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01.
arXiv (CS.AI) 2026-06-19

Exploring Feature Extraction Technique Parameters for Acoustic Gunshot Classification

arXiv:2606.19568v1 Announce Type: cross Abstract: Acoustic gunshot detection is a problem with applications across civilian public safety, military operations, and wildlife conservation, yet the field lacks a rigorous exploration of feature extraction techniques with a focus on generalization to realistic data. The mixed effectiveness of commercial gunshot detection and classification systems indicates an open problem that is not adequately addressed by the current literature. In this paper, we present a systematic investigation of common feature extraction techniques using a dataset of 23,000 gunshot recordings across 85 firearms and 21 calibers. We benchmark three feature extraction techniques with 12 total unique parameter sets using ResNet-18. Our results demonstrate that using the correct feature extraction technique can improve top-1 accuracy by up to 20%, and utilizing the correct parameters for a given feature extraction technique can improve that value by up to 4.7%.

02.
arXiv (CS.CL) 2026-06-18

Leadership as Coordination Control: Behavioral Signatures and the Recovery-Advantage Boundary in Multi-Agent LLM Teams

Authors:

Team science holds that leadership is contingent: it helps only under specific conditions, and capable, autonomous teams may need none at all. We ask the analogous question for multi-agent LLM teams: under what measurable conditions does process-level coordination control add value, and do those conditions match what team science predicts? We use behavioral signatures (majority lock-in, exploration, recovery from an incorrect round-0 consensus) and per-action ablations, clean because each controller is an explicit action set, not a monolithic prompt. We operationalize three classical leadership styles (transactional, transformational, situational) as controllers over a shared action vocabulary (explore, revise, accept, synthesize). A matched controller with the same actions but an arbitrary rule recovers no better than majority voting, so the theory-derived rule, not the vocabulary, does the work. Across four task regimes and three open-weight model families, no controller dominates by accuracy, as the contingency view predicts: transactional control matches a shared round-0 vote on all 12 (model, regime) combinations to within 1.3pp, and gains appear only on the one combination where the round-0 majority is unreliable (llama-4-scout social; situational +8pp over flat). A recovery-advantage account, tested with four boundary probes, says a controller beats plain interaction only where the round-0 majority is unreliable, the task is recoverable, and undirected interaction does not already repair it. These regions map onto contingency theory (leadership substitutes, path-goal redundancy, the situational readiness gap), so a largely null accuracy result is what the theory predicts, not a failure of the controllers. We read process-level coordination control as a contingency to be measured and theory-mapped, not a leaderboard to be topped.

03.
arXiv (CS.CL) 2026-06-11

Schützen: Evaluating LLM Safety in Bulgarian and German Contexts

Large language models are increasingly deployed across professional domains, bringing hard-to-predict risks, including the generation of harmful or disrespectful content. Although substantial progress has been made in developing safety evaluation datasets, existing resources remain overwhelmingly English- and Chinese-centric. This limitation is particularly pronounced when evaluating languages that operate within shared sociocultural, legal, and ethical contexts. To address this gap, we introduce Sch\"{u}tzen: a German–Bulgarian safety dataset designed to assess model answerability under risk, covering both a low-resource language (Bulgarian) and a high-resource language (German). Experiments with multilingual and language-specific LLMs reveal pronounced cross-language differences in safety behavior, highlighting the necessity of tailored, region-specific evaluation resources to support the responsible deployment of LLMs in Germany and Bulgaria. Datasets and code are available at https://github.com/xnlp-lab/Schutzen. Warning: this paper contains examples that may be offensive, harmful, or biased.

04.
arXiv (CS.CV) 2026-06-17

ED3R: Energy-Aware Distributed Disaster Detection Enabled by Cooperative Robotic Agents

Robotics are expected to support environmental monitoring and natural disaster management, where decisions must be made under uncertainty, resource limitations, and strict operational constraints. In critical missions, such as wildfires, robotic agents must not only identify hazardous events with sufficient confidence, but also manage the energy cost and time until detection. This paper introduces ED3R, an energy-aware distributed framework for wildfire detection under uncertainty. ED3R enables hierarchical cooperative decision-making between a robot and a remote controller. The remote controller decides upon the robot's motion, while the robot senses the environment and decides where to execute the wildfire detection (onboard or remotely) and how. The common goal is to detect wildfires with a required confidence while minimizing the energy consumed by any robot operation. ED3R further integrates mechanisms to avoid nearby obstacles, prevent redundant exploration, enable adaptive early mission completion, and ensure feasibility through a custom penalty function. ED3R also introduces a forward-looking capability, enabled through distributed neural regression models that allow the agents to anticipate the future by evaluating candidate strategies before execution. The framework is evaluated through realistic robotics simulations, ablation studies, and baseline comparisons. Overall, ED3R achieves a mission success rate of up to 97.18%. Especially in the most demanding missions, it reduces energy consumption by up to 36.4% and detects wildfires up to 41% faster than baselines.

05.
bioRxiv (Bioinfo) 2026-06-16

Evidence for recombination in dengue virus genomes

Recombination is a key driver of RNA virus evolution, yet its extent and evolutionary implications in dengue virus (DENV) remain incompletely understood. We conducted a comprehensive, genome-wide recombination screen across 6,905 complete DENV genomes representing all four serotypes, 82 countries, and eight decades of sampling (1944-2023) retrieved from the Bacterial and Viral Bioinformatics Resource Center. Using seven complementary recombination detection methods implemented in RDP5, we identified 66 recombination events across 53 unique recombinant sequences, of which 29 are newly described. Events included intra-genotypic (n = 18), inter-genotypic (n = 32), and inter-serotypic (n = 16) exchanges spanning 14 genotypes and four continents, with no meaningful serotype-level enrichment (Cramer's V = 0.054). Recombination was concentrated in non-structural genes, most frequently NS3 (19 events), NS5 (17), and NS2 (12), while the capsid gene contained no recombination events, consistent with strong functional constraint. Single-nucleotide polymorphism analyses confirmed low divergence between recombinants and their inferred parents in both recombinant and non-recombinant regions. Phylogenomic analysis of 6,642 sequences revealed that recombinants cluster significantly closer to their major parents (p = 8.9 x 10-6 ) and that their removal does not significantly alter tree topology (p = 0.898), suggesting that the short length of recombinant regions limits phylogenetic conflict. We also introduce RECOSIM, an unsupervised machine-learning tool for recombination detection that achieved higher precision than RDP5 on both simulated (93.4% vs. 80.0%) and empirical (98.1% vs. 39.3%) datasets. Collectively, these results establish recombination as a widespread, pan-serotypic phenomenon in DENV with implications for genomic surveillance, vaccine evaluation, and evolutionary inference.

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

High-efficiency telecom conversion of heralded atomic biphoton wavepackets

arXiv:2603.09824v2 Announce Type: replace Abstract: We demonstrate high-efficiency telecom frequency conversion of heralded atomic biphoton wavepackets using a diamond-type atomic ensemble. By placing a 2.5 MHz heralded-photon spectrum within the high-efficiency region of the converter response, we achieve a conversion efficiency of 79.4(2.6)% while maintaining strong time-resolved correlations and well-defined temporal wavepackets. For a broader 17.4 MHz input bandwidth, the conversion efficiency is reduced to about 55%, whereas the temporal waveform remains largely preserved. This behavior reflects the nearly flat central response of the converter, which mainly causes spectral-edge loss rather than temporal-mode distortion. These results identify spectral matching as an effective route to efficient and low-distortion telecom conversion of narrowband quantum light from atomic systems.

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

Beyond English: Uncovering the Multilingual Gap in Vision-Language-Action Models

Vision-Language-Action models have recently demonstrated promising capabilities in learning generalist robot policies from large-scale multimodal data. However, most existing VLA systems are trained and evaluated primarily with English instructions, leaving their ability to understand and execute instructions in other languages largely unexplored. While the underlying large language models often possess multilingual capabilities, it remains unclear whether these multilingual capabilities transfer to VLAs during training. In this work, we present the first systematic study of multilingual instruction following in VLA models. We first construct multilingual instructions by extending existing benchmarks with translations of their instructions. Using these instructions, we evaluate several representative VLA models across a range of tasks in simulation settings. Our experiments reveal a significant multilingual gap: models trained primarily on English instructions exhibit substantial performance degradation when evaluated on other languages, even when the underlying language backbone is multilingual. We provide several findings and analyses to understand the multilingual gap. Cross-lingual transfer behavior analysis shows that performance drops correlate with both instruction understanding and action execution. Representation analyses suggest that multilingual instruction-caused representation shifts may contribute to the multilingual gap. Motivated by these findings, we further explore strategies to improve multilingual performance in VLAs. We propose a simple yet effective multilingual fine-tuning approach, Multilingual Principal Component Alignment, which leverages Principal Component Analysis to get the principal component subspace and align projected multilingual representations, effectively reducing the multilingual performance gap.

08.
arXiv (CS.CV) 2026-06-18

Global Offshore Wind Infrastructure: Deployment and Operational Dynamics from Dense Sentinel-1 Time Series

The offshore wind energy sector is expanding rapidly, increasing the need for independent, high-temporal-resolution monitoring of infrastructure deployment and operation at global scale. While Earth Observation based offshore wind infrastructure mapping has matured for spatial localization, existing open datasets lack temporally dense and semantically fine-grained information on construction and operational dynamics. We introduce a global Sentinel-1 synthetic aperture radar (SAR) time series data corpus that resolves deployment and operational phases of offshore wind infrastructure from 2016Q1 to 2025Q1. Building on an updated object detection workflow, we compile 15,606 time series at detected infrastructure locations, with overall 14,840,637 events as analysis-ready 1D SAR backscatter profiles, one profile per Sentinel-1 acquisition and location. To enable direct use and benchmarking, we release (i) the analysis ready 1D SAR profiles, (ii) event-level baseline semantic labels generated by a rule-based classifier, and (iii) an expert-annotated benchmark dataset of 553 time series with 328,657 event labels. The baseline classifier achieves a macro F1 score of 0.84 in event-wise evaluation and an area under the collapsed edit similarity-quality threshold curve (AUC) of 0.785, indicating temporal coherence. We demonstrate that the resulting corpus supports global-scale analyses of deployment dynamics, the identification of differences in regional deployment patterns, vessel interactions, and operational events, and provides a reference for developing and comparing time series classification methods for offshore wind infrastructure monitoring.

09.
medRxiv (Medicine) 2026-06-18

Biomedical Capacity, Governance, and Health Security: A Dominican Republic Research Analysis of Stakeholder Perspectives

The COVID-19 pandemic exposed critical vulnerabilities in globally concentrated biomedical supply chains and accelerated interest in nearshoring and hemispheric health-security strategies. The Dominican Republic, already the third-largest medical device exporter in Latin America, occupies a strategically significant but institutionally constrained position within this realignment. This study evaluates stakeholder perceptions of the principal opportunities and barriers affecting biomedical ecosystem development in the Dominican Republic, with particular attention to governance, workforce capacity, and value-chain upgrading pathways. Methods. A concurrent mixed-methods design was employed, integrating a cross-sectional electronic survey of 142 purposively sampled domain experts (administered September-December 2025) with a qualitative executive consultation with senior government and industry leaders. Survey analyses combined descriptive statistics, one-sample t-tests against the scale neutral midpoint, chi-square goodness-of-fit tests, Friedman non-parametric ranking, Spearman rank correlations, and exploratory linear and logistic multivariable regression. Qualitative responses were analyzed using a framework approach grounded in the Triple Helix model of innovation systems. Results. Perceived government support was significantly below neutral (mean = 2.67, SD = 1.12; p = 0.034). Workforce shortages (83.3%) and weak academia-industry collaboration (71.4%) were the most frequently endorsed barriers ({chi}2(5) = 18.7, p = 0.002). Regulatory modernization (88.1%) and workforce development (85.7%) ranked as the highest-priority policy levers (Friedman p = 0.005). Clinical trials and contract research organization services were the dominant sub-sector priority (76.2%, binomial p < 0.001). In multivariable analysis, perceived government support, talent availability, and confidence in IP protection jointly explained 46% of the variance in sector competitiveness (R2 = 0.46, p < 0.001). Strong majority support existed for a formal public-private biomedical coordination authority (73.8%, p < 0.001).Conclusion. Institutional credibility and advanced human capital–rather than geography or market access–are the perceived binding constraints on the Dominican Republics biomedical trajectory. Regulatory modernization, targeted workforce investment, and the establishment of a national biomedical coordination authority represent the highest-leverage interventions for positioning the country as a hemispheric hub for biomedical manufacturing, clinical research, and health security.

10.
arXiv (CS.LG) 2026-06-16

libhmm: A Modern C++20 Library for Hidden Markov Models with Correct MLE Emission M-Steps

Authors:

arXiv:2605.29208v2 Announce Type: replace-cross Abstract: We describe libhmm, a C++20 library for Hidden Markov Model parameter estimation, sequence decoding, and model selection. libhmm addresses two gaps in existing software: the absence of a well-maintained, zero-dependency C++ HMM library suitable for embedding in production systems, and the widespread use of method-of-moments (MOM) approximations in the emission distribution M-step of the Baum-Welch algorithm. The library implements correct maximum likelihood estimators for sixteen scalar emission distributions, including an ECME algorithm for the location-scale Student-t distribution, Newton-Raphson maximization for Gamma, Beta, Weibull, and Negative Binomial distributions, and the von Mises distribution for circular data. All forward-backward and Viterbi calculations operate in full log-space. SIMD acceleration is provided for AVX-512, AVX2, SSE2, and ARM NEON via compile-time dispatch with scalar fallback. Version 4 adds multivariate observation support via the BasicHmm template, with three multivariate emission families (diagonal Gaussian, full-covariance Gaussian, and independent components) each with correct weighted MLE M-steps. Python bindings are available via the companion package pylibhmm. We compare libhmm against established C and C++ HMM libraries and against published R reference packages on seven real-data benchmarks, and discuss the architectural tradeoffs made in the design.

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

Random Grover Search

arXiv:2606.11759v1 Announce Type: new Abstract: Grover's algorithm achieves a quadratic speedup for unstructured search given a global oracle for the target set. In many applications, however, the target set is specified as the intersection of multiple constraint sets. Constructing a global oracle for the intersection can be costly, whereas the individual constraint oracles are often much simpler to implement. We study a randomized Grover search algorithm that directly uses these constraint oracles. At each iteration, one of the corresponding Grover operators is selected at random. For the two-operator case with uniform sampling, we prove that the success probability approaches one after \[ \Theta \left(\frac\pi4\sqrt{\frac{N}{r}}\right) \] iterations, where $r$ is the size of the intersection. Thus, the algorithm achieves the same asymptotic query complexity as standard Grover search but without requiring a global oracle. We then generalize the analysis to arbitrary sampling distributions and an arbitrary number of Grover operators through an auxiliary operator that approximates the expected Grover evolution, while retaining the same asymptotic complexity. We further show that highly biased sampling distributions can still achieve near-unit success probability, enabling cheaper Grover operators to be used more frequently. Finally, we prove asymptotic optimality and support the theoretical results with numerical simulations.

12.
arXiv (math.PR) 2026-06-18

The FBSDE approach to sine-Gordon up to $6\pi$

arXiv:2401.13648v3 Announce Type: replace-cross Abstract: We develop a stochastic analysis of the sine-Gordon Euclidean quantum field $(\cos (\beta \varphi))_2$ on the full space up to the second threshold, i.e. for $\beta^2 < 6 \pi$. The basis of our method is a forward-backward stochastic differential equation (FBSDE) for a decomposition $(X_t)_{t \geqslant 0}$ of the interacting Euclidean field $X_{\infty}$ along a scale parameter $t \geqslant 0$. This FBSDE describes the optimiser of the stochastic control representation of the Euclidean QFT introduced by Barashkov and one of the authors. We show that the FBSDE provides a description of the interacting field without cut-offs and that it can be used effectively to study the sine-Gordon measure to obtain results about large deviations, integrability, decay of correlations for local observables, singularity with respect to the free field, Osterwalder-Schrader axioms and other properties.

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

Estimating Tail Risks in Language Model Output Distributions

arXiv:2604.22167v2 Announce Type: replace-cross Abstract: Language models are increasingly capable and are being rapidly deployed on a population-level scale. As a result, the safety of these models is increasingly high-stakes. Fortunately, advances in alignment have significantly reduced the likelihood of harmful model outputs. However, when models are queried billions of times in a day, even rare worst-case behaviors will occur. Current safety evaluations focus on capturing the distribution of inputs that yield harmful outputs. These evaluations disregard the probabilistic nature of models and their tail output behavior. To measure this tail risk, we propose a method to efficiently estimate the probability of harmful outputs for any input query. Instead of naive brute-force sampling from the target model, where harmful outputs could be rare, we operationalize importance sampling by creating unsafe versions of the target model. These unsafe versions enable sample-efficient estimation by making harmful outputs more probable. On benchmarks measuring misuse and misalignment, these estimates match brute-force Monte Carlo estimates using 10-20x fewer samples. For example, we can estimate probability of harmful outputs on the order of 10^-4 with just 500 samples. Additionally, we find that these harmfulness estimates can reveal the sensitivity of models to perturbations in model input and predict deployment risks. Our work demonstrates that accurate rare-event estimation is both critical and feasible for safety evaluations. Code is available at https://github.com/rangell/LMTailRisk

14.
arXiv (CS.CL) 2026-06-24

Quantifying Prior Dominance in RAG Systems

Authors:

Retrieval-Augmented Generation (RAG) grounds Large Language Models in external knowledge, yet current evaluations rely on discrete heuristics that suffer from ''epistemic blindness'' - failing to distinguish genuine contextual information extraction from parametric memory recall. To address this, we introduce the Normalized Context Utilization (NCU) metric, leveraging continuous token log-probabilities across zero-shot, oracle, and adversarial conditions to strictly quantify contextual information gain. Evaluating architectures ranging from 1.5B to 72B parameters alongside a proprietary commercial API reveals that for strict factual extraction (without Chain-of-Thought reasoning), traditional scaling laws exhibit extreme diminishing returns: highly efficient Small Language Models (SLMs) match or outperform high-capacity architectures. Furthermore, we demonstrate that ``Prior Dominance'' correlates with model scale and proprietary alignments. The evaluated commercial API not only overrode explicit external evidence in nearly half of adversarial conflicts, but also frequently suffered from systemic confidence collapse (Negative Transfer) when its parametric priors were contradicted. Our findings highlight the structural epistemic advantage and superior contextual adherence of SLMs in strict extraction workflows.

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

Towards Efficient Large Language Reasoning Models via Extreme-Ratio Chain-of-Thought Compression

arXiv:2602.08324v5 Announce Type: replace Abstract: Chain-of-Thought (CoT) reasoning successfully enhances the reasoning capabilities of Large Language Models (LLMs), yet it incurs substantial computational overhead for inference. Existing CoT compression methods often suffer from a critical loss of logical fidelity at high compression ratios, resulting in significant performance degradation. To achieve high-fidelity, fast reasoning, we propose a novel EXTreme-RAtio Chain-of-Thought Compression framework, termed Extra-CoT, which aggressively reduces the token budget while preserving answer accuracy. To generate reliable, high-fidelity supervision, we first train a dedicated semantically-preserved compressor on mathematical CoT data with fine-grained annotations. An LLM is then fine-tuned on these compressed pairs via a mixed-ratio supervised fine-tuning (SFT), teaching it to follow a spectrum of compression budgets and providing a stable initialization for reinforcement learning (RL). We further propose Constrained and Hierarchical Ratio Policy Optimization (CHRPO) to explicitly incentivize question-solving ability under lower budgets by a hierarchical reward. Experiments on three mathematical reasoning benchmarks show the superiority of Extra-CoT. For example, on MATH-500 using Qwen3-1.7B, Extra-CoT achieves over 73\% token reduction with an accuracy improvement of 0.6\%, significantly outperforming state-of-the-art (SOTA) methods. Our source codes have been released at https://github.com/Mwie1024/Extra-CoT.

16.
arXiv (CS.CV) 2026-06-12

JSCGC: Joint Source-Channel-Generation Coding for Wireless Generative Communications

Conventional communication systems, including both separation-based coding and learning-based joint source-channel coding (JSCC), are typically designed under Shannon's rate-distortion theory. However, relying on generic distortion metrics fails to capture complex human visual perception, often resulting in blurred or unrealistic reconstructions. In this paper, we propose Joint Source-Channel-Generation Coding (JSCGC), a generative communication paradigm that replaces the conventional decoder with a generative model at the receiver. The received signal is treated as a condition that controls the sampling process into the learned conditional distribution, reformulating communication from deterministic reconstruction for distortion minimization to controlled generation for mutual information maximization under perceptual constraints. Based on this formulation, we develop a unified joint training and efficient stochastic sampling framework, and provide theoretical analysis of its effectiveness in both learning and inference stages. Extensive experiments on latent-space image transmission demonstrate that the JSCGC consistently improves feature-based, semantic-level, and distributional quality across diverse channel conditions, while exhibiting a distinct error behavior characterized by semantic inconsistency rather than distortion.

17.
medRxiv (Medicine) 2026-06-22

Early-life nutritional environment is associated with late-life cognition in the Health and Retirement Study, a pellagra epidemic natural experiment

Early-life exposures are important to several late-life health outcomes. We sought to study the effect of an in utero nutritional environment and its interaction with Alzheimer's disease (AD) genetic risk on late-life cognitive function. We used a natural experiment created by the pellagra epidemic, a nutritional disease caused by a vitamin B3 deficiency, to evaluate the association between in utero pellagra epidemic exposure and late-life cognitive function in the Health and Retirement Study (N = 18,285). We also evaluated whether the in utero exposure could modify the AD polygenic score's (PGS) effect on cognition. In utero pellagra epidemic exposure was significantly associated with cognition ({beta} = -0.025). However, these effects were not isolated to the prenatal period as exposure during childhood periods also had an effect. The interaction between the in utero exposure and the AD PGS was significant, where the genetic effect on cognition was amplified with increasing (progressively worse) in utero exposure levels. These associations imply that the early-life nutritional environment affects late-life cognitive function and that these effects can modify genetic risk.

18.
arXiv (CS.CL) 2026-06-17

NarrativeWorldBench: A Frontier-Saturated Benchmark and a Latent World Model for Long-Horizon Co-Creative Audio Drama

Long-form serialized audio drama, with arcs that run for 200 to 800 episodes, is a major creative medium and a setting where frontier large language models (LLMs) fail. We benchmark 21 models, spanning classical, fine-tuned, open-frontier, closed-frontier, and reasoning tiers, on a uniform set of structural narrative metrics. All closed-frontier systems saturate at a plot-beat F1 in the band [0.78, 0.81] and collapse by about -0.20 F1 at horizon h=200. We introduce NarrativeWorldBench, an open benchmark of nine narrative-structure metrics evaluated across horizons h in {10, 20, 50, 100, 200}, with cross-lingual evaluation across four Indic languages (Hindi, Tamil, Telugu, Marathi). We introduce N-VSSM, a Narrative Variational State-Space Model that maintains a structured 256-dimensional latent world state over more than 200 episodes via a Mamba-2 backbone with an event-conditioned posterior and an 8B decoder. N-VSSM holds plot-beat F1 >= 0.84 across all horizons at 4x lower compute than the closed-frontier band. A learned Cultural Transfer Function lifts cross-language fidelity by +0.20 to +0.23 Likert points. In a within-subjects writer study (n = 12 professional authors, 240 trials), N-VSSM is preferred over Claude Opus 4.5 on long-arc consistency 71% of the time and rated +1.3 Likert points higher on controllability.

19.
medRxiv (Medicine) 2026-06-22

The direct economic impact of surgical non-response in orthopaedic hip, knee, and spine surgery for osteoarthritis: a cost-utility analysis

Background Annually, nearly 2 million hip, knee, and spinal inpatient surgeries are performed in Canada and the US for osteoarthritis (OA), costing over $37 billion in hospital expenditures. However, 15-30% of patients experience limited or no improvement, resulting in poor value for money. This study evaluated the one-year cost-utility of joint and spine procedures for OA by comparing non-responders to responders, considering various responder definitions. Methods Individual micro-costing data were collected for 1,175 elective hip, knee, and spine patients enrolled in the Longitudinal Evaluation in the Arthritis Program - Osteoarthritis (LEAP-OA) between 2014 and 2018. Quality-adjusted life years (QALYs) were derived using the SF-6D utility index. One-year incremental cost-utility ratios (ICURs) were calculated from the hospital perspective. Results Responder rates varied by definition, ranging from 78%-94% for hip replacements, 64%-90% for knee replacements, 60%-64% for spine fusions, and 50%-68% for spine decompressions. Corresponding ICURs were: $45,956-$51,773/QALY for responders versus $108,593-$485,762/QALY for non-responders for hip replacements; $54,831-$71,151/QALY for responders versus $200,486-$1,203,596/QALY for non-responders for knee replacements; $65,980-$74,422/QALY for responders versus $262,039-$729,686/QALY for non-responders for spine fusions; and $29,947-$42,168/QALY for responders versus $63,195-$662,586/QALY for non-responders for spine decompressions. Conclusions While surgical response rates were highly dependent on the responder definition, ICURs for non-responders were significantly higher than those for responders across all definitions. Beyond the negative impact on patients, there is a compelling economic argument for investment in improved pre-operative identification of patients at risk of surgical non-response. Such efforts could enable more personalized, value-based care pathways and reduce the provision of low-value surgical interventions.

20.
PLOS Computational Biology 2026-06-22

Towards modeling phage therapy

by Rob J. de Boer, Robert Schooley, Alan S. Perelson Patients infected with life-threatening multi-drug resistant (MDR) bacteria have been treated with cocktails of bacteriophages. This is a complicated form of personalized medicine as the phages given to a patient have to be selected beforehand on the basis of their lytic capacity of the infecting bacteria. Because bacteria rapidly become resistant, the evolution of resistance to a diverse cocktail of phages is a complicated dynamical process, during which competing bacterial strains replace one another by accumulating several resistance mechanisms, each of which may involve a fitness cost. As a consequence, it is typically not known why a particular phage therapy succeeded or failed, and how one can optimize the composition of the cocktails to maximize the rate of success. To improve upon this, we extend an existing in vivo-calibrated mouse model into a novel mathematical model for the human situation, and include multiple phages infecting multiple bacterial strains, differing in their resistance to each of the phages. We adjust several parameter estimates of the bacterial model to the human situation, and use the model to describe a successful case of phage therapy involving several cocktails, each containing several phages. In the model, treatment success crucially depended on pretreatment resistance levels, and on the diversity and the timing of the cocktails. Once an appropriate cocktail is found, it is less important to further optimize the infection rates of the phages. Resistant bacterial strains expand rapidly when sensitive strains decline, and the higher the infectivity of the phages, the faster resistant strains expand. Because resistance evolves rapidly, it is best to provide a diverse set of phages right from the start of therapy, i.e., to hit hard and early, and create a high genetic barrier to bacterial resistance.

21.
medRxiv (Medicine) 2026-06-17

Cardio Heart Connect: Protocol for a Randomized Trial of a Commercially Available mHealth Fitness Intervention for Cardiac Rehabilitation After Transcatheter Aortic Valve Replacement

Background: Despite ample evidence of the benefits of cardiac rehabilitation (CR), few transcatheter aortic valve replacement (TAVR) patients participate. Commercially available mobile health offers an opportunity to deliver activity-promotion content to populations that are challenged to participate in CR. This study aims to test the efficacy of clinically controlled, commercially available fitness programming for improving physical activity and cardiovascular health outcomes designed to be initiated while patients are on waitlists for traditional CR. Methods: The Cardio Heart Connect study is a hybrid type I effectiveness-implementation trial aiming to enroll N=200 patients who have been placed on a cardiac rehab waitlist following a TAVR procedure from the University of Colorado Hospital Heart and Vascular Center. Participants will be randomized 1:1 to the Cardio Heart Connect intervention with commercially available fitness or attention control, designed to control for technology access. At baseline, post-intervention (8 weeks), and follow-up (12 months), we will assess the primary outcome of participants? daily steps as measured by smartwatch accelerometer and secondary outcomes of interest including functional capacity (Duke Activity Status Index; VO2max), quality of life (Kansas City Cardiomyopathy Questionnaire), and cardiovascular health status (Life Essential 8). In addition, we will use mixed methodologies to evaluate the implementation of intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Conclusions: Commercially available fitness programs have the potential to provide more accessible opportunities for patients recovering from TAVR to engage in physical activity and may be preferred due to their customizability, convenience, and ease of scheduling. Overall, this study will provide insight into the use of commercial mHealth to promote activity following TAVR.

22.
arXiv (CS.CV) 2026-06-18

Prior-guided Fusion of Multimodal Features for Change Detection from Optical-SAR Images

Multimodal change detection (MMCD) identifies changed areas in multimodal remote sensing data, demonstrating significant application value in land use monitoring and urban sustainable development. However, literature MMCD approaches exhibit limitations in both cross-modal interaction and exploiting modality-specific characteristics. This leads to insufficient modeling of fine-grained change information, thus hindering the precise detection of semantic changes. To address these problems, we propose STSF-Net, a framework designed for MMCD between optical and SAR images. STSF-Net jointly models modality-specific and spatio-temporal common features to enhance change representations. Specifically, modality-specific features are exploited to capture genuine semantic change signals, while spatio-temporal common features are embedded to suppress pseudo-changes caused by differences in imaging mechanisms. Furthermore, we introduce an optical and SAR feature fusion strategy that adaptively adjusts multimodal feature importance based on semantic priors obtained from visual foundation models. Finally, we introduce the novel Delta-SN6 dataset, the first openly-accessible multiclass MMCD benchmark consisting of very-high-resolution fully polarimetric SAR and optical images. Experimental results on Delta-SN6, BRIGHT, and Wuhan datasets demonstrate that our method outperforms the state-of-the-art by 3.21%, 0.87%, and 1.32% in mIoU, respectively.

23.
arXiv (CS.CL) 2026-06-11

Verifiable Environments Are LEGO Bricks: Recursive Composition for Reasoning Generalization

Reinforcement Learning (RL) with verifiable environments has emerged as a powerful approach for enhancing the reasoning capabilities of Large Language Models (LLMs). While prior research demonstrates that scaling environment quantity improves RL performance, existing manual or individual construction methods suffer from linear scaling limits, thereby hindering scalable reasoning generalization. This paper introduces RACES (Recursive Automated Composition for Environment Scaling), a framework that conceptualizes verifiable environments as composable building blocks that can be recursively assembled. The key insight is that when the codomain (output type) of one environment matches the domain (input type) of another, they can be automatically fused into a new verifiable environment, enabling recursive composition. RACES is implemented with 300 individual environments and defines a set of composition operators (\textsc{SEQUENTIAL}, \textsc{PARALLEL}, \textsc{SORT}, and \textsc{SELECT}) that induce diverse reasoning patterns. Extensive experiments show that RL training on these composite environments consistently enhances reasoning generalization. Specifically, RACES improves DeepSeek-R1-Distill-Qwen-14B by an average of 3.1 points (from 48.2 to 51.3) and boosts Qwen3-14B performance from 58.8 to 61.1 on six benchmarks, which are unseen during the construction of training environments. Moreover, RACES achieves performance comparable to training on 300 individual environments using only 50 base environments, demonstrating significant efficiency in environment utilization.

24.
arXiv (math.PR) 2026-06-24

Sim-to-Real Betting on the E-Process: Bringing "simulators" to anytime-valid confidence sequences

arXiv:2606.24038v1 Announce Type: cross Abstract: This note describes an integration of the sim-to-real performance estimate with betting (from Chen et al.) and the safe anytime-valid inference (from Ramdas et al.). Using the scaled simulators. The method produces efficient, reliable certificates for the mean estimate, an approach that is especially valuable in robot performance testing. This note gives a primary, self-contained account of the construction; preliminaries of the respective methods are kept at a minimum, and one shall refer to the original works for full detail. Some synthetic examples demonstrating the proposed algorithm can be found at https://github.com/ISUSAIL/Bet4Sim2Real-EProcess.

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

CSPO: Constraint-Sensitive Policy Optimization for Safe Reinforcement Learning

arXiv:2606.14415v1 Announce Type: new Abstract: Safe reinforcement learning (Safe RL) aims to maximize expected return while satisfying safety constraints, typically modeled as Constrained Markov Decision Processes (CMDPs). While primal-dual methods scale well to deep RL, they often suffer from delayed constraint correction, leading to oscillatory behavior and prolonged safety violations. In this paper, we propose Constraint-Sensitive Policy Optimization (CSPO), a first-order primal-dual method that incorporates local constraint sensitivity into policy updates. CSPO augments the primal objective with a constraint-sensitive correction derived from the shortest signed distance to the safety boundary, enabling smarter recovery steps back to safety, compensating for delayed Lagrange multiplier updates, reducing oscillations near the boundary, and preserving the KKT solutions of the original constrained problem. Experiments on navigation and locomotion benchmarks demonstrate that CSPO achieves faster safety recovery and high reward preservation, resulting in higher constrained returns compared to state-of-the-art primal-dual and penalty-based methods