The total eclipse of bioinformatics: From disruption to convention, and a gentle warning
by Christos A. Ouzounis
Academic Intelligence · Curated Daily
AcademicHub aggregates real-time literature from top journals and preprint platforms. Build your personal research radar and let large language models compile cross-disciplinary analysis briefings automatically.
by Christos A. Ouzounis
Background Risk stratification tools for childhood pneumonia have been proposed to improve identification of children at highest risk of death, particularly in low-resource settings. However, their added value over the WHO Integrated Management of Childhood Illness (IMCI) criteria and danger signs remains uncertain. Methods We conducted a secondary analysis of a multi-country randomised controlled trial of children without HIV hospitalised with pneumonia in Mozambique, South Africa, Uganda, Zambia, and Zimbabwe. We evaluated the performance of five published risk scores alongside WHO IMCI severity classification and danger signs. Discrimination for (1) in-hospital mortality, (2) 28-day mortality, and (3) 28-day readmission or death was assessed using area under the receiver operating characteristic curve (AUC). Comparative performance and clinical utility were examined. Results Of the 1010 participants, 18 (1.8%) died in hospital, 22 (2.2%) died in hospital or in the 7 days post-discharge, and 63 (6.2%) died or were readmitted by day 28. Univariate case-fatality rates were highest for variables associated with malnutrition, convulsions, and hypoxaemia. All risk scores demonstrated moderate discrimination for in-hospital and in-hospital+7-day mortality (AUC range approximately 0.75-0.84), with no meaningful differences between models, and performed similarly to the WHO danger signs and IMCI severity classification. In contrast, all approaches performed poorly in predicting 28-day readmission or death (AUC approximately 0.54-0.58). No risk score consistently outperformed simple clinical criteria. Conclusions In this multi-country dataset, we found no evidence that published paediatric pneumonia risk scores meaningfully outperform WHO IMCI-based clinical assessment for predicting mortality. The relatively small number of mortality events limits precision, and modest differences cannot be excluded. These findings suggest that, in low-resource settings, strengthening implementation of existing WHO clinical criteria may be more effective than adopting more complex prediction tools.
arXiv:2606.16532v1 Announce Type: cross Abstract: Audio deepfake detectors often fail to generalize across speakers, as they learn speaker-identity features rather than synthesis artifacts, known as implicit identity leakage. Existing methods address this but incur architectural complexity or training instability. This paper proposes a dual-granularity orthogonal disentanglement framework enforcing feature independence at two levels: sample-level cosine orthogonality captures directional decorrelation, while batch-level cross-covariance regularization eliminates linear correlations across embedding dimensions. A curriculum disentanglement schedule progressively strengthens the orthogonality constraint without auxiliary networks or adversarial dynamics. Experiments on ASVspoof 2019 LA, ASVspoof 2021 DF, and In-the-Wild datasets demonstrate that the proposed method achieves 1.35%, 7.88%, and 21.58% equal error rates (EER), respectively, surpassing gradient reversal disentanglement by 2.60% absolute on cross-dataset transfer.
Diffusion models (DMs) have become the leading choice for generative tasks across diverse domains. However, their reliance on multiple sequential forward passes significantly limits real-time performance. Previous acceleration methods have primarily focused on reducing the number of sampling steps or reusing intermediate results, failing to leverage variations across spatial regions within the image due to the constraints of convolutional U-Net structures. By harnessing the flexibility of Diffusion Transformers (DiTs) in handling variable number of tokens, we introduce RAS, a novel, training-free sampling strategy that dynamically assigns different sampling ratios to regions within an image based on the focus of the DiT model. Our key observation is that during each sampling step, the model concentrates on semantically meaningful regions, and these areas of focus exhibit strong continuity across consecutive steps. Leveraging this insight, RAS updates only the regions currently in focus, while other regions are updated using cached noise from the previous step. The model's focus is determined based on the output from the preceding step, capitalizing on the temporal consistency we observed. We evaluate RAS on Stable Diffusion 3 and Lumina-Next-T2I, achieving speedups up to 2.36x and 2.51x, respectively, with minimal degradation in generation quality. Additionally, a user study reveals that RAS delivers comparable qualities under human evaluation while achieving a 1.6x speedup. Our approach makes a significant step towards more efficient diffusion transformers, enhancing their potential for real-time applications.
arXiv:2606.24385v1 Announce Type: new Abstract: We study a stochastic mean-field interacting particle system whose state space is $\Y = \Tt^d \times \cP(U)$, where the first component represents a spatial variable and the second one is a probability measure over a compact metric space $U$. The dynamics are driven by locally Lipschitz drift operators: the spatial component evolves according to a Brownian diffusion, while the measure-valued component is perturbed by a projected cylindrical noise acting in the Arens–Eells space. We first establish existence and uniqueness of strong solutions for both the $N$-particle system and the associated nonlinear McKean–Vlasov equation under locally Lipschitz and linear growth assumptions on the drift coefficients. We then prove propagation of chaos: as $N\to\infty$, the empirical measure converges in expectation in Wasserstein–1 distance towards the unique McKean–Vlasov solution. Further, we investigate exponential convergence of the nonlinear McKean–Vlasov dynamics towards a unique invariant measure.
arXiv:2605.01169v2 Announce Type: replace Abstract: The presence of stochastic elements in combinatorial optimization problems makes them particularly challenging, as such problems quickly become intractable for classical computers even at relatively small sizes. In this work, we propose a novel quantum-classical hybrid scheme for solving a class of stochastic optimization problems known as chance-constrained knapsack problems, in which item weights follow probability distributions and constraints may be violated within a specified risk tolerance. Our method employs knapsack-specific QAOA-based circuits to generate samples which, when combined with a new self-consistent classical recovery scheme introduced in this work, produce high-quality solutions. Experiments carried out on IBM Heron processors, using circuits with depths up to 177 and comprising 3443 gates acting on as many as 150 qubits, yield solutions that indicate performance comparable to classical optimization schemes. The proposed quantum-classical scheme paves the way to tackling such problems, with the potential to outperform approaches that rely solely on classical computation.
arXiv:2509.22037v2 Announce Type: replace-cross Abstract: We prove optimal non-commutative analogues of the classical Law of Iterated Logarithm (LIL) for both martingales and sequences of independent (non-commutative) random variables. The classical martingale version was established by Stout [Sto70b] and the independent case by Hartman-Wintner [HW41]. Our approach relies on a key exponential inequality essentially due to Randrianantoanina [Ran24] that improves that from Junge and Zeng [JZ15]. It allows to derive an optimal non-commutative Stout-type LIL just as in [Zen15], from that martingale result we then deduce a non-commutative Hartman-Wintner type LIL for independent sequences of random variables.
arXiv:2603.29237v3 Announce Type: replace Abstract: Enforcing prescribed global integral constraints in mesh-free neural PDE solvers is challenging in high-dimensional domains. Existing projection methods for spatial integrals are often tied to fixed grids or uniform quadrature, which can conflict with randomly sampled physics-informed neural networks (PINNs) and scale poorly with dimension. High-order differential operators also increase reverse-mode automatic differentiation memory costs. We propose Stochastic Dimension Implicit Functional Projection (SDIFP), a quadrature-level framework for enforcing prescribed first and second spatial moments. SDIFP replaces tensor-product nodal projection by a global affine correction of the neural-network output, with two scalar coefficients determined from a weighted quadrature rule. Under positive target variance and nonzero empirical raw variance, this correction is the nearest-point projection, in the weighted quadrature norm, onto the empirical two-moment constraint set. Thus, the prescribed moments are exact for the selected quadrature rule, while continuum errors are quadrature errors of the corrected field. For decomposable high-dimensional linear operators, SDIFP combines affine moment correction with stochastic operator-subset sampling. With independent residual and derivative sampling and conditionally unbiased coefficient-gradient estimation, the resulting estimator is unbiased for the specified quadrature-based residual objective; the shared-subset fast mode is biased in general. SDIFP avoids tensor-product quadrature for moment enforcement, separates forward quadrature evaluation from the reverse-mode graph, and retains pointwise inference efficiency once the affine coefficients are fixed or precomputed.
arXiv:2606.16112v1 Announce Type: cross Abstract: Residual architectures are ubiquitous in deep learning, but they suffer from a subtle structural limitation: the norm of the residual stream can grow rapidly with depth. As a result, updates from later layers become small relative to the accumulated residual state. This reduces their impact on the representation and limits the benefits of scaling models in depth. To address this, we introduce NAG, a norm-agnostic residual architecture that separates magnitude from directional information in the residual stream, preserving meaningful layer contributions throughout depth and preventing later updates from being systematically suppressed by residual-norm growth. Importantly, NAG introduces only a negligible number of additional parameters and relies on simple operations that are easily kernel-fusible, preserving training efficiency in practice. We show that this architecture outperforms baseline Transformers, with gains that increase substantially as depth grows, enabling effective training of much deeper models. The norm-agnostic formulation also leads to an interpretable Mixture-of-Depths (MoD) mechanism that adaptively skips both attention and MLP layers. Beyond serving as a post-training accuracy-compute tradeoff, this mechanism can be used as a pretraining-time scaling strategy: under iso-FLOP training, compute saved by reducing per-token forward-pass cost can be reinvested into training on more tokens while keeping the total parameter count and KV-cache budget fixed. In our experiments, moderate Mixture-of-Depths rates of approximately 20%-25% match full-depth baseline performance under equal training compute while substantially reducing the number of executed layer parameters and forward-pass FLOPs. These results identify sparsity in depth as a new scaling axis for fixed-compute training, enabling very deep yet FLOP-efficient models.
arXiv:2606.12200v1 Announce Type: cross Abstract: We study policy representation learning from unlabeled multi-policy behavioral data. Each episode is generated by a fixed policy, but policy labels are unavailable. This setting appears in robotics play, demonstrations, games, racing, and other datasets where heterogeneous behaviors are mixed without annotations. We introduce Behavioral INR, a self-supervised generative model that adapts implicit neural representations (INRs) from vision to behavior. Instead of mapping coordinates to RGB values, Behavioral INR represents a policy as a state-action function mapping states to subsequent actions. An episode-level latent modulates this function through FiLM layers, yielding a generative prior over policies and allowing policy identity to be inferred without supervision. Because INRs treat each datapoint as samples from an underlying function, the same model naturally accommodates variable episode lengths and different sampling granularities, as in vision INRs with different image resolutions. We also define policy-level out-of-distribution (OOD) shifts along state-distribution and action-distribution axes, which arise when policies overlap in states or actions but are not captured by standard behavioral OOD settings based only on new agents or environments. We evaluate on synthetic Gaussian random field data, MuJoCo demonstrations with controlled OOD splits, and real-world chess, Formula 1 racing, robotics, and Seek-Avoid datasets. Behavioral INR most consistently improves policy identifiability in the hardest continuous state-action settings, especially when longer episodes, more policies, and OOD splits reduce the usefulness of marginal shortcuts; amortized history encoders remain competitive when policy identity can be recovered from symbolic repetition or low-dimensional action statistics. We release code and checkpoints.
arXiv:2512.13069v2 Announce Type: replace Abstract: Accurate aerodynamic prediction often relies on high-fidelity simulations; however, their prohibitive computational costs severely limit their applicability in data-driven modeling. This limitation motivates the development of multi-fidelity strategies that leverage inexpensive low-fidelity information without compromising accuracy. Addressing this challenge, this work presents a multi-fidelity deep learning framework that combines autoencoder-based transfer learning with a newly developed Multi-Split Conformal Prediction (MSCP) strategy to achieve uncertainty-aware aerodynamic data fusion under extreme data scarcity. The methodology leverages abundant Low-Fidelity (LF) data to learn a compact latent physics representation, which acts as a frozen knowledge base for a decoder that is subsequently fine-tuned using scarce HF samples. Tested on surface-pressure distributions for NACA airfoils (2D) and a transonic wing (3D) databases, the model successfully corrects LF deviations and achieves high-accuracy pressure predictions using minimal HF training data. Furthermore, the MSCP framework produces robust, actionable uncertainty bands with pointwise coverage exceeding 95%. By combining extreme data efficiency with uncertainty quantification, this work offers a scalable and reliable solution for aerodynamic regression in data-scarce environments.
arXiv:2606.16152v1 Announce Type: new Abstract: Knowledge distillation from powerful reasoning models is widely used to improve Small Language Models (SLMs) on mathematical reasoning, often assuming that traces with higher reward model scores provide more useful supervision. We identify a counterintuitive Quality-Utility Paradox in mathematical reasoning distillation. Data refined or synthesized by a stronger Oracle obtains higher perceived quality according to reward models, yet consistently underperforms traces generated by the SLM itself and selected through rejection sampling across Qwen2.5, LLaMA-3, and DeepSeek families. Our analysis shows that Oracle refinement couples logical repair with distributional drift away from the SLM's native reasoning distribution. This drift increases the learner's adaptation cost and can outweigh the benefit of improved reasoning logic. To test this mechanism, we introduce Style-Aligned Refinement, which preserves the native trajectory of the SLM while retaining logical repair from the Oracle. This intervention lowers adaptation cost and restores downstream utility. These findings suggest that effective mathematical reasoning distillation should jointly optimize perceived solution quality and learner-data compatibility, rather than relying solely on reward-model scores. The datasets and code are available at https://github.com/Dracoqhl/Quality-Utility-Paradox.
Insect classification is important for agricultural management and ecological research, as it directly affects crop health and production. However, this task remains challenging due to the complex characteristics of insects, class imbalance, and large-scale datasets. To address these issues, we propose BioAutoML-NAS, the first BioAutoML model using multimodal data, including images, and metadata, which applies neural architecture search (NAS) for images to automatically learn the best operations for each connection within each cell. Multiple cells are stacked to form the full network, each extracting detailed image feature representations. A multimodal fusion module combines image embeddings with metadata, allowing the model to use both visual and categorical biological information to classify insects. An alternating bi-level optimization training strategy jointly updates network weights and architecture parameters, while zero operations remove less important connections, producing sparse, efficient, and high-performing architectures. Extensive evaluation on the BIOSCAN-5M dataset demonstrates that BioAutoML-NAS achieves 96.81% accuracy, 97.46% precision, 96.81% recall, and a 97.05% F1 score, outperforming state-of-the-art transfer learning, transformer, AutoML, and NAS methods by approximately 16%, 10%, and 8% respectively. Further validation on the Insects-1M dataset obtains 93.25% accuracy, 93.71% precision, 92.74% recall, and a 93.22% F1 score. These results demonstrate that BioAutoML-NAS provides accurate, confident insect classification that supports modern sustainable farming.
Background: Estimating tumor fraction from whole-genome cell-free DNA sequencing is critical for liquid biopsy, but is hampered by weak signals and baseline noise at low tumor fractions. Existing computational methods often require matched controls or large labeled datasets for training and lack uncertainty quantification. To address these gaps, we developed purNPE, a Bayesian deep-learning framework trained without labeled cancer cell-free DNA samples. Specifically, purNPE leverages a two-part generative model: one component simulates diverse tumor copy-number profiles based on evolutionary genealogies, while a second, data-driven component learns and replicates realistic sequencing background patterns from cancer-free cell-free DNA. By training a Neural Posterior Estimator on synthetic tumor profiles augmented with learned noise, purNPE performs amortized inference in milliseconds without needing a reference sample set at inference. Results: In a real-world pan-cancer cohort, purNPE achieved comparable performance with existing methods against orthogonal mutant-allele-fraction validation (MAE = 0.066). In silico and semi-synthetic experiments suggested analytical sensitivity around 1% tumor fraction under the evaluated conditions and showed strong classification accuracy in low tumor fractions (AUC = 0.98 for TF [≤] 3% versus controls). Conclusions: This work provides a framework for using simulation-based inference to derive calibrated, uncertainty-aware TF estimates, offering a potential alternative to traditional data-dependent methods.
Large language models (LLMs) are becoming a major way for consumers to find products, but we do not yet understand how brands compete in this new channel. We study brand dynamics in LLM recommendations using skincare products – a category where consumers cannot easily judge quality before buying and must rely on brand reputation – across three commercial LLMs (GPT-4o-mini, Claude Sonnet, Gemini 3 Flash), with a robustness check on search goods. In three experiments, we find: (1) a Conditional Monopoly where well-known brands get recommended 100% of the time (IAI = 10.0) when all products have the same specifications, but this dominance disappears with less than a +0.1-star rating advantage for a competitor; (2) authority-style marketing language, including fabricated clinical-evidence claims, breaks this monopoly at a Bias Surplus Value equal to +0.17 rating points, with each model responding differently; and (3) a social dilemma in multi-brand GEO competition: when all brands adopt the same optimization strategy, individual payoff falls from +0.802 to +0.007 in our payoff proxy, and non-participating brands receive zero recommendations in our tests. Our results suggest that generative engine optimization (GEO) should be studied not only as a security risk, but also as an emerging marketing practice that shapes market competition.
Empathetic spoken dialogue systems require not only semantically appropriate responses but also emotionally aligned prosodic expression. However, cascade pipelines often discard acoustic cues during speech-to-text conversion, while end-to-end speech models lack interpretable control over emotion and knowledge integration. To address these challenges, we propose PRISM, a multi-agent framework for empathetic spoken dialogue that decouples speech perception, response generation, and speech synthesis into coordinated components. PRISM introduces a prosody-to-language translation mechanism to stabilize large language model reasoning and enables on-demand invocation of external knowledge tools for empathetic dialogue generation. Experimental results demonstrate that PRISM achieves consistent improvements in empathy, prosodic appropriateness, and text response generation quality across objective and subjective metrics. Our code is available at: https://github.com/Bxzfrm/PRISM.
Modern Automatic Speech Recognition (ASR) systems have made remarkable progress on standard benchmarks, yet performance gaps have emerged under real-world distribution shifts, caused by recording conditions, accents, speech impairments, and noise. Existing datasets and benchmarks typically isolate these factors, which overlooks their co-occurrence in real-world applications. In this paper, we argue that model robustness can be treated as a dynamic capability that continually develops, and we introduce MoDiCoL, a Modular Diagnostic Continual Learning dataset designed for controlled analysis of linguistic content, speaker characteristics, and acoustic environments. Furthermore, we propose a real-world-inspired continual learning curriculum to simulate incremental updates and study how robustness is acquired, transferred, and forgotten. We evaluate three continual learning strategies and provide detailed insights into robustness under evolving conditions.
arXiv:2606.12620v1 Announce Type: cross Abstract: Thanks to the rapid adoption of AI code assistants powered by large language models (LLMs), industry codebases are, increasingly, a hybrid of AI- and human-authored code. For risk management and productivity analysis purposes, it is crucial to enable fine-grained location detection of AI-generated code. To develop algorithms for this task, quality benchmarks are needed to assess performance. However, existing benchmarks tend to comprise academic, LeetCode-style problems and presume a code snippet is either completely human-authored or completely AI-authored, which is not reflective of the diverse intents and styles of industry codebases utilizing AI code assistants. To fill these gaps, we introduce HybridCodeAuthorship, a novel benchmark of Python code files with interleaved human- and AI-authored lines of code to simulate authentic utilization of AI code assistants. In this paper, we first present our dataset construction pipeline, which leverages CodeSearchNet, a massive collection of links to open sourced repositories on GitHub. We then benchmark the performance of two state-of-the-art AI-generated code detection algorithms at both the line- and chunk-level. Experimental results demonstrate that HybridCodeAuthorship is a challenging benchmark with a top-scoring algorithm, AIGCode Detector, obtaining a highest F1 score of 0.48 and 0.56 on chunk-level and line-level code detection tasks, respectively.
Vision encoders for retrieval are typically trained with class-label supervision: each training pair reduces to a scalar that uniformly pushes the embedding apart or pulls it together, as if every visual attribute either differed or matched. A multimodal large language model (MLLM), shown the same pair, can articulate those attributes and use them to predict whether the images share a class. We propose SAGA, a framework that turns this language-grounded, attribute-aware perception into a training signal for the encoder itself. Specifically, we use Group Relative Policy Optimization (GRPO) to reward the MLLM for correct predictions on the vision encoder's tokens. Since correct predictions require those tokens to expose the specific attributes that differ or match between the pair, the gradient pushes the encoder to encode them, replacing the uniform pair-level scalar with attribute-resolved supervision. An auxiliary attention-distillation loss anchors the encoder's embedding to tokens the MLLM attended to, and a standard metric-learning loss shapes the embedding geometry for nearest-neighbour retrieval. The MLLM is frozen throughout and discarded at inference, matching the deployment cost of a metric-learning baseline. SAGA improves Recall@1 by 3 to 6 points over state-of-the-art baselines on CUB-200-2011, Cars-196, FGVC-Aircraft, and iNaturalist Aves on zero-shot image retrieval.
arXiv:2606.11525v1 Announce Type: cross Abstract: Contrastive Reinforcement Learning (CRL) has seen recent success in a wide variety of goal-conditioned robotics tasks by learning structured representations of the dynamics. However, despite its success in locomotion and simpler control domains, CRL often struggles in interaction-rich manipulation. We argue that a key source of this difficulty is object-centric interaction, such as contact or grasping, that induces distinct changes in the underlying dynamic modes. In this work, we formulate manipulation dynamics as a piecewise-smooth Markov process and show that interaction-induced mode changes create piecewise nonlinear reachability structures that are difficult for standard CRL energy functions to represent and plan over. Based on this analysis, we introduce Interaction-weighted Resampling (IWR). IWR performs interaction-aware resampling around phases before, during, and after interactions, encouraging the learned representation to preserve the mode boundaries that determine future reachability to capture multi-modal and piecewise nonlinear reachability. Across interaction-centric environments, including 2D dynamic control, robotic manipulation, and robot air hockey, IWR improves both sample efficiency and overall performance over prior CRL methods, with 19.8% average improvement in simulation. Finally, using a sim-to-real pipeline with policies trained by IWR, we demonstrate the first real-world goal-conditioned robot air hockey agent capable of hitting goals, improving success from 25% to 60%. Project Page: IWR-arxiv.github.io.
arXiv:2506.17496v3 Announce Type: replace-cross Abstract: We introduce the Zeta Tail$\left(a\right)$ probability distribution as a new model for random damage-event counts in risk analysis. Although a natural analogue of the Geometric$\left(p\right)$ distribution, Zeta Tail$\left(a\right)$ has received little attention in the scholarly literature. In the present work, we show this distribution to be reasonably tractable by deriving various fundamental properties, including moments, generating functions, and reliability functions. We then assess its usefulness as an alternative to Geometric$\left(p\right)$, both theoretically and through application to a set of meteorological data. Finally, we discuss conceptual differences between employing the Zeta Tail$\left(a\right)$ model conditionally (i.e., given observed data with certain known characteristics) and unconditionally (i.e., for arbitrary, as yet unobserved data).
Long Video Question Answering (LVQA) requires identifying sparse, query-relevant evidence within hours-long untrimmed videos. Existing approaches either process videos densely with large vision-language models (VLMs), incurring prohibitive computational cost, or rely on sparse caption-based reasoning, which often misses temporally localized and motion-centric evidence. We introduce TimeProVe, a cost-efficient hybrid framework for temporally grounded reasoning in long videos. TimeProVe first employs lightweight modules to generate action-grounded answer–evidence hypotheses and subsequently invokes an expensive VLM only for targeted verification. The core of our framework lies in the Action-based Candidate Evidence (ACE) module, which converts temporally localized actions into query-conditioned candidate answers and supporting evidence windows through lightweight LLM reasoning. We further introduce OpenTSUBench (OTB), an open-ended benchmark designed to evaluate temporally grounded reasoning in real-world Activities of Daily Living (ADL) scenarios. Experiments show that TimeProVe outperforms the strongest baseline on OTB by 7.3%, while reducing VLM calls by 75% and inference cost by 93%. Furthermore, without explicit temporal grounding training, TimeProVe achieves competitive performance on Charades-STA, and reaches state-of-the-art results when enhanced with grounding VLMs.
arXiv:2606.15260v1 Announce Type: cross Abstract: Reinforcement learning with massively parallel simulations has become a standard framework for developing robust, deployable policies; however, most existing approaches still rely on simple Gaussian policy parameterizations. Diffusion models provide a more expressive policy class and have shown strong performance on challenging control problems, yet most diffusion-based RL methods are designed for offline or off-policy training. In this work, we ask whether diffusion policies can be trained effectively in the massively parallel, on-policy regime. To this end, we introduce Trust-region Diffusion Policies (TruDi), which enables diffusion policies for on-policy RL with massively parallel simulations. This setting is particularly challenging because the data distribution changes quickly across updates, making stable training with complex policies difficult. TruDi addresses this by integrating a trust-region optimization rule to enforce a KL-divergence constraint over the entire diffusion trajectory. Empirically, we evaluate TruDi on a diverse set of 4 massively parallel RL benchmarks comprising a total of 73 tasks. Across these tasks, TruDi consistently outperforms or is on-par with strong baselines on standard tasks and achieves clear gains on more challenging humanoid control tasks, establishing a strong new baseline for massively parallel on-policy RL.
The gene-therapy trial aims to treat glaucoma by rejuvenating cells in the optic nerve. Plus, the mystery of how things freeze and encouragement to go out into the sunlight. The gene-therapy trial aims to treat glaucoma by rejuvenating cells in the optic nerve. Plus, the mystery of how things freeze and encouragement to go out into the sunlight.
Introduction Patients with nephrolithiasis face challenges in making a high-quality, preference sensitive decision. Our prior work established feasibility and patient acceptance of a software-based decision aid (DA). The objectives for this study were to identify implementation strategies for the DA in routine care and determine whether DA implementation enhances decisional quality for patients. Methods New nephrolithiasis patients were recruited from the institution Medical Center from June 2018 to April 2024 to receive a software-based pre-visit DA that measured care preferences and used decision analysis to rank treatments. The RE-AIM framework and Plan-Do-Study-Act (PDSA) cycles were used to improve implementation outcomes. Patients completed survey instruments evaluating decisional conflict, shared decision-making, care satisfaction, and treatment choice following their provider visit. These metrics were compared in the DA cohort (n=81) to those in a usual care cohort (n=78) with Wilcoxon rank-sum and Chi-square (or Fishers exact) tests. Results Implementation data revealed sustained reach and progressive improvement in fidelity. The DA cohort reported higher decisional quality relative to controls (p=0.003) and reported greater support/advice to make a choice (p=0.005). The DA cohort more often discussed options with their doctor (87.5% vs 69.2%, p=0.005) and were more likely to be promoters of their provider (p