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02.
arXiv (CS.AI) 2026-06-25

Interpretable Concept-Guided Polynomial Tabular Kolmogorov-Arnold Network for EEG-Based Mild Cognitive Impairment Detection

arXiv:2606.25434v1 Announce Type: cross Abstract: Early and scalable detection of mild cognitive impairment (MCI) remains an unresolved clinical challenge. Existing EEG-based screening approaches are constrained by handcrafted feature pipelines that discard neurophysiologically meaningful domain structure and deep learning classifiers that sacrifice interpretability for performance. No existing work unifies physiologically organized concept encoders, cross-concept interaction modeling, and nonlinear tabular classification in a sleep EEG-based MCI detection framework. This study proposes Concept-guided Polynomial-transformed Tabular learning using Kolmogorov-Arnold Network (CPTabKAN), which maps heterogeneous EEG-derived features into domain-informed concept representations, expands them via degree-2 polynomial transformation to expose first- and second-order interactions, and applies a Fourier-parameterized TabKAN classifier to learn nonlinear decision boundaries. CPTabKAN was evaluated on the Study of Osteoporotic Fractures cohort (372 subjects, overnight polysomnography), using 1,379 features organized into ten physiologically motivated concept groups. Under 10-fold cross-validation, CPTabKAN-Second Order achieved a weighted F1-score of 0.9038 (SD 0.034), outperforming GradientBoosting by 5.65 percentage points (t(9)=1.934,p=0.043, one-sided paired test), with advantages persisting under SMOTE-based balancing. Ablation analysis confirmed independent contributions from each component. Concept importance analysis revealed that power spectral density, multi-scale entropy, and Hjorth parameters dominated first-order weights, while cross-concept interactions involving Lempel-Ziv-Welch complexity, statistics, demographics, and slow oscillations exceeded all first-order scores. These results demonstrate that concept-structured, interaction-aware tabular learning surfaces physiologically coherent reasoning, supporting clinical trust.

03.
arXiv (CS.CV) 2026-06-15

MirrorCheck: Efficient Adversarial Defense for Vision-Language Models

Vision-Language Models (VLMs) are increasingly susceptible to sophisticated adversarial attacks, including adaptive strategies specifically designed to bypass existing defenses. To address this vulnerability, we propose MirrorCheck, a robust and model-agnostic detection framework that operates effectively in both unimodal and multimodal settings. MirrorCheck leverages Text-to-Image (T2I) models to regenerate visual content from captions produced by the target model and assesses semantic consistency by comparing feature-space embeddings between the original and synthesized images. To enhance robustness against adaptive attacks, MirrorCheck introduces a stochastic defense strategy that randomly selects T2I generators and image encoders from a diverse model zoo. Additionally, we incorporate a novel One-Time-Use (OTU) perturbation applied to the selected encoder embeddings, regulated by a scaling factor, which decreases the effectiveness of adaptive attacks. Extensive experiments across multiple threat scenarios demonstrate that MirrorCheck consistently outperforms baseline methods, and maintains its utility even under strong adaptive adversarial conditions.

04.
arXiv (CS.AI) 2026-06-16

An Integrated System for Real-Time Student Assessment and Career Guidance Using Neural Networks in Computing Disciplines

arXiv:2606.15831v1 Announce Type: new Abstract: Many undergraduate students in Computer Science (CS) and Software Engineering (SWE) struggle to identify suitable career paths, particularly when their academic performance, abilities, and interests do not fully align. To address this issue, this study proposes an AI-driven Student Assessment and Career Prediction System that integrates a Career Guidance Expert (CGE) system with a Web-Based Student Assessment (WBSA) platform. Within the integrated framework, CGE enhances personalized career recommendations using AI while also assisting students after graduation in identifying suitable jobs, research domains, and higher study opportunities aligned with their skills and interests. The WBSA platform further strengthens interaction between students and faculty through assessments, personalized tasks, mentorship activities, and a secure real-time chat application. The CGE system employs a Multilayer Perceptron (MLP) model trained on real-world academic and extracurricular data collected using the snowball sampling method from the students of universities, achieving a validation accuracy of 94.71% in predicting personalized career paths. A pre-survey was conducted across universities to evaluate the proposed model before deployment. The WBSA system was developed as a modern web application using technologies such as Node.js, Next.js, and PostgreSQL to ensure scalability, responsiveness, and secure data management. The overall system is supported by a secure cloud-based infrastructure, the platform provides reliable performance while assisting graduates to select suitable career path in IT sector. In addition, a post-survey involving both students and faculty was conducted to gather feedback and further improve the overall effectiveness and usability of the system.

05.
arXiv (CS.LG) 2026-06-17

The Morse Transform for Discrete Shape Analysis

arXiv:2503.04507v2 Announce Type: replace-cross Abstract: The geometry of an object plays a vital role in modulating its interactions with the physical world. It nevertheless remains difficult to describe geometric information numerically for the purposes of statistical inference or classification tasks. Here, we introduce a new topological transform which leverages directional piecewise-linear Morse theory to quantify the geometry of an embedded object by cataloguing critical points across multiple height-functions. The output of this Morse transform records both the heights and the local topological type (peak, trough or saddle) of the critical points that characterise the underlying shape, retaining finer information than the Euler characteristic transform whilst naturally prioritising a shape's outermost regions. Crucially, this output can be further compressed into a rich but compact feature vector. We benchmark the Morse feature vector as a descriptor for ligand-based virtual screening (LBVS), which intrinsically depends on the shape of molecules. Under a common gradient-boosted tree classification pipeline, Morse descriptors achieve the highest mean AUROC when compared to other topological transform descriptors and to standard shape-based LBVS descriptors.

06.
arXiv (math.PR) 2026-06-25

Face volume densities of positive-intensity and ideal Poisson–Voronoi tessellations in hyperbolic spaces

arXiv:2606.26049v1 Announce Type: new Abstract: We determine analytically for all $k\in\{0,1,\ldots,d-1\}$ the $k$-volume densities of a Poisson–Voronoi tessellation of intensity $\lambda>0$ in the $d$-dimensional hyperbolic space of constant curvature $-1$. This largely extends previous results of Isokawa in dimensions two and three. As applications, we provide closed form expressions for all face volume densities and all typical face volumes of the ideal Poisson–Voronoi tessellation (IPVT), which is the low-intensity limit as $\lambda\downarrow0$ of the hyperbolic Poisson–Voronoi tessellation. As a main tool we develop a new Blaschke–Petkantschin–type formula in hyperbolic space.

07.
medRxiv (Medicine) 2026-06-22

Evidence-guided AI regularization for suicidal ideation prediction in pediatric bipolar disorder

Background: Suicide prediction models in psychiatry often rely on purely data-driven feature selection, which can produce unstable and clinically opaque predictor sets in modest-sized samples. We developed Evidence-Based AI LASSO (EBAL), an evidence-guided regularization framework that incorporates curated clinical evidence into feature-specific penalty factors for interpretable prediction. Methods: Baseline data from 136 youth with confirmed bipolar spectrum disorder in the Greater Houston Area Bipolar Registry were analyzed using 20 candidate clinical predictors. Forty higher-level evidence documents on suicidality and related predictor domains were curated through a structured evidence synthesis workflow and indexed as an auditable evidence corpus. An open-weight large language model assigned feature-specific penalty factors using a prespecified scoring rubric, and these penalties were used to fit a weighted LASSO model. EBAL was compared with a standard evidence-agnostic LASSO using nested leave-one-out cross-validation. Results: For suicidal ideation, EBAL achieved an AUROC of 0.768, balanced accuracy of 0.757, sensitivity of 0.758, and specificity of 0.757. The standard LASSO achieved an AUROC of 0.760 and balanced accuracy of 0.715. EBAL improved balanced accuracy (+0.042, p=0.010) and Matthews correlation coefficient (+0.079, p=0.010), while retaining fewer stable predictors than standard LASSO (11/20 vs 18/20). The strongest positive predictors were current depressed mood, duration of mood disorder illness, and comorbid generalized anxiety disorder. For suicidal behavior, both models performed near chance and retained all candidate predictors. Limitations: The study was cross-sectional, single-site, and modest in sample size, with no external validation cohort. Conclusions: EBAL produced a sparser and more clinically coherent model for suicidal ideation in pediatric bipolar disorder, but did not improve prediction of suicidal behavior. These findings support evidence-guided regularization as a transparent strategy for aligning psychiatric prediction models with prior clinical knowledge while preserving interpretability.

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

Disagreement-Based Cross-Model Routing for Implicit Video Question Answering

We study multiple-choice video question answering on the ImplicitQA benchmark, where the correct answer is never explicitly shown but must be inferred from off-screen events, line-of-sight cues, causal structure, and cross-shot spatial layout. On this benchmark a single frontier video LLM already operates near its accuracy ceiling, and we observe that conventional self-consistency strategies – majority voting across repeated samples of the same model – can hurt rather than help, because the model's errors on hard questions are correlated. We propose disagreement-based cross-model routing, a pure inference-time procedure that requires no labels and no training. We triple-sample a native-video model (Gemini 3.1 Pro Preview) at temperature zero, exploit the genuine sample-to-sample variance of its video-processing pipeline to identify the roughly 20% subset of questions where the three samples disagree, and route only that subset to a second model from a different family (Claude Opus 4.8) that consumes uniformly sampled frames with adaptive thinking. On the 1001-question validation set with public ground truth – our main evaluation – the method improves AvgAcc by +1.43 over the best single sample of the primary model, with per-category gains concentrated on Motion & Trajectory (+5.49), Inferred Counting (+3.45), and Vertical Spatial Reasoning (+1.82) – the categories most dependent on cross-shot reference resolution. The same pipeline applied to the held-out 172-question CVPR 2026 ImplicitQA challenge test set achieves 82.03 AvgAcc / 79.71 MacroAvgAcc (+1.81 over the best single sample of the primary model), confirming the validation result on an independent split.

09.
arXiv (CS.CV) 2026-06-18

Efficient Image-to-Image Schrödinger Bridge for CT Field of View Extension

Computed tomography (CT) is a cornerstone imaging modality for non-invasive, high-resolution visualization of internal anatomical structures. However, when the scanned object exceeds the scanner's field of view (FOV), projection data are truncated, resulting in incomplete reconstructions and pronounced artifacts near FOV boundaries. Conventional reconstruction algorithms struggle to recover accurate anatomy from such data, limiting clinical reliability. Deep learning approaches have been explored for FOV extension, with diffusion generative models representing the latest advances in image synthesis. Yet, conventional diffusion models are computationally demanding and slow at inference due to their iterative sampling process. To address these limitations, we propose an efficient CT FOV extension framework based on the image-to-image Schrödinger Bridge (I$^2$SB) diffusion model. Unlike traditional diffusion models that synthesize images from pure Gaussian noise, I$^2$SB learns a direct stochastic mapping between paired limited-FOV and extended-FOV images. This direct correspondence yields a more interpretable and traceable generative process, enhancing anatomical consistency and structural fidelity in reconstructions. I$^2$SB achieves superior quantitative performance, with root-mean-square error (RMSE) values of 49.8 HU on simulated noisy data and 152.0 HU on real data, outperforming state-of-the-art diffusion models such as conditional denoising diffusion probabilistic models (cDDPM) and patch-based diffusion methods. Moreover, its one-step inference enables reconstruction in just 0.19 s per 2D slice, representing over a 700-fold speedup compared to cDDPM (135 s) and surpassing DiffusionGAN (0.58 s), the second fastest. This combination of accuracy and efficiency indicates that I$^2$SB has potential for real-time or clinical deployment.

10.
arXiv (CS.CL) 2026-06-11

ICA Lens: Interpreting Language Models Without Training Another Dictionary

Finding interpretable directions in language-model representations is critical for understanding and controlling model behavior. Sparse autoencoders (SAEs) have become the standard tool for this purpose, but using them as the default first lens often requires training, storing, and evaluating large overcomplete dictionaries. This bottleneck limits rapid exploration and raises a fundamental question: how much interpretable structure is already visible from activation geometry before training another neural dictionary? Our intuition is simple: many interpretable directions are selective on tokens, and these directions should look less Gaussian than random directions. We therefore revisit independent component analysis (ICA), a classical method for finding non-Gaussian directions, as a compact lens for language-model interpretability. We find that ICA has been underestimated for LLM interpretability, because prior uses often relied on off-the-shelf ICA implementations that are brittle on LLM activations and lacked systematic tools for inspecting and evaluating the recovered directions. To bridge these gaps, we introduce ICALens, the first practical workflow for stable, efficient, and auditable ICA analysis of LLM representations. It combines an optimized GPU-parallel FastICA pipeline with LLM-specific stability recipes and better fitting diagnostics, enabling efficient and reliable layer-wise analysis. Across GPT-2 Small, Gemma 2 2B, and Qwen 3.5 2B Base, ICALens efficiently recovers compact, human-interpretable directions without per-layer gradient-based dictionary training. On SAEBench, ICA is competitive with public SAEs in sparse probing and outperforms them in targeted probe perturbation under small-to-medium budgets. These results suggest that ICA should not be viewed as a weak baseline, but as an efficient and complementary first lens for exploring language-model representations.

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

From Bounding Boxes to Visual Reasoning: An On-Policy Data Annotation Tool for Vision-Language Models

Vision-language models (VLMs) are rapidly advancing toward sophisticated grounded structured visual reasoning. Training models for such advanced capabilities demands a new genre of data that seamlessly unifies spatial coordinates, open-vocabulary descriptions, structured attributes, and topological relationships into a singular representation. However, existing data annotation tools fundamentally fail to meet these intricate demands, suffering from three systematic bottlenecks: limited expressiveness, severe annotation-training decoupling, and poor data reusability. To bridge this infrastructure gap, we introduce an open-source annotation tool, ScreenAnnotator. First, we define a unified annotation atom schema that binds spatial, semantic, and structural primitives into a single unit. Second, we implement an on-policy annotation loop embedded with a Bayesian Annotation Verifier (BAV). Finally, we design a template-driven multi-task data synthesis process dynamically transforms static atoms into diverse multi-dimensional reasoning tasks, eliminating redundant re-annotation. The on-policy loop drives the annotation accept rate to nearly 100% on flowcharts and 77% on GUI screenshots, while steadily reducing per-image annotation time as labeled data accumulate. In the flowchart scenario, fine-tuning a VLM yields 76.1% average accuracy, which is a 35.1% point absolute gain. Our code is available at: https://github.com/WnQinm/Annotator.

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

Rapid Poison: Practical Poisoning Attacks Against the Rapid Response Framework

The Rapid Response (RR) framework, deployed in production systems, including Anthropic's ASL-3 safeguards, continuously improves jailbreak-detection classifiers. When new jailbreaks emerge that bypass these classifiers, Rapid Response generates synthetic variants for training, helping the model generalize from the new attacks and quickly adapt. We reveal that prompt injection can infiltrate this pipeline to deliver poisoned samples into the classifier's training set, enabling two attack objectives: (I) targeted poisoning attacks that create false positives on harmless samples by categorizing them as a jailbreak, with a specific desired feature (e.g., certain formatting, subject, or keyword), (II) concept-based backdoor attacks that induce false negatives on jailbreak inputs, generalizing even to jailbreaks from attack strategies the defender explicitly trained against, when the backdoor trigger is present. Importantly, our threat model restricts adversaries to modifying only jailbreak samples (not benign data or labels), a constraint unexplored by prior work that makes the second objective particularly challenging. We address this with Omission Attack, which exploits a new phenomenon: when training on concept-absent unsafe samples, the classifier misassociates that concept's presence with the safe label. Both attacks cause substantial and in some cases near-complete label flipping at only a 1% poisoning rate, achieving up to 100% false positive rates and up to 96% false negative rates.

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

Gaussian Mean Field Variational Inference can Overestimate Predictive Variance

arXiv:2606.25745v1 Announce Type: cross Abstract: Mean Field Variational Inference (MFVI) is widely understood to underestimate posterior variance. By analysing conjugate Bayesian Linear Regression (BLR), we show that this characterization is incomplete: while MFVI underestimates the variance in parameter space, it can overestimate the predictive variance compared to the exact posterior. We show that if the MFVI posterior underestimates predictive variances in some directions, it necessarily overestimates them in others. Crucially, this overestimation occurs in directions where the training data concentrates. This leads to the surprising result that, for a test point drawn from the training distribution, MFVI's expected predictive variance exceeds that of the exact posterior. We demonstrate a pathological case of this effect, where the MFVI posterior fails to reduce predictive variance compared to the prior on in distribution data. We connect these results to the Cold Posterior Effect, arguing that varying the temperature can correct this overestimation, yielding predictions closer to those of the exact posterior. We validate our theory on synthetic and real-world regression tasks.

14.
arXiv (CS.AI) 2026-06-24

PixJail: Self-Evolving Paper-to-Pipeline Reproduction for Text-to-Image Jailbreak Evaluation

arXiv:2606.24081v1 Announce Type: cross Abstract: As Text-to-Image (T2I) jailbreak techniques evolve rapidly, existing benchmarks and reproduction workflows often struggle to keep pace. More importantly, T2I jailbreak evaluation is not a single prompt-level test, but a pipeline-level problem shaped by multiple stages, including prompt transformation, image generation, safety filtering, and multimodal judging. This makes results across papers difficult to reliably reproduce and fairly compare. To bridge this gap, we propose PixJail, a self-evolving paper-to-pipeline agent framework for reproducible T2I jailbreak evaluation. Given a T2I jailbreak paper and optional reference code, PixJail rapidly constructs a paper-specific attack module and a runnable evaluation pipeline under a unified contract, while faithfully reproducing the original experimental results. PixJail further maintains a memory bank that stores paper digests, attack evolution patterns, reusable templates, failure cases, and versioned artifacts, enabling future reproduction efforts to reuse prior experience. We reproduce eleven representative T2I jailbreak methods, including both code-available and code-unavailable papers. Under their original settings, our framework accurately recovers prior results with minimal error (2.1\% average, 0\% median). We hope that PixJail can serve as a unified foundation for future T2I jailbreak reproduction and evaluation, significantly reducing manual effort.

15.
arXiv (CS.AI) 2026-06-25

Are Tabular Foundation Models Robust to Realistic Query Distribution Shifts in Microbiome Data?

arXiv:2606.24995v1 Announce Type: cross Abstract: Tabular foundation models (TFMs) achieve strong performance on microbiome abundance data, yet their robustness under realistic distribution shift remains poorly characterized. We introduce a benchmark that evaluates the robustness of TFMs to biologically inspired perturbations across six gut microbiome datasets spanning four disease contexts. In this in-context learning setting, models receive unperturbed support sets as context and are evaluated on perturbed query samples. To isolate robustness beyond "shortcut" features, we preserve the most discriminative taxa and apply three controlled perturbation strategies: (i) removal of high-abundance (uninformative) taxa, (ii) sparsification via increased zero-inflation, and (iii) zero-imputation via spurious non-zero injections. Our results show that protecting discriminative features is insufficient to guarantee stability under support-query shift: across datasets, all perturbations degrade model performance, with zero-imputation consistently the most harmful, indicating that corrupting global feature structure can break generalization even when key taxa are retained. Sparsification disproportionately affects TFMs relative to a classical random forest baseline, suggesting greater sensitivity to zero-inflation-type shifts. The code is publicly available at: https://github.com/UMMISCO/metagenomics-fm/.

16.
arXiv (CS.AI) 2026-06-24

Repeated Shared Access Enables Grokking, but Edit Propagation Depends on an Addressable Memory

作者:

arXiv:2606.20737v2 Announce Type: replace Abstract: We study factual edit propagation in a controlled synthetic knowledge-graph QA setting using a 2x2 grid that crosses loop recurrence with shared-memory access: a dense transformer (Dense), a looped transformer (Loop), a dense backbone with shared memory (Dense+Mem), and a looped backbone with shared memory (loop-memory coupling, LMC). The two factors dissociate. For learning, both routes to repeated shared access – looped recomputation and repeated memory rereading – cross the out-of-distribution (OOD) grokking barrier that Dense fails, so repeated shared access is the behavioral regularity, not a specific architecture. For editing, the substrates split along a different axis: applying a single localized factual edit (conditioned on direct success) and measuring 2-hop propagation on a shared pre-edit-correct set, the edit propagates strongly in both memory-bearing cells (LMC 0.78-0.92, Dense+Mem 0.71-0.96) and only weakly in the memory-free ones (Loop 0.04-0.30, Dense 0.00-0.03). The split is along the memory axis, not the loop axis: every memory-bearing seed exceeds every memory-free seed, with no detectable difference between the two memory cells. Crucially Dense+Mem has no recurrence, so the propagating ingredient is an addressable site that an edit can write to and later computation rereads, not loop recomputation; Loop is at best a partial intermediate. The affordance survives coarsening the store (N=128 to N=13): propagation attenuates but the memory/no-memory split persists, so fine granularity buys precision rather than the affordance itself. These results dissociate learning competence from editing affordance – repeated shared access suffices to grok, but edit propagation depends on whether the substrate exposes an addressable memory that the forward computation can write to and later reread, an affordance that loop recurrence provides only partially.

17.
bioRxiv (Bioinfo) 2026-06-18

MorphoStat: A Statistics-Aware Pipeline for Morphological Profiling Analysis

作者:

High-content imaging produces thousands of morphological measurements per cell. Interpreting these measurements requires normalization to remove plate effects, statistical tests selected on the basis of data distribution, and control over false discoveries across many features tested at once. MorphoStat is an open-source Python pipeline that applies this sequence of steps automatically. Given a CSV file from CellProfiler or a compatible imaging platform, it removes low-quality wells, normalizes each plate against DMSO controls using a MAD-scaled z-score, routes each feature to a parametric or nonparametric test based on a distributional check, applies Benjamini Hochberg correction, and writes out results and publication-ready figures. On the BBBC021 benchmark (MCF-7 breast-cancer cells, 632 wells, 473 features), MorphoStat recovered 12 of 13 known mechanism-of-action classes in principal component space, confirming that the normalization and statistical routing work as intended. The tool is available at https://github.com/Almunthir334/morphostat (DOI: 10.5281/zenodo.20354069) under the MIT license.

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

Cross-Lingual Exploration for Parametric Knowledge

Parametric knowledge in Large Language Models is not equally accessible across languages. As a result, standard inference techniques often struggle to surface localized facts, leading to failures in cross-lingual knowledge transfer and consistency. In this work, we investigate techniques for accessing hidden factual knowledge by exploring cross-lingual prompting strategies. We identify four inherent dimensions of cross-lingual exploration that directly govern parametric knowledge retrieval and evaluate them on multilingual factual benchmarks covering 17 typologically diverse languages. Our results demonstrate that cross-lingual exploration significantly improves knowledge transfer and factual recall, representing a more efficient compute Pareto frontier than native-language scaling. Furthermore, we observe corresponding improvements in cross-lingual consistency, exceeding what can be explained by accuracy gains alone. Overall, our work establishes multilingual prompt exploration as a highly effective inference-time strategy for unlocking latent parametric knowledge.

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

Dual-Agent Framework for Cross-Model Verified Translation of Natural-Language Protocols into Robotic Laboratory Platform

arXiv:2606.20120v1 Announce Type: cross Abstract: Biological experiment protocols are written in natural language, whereas automation systems rely on predefined control commands, creating a semantic gap that limits autonomous execution. Microplate-based automatic experiments are particularly challenging due to the need to simultaneously control well mapping, sample-reagent combinations, replicate placement, and parallel dispensing. This study proposes an agent-based protocol translation framework that converts natural-language microplate-based protocols into executable control commands for a robotic laboratory platform. A Parser Agent formalizes the natural-language protocol into a structured representation, and a rule-based mapping engine deterministically incorporates the operational constraints of the robotic laboratory platform to generate device-level control commands. A heterogeneous LLM Validation Agent verifies completeness, parameter accuracy, and execution order, and triggers a self-correction loop with structured feedback when errors are detected. A sweep involving 7 Parsers and 3 Validators on randomly selected ELISA protocols evaluates how model scale and Validator type affect translation accuracy and pass rates under cross-model verification. The accuracy-latency trade-off is further verified by comparing the rule-based mapping of the proposed framework with LLM end-to-end direct mapping. Finally, Bradford assay-based protein quantification using a microplate was demonstrated on a robotic laboratory platform, validating end-to-end autonomous execution from natural-language protocols to real-world experiments. The proposed framework provides a flexible approach to narrowing the semantic gap between natural-language protocols and microplate-based self-driving laboratories.

20.
medRxiv (Medicine) 2026-06-18

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

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

21.
medRxiv (Medicine) 2026-06-11

Advancing Clinical Implementation of Cardiovascular Polygenic Risk Scores Through Patient-Level Robustness Assessment

Background and Aims: Polygenic risk scores (PRSs) for atherosclerotic cardiovascular disease (ASCVD) can perform equivalently at the population level yet disagree for individual patients. We examined whether such intra-individual variability reflects genuinely complementary risk information or mainly statistical and methodological uncertainty, and whether it affects clinical classification once PRSs are integrated into SCORE2-OP. Methods: In 4,137 ASCVD-free participants of the CoLaus|PsyCoLaus cohort (478 incident events over a median 14.4 years), we identified 16 ASCVD-PRSs with practically equivalent population-level performance using Bayesian equivalence testing. We quantified intra-individual variability (standard deviation, coefficient of variation, intraclass correlation, Cohen's kappa, extreme discordance), tested whether discordance exceeded chance, decomposed scores into shared and unique genetic components, and assessed variability after integration into SCORE2-OP, benchmarked against perturbation of systolic blood pressure. Results: For a typical individual, risk estimates varied by 18 percentile points across PRSs. Discordance matched chance expectations under a shared-signal model, with no distinct phenotypic profile among discordant individuals, and predictive power resided overwhelmingly in the shared genetic component. Variability tracked PRS size and weighting rather than distinct variants. After integration into SCORE2-OP, 75.6% of participants were placed in different categories by at least one model and 54.6% as both low and high risk; instability was concentrated near guideline thresholds and far exceeded that from blood-pressure measurement error. Conclusions: Equivalent population-level performance is not sufficient to treat PRSs as interchangeable at the individual level, and methodological standardisation and pragmatic clinical trials remain necessary to determine whether PRS integration improves long-term cardiovascular outcomes.

22.
arXiv (CS.AI) 2026-06-18

A Distributionally Robust Reinforcement Learning Framework for Constrained Urban EV Dispatch

arXiv:2604.25848v2 Announce Type: replace Abstract: We study city-scale control of electric-vehicle (EV) ride-hailing fleets where dispatch, repositioning, and charging decisions must respect charger and feeder limits under uncertain, spatially correlated demand and travel times. We formulate the problem as a hex-grid semi-Markov decision process (semi-MDP) with mixed actions – discrete actions for serving, repositioning, and charging, together with continuous charging power – and variable action durations. To guarantee physical feasibility during both training and deployment, the policy learns over high-level intentions produced by a masked, temperature-annealed actor. These intentions are projected at every decision step through a time-limited rolling mixed-integer linear program (MILP) that strictly enforces state-of-charge, port, and feeder constraints. To mitigate distributional shifts, we optimize a Soft Actor-Critic (SAC) agent against a Wasserstein-1 ambiguity set with a graph-aligned Mahalanobis ground metric that captures spatial correlations. The robust backup uses the Kantorovich-Rubinstein dual, a projected subgradient inner loop, and a primal-dual risk-budget update. Our architecture combines a two-layer Graph Convolutional Network (GCN) encoder, twin critics, and a value network that drives the adversary. Experiments on a large-scale EV fleet simulator built from NYC taxi data show that PD-RSAC achieves the highest net profit, reaching \$1.22M, compared with \$0.58M-\$0.70M for strong heuristic, single-agent RL, and multi-agent RL baselines, including Greedy, SAC, MAPPO, and MADDPG, while maintaining zero feeder-limit violations.

23.
medRxiv (Medicine) 2026-06-24

Topical fresh Taraxacum mongolicum wet dressing as an adjunct to ceftriaxone for localized skin and soft tissue infections: A single-center assessor-blinded randomized controlled trial

Background: Localized skin and soft tissue infections may need systemic antibacterials, but local inflammation can delay symptom recovery. We evaluated whether topical fresh Taraxacum mongolicum wet dressing added to ceftriaxone was associated with short-term benefit in selected clinically stable adults. Methods: In this single-center, assessor-blinded, three-arm randomized trial, 180 adults aged 18-74 years were randomized 1:1:1 to topical T. mongolicum plus intravenous ceftriaxone, topical T. mongolicum alone, or ceftriaxone alone for 7 days. The primary outcome was day-7 clinical response assessed by blinded independent assessors using prespecified global clinical improvement criteria. Analyses followed the intention-to-treat principle; sensitivity analyses assessed robustness. Results: Day-7 clinical response rates were 91.67% (55/60), 76.67% (46/60), and 68.33% (41/60) in the combined, T. mongolicum, and ceftriaxone groups, respectively (overall P = 0.006). Compared with ceftriaxone alone, combined therapy had a higher response rate (risk difference, 23.3 percentage points; 95% CI, 9.6 to 37.0; risk ratio, 1.34; 95% CI, 1.11 to 1.62). Sensitivity analyses were directionally consistent. Secondary outcomes and bacterial clearance favored the combined group. No serious adverse events were reported. Conclusions: In selected clinically stable adults with localized skin and soft tissue infections, adjunctive topical fresh T. mongolicum plus ceftriaxone was associated with improved short-term outcomes compared with ceftriaxone alone. Findings require cautious interpretation because this was a single-center, partially blinded trial without a placebo dressing control. The dressing should not replace antibiotics, drainage, or urgent care when indicated. Trial registration: International Traditional Medicine Clinical Trial Registry, ITMCTR2026000549.

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

Decomposing Prediction Mechanisms for In-Context Recall

arXiv:2507.01414v2 Announce Type: replace Abstract: We introduce a new family of toy problems that combine features of linear-regression-style continuous in-context learning (ICL) with discrete associative recall. We pretrain transformer models on sample traces from this toy, specifically symbolically-labeled interleaved state observations from randomly drawn linear deterministic dynamical systems. We study if the transformer models can recall the state of a sequence previously seen in its context when prompted to do so with the corresponding in-context label. Taking a closer look at this task, it becomes clear that the model must perform two functions: (1) identify which system's state should be recalled and apply that system to its last seen state, and (2) continuing to apply the correct system to predict the subsequent states. Training dynamics reveal that the first capability emerges well into a model's training. Surprisingly, the second capability, of continuing the prediction of a resumed sequence, develops much earlier. Via out-of-distribution experiments, and a mechanistic analysis on model weights via edge pruning, we find that next-token prediction for this toy problem involves at least two separate mechanisms. One mechanism uses the discrete symbolic labels to do the associative recall required to predict the start of a resumption of a previously seen sequence. The second mechanism, which is largely agnostic to the discrete symbolic labels, performs a "Bayesian-style" prediction based on the previous token and the context. These two mechanisms have different learning dynamics. To confirm that this multi-mechanism (manifesting as separate phase transitions) phenomenon is not just an artifact of our toy setting, we used OLMo training checkpoints on an ICL translation task to see a similar phenomenon: a decisive gap in the emergence of first-task-token performance vs second-task-token performance.

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PLOS Computational Biology 2026-06-08

Statistics of cortical representational drift can enable robust readout

by Charles Micou, Timothy O’Leary Representational drift of fixed stimuli, learned tasks and familiar environments is observed in many brain areas, leading to reconfiguration of population codes over days to weeks. This raises the question of whether downstream brain regions employ mechanisms to track changes in population activity and thus preserve the fidelity of the information they extract. We show that the statistical properties of drift have a significant impact on such mechanisms. Over an extended period, a net change in population tuning due to drift can arise from an accumulation of small changes distributed across the population, or via abrupt jumps that affect smaller subsets of cells at each time point. We demonstrate that an adaptive readout can exploit the heavy-tailed statistics of abrupt jumps to maintain a more stable readout using a simple inference mechanism. Using experimental data, we investigate the extent to which heavy-tailed drift statistics are observed during representational drift in the posterior parietal cortex and visual cortex. We find that experimentally measured drift does not conform to a Gaussian random walk. Instead, we find sudden jumps in neural tuning that would be advantageous for a downstream observer adapting to changes in representation. These observations motivate future study to determine whether adaptive decoding mechanisms exist in the brain and to determine the physiological mechanisms that shape the statistics of representational drift.