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01.
arXiv (CS.CV) 2026-06-11

Frames2LoRA: Parametric Video Internalization for Vision-Language Models

Processing video in vision-language models is expensive: each frame occupies hundreds of tokens, and inference cost scales with every frame and every repeated query. We introduce Frames2LoRA, a method for parametric video internalization. A perceiver hypernetwork reads the intermediate representations produced layer-by-layer as a frozen VLM encodes a video, and generates a Low-Rank Adaptation (LoRA) adapter in a single forward pass. Unlike standard LoRA fine-tuning, which requires iterative gradient updates, Frames2LoRA predicts these weights directly from the video. Trained for SmolVLM2 500M and 2.2B on video summarization and captioning, Frames2LoRA enables the same frozen VLM to answer queries from the adapter alone, with zero visual tokens in its context at query time. Frames2LoRA is statistically non-inferior and equivalent to direct video-in-context inference across all five captioning benchmarks at both model scales, and across seven of eight video question answering benchmark-scale pairings. Although trained only on 12 frames at 384px, it remains stable up to 1,024 frames and 1024px, where direct video-in-context inference often degenerates. Across this sweep, it reduces answer-time visual-token load by up to 1,500x and query TTFT by 6-80x, while preserving video-faithful outputs. We also find that independently generated adapters for non-overlapping video segments can compose in rank space, suggesting a path toward chunked long-video internalization.

02.
arXiv (CS.AI) 2026-06-11

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

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

03.
arXiv (CS.CV) 2026-06-19

Neural Events: Discrete Asynchronous Autoencoders for Event-Based Vision

Event cameras capture dynamic scenes with exceptional temporal fidelity by representing them as a continuous stream of microsecond resolution events. Each individual event, however, only carries minimal semantic value, merely signaling a localized brightness change. To derive meaningful signals, downstream algorithms need to quickly integrate cues from a potentially massive torrent of low-information events. Current architectures, however, are easily overwhelmed, struggling to balance capturing fine-grained temporal dynamics and maintaining a manageable data throughput. This paper proposes a framework to re-tokenize event streams into a small set of highly informative neural events, each representing a local spatio-temporal context window with a discrete learnable code. Every time this code flips, a neural event is triggered, yielding a highly compressed data stream. We demonstrate that, across object detection and classification, networks trained on neural events are on par or surpass the performance of state-of-the-art approaches while reducing the event rate by a factor of 2.0.

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

Why Tree-Style Branching Matters for Thought Advantage Estimation in GRPO

Group Relative Policy Optimization (GRPO) trains Chain-of-Thought reasoning with verifiable rewards, but estimating thought-level advantages without value functions often suffers from high variance. Although tree-style branching is used in practice to reduce variance, it lacks a theoretical explanation of why it works and whether it is important or potentially necessary. We study thought-level advantage estimation in GRPO from a variance perspective under a minimal tree-style setting where multiple continuations are sampled for each thought. Using the multivariate delta method, we reveal a sampling-dimension asymmetry. Increasing sampled thoughts ($K$) leaves a strictly positive estimation-variance floor, whereas increasing continuations per thought ($M$) drives the leading-order estimation variance to zero at rate $1/M$. This implies that, within the fixed-temperature GRPO-style estimator without value models studied here, accurate thought-level advantage estimation cannot be achieved by scaling thought sampling alone, making continuation-level branching a principled and potentially necessary mechanism rather than a heuristic. Experiments further provide empirical evidence for its effectiveness and potential necessity, demonstrating improved optimization stability, training efficiency, and final performance not only in math but also across vision domains and under different model architectures and sizes.

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

AIChilles: Automatically Uncovering Hidden Weaknesses in AI-Evolved Systems

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

06.
arXiv (CS.LG) 2026-06-16

Prediction of Runtime Parameters of Parallel Chemistry Applications via Active and Generative Learning

arXiv:2606.16226v1 Announce Type: new Abstract: In this work, we develop two main Machine Learning based approaches to predict the runtime parameters of highly scalable parallel chemistry computations.These approaches employ active and generative learning together with the empirically determined gradient boosted regression tree models chosen among a rich suite of machine learning models. When evaluated on Coupled-Cluster with Singles and Doubles computations, our models achieve a mean absolute error percentage (MAPE) as low as 0.023 and a coefficient of determination as high as 99.9%. Furthermore, when combined with active learning to mitigate the lack of large amounts of training data, our models score a MAPE about 0.2 with 20-25% of the original dataset.

07.
arXiv (math.PR) 2026-06-11

Mean-field limits for stochastic particle systems on dense graphs

arXiv:2606.11369v1 Announce Type: new Abstract: We study stochastic interacting particle systems whose interaction structure is described by dense weighted directed graphs converging to a graphon. In the thermodynamic limit, we prove a law of large numbers for the empirical measure process and derive a deterministic nonlinear master equation describing the macroscopic evolution. The limiting equation retains the heterogeneous interaction structure of the microscopic system through the limiting graphon, allowing for spatially non-homogeneous behaviors such as localized or community-type interactions.

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

Self-Supervised Multisensory Pretraining for Contact-Rich Robot Reinforcement Learning

arXiv:2511.14427v4 Announce Type: replace-cross Abstract: Effective contact-rich manipulation requires robots to synergistically leverage vision, force, and proprioception. However, Reinforcement Learning agents struggle to learn in such multisensory settings, especially amidst sensory noise and dynamic changes. We propose MultiSensory Dynamic Pretraining (MSDP), a novel framework for learning expressive multisensory representations tailored for task-oriented policy learning. MSDP is based on masked autoencoding and trains a transformer-based encoder by reconstructing multisensory observations from only a subset of sensor embeddings, leading to cross-modal prediction and sensor fusion. For downstream policy learning, we introduce a novel asymmetric architecture, where a cross-attention mechanism allows the critic to extract dynamic, task-specific features from the frozen embeddings, while the actor receives a stable pooled representation to guide its actions. Our method demonstrates accelerated learning and robust performance under diverse perturbations, including sensor noise, and changes in object dynamics. Evaluations in multiple challenging, contact-rich robot manipulation tasks in simulation and the real world showcase the effectiveness of MSDP. Our approach exhibits strong robustness to perturbations and achieves high success rates on the real robot with as few as 6,000 online interactions, offering a simple yet powerful solution for complex multisensory robotic control. Website: https://msdp-pearl.github.io/

09.
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.

10.
arXiv (quant-ph) 2026-06-16

Boson Sampling as a Probe of Chaotic and Integrable Quantum Dynamics in a Photonic Chip

arXiv:2605.25398v2 Announce Type: replace Abstract: Quantum chaos plays a key role in understanding complex quantum dynamics, while integrated photonics offers unique advantages for quantum applications, including high-speed operation, scalability, and programmable unitary transformations. However, integrated photonic approaches to probing quantum chaos remain largely unexplored, owing to the absence of a clear connection between programmable photonic dynamics and established chaos diagnostics. In this work, we establish Fock-state boson sampling as a practical probe of quantum chaos by exploiting the sensitivity of multiphoton interference to the random-matrix properties of underlying single-particle unitary dynamics. More importantly, we design and fabricate a programmable quantum photonic chip to experimentally implement this framework, achieving the first integrated-photonic demonstration of quantum-chaos probes based on boson sampling. Experimental results show that the three complementary probes proposed in this work, namely the distance to Porter–Thomas statistics, Shannon entropy, and Out-of-Time-Ordered-Correlator-equivalent observables, exhibit close agreement with theoretical predictions and consistently distinguish chaotic and integrable dynamics. Our work provides a scalable route for investigating complex quantum dynamics on programmable photonic platforms while leveraging the intrinsic advantages of boson sampling through multiphoton interference and complex output statistics.

11.
medRxiv (Medicine) 2026-06-18

From Paper Letters to an Integrated Digital Workflow: Improving Efficiency, Reliability, and Engagement in Health Guidance

Background: Post-checkup health guidance in Japan has traditionally relied on paper-based communication and manual administrative processes. These workflows are time-consuming, prone to transcription errors, and can delay timely engagement with health guidance recipients. Objective: To assess whether replacing a paper-based workflow with an integrated digital system using Microsoft Access, robotic process automation (RPA), and web-based responses could improve administrative efficiency, operational reliability, and engagement among health guidance recipients. Methods: This single-site quality improvement initiative redesigned the existing letter-based workflow. Access served as a central interface for managing recipients and generating guidance letters. RPA (EzRobot) automated repetitive clerical and billing-related tasks. A web form accessed via a QR code enabled recipients to respond digitally. Outcomes included manual administrative handling time per case, occurrence of transcription-related errors, health guidance completion rate, and guidance duration distribution. Results: Following implementation, staff active handling time per case decreased from approximately 10 minutes to less than 1 minute (approximately 30 seconds), while automated RPA execution typically required about 4-5 minutes per case without staff input. No transcription-related errors were detected during the post-implementation observation period. Health guidance completion rates improved from 28.3% to 39.2% (chi-square test, P=200 days decreased from 30.5% to 20.9% and cases with >=240 days decreased from 13.6% to 8.9% (R4 n=59, R5 n=158). Conclusion: An integrated Access-RPA-Web workflow was associated with improvements in administrative efficiency and operational reliability in post-checkup health guidance while retaining human verification and exception handling. This pragmatic, non-AI-dependent approach may offer a useful model for process-level improvement in preventive care settings.

12.
arXiv (CS.AI) 2026-06-11

GEAR-VLA: Learning Geometry-Aware Action Representations for Generalizable Robotic Manipulation

arXiv:2606.08530v2 Announce Type: replace-cross Abstract: Vision-Language-Action (VLA) models achieve strong benchmark performance but still struggle in real-world deployment with unseen objects, background shifts, and different robot embodiments. We argue that this stems from the lack of a unified geometry-aware manipulation representation, leaving existing VLAs vulnerable to low-level trajectory supervision, misaligned 3D features, and embodiment differences. To address this, we propose GEAR-VLA, a VLA framework for learning unified geometry-aware action representations for generalizable robotic manipulation. GEAR-VLA adopts coarse-to-fine action learning, where multi-source embodied pretraining equips the VLM with embodied reasoning and discrete action understanding before latent action tokens connect action semantics to a gradient-decoupled DiT continuous action expert. It further performs semantic-aligned 3D integration by aligning a trainable 3D spatial backbone with the VLA representation while freezing the original VLM-aligned visual pathway. To share this representation across robots, GEAR-VLA uses embodiment canonicalization, where embodiment-aware states and embodiment-invariant actions confine robot differences to the low-level interface. Extensive simulation and real-world experiments demonstrate strong generalization: GEAR-VLA achieves state-of-the-art performance on LIBERO, zero-shot LIBERO-Plus, and RoboTwin 2.0, reaches 85.9% success on AgileX and 81.0% on the pretraining-unseen LDT-01 embodiment, and obtains 90.1% success on a 6,360-trial universal grasping benchmark with 212 unseen objects. Code and models will be released at https://github.com/babynabeauty/GEAR-VLA.

13.
arXiv (CS.AI) 2026-06-16

ToolSelf: Unifying Task Execution and Self-Reconfiguration via Tool-Driven Emergent Adaptation

arXiv:2602.07883v4 Announce Type: replace Abstract: LLM-powered agentic systems excel at complex long-horizon tasks, but remain constrained by static configurations fixed before execution. Such rigidity forces a trade-off between domain-specific performance and cross-task generalization: strong priors and compact tool spaces aid specialization but weaken transfer, while task-agnostic workflows and broad action spaces expand coverage but dilute guidance. Existing pre-execution optimization, planner-worker orchestration, and configuration patching fall short of resolving this tension, as they decouple adaptation from execution, causing information loss, fragmented optimization, and ambiguous credit assignment. We propose ToolSelf, a tool-driven runtime self-reconfiguration paradigm that abstracts configuration updates as a standardized tool interface and unifies execution and adaptation within one policy's action space. The execution agent can dynamically update sub-goals, strategies, toolboxes, context, and context-management modes based on task progress and feedback. We further introduce Configuration-Aware Two-stage Training (CAT), which combines rejection sampling fine-tuning with trajectory-level KTO reinforcement learning to internalize self-reconfiguration. Across diverse benchmarks, zero-shot ToolSelf rivals task-specialized agents; after CAT training, ToolSelf gains 28.8 points over the static-configuration baseline on average, illuminating a path toward emergent adaptivity that obviates manually injected guidance. The code is available at https://github.com/lian-tian-mo-zun/ToolSelf.

14.
arXiv (CS.CV) 2026-06-17

EventDrive: Event Cameras for Vision-Language Driving Intelligence

Event cameras sense the world through asynchronous brightness changes with microsecond latency and high dynamic range, offering motion fidelity far beyond frame-based sensors and capturing temporal structure that conventional exposures often miss. These properties make events a powerful complement to RGB in autonomous driving, especially under blur, glare, and rapid motion, where frame-based perception can become unreliable. However, existing event-aware vision-language models remain limited to generic perception and do not reveal how event sensing contributes to reasoning and decision-making across the full driving loop. We present EventDrive, a large-scale benchmark and model suite that unifies event streams, RGB frames, and language supervision across four core dimensions: Perception, Understanding, Prediction, and Planning, covering captions, structured QA, grounding, motion-state recognition, trajectory forecasting, and planning tasks. Building on this foundation, EventDrive-VLM introduces a multi-horizon event pyramid and a temporal-horizon mixture-of-experts module to adaptively encode and fuse asynchronous and frame-based information for downstream reasoning. Comprehensive evaluation across diverse tasks shows that event streams provide substantial gains in temporal precision, motion awareness, and robustness, bringing event sensing into the center of driving intelligence.

15.
arXiv (CS.CV) 2026-06-17

Attention Alignment Between Humans and Vision-Language Models

Visual perception depends on top-down goals and bottom-up sensory mechanisms. Vision-language models implement both, allowing us to treat each component as a separable hypothesis about what drives where we look. We compared spatial attention maps from six vision-language models against human fixation heatmaps recorded on 200 images during two tasks (general description and social captioning). The six models spanned a 2$\times$2 factorial of CNN vs.\ ViT encoders crossed with LSTM vs.\ Transformer decoders, plus Molmo 7B-D and Qwen3.5 9B. We found that both decoder and encoder architecture shaped alignment, but decoder choice dominated. LSTM vs.\ Transformer decoders increased alignment by 40–50 percentage points (80–87\% vs.\ 40–59\% of the human noise ceiling). In contrast, CNN vs.\ ViT encoders contributed a secondary 5–20 point advantage depending on decoder family, with CNN-LSTM the most aligned model overall (85–87\%). Despite their alignment advantage, LSTM-decoder attention maps were spatially diffuse and minimally task-differentiated; ViT-Transformer, the weakest in alignment, showed the sharpest spatial concentration and strongest task differentiation. A hemispatial-neglect simulation confirmed that ablating attention impacted LSTM decoders more than Transformer decoders. In an exploratory extension using TRIBE-simulated synthetic neural responses, fixation alignment and neural relevance dissociate: CNN-Transformer attention maps better predicted synthetic brain activity despite lower fixation alignment, with attention maps best predicting early visual cortex. Together, top-down and bottom-up components trade off what they predict in behavioral and synthetic neural data.

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

Agentic Environment Engineering for Large Language Models: A Survey of Environment Modeling, Synthesis, Evaluation, and Application

Environments serve as interactive systems for large language model (LLM) based agents across diverse scenarios and play a crucial role in driving the continual evolution of model capabilities. Despite this importance, existing work lacks a systematic categorization and deep analysis. This paper systematically studies current researches on agentic environments from the perspective of the environment engineering lifecycle, covering their modeling, synthesis, evaluation and application. Specifically, the paper first introduces representative environments from the perspectives of eight attributes and eight domains, providing detailed analyses of their development paths and highlighting their core capabilities. Second, for automated environment synthesis, two paradigms are introduced, such as symbolic synthesis and neural synthesis. This paper also shows different environment evaluation methods in each paradigm. Thirdly, the corresponding environment applications from the perspective of agent-environment co-evolution are discussed. In specific, the paper characterizes the primary pathways for agent evolution in dynamic environments from four complementary perspectives: memory-centric experience evolution, orchestration-centric workflow evolution, trajectory-centric offline evolution, and exploration-centric online evolution. And three paradigms of environment evolution are identified, namely neural-driven, difficulty-driven, and scaling-driven approaches. At last, several promising future directions are discussed, including Environment-as-a-Service, Multi-agent Environments, and Neural-Symbolic Environments.

17.
arXiv (CS.CV) 2026-06-18

Rethinking Text-to-Image as Semantic-Aware Data Augmentation for Indoor Scene Recognition

In the realm of computer vision, indoor image recognition presents challenges due to the intricate interplay of lighting conditions, occlusions, and diverse object arrangements within confined spaces. To address the lacks of training indoor images, we introduce a novel approach leveraging Stable Diffusion (SD) for the generation of synthetic images, which serve as a powerful data augmentation tool. The utilization of SD offers a principled framework for synthesizing diverse and realistic indoor scenes, thereby enriching the training data pool for robust indoor image recognition models. Experimental findings on the MIT Indoor Scene dataset reveal the potential of our proposed approach in enhancing the training of deep models when authentic data is limited. Furthermore, to prevent the misuse of SD synthetic images, we introduce a counter measure based on DIffusion Reconstruction Error (DIRE). The powerful DIRE presentation enables training robust classifiers only using lightweight deep models. Experiments show that our approach can perfectly recognize SD generated images with the accuracy of 100% using MobilenetV3.

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

Where Did It Go Wrong? Process-Level Evaluation of Web Agents with Semantic State Tracking

arXiv:2606.15673v1 Announce Type: new Abstract: Web agents act through long interaction sequences, yet existing benchmarks evaluate only terminal success, discarding all process information and offering little guidance on improvement. In this work, we conduct a process-level analysis of web agents. We introduce WebStep, a benchmark of 1,800 task instances with controlled difficulty and automatic semantic state tracking. Each website exposes a deterministic semantic MDP alongside the GUI: the agent operates on the interface, while the environment records high-level states and transitions in the background, enabling fine-grained analysis without manual annotation. Based on the semantic trajectory, we first show that process metrics reveal differences invisible to outcome evaluation: three agents whose success rates cluster within 31-33% diverge in exploration reach versus execution accuracy. Then, decomposing by skill characterizes the nature of these differences, exposing opposite per-skill rankings hidden within the same website: e.g., on Housing, OpenAI CUA outperforms Qwen3.5 by 23.7% on commit actions yet underperforms it by 15.6% on filtering, pinpointing a concrete skill to improve even within a domain. Bifurcation analysis further localizes the decisive error that loses the task and shows that this error is agent-specific rather than shared. Finally, these differences widen as tasks grow harder: success rate is similar on easy tasks but separates sharply as exploration becomes more demanding. Our process-level analysis opens a new avenue in web agent evaluation, providing fine-grained and actionable insight into where and how each agent should be improved.

19.
arXiv (CS.LG) 2026-06-17

QueryMarket: Cost-Aware Online Active Learning in Data Markets

arXiv:2606.17805v1 Announce Type: new Abstract: Data acquisition is a major bottleneck for learning in real-time streams: analysts must decide on the fly which labels to purchase while respecting a rolling budget. However, existing online active learning rarely unifies pricing, information gain, and rolling budget constraints under concept drift. We introduce QueryMarket, a market-inspired framework that queries each incoming data point based on its estimated utility to the model and its price. Within this framework, we propose OVBAL (online variance-based active learning), which integrates data pricing with information-driven selection by estimating each sample's marginal utility via a D-optimality criterion with exponential forgetting and executing cost-aware purchases under rolling budget constraints. OVBAL yields a simple, fully online decision rule that adapts to nonstationary streams and heterogeneous label costs. Experiments on synthetic data and a real-world solar power generation forecasting task show that OVBAL is particularly effective under seller-centric pricing and yields a more favorable long-run error-cost trade-off in the real-world task under both pricing schemes.

20.
arXiv (quant-ph) 2026-06-16

Noise-Adaptive Predictive Dynamical Decoupling

arXiv:2606.15769v1 Announce Type: new Abstract: Protecting quantum coherence against realistic environmental noise remains one of the fundamental obstacles to scalable quantum technologies. We develop a noise-adaptive dynamical decoupling framework that combines analytical open-quantum-system modeling with machine-learning-based forecasting for a qubit interacting with random telegraph noise. Unlike conventional dynamical decoupling protocols based on fixed pulse schedules, the proposed approach continuously forecasts short-time coherence evolution and adaptively applies control pulses according to the instantaneous noise dynamics. We investigate stationary and non-stationary environments spanning both Markovian and non-Markovian regimes. Numerical simulations demonstrate that the machine-learning-assisted adaptive control strategy substantially outperforms conventional periodic dynamical decoupling while using a comparable number of control pulses. The improvement becomes particularly pronounced in non-Markovian and non-stationary regimes, where memory effects, coherence revivals, and temporally evolving noise strongly limit the effectiveness of static pulse protocols. These results establish predictive machine-learning-assisted dynamical decoupling as a promising and scalable framework for adaptive quantum control in realistic noisy quantum devices.

21.
medRxiv (Medicine) 2026-06-11

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

22.
arXiv (math.PR) 2026-06-15

Stability of Synthetic Ricci Curvature Lower Bounds for Inverse Limit Extended Metric Measure Spaces

arXiv:2606.14322v1 Announce Type: cross Abstract: We show that every Polish extended metric measure space arises as an inverse limit of metric measure spaces up to isomorphism. We then prove that synthetic Ricci curvature lower bounds and several functional inequalities, including the log-Sobolev, Talagrand, Poincaré, and dimension-free Harnack inequalities are stable under inverse limit. We discuss applications to infinite-dimensional spaces, including abstract Wiener spaces and their quotient spaces.

23.
medRxiv (Medicine) 2026-06-10

Estimating COVID-19 Cumulative Incidence from Seroprevalence Surveys accounting for Time-Varying Seroreversion: A Fully Bayesian Methodology

Seroprevalence surveys reveal the extent of humoral immunity against pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and under some circumstances represent cumulative incidence of prior infection. However, antibody waning - or seroreversion - biases these estimates by reducing assay sensitivity in a time-varying manner. Because assay sensitivity decays over time, naively using serosurveys can substantially bias estimates of SARS-CoV-2 cumulative incidence and fatality rates. The Bayesian assay-specific, time-varying sensitivity adjustment developed in this paper can reliably correct for this bias and account for the delay between infection and serosurvey. In seroprevalence studies conducted in the United States in 2020, adjusting for time-varying sensitivity increased cumulative incidence by up to 1.4-fold, with an adjustment of 1.08 for a national study. Our estimates contrast with a previously published 2-fold adjustment that did not account for assay design. This suggests that previous analyses overestimated cumulative incidence by applying seroreversion corrections that did not account for assay-specific effects, or underestimated cumulative incidence by not applying seroreversion corrections. These biases imply fatality rate underestimation and overestimation, respectively. Our model provides a framework for design-specific time-varying sensitivity corrections in seroprevalence surveys for other pathogens.

24.
arXiv (CS.CL) 2026-06-15

Simulating Students' Java Programming Errors with Large Language Models

Understanding student errors in the programming is a cornerstone of programming education, yet obtaining a representative set of student errors for any newly designed task remains slow and costly, since authentic submissions only accumulate after extensive classroom deployment. This paper explores whether large language models (LLMs) can serve as scalable proxies for students by simulating realistic logical errors in code submissions. Using the CodeWorkout dataset of 74,000+ unique student Java submissions across 37 problems, we evaluate five LLMs under three mainstream prompting strategies: Input-Output (IO), Chain-of-Thought (CoT), and iterative Self-Refine. We assess performance along two key dimensions: diversity (the range of distinct error patterns) and alignment (alignment with authentic student mistakes), and examine how these vary by struggling level of programming tasks. Our quantitative findings reveal that while all models generate diverse errors, their alignment to human submissions diverges: Claude Sonnet 4 achieves the most balanced performance. In addition, we conducted a blinded expert annotation study (N = 401) comparing synthetic and authentic errors. This qualitative analysis confirms that the generated errors are functionally indistinguishable from authentic student errors. Moreover, higher-struggling-level problems elicit more diverse but less student-like errors. These results highlight trade-offs in using LLMs to simulate human learners and suggest design considerations for integrating synthetic errors into teachable agents, intelligent tutoring systems, and large-scale learning analytics.

25.
medRxiv (Medicine) 2026-06-18

The relationship between serotonin transporter occupancy and extracellular serotonin concentration is hyperbolic, not linear: implications for safely tapering antidepressants

Background: Hyperbolic tapering is an increasingly recognized approach for discontinuing serotonin reuptake inhibitor (SRI) antidepressants that involves non-linear dose reductions with equal stepwise reductions in serotonin transporter (SERT) occupancy to mitigate withdrawal symptoms. Its theoretical basis is the hyperbolic relationship between SRI dose and SERT occupancy reported in radioligand imaging studies. Hyperbolic tapering implicitly assumes that changes in SERT occupancy approximate changes in biologic effect and withdrawal risk. Because SERT occupancy plateaus across the therapeutic dose range of SRIs, this framework predicts relatively small biologic effects and withdrawal risk within this range. However, SERT occupancy influences serotonergic activity only indirectly via its effects on extracellular serotonin concentrations, and the relationship between these two variables is poorly characterized. Methods: We developed a two-pathway clearance model derived from mass-action kinetics to evaluate the steady-state relationship between SERT occupancy and extracellular serotonin concentrations under chronic SRI treatment. Results: Our analysis indicates that serotonin concentrations increase hyperbolically as transporter occupancy increases, suggesting that biologically meaningful differences in serotonergic signaling persist across the therapeutic dose range of SRIs despite plateauing occupancy. Conclusions: Our model predicts a hyperbolic relationship between SERT occupancy and extracellular serotonin concentrations, suggesting that changes in occupancy may not map proportionally onto serotonergic effect. These findings provide a potential mechanistic explanation for dose-dependent clinical effects of SRIs despite plateauing transporter occupancy and generate testable hypotheses regarding antidepressant tapering strategies. Empirical validation is warranted.