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01.
Nature Biotechnology 2026-06-22

Affordable centimeter-scale 3D microscopy with submicrometer resolution

Authors: Unknown Author

Submicrometer-resolution three-dimensional (3D) imaging of large samples has been constrained by the short working distance, high cost and inflexible design of immersion objectives. We developed hybrid solid–liquid optics (HySIL) — a refractive framework with index-matched components — for submicrometer-resolution 3D imaging of centimeter-scale samples in various immersion media using inexpensive air objectives.

02.
arXiv (CS.CV) 2026-06-18

Low-Cost Neuromorphic Fall Detection Using Synthetic Event Data and Hybrid SNNs

This work presents the development of hybrid models that integrate spiking neural networks (SNNs) with components of convolutional neural networks (CNNs) to learn from simulated event-based camera data (Dynamic Vision Sensor, DVS) generated from conventional smartphone videos. Aimed primarily at human fall detection, the approach leverages the energy efficiency and spatio-temporal processing capabilities of SNNs by converting video frames into event-based data. The proposed models are evaluated through simulations on multiple datasets, comparing their performance to that of traditional machine learning models. Results demonstrate significant gains in efficiency without sacrificing accuracy, underscoring the potential of combining SNNs and DVS technology for complex tasks in real-world environments.

03.
arXiv (CS.CV) 2026-06-12

QueryOcc: Query-based Self-Supervision for 3D Semantic Occupancy

Learning 3D scene geometry and semantics from images is a core challenge in computer vision and a key capability for autonomous driving. Since large-scale 3D annotation is prohibitively expensive, recent work explores self-supervised learning directly from sensor data without manual labels. Existing approaches either rely on 2D rendering consistency, where 3D structure emerges only implicitly, or on discretized voxel grids from accumulated lidar point clouds, limiting spatial precision and scalability. We introduce QueryOcc, a query-based self-supervised framework that learns continuous 3D semantic occupancy directly through independent 4D spatio-temporal queries sampled across adjacent frames. The framework supports supervision from either pseudo-point clouds derived from vision foundation models or raw lidar data. To enable long-range supervision and reasoning under constant memory, we introduce a contractive scene representation that preserves near-field detail while smoothly compressing distant regions. QueryOcc surpasses previous camera-based methods by 26% in semantic RayIoU on the self-supervised Occ3D-nuScenes benchmark while running at 11.6 FPS, demonstrating that direct 4D query supervision enables strong self-supervised occupancy learning. https://research.zenseact.com/publications/queryocc/

04.
arXiv (CS.LG) 2026-06-15

Time Series Causal Discovery via Context-Conditioned and Causality-Augmented Pretraining

arXiv:2605.26759v2 Announce Type: replace Abstract: Causal discovery from time series is critical for many real-world applications, such as tracing the root causes of anomalies. Existing approaches typically rely on dataset-specific optimization, making it difficult to transfer their causal discovery capabilities to new time series governed by diverse causal mechanisms. In this paper, we propose PTCD, a novel Pretraining framework for Time-series Causal Discovery, which improves cross-task generalization through context-conditioned modeling and transferable causal augmentation. To model complex temporal causal dependencies, PTCD employs a dual-scale iterative attention mechanism to capture window-level causal relationships, and a Gaussian mixture with a context-level routing mechanism to handle heterogeneous exogenous distributions. To further address distribution shifts across causal graphs, PTCD adopts a pretraining paradigm on synthetic datasets that integrates intervention-based learning and a causal mixup strategy, promoting stable causal discovery and stronger generalization. Extensive experiments on multiple real-world out-of-distribution (OOD) datasets demonstrate that PTCD excels in both causal discovery and root cause identification.

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

Silent Failures in Federated Personalization of Foundation Models

arXiv:2606.00947v2 Announce Type: replace-cross Abstract: Foundation models are increasingly personalized on decentralized private data through federated learning and are now deployed at scale under growing regulatory requirements for post-market monitoring. We argue that this convergence creates a distinct and under-recognized class of trustworthiness failures, which we term "Silent Failures." These include amplified bias, fairness collapse, and alignment erosion that may remain difficult to detect because federated learning's privacy constraints limit visibility into model behavior. A landscape analysis of existing benchmarks reveals a structural divide. Federated benchmarks evaluate system performance but provide limited insight into model behavior, whereas centralized trustworthiness benchmarks assess behavior but require model access incompatible with federated privacy. We introduce a taxonomy of six silent failure modes arising from the interaction of foundation model personalization, dataset shift, and core federated constraints. Our analysis shows that privacy-preserving training alone is insufficient for trustworthy deployment. We conclude with a research agenda for privacy-preserving behavioral evaluation and propose that silent failures become a standard diagnostic category for trustworthy federated artificial intelligence.

07.
arXiv (quant-ph) 2026-06-15

No classical particle limit for massless quanta

arXiv:2606.14632v1 Announce Type: new Abstract: We investigate whether relativistic massless classical particles may emerge as the classical limit of massless quanta. To address this question independently of any specific dynamics, environment, or pointer basis, we develop an axiomatic and purely kinematical framework for the coarse-graining approach. In this formulation, a candidate classical phase space is taken as the outcome space of a POVM subject only to minimal classicality and covariance under the relevant spacetime symmetry group. Applying this framework to the Poincaré group, we prove a no-go theorem for massless particles: the covariance requirement is incompatible with the operational conditions for classicality. The theorem leaves open field-like limits of massless quanta, for example the emergence of electromagnetic or gravitational fields, while ruling out classical massless particles, such as classical photons or gravitons.

08.
arXiv (CS.CL) 2026-06-16

The Answer Lies Within: Self-Derived Rewards Enable Explainable Relation Extraction

Despite the remarkable reasoning capabilities of large language models, they still struggle with one-shot relation extraction without predefined relation labels. We identify two pitfalls: models are often misled by irrelevant tokens instead of relation-conveying semantics, and they often fail to align with the abstraction level human annotators expect. We introduce a novel framework that closes this gap with two components: (1) COGRE, a cognitively-inspired reasoning framework that structures RE into a series of processes mimicking human text-processing; and (2) HIT@DICT, a reinforcement learning intermediate reward strategy that encourages reasoning to align with relational labels by rewarding relation-relevant phrases in reasoning. The reward is derived on a credit dictionary automatically extracted from correct predictions. Our experiments show that our framework improves both accuracy and explanation quality by addressing these two pitfalls. For example, COGRE with Qwen2.5-14B-Instruct on One-shot NYT29 achieves 24.65% F1, surpassing prior reasoning-based designs. Optimizing this approach with RL using HIT@DICT further improves performance by +23.46% points. Finally, human evaluation shows that our best model generates relational phrases closely aligned with gold labels, increasing human explanation quality ratings by 54% (relative).

09.
bioRxiv (Bioinfo) 2026-06-12

PeptiDIA: A Machine Learning Framework for Enhanced Peptide Identification in Fast-Gradient Data-Independent Acquisition Proteomics

Data-independent acquisition (DIA) mass spectrometry has become increasingly prevalent in proteomics as advances in instrumentation, chromatography, and computational analysis have enabled robust proteome identification across complex biological samples. However, analytical depth achieved with fast chromatographic gradients remains lower than that obtained using long-gradients, reflecting a throughput-depth trade-off. Here, we present PeptiDIA, a machine learning framework that enhances peptide identification in fast-gradient DIA data by leveraging paired fast and long-gradient acquisitions from identical samples. PeptiDIA processes DIA-NN outputs generated at relaxed false discovery rate thresholds to obtain expanded candidate peptide pools and trains gradient-boosted decision tree models using long-gradient identifications as reference labels. The model integrates DIA-NN features with engineered peptide descriptors and applies isotonic regression to calibrate probabilities, enabling controlled peptide recovery relative to the long-gradient reference. Applied to human and murine datasets spanning six tissues acquired on an Orbitrap Exploris 480, PeptiDIA increased peptide identifications by 25-34% at 1% target reference-discordance rate (RDR) and increased the number of protein groups containing at least one rescued peptide by 15-17%. Overall, PeptiDIA improves the identification depth of fast-gradient DIA-NN workflows without altering acquisition strategies. The framework is available as a web application and command-line tool at https://github.com/Jordano700/PeptiDIA.

10.
PLOS Computational Biology 2026-06-09

Evolution of phenocopying in a dynamical model of developmental trajectories

by Yuuki Matsushita, Archishman Raju Developmental trajectories are known to be canalized, or robust to both environmental and genetic perturbations. However, even when these trajectories are decanalized by an environmental perturbation outside the range of conditions to which they are robust, they often produce phenotypes similar to known mutants, called phenocopies. This correspondence between the effects of environmental and genetic perturbations has received little theoretical attention. Here, we study an abstract regulatory model that is evolved to follow a specific trajectory. We then study the effects of small and large perturbations to the trajectory, both by changing parameters and by perturbing the state at specific times. We find that the phenomenon of phenocopying emerges in evolved trajectories and is not present in a null model of randomly sampled trajectories. Our results suggest that, in this class of dynamic models, evolution can allow high-dimensional phenotypic landscapes to simultaneously exhibit robustness and phenocopying.

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

Follow the Latent Roadmap: Navigating Revocable Decoding for Diffusion LLMs with Anchor Tokens

Diffusion Large Language Models (dLLMs) offer a promising avenue for parallel generation but face a trade-off between decoding speed and quality. While revocable decoding strategies attempt to mitigate errors by verifying and remasking tokens, they typically operate within a mixed-quality context. This leads to two critical failures: Error Propagation, where new tokens absorb toxic information from erroneous context, and Local Error Reinforcement, where errors mutually reinforce each other to evade detection. To alleviate these challenges, we propose ASRD (Anchor Supervised Revocable Decoding), a training-free framework that operates within the embedding space. ASRD explicitly decouples the decoding context into trusted Anchor Tokens, which are identified via temporal consistency, and uncertain candidates. Leveraging a dynamic Anchor Tokens Cache, we introduce two complementary mechanisms: (1) Anchor-Guided Generation, which injects entropy-weighted anchor signals into masked positions to implicitly rectify attention toward the reliable global skeleton; and (2) Anchor-Perturbed Verification, which applies orthogonal perturbations to uncertain candidate tokens, destabilizing and remasking errors driven by fragile local consensus. Extensive experiments on math and coding benchmarks demonstrate that ASRD outperforms recent remasking baselines, achieving accuracy improvements of up to 6.4\% while accelerating inference throughput by up to 7.2$\times$.

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

PSyGenTAB: A Privacy-Preserving Framework for Synthetic Clinical Tabular Data Generation via Constrained Optimization

arXiv:2606.18518v1 Announce Type: cross Abstract: The development of medical AI is constrained by limited access to high-quality clinical data due to institutional silos and strict privacy regulations such as HIPAA and GDPR. Synthetic data generation offers a potential solution, but existing methods lack principled mechanisms to explicitly manage the privacy-utility trade-off, often degrading clinically meaningful patterns or risking patient re-identification. We present PSyGenTAB, a privacy-preserving generative framework that formulates synthetic healthcare data generation as a constrained optimization problem solved using the Augmented Lagrangian Method. By embedding configurable privacy constraints directly into model training, PSyGenTAB enforces minimum privacy thresholds while maximizing clinical data utility. Across multiple clinically motivated benchmarks, PSyGenTAB preserves inter-feature clinical relationships and minority-class diagnostic patterns essential for reliable health AI. Downstream evaluation using Train-on-Synthetic, Test-on-Real and Train-on-Real, Test-on-Synthetic protocols shows that models trained on synthetic data achieve performance comparable to those trained on real patient records. Privacy auditing further demonstrates reduced exact record reproduction and strong resilience to membership inference attacks. These results establish PSyGenTAB as a principled framework for balancing privacy protection and clinical utility in synthetic healthcare data, supporting secure cross-institutional AI development.

13.
medRxiv (Medicine) 2026-06-15

Primary care practitioners preconception health literacy and information-seeking: A cross-sectional survey.

Background Parental health before pregnancy influences maternal and child outcomes. Primary care professionals, including general practitioners [GPs], midwives, and naturopaths, can provide preconception care, yet many report limited knowledge and difficulty accessing relevant information. This study described Australian GPs, midwives, and naturopaths preconception health literacy, including knowledge and ability to access information. Methods Between July and September 2022, Australian GPs, midwives, and naturopaths completed a 32-item online cross-sectional survey. Participants were recruited through professional associations, and data were analysed using descriptive and inferential statistics Results Participants (N=373) included naturopaths (40.7%), GPs (32.4%), and midwives (26.8%). Reported barriers to clinician health literacy including lack of preconception care resources (25.5%), and limited clinician knowledge (23.6%). The proportion identifying limited clinician knowledge differed significantly between professions (GP: 31.4%; midwives: 23.0%; naturopaths: 17.8%; p=0.030). The highest level of accurate knowledge regarding preconception exposures was for pre-pregnancy obesity (82.7%), while low birth weight was the most accurately identified preconception outcomes (83.7%). Incorrect responses were most common for maternal multivitamin use as an exposure (28.3%) and childhood leukaemia as an outcome (26.3%). Differences between professions were strongest for infant outcomes, with moderate associations observed for shoulder dystocia (V=.2355), precipitous labour (V=.2173), macrosomia (V=.2060), labour dystocia (V=.2018) and cryptorchidism (V=.2018). Discussion Preconception health literacy varies across primary care professions. Clinicians require greater access to targeted resources and education tailored to their differing scopes of practice and experience. Improving clinician preconception health literacy may strengthen consistent evidence-based care and support better maternal, child, and long-term family health outcomes.

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

Utility-Aware DRL-Based TXOP Adaptation for NR-U and Wi-Fi Coexistence Networks

arXiv:2605.00457v4 Announce Type: replace-cross Abstract: The coexistence of NR-U and Wi-Fi in the unlicensed spectrum introduces a challenging resource management problem, where heterogeneous channel access mechanisms can lead to unbalanced spectrum utilization and severe Wi-Fi performance degradation. To address this issue, this paper proposes a utility-aware deep reinforcement learning (DRL) framework for adaptive transmission opportunity (TXOP) control in NR-U/Wi-Fi coexistence networks. The coexistence process is formulated as a Markov decision process (MDP), in which the NR-U TXOP duration is treated as a controllable variable for regulating post-access channel occupancy. A deep Q-network (DQN) is then employed to learn adaptive TXOP control policies through online interaction with the coexistence environment. A key feature of the proposed framework is the integration of a configurable reward and criterion design, which enables explicit control of the fairness-efficiency-utility tradeoff. Three operating policies are developed, namely absolute fairness, moderate fairness, and utility-oriented moderate fairness, to characterize different coexistence operating points. Simulation results show that the proposed framework achieves a Jain fairness index above 0.9 under strict fairness control. Compared with the absolute fairness policy, the moderate fairness policy improves aggregate throughput by 68.22%, while the utility-oriented policy achieves a 177.6% improvement under the adopted utility evaluation metric. These results demonstrate that the proposed utility-aware DRL framework provides an effective and flexible solution for adaptive TXOP control and tradeoff management in heterogeneous unlicensed coexistence networks.

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

FashionChameleon: Towards Real-Time and Interactive Human-Garment Video Customization

Human-centric video customization, particularly at the garment level, has shown significant commercial value. However, existing approaches cannot support low-latency and interactive garment control, which is crucial for applications such as e-commerce and content creation. This paper studies how to achieve interactive multi-garment video customization while preserving motion coherence using only single-garment video data. We present FashionChameleon, a real-time and interactive framework for human-garment customization in autoregressive video generation, where users can interactively switch garment during generation. FashionChameleon consists of three key techniques: (i) Instead of training on multi-garment video data, we train a Teacher Model with In-Context Learning on a single reference-garment pair. By retaining the image-to-video training paradigm while enforcing a mismatch between the reference and garment image, the model is encouraged to implicitly preserve coherence during single-garment switching. (ii) To achieve consistency and efficiency during generation, we introduce Streaming Distillation with In-Context Learning, which fine-tunes the model with in-context teacher forcing and improves extrapolation consistency via gradient-reweighted distribution matching distillation. (iii) To extend the model for interactive multi-garment video customization, we propose Training-Free KV Cache Rescheduling, which includes garment KV refresh, historical KV withdraw, and reference KV disentangle to achieve garment switching while preserving motion coherence. Our FashionChameleon uniquely supports interactive customization and consistent long-video extrapolation, while achieving real-time generation at 23.8 FPS on a single GPU, 30-180$\times$ faster than existing baselines.

16.
arXiv (CS.AI) 2026-06-18

Pareto Q-Learning with Reward Machines

arXiv:2606.19134v1 Announce Type: cross Abstract: We present Pareto Q-Learning with Reward Machines (PQLRM), a multi-objective reinforcement learning algorithm for tasks whose reward structure is specified by a set of reward machines (RMs). PQLRM combines Pareto Q-Learning (PQL), which maintains sets of vector-valued Q-estimates to approximate the Pareto front, with enhancements from Q-Learning with Reward Machines (QRM), which exploits the factored automaton structure of the reward signal. This yields a multi-policy algorithm that remains sample-efficient under non-Markovian, RM-encoded rewards. Experimental trials show that PQLRM converges faster than a naive PQL baseline applied to the cross-product MDP and can synthesize Pareto-optimal policies that QRM cannot.

17.
arXiv (math.PR) 2026-06-16

Sharp One-Dimensional Sub-Gaussian Comparison in Convex Order

Authors:

arXiv:2604.26819v2 Announce Type: replace Abstract: We prove that any random variable $X$ whose moment generating function is point-wise upper bounded by that of $ G \sim \mathcal{N}(0,1) $ must be dominated by $ G/\mathbb{E}[|G|] $ in convex order, meaning $ \mathbb{E}[f(X)] \le \mathbb{E}[f(G/\mathbb{E}[|G|])] $ for all convex $f$. This is sharp as witnessed by $ X \sim \mathrm{Unif}(\{-1,1\}) $ and $ f(x) = |x| $.

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

CRAFTIIF: Cross-Resolution Analytic Four-Type Interpretable Isolation Forest for Multivariate Time Series Anomaly Detection

Authors:

arXiv:2606.13486v1 Announce Type: cross Abstract: Anomaly detection in multivariate time series is challenged by four structurally distinct anomaly types – point (isolated spikes), distributional (level shifts), temporal (rhythm changes), and collective (inter-sensor correlation breakdowns) – each requiring different feature representations. Most unsupervised methods target only one or two types and provide limited interpretability. We present CRAFTIIF (Cross-Resolution Analytic Four-Type Interpretable Isolation Forest), a fully unsupervised framework targeting all four types without dataset-specific tuning. CRAFTIIF generates K=500 random analytic wavelet feature draws across four families (Morlet, DOG, Haar, Coiflet), each targeting a specific anomaly type, feeding five structured Isolation Forests – one per type plus a meta-IF for compound anomalies. An adaptive Otsu/MAD threshold calibrates detection automatically across anomaly rates from 0.1% to 69.2%. Because each IF is trained exclusively on type-specific features, branch firing provides direct anomaly-type attribution by construction, without post-hoc explanation. Evaluated on all 19 datasets of the mTSBench benchmark (Zhou et al., TMLR 2026), CRAFTIIF achieves mean F1=0.228 (all 19 datasets) and F1=0.322 (13 detectable datasets), ranking first among all 25 evaluated methods on VUS-PR (0.463 vs. previous best 0.329, +40.7%). A diagnostic framework – oracle F1, detectability limits, and branch separation ratios – identifies 6 of 19 datasets as fundamentally undetectable by any unsupervised method. Ablation over 11 conditions confirms adaptive thresholding (+38% F1), four-branch structure (+20%), and meta-IF (+23%) are each essential. Code: https://github.com/smitswil/craftiif

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

Risk Under Pressure: Compute-Aware Evaluation of Adversarial Robustness in Language Models

arXiv:2606.11409v1 Announce Type: cross Abstract: Adversarial robustness evaluations of large language models (LLMs) typically report attack success rate (ASR) under fixed query budgets, implicitly treating all attacks as equally costly. In practice, the computational expense of different attack strategies can vary by orders of magnitude. Consequently, ASR at a fixed budget can obscure the true effort required to jailbreak a model, thereby making it hard to determine whether an attack's cost justifies its payoff to the attacker. We propose a compute-aware evaluation framework based on computational pressure, measured in cumulative floating-point operations (FLOPs), as a proxy for adversarial effort. We introduce risk-compute curves, which map compute budgets to attack risk, and derive two metrics that summarize the average pressure required for a given attack to succeed. Across ten models spanning three families and four different stages in language model training and alignment, evaluated with three attack strategies (gradient-based, iterative refinement, and template-based) on two jailbreak robustness benchmarks, we find: (1) alignment training has non-monotonic effects on compute-space robustness; (2) scaling model size reduces gradient-based attack effectiveness but has limited impact on cheaper template-based attacks; (3) gradient-based attacks optimized on a surrogate model can transfer to a separate target model, providing a way to reduce attacker costs; (4) compute cost varies by up to ${\approx}5{\times}$ across harm categories within a single model; and (5) safety-aligned RL increases aggregate cost while leaving some categories disproportionately accessible. We release our framework to enable compute-aware risk assessment and evaluation.

20.
arXiv (CS.AI) 2026-06-24

FP8 is All You Need (Part 2): Efficient Ozaki-Bailey Style FFT Through Tensor-core Garner Reformulation and Kulisch Escape Route

arXiv:2606.23698v1 Announce Type: cross Abstract: NVIDIA's Blackwell Ultra (B300) cuts FP64 vector throughput to ~1.3 TFLOPS per GPU, roughly 30x below B200 and well below the level at which bandwidth-limited FP64 workloads stay memory-bound. The Ozaki Scheme II framework recovers FP64-equivalent throughput by routing dense matrix multiply through FP8 tensor cores with a mantissa-sliced Chinese-remainder reconstruction. A companion Part (1) paper covers dense GEMM, batched GEMV, stencils, and SpMV; this paper adds the fifth canonical primitive, the 3-D FFT. We present Ozaki-Bailey FFT, an emulated 3-D FFT via the Bailey six-step decomposition with both 1-D FFT GEMMs on FP8 tensor cores. Bailey's small inner factor k ~ sqrt(N) (k=32 for N=1024) puts the kernel in the regime k

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

Patcher: Post-Hoc Patching of Backdoored Large Language Models

arXiv:2606.02995v2 Announce Type: replace-cross Abstract: Large language models remain vulnerable to jailbreak backdoor attacks, where adversaries poison safety alignment data to embed hidden triggers that bypass safety mechanisms. Existing defenses often require comprehensive attack information or multiple triggered examples, making them impractical when defenders only observe a single reported failure case without knowing whether it stems from a backdoor attack or a natural alignment bug. This paper presents Patcher, a post-hoc defense framework that repairs backdoored language models using only a single reported failure case and the model parameters. Patcher operates in two stages. First, it localizes backdoor triggers by computing response-conditioned gradient-based saliency scores and applying adaptive clustering to separate triggers from benign context. Second, it patches the model through a constrained fine-tuning objective that breaks the trigger-response association while preserving benign-task utility and robustness to non-triggered jailbreak attacks through KL-divergence constraints. We conduct extensive evaluations across multiple backdoor attack strategies and demonstrate that Patcher successfully localizes triggers and neutralizes backdoors while maintaining model utility. We further show robustness against adaptive attacks designed to evade our defense. This work represents a significant step toward practical defenses against training-time attacks in deployed language models.

23.
arXiv (CS.AI) 2026-06-18

Where Did the Variability Go? From Vibe Coding to Product Lines by Regeneration

arXiv:2606.19042v1 Announce Type: cross Abstract: In vibe coding, an emerging AI-driven paradigm, an LLM generates an entire program from a natural language prompt, but what happens to the variability that traditional software engineering carefully builds into code? To answer this question, we conducted an exploratory analysis on 10 vibe coded C/C++ projects, which suggests that there is near-zero in-artifact variability, i.e., at compile and runtime. All variability decisions are resolved at a single new binding time, generation time, the moment the LLM produces the source code. Rather than treating this as a defect to fix, we propose Variability by Regeneration (VbR), to our knowledge the first product-line approach in which the LLM acts as the derivation engine, generating a purpose-built, free of dead code binary for each variant from a declarative specification, while a variant dispatcher transparently routes user requests to the matching binary. We formalise VbR, contrast it with classical SPL derivation, and demonstrate its full pipeline on a wc product family. For SPL engineering, variability in AI-generated software belongs in the specification, not in the code.

24.
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)

25.
arXiv (CS.AI) 2026-06-17

Conservation Laws for Modern Neural Architectures

arXiv:2606.17816v1 Announce Type: cross Abstract: Understanding gradient descent dynamics is key to explaining the success of over-parameterized models, where implicit bias manifests through conservation laws in gradient flow. While such laws are well understood for linear and ReLU networks, they remain largely unexplored for modern architectures. This work develops a unified framework to characterize conservation laws for contemporary models, including feedforward networks with GELU, SiLU, and SwiGLU activations, multihead attention with sinusoidal and rotary positional encodings, and Mixture-of-Experts architectures under diverse gating designs. Our theoretical findings are supported by experiments that validate the predicted invariants.