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01.
PLOS Computational Biology 2026-06-01

Challenges and progress in RNA velocity: Comparative analysis across multiple biological contexts

Authors:

by Sarah Ancheta, Leah Dorman, Guillaume Le Treut, Abel Gurung, Greg Huber, Loïc A. Royer, Alejandro Granados, Merlin Lange Single-cell RNA sequencing is revolutionizing our understanding of cell state dynamics, allowing researchers to capture and quantify the transcriptomic profile of a single cell at a specific timepoint. Among the computational techniques used to predict cellular trajectories, RNA velocity has emerged as a predominant tool for modeling transcriptional dynamics. RNA velocity leverages the mRNA maturation process to generate velocity vectors that predict the likely future state of a cell, offering insights into cellular differentiation, aging, and disease progression. Although this technique has shown promise across biological fields, the performance accuracy varies depending on the RNA velocity method and dataset. We established a comparative pipeline and analyzed the performance of five RNA velocity methods on three datasets based on local consistency, method agreement, identification of driver genes, and robustness to sequencing depth. This benchmark provides a resource for scientists to understand the strengths and limitations of different RNA velocity methods.

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

AI-Driven Test Case Generation from Natural Language Requirements: A Survey of Techniques and Research Gaps

arXiv:2606.06563v2 Announce Type: replace-cross Abstract: Software testing is critical for verifying that systems meet specified requirements, yet remains among the most time-consuming and expensive activities in development. Requirements-based test generation allows test cases to be derived early from requirements artifacts, but generating them directly from natural language is challenging due to inherent ambiguity and imprecision. Recent advances in AI, natural language processing (NLP), and large language models (LLMs) have made automating this pipeline increasingly feasible, while introducing new risks including hallucination, reduced traceability, and inconsistent evaluation. This survey addresses four research questions: what AI and NLP techniques have been proposed for generating test cases from natural language requirements; what tools and frameworks support these approaches; how generated test cases are evaluated; and what research gaps remain. Following Kitchenham and Charters' systematic review guidelines, we searched major scholarly databases spanning 2000-2025 and, after applying strict inclusion criteria, identified 21 primary studies. The literature is organized into three evolutionary eras, revealing that no existing approach simultaneously satisfies six key quality dimensions: automation, ambiguity handling, domain applicability, traceability, evaluation thoroughness, and hallucination control. The survey makes three main contributions: a three-era evolutionary synthesis of AI-based test generation; a six-criteria gap analysis showing no current approach fully addresses all quality dimensions; and four actionable research guidelines targeting hallucination, traceability, complexity sensitivity, and compliance.

03.
arXiv (CS.CV) 2026-06-17

Flash-GRPO: Efficient Alignment for Video Diffusion via One-Step Policy Optimization

Group Relative Policy Optimization has emerged as essential for aligning video diffusion models with human preferences, but faces a critical computational bottleneck: training a 14B parametered model typically demands hundreds of GPU days per experiment. Existing efficiency methods reduce costs through sliding window subsampling training timesteps, but fundamentally compromise optimization, exhibiting severe instability and failing to reach full trajectory performance. We present Flash-GRPO, a single-step training framework that outperforms full trajectory training in alignment quality under low computational budgets while substantially improving training efficiency. Flash-GRPO addresses two critical challenges: iso-temporal grouping eliminates timestep-confounded variance by enforcing prompt-wise temporal consistency, decoupling policy performance from timestep difficulty; temporal gradient rectification neutralizes the time-dependent scaling factor that causes vastly inconsistent gradient magnitudes across timesteps. Experiments on 1.3B to 14B parameter models validate Flash-GRPO's effectiveness, demonstrating substantial training acceleration with consistent stability and state-of-the-art alignment quality.

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

Learning Task-Aware Sampling with Shared Saliency through Density-Equalizing Mappings

In image and surface-based learning tasks, convolutional features are typically extracted using receptive fields that are sampled uniformly across the entire domain. However, informative structures are rarely distributed uniformly in practice and are often concentrated in localized regions. Such phenomena are particularly common in medical imaging, where pathological changes are spatially confined. Consequently, uniform convolution allocates equal computational effort to both informative and uninformative regions, resulting in inefficient feature extraction and suboptimal utilization of model capacity. To address this issue, we propose a framework for task-adaptive sampling that dynamically redistributes computational attention according to the spatial importance of the data. Specifically, we introduce the Density-Equalizing Convolutional Neural Network (DECNN), which employs density-equalizing mappings to guide convolution through a learned density function. The density function encodes the relative importance of different regions and induces a transformation that enlarges informative areas while compressing less relevant ones. As a result, convolutional receptive fields are redistributed non-uniformly over the domain, enabling denser sampling in task-relevant regions. By coupling this importance-driven transformation with convolution, DECNN performs adaptive feature extraction that focuses computational resources on informative structures. This leads to more efficient use of model capacity, yielding a lightweight yet expressive architecture while simultaneously producing an interpretable saliency map. Experiments on image classification and craniofacial surface analysis demonstrate that DECNN achieves competitive or superior performance with fewer parameters, accurately identifies task-relevant regions, and remains robust under complex geometric variations.

05.
arXiv (math.PR) 2026-06-16

A small noise approximation for Muller's Ratchet

arXiv:2606.15842v1 Announce Type: new Abstract: We consider an infinite system of SDEs with Fleming-Viot noise indexed by $k=0,1,2,\dots$, whose parameters $\alpha,\lambda$, and $\nu$ are the (deleterious) selection coefficient, the (uni-directional) mutation rate, and a quantity which determines the size of the system's fluctuations. The SDE's unique weak solution $X(t) = (X_k(t))_{k=0,1,2,...}$ models what is known in population genetics as Muller's ratchet. Here, $X_k(t)$ stands for the frequency of individuals carrying $k$ deleterious mutations. Since the mutation process is uni-directional, $t\mapsto \inf\{k: X_k(t)> 0\}$ is non-decreasing for almost every path of $X$, and we refer to an increase as a click of Muller's ratchet. A long standing question concerns the clicking rate of Muller's ratchet. Using Duhamel's principle for semigroups, we give a partial answer by approximating $E(\sum_{k=1}^\infty kX_k(t) )$ and $E\big(X_0(t)\big)$ up to $O(1/\nu^2)$ for fixed $\alpha$, $\lambda$ and $t>0$. Our results suggest that $\psi:=\nu \alpha e^{-\lambda/\alpha}$ is a crucial quantity also when the mutation/selection ratio $\theta = \lambda/\alpha$ is moderately large: for large $\nu \alpha$, clicking of the ratchet on the time scale $\frac 1\alpha \log \theta$ becomes rare as soon as $\psi$ becomes large.

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

MetaboNet-Bench: A Multi-modal Benchmark for Glucose Forecasting in Type 1 Diabetes

arXiv:2606.18640v1 Announce Type: new Abstract: Glucose forecasting algorithms are an important aspect of glycemic control management in type 1 diabetes. So far, the research community has developed numerous algorithms and models for forecasting. However, it is well-recognized that the lack of standardized model performance evaluation benchmarks makes fair comparison difficult and hinders further innovation, and thus benchmark standardization is in urgent need. Furthermore, many published glucose forecasting algorithms are limited to CGM data alone, ignoring other multimodal signals such as insulin dosing and carbohydrate intake. Here, we introduce MetaboNet-Bench, a benchmark for multimodal glucose forecasting for patients with type 1 diabetes that provides an extensible open-source evaluation framework for comparison of glucose forecasting algorithms that leverage glucose, insulin, and carbohydrate data. We then demonstrate its utility by benchmarking several recently published glucose forecasting models and a custom multimodal time-series model, representing different model architectures. The results show that the benefit of adding data modalities is conditioned on the complexity of the model and that incorporating more clinical metrics helps identify meaningful gaps to fill for future research.

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

JE-IRT: A Geometric Lens on LLM Abilities through Joint Embedding Item Response Theory

Standard LLM evaluation practices compress diverse abilities into single scores, obscuring their inherently multidimensional nature. We present JE-IRT, a geometric item-response framework that embeds both LLMs and questions in a shared space. For question embeddings, the direction encodes semantics and the norm encodes difficulty, while correctness on each question is determined by the geometric interaction between the model and question embeddings. This geometry replaces a global ranking of LLMs with topical specialization and enables smooth variation across related questions. Building on this framework, our experimental results reveal that out-of-distribution behavior can be explained through directional alignment, and that larger norms consistently indicate harder questions. Moreover, JE-IRT naturally supports generalization: once the space is learned, new LLMs are added by fitting a single embedding. The learned space further reveals an LLM-internal taxonomy that only partially aligns with human-defined subject categories. We also show that simple linear probes of the embedding space recover cross-subject ability directions, such as an arithmetic axis that highlights quantitatively demanding questions in seemingly distant subjects like virology and global facts. JE-IRT thus establishes a unified and interpretable geometric lens that connects LLM abilities with the structure of questions, offering a distinctive perspective on model evaluation and generalization.

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

Improve Large Language Model Systems with User Logs

Scaling training data and model parameters has long driven progress in large language models (LLMs), but this paradigm is increasingly constrained by the scarcity of high-quality data and diminishing returns from rising computational costs. As a result, recent work is increasing the focus on continual learning from real-world deployment, where user interaction logs provide a rich source of authentic human feedback and procedural knowledge. However, learning from user logs is challenging due to their unstructured and noisy nature. Vanilla LLM systems often struggle to distinguish useful feedback signals from noisy user behavior, and the disparity between user log collection and model optimization (e.g., the off-policy optimization problem) further strengthens the problem. To this end, we propose UNO (User log-driveN Optimization), a unified framework for improving LLM systems (LLMsys) with user logs. UNO first distills logs into semi-structured rules and preference pairs, then employs query-and-feedback-driven clustering to manage data heterogeneity, and finally quantifies the cognitive gap between the model's prior knowledge and the log data. This assessment guides the LLMsys to adaptively filter out noisy feedback and construct different modules for primary and reflective experiences extracted from user logs, thereby improving future responses. Extensive experiments show that UNO achieves state-of-the-art effectiveness and efficiency, significantly outperforming Retrieval Augmented Generation (RAG) and memory-based baselines. We have open-sourced our code at https://github.com/bebr2/UNO .

09.
arXiv (CS.LG) 2026-06-15

Implicit Variational Rejection Sampling

arXiv:2606.14235v1 Announce Type: new Abstract: Variational Inference (VI) is a fundamental inference technique in Bayesian machine learning for approximating complex posterior distributions. Traditional VI often relies on the mean-field factorization, which can inadequately capture true posterior complexity. Recent advancements have leveraged neural networks to model implicit distributions, offering increased flexibility. However, the practical constraints of neural network architectures still produces inaccuracies. In this paper, we propose a method called Implicit Variational Rejection Sampling (IVRS), which integrates implicit distributions with rejection sampling to improve the posterior approximation. Our method uses neural networks to construct implicit proposal distributions, and rejection sampling with a discriminator network that estimates the density ratio between the implicit proposal and the true posterior for refining the approximation. Towards this end, we introduce the Implicit Resampling Evidence Lower Bound (IR-ELBO) as a metric to characterize the resampled distribution's quality and derive a tighter variational lower bound. Experimental results demonstrate that our method outperforms traditional variational inference techniques.

10.
arXiv (CS.AI) 2026-06-12

MP3: Multi-Period Pattern Pre-training forSpatio-Temporal Forecasting

arXiv:2606.13119v1 Announce Type: cross Abstract: Spatio-Temporal forecasting is crucial in diverse fields, such as transportation, climate, and energy. Urban spatio-temporal data exhibits temporal mirage: similar short-window inputs have divergent future trends, and vice versa. Existing spatio-temporal graph neural networks (STGNNs) cannot effectively identify such mirages. We argue that the core reason lies in the short-window inputs that have incomplete period observation, heterogeneous global spatial correlation, and cross-period superposition causality. To bridge this gap, we develop a novel Multi- Period Pattern Pre-training (MP3), a plug-and-play pre-training plugin for distinguishing temporal mirages. MP3 presents two core innovations: (1) The multi-period pattern learning is designed to learn multi-period patterns from long time series. Specifically, multi-period temporal modeling leverages edge convolution to identify different multi-period patterns. Multi-period spatial modeling uses a bottleneck project and a global memory bank to capture heterogeneous global spatial relations efficiently. Cross-period pattern interaction employs a causality-enhanced Transformer to capture dependencies across different period patterns. (2) This plugin can seamlessly integrate into existing STGNN backbones to strengthen their forecasting performance. The experiment on five STGNN baselines across five real-world datasets (including a large-scale dataset CA) verify the effectiveness, superior scalability and strong adaptability of MP3, which brings consistent and robust performance improvements across all evaluated baselines. On average, MP3 reduces the MAE 4.7% and the RMSE 5.0%. The code can be available at https://github.com/YAN-outlook/MP3.

11.
arXiv (math.PR) 2026-06-17

Persistence diagrams of random triangular matrices over finite fields

arXiv:2606.17895v1 Announce Type: cross Abstract: Let us consider a random infinite lower triangular matrix, where the entries on and below the diagonal are i.i.d. uniform random elements of a fixed finite field. We investigate the evolution of the span of the first $n$ rows of this matrix as $n$ grows. Many properties of this evolving subspace can be captured with the help of the verbose persistence diagram, which is a standard tool in stochastic topology and topological data analysis. We give an explicit formula for the distribution of the persistence diagram. We prove a law of large numbers for the distribution of lifetimes. We also describe the fluctuations of the persistent Betti numbers.

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

LUCID: Learned Undersampling-Adaptive Consistency-Guided Inference with Deterministic Flow Matching for Sparse-View CT Reconstruction

Sparse-view CT reduces radiation dose and scanning time by acquiring fewer projection views, but angular undersampling makes reconstruction severely ill-posed, causing streak artifacts, structural blurring, and loss of fine details. Existing supervised methods are often tied to specific sampling settings, whereas generative methods may introduce anatomically inconsistent hallucination-like structures under severe undersampling. We propose Lucid, a sparsity-adaptive, consistency-guided reconstruction framework based on a Flow Matching generative prior for sparse-view CT. Lucid is trained only on high-quality CT images to learn a continuous transport between a Gaussian distribution and the high-quality CT image distribution, independent of view sampling. During inference, the sampling sparsity level is explicitly incorporated to adapt the generative trajectory of a single pretrained model. Specifically, Lucid constructs a degradation-matched initial state by sparsity-weighted fusion of the sparse-view FBP image and Gaussian noise, performs sparsity-modulated Flow Matching updates, and applies projection-domain data-consistency correction after each prior update. Experiments under multiple sparse-view settings show that Lucid achieves stable reconstruction performance across different sampling densities, improves image quality and structural fidelity, and reduces the risk of hallucination-like structures in generative sparse-view CT reconstruction.

13.
arXiv (CS.LG) 2026-06-17

Weisfeiler Lehman Test on Combinatorial Complexes: Generalized Expressive Power of Topological Neural Networks

arXiv:2605.00725v2 Announce Type: replace Abstract: Topological neural networks have emerged as effective tools for modeling higher-order relational structures beyond pairwise graphs, including hypergraphs, simplicial complexes, and cell complexes. However, existing Weisfeiler-Leman type expressivity analyses are typically developed on different structural domains and rely on domain-specific neighborhood systems, making their expressive powers difficult to compare within a common formalism. In this paper, we introduce the Combinatorial Complex Weisfeiler-Leman (CCWL) framework, a unified expressive power refinement defined on combinatorial complexes. By exploiting the ability of combinatorial complexes to represent both set-type relations and part-whole hierarchies, CCWL performs topological color refinement through four structural neighborhoods: boundary, co-boundary, lower adjacency, and upper adjacency. We show that, under specified lifting maps, CCWL can simulate several domain-specific WL-type refinements, thereby providing a common theoretical baseline for analyzing topological message passing. We further study the neighborhood sufficiency problem and prove that, under explicit coverage conditions, a reduced refinement using only lower- and upper-adjacent bridge information preserves the distinguishing power of the full four-neighborhood CCWL refinement. Guided by this theoretical result, we instantiate the reduced refinement as the Combinatorial Complex Isomorphism Network (CCIN). Experiments on synthetic and real-world benchmarks demonstrate that CCIN achieves competitive performance against representative graph and topological neural network baselines. Ablation studies and resource-efficiency analyses further support the effectiveness of the proposed lower/upper-neighborhood design.

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

Entropy-Gated Latent Recursion

arXiv:2606.16620v1 Announce Type: cross Abstract: Inference-time scaling has become the dominant lever for improving language-model reasoning, but existing methods derive rollout diversity from a single source: stochastic token-level sampling. We argue that this single-axis sampling space is fundamentally limiting, and identify a second, fully deterministic and complementary axis: the layer span $L$ at which a frozen model's top decoder layers are recursively re-applied at high-uncertainty tokens. Different choices of $L$ produce distinct rollouts that solve different subsets of problems, with no stochasticity. We instantiate this axis through Entropy-Gated Latent Recursion (EGLR), a training-free decoding procedure that re-applies the top-$L$ layers for at most $K_{\max}$ iterations until the next-token distribution converges. Combined with $T$ temperature samples, EGLR turns a single-axis stochastic rollout pool into an $L\times T$ Cartesian sampling space at almost the same per-rollout cost. We characterize this space across $8$ instruction-tuned models and $6$ math reasoning benchmarks, and show that the $L$-axis is genuinely complementary to temperature: on MATH-500 with Qwen2.5-3B-Instruct, the joint $L\times T$ oracle reaches $91.6\%$, $+8.2$ percentage points beyond the temperature-only oracle ($83.4\%$) and $+10.4$ points beyond the layer-only oracle ($81.2\%$), confirming that the two axes capture genuinely complementary problems. The expanded rollout pool provides richer per-prompt candidates for any downstream procedure that consumes rollouts, including self-consistency, best-of-$N$ with verifiers, and group-relative RL training (GRPO), opening a new direction for inference-time scaling that does not rely on stochastic noise.

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

Knowledge-Based Zero-Replay Debugging of Multi-Agent LLM Traces

arXiv:2606.14805v1 Announce Type: cross Abstract: Reliable operation of multi-agent large language model (LLM) systems depends on debugging long execution traces, where the few causally decisive events are buried in unstructured logs of messages, routes, memory writes, and tool calls. The standard tool is counterfactual replay (rewind, edit, and re-run the trajectory to measure each event's effect), but its cost grows linearly with the number of candidate events, making exhaustive replay infeasible at scale. We frame trace debugging as a knowledge-based decision-support problem. Each trace is compiled into a structured event knowledge graph over routing, memory, tool-use, uncertainty, and latent evidence, and a calibrated predictor decides where a scarce replay budget should be spent. We do not propose a new replay oracle; we propose a method to predict its results without paying the replay cost. We formulate zero-replay counterfactual-effect prediction: given a trace under a fixed budget, predict which events the oracle would mark high-effect before any replay is performed. BranchPoint-Latent is a lightweight predictor over observable, structural, uncertainty, and latent features of the knowledge graph. Calibrated against a deterministic replay oracle across 37 trace families, a single learning-to-rank gradient-boosted predictor raises per-trace localization (Branch Recall@5) from 0.73 to 0.93 on held-out families at zero oracle-replay cost. Rather than claiming universal dominance, we characterize when cheap graph centrality suffices and when learned evidence is necessary. The result is an auditable, cost-efficient decision-support system for AI-reliability debugging, positioned explicitly on the cost-accuracy frontier with reproducible artifacts.

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

FOCUS: DLLMs Know How to Tame Their Compute Bound

Diffusion Large Language Models (DLLMs) offer a compelling alternative to Auto-Regressive models, but their deployment is constrained by high decoding cost. In this work, we identify a key inefficiency in DLLM decoding: while computation is parallelized over token blocks, only a small subset of tokens is decodable at each diffusion step, causing most compute to be wasted on non-decodable tokens. We further observe a strong correlation between attention-derived token importance and token-wise decoding probability. Based on this insight, we propose FOCUS, an inference system designed for DLLMs. By dynamically focusing computation on decodable tokens and evicting non-decodable ones on-the-fly, FOCUS increases the effective batch size, alleviating compute limitations and enabling scalable throughput. Empirical evaluations demonstrate that FOCUS achieves up to 3.52$\times$ throughput improvement over the production-grade engine LMDeploy in large-batch settings, while preserving or improving generation quality across multiple benchmarks.

17.
medRxiv (Medicine) 2026-06-18

Evaluating Deep-Learning Based Quantification of Breast Arterial Calcification on Mammography for Cardiovascular Risk Assessment

Purpose: To develop and evaluate a deep learning model for automated quantification of breast arterial calcification (BAC) on screening mammography and to assess whether AI-derived BAC burden predicts major adverse cardiovascular events (MACE) in women. Methods: In this retrospective study, 202,006 women who underwent screening mammography without history of MACE were included. A BAC segmentation model was trained on an expert-annotated dataset using a multi-task U-Net with a ResNet-18 encoder to detect and segment BAC. BAC burden was quantified as area (mm{superscript 2}) from model-generated masks using DICOM pixel spacing and categorized by tertiles into low, intermediate, and high. The PREVENT score and incident MACE were identified from electronic health records. Cox proportional hazards models were developed to evaluate AI-derived BAC burden and PREVENT score alone, and combined models for 5 - and 10-year cardiovascular risk prediction. Results: Among 202,006 women (mean age 54.8{+/-}11.7 years), 23.1% had AI-detected BAC, and 7,701 (3.8%) developed incident MACE during a median follow - up of 7.5 years. On the geographically held-out test set, the BAC model achieved an AUROC of 0.97, Dice score of 0.6678, and Pearson correlation of 0.961 between AI-derived and manually annotated BAC burden. BAC burden increased with age and was higher among women who developed MACE. Five - year MACE incidence increased across BAC categories from 1.5% in women without BAC to 6.9% in those with high BAC burden. BAC burden alone showed modest prediction of MACE, with 5-year and 10-year AUROCs of 0.661 and 0.650, respectively, while PREVENT achieved AUROCs of 0.781 and 0.771. Adding BAC to PREVENT produced minimal improvement in discrimination. Conclusion: Deep learning-based BAC quantification from routine mammography is feasible, accurate, and associated with future cardiovascular risk. Although BAC added little to PREVENT for overall discrimination, it may serve as a scalable opportunistic imaging biomarker to identify women at elevated cardiovascular risk and support preventive care.

18.
arXiv (quant-ph) 2026-06-16

Quantum learning with a single-atom sensor

arXiv:2606.15071v1 Announce Type: new Abstract: The ability to gather information and to act upon it is at the core of every learning agent. But what is the impact of quantum mechanics on an agent's ability to sense external inputs and to translate them into actions? Here we address the question for a prototype task of learning agency at the quantum scale: rotating a single spin based on information gathered by a single atom. We determine the ultimate performance limit for this task, revealing a fundamental tradeoff between entanglement at the sensing stage and coherence at the action stage: if the single-atom sensor is not entangled with the quantum system serving as the agent's internal memory, then the best learning strategy requires a coherent transfer of quantum information from the sensor to the system that controls the agent's actions. In contrast, if the sensor is initially entangled with the agent's memory, then the transfer of quantum information is no longer necessary. Our results indicate that the quantum properties of the sensor radically affect the optimal way to convert external stimuli into actions, revealing a link between quantum sensing and the behavior of quantum agents.

19.
arXiv (CS.CL) 2026-06-11

TokenRatio: Principled Token-Level Preference Optimization via Ratio Matching

Direct Preference Optimization (DPO) is a widely used RL-free method for aligning language models from pairwise preferences, but it models preferences over full sequences even though generation is driven by per-token decisions. Existing token-level extensions typically decompose a sequence-level Bradley-Terry objective across timesteps, leaving per-prefix (state-wise) optimality implicit. We study how to recover token-level preference optimality using only standard sequence-level pairwise comparisons. We introduce Token-level Bregman Preference Optimization (TBPO), which posits a token-level Bradley-Terry preference model over next-token actions conditioned on the prefix, and derive a Bregman-divergence density-ratio matching objective that generalizes the logistic/DPO loss while preserving the optimal policy induced by the token-level model and maintaining DPO-like simplicity. We introduce two instantiations: TBPO-Q, which explicitly learns a lightweight state baseline, and TBPO-A, which removes the baseline through advantage normalization. Across instruction following, helpfulness/harmlessness, and summarization benchmarks, TBPO improves alignment quality and training stability and increases output diversity relative to strong sequence-level and token-level baselines.

20.
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)

21.
Nature (Science) 2026-06-10

A prognostic human brain network for diffuse midline glioma

Authors:

Diffuse midline gliomas (DMGs) are near-universally lethal tumours of the childhood central nervous system1,2. In animal models, DMGs form brain-wide integrated networks through neuron-to-glioma synapses3–6 and glioma-to-glioma gap junctional coupling3. This extensive connectivity robustly promotes the growth and invasion of DMG3–9 and other glial malignancies10–12 through paracrine mechanisms and direct neuron-to-glioma synapses. However, the organization and clinical implications of these connections in the living human brain remain to be elucidated. Here, we develop tumour network mapping to compute the brain-wide connectivity profile of DMG, defining a conserved brain network across pontine and thalamic DMG associated with patient short-term survival (DMG network). Tumour functional connectivity with the DMG network was independently predictive of patient overall survival across two external validation cohorts. Tumour growth mapped to DMG network-specific trajectories and peak in-network neurometabolic changes across development spatiotemporally aligned with the peak age incidence of DMG. Analyses of single-nucleus RNA sequencing data confirmed diverse synaptic gene enrichment in high-connectivity DMG. Strikingly, incidental surgical resection of high-connectivity thalamic DMG tissue conferred a significant survival advantage. Collectively, these data define a conserved and prognostically important brain network in children with DMG, consistent with the hypothesis that DMGs exploit otherwise healthy brain circuits to promote tumour growth. Tumour network mapping of diffuse midline glioma (DMG) defines a conserved and prognostically important brain network in children with DMG, consistent with the hypothesis that DMGs exploit otherwise healthy brain circuits to promote tumour growth.

22.
arXiv (CS.CL) 2026-06-11

Decoding Multimodal Cues: Unveiling the Implicit Meaning Behind Hateful Videos

Hateful videos have become prevalent on online platforms, highlighting an urgent need for effective detection. However, existing studies primarily focus on binary classification and fail to provide contextual rationales that reveal the implicit meanings behind these judgments, significantly undermining model explainability. To fill this gap, we aim to achieve explainable hateful video detection, enabling models to provide contextual rationales that integrate relevant evidence and logical reasoning alongside decisions. This approach can comprehensively enhance the understanding of video content and the explainability of the decision-making process. We first introduce two datasets, Ex-HateMM and Ex-ImpliHateVid, for explainable hateful video detection. Each dataset provides fine-grained annotations of multimodal harmful elements, along with contextual rationales. We then propose an Information Augmentation and Reasoning Enhancement (IARE) framework designed for explainable detection. The framework employs an information augmentation phase that leverages the multimodal chain-of-thought to integrate harmful elements, thereby enriching rationale evidence. Additionally, IARE incorporates a reasoning enhancement phase, in which Direct Preference Optimization guides the model toward correct reasoning paths and away from incorrect ones, thereby improving the logical coherence of its justifications. We conduct extensive experiments on the two datasets, comparing multiple baselines with our proposed IARE framework. The results demonstrate that IARE achieves state-of-the-art performance while also generating accurate rationales.

23.
arXiv (CS.AI) 2026-06-16

Multi-Grade Deep Learning for Partial Differential Equations with Applications to the Burgers Equation

arXiv:2309.07401v2 Announce Type: replace-cross Abstract: Deep neural networks (DNNs) show great promise for solving partial differential equations (PDEs), but their deep architectures introduce complex, large-scale, non-convex optimization challenges. Nonlinear PDEs, like the viscous Burgers' equation, compound these difficulties due to steep gradients and shock-like solutions. To address this, we propose a two-stage multi-grade deep learning (TS-MGDL) method. In the first stage, shallow networks are trained progressively grade by grade to fit the target function from low- to high-frequency components; previously learned grades are frozen, and each new residual block is trained solely to minimize the remaining approximation error. The second stage unfreezes and retrains selected layers using the first-stage network as initialization, achieving an interpretable, stable hierarchical refinement while mitigating optimization complexity. Furthermore, we theoretically prove that each grade and stage in TS-MGDL monotonically reduces the loss function under an appropriate optimization strategy. Numerical experiments on 1D, 2D, and 3D viscous Burgers' equations demonstrate that TS-MGDL significantly outperforms single-grade learning (SGL), reducing predictive errors by up to a factor of 60.

24.
arXiv (CS.AI) 2026-06-18

Scalable Batch Bayesian Optimization Via Subspace Acquisition Functions

arXiv:2411.16206v3 Announce Type: replace-cross Abstract: Extending Bayesian optimization to batch evaluation can enable the designer to make the most use of parallel computing technology. However, most of current batch approaches do not scale well with the batch size. That is, their optimization efficiencies often deteriorate as the batch size increases. To address this issue, we propose a simple and efficient approach to extend Bayesian optimization to large-scale batch evaluation in this work. Different from existing batch approaches, the idea of the new approach is to draw a batch of axis-aligned subspaces of the original problem and select one point from each subspace using existing acquisition functions. Numerical experiments show that our proposed approach speedups the convergence significantly when compared with the sequential Bayesian optimization algorithm, and performs very competitively when compared with ten batch Bayesian optimization algorithms. The implementation of our proposed approach is available at https://github.com/zhandawei/SubSpace_Acquisition_Functions.

25.
medRxiv (Medicine) 2026-06-10

Estimating COVID-19 Cumulative Incidence from Seroprevalence Surveys accounting for Time-Varying Seroreversion: A Fully Bayesian Methodology

Seroprevalence surveys reveal the extent of humoral immunity against pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and under some circumstances represent cumulative incidence of prior infection. However, antibody waning - or seroreversion - biases these estimates by reducing assay sensitivity in a time-varying manner. Because assay sensitivity decays over time, naively using serosurveys can substantially bias estimates of SARS-CoV-2 cumulative incidence and fatality rates. The Bayesian assay-specific, time-varying sensitivity adjustment developed in this paper can reliably correct for this bias and account for the delay between infection and serosurvey. In seroprevalence studies conducted in the United States in 2020, adjusting for time-varying sensitivity increased cumulative incidence by up to 1.4-fold, with an adjustment of 1.08 for a national study. Our estimates contrast with a previously published 2-fold adjustment that did not account for assay design. This suggests that previous analyses overestimated cumulative incidence by applying seroreversion corrections that did not account for assay-specific effects, or underestimated cumulative incidence by not applying seroreversion corrections. These biases imply fatality rate underestimation and overestimation, respectively. Our model provides a framework for design-specific time-varying sensitivity corrections in seroprevalence surveys for other pathogens.