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01.
arXiv (CS.AI) 2026-06-16

Revisiting Chebyshev Polynomial and Anisotropic RBF Models for Tabular Regression

arXiv:2602.22422v2 Announce Type: replace-cross Abstract: Smooth-basis models such as Chebyshev polynomial regressors and radial basis function (RBF) networks are well established in numerical analysis. Their continuously differentiable prediction surfaces suit surrogate optimisation, sensitivity analysis, and other settings where the response varies gradually with inputs. Despite these properties, smooth models seldom appear in tabular regression, where tree ensembles dominate. We ask whether they can compete, benchmarking models across 55 regression datasets organised by application domain. We develop an anisotropic RBF network with data-driven centre placement and gradient-based width optimisation, a ridge-regularised Chebyshev polynomial regressor, and a smooth-tree hybrid (Chebyshev model tree); all three are released as scikit-learn-compatible packages. We benchmark these against tree ensembles, a pre-trained transformer, and standard baselines, evaluating accuracy alongside generalisation behaviour. The transformer ranks first on accuracy across a majority of datasets, but its GPU dependence, inference latency, and dataset-size limits constrain deployment in the CPU-based settings common across applied science and industry. Among CPU-viable models, smooth models and tree ensembles are statistically tied on accuracy, but the former tend to exhibit tighter generalisation gaps. We recommend routinely including smooth-basis models in the candidate pool, particularly when downstream use benefits from tighter generalisation and gradually varying predictions.

02.
arXiv (CS.AI) 2026-06-15

STaR-DRO: Stateful Tsallis Reweighting for Group-Robust Structured Prediction

arXiv:2604.09737v2 Announce Type: replace-cross Abstract: Structured prediction with large language models requires outputs that are label-accurate, ontology-constrained, structurally valid, and evidence-grounded under label imbalance and heterogeneous group difficulty. We present a unified framework for ontology-constrained generation. First, we introduce a modular prompt-engineering architecture combining XML-style structure, expert disambiguation rules, chain-of-thought reasoning, metadata-aware decision logic, schema contracts, and a self-validation gate. It targets recurrent in-context failures, including format drift, label ambiguity, evidence hallucination, and metadata-conditioned confusion. Second, we propose STaR-DRO, combining Tsallis mirror ascent, sparse entmax-style primal mapback, EMA-smoothed group-loss tracking, rescaled ascent signals, and bounded excess-only multipliers. Unlike conventional DRO, which relies on dense Shannon-entropy exponentiated-gradient updates, can introduce high-variance stochastic reweighting, assigns positive adversarial mass to groups that are not persistently hard, and incurs costs through simplex competition, STaR-DRO upweights only persistently hard groups without suppressing easier ones. We evaluate the framework on EPPC Miner, a clinically grounded high-stakes structured-prediction task requiring hierarchical label prediction and evidence-span extraction from patient-provider secure messages. Across 1B-70B Llama models, prompt engineering improves zero-shot extraction, yielding an average label F1 gain of +14.46 and a Span F1 gain of +17.40. Building on supervised fine-tuning, STaR-DRO further improves accuracy and robustness, increasing average label F1 by +1.08 and +2.20 while reducing mean groupwise validation cross-entropy by 21.3% and 14.8% relative to SFT and standard DRO, respectively. These results advance reliable automated communication mining for patient-centered clinical care analysis.

03.
medRxiv (Medicine) 2026-06-11

Maternal deaths associated factors in the Conflict-Affected North West Region of Cameroon. Lessons from a cross-sectional survey

Background Maternal mortality is a significant global public health crisis, particularly in sub-Saharan Africa and conflict-affected regions. Cameroon's maternal mortality ratio is high at 406 deaths per 100,000 live births, while the ongoing Anglophone conflict has further exacerbated maternal healthcare delivery in the North West Region (NWR){middle dot} Despite the evidence-based interventions like partographs, obstetric kits, birth preparedness plans, and active management of the third stage of labour, implementation gaps persist across health facilities. Objective The study aimed to assess factors related to preventable maternal deaths in the NWR of Cameroon by exploring maternal health service usage, implementation of obstetric measures, demand-side challenges, accessibility barriers, and health system weaknesses. Methodology The study employed a quantitative descriptive cross-sectional survey design{middle dot} Data was collected with structured questionnaires from postpartum women and healthcare workers in selected health facilities and catchment communities in the NWR{middle dot} Also, a multistage sampling technique was adopted, and Cochran's formula generated a sample size of 109 respondents{middle dot} In addition, data were analysed using SPSS version 27 and Stata version 18, employing descriptive and inferential statistics. Results In this study, while 70{middle dot}64 percent of females attended at least 4 ANC visits, only 38{middle dot}53 percent met WHO ANC adequacy requirements. Facility delivery was 96{middle dot}33 percent, yet only 38{middle dot}46 percent received completed delivery plans. Conflict-related challenges affected access, with 44{middle dot}95 percent reporting insecurity-associated movement difficulties, while 44{middle dot}95 percent reported increased transportation expenses due to the conflict. Near-miss complications were reported among 27.52 percent of participants. Delivery record reviews indicated that obstetric kits were utilised in 81{middle dot}76 percent of deliveries, partographs were accessible in 86{middle dot}49 percent of records but correctly filled in just 60{middle dot}81 percent , while oxytocin administration was 95{middle dot}95 percent. Integrated Health Centres showed poorer adherence with intrapartum interventions compared with District and Regional Hospitals (p

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

EmoFSM: A Finite State Machine for Emotional Support Conversation

Emotional support conversation (ESC) aims to alleviate people's emotional distress through effective conversations. Although large language models (LLMs) have made remarkable progress in ESC, most of these studies may not define the diagram from a state-model perspective, thereby providing a suboptimal solution for long-term satisfaction. To address such an issue, we leverage the Finite State Machine (FSM) on LLMs, and propose a framework called EmoFSM. Our framework allows a single LLM to bootstrap the planning during ESC, and self-reason the seeker's emotion, support strategy, and the final response upon each conversation turn. Substantial experiments in ESC datasets suggest that EmoFSM outperforms many baselines, including direct inference, self-fine, chain of thought, finetuning, and externally supported methods, even those with many more parameters.

05.
arXiv (CS.AI) 2026-06-18

Self-Evolving Multi-Agent Systems via Textual Backpropagation

arXiv:2506.09046v3 Announce Type: replace-cross Abstract: Leveraging multiple Large Language Models (LLMs) has proven effective for addressing complex, high-dimensional tasks, but current approaches often rely on static, manually engineered multi-agent configurations. To overcome these constraints, we present the Agentic Neural Network (ANN), a framework that conceptualizes multi-agent collaboration as a layered neural network architecture. In this design, each agent operates as a node, and each layer forms a cooperative team focused on a specific subtask. Our framework follows a two-phase optimization strategy: (1) Forward Phase - Drawing inspiration from neural network forward passes, tasks are dynamically decomposed into subtasks, and cooperative agent teams with suitable aggregation methods are constructed layer by layer. (2) Backward Phase - Mirroring backpropagation, we refine both global and local collaboration through iterative feedback, allowing agents to self-evolve their roles, prompts, and coordination. This neuro-symbolic approach enables our framework to create new or specialized agent teams post-training, delivering notable gains in accuracy and adaptability. Across seven benchmark datasets, our work surpasses leading multi-agent baselines under the same configurations, showing consistent performance improvements.

06.
medRxiv (Medicine) 2026-06-22

Assessment of adaptive functioning in Angelman syndrome using the Vineland Adaptive Behavior Scales, Third Edition

Purpose: This study examined longitudinal trajectories of adaptive functioning in 331 individuals with Angelman syndrome (AS) using the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) and examined differences by molecular subtype. Methods: A total of 331 individuals (156 females, 47%) with genetically confirmed AS (ages 6 months to 52 years) were assessed between 2018 and 2025, including 207 with a deletion subtype, 63 with uniparental disomy or imprinting defect, and 61 with a UBE3A point mutation. Growth scale values were analyzed using linear mixed-effects models with log2-transformed age. Results: Individuals with deletion subtypes demonstrated significantly lower adaptive functioning across domains compared to those with non-deletion subtypes. Adaptive skills across all Vineland-3 subdomains increased nonlinearly with age, showing faster growth early in life that slowed over time, with largely parallel trajectories across subtypes. Conclusion: Individuals with AS demonstrate slow but steady growth in adaptive functioning that continues into adulthood, with progress varying by molecular subtype. These findings provide updated natural history benchmarks and demonstrate the utility of the Vineland-3 for clinical trials.

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

AIChilles: Automatically Uncovering Hidden Weaknesses in AI-Evolved Systems

arXiv:2606.15834v1 Announce Type: new Abstract: The computer systems community has recently seen growing interest in AI-driven system evolution, where AI agents iteratively rewrite systems. Frameworks such as AdaEvolve and Engram report 12-60% score improvements over human-designed algorithms. While these results are promising, there are practical concerns if these AI-evolved programs can perform worse on unseen workloads and exhibit scalability regressions. Given the speed and scale of AI-generated code, we need automated mechanisms to uncover such identify hidden weaknesses in AI-evolved systems programs. To this end, we develop AIChilles that takes as input a baseline program $P$ and an AI-evolved program $P'$, AIChilles searches for valid workloads where $P'$ regresses relative to $P$ in correctness, runtime, memory usage, or output quality. To tackle the diversity in system applications, weakness types and potential bugs, AIChilles combines deterministic workload-parameter extraction, agent-based constraint inference, differential oracles, and code-frequency coverage to discover diverse failures. Across five system applications and 30 AI-evolved programs, AIChilles finds 49 distinct hidden weaknesses. We also show that explicitly including AIChilles in the AI-driven development lifecycle can mitigate several of these weaknesses.

08.
arXiv (CS.AI) 2026-06-15

Hy-Embodied-0.5-VLA: From Vision-Language-Action Models to a Real-World Robot Learning Stack

arXiv:2606.14409v1 Announce Type: cross Abstract: In this report, we present Hy-Embodied-0.5-VLA, abbreviated as HyVLA-0.5, an end-to-end system that spans the full robot learning stack: data collection, model design, continued pre-training and supervised fine-tuning, RL post-training, and real-world deployment. Each component serves a distinct role in this stack.

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

A theoretical model for task routing in mixture-of-expert transformers

arXiv:2606.14398v1 Announce Type: new Abstract: Mixture-of-experts (MoE) layers enable the scaling of transformer models while keeping the inference compute fixed. While task-expert specialization has been observed in empirical studies of frontier MoE transformer models, existing theoretical work analyzes this using continuous mixture models that cannot be used to model natural language effectively. An important open question is to theoretically explain task-expert specialization in transformer MoE models using discrete models of language. To address this, we represent structured knowledge via syntactic templates and finite key-value dictionaries, and prove formally that a single-layer MoE transformer can encode knowledge by using experts that specialize in the corresponding tasks. Our construction shows how queries are routed to unique, task-specific experts whose size depends solely on the intrinsic complexity of the given task (i.e. the combined size of its syntactic templates and factual dictionary). Our construction provides a theoretical support for empirical results on localized knowledge circuits in MoE models. We support our theoretical findings with experiments evaluating model performance under varying MoE loss functions.

10.
arXiv (quant-ph) 2026-06-19

Variational Polaron Theory for Ground States of Strongly Coupled Light-Matter and Electron-Phonon Systems

arXiv:2606.19748v1 Announce Type: cross Abstract: Strong light-matter and electron-phonon coupling generate ground states dressed by virtual bosonic excitations, making bare-state truncations and perturbative treatments unreliable in the ultrastrong-coupling regime. We introduce a nonperturbative variational ground-state framework based on a state-dependent polaron transformation, combined with a product-state ansatz and a second-order perturbative correction for residual matter-boson entanglement. We show that the optimized transformed frame becomes asymptotically decoupled at infinite coupling, because the leading linear coupling is canceled while off-diagonal matter transitions are suppressed by displaced-oscillator overlaps. The approach is asymptotically correct in both weak- and strong-coupling limits and remains accurate in the intermediate regime, where fixed polaron transformations are least reliable. Dicke-model benchmarks reproduce ground-state energies, fidelities, and the superradiant transition, with second-order energy errors below 0.2%. Holstein-model benchmarks yield errors below 0.5% and clarify how translational symmetry affects wave-function quality. This dressed-basis framework enables nonperturbative modeling of strongly coupled light-matter and electron-phonon systems.

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

Lost in a Single Vector: Improving Long-Document Retrieval with Chunk Evidence Aggregation

Dense retrieval ranks one query vector against one document vector. On long documents, this interface can fail when a short but decisive span is weakened during document encoding before ranking. We study this failure mode as document-side early compression and introduce the Evidence Dilution Index (EDI) to measure how far a document-level representation falls below the strongest chunk-level evidence within the same gold document. Guided by this view, we propose DICE (Document Inference via Chunk Evidence), a training-free document-side strategy that splits documents into chunks, encodes them independently with a frozen model, and aggregates them back into a single vector while preserving the standard one-query-one-document interface. On LongEmbed, DICE improves retrieval across four backbones, with the largest gains on slices beyond 4k tokens: for Dream, Passkey >4k rises from 30.0 to 90.0 and Needle >4k from 23.3 to 74.0. Across 12,779 filtered samples, DICE yields lower EDI than the single-vector baseline in 92.8% of cases. These results establish document-level encoding as a practical and underexplored lever for long-document retrieval.

12.
arXiv (CS.CV) 2026-06-15

RATS! Patches Talk Through Registers: Emergent Parts in Register Attention Transformers

When humans see a bird, they recognize far more than just "bird" – they see a head, wings, and talons, a structured assembly of reusable parts that can be identified across every bird they have ever seen. We ask whether a self-supervised visual model can discover the same compositional structure on its own. To this end, we propose RATS (Register Attention Transformers), which decomposes the classification token into N learnable register tokens that route patch information through an L->N->N->L bottleneck via a three-step compress-communicate-broadcast attention. The N registers are partitioned across the H attention heads, so that registers assigned to different heads do not interact with each other. Without auxiliary losses or part annotations, each register spontaneously specializes into a proto-semantic region whose emerging structure resembles object parts. RATS surpasses all baselines by +12 mIoU on average across five segmentation benchmarks, with consistent gains on ADE20K (+1.11 mIoU) and COCO (+0.2 AP^m). Its register dictionary further exhibits part-level consistency and semantic proximity across related categories. Our results suggest that RATS may provide a useful architectural prior for structured and interpretable visual representation learning.

13.
arXiv (CS.CL) 2026-06-12

Polar: A Benchmark for Evaluating Political Bias in LLMs

Political bias in large language models (LLMs) is increasingly significant, but difficult to measure reproducibly across political and linguistic contexts. We introduce Polar, a 4,026-instance multiple-choice benchmark that measures political bias through option-level likelihoods rather than prompt-based generation. Polar covers two ideological axes and eight issue categories derived from the Manifesto Project, and evaluates models in parallel across U.S. and South Korean political contexts. Across 38 LLMs, measured bias varies systematically with political context, issue category, model group, and presentation language. All models lean left-progressive on U.S. political content, but show more centered and mixed patterns on South Korean content. Translation experiments further show that presentation language alone can shift measured bias. These findings highlight the need for multilingual and cross-contextual evaluation of political bias in LLMs.

14.
arXiv (quant-ph) 2026-06-16

Information geometry and entanglement under phase-space deformation through nonsymplectic congruence transformation

arXiv:2505.02269v3 Announce Type: replace Abstract: The Fisher-Rao (FR) information matrix is a central object in multiparameter quantum estimation theory. The geometry of a quantum state can be envisaged through the Riemannian manifold generated by the FR-metric corresponding to the quantum state. Interestingly, any congruence transformation $GL(2n,\mathbb{R})$ in phase space leaves the FR-distance for Gaussian states invariant. In the present paper, we investigate whether this isometry affects the entanglement in the bipartite system. It turns out that the entanglement-generating congruent transformation depends upon the system and background space. To make our study relevant to physical systems, we choose Bopp's shift in phase space as an example of $GL(2n,\mathbb{R})$, so that the results can be interpreted in terms of noncommutative (NC) phase-space deformation. We provide an estimation of the measure of entangled states over separable states for bipartite Gaussian states under a Bopp's shift. Since the dynamics of free oscillators in background NC-space is mathematically equivalent to the dynamics of a charged particle under a homogeneous magnetic field, we provide an outline for a gedankenexperiment through photocurrent measurement in order to determine the effects of congruent transformation on the distinguishibility of Gaussian states.

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

Beyond Domains: Reusing Web Skills via Transferable Interaction Patterns

Large language model (LLM) web agents are usually deployed as tool callers: each turn, the model reads a fresh page observation and emits one structured tool action. When every action is a low-level primitive, horizons grow quickly and so do policy-facing LLM completions, dominating latency and cost on benchmarks such as Mind2Web and WebArena. Recent systems therefore wrap repeated interaction fragments as web skills: callable tools built from successful trajectories or induced programs, so one call can replace several primitives. However, prior skill libraries are still triggered mainly by instruction similarity or coarse site metadata, which yields low skill reuse on held-out sites and leaves much of the potential step and token reduction on the table. We present SkillMigrator, an agent that learns reusable web skills and transfers them across sites by matching layout structure rather than specific element references. Each induced skill is stored as a transferable interaction pattern (TIP): the skill paired with a structural sketch of the snapshot at induction time. At test time, SkillMigrator retrieves TIPs by layout similarity and grounds their references on the live page. The rest of the stack is standard: accessibility-snapshot observations with stable references, and fixed tool calling over primitives plus skill invocations. Compared with the state-of-the-art approaches, SkillMigrator reduces the average LLM-action count on successful trajectories by 8-10% across both WebArena and Mind2Web at matched success rate.

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

Sycophancy as Material Failure under Pushback Loading: A Multi-Axis Characterization Across Three Loading Cases and up to Seventeen Material Charges

Sycophancy in LLMs is documented across 70+ papers, but expert agreement on construct boundaries remains low (ICC=.184; Ye et al., 2026). The construct fragments because behavioral classification depends on which surface form is privileged. We adopt a materials-science framing: conversation as test specimen under load, LLM-model as material charge, pushback as progressive load, stance-flip as material failure. We characterize this failure across three loading cases (debate n=1000; false-presuppositions n=3400; ethical-setting n=3400; 10-17 material charges per case; 7800 specimens total) using 14 turn-level axis-measurements spanning velocity, damage accumulation, frame-drift, brittleness, and direction stability, plus three speaker-resolved axes from an independent pipeline. The measurements are Hooke-coupled ($\sigma = E \cdot \varepsilon$ analog) and reproduce across loading cases with effects up to $|r_{rb}| = 0.35$ on debate; the sign structure adds a second pattern: the ethical-setting case inverts the velocity and accumulation blocks. Variance composition partitions into two profiles: debate is charge-dominated (brittle-fracture-like: the material grade decides), false-presuppositions and ethical-setting are topic-dominated (creep-like: the load decides); the ratios (2.03 vs 0.13/0.17) are estimator-dependent, for debate even in direction. Cross-judge reliability (GPT-4o vs Haiku 4.5) shows debate scoring is judge-robust (Cohen's $\kappa = 0.88$) while false-presupposition scoring is judge-sensitive ($\kappa = 0.36$) – a caveat single-judge benchmarks must report. This is the methodological move Ye et al.'s diagnosis calls for: a multi-axis characterization that does not depend on which surface form of the construct one privileges.

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

FedSPC: Shared Parameter Correction for Personalized Federated Learning

arXiv:2606.13748v1 Announce Type: new Abstract: Personalized federated learning (PFL) is one of the important approaches in federated learning for addressing statistical heterogeneity while enabling client-specific adaptation. Many PFL methods split the model into shared and personalized parameters, which are jointly trained on each client. However, this creates an optimization issue: shared parameters are updated by clients optimizing different local objectives, which can lead to inconsistent shared updates and weaken the shared representation. To address this problem, we propose Federated Shared Parameter Correction (FedSPC), a modular correction method for PFL. FedSPC applies control-variate correction only to the shared parameters of a given PFL method, while leaving personalized parameters unchanged. It can be integrated into three common PFL settings: shared feature extractors, shared classifiers, and fully shared models with local regularization. Experiments on CIFAR-100 and Tiny-ImageNet with ViT, ResNet-34, and VGG-11 show that FedSPC improves performance across representative PFL methods, including FedPer, FedRep, FedBABU, LG-FedAvg, and Ditto.

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

LUCID: Learning Embodiment-Agnostic Intent Models from Unstructured Human Videos for Scalable Dexterous Robot Skill Acquisition

arXiv:2606.11628v1 Announce Type: cross Abstract: The most widely-adopted robot learning pipelines today learn skills from robot demonstrations or structured human data, which are expensive to collect and tied to specific embodiments. In contrast, unstructured human videos provide a scalable alternative. They contain diverse manipulation demonstrations across objects, scenes, and strategies, but are not directly connected to robot action. We propose LUCID, a two-stage framework that learns task intent from unstructured human videos drawn from internet-scale datasets and learns robot control in massively-parallel simulation. The intent model predicts short-horizon intent (what should happen next in the scene) from the current observation in closed loop. An embodiment-specific sensorimotor policy converts this intent into robot actions. The intent interface is shared across controllers, so the same intent model can be applied to different embodiments, from our primary dexterous hand to a parallel-jaw gripper. We evaluate LUCID on five real-world manipulation tasks: stirring, wiping, and binning supervised by only internet video, with zero-shot transfer to novel scenes and object instances; and push-T and cable routing supervised by 1 hr each of self-collected smartphone video. Project page: https://lucid-robot.github.io/.

20.
arXiv (CS.CV) 2026-06-11

FronTalk: Benchmarking Front-End Development as Conversational Code Generation with Multi-Modal Feedback

We present FronTalk, a benchmark for front-end code generation that pioneers the study of a unique interaction dynamic: conversational code generation with multi-modal feedback. In front-end development, visual artifacts such as sketches, mockups and annotated creenshots are essential for conveying design intent, yet their role in multi-turn code generation remains largely unexplored. To address this gap, we focus on the front-end development task and curate FronTalk, a collection of 100 multi-turn dialogues derived from real-world websites across diverse domains such as news, finance, and art. Each turn features both a textual instruction and an equivalent visual instruction, each representing the same user intent. To comprehensively evaluate model performance, we propose a novel agent-based evaluation framework leveraging a web agent to simulate users and explore the website, and thus measuring both functional correctness and user experience. Evaluation of 20 models reveals two key challenges that are under-explored systematically in the literature: (1) a significant forgetting issue where models overwrite previously implemented features, resulting in task failures, and (2) a persistent challenge in interpreting visual feedback, especially for open-source vision-language models (VLMs). We propose a strong baseline to tackle the forgetting issue with AceCoder, a method that critiques the implementation of every past instruction using an autonomous web agent. This approach significantly reduces forgetting to nearly zero and improves the performance by up to 9.3% (56.0% to 65.3%). Overall, we aim to provide a solid foundation for future research in front-end development and the general interaction dynamics of multi-turn, multi-modal code generation. Code and data are released at https://github.com/shirley-wu/frontalk

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

BALTO: Balanced Token-Level Policy Optimization for Hallucination Mitigation

Hallucinations remain a major obstacle to deploying large language models (LLMs) in knowledge-intensive settings, where generated responses must be faithfully grounded in provided evidence. Reinforcement learning (RL) is a promising direction for hallucination mitigation, but response-level faithfulness rewards suffer from a granularity mismatch: localized hallucinations can cause supported content to receive spurious penalties. Although recent work introduces fine-grained feedback such as claim-level verification and token-level rewards, unbalanced credit assignment can still induce length, verbosity, or optimization-noise biases. We propose BALTO, a Balanced Token-level Policy Optimization framework for hallucination mitigation. BALTO extracts checkable factual claims, verifies them against the reference context, and projects claim-level judgments to token-level labels. A balanced token-level credit assignment mechanism is introduced into the framework. This design redistributes probability mass from unsupported content toward faithful content, rather than suppressing the entire response. We systematically analyze the limitations of response-level rewards from a theoretical standpoint, and prove BALTO's advantages in training stability and optimization efficiency for hallucination mitigation. Experiments on ConFiQA, RAGTruth, and FinLLM-Eval show that BALTO achieves the highest faithfulness across all six model–benchmark settings and consistently outperforms existing post-training baselines in Q-Score, demonstrating a stronger faithfulness–informativeness trade-off.

22.
medRxiv (Medicine) 2026-06-16

Care Delivery Gap framework: a proof-of-concept patient-reported measure of guideline-referenced care-process omissions in sickle cell disease

Abstract Background:Sickle cell disease (SCD) is concentrated in sub-Saharan Africa, where delivery of guideline-referenced care remains challenging. Current evaluation approaches rely largely on access indicators and clinical outcomes, which do not directly measure care delivery. We developed the Care Delivery Gap (CDG) framework, a patient-reported approach for identifying care-process omissions, and conducted a proof-of-concept study to assess feasibility and explore variation across income strata. Methods: We conducted a cross-sectional framework-development study involving a proof-of-concept sample of 52 individuals with SCD or caregivers recruited through clinics and moderated SCD communities across Africa, North America, and Europe between June 2025 and March 2026. The CDG framework assessed patient-reported omissions in specialist involvement, follow-up continuity, cardiovascular screening, and biochemical surveillance. Analyses were descriptive. Results: Substantial multi-domain care-process omissions were identified despite high reported healthcare engagement. Across geographic income strata, cardiovascular screening was reported by 4/35 (11%) LMIC versus 16/17 (94%) HIC participants, and regular follow-up within the preceding 12 months by 14/35 (40%) versus 16/17 (94%), respectively. High CDG scores, representing 1 omissions across three or four domains, occurred in 20/35 (57%) LMIC compared with 1/17 (6%) HIC participants. Similar disparities were observed across specialist review and vitamin B12 surveillance domains. Conclusion: A structured patient-reported framework identified multi-domain omissions in guideline-referenced SCD care, including among individuals reporting healthcare access. The divergence between access indicators and reported care delivery suggests that service contact alone may not reflect care quality. The framework provides a feasible foundation for future process-level quality measurement in high-burden settings.

23.
arXiv (quant-ph) 2026-06-19

Unveiling coherent dynamics in non-Markovian open quantum systems: exact expression and recursive perturbation expansion

arXiv:2506.04097v2 Announce Type: replace Abstract: We introduce a systematic framework to derive the effective Hamiltonian governing the coherent dynamics of non-Markovian open quantum systems. By applying the minimal dissipation principle, we uniquely isolate the coherent contribution to the time-local generator of the reduced dynamics. We derive a general expression for the effective Hamiltonian and develop a recursive perturbative expansion that expresses it in terms of system-bath interaction terms and bath correlation functions. This expansion provides a systematic tool for analyzing energy renormalization effects across different coupling regimes. Applying our framework to paradigmatic spin systems, we reveal how environmental correlations influence energy shifts and eigenbasis rotations, offering new insights into strong-coupling effects and non-Markovian quantum thermodynamics.

24.
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.

25.
arXiv (CS.AI) 2026-06-16

Deep Q-Learning on Hölder Spaces

Authors:

arXiv:2606.16846v1 Announce Type: cross Abstract: We study the operator-theoretic core of Q-learning in continuous-time stochastic control with continuous states and actions. In value-based reinforcement learning, each Q-learning or DQN update is built from a Bellman optimality target; our analysis isolates this target in a diffusion setting and studies its regularity and approximation complexity. Under uniform ellipticity and Hölder-regular coefficients, we show that a Bellman update maps bounded inputs into an anisotropic regularity class, smoothing the state variable while leaving only Lipschitz dependence on the action variable. This yields a compact family of Bellman iterates and motivates a tensor-product DeepONet architecture adapted to the mixed regularity of the problem. We then derive explicit approximation and resource bounds, together with a stiffness–complexity trade-off as the time step $\delta \to 0$. The resulting theory makes a direct contribution to Q-learning theory at the level of Bellman target regularity and approximation in continuous stochastic control. At the same time, we do not claim a full convergence theorem for practical sampled Q-learning with exploration, replay, and stochastic gradient updates.