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01.
arXiv (CS.LG) 2026-06-15

Compressed Computation is (probably) not Computation in Superposition

arXiv:2606.14673v1 Announce Type: new Abstract: We study whether the Compressed Computation (CC) toy model (Braun et al., 2025) is an instance of computation in superposition. The CC model appears to compute 100 ReLU functions with just 50 neurons, achieving a better loss than expected from only representing 50 ReLU functions. We show that the model mixes inputs via its noisy residual stream, corresponding to an unintended mixing matrix in the labels. Splitting the training objective into the ReLU term and the mixing term, we find that performance gains scale with the magnitude of the mixing matrix and vanish when the matrix is removed. The learned neuron directions concentrate in the subspace associated with the top 50 eigenvalues of the mixing matrix, suggesting that the mixing term governs the solution. Finally, a semi-non-negative matrix factorization (SNMF) baseline derived solely from the mixing matrix reproduces the qualitative loss profile and improves on prior baselines, though it does not match the trained model. These results suggest CC is not a suitable toy model of computation in superposition.

02.
arXiv (CS.CV) 2026-06-18

BrainFusionNet: a deep learning and XAI model to understand local, global, and sequential features of MRI images for improved brain tumour detection

The noise of Magnetic Resonance Imaging MRI poses challenges for Deep Learning DL when tumor boundaries are obscured tumor location and appearance are complex Therefore we develop BrainFusionNet that combines Convolutional Neural Networks CNNs Vision Transformers ViT and Gated Recurrent Units GRUs to extract spatial contextual and sequential features from MRI images for improved brain tumor classification Furthermore explainable AI such as SHAP LIME and GradCAM are integrated to visualise and highlight image regions that contribute to BrainFusionNets decisionmaking process The proposed BrainFusionNet model is evaluated on two publicly available MRI datasets Kfold validation suggests 98 accuracy on both datasets The model was compared with the six stateoftheart SOTA CNNs and transfer learning Among the SOTA CNNs DenseNet121 and VGG16 achieved the highest accuracy of 96 The novelty of BrainFusionNet is that the hybrid model effectively extracts local and global features from MRI images even in smallscale tumor regions and small tumor sizes The model has a balanced sequential CNN architecture to capture lowlevel and deeperlayer features a customized ViT that captures local features stabilizes gradient flow and reduces the risk of vanishing gradients during MRI image training The CNN and ViT outputs are fed into a GRU for final classification Furthermore we analyze pixel intensities to determine whether MRI image quality affects image classification Our findings are very novel in image interpretation as we found that the distribution of pixel intensities in MRI images affects DL performance

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

MacrOData: New Benchmarks of Thousands of Datasets for Tabular Outlier Detection

arXiv:2602.09329v3 Announce Type: replace Abstract: Quality benchmarks are essential for fairly and accurately tracking scientific progress and enabling practitioners to make informed methodological choices. Outlier detection (OD) on tabular data underpins numerous real-world applications, yet existing OD benchmarks remain limited. The prominent OD benchmark AdBench is the de facto standard in the literature, yet comprises only 57 datasets. In addition to other shortcomings discussed in this work, its small scale severely restricts diversity and statistical power. We introduce MacrOData, a large-scale benchmark suite for tabular OD comprising three carefully curated components: OddBench, with 790 datasets containing real-world semantic anomalies; OvrBench, with 856 datasets featuring real-world statistical outliers; and SynBench, with 800 synthetically generated datasets spanning diverse data priors and outlier archetypes. Owing to its scale and diversity, MacrOData enables comprehensive and statistically robust evaluation of tabular OD methods. Our benchmarks further satisfy several key desiderata: We provide standardized train/test splits for all datasets, public/private benchmark partitions with held-out test labels for the latter reserved toward an online leaderboard, and annotate our datasets with semantic metadata. We conduct extensive experiments across all benchmarks, evaluating a broad range of OD methods comprising classical, deep, and foundation models, over diverse hyperparameter configurations. We report detailed empirical findings, practical guidelines, as well as individual performances as references for future research. All benchmarks containing 2,446 datasets combined are open-sourced, along with a publicly accessible leaderboard hosted at https://huggingface.co/MacrOData-CMU.

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

GraphWorld: Long-Horizon Planning with World Models for End-to-End Autonomous Driving

End-to-end autonomous driving has made significant progress by unifying perception, prediction, and planning within a single learning framework, achieving strong performance in short-horizon decision making. However, most existing E2E-AD methods remain confined to short-horizon planning and lack the ability to model long-term temporal dependencies, which severely limits their generalization and security in complex and highly interactive driving scenarios. In this work, we propose GraphWorld, an E2E-AD framework that explicitly enhances long-horizon planning through latent world modeling. We introduce an Ego-Centric Interaction Graph, which adaptively models critical neighboring agents based on spatial proximity, and propagates relational context to planning queries via cross-node cross-attention. We present a World-State-Conditioned Planning that learns ego-centric latent world representations by modeling interactions between an ego vehicle and surrounding agents. This latent world state captures key interaction dynamics and safety-relevant semantics, and serves as a conditioning signal to guide long-horizon, safety-aware trajectory planning. Extensive experiments on Bench2Drive, NAVSIMv1/2, and nuScenes demonstrate that GraphWorld significantly reduces collision rates and improves long-horizon planning performance, validating its effectiveness in complex driving environments.

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

Approximately Decoding the Colour Code

作者:

arXiv:2606.18035v1 Announce Type: new Abstract: Recently we showed that minimum weight decoding in the (6.6.6 planar) colour code is NP-hard. However, it remained an open question as to whether it was possible to approximate the minimum weight decoding arbitrarily closely in polynomial time. In this paper we prove that it is possible: for any $\varepsilon>0$ there is an polynomial time algorithm that, given a syndrome, can find an error-set generating that syndrome whose weight is at most $1+\varepsilon$ times the weight of the minimum weight decoding. As a consequence we see that, for any $\varepsilon>0$, there is a polynomial time algorithm that can correct all errors of weight up to $(1-\varepsilon)d/2$ in the distance $d$ colour code (so almost up to the theoretical $d/2$ limit). The polynomial we give is impractically large, but it does open the door for sensible polynomial time algorithms that approximate minimum weight decoding and, in particular, shows that approximate decoding is not NP-hard.

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

LLM-Powered AI Agent Systems and Their Applications in Industry

arXiv:2505.16120v3 Announce Type: replace Abstract: The emergence of Large Language Models (LLMs) has reshaped agent systems. Unlike traditional rule-based agents with limited task scope, LLM-powered agents offer greater flexibility, cross-domain reasoning, and natural language interaction. Moreover, with the integration of multi-modal LLMs, current agent systems are highly capable of processing diverse data modalities, including text, images, audio, and structured tabular data, enabling richer and more adaptive real-world behavior. This paper comprehensively examines the evolution of agent systems from the pre-LLM era to current LLM-powered architectures. We categorize agent systems into software-based, physical, and adaptive hybrid systems, highlighting applications across customer service, software development, manufacturing automation, personalized education, financial trading, and healthcare. We further discuss the primary challenges posed by LLM-powered agents, including high inference latency, output uncertainty, lack of evaluation metrics, and security vulnerabilities, and propose potential solutions to mitigate these concerns.

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

My Chemical Harness: Evolutionary Molecular Design over Synthetic Pathways with Large Language Model Agents

arXiv:2606.11256v1 Announce Type: cross Abstract: Designing molecules with target properties is most useful when candidate structures are accompanied by feasible synthetic routes. We introduce My Chemical Harness, a route-native evolutionary framework for goal-directed molecular design in which the search population consists of executable synthetic pathways rather than isolated molecular graphs. Each route is built from purchasable building blocks and reaction templates, executed by deterministic chemistry tools, and scored through task-specific molecular oracles. Large language models (LLMs) are used only as strategy controllers that select high-level preferences over route length, move type, reaction families, motifs, and exploration pressure, while local code performs route construction, validation, deduplication, scoring, selection, and memory updates. This separation lets the LLM guide exploration without allowing it to introduce hallucinated products or unsupported reaction steps. On a soluble epoxide hydrolase proxy task, our LLM agent improves over single pass LLM and deterministic controllers, reaching state-of-the-art performance across the sEH score, synthetic accessibility score, and AiZynthFinder success rate metrics. These results suggest that constrained LLM agents can play a significant role in molecular discovery without requiring training, fine-tuning, or dedicated generative models.

09.
arXiv (CS.CV) 2026-06-12

SmartFont: Dynamic Condition Allocation for Few-Shot Font Generation

Few-shot font generation simultaneously requires global structural completeness and fine-grained local style fidelity. Existing methods usually either rely on global content-style modeling, which is robust but imperfectly disentangled, or emphasize component/local modeling, which captures fine details but relies heavily on local priors and reference coverage. We argue that the key challenge is not merely to learn purer conditions, but to organize complementary yet biased global and local conditions through multi-level allocation during generation. To this end, we propose SmartFont, a diffusion-based few-shot font generation framework that combines global content-style generation with weakly supervised local corrective experts. The local branch performs semantic-spatial allocation by learning expert-wise local concepts and semantically meaningful spatial maps under weak component supervision, enabling fine-grained correction without requiring explicit component-conditioned inference. On top of this, a denoising-state condition allocation module adaptively weights global content, global style, and local corrective feature across timesteps and injection blocks. Extensive experiments show that SmartFont achieves better global-local balance, improves glyph quality and local detail fidelity.

10.
arXiv (CS.CL) 2026-06-16

Dual-Uncertainty Guided Policy Learning for Multimodal Reasoning

Reinforcement learning with verifiable rewards (RLVR) has advanced reasoning capabilities in multimodal large language models. However, existing methods typically treat visual inputs as deterministic, overlooking the perceptual ambiguity inherent to the visual modality. Consequently, they fail to distinguish whether a model's uncertainty stems from complex reasoning or ambiguous perception, preventing the targeted allocation of exploration or learning signals. To address this gap, we introduce DUPL, a dual-uncertainty guided policy learning approach for multimodal RLVR that quantifies and leverages both perceptual uncertainty (via symmetric KL divergence) and output uncertainty (via policy entropy) to guide policy updates. By establishing an uncertainty-driven feedback loop and employing a dynamic branch prioritization mechanism, DUPL recalibrates the policy advantage to focus learning on states with high perceptual or decisional ambiguity, enabling effective targeted exploration beyond passive data augmentation. Evaluated on diverse multimodal reasoning benchmarks spanning mathematical and general domains, DUPL achieves solid gains. It improves Qwen2.5-VL accuracy by up to $12.3%$ (3B) and $7.9%$ (7B), and Qwen3-VL-Instruct by up to $10.7%$ (4B) and $12.4%$ (8B), consistently outperforming GRPO, while seamlessly generalizing to alternative algorithms (DAPO, $+6.5%$ avg) and architectures (LLaVA-OneVision-1.5, $+4.7%$ avg). These results demonstrate that DUPL is an effective and generalizable approach for multimodal RLVR.

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

PaperJury: Due-Process Review for Bounded LaTeX Revision

Pre-submission hardening of human-authored LaTeX computer science papers differs from drafting assistance because it requires adversarial whole-paper review, explicit no-fix outcomes, and bounded artifact-safe revision. Existing writing assistants, critique generators, and judge-centered loops lack durable issue identity across rounds, deterministic routing from critique to adjudication, and manuscript control that can reject invalid concerns or defer author-dependent ones. We present PaperJury, a closed-loop review-verdict-revise-verify system built on a deterministic-versus-semantic split: deterministic orchestration manages decomposition, a frozen claim spine, a durable ledger, routing, stopping, and exact-once patch application, while semantic agents are limited to bounded review, judgment, and repair. PaperJury combines bounded holistic review, contestability-based routing, a due-process trial, and risk-proportional guard chains for anchor-bounded edits, yielding terminal outcomes of invalid-drop, valid-fixable, and author-required. In a two-arm expert-review evaluation on held-out Vision, natural language processing, and machine learning papers against four baselines, we assess issue quality, verdict and routing quality, edit safety, convergence behavior, and cost, supporting the thesis that load-bearing safety and completion logic should reside in deterministic orchestration rather than model discretion. PaperJury is available at https://github.com/u7079256/paperjury.

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

TerraMARS: A Domain-Adapted Small-Language-Model Pipeline for Mars Terraforming Literature

Researchers are interested in learning about Mars so that it may eventually become habitable for humans. To achieve this, there is a need for comprehensive knowledge of the planet's atmosphere, hydrology, surface chemistry, radiation environment, and spatial features through the scientific literature. These contain valuable information and meaningful quantitative constraints that can be used in other models and studies, such as habitability assessment and future terraforming studies. We present TerraMARS, an end-to-end information extraction pipeline that combines a domain-adapted Small Language Model to answer Mars terraforming-related questions and convert unstructured Mars science text into machine-readable structured outputs in JavaScript Object Notation (JSON) format. A corpus of open-access papers is collected and processed using a multistage retrieval and chunking framework. Google Gemma 3 1B was adapted to the domain using Quantized Low-Rank Adaptation (QLoRA) fine-tuning on Mars-specific question-answering and information extraction datasets. The resulting pipeline generates both types of output and provides a foundation for integrating knowledge from scientific literature into downstream applications like digital twins and habitability modeling for Mars. The output from this pipeline looks promising, but further improvements are needed to increase extraction accuracy and factual consistency.

13.
arXiv (CS.CV) 2026-06-18

SegmentAnyTreeV2: Scaling Transformer-Based Tree Instance Segmentation Across Sensors, Platforms, and Forests

We present SegmentAnyTreeV2, a sensor- and platform-agnostic framework for semantic and instance segmentation of forest point clouds. The model combines a serialization-based Point Transformer v3 backbone with a lightweight semantic head and a tree-focused cross-attention mask decoder. Semantic predictions restrict instance decoding to tree-class voxels, while instance-aware query initialization, one-to-many seed supervision, and asymmetric mask scoring improve separation in dense and structurally complex stands. We further introduce FOR-instance v3, an expanded benchmark comprising 427 scenes and 26,496 annotated trees across diverse biomes, forest structures, and LiDAR platforms. On the FOR-instanceV2 test split, SegmentAnyTreeV2 achieves 90.5% precision, 80.2% recall, 85.0% F1, 90.7% coverage, and 87.6% semantic mIoU, outperforming previous learning-based methods in both instance detection and mask completeness. Zero-shot evaluation on independent sites further demonstrates strong cross-domain generalization.

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

Pathway-Structured Privileged Distillation for Deployable Computational Pathology

Integrating transcriptomics and histopathology can improve cancer risk modelling, yet practical use is constrained by the limited availability of RNA profiling in routine settings. Here we introduce Mixture of Pathway Experts (MoPE), a knowledge-distillation framework that reframes multimodal learning as privileged distillation for histology-only inference. MoPE is motivated by the partial observability between RNA profiles and whole-slide images: histology can capture morphology-linked consequences of certain molecular programmes, but cannot be expected to reconstruct the full transcriptomic state. MoPE encodes RNA-derived pathways and transfers the molecular supervision to pathway-indexed pathology experts through memory-usage alignment. Across diverse public benchmarks and two independent breast cancer cohorts, MoPE consistently improved WSI-only inference performance relative to baseline methods. Pathway-usage analyses and human-audited visual inspection provide bounded inspection of model behaviour and candidate morphology-linked readouts. These results support pathway-structured privileged distillation as a promising route to using molecular information during training while preserving RNA-free inference.

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

Implicit vs. Explicit Prompting Strategies for LVLMs in Referential Communication

Two recent studies (Jones et al. (2026); Zeng et al. (2026)) reach apparently contradictory conclusions about whether LVLMs can coordinate on efficient referring expressions. We control for task differences between the studies while directly comparing their prompting styles. We replicate the finding that models can coordinate efficient referring expressions when explicitly prompted to do so, suggesting that other task differences are not responsible for divergent results. However, we also find that the same models fail to infer the need for communicative efficiency from a more implicit prompt, highlighting critical differences between how humans and AI systems communicate.

17.
arXiv (quant-ph) 2026-06-11

Additivity and chain rules for quantum entropies via multi-index Schatten norms

arXiv:2502.01611v3 Announce Type: replace Abstract: The primary entropic measures for quantum states are additive under the tensor product. In the analysis of quantum information processing tasks, the minimum entropy of a set of states, e.g., the minimum output entropy of a channel, often plays a crucial role. A fundamental question in quantum information and cryptography is whether the minimum output entropy remains additive under the tensor product of channels. Here, we establish a general additivity statement for the optimized sandwiched Rényi entropy of quantum channels. For that, we generalize the results of [Devetak, Junge, King, Ruskai, CMP 2006] to multi-index Schatten norms. As an application, we strengthen the additivity statement of [Van Himbeeck and Brown, 2025] thus allowing the analysis of time-adaptive quantum cryptographic protocols. In addition, we establish chain rules for Rényi conditional entropies that are similar to the ones used for the generalized entropy accumulation theorem of [Metger, Fawzi, Sutter, Renner, CMP 2024].

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

Does VLA Even Know the Basics? Measuring Commonsense and World Knowledge Retention in Vision-Language-Action Models

arXiv:2606.19297v1 Announce Type: new Abstract: Embodied Vision-Language-Action (VLA) models are typically obtained by fine-tuning powerful pretrained VLMs on robotics data, yet it is unclear how much commonsense and factual knowledge they retain after adaptation. Failures on knowledge-sensitive tasks are ambiguous, conflating missing knowledge with poor generalization of low-level control. We introduce Act2Answer, a lightweight protocol that adapts VLM knowledge benchmarks to VLA evaluation by requiring agents to answer through action. Each question becomes a short tabletop episode where the agent performs a single object-placement action to select among candidate answers, yielding an action-grounded success rate with reduced control confounds. We curate a test suite of such environments across diverse commonsense and world-knowledge categories and introduce layerwise intent probing to localize answer-relevant information across the VLM backbone and action head. In a large-scale study of 7 VLA models and 9 VLM baselines, we systematically rank models across categories, finding that VLAs show solid performance on simple concepts while exhibiting larger gaps on richer semantic categories relative to their source VLMs, that VQA co-training is associated with better knowledge retention, and that answer-relevant signals peak in middle VLA layers but attenuate in upper layers. Act2Answer is available at https://tttonyalpha.github.io/act2answer/.

19.
arXiv (CS.LG) 2026-06-11

Bootstrapped Monitoring: Leveraging Transparent Reasoning to Oversee Stronger AI Agents

arXiv:2606.11998v1 Announce Type: new Abstract: Trusted monitoring is a cornerstone of AI control. However, as frontier models grow more capable, the increasing capabilities gap between trusted and untrusted models may render trusted models unreliable monitors. We introduce bootstrapped monitoring, a protocol that addresses this by inserting a stronger, intermediate untrusted model with transparent chain-of-thought reasoning into the oversight chain. The untrusted monitor ($U_m$) evaluates the agent's actions, while a weaker trusted model ($T$) oversees $U_m$'s reasoning to detect collusion. We evaluate bootstrapped monitoring on multi-turn software engineering tasks (BashArena) across multiple agents and monitors. Bootstrapped monitoring substantially improves catch rates over trusted-only monitoring, even when the untrusted monitor actively colludes with the agent, provided we have access to its raw chain-of-thought. Our results suggest that bootstrapped monitoring can extend the useful lifetime of trusted models in control as AI capabilities advance.

20.
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.

21.
arXiv (CS.LG) 2026-06-11

RCAP: Robust, Class-Aware, Probabilistic Dynamic Dataset Pruning

arXiv:2606.11761v1 Announce Type: new Abstract: Dynamic data pruning techniques aim to reduce computational cost while minimizing information loss by periodically selecting representative subsets of input data during model training. However, existing methods often struggle to maintain strong worst-group accuracy, particularly at high pruning rates, across balanced and imbalanced datasets. To address this challenge, we propose RCAP, a Robust, Class-Aware, Probabilistic dynamic dataset pruning algorithm for classification tasks. RCAP applies a closed-form solution to estimate the fraction of samples to be included in the training subset for each individual class. This fraction is adaptively adjusted in every epoch using class-wise aggregated loss. Thereafter, it employs an adaptive sampling strategy that prioritizes samples having high loss for populating the class-wise subsets. We evaluate RCAP on six diverse datasets ranging from class-balanced to highly imbalanced using five distinct models across three training paradigms: training from scratch, transfer learning, and fine-tuning. Our approach consistently outperforms state-of-the-art dataset pruning methods, achieving superior worst-group accuracy at all pruning rates. Remarkably, with only $10\%$ data, RCAP delivers $>1\%$ improvement in performance on class-imbalanced datasets compared to full data training while providing an average $8.69\times$ speedup. The code can be accessed at https://github.com/atif-hassan/RCAP-dynamic-dataset-pruning

22.
arXiv (CS.CL) 2026-06-16

MosaicQuant: Inlier-Outlier Disaggregation for Unified 4-Bit LLM Quantization

4-bit quantization significantly reduces the memory footprint and accelerates the inference of large language models (LLMs). However, its limited bit-width representation struggles to faithfully capture both dense common values (inliers) and rare large-magnitude values (outliers), causing substantial accuracy degradation. Existing mixed-precision methods mitigate this by retaining outliers in high precision, but at the cost of breaking the uniformity of low-bit execution, introducing precision conversion and extra data movement that undermine practical speedup. We propose MosaicQuant, a unified 4-bit LLM quantization paradigm built on a novel principle of inlier–outlier disaggregation. Rather than elevating outlier precision, MosaicQuant quantizes the full weight matrix into a dense 4-bit base component, where inliers are captured faithfully while outlier are inevitably quantized. A sparse 4-bit residual component is then introduced to compensate for these quantization errors, selectively targeting the most error-critical weight blocks where output distortion is shown to be concentrated. However, a unified representation alone is insufficient, as naïvely executing the sparse residual as a separate kernel still breaks the unified low-bit inference pipeline. To bridge this gap, we introduce ZipperEngine, which fuses sparse block computation into the dense 4-bit GEMM kernel via an overlapped pipeline, unifying not only the representation but also the execution into a single coherent low-bit inference pipeline. Extensive experiments on LLaMA3 and Qwen3 demonstrate that MosaicQuant preserves near-FP16 accuracy while achieving up to $1.24\times$ speedup over the W16A16 baseline.

23.
arXiv (CS.AI) 2026-06-15

Hierarchical ODE: Learning Continuous-Time Physical Prototypes for Early Link Failure Detection

arXiv:2606.14284v1 Announce Type: cross Abstract: Time series prototype learning is fundamentally challenged by observational ambiguity. Discrete architectures fail to resolve this, as they lack the capacity to decouple stochastic noise from continuous dynamics. Furthermore, rigid closed-set assumptions fail to capture unseen diversity. To address these limitations, we propose a hierarchical ordinary differential equation clustering network, which utilizes neural ordinary differential equation to model latent state evolution as a continuous integral curve. This formulation enforces temporal continuity to effectively disentangle smooth feature trends from stochastic noise, while our adaptive hierarchical mechanism autonomously determines the appropriate number of prototypes without rigid prior constraints. Validated on the early link failure detection task with irregularly sampled time series, the proposed method effectively extracts underlying physical prototypes, thereby enabling robust failure detection. Our code is available at https://github.com/NJ-LNN/Hierarchical-ODE.

24.
medRxiv (Medicine) 2026-06-15

Wellbeing After Stroke-2 (WAterS-2): a feasibility study with process evaluation exploring inclusive, accessible, online psychological support after stroke

Objectives: Explore feasibility and acceptability of upskilling a workforce to deliver a co-developed intervention, based on Acceptance and Commitment Therapy (ACT), to support psychological adjustment post-stroke targeting underserved groups. Design: Multi-site, single-arm feasibility study with embedded mixed-methods process evaluation (ISRCTN17628580). Setting: Four NHS community stroke services across England. Participants: 1. Stroke survivors [≥]18 years of age, [≥]4 months post-stroke, reporting psychological difficulties adjusting to stroke, able to consent and access remote group sessions in English; 2. Group facilitators from NHS stroke services, not ACT specialists. Intervention: WAterS-2: an eight-session, remotely-delivered ACT-informed group intervention. Outcome measures: Recruitment, fidelity, safety, acceptability and perceived value were assessed using fidelity checklists, post-intervention surveys and semi-structured interviews with stroke survivors and facilitators. Clinical outcomes including mood (HADS), wellbeing (ONS4), psychological flexibility (AAQ-ABI), measured post-group and three-months later. Results: Nineteen stroke survivors recruited (mean 9.6 months post-stroke; n=5 (26%) minoritised ethnicities; n=10 (52%) with aphasia). Thirteen facilitators - including two peer support workers - delivered the intervention with fidelity following structured training across four services. Drop-out was low (2/19; 11%); with 15 (79%) attending [≥]5/8 sessions. Remote data collection was feasible (79% follow-up completion), with no adverse events recorded. Acceptability was high: survivors valued peer connection, grounding and mindfulness practices. ACT metaphors were helpful for some but challenging for others, including some with aphasia. Online delivery was suitable but limited informal connection. Facilitators reported increased capability, incorporating ACT skills into routine care. NHS workforce pressures and geographically-constrained referral pathways limited recruitment reach. Conclusions: WAterS-2 is feasible, safe, acceptable and inclusive. A mixed workforce, including NHS peer support workers, can be upskilled to deliver with fidelity. Inclusion of underserved groups is achievable but requires active strategies beyond standard NHS referral routes. Findings inform a provisional logic model and a future pragmatic trial.

25.
medRxiv (Medicine) 2026-06-22

Assessment of adaptive functioning in Angelman syndrome using the Vineland Adaptive Behavior Scales, Third Edition

Purpose: This study examined longitudinal trajectories of adaptive functioning in 331 individuals with Angelman syndrome (AS) using the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) and examined differences by molecular subtype. Methods: A total of 331 individuals (156 females, 47%) with genetically confirmed AS (ages 6 months to 52 years) were assessed between 2018 and 2025, including 207 with a deletion subtype, 63 with uniparental disomy or imprinting defect, and 61 with a UBE3A point mutation. Growth scale values were analyzed using linear mixed-effects models with log2-transformed age. Results: Individuals with deletion subtypes demonstrated significantly lower adaptive functioning across domains compared to those with non-deletion subtypes. Adaptive skills across all Vineland-3 subdomains increased nonlinearly with age, showing faster growth early in life that slowed over time, with largely parallel trajectories across subtypes. Conclusion: Individuals with AS demonstrate slow but steady growth in adaptive functioning that continues into adulthood, with progress varying by molecular subtype. These findings provide updated natural history benchmarks and demonstrate the utility of the Vineland-3 for clinical trials.