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01.
arXiv (CS.AI) 2026-06-24

Decentralized Coordination of Autonomous Traffic Through Advanced Air Mobility Corridors

arXiv:2606.23832v1 Announce Type: cross Abstract: The use of dedicated corridors for Advanced Air Mobility (AAM) traffic is one of the most commonly proposed pathways to integrating them into existing airspace operations. Most prior research has focused on the design of networks of AAM corridors and conflict resolution for aircraft within corridors. It is also generally believed that while attractive from an implementation perspective, corridor-based operations may be inefficient, especially in the absence of centralized traffic management. In this paper, we show that contrary to this belief, it is possible for autonomous aircraft to learn to self-organize into corridor flows in decentralized settings. We illustrate our approach using scenarios in which fixed-wing aircraft need to safely and efficiently traverse (1) a single corridor with metering after the exit, (2) a sequence of two consecutive corridors, and (3) a corridor that splits into two. We find that in decentralized settings with only local information, the aircraft are able to conform to the corridor boundaries more than 94% of the time and reach their goal in a relatively efficient manner. Furthermore, tactical interventions to handle violations of the separation minimum are needed only infrequently in low- and medium-density settings. However, such tactical interventions become more frequently necessary only when traffic density is high.

02.
arXiv (CS.AI) 2026-06-25

CrossAccent-TTS: Cross-Lingual Accent-Intensity Controllable Text-to-Speech via Disentangled Speaker and Accent Representations

arXiv:2606.25403v1 Announce Type: cross Abstract: Accent conversion and controllability remain fundamental challenges in cross-lingual text-to-speech (TTS), particularly for low-resource and phonetically diverse Indic languages. While recent large language model (LLM)-based TTS systems exhibit strong cross-lingual generalization, they provide limited explicit control over accent characteristics and intensity. In this paper, we propose CrossAccentTTS, a framework that enables both accent control and conversion while preserving speaker identity. Specifically, we introduce an Accent Intensity Controller (AIC) that injects weighted language embeddings into the accent subspace, allowing smooth interpolation between accents and fine-grained modulation of accent strength at inference time. Experiments on the Indic Multilingual and L2-arctic datasets shows that CrossAccent-TTS achieves precise control of accent intensity, outperforming strong baselines in accent similarity and controllability by maintaining speaker similarity and naturalness.

03.
arXiv (math.PR) 2026-06-16

High-Order Talagrand and Eldan–Gross Inequalities via Besov-Type Variance Functionals

arXiv:2606.14876v1 Announce Type: new Abstract: By introducing high-order Besov-type variance functionals that generalize the canonical variance, we develop a unified framework for proving high-order Talagrand-type inequalities that relate high-order energies to Fourier weights. Applying this machinery, we establish high-order Poincaré-type, $L^p$–$L^q$, isoperimetric-type, Falik–Samorodnitsky and Eldan–Gross inequalities, all with explicit constants, in both the Boolean and Gaussian settings. Fundamentally, our semigroup-based framework relies primarily on hypercontractivity and high-order Bismut-type derivative estimates, and is broadly applicable.

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

Generalization Guarantees for Multi-Input Neural Operator Learning in Sobolev Spaces

arXiv:2606.17419v1 Announce Type: new Abstract: We develop approximation and generalization error estimates for multi-input neural operators, with the output error measured in Sobolev norms. In contrast to standard operator-learning settings with a single input function, our framework allows multiple input functions defined on possibly different domains, with different dimensions and Sobolev regularities. The derived rates explicitly quantify the contribution of each input space to the final error bound. In particular, in the balanced regime, the approximation and generalization rates are governed by the interaction between the input dimensions, regularities, and Sobolev orders, while the dependence on the model complexity retains a \(\log\log/\log\)-type structure. Our analysis provides a general theoretical framework for multi-input operator learning, including Sobolev training, and is applicable to operator learning problems arising from partial differential equations and scientific computing.

05.
arXiv (math.PR) 2026-06-18

A Stochastic ISCS Markov Model for Fake News Propagation

Authors:

arXiv:2606.18282v1 Announce Type: cross Abstract: This paper studies the propagation of fake news through a stochastic rumor spreading model based on Markov chains. Inspired by classical epidemiological SIR models, we consider a generalization of the Daley-Kendall framework for rumours that incorporates fact-checkers, following the Ignorant/Spreader/Checker/Stifler model introduced in Piqueira (2020). The model analyzes the influence of checkers on fake news dynamics. Numerical simulations are used to illustrate the behavior of the system and the impact of fact-checkers.

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

UP-NRPA: User Portrait based Nested Rollout Policy Adaptation for Planning with Large Language Models in Goal-oriented Dialogue Systems

To address the challenge that current dialogue policy planning methods struggle to dynamically adapt to diverse user characteristics, this paper proposes a User Portrait based Nested Rollout Policy Adaptation (UP-NRPA) online framework with Large Language Models. In contrast to conventional approaches dependent on model training and require offline reinforcement learning policy models for user groups, UP-NRPA enables dynamic customization of dialogue strategies through an adaptive mechanism. This is achieved by leveraging real-time user feedback alongside personality, preferences, and objectives mapped from the current user portrait, thereby adapting to user characteristics without offline reinforcement learning. In collaborative and non-collaborative dialogue benchmarks, UP-NRPA demonstrated considerable benefits, achieving an impressive 100% success rate in multiple dialogue tasks. Particularly in negotiation tasks, the sale-to-list ratio (SL) increased by 56.41%. This demonstrates that UP-NRPA can adapt to diverse user needs without requiring a training mechanism, enabling the dialogue system to adapt to user characteristics.

07.
arXiv (quant-ph) 2026-06-17

From Period Finding to Lattice Sampling: Experimental Insights into Shor's and Regev's Factoring Algorithms

arXiv:2606.17647v1 Announce Type: new Abstract: Quantum algorithms for integer factorization represent one of the most prominent applications of quantum computation, with far-reaching implications for modern cryptography. While Shor's algorithm provides a polynomial-time solution in the ideal quantum model, its practical implementation is severely constrained by the limitations of current noisy intermediate-scale quantum (NISQ) hardware. These constraints have motivated the exploration of alternative factoring algorithms with different structural and resource trade-offs. In this work, we present an experimental study of Regev's quantum factoring algorithm, implemented on real quantum hardware, and compare its behavior with that of Shor's algorithm under analogous conditions. Focusing on the case N = 15, we execute both algorithms on the QMIO quantum computer at the Centro de Supercomputacion de Galicia (CESGA) and contrast the results with one of IBM's open-access quantum computers and ideal simulations. This parallel execution enables a low-level comparison of the two algorithms, highlighting how their respective quantum implementations interact with hardware noise, limited circuit depth, and finite sampling. Our analysis emphasizes the different ways in which Shor's and Regev's algorithms encode arithmetic structure into quantum states through Fourier sampling in one and higher dimensions, respectively, and how these differences manifest in experimental outcomes. Although neither algorithm demonstrates a practical advantage in the small N regime, the results provide insight into their relative robustness and failure modes on contemporary quantum devices. This study illustrates the value of experimental benchmarking of alternative quantum factoring algorithms as a means of understanding the practical implications of algorithmic design choices in the NISQ era.

08.
arXiv (CS.CV) 2026-06-11

Feature extraction for plant growth estimation

Precision agriculture requires the estimation of plant growth stages in real-time. When the plant growth stage is known, the wastage of resources in cultivation, such as nutrients and water, is reduced as only the required resources need to be supplied. Plants at different growth stages, however, have similar morphological features, which can make autonomous growth stage estimation difficult. This paper presents two feature extraction methods for growth stage estimation: one that uses a bank of Gabor filters and morphological operations, and the other that uses pre-trained convolutional neural networks (CNNs) and transfer learning. We test these methods on a publicly available plant growth stage dataset (``bccr-segset``) for two species, canola and radish, grown and captured under indoor conditions. The two proposed feature extraction methods are compared, using support vector machines and boosted trees as classifiers. We find that both methods are suitable for real-time applications, and that CNN features outperform the hand-crafted features, both with regard to speed and accuracy. The best system (VGG-19 features, classified with a radial basis function support vector machine) obtained an accuracy of 98.4% for both species, processing an image in 0.08 seconds.

09.
medRxiv (Medicine) 2026-06-10

A risk-of-contagion index using a Bayesian based model for the COVID-19 epidemic in Mexico

During the COVID-19 pandemic, limited testing capacity and reporting delays complicated epidemic surveillance and decision-making in Mexico. We calibrated textit{covidestim}, a Bayesian nowcasting model, to estimate the total SARS-CoV-2 infections from reported cases and deaths using Mexican surveillance data. Disease-progression distribution priors were calibrated using Mexico City records and validated through comparisons with national seroprevalence surveys, hospitalization data, and annual reported severe-case rates across all states. Using the reconstructed estimates of active infections, we implemented an event-based risk framework that quantifies the probability of encountering at least one infectious individual in gatherings of different sizes. This probability was subsequently translated into a four-level epidemiological traffic-light indicator and computed at both state and municipality levels. The resulting estimates revealed substantial spatial heterogeneity that is obscured by state-level aggregation, particularly in states with marked differences between urban and rural municipalities. To evaluate consistency with public-health indicators, we compared the proposed risk classification with the official Mexican epidemiological traffic-light system, considering interpretable gathering sizes relevant to public-health decision making. Weekly reports derived from this framework were delivered to policymakers in the State of Queretaro in Mexico, as an anticipation tool for school reopening and public-space management. This demonstrates that this Bayesian reconstruction of infections combined with event-based risk metrics can provide an interpretable and generalizable municipality-level complement to routine surveillance systems, particularly in regions with limited testing capacity and heterogeneous local transmission dynamics.

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

Personal Care Utility: Health as Everyday Infrastructure

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

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

DeMix: Debugging Training Data with Mixed Data Error Types by Investigating Influence Vectors

arXiv:2606.11616v1 Announce Type: new Abstract: High-quality training data is essential for the success of machine learning models. However, real-world datasets often contain mixed types of errors arising from systematic flaws in data preparation pipelines, including label errors, feature errors, and spurious correlations. Effective debugging of training data requires both detecting erroneous samples and identifying their specific error types to enable targeted repair, yet existing data cleaning and attribution methods fail to adequately address this dual requirement. In this paper, we propose DeMix, a novel framework that simultaneously diagnoses erroneous samples and their error types. Our key insight is that different error types produce distinct patterns on model behavior. DeMix captures such error-specific patterns by influence vectors that characterize how each training sample affects model predictions across all validation samples. We formulate training data debugging as a multi-label classification problem where a classifier is developed to predict error types directly from influence vectors. We further introduce an intervention-based learning strategy that guides the classifier to capture invariant rationales specific to each error type, ensuring the learned classifier generalizes effectively. Empirical evaluations on 11 tasks across tabular data prediction, recommendation systems, and LLM alignment demonstrate that DeMix significantly outperforms state-of-the-art approaches, achieving a 22.61% improvement in data debugging F1-score and a 9.32% gain in task model performance after data repair. Code is available at: https://github.com/SJTU-DMTai/DeMix.

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

From Nominal Intensity to Equivalent Rainfall: A Path-Based Credibility Evaluation Framework for Simulated Rainfall in Autonomous-Driving Perception Tests

Credible simulated-rainfall conditions are essential for identifying perception-system boundaries and supporting SOTIF-oriented risk assessment in automated driving. However, closed-field tests are often described only by nominal rainfall intensity or single-point measurements, making it difficult to align simulated rain fields with real rainfall and map test results to real-world scenarios. This paper proposes a path-based credibility evaluation method for simulated rainfall in autonomous-driving perception tests. Using the drop size and velocity joint distribution of real rainfall as the reference, each candidate path is represented by path-equivalent rainfall intensity, an uncertainty band, and a path-averaged Realism of Raindrop Distribution (RRD) score. Lidar target point-cloud count and mean reflectivity are further used for perception-consistency correction, quantifying the proxy capability of each simulated-rainfall path for real-rainfall perception effects. Experiments are conducted using about 10,000 real-rainfall raindrop-spectrum samples, 728 RainSense perception samples, and 45 spatial sampling points in a 2.4 m x 7.2 m simulated-rainfall area. Results show that spatial non-uniformity remains under the same nominal condition, confirming the need for path-based evaluation. The method identifies Path IV and Path VI as preferable candidates, with results of 11.54 +/- 0.31 mm/h, RRD = 0.43, and 8.28 +/- 0.34 mm/h, RRD = 0.46, respectively. These paths show more balanced performance in rainfall-intensity stability, raindrop-spectrum realism, and perception consistency. The proposed method supports path selection, condition description, and credible interpretation of autonomous-driving perception tests under rainfall.

14.
arXiv (CS.CL) 2026-06-19

Granularity-Regulated Adaptive Computational Efficiency for Optimal Verification in Test-Time Scaling

Test-time scaling (TTS) has emerged as a powerful paradigm for improving the reasoning performance of large language models (LLMs) by investing additional compute at inference time. A central component of TTS is the verifier, which selects or scores candidate solutions to guide the search process. While prior work has explored the benefit of verification, a fundamental question remains underexplored: what is the optimal granularity of verification under a given compute budget? Coarse-grained outcome reward models (ORMs) and fine-grained process reward models (PRMs) represent two extremes, yet neither alone achieves compute-optimality across all regimes. In this paper, we establish a unified theoretical framework, called GRACE (\underline{G}ranularity-\underline{R}egulated \underline{A}daptive \underline{C}omputational \underline{E}fficiency), that characterizes the optimal verification granularity as an explicit function of problem difficulty, verifier accuracy, and compute budget. We prove that there exists a phase transition: fine-grained verification dominates when either the compute budget is large or the problem is hard, whereas coarse-grained verification is preferred in the low-budget, easy-problem regime. Our theory unifies Best-of-$N$, beam search, and step-level MCTS within a single Pareto-optimality framework, and motivates an adaptive granularity strategy that provably achieves the compute-performance Pareto frontier. Empirical results on MATH-500, GSM8K, and AIME benchmarks corroborate all four theoretical claims, with our adaptive strategy outperforming fixed-granularity baselines by up to 3.1\% accuracy at matched compute.

15.
medRxiv (Medicine) 2026-06-22

Substantia Nigra and Subthalamic Nucleus Deep Brain Stimulation Exert Opposing Effects on Novelty Recognition in Parkinson's Disease

Episodic memory plays a critical role in supporting adaptive behavior; however, whether it can be causally regulated in humans via deep subcortical stimulation remains unclear. In the present study, we investigated the differential effects of substantia nigra (SN) and subthalamic nucleus (STN) stimulation on episodic memory, as well as the underlying mechanisms of its associated brain networks, using a recognition memory task combined with concurrent functional magnetic resonance imaging in patients with Parkinson's disease. SN-DBS increased recognition sensitivity and reduced false alarms at both frequencies, whereas 10 Hz STN-DBS reduced sensitivity and increased false alarms. Functional connectivity analyses in the absence of DBS stimulation identified a false recognition-related network linking nigral, pallidal, subthalamic, medial temporal, frontal, and occipital regions. SN-DBS-related false alarm reduction tracked modulation of this circuit and was marked by its baseline vulnerability state. These behavioral effects mapped onto target-dependent parieto-occipital and SN-visual retrieval pathways, supporting a model in which DBS bidirectionally regulates recognition memory through target- and frequency-dependent subcortical-cortical circuits.

16.
arXiv (quant-ph) 2026-06-25

Distillation of supersinglet states

arXiv:2509.20962v2 Announce Type: replace Abstract: We introduce an entanglement distillation (purification) protocol for supersinglet states composed of N qubits. The supersinglet state we target is a total spin zero state with zero spin variance, and has a fully entangled structure involving all qubits. In our distillation protocol, three copies of an initial spin zero state are measured in the local total spin basis such that a higher fidelity supersinglet state is generated upon postselection. The initial state can be prepared using conventional Bell state distillation methods distributed in a way to target the supersinglet symmetries. The protocol uses only local operations and classical communications, and is suitable for long-distance applications such as quantum clock synchronization and cryptography, and avoids a high dimensional Schur transform such that it can be used for tasks such as quantum metrology.

17.
arXiv (CS.CL) 2026-06-12

An End-to-End Hybrid Framework for Rumour Detection in Low-Resources Algerian Dialect

The rapid growth of social media has intensified the spread of rumours. This issue is more challenging in the Algerian context due to the informal and code-switched nature of dialectal content, the scarcity of annotated resources, and the limited effectiveness of standard Arabic NLP tools on dialect text. This paper presents an end-to-end rumour detection hybrid framework for Algerian dialect social media content. We build a domain-specific annotated dataset by combining real social media posts, synthetic data, and the FASSILA corpus, with automatic labeling based on a similarity-based annotation process. A transliteration pipeline is also introduced to generate parallel datasets in Arabic script and Arabizi. We evaluate multiple approaches, including classical machine learning, deep learning, transformers, and hybrid models. Experimental results show that a hybrid approach combining transformer embeddings with a classical classifier achieves the best performance, reaching an F1-score of 0.84. We also find that domain-specific pre-training is more important than model size, with social media-trained models outperforming larger models trained on formal Arabic corpora. These results demonstrate the feasibility of rumour detection in low-resource Algerian dialect settings.

18.
medRxiv (Medicine) 2026-06-24

CerViX-Net: A Multi-Branch Fusion of Vision Transformer and Convolutional Neural Networks for Cervical Cancer Detection using Cytology Images

Authors:

Cervical cancer represents a pressing global health challenge, emphasizing the critical need for accurate and timely diagnostic methods to facilitate effective treatment and improve survival rates. In response to this challenge, the study presents CerViX-Net, an innovative classification framework designed to advance cervical cancer detection through enhanced computational efficiency and diagnostic accuracy. The development of CerViX-Net is motivated by the limitations of traditional diagnostic models, particularly in handling the computational and memory demands of large-scale data, while ensuring precise feature extraction and classification. CerViX-Net employs a hybrid deep learning architecture that combines the capabilities of ResNet50, EfficientNet-B0, and a Modified Vision Transformer (ViT) module. The ResNet50 branch extracts hierarchical features through stacked convolutional and identity blocks. In another path, the modified ViT module transforms image patches via linear projection, augments them with positional and class embeddings, and processes them using Parallel Transformer Encoder layers to model contextual relationships. Concurrently, EfficientNet-B0 utilizes MBConv blocks to extract multi-scale representations. The feature outputs from all three branches are integrated and passed through a classification head consisting of dropout layers and dense layers to ensure robust and accurate predictions. The proposed framework is rigorously evaluated on the Mendeley LBC dataset, achieving exceptional performance metrics with an accuracy of 99.69%, precision of 99.28%, recall of 99.48%, and an F1-score of 99.52%. The robustness of CerViX-Net is further validated on the SIPaKMeD and Herlev Pap Smear datasets, where it demonstrates comparable excellence, underscoring its efficacy and adaptability across diverse cytology datasets. Statistical validation using Friedman's test further reinforces its superiority over competing methods.

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

How Large Language Models Source Brand Reputation Across Languages and Markets

When a large language model (LLM) answers a question about a company, it grounds the answer in retrieved web sources, and those sources decide what the model says. Most analysis of AI brand visibility looks at the answer text. This study looks one step earlier, at the citations. We merge three Rankfor.AI datasets covering 128 brands across 12 home markets and 13 languages, and analyse 167,551 URL-grounded citations (189,974 total attribution rows). We classify each citation by domain and source type and measure where AI gets its brand information, by language and by market. Four patterns hold. First, AI grounds brand answers overwhelmingly in third-party sources: 85.7% of citations point to sites the brand does not own, against 14.3% owned. Second, the source base is concentrated and long-tailed: 80% of citations come from about 18% of domains, fitting a Zipf law (alpha = 0.86, R^2 = 0.983). Third, one reference site dominates almost everywhere: Wikipedia is the most-cited domain in 11 of 12 languages, the exception being Lithuanian, where the business daily vz.lt edges it (4.38%). Fourth, the source mix is market-specific at the margin: for 46 Polish national brands the most-cited domain is YouTube, and four HR and careers portals supply 637 citations against 297 for Polish Wikipedia, about twice as many.

20.
arXiv (CS.CV) 2026-06-25

A welding penetration prediction model for laser welding process based on self-supervised learning using physics-informed neural networks

The laser welding full-penetration is of critical importance, as it constitutes one of the fundamental factors in achieving defect-free welded joints. Accurate prediction of the penetration state is therefore essential for ensuring weld quality. To this end, this paper introduces SimPhysNet, a novel algorithm that achieves high classification accuracy in laser welding penetration prediction using only a limited number of labelled images. This approach effectively overcomes the limitations of supervised learning classification algorithms, which are hindered in industrial applications by their dependence on extensive, high-quality labelled data. The core of SimPhysNet is a unique self-supervised learning paradigm that embeds physical priors into a contrastive learning framework. By incorporating a physics-informed neural network (PINN), the model is guided to extract physically meaningful features of the molten pool and keyhole from a large set of unlabelled data, while three image augmentation tasks further enhance its generalization capabilities. Subsequently, a few-shot learning strategy, based on prototypical networks, enables robust classification by constructing class representations from a minimal set of labelled images. Experimental results demonstrate that SimPhysNet achieves a classification accuracy of 96.06% using only 200 labelled images (approximately 5% of the total labelled dataset), which is comparable to the performance of conventional supervised learning algorithms that utilize the entire labelled dataset. This work presents a new, efficient, and highly accurate method, providing the way for the intelligent automation of laser welding.

21.
arXiv (CS.AI) 2026-06-11

Multimodal Ordinal Modeling of Alzheimer's Disease Severity Using Structural MRI and Clinical Data

arXiv:2606.11794v1 Announce Type: cross Abstract: Neurodegenerative diseases such as Alzheimer's disease (AD) require accurate and scalable tools for assessing disease severity, yet current clinical staging remains time-intensive and prone to variability. We propose an attention-enhanced multimodal machine learning framework with ordinal regression for automated and interpretable AD severity staging. The framework integrates T1-weighted MRI with demographic and genetic variables and compares unimodal and multimodal architectures using ordinal and non-ordinal prediction heads. Models were trained and validated using cohort-stratified splits derived from the ADNI, AIBL, and NIFD datasets. A strictly held-out test set was constructed using subjects excluded from all training, validation, preprocessing, and hyperparameter tuning procedures, with subject-level splitting employed throughout to prevent data leakage. Among unimodal approaches, the T1-weighted MRI model achieved slightly higher adjacent-stage accuracy (0.963) and agreement with clinical staging (QWK 0.444) than the tabular model (QWK 0.433). Integrating imaging, demographic, and genetic information improved overall performance. The multimodal non-ordinal baseline achieved the lowest prediction error (MAE 0.340), whereas the ordinal multimodal model achieved the highest adjacent-stage accuracy (0.970) and strongest agreement with clinical staging (QWK 0.549). These findings indicate that ordinal formulations better capture the ordered structure of the CDR scale and yield predictions more consistent with clinical staging. Explainability analyses using Grad CAM++ and SHAP demonstrated anatomically and clinically plausible model behavior, supporting transparent decision-making. Overall, attention-based multimodal learning with ordinal regression represents a robust, interpretable, and scalable approach for automated AD severity staging and AI-assisted clinical decision support.

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

Context-Aware Optimization of Follow-Up Intervals for Type 2 Diabetes Care Using Markov Decision Processes

arXiv:2606.19092v1 Announce Type: cross Abstract: Chronic disease management relies on regular patient-provider interactions to follow-up on disease progression and control. For Type 2 Diabetes (T2D), current guidelines prescribe fixed time intervals between subsequent primary care visits for all patients, overlooking heterogeneity in clinical trajectories and patient characteristics. This study introduces a Contextual Markov Decision Process (CMDP) model to optimize subpopulation-specific follow-up interval decisions using Electronic Health Record (EHR) data from 22,154 T2D patients across 10 primary care clinics. Contexts are identified by: i) dimensionality reduction of variables representing the individual health trajectories utilizing Principal Component Analysis, and ii) assigning patients to contexts via principal components and additional patient-level features using clustering. Two distinct contexts emerged, representing a lower- and a higher-risk subpopulation. CMDP-derived policies recommend: (i) follow-up within 1 month if lab value at current visit is unmeasured; (ii) up to 3 months for elevated lab values or recent hospitalizations; and (iii) 6 to 12 months for sustained glycemic control, with shorter follow-up intervals for patients in high-risk context. The optimal policies achieved lower expected cumulative cost than benchmarks (e.g., in the higher-comorbidity context, the CMDP policy reduced cost by about 34.8%, and in the lower-comorbidity context by about 6.4%, relative to an American Diabetes Association-like fixed interval follow-up policy. These findings demonstrate how context-aware approaches can inform adaptive follow-up strategies, and have the potential to advance chronic care management in primary care by synthesizing machine learning and probabilistic decision models.

23.
medRxiv (Medicine) 2026-06-10

Human-centred design approaches to health facility design: Evidence from perinatal care settings in Ethiopia and Bangladesh

While significant progress has been made in perinatal outcomes over recent decades in low- and middle-income countries (LMICs), maternal and newborn quality improvement initiatives often fail to account for the spatial conditions in which they are implemented. Health systems are increasingly deploying evidence-based care models into built environments that are not optimally structured to meet the needs of its patient population. As the principal users, patients and health care workers can offer pragmatic insights about improving these structural designs. Our objective was to gather insights from patients, providers, and companions about how the physical design of their health facilities influenced their experience receiving or delivering perinatal care. We conducted a prospective observational study using a human-centred design (HCD) approach to analyse perceptions of the quality of perinatal care across two low resource settings: Ethiopia and Bangladesh. Using engagement and assessment tools, we conducted interviews, focus groups, facility walk-throughs, co-design workshops, and infrastructural assessments with patients, companions, providers, and Ministry of Health representatives. Descriptive statistics and thematic analysis were used to identify key learnings and develop recommendations. Across both countries, participants identified the need for facility layouts that better support privacy, mobility during labour, alternative birth positions, companion involvement, cultural and religious practices, sanitation, and provider visibility. Based on these insights, we developed six recommendations to better align health facility infrastructure with maternal and newborn care delivery needs. Our findings suggest that investments in health facility infrastructure may improve care experiences and help enable respectful, safe, and evidence-based maternal and newborn care. Alongside targeted spatial improvements, government authorities responsible for health facility planning should incorporate participatory design processes to ensure infrastructure reflects the needs of patients, companions, and providers and supports high-quality care delivery.

24.
bioRxiv (Bioinfo) 2026-06-18

A data-driven rediscovery of the specificity-conferring code of adenylation domains in nonribosomal peptide synthetases

Nonribosomal peptide synthetases (NRPSs) are large modular enzymes that assemble structurally diverse peptides, many of pharmacological importance, including antibiotics and immunosuppressants. Within each NRPS module, the adenylation (A) domain selects the substrate to be incorporated, a choice governed by a small set of residues lining the binding pocket. For two decades, computational prediction of A-domain substrate specificity has relied on residue sets - most prominently the Stachelhaus code and the 34-residue "8 Angstrom code" - that were defined by spatial proximity to the substrate rather than by demonstrated predictive value. Here we revisit which residues govern substrate specificity from a purely data-driven perspective. We assembled a non-redundant dataset of 5,366 A-domain sequences (4,693 bacterial and 673 fungal) and used information-theoretic measures to rank alignment positions by their statistical association with substrate identity, without restricting candidate positions to any predefined structural shell. This procedure yielded two compact, kingdom-specific codes: IG15B (15 positions) for bacterial and IG13F (13 positions) for fungal A-domains. Both match or exceed the predictive accuracy of the 34-residue 8 Angstrom code while using fewer than half its positions, and both independently recover the majority of the classical Stachelhaus positions. Notably, our analysis identifies four positions (242, 280, 281, and 284) that lie outside all conventional codes yet carry non-redundant specificity information and co-localize with classical determinants on two helices flanking the binding pocket. These positions provide new candidate sites for the rational engineering of A-domain specificity.

25.
arXiv (CS.CL) 2026-06-12

Can Factual Opinions Be Edited (Manipulated) in Large Language Models?

Large Language Models (LLMs) are increasingly integrated into various domains, making knowledge editing techniques crucial yet potentially hazardous. Current editing methods primarily target atomic facts, overlooking the significant risks associated with manipulating factual opinions, e.g., documented stances of public figures on societal issues. Such manipulation could reshape public images, influence elections, and alter societal views. To systematically assess this threat, we introduce the Factual Opinion Editing with Evidence (FOE) benchmark, which encompasses 261 public figures, 19 issue categories, and 2,178 complete opinion records. Our evaluations demonstrate that current editing techniques struggle significantly with factual opinions, often achieving only superficial changes while failing to preserve consistency between the edited opinion and the supporting evidence generated by the model. To address this limitation, we further propose a simple yet effective Self-Generated Evidence-Aligned method that achieves opinion-evidence alignment without relying on explicit instructions. Together, our benchmark and method provide a foundation for understanding the emerging security implications of factual opinion editing in LLMs.