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01.
medRxiv (Medicine) 2026-06-22

Leishmaniasis on YouTube: a critical appraisal of the quality, reliability, and transparency of educational content

Background: Leishmaniasis is a neglected tropical disease of significant global public health importance, for which accurate information is essential to support prevention and early care-seeking, particularly in endemic, resource-limited settings. YouTube is a widely used source of health information, but the quality and reliability of leishmaniasis-related content have not been evaluated. We aimed to assess the quality, reliability, and transparency of English-language YouTube videos on leishmaniasis. Methods: We conducted a cross-sectional analysis of YouTube videos retrieved via the YouTube Data API on 15 June 2026 using the terms "leishmaniasis," "cutaneous leishmaniasis," and "visceral leishmaniasis." After applying eligibility criteria and screening the 150 most-viewed eligible videos, 48 videos were included. Two reviewers independently assessed each video using the modified DISCERN (mDISCERN) tool, the Global Quality Score (GQS), and the JAMA benchmark criteria, with disagreements resolved by consensus. Inter-rater agreement was assessed using the intraclass correlation coefficient (ICC), and associations were examined using Spearman's rank correlation. Results: Of 402 videos retrieved, 48 met the inclusion criteria. The median GQS was 3.00 (IQR 2.00-4.00) and median mDISCERN was 3.00 (IQR 2.38-4.50), indicating moderate quality and reliability, while the median JAMA score was 2.00 (IQR 1.00-2.00), reflecting limited transparency; no video met all four JAMA criteria. The overwhelming majority of videos (47/48, 97.9%) were of professional or institutional origin. Inter-rater agreement was good to excellent (ICC 0.883 for GQS, 0.896 for mDISCERN, 1.000 for JAMA). The instruments were strongly inter-correlated (mDISCERN-GQS rho = 0.841, p < 0.001). Quality scores did not correlate positively with views, likes, or video duration; comments correlated weakly and negatively with mDISCERN (rho = -0.337, p = 0.031) and JAMA (rho = -0.381, p = 0.014). Conclusions: YouTube videos on leishmaniasis are of moderate quality and reliability but limited transparency, and are produced almost exclusively by professional sources. Video popularity, length, and age were not indicators of quality. There is a need for experts and institutions to produce clearly authored, well-sourced, and transparent educational content on this neglected tropical disease.

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

Generative AI and the future of scientometrics: current topics and future questions

In this paper, we contribute to the debate on generative artificial intelligence (GenAI) in scientometrics. We argue that moving from a trial-and-error approach to an explainable and actionable use requires a principled understanding of strengths and weaknesses of GenAI as compared with other techniques and with human judgment. To this end, we introduce a conceptual framework based on the distinction between the semantic dimensions of texts, i.e. the meanings attributed to words, and their pragmatic dimension, i.e. their embedding within communicative situations. We leverage this framework to interpret the results of applications of GenAI in scientometrics and to provide guidance to users. Specifically, we conclude that key parameters to be considered are the nature of the task, the level of granularity of the analysis and whether the goal was descriptive, inferential or evaluative. These parameters lead to different strategies for using GenAI and human-machine integration. Finally, we suggest that, by generating large amounts of scientific language, GenAI might affect textual characteristics used to measure science, such as authors, words, and references. We argue that careful empirical work and theoretical reflection will be essential to remain capable of interpreting the evolving patterns of knowledge production in the age of AI.

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

The Coin Flip Judge? Reliability and Bias in LLM-as-a-Judge Evaluation

LLM-as-a-Judge is now widely used to rank model outputs, train reward models, and populate public leaderboards, but its run-to-run reliability remains under-characterized. We study repeated identical evaluations on 29 tasks spanning 10 categories using two OpenAI judge models (GPT-4o-mini and GPT-4.1-mini), with 50 pairwise trials and 50 pointwise trials per question, supplemented by temperature and prompt-sensitivity ablations. Across judges, pairwise preferences flip on average 13.6% of the time, with 28% of questions exceeding a 20% flip rate and one question reaching 56%. GPT-4o-mini also exhibits a significant first-position bias (72% A-majority, p = 0.024). At the same time, mean pointwise score gaps are small (0.19–0.36 on a 10-point scale) and not statistically significant in aggregate, producing a pairwise–pointwise gap: judges frequently choose a winner even when their own scalar scores provide little evidence of a meaningful quality difference. Beyond within-judge instability, cross-judge agreement is only 76% ($\kappa = 0.51$), semantically equivalent prompt templates change majority outcomes in 25% of tested cases, and deterministic decoding reduces but does not eliminate inconsistency. A reliability curve analysis shows that, in our dataset, 11 repeated trials are needed for a majority vote to recover the 50-trial reference verdict with 95% probability on average, rising to 15 for high-variance questions. These findings suggest that single-trial LLM judging is often too noisy for high-stakes evaluation, and that multi-trial aggregation, position randomization, and explicit uncertainty reporting should be standard practice. Because both judges are from a single provider, cross-provider replication remains an important next step.

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

SceneCraft: Interactive System for Image Editing via Scene Graph

Recent advances in generative AI have enabled natural language-driven image editing, yet existing systems often fail in complex scenes with multiple interacting objects because they rely heavily on users crafting precise text prompts. To address the absence of structured control, we propose SceneCraft, a novel interactive framework that bridges user intent and model execution by representing images as editable scene graphs. Instead of guessing text prompts through trial and error, users interact directly with a visual graph to perform complex spatial and relational operations. These graph modifications are automatically translated into precise, context-aware editing prompts, effectively eliminating linguistic ambiguity. To ensure robust and diverse results, structured prompts are dispatched to multiple state-of-the-art generative models. Evaluations across diverse editing scenarios show that SceneCraft provides a more intuitive control mechanism, significantly reducing the cognitive burden of manual prompt engineering while generating outputs that users consistently rate as higher in quality and fidelity.

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

Learning and Generating Mixed States Prepared by Shallow Channel Circuits

arXiv:2604.01197v4 Announce Type: replace-cross Abstract: Learning quantum states from measurement data is a central problem in quantum information and computational complexity. In this work, we study the problem of learning to generate mixed states on a finite-dimensional lattice. Motivated by recent developments in mixed state phases of matter, we focus on arbitrary states in the trivial phase. A state belongs to the trivial phase if there exists a shallow preparation channel circuit under which local reversibility is preserved throughout the preparation. We prove that any mixed state in this class can be efficiently learned from measurement access alone. Specifically, given copies of an unknown trivial phase mixed state, our algorithm outputs a shallow local channel circuit that approximately generates this state in trace distance. The sample complexity and runtime are polynomial (or quasi-polynomial) in the number of qubits, assuming constant (or polylogarithmic) circuit depth and gate locality. Importantly, the learner is not given the original preparation circuit and relies only on its existence. Our results provide a structural foundation for quantum generative models based on shallow channel circuits. In the classical limit, our framework also inspires an efficient algorithm for classical diffusion models using only a polynomial overhead of training and generation.

06.
medRxiv (Medicine) 2026-06-12

An integrative multi-omics framework identifies epigenetic dysregulation of HAND2 as a potential primary driver of impaired enteric neural crest cell differentiation in Hirschsprung Disease

Hirschsprung disease (HSCR) is a congenital neurodevelopmental disorder characterized by segmental aganglionosis due to impaired developmental processes of enteric neural crest cells (NCCs). Despite being the leading genetic cause of functional intestinal obstruction in early childhood, HSCR represents a paradigmatic challenge in precision medicine: its multifactorial etiology, complex gene-environment interactions and limited resolution of single-modality analyses have long hindered mechanistic understanding and therapeutic translation. Here, we applied an integrative multi-omics approach combining genetic, phenotypic, epigenomic and transcriptomic analyses of matched ganglionic and aganglionic formalin-fixed paraffin-embedded (FFPE) patient tissues, complemented by patient-specific in vitro models. Beyond established genetic contributors, our integrative approach reveals novel regulatory pathways predominantly affecting enteric NCC differentiation, with convergent evidence pointing to epigenetic dysregulation as a primary disease mechanism. Notably, we identified over 1,300 differentially methylated positions between ganglionic and aganglionic FFPE samples, with HAND2 emerging as a key candidate due to multiple hypermethylated sites and consistently reduced expression levels in aganglionic tissues and in vitro models, suggesting a potential role in HSCR pathophysiology. We propose that our multi-omics approach offers a powerful and comprehensive framework for dissecting disease mechanisms. Beyond advancing biological understanding, this strategy holds promise for paving the way for molecularly informed patient stratification and supporting the development of personalized treatment and postoperative management strategies.

07.
arXiv (CS.AI) 2026-06-15

An Analysis of the Coordination Gap between Joint and Modular Learning for Job Shop Scheduling with Transportation Resources

arXiv:2604.24117v2 Announce Type: replace Abstract: Efficient job-shop scheduling with transportation resources is critical for high-performance manufacturing. With the rise of "decentralized factories", multi-agent reinforcement learning has emerged as a promising approach for the combined scheduling of production and transportation tasks. Prior work has largely focused on developing novel cooperative architectures while overlooking the question of when joint training is necessary. Joint training denotes the simultaneous training of job and automatic guided vehicle scheduling agents, whereas modular training involves independently training each agent followed by post-hoc integration. In this study, we systematically investigate the conditions under which joint training is essential for optimal performance in the job-shop scheduling problem with transportation resources. Through a rigorous sensitivity analysis of resource scarcity and temporal dominance, we quantify the coordination gap – the performance difference between these two training modalities. In our evaluation, joint training outperforms the majority of dispatching rule combinations and modular training approaches. However, the coordination gap advantage diminishes in bottleneck environments, particularly under severe transport and processing constraints. These findings indicate that modular training represents a viable alternative in environments where a single scheduling task dominates. Overall, our work provides practical guidance for selecting between training modalities based on environmental conditions, enabling decision-makers to optimize reinforcement learning-based scheduling performance.

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

DrivingAgent: Design and Scheduling Agents for Autonomous Driving Systems

Many autonomous driving systems are increasingly incorporating foundation models to improve generalization and handle long-tail scenarios. However, this trend introduces two key challenges: (i) the manual and labor-intensive process of designing and integrating new models, and (ii) the lack of intelligent, dynamic scheduling mechanisms to meet strict real-time constraints. While Large Language Model (LLM)-based agents offer a promising avenue for automation, existing frameworks are ill-suited for autonomous driving. Specifically, they fail to distinguish between the fundamentally different requirements of system design and real-time scheduling, treat modules as opaque black boxes, and are not designed for continuous operation. To address these limitations, we propose DrivingAgent, a novel agent framework tailored to the dual challenges of autonomous driving system design and scheduling. In the design phase, DrivingAgent automates module development by interpreting system architecture, generating code, and validating modules via super-network training. In the scheduling phase, it employs a lightweight LLM trained with reinforcement learning to dynamically orchestrate system modules in real time, supported by a structured memory that integrates long-term storage with timestamped short-term context. Experimental results demonstrate that DrivingAgent achieves a superior speed–accuracy trade-off on both the nuScenes and Bench2Drive benchmarks.

09.
arXiv (quant-ph) 2026-06-16

The Quantum Transition State

arXiv:2606.10266v2 Announce Type: replace Abstract: The transition state – the critical configuration separating reactants from products – is the central organizing concept of chemical reaction rate theory, yet for nearly a century it has been thought to have no exact quantum counterpart: the recrossing-free, one-way flux through a transition state appears to demand simultaneous knowledge of position and momentum, in conflict with the uncertainty principle. We show this obstruction is illusory and construct the quantum transition state directly from the exact quantum flow. Its stable and unstable invariant manifolds intersect in a unique bounded trajectory – the quantum transition-state trajectory – anchoring a moving dividing surface that each reactive characteristic crosses exactly once, yielding a one-way flux of the standard quantum probability current. The geometric framework underlying classical transition-state theory thus survives intact in exact quantum mechanics, in a fundamentally quantum form.

10.
arXiv (math.PR) 2026-06-18

Functional central limit theorems for non-local branching Markov processes

arXiv:2502.19382v2 Announce Type: replace Abstract: The aim of this paper is to study the fluctuations of a general class of supercritical branching Markov processes with non-local branching mechanisms. We establish functional central limit theorems and show that the limiting behaviour falls into three regimes, determined by the size of the spectral gap associated with the first-moment semigroup of the branching process. The main novelty is to develop a unified functional fluctuation theory for spatial branching Markov processes with non-local reproduction, allowing a general finite-dimensional spectral structure for the first-moment semigroup, including non-simple leading eigenvalues and nilpotent Jordan-type components. In doing so, we extend the classical small, critical and large fluctuation trichotomy beyond the finite-type and local spatial settings, and obtain limiting processes that capture the covariance structure induced by non-local offspring displacement.

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

Accelerating Speculative Diffusions via Block Verification

arXiv:2606.13426v1 Announce Type: new Abstract: Speculative decoding speeds up LLM inference by using a draft model to generate tokens, with an acceptance-rejection scheme that ensures that the output matches the target distribution. Adapting this to continuous diffusions is difficult because speculative sampling requires drawing from a residual distribution. While straightforward in discrete spaces, efficiently sampling this residual in continuous space is non-trivial. Consequently, existing diffusion adaptations either use computationally inefficient sampling techniques or rely on an alternative scheme. In this work, we introduce a novel scheme that efficiently implements the original speculative sampling mechanism for diffusion models. Our approach offers a critical advantage over current methods: it enables us to adapt block verification from LLMs to diffusions – which provably improves the acceptance rate of drafts. Furthermore, we formalize and analyze the Free Drafter, a heuristic self-speculative drafter for diffusions that requires no training. By enabling block verification, our Free Drafter yields up to a 6.3% speedup over existing speculative methods with no additional training and negligible overhead beyond the existing parallel verification pass.

12.
medRxiv (Medicine) 2026-06-15

Efficacy of Painhunting Therapy for Event-Related Depression: A Randomized Controlled Trial with Crossover Replication

Background. Depression affects an estimated 332 million people worldwide and is a leading cause of disability, with up to 80% of major depressive episodes preceded by an identifiable adverse life event [17,18]. First-line treatments target symptoms rather than the precipitating event and are resource-intensive: standard CBT averages roughly 12 sessions, and antidepressant discontinuation carries relapse rates near 35% at six months [8]. These limitations create a clear rationale for brief, structured interventions that address the cognitive and somatic sequelae of adverse life events directly. Painhunting therapy is one such intervention, in which each session targets a discrete adverse event through a structured incident-processing procedure. Methods. We conducted a two-arm, parallel-group, single-site randomised controlled trial comparing Painhunting therapy (Arm A, immediate; n=42) with a waitlist control (Arm B, delayed; n=42) in adults with PHQ-9 >= 9 and active psychological distress related to an adverse life event. After the primary endpoint at T2 (approximately two weeks post-randomisation), Arm B crossed over to active treatment, with T3 as the post-crossover endpoint at approximately four weeks. The primary outcome was PHQ-9 at T2 (between-arm contrast); secondary outcomes were ICG, GAD-7, WHO-DAS 2.0 (12-item), and the Global Impression of Change (GIC). Pre-specified analyses included intention-to-treat, per-protocol, and single-exclusion sensitivity populations. Results. Eighty-four participants were randomised (198 applications, 134 completed screening questionnaire, 119 passed psychometric screening). At T2, mean PHQ-9 was 2.32 (SD 2.59) in Arm A and 16.56 (SD 6.76) in Arm B, yielding an ITT between-arm Cohen d = 2.78 (95% CI 2.19-3.76, p < 0.001). Within-arm paired reductions during each arm's active-treatment window reproduced this magnitude (Arm A T0 to T2 change 14.71, Morris d = 2.80; Arm B T2 to T3 change 14.19, Morris d = 2.77, eligible n=26). Treatment gains were durable at the T4 follow-up (week 8). Aligning each arm to its own end-of-treatment timepoint, the off-treatment drift to week 8 was almost identical between arms: Arm A rose 0.78 points from T2 to T4 (2.19 to 2.97, n=37) and Arm B rose 1.59 points from T3 to T4 (4.74 to 6.33, n=27), the latter falling to 0.77 points once a single documented relapse case (R59) is excluded (4.81 to 5.58, n=26). This small off-treatment rebound then stabilised rather than continuing: Arm A was essentially unchanged from T3 to T4 (change +0.05), with concordant maintenance on ICG, GAD-7, and WHO-DAS. At T4, 68% of Arm A and 41% of Arm B remained in remission (PHQ-9 < 5). Secondary measures (ICG, GAD-7, WHO-DAS) moved in the same direction and to comparable magnitude at every timepoint. The waitlist window in Arm B showed essentially no change on any measure (PHQ-9 change 0.22, p = 0.81). Sensitivity analyses excluding six sub-threshold T2 cases, the single treated-in-error case (R82), the R59 relapse case, and one late T2 submitter left all conclusions unchanged. Conclusions. Painhunting therapy produced large and statistically robust reductions in depression, complicated grief, anxiety, and functional disability over a brief course of three to four sessions, with effect sizes substantially exceeding benchmarks reported for established first-line psychotherapies including CBT and EMDR. Critically, these gains persisted at the week-8 follow-up: depression scores in the immediate-treatment arm were essentially unchanged from four weeks to eight weeks post-randomisation, indicating that the benefit reflects durable change rather than a transient post-session dip. Treatment-window concordance between arms, durability of gains at one month off-treatment, and the flat waitlist trajectory together strengthen the evidence for genuine efficacy rather than spontaneous remission. Baseline covariates including therapeutic alliance, treatment expectancy, self-efficacy, age, and sex showed near-zero associations with outcome, reducing the plausibility of allegiance bias or expectancy effects as primary drivers. The differential retention between arms (88% vs 64% at T3) is attributable to the waitlist design and is discussed as a limitation. These findings support proceeding to a confirmatory active-comparator trial against manualized CBT. Trial registration: ClinicalTrials.gov NCT07490691, prospectively registered.

13.
arXiv (CS.CL) 2026-06-19

Closing the Calibration Gap in Semantic Caching

Semantic caching cuts LLM inference costs by serving a cached response to semantically similar queries. Standard practice evaluates these systems using PR-AUC, a metric that only measures how well scores rank and ignores whether they are usable at a fixed threshold. We show this mismatch leads to systematically poor deployment choices, as models with the highest PR-AUC are often the worst in operation. We introduce Precision-Cache Hit Ratio (P-CHR) AUC, a cache-aware metric that measures precision across cache utilization levels, and Calibration Retention Rate (CRR), which captures how much offline ranking quality survives at deployment. We decompose the operational gap between offline and deployed quality into a recoverable calibration component and an irreducible structural component fixed by the dataset's positive rate. Our experiments show that the calibration gap is governed by the training objective rather than data scale, and post-hoc calibration only partially closes it. Ultimately, model selection for semantic caching is a calibration problem, not a ranking one, and measuring it is the first step to closing the gap.

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

All Eyes on the Workflow: Automated and Efficient Event Discovery from Video Streams

Disciplines such as business process management and process mining aid organizations by discovering insights about processes on the basis of recorded event data. However, an obstacle to process analysis is data multi-modality: for instance, data in video form are not directly interpretable as events. Existing approaches rely on a dictionary of activity label as input, cannot provide frame-by-frame labeling explanations, or rely on superseded computer vision techniques. In this work, we present SnapLog, an approach to extract event data from videos by converting frames to feature vectors using image embeddings and performing temporal segmentation through frame-wise similarity matrices. A generalized few-shot classification is then used to assign labels to the video segments, yielding labeled, timestamped sub-sequences of frames that are interpretable as events. Conventional process mining techniques can be used to analyze the resulting data. We show that our approach produces logs that accurately reflect the process in the videos.

15.
arXiv (quant-ph) 2026-06-19

Recursive perturbation approach to time-convolutionless master equations: Explicit construction of generalized Lindblad generators for arbitrary open systems

arXiv:2506.04095v2 Announce Type: replace Abstract: We develop a recursive perturbative expansion for the time-convolutionless (TCL) generator of an open quantum system in a generalized Lindblad form. This formulation provides a systematic approach to derive the generator at arbitrary order while preserving a Lindblad-like structure, without imposing assumptions on the system or environment beyond an initially uncorrelated state. The generator is written, at all orders, in a canonical form, which also corresponds to the minimal dissipation condition, which uniquely specifies the decomposition of the generator into Hamiltonian and dissipative contributions. To validate the method and show its effectiveness in addressing non-Markovian dynamics and strong-coupling effects, we compute the generator explicitly up to fourth order.

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

Functional Gradient Descent with Adaptive Representations

arXiv:2606.16926v1 Announce Type: cross Abstract: Functional optimization problems are typically solved by optimizing the parameters of a fixed representation, such as a neural network, resulting in highly nonconvex losses that complicate both training and theoretical analysis. An interesting alternative is functional gradient descent (FGD), that is, gradient descent directly in function space, which benefits from strong convergence results and admits a clean theory. However, FGD is difficult to implement in practice because functional gradients are infinite-dimensional, and thus cannot be fully computed nor stored in memory. Existing implementations therefore rely on fixed approximations, which introduce approximation error. We propose a new, theoretically-grounded FGD algorithm that adapts the representation of the functional gradients over the course of optimization. By explicitly incorporating this approximation into the analysis, we establish convergence to a stationary point (for smooth losses) and to a global minimizer (under smoothness + a Polyak-Lojasiewicz-type condition) regardless of our approximations. To the best of our knowledge, this is the first implementable FGD method with such guarantees in a general setting. We demonstrate the effectiveness of our method on regression, numerical solution of PDEs, and modern computer vision. Across settings, our method consistently outperforms both FGD with fixed approximations and neural network baselines in efficiency and accuracy.

17.
PLOS Computational Biology 2026-06-22

Ten simple rules for making the supplement increase your paper’s impact

作者:

by Volker Grimm, Uta Berger, Stefano Mammola Have you ever lost hours navigating supplementary materials—clicking between the main text and dozens of auxiliary files only to encounter broken links, illegible figures, and undefined variables and acronyms? If so, you’re not alone. What should support scientific communication has instead become an obstacle: supplementary information (SI) increasingly suffers from inconsistent formatting, poor accessibility, and fragmented organization that impedes rather than advances understanding. This is disheartening since the SI, if used effectively, has the power to enhance transparency, credibility, and reproducibility of research. Therefore, we propose 10 simple rules to help authors design SI that genuinely increase the impact of their research. The rules emphasize treating SI with the same care as the main text, using it strategically to support the scientific narrative while preserving clarity and focus. Key recommendations include creating a single, well-structured, self-contained SI master document; ensuring explicit cross-referencing between the main text and SI; making SI machine-readable; and avoiding the misuse of SI as a substitute for proper data repositories. We also highlight the importance of creativity in choosing appropriate formats and strict adherence to journal-specific guidelines. Finally, when available, we advocate the use of standardized templates to improve consistency, readability, and reuse across studies. By following these rules, authors can substantially increase the scientific impact of their work while at the same time contributing to more sustainable research practices.

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

Does AI Reviewer See the Full Picture? Attacking and Defending Multimodal Peer Review

The integration of Large Language Models (LLMs) and Multimodal LLMs (MLLMs) into scientific peer-review workflows introduces novel and significant risks for adversarial manipulation, especially given the multimodal nature of scientific papers where figures, not just text, convey core evidence. This creates a significant gap: current robustness studies on AI peer-review are overwhelmingly text-only. Moreover, the problem is distinct from standard jailbreaking, as a peer-review attack seeks to induce a domain-specific, targeted failure (e.g., "inflate this score") rather than a general safety policy violation, for which no practical defenses exist. To address this, we introduce PaperGuard, the first comprehensive benchmark designed to systematically evaluate and defend AI-generated peer-review against these domain-specific, cross-modal attacks. Our framework is built on three pillars: (1) a new multimodal peer-review dataset spanning multiple scientific domains; (2) a unified suite of attacks, including black-box prompt injections and white-box perturbations, specifically designed to target both text (GCG) and figures (PGD); and (3) a practical defense, motivated by the long-context challenge of academic papers, that uses chunk-based embedding search to efficiently localize and mitigate harmful instructions. Our extensive experiments, conducted across state-of-the-art models, confirm that AI reviewers are pervasively vulnerable. PaperGuard establishes the foundational benchmark, protocols, and actionable defense necessary to pioneer trustworthy, attack-resilient AI-assisted scholarly reviewing.

19.
medRxiv (Medicine) 2026-06-18

Hospital staff views on the visibility, role and impact of Acute Learning Disability Liaison Services in Wales: a service evaluation

People with a learning disability experience marked health inequalities. In Wales, Acute Learning Disability Liaison Services (ALDLS) are delivered by specialised learning disability services, and all roles within them are undertaken by Learning Disability Liaison Nurses (LDLN). These services aim to enable access to, and delivery of, secondary care by supporting reasonable adjustments, facilitating communication, and coordinating care for people with learning disability during hospital encounters. However, independent evidence of the impact of ALDLS on patient care remains limited. This evaluation tries to address this evidence gap by examining hospital staff perceptions of the visibility, role, and impact of ALDLS across Welsh Health Boards, with the aim of informing service design and development and improving secondary care access and care for people with learning disability. The service evaluation used a qualitative approach involving interviews and a focus group with hospital staff across the seven Welsh Health Boards who had experience working with or interacting with ALDLS staff to care for patients with learning disability. Findings cover six key areas including i) visibility and delivery of ALDLS, ii) Barriers and challenges to effective ALDLS delivery, iii) Enablers of effective ALDLS delivery, iv) Positive impacts for patients with learning disability, v) Negative impacts and unintended consequences when the service is absent or limited, and vi) Participants recommendations for future improvements of ALDLS. To synthesise the findings, we developed an overview diagram, which illustrates how ALDLS may influence care quality in acute hospitals. The overview places the liaison service at the centre, showing how organisational enablers and barriers shape its delivery, and how its core functions support improvements in safety, timeliness, effectiveness, efficiency, equity, and patient-centred care. From the findings we have identified recommendations for practice and policy. These include that ALDLS should be recognised as a core, safety-critical component of acute hospital care for people with a learning disability, rather than an optional add-on. In practice, services should be more visibly embedded within routine pathways, with consistent site-based presence, clear referral criteria, early identification through electronic flagging and notification systems, and routine involvement in multidisciplinary planning for complex admissions and procedures. At policy level, ALDLS provision should be recognised within equality and patient safety frameworks as an essential service requiring sustained investment, national minimum configuration standards, adequate staffing, and better-integrated digital systems to support continuity, equitable access, and person-centred care.

20.
arXiv (CS.AI) 2026-06-17

Small Initialization Matters for Large Language Models

arXiv:2606.17945v1 Announce Type: new Abstract: Large language models provide a tractable system for asking how intelligence itself emerges, rather than only how LLMs can be engineered. Although progress is usually attributed to scale, data and architecture, we show that parameter initialization is a gene-like determinant of training and, in particular, of model capacity. Reducing the initialization scale consistently improves pretraining, with the largest gains on reasoning-demanding tasks. We identify two widely used empirical settings that restrain the advantage of small initialization, and show how relaxing them restores favorable scaling. We further uncover a critical initialization that balances the reasoning and training. Mechanistically, small initialization drives a distinct developmental trajectory: parameters first condense into low-complexity structures and later expand into richer representations, giving concrete form to the idea that compression is intelligence. Token-level analyses show that the gains concentrate on non-trivial, context-constrained predictions rather than all tokens uniformly. These results motivate a simple $\gamma$-initialization rule: expose initialization rage as an explicit knob and use small initialization by default, an almost cost-free intervention that improves pretraining and strengthens reasoning across model scales.

21.
arXiv (CS.AI) 2026-06-12

Benchmarking Counterfactual Prediction in Epidemic Time Series with Time-Varying Interventions

arXiv:2606.05692v2 Announce Type: replace-cross Abstract: Deep learning has enabled significant advances in time-series causal inference, yet progress remains constrained by the lack of realistic benchmarks with observable counterfactual outcomes. Existing datasets either rely on real-world observations without ground-truth counterfactuals or on simplified simulations that fail to capture complex causal dynamics. To address this gap, we develop a large-scale benchmark for counterfactual prediction in epidemic time series under dynamic interventions. Unlike existing benchmarks, it supports static and time-varying treatments, as well as both single-policy and multi-policy intervention settings, enabling evaluation of causal inference methods across a broad range of causal inference scenarios. Leveraging a calibrated agent-based model grounded in real-world demographic, mobility, epidemiological, and policy data, we generate realistic counterfactual trajectories across more than 150 U.S. counties. Using this benchmark, we evaluate widely used and state-of-the-art causal inference methods, revealing substantial performance differences and highlighting the challenges of realistic time-series causal reasoning.

22.
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.

23.
medRxiv (Medicine) 2026-06-17

Real-World Effectiveness and Safety of Avacopan in ANCA-Associated Vasculitis: A Systematic Literature Review and Meta-analysis

Background: The efficacy and safety of avacopan in ANCA-associated vasculitis (AAV) has been established in randomized trials of of avacopan as a glucocorticoid (GC) sparing therapy. However, real world evidence (RWE) has an important role in confirming effectiveness and evaluating safety in more generalizable settings. This study aimed to synthesize RWE on the effectiveness and safety of avacopan in adults with AAV. Methods: A systematic literature review and meta analysis of non interventional real world studies was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Eligible studies included adults with AAV treated with avacopan in routine clinical practice. Pooled estimates of effectiveness and safety outcomes were calculated using random effects meta-analyses. Primary outcomes included remission at 6 and 12 months and sustained remission at 12 months. Secondary outcomes included relapse, GC use and dosing, hepatotoxicity, infections, and treatment discontinuation. Exploratory outcomes included changes in estimated glomerular filtration rate (eGFR) and dialysis related endpoints. Results: A total of 71 studies were included and contributed to quantitative analyses. Pooled remission for patients on avacopan was 87% (95% CI: 75%-94%) at 6 months and 93% (95% CI: 86%-97%) at 12 months, and sustained remission was 86% (95% CI: 74%-93%) at 12 months. Relapse at 12 months was low (7%; 95% CI: 4%-11%). GC use was 36% at both 6 and 12 months. Improvements in eGFR were observed at 6 months (18 mL/min/1.73 m2) and 12 months (18 mL/min/1.73 m2), and dialysis liberation was 66% in a limited subset. Among avacopan patients, 11% experienced any hepatotoxicity, including 7% with serious (defined as directly reported or requiring hospitalization) hepatotoxicity, while 7% experienced serious (defined as directly reported or requiring hospitalization) infection. Conclusions: In real world clinical practice, avacopan is associated with high remission rates, low relapse rates, and a consistent GC sparing effect, with effectiveness comparable to standard of care regimens. Findings support its clinical use with appropriate safety monitoring; however, the observed heterogeneity in hepatotoxicity and the limited comparative effectiveness evidence highlight areas requiring further investigation.

24.
bioRxiv (Bioinfo) 2026-06-18

segSHAPE: RNA secondary structure prediction from nanopore direct RNA sequencing

RNAs adopt complex structures that regulate key biological processes, making accurate structure prediction essential. Chemical probing coupled with Nanopore direct RNA sequencing (DRS) offers a route to single-molecule structural inference, but current tools are limited by inaccurate signal-to-sequence alignment, which degrades modification-rate estimation and downstream structure prediction. Here we introduce segSHAPE for RNA secondary structure prediction from Nanopore DRS data (both RNA002 and RNA004 chemistries), a probe-agnostic framework that improves signal alignment using prior information of basecalling and per-read signal baseline shift correction, learns position-specific k-mer raw signal parameters, and estimates per-nucleotide modification rates with an unsupervised anomaly detector. On three public RNA002 DRS datasets spanning different chemical probes (AcIm, NAI-N3) and RNAs from 421 to 1552 nt, segSHAPE achieves the highest F1 score and Matthews correlation coefficient (MCC) on all RNAs, exceeding the strongest baseline by 3.4 to 5.8 percentage points in MCC. It additionally captures the ligand-induced conformational change of the thiamine pyrophosphate (TPP) riboswitch RNA directly from RNA002 DRS data using the DEPC probe. On a public RNA004 DRS dataset, segSHAPE improves over the sm-PORE-cupine baseline by 17 ROC-AUC points in modification rate estimation and by 6.7 MCC points in structure prediction. These results establish segSHAPE as a unified, probe-agnostic pipeline for RNA structure prediction from Nanopore DRS data.

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

Can Deep Neural Networks Improve Compression of Very Large Scientific Data?

arXiv:2606.14353v1 Announce Type: new Abstract: Error-bounded lossy compression is a fundamental technique for managing the rapidly growing volumes of scientific data produced by modern simulations and observational instruments. Most state-of-the-art-compressors follow a prediction-residual paradigm, where compression effectiveness depends on the quality of the predictor: more accurate predictions generate smaller residuals that are easier to compress. This observation raises a question: can modern machine learning models serve as superior predictors for scientific data compression? Answering this question directly is challenging because developing compression-specific ML predictors requires substantial resources. Instead, we leverage the climate domain where highly accurate pretrained weather forecasting foundation models already exist, making them an ideal testbed. We present a framework that integrates spatial and temporal deep learning models into a conventional error-bounded compression pipeline. The framework supports auto-regressive forecasting models and avoids error accumulation. Using ERA5 climate data as a representative large-scale scientific dataset, we evaluate three distinct ML predictors: a VAEformer-based codec (CRA5), a graph neural network forecaster (GraphCast), and a vision-transformer forecaster (Aurora), against the state-of-the-art compressor SZ3.1 under identical quantization and entropy-coding backends. Our evaluation over approximately 1.7 TB of data reveals a surprising result: although ML predictors generate more accurate predictions and can improve reconstruction quality by up to 91% while achieving up to 9.6x higher compression ratios for highly predictable variables, they do not improve overall dataset-level compression ratio. We show that prediction accuracy alone is insufficient: the spatial structure of the resulting residuals plays a decisive role in entropy coding efficiency.