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01.
arXiv (quant-ph) 2026-06-17

Split-Head Quantum Generative Adversarial Network for Crystalline Material Discovery

arXiv:2606.17852v1 Announce Type: new Abstract: The discovery of novel crystalline materials is a critical challenge in computational materials science, often limited by the spatial representation limitations and mode collapse typical of classical generative models. Traditionally, developing Quantum GANs for continuous 3D space is hindered by the limited capacity of near-term hardware. To overcome this, we adapt a physics-informed "split-head" architecture right from the quantum trunk to explicitly decouple macroscopic lattice bounds from microscopic atomic coordinates, significantly maximizing resource efficiency. This study disentangles the contributions of quantum circuits from these architectural priors by evaluating a Split-Head Quantum Generative Adversarial Network against an architecture-matched classical ablation model. Evaluated on the highly constrained Mg-Mn-O system, the results reveal a highly nuanced performance dichotomy between the advanced models. The architecture-matched classical ablation model demonstrated superior thermodynamic precision. Conversely, the integration of quantum circuits in the SH-QGAN drove unparalleled structural breadth and latent space exploration, more than doubling the ablation's geometric validity and successfully generating novel, metastable candidates converging on the Mg2MnO4 stoichiometry. These findings clarify that while architectural separation of cell and atom generation drives strict thermodynamic precision, quantum feature mapping independently provides the spatial diversity necessary to overcome mode collapse. Both mechanisms offer distinct, complementary enhancements for the generative discovery of advanced materials.

02.
arXiv (quant-ph) 2026-06-16

Superresolution technique beyond the diffraction limit under a structured beam via different optical nanostructures

arXiv:2602.19417v2 Announce Type: replace-cross Abstract: To overcome the limit of diffraction while achieving the superresolution technique, solid immersion lenses are the key optical elements for data storage and nanophotonics applications. Recent demonstrations have shown how different nanostructures (such as elliptical solid immersion lenses) are used in diverse fields of increasing resolution in the presence of a structured Gaussian beam. By applying twisted beams such as angular momentum beams (Laguerre- Gaussian) and spatial higher-order Gaussian beams (Hermite- Gauss), we can attain a sharp near-field focal spot pattern, which is considerably better than the conventional solid immersion lens structure in ~mm scale specifically for imaging beyond diffraction limit. Our computation results present a resolution of ~27 nm under a specific Hermite -Gauss mode illumination on a pyramidal shape nanolens structure. By numerical simulations, tolerance has been confirmed with a slight variation in beam size and geometrical modification to make the model compatible with fabrication errors. This narrow bandwidth intensity distribution can be utilized for scanning the sample with higher resolution, especially in the field of quantum technology.

03.
arXiv (quant-ph) 2026-06-25

Spectral Leakage and Masking Effects in the Measurement of Hyperuniformity

Authors:

arXiv:2606.24904v1 Announce Type: cross Abstract: The detection of hyperuniformity relies critically on accurate characterization of the small-wavenumber behavior of the static structure factor of the system. In practice, however, measurements are performed on finite subsystems or through incomplete observations that effectively mask portions of the underlying configuration. Inspired by a recent numerical study [Y. Liu, X. Li, J. Tian, X. Yan, G. Zhang, {\it J. Chem. Phys.} {\bf 164}, 094102 (2026)], we develop a unified theoretical framework that quantifies how finite windows and spatially correlated binary masks modify the observed structure factor. We show that the measured structure factor $S_{obs}(k)$ is the convolution of the intrinsic structure factor with the spectral density of the observation function, whether it is a compact window or an extended random mask. For generic hyperuniform systems with small-$k$ scaling $S(k)\sim k^{\alpha}$, finite observation window induces a universal quadratic leakage term at sufficiently small wavenumbers (i.e., $k \lesssim 1/L$), leading to an apparent $k^{2}$ scaling independent of the true exponent. The true hyperuniform exponent $\alpha$ can only be measured in the intermediate regime $1/L \ll k \ll q_c$. In stealthy hyperuniform systems, where the intrinsic structure factor possesses a spectral gap, all observed small-$k$ power arises entirely from this convolution mechanism. For spatially correlated masks, we derive the corresponding convolution relation in terms of the mask spectral density and identify conditions under which hyperuniform signatures are suppressed, preserved, or distorted. Our results establish quantitative criteria for reliably extracting intrinsic scaling exponents and distinguishing genuine hyperuniform order from measurement-induced artifacts.

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

From Verdict to Process: Agentic Reinforcement Learning for Multi-Stage Fact Verification

arXiv:2606.13262v1 Announce Type: new Abstract: Recent approaches combining Large Language Models (LLMs) with retrieval-augmented reasoning have shown promise for automated fact verification. To process complex claims, these verification pipelines typically execute multi-stage workflows that coordinate tightly coupled modules, including claim decomposition, evidence gathering, and verdict prediction. However, existing methods optimize individual stages in isolation or rely on fixed heuristics, which limits adaptive coordination among stages and can lead to suboptimal outcomes. In this work, we propose ProFact, an agentic reinforcement learning framework for end-to-end optimization of multi-stage fact verification trajectories. ProFact trains a unified policy to coordinate claim decomposition, evidence seeking, answer generation, and verdict prediction. To address the sparse and delayed supervision provided by final veracity labels, ProFact introduces process-aware rewards that provide stage-level learning signals throughout the verification process. Empirical evaluation shows that ProFact consistently outperforms strong baselines in both verification performance and inference efficiency. These results highlight the effectiveness of process-aware trajectory optimization for multi-stage fact verification.

05.
arXiv (CS.AI) 2026-06-24

CompressKV: Semantic-Retrieval-Guided KV-Cache Compression for Resource-Efficient Long-Context LLM Inference

arXiv:2606.24467v1 Announce Type: new Abstract: Long-context large language model (LLM) inference is increasingly constrained by the memory footprint and decoding cost of key-value (KV) caches, limiting sustainable deployment on resource-constrained hardware. Existing KV cache eviction methods typically apply heuristic token scoring over all heads in GQA-based LLMs. These methods ignore the different functionalities of attention heads, leading to the eviction of critical tokens and thus degrading the performance of LLMs. To address this issue, we propose CompressKV, a resource-efficient KV-cache compression framework for GQA-based LLMs. Instead of aggregating attention scores from all heads, CompressKV identifies Semantic Retrieval Heads (SRHs) that capture both the initial and final tokens of a prompt and semantically important mid-context evidence, and uses them to select tokens whose KV pairs should be retained. Furthermore, CompressKV allocates cache budgets across layers according to offline estimates of layer-wise eviction error. Experiments on LongBench and Needle-in-a-Haystack show that CompressKV consistently outperforms existing KV-cache eviction methods across memory budgets. Notably, it preserves over 97\% of full-cache performance using only 3\% of the KV cache on LongBench question-answering tasks and achieves 90\% accuracy with just 0.7\% KV storage on Needle-in-a-Haystack. These results demonstrate an improved resource–performance trade-off for long-context LLM inference. Our code is publicly available at: https://github.com/TUDa-HWAI/CompressKV

06.
medRxiv (Medicine) 2026-06-22

The circulating blood proteome of childhood acute leukemia

The circulating blood proteome provides a systemic readout of disease biology and holds promise for advancing diagnostics and disease monitoring in pediatric leukemia. Here, we profiled 3072 proteins in diagnostic serum from 54 children with acute lymphoblastic leukemia (ALL), 21 with acute myeloid leukemia (AML), and 12 healthy controls using the Olink Proximity Extension Assay. We observed profound alterations in circulating protein levels in leukemia patients compared with controls and identified immunophenotype-specific proteins, including SIGLEC15 in B-cell precursor ALL (BCP-ALL), NOTCH1 in T-ALL, and CEBPA in AML, all which remained high even in patients with low (

07.
arXiv (CS.CL) 2026-06-17

Decoding Hidden Deception in Reasoning LLMs: Activation Explainers for Deception Auditing

As LLMs acquire stronger reasoning capabilities, deceptive behavior becomes an increasingly serious safety concern. Existing deception monitors either score visible transcripts or derive scalar probe scores from representation vectors, leaving little inspectable evidence about why a response is suspicious. We introduce STATEWITNESS, an activation explainer for deception auditing. A separate decoder reads a target model's hidden states, then answers natural-language queries or emits structured reports about them. We evaluate STATEWITNESS on two target reasoning LLMs across seven deception datasets. STATEWITNESS reaches 0.916 mean AUROC, a relative gain of 11.6% over the best black-box text monitor and 25.0% over the best activation-probe baseline under the same evaluation protocol. When combined with existing monitors, STATEWITNESS reduces missed deceptive examples in simple threshold ensembles. Beyond scalar detection, the decoder returns query-level answers, schema reports, and token- or sentence-level evidence traces for human inspection. We view this interface as a potential building block for broader interpretability and alignment tools.

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

BSViT: A Burst Spiking Vision Transformer for Expressive and Efficient Visual Representation Learning

Spiking Vision Transformers (S-ViTs) offer a promising framework for energy-efficient visual learning. However, existing designs remain limited by two fundamental issues: the restricted information capacity of binary spike coding and the dense token interactions introduced by global self-attention. To address these challenges, this work proposes BSViT, a burst spiking-driven Vision Transformer featuring a Dual-Channel Burst Spiking Self-Attention (DBSSA) mechanism. DBSSA encodes queries with binary spikes and keys with burst spikes to enhance representational capacity. The value pathway adopts dual excitatory and inhibitory binary channels, enabling signed modulation and richer spike interactions. Importantly, the entire attention operation preserves addition-only computation, ensuring compatibility with energy-efficient neuromorphic hardware. To further reduce spike activity and incorporate spatial priors, a patch adjacency masking strategy is introduced to restrict attention to local neighborhoods, resulting in structure-aware sparsity and reduced computational overhead. In addition, burst spike coding is systematically integrated across the network to increase spike-level representational capacity beyond conventional binary spiking. Extensive experiments on both static and event-based vision benchmarks demonstrate that BSViT consistently outperforms existing spiking Transformers in accuracy while maintaining competitive energy efficiency.

09.
arXiv (CS.AI) 2026-06-24

Themis: An explainable AI-enabled framework for Reinforcement Learning with Human Feedback

arXiv:2606.24622v1 Announce Type: new Abstract: Training safe Reinforcement Learning (RL) systems is inherently challenging, with no guarantee of avoiding unwanted behaviors. The most effective defenses against this are (i) transparency through explainability and (ii) alignment via human feedback. While both show promising results, no publicly available framework currently combines them. To address this, we introduce Themis, an XAI-enabled testing and evaluation framework for Reinforcement Learning from Human Feedback. Themis supports over 200 widely used environments and is easily configurable for experiments in RL, transparency, and alignment. Our results show that Themis can train reward models that match or outperform the environment's true reward signal using human preferences. We also provide a cloud-based platform for collecting human feedback and managing experiments. It is user-friendly, auto-scalable, and supports large participant groups across multiple experiments without extra development overhead. Tests show Themis can support one thousand users in back-to-back experiments on a modest commercial machine.

10.
arXiv (CS.AI) 2026-06-24

Red-Teaming the Agentic Red-Team

arXiv:2606.24496v1 Announce Type: cross Abstract: The use of agentic systems to perform offensive security operations has moved from a theoretical possibility to a commoditized capability. However, while the community has focused on creating more and more capable agents, less attention has been allocated to assessing the security of those systems. In this work, we present the first in-depth security analysis of the most widely used agentic systems for offensive security operations. We show that most of these tools share common design flaws that enable an active adversary to exfiltrate API keys, establish persistent footholds, and fully compromise the operator's machine, even when the agent operates inside a sandboxed container. To support our analysis, we introduce a full cyber kill chain for such agentic systems, capturing the progression from initial LLM manipulation to lateral movement, persistence, guardrail bypass, and sandbox escape. Building on our security analysis, we derive a robust architecture for agentic offensive-security tools and propose actionable, broadly applicable design principles that mitigate the disclosed attack paths at the architectural level.

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

RaBiT: Residual-Aware Binarization Training for Accurate and Efficient LLMs

arXiv:2602.05367v3 Announce Type: replace Abstract: Efficient deployment of large language models (LLMs) requires extreme quantization, forcing a critical trade-off between low-bit efficiency and performance. Residual binarization enables hardware-friendly, matmul-free inference by stacking binary ($\pm$1) layers, but is plagued by pathological feature co-adaptation. We identify a key failure mode, which we term inter-path adaptation: during quantization-aware training (QAT), parallel residual binary paths learn redundant features, degrading the error-compensation structure and limiting the expressive capacity of the model. While prior work relies on heuristic workarounds (e.g., path freezing) that constrain the solution space, we propose RaBiT, a novel quantization framework that resolves co-adaptation by algorithmically enforcing a residual hierarchy. Its core mechanism sequentially derives each binary path from a single shared full-precision weight, which ensures that every path corrects the error of the preceding one. This process is stabilized by a robust initialization that prioritizes functional preservation over mere weight approximation. RaBiT redefines the 2-bit accuracy-efficiency frontier: it achieves state-of-the-art performance, rivals even hardware-intensive Vector Quantization (VQ) methods, and delivers a $4.49\times$ inference speed-up over full-precision models on an RTX 4090. Code is available at https://github.com/SamsungLabs/RaBiT.

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

Augmenting Dysarthric Speech Severity Assessment with MOS Supervision

arXiv:2606.18645v1 Announce Type: cross Abstract: Dysarthria is a speech disorder marked by reduced intelligibility and communicative effectiveness. Automatic utterance-level assessment of dysarthric speech can support scalable speech monitoring and therapy-related analysis. Yet training such systems is bottlenecked by the scarcity of clinically annotated dysarthric speech. This work proposes to augment dysarthric speech assessment using data from speech synthesis evaluations, specifically human-annotated utterances with Mean Opinion Score (MOS) labels from the QualiSpeech corpus. Experiments show that fine-tuning on speech synthesis assessment data consistently improves performance on both intelligibility and naturalness prediction, while joint training yields gains primarily on naturalness. These results suggest that synthesis artifacts and dysarthric speech share perceptual commonalities, and speech synthesis evaluation corpora offer a practical augmentation source that reduces reliance on scarce clinical annotations.

13.
arXiv (CS.CV) 2026-06-25

1000 Rallies: An Event-Camera Dataset and Real-Time Learned Ball-State Estimation for Robotic Table Tennis

Robotic table tennis has emerged as a compelling benchmark for real-time robotic perception due to its fast ball dynamics and stringent timing requirements. Accurate, high-frequency, and low-latency ball state estimation is critical for reliable trajectory prediction and timely control. Traditional frame-based cameras face an inherent trade-off: low frame rates leave temporal blind spots that miss fast-moving objects and high frame rates raise data and computational cost. Event cameras instead offer microsecond temporal resolution and, under sufficient illumination, remain largely free of motion blur even at high ball speeds. However, the community lacks large-scale datasets to develop and benchmark event-based perception in realistic sports scenarios. We address this gap by introducing the first large-scale event-camera dataset for table tennis, comprising over 1000 rallies from a diverse group of players ranging from amateurs to elite-level athletes. Each recording captures the event stream alongside 14 synchronized high-speed frame-based cameras at 200 FPS, which we use to produce 1 kHz pseudo ground-truth labels for ball position, velocity, and spin. Building on this dataset, we train a convolutional neural network robust to background player motion that jointly estimates the ball's position and velocity in the image-plane from events. Treating the predicted velocity as an additional measurement in the Kalman filter reduces bounce-point prediction error by 36% relative to a position-only baseline. Finally, we close the perception-action loop by integrating the event-based system with a Stäubli robotic arm, enabling the first real-time human-robot table tennis rallies driven by event-based perception.

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

A Large-Scale Multi-Dimensional Empirical Study of LLMs for Conversation Summarization

Despite the significant advancement of LLMs in conversation summarization, their evaluation remains limited by insufficient scenarios, input lengths, and sample sizes. Furthermore, existing benchmarks often omit frontier reasoning systems and efficient small models, or lack fine-grained, multi-dimensional assessments. To bridge these gaps, we propose OmniCSEval, a unified benchmark comprising 1,800 diverse conversations across six real-world scenarios, featuring context lengths ranging from 128 to 32k tokens. For fine-grained evaluation, we employ a bidirectional fact-checking framework that integrates key fact matching to assess completeness and conciseness, alongside summary fact verification to evaluate faithfulness. To ensure reliable assessment, we establish a human-LLM collaborative pipeline for key fact extraction and a multi-LLM consensus verifier for summary fact decomposition. Leveraging this framework, we evaluate 28 LLMs across four distinct categories grouped by reasoning capability and model scale. Our extensive empirical study reveals critical insights regarding the cross-scenario challenges current LLMs continue to face, the impacts of reasoning and scale, and the efficiency and adaptability of reasoning models. We also provide guidance for system selection in real-world deployments.

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

Quantile Transfer for Reliable Operating Point Selection in Visual Place Recognition

Visual Place Recognition (VPR) is a key component for localisation in Global Navigation Satellite System (GNSS)-denied environments, but its performance critically depends on selecting an image matching threshold (operating point) that balances precision and recall. Thresholds are typically hand-tuned offline for a specific environment and fixed during deployment, leading to degraded performance under environmental change. We propose a method that automatically selects the operating point of a VPR system to maximise recall at 100% precision. The method uses a small calibration traversal with known correspondences and transfers thresholds to deployment via quantile normalisation of similarity score distributions. This quantile transfer ensures that thresholds remain stable across calibration sizes and query subsets. Experiments with seven state-of-the-art VPR techniques across five benchmark datasets demonstrate that our proposed approach consistently outperforms existing baselines, enabling the underlying VPR technique to operate at 100% precision in approximately twice as many deployment scenarios (median improvement), while retrieving up to 29% more correct matches at that precision. The method eliminates manual tuning by adapting to new environments and generalising across operating conditions. Our code is available at https://github.com/DhyeyR-007/Quantile-Transfer-for-Reliable-VPR.

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

Plug-and-Adapt: Multimodal Coreference Resolution at First Sight with a Pretrained Alignment Model

Visual information helps resolve ambiguity in coreference resolution, leading to notable performance gains. However, existing Multi-modal Coreference Resolution (MCR) methods require training with (partially) annotated data from the target dataset before they can be applied, preventing their direct usability and raising concerns about generalization. While Vision-Language Large Models (VLLMs) with billions of parameters offer promising zero-shot capabilities, they remain largely inaccessible. Their massive size limits deployability, and many are only accessible through paid APIs. In this paper, we propose a plug-and-adapt method that strategically adapts a carefully pre-trained alignment model for immediate use in MCR tasks, designed to eliminate the need for training on scarce benchmark datasets or relying on resource-intensive VLLMs. Specifically, we first pre-train a fine-grained alignment model between textual and visual contextual information using vision-language alignment datasets. We then repurpose the alignment model to MCR through similarity aggregation by fusing visual and categorical cues with evidence theory, thereby enhancing effectiveness. Experiments on the Coreference Image Narratives (CIN) benchmark dataset demonstrate the effectiveness of our method, achieving a 5.31\% and 2.12\% improvement in CoNLL F1 over SOTA dedicated methods and popular VLLMs, respectively. We further evaluate our method on a masked CIN dataset for robustness testing and on a specially constructed VCR-MCR dataset for generalization assessment, with results confirming both capabilities.

17.
arXiv (CS.AI) 2026-06-24

E-MRL: Cross-view Aligned Evidence-driven Multimodal Reinforcement Learning for Reliable 3D Tumor Analysis

arXiv:2606.23888v1 Announce Type: cross Abstract: While Vision-Language Models (VLMs) show great promise in volumetric medical report generation, they frequently suffer from visual hallucinations and a lack of grounding in 3D CT data. Current Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL) strategies typically optimize text fidelity alone, essentially rewarding correct diagnoses derived from language priors rather than genuine visual perception. To address this, we propose cross-view aligned Evidence-driven Multimodal Reinforcement Learning (Evidence-MRL, noted as E-MRL), a reliable RL reasoning framework that formulates the generation process as a Markov Decision Process of "diagnosis-localization-verification". Unlike standard approaches, our model is explicitly trained to identify a "key evidence slice" alongside the global diagnostic report, grounding its findings in verifiable visual evidence. Crucially, we introduce a novel cross-view consistency reward, which validates the semantic alignment between the golden-standard report and a local visual re-query of the selected key slice, providing additional rewards for correctly-localized reasoning. Experiments on large-scale 3D CT tumor datasets demonstrate that E-MRL significantly reduces hallucinations and improves diagnostic accuracy compared to SFT and RL baselines, offering a clinically interpretable solution for visually-grounded and tumor analysis.

18.
arXiv (CS.LG) 2026-06-25

DFMU: Data-Frugal Machine Unlearning

arXiv:2606.25410v1 Announce Type: new Abstract: Machine unlearning is an emerging domain that ensures the safe removal of elements (includes concepts, attributes, entity and class) from the trained model along with least drop in model performance. The domain of machine unlearning brings its own indigenous challenges since the removal of pre-trained elements from model will always degrade the model performance on remaining elements. The existing methods basically rely on retraining for removal of elements from the pre-trained model, which is compute extensive. In this work, we propose a machine unlearning method which helps to reduce the computational requirement for faster retain-dataset accuracy convergence which also does not require extensive retraining of the pre-trained model. The proposed method, Data-Frugal Machine Unlearning (DFMU) requires only a single forward and backward pass for computing the importance score of various computational blocks of a model. The importance score computation is based on knowledge preserving pruning which helps to converge faster and requires far less data as compared to the existing methods. Experimentally, it achieves 40% more retain-accuracy with just 13% of data samples in comparison with SOTA method on various public datasets and also averages 88% faster processing time for forgetting a given class.

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

TouchThinker: Scaling Tactile Commonsense Reasoning to the Open World with Large-scale Data and Action-aware Representation

arXiv:2606.11637v1 Announce Type: new Abstract: Touch is a key modality for embodied agents to understand the physical world. Although recent work has incorporated tactile signals into language systems for tactile commonsense reasoning, scaling such systems to realistic open-world settings remains challenging due to two key bottlenecks: (1) current tactile reasoning datasets remain limited in format and scale, providing insufficient supervision for reasoning from tactile observations to physical commonsense and hindering the learning of transferable tactile commonsense; (2) Tactile signals are inherently redundant and action-specific, yet existing methods often overlook these properties, resulting in inefficient representations with limited semantic expressiveness. To address these limitations, we propose TouchThinker, a tactile-language framework that scales tactile commonsense reasoning to the open world from both data and representation perspectives. First, we construct TouchThinker-1M, a million-scale, multi-source tactile reasoning dataset covering 415 objects, 8 scenarios, and 7 sensor types, providing a solid data foundation for open-world generalization. We further introduce TouchThinker-Bench, an open-world benchmark with more realistic and diverse tasks. Then, we propose action-aware modeling mechanism to improve tactile representation efficiency and enable efficient reasoning. Experimental results demonstrate that TouchThinker achieves competitive performance against state-of-the-art models across multiple datasets. Our code and dataset will be made available at: https://github.com/lvkailin0118/TouchThinker.

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

SANA: What Matters for QA Agents over Massive Data Lakes?

Exploratory question answering (EQA) over data lakes requires an LLM agent to discover relevant sources, analyze retrieved data, and adapt its actions based on intermediate results. End-to-end accuracy alone cannot distinguish failures in search, planning, data analysis, or the agent's Action Policy: its decisions about what to do next and when to submit an answer. We present SANA (Search Agent Navigation Ablation framework), a diagnostic ablation framework that transforms EQA tasks into runtime profiles containing gold source sequence, sanitized subquestions, and execution records. SANA uses these profiles to construct idealized search, planning, and data-analysis tools, allowing each component to be ablated; the residual gap is diagnostic evidence for policy failures. To illustrate SANA as a reusable evaluation framework, we adapted two recent EQA benchmarks, LakeQA and KramaBench, and evaluated lightweight and mid-sized agents under fixed prompts, budgets, data lakes, and runtimes. Across both benchmarks, data analysis is a consistent bottleneck while planning is less so. Search is a major limitation in LakeQA's large data-lake setting, but less so for the smaller-scale KramaBench. SANA thus deconstructs end-to-end task accuracies into a diagnosis of where data-lake agents fail, and allows for systematic comparisons of progress in search, planning, data analysis, and agent design.

23.
medRxiv (Medicine) 2026-06-15

Unveiling the Awareness of Private Health Insurance Coverage among Healthcare Professionals in Freetown, Sierra Leone: Insights Extracted from Their Perspectives.

Our study is an assessment of the knowledge, personal coverage, and related determinants of private health insurance as revealed by healthcare professionals in Freetown, the urban capital of Sierra Leone. This study stands as a precursor for Low- and Middle-Income Countries (LMICs), like Sierra Leone, seeking to establish Universal Health Coverage (UHC) to provide healthcare access and coverage through publicly arranged risk pooling, designed to help protect against unmanageable medical costs. In parallel, such countries face significant challenges with achieving sustainable universal coverage due to limited public resources, inefficient allocation systems, uneasy reliance on out-of-pocket payments, and large struggling populations. Our research sheds particular light on how healthcare professionals view their own participation with private healthcare options. A cross-sectional, analytical study was conducted, openly recruiting individuals from various facilities in Freetown. Using the Yamane Formula, a sample size of 109 participants was calculated. STATA 14.0 was used for data analysis. Our findings revealed that 96 (88.9%) participants did not have private health insurance, while 12 (11.1%) did have private coverage. However, 105 (97.2%) reported other modes of health insurance, with only 3 (2.8%) uninsured. Notably, 97.2% expressed willingness to join a private health insurance scheme. Our study found no statistically significant associations between selected indicators (demographic or socioeconomic fac tors) and current insurance coverage among study participants. These results highlight a low prevalence and understanding of private health insurance among healthcare professionals in a representative urban center in Sub-Saharan Africa (SSA), while acknowledging high willingness to enroll. The lack of any significant determinants suggests other unexamined factors, such as cost, accessibility, or awareness, capable of influencing the adoption and implementation of a universal health program.

24.
medRxiv (Medicine) 2026-06-15

Comparative Analysis of Machine Learning Models vs. Traditional Clinical Calculators for Cardiovascular Risk Prediction

Background: Cardiovascular diseases (CVD) remain the leading global cause of mortality, responsible for approximately 31% of all deaths worldwide in 2021. Traditional risk calculators, including Framingham, ASCVD, SCORE, and SCORE2, have long constituted the cornerstone of primary prevention strategies; however, they were derived predominantly from high-income European and North American populations, thereby limiting their predictive accuracy in diverse epidemiological contexts, particularly among Hispanic/Latino communities. Machine learning (ML) offers an alternative to capture the non-linear interactions inherent in biomedical data. Objective: The present study develops and validates ML-based models for cardiovascular mortality prediction using the National Health and Nutrition Examination Survey (NHANES) 1999-2018 dataset, and systematically compares their discriminative performance against eleven conventional clinical CVD risk calculators. Materials and Methods: A dedicated software platform, "CardioPrediQ," was designed to integrate multiple CVD calculators with ML-based risk assessment. A cohort of 12,847 participants with 16 predictor variables was derived from NHANES. Six algorithms (Logistic Regression, Cox Proportional Hazards, Gradient Boosting, AdaBoost, Random Forest, and Extra Trees) were trained in combination with six class-balancing strategies, yielding 36 model configurations. All models were trained on a stratified 70/30 split and calibrated using the Saerens prior probability adjustment method. Performance was evaluated using AUC-ROC, sensitivity, specificity, F1-score, and a weighted composite score. DeLong's test was employed to assess the statistical significance of AUC differences between the best-performing ML model and each conventional calculator. Results: Gradient Boosting with 2:1 oversampling and Saerens calibration achieved the best overall performance (AUC = 0.8934; composite score = 0.7904), outperforming all traditional calculators in composite ranking. The top six positions were occupied exclusively by ML and statistical models. The mean age of cardiovascular decedents was 67.43 years compared with 47.74 years among survivors. DeLong's test confirmed statistical superiority over six traditional CVD calculators (p < 0.05), whereas the difference against the top-performing calculators (ASCVD, HEARTS Caribbean, ASCVD Colombia, SCORE2, HEARTS North America) did not reach statistical significance. Age dominated feature importance at 41.2% relative weight, followed by systolic blood pressure (18.7%). Saerens calibration reduced the Brier score from 0.1286 to 0.1158, substantially improving probability calibration. Conclusions: ML models demonstrated superior composite performance over traditional calculators. The statistical equivalence with the highest-performing conventional calculators in the NHANES cohort is context-dependent and validates the methodological pipeline. The CardioPrediQ platform addresses the critical need for integrated, scalable CVD risk assessment tools, which is particularly relevant for Latin American populations where calculator validation remains limited. These findings support the integration of calibrated ML-based risk prediction into clinical practice while underscoring the importance of probability calibration for informed clinical decision-making.

25.
medRxiv (Medicine) 2026-06-22

Development and validation of a risk prediction algorithm to estimate all-cause mortality among community-dwelling Canadians: the Mortality Population Risk Tool (MPoRT)

BACKGROUND: The risk of all-cause mortality can inform decision-making for chronic disease prevention. We developed a predictive algorithm to estimate the 5-year risk of death among community-dwelling adults. METHODS: We derived and validated the Mortality Population Risk Tool (MPoRT) using data from population health surveys in Canada (the Canadian Community Health Survey) and the United States (the National Health Interview Survey), survey years 2001 to 2011, linked to vital statistics. The outcome was death within five years of the survey response. The algorithm was developed using data from Ontario respondents using a Cox proportional hazards model, then modified and re-estimated to allow cross-national assessment in Canada and the United States. Twenty-three prespecified predictors were assessed: seven sociodemographic, six behavioural, and ten general health and chronic disease. RESULTS: 527,369 respondents aged 20 to 105 years were included in the Canadian and United States development and validation cohorts, with 43,758 deaths during 3.68 million person-years follow-up. The final sex-specific MPoRT algorithms each contained 21 variables, showing strong discrimination (C-statistic: females 0.874 [0.871–0.877]; males 0.867 [0.865–0.871]) and good calibration overall and in 246 of 247 subgroups. Discrimination was modestly attenuated (0.01 decrease in C-statistic) in cross-national validation between Canada and the United States, with good calibration across all 71 subgroups. INTERPRETATION: MPoRT accurately discriminated all-cause mortality using only self-reported data, enabling broad application without clinical measures. While validation outside North America is needed to confirm broader applicability, MPoRT is designed for straightforward recalibration using routinely available national mortality data. This supports targeted chronic disease prevention strategies at both the population and individual levels, though the limitations inherent to self-reported predictors should be considered when interpreting predictions.