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01.
medRxiv (Medicine) 2026-06-10

Epidemiology of Cervical Precancerous Lesions: Prevalence and Predictors from Pap Smear Screening in Hawassa City Hospitals, Sidama Region, Ethiopia. Institutional-Based Cross-sectional Study

Background: Cervical cancer is the fourth most common cancer in women worldwide and remains a major public health challenge. In Ethiopia, it is the second leading cause of cancer deaths, with around 8,000 new cases and 6,000 deaths each year. Region?specific data on the prevalence and predictors of precancerous lesions remain scarce, yet such information is vital for guiding targeted reproductive health strategies. This study therefore examined the prevalence and predictors of cervical precancerous lesions among women aged 21-60 years undergoing Pap smear screening in public hospitals in Hawassa City, Sidama Region. Methods: An institution-based cross-sectional study was conducted among 241 women attending Pap smear screening at public hospitals in Hawassa City from March to August 2025. Sociodemographic and clinical data were collected via interviews and medical records. Lesions were classified based on the standardized international framework for reporting cervical cytology results from Pap smears per the Bethesda system. Multivariable logistic regression identified predictors p

02.
arXiv (CS.AI) 2026-06-16

Unifying Post-hoc Explanations of Knowledge Graph Completions

arXiv:2507.22951v2 Announce Type: replace Abstract: Knowledge Graphs organize information as entity-relation-entity triples, enabling machine learning models to predict plausible missing triples in a task known as Knowledge Graph Completion (KGC). Post-hoc explainability for KGC addresses the problem of identifying which triples most influence the predictions of machine learning models. Currently, the field lacks formalization and consistent evaluations, hindering reproducibility and cross-study comparisons. This paper argues for a unified taxonomy for post-hoc explainability in KGC. First, we propose a characterization of post-hoc explanations via multi-objective optimization that unifies existing post-hoc explainability algorithms in KGC and the explanations they produce, balancing explanation effectiveness and conciseness. Next, we examine improved evaluation protocols based on popular metrics, such as Mean Reciprocal Rank and Hits@k, through illustrative experiments. Finally, we stress the importance of interpretability as the ability of explanations to address queries meaningful to end users. By unifying methods and discussing evaluation standards, this work puts forward a case for more reproducible and impactful research in KGC explainability.

03.
medRxiv (Medicine) 2026-06-12

Association of circulating endothelial progenitor cell count and functional outcome in patients with acute ischemic stroke due to intracranial large vessel occlusion

Background: Circulating endothelial progenitor cells (cEPCs) contribute to vascular repair following an ischemic stroke. The aim of the study was to evaluate the association between cEPCs and functional outcomes in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) who received endovascular therapy (EVT). Methods: Prospective study of patients with LVO-AIS who received EVT. Blood samples were obtained within 24 +- 12 hours and on day 7+-1 from stroke onset. cEPCs were detected using flow cytometry (CD34+/VEGFR2+/CD133+). The primary endpoint was a favourable functional outcome (modified Rankin Scale 0-2) at three months of follow-up. Secondary endpoints include baseline to 24 hours/day 7 changes in the National Institutes of Health Stroke Scale (NIHSS) score and collateral circulation (CC) status. Bivariate and multivariable logistic regression analyses were performed. Results: Included were 90 patients (73.2+-12.7 years, 41.1% women) in 42 of whom (46.7%) cEPCs were detected at 24 hours. On day 7, cEPCs were detected in 27 (43.6%) of 62 patients for which this information was available. Atrial fibrillation, prior anticoagulant treatment and stroke onset-to-door time

04.
arXiv (CS.LG) 2026-06-12

TEDD: Robust Detection of Unstable Temporal Features

arXiv:2606.12643v1 Announce Type: new Abstract: When working with real-world temporal data, it is common to encounter features whose distribution is changing over time. The naive employment of Machine Learning models on this unstable data might lead to rapidly degrading performance, especially if the new distribution is much different from what was previously seen during training. In order to cope with this problem, it is critical to automatically identify features that are changing over time. With these features detected, data scientists and other practitioners will be able to mitigate the issue (for instance, by applying data transformations), deploying more robust models that retain high performance for longer periods of time. In this paper, we describe which temporal changes a feature should not suffer from, and propose TEDD, a technique to a) identify when a dataset might lead to an unstable Machine Learning model and b) automatically detect which features cause such lack of robustness. In order to achieve it, we leverage a regression model to highlight which features contribute to a good prediction of an instance's timestamp. We compare our approach to other methods in real and synthetic data, testing their detection capability on all simple change patterns. We show that our method: detects all types of basic changes, both for numerical and categorical features; can detect multivariate drifts; returns a comparable value measuring the amount of change of each feature; requires no parameter tuning; and is scalable both on number of features and instances of the dataset.

05.
arXiv (math.PR) 2026-06-17

Convergence rate of Euler–Maruyama scheme to the invariant probability measure under total variation distance for the SDEs

arXiv:2505.04218v3 Announce Type: replace Abstract: This article shows the geometric decay rate of Euler-Maruyama scheme for one-dimensional stochastic differential equation towards its invariant probability measure under total variation distance. Firstly, the existence and uniqueness of invariant probability measure and the uniform geometric ergodicity of the chain are studied through introduction of non-atomic Markov chains. Secondly, the equivalent conditions for uniform geometric ergodicity of the chain are discovered, by constructing a split Markov chain based on the original Euler-Maruyama scheme.

06.
medRxiv (Medicine) 2026-06-10

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

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

07.
arXiv (CS.AI) 2026-06-11

End-to-End Machine Learning for Depressive State Classification via EEG and fNIRS

arXiv:2606.11555v1 Announce Type: cross Abstract: The escalating demand for mental healthcare, driven by rising societal stress, highlights the limitations of traditional psychiatric diagnostics. Conventional methods - relying primarily on clinical interviews and patient self-reports - are inherently vulnerable to subjective bias and the varying empirical judgment of practitioners. To address the need for quantitative evaluation, biological signal-based detection, including electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), has emerged as a promising objective alternative. Such technology is particularly vital for identifying latent depressive states that may be unrecognized by the subjects themselves. Furthermore, in aging populations, the high comorbidity between depression and dementia necessitates early differentiation to prevent mutual symptom exacerbation and maintain Quality of Life (QoL). This pilot study of eleven healthy students establishes a framework for biological signal-based depression detection, serving as a foundational step toward automated, objective diagnostic tools for clinical use.

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

Beyond the Golden Teacher: Enhancing Graph Learning through LLM-GNN Co-teaching

arXiv:2606.11583v1 Announce Type: new Abstract: Text-attributed graphs (TAGs) underlie real-world applications such as citation networks, social media, and e-commerce. Few-shot graph learning on TAGs is hard: with only a handful of labels per class and the rest of the graph unannotated, neither GNNs nor LLMs can learn well on their own. GNNs read topology and fail on cold nodes; LLMs read text and fail on text-ambiguous nodes. Existing LLM-GNN methods all follow the same recipe: designate one model as the golden teacher and use its outputs (e.g., features or pseudo-labels) to supervise the other. We argue this golden-teacher assumption breaks under sparse supervision: neither model is golden, and treating either as such transfers its blind spots into the student. We therefore ask: can we avoid designating either model as the golden teacher, and still perform effective graph learning? We answer with LLM-GNN Co-Teaching, a bidirectional co-teaching framework in which neither model is fixed as teacher. The GNN and LLM exchange their most confident pseudo-labels under an architecture-specific small-loss criterion, and both update every round. Supervision is then mined from the trajectory: whenever a node moves from cross-model contradiction at round t to cross-model agreement at round t+1, the LLM's two answers on the same input form a preference pair (old contradicting self < new peer-endorsed self) for DPO training. We call this Round-based Pseudo-Label Preference Optimization (RPL-PO). On six benchmarks, LLM-GNN Co-Teaching consistently outperforms GNN-as-Judge and all prior methods, with absolute 3-shot gains of 7.86% on Cora and 7.73% on ogbn-arxiv; improvements carry over to 5-shot and to zero-shot cross-dataset transfer. Error-structure analysis further shows that abandoning the golden-teacher assumption substantially improves the LLM's graph learning capability on challenging samples.

10.
arXiv (CS.CV) 2026-06-18

Learning to Distort: Weakly-Supervised Image Quality Transfer for Prostate DWI Correction

Single-shot echo-planar prostate diffusion-weighted imaging (DWI) is frequently complicated by geometric distortions, which impact the ability to derive reliable diagnoses from such images. Developing automated correction methods is challenged by the absence of paired distorted and undistorted clinical scans. In this paper, we first propose a novel weakly-supervised image quality transfer (IQT) framework from undistorted to distorted images that utilizes image quality assessment (IQA) signals to supervise the transfer process. Unlike traditional methods that require expensive, voxel-wise paired data or resort to developing unpaired algorithms, our approach utilizes image-level quality labels (here, distorted vs. undistorted) to establish latent quality prototypes within a pre-trained feature space. Recognizing that simulating realistic distortions is more reliable than direct unpaired correction, we describe a weakly-supervised prototype flow matching algorithm to explicitly regularize generative trajectories towards distorted prototypes, producing realistic susceptibility artifacts that mimic clinical degradations. By synthesizing these realistic pairs, we enable a second IQT model to be trained in the forward direction for distortion correction. Experimental results demonstrate that our generated images successfully mimic the diagnostic interference of real-world artifacts, which leads to more capable distortion correction IQT models. In addition to qualitative comparisons, we also conduct exhaustive quantitative evaluations that compare our approach with existing unpaired approaches (e.g., CycleGAN, UNIT-DDPM, and OT-FM) - as either forward or reverse alternatives - by assessing clinical downstream task performance in PI-RADS and Gleason score classification, using both in-distribution and external data sets.

11.
arXiv (CS.CV) 2026-06-16

Bridging Information Asymmetry: A Hierarchical Framework for Blind Face Restoration with Reduced Uncertainty

Blind face restoration remains a persistent challenge due to the inherent ill-posedness of reconstructing holistic structures from severely constrained observations. Current generative paradigms, while capable of synthesizing realistic facial details, remain limited by the under-constrained nature of blind restoration, where severely degraded inputs can be mapped to plausible yet identity-inconsistent outputs. To address this issue, we present Pref-Restore, a hierarchical framework for BFR with reduced restoration uncertainty. Our design is organized around three complementary principles: (1) Semantic Information Augmentation, where an auto-regressive semantic branch converts image and text cues into structured tokens that provide a stable high-level anchor; (2) Texture-level Fidelity Alignment, where the diffusion generator is trained under this anchor to recover identity-relevant details; and (3) Fidelity-constrained Preference Optimization, where a face-aware reward refines the diffusion trajectory while controlling the quality–fidelity trade-off. Extensive experiments on synthetic and real-world benchmarks show that Pref-Restore achieves state-of-the-art performance, with stronger identity-sensitive fidelity and lower restoration uncertainty across repeated sampling. Systematic ablations further attribute these gains to the proposed hierarchical design, showing the necessity of staged training, the robustness and quality dependence of the text pathway, and the benefit of fidelity-constrained preference optimization.

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

Multi-Rate Mixture of Experts for Accelerating Liquid Neural Network Training

arXiv:2606.12240v1 Announce Type: cross Abstract: Multivariate time-series data often exhibit complex temporal dependencies, irregular sampling, and heterogeneous dynamics across multiple time scales, making accurate sequence modeling particularly challenging. Traditional recurrent neural networks (RNNs), such as Long Short-Term Memory (LSTM) networks, operate in discrete time and may struggle to effectively capture continuous and irregular temporal behaviors. Liquid Neural Networks (LNNs) address some of these limitations through continuous-time dynamics, but standard LNN architectures typically rely on a single dynamical system, limiting their ability to model heterogeneous temporal patterns. To address these challenges, we propose a Multi-Rate Mixture-of-Experts (MR-MoE) framework built on top of Liquid Neural Networks. In the proposed architecture, multiple LNN-based experts operate at distinct time scales, enabling the model to explicitly separate fast-changing dynamics from slow-evolving temporal trends. A gating network further enables adaptive expert specialization based on input conditions. In addition, we incorporate both feature-level and temporal attention mechanisms to improve robustness, interpretability, and long-range dependency modeling. Feature-level attention suppresses noisy or irrelevant variables, while temporal attention selectively focuses on informative historical states. We evaluate the proposed framework on a complex multivariate time-series prediction task and compare it against strong baselines, including LSTM, monolithic LNN, and standard MoE models. Experimental results demonstrate that the proposed MR-MoE framework consistently achieves improved AUROC and AUPRC performance while maintaining favorable computational efficiency. These results highlight the effectiveness of combining continuous-time dynamics, multi-scale expert decomposition, and adaptive attention mechanisms for time-series modeling.

14.
arXiv (CS.CV) 2026-06-18

Semantic Router: On the Feasibility of Hijacking MLLMs via a Single Adversarial Perturbation

Multimodal Large Language Models (MLLMs) are increasingly deployed in stateless systems, such as autonomous driving and robotics. This paper investigates a novel threat: Semantic-Aware Hijacking. We explore the feasibility of hijacking multiple stateless decisions simultaneously using a single universal perturbation. We introduce the Semantic-Aware Universal Perturbation (SAUP), which acts as a semantic router, "actively" perceiving input semantics and routing them to distinct, attacker-defined targets. To achieve this, we conduct theoretical and empirical analysis on the geometric properties in the latent space. Guided by these insights, we propose the Semantic-Oriented (SORT) optimization strategy and annotate a new dataset with fine-grained semantics to evaluate performance. Extensive experiments on three representative MLLMs demonstrate the fundamental feasibility of this attack, achieving a 66% attack success rate over five targets using a single frame against Qwen.

15.
arXiv (CS.CV) 2026-06-17

Pareto LoRA: Mitigating Modality Imbalance in Unified Multimodal Models via Pareto-Optimal Gradient Integration

Unified multimodal models (UMMs) have recently emerged as a promising paradigm for integrating multimodal understanding and generation within a single autoregressive transformer. However, during multimodal instruction tuning, these models often exhibit pronounced modality imbalance: language gradients dominate optimization, thus leading to lower image generation quality, especially under parameter-efficient fine-tuning such as LoRA. In this work, we systematically analyze modality imbalance in LoRA-based fine-tuning of UMMs for interleaved text-image generation. We show that vision modality performance degrades substantially more than text modality performance when compared to unimodal counterparts, and that modality-specific gradients can differ by orders of magnitude across various tasks and layers. Motivated by this observation, we reformulate the multimodal instruction tuning as a bi-objective optimization problem and propose Pareto LoRA, a Pareto-optimal gradient integration strategy that balances the text and image objectives by modulating the gradient direction and strength. Experiments on the CoMM benchmark with Emu2 demonstrate that Pareto LoRA consistently improves multimodal generation balance, achieving up to 44.9% gains in perceptual image quality over vanilla LoRA while maintaining comparable text performance.

16.
arXiv (CS.AI) 2026-06-19

UltraQuant: 4-bit KV Caching for Context-Heavy Agents

arXiv:2606.20474v1 Announce Type: cross Abstract: Context-heavy agents place unusual pressure on the key-value (KV) cache: long prefixes are reused across many short turns, while concurrency determines whether the serving system can keep GPUs utilized. We study 4-bit KV-cache compression for this setting, using TurboQuant-style rotation and codebook quantization as a quality anchor and vLLM FP8 KV caching as the deployment anchor. We report three contributions. First, we frame 4-bit KV caching around multi-round agent workloads where task quality, cache residency, and serving throughput must be measured jointly. Second, we describe the practical design choices needed to make the 4-bit path robust, including asymmetric K/V treatment, Walsh-Hadamard rotation, QJL removal, and block-scale variants. Third, we present serving optimizations on AMD GPUs, including optimized decode-attention kernels and UltraQuant, an FP4 approximation path that uses FP8 queries, FP4 KV tensors, UE8M0 group scales, and native scaled-MFMA support on CDNA4. On a long-context, multi-turn agentic workload, UltraQuant cuts P50 time-to-first-token by 3.47x in the cache-pressured late rounds (2.3x across all rounds) and raises output throughput by 1.63x over the FP8 KV baseline.

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

Rethinking Scaffolding in LLM Tutors: The Interactional Mismatch Between Benchmarks and Real-World Deployments

arXiv:2606.15766v1 Announce Type: new Abstract: A central pedagogical value evaluated in AI tutor benchmarks is scaffolding: guiding students through graduated steps toward a solution. Alignment and evaluation methods for embedding scaffolding behaviour into chatbots, however, rest on an implicit assumption: that students will take up the scaffolding and engage in the conversation. To examine whether this assumption holds, we introduce an evaluation pipeline around two metrics - Chatbot Scaffolding and Student Uptake - and apply them across nine datasets of 9,490 chats, spanning AI tutor benchmarks and real-world deployments of educational chatbots. Our analysis reveals that while benchmarks assume a high-scaffolding, high-student-uptake environment, students in real-world settings exhibit lower levels of uptake overall - frequently bypassing the chatbot's pedagogical framing to drive the interaction toward their own learning goals at little interpersonal cost. We argue that bypassing scaffolding is not necessarily detrimental; rather, it frequently highlights a mismatch between a chatbot's pedagogical framing and the student's learning goals. To meaningfully evaluate the effectiveness of a chatbot's assistance, future benchmarks must move beyond the assumption that students will simply take up the scaffolding, and instead evaluate how these chatbots navigate diverse learning contexts and student-driven interaction patterns.

18.
arXiv (CS.AI) 2026-06-11

MPC-Patch-Bench: Security-Aware LLM Code Patch for Multi-Party Computation

arXiv:2606.11416v1 Announce Type: cross Abstract: Repository-level benchmarks for evaluating Large Language Model (LLM) code repair on Secure Multi-Party Computation (MPC) software do not yet exist, and directly transplanting general-purpose benchmarks such as SWE-bench fails on three structural fronts: (i) MPC repositories are dominated by generic Python infrastructure rather than cryptographic logic; (ii) high-value MPC fixes lack the standardized tests rigid extraction pipelines require; and (iii) standard fail-to-pass evaluation is insufficient for code that must also be cryptographically safe. MPC is increasingly deployed for privacy-preserving machine learning, biomedical collaboration, and secure analytics. Existing MPC-specific code-synthesis efforts cover only operator-level or single-framework tasks; evaluating LLM agents on real repository-level MPC repair instead demands MPC-aware data curation and a verifier matched to the security and numerical-fidelity guarantees MPC programs must obey neither of which existing benchmarks provide. We introduce MPC-Patch-Bench, a repository-level benchmark organised around two frameworks. (1)The Data Curation Framework combines a domain-specific curation agent that filters raw pull requests through three cryptographic layers with a human-AI completion engine that synthesizes missing problem statements and Fail-to-Pass/Pass-to-Pass tests, yielding 205 fully verified instances. (2)The MPC Verifier provides dedicated security and numerical-fidelity checks via dynamic differential testing against plaintext oracles and MPC-specific static analysis rules that flag unsafe reveals, insecure arithmetic, and illegal public/private casts. The strongest evaluated LLM functionally resolves only 22.9% of MPC-Patch-Bench tasks; the MPC Verifier further reduces verified resolution to 17.1%, with up to 40% of functionally-passing patches rejected for cryptographic or numerical-fidelity violations.

19.
medRxiv (Medicine) 2026-06-16

Using visual biofeedback to reduce step length error at fast walking speeds is feasible after stroke

Background and Purpose: Walking after stroke is often characterized by persistent biomechanical impairments and reduced walking capacity. While visual biofeedback can improve gait mechanics and fast walking can enhance capacity, it is unclear whether individuals post-stroke can effectively use biofeedback at higher walking speeds to address both deficits simultaneously. This study examined the effects of walking speed on the ability of participants with chronic stroke to reduce step length (SL) errors using visual biofeedback. Methods: Sixteen individuals with chronic stroke walked on a treadmill at slow, self-selected, and fast speeds with and without visual SL biofeedback. Absolute SL error relative to individualized targets was calculated for paretic and non-paretic limbs. Linear mixed-effects models with piecewise linear splines assessed the effects of speed, limb, and feedback condition. Post hoc comparisons were performed for significant interactions. Results: At lower speeds, increasing speed reduced SL error in both limbs (p < 0.001). At higher speeds, the effects of speed were dependent on limb and condition (p < 0.001). Paretic SL error increased with speed without feedback but remained stable with feedback (p < 0.001). Non-paretic SL error decreased with speed regardless of condition. SL error was greater in the paretic limb overall (p < 0.001). Discussion and Conclusions: Fast walking alone did not reduce paretic SL errors. Participants with chronic stroke can effectively use visual biofeedback to reduce paretic SL errors at higher speeds, supporting its integration into high-intensity gait training to simultaneously treat biomechanical impairments and walking capacity deficits after stroke.

20.
arXiv (CS.AI) 2026-06-19

Improving End-to-End Speech Recognition for Dysarthric Speech through In-Domain Data Augmentation

arXiv:2606.19797v1 Announce Type: cross Abstract: Dysarthric speech recognition is crucial for facilitating effective communication among individuals with dysarthria. However, accurately recognizing dysarthric speech poses significant challenges due to varying severity levels and limited data availability. In this paper, we explore data augmentation techniques for dysarthric automatic speech recognition (ASR) systems by fine-tuning the End-to-End pre-trained Wav2Vec2 model, with a specific focus on severity levels. To address the challenges of data scarcity and the need for extensive data in fine-tuning pre-trained ASR systems for dysarthric speech, we investigate four prominent data augmentation methods: Speaking-Rate Modification (SRM), Pitch Modification (PM), Formant Modification (FM), and vocal tract Length Perturbation (VTLP), tailored to different aspects of dysarthria. The study uses individually fine-tuned Wav2Vec2 models for each severity class as baseline systems. Additionally, we conducted severity-specific fine-tuning of the ASR model using augmented data. Results demonstrate distinct efficacy patterns for each augmentation technique across severity levels. The best WERs were achieved with SRM ($s$=0.8) for low (9.02\%) and medium (38.11\%) severities, and with PM ($\tau$=0.8) for high severity (55.15\%), reflecting relative improvements of 30.02\%, 16.64\%, and 15.47\%, respectively. These results confirm the effectiveness of the augmentation methods in improving dysarthric ASR performance.

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

Model-Native Computing Architecture: Envisioning Future System Architecture Through the Lens of Computer Architecture

arXiv:2606.00288v2 Announce Type: replace Abstract: Large language models are undergoing a transition from model technology to system technology. Engineering challenges like cache reuse, context capacity, agent scheduling, and permission control resemble classical computer systems problems. This raises a question: if we treat the LLM as a CPU, KV cache as processor cache, context window as main memory, and agent framework as an operating system, can decades of computer architecture wisdom guide next generation model native systems? This paper pursues this analogy as a visionary survey. We map computer architecture concepts onto the emerging model native stack, survey literature across LLM as OS, memory management, agent frameworks, tool protocols, multi agent coordination, cognitive architectures, and safety governance, finding that each addresses a different layer without a unifying model. We propose the Intelligent Computing Architecture (ICA): six functional layers with interface contracts and design axioms. We resolve the tension over whether the LLM resembles a CPU or OS via a dual plane architecture a probabilistic execution plane (what can be computed) and a deterministic control plane (what should be computed), with every layer passing through as a graded crossover. We propose three Amdahl style design heuristics Semantic Locality, Context Budget, and Agent Speedup as organizing back of envelope models, illustrate their parameter ranges with published data, and identify predictive validation as the principal open task. We articulate analogy boundaries, note differences between silicon and model era architectures, and propose a research roadmap. This is a conceptual and survey contribution with no new experimental results.

22.
arXiv (CS.AI) 2026-06-15

Adversarial Concept Search: Predicting Compositional Errors From Feature Geometry

arXiv:2606.13934v1 Announce Type: new Abstract: Humans cannot always intuit what scenarios are most challenging to LLMs. Hoping to capture challenging edge cases, developers either design problems to be difficult for humans or curate extensive benchmarks. What if we could instead anticipate which scenarios a model will fail on? In this paper, we use an LLM's representational geometry to predict which concept combinations it will fail on. We attribute this compositional failure to interference between salient features. In tasks that require systematic composition - toy programmatic settings, multihop reasoning, multilingual factual recall - we find that when a pair of concepts is encoded near-orthogonally, the model reliably composes them. When their linear encodings are close, producing interference, the model fails to compose them. Our method reliably anticipates failure modes across different compositional tasks, without evaluating specific inputs. These results lay the groundwork to use representational geometry to identify high-risk examples, construct targeted stress tests, and provide a scalable foundation for active learning in real-world deployment.

23.
medRxiv (Medicine) 2026-06-18

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

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

24.
arXiv (CS.CV) 2026-06-12

GAE: Unleashing Physical Potential of VLM with Generalizable Action Expert

Vision-language models demonstrate strong reasoning and planning abilities, yet grounding these predictions into precise robot actions remains a central challenge. Existing Vision-Language-Action methods typically entangle reasoning and action generation, leading to limited generalization. We propose Generalizable Action Expert (GAE), a task-agnostic model that converts sparse geometric plans into dense robot actions. Our approach introduces a sparse geometric interface: the VLM predicts sparse 3D waypoints representing high-level intention, while GAE maps these waypoints together with real-time point cloud observations to continuous action trajectories. GAE is pretrained on a large-scale pointcloud-trajectory dataset comprising 150k trajectories from both simulation and real-world robots. To further improve efficiency and generalization, we introduce an Action Pre-training, Pointcloud Fine-tuning (APPF) scheme that decouples learning action dynamics from geometry grounding. After pretraining, GAE is frozen and reused across downstream tasks, requiring only lightweight fine-tuning of the VLM to produce the sparse interface. Experiments show that our method achieves strong performance and generalization across diverse visual domains, camera viewpoints, and natural language instructions.

25.
medRxiv (Medicine) 2026-06-22

Use of the Pharmacy First service in England in the first 12 months: geographic variation and health system context

Objectives: The Pharmacy First (PF) service was introduced across England from 31 January 2024 to expand the clinical role of community pharmacies and improve access to primary care. This paper describes use of PF in its first 12 months, in terms of uptake, access routes, consultation outcomes, geographic variations, service costs and antimicrobial supply. Methods: A descriptive analysis of all PF consultations submitted for payment to NHS Business Services Authority in England between 31 January 2024 and 31 January 2025. Pharmacy-level consultation data were linked to national data on population, location and pharmacy characteristics. PF use was examined using population-standardised consultation rates and consultations per pharmacy. Results: During the first year of implementation, 2,205,731 PF consultations were recorded as delivered across 11,349 pharmacies, with payment of GBP123 million to pharmacies. Uptake increased steadily over time. Most consultations were for acute sore throat (33%) and uncomplicated urinary tract infection (27%), with corresponding antibiotics, phenoxymethylpenicillin and nitrofurantoin being the most supplied. Most people self-referred (74%) into the service, with 95% of consultations managed without onward referral. Substantial geographic variation was observed. Northern regions had higher use based on the eligible population. The South East and Midlands had higher activity per pharmacy. London showed a distinct pattern, with higher self-referral into the service, lower medication supply and higher referral to other healthcare services. Higher consultation volume was weakly associated with pharmacy characteristics, including opening hours, pharmacy type and retail setting, and local context, in terms of socio-economic and geographic factors. Conclusions: PF had immediate uptake and is operating primarily as a direct-access model for common acute conditions. Findings suggest that PF is contributing to improved access to care and may shift demand away from general practice. However, the service uptake appears to be shaped by geographic location, proximity to other healthcare services and pharmacy characteristics.