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01.
medRxiv (Medicine) 2026-06-15

Using wastewater surveillance to explore community-level dietary intake in sewered and non-sewered sanitation systems in Malawi, Africa

Wastewater can be used to measure biomarkers that reflect population-level dietary intake and diversity; however, how this approach may apply in a low-income country remains a knowledge gap. This study aims to evaluate whether select dietary-related metabolites can be detected in wastewater and environmental surveillance (WES) samples from both sewered and non-sewered sanitation systems in Malawi, Africa. Fourteen WES samples were collected and analyzed from two university campuses in Mzuzu and Thyolo, Malawi. Four targets were analyzed: N-methyl-2-pyridone-5-carboxamide (2PY; a biomarker of vitamin B3), 4-pyridoxic acid (4-PA; a biomarker of vitamin B6), as well as enterodiol and enterolactone (biomarkers of dietary fiber and polyphenol consumption). An 18-question survey, paired spatiotemporally with the WES measurements, assessed self-reported daily dietary intake, food insecurity, and nutrient deficiency symptoms among 500 respondents. Among the 14 WES samples, 2PY, 4-PA, and enterolactone were detected, while enterodiol was not detected above the method limit (

02.
bioRxiv (Bioinfo) 2026-06-19

StickForStats: automated statistical assumption validation for reproducible computational biology

Reproducible computational biology depends on statistical decisions that routine workflows often skip: verifying that a differential-expression test's assumptions hold across all genes, that a strategy-comparison ANOVA is robust to non-normality, or that a meta-analysis is not distorted by publication bias. Surveys consistently find that fewer than 20% of published biomedical studies report checking these assumptions, and existing statistical software leaves validation to the analyst as an optional step. We present StickForStats, an open-source web platform that reframes assumption validation as a default precondition for every analysis. Its Guardian system–a middleware pipeline of eight validators (normality, variance homogeneity, independence, outliers, sample size, modality, linearity, homoscedasticity)–checks assumptions before execution and, on critical violations, reroutes to an appropriate nonparametric alternative with a documented decision trail. At genome scale, applying Guardian to a 91-sample synovial-sarcoma RNA-seq study (GSE271517) cascaded 90.6% of 27,221 genes to a rank-based test and flipped the differential-expression verdict for 553 genes–479 rescued from an under-powered t-test and 74 outlier-driven false positives rejected–materially changing the gene list a biologist would act on. The same automatic validation generalizes across domains: a CRISPR editing-strategy comparison (ANOVA F = 1122, with Guardian recommending Kruskal-Wallis H = 36.6), an ordinal correlation (Pearson r = 0.476 corrected to Spearman {rho} = 0.479), and a sixteen-trial clinical meta-analysis revealing severe publication bias (Egger's t = -5.78, p < 0.001); a complementary module extends the same validators to published manuscripts, checking claims against CONSORT, STROBE, ICH-E9, and JARS-Quant reporting standards. By making assumption validation automatic and transparent, StickForStats targets a tractable, under-served contributor to irreproducibility. The platform is MIT-licensed, validated against SciPy and R, and freely available at https://github.com/visvikbharti/stickforstats_new.

04.
arXiv (math.PR) 2026-06-16

Super-Arrhenius relaxation of the triangular plaquette model in any dimension

arXiv:2606.16259v1 Announce Type: new Abstract: Consider the following plaquette model from statistical physics: a lamp lies at every vertex of the triangular lattice and a switch lies at every even vertex of the (bipartite) dual hexagonal lattice. Each switch toggles the three lamps on its face. The energy of a configuration is the number of ON lamps. For the Glauber dynamics associated with the Gibbs measure defined by this Hamiltonian at any inverse temperature $\beta>0$, we show that, in any dimension $d\ge 2$, the infinite volume relaxation time satisfies \[e^{\beta^2/C}/C \le T_{\mathrm{rel}}\le Ce^{e^{C\beta}}\] for some $C>0$. Our result entails that the Gibbs measure is unique. The $e^{\beta^2}$ scaling was conjectured by Newman and Moore in 1999 and matches the behaviour of supercritical rooted kinetically constrained models such as the East model, thus recovering fragile glass phenomenology in the absence of kinetic constraints. More precisely, we show that, on a torus of side length $2^k$, when $\beta\to\infty$ and $k/\beta\to0$, we have $T_{\mathrm{rel}}=e^{2\beta k(1+o(1))}$. Quite surprisingly, however, we also prove that, on non-periodic finite domains of size $n\le e^{\beta/C}$ for large $C>0$, we have the much larger asymptotics $\ln T_{\mathrm{rel}}=\beta n^{\Theta(1)}$. The main ingredients of the proofs are new results in extremal and enumerative combinatorics and rely on renormalisation ideas for the dynamics and its groundstates also known as the Ledrappier subshift. We note consequences of our results to geometric group theory (more precisely to the complexity of the word problem for the Baumslag finitely presented group) and to ergodic theory.

05.
arXiv (CS.AI) 2026-06-19

Review of Machine Learning Models for Solar Energetic Particle Prediction

arXiv:2606.19539v1 Announce Type: cross Abstract: Solar energetic particle (SEP) events have attracted increasing attention due to their significant radiation hazards for aviation, spacecraft electronics, and human missions beyond Earth's magnetosphere. From a scientific perspective, SEP events are intriguing because they arise from a set of physical processes extending from the solar surface and corona through the heliosphere, offering insight into particle acceleration and transport mechanisms that are widely applicable across astrophysics. Therefore, advancing our ability to understand and predict SEP events is essential both for deepening our knowledge of such mechanisms and for safeguarding space technologies and exploration. Traditionally, researchers have modeled SEPs using physics-based simulations and empirical methods. More recently, machine learning (ML) has emerged as a new tool for understanding and predicting SEP events. The purpose of this manuscript is to review the currently available ML models for SEP prediction, identify the datasets used for training, compare their architectures, inputs, and outputs, and, based on these insights, outline good practices and recommendations for future research.

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

RIVET: Robust Idempotent Voice Attribute Editing

arXiv:2606.19629v1 Announce Type: cross Abstract: Voice attribute editing models modify characteristics such as age and gender while preserving speaker identity. In large-scale speech datasets, however, attribute annotations are often noisy or inconsistent, which can cause conditional generative models to produce unstable edits. In this work, we show that idempotency provides an effective mechanism for improving robustness to noisy labels. An idempotent operator is one for which repeated application does not change the result, i.e., f(f(x)) = f(x). Enforcing this property acts as an implicit regularizer that reduces sensitivity to mislabeled examples. We introduce RIVET, a training framework that incorporates an idempotency objective to improve robustness to label noise. We evaluate RIVET under controlled label noise and on the GLOBE dataset with naturally noisy annotations. RIVET improves editing success and better preserves speaker identity than standard training, showing that idempotency improves robustness in voice editing models.

07.
arXiv (quant-ph) 2026-06-15

Quantum gates with parametrically driven multi-qubit couplers

arXiv:2606.14522v1 Announce Type: new Abstract: Superconducting quantum processors could significantly profit from enhanced connectivity together with precise control of interactions and gates between qubits. Here we investigate plaquettes of four qubits that are coupled via a central tunable coupling circuit, so that not only gates between qubits connected by an edge of the plaquette can be executed but also between qubits across the diagonal. By numerically and analytically analyzing parametrically driven processes, we explore $\sqrt{iSWAP}$-gates between any pair of qubits, also across the diagonal, as well as three-qubit interactions and gates. For experimentally available circuit parameters, we for example find $\sqrt{iSWAP}$-gates with a gate time of 50 ns and 99.9\% fidelity, which is decreased to 99.4\% if two such gates are executed in parallel on disjoint qubit pairs in the plaquette. For three-qubit gates we find fidelities of 95\% fidelity at a gate time of 200 ns.

08.
medRxiv (Medicine) 2026-06-16

Adherence to Red Reflex and Vision Screening Recommendations: A Deep Dive into Primary Care Implementation Gaps

Introduction: Early childhood vision screening is critical for detecting amblyopia and other vision-threatening conditions. Despite screening recommendations during well-child visits, rates remain low. Red reflex assessment is recommended to identify serious ocular pathology, yet its use in primary care is not well described. We examined rates and drivers of vision screening in pediatric primary care. Methods: We conducted a retrospective review of electronic health records for children 3 to 5 years attending well-child visits in 2022 in one of three representative primary care clinics within a university health system. Outcomes were documented red reflex and functional vision tests. We evaluated associations with patient demographics and clinic site using multivariable logistic regression Results: Among 1,003 visits, 21.1% (n=212) had a documented red reflex assessment, and 60.8% (n=610) a functional vision test. Younger children (ages 3 and 4 vs. 5 years) had higher odds of red reflex assessment [adjusted odds ratio (aOR) 9.00 and 8.64], and lower odds of a functional vision (aOR 0.47 and 0.59) test. Females had higher odds of red reflex assessment (aOR 1.53). Other/Multiracial children had lower odds of red reflex assessment than Non-Hispanic White children (aOR 0.48). Screening rates varied significantly by clinic site Conclusions: Visual function and red reflex assessment are inconsistently performed in pediatric primary care, with particularly low rates of red reflex documentation. Screening rates varied between clinics and were affected by age. These findings highlight missed opportunities for early detection of vision-threatening conditions and identify targets for improving adherence to pediatric vision screening recommendations

09.
arXiv (CS.CL) 2026-06-17

Reading between the Lines: Leveraging Large Language Models for Global Dementia and Depression Assessment from Clinical Interviews

Dementia and depression are the most prevalent neuropsychiatric disorders in geriatric populations, and their overlapping symptoms pose major challenges for differential diagnosis. In this study, we investigate open-weights Large Language Models (LLMs) for predicting dementia and depression severity from speech samples collected during standardized history taking interviews with 154 German-speaking subjects. We introduce an observer-based Global Depression Scale (GDS-D) aligned with the established Global Deterioration Scale (GDS), enabling parallel global staging of affective and cognitive symptoms. We compare three LLMs (Mistral 3.1, DeepHermes, Qwen3) in two settings: (1) zero-shot prediction and (2) LLM-based feature extraction for Support Vector Regression, using human and pause-enriched transcripts. Results show that LLMs effectively predict depression severity in zero-shot settings (best MAE of 0.60), while dementia assessment benefits substantially from structured feature extraction (best MAE of 0.78), reducing errors by up to 35% over zero-shot baselines. Pause-enriched transcripts achieve competitive performance with human transcriptions, demonstrating the viability of fully automatic screening pipelines for differential neuropsychiatric assessment.

10.
arXiv (quant-ph) 2026-06-19

Maximum entropy principle for quantum processes

arXiv:2506.24079v3 Announce Type: replace Abstract: The maximum entropy principle, as applied to quantum systems, is a fundamental prescript positing that for a quantum system for which we only have partial knowledge, the maximum entropy state consistent with the partial knowledge is a valuable choice as the system's state. An intriguing result is that in case the only prior knowledge is of a fixed energy, the maximum entropy state turns out to be the thermal state, a ubiquitous state in several arenas, especially in statistical mechanics. We extend the consequences of this principle from static quantum states to dynamic quantum processes. We establish that a quantum channel attains maximal output entropy under a fixed energy constraint if and only if it is an absolutely thermalizing channel, where the fixed output is the thermal state corresponding to that energy. Our results have potential implications for understanding the informational and thermodynamic utility of quantum channels under physical constraints. As an application, we examine the consequences for private randomness distillation from fixed energy constrained quantum processes.

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

Electrical Noise Produced by Micron-Sized Particles above a Surface Paul Trap

arXiv:2606.19585v1 Announce Type: new Abstract: Electric field noise produced by the surface of ion trap electrodes reduces the fidelity of quantum computing operations. Despite decades of investigation its microscopic origins remain unclear. Here, we measure electric field noise at trapping locations along the symmetry axis of a linear surface Paul trap. We find that noise levels vary by three orders-of-magnitude in one 600$\,\mu$m section of the trap. Optical and scanning electron microscope images show micron-sized particles close to the trapping locations with the highest noise levels. We find that modeling the particles as a lossy dielectric with a effective loss tangent $\tan\theta=0.33(0.06)$ describes the magnitude of the noise, as well as its spatial and frequency dependence. Our observations may explain the large variation of reported noise levels in literature.

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

The Unreasonable Effectiveness of Discrete-Time Gaussian Process Mixtures for Robot Policy Learning

arXiv:2505.03296v2 Announce Type: replace-cross Abstract: We present Mixture of Discrete-time Gaussian Processes (MiDiGap), a novel approach for flexible policy representation and imitation learning in robot manipulation. MiDiGap enables learning from as few as five demonstrations using only camera observations and generalizes across a wide range of challenging tasks. It excels at long-horizon behaviors such as making coffee, highly constrained motions such as opening doors, dynamic actions such as scooping with a spatula, and multimodal tasks such as hanging a mug. MiDiGap learns these tasks on a CPU in less than a minute and scales linearly to large datasets. We also develop a rich suite of tools for inference-time steering using evidence such as collision signals and robot kinematic constraints. This steering enables novel generalization capabilities, including obstacle avoidance and cross-embodiment policy transfer. MiDiGap achieves state-of-the-art performance on diverse few-shot manipulation benchmarks. On constrained RLBench tasks, it improves policy success by 76 percentage points and reduces trajectory cost by 67%. On multimodal tasks, it improves policy success by 48 percentage points and increases sample efficiency by a factor of 20. In cross-embodiment transfer, it more than doubles policy success. We make the code publicly available at https://midigap.cs.uni-freiburg.de.

13.
arXiv (math.PR) 2026-06-12

Voronoi Percolation: Topological Stability and Giant Cycles

arXiv:2601.00793v2 Announce Type: replace Abstract: We study the topological stability of Voronoi percolation in higher dimensions. We show that slightly increasing p allows a discretization that preserves increasing topological properties with high probability. This strengthens a theorem of Bollobás and Riordan and generalizes it to higher dimensions. As a consequence, we prove a sharp phase transition for the emergence of i-dimensional giant cycles in Voronoi percolation on the 2i-dimensional torus.

14.
arXiv (CS.LG) 2026-06-11

Anatomy of Post-Training: Using Interpretability to Characterize Data and Shape the Learning Signal

arXiv:2606.12360v1 Announce Type: new Abstract: Language-model post-training is the main stage at which model behavior is shaped, yet it still largely involves optimization of scalar rewards that summarize diverse desiderata. This abstraction gives practitioners little visibility into what their data actually teaches models, allowing spurious correlations to be learned by a model and inducing undesirable behaviors such as over-stylization and sycophancy. To address this problem, we ask: can we inspect a preference dataset before optimization and decide, at the level of concepts, which behaviors a model should be allowed to learn? Motivated by this, we introduce a data-centric post-training pipeline that uses interpretability protocols to develop statistical hypotheses for the latent concepts separating preferred from dispreferred generations, making them explicit for fine-grained user feedback. Building on this view, we unify several interpretability-based training protocols as ways of shaping rewards via feature or data interventions. Empirically, we show that our pipeline diagnoses undesirable signals in existing preference data, mitigates off-target learning, and can also help amplify or shape desired properties such as safeguards and model personality. More broadly, our results suggest that interpretability can turn post-training from optimizing opaque proxy rewards into a process of auditing and sculpting the learning signal itself.

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

A spectral audit framework reveals task-dependent aperiodic reliance across EEG and ECG deep learning

arXiv:2606.08583v2 Announce Type: replace Abstract: Deep learning on physiological time series is interpreted through domain-specific features – oscillatory rhythms in EEG, morphological complexes in ECG – yet these signals sit atop a broadband aperiodic 1/f-like envelope that covaries with arousal, age, and pathology. We introduce a spectral audit framework combining aperiodic/periodic decomposition, phase-preserving Fourier interventions, sham controls, and simulation validation. Aperiodic reliance was task-dependent and architecture-general: across six neural architectures, flattening drops exceeded 0.42 balanced-accuracy points for sleep-wake classification, reached 0.07-0.13 for clinical abnormality detection, and remained minimal for motor imagery. Six of seven EEG foundation models showed FDR-significant aperiodic reliance on clinical EEG; age/sex and recording-era controls reduced but did not eliminate the effect. Applying the audit to PTB-XL ECG revealed neural drops of 0.32–0.36 persisting after demographic matching, confirming this confound class extends beyond EEG. Aperiodic controls should become standard for interpretable physiological time-series deep learning.

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

Algorithmic Prompt Generation for Diverse Human-like Teaming and Communication with Large Language Models

Understanding how humans collaborate and communicate in teams is essential for improving human-agent teaming and AI-assisted decision-making. However, relying solely on data from large-scale user studies is impractical due to logistical, ethical, and practical constraints, necessitating synthetic models of multiple diverse human behaviors. Recently, agents powered by Large Language Models (LLMs) have been shown to emulate human-like behavior in social settings. But, obtaining a large set of diverse behaviors requires manual effort in the form of designing prompts. On the other hand, Quality Diversity (QD) optimization has been shown to be capable of generating diverse Reinforcement Learning (RL) agent behavior. In this work, we combine QD optimization with LLM-powered agents to iteratively search for prompts that generate diverse team behavior in a long-horizon, multi-step collaborative environment. We first show, through a human-subjects experiment, that humans exhibit diverse coordination and communication behavior in this domain. We then present a series of experiments showing that our approach captures behaviors that are difficult to observe without large-scale data collection, and a follow-up user study to show that these generated behaviors are human-like. Our findings highlight the combination of QD and LLM-powered agents as an effective tool for studying teaming and communication strategies in multi-agent collaboration.

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

When Life Gives You BC, Make Q-functions: Extracting Q-values from Behavior Cloning for On-Robot Reinforcement Learning

arXiv:2605.05172v2 Announce Type: replace-cross Abstract: Behavior Cloning (BC) has emerged as a highly effective paradigm for robot learning. However, BC lacks a self-guided mechanism for online improvement after demonstrations have been collected. Existing offline-to-online learning methods often cause policies to replace previously learned good actions due to a distribution mismatch between offline data and online learning. In this work, we propose Q2RL, Q-Estimation and Q-Gating from BC for Reinforcement Learning, an algorithm for efficient offline-to-online learning. Our method consists of two parts: (1) Q-Estimation extracts a Q-function from a BC policy using a few interaction steps with the environment, followed by online RL with (2) Q-Gating, which switches between BC and RL policy actions based on their respective Q-values to collect samples for RL policy training. Across manipulation tasks from D4RL and robomimic benchmarks, Q2RL outperforms SOTA offline-to-online learning baselines on success rate and time to convergence. Q2RL is efficient enough to be applied in an on-robot RL setting, learning robust policies for contact-rich and high precision manipulation tasks such as pipe assembly and kitting, in 1-2 hours of online interaction, achieving success rates of up to 100% and up to 3.75x improvement against the original BC policy. Code and video are available at https://pages.rai-inst.com/q2rl_website/

18.
medRxiv (Medicine) 2026-06-10

Healthy Heart Actions Right Time (HHART): Co-design priorities to connect Aboriginal and Torres Strait Islander community and clinic activities for healthy hearts

Aim: Healthy Heart Actions Right Time (HHART) is a multi-phased research project that seeks to identify, implement and evaluate strategies to connect community and clinical activities to reduce the burden of heart disease for Aboriginal and Torres Strait Islander people. The aim in Phase One was to identify priority activities for two participating services. Background: The ongoing effects of colonisation drive a disproportionate burden of heart disease for Aboriginal and Torres Strait Islander people. Clinical and community groups both have established strengths in reducing the risk of heart disease, but these are not always well connected. Methods: Using a case study methodology in two locations we partnered in a 12-month co-design process to identify priority activities to connect clinical and community activities. Findings: Three priorities emerged from the Phase One co-design process: (i) community-led gardening as a strategy to promote heart health through connection and healthy lifestyles; (ii) community days to increase engagement in heart checks and strengthen community-clinic relationship; and (iii) clinic-led development of culturally relevant education resources to promote clinician confidence and community heart health knowledge.

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

Towards Fully Automated Exam Grading: Fairness-Aware Recognition of Handwritten Answers with Foundation Models

Correcting handwritten exams by hand is time-consuming and error-prone, particularly for large cohorts, while fully digital exams tend to force a didactic narrowing towards closed question formats. A practical middle ground keeps paper-based, problem-oriented tasks but records the assessment-relevant answers as single capital letters in a table that a machine can read. The open question is whether this reading can be made accurate and, above all, fair enough for unsupervised grading. Earlier automated approaches reached only about 88%–91% recognition – too low – and failed on the cases that matter most: answers placed outside the cell, crossed out, or written in cursive. We show that general-purpose vision-language foundation models (VLMs), which interpret the page rather than match pixel templates, close this gap. On a benchmark of 61 anonymised exams (3141 answer positions) the best model reaches 98.4% accuracy, well above the previous baseline. Crucially, we centre the evaluation on fairness: we distinguish false negatives (a correct answer marked wrong, which disadvantages the student) from false positives, and a lightweight prompt that supplies the reference solution as context lowers the false-negative rate to 0.58%. Under an exemplary grading scheme only three of the 61 exams would be graded worse, all caught by a student self-review step. Fully automated, fairness-aware exam grading at scale is therefore defensible; we release the anonymised benchmark to support reproducibility.

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

QPILOTS: Efficient Test-Time Q-Steering for Flow Policies

arXiv:2606.14801v1 Announce Type: cross Abstract: Flow-matching and diffusion policies are expressive action generators, but optimizing them with temporal-difference reinforcement learning (RL) remains difficult. Effective policy extraction requires exploiting the critic's action gradient, yet directly backpropagating this signal through a multi-step denoising process can be numerically unstable. Existing methods work around this either by discarding gradient information, distilling the policy into a simpler one-step actor, or repeatedly fine-tuning the denoising policy as the critic improves. We propose QPILOTS, a method that leaves the original policy unmodified and steers the denoising process at inference time. At each denoising step, instead of evaluating the critic on the noisy intermediate action where critic predictions are unreliable, we first project that intermediate state to an estimate of the final clean action and compute the critic gradient there. We introduce two variants: QPILOTS-U uses a fast single-point approximation, while QPILOTS-M draws differentiable posterior samples via a learned auxiliary network. On a standard offline-to-online RL benchmark, QPILOTS achieves the best aggregate performance, reaching an average success rate of 90% across 50 tasks. We also apply QPILOTS to steer a large, frozen, pretrained Vision-Language Action (VLA) foundation model, outperforming or matching prior inference-time approaches across six manipulation tasks in simulation.

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

The Reservoir Attention Network: Cross-Pass State in Pretrained Transformers via Content-Addressable Reservoir Injection

arXiv:2606.15678v1 Announce Type: cross Abstract: A feasibility and dynamics study of the Reservoir Attention Network (RAN), an architecture that injects a fixed, randomly-initialized reservoir into the mid-layer attention of a pretrained transformer to carry state across forward passes. Experiments span GPT-2 (124M, 355M) to Qwen2.5 (0.5B, 1.5B) on a single consumer GPU. The tasks are minimal probes chosen to isolate individual mechanisms; the broader always-alive agent vision is treated throughout as compute-limited future work, not a claim of this paper. The reservoir is left untrained (fixed random) by design: this isolates whether untrained recurrent dynamics alone suffice to carry usable cross-pass state, leaving trained recurrence as a complementary, more expensive direction.

22.
arXiv (CS.LG) 2026-06-17

Geodesic Calculus on Implicitly Defined Latent Manifolds

arXiv:2510.09468v3 Announce Type: replace Abstract: Latent manifolds of autoencoders provide low-dimensional representations of data, which can be studied from a geometric perspective. We propose to describe these latent manifolds as implicit submanifolds of some ambient latent space. Based on this, we develop tools for a discrete Riemannian calculus approximating classical geometric operators. These tools are robust against inaccuracies of the implicit representation often occurring in practical examples. To obtain a suitable implicit representation, we propose to learn an approximate projection onto the latent manifold by minimizing a denoising objective. This approach is independent of the underlying autoencoder and supports the use of different Riemannian geometries on the latent manifolds. The framework in particular enables the computation of geodesic paths connecting given end points and shooting geodesics via the Riemannian exponential maps on latent manifolds. We evaluate our approach on various autoencoders trained on synthetic and real data.

23.
medRxiv (Medicine) 2026-06-18

Cost-effectiveness of a virtual fracture clinic versus traditional in-person fracture clinic care for adults with acute simple fractures: a protocol for a health economic evaluation within the RECITAL trial

ABSTRACT Introduction Traditional in-person fracture clinics are often overcrowded and inconvenient for patients. Virtual fracture clinics aim to address some of these concerns by improving the efficiency of the orthopaedic service and reducing unnecessary interventions while maintaining safety and quality of care. The RECITAL trial is a non-inferiority randomised controlled trial comparing follow-up care provided at a virtual fracture clinic for people with acute simple fractures to follow-up care provided at an in-person fracture clinic. This study describes the protocol for an economic evaluation of RECITAL where the primary aim is to investigate the cost-effectiveness of a virtual fracture clinic compared with traditional in-person fracture clinic care from a health system perspective. Methods and analysis The RECITAL trial recruited 312 participants with acute simple fractures and randomised them to receive follow-up care provided at a virtual fracture clinic or follow-up care provided at an in-person fracture clinic. We will conduct a within-trial analysis from a health system perspective (primary analysis), as well as a health service, patient and societal perspective. The economic evaluation will estimate the difference in the cost of resource inputs on an intention to treat basis used by participants in the two arms of the trial, allowing comparisons to be made between the in-person and virtual fracture clinics. Data for intervention costs and healthcare utilisation will be collected from trial records, hospital electronic medical records and district performance units. The results of the economic evaluation will be expressed in terms of incremental cost per utility weight gained at 12 weeks and will be plotted on a cost-effectiveness plane. Bootstrapping by resampling will be used to estimate 95% confidence intervals around costs and outcomes, and to calculate the confidence intervals around the incremental cost-effectiveness ratio. A cost-effectiveness acceptability curve (CEAC) will be plotted, which will provide information about the probability that an intervention is cost-effective, given the level of a decision makers willingness to pay for each additional outcome. Ethics and Dissemination The trail was approved by the SLHD Ethics Review Committee (RPAH Zone) (X23-0200 and 2023/ETH01038). The findings will be disseminated through a peer-reviewed journal and conference presentations. Trial registration number The trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR; 12623000934640)

24.
bioRxiv (Bioinfo) 2026-06-16

Infectious Disease Forecasting via Physics-Informed Machine Learning

Infectious disease transmission evolves as a dynamic process shaped by biological mechanisms, population behavior, and intervention policies, yet public health responses are often driven by lagging indicators. Accurate short- and long-term disease forecasting is essential for the timely deployment of intervention strategies, healthcare capacity planning, and uncertainty-aware, risk-informed decision-making. To address this challenge, three broad classes of forecasting models have traditionally been used: statistical, machine learning, and mechanistic approaches. However, each of these modeling paradigms faces fundamental limitations. In particular, traditional statistical models often lack the flexibility needed to capture complex disease dynamics, machine learning approaches require large, high-quality data streams, and mechanistic models are notoriously difficult to calibrate. To overcome these challenges, we propose a novel physics-informed machine learning (PIML) framework for forecasting infectious disease dynamics. Our approach simultaneously forecasts new case and hospitalization counts, along with other key epidemiological quantities such as the time-varying reproduction number. This is achieved through the design of a machine learning model and estimation strategy regularized by a system of differential equations that encode disease dynamics of the SIHR model, thereby bridging the gap between purely data-driven and mechanistic models. We demonstrate the proposed methodology through in-depth numerical studies and an application to COVID-19 data collected in the state of South Carolina.

25.
arXiv (CS.AI) 2026-06-19

Beyond Static Leaderboards: Predictive Validity for the Evaluation of LLM Agents

arXiv:2606.19704v1 Announce Type: new Abstract: Agent benchmarks are growing fast, but no single benchmark touches more than four or five of the dimensions that deployment exposes. This paper aggregates the largest coordinated deep-dive of one MCP-based industrial-agent benchmark to date: fourteen parallel implementation studies covering new asset classes (including a multi-modal visual extension), alternative orchestrations, retrieval strategies, reasoning modes, infrastructure optimizations, and evaluation-methodology probes. Consolidating those studies with seven prior agent benchmarks, we argue that aggregate-score leaderboards systematically underspecify deployed-agent evaluation. Rankings derived from aggregate scores do not transfer to out-of-distribution settings; recent public-to-hidden competition retrospectives provide direct empirical evidence of this rank instability. We propose ranking configurations by predictive validity, the correlation between in-sample and out-of-sample rank, rather than in-sample mean, and report a twelve-tier measurement apparatus that exposes the deployment-relevant dimensions HELM and its agent-era successors collapse. The position is operationalized through three falsifiable out-of-distribution criteria with explicit thresholds; existing evidence partly supports it but is too thin to confirm. We close with a pre-registered pilot design and a field-level vision for what the next generation of agentic benchmarks should report.