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02.
arXiv (CS.CL) 2026-06-11

Context-Aware Multimodal Claim Verification in Spoken Dialogues

Every day, millions absorb claims from podcasts and streams that no fact-checker ever sees. Spoken misinformation is built through conversation, where credibility comes not from facts alone but from how claims are framed, reinforced, or left unchallenged across turns. Yet fact-checking has focused on isolated text, leaving dialogue audio under-studied. We introduce MAD2, a new Multi-turn Audio Dialogues benchmark for spoken claim verification, containing 1,000 two-speaker dialogues with 3,368 check-worthy claims and approximately 10 hours of audio, and propose calibrated multimodal fusion of a context-aware audio encoder and a dialogue-aware text model. Across settings, adding dialogue context improves verification, but the gains depend on scenario type. Using only preceding context often matches offline performance, supporting live-moderation settings, and audio contributes most when transcript-based models are destabilized by additional context. Overall, conversational structure matters more for verification than misinformation framing.

03.
medRxiv (Medicine) 2026-06-15

ECHOCARDIOGRAPHY ABNORMALITIES IN PREECLAMPSIA WITH SEVERE FEATURES.

Purpose To determine the frequency of echocardiographic abnormalities in women with preeclampsia with severe features. To describe the spectrum and types of echocardiographic abnormalities associated with preeclampsia with severe features. Method This is a Prospective observational study conducted in Vani Vilas hospital attached to Bangalore Medical College and Research Institute, Bangalore from January 2023 to December 2025. 560 pregnant women diagnosed with severe preeclampsia(SPE) were included in the study. Chronic hypertension without superimposed preeclampsia, underlying cardiac diseases and previous history of peripartum cardiomyopathy were excluded from the study. Transthoracic echocardiography-TTE (2D ECHO) was done to evaluate cardiac structure and function. Echocardiographic abnormalities identified during the study were documented and analysed using descriptive statistical methods. Results Abnormalities in ECHO was noted in 23.03%. A unique finding was the documentation of elevated pulmonary artery systolic pressures (PASP) suggestive of Pulmonary Hypertension (PH) (PASP >35 mm HG) among 20.25% of the participants. It was also the commonest abnormality on ECHO. Mild PH was the commonest (15.71%), moderate PH was seen in 3.92% and severe PH in 0.71% of cases. Next most frequent abnormality was moderate to severe valvular regurgitation (10%), followed by left ventricular hypertrophy (5.53%). Diastolic dysfunction (DD) was seen in 3.92%, systolic dysfunction(SD) in 3.57%, chamber dilatation in 3.57% and LV global hypokinesia in 3.03% cases of SPE Conclusion Preeclampsia with severe features (SPE) is associated with 23.03% abnormalities on echocardiography. SPE is associated with systolic dysfunction, diastolic dysfunction, chamber dilatation, valvular regurgitation, left ventricular hypertrophy and pulmonary hypertension.

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

Vision-Encoder Behavioral Fingerprints of Image-to-Image Generative Models: A Training-Paradigm-Driven Taxonomy of Six Commercial APIs

Authors:

We study six production image-to-image AI systems (gpt-image-1, Gemini 2.5 Flash Image, Flux Kontext, SDXL img2img, SD3 img2img, and Qwen Image Edit) under a content-adaptive sub-JND adversarial perturbation pipeline, scoring all outputs by frozen DINOv2 ViT-B/14 token distances against clean references. Across a 3,588-call corpus spanning COCO photographs, CelebA-HQ portraits, and AI-generated inputs, the six systems partition into two image-invariant behavioral bands on a 2D (patch_mean, ssim_clean) plane: edit-trained models (Flux Kontext, Qwen Edit, Gemini) cluster in a tight band, while T2I-base models adapted at sampling time (SDXL, SD3, gpt-image-1) cluster in a drift band.

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

High-Dimensional Random Projection for Activation Steering in Language Models

arXiv:2606.15092v1 Announce Type: new Abstract: Activation steering has emerged as a key methodology for controlling the behavior of large language models (LLMs). Existing difference-in-means based methods, however, are fundamentally limited: they capture only mean differences between class activations and fail to recover discriminative signals that naturally exist in the nonlinear feature subspace under the superposition hypothesis. Motivated by that, we propose High-Dimensional Random-projection for Activation Steering (HiDRA), a training-free approach that integrates seamlessly with existing activation steering methods. By performing activation addition in the projected high-dimensional space, HiDRA can provably capture a better discriminative structure beyond the reach of linear methods. Experiments across diverse LLM families and benchmarks demonstrate that HiDRA consistently outperforms baseline counterparts, achieving stronger behavioral control without significant computational overhead.

06.
bioRxiv (Bioinfo) 2026-06-20

MIRATS framework: Normative multiscale characterization of brain regulatory systems across sex and age using multimodal MRI

Authors:

Deep brain systems involved in arousal, autonomic regulation, sensory integration, and homeostatic control remain underrepresented in conventional whole-brain neuroimaging frameworks. In particular, diencephalic and brainstem nuclei are often insufficiently represented in cortex-centered analyses, limiting the normative references needed to interpret systems-level variation in health and disease. To address this gap, we developed a unified multiscale framework with explicit representation of deep nuclei. By integrating cerebral, cerebellar, diencephalic, and brainstem atlases in standard space, we constructed a 220-region whole-brain parcellation and extracted complementary features at three analytical scales: nodal properties, edge-wise connectivity, and persistent-homology-based topological descriptors. We applied this framework to healthy adults from the Human Connectome Project-Aging cohort to characterize normative multiscale organization and test sex- and age-related variation. Applied to this cohort, our framework revealed pronounced heterogeneity across anatomical systems. Brainstem and diencephalic nuclei showed multiscale feature profiles distinct from those of cerebral and cerebellar regions across nodal, edge-wise, and higher-order topological scales. Sex comparisons identified selective differences across different scales, whereas age modeling revealed widespread but feature- and system-dependent variation across adulthood. Together, these findings show that normative whole-brain organization in this deep-system-aware space is structured by system-specific rather than globally uniform patterns. These findings establish a normative multiscale framework for characterizing brainstem-diencephalic-cerebellar-cerebral organization in healthy adults and provide a quantitative reference for future translational studies of disease-related abnormalities in deep regulatory systems.

07.
arXiv (quant-ph) 2026-06-12

Multiple Topological Haldane Phases for Symmetry-Protected Quantum Information Processing

arXiv:2606.12685v1 Announce Type: new Abstract: Symmetry-protected topological phases have attracted significant interest at the fundamental level and as a potential platform for quantum information processing, owing to their protected edge states and resilience to perturbations. Applying these features for practical and efficient quantum computation is highly desirable, but remains an open challenge. Here, we demonstrate the partitioning into multiple independent Haldane phase subsystems of a single spin-1/2 ladder system and propose this as a scalable architecture for gate-based quantum computation, which takes advantage of the symmetry-protected topological order. We encode qubits in the two topological states of the $S^{z}=0$ sector of each subsystem. Finite-size effects, typically viewed as detrimental, instead provide a controllable energy splitting that enables single-qubit rotations using only local magnetic fields. An Ising-type interaction between neighboring subsystem edges generates entangling gates, enabling universal quantum computation driven by two control parameters that are easily accessible experimentally. Our results demonstrate how symmetry-protected topological phases can be directly harnessed for circuit-model quantum computation in realistic systems.

08.
arXiv (CS.AI) 2026-06-12

WISE: A Long-Horizon Agent in Minecraft with Why-Which Reasoning

arXiv:2606.12852v1 Announce Type: new Abstract: Rapid advances have been made in developing general-purpose embodied agent in environments like Minecraft through the adoption of LLM-augmented hierarchical approaches. Despite their promise, low-level controllers often become performance bottlenecks due to repeated execution failures. We argue that a key limitation is not only the lack of episodic memory, but also the decoupling of what-where-when memory from which-why reasoning. To address this, we propose WISE (Which-Why Informed Semantic Explorer), a long-horizon agent framework with an enhanced low-level controller equipped with a Causal Event Graph that augments episodic memory with explicit causal structure linking observations to task relevance. Unlike prior work such as MrSteve, which relies on feature similarity for retrieval, WISE enables robust recall under viewpoint changes and supports opportunistic task reordering through causal reasoning. Building on this memory, we propose an Opportunistic Task Scheduler that dynamically re-prioritizes subtasks when causally relevant opportunities are detected. We further equip WISE with a multi-scale progressive exploration strategy to provide spatially comprehensive observations for downstream reasoning. Experiments show that WISE largely improves task success and efficiency on long-horizon sparse tasks, particularly in settings requiring adaptive decision-making.

09.
bioRxiv (Bioinfo) 2026-06-18

fuzzyfold: a high-performance framework for stochastic RNA folding kinetics

Authors:

The analysis of nucleic acid secondary structures is overwhelmingly dominated by methods that analyze the thermodynamic equilibrium distribution and which ignore all dynamic aspects of nucleic acid folding. Yet, there are numerous popular examples of nucleic acid folding that rely on kinetic models, such as RNA riboswitches or DNA strand displacement systems. Here, I am presenting fuzzyfold, a Rust-based software package for nucleic acid secondary structure analysis with an explicit focus on stochastic modeling. The framework introduces three-way and four-way shift moves with a biophysically motivated rate-model parameterization, and it is developed with an emphasis on both model flexibility and performance, e.g. allowing for the generation of single co-transcriptional trajectories for thousand-nucleotide long RNA molecules in just a few minutes. The main strength of the fuzzyfold package, however, is its focus on user and developer interfaces for long-term development. It provides easily installable command-line interfaces, e.g. for aggregating data from multiple parallel trajectories efficiently into an ensemble-level dynamic analysis. For developers, the code-base supports straight-forward substitution of thermodynamic and kinetic free-energy models, and a flexible library interface with Python bindings, enabling integration of individual components into custom computational workflows.

10.
arXiv (CS.AI) 2026-06-15

Learning High Coverage Discriminative Parsimonious Rulesets

arXiv:2606.14156v1 Announce Type: cross Abstract: Learning systems based on IF-THEN rule representations readily offer interpretability, making them a crucial focus in contemporary AI research. A key objective for such rule sets is to achieve both high discriminative power and interpretability. While existing state-of-the-art algorithms implicitly prioritize predictive accuracy, they often fall short on one or more quality metrics that ensure interpretability, such as coverage and parsimony of rule sets. Motivated by this, this paper propose the development of CDPR, which aims to create highly accurate and interpretable rule sets for classification problems. To the best of our knowledge, this represents the first attempt to establish such an approach. In this study, we introduce two algorithms rooted in submodular maximization, which not only provide provable guarantees on coverage but also yield rule sets that are both discriminative and parsimonious. We empirically demonstrate that rule sets learned through our approaches achieve higher accuracy and interpretability and has more than a 2.5-fold improvement in average coverage rates when compared to the next best algorithm.

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

A Zero-shot Generalized Graph Anomaly Detection Framework via Node Reconstruction

arXiv:2606.12673v1 Announce Type: cross Abstract: Cross-domain graph anomaly detection (GAD) aims to identify abnormal nodes in unseen target graphs, showing strong potential in real-world applications with heterogeneous graph data. However, existing methods often depend on dataset-specific feature semantics and structural patterns, which limits their ability to generalize across different domains. To address this challenge, we propose AlignGAD, a zero-shot generalized graph anomaly detection framework. Our framework is built upon three key components: a Global Unification Module that aligns heterogeneous node features and normalizes graph signals in the spectral domain; a Clustering Module that constructs cluster-aware graph views to capture group-level abnormal patterns; and a Node Discrepancy Scoring Module that measures reconstruction discrepancy and aggregates anomaly evidence from different graph views. Experiments on multiple real-world datasets demonstrate the effectiveness of AlignGAD under the zero-shot GAD setting.

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

Beyond AHI: An Interpretable Causal-Discovery-Guided Framework for Sleep Recovery in Connected Health

arXiv:2606.18506v1 Announce Type: new Abstract: Objective sleep assessment relies on polysomnography (PSG), yet clinical impact is often better reflected in patient-reported outcomes (PROs) such as sleepiness and fatigue. Existing summary indices, including the Apnea-Hypopnea Index (AHI), provide limited insight into the multidomain physiology underlying functional recovery. We propose an interpretable, causal-discovery–guided framework for deriving a hierarchical Sleep Recovery Score (SRS) from multimodal PSG. Using two large population cohorts (MESA: n=1540; MrOS: n=825), we apply directed acyclic graph (DAG) learning to identify candidate physiological drivers spanning respiratory burden, hypoxic burden, sleep fragmentation, sleep architecture, and autonomic regulation. Although derived from clinical PSG, these domains map naturally to sensing streams increasingly available in connected health technologies, including wearable ECG, oximetry, and sleep-stage estimation devices. To preserve mechanistic plausibility, we introduce a two-stage screening process that combines physiology-based constraints with constrained LLM-assisted auditing to identify and remove structural confounders and construct-overlapping variables. Across cohorts, these five domains emerge as recurrent physiological domains associated with recovery, and the resulting SRS shows up to 2.5$\times$ stronger alignment with perceived recovery than AHI. By linking multimodal sleep physiology to patient-centered outcomes through an interpretable, bias-aware, and domain structured framework, this work provides a practical foundation for recovery modeling across both clinical sleep studies and emerging smart and connected health settings.

13.
arXiv (CS.CV) 2026-06-11

MultiToP: Learning to Patch Visual Tokens to Mitigate Hallucinations in Video Large Multimodal Models

Video Large Multimodal Models have achieved remarkable progress in video understanding, yet they remain prone to hallucinations, where generated responses are not faithfully supported by the input video. In this paper, we propose MultiToP, a multimodal-context-aware visual token patching framework that mitigates hallucinations by refining unreliable visual tokens before language generation. MultiToP introduces a lightweight Visual Token Patcher to predict token-level replacement distributions and selectively substitute unreliable visual tokens with a dynamic global patch token. To train the patcher effectively, we further propose information-guided rank calibration, which uses answer-conditioned frame-level information cues derived from the backbone to guide token replacement. Combined with ground-truth answer supervision and sparsity regularization, MultiToP enables localized visual evidence refinement without modifying the original model. Extensive experiments demonstrate that MultiToP effectively reduces hallucinations on Vript-HAL with negligible inference overhead, improving the F1 scores of Qwen3-VL-4B-Instruct by 50.60% over the vanilla model. Meanwhile, MultiToP preserves general video understanding ability, yielding an 18.58% relative accuracy gain on ActivityNet-QA for Video-LLaVA-7B.

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

Instance-Aware Knowledge Distillation for Semi-Supervised Learning of an On-Board Multi-Task Dense Prediction Model for Collision Avoidance System

Collision avoidance systems have evolved toward camera-based deep learning approaches for driving scene understanding. However, deployment in edge environments such as country clubs is constrained by limited computational resources and unreliable communication infrastructure. Moreover, constructing large-scale datasets for the target domain involves substantial annotation cost. To address these limitations, we propose an instance-aware knowledge distillation framework for semi-supervised learning. Specifically, we generate pseudo labels that mitigate teacher bias by leveraging domain priors from the teacher and instance-centric knowledge from foundation models. The trained lightweight student is deployed in the proposed collision avoidance system and performs multiple dense prediction tasks in real-time. The system detects frontal obstacles and encodes their spatial information into controller area network messages for automated guided vehicle operation. To achieve this, we construct a large-scale country club dataset and perform field validation of the proposed system. Experimental results demonstrate that the student outperforms the large teacher in instance segmentation while mitigating performance degradation in monocular depth estimation. Compared with the teacher, the student reduces FLOPs by 22.68$\times$ and parameters by 14.33$\times$, achieving 6.46 FPS on a low-cost edge device.

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

HierSVA: A Data Synthesis Pipeline, Dataset, and Benchmark for LLM-Driven Hierarchical Hardware Formal Verification

arXiv:2606.13706v1 Announce Type: cross Abstract: We present HierSVA, an integrated suite that combines a pipeline, dataset, and benchmark for LLM-driven hierarchical hardware formal verification. HierSVA-SP pairs an RTL preprocessing toolchain with an LLM-in-the-loop formal verification flow to produce reference SystemVerilog Assertions (SVA) on hierarchical RTL. Applying it to BaseJump STL yields HierSVA-DS, a dataset of 342 modules, with hierarchy metadata and depths 0–9, accompanied by a deep subset of 28 module-bug pairs with natural-language specifications and bug variants. HierSVA-B decomposes assertion quality into six metric axes: syntax correctness, assertion proof success rate, vacuity, specification faithfulness, mutation coverage, and formal core coverage. Applying HierSVA-B to twelve recent LLMs reveals three findings. First, the module-level compile rate is 67.1\%; among generated assertions in evaluable runs, 82.1\% prove non-vacuously, but the corresponding assertion sets detect only 70.2\% of eligible injected faults and cover 36.2\% of the formal core. Second, on 211 evaluable model–module entries in the deep subset, assertion sets flag buggy RTL with 0.87 recall, but 40\% of predicted-buggy outcomes are false positives on correct RTL, limiting precision to 0.60. Third, agentic mode improves S1-style provability and strength metrics, but gains plateau and oscillate. Codes and artifacts are available at \href{https://github.com/HierSVAAnon/HierSVACodeAndArtifacts}{https://github.com/HierSVAAnon/HierSVACodeAndArtifacts}. Dataset is available at \href{https://huggingface.co/datasets/AnonymousHierSVA/HierSVA}{https://huggingface.co/datasets/AnonymousHierSVA/HierSVA}.

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

A Fixed-Point Neural Operator for Size- and Functional-Transferable Hamiltonian Prediction

arXiv:2606.14498v1 Announce Type: cross Abstract: Predicting the Kohn-Sham Hamiltonian with machine learning can accelerate density functional theory while retaining access to molecular orbitals, energy levels, and electronic-structure observables that energy-only surrogates cannot resolve. Yet element-wise agreement with the converged Hamiltonian, an implicit fixed point of the self-consistent field iteration, does not determine the occupied subspace that governs orbital energies and densities. Here we present HamEvo, a neural operator that learns the single-step self-consistent update and returns the converged Hamiltonian as its fixed point. HamEvo is pre-trained on intermediate self-consistent trajectories and calibrated at equilibrium with density-matrix supervision. Across benchmarks from MD17 to drug-like QMugs, HamEvo lowers Hamiltonian errors by 35-49% over direct-regression and deep-equilibrium baselines, and predicts QMugs HOMO and LUMO energies with mean absolute errors of 0.036 and 0.053 eV, near the 1 kcal/mol chemical-accuracy scale. Few-shot fine-tuning with only 20 reference conformations extends HamEvo to molecules of up to 122 atoms, well beyond the size range covered by pre-training. With thermal molecular-dynamics sampling, HamEvo captures temperature-dependent HOMO-LUMO gap renormalization beyond the harmonic approximation. Inference is up to 242 times faster than conventional DFT.

18.
arXiv (CS.CL) 2026-06-15

SIMMER: Benchmarking Latent Failures in LLM Executable Planning with a World Model

Large language models (LLMs) are increasingly deployed as planners for autonomous agents in household environments. While existing benchmarks evaluate whether LLM-generated plans execute successfully, they overlook a critical type of failure: latent failures. Unlike immediate failures that trigger instant feedback at execution time and enable timely correction, latent failures do not immediately halt plan execution but silently compromise goal achievement. In severe cases, they cause irreversible harm. To address this gap, we introduce SIMMER, a benchmark for evaluating latent failures in LLM planning through a human-curated symbolic world model grounded in the kitchen domain. SIMMER defines a world model comprising 77 actions, 262 unique objects, and approximately 46,800 possible interactions that are semantically realistic, derived from real-world cooking scripts. It then leverages a state machine executor that validates plans against the world model and detects immediate precondition violations, latent hazards, and irreversible failures. Experiments across six LLMs show that even frontier models achieve at most 17% error-free plans. Moreover, up to 56% of plans contain latent failures, the majority of which lead to irreversible consequences. We further demonstrate that explicit state reasoning via counterfactual foresight simulation can reduce latent failures by up to 72% and irreversible cases by up to 75%, suggesting a promising direction for more robust LLM planners.

19.
medRxiv (Medicine) 2026-06-16

Cross-sectional study of the association between depressive symptoms and attentional bias to emotional stimuli in patients with acute stroke: Study protocol

Post-stroke depression affects approximately 30% of patients after stroke and is associated with delayed recovery in activities of daily living, reduced rehabilitation effectiveness, and poorer quality of life. Attentional bias modification may provide a low-burden, nonpharmacological approach for patients in the acute phase of stroke. However, before such an intervention can be implemented in clinical practice, it is necessary to clarify whether attentional bias is present in patients with acute stroke and depressive symptoms, whether cognitive function influences the manifestation of this bias, and which task and stimulus formats are most appropriate for assessment. This multicenter, cross-sectional observational study will enroll patients with acute stroke between 7-30 days after stroke onset. Depressive symptoms will be assessed using the depression subscale of the Hospital Anxiety and Depression Scale. Attentional bias will be measured under four task conditions based on the dot-probe task and the cue-target task, using face and word stimuli. Secondary assessments will include cognitive function, anxiety symptoms, activities of daily living, health-related quality of life, and clinical background variables. The aims of this study are to investigate the association between depressive symptoms and attentional bias in patients with acute stroke, compare attentional bias characteristics across task and stimulus types, and examine the potential influence of cognitive function on this association. The findings are expected to provide an empirical basis for designing future attentional bias modification protocols targeting post-stroke depression in the acute phase. This study has been registered with the UMIN Clinical Trials Registry (UMIN000059166).

20.
arXiv (CS.AI) 2026-06-15

Generative AI for Managerial Decision-Making under Ambiguity and Sycophancy

arXiv:2603.03970v2 Announce Type: replace Abstract: Generative artificial intelligence (GenAI) is increasingly being integrated into complex business workflows, fundamentally shifting the boundaries of managerial decision-making. However, the reliability of its strategic advice in ambiguous business contexts remains a critical knowledge gap. To address this gap, this study compares multiple GenAI models in their ability to detect ambiguity, examines whether a systematic ambiguity-resolution process improves response quality, and investigates their susceptibility to sycophantic behavior when confronted with flawed managerial directives. Using a novel four-dimensional business ambiguity taxonomy, we conducted a human-in-the-loop experiment across strategic, tactical, and operational scenarios. The resulting decisions were assessed through a human-validated automated evaluation framework based on agreement, actionability, justification quality, and constraint adherence. The results show that our approach not only distinguishes different types of ambiguity, but also reveals how ambiguity resolution systematically changes model behavior. In particular, resolving ambiguities improved decision quality across all managerial levels, with the strongest gains observed in constraint adherence. The analysis further showed that sycophantic behavior is not uniform across models: some models challenged flawed assumptions, whereas others tended to comply with them. This study contributes to the bounded rationality literature by positioning GenAI as a cognitive scaffold that can detect and resolve ambiguities managers might overlook, while demonstrating that its artificial limitations require human oversight to ensure its reliability as a strategic partner.

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

FM-Agent: Scaling Formal Methods to Large Systems via LLM-Based Hoare-Style Reasoning

arXiv:2604.11556v2 Announce Type: replace-cross Abstract: LLM-assisted software development has become increasingly prevalent, and can generate large-scale systems, such as compilers. It becomes crucial to strengthen the correctness of the generated code. However, automated reasoning for large-scale systems remains challenging due to code complexity. Hoare logic offers an approach to decomposing a large system into smaller components and reasoning about them separately (i.e., compositional reasoning). However, existing works still struggle to scale, because Hoare logic requires writing formal specifications for each function, imposing a heavy human burden. The problem is exacerbated when code is generated by LLMs, as developers lack a deep understanding of each function's expected behavior. This paper presents FM-Agent, the first framework that realizes automated compositional reasoning for large-scale systems. Leveraging LLMs, FM-Agent introduces a top-down paradigm to automatically generate function-level specifications. Specifically, FM-Agent derives the specification of a function from how its callers expect the function to behave, so the generated specifications can reflect the developer's intent of a function even if the implementation is buggy. Developers' intent is usually expressed in natural language, while existing verifiers only support formulas. Therefore, FM-Agent generalizes Hoare-style inference to reason about functions against natural-language specifications. Finally, to confirm bug existence and explain bug causes, FM-Agent automatically generates test cases to trigger potential bugs. In our evaluation, FM-Agent successfully reasons about large-scale systems within 2 days, each of which has up to 143k LoC. These systems have already been tested by their developers, but FM-Agent still finds 522 newly discovered bugs. These bugs can cause serious consequences, including system crashes and incorrect execution results.

22.
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)

23.
arXiv (CS.LG) 2026-06-19

Towards Modality-imbalanced Federated Graph Learning: A Data Synthesis-based Approach

arXiv:2606.20382v1 Announce Type: new Abstract: MultiModal Federated Graph Learning (MM-FGL) offers a natural collaborative training paradigm, but its practical deployment is challenged by two granularities of modality imbalance. Client-level imbalance occurs when certain clients lack entire modalities, while node-level imbalance occurs when individual nodes exhibit missing visual or textual attributes. While several relevant studies exist, our investigation reveals that they predominantly target graph-agnostic or centralized scenarios, rendering them difficult to adapt directly. To address these challenges, we formalize modality-imbalanced MM-FGL as an implicit graph-aware latent semantic representation synthesis problem. This paradigm recovers missing modal semantics directly within the representation space, thereby maximizing alignment with the original data's semantic distribution and mitigating the high variance induced by missing modalities. To this end, we propose FedMGS (Federated Modality-aware Graph Synthesis), which integrates three core components. The availability-aware graph encoder prevents missing modalities from contaminating local structural propagation. The prototype-guided latent semantic synthesizer establishes cross-client semantic anchors for unavailable modalities. The reliability-calibrated semantic fusion mechanism regulates the impact of recovered latent representations prior to predictive readout. Extensive experiments on four tasks show that FedMGS consistently outperforms competitive baselines with gains up to 17.41% with best efficiency-performance tradeoff.

24.
arXiv (quant-ph) 2026-06-19

Sparse Configuration Interaction for the Electronic Schrödinger Equation Revisited: Complete Basis Set Limit Complexity and Quantum-Encoding Impact

arXiv:2606.20385v1 Announce Type: new Abstract: In this article we revisit regularity results for eigenfunctions in the discrete spectrum of the electronic Schrödinger equation and study their consequences for approximation complexity. In particular, for the convergence to the complete basis set limit, it can be shown that the curse of dimensionality in the leading algebraic exponent can be mitigated. That is, for general sparse grid constructions, the main term of the convergence rate with respect to the number of degrees of freedom is independent of the number of electrons. These insights indicate potential benefits for classical numerical solvers of the electronic Schrödinger equation and also for quantum-computing approaches through new qubit-efficient wavefunction encodings.

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

Scalable Production Scheduling: Linear Complexity via Unified Homogeneous Graphs

arXiv:2604.23841v2 Announce Type: replace-cross Abstract: Efficiently solving the Job Shop Scheduling Problem in real-world industrial applications requires policies that are both computationally lean and topologically robust. While Reinforcement Learning has shown potential in automating dispatching rules, existing models often struggle with a scalability bottleneck caused by quadratic graph complexity or the architectural overhead of heterogeneous layers. We introduce a unified graph framework that employs feature-based homogenization to project distinct node roles into a shared latent space. This allows a standard homogeneous Graph Isomorphism Network to capture complex resource contention with linear complexity, ensuring low-latency inference for large-scale industrial applications. Our empirical results demonstrate that our framework achieves state-of-the-art performance while exhibiting consistent zero-shot generalization. We identify the job-to-machine ratio as the primary driver of policy effectiveness, rather than absolute problem size. Based on this, we propose a hypothesis of structural saturation, demonstrating that policies trained on critically congested instances ($\mathcal{J} \approx \mathcal{M}$) learn scale-invariant resolution strategies. Agents trained at this saturation point internalize invariant conflict-resolution logic, allowing them to treat massive rectangular instances as a sequential concatenation of saturated sub-problems. This approach eliminates the need for expensive scale-specific retraining and prevents overfitting to statistical shortcuts, providing a robust and efficient pathway for deploying RL solutions in dynamic production environments.