mine the co-methylation patterns pre-planted in the data, which is significantly better than the current mainstream biclustering algorithm. In real human m6A sequencing data with 32 samples, this algorithm mined two effective co-methylation patterns, which were enriched to different biological processes, such as negative regulation of phosphorylation and peptidyl lysine methylation, etc. The scoring results of GEO_Score indicate that the results of this algorithm are more biologically meaningful than the clustering results of current mainstream m6A co-methylation pattern mining algorithms.

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07.
medRxiv (Medicine) 2026-06-11

Beyond External Load: Integrative Immune Monitoring Reveals Injury-Predictive Signals in the Athlete's Internal State

Authors:
Heyn↗Perron↗Rodas↗Mendizabal Sasieta↗Grzelak↗Soto↗Capelli↗Martin-Garcia↗Mallol↗Pruna↗Gomez-Chereguini↗

Abstract (already in the PDF; paste if a box is required): Injury risk prediction in elite football relies almost exclusively on external load metrics derived from GPS tracking, overlooking the molecular state of the athlete. We monitored 26 male players from FC Barcelona's first team across the 2025 calendar year, integrating GPS-derived training load with longitudinal blood-based immune monitoring (systemic inflammation and TCR-derived immune age). Immune age acceleration and inflammation were elevated in the 14 days preceding musculoskeletal injuries. A logistic regression model combining external load, inflammation, immune age acceleration, and career injury history reached an overall AUC of 0.678 and a mean per-player AUC of 0.754 (SD 0.146), improving on a GPS-only baseline of 0.541. Applied to 2026 data, the frozen model ranked players who later sustained non-contact musculoskeletal injuries high in the risk distribution. Together, our data suggest multimodal immune monitoring in elite football to reveal the athlete's internal physiological state, which carries injury-relevant information that external load alone does not capture.

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08.
arXiv (math.PR) 2026-06-17

Large deviation principle for friendship-biases in Galton–Watson trees

Authors:
Frank den Hollander↗Azadeh Parvaneh↗

arXiv:2606.17381v1 Announce Type: new Abstract: In this paper we consider the friendship-bias of the vertices in an infinite rooted Galton–Watson tree. The friendship-bias of a vertex is the difference between the average degree of the neighbours of the vertex and the degree of the vertex itself. A vertex is said to be of type $\chi \in S$, with $S = \{-,0,+\}$, when its friendship-bias is, respectively, strictly negative, zero or strictly positive. We consider the fractions $f_l^\chi$ of vertices of type $\chi \in S$ along a random downward path up to branching depth $l \in \mathbb{N}$ and derive a large deviation principle (LDP) for the triple $(f_l^\chi)_{\chi \in S}$ as $l\to\infty$. The branching depth of a vertex counts the number of branchings that occur along the path that connects the vertex to the root of the tree. The rate in the LDP is $l$, while the rate function in the LDP is identified in terms of a variational formula minimising a relative entropy under a linear constraint. We focus on the case of binary branching, for which the rate function is already quite involved. We identify the qualitative properties of the rate function and show how it can be computed numerically. We briefly indicate how to proceed for more general branching and for vertex types along a tree consisting of a finite number of random downward paths. Our paper is the first to consider large deviations of vertex types.

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

Personal Care Utility: Health as Everyday Infrastructure

Authors:
Mahyar Abbasian↗Elahe Khatibi↗Saba A. Farahani↗Nitish Nagesh↗Arshia Ilaty↗Hooman Sajjadi↗Amir Rahmani↗Ramesh Jain↗

Healthcare is essential, expert, and episodic by design - built around the roughly one hour per year a person spends with a clinician. The 8,759 hours outside clinical settings, where eating, sleeping, movement, medication, and stress actually shape long-term health, have no comparable infrastructure. The bottleneck for personalized health is not raw data or reasoning capability; it is the absence of that infrastructure layer. This paper introduces the Personal Care Utility (PCU): a layered, event-driven architecture proposed as the missing utility for everyday health, in the way that payments, networks, and power are utilities for their domains. PCU organizes continuous personal signals into semantically meaningful life events through a Personicle, estimates dynamic health state against personal baselines, reasons about cause and context, and routes guidance through an orchestrator that separates clinical decision logic, behavioral strategy selection, and natural-language expression. This separation lets large language models support reasoning and communication while keeping safety-critical clinical decisions grounded in validated evidence. We instantiate PCU for Type 2 Diabetes - turning CGM, meal, activity, medication, sleep, stress, and clinical data into glycemic events, individualized state estimates, causal explanations, and knowledge-grounded interventions. A day-in-the-life scenario shows the same infrastructure producing real-time nudges, weekly summaries, medication check-ins, silence, or deterministic safety alerts depending on context and risk. We close with how PCU generalizes to other chronic conditions and the governance questions any always-on personal health utility must address. The result is a blueprint that treats personalization not as a final messaging layer, but as an architectural property of everyday health guidance.

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10.
arXiv (CS.LG) 2026-06-19

Multi-Granular Attention-Driven Reinforcement Learning Framework for Web Intelligent Enhancement Systems

Authors:
Navin Chhibber↗Deepak Singh↗Anokh Kishore↗Nikita Chawla↗K. Anguraj↗

arXiv:2606.19690v1 Announce Type: new Abstract: From the past few years, web intelligent enhancement systems increasingly rely on heterogeneous and dynamic web data to deliver personalized, context-aware services. However, traditional machine learning, deep learning, and reinforcement learning models often struggle with semantic understanding, adaptability, and scalability in continuously evolving web environments. In this research, a Multi-Granular Attention-based Reinforcement Web Intelligent Enhancement System (MGAR-WIES) is proposed to address the challenges by integrating semantic graph modeling, attention mechanisms, and adaptive reinforcement learning. Initially, heterogeneous web data comprising structured, semi-structured and unstructured sources are collected and preprocessed for generating unified feature representations. These representations are transformed into a dynamic semantic graph, where entities and their relationships are modeled by using graph embeddings enhanced by attention mechanisms for capturing both local relevance and global contextual dependencies. Subsequently, an adaptive multi-agent reinforcement learning strategy leverages the attention-aware semantic states to optimize personalized web actions like content recommendation, navigation optimization, and service adaptation. Finally, the continuous online feedback is further integrated to update graph representations and learning policies in real time by ensuring sustained adaptability and performance. The proposed MGAR-WIES acheived better results in terms of accuracy (80%) when compared with existing approaches.

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

GRAPE: Guided Parameter-Space Evolution for Compact Adversarial Robustness

Authors:
Zhiyuan Ye↗Xiangyu Zhou↗Ji Qi↗Hao Zhang↗Yi Zhou↗

arXiv:2606.14865v1 Announce Type: cross Abstract: Adversarial Training (AT) improves neural network robustness, but most methods train a fixed parameter space from the start. This paper asks whether the order in which parameters become optimizable can affect the final robust solution, even when the final architecture or computation budget is controlled. We propose GRAPE, Guided Parameter-Space Evolution, a training framework for compact adversarial robustness. GRAPE combines parameter-space stabilization with progressive hidden expansion: it stabilizes robust optimization in the currently exposed space, gradually releases new optimizable dimensions, and uses an adversarial spectral utilization score to guide newly released capacity toward high-pressure modules. In contrast to fixed-structure AT, GRAPE treats robust model learning as a process of progressive parameter-space exposure and evolution. Under the standard $\ell_\infty$ threat model on CIFAR-10, with fixed-structure ResNet-18 AT as a controlled reference, GRAPE improves PGD-20 robust accuracy from 51.70% to 56.94% at a nearly matched computation budget with a FLOPs ratio of 1.009x, while reducing parameter count by about 21.4%. A sequential grow variant with the same final ResNet-18 architecture reaches 56.52% PGD-20 robust accuracy, indicating that the gain is not only due to final architecture differences but also to the parameter-space exposure path. These results suggest that guided parameter-space evolution can yield compact and robust parameter configurations under matched computation.

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12.
arXiv (CS.AI) 2026-06-11

APPO: Agentic Procedural Policy Optimization

Authors:
Xucong Wang↗Ziyu Ma↗Yong Wang↗Yuxiang Ji↗Shidong Yang↗Guanhua Chen↗Pengkun Wang↗Xiangxiang Chu↗

arXiv:2606.12384v1 Announce Type: cross Abstract: Recent advances in agentic Reinforcement Learning (RL) have substantially improved the multi-turn tool-use capabilities of large language model agents. However, most existing methods assign credit over coarse heuristic units, such as tool-call boundaries or fixed workflows, making it difficult to identify which intermediate decisions influence downstream outcomes. In this work, we study agentic RL from two perspectives: where to branch and how to assign credit after branching. Our pilot analysis shows that influential decision points are broadly distributed throughout the generated sequence rather than concentrated at tool calls, while token entropy alone does not reliably reflect their impact on final outcomes. Motivated by these observations, we propose Agentic Procedural Policy Optimization (APPO), which shifts branching and credit assignment from coarse interaction units to fine-grained decision points in the sequence. APPO selects branching locations using a Branching Score that combines token uncertainty with policy-induced likelihood gains of subsequent continuations, enabling more targeted exploration while filtering out spurious high-entropy positions. It further introduces procedure-level advantage scaling to better distribute credit across branched rollouts. Experiments on 13 benchmarks show that APPO consistently improves strong agentic RL baselines by nearly 4 points, while keeping efficient tool-calls and maintaining behavior interpretability.

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13.
arXiv (CS.LG) 2026-06-18

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

Authors:
Blaise Ag\"uera y Arcas↗Travis Beals↗Maria Biggs↗Jessica V. Bloom↗Thomas Fischbacher↗Konstantin Gromov↗Urs K\"oster↗Rishiraj Pravahan↗James Manyika↗

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

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14.
Nature (Science) 2026-06-15

Nanocrystal-tailored recombination for all-perovskite tandem solar modules

Authors:
Ke Xiao↗

The commercialization of all-perovskite tandem solar modules is hindered by the reliance on the conventional gold-based tunnel recombination junction (TRJ)1,2. Specifically, this TRJ introduces substantial near-infrared parasitic absorption3 and suffers from interfacial instability4, limiting both photocurrent generation and operational durability. Here, we develop a solution-processed interconnecting layer based on surface-engineered indium oxide (In2O3) nanocrystals featuring high optical transparency, wherein controlled nanocrystal morphology and tailored ligand chemistry enable smooth interfacial contact and favorable energy level alignment. Critically, we introduce a phosphonic acid additive into the lead–tin (Pb–Sn) perovskite precursor, which synergistically improves the electronic contact with the In2O3 recombination layer, thereby enhancing hole extraction. In addition, the additive regulates perovskite crystallization to mitigate residual strain during film formation, ensuring high-quality large-area deposits. This coordinated interfacial and crystallization engineering strategy simultaneously enhances carrier recombination efficiency at the interconnection layer, improves carrier extraction, and promotes large-area film uniformity in all-perovskite tandems. As a result, a 65-cm2 all-perovskite tandem solar module achieves a certified power conversion efficiency of 26.2%5, with an open-circuit voltage of 2.182 V, a fill factor of 77.4%, and a short-circuit current density of 15.6 mA cm-2 in terms of averaged subcell performance, measured by Japan Electrical Safety and Environment Technology Laboratories (JET). This marks a significant advance toward scalable perovskite tandem photovoltaics.

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

One-Step Generalization Ratio Guided Optimization for Domain Generalization

Authors:
Sumin Cho↗Dongwon Kim↗Kwangsu Kim↗

arXiv:2606.16301v1 Announce Type: new Abstract: Domain Generalization (DG) aims to train models that generalize to unseen target domains but often overfit to domain-specific features, known as undesired correlations. Gradient-based DG methods typically guide gradients in a dominant direction but often inadvertently reinforce spurious correlations. Recent work has employed dropout to regularize overconfident parameters, but has not explicitly adjusted gradient alignment or ensured balanced parameter updates. We propose GENIE (Generalization-ENhancing Iterative Equalizer), a novel optimizer that leverages the One-Step Generalization Ratio (OSGR) to quantify each parameter's contribution to loss reduction and assess gradient alignment. By dynamically equalizing OSGR via a preconditioning factor, GENIE prevents a small subset of parameters from dominating optimization, thereby promoting domain-invariant feature learning. Theoretically, GENIE balances convergence contribution and gradient alignment among parameters, achieving higher OSGR while retaining SGD's convergence rate. Empirically, it outperforms existing optimizers and enhances performance when integrated with various DG and single-DG methods.

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

QueryMarket: Cost-Aware Online Active Learning in Data Markets

Authors:
Xiwen Huang↗Pierre Pinson↗

arXiv:2606.17805v1 Announce Type: new Abstract: Data acquisition is a major bottleneck for learning in real-time streams: analysts must decide on the fly which labels to purchase while respecting a rolling budget. However, existing online active learning rarely unifies pricing, information gain, and rolling budget constraints under concept drift. We introduce QueryMarket, a market-inspired framework that queries each incoming data point based on its estimated utility to the model and its price. Within this framework, we propose OVBAL (online variance-based active learning), which integrates data pricing with information-driven selection by estimating each sample's marginal utility via a D-optimality criterion with exponential forgetting and executing cost-aware purchases under rolling budget constraints. OVBAL yields a simple, fully online decision rule that adapts to nonstationary streams and heterogeneous label costs. Experiments on synthetic data and a real-world solar power generation forecasting task show that OVBAL is particularly effective under seller-centric pricing and yields a more favorable long-run error-cost trade-off in the real-world task under both pricing schemes.

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17.
medRxiv (Medicine) 2026-06-16

Upper airway disease in primary ciliary dyskinesia: Clinical management and factors influencing decision-making, a multicentre analysis

Authors:
Gkatzou↗Campos↗Karavasiloglou↗Fernandez-Rodriguez↗Alexandru↗Anagiotos↗Armengot↗Aslan↗A. T↗Bon↗I. C. M↗Boon↗…

Background Upper airway disease is common in primary ciliary dyskinesia (PCD), but management evidence is limited. We aimed to describe management practices and identify factors influencing management decisions. Methods Using data from the Ear-Nose-Throat (ENT) Prospective International Cohort of patients with PCD (EPIC-PCD) and an ENT-specialist survey across participating centres, we described management practices recorded at routine follow-up. We assessed clinical factors associated with practices via mixed-effects logistic regression models. In a subgroup of patients, we assessed factors associated with initiation or discontinuation of practices. Results We included 579 patients: median age 15 years, 46% female. Nasal rinsing (54%) and nasal corticosteroids (22%) were most frequently prescribed. Among 466 patients with available data, 47 had grommets (10%) and 42 hearing aids (9%). Nasal corticosteroids and rinsing were more frequently prescribed in patients with polyps (odds ratio [OR] 3.74, 95% confidence interval [CI] 1.80-7.76; OR 3.39, 95% CI 1.37-8.37) or turbinate hypertrophy (OR 1.89, 95% CI 1.03-3.47; OR 2.89, 95% CI 1.55-5.38), and upper airway nebulisation in patients with frequent nasal symptoms (OR 2.86, 95% CI 1.11-7.39). Management practices differed between centres, as seen also by the specialists survey responses. In 177 patients with multiple visits, initiation of nasal rinsing was associated with frequent nasal symptoms (OR 3.18, 95% CI 1.24-8.18) and turbinate hypertrophy (OR 3.21, 95% CI 1.20-8.59). Conclusion Upper airway disease management in PCD varies and is partly guided by symptom burden and clinical findings. This variation across centres highlights the need for care standardisation and PCD-specific management guidelines.

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18.
arXiv (CS.AI) 2026-06-18

A Clinician-Centered Pipeline for Annotation and Evaluation in Ultrasound AI Studies

Authors:
Fangyijie Wang↗Jianjun Yu↗Wentao Shi↗Haixia Huang↗Ran Shi↗Gu\'enol\'e Silvestre↗Kathleen M. Curran↗

arXiv:2606.19174v1 Announce Type: cross Abstract: Clinician-centered evaluation is critical for validating medical AI systems, especially in ultrasound imaging where quantitative metrics do not always capture clinical usability. Existing medical image platforms primarily focus on dataset labeling. They lack integrated support for blinded model comparison and reproducible evaluation workflows. We present a clinician-centered pipeline for remote annotation and evaluation in ultrasound AI studies. The proposed pipeline uses a centralized server and lightweight browser interfaces to enable clinicians to perform annotation, blinded ranking, and review without local dataset downloads. The pipeline also supports multi-rater participation, centralized result aggregation, and automated statistical analysis. We validate the pipeline in a fetal ultrasound segmentation study with six raters spanning expert, generalist, and non-expert experience levels. The system automatically generated Spearman correlation, Kendall's $\tau$, and top-1 selection statistics. Results indicated moderate to strong agreement across experts and other groups. The blinded evaluation results showed a tendency for later active learning models to be preferred. These outcomes suggest that the pipeline can support clinician-centered annotation and reproducible human-\ac{AI} evaluation studies in ultrasound imaging. The proposed pipeline is available on \href{https://github.com/13204942/SonoRate}{GitHub}.

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19.
arXiv (quant-ph) 2026-06-11

Large Fluctuations in Open Quantum Systems

Authors:
V. Yu. Mylnikov↗S. O. Potashin↗A. Kamenev↗

arXiv:2606.11822v1 Announce Type: new Abstract: We study statistics of atypical measurement outcomes in the steady states of driven open quantum systems. In equilibrium, the probability distribution over the phase space, as encoded in, e.g., the Wigner function, is analytic in the phase-space coordinates. We show that this property is generically lost in driven dissipative systems: their {\it large-deviation function} develops lines and surfaces across which its derivatives are discontinuous. As an illustrative example, we consider a parametrically driven Kerr oscillator coupled linearly and/or nonlinearly to a dissipative bath. Rare fluctuations in the amplitude and phase of the induced oscillations are governed by semiclassical instanton trajectories of the corresponding Keldysh-Lindblad action. We demonstrate that a given fluctuation can be realized through multiple distinct instanton trajectories. The competition between these trajectories leads to abrupt switching of the dominant instanton and, consequently, to non-analytic features in the large-deviation function.

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20.
arXiv (CS.AI) 2026-06-11

Quality Adaptive Angular Margin Learning for Respiratory Sound Classification

Authors:
Yoon Tae Kim↗Heejoon Koo↗Miika Toikkanen↗June-Woo Kim↗

arXiv:2606.11915v1 Announce Type: cross Abstract: We present a quality-adaptive angular-margin learning framework that improves feature generalization by enforcing intra-class compactness and inter-class separability. Our framework, titled QLung, introduces a no-reference audio quality margin derived from spectral entropy and root-mean-square energy, which adaptively scales angular margins based on recording quality. To this end, we propose a log-scaled angular margin that stabilizes training under severe class imbalance. We also use an angular classifier that normalizes features and class weights, ensuring margin penalties are applied consistently on the unit hypersphere. Our approach improves in-distribution performance on the ICBHI dataset by 2.46\% over the cross-entropy baseline, and most significantly, achieves the strongest out-of-distribution performance on the SPRSound dataset compared to prior state-of-the-art methods. Code is available at https://github.com/RSC-Toolkit/QLung.

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21.
arXiv (CS.AI) 2026-06-16

Theorem-Grounded Execution Ontologies for Interpretable Machine Reasoning

Authors:
Raghu Anantharangachar↗

arXiv:2606.16010v1 Announce Type: cross Abstract: Large language models have achieved impressive performance on reasoning tasks spanning mathematics, science, programming, and commonsense inference. Despite these advances, their reasoning processes remain largely latent, making them difficult to interpret, verify, replay, debug, and transfer across domains. Existing approaches such as chain-of-thought, tree-of-thoughts, graph-of-thoughts, and tool-augmented reasoning expose intermediate reasoning artifacts but typically lack explicit execution semantics, formal state representations, and verifiable reasoning structures. We introduce Theorem-Grounded Execution Ontologies (TGEO), a framework that models reasoning as an executable state-transition process rather than a sequence of generated tokens. Given an input problem, TGEO identifies relevant theorem families, binds the problem to a domain ontology, discovers semantic objects, instantiates states and operators, constructs predicates and contracts, and synthesizes an executable reasoning graph. The resulting graph provides an interpretable, replayable, and auditable representation of reasoning in which every state transition, operator application, and validation step is explicitly represented. TGEO integrates five architectural components: (1) theorem-grounded reasoning priors, (2) executable ontologies, (3) operator-mediated state transitions, (4) predicate and contract-based execution validation, and (5) architectural auditing and failure localization. We evaluate TGEO on theorem-intensive reasoning tasks derived from mathematical benchmark domains and a curated Golden Execution Suite. Our findings demonstrate the value of executable reasoning representations for interpretable, verifiable, and reproducible AI reasoning systems.

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22.
arXiv (CS.AI) 2026-06-12

Structured Testbench Generation for LLM-Driven HDL Design and Verification-Oriented Data Curation

Authors:
En-Ming Huang↗Yu-Hung Kao↗Ren-Hao Deng↗Wei-Po Hsin↗Yao-Ting Hsieh↗Cheng Liang↗Hsiang-Yu Tsou↗Mu-Chi Chen↗Yu-Kai Hung↗Shao-Chun Ho↗Po-Hsuang Huang↗Shih-Hao Hung↗…

arXiv:2606.12983v1 Announce Type: new Abstract: Automated testbench generation has become a critical bottleneck in large language model (LLM)-driven Register Transfer Level (RTL) workflows, where large numbers of candidate designs must be verified rapidly and reliably. Existing prompt-based approaches treat testbench generation as unconstrained code synthesis, yielding stochastic outputs with high token cost, low reproducibility, and insufficient coverage. To address this gap, we present STG, a Structured Testbench Generation framework that exploits the inherent structure of hardware designs to generate deterministic testbenches. As a direct verification tool, STG runs 720x faster than an iterative LLM-based testbench generation flow and higher rate of successful compilation, achieves higher coverage, and reduces false-pass verdicts on incorrect DUTs. STG also helps identify errors in RTL generation benchmarks by exposing faulty benchmark testbenches. As a data curation engine, it is 11x faster than LLM-based filtering on a single CPU core with 127x less energy, and the resulting distilled models provide state-of-the-art performance in our multi-benchmark evaluation. As a test-time scaling oracle, it reduces node count by 14-47\%. Our models are available at https://huggingface.co/collections/AS-SiliconMind/siliconmind-v12.

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

HPSv3++: Scaling Reward Models Across the Full Spectrum of Diffusion Model Capabilities

Authors:
Yijun Liu↗Jie Huang↗Zeyue Xue↗Yuming Li↗Ruizhe He↗Haoran Li↗Shijia Ge↗Siming Fu↗

Reward models guide text-to-image (T2I) systems toward outputs aligned with human preferences. However, typical reward models such as HPSv3 are trained on pre-annotated data from earlier T2I models, without accounting for quality discriminative shifts arising from evolving model capabilities and reinforcement learning (RL) iterations, limiting their broader applicability. In this work, we propose HPSv3++, a reward model framework that elevates the HPSv3 model for varying T2I model capabilities and their RL iteration changes across the full capability-iteration spectrum. Specifically, we first introduce HPDv3++, a 212K dual-dimension preference dataset annotated for text fidelity and aesthetic quality using a recent high-capability (Qwen-Image) model with human supervision. We then propose a two-stage training framework. Stage 1 employs data-aware orthogonal gradient projection to incorporate diverse aesthetic perception from HPDv3++ while preserving the original effective human preference knowledge in HPSv3. Stage 2 further leverages unlabeled data from T2I models spanning different capability levels and RL iterations, and introduces a joint capability-iterations conditioned signal for the reward model together with a standard deviation-driven unsupervised guidance mechanism, strengthening reward model across the capability-iteration spectrum. HPSv3++ achieves state-of-the-art preference prediction, outperforming HPSv3 9.8% on HPDv3, 5.5% on GenAI-Bench, while achieving 79.1%/88.1% on our proposed HPDv3++. When used for T2I RL training, it consistently improves GenEval scores across diverse T2I models, demonstrating its wide-range capabilities. The code is available at https://github.com/PlantPotatoOnMoon/HPSv3-PlusPlus.

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24.
arXiv (CS.CV) 2026-06-17

SkillMoV: Mixture-of-View Routing with Prototype-Conditioned Gating for Unified Multi-View Proficiency Estimation

Authors:
Edoardo Bianchi↗Antonio Liotta↗

Estimating human proficiency from video is a key challenge for automated skill assessment, with applications in sports coaching, music pedagogy, surgical training, and workplace learning. Existing approaches often focus on individual scenarios or rely on shared multi-view aggregation, limiting their ability to adapt to heterogeneous camera viewpoints and activity domains. We introduce SkillMoV, a unified, parameter-efficient framework for multi-scenario proficiency estimation from synchronized multi-view video. At its core, SkillMoV introduces a Mixture-of-View Projector (MoVP), which adapts the mixture-of-experts paradigm to camera-specific view features. MoVP is composed of four stages: (i) a Mixture-of-View soft router with twelve expert MLPs that learns view-dependent expert preferences without camera-identity supervision; (ii) cross-view attention to align synchronized cameras; (iii) learnable prototype anchoring to condition the representation on class-level reference vectors; and (iv) a prototype-conditioned gated projection that produces the final skill embedding. We evaluate SkillMoV on EgoExo4D across six skill domains and three separately trained view configurations: Ego, Exos, and Ego+Exos. SkillMoV reaches 50.17% overall accuracy in the Exos setting with a single model trained jointly across all scenarios, surpassing the strongest reported Exos result among the compared methods by 3.57 percentage points. In Ego+Exos, SkillMoV remains close to the best reported result in that setting (47.63% versus 48.20%). Ablations on the selected Exos configuration validate each component: MoV routing contributes +6.61 pp over attentive aggregation, cross-view attention +4.92 pp, prototype anchoring +4.07 pp, and stochastic view dropout +3.90 pp. Through LoRA adaptation, SkillMoV trains only 23.32% of its parameters and adds limited measured overhead relative to a LoRA-only baseline.

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25.
arXiv (CS.AI) 2026-06-16

When Generator Replay Degrades: Projected Rehearsal Orchestration for Heterogeneous Federated Class-Incremental Learning

Authors:
Thinh T. H. Nguyen↗Khoa D. Doan↗Binh T. Nguyen↗Danh Le-Phuoc↗Kok-Seng Wong↗

arXiv:2606.15695v1 Announce Type: cross Abstract: Federated class-incremental learning (FCIL) becomes substantially harder when clients observe different label subsets, progress through tasks at different stages, and provide uneven supervision for the same semantic concepts. Existing FCIL methods often preserve old knowledge through input-space synthesis, but they can be fragile under heterogeneous task streams and difficult to transfer across modalities. To alleviate such issues, we propose PRO, a framework that replaces synthetic input replay with projected rehearsal orchestration. To remove external pretraining, we evaluate all methods under the same warmup. After this, PRO maintains compact class-level projected memories on the server and allows clients perform balanced pseudo multi-task training over current examples and old projected memories. To handle stronger representation drift, we further introduce PRO-MAX, which augments PRO with neighborhood-weighted memory alignment while preserving the same server-light principle that the server only aggregates model updates and memory statistics. Across image, text, and graph benchmarks, PRO and PRO-MAX improve retention and final utility under heterogeneous streams while remaining competitive in homogeneous FCIL. Even when baselines are given expanded replay budgets, they degrade under supervision imbalance and stage misalignment, indicating that replay quantity alone does not resolve replay-quality failures. Additional weak-task diagnostics further show that larger replay mismatch is associated with larger downstream degradation, while our method keeps projected memories better aligned with the evolving representation.

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