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01.
medRxiv (Medicine) 2026-06-18

Hard to Halt: Automation Bias in Agent-Driven Sequencing Prior Authorization Workflows

Purpose: Prior authorization (PA) for exome or genome sequencing is a time-consuming process that impedes timely rare disease diagnosis. Large language model-based browser agents offer potential for automating these workflows, but their clinical reliability remain uncharacterized. Methods: We developed a sandbox compromising a simulated ES/GS PA submission payer portal and a synthetic EHR containing 836 patient records spanning compliant profiles and deficient profiles with different types of issues. Gemini 3 Pro, Gemini 3 Flash, and Claude Opus 4.5 were evaluated on task completion rate, form completion accuracy, and appropriate withholding for deficient profiles. Results: Larger models achieved much higher task completion rates (Gemini 3 Pro 95.45%, Claude Opus 4.5 93.67%) compared to Gemini 3 Flash (56.05%), but nearly universally failed to withhold submission for deficient profiles whereas Gemini 3 Flash ironically demonstrated superior withholding performance (17.33%). In a non-agentic setting, Gemini 3 Pro correctly identified 91% of the issues in deficient profiles, indicating that withholding failure is attributable to the browser interaction rather than the model's reasoning limitations. Conclusion: Current LLM-based browser agents exhibit a systematic bias towards form submission that poses risks in PA workflows. A modular, multi-agent architecture with human supervision is necessary for a safe clinical deployment.

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

SpecAlign: Efficient Specification-Grounded Alignment of Large Language Models via Synthetic Data

arXiv:2606.16276v1 Announce Type: new Abstract: As large language models (LLMs) are increasingly deployed in real-world applications, alignment is no longer governed by a single universal notion of safety or helpfulness, but instead by provider- or application-specific model specifications. These specifications are typically long, structured, and frequently updated, yet existing alignment pipelines lack a systematic mechanism to operationalize them as training signals. In this paper, we propose specification-grounded alignment, a new alignment paradigm that treats provider-authored model specifications as the primary alignment target rather than abstract principles or static benchmarks. To instantiate this paradigm, we introduce SpecAlign, a framework that synthesizes alignment data directly from specification documents. SpecAlign combines structured rule annotation, controllable specification instantiation, and multi-agent adversarial data synthesis to generate fine-grained, boundary-aware preference pairs that capture both compliant behaviors and meaningful specification violations. Experiments across multiple model specifications and backbone models demonstrate that training with SpecAlign consistently improves rule compliance while preserving general capabilities and avoiding over-conservative behavior. These results suggest that grounding alignment in explicit model specifications enables rapid, precise, and scalable adaptation of LLM behavior to evolving policy requirements.

03.
medRxiv (Medicine) 2026-06-18

Cost analysis of overseas versus domestic vaccination of US-bound refugees

Context: To ensure healthy resettlement and protect US health security, the Vaccination Program for US-bound Refugees (VPR) offers some recommended vaccines to refugees overseas before resettlement to the United States. The selected vaccines and number of doses vary by country of departure. VPR was found to be cost-saving in 2018 but had since expanded to more sites. Objective: Assess VPR's current costs and impact on post-arrival domestic vaccination needs and costs. Setting and Participants: A model-based analysis of the Federal government costs for VPR and post-arrival (US) vaccination of resettled refugees separated across five regions: Africa, Asia, the Middle East and North Africa/Republic of Turkiye and Middle East, Europe, and the Americas using fiscal year 2024 data. Design: We quantified and compared full vaccination costs for refugees under two scenarios: (1) 'No VPR' and (2) 'VPR'. Refugees would receive no vaccines overseas and be fully vaccinated after US arrival under 'No VPR'. Under 'VPR', refugees receive one or two doses of selected vaccines overseas before completing vaccination schedules after arrival. Main Outcomes: Costs were reported in 2023 US dollars for 'VPR' and 'No VPR' scenarios and further subdivided by grouping countries/sites depending on whether the International Organization for Migration (IOM) provides vaccination services for refugees (IOM sites) versus non-IOM providers (non-IOM sites). Results: 'VPR' resulted in average net cost savings of $147 per person or $14.7 million per 100,000-refugee cohort compared to providing all vaccines after US arrival ('No VPR'). 'VPR' was cost-saving across most regions, except for IOM sites in Europe, where a net cost of $44 per person was observed. Net cost savings per person were highest for IOM sites in Africa ($333). Conclusions: VPR remains a cost-saving strategy, while protecting US-bound refugees' health and US health security by preventing disease outbreaks during resettlement.

04.
arXiv (CS.CV) 2026-06-19

World Engine: Towards the Era of Post-Training for Autonomous Driving

Autonomous vehicles must operate safely in the real world, where errors can have severe consequences. Although modern end-to-end driving policies excel in routine scenarios, their reliability is limited by the scarcity of safety-critical ``long-tail'' events in real driving datasets. These rare interactions define the practical safety boundary of the learned policy, yet they are difficult to collect at scale in the real world. Here we show that this fundamental limitation can be addressed by post-training pre-trained driving models on synthesized high-stakes interactions. We introduce World Engine, a generative framework that reconstructs high-fidelity interactive environments from real-world logs and systematically extrapolates them into realistic safety-critical variations. This paradigm enables reinforcement-based post-training to align policies with safety constraints, circumventing the physical risks inherent in real-world exploration. On a public benchmark built on nuPlan, World Engine substantially reduces failures in rare safety-critical scenarios and yields significantly larger gains than scaling pre-training data alone. Furthermore, when deployed on a production-scale autonomous driving system, the resulting policy reduces simulated collisions and demonstrates measurable improvements in on-road testing, showing that post-training on synthesized, safety-critical interactions offers a scalable and effective pathway to safer autonomous driving. The full codebase suite, including training, is released to the public.

05.
arXiv (CS.CV) 2026-06-16

AVA-VLA: Improving Vision-Language-Action models with Active Visual Attention

Vision-Language-Action (VLA) models have shown remarkable progress in embodied tasks recently, but most methods process visual observations independently at each timestep. This history-agnostic design treats robot manipulation as a Markov Decision Process, even though real-world robotic control is inherently partially observable and requires reasoning over past interactions. To address this mismatch, we reformulate VLA policy learning from a Partially Observable Markov Decision Process perspective and propose AVA-VLA, a framework that conditions action generation on a recurrent state that serves as a neural approximation to the agent's belief over task history. Built on this recurrent state, we introduce Active Visual Attention (AVA), which dynamically reweights visual tokens in the current observation to focus on regions most relevant given both the instruction and execution history. Extensive experiments show that AVA-VLA achieves state-of-the-art performance on standard robotic benchmarks, including LIBERO and CALVIN, and transfers effectively to real-world dual-arm manipulation tasks. These results demonstrate the effectiveness of temporally grounded active visual processing for improving VLA performance in robotic sequential decision-making. The project page is available at https://liauto-dsr.github.io/AVA-VLA-Page.

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

An Introduction to Causal Reinforcement Learning

arXiv:2606.24160v1 Announce Type: new Abstract: Causal inference provides a set of principles and tools that allow one to combine data and knowledge about an environment to reason with questions of counterfactual nature, i.e., what would have happened had reality been different, even when no data of this unrealized reality is currently available. Reinforcement learning provides methods to learn a policy that optimizes a specific measure (e.g., reward, regret) when the agent is deployed in an environment and pursues an exploratory, trial-and-error approach. These two disciplines have evolved independently and with virtually no interaction between them. We note that they operate over different aspects of the same building block, counterfactual relations, which makes them umbilically connected. Based on these observations, novel learning opportunities arise when this connection is explicitly acknowledged and mathematized. To realize this potential, we note that any environment where the RL agent is deployed can be decomposed as a collection of autonomous mechanisms with different causal invariances, parsimoniously modeled as a structural causal model; any standard RL setting implicitly encodes such a model. This formalization allows us to put under a unifying treatment different modes of learning, including online, off-policy, and causal calculus learning, which appear unrelated in the literature. However, these modalities are not exhaustive: we introduce several natural and pervasive classes of learning settings that entail novel dimensions of analysis. Specifically, we introduce and discuss through causal lenses generalized policy learning, where to intervene, imitation learning, and counterfactual learning. These tasks lead to a broader view of counterfactual learning and suggest great potential for studying causal inference and reinforcement learning side by side, which we call causal reinforcement learning (CRL).

07.
medRxiv (Medicine) 2026-06-16

Doctors, Wellness Influencers, and Probiotic Gummies: A Cross-Sectional Analysis of Gut Health Claims and Financial Conflicts on TikTok

TikTok has emerged as a major source of health information, yet concerns persist regarding the accuracy of content and influence of financial conflicts. Gut health content is particularly vulnerable to misinformation. This study examined the relationship between creator profession ("medical" versus "non-medical") and the quality of gut health claims and the presence of financial conflicts on TikTok. We conducted a cross-sectional study of 412 TikTok creator accounts identified using the search terms "guthealth," "gutcleansing," and "digestion." One video per creator was analyzed. Creator profession was categorized as medical or non-medical. Health claim quality was coded as high, moderate, or poor. Financial conflicts (Showcase, Subscription, external links) were assessed. Modified Poisson regression was used to estimate prevalence ratios (PRs) of health claim quality (high versus poor- or moderate-quality) and financial conflicts between medical and non-medical creators, and negative binomial regression was used to evaluate associations between claim quality and number of video likes. Non-medical creators were more likely than medical creators to present poor- or moderate-quality health claims (adjusted PR: 2.33; 95% CI: 1.50-3.62). Most creators (92%) exhibited at least one financial conflict, and Showcase use was greater among non-medical creators (adjusted PR: 1.57; 95% CI: 1.02-2.42). Videos containing moderate- and poor-quality health claims received three times as many likes as videos containing high-quality claims. Non-medical creators disproportionately produced lower-quality gut health content on TikTok, and misleading claims received greater engagement. These findings highlight a misalignment between information quality and visibility, emphasizing the need for interventions promoting evidence-based health communication.

08.
arXiv (CS.LG) 2026-06-11

Tensor Methods: A Unified and Interpretable Approach for Material Design

arXiv:2602.10392v2 Announce Type: replace Abstract: When designing new materials, it is often necessary to tailor the material design to have some desired properties. As the set of design parameters grow, the search space grows exponentially, making the actual synthesis and evaluation of all material combinations virtually impossible. Even using traditional computational methods such as Finite Element Analysis becomes too computationally heavy to search the design space. Recent methods use machine learning (ML) surrogate models to more efficiently determine optimal material designs; unfortunately, these methods often (i) are notoriously difficult to interpret and (ii) under perform when the training data comes from a non-uniform sampling of the design space. We suggest the use of tensor completion methods as an all-in-one approach for interpretability and predictions. We observe classical tensor methods are able to compete with traditional ML in predictions, with the added benefit of their interpretable tensor factors (which are given completely for free, as a result of the prediction). In our experiments, we are able to rediscover physical phenomena via the tensor factors, indicating that our predictions are aligned with the true underlying physics of the problem. This also means these tensor factors could be used by experimentalists to identify potentially novel patterns, given we are able to rediscover existing ones. We also study the effects of both types of surrogate models when we encounter training data from a non-uniform sampling of the design space. We observe more specialized tensor methods that can give better generalization in these non-uniforms sampling scenarios. We find the best generalization comes from a tensor model, which is able to improve upon the baseline ML methods by up to 5% on aggregate $R^2$, and halve the error in some out of distribution regions.

09.
medRxiv (Medicine) 2026-06-11

Genetic Susceptibility to Incisional Hernia: Evaluation of Hernia Polygenic Risk Scores

Objectives: Incisional hernia (IH) affects 13-30% of people after abdominal surgery, resulting in substantial morbidity and costs. While clinical risk factors have been studied extensively, genomic risk for IH is incompletely understood. We aimed to evaluate the impact of polygenic risk scores (PRS) on IH risk prediction. Methods] We created and evaluated three PRS for abdominal hernia, ventral hernia and latent hernia susceptibility for prediction of IH in an institutional biobank. The primary outcome was defined as the diagnosis or repair of an IH based on ICD-9/10-CM/PCS and CPT codes. Clinical covariates included age, sex, body mass index (BMI), smoking status, index procedure type, and perioperative surgical site infection. A phenome-wide association study (PheWAS) was performed to assess clinical associations with increased PRS. We then tested the ability of the PRS to improve prediction for IH by modeling clinical covariates with and without PRS in patients who underwent abdominal surgery. Model performance was assessed using 10 iterations of 5-fold cross-validation to estimate Brier scores and area under the receiver operating characteristic curve (AUROC), which were compared using cross-model Bayesian analysis of variance. Results: In 55,809 subjects, assessed PRS was significantly associated with incisional, umbilical, and ventral hernia on PheWAS, with 1.19 greater odds of developing IH per 1-SD increase in PRS (95% CI: 1.13-1.25, P < 0.001). Of 9,909 subjects who underwent qualifying abdominal surgery, 706 developed IH. In this cohort, the latent hernia susceptibility PRS was associated with a 16% increased hazard of developing IH per 1-SD increase (HR 1.16; 95% CI: 1.07-1.26; P < 0.001). Compared to a predictive model using clinical covariates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC = 0.660, 95% CI: 0.653-0.666), addition of the PRS showed similar Brier score and AUROC estimates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC: 0.667, 95% CI: 0.661-0.673) at five years. Cross-model Bayesian analysis demonstrated >99% probability of practical equivalence when trying to detect a difference of [&ge;] 0.02. Conclusion: All three PRS for hernia were independently associated with IH, suggesting that genomic factors contribute significantly to IH development. However, none of the three PRS meaningfully improved clinical IH risk prediction in patients who underwent abdominal surgery. This suggests that clinical comorbidities and surgical techniques may be equally as important as genomic architecture.

10.
arXiv (CS.LG) 2026-06-18

Estimating carbon pools in the European Shelf sea environment: replacing reanalysis by model-informed machine learning?

arXiv:2508.10178v3 Announce Type: replace-cross Abstract: Shelf seas are important for the economy and the carbon cycle, but shelf sea observations for carbon pools are often sparse, or highly uncertain. An alternative can be provided by carbon reanalyses (whether assimilating proxy variables, such as chlorophyll-$a$, or directly carbon), but these are often expensive to run. We propose to use a computationally cheap ensemble of neural networks (i.e. deep ensemble) to learn the relationship between the directly observable (atmospheric, riverine and ocean) variables and marine carbon pools from a coupled physics-biogeochemistry model. The deep ensemble was trained on a North-West European Shelf (NWES) physical-biogeochemistry model free run simulation. After training, the deep ensemble was run using inputs from the NWES reanalysis instead of the free run, demonstrating that it can efficiently predict several NWES carbon pools (e.g., detritus, zooplankton, heterotrophic bacteria) in much better agreement with the reanalysis than the free run, while also providing uncertainty information. We further show that the deep ensemble performs similarly well when it is driven directly by the observations assimilated into the reanalysis, with the limitation that carbon pools can then be predicted only at the observed locations and times. We focus on explainability of the results and demonstrate potential use of the deep ensembles for future climate what-if scenarios. We suggest that model-informed machine learning presents a viable alternative to expensive reanalyses and could complement observations, wherever they are missing and/or highly uncertain.

11.
arXiv (CS.CV) 2026-06-24

High-Fidelity Synthetic Transmission Electron Microscopy Image Generation Using Diffusion Probabilistic Models for Data-Limited Semiconductor Metrology

Advanced semiconductor nodes drastically increased demand for Transmission Electron Microscopy (TEM), yet destructive sample preparation, slow imaging and high costs severely limit the availability of diverse datasets needed for downstream machine learning (ML). Synthetic data generation is becoming essential, but current generative models often miss TEM-specific noise, structural detail, and stochastic variability crucial for evaluation. We present a Denoising Diffusion Probabilistic Model (DDPM) framework for synthetic TEM image generation under extreme data scarcity. A progressive patch-based training strategy scales from low-resolution patches to full images, enabling from-scratch training with only 15 samples. We integrate a custom TrivialAugment adaptation, cross-process domain transfer, classifier guidance, and RePaint-style inpainting, culminating in full-image generation that preserves global structural and spatial relationships in compliance with FAB metrology requirements. Beyond synthesis, we repurpose DDPM feature representations for segmentation, partitioning encoder feature maps to obtain coherent region masks. Our synthetic images achieve up to MS-SSIM > 0.98 and qualitative expert assessment consistent with structural similarity results, facilitating downstream ML training for defect detection, segmentation, and metrology while preserving statistical and physical realism.

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

ToolChain-CRC: Conformal Risk Control for Agentic AI Under Retrieval and Tool-Use Drift

arXiv:2606.18467v1 Announce Type: cross Abstract: Modern AI agents retrieve documents, call tools, check intermediate information, and then produce a final answer or action. This creates a risk-control problem that is not visible from the final answer alone. A final response may look acceptable even when the retrieval was weak, a tool output was wrong, or an earlier step was unsupported. We propose ToolChain-CRC, a conformal risk-control method for retrieval-augmented and tool-using agents under drift. The method treats each agent run as a full trajectory of actions, observations, and final output. It builds step-level risk scores, combines them into a trajectory risk score, calibrates an accept-or-intervene rule, and adds an anytime alarm that can stop risky runs before the final answer. We prove trajectory-level risk control under exchangeable calibration runs, give a drift-aware extension with auditable constants, and prove an anytime escalation rule through a supermartingale construction. Experiments cover synthetic tool-chain drift, RAG/tool-use stress tests, public SQuAD-derived retrieval tasks, an API-free agentic QA case study, ablations, target-risk sensitivity checks, 20-seed robustness checks, a drift-margin audit, and a live RAG/tool-use agent benchmark. Across these settings, final-answer-only calibration can miss retrieval and tool failures, while trajectory-level calibration keeps accepted-trajectory risk below the target.

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

Control-Plane Placement Shapes Forgetting: An Architectural Study of Agent Memory Across Thirteen System Configurations

作者:

Where an LLM sits in an agent memory pipeline – between the recall plane that retrieves stored facts (extensively benchmarked) and the control plane that mutates them via supersede, release, purge (largely untested) – shapes which forgetting failure modes the system recovers. Comparing thirteen system configurations on a 385-case adversarial surface, we observe three placement regimes with partly complementary coverage: deterministic primitives suffice for lexical/temporal categories but fail canonicalization (5% on identifier-obfuscation, 0% on cross-lingual); inscribe-time LLM recovers canonicalization (100%) but cannot help intent-aware deletion (0% on prefix-collision and compound-fact); a mutation-time hook recovers intent-aware deletion (78-85%) and brightens nearly all categories simultaneously (91.7-93.2% overall, $0.17 per 385-case run, 2.3s/case mutation latency vs. 64-191ms/case deterministic, recall path unchanged). We expose the trade-off via ForgetEval, a 1000-case templated suite plus a 385-case adversarial layer (132 hand-crafted + 253 LLM-drafted oracle-validated) scored by deterministic substring match, paired with a six-method Adapter Protocol with honest N/A scoring that lets heterogeneous memory stores enter in 130 lines. Admission is corroborated by 10-annotator IAA (Fleiss' kappa = 0.958) and a 77-case external-authored subset (four blind contributors) that replicates the canonicalization asymmetry and amplifies the joint-placement lift (+27.8 pt). Production failures are predominantly forgetting failures rather than recall failures, yet existing benchmarks measure only recall. ForgetEval and all adapters are released under MIT.

15.
arXiv (CS.CL) 2026-06-19

MENTOR: Reinforcement Learning via Flexible Teacher-Optimized Rewards for Tool-Use Distillation

Distilling the tool-use capabilities of large language models (LLMs) into small language models (SLMs) is essential for their practical application. The predominant approach, supervised fine-tuning (SFT), suffers from poor out-of-domain (OOD) generalization due to its rigid alignment with static teacher trajectories. While reinforcement learning (RL) offers an alternative, the capacity limitations of SLMs pose a severe dilemma: sparse outcome rewards provide insufficient guidance, whereas strict trajectory matching imposes overly restrictive constraints. To bridge this capacity-driven gap, we propose MENTOR, which introduces a flexible yet process-aware reward structure. Instead of enforcing rigid replication, MENTOR uses the teacher's reference to guide tool-use behavior, balancing behavioral alignment with downstream performance. Extensive experiments on controlled executable-tool benchmarks demonstrate that MENTOR improves OOD tool-use performance compared to SFT and strict RL baselines. Our findings suggest that within verifiable tool-use environments, flexible tool-use alignment offers a more effective approach than strict trajectory replication for developing adaptable small models.

16.
Nature (Science) 2026-06-17

Rock weathering can counteract river CO<sub>2</sub> emissions induced by permafrost thaw

作者:

Climate-induced permafrost thaw unlocks large stores of organic carbon that are mineralized and emitted as carbon dioxide (CO2) from rivers to the atmosphere1. Concurrently, warming and permafrost thaw can increase mineral weathering rates, thus affecting the release and sequestration of inorganic carbon2–4. Yet how these biological and geological carbon cycles interact and jointly affect CO2 dynamics (emission compared with drawdown) in permafrost rivers remains unknown5. Here we combine CO2 emissions, organic and inorganic solute concentrations, dual carbon isotopes (δ13C–Δ14C) and geochemical modelling to infer how permafrost thaw may affect river biogeochemistry over decades to centuries across the Qinghai–Tibet Plateau. Leveraging a gradient of thermal permafrost degradation, we find that river CO2 emissions decline, whereas solute fluxes from rock weathering increase with decreasing permafrost cover. Across this region, net CO2 drawdown fluxes from rock weathering are about 35% of river CO2 emissions, varying from around 15% in catchments with continuous permafrost to more than 100% in catchments with discontinuous or isolated permafrost. Thus, carbon fluxes from chemical weathering may become increasingly important with ongoing permafrost thaw, potentially even outpacing river CO2 emissions. Our findings disentangle the interplay between biological and geological carbon fluxes that are important for the cryosphere and the global carbon cycle. Permafrost thaw on the Qinghai–Tibet Plateau increases rock-weathering rates while reducing river CO2 emissions, suggesting geological carbon fluxes may eventually outpace thaw-driven emissions.

17.
arXiv (CS.AI) 2026-06-11

"That's AI Slop, You Bot!" Studying Accusations, Evidence, and Credibility in Online Discourse Towards LLM-Generated Comments

arXiv:2606.12073v1 Announce Type: cross Abstract: Generative AI has made fluent prose cheap to produce, breaking the old promise to readers that good writing meant real thinking. How have readers responded, and what can this tell us about changing anti-AI attitudes? We analyzed 25 million comments from Hacker News and Reddit (2023-2026), combining LLM judgment on 7,500 sampled accusations of AI use, sentiment trajectories, speech-act coding of 300 confirmed accusations of AI use, and a matched-control test of accused versus non-accused parent comments. We found that the pejorative-label share of accusations rose more than tenfold on both platforms while a placebo vocabulary of pre-2022 inauthenticity terms (shill, astroturf) did not. This shift reflected a fast-growing trend of branding any suspicious or seemingly inauthentic prose as "AI slop". The slop frame now constitutes 94 percent of pejorative mentions, with the dominant comments shifting in tone from mockery toward gatekeeping and structural protest. The key surprise comes from a matched-control test which found that prose features that statistically distinguish AI from human text do not predict which human text gets accused as AI. The new accusations work as social gatekeeping of perceived authenticity without actually screening for AI. This research extends signaling theory by showing that substitute signals used socially can grow even when inaccurate if the underlying detection problem cannot be solved at the non-expert level. It shows that AI's effects on writing from the reader side are distinct from those on the production (writer) side. Detection technology cannot resolve this dynamic because the social function of accusations is increasingly to perform social gatekeeping and in-group signaling as opposed to identifying AI-generated writing.

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

Stabilizing Physics-Informed Consistency Models via Structure-Preserving Training

arXiv:2602.09303v2 Announce Type: replace Abstract: We propose a physics-informed consistency modeling framework for solving partial differential equations (PDEs) via fast, few-step generative inference. We identify a key stability challenge in physics-constrained consistency training, where PDE residuals can drive the model toward trivial or degenerate solutions, degrading the learned data distribution. To address this, we introduce a structure-preserving two-stage training strategy that decouples distribution learning from physics enforcement by freezing the coefficient decoder during physics-informed fine-tuning. We further propose a two-step residual objective that enforces physical consistency on refined, structurally valid generative trajectories rather than noisy single-step predictions. The resulting framework enables stable, high-fidelity inference for both unconditional generation and forward problems. We demonstrate that forward solutions can be obtained via a projection-based zero-shot inpainting procedure, achieving consistent accuracy of diffusion baselines with orders of magnitude reduction in computational cost.

19.
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)

20.
arXiv (CS.CL) 2026-06-12

SkillCAT: Contrastive Assessment and Topology-Aware Skill Self-Evolution for LLM Agents

Skill self-evolution methods for LLM agents aim to turn execution trajectories into reusable skill documents, but current pipelines typically learn from one trajectory per task, merge candidate skill patches before checking them, and load the full skill corpus before inference. We propose SkillCAT, a training-free framework that separates this process into three stages. Contrastive Causal Extraction (CCE) samples multiple trajectories for each task and compares same-task success/failure pairs to identify evidence that explains outcome differences. Assessment-Augmented Evolution (AAE) replays each candidate patch on source-task clones and keeps only patches that improve or preserve task outcomes before hierarchical skill patch merging. Topology-Aware Task Execution (TTE) compiles the evolved skills into a routable sub-skill topology, so inference loads only the capability nodes relevant to the task. We evaluate SkillCAT on common agent benchmarks, including SpreadsheetBench, WikiTableQuestions, and DocVQA, and further test cross-model and out-of-distribution generalization. Across these settings, SkillCAT raises the average score over baselines by up to 40.40%, demonstrating reliable skill evolution without model training.

21.
arXiv (CS.CV) 2026-06-17

High-Fidelity 3D Geometric Reconstruction of Pelvic Organs from MRI: A Hybrid Deep Learning and Iterative Optimization Approach

Patient-specific 3D reconstruction of pelvic organ geometry from MRI is important for pelvic floor modeling and downstream patient-specific analysis. However, while previous studies have focused primarily on either image segmentation or downstream use of 3D models, the reconstruction of high-fidelity, high-quality geometries remains labor-intensive and poorly standardized. The study introduced a hybrid deformable shape modeling framework that integrates deep learning prediction with iterative optimization for the reconstruction of the bladder, uterus, and rectum. The framework consists of three core components: a geometry-aware multi-level deep learning architecture that preserves topological consistency of pelvic organs; a two-stage amortized optimization training strategy that balances global shape capture and local surface refinement; and a holistic synergy mechanism–where iterative optimization provides supervision for deep learning during the training phase, and during inference, deep learning rapidly predicts the global organ morphology, followed by iterative optimization to refine local surfaces and mesh quality. This framework demonstrated marked superiority in geometric fidelity than current mainstream deep learning-based organ reconstruction models. For individual anatomical structures, the reconstructed 3D geometries for the bladder, rectum, and uterus achieved significantly lower Chamfer Distance values and higher Dice Similarity Coefficient scores. In addition, while maintaining high computational efficiency, the proposed architecture yielded superior overall volumetric mesh quality. At the patient level, the framework achieved higher mean values for the 10 worst elements for both minSICN and minSIGE compared to traditional geometric post-processing algorithms.

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

Deep Learning and Elicitability for McKean-Vlasov FBSDEs With Common Noise

arXiv:2512.14967v2 Announce Type: replace Abstract: We present a novel numerical method for solving McKean–Vlasov forward–backward stochastic differential equations (MV–FBSDEs) with common noise, combining Picard iterations, elicitability and deep learning. The key innovation involves elicitability to derive a pathwise loss function, enabling efficient training of neural networks to approximate both the backward process and the conditional expectations arising from common noise, without requiring computationally expensive nested Monte Carlo simulations. The mean-field interaction term is parameterized via a recurrent neural network trained to minimize an elicitable score, while the backward process is approximated through a hybrid feedforward and recurrent network representing the decoupling field. We validate the algorithm on a systemic-risk inter-bank borrowing and lending model, where analytical solutions exist, demonstrating accurate recovery of the true solution. We further extend the model to quantile-mediated interactions, showcasing the flexibility of the elicitability framework beyond conditional means or moments. Finally, we apply the method to a non-stationary Aiyagari–Bewley–Huggett economic growth model with endogenous interest rates, illustrating its applicability to complex mean-field games without closed-form solutions.

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

Predicting the Neutrino Mass Ordering Using Neural Networks

arXiv:2606.03745v1 Announce Type: cross Abstract: Determining the neutrino mass ordering remains a central open problem in particle physics. While next-generation long-baseline experiments are expected to resolve this question, current data provide limited sensitivity because the spectral differences between normal and inverted ordering are subtle and entangled with parameter degeneracies. We investigate a machine-learning strategy for mass-ordering determination using a feed-forward neural-network classifier trained on synthetic long-baseline datasets generated with three-flavour oscillation probabilities, matter effects, and statistical fluctuations. We evaluate the classifier against standard $\chi^2$ and $\log\mathcal{L}$ approaches using common discrimination metrics, including receiver-operating-characteristic curves, to quantify sensitivity and to illustrate how operating points can be selected to prioritise purity or efficiency. We find that the neural network achieves performance comparable to conventional fits for the scenarios studied, providing a flexible, independent cross-check of established analyses. The framework can be extended to incorporate systematic uncertainties and to explore joint inference of oscillation parameters, and it may also serve as a pedagogical tool for introducing machine-learning methods in neutrino physics.

24.
bioRxiv (Bioinfo) 2026-06-13

ADMETron: An AI-driven SaaS platform for comprehensive ADMET prediction and compound prioritisation

ONTOSIGHT(R) ADMETron is an AI-driven platform designed for rapid prediction and visualization of Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) properties to support modern drug discovery. The platform integrates an interactive web interface with a scalable predictive engine, enabling high-throughput virtual screening and batch analysis of chemical compounds. Its core architecture combines recurrent neural network (RNN)-derived molecular embeddings from SMILES representations with physicochemical descriptors, which are subsequently modeled using gradient boosting machines (GBMs). This framework provides predictions across 34 ADMET endpoints, including physicochemical properties, absorption, CYP450 interactions, hERG liability, and mutagenicity. The predictive performance of ADMETron was evaluated using benchmark datasets from the Therapeutics Data Commons (TDC), demonstrating strong performance and generalizability across both classification and regression tasks. Beyond predictive modeling, the platform introduces an interactive radar graph-based structure-activity relationship (SAR) visualization framework that enables real-time comparison of multiple compounds and reference drugs across selected ADMET parameters. This feature facilitates intuitive interpretation of multidimensional molecular profiles and supports lead optimization and compound prioritization. Comparative assessment against widely used online ADMET tools further demonstrated broad endpoint coverage spanning pharmacokinetic, physicochemical, toxicity, and medicinal chemistry properties within a unified environment. Together, these capabilities establish ADMETron as a comprehensive platform for ADMET assessment and data-driven decision-making in drug discovery. (https://admetron.partex.ai/).

25.
arXiv (math.PR) 2026-06-11

Micro-macro population dynamics models of benthic algae with long-memory decay and generic growth

arXiv:2505.04289v4 Announce Type: replace Abstract: Benthic algae as a primary producer in riverine ecosystems develop biofilms on the riverbed. Their population dynamics involve growth and decay processes, the former owing to the balance between biological proliferation and mortality, while the latter to mechanical abrasion because of the transport of sediment particles. Contrary to the assumptions of previous studies, the decay has experimentally been found to exhibit long-memory behavior, where the population decreases at an algebraic rate. However, the origin and mathematical theory of this phenomenon remain unresolved. The objective of this study is to introduce a novel mathematical model employing spin processes to describe microscopic biofilm dynamics. A spin process is a continuous-time jump process transitioning between states 0 and 1, and the continuum limit of these processes captures the long-memory decay and generates generic growth. The proposed framework leverages heterogeneous spin rates, achieved by appropriately superposing spin processes with distinct rates, to reproduce the long-memory decay. Computational simulations demonstrate the behavior of the model, particularly emphasizing rate-induced tipping phenomena. This mathematical model provides a computationally tractable interpretation of benthic algae dynamics and their long-term prediction, relevant to river-engineering applications.