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01.
arXiv (CS.CV) 2026-06-16

DPC-VQA: Decoupling Quality Perception and Residual Calibration for Video Quality Assessment

Recent multimodal large language models (MLLMs) have shown promising performance on video quality assessment (VQA) tasks. However, adapting them to new scenarios remains expensive due to large-scale retraining and costly mean opinion score (MOS) annotations. In this paper, we argue that a pretrained MLLM already provides a useful perceptual prior for VQA, and that the main challenge is to efficiently calibrate this prior to the target MOS space. Based on this insight, we propose DPC-VQA, a decoupling perception and calibration framework for video quality assessment. Specifically, DPC-VQA uses a frozen MLLM to provide a base quality estimate and perceptual prior, and employs a lightweight calibration branch to predict a residual correction for target-scenario adaptation. This design avoids costly end-to-end retraining while maintaining reliable performance with lower training and data costs. Extensive experiments on both user-generated content (UGC) and AI-generated content (AIGC) benchmarks show that DPC-VQA achieves competitive performance against representative baselines, while using less than 2% of the trainable parameters of conventional MLLM-based VQA methods and remaining effective with only 20% of MOS labels. The code will be released upon publication.

02.
arXiv (CS.CV) 2026-06-12

Amnesia: A Stealthy Replay Attack on Continual Learning Dreams

Continual learning (CL) models often use experience replay to reduce catastrophic forgetting, but their robustness to replay sampling interference remains underexplored. Existing CL attacks alter inputs or training pipelines (poisoning/backdoors) and rarely include explicit auditable constraints, limiting realism. Here, auditability means a monitor can verify compliance from sampler-visible telemetry - e.g., logged replay index/label statistics - by checking that the realized replay class histogram stays close to a nominal baseline and that replay rate is unchanged per batch and/or over a rolling window. We study a limited-privilege insider who controls only replay index selection, not pixels, labels, or model parameters, while staying within auditable limits such as queue priorities. We introduce Amnesia, a replay composition attack that maximizes degradation under two budgets: a visibility budget delta bounding the TV/KL divergence from a nominal class histogram p0, and a mass budget f fixing the replay rate. Amnesia has two steps: (i) compute lightweight class utilities, such as EMA loss or confidence, to tilt p0 toward harmful classes; and (ii) project the tilt back into the delta-ball using efficient KL (exponential tilt) or TV (balanced mass redistribution) optimizers. A windowed scheduler enforces rolling audits. Across challenging CL benchmarks and strong replay baselines, Amnesia consistently lowers final accuracy (ACC) and worsens backward transfer (-BWT). The KL variant delivers high impact while remaining largely undetected under multiple audit schemes, including per-batch and rolling-window checks. The TV variant is more damaging but easier to detect, especially under tight per-class constraints. These results expose index-only replay control as a practical, auditable threat surface in CL systems and establish a principled impact-visibility trade-off.

03.
arXiv (CS.AI) 2026-06-12

A Minimal Model of Bounded Trade-Off Screening in Multi-Attribute Choice

arXiv:2606.13201v1 Announce Type: new Abstract: Human decision-making often involves choosing between multi-attribute alternatives, yet classical models assume fully compensatory utility aggregation despite evidence that people reject options with poor performance on critical attributes. We propose a bounded trade-off reasoning framework in which decisions are governed by a screening process that evaluates the balance between gains and losses across attributes. The model introduces a trade-off tolerance parameter that controls acceptable imbalance and can vary across contexts. Through simulation, we show that this mechanism produces preference patterns that differ from standard utility-based models and captures context-dependent variation in trade-off behavior. These results establish bounded trade-off screening as a plausible computational mechanism for multi-attribute choice and generate testable predictions for future behavioral studies.

04.
arXiv (math.PR) 2026-06-16

A Machine-Checked Itô Calculus for Brownian Motion

arXiv:2606.15089v1 Announce Type: cross Abstract: We present a machine-checked development of the $L^2$ Itô calculus of Brownian motion on a bounded time interval $[0,T]$, formalized in Lean 4 on top of Mathlib and the BrownianMotion package. The development contains: the construction of the Itô integral as an isometry of Hilbert spaces, from a predictable-rectangle $\pi$-system through the density of simple adapted processes; the Itô integral as a process, proved to be an $L^2$-continuous martingale through a single structural identity (the integral at time $t$ is the conditional-expectation projection of its terminal value onto $\mathcal{F}t$), from which adaptedness, the martingale property, the contraction bound, and both the terminal and the time-indexed Itô isometries follow as corollaries; and Itô's formula for $C^3$ functions with bounded derivatives, including its time-dependent form $df = f_x,dB + (f_t + \tfrac12 f{xx}),dt$, obtained by a discrete-to-continuous argument through weighted quadratic variation and explicit $L^2$ remainder bounds. To our knowledge this includes the first machine-checked proof of Itô's formula, and the first machine-checked construction of the Itô integral as a martingale-valued process, in any proof assistant. We are deliberate about the boundary: the theory is the $L^2$ theory on $[0,T]$ with bounded-derivative integrand classes; localization to the unrestricted $C^2$ formula, integrators beyond Brownian motion, and pathwise statements are out of scope, and we say precisely why and where. The development is roughly 7,200 lines of Lean across 22 modules; every theorem is sorry-free, the axioms of each headline result are pinned to Mathlib's classical defaults by a build-enforced gate, and the whole is reproducible from a pinned toolchain.

05.
arXiv (quant-ph) 2026-06-17

Practical Tests and Witnesses of Fermionic non-Gaussianity

arXiv:2605.26218v2 Announce Type: replace Abstract: Fermionic Gaussian states describe free fermions and underlie the mean-field picture of matter, from metals to superconductors; they are also efficiently simulable on classical computers. Departures from Gaussianity – the correlations produced by interactions – are therefore what make a fermionic system hard to simulate classically and useful for quantum computation, analogous to the role of magic in stabilizer-based quantum computation. Yet detecting and quantifying such non-Gaussianity at scale has remained challenging. Here we introduce practical tests and witnesses of fermionic non-Gaussianity built on fermionic antiflatness, a measure derived from the two-point covariance matrix. We estimate it with two protocols – a two-copy Bell measurement and a single-copy scheme using commuting Majorana bilinears – that determine whether a state is Gaussian or far from it at lower measurement cost than existing approaches, using only operations native to fault-tolerant hardware. For mixed states, a purity-corrected witness certifies non-Gaussianity and remains robust under strong noise; running it on the IQM quantum processor, we find that noise can both reduce and enhance non-Gaussianity. Finally, we show that preparing pseudorandom fermionic states requires extensive non-Gaussianity. Together, these tools enable the study and certification of non-Gaussian fermionic resources on present-day quantum devices.

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

ThinkJEPA: Empowering Latent World Models with Large Vision-Language Reasoning Model

Recent progress in latent world models (e.g., V-JEPA2) has shown promising capability in forecasting future world states from video observations. Nevertheless, dense prediction from a short observation window limits temporal context and can bias predictors toward local, low-level extrapolation, making it difficult to capture long-horizon semantics and reducing downstream utility. Vision–language models (VLMs), in contrast, provide strong semantic grounding and general knowledge by reasoning over uniformly sampled frames, but they are not ideal as standalone dense predictors due to compute-driven sparse sampling, a language-output bottleneck that compresses fine-grained interaction states into text-oriented representations, and a data-regime mismatch when adapting to small action-conditioned datasets. We propose a VLM-guided JEPA-style latent world modeling framework that combines dense-frame dynamics modeling with long-horizon semantic guidance via a dual-temporal pathway: a dense JEPA branch for fine-grained motion and interaction cues, and a uniformly sampled VLM thinker branch with a larger temporal stride for knowledge-rich guidance. To transfer the VLM's progressive reasoning signals effectively, we introduce a hierarchical pyramid representation extraction module that aggregates multi-layer VLM representations into guidance features compatible with latent prediction. Experiments on hand-manipulation trajectory prediction show that our method outperforms both a strong VLM-only baseline and a JEPA-predictor baseline, and yields more robust long-horizon rollout behavior.

07.
arXiv (CS.CV) 2026-06-16

DriveReward: A Comprehensive Dataset and Generative Vision-Language Reward Model for Autonomous Driving

Reward models play a pivotal role in reinforcement learning (RL) and multi-modal trajectory selection for autonomous driving. However, acquiring such rewards typically relies on hand-crafted rule-based objectives or perception ground truth, which hinders generalization for data-scaling. While Vision-Language Models (VLMs) have demonstrated feasibility as reward models in other domains, their effectiveness in driving tasks remains underexplored. In this work, we bridge this gap by (1) introducing DriveReward, a reasoning trajectory evaluation dataset rigorously labeled via temporally-grounded visual guidance, and augmented with counterfactual driving behaviors., (2) alongside a specialized Vision-Language Reward Model. To address the scarcity of failure cases in conventional datasets, we propose a counterfactual data annotation scheme to construct cases encompassing diverse driving styles and erroneous behaviors. Evaluations on our proposed benchmark reveal that even leading open-source and proprietary VLMs fail to excel across all tasks, highlighting significant room for improvement in existing models. Building on these findings, we subsequently tailor a specialized 1B reward model that outperforms larger VLMs on task-specific reward alignment. Finally, we validate our reward model's effectiveness by integrating it into RL finetuning and multi-modal trajectory scoring across multiple baselines, achieving performance comparable to rule-based reward calculations in both open-loop and closed-loop evaluation.

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

ATV-Net: Adaptive Triple-View Network with Dynamic Feature Fusion

Recent advances in semantic segmentation rely heavily on attention-based and transformer-style architectures that, while accurate, introduce considerable architectural complexity and computational cost. This paper asks whether a compact CNN-based segmentation head can remain competitive by adaptively selecting useful receptive-field evidence. We propose ATV-Net, an Adaptive Triple-View Network that attaches a lightweight head to a conventional backbone. The head organizes three complementary views – point-wise, neighborhood-level, and enlarged context – and fuses them through an Adaptive Decision Gate that generates image-dependent weights from global feature statistics. This allows the model to emphasize different receptive-field responses according to scene content, without dense attention or multi-scale aggregation. Experiments on Cityscapes and Pascal VOC 2012 show that ATV-Net achieves 80.31% mIoU on Cityscapes with ResNet-101 and 80.90% with ConvNeXt-Tiny, and 86.7% and 88.5% mIoU on Pascal VOC 2012, respectively, while requiring fewer GFLOPs than representative context-aggregation and attention-based heads. The results indicate that adaptive receptive-field selection remains a practical and effective design choice for CNN-based semantic segmentation.

09.
arXiv (CS.LG) 2026-06-16

OptEMA: Adaptive Exponential Moving Average for Stochastic Optimization with Zero-Noise Optimality

作者:

arXiv:2603.09923v4 Announce Type: replace Abstract: Exponential moving averages (EMAs) are a central component of widely used adaptive optimizers such as Adam. However, existing analyses of Adam-style methods often yield suboptimal guarantees in the zero-noise regime, rely on open-loop parameter schedules, or require prior knowledge of smoothness constants. Motivated by these limitations, we introduce OptEMA and analyze two complementary variants: OptEMA-M, which applies an adaptive, decreasing EMA coefficient to the first moment with a fixed second-moment decay, and OptEMA-V, which swaps these roles. At the heart of these variants is a Corrected AdaGrad-Norm coefficient schedule. This formulation renders OptEMA algorithmically closed-loop and Lipschitz-free, meaning its effective stepsizes are trajectory-dependent and require no parameterization via the Lipschitz constant. Under lower-boundedness, unbiasedness, bounded variance, average smoothness, and a bounded stochastic-gradient condition used to control the adaptive normalizers, we prove that both variants achieve the unified noise-adaptive rate $\tilde{\mathcal{O}} \left(T^{-1/2}+\sigma^{1/2}T^{-1/4}\right)$ for the averaged gradient norm. In the zero-noise regime, these bounds automatically reduce to the nearly optimal deterministic rate $\widetilde{\mathcal{O}}(T^{-1/2})$ without manual hyperparameter retuning.

10.
arXiv (CS.AI) 2026-06-17

CogGen: Cognitive-Load-Inspired Fully Unsupervised Deep Generative Modeling for Compressively Sampled MRI Reconstruction

arXiv:2603.04438v3 Announce Type: replace-cross Abstract: Fully unsupervised deep generative modeling (FU-DGM) offers significant potential for compressively sampled magnetic resonance imaging (CS-MRI) reconstruction. Representative FU-DGM formulations, such as deep image prior (DIP) and implicit neural representation (INR), employ architectural bias to induce a low-dimensional manifold in the image space that aligns with the forward observation. However, as the underlying inverse system is highly ill-posed, prolonged iterative fitting in FU-DGM typically leads to poor efficiency and noise amplification. In this paper, guided by the cognitive principle of easy-to-hard learning, we propose CogGen, an FU-DGM framework that reformulates CS-MRI reconstruction as a staged inversion problem. Specifically, CogGen implements an self-paced curriculum learning (SPCL)-driven progressive scheduling strategy through an MRI-aware dual-threshold weighting criterion, which adaptively regulates k-space measurement participation. The data-consistency residual thresholding evaluates the fitting reliability of the current generator, while the k-space radius thresholding controls stage-wise measurement exposure, thereby avoiding uniform fitting throughout optimization. Theoretically, our analysis shows that, when early stages favor easy-to-fit measurements, CogGen yields a reduced local sufficient-iteration bound and a smaller cumulative noise-amplification bound, explaining the improved convergence behavior and reconstruction fidelity of CogGen within a finite iteration budget. Numerical experiments demonstrate that both CogGen instantiations, CogGen-DIP and CogGen-INR, achieve superior performance over prevailing CS-MRI reconstruction techniques, including unsupervised and supervised pipelines.

11.
arXiv (quant-ph) 2026-06-16

A complexity theory for non-local quantum computation

arXiv:2505.23893v2 Announce Type: replace Abstract: Non-local quantum computation (NLQC) replaces a local interaction between two systems with a single round of communication and shared entanglement. Despite many partial results, it is known that a characterization of entanglement cost in at least certain NLQC tasks would imply significant breakthroughs in complexity theory. Here, we avoid these obstructions and take an indirect approach to understanding resource requirements in NLQC, which mimics the approach used by complexity theorists: we study the relative hardness of different NLQC tasks by identifying resource efficient reductions between them. Most significantly, we prove that $f$-measure and $f$-route, the two best studied NLQC tasks, are in fact equivalent under $O(1)$ overhead reductions. This result simplifies many existing proofs in the literature and extends several new properties to $f$-measure. For instance, we obtain sub-exponential upper bounds on $f$-measure for all functions, and efficient protocols for functions in the complexity class $\mathsf{Mod}_k\mathsf{L}$. Beyond this, we study a number of other examples of NLQC tasks and their relationships.

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

Architecture-Aware Reinforcement Learning Makes Sliding-Window Attention Competitive in Math Reasoning

arXiv:2606.11634v1 Announce Type: new Abstract: The rapid progress of reasoning and agentic large language models (LLMs) has increased the demand for long-context inference, but self-attention (SA) scales quadratically with context length. To address this, we study SWARR (Sliding-Window Attention with Reinforced Adaptation for Math Reasoning), a practical recipe for adapting SWA models to mathematical reasoning. SWARR has two stages: (1) efficient conversion from a pretrained SA model to SWA with supervised fine-tuning (SFT), which avoids pretraining a new base model, and (2) policy adaptation with reinforcement learning (RL). We find that SWA still underperforms SA after SFT, and we hypothesize that this gap is caused in part by a data-architecture mismatch: most SFT data are prepared for SA models and may contain long-range dependencies that are difficult for SWA to model. Because on-policy RL optimizes self-generated trajectories under the SWA constraint, it can adapt trajectories to better match SWA. Experiments on mathematical reasoning benchmarks show that this recipe substantially narrows the gap between SWA and SA, recovering much of the accuracy lost during SWA conversion while preserving the efficiency benefits of linear-complexity attention. Our central contribution is the empirical finding that RL changes the conclusion one would draw from conversion and SFT alone about SWA's viability for math reasoning.

13.
arXiv (CS.CV) 2026-06-17

Bridging Spatial And Frequency Views For Disaster Assessment: Benefits And Limitations

Rapid assessment of building damage from satellite imagery is essential for effective disaster response and recovery. While most deep learning methods rely on spatial-domain features, frequency-domain representations can capture complementary structural cues such as debris patterns and collapse-induced textures. This study presents a controlled comparison of spatial-domain, frequency-domain, and dual-domain deep learning approaches for multi-class building damage classification using post-disaster imagery from the xView2 (xBD) dataset. To ensure fairness, all models are built on an EfficientNet-B0 backbone and trained under identical settings, differing only in their input representations and fusion strategies. Performance is evaluated using accuracy, macro F1-score, per-class metrics, and confusion matrices. Results show that dual-domain models provide measurable improvements over single-domain approaches. The dual spatial configuration achieves the highest test accuracy (0.4688) and lowest loss, while the spatial-only model attains the best macro F1-score (0.4254), indicating more balanced class performance. In contrast, frequency-only models perform worst and exhibit overfitting, suggesting limited generalization. Despite these gains, all models struggle to detect subtle damage levels, particularly the Minor class, due to class imbalance and fine-grained visual ambiguity. While dual-domain approaches improve detection of severe damage, challenges remain. These findings highlight the benefits and limitations of hybrid representations and motivate future work on data balancing, advanced fusion, and regularization.

14.
Nature (Science) 2026-06-08

GPR15-guided CD8<sup>+</sup> T regulatory cells control intestinal inflammation

作者:

Inflammatory bowel disease (IBD) causes chronic suffering from gastrointestinal inflammation and dysfunction that can progress to colon cancer1,2. The disease prevalence is increasing and there is an urgent need to better understand its pathogenic mechanisms to improve treatment. We show that GPR15, a G protein-coupled receptor (GPCR) expressed in immune cells and previously described as an entry co-factor for human and simian immunodeficiency viruses3, is a marker and homing receptor for a subset of intramucosal GPR15-guided regulatory CD8+ T lymphocytes (CD8+ TIGR). Deleterious GPR15 gene variants in humans cause defective homing of CD8+ TIGR and are associated with severe early-onset IBD. Moreover, CD8+ TIGR cells are reduced in the intestinal mucosa of sporadic IBD patients. In mice, GPR15 deficiency impairs colonic homing of CD8+ TIGR cells, leading to accumulation of inflammatory macrophages and increased susceptibility to colitis. CD8+ TIGR cells potently kill macrophages activated by intestinal damage or disease using Fas ligand (FasL) and TNF-related weak inducer of apoptosis (TWEAK). The identification of CD8+ TIGR cells yields new insights into organ-specific immune regulation and potential therapeutics for IBD.

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

Unsupervised Learning of Efficient Exploration: Pre-training Adaptive Policies via Self-Imposed Goals

arXiv:2601.19810v2 Announce Type: replace-cross Abstract: Unsupervised pre-training can equip reinforcement learning agents with prior knowledge and accelerate learning in downstream tasks. A promising direction, grounded in human development, investigates agents that learn by setting and pursuing their own goals. The core challenge lies in how to effectively generate, select, and learn from such goals. Our focus is on broad distributions of downstream tasks where solving every task zero-shot is infeasible. Such settings naturally arise when the target tasks lie outside of the pre-training distribution or when their identities are unknown to the agent. In this work, we (i) optimize for efficient multi-episode exploration and adaptation within a meta-learning framework, and (ii) guide the training curriculum with evolving estimates of the agent's post-adaptation performance. We present ULEE, an unsupervised meta-learning method that combines an in-context learner with an adversarial goal-generation strategy that maintains training at the frontier of the agent's capabilities. On XLand-MiniGrid benchmarks, ULEE pre-training yields improved exploration and adaptation abilities that generalize to novel objectives, environment dynamics, and map structures. The resulting policy attains improved zero-shot and few-shot performance, and provides a strong initialization for longer fine-tuning processes. It outperforms learning from scratch, DIAYN pre-training, and alternative curricula. Code is available at: https://github.com/Octavio-Pappalardo/ulee-jax

16.
arXiv (CS.CL) 2026-06-17

Your AI Travel Agent Would Book You a Bullfight: An Agentic Benchmark for Implicit Animal Welfare in Frontier AI Models

AI agents are moving from advisors to actors, booking travel, planning menus, and running procurement on behalf of users. Existing benchmarks for AI and animal welfare evaluate model text responses to question-answer prompts, leaving open whether the welfare reasoning surfaced in those responses transfers to agentic deployment where the model must take actions with tools. We introduce TAC (Travel Agent Compassion), the first agentic benchmark measuring whether AI agents avoid options involving animal exploitation when acting on behalf of users. TAC presents an AI agent with twelve hand-authored travel booking scenarios across six categories of animal exploitation, augmented to forty-eight samples to control for price, rating, and position confounds. We evaluate seven frontier models from four labs. Every model scores below the chance level of sixty-four percent, with the best performer (Claude Opus 4.7) at fifty-three percent. A single welfare-aware sentence in the system prompt yields gains of forty-seven to sixty-three percentage points in Claude and GPT-5.5, twenty-six points in GPT-5.2, and under twelve points in DeepSeek and Gemini. An auxiliary Inspect Scout audit of 288 base-condition transcripts from the top two performers, using Gemini 2.5 Flash Lite as judge, flags zero transcripts for evaluation awareness, suggesting the below-chance rates do not stem from the models recognising the evaluation. We discuss implications for category-level variation across cultural domains, the limits of text-response welfare benchmarks, and the EU General-Purpose AI Code of Practice systemic risk framework.

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

Neural network surrogates with uncertainty quantification for inverse problems in partial differential equations

arXiv:2606.20417v1 Announce Type: new Abstract: Inverse problems for differential equations arise throughout science and engineering, where one seeks to infer unknown model parameters from noisy or incomplete observations. Traditional numerical methods for these problems are often computationally expensive, particularly in Bayesian settings where evaluating the likelihood becomes costly for complex forward models and high-dimensional parameter spaces. To address this challenge, we introduce DeepGaLA, a neural-network surrogate for differential equation solvers that provides uncertainty-aware predictions, reducing overconfident inference when training data are limited. To evaluate the fidelity of the surrogate-induced posterior approximations in practice, we show that a short run of delayed-acceptance Markov chain Monte Carlo can serve as an effective diagnostic. Across a range of numerical experiments, DeepGaLA delivers forward-model approximations with accuracy comparable to established Gaussian-process surrogates, while better maintaining efficiency as parameter dimension grows. Moreover, it can incorporate differential-equation constraints, including in nonlinear settings. Overall, these results indicate that uncertainty-quantified neural surrogates can enable scalable and reliable Bayesian inference for inverse problems in complex systems.

19.
arXiv (CS.CV) 2026-06-12

TetherCache: Stabilizing Autoregressive Long-Form Video Generation with Gated Recall and Trusted Alignment

Autoregressive video diffusion models provide a natural formulation for streaming and variable-length video generation by conditioning newly generated frames on previously generated content. However, extending these models to minute-level generation remains challenging: the limited KV-cache budget prevents the model from retaining the full history, while repeatedly conditioning on self-generated frames induces a context distribution shift that accumulates over time, leading to visual artifacts, quality degradation, and temporal drift. In this paper, we propose TetherCache, a training-free and plug-and-play cache management strategy for drift-resistant long video generation. TetherCache organizes the cache into sink, memory, and recent regions, and introduces two complementary mechanisms. First, GRAB (Gated Recall with Attention-Diversity Balancing) selects long-range memory frames using a gated score that combines attention-based relevance with temporal diversity, preserving informative yet diverse historical context under a fixed cache budget. Second, TAME (Trusted Alignment via Memory Editing) lightly edits newly recalled memory tokens by aligning their statistics to a trusted context distribution, reducing the pollution caused by drifted historical features. Built on Self-Forcing, TetherCache consistently improves long-video generation quality on VBench-Long across 30s, 60s, and 240s settings. In particular, for 240s generation, it substantially improves overall and semantic scores while reducing quality drift from 7.84 to 1.33, demonstrating its effectiveness for stable long-horizon autoregressive video diffusion.

20.
medRxiv (Medicine) 2026-06-18

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

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

21.
medRxiv (Medicine) 2026-06-15

Routine use of oral iron for people with heart failure and iron deficiency in primary care; retrospective cohort study

Aims: Iron deficiency is common among people with heart failure and associated with morbidity and mortality. While intravenous iron improves clinical outcomes, oral iron continues to be prescribed in routine practice despite limited evidence of benefit. Methods: We completed a retrospective primary care cohort study (2016 to 2021) to investigate the proportion of people with an incident diagnosis of heart failure who had iron deficiency identified (defined as ferritin

22.
medRxiv (Medicine) 2026-06-15

Cost-Performance Evaluation of Large Language Models for Aspect-Based Sentiment Analysis of HCAHPS Patient Comments: A Validation Study

Background: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) free-text comments contain actionable feedback, but timely, scalable, and affordable sentiment analysis remains challenging for health systems that rely on third-party vendors. Objectives: To evaluate cost-performance tradeoffs between a cost-optimized and a flagship large language model (LLM) for aspect-based sentiment analysis of HCAHPS comments, using human inter-rater agreement as a reproducibility benchmark. Methods: We analyzed 512 free-text HCAHPS comments collected from two community hospitals in calendar year 2023. Six trained reviewers (medical students, recent medical graduates, and practicing internists) independently assigned positive, negative, or neutral labels to each comment-aspect pair; the majority label among three reviewers formed the consensus reference standard. Two OpenAI models - GPT-5-nano (cost-optimized) and GPT-5 (flagship) - were prompted in a zero-shot setting via the OpenAI API. We calculated pairwise Cohen's {kappa} to establish a human inter-rater baseline, then compared each model's labels to the consensus using Cohen's {kappa}, accuracy, weighted F1, and per-call cost and latency. Results: Mean human inter-rater agreement was {kappa} = 0.79 (substantial). Both LLMs exceeded this baseline (cost-optimized {kappa} = 0.85; flagship {kappa} = 0.85) with nearly identical accuracy (0.92) and weighted F1 (0.93 vs. 0.93). Performance was strong on positive (F1 ~ 0.97) and negative (F1 ~ 0.90) classes but poor on the underrepresented neutral class (F1

23.
arXiv (CS.CV) 2026-06-11

VL-DINO: Leveraging CLIP Vision-Language Knowledge for Open-Vocabulary Object Detectio

Vision-language models like CLIP can provide rich semantic priors for open-vocabulary object detection. However, jointly integrating both textual and visual knowledge into detection architectures remains challenging. In this paper, we propose VL-DINO, an open-vocabulary detector that enhances DINO through more effective exploitation of CLIP's vision-language knowledge. Specifically, a Query-guided Positive Sample Construction (QPSC) module is first developed to construct additional high-quality positive samples, enabling the vanilla DINO framework to better accommodate mixed training across heterogeneous data sources while providing more vision-language alignment signals, thereby incorporating richer textual knowledge during training. A Visual Semantic Encoder (VSE) module is then introduced to distill CLIP visual knowledge into backbone-extracted features, producing fused features for subsequent encoder refinement. Based on the fused features, an Object-Region Semantic Alignment (ORSA) module extracts object-centric region features and aligns them with the corresponding textual embeddings, further incorporating textual cues. In the zero-shot setting, VL-DINO-T and VL-DINO-L achieve 36.3 and 38.1 AP on the LVIS benchmark, respectively, consistently outperforming prior advanced approaches. Extensive experiments demonstrate the effectiveness and competitive performance of the proposed design.

24.
arXiv (CS.LG) 2026-06-17

OmniPlan: An Adaptive Framework for Timely and Near-Optimal Network Planning Optimization

arXiv:2606.18105v1 Announce Type: cross Abstract: Network planning optimization is a fundamental problem across diverse domains, including transportation systems, communication networks, and power grids. It requires simultaneous optimization of multiple competing objectives under complex constraints. Existing network planning optimization frameworks rely on mixed integer programming (MIP) solvers, heuristics, and deep reinforcement learning (DRL) models to compute planning decisions. However, they lack effective adaptability to diverse and dynamic user intents, thus leading to the trade-off between execution time and optimality. In this paper, we propose OmniPlan, an adaptive framework that achieves both timeliness and near-optimality in network planning optimization. To achieve the adaptability lacking in existing solutions, OmniPlan employs a large language model (LLM)-based interpreter to convert heterogeneous natural-language intents into a unified and quantifiable user-preference vector. Then it employs a mixture-of-experts architecture that integrates MIP solvers, heuristics, and DRL models as specialized experts, where OmniPlan adapts to diverse intents by dynamically selecting timely and near-optimal experts. Finally, it incorporates a DRL-based expert configuration module that fine-tunes optimization objective weights to align planning decisions with user-specific preferences. We evaluate OmniPlan with a representative real-world workload, i.e., distributed machine learning (ML), where we leverage OmniPlan to offload a wide spectrum of ML inference tasks, e.g., decision trees, SVM, naive Bayes, XGBoost, and random forests, onto a network of hardware devices. Our experiments on a real-world testbed indicate that OmniPlan achieves near-optimal and low-execution-time offloading for real-world ML inference tasks, reducing latency by up to 97.8\% and network device resource consumption by up to 11.5\%.

25.
arXiv (CS.CV) 2026-06-12

ReFoCUS: Reinforcement-guided Frame Optimization for Contextual Understanding

Recent progress in Large Multi-modal Models (LMMs) has enabled effective vision-language reasoning, yet the ability to video understanding remains constrained by suboptimal frame selection strategies, albeit with the rapid development of video-specialized LMMs. Prior works attempted to solve this with static heuristics or external retrieval modules to feed frame-level information, but these approaches often fail to capture visual cues grounded to the given user queries conflating raw visual dynamics with true semantic relevance. In this paper, we introduce ReFoCUS (Reinforcement-guided Frame Optimization for Contextual UnderStanding), the first framework to integrate online policy-gradient reinforcement learning into frame-level optimization for video-LLMs. ReFoCUS aims to learn a frame selection policy, leveraging reward signals derived from reference models to capture their underlying scoring behavior over frame combinations that best support temporally grounded responses. To efficiently explore the large combinatorial frame space, we employ an autoregressive and query-conditional selection architecture that ensures contextual consistency while reducing complexity. Our policy learning removes the need for explicit frame-level supervision, as it implicitly discovers optimal and semantically consistent frame compositions. ReFoCUS consistently improves reasoning accuracy across multiple video QA benchmarks, demonstrating the advantage of aligning frame selection with model-internal utility.