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01.
arXiv (math.PR) 2026-06-16

High-Order Talagrand and Eldan–Gross Inequalities via Besov-Type Variance Functionals

arXiv:2606.14876v1 Announce Type: new Abstract: By introducing high-order Besov-type variance functionals that generalize the canonical variance, we develop a unified framework for proving high-order Talagrand-type inequalities that relate high-order energies to Fourier weights. Applying this machinery, we establish high-order Poincaré-type, $L^p$–$L^q$, isoperimetric-type, Falik–Samorodnitsky and Eldan–Gross inequalities, all with explicit constants, in both the Boolean and Gaussian settings. Fundamentally, our semigroup-based framework relies primarily on hypercontractivity and high-order Bismut-type derivative estimates, and is broadly applicable.

02.
arXiv (CS.LG) 2026-06-17

Half a Link can Be Enough to Predict a Whole Link: Understanding Generalization in Knowledge Graph Foundation Models

arXiv:2606.18001v1 Announce Type: new Abstract: Knowledge graph (KG) foundation models (KGFMs) are zero-shot generalizers: trained once, they can predict links on unseen graphs without retraining. However, understanding when and how they can robustly generalize across KGs is still an open question. In this paper, we shed some light on their generalization mechanisms highlighting how their performance on unseen KGs is not uniform when it comes to partially seen links, which we call half-links. In fact, we show that to predict a test triple $(h,r,t)$ it might suffice in practice to have observed the half-link $(h,r)$ or $(r,t)$ in the inference graph. This yields a taxonomy of four scenarios when combinations of these half-links are observed or not. In a rigorous stratified analysis over these scenarios, we reveal that SoTA KGFMs use seen half links for predictions, while unseen half-links pose different challenges. As such, our finer-grained taxonomy can be a diagnostic protocol for robust KGFM generalization and highlights where novel KGFMs can improve.

03.
arXiv (CS.AI) 2026-06-16

Large Language Models as Optimizers: A Survey of Direct vs. Tool-Augmented Approaches and Their Performance Frontiers

arXiv:2606.15577v1 Announce Type: new Abstract: Large Language Models (LLMs) are increasingly involved in complex mathematical optimization, even if the pragmatic user who triggers them is unaware of it. After all, many real-world problems reduce to the search for better or the best solutions. The field of LLM-as-optimizer has three paradigms: direct optimization, tool-augmented optimization, and tool-creating optimization. Direct optimization uses iterative prompting and heuristic generation to navigate solution spaces. Tool-augmented optimization translates natural language problems into formal specifications and orchestrates external solvers. Tool-creating optimization goes further, using LLMs to discover reusable algorithms or heuristics that can be deployed at zero marginal LLM cost. We describe current performance frontiers based on the benchmarks from the literature. We identify the critical reasoning gap in current architectures and argue for trade-offs between the future potential of direct optimization and the auditability of tool-augmented optimization. Even future, more powerful models might opt for tool-making to improve operational efficiency for repetitive families of problems.

04.
arXiv (CS.CL) 2026-06-11

Experience Makes Skillful: Enabling Generalizable Medical Agent Reasoning via Self-Evolving Skill Memory

Medical agent systems are increasingly expected to support interactive clinical decision making rather than only static question answering. In such settings, effective agents must reuse prior experience across evolving cases, yet existing memory mechanisms often retain raw historical traces that are redundant, noisy, and difficult to govern. More importantly, they rarely distinguish which memories are truly useful for future reasoning. This limits their ability to accumulate compact and reliable experience for long-horizon clinical reasoning. To close this gap, we propose SkeMex, a post-deployment self-evolution framework that improves medical agents through a skill-based memory without updating model weights. SkeMex distills informative interaction trajectories into structured skills that encode reusable procedural knowledge, and organizes them into a multi-branch repository spanning general, task-specific, and action-level experience. To determine which memories should be reused and retained, SkeMex estimates context-dependent utility from environment feedback and uses it to guide value-aware retrieval and repository governance. A closed-loop ``Read–Write–Assess–Govern" lifecycle further supports continual evolution by writing new skills, updating utilities, promoting useful memories, and removing harmful entries. Experiments across diverse clinical tasks show that SkeMex consistently outperforms representative memory-based agents in both offline and online settings. It also generalizes across model backbones and supports transferable skill memory. All data and code will be released publicly.

05.
arXiv (CS.AI) 2026-06-12

A Study of Belief Revision Postulates in Multi-Agent Systems (Extended Version)

arXiv:2605.02249v2 Announce Type: replace Abstract: We investigate the belief revision problem in epistemic planning, i.e., what will be the beliefs of all agents in a multi-agent system after an agent gains the belief in some state property. Based on the standard representation in epistemic planning of agents' beliefs via a single multi-agent Kripke model, we generalize the classical AGM belief revision postulates to the multi-agent setting, with the aim to provide a formal framework for evaluating dynamic epistemic reasoning frameworks in which the beliefs of all agents as the result of actions are computed. As an example of a simple operator that satisfies all of the generalized AGM postulates, we present generalized full-meet multi-agent belief revision. We moreover define a generalization of the standard postulates for iterated revision, present a more sophisticated, event model based revision operator, and discuss the potential issues in defining an epistemic operator on Kripke models that can satisfy all of the generalized postulates for iterated multi-agent belief revision.

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

ReCal: Reward Calibration for RL-based LLM Routing

arXiv:2606.12479v1 Announce Type: cross Abstract: Large language model (LLM) routing has emerged as an effective paradigm for leveraging the complementary strengths of multiple LLMs through dynamic model and reasoning-strategy selection. Recent reinforcement learning (RL)-based routing methods further improve routing quality by optimizing routing policies from interaction feedback. However, they still struggle to provide informative and comparable learning signals under heterogeneous tasks with varying difficulty. In practice, multiple objectives (e.g., correctness, format behavior) are aggregated into a single scalar reward, leading to ambiguous credit assignment and conflicting optimization signals. Moreover, reward signals exhibit significant variability across instances, where some instances produce higher or more variable rewards, introducing optimization bias that favors trivial samples over informative ones. To address these issues, we propose ReCal, a \underline{Re}ward \underline{Cal}ibration framework for RL-based LLM routing. We first introduce a hierarchical reward decomposition mechanism with component-wise advantage estimation. We further propose a distribution-aware optimization strategy that calibrates optimization variability through variance-aware reweighting and per-dataset normalization. Experiments on seven datasets demonstrate that ReCal consistently improves routing performance, and training stability over baselines. Code is available at https://anonymous.4open.science/r/ReCal.

07.
medRxiv (Medicine) 2026-06-23

Default Handling of the Non-Assessable Verbal Glasgow Coma Scale Misclassifies Illness Severity in Mechanically Ventilated Patients: A Retrospective Analysis

Background: The Glasgow Coma Scale (GCS) is a universal neurologic severity score in the intensive care unit and is incorporated into APACHE, SOFA, mortality prediction models, ICU benchmarking, and quality metrics. In mechanically ventilated patients, however, the verbal component cannot be assessed. Common conventions, including assigning a normal total GCS of 15 or excluding patients with missing verbal scores, may misclassify the sickest patients as neurologically normal or remove them from analysis. Objective: To quantify non-assessable verbal GCS examinations after acute brain injury and determine how different handling conventions affect severity scoring and mortality-model performance across two independent critical care databases. Materials and Methods: We conducted a retrospective cohort study of adults with acute brain injury during their first ICU stay in MIMIC-IV, with replication in eICU-CRD. A verbal examination was considered non-assessable when documented as No Response-ETT. We measured the burden and determinants of non-assessability, compared the MIMIC-IV derived GCS convention with a component-aware GCS, and evaluated mortality-model handling strategies. Results: Among 14,230 patients, 45.2% had a non-assessable verbal examination, and 47.5% of ventilated patients had no assessable verbal score in the first 24 hours. Non-assessability was strongly associated with mechanical ventilation and mortality. The MIMIC-IV derived GCS assigned a score of 15 to 42.9% of patients and placed 11.6% in the lowest severity category despite eye and motor findings consistent with GCS [≤]9. Complete-case handling excluded 28.5% of patients, who accounted for 50.2% of deaths. Similar distortions were observed in eICU-CRD/APACHE across 171 hospitals. Discussion: Default-to-normal scoring can make severely ill intubated patients appear neurologically normal, while complete-case analysis removes the highest-risk patients. Conclusion: Non-assessable verbal GCS in mechanically ventilated patients should be explicitly flagged and reported in ICU severity scores, risk-adjusted mortality models, and benchmarking systems.

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

VLGA: Vision-Language-Geometry-Action Models for Autonomous Driving

Vision-language-action (VLA) models can describe scenes and reason about them in language, yet still struggle to ground their actions in the dense 3D world around them. Existing approaches either inject features from a frozen 3D foundation model without an objective that ensures the policy uses them, or constrain geometry with sparse box and map losses that provide no dense spatial signal. We introduce VLGA, the first vision-language-action model supervised to reconstruct the dense 3D world it drives through. VLGA introduces geometry as a fourth modality alongside vision, language, and action through a dedicated expert supervised by a per-pixel pointmap regression loss against LiDAR. Extensive experiments conducted on challenging nuScenes and Bench2Drive datasets for open-loop and closed-loop evaluations, respectively, show the superiority of VLGA over counterpart VLA methods. In particular, on open-loop nuScenes, VLGA sets a new state of the art among VLA methods without ego status, with the lowest L2 (0.50\,m average) and 3-second collision rate (0.18\%). On closed-loop Bench2Drive, VLGA attains the state-of-the-art driving score of 79.08, +0.71 over the strongest prior VLA, at comparable efficiency and comfort.

09.
Nature (Science) 2026-06-22

Daily briefing: First-ever ‘nuclear’ clocks put atomic clocks in the shade

作者:

Two research teams have created a new, long-awaited type of timekeeper. Plus, how backlash has saved an ocean-monitoring network targeted by Trump and how our cultural heritage is put at risk by climate change. Two research teams have created a new, long-awaited type of timekeeper. Plus, how backlash has saved an ocean-monitoring network targeted by Trump and how our cultural heritage is put at risk by climate change.

10.
arXiv (CS.LG) 2026-06-19

Comparing Linear Probes with Mahalanobis Cosine Similarity

arXiv:2606.19603v1 Announce Type: new Abstract: Linear probes are widely used in interpretability research and often compared by cosine similarity. The Mahalanobis cosine similarity (MCS) between two directions, which reweights the inner product by test data covariance, is a natural task-aware refinement. Ying et al. (2026) report that a probe's MCS to a reference probe trained on the out-of-distribution (OOD) data near-perfectly linearly predicts the probe's OOD AUROC (R^2 = 0.98). Here, we extend this empirical finding across models, layers, and concept domains, and prove this general phenomenon in closed form: For balanced classes whose projections are Gaussian, OOD AUROC and MCS to the reference probe are linear because both are sigmoid-shaped functions of the probe's signal-to-noise ratio (SNR) on the test data. The theory also predicts when this linearity fails, which we verify empirically. MCS offers a theoretically grounded and empirically effective alternative to Euclidean cosine similarity for comparing linear probes.

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

CP4SBI: Local Conformal Calibration of Credible Sets in Simulation-Based Inference

arXiv:2508.17077v3 Announce Type: replace-cross Abstract: Current experimental scientists have been increasingly relying on simulation-based inference (SBI) to invert complex non-linear models with intractable likelihoods. However, posterior approximations obtained with SBI are often miscalibrated, causing credible regions to undercover true parameters. We develop $\texttt{CP4SBI}$, a model-agnostic conformal calibration framework that constructs credible sets with local Bayesian coverage. Our two proposed variants, namely local calibration via regression trees and CDF-based calibration, enable finite-sample local coverage guarantees for any scoring function, including HPD, symmetric, and quantile-based regions. Experiments on widely used SBI benchmarks demonstrate that our approach improves the quality of uncertainty quantification for neural posterior estimators using both normalizing flows and score-diffusion modeling.

13.
arXiv (CS.CL) 2026-06-15

Coping in Crisis: Computational Modeling of Coping Styles in Digital Crisis Discourse During the 2023 Turkiye Earthquake

How do people cope when disaster strikes and can we detect it at scale, in real time, from what they write? This study addresses that question using over one million Turkish-language tweets posted in the aftermath of the February 6, 2023 earthquake in Turkiye, which unfolded in a deeply polarized political context just months before a national election. Drawing on Lazarus and Folkman's (1984) coping theory, we develop a multi-label BERTurk classifier to detect three coping styles (problem-focused, emotion-focused, and meaning-making) across four theoretically motivated crisis phases. BERTurk achieves a macro F1 of 0.693, substantially outperforming a zero-shot mDeBERTa baseline (macro F1 = 0.324). Applied to the full corpus, the classifier reveals a clear temporal trajectory: problem-focused coping dominates the urgency phase and declines sharply, emotion-focused coping rises and stabilizes, and meaning-making increases monotonically. Anger correlates most strongly with meaning-making (Spearman r = 0.387), suggesting it functions as a mobilizing force toward blame attribution rather than practical action. These findings demonstrate that coping theory can be reliably operationalized in real-world digital crisis data and that doing so can help humanitarian organizations tailor their responses to where a population actually is.

14.
medRxiv (Medicine) 2026-06-18

Web-based education on Metabolism and Obesity is associated with improved lifestyle and health behaviours among Brazilian school teachers

Background: Obesity is a major global public health challenge, and teachers play a critical role in school-based health promotion. This study examined the perceived impact of a web-based educational program on metabolism and obesity delivered to Brazilian school teachers. Methods: This analytical cross-sectional study included 217 teachers who responded to the evaluation questionnaire after attending the course between 2017 and 2022. Statistical analyses included logistic regression and chi-square tests. Findings: Course completion rate was 81.98%, substantially exceeding the 5-15% typical of global MOOCs. However, ethnic disparities were observed: White respondents were 4.95 times more likely to complete the course than Black respondents (p=0.00097) and Brown respondents were 3.05 times more likely (p=0.0268) than Black respondents. Among non-completers, lack of time (64.7%) was the primary barrier. Participation was concentrated in Sao Paulo (77%), with no respondents from three northern states. Perceived difficulty showed a non-significant trend (p=0.0893) where by Black respondents had the lowest predicted difficulty; the most challenging course material was Scientific Content/Reading papers (50%). Completion was strongly associated with applying learned activities in teaching (p

15.
arXiv (CS.LG) 2026-06-11

Neural ensemble Kalman filter: Data assimilation for compressible flows with shocks

arXiv:2602.23461v2 Announce Type: replace-cross Abstract: Data assimilation (DA) for compressible flows with shocks is challenging because many classical DA methods generate spurious oscillations and nonphysical features near uncertain shocks. We focus here on the ensemble Kalman filter (EnKF). We show that the poor performance of the EnKF may be attributed to the bimodal forecast distribution that can arise in the vicinity of an uncertain shock location; this violates the assumptions underpinning the EnKF, which assume a forecast which is close to Gaussian. To address this issue we introduce the new neural EnKF. The basic idea is to systematically embed neural function approximations within ensemble DA by mapping the forecast ensemble of shocked flows to the parameter space (weights and biases) of a deep neural network (NN) and to subsequently perform DA in that space. The nonlinear mapping encodes sharp and smooth flow features in an ensemble of NN parameters. Neural EnKF updates are therefore well-behaved only if the NN parameters vary smoothly within the neural representation of the forecast ensemble. We show that such a smooth variation of network parameters can be enforced via physics-informed transfer learning, and demonstrate that in so-doing the neural EnKF avoids the spurious oscillations and nonphysical features that plague the EnKF. The applicability of the neural EnKF is demonstrated through a series of systematic numerical experiments with the inviscid Burgers' equation, the Sod shock tube, and a two-dimensional blast wave.

16.
medRxiv (Medicine) 2026-06-22

Starting, stopping and restarting. Patterns of Methylphenidate Use over 14 years in a large public health system

Background Persistence with stimulant medication is poor in children and adolescents with ADHD, and the evidence base is derived predominantly from high-income countries. We describe methylphenidate utilisation patterns and predictors of 12-month retention across 14 years in a large South African public health service. Methods Retrospective cohort study using routine pharmacy data from the Western Cape provincial health service (2011-2024). Children aged 5-18 at first prescription were included. Treatment episodes were defined as continuous prescription sequences with no gap exceeding 90 days and classified as initiations or restarts. Logistic regression modelled 12-month retention against early visit frequency and formulation type as pre-specified exposures. Findings 421,925 prescription events for 23,243 children across 115 facilities generated 65,885 treatment episodes. Median age at first prescription was 10 years (IQR 8-12); 77.6% were male. Kaplan-Meier 12-month survival was 28.2% for initiations and 15.4% for restarts, substantially below high-income country comparators. A quarter of all initiating prescriptions were not followed by a subsequent dispensing event; nearly 40% of patients had three or more treatment episodes. Early visit frequency was the strongest predictor of 12-month retention (high vs low: OR 2.85, 95% CI 2.65-3.06). The sustained-release formulation effect was present but attenuated on multivariable adjustment. Treatment re-initiations showed a marked seasonal pattern consistent with the South African school calendar. Interpretation Twelve-month retention was markedly lower than high-income country rates. Against a backdrop of high attrition, both early visit frequency and sustained-release formulation access predicted persistence; clinical engagement and reducing structural barriers to access are modifiable factors in this setting. Funding None.

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

Small LLMs: Pruning vs. Training from Scratch

Pruning promises a shortcut to strong small language models. In this work, we examine this promise by pruning Llama-3.1-8B at pruning ratios of 0.5–0.8 with six methods spanning depth, width, and sparse granularities, under two controlled token-matched settings. (1) With the same training token budget, pruned initialization consistently outperforms random initialization. This shows that the parent model provides a strong starting point, although the advantage narrows as the training token budget grows and as the pruning ratio rises, nearly vanishing at the highest pruning ratio we study. (2) When training from scratch is instead given the full token budget consumed by the whole pipeline, pruning at finer granularities still retains an advantage, while coarser structured pruning can be matched or surpassed. This suggests that the parent model transfers knowledge that additional training tokens alone cannot fully recover, but only at fine granularity. Taken together, our results yield a clear recommendation: with a large pretrained model in hand and a limited training token budget, pruning is better than training from scratch; when the training budget is not limited, training from scratch can be competitive for coarser pruning, so a large pretrained parent is not always necessary.

18.
arXiv (CS.LG) 2026-06-19

Entropy Estimation in Multi-Qutrit Systems via Variational and Classical Neural Networks

arXiv:2606.20504v1 Announce Type: cross Abstract: We present a systematic study of von Neumann entropy estimation in multi-qutrit quantum systems using two complementary approaches: variational quantum algorithms (VQAs) and classical convolutional neural networks (CNNs), evaluated using an ideal (noise-free) quantum simulator. For systems up to three qutrits, we construct and evaluate 11 hardware-efficient SU(3)-inspired ansatzes. A parameter sweep shows that estimation accuracy is primarily determined by the number of trainable parameters, provided sufficient entanglement is present. Based on this study, we fix the parameter count to approximately 120 for subsequent experiments, observing that increasing entangling-gate counts beyond a threshold yields only marginal improvements. For larger systems (two to five qutrits), we use a CNN trained on measurement outcomes from tensor-product mutually unbiased bases. The model achieves accurate and stable predictions and exhibits a systematic improvement in performance with system size, with the highest errors for two-qutrit systems and the lowest for five-qutrit systems. Notably, using only 12.5% of the measurements required for full state tomography is sufficient to reach 90th-percentile absolute errors of approximately 0.13-0.16 nats for both four- and five-qutrit systems. The CNN model is also robust to shot noise and generalizes well to out-of-distribution states. Overall, within the simulated settings studied here, our results indicate a transition in practical methods: VQAs are effective for small systems, while CNN-based estimators offer improved scalability and robustness for larger qutrit systems.

19.
arXiv (CS.CL) 2026-06-16

Beyond Retrieval: Learning Compact User Representations for Scalable LLM Personalization

Personalizing large language models requires adapting model behavior to individual users while preserving robustness and deployment-scale efficiency. Existing approaches typically personalize LLMs either at the input level, by retrieving user histories or constructing profile prompts, or at the parameter level, by maintaining user-specific parameter-efficient modules. The former makes personalization sensitive to retrieval quality and prompt design, whereas the latter incurs storage and maintenance costs that grow with the user population. To address these limitations, we propose TAP-PER (Temporal Attentive Prefix for PERsonalization), a prefix-based framework that encodes user preferences as learnable representations, eliminating explicit prompt construction and replacing heavy per-user adapters with lightweight user-state prefix embeddings. Inspired by personalized recommendation systems, TAP-PER decomposes user modeling into user-state and query-conditioned components, and incorporates temporal signals to capture the evolving nature of user interests. Experiments on six LaMP tasks show that TAP-PER consistently outperforms prompt-based and model-based baselines across classification, rating, and generation settings. Moreover, TAP-PER uses 130x fewer per-user parameters than OPPU and roughly half the total parameter footprint of PER-PCS at the 1,000-user scale, demonstrating that scalable LLM personalization can be achieved without explicit prompt construction or heavy per-user adapters.

20.
arXiv (CS.CV) 2026-06-16

When the Past Matters: FlashBack Memory for Precipitation Nowcasting

Accurate precipitation nowcasting is crucial for disaster mitigation and socio-economic planning, yet existing methods often struggle with false alarms, missed events, and long range dependency modeling at high spatiotemporal resolution. To address these challenges, we propose FlashBack Memory (FB), a module that dynamically retrieves key historical states and integrates them via an adaptive fusion gate, enhancing the spatiotemporal representation capability of recurrent-based models. We incorporate FB into PredRNN, PredRNNpp, MIM, MotionRNN, and PredRNN-V2, and evaluate on CIKM2017, Shanghai2020, and SEVIR datasets. Experimental results demonstrate that FB significantly improves MSE, MAE, SSIM, and CSI metrics, particularly for high-intensity rainfall and long-sequence predictions, while reducing false alarms and missed events and enhancing temporal consistency and spatial localization. The proposed method provides a general and efficient memory enhancement mechanism, improving the overall performance of recurrent-based precipitation nowcasting models.

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

Examining the Limits of Word2Vec with Toki Pona

Word2Vec's effectiveness at generating semantic embeddings has been widely validated, yet it has been tested almost exclusively on languages with large vocabulary inventories. This study examines whether Word2Vec can successfully capture semantic relationships within an extremely reduced vocabulary using data from Toki Pona, a constructed language with approximately 130 words. We sourced 1.4 million sentences (7.95 million tokens) from the Toki Pona community for training. Approximately 23% of sentences in the corpus contain non-Toki Pona tokens such as named entities, loanwords, and neologisms. To investigate whether this linguistic noise enhances or hinders performance – a topic rarely addressed in word embedding literature – we trained two distinct models: one retaining these incidental tokens and another filtering them out completely. Evaluation was conducted using quantitative methods measuring word proximity to semantic category centroids, automated silhouette scores via agglomerative clustering, and qualitative analysis utilizing representational similarity matrices compared against English. The results indicate that while sparse, non-core tokens do not affect the relative structure of the learned embeddings, they actually draw similar words closer together in the vector space. Importantly, Word2Vec's effectiveness depends more on distributional patterns than lexicon size even at this extreme lower bound.

22.
arXiv (CS.LG) 2026-06-12

Thermodynamic assessment of machine learning models for solid-state synthesis prediction

arXiv:2602.04075v2 Announce Type: replace-cross Abstract: Machine learning models have recently emerged to predict whether hypothetical solid-state materials can be synthesized. These models aim to circumvent direct first-principles modeling of solid-state phase transformations, instead learning from large databases of successfully synthesized materials. Here, we assess the alignment of several recently introduced synthesis prediction models with material and reaction thermodynamics, quantified by the energy with respect to the convex hull and a metric accounting for thermodynamic selectivity of enumerated synthesis reactions. A dataset of successful synthesis recipes was used to determine the likely bounds on both quantities beyond which materials can be deemed unlikely to be synthesized. With these bounds as context, thermodynamic quantities were computed using the CHGNet foundation potential for thousands of new hypothetical materials generated using the Chemeleon generative model. Four recently published machine learning models for synthesizability prediction were applied to this same dataset, and the resultant predictions were considered against computed thermodynamics. We find these models generally overpredict the likelihood of synthesis, but some model scores do trend with thermodynamic heuristics, assigning lower scores to materials that are less stable or do not have an available synthesis recipe that is calculated to be thermodynamically selective. In total, this work identifies existing gaps in machine learning models for materials synthesis and introduces a new approach to assess their quality in the absence of extensive negative examples (failed syntheses).

23.
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

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

From Physics to Representation: Audio Learning with Synthetic Pre-training via Procedural Generation

arXiv:2606.14791v1 Announce Type: cross Abstract: Self-supervised learning advances audio representation for multimedia analysis. However, prevailing data-centric approaches rely on massive real-world corpora, increasing training costs, curation burdens, and privacy barriers. To address this, we present AudioPG, a procedural synthesis framework eliminating real audio recordings during pre-training. AudioPG trains a Transformer-based masked autoencoder on waveforms generated on-the-fly from basic acoustic primitives and composition rules. The encoder transfers effectively to real audio benchmarks, achieving 90.60% accuracy on ESC-50, 0.546 mAP on FSD50K, 88.17% on UrbanSound8K, and 97.03% on Speech Commands V2. Notably, pre-training completes in under 20 minutes on a single GPU. Latent space analysis reveals physical factors, including fundamental frequency and relative intensity, emerge in orthogonal subspaces, making representations linearly decodable. These results establish procedural synthesis as an efficient, interpretable pre-training signal when large-scale corpora are unavailable. Our code is available at: https://github.com/Freyliu0516/audioPG.

25.
arXiv (CS.CV) 2026-06-18

Confidence is Not Reliability: Rethinking MC Dropout in Brain Tumour Segmentation

Glioma segmentation in multiparametric MRI is a critical component of treatment planning. A segmentation model that fails silently on treatment-critical sub-regions represents a patient safety risk that overlap-based metrics such as Dice scores cannot expose. We ask whether voxel-level uncertainty estimation via Monte Carlo (MC) Dropout can reliably identify segmentation errors in clinically critical sub-regions, and whether calibration failure modes are detectable from standard reporting metrics alone. In an empirical two-model case study on 126 BraTS21 patients, we evaluate a high-performance pretrained SegResNet and a locally trained UNet with residual units (UNet-Res). MC dropout preserved segmentation accuracy ($|\Delta Dice|$ $