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

A Tail-Respecting Splitting Numerical Scheme for Lévy-Driven SDEs With Superlinear Drifts

arXiv:2504.07255v3 Announce Type: replace Abstract: We present an explicit numerical approximation scheme, denoted by $\{X^n\}$, for the effective simulation of solutions $X$ to a multivariate stochastic differential equation (SDE) with a superlinearly growing $\kappa$-dissipative drift, where $\kappa>1$, driven by a multiplicative heavy-tailed Lévy process that has a finite $p$-th moment, with $p>0$. We show that the strong $L^{p_X}$-convergence $\sup_{t\in[0,T]}\mathbf E \|X^n_t-X_t\|^{p_X}=\mathcal O (h_n^{\gamma})$ holds for any $p_X\in (0,p+\kappa-1)$, which is exactly the range where the $p_X$-moment of the solution is known to be finite. Additionally, for any $p_X\in (0,p)$ we establish strong uniform convergence: $\mathbf E\sup_{t\in[0,T]} \|X^n_t-X_t\|^{p_X}=\mathcal{O} ( h_n^{\delta} )$. In both cases we determine the convergence rates $\gamma$ and $\delta$. In the special case of SDEs driven solely by a Brownian motion, our numerical scheme preserves super-exponential moments of the solution. The scheme $\{X^n\}$ is realized as a combination of a well-known Euler method with a Lie-Trotter type splitting technique.

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

Exposing the Illusion of Fairness: Auditing Vulnerabilities to Distributional Manipulation Attacks

arXiv:2507.20708v3 Announce Type: replace Abstract: The rapid deployment of AI systems in high-stakes domains, including those classified as high-risk under the The EU AI Act (Regulation (EU) 2024/1689), has intensified the need for reliable compliance auditing. For binary classifiers, regulatory risk assessment often relies on global fairness metrics such as the Disparate Impact ratio, widely used to evaluate potential discrimination. In typical auditing settings, the auditee provides a subset of its dataset to an auditor, while a supervisory authority may verify whether this subset is representative of the full underlying distribution. In this work, we investigate to what extent a malicious auditee can construct a fairness-compliant yet representative-looking sample from a non-compliant original distribution, thereby creating an illusion of fairness. We formalize this problem as a constrained distributional projection task and introduce mathematically grounded manipulation strategies based on entropic and optimal transport projections. These constructions characterize the minimal distributional shift required to satisfy fairness constraints. To counter such attacks, we formalize representativeness through distributional distance based statistical tests and systematically evaluate their ability to detect manipulated samples. Our analysis highlights the conditions under which fairness manipulation can remain statistically undetected and provides practical guidelines for strengthening supervisory verification. We validate our theoretical findings through experiments on standard tabular datasets for bias detection. Code is publicly available at https://github.com/ValentinLafargue/Inspection.

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

SEVRA-BENCH: Social Engineering of Vulnerabilities in Review Agents

arXiv:2606.13757v1 Announce Type: cross Abstract: Large language model (LLM) reviewers are increasingly used in pull-request (PR) workflows, where their approvals help decide which code is merged into a repository. This raises a question that benchmarks for static vulnerability detection or code generation do not address: can an automated reviewer reject a malicious contribution when the attacker controls both the code change and the accompanying PR text? We introduce SEVRA-BENCH (Social Engineering of Vulnerabilities in Review Agents), a benchmark that measures how often an automated reviewer approves such adversarial pull requests. Each malicious PR in SEVRA-BENCH is built from a real project commit that previously fixed a vulnerability listed in the Common Vulnerabilities and Exposures (CVE) database. We automatically invert that fix to restore the original vulnerable code and submit it as a pull request wrapped in one of 15 social-engineering framings, which vary the claims made, the supporting evidence, the urgency conveyed, signals of prior approval, and appeals to authority. SEVRA-BENCH contains 1,062 malicious PRs drawn from Common Vulnerabilities and Exposures (CVE)-linked fixes across the top 10 entries of the 2025 Common Weakness Enumeration (CWE) Top 25. In a realistic setting, we evaluate 8 current LLMs as code review agents on PRs that introduce vulnerabilities previously reported in public disclosures. Our results reveal a sharp gap in security capabilities between closed- and open-source models. We hope SEVRA-BENCH will serve as a valuable resource for advancing open-source models and narrowing this gap.

04.
arXiv (CS.CL) 2026-06-12

Helping Figures Tell their Story! Paper-Grounded Video Generation Explaining Complex Scientific Figures

Scientific figures compress complex pipelines into a single canvas, yet understanding them requires paper-grounded, step-by-step narration aligned with visual highlights a capability missing from current video generation systems and benchmarks. To address this, we introduce paper-grounded figure-to-video generation: generating narrated, region-grounded walkthrough videos from a figure and its paper. We propose MINARD (Multimodal Interpretation of Narrated Architecture via Region Decomposition), a pipeline that generates paper-grounded narrations and sequentially grounds them to figure regions. We also release FigTalk, a benchmark with new sequential and component-level grounding metrics derived. On FigTalk, MINARD generates humanlike, paper-faithful narrations and outperforms narration-conditioned figure spatial grounding compared to existing approaches in both automatic and human evaluation

05.
arXiv (CS.AI) 2026-06-19

FundaPod: A Multi-Persona Agent Pod Platform with Knowledge Graph Memory for AI-Assisted Fundamental Investment Research

arXiv:2605.27864v4 Announce Type: replace Abstract: Large language models (LLMs) are increasingly applied in finance, yet most existing work emphasizes trading signals or financial NLP tasks centered on prediction. Institutional fundamental research, by contrast, requires human analysts or AI agents to gather evidence, identify business drivers, compare competing viewpoints, and generate investment memos. Its broader goal is not merely to predict outcomes, but to produce investment plans that are transparent, reusable, and verifiable, while contributing to the cumulative development of investment knowledge. We present FundaPod, a multi-persona agent platform for AI-assisted fundamental investment research. We argue that fundamental research is a human-centric decision-support task that is qualitatively distinct from trading-signal generation, and is therefore better served by an independence-preserving architecture. In FundaPod, AI agents with different personas, such as value investors or macro strategists, conduct research independently under a shared provenance contract. Their disagreements are then surfaced post hoc for adjudication by the human portfolio manager (PM) through a knowledge-graph memory system. This paper contributes five design principles for human-AI hybrid systems supporting fundamental research, grounded in design-science practice and theories of cognitive isolation and human-machine coordination. It also describes four architectural mechanisms: a persona distillation pipeline that turns public investor materials into deployable agents; a declarative skill registry that lets the planner derive typed task graphs; a grounded evidence model that links memo claims to verifiable sources; and a knowledge-graph "second brain" that connects tickers, memos, analysts, and themes. We demonstrate the architecture through a complete case study and a persona-based memo comparison.

06.
medRxiv (Medicine) 2026-06-16

Non-invasive Detection of Fasciculation Using Surface EMG with a Wavelet-Based Analytical Method (DEWCS)

Objective: Needle electromyography (nEMG) is essential for diagnosing neuromuscular disorders but is invasive and often painful. We employed single-channel bipolar surface EMG (sEMG) analyzed with a novel wavelet-based analytical approach, Detecting and Extracting Elemental Wave Components based on a Wavelet Coefficient Set (DEWCS) and investigated whether fasciculation-related activity could be identified. Methods: In this prospective study, 28 patients undergoing nEMG for suspected neuromuscular disorders and 13 healthy controls were included. Resting-state sEMG was recorded from selected muscles using single-channel bipolar active electrodes at a high sampling rate. DEWCS was used to extract indices reflecting fast- and slow-type motor unit (MU)-related activity. These standardized indices were evaluated against nEMG-detected fasciculation potentials using generalized estimating equation logistic regression to account for within-subject clustering. Diagnostic performance was assessed by receiver operating characteristic analysis. Results: A total of 67 muscles from 38 participants were analyzed. Indices of fast- and slow-type MU-related activity were significantly associated with fasciculation potentials (slow: OR 5.10, p = 0.0041; fast: OR 2.38, p = 0.0162). The combined model showed excellent discrimination (area under the curve = 0.97), outperforming either index alone. Muscle region had no significant effect. Conclusions: A single-channel bipolar sEMG setup combined with DEWCS detected fasciculation-related activity with promising accuracy. This method may serve as a non-invasive surrogate marker of lower motor neuron involvement. Further validation in larger cohorts is warranted. Significance: This non-invasive sEMG approach may help detect fasciculation-related activity and complement nEMG in neuromuscular diagnostics.

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

daVinci-kernel: Co-Evolving Skill Selection, Summarization, and Utilization via RL for GPU Kernel Optimization

GPU kernel optimization represents a paradigm where functional correctness is assumed and execution efficiency is the objective. We present daVinci-kernel, a reinforcement learning framework that couples skill discovery with skill exploitation through a dynamically evolving skill library. daVinci-kernel jointly trains three agents sharing one LLM backbone: a Skill Selection Agent that retrieves relevant techniques via BM25 and LLM reranking, a Policy Agent that generates multi-turn CUDA/Triton kernels conditioned on selected skills, and a Skill Summary Agent that distills successful rollouts into reusable skills. Candidate skills are added only after execution-based verification confirms reproducible speedups. All three agents share a single LLM backbone, are initialized via a structured SFT cold start on diversity-filtered data, and are then jointly optimized end-to-end with multi-turn REINFORCE and per-agent advantage estimation. On KernelBench, daVinci-kernel-14B achieves 37.2%, 70.6%, and 32.2% on Level 1, Level 2, and Level 3 under the Fast$_1$ threshold, outperforming the strongest prior RL-trained model, Dr.Kernel-14B.

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

DynaTok: Token-Based 4D Reconstruction from Partial Point Clouds

We address 4D reconstruction from partial point cloud sequences, where depth-sensor observations are incomplete, unordered, and lack explicit temporal correspondences. This geometry-only setting is challenging due to missing observations and ambiguous dynamics. While recent progress has largely relied on image-based methods, existing point-based approaches typically focus on single objects, assume relatively complete inputs, or require explicit correspondences. To address these limitations, we propose DynaTok, a point-based framework for correspondence-free 4D reconstruction from partial point cloud sequences without images. DynaTok encodes frames into compact latent tokens, aggregates incomplete observations over time with a Transformer-based spatiotemporal encoder, and decouples geometry and motion through residual tokens in a unified model. A flow-matching decoder then reconstructs complete, temporally consistent 4D point-cloud sequences conditioned on the latent tokens. Experiments on object- and scene-level benchmarks demonstrate improved reconstruction quality and temporal coherence from partial point cloud observations. Project page: https://wrchen530.github.io/dynatok/.

09.
arXiv (CS.AI) 2026-06-19

Modeling Day-Long ECG Signals to Predict Heart Failure Risk with Explainable AI

arXiv:2601.00014v2 Announce Type: replace-cross Abstract: Heart failure (HF) affects 11.8% of adults aged 65 and older, reducing quality of life and longevity. Preventing HF can reduce morbidity and mortality. We hypothesized that artificial intelligence (AI) applied to 24-hour single-lead electrocardiogram (ECG) data could predict the risk of HF within five years. To research this, the Technion-Leumit Holter ECG (TLHE) dataset, including 69,663 recordings from 47,729 patients, collected over 20 years was used. Our deep learning model, DeepHHF, trained on 24-hour ECG recordings, achieved an area under the receiver operating characteristic curve of 0.80 that outperformed a model using 30-second segments and a clinical score. High-risk individuals identified by DeepHHF had a two-fold chance of hospitalization or death incidents. Explainability analysis showed DeepHHF focused on arrhythmias and heart abnormalities. This study highlights the feasibility of deep learning to model 24-hour continuous ECG data, capturing paroxysmal events essential for reliable risk prediction. Artificial intelligence applied to single-lead Holter ECG is non-invasive, inexpensive, and widely accessible, making it a promising tool for HF risk prediction.

10.
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.

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

Do Safety Monitors Stay Reliable After an Update? Benchmarking and Predicting Activation-Monitor Staleness

Authors:

Activation monitors-lightweight probes trained on a language model's internal representations-are an increasingly common layer in deployment safety stacks. Deployed models however are rarely static: they are quantized, fine-tuned, adapted with LoRA, or served with merged adapters while the monitor remains frozen. We present the first systematic test of whether this implicit contract holds: whether activation monitors trained on a base model remain reliable after these routine model updates. Across multiple safety-relevant monitors, model depths, update families, and open-weight models, we find a sharp split: quantization-style updates largely preserve frozen probe performance, while fine-tuning-style updates frequently make probes stale. Fragility is highly monitor-dependent, with privacy/PII probes most affected and refusal-compliance probes comparatively stable, showing that retraining a behavior need not stale its corresponding monitor. QLoRA is especially damaging despite NF4 quantization alone being relatively benign, suggesting that quantization becomes riskier when combined with adaptation. We further show that degradation is predictable from pre-deployment features, enabling revalidation budgets to be triaged toward the monitors most likely to fail. These results suggest that fine-tuning should trigger activation-monitor revalidation by default, while prediction can help prioritize which monitors to check first.

12.
arXiv (CS.LG) 2026-06-16

A Spatio-Temporal Expert Prefetching Framework for Efficient MoE-based LLM Inference

arXiv:2606.15453v1 Announce Type: cross Abstract: Mixture-of-Experts (MoE) based large language models (LLMs), such as Qwen and DeepSeek, have recently emerged as an effective approach to improving model capacity without proportionally increasing computational cost. By replacing the conventional feed-forward network in dense LLMs with a set of experts and activating only a subset of them for each input token, MoE models significantly increase the total number of parameters while keeping the per-token computation relatively manageable. However, this dynamic and irregular expert activation pattern also introduces substantial expert loading overhead during inference, since the required experts must be fetched on demand according to token-dependent routing results. As a result, expert loading latency becomes a major source of performance and energy inefficiency. To this end, we first perform a comprehensive analysis of expert selection behavior in various MoE-based LLMs and applications, including language understanding and code generation. Our analysis reveals that, within each application domain, expert requests exhibit strong correlation across both adjacent MoE layers and consecutive decoding tokens, making future expert activations predictable. Based on this insight, we propose ST-MoE, a spatio-temporal expert prefetching framework that proactively stages experts ahead of use to overlap expert loading with ongoing computation. ST-MoE combines a lightweight runtime prediction mechanism that preserves the original routing behavior with a reconfigurable hardware design that efficiently supports dynamic expert prefetching. The combined effect of the prediction mechanism with the supporting hardware significantly improves MoE inference performance and energy efficiency while preserving model inference accuracy.

13.
bioRxiv (Bioinfo) 2026-06-15

oxo-flow: compiled, memory-safe bioinformatics workflow orchestration

Authors:

Bioinformatics analyses depend on workflow engines to coordinate dozens of computational tools across complex dependency chains. The most widely adopted engines-Snakemake, Nextflow, the Common Workflow Language (CWL), and the Workflow Description Language (WDL)-run on interpreted or just-in-time (JIT) compiled language runtimes, incurring hundreds of milliseconds of startup latency and providing no compile-time safety guarantees from the host language. We developed oxo-flow, a workflow engine written in Rust that compiles to a single native binary. On an Apple M5 processor, oxo-flow parses, validates, and dry-runs a production-scale workflow in roughly 22 milliseconds-before Snakemake or Nextflow have finished loading their runtime environments. Peak memory usage is 16 megabytes, representing six- to seven-fold reductions relative to Snakemake and Nextflow. Dry-run latency is essentially independent of workflow size: a hundred-fold increase in rule count adds approximately 0.4 milliseconds. oxo-flow integrates 31 command-line tools, a REST interface with 60 endpoints, an embedded web application, and native cluster submission into a single 10-megabyte binary. It provides per-rule environment isolation across seven backends, checkpoint-based fault tolerance with cryptographic output verification, and a formal installation and operational qualification protocol for regulated laboratory environments. Ten curated workflows and three demonstration pipeline repositories are available. oxo-flow is freely available under Apache License 2.0 at https://github.com/Traitome/oxo-flow.

14.
arXiv (CS.CL) 2026-06-19

Granularity-Regulated Adaptive Computational Efficiency for Optimal Verification in Test-Time Scaling

Test-time scaling (TTS) has emerged as a powerful paradigm for improving the reasoning performance of large language models (LLMs) by investing additional compute at inference time. A central component of TTS is the verifier, which selects or scores candidate solutions to guide the search process. While prior work has explored the benefit of verification, a fundamental question remains underexplored: what is the optimal granularity of verification under a given compute budget? Coarse-grained outcome reward models (ORMs) and fine-grained process reward models (PRMs) represent two extremes, yet neither alone achieves compute-optimality across all regimes. In this paper, we establish a unified theoretical framework, called GRACE (\underline{G}ranularity-\underline{R}egulated \underline{A}daptive \underline{C}omputational \underline{E}fficiency), that characterizes the optimal verification granularity as an explicit function of problem difficulty, verifier accuracy, and compute budget. We prove that there exists a phase transition: fine-grained verification dominates when either the compute budget is large or the problem is hard, whereas coarse-grained verification is preferred in the low-budget, easy-problem regime. Our theory unifies Best-of-$N$, beam search, and step-level MCTS within a single Pareto-optimality framework, and motivates an adaptive granularity strategy that provably achieves the compute-performance Pareto frontier. Empirical results on MATH-500, GSM8K, and AIME benchmarks corroborate all four theoretical claims, with our adaptive strategy outperforming fixed-granularity baselines by up to 3.1\% accuracy at matched compute.

15.
arXiv (CS.AI) 2026-06-18

Scalable Batch Bayesian Optimization Via Subspace Acquisition Functions

arXiv:2411.16206v3 Announce Type: replace-cross Abstract: Extending Bayesian optimization to batch evaluation can enable the designer to make the most use of parallel computing technology. However, most of current batch approaches do not scale well with the batch size. That is, their optimization efficiencies often deteriorate as the batch size increases. To address this issue, we propose a simple and efficient approach to extend Bayesian optimization to large-scale batch evaluation in this work. Different from existing batch approaches, the idea of the new approach is to draw a batch of axis-aligned subspaces of the original problem and select one point from each subspace using existing acquisition functions. Numerical experiments show that our proposed approach speedups the convergence significantly when compared with the sequential Bayesian optimization algorithm, and performs very competitively when compared with ten batch Bayesian optimization algorithms. The implementation of our proposed approach is available at https://github.com/zhandawei/SubSpace_Acquisition_Functions.

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

Succeeding at Scale: Enterprise Retrieval Benchmark Construction and Index-Preserving Query Adaptation for Multi-Tenant Search

Large-scale multi-tenant retrieval systems generate extensive query logs but lack curated relevance labels for effective domain adaptation, resulting in substantial underutilized "dark data." This challenge is compounded by the high cost of model updates, as jointly fine-tuning query and document encoders requires full corpus re-indexing, which is impractical in multi-tenant settings with thousands of isolated indices. We introduce DevRev-Search, a passage retrieval benchmark for technical customer support built via a fully automated pipeline. Candidate generation uses fusion across diverse sparse and dense retrievers, followed by an LLM-as-a-Judge for consistency filtering and relevance labeling. We further study and systematically evaluate index-preserving query-only adaptation strategies that fine-tune only the query-encoder while keeping the document indices fixed. Experiments on DevRev-Search, SciFact, and FiQA-2018 show that parameter-efficient fine-tuning of the query encoder delivers a remarkable quality-efficiency trade-off, enabling scalable and practical enterprise multi-tenant retrieval.

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

Human-Enhanced Loop Modeling (HELM): Agent-Based Finite Element Modeling of Concrete Bridge Barriers

arXiv:2606.12025v1 Announce Type: new Abstract: Finite element (FE) modeling of safety-critical infrastructure such as bridge barriers requires high-fidelity nonlinear dynamic analysis, yet the current FE modeling process remains labor-intensive and lacks automation. This paper presents the Human-Enhanced Loop Modeling (HELM) framework, a collaborative human-agent protocol that decomposes long-sequence finite element modeling into discrete, visually verifiable checkpoints across geometry generation, boundary condition definition, and material assignment. The framework is demonstrated through a 20-case matrix of reinforced concrete bridge barriers under MASH TL-4 and TL-5 lateral loading conditions, interfacing specialized agents with two widely used commercial FE softwares, i.e., ANSYS and LS-PrePost. Experimental results show that HELM improves the baseline autonomous modeling success rate from 20% to 75%, with agent-level pass rates for geometry and boundary condition tasks approximately doubling. Error analysis reveals that spatial reasoning and algebraic logic limitations constitute the primary failure modes, underscoring the value of structured human-in-the-loop intervention for modeling automation. The complete agent design code and prompts are open-sourced and can be accessed at: https://github.com/SimAgentDev/Ansys-LSPP-AgentKit.

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

Group-Sparse Matrix Factorization for Transfer Learning of Word Embeddings

Unstructured text provides decision-makers with a rich data source in many domains, ranging from product reviews in retail to nursing notes in healthcare. To leverage this information, words are typically translated into word embeddings – vectors that encode the semantic relationships between words – through unsupervised learning algorithms such as matrix factorization. However, learning word embeddings from new domains with limited training data can be challenging, because the meaning/usage may be different in the new domain, e.g., the word ``positive'' typically has positive sentiment, but often has negative sentiment in medical notes since it may imply that a patient tested positive for a disease. In practice, we expect that only a small number of domain-specific words may have new meanings. We propose an intuitive two-stage estimator that exploits this structure via a group-sparse penalty to efficiently transfer learn domain-specific word embeddings by combining large-scale text corpora (such as Wikipedia) with limited domain-specific text data. We bound the generalization error of our transfer learning estimator, proving that it can achieve high accuracy with substantially less domain-specific data when only a small number of embeddings are altered between domains. Furthermore, we prove that all local minima identified by our nonconvex objective function are statistically indistinguishable from the global minimum under standard regularization conditions, implying that our estimator can be computed efficiently. Our results provide the first bounds on group-sparse matrix factorization, which may be of independent interest. We empirically evaluate our approach compared to state-of-the-art fine-tuning heuristics from natural language processing.

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

Stochastic Linear Contextual Bandits with Bounded Noise: A Set-Membership Approach

arXiv:2606.20022v1 Announce Type: cross Abstract: This paper considers stochastic linear contextual bandits (SLCB) with bounded reward noise. Existing works typically assume sub-Gaussian reward noise and bounded expected rewards, under which the optimal regret bound scales as $\tilde{O}(\sqrt{T})$ in terms of horizon $T$. However, in many applications, realized/observed rewards are also naturally bounded, implying bounded reward noise. Bounded noise is more informative than the sub-Gaussian condition but has not been leveraged explicitly in the SLCB literature. In this paper, we propose a novel algorithm SME-OFU by utilizing an uncertainty quantification method called set-membership estimation (SME) and applying the principle of optimism in the face of uncertainty (OFU). Our algorithm enjoys an improved regret bound $O(\log T)$. Notice that this does not contradict the existing optimal bound $\tilde{O}(\sqrt{T})$ for sub-Gaussian noise because bounded noise is a stronger condition. Finally, simulations show empirical improvements of SME-OFU over a benchmark algorithm designed for sub-Gaussian noise when the reward noise is bounded.

20.
medRxiv (Medicine) 2026-06-16

Care Delivery Gap framework: a proof-of-concept patient-reported measure of guideline-referenced care-process omissions in sickle cell disease

Abstract Background:Sickle cell disease (SCD) is concentrated in sub-Saharan Africa, where delivery of guideline-referenced care remains challenging. Current evaluation approaches rely largely on access indicators and clinical outcomes, which do not directly measure care delivery. We developed the Care Delivery Gap (CDG) framework, a patient-reported approach for identifying care-process omissions, and conducted a proof-of-concept study to assess feasibility and explore variation across income strata. Methods: We conducted a cross-sectional framework-development study involving a proof-of-concept sample of 52 individuals with SCD or caregivers recruited through clinics and moderated SCD communities across Africa, North America, and Europe between June 2025 and March 2026. The CDG framework assessed patient-reported omissions in specialist involvement, follow-up continuity, cardiovascular screening, and biochemical surveillance. Analyses were descriptive. Results: Substantial multi-domain care-process omissions were identified despite high reported healthcare engagement. Across geographic income strata, cardiovascular screening was reported by 4/35 (11%) LMIC versus 16/17 (94%) HIC participants, and regular follow-up within the preceding 12 months by 14/35 (40%) versus 16/17 (94%), respectively. High CDG scores, representing 1 omissions across three or four domains, occurred in 20/35 (57%) LMIC compared with 1/17 (6%) HIC participants. Similar disparities were observed across specialist review and vitamin B12 surveillance domains. Conclusion: A structured patient-reported framework identified multi-domain omissions in guideline-referenced SCD care, including among individuals reporting healthcare access. The divergence between access indicators and reported care delivery suggests that service contact alone may not reflect care quality. The framework provides a feasible foundation for future process-level quality measurement in high-burden settings.

22.
arXiv (quant-ph) 2026-06-12

Beyond the Unruh vacuum: multi-time correlations in black hole collapse and evaporation

arXiv:2606.13383v1 Announce Type: new Abstract: The black hole information paradox originates from the thermal character of Hawking radiation, which appears to erase information about the collapsing matter. However, thermality constrains only observables defined at a single time and leaves the structure of temporal quantum correlations largely unexplored. Here we show that multi-time quantum-field correlations provide a concrete mechanism for the survival of pre-collapse information in black hole evaporation. Using a two-dimensional model of gravitational collapse and evaporation, we demonstrate that late-time multi-time correlations are not fully reproduced by the Unruh vacuum. In particular, they contain a contribution that depends explicitly on parameters characterizing the pre-collapse state, despite the thermal character of the asymptotic radiation. Our results identify measurable multi-time correlations as carriers of information in Hawking radiation and suggest that formulations of the black hole information paradox based solely on single-time observables are incomplete.

23.
arXiv (CS.LG) 2026-06-18

Online Reward-Punishment Learning from Fixed-Channel Perceptual Event Streams without Environment Rewards

Authors:

arXiv:2606.18963v1 Announce Type: new Abstract: We study online reward-punishment learning when the environment provides no scalar reward or evaluative label. At each step the agent receives only a fixed-channel perceptual packet, and quantities such as pain, energy, contact, damage, or cognitive error are treated as perceptual dimensions whose valence must be inferred from transition consequences. OHIRL separates four roles: M_psi learns next-packet prediction, D_omega models residual dynamics, C_eta is a fixed internal post-transition trajectory evaluator, and B_xi learns to use the resulting value evidence for later policy updates and action scoring. C_eta uses a recovery-positive and persistence/growth-negative residual-regulation orientation; a coefficient-origin audit shows that equal-unit, raw-equal, and random monotone variants preserve more than 92% of the released top-action rankings, while sign inversion preserves 0%. The reward-free protocol exposes observation transitions while withholding environment rewards, delayed external evaluators, success labels, and action-goodness labels. A conditional error decomposition separates B_xi evidence-estimation error from residual policy-optimization error. In a 2x2-XOR packet task, medicine and chili acquire opposite value under visual XOR contexts, and the same pain or spice increase can be positive or negative depending on consequence structure; B_xi reaches 0.952 balanced reward-sign accuracy. In a full online-interleaved audit, M_psi reaches holdout R2=0.907, B_xi reaches 0.940 sign accuracy, and the policy reaches 0.979 optimal-action accuracy, while immediate packet scores, prediction-error rewards, shuffled targets, zero reward, and error-reduction controls collapse. Hidden-reward CartPole and Taxi controls, public-context no-leakage audits, and module-role ablations further test information boundaries and component necessity.

24.
medRxiv (Medicine) 2026-06-11

Corticospinal tract risk modifies motor recovery after minimally invasive surgery for intracerebral hemorrhage: a secondary analysis of MISTIE-III

Objective: Outcome after surgical hematoma evacuation for intracerebral hemorrhage (ICH) depends on hematoma location. As corticospinal tract (CST) integrity affects motor recovery after stroke, we hypothesized that CST integrity drives heterogeneity in surgical outcomes and investigated this in a secondary analysis of MISTIE-III participants. Methods: Risk of CST injury was categorized into four levels, based on the interaction between the CST, the hematoma, and perihematomal edema (PHE) on automatically segmented stability CT: no risk, PHE infiltration, hematoma infiltration, and complete interruption of the CST. Associations with outcome were tested using multivariable linear regression for motor National Institutes of Health Stroke Scale (NIHSS) at day 180 and ordinal regression for modified Rankin Scale (mRS) at day 365, introducing an interaction term between CST risk and treatment group. Results: Day 180 motor NIHSS was significantly lower for 'no risk' ({beta}:-3.77, [95% confidence interval [CI]: -5.8 to -1.70], p=0.0003) and 'PHE infiltration' ({beta}:-2.3, [95%CI: -3.5 to -1.1]; p=0.0002) vs. 'complete interruption'. Surgery was associated with lower Day 180 motor NIHSS in participants with hematoma infiltration ({beta}:-2.07, [95%CI: -3.8 to -0.4], p=0.016). Compared to complete interruption, 'no risk' (adjusted odds ratio [aOR]:0.27, [95%CI: 0.10 to 0.74], p=0.01) and 'PHE infiltration' (aOR:0.41, [95%CI: 0.23 to 0.74]; p=0.003) were associated with lower odds of unfavorable day 365 mRS. Surgery was associated with lower mRS in participants with no risk (aOR:0.23, [95%CI: 0.05 to 0.97, p=0.045). Interpretation: Increasing CST risk is associated with worse motor recovery (day 180) and disability (day 365). CST risk modifies the effect of the MISTIE-III procedure on motor recovery and disability.

25.
medRxiv (Medicine) 2026-06-22

A Plasmodium vivax controlled human infection and transmission model to evaluate interventions across the life cycle

Background Plasmodium vivax is an underappreciated cause of malaria disease burden. No reproducible and standardized full life-cycle controlled human malaria infection (CHMI) model to accelerate development of novel interventions is available. Methods This transmission-CHMI trial was conducted in Nijmegen, Netherlands. Healthy, malaria-naive adults were sequentially enrolled into three cohorts of four and inoculated with the asexual blood-stage isolate PvW1. Primary endpoint was proportion of oocyst-positive laboratory-reared Anopheles stephensi mosquitoes. The sequential design allowed for adaptations between cohorts. At parasitemia >10 parasites/microL or symptom onset, participants received oral gametocyte-sparing treatment (GST): mepacrine (Cohort 1 and 3; 100 mg at 0, 8 16 hours, then once daily for 3 days) or piperaquine (Cohort 3; 480 mg single-dose). Transmission was assessed by direct skin feeding (DSF) and membrane feeding assay (DMFA) with and without enrichment of gametocytes. End-of-study treatment was atovaquone-proguanil (1000/400 mg once daily for 3 days). The trial was registered: NL-OMON57011. Findings Participants were enrolled between September 17, 2024 and March 25, 2025, all (12/12) developed parasitemia and transmitted PvW1 to mosquitoes. No serious adverse events occurred. Most adverse reactions were related to malaria. Mepacrine and piperaquine reduced asexual parasitemia while preserving gametocytemia and transmission. Peak transmission occurred within 3 days after GST and depended on the parasite developmental cycle, with highest gametocyte-infectivity ~48 h post ring-stage. In Cohort 3, mosquito infection reached 100% in all transmission assays. Median peak oocyst counts were 24 (IQR: 14-31) for DSF, 17 (12-19) for DMFA, and 150 (116-199) for enriched DMFA. A two-fold increase in pre-GST maximal parasitemia was associated with 20 additional oocysts (95% CI 8,6-32) in enriched DMFA. Sporozoites were viable in primary human hepatocytes. Interpretation A PvW1 transmission-CHMI is reproducible and safe, enabling P. vivax sporozoite production, relapse models and evaluation of transmission-blocking interventions.