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

MedLatentDx: Latent Multi-Agent Communication for Cross-Hospital Rare-Disease Diagnosis

Rare diseases affect over $300$ million patients across more than $7{,}000$ conditions, yet no single hospital encounters enough cases of any one condition for reliable diagnosis. Cross-hospital collaboration could help by allowing a diagnosing institution to use distributed, case-specific diagnostic evidence, but privacy regulations restrict the transmission of identifiable clinical text across institutional boundaries. This setting raises two challenges: existing medical agent systems often rely on textual evidence exchange, while raw latent states such as hidden states and KV caches may still reveal prompt-derived clinical content. We introduce MedLatentDx, a latent multi-agent communication framework in which hospital agents keep private clinical records and retrieved cases local, and send compact latent KV blocks to a host agent for rare-disease diagnosis. MedLatentDx supports two deployment settings: same-backbone hospital agents use latent KV distillation, while hospitals with different LLM backbones use cross-family latent alignment. On CrossRare-Bench, a self-built large-scale rare-disease benchmark with hospital-level partitions, MedLatentDx improves cross-hospital diagnostic performance while reducing reconstructable clinical content relative to raw-latent communication baselines.

02.
arXiv (quant-ph) 2026-06-17

Optimal Calibration of Quantum Network Links

arXiv:2606.18167v1 Announce Type: new Abstract: The reliable distribution of entanglement is essential for the effective operation of quantum networks. Due to fundamental differences between quantum and classical communication systems, it is necessary to develop specialised algorithms and protocols that also account for quantum-specific constraints. In this work, we focus on the issue of recalibration. As suggested by recent experimental studies, the process of local entanglement generation in a quantum link degrades over time due to environmental changes that have to be estimated and compensated via a calibration operation, during which the link is not available. Therefore, in such a quantum network, every link alternates between an activation period, during which it operates normally, and a calibration period, during which it cannot participate in the end-to-end entanglement distribution, thereby creating a trade-off between link quality (the fidelity of generated pairs, which decays during activation) and availability (the fraction of time the link is usable, which calibration reduces). We develop analytically a protocol for optimally assigning activation periods to each link in linear quantum repeater chains, subject to any general end-to-end fidelity requirements and local initial fidelity thresholds. Building on this foundation, we extend to general quantum networks, where multiple paths may cross at common links, proposing a heuristic approach evaluated in simulations and compared with a benchmark, numerical approach, and theoretical bounds.

03.
arXiv (CS.CL) 2026-06-11

ProHiFlo: Hierarchical Flow Matching with Functional Guidance for De Novo Protein Generation

De novo protein generation has transformative potential in therapeutic design, enzyme engineering, and synthetic biology. While diffusion-based and flow matching approaches have achieved progress, they typically operate at single resolution and lack mechanisms for incorporating functional constraints. We introduce ProHiFlo, a hierarchical flow matching framework with three innovations: (1) coarse-to-fine generation that models backbone geometry before refining to all-atom coordinates, reducing computational cost while maintaining accuracy; (2) functional guidance leveraging pretrained predictors to steer generation toward desired properties without retraining; (3) adaptive SE(3)-equivariant architecture for efficient multi-scale processing. Experiments on unconditional generation, motif scaffolding, and functional design demonstrate state-ofthe-art performance while requiring 4 fewer sampling steps. On enzyme active site scaffolding, ProHiFlo achieves 58.9% success rate compared to 41.2% for RFDiffusion.

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

Asymptotic behavior of some strongly critical decomposable 3-type Galton–Watson processes with immigration

arXiv:2406.09852v2 Announce Type: replace Abstract: We study the asymptotic behavior of a critical decomposable 3-type Galton-Watson process with immigration when its offspring mean matrix is triangular with diagonal entries 1. It is proved that, under second or fourth order moment assumptions on the offspring and immigration distributions, a sequence of appropriately scaled random step processes formed from such a Galton-Watson process converges weakly. The limit process can be described using independent squared Bessel processes $({\mathcal X}_{t,1})_{t\geq0}$, $({\mathcal X}_{t,2})_{t\geq0}$, and $({\mathcal X}_{t,3})_{t\geq0}$, the linear combinations of the integral processes of $({\mathcal X}_{t,1})_{t\geq0}$ and $({\mathcal X}_{t,2})_{t\geq0}$, and possibly the 2-fold iterated integral process of $({\mathcal X}_{t,1})_{t\geq0}$. The presence of the 2-fold iterated integral process in the limit distribution is a new phenomenon in the description of asymptotic behavior of critical multi-type Galton-Watson processes with immigration. Our results complete and extend some results of Foster and Ney (1978) for some strongly critical decomposable 3-type Galton-Watson processes with immigration.

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

Pixels to Proofs: Probabilistically-Safe Latent World Model Control via Parallel Conformal Robust MPC

We present SLS^2, a framework for safe feedback motion planning from pixels using robust model predictive control (MPC) in learned latent world models. Our approach trains an action-conditioned joint-embedding world model with compact Markovian latent states, enabling efficient gradient-based trajectory optimization through learned latent dynamics. To enforce safety for the true system despite imperfect latent predictions, we inform a GPU-accelerated system level synthesis (SLS) robust MPC scheme with conformal prediction to obtain calibrated latent error bounds and robust latent-space constraint sets. We further learn and conformalize a latent constraint checker, allowing the SLS planner to impose probabilistic safety constraints during closed-loop execution. We evaluate our method on vision-based control tasks, where it improves both goal-reaching performance and safety over latent world-model and safe-planning baselines.

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

Triangular-Reference Schrödinger Bridges for Time Series Generation

arXiv:2605.27478v3 Announce Type: replace-cross Abstract: Schrödinger bridges for time series (SBTS) generate synthetic paths by projecting, in relative entropy, a Brownian reference onto the path laws that match the joint distribution of the data on the observation grid. The Brownian reference, however, fixes the quadratic variation of the generated paths, which is restrictive when stochastic volatility, correlated noise, or rank-deficient covariance structures must be reproduced. We introduce "Triangular-Reference Schrödinger Bridges for Time Series" (TR-SBTS), which keeps the entropy-projection backbone of SBTS but replaces the Brownian reference by a triangular, volatility-informed, intervalwise frozen reference on a state augmented with latent covariance descriptors. The construction remains a single entropy projection on the augmented state: the minimiser is the \(h\)-transform of the reference, and on each frozen interval the optimal drift has the logarithmic-gradient form \(b^\star(t,x)=A\,\nabla\log H(t,x)\), intrinsic to the active covariance directions when the frozen covariance \(A\) is degenerate. We prove stability of the frozen approximation and consistency of the associated regularised kernel estimators, describe a reference-aware Nadaraya–Watson implementation of the conditional next-increment law, and evaluate the construction on numerical experiments.

07.
arXiv (CS.CV) 2026-06-12

JSCGC: Joint Source-Channel-Generation Coding for Wireless Generative Communications

Conventional communication systems, including both separation-based coding and learning-based joint source-channel coding (JSCC), are typically designed under Shannon's rate-distortion theory. However, relying on generic distortion metrics fails to capture complex human visual perception, often resulting in blurred or unrealistic reconstructions. In this paper, we propose Joint Source-Channel-Generation Coding (JSCGC), a generative communication paradigm that replaces the conventional decoder with a generative model at the receiver. The received signal is treated as a condition that controls the sampling process into the learned conditional distribution, reformulating communication from deterministic reconstruction for distortion minimization to controlled generation for mutual information maximization under perceptual constraints. Based on this formulation, we develop a unified joint training and efficient stochastic sampling framework, and provide theoretical analysis of its effectiveness in both learning and inference stages. Extensive experiments on latent-space image transmission demonstrate that the JSCGC consistently improves feature-based, semantic-level, and distributional quality across diverse channel conditions, while exhibiting a distinct error behavior characterized by semantic inconsistency rather than distortion.

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

Send a SCOUT First: Pre-hoc Reasoning for Adaptive Detector Allocation in Prompt-Injection Defense

arXiv:2605.30837v2 Announce Type: replace-cross Abstract: Prompt-injection detectors are heterogeneous: each is strong on a different slice of attacks, and none is always reliable. Yet existing systems still treat detection as a fixed single-detector pipeline, committing every request to one detector's blind spots. We reframe defense as detector allocation: given a heterogeneous pool, decide per request which detectors to run and whether to escalate to an LLM judge. Our framework SCOUT (Scalable and Controllable Outcome-prediction for Uncertainty-aware Triage) makes this decision dynamic by predicting each detector's per-sample reliability and latency from how it behaved on similar past inputs, and exposes a single safety-utility threshold to the operator (where utility bundles benign-pass rate and wall-clock). To evaluate this setting, we build SCOUT-450, a benchmark that captures the structurally complex, agent-facing injections that older prompt-injection sets under-represent. On SCOUT-450, a safety-oriented operating point reduces attack-success rate by 46% and total wall-clock by 40% relative to an always-on GPT-4o judge, at a 5.1-point benign-utility drop. SCOUT also transfers to three external benchmarks (BIPIA, IPI, and IHEval), improving the safety-utility frontier.

09.
arXiv (CS.CV) 2026-06-15

HiLo-Token: Input-Adaptive High-Low Frequency Token Compression for Efficient Image Editing

Creative image editing tools, such as Photoshop's Remove or Generative Fill buttons, are central to everyday customer use and account for a major share of traffic in Photoshop and Lightroom. However, current generative AI models face significant latency challenges, which become even more pronounced when transitioning from convolution-based U-Nets to Diffusion Transformers (DiTs). In our evaluation on hundreds of representative image editing samples spanning a wide range of mask ratios, the DiT module alone accounts for an average of 73% of the total model latency, even after being distilled from 50 timesteps down to 8 timesteps. To tackle this challenge, we propose $HiLo-Token$, an input-adaptive token compression framework that allocates more token budget to high-frequency, rich-context regions while assigning fewer tokens to low-frequency areas. Specifically, for the editing region specified by the user mask, we retain all tokens within a dilated mask to preserve strong locality and contextual relevance. Outside the editing region, we introduce a simple yet effective high-frequency token selection strategy based on spatial frequency to capture important local details, while using tokens from a 16x downsampled image to represent low-frequency components and preserve the blurry but global structure. Extensive experiments on production-level evaluation data validate the effectiveness of the proposed method, achieving 3.13x, 2.59x, and 1.67x DiT speedups on A100-80GB for image editing tasks across small, medium, and large mask ratio categories with average ratios of 6.38%, 15.92%, and 35.36%, respectively, without any regression in generation quality.

10.
arXiv (CS.CV) 2026-06-18

Taming I2V models for Image HOI Editing: A Cognitive Benchmark and Agentic Self-Correcting Framework

Current image editing methods excel at static attributes but fail at complex Human-Object Interactions (HOI), a critical challenge unaddressed by existing benchmarks that conflate HOI with static attributes, relying on global metrics incapable of simultaneously assessing dynamic interaction validity and entangled human-object pair preservation. Thus, we first introduce HOI-Edit, a comprehensive benchmark with three progressive cognitive levels, which features an automated metric HOI-Eval that reliably evaluates instance-level interaction by letting VLM Q&A after thinking with images containing grounded Human-Object pairs. Considering the task's essence of remodeling dynamic relationships, we benchmark Image-to-Video (I2V) models, finding them inherently suited for dynamic editing due to their temporal generation capabilities. Crucially, beyond superior performance, this capability provides a "replay of the failure process," offering unique diagnosability into why errors occur. We thus propose SCPE (Self-Correcting Process Editing), a novel, agentic self-correcting framework that constrains the generation of I2V models through iteratively refined prompts, enabling the generated videos to more accurately present the target HOI. Extracted frames from these videos are the final editing results. On HOI-Edit, SCPE achieves performance competitive with state-of-the-art (SOTA) editing models like Nano Banana on interaction. Code is available at https://github.com/oceanflowlab/HOI-Edit.

11.
arXiv (CS.CL) 2026-06-17

RooseBERT: A New Deal For Political Language Modelling

The increasing amount of political debates and politics-related discussions calls for the definition of novel computational methods to automatically analyse such content with the final goal of lightening up political deliberation to citizens. However, the specificity of the political language and the argumentative form of these debates (employing hidden communication strategies and leveraging implicit arguments) make this task very challenging, even for current general-purpose pre-trained Language Models (LMs). To address this, we introduce a novel pre-trained LM for political discourse language called RooseBERT. Pre-training a LM on a specialised domain presents different technical and linguistic challenges, requiring extensive computational resources and large-scale data. RooseBERT has been trained on large political debate and speech corpora (11GB) in English. To evaluate its performances, we fine-tuned it on multiple downstream tasks related to political debate analysis, i.e., stance detection, sentiment analysis, argument component detection and classification, argument relation prediction and classification, policy classification, named entity recognition (NER). Our results show improvements over general-purpose LMs on the majority of these tasks, highlighting how domain-specific pre-training enhances performance in political debate analysis. We release RooseBERT for the research community.

12.
medRxiv (Medicine) 2026-06-10

Longitudinal brain structural changes during clozapine treatment: associations with neuroreceptor architecture and clinical response

In treatment-resistant schizophrenia, clozapine treatment has been associated with longitudinal reductions in subcortical volumes, ventricular enlargement, and widespread cortical thinning. However, it is unknown how these structural changes relate to clozapines pharmacological profile and clinical efficacy. We combined five longitudinal datasets with MRI acquired before and on average 5 months after clozapine initiation in 143 individuals to quantify brain structural changes and their association with normative maps relating to neuroreceptor architecture and physiological systems, and improvement in symptom severity. Clozapine treatment was associated with grey matter volume reductions across multiple subcortical regions (including the amygdala, hippocampus, thalamus, caudate, putamen and nucleus accumbens), increases in pallidal volume, ventricular enlargement, and widespread cortical thinning. Cortical regions showing the greatest magnitude of thinning corresponded to areas with higher normative densities of serotonergic 5-HT1A, 5-HT2A and 5-HT4 receptors. Changes in subcortical volume or cortical thickness during clozapine treatment were not associated with changes in total or positive symptom severity. In addition, baseline subcortical volume, cortical thickness, or gyrification prior to starting clozapine did not predict subsequent symptom improvement. Cortical thinning may partly reflect clozapines activity at serotonergic receptors, which have been implicated in cortical network stabilisation and neuroplasticity, however structural remodelling during clozapine treatment may reflect a process independent from its clinical efficacy in improving core symptoms of psychosis.

13.
arXiv (CS.LG) 2026-06-12

An Empirical Study on Predictive Maintenance for Component X in Heavy-Duty Scania Trucks

arXiv:2606.12486v1 Announce Type: new Abstract: Condition-based Predictive Maintenance (PdM) for truck fleets has gained momentum in recent years. This maintenance strategy aims to minimize unplanned downtimes and reduce costs by monitoring the health status of vehicles and taking proactive action based on their condition. However, the implementation of condition-based PdM systems is challenging due to the large volume of data generated by the trucks, the inherent complexity of detecting failures through sensor data and the difficulties in finding cost-effective trade-offs in the solution's implementation. In this paper, we define and validate a condition-based PdM methodology built on the assumption that the wear-and-tear state of the monitored component can be represented as a monotonically non-decreasing time series. It involves selecting only the most recent observations from the time series and transforming them into a tabular format for classification using machine learning (ML) models designed for tabular data. Our results indicate that the proposed methodology reduces costs on the Scania Component X dataset compared to current state-of-the-art (SOTA) approaches, while also simplifying the modeling process through AutoML.

14.
arXiv (CS.AI) 2026-06-11

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

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

15.
arXiv (CS.CV) 2026-06-16

Cascaded Sparse Autoencoders Learn Multi-Level Visual Concepts in Multimodal LLMs

Multimodal Large Language Models (MLLMs) have demonstrated strong performance on vision-language tasks, yet their internal visual representations remain difficult to interpret. Sparse Autoencoders (SAEs) provide a scalable way to decompose dense model activations into sparse, interpretable features. However, existing SAE architectures primarily recover flat feature dictionaries and are less suited for explicit multi-level concept organization. In this paper, we introduce cascaded sparse autoencoders (CSAEs) for learning hierarchical visual concepts in MLLMs. Rather than nesting or stacking SAE sparse activation codes, CSAEs train a second-level SAE directly on the decoder weights of the first-level SAE, treating learned low-level feature directions as inputs for higher-level abstraction. This design enables CSAEs to learn "concepts of concepts" while avoiding drawbacks from the shared-prefix coupling of nesting, Matryoshka-style hierarchies and the bottlenecks of naively stacked SAEs. Experiments across Qwen3-VL, Gemma-3, and LLaVA on multiple visual datasets show that CSAEs improve interpretability in terms of hierarchical concept coherence over state-of-the-art SAE baselines. Results on concept steering further demonstrate that the learned concept groups support effective group-level interventions in MLLM outputs.

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

Fermions are fundamentally more nonlocal than Bosons

arXiv:2606.12363v1 Announce Type: new Abstract: Bell's theorem shows that entangled quantum particles can exhibit correlations that classical particles cannot reproduce without an additional nonlocal resource, such as communication. In this sense, quantum particles are fundamentally more nonlocal than classical ones, and entanglement becomes unavoidable in physics. Here we prove the analogous result within quantum theory itself: indistinguishable fermions transmitted through a quantum network can generate correlations that distinguishable particles or indistinguishable bosons cannot reproduce without additional communication. In the same sense, fermions are fundamentally more nonlocal than bosons or distinguishable particles, motivating fermionic anticommutation and indistinguishability as unavoidable operational resources. Our result further implies that fermions can strictly surpass all qubit-based protocols for certain distributed computing tasks, demonstrating that a complete understanding of information processing requires going beyond qubits to fermionic information carriers - febits.

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

Multi-agent Framework for Time-Sensitive Complementary Collaboration in Minecraft

arXiv:2606.15684v1 Announce Type: new Abstract: We present TickingCollabBench, a Minecraft-based multi-agent benchmark for a novel class of time-sensitive complementary collaboration tasks. Our benchmark reflects four core characteristics of real-world collaboration: agent heterogeneity, mandatory collaboration, dynamic environments, and strict real-time constraints with failure risks. To enable this, we develop the TickingCollab framework, which supports the generation of diverse dynamic environments and abstracts Minecraft's primitive APIs to enable declarative YAML task specifications for composing these events. Building on this, we design a feasibility-aware automated benchmark generation pipeline, where an LLM drafts structurally diverse task configurations and feasibility verifier filters out invalid ones using approximate constraints. Evaluations demonstrate that lang latency and inherent difficulty of coordinating under partial observability and agent heterogeneity cause LLMs to frequently fail under dynamic environments and fall significantly short of a global-knowledge oracle.

18.
medRxiv (Medicine) 2026-06-10

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

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

19.
arXiv (CS.CV) 2026-06-15

Towards Mitigating Hallucinations in Large Vision-Language Models by Refining Textual Embeddings

Hallucinations in Large Vision-Language Models (LVLMs) remain a persistent challenge, often stemming from inadequate integration of visual information during multimodal reasoning. A key cause is the model's over-reliance on textual priors and underutilization of visual cues, leading to outputs that are linguistically fluent but visually inaccurate. For example, given an image of an empty kitchen countertop, an LVLM might hallucinate a "bowl of fruit" or "cup of coffee", relying on language associations rather than visual evidence. Most LVLMs incorporate visual features by appending them to the input stream of a pre-trained LLM and training on large-scale vision-language datasets. Our systematic analysis reveals that this strategy often leads to over-dependence on textual information due to the inherent bias of LLMs towards language-dominant representations. This imbalance skews attention towards the text over visual content, weakening the model's ability to ground outputs in visual inputs. To address this, we propose a simple yet effective visual feature incorporation method that encourages the model to learn visually-informed textual embeddings distinct from those of the base LLM and promotes a more balanced attention distribution. Experimental results across multiple hallucination benchmarks demonstrate that our method significantly reduces hallucinations and fosters more balanced multimodal reasoning. Notably, our approach achieves substantial gains, including +9.33% on MMVP-MLLM, +2.99% on POPE-AOKVQA, up to +3.4% on Merlin, and +3% on the hard-data split of HallusionBench.

20.
arXiv (CS.LG) 2026-06-11

Composing Linear Layers from Irreducibles

arXiv:2507.11688v4 Announce Type: replace Abstract: Contemporary large models often exhibit behaviors suggesting the presence of low-level primitives that compose into modules with richer functionality, but these fundamental building blocks remain poorly understood. We investigate this compositional structure in linear layers by asking: can we identify/synthesize linear transformations from a minimal set of geometric primitives? Using Clifford algebra, we show that linear layers can be expressed as compositions of bivectors – geometric objects encoding oriented planes – and introduce a differentiable algorithm that decomposes them into products of rotors. This construction uses only O(log^2 d) parameters, versus O(d^2) required by dense matrices. Applied to the key, query, and value projections in LLM attention layers, our rotor-based layers match the performance of strong baselines such as block-Hadamard and low-rank approximations. Our findings provide an algebraic perspective on how these geometric primitives can compose into higher-level functions within deep models.

21.
arXiv (CS.LG) 2026-06-19

A Model-Driven Approach for Developing Families of Reinforcement Learning Environments

arXiv:2606.20324v1 Announce Type: cross Abstract: Virtual training environments are software-intensive systems in which reinforcement learning (RL) agents learn, adapt, and demonstrate meaningful behavior. Virtual training environments offer a safe and cost-efficient alternative to training agents in real-world settings. However, to converge, most realistic RL problems require training in multiple, mostly similar but slightly different environments - i.e., families of environment variants. The typical development process of environment families is a labor-intensive and error-prone manual endeavor that does not scale well. To alleviate these issues, in this paper, we propose a model-driven approach for developing families of RL training environments. To obtain the family of environments, we develop an approach and prototype tool. In our approach, a hybrid genetic algorithm - a combination of population-based global search and heuristic local search - generates environment families. Mutations and constraints are expressed as model transformations and are operationalized into a search process by a state-of-the-art model transformation engine. We demonstrate the soundness of our approach in a wildfire mitigation scenario and curriculum learning - a particular learning paradigm that relies on environment families.

22.
medRxiv (Medicine) 2026-06-11

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

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

23.
arXiv (math.PR) 2026-06-18

Multi-Dimensional Cohomological Phenomena in the Lower Multiparametric Model

作者:

arXiv:2402.02573v4 Announce Type: replace-cross Abstract: In the past two decades, extensive research has been conducted on the (co)homology of various models of random simplicial complexes. So far, it has always been examined merely as a list of groups. This paper expands upon this by describing both the ring structure and the Steenrod-algebra structure of the cohomology of the lower multiparametric model. We prove that the ring structure is always a.a.s trivial, while, for certain parameters, the Steenrod-algebra a.a.s acts non-trivially. This reveals that complex multi-dimensional topological structures appear as subcomplexes of this model.

24.
medRxiv (Medicine) 2026-06-22

An integrated AI-microfluidic platform reveals the broad persistence and developmental potential of rare sperm in non-obstructive azoospermia

Non-obstructive azoospermia (NOA) represents the most severe form of male infertility, severely limiting a patient's prospects for biological fatherhood when surgical retrieval fails. However, the true biological limits of NOA remain obscured by the inherent limitations of conventional gamete recovery protocols: standard centrifugation frequently causes substantial cell loss, masking extremely rare sperm, while surgical interventions are constrained by spatial sampling biases. Here we report SpermSeek, an integrated AI-guided microfluidic platform for real-time, non-destructive isolation of single sperm directly from semen. Operating at scalable throughput (0.36 mL/h), the system achieves 98.3% detection precision and a 95.5% target encapsulation efficiency, suppressing background debris. In a 59-patient NOA cohort, SpermSeek detected morphologically identifiable sperm in 64.4% (38/59) of cases, spanning diverse genetic etiologies, including AZFb/c microdeletions, and severe histopathological phenotypes, such as Sertoli-cell-only syndrome (SCOS). Notably, among a sub-cohort of 41 patients who remained consistently sperm-negative despite prior medical or micro-TESE interventions, our platform identified gametes in 53.7% (22/41) of these cases. Comprehensive safety profiling in healthy human donors and wild-type mice confirmed that processed sperm retain high DNA integrity and epigenomic concordance (r=0.98), supporting transgenerational developmental stability in mice. Furthermore, in a 26-patient validation cohort, SpermSeek recovered rare sperm in 11 cases. Utilizing gametes from a subset (n=5), we demonstrated their capacity to support early human embryogenesis, yielding high-quality cleavage-stage embryos with confirmed genomic euploidy. This work establishes a highly sensitive framework for re-examining the biological limits of human spermatogenesis, laying the foundation to expand autologous reproductive options for patients refractory to conventional retrieval protocols.

25.
arXiv (CS.AI) 2026-06-16

Emergent Strategic Reasoning Risks in AI: A Taxonomy-Driven Evaluation Framework

arXiv:2604.22119v2 Announce Type: replace Abstract: As reasoning capacity and deployment scope grow in tandem, large language models (LLMs) gain the capacity to engage in behaviors that serve their own objectives, a class of risks we term Emergent Strategic Reasoning Risks (ESRRs). These include, but are not limited to, deception (intentionally misleading users or evaluators), evaluation gaming (strategically manipulating performance during safety testing), and reward hacking (exploiting misspecified objectives). Systematically understanding and benchmarking these risks remains an open challenge. To address this gap, we introduce ESRRSim, a taxonomy-driven agentic framework for automated behavioral risk evaluation. We construct an extensible risk taxonomy of 7 categories, which is decomposed into 20 subcategories. ESRRSim generates evaluation scenarios designed to elicit faithful reasoning, paired with dual rubrics assessing both model responses and reasoning traces, in a judge-agnostic and scalable architecture. Evaluation across 11 reasoning LLMs reveals substantial variation in risk profiles (detection rates ranging 14.45%-72.72%), with dramatic generational improvements suggesting models may increasingly recognize and adapt to evaluation contexts.